Minimally invasive integrated traditional Chinese and Western medicine therapy for hepatolithiasis based on the SELECT concept / 临床肝胆病杂志

Hepatolithiasis is difficult to treat in clinical practice and has high recurrence rate and incidence rate of complications, improper diagnosis and treatment can easily lead to hepatic insufficiency, and thus it has become one of the difficult problems to be solved in clinical practice. With the improvement of medical equipment and the wide application of various minimally invasive endoscopic techniques, most patients with hepatolithiasis can receive effective treatment. Traditional Chinese medicine therapy can prevent the recurrence of calculi and promote patients’ recovery during the perioperative period. Based on the SELECT (Spyglass, ERCP, Laparoscopy, EUS, Choledochoscopy, Traditional Chinese Medicine) concept, minimally invasive treatment with a combination of various endoscopies should be selected according to the type and clinical features of hepatolithiasis and integrated traditional Chinese and Western medicine therapy should be given in the perioperative period to realize the minimally invasive, diversified, and individualized integrated traditional Chinese and Western medicine therapy for hepatolithiasis.

Application of minimally invasive integrated traditional Chinese and Western medicine therapy based on the SELECT concept in the treatment of acute pancreatitis / 临床肝胆病杂志

Acute pancreatitis (AP) is one of the common digestive diseases. With the advances in technology, the treatment concept of AP has changed, more and more minimally invasive techniques have been applied in the treatment of AP, especially severe acute pancreatitis (SAP). Although there are various different minimally invasive treatment methods for AP, no reliable clinical studies have reported that one technique is significantly better than others. The therapeutic effect of integrated traditional Chinese and Western medicine therapy in acute pancreatitis (AP) has been widely recognized. In recent years, our team has accumulated rich experience in integrated traditional Chinese and Western medicine therapy for AP and has proposed the innovative SELECT concept (Spyglass, ERCP, Laparoscopy, EUS, Choledochoscopy, and Traditional Chinese Medicine) for diagnosis and treatment. The optimal combination of various endoscopies is SELECTed based on the severity and etiology of AP, and traditional Chinese medicine treatment can be used as well to realize the advantages of minimally invasive integrated traditional Chinese and Western medicine therapy in the treatment of AP. This article elaborates on the minimally invasive treatment methods for each clinical stage of SAP based on the SELECT concept.

Application of minimally invasive integrated traditional Chinese and Western medicine therapy based on the SELECT concept in the diagnosis and treatment of hepatobiliary and pancreatic diseases / 临床肝胆病杂志

Hepatobiliary and pancreatic diseases are common and frequently occurring diseases in the digestive system, and several hepatobiliary and pancreatic diseases are difficult to diagnose and treat, with a high incidence rate of complications. With the development of minimally invasive devices and instruments and the application of various laparoscopic/endoscopic techniques, most hepatobiliary and pancreatic diseases can be diagnosed and treated by minimally invasive techniques. Traditional Chinese medicine plays an important synergistic role during the perioperative period for hepatobiliary and pancreatic diseases and can accelerate the recovery of patients. The team of Liaoning Provincial Center for Integrated Traditional Chinese and Western Medicine Therapy for Biliary and Pancreatic Diseases led by the authors has mastered various laparoscopic and endoscopic techniques and proposed the concept of SELECT (Spyglass, ERCP, Laparoscopy, EUS, Choledochoscopy, and traditional Chinese medicine) by summarizing the successful experience in the treatment of hepatobiliary and pancreatic diseases in recent years. The optimal combination of minimally invasive multi-endoscopic techniques is selected based on the features of different hepatobiliary and pancreatic diseases, and traditional Chinese medicine treatment is also applied in the perioperative period, so as to achieve minimally invasive, individualized, and precise integrated traditional Chinese and Western medicine therapy for hepatobiliary and pancreatic diseases.

Application of combination of various endoscopic techniques in treatment of bile duct stones / 临床肝胆病杂志

Bile duct stones are a common disease in clinical practice in China,and due to a high incidence rate of complications and complex causes,its clinical diagnosis and treatment has become a difficult problem which needs to solved urgently.With the development of science and technology and the enhanced knowledge of this disease,many treatment methods for this disease have emerged.This article summarizes the successful experience in the treatment of bile duct stones in the Center for Integrated Traditional Chinese and Western Medicine Therapy for Biliary and Pancreatic Diseases in our hospital.With reference to the type and distribution characteristics of bile duct stones,a combination of various endoscopic techniques,such as laparoscopy,choledochoscopy,and duodenoscopy,can achieve the goal of minimally invasive,diverse,and individualized diagnosis and treatment and provide feasible thoughts and strategies for the treatment of bile duct stones.

1:2 matched case-control study on the risk factors related to congenital heart disease during the peri-conceptional period / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the possible risk factors during the periconceptional period relevant on the occurrence of congenital heart diseases (CHD) in the offspring.</p><p><b>METHODS</b>A 1:2 matched case-control study was designed. From January 2012 to January 2014 in a district from Wuhan city, HuBei province, children were proved by MCH institutions through the "free screening for congenital heart disease" program. Cases with CHD were screened out by conventional auscultation, echocardiography figure and confirmed by physicians from the high-level hospitals. According to age, gender, community paired healthy children were chosen as controls. EpiData 3.1 software was used to input data, using SPSS 11.5 software to analyze the possible risk factors under simple and multiple factors logistic regression.</p><p><b>RESULTS</b>Information from parents of 138 cases and 276 controls was collected. 27 major factors from the conditional logistic regression analysis showed that factors as:mental stress during early pregnancy, calcium supplement in the early stage of pregnancy, pregnancy malnutrition, having histories of abnormal childbearing, women with multiparous experiences and residence nearby sources of pollution (enterprises) etc. were associated with the incidence of congenital heart disease in the offspring. Data from the multivariate logistic regression analysis showed that factors as:mental stress during early pregnancy (HR = 3.35, 95%CI: 1.28-8.79), pregnancy malnutrition during pregnancy (HR = 1.50, 95% CI:1.10-2.03) and with abnormal childbearing history (HR = 1.62, 95% CI:1.03-2.57) were risk factors. However, calcium supplement during early pregnancy (HR = 0.40, 95% CI:0.25-0.65) could reduce the risk of CHD.</p><p><b>CONCLUSION</b>The occurrence of CHD might be related to factors as:mental stress during early pregnancy, calcium supplement during early pregnancy, pregnancy malnutrition and having histories of abnormal childbearing. Peri-conceptional care should be strengthened to reduce the incidence of congenital heart disease.</p>

Avoiding injuries to aberrant right posterior hepatic duct during laparoscopic cholecystectomy / 中华肝胆外科杂志

Objective To investigate how to avoid and deal with injuries to the aberrant right posterior hepatic duct during laparoscopic cholecystectomy (LC).Method We studied 1 710 patients who underwent LC in our unit from January 2011 to November 2013.There were 5 patients with right posterior hepatic duct abnormally,and this paper analysed the cases.Results In the 5 patients,one patient had the right posterior hepatic duct draining into the gallbladder body (Ⅰ A type),two patients had the right posterior hepatic duct draining into the cystic duct (ⅢA type),and two patients had the cystic duct draining into the right posterior hepatic duct (ⅢB type).There was no damage to the right posterior hepatic duct during operation.One patient was converted from LC to open operation.The major aberrance was class Ⅲ.Conclusions Variant bile duct is an important cause of bile duct injuries during LC.The right posterior hepatic duct variation is the most common form.To raise our vigilance and fully understand the types of aberrant right posterior hepatic duct,reasonable use of preoperative MRCP and intraoperative cholangiography in selected patients are fundamental.Aberrant right posterior hepatic duct injuries can effectively be avoided.

Application of endoscopic pancreatic duct exploration in precise pancreatectomy for intraductal papillary mucinous neoplasms / 中华消化外科杂志

The diagnostic rate of intraductal papillary mucinous neoplasms (IPMNs) has been increased as the improvement of imaging and endoscopic techniques.All main duct type and mixed variant IPMNs should be resected as long as the patient is a good surgical candidate with reasonable life expectancy.Evaluation of resection margin ( especially circumferential margins) is very important to prevent the recurrence of IPMNs,and intraoperative pancreatoscopy plays an important role in determining the appropriate size for pancreatic resection.In this article,the experience in the treatment of 1 patient with IPMNs by precise pancreatectomy guided by endoscopy-assisted intraoperative pancreatic duct inspection was introducted.