Clinical efficacy of pancreaticoduodenectomy with TRIANGLE operation in the treatment of pancreatic head cancer / 中华消化外科杂志

Objective:To investigate the clinical efficacy of pancreaticoduodenectomy with TRIANGLE operation in the treatment of pancreatic head cancer.Methods:The retrospective cohort study was conducted. The clinicopathological data of 51 patients with pancreatic head cancer who were admitted to the Sichuan Provincial People′s Hospital, Affiliated Hospital of School of Medicine of University of Electronic Science and Technology of China from January 2017 to July 2018 were collected. There were 33 males and 18 females, aged from 42 to 74 years, with a median age of 56 years. Of the 51 patients, 24 cases undergoing standard pancreaticoduodenectomy, in which No.12, 13 and 17 lymph nodes were dissected, combined with transcatheter arterial infusion chemo-therapy (TAI) were allocated into the standard group, and 27 cases undergoing pancreaticoduo-denectomy with TRIANGLE operation, in which No.7, 8, 9, 12, 13, 16, 17 lymph nodes were dissected, combined with TAI were allocated into the TRIANGLE group, respectively. Observation indicators: (1) intraoperative conditions of the two groups; (2) postoperative conditions of the two groups; (3) follow-up and survival. Follow-up was conducted using outpatient examination and telephone interview once three months to detect tumor recurrence and metastasis and survival of patients up to July 2021 or the death of patient. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was analyzed using the chi-square test or the Fisher exact probability. Comparison of ordinal data was analyzed using the rank sum test. Kaplan‐Meier method was used to calculate the survival rate and median survival time and draw survival curve. Log‐Rank test was used for survival analysis. Results:(1) Comparison of intraoperative conditions between the two groups. The operation time, volume of intraoperative blood loss, cases with intraoperative blood transfusion were (501±61)minutes, (563±278)mL, 4 in the standard group, versus (556±46)minutes, (489±234)mL, 6 in the TRIANGLE group, respectively. There was a significant difference in the operation time between the two groups ( t=3.62, P<0.05) but there was no significant difference in the volume of intraoperative blood loss or cases with intraoperative blood transfusion between the two groups ( t=1.03, χ2=0.25, P>0.05). (2) Comparison of postoperative conditions between the two groups. Of the 51 patients, 30 had 50 times of postoperative complications, including 18 times of grade Ⅰ complications of Clavien-Dindo classification, 29 times of grade Ⅱ complications of Clavien-Dindo classification, 2 times of grade Ⅲa complications of Clavien-Dindo classification, 1 time of grade Ⅲb complications of Clavien-Dindo classification, respectively. Cases with postoperative complications, cases with delayed gastric emptying, cases without or with pancreatic fistula as class A or class B, cases with biliary fistula, cases with bleeding, cases with diarrhea were 15, 4, 13, 7, 4, 4, 2, 2 in the standard group, versus 15, 6, 14, 10, 3, 4, 1, 3 in the TRIANGLE group, respectively. There was no significant difference in cases with postoperative complications, cases with delayed gastric emptying, cases with pancreatic fistula between the two groups ( χ2=0.16, 0.02, Z=-0.04, P>0.05) and there was no significant difference in cases with biliary fistula, cases with bleeding, cases with diarrhea between the two groups ( P>0.05). Cases with complications as Clavien-Dindo grade Ⅰ, grade Ⅱ, grade Ⅲ were 10, 11, 2 in the standard group, versus 8, 18, 1 in the TRIANGLE group, showing no significant difference between the two groups ( Z=-0.67, P>0.05). The duration of postoperative hospital stay was (23±8)days in both of the standard group and the TRIANGLE group, showing no significant difference between the two groups ( t=0.31, P>0.05). (3) Follow-up and survival. All the 51 patients were followed-up for 6 to 54 months, with a median follow-up time of 17 months. The postoperative 1-year overall survival rate was 75.0% and 81.5% in the standard group and the TRIANGLE group, respectively. The postoperative 3-year overall survival rate was 12.5% and 22.2% in the standard group and the TRIANGLE group, respectively. The median postoperative survival time was 15.00 months (95% confidence interval as 12.63 to 17.37 months) and 21.00 months (95% confidence interval as 15.91 to 19.62 months) in the standard group and the TRIANGLE group, respectively. There was a significant difference in survival of patients between the two groups ( χ2=4.30, P<0.05). Cases with tumor recurrence during post-operative 1 year and 3 year were 9 and 20 in the standard group, versus 6 and 15 in the TRIANGLE group, respectively. There was no significant difference in cases with tumor recurrence during postoperative 1 year between the two groups ( P>0.05) and there was a significant difference in cases with tumor recurrence during postoperative 3 year between the two groups ( P<0.05). Conclusion:Compared with standard pancreaticoduodenectomy, pancreaticoduodenectomy with TRIANGLE operation can prolong the median survival time of patients with pancreatic head cancer without increasing surgical related complications.

Clinical efficacy of different treatment methods for chronic pancreatitis based on M-ANNHEIM system / 中华消化外科杂志

Objective:To evaluate the clinical efficacy of different treatment methods for chronic pancreatitis based on M-ANNHEIM system.Methods:The retrospective cross-sectional study was conducted. The clinicopathological data of 177 patients with chronic pancreatitis from two medical centers between July 2008 and July 2018 were collected, including 95 in the Sichuan Provincial People′s Hospital and 82 in the West China Hospital of Sichuan University. There were 100 males and 77 females, aged (49±5)years, with a range from 29 to 72 years. The M-ANNHEIM system was used to decide clinical stages of chronic pancreatitis. Patients in different clinical stages received drug, endoscopic or surgical treatment. Observation indicators: (1) general data and follow-up of patients; (2) treatment of patients in asymptomatic stage; (3) treatment of patients in stage Ⅰ; (4)treatment of patients in stage Ⅱ; (5) treatment of patients in stage Ⅲ; (6) treatment of patients in stage Ⅳ; (7) aggravation and new-onset of diabetes; (8) complications. Follow-up using outpatient examination, telephone, mail, and Sojump was performed to collect data for M-ANNHEIM system up to December 2018. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed by the AVONA. Repeated measurement data were analyzed using repeated ANOVA. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. Results:(1) General data and follow-up of patients: there were 11, 72, 55, 31, and 8 patients with chronic pancreatitis classified as asymptomatic stage, stage Ⅰ, stage Ⅱ, stage Ⅲ, stage Ⅳ of M-ANNHEIM system before treatment. Of the 177 patients, 49, 49, and 79 patients underwent drug, endoscopic and surgical treatment, respectively. All the 177 patients were followed up for (2.4±0.5)years. (2) Treatment of patients in asymptomatic stage: 11 patients in asymptomatic stage underwent drug treatment. The M-ANNHEIM score was 1.91±0.21 before treatment, and 1.27±0.14, 1.73±0.19, 2.09±0.16 at 1 month, 12 months, 24 months after treatment, respectively. (3) Treatment of patients in stage Ⅰ: of the 72 patients in stage Ⅰ, 13 underwent drug treatment, 26 underwent endoscopic treatment, and 33 underwent surgical treatment. The M-ANNHEIM score of patients undergoing drug treatment was 8.11±1.05 before treatment, and 6.31±0.31, 7.69±0.24, 10.00±0.23 at 1 month, 12 months, 24 months after treatment, respectively. The M-ANNHEIM score of patients undergoing endoscopic treatment was 8.42±0.93 before treatment, and 5.13±0.25, 6.89±0.20, 8.27±0.24 at 1 month, 12 months, 24 months after treatment, respectively. The M-ANNHEIM score of patients undergoing surgical treatment was 8.13±0.77 before treatment, and 4.79±0.15, 5.42±0.22, 7.76±0.20 at 1 month, 12 months, 24 months after treatment, respectively. There was no significant difference in M-ANNHEIM score before treatment between patients receiving different treatments ( F=1.23, P>0.05). For patients in M-ANNHEIM stage Ⅰ, at 1 month after treatment, there was a significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment ( F=2.94, 4.98, P<0.05); there was no significant difference in M-ANNHEIM score between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=1.26, P>0.05). At 12 months after treatment, there was a significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment, between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=2.43, 5.99, 4.80, P<0.05). At 24 months after treatment, there was a significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment ( F=4.61, 6.29, P<0.05); there was no significant difference in M-ANNHEIM score between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=1.63, P>0.05). (4) Treatment of patients in stage Ⅱ: of the 55 patients in stage Ⅱ, 8 underwent drug treatment, 15 underwent endoscopic treatment, and 32 underwent surgical treatment. The M-ANNHEIM score of patients undergoing drug treatment was 12.61±1.16 before treatment, and 11.63±0.26, 12.57±0.30, 14.50±0.27 at 1 month, 12 months, 24 months after treatment, respectively. The above indicators of patients undergoing endoscopic treatment was 12.42±1.43, 8.47±0.24, 11.07±0.21, 11.93±0.30, respectively. The above indicators of patients undergoing surgical treatment was 12.53±1.22, 8.78±0.15, 9.94±0.21, 11.00±0.24, respectively. There was no significant difference in M-ANNHEIM score before treatment between patients receiving different treatments ( F=1.38, P>0.05). For patients in M-ANNHEIM stage Ⅱ, at 1 month after treatment, there was a significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment ( F=8.37, 8.48, P<0.05); there was no significant difference in M-ANNHEIM score between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=1.13, P>0.05). At 12 months after treatment, there was a significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment, between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=4.13, 8.48, 3.33, P<0.05). At 24 months after treatment, there was a significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment, between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=5.61, 6.83, 2.26, P<0.05). (5) Treatment of patients in stage Ⅲ: of the 31 patients in stage Ⅲ, 9 underwent drug treatment, 8 underwent endoscopic treatment, and 14 underwent surgical treatment. The M-ANNHEIM score of patients undergoing drug treatment was 17.25±0.89 before treatment, and 17.11±0.35, 18.44±0.41, 17.33±0.44 at 1 month, 12 months, 24 months after treatment, respectively. The above indicators of patients undergoing endoscopic treatment was 17.38±1.06, 15.00±0.53, 16.50±0.33, 16.88±0.44, respectively. The above indicators of patients undergoing surgical treatment was 17.63±1.06, 14.64±0.34, 16.00±0.35, 16.57±0.33, respectively. There was no significant difference in M-ANNHEIM score before treatment between patients receiving different treatments ( F=1.19, P>0.05). For patients in M-ANNHEIM stage Ⅲ, at 1 month after treatment, there was a significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment ( F=3.37, 4.82, P<0.05); there was no significant difference in M-ANNHEIM score between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=0.59, P>0.05). At 12 months after treatment, there was a significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment ( F=3.63, 4.48, P<0.05); there was no significant difference in M-ANNHEIM score between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=0.95, P>0.05). At 24 months after treatment, there was no significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment, between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=0.73, 1.41, 0.55, P>0.05). (6) Treatment of patients in stage Ⅳ: 8 patients in stage Ⅳ underwent drug treatment. The M-ANNHEIM score of patients was 17.94±0.59 before treatment, and 18.01±0.34, 17.54±0.19, 17.34±0.26, 17.88±0.43 at 1 month, 6 months, 12 months, 24 months after treatment, respectively. (7) Aggravation and new-onset of diabetes: of 49 patients undergoing endoscopic treatment, 17 had diabetes before treatment, 5 had aggravated diabetes and 11 had new-onset of diabetes after treatment. Of 79 patients undergoing surgical treatment, 31 had diabetes before treatment, 21 had aggravated diabetes and 7 had new-onset of diabetes after treatment. There were significant differences in the aggravation and new-onset of diabetes between the two groups ( χ2=2.07, 2.04, P<0.05). (8) Complications: 49 patients undergoing drug treatment had no treatment related complications. Of 49 patients undergoing endoscopic treatment, 4 patients with stent related complications were cured after replacing stent under endoscopy, 6 patients had acute pancreatitis, 2 had gastrointestinal bleeding including 1 patient was cured after endoscopic hemostasis, other patients with complications were improved after symptomatic and supportive treatment. Of 79 patients undergoing surgical treatment, 17 had pancreatic leakage (including 11 of biochemical leakage, 5 of grade B pancreatic leakage, and 1 of grade C pancreatic leakage), 3 had postoperative gastroparesis, 3 had intraabdominal infection, 1 had deep venous thrombosis, 2 had hemorrhage of which 1 combined with grade C pancreatic leakage was improved after open hemostasis and 1 was improved after interventional treatment, other patients with complications were improved after symptomatic and supportive treatment. Conclusions:For chronic pancreatitis, individualized treatment should be formulated according to the different stages. M-ANNHEIM score system can be used the evaluate clinical efficacies of drug treatment, endoscopic treatment, and surgical treatment.

Clinical efficacy of low-dose decitabine and homoharringtonine combined with CAG regimen in treatment of acute myeloid leukemia / 白血病·淋巴瘤

Objective To evaluate the efficacy and safety of low-dose decitabine and homoharringtonine combined with CAG regimen (cytarabine, aclarubicin and recombinant human granulocyte colony-stimulating factor) (DHCAG regimen) in treatment of acute myeloid leukemia (AML). Methods Nineteen patients who were treated with DHCAG regimen in the 920th Hospital of Joint Logistics Support Force from July 2017 to June 2018 were retrospectively analyzed. Among them, 13 cases were newly diagnosed, 6 cases were ineffective or relapsed; 2 cases were elderly (≥60 years old); 15 cases had pulmonary infection before chemotherapy, and 4 cases had no lesions in the lungs when admitted to hospital. The remission rate and chemotherapy-related adverse reactions were analyzed. Results After 19 patients received one course of DHCAG regimen, 16 patients had complete remission, 1 patient had partial remission, 2 patients had no remission, and the overall response rate was 89.5% (17/19). Four patients with undetected lung disease before chemotherapy had no infection in the lungs after treatment. Among 15 patients with pulmonary infection before treatment, 1 patient died of pulmonary infection progress, the remaining 14 cases were grade 1-2 infection. 7 cases had bleeding, and 3 cases had nausea and vomiting, all of which were grade 1-2. Conclusion The remission rate of DHCAG regimen in treatment of AML is high, and its adverse reactions are tolerable.

Topographic anatomy of facial artery and medial canthus artery / 中华医学美学美容杂志

Objective To explore the layers of the facial and angular arteries between the orbital notch and the antegonial notch.Methods Anatomical studies were performed on 5 cases of adult cadavers (10 sides).Parallel lines were drawn on each cadaver through the position of the orbital incise,inner canthus,above of wing nose,nasal wing point,mouth angle,anterior incise.When the region of the arterial level changes,the parallel lines could be temporarily divided.The levels of the arteries that appeared on every horizontal line were recorded.Results The surface artery between the orbital notch (including the supraorbital notch) and the inner canthus (including the inner cantholes) was mainly in the orbicularis muscle layer.In the middle of the inner canthus and the highest point of the nasal wing,1/3 of the arteries were mainly walking in the orbicularis orbicularis muscular layer,and the next 1/3 were mainly located in the superficial layer or subcutaneous fat layer of the orbicularis oculi muscle.The highest point of the nose wing was found in the middle of the subcutaneous fat.The main line between the top of the nose and the lower part of the nose was deep in the subcutaneous fat.At the bottom of the nose,the main line was located in the fat layer of the zygomaticus,the zygomaticus maximus.In the middle and upper part of the nose and the middle of the mouth,a third of the main lines were walking in the lower fat layer (from shallow to deep) under the zygomaticus,and the next 1/3 segment was found in the subcutaneous fat deep.On the outside of the corner of the mouth,the main line was walking the subcutaneous fat layer or the lower fat layer of the platysma.Conclusions This study preliminarily clarifies the walking level of the facial artery from the upper orbital notch and the anterior notch of the angle.Bearing in mind the depth and the location of the vasculature within each zone,clinical practitioners can tailor their injection techniques to prevent vessel injury and avoid cannulation.

Prevalence of Clonorchis sinensis infection and effect of albendazole treat-ment among residents in two communities of Zhongshan City / 中国血吸虫病防治杂志

Objective To understand the prevalence of Clonorchis sinensis infection among residents in two communities of Zhongshan City,and evaluate the effect of albendazole treatment,so as to offer the evidence for formulating the strategy of clo-norchiasis prevention and control.Methods The stool specimens were collected from the residents of two comprehensive dem-onstration areas,and the eggs of C.sinensis were detected by Kato-Katz technique.Those who were tested positive were treated with albendazole(0.4,twice a day for 4 days in adults,and half dosage for children aged 16 years or below).Three weeks after the treatment,the stool specimens were recollected and retested to evaluate the effect. Results A total of 532 people were in-vestigated and 96 were tested positive,with an infection rate of 18.05%.The infection rate was 28.63%(69/241)in the males and 9.28%(27/291)in the females,and there was a significant difference between them(Χ2=334.99,P<0.01).The infection rate increased with the increase of the age(Χ2=63.84,P<0.01).Among the 96 positive residents,94 received the albendazole treatment,and 86 were retested after the treatment with a negative conversion rate of 91.86%(79/86).Of the 7 residents without the conversion,5 had irregular medication.No severe adverse reactions were reported during the period of treatment. Conclu-sions The infection rate of C.sinensis among residents in the two communities of Zhongshan City is high,especially among the males and aged people.The effect of albendazole is good in the treatment of C.sinensis infection.In the future,the general sur-vey and treatment should be strengthened in order to lower the infection rate.

Effects of short-term closing live poultry markets in controlling the H7N9 avian influenza pollution / 中国人兽共患病学报

Short-term closing live poultry markets have been frequently adopted to control H7N9 epidemic.To evaluate the effect of short-term closing live poultry markets,we analyzed the data of environment surveillance of H7 by RT-PCR,and the human H7N9 cases in Zhongshan City from Feb 2014 to May 2017.RRx =The positive rate during the x-th week after closing / the positive rate of the week before closing days * 100％.Three rounds of short-term closing live poultry markets were administered.Round one:from Feb 10 to 23,2014,the neighboring cities didn't synchronize.The H7 positive rate increased since the trade recovered,and RR1 =0.40 (95％CI:0.28-0.59),RR3 =0.63 (95％CI:0.32-1.24),RR4 =0.83 (95％CI:0.48 -1.46).Two human cases were reported in May,2014.Round two:from Feb 19 to 28,2015,the neighboring cities synchronized as the province policy.The H7 positive rate maintained a level lower than 10％ since the trade recovered,and RR1 =0.15 (95％CI:0.07-0.34),RR2=0.21 (95％CI:0.10-0.41),RR3 =0.03 (95％CI:0.00-0.18),RR4 =0.10 (95％CI:0.04-0.27).No more human cases reported in that epidemic season.Round three:from Jan 8 to 21,2017,the neighboring cities didn't synchronize with Zhongshan City.The H7 positive rate had increased since the trade recovered,and RR1 =0.25 (95 ％ CI:0.09-0.68),RR3 =0.37 (95％CI:0.14-1.00),RR4 =1.07 (95％CI:0.54-2.11).Two human cases were reported in Feb,2017.Results indicated that,if the policy of closing live poultry markets was administered in single city,the environment pollution rate would rise shortly and the risk of human infection would increase once the trade recovered.However,if it was synchronously administered in all the cities in one region,the environment pollution rate could maintain at a low level and the risk of human infection would reduce enormously.

Effects of chrysin on impaired vascularendothelial function induced by high glucose / 中国药理学通报

Aim To explore the effects of chrysin on endothelial dysfunction induced by acute high glucose.Methods ① The effects of chrysin on normal isolated aortic at contraction induced by PE and on endothelial dysfunction induced by high glucose were tested in the following medium: normal group,chrysin group;normal-glucose group: glucose 11mmol·L-1 in Krebs' solution;high-glucose group: glucose 44 mmol·L-1 in Krebs' solution;mannitol group: mannitol 33 mmol·L-1 in Krebs' solution and chrysin group: 44 mmol·L-1 Glu+chrysin 1.0 μmol·L-1 in Krebs' solution.② The effects of chrysin on HUVEC cell viability after incubated in high glucose were observed in the following groups: normal-glucose group: glucose 5.5 mmol·L-1 in culture solution;high-glucose group: glucose 33.3 mmol·L-1 in culture solution;mannitol group: mannitol 27.8 mmol·L-1 in culture solution and chrysin group: chrysin(25,50 μmol·L-1)in culture solution.And the NO release was also testd in these groups.Results ① Chrysin could induce vaso-dilation in a dose-dependent manner at normal glucose.The Emax was(58.94±9.61)％,and the EC50 value was 51.9 μmol·L-1.After incubating the aortic rings with high glucose(44 mmol·L-1)for 4 h,there were significant differences in ACh-induced vascular relaxation between the normal glucose group and the high glucose group.The Emax was(32.12±3.92)％and the EC50 value was 78.0 μmol·L-1 of high glucose group(P<0.01).The endothelium-independent relaxation induced by SNP was not significantly different between the two groups.And chrysin(1.0 μmol·L-1)could reverse the decline of ACh-induced vasorelaxation response induced by high glucose(44 mmol·L-1).The Emax was(70.7±3.87)％and the EC50 value was 0.852 μmol·L-1.② The cell viability of HUVEC was depressed after incubated in high glucose,and chrysin could reverse the decline in a concentration-dependent way.And chrysin in defferent concentrations could increase the cell NO release.Conclusion Chrysin could prevent the acute high glucose-induced vascular endothelial dysfunction and could increase the NO release.

Investigation on epidemic status of clonorchiasis sinensis based on inpatients in Zhongshan City,China / 中国血吸虫病防治杂志

Objective To understand the prevalence and epidemiological features of clonorchiasis sinensis based on inpa-tients in Zhongshan City. Methods All of the 23 town hospitals in Zhongshan City were selected as the surveillance hospitals in 2016. Among the inpatients from those hospitals,those lived in the city longer than 6 months were selected as the surveillance subjects. The stool specimens of the subjects were collected and examined by the modified Kato-Katz thick smear method for the eggs of Clonorchis sinensis. The crude infection rates of C. sinensis of the subjects were standardized according to the age and sex compositions of the population in Zhongshan City,2016. Meanwhile,the infection rates of the subjects from different towns and those combined with related clinical diseases were analyzed. Results A total of 2667 people were included in the surveil-lance,among which 219 were tested as positives,with a crude infection rate of 8.21％. For the positives,the male accounted for 81.74％(179/219),and their age ranged from 4 to 89 years with the mean value of(62.20±13.80)years. After standardization by age and sex composition,the infection rate was 3.62％for the whole population,the rates of the male and the female were 5.46％and 1.53％,respectively,and the former was 3.57 times as high as the latter. Both the infection rates of the male and the female rose as the age increasing(χ2 male=99.91,χ2 female=16.51,both P<0.01). The standardized infection rates among the subjects in different towns ranged from 0 to 10.40％,and the rates in the north towns were higher than those in the south towns. The standardized rate was 9.22％for the subjects combined with gallstone,3.40％for those not combined with gallstone,and the former was 2.71 times as high as that of the latter. Conclusion The people aged 30 years and above,with gallstone or living in towns with high C. sinensis infection rates are the key population for prevention and control of clonorchiasis in Zhongshan City.

Investigation on sanitation of freshwater aquaculture environments and Clo-norchis sinensis intermediate host infection in a city of Pearl River Delta re-gion,China / 中国血吸虫病防治杂志

Objective To understand the current status of the sanitation of freshwater aquaculture environments ,and Clo-norchis sinensis infection of freshwater fish in the aquaculture and market in a city of Pearl River Delta region,so as to provide the evidence for formulating the prevention and control strategy of clonorchiasis sinensis. Methods In 2016,based on the dis-tribution of freshwater aquaculture,36 freshwater fish ponds among 14 towns were selected for sampling and investigation,and 10-20 pieces were collected from each pond. Besides,3 aquatic product wholesale markets were included,among which 3-6 stalls were selected from each market,and 20-30 pieces were collected from each stall. The metacercaria in the fish was exam-ined by the digestion method. Results In the 36 fish ponds,there were no toilets with the stool being drained into fish ponds di-rectly,and there was only one pond with duck sheds with the stool being drained into fish ponds directly. Totally 437 pieces of freshwater fish from ponds were detected,with a metacercaria positive rate of 4.35％(19/437). The metacercaria positive fish were distributed in 50％(7/14)of towns and 25％(9/36)ponds. The positive rates of crucian carp,grass carp,dace,aristich-thysnobilis,and tilapia were 13.95％(6/43),4.76％(9/189),4.44(2/45),1.55％(2/129),and 0(0/31)respectively,with statistically significant difference(χ2=13.46,P=0.01). Totally 307 pieces of freshwater fish were collected from the wholesale markets,with a total positive rate of 1.95％(6/307). The positive rate of grass carp and aristichthysnobilis were 3.20％(4/125) and 2.78％(2/72)respectively,and no positive samples were found in crucian carp,dace and tilapia,with no statistically sig-nificant difference among the different fish in the infection rate(Fisher exact P=0.75). Conclusions The sanitation of fresh-water aquaculture environments in a city of Pearl River Delta region is relative good. However,there are different degrees of Clo-norchis sinensis infection of freshwater fish in some aquaculture environments and markets.

Exploration on the treatment ofin terms of the conception vessel / 中国针灸

Diabetes is in the category ofin TCM, which is mainly discussed in light ofdeficiency. The conception vessel is the sea ofmeridians, acting on regulating the accumulation and irrigation ofand blood of twelve meridians and collaterals. The physiological function of the conception vessel is closely related to the pathogenesis of, its running course is highly coincident with the location ofand the symptoms ofare relevant with the indications of the conception vessel. Hence, harmonizingand blood of the conception vessel may be an effective approach to the prevention and treatment of.

Interferon therapy after curative surgical intervention to improve prognosis in patients with hepatitis C-related hepatocellular carcinoma: a Meta-analysis / 中华肝胆外科杂志

Objective To evaluate the effects of interferon therapy after curative surgical intervention on improving prognosis of patients with hepatitis C-related hepatocellular carcinoma (HCC).Methods We searched randomized clinical trials from 1990 to 2015 on interferon therapy after curative surgical intervention in patients with hepatitis C-related HCC from the Cochrane Library,the Cochrane Database of Systematic Reviews,MEDLINE and Embase.A Meta-analysis was carried out using Revman 5.Results There were 7 studies included in this research.The results showed that interferon therapy after curative surgical intervention in patients with hepatitis C-related HCC reduced the recurrence rate of HCC at 3 years (RR =0.84,95％ CI 0.73 ～0.97,P ＜0.05).The therapy could not improve the 3-year survival rate in these patients (RR =1.04,95％ CI 0.90 ～ 1.21,P ＞ 0.05).Stratified subgroup analyses showed interferon therapy after liver resection reduced the recurrence rate (RR =0.62,95 ％ CI 0.39 ～ 1.00,P =0.05).For patients with tumors less than 3 cm,interferon therapy reduced the recurrence rate (RR =0.82,95％ CI 0.69 ～ 0.98,P ＜ 0.05).Conclusion Interferon therapy after curative surgical intervention improved prognosis in patients with hepatitis C-related HCC.

Clinical outcome of autologous hematopoietic stem cell infusion via hepatic artery or portal vein in patients with end-stage liver diseases / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the efficacy of hematopoietic stem cell (HSC) transplantation via the hepatic artery vs. the portal vein for end-stage liver disease (ESLD).</p><p><b>METHODS</b>Patients with hepatic decompensation were prospectively recruited from September 2010 to September 2012 to receive HSC transplantation via the hepatic artery or the portal vein. Liver function was examined at 3, 6, and 12 months after transplantation. Liver biopsy Results were analyzed using the Knodell score.</p><p><b>RESULTS</b>Eighty patients (58 males and 22 females) were enrolled in the study. The Child-Pugh score was grade B in 69 cases, and grade C in the remaining 11 cases. HSC transplantation was performed via the portal vein in 36 patients and via the hepatic artery in 44 patients. ALT levels decreased while serum albumin levels increased significantly in both groups at 6 and 12 months after HSC transplantation (P<0.05 compared with pre-transplantation levels). Total bilirubin levels decreased significantly in both groups at 3, 6, and 12 months after HSC transplantation (P<0.05 compared with pre-transplantation levels). Additionally, prothrombin time decreased in both groups at 12 months after HSC transplantation (P<0.05 compared with pre-transplantation level). There were no significant differences in ALT, total bilirubin and prothrombin time between the two groups either before or after transplantation. Moreover, Knodell score decreased significantly at 6 and 12 months. Histological examination showed that liver cell edema, degeneration, necrosis, and inflammation were significantly relieved at 3, 6, and 12 months after transplantation. The incidence of portal vein thrombosis, upper gastrointestinal bleeding, and hepatic encephalopathy were 1.25%, 3.75%, and 2.5% respectively. The one-year survival rate was 100%.</p><p><b>CONCLUSIONS</b>Autologous HSC transplantation improves liver function and histology in ESLD patients. The administration route of HSC has no significant impact on the efficacy of transplantation.</p>

Autologous peripheral blood CD34+ stem cells transplanted into 100 patients with advanced cirrhosis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate whether transplantation of autologous peripheral blood CD34+ stem cells is a viable approach for treating patients with advanced cirrhosis,which is currently hindered by a shortage in liver donors.</p><p><b>METHODS</b>A total of 100 patients with advanced cirrhosis and who had failed to respond to conservative therapy were recruited for transplantation of autologous peripheral blood CD34+ stem cells.The success of transplantation was investigated 6-and 12-months later by measuring markers of liver biosynthesis function (coagulation,albumin level,indocyanine green clearance,Child-Pugh score) and assessing pathological changes (Knodell score) and morphologic changes in the liver tissue.Complications were also recorded during follow-up.</p><p><b>RESULTS</b>The 1-year cumulative survival rate was 100%. Fifty-two patients with massive ascites showed gradual reduction and disappearance of the ascites.Four patients experienced upper gastrointestinal bleeding and three patients developed with hepatic encephalopathy (I-II degree) at 3 months post-transplantation.All patients showed significantly improved liver biosynthesis function,liver elasticity and Knodell score after transplantation (P less than 0.05).</p><p><b>CONCLUSION</b>Autologous peripheral blood CD34+ stem cell transplantation is a safe and effective treatment for advanced cirrhosis,and has high cost-benefit since it improves liver function,liver histology,and quality of life.</p>

Toxicity assessment of hydroxyapatite-coated mechanical heart valve embedded with collagen to vascular endothelial cells / 中国组织工程研究

BACKGROUND:In early experiments, we prepared hydroxyapatite-coated mechanical heart valve embedded with col agen using impulse laser sediment method. OBJECTIVE:To further analyze the histocompatibility and toxicity of hydroxyapatite-coated mechanical heart valve embedded with col agen. METHODS:After passage, canine vascular endothelial cellsuspension was inoculated onto the hydroxyapatite-coated mechanical heart valve embedded with col agen. One group was inoculated in 5%CO2, 37 ℃ incubator for 3 weeks static culture, and the other group was inoculated in 5%CO 2 , 37 ℃ incubator for 3 weeks spinner culture. Scanning electron microscope was used to observe cellattachment on the material. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was used to the proliferative capacity of vascular endothelial cells cultured with the hydroxyapatite-coated mechanical heart valve embedded with col agen. RESULTS AND CONCLUSION:During the spinner culture, adherent cells were found on the surface of mechanical heart valve, and the cells distributed evenly and confluent at 21 days to cover the surface of the material. The number of adherent cells in the spinner culture was higher than that in the static culture. The cells during the static culture were aggregated and distributed irregularly. The mechanical heart valve exhibited no effects on the proliferation of canine vascular endothelial cells which grew wel . These findings indicate that the hydroxyapatite-coated mechanical heart valve embedded with col agen exert no effect on proliferation of vascular endothelial cells, has no toxicity and has good biocompatibility.

Colorimetric detection of norovirus genotype GII by reverse transcription loop-mediated isothermal amplification / 病毒学报

A simple, rapid and sensitive colorimetric reverse transcription loop-mediated isothermal amplification (RT-LAMP) method was established to detect norovirus genotype GII. The method employed a set of six specially designed primers that recognized eight distinct sequences of RNA-dependant RNA polymerase and capsid protein gene for amplification of nucleic acid under isothermal conditions at 65 degrees C for 60 minutes. The amplification process of RT-LAMP was monitored by the addition of HNB (Hydroxy naphthol blue) dye prior to amplification. A positive reaction was indicated by a color change from violet to sky blue and confirmed by agarose electrophoresis. The specificity of the RT-LAMP was validated by detecting several different diarrhea viruses including norovirus genotype GII. The sensitivity was determined by serial dilutions of RNA molecules from in vitro transcription of norovirus genotype GII in parallel with conventional RT-PCR detection. The assay was further evaluated with 93 clinical specimens of diarrhea patients. The results showed that the sensitivity of RT-LAMP was 1 000 copies/microL with a high specificity and the relative sensitivity was at the same level as that of conventional RT-PCR. Positive rate of RT-LAMP in analysis of clinical specimens was approximately the same as that of conventional RT-PCR as well. This colorimetric RT-LAMP assay was potential for rapid detection of norovirus genotype GII on spot due to the observation of visual result with high specificity and sensitivity, time-saving and cost benefit.

Detection and typing of human papillomavirus by a GeXP based multiplex PCR assay / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To establish a new and rapid GeXP based multiplex PCR assay for the detection and typing of human papillomavirus 6, 11, 31, 33 and 52.</p><p><b>METHODS</b>Nucleotide sequences of HPV6, HPV11, HPV31, HPV33 and HPV52 from NCBI were obtained and compared. Genotype-specific primers were then designed and the sensitivity and specificity of multiple PCR assay was evaluated. Optimized assay was further validated with 30 clinical specimens collected from the cervical secretions of patients.</p><p><b>RESULTS</b>A GeXP based multiplex PCR was developed for sensitive detection and reliable differentiation of five HPV genotypes (HPV6, 11, 31, 33 and 52),</p><p><b>CONCLUSION</b>A GeXP based multiplex PCR assay is demonstrated to be a new and rapid technique for simultaneous detection and typing of 5 different human papillomaviruses.</p>

Colorimetric detection of HPV6 and HPV16 by loop mediated isothermal amplification / 病毒学报

A simple, rapid and sensitive colorimetric loop mediated isothermal amplification (LAMP) method was established to detect HPV6 and HPV 16 respectively. The method employed a set of four specially designed primers that recognized six distinct sequences of HPV6-E6 or HPV16-E7 for amplification of nucleic acid under isothermal conditions at 63 degrees C for one hour. The amplification process of LAMP was monitored by the addition of HNB (hydroxy naphthol blue) dye prior to amplification. A positive reaction was indicated by a color change from violet to sky blue and confirmed by real-time turbidimeter and agarose electrophoresis. Thirteen cervical swab samples having single infection with 13 different HPV genotypes were examined to evaluate the specificity. A serial dilution of a cloned plasmid containing HPV-E6 or HPV-E7 gene was examined to evaluate the sensitivity. The results showed that no cross-reaction with other HPV genotypes was observed. The colorimetric LAMP assay could achieve a sensitivity of 1000 copies, 10-20 times lower than that of real-time PCR. The assay was further evaluated with 62 clinical specimens and consistent results were obtained compared with the detection using Kai Pu HPV Genotyping Kit. We concluded that this colorimetric LAMP assay had potential usefulness for the rapid screening of the HPV6 or HPV16 infection in the laboratories and hospitals of provincial and municipal region in China.

Effect of 90 percentage portal branch ligation on liver regeneration and expression of metalloproteinase and tissue inhibitors of metalloproteinases in rats / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the effect of 90% portal branch ligation on liver regeneration and expression of metalloproteinases and tissue inhibitors of metalloproteinases in rats.</p><p><b>METHODS</b>Ninety-six SD rats were randomly divided into Sham-PBL group and portal vein branches ligation group. The weight of both ligated and unligated lobes of liver were measured at post operation day (POD) 0.5, 1, 3, 5, 7, 14, 21 and 28. The morphological changes of the non-ligated liver lobes were observed by microscope. The expression of PCNA, MMP2, MMP9 and TIMP2 of the non-ligated liver lobes were studied by immunohistochemistry.</p><p><b>RESULTS</b>1) 95.8% rats survived from the ligation of 90% portal branch. Hepatic lobe at the ligated side diminished progressively after ligation, whereas the lobes of the unligated side underwent compensatory regeneration. The ratio of non-ligated lobes weight to the whole liver increased slowly within 1d, speeded up significantly during 1-5d period, increased slowly after POD5, and got the plateau stag at POD7; 2) PCNA index were markedly increased within POD 0.5-3 (P < 0.01). It reached the peak at POD5 and decreased slightly at POD7, but still higher than Sham-PBL group level, then gradually returned to normal. 3) The expression of MMP2,MMP9 and TIMP2 in the non-ligated liver lobes were markedly increased at 1d. It reached the peak at POD7 and gradually returned to normal within POD7-28. 4) The MMP2 and PCNA in liver had a positive correlation at POD 0.5, 1, 5, 7, 14. The expressions of MMP9 and PCNA had a positive correlation at POD 0.5, 1, 7, 21.</p><p><b>CONCLUSION</b>The expressions of TIMP2 and PCNA had a positive correlation at POD1, 7, 14, 21. The expression of MMP2, MMP9 and TIMP2 of the non-ligated liver lobes is markedly increased at POD1. It reaches the peak at POD7, and dropped to normal level gradually. The expressions of MMP2, MMP9 and TIMP2 and PCNA were correlated in 90% portal branch Ligation rats. The expression of MMP2,MMP9 and TIMP2 may play a pivotal role in liver regeneration.</p>

Relationship between portal vein pressure and liver regeneration after portal branch ligation in rats / 中华消化外科杂志

Objective To investigate the relationship between portal vein pressure and liver regeneration after 90% portal branch ligation in rats.Methods Forty-five male SD rats underwent 90% portal branch ligation (including 5 rats underwent sham operation),and then the changes of portal vein pressure and weight of unligated hepatic lobes were detected.The morphological changes of hepatocytes of the unligated hepatic lobes were observed under a light microscope.Proliferative cell nuclear antigen(PCNA)index was detected by immunohistochemistry,and hepatocyte apoptosis of the unligated hepatic lobes by TUNEL method.All data were analyzed by Pearson rank correlation analysis and t test.Results Thirty-eight out of 40 rats survived(95%).The ligated hepatic lobes diminished progressively,whereas the unligated hepatic lobes regenerated.Preoperative portal vein pressure was(9.1±1.8)cm H_2O(1 cm H_2O=0.098 kPa),and it was increased significantly shortly after the ligation and reached (15.8±2.7)cm H_2O 12 hours later(t=6.847,P＜0.05).The portal vein pressure decreased from(13.6±2.3)cm H_2O at day 1 to(9.3±2.0)cm H_2O at day 28.Preoperative positive PCNA index was 7%±3%,which was significantly lower than 14%±5%at postoperative 12 hours,21%±6%at day 3 and 26%±7%at day 5(t=9.129,P＜0.05),and it began to return to normal at day 5.Few apoptotic hepatoeytes were observed in preoperative liver tissue and unligated hepatic lobes.The expression of PCNA in unligated hepatic lobes and portal vein pressure had apositive correlation at postoperative day 1,3,5(r=0.913,0.896,0.908,P<0.05)and a negative correlation at postoperative day 14(r=-0.926,P<0.05).Conclusions The regeneration of hepatocytes in unligated hepatic lobes is activated after 90% portal branch ligation,and the regenerated liver compensates the weight loss of the ligated hepatic lobes.Liver is regenerated mainly by speeding hepatocyte proliferation rather than reducing hepatocyte apoptosis.Changes of portal vein pressure may play an important role in liver regeneration.

K-space undersampling algorithm based on PROPELLER MRI technique / 中国医疗器械杂志

PROPELLER (periodically rotated overlapping parallel lines with enhanced reconstruction) is a new method of MRI data collection and reconstruction technique for reducing motion artifact. However, the minimum imaging time in PROPELLER is markedly longer than in conventional fast MRI. Through the current research of K-Space Undersampling algorithm based on PROPELLER technique, a proper undersampling method is conducted and then proved by simulation. The new data collection method can shorten the PROPELLER time without causing more image artifacts, which improves the value of PROPELLER technique.