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Objective To evaluate the significance of double pancreatico-jejunostomy in preventing pan-creatic fistula after central pancreatectomy (CP). Methods The clinical data of 10 patients who were admitted to the Affiliated Hospital of Inner Mongolia Medical University from Feb. 2012 to Dec. 2018 were analyzed retro-spectively. Results All the 10 patients underwent CP, closure of the proximal pancreatic stump, and end-to-side invaginated pancreaticojejunostomy; At the same time, invaginated pancreaticojejunal anastomosis or duct-to-mu-cosa pancreaticojejunostomy was performed to the distal pancreatic remnant. The duration of the operation was (240±60) min, and the average intraoperative blood loss was 300 ml. Incidence of pancreatic fistulas was 30％(3/10). There were no grade B or C pancreatic fistulas, or perioperative deaths. The duration of postoperative hospital stay varied from 9 to 25 days. Endocrine and exocrine functions were well maintained during the follow-ups of 7 months to 5 years, and no tumors recurred. Conclusions Although operation time and technical diffi-culty increase, central pancreatectomy using double pancreaticojejunostomy is safe, feasible, and appears to be as-sociated with a low rate of postoperative pancreatic fistulas.
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Objective@#To evaluate the significance of double pancreatico-jejunostomy in preventing pancreatic fistula after central pancreatectomy (CP) .@*Methods@#The clinical data of 10 patients who were admitted to the Affiliated Hospital of Inner Mongolia Medical University from Feb. 2012 to Dec. 2018 were analyzed retrospectively.@*Results@#All the 10 patients underwent CP, closure of the proximal pancreatic stump, and end-to-side invaginated pancreaticojejunostomy; At the same time, invaginated pancreaticojejunal anastomosis or duct-to-mucosa pancreaticojejunostomy was performed to the distal pancreatic remnant. The duration of the operation was (240±60) min, and the average intraoperative blood loss was 300 ml. Incidence of pancreatic fistulas was 30% (3/10) . There were no grade B or C pancreatic fistulas, or perioperative deaths. The duration of postoperative hospital stay varied from 9 to 25 days. Endocrine and exocrine functions were well maintained during the follow-ups of 7 months to 5 years, and no tumors recurred.@*Conclusions@#Although operation time and technical difficulty increase, central pancreatectomy using double pancreaticojejunostomy is safe, feasible, and appears to be associated with a low rate of postoperative pancreatic fistulas.
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Objective:To observe the influence of Danhong injection on interleukin-17 (IL-17)expression after percu-taneous coronary intervention (PCI)in patients with ST segment elevation myocardial infarction (STEMI),and ex-plore its protective effect on myocardial ischemia-reperfusion injury (MIRI)after PCI.Methods:A total of 300STEMI patients undergoing PCI in department of cardiology were selected.They were randomly divided into routine treatment group (n=150)and Danhong injection group (n=150).Enzyme linked immunosorbent assay (ELISA) was used to measure levels of IL-17 and IL-6. Results:There were no significant difference in expression levels of IL-17 and IL-6 between two groups before PCI (P >0.05).On 12h after PCI,IL-17 levels of two groups signifi-cantly rose (P 0.05).Total effective rate of Danhong group was significantly higher than that of routine treat-ment group (92.7% vs.81.3%,P <0.05).Compared with routine treatment group on 72h after PCI,there were significant reductions in levels of IL-17 [(31.4±6.1)ng/ml vs.(23.2±4.3)ng/ml]and IL-6 [(60.3±11.6)ng/ml vs.(42.7±8.4)ng/ml],significant rise in left ventricular ejection fraction [(43.6±4.5)% vs.(53.7±5.6)%] and significant reduction in myocardial infarction area [(22.7±4.3)% vs.(17.2±3.7)%]in Danhong injection group,P <0.05 all.Conclusion:Danhong injection decreases expressions of IL-17 and IL-6,it may be mechanism improving MIRI after PCI,thereby diminishes myocardial infarction area,and improves heart function,which is worthy extending.
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A UPLC-MS/MS method based on metabonomic skills was developed to study the serum metabolic changes of rats after acute liver injury induced by CCl4 and to evaluate the action mechanism of Si-Ni-San. The integrated data were exported for principal components analysis (PCA) by using SIMCA-P software, in order to find the potential biomarkers. It showed that clear separation of healthy control group, model group, silymarin group, Si-Ni-San group was achieved by using the PCA method. Nine significantly changed metabolites were identified as potential biomarkers of acute liver injury. Compared with the health control group, the model group rats showed higher levels of phenylalanine, tryptophan and GCDCA together with lower levels of LPC 16 : 0, LPC 18 : 0, LPC 18 : 1, LPC 16 : 1, LPC 20 : 4 and LPC 22 : 6. These changes of serum metabolites suggested that the disorders of amino acid metabolism, lipid metabolism, bile acid biosynthesis and anti-oxidative damage were related to acute liver injury induced by CCl4. Si-Ni-San might have the anti-liver injury effect on all these four metabolic pathways.
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This study was aimed to establish an HPLC method to simultaneous determine 6 kinds of monoester and diester aconitum alkaloids. The content of alkaloids in aconite roots, black and white prepared lateral root of aconite and the compatibility of aconite roots with rhubarb were determined. This study provided reference for the interpreta-tion of the attenuation of processing and compatibility of medicines from chemical component aspect. The HPLC analysis was performed on a Phenomenex Gemini C18 (4.6 mm í 250 mm, 5 μm) with 40 mmol·L-1 ammonium ac-etate (adjusted to pH 9.8 with ammonia water) and acetonitrile as mobile phase, with a gradient elution at the flow rate of 1.0 mL·min-1 and a detection wavelength of 235 nm. The results showed that 6 alkaloids in aconite roots achieved favorable separation and a good linearity relationship (r > 0.999) over the studied concentration range. The extraction recoveries were ranged from 96.9% to 102.4% for the 6 alkaloids. The content of diester alkaloids de-creased markedly in processed products and the compatibility of aconite roots with rhubarb compared with the raw a-conite roots. It was concluded that this method was stable, reliable, simple and practical. It can be used for the si-multaneous determination of 6 kinds of monoester and diester aconitum alkaloids in aconite roots. This processing and compatibility can significantly reduce the content of alkaloids in aconite roots in order to reduce its toxicity.
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Objective To find out risk factors affecting the prognosis of adult cardiogenic shock patients treated with extracorporeal membrane oxygenation.Methods From January 2003 to December 2010,patients with cardiogenic shock required veno-arterial ECMO after failure of conventional therapy and intra-aortic balloon pump counterpulsation therapy were retrospectively studied. Patients with severe traumatic brain injury,advanced malignancies and multiple organ failure were excluded.All patients were divided into survival group and death group.The risk factors were found out using one-way ANOVA and a multivariate logistic regression analysis was used to determine independent factors associated with survival.Results Thirty-one patients successfully weaned from ECMO. Twenty-two patients were successfully discharged.The average duration of ECMO was 41.56 ± 43.07 hours.Factors associated with failure of hospital discharge were age,pre-ECMO levels of ejection fraction,pre-ECMO levels of lactate,disseminated intravascular coagulation,renal failure and multiorgan failure (P ＜ 0.05). Conclusions Irreversible heart failure and the complications are significantly correlated with survival,and the early use of ECMO for cardiogenic shock and recognize the factors are key to the success of ECMO treatment.
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Objective To investigate the effects of extracorporeal membrane oxygenation (ECMO) in severe cardiopaths with crisis. Methods Fourteen cases of severe eardiopaths with crisis were treated by ECMO with V A- ECMO technique, whose pump was centrifugal pump and whose tubes was spread byheparin. The cases included 8 fulminating myocarditis (FM) cases with ventricular arrhythmias or/and acute heart failure or/and cardiac shock and 6 acute myocardial infarction cases with pump failure or cardiac shock,in whom 10 cases with cardiorespiratory resuscitation. Haemodynamics and blood gas analysis, and so on were measured before and after treatment. Results The support time of ECMO was 3-106 h, mean (32.4±27.6) h. After ECMO mean arterial blood pressure (MAP), left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDd), partial pressure of arterial oxygen, saturation of blood oxygen improved (P < 0.05 or < 0.01 ), negative value of base excess decreased significantly( P < 0.01 ). MAP had notchanged before and after stopping ECMO [ (80.02±10.20) wan Hg (1 mm Hg = 0.133 kPa) vs (76.34±9.15) mm Hg] (P > 0.05), however, LVEF and LVEDd improved continually (P <0.05). Conclusion ECMO can provide oxygen supply and stable circulation volume for severe cardiopaths with crisis to recover cardiorespiratory function or save valuable time to treat primary disease.
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Objective To investigate the effects and values of extracorporeal membrane oxygenation (EC-MO) used in patients after cardiac arrest. Method During five years period from June 2002 to June 2007,fifteen cases taken for cardiopulmonary resuscitation were treated by using ECMO in the emergency department and ICU. All the measures for disgnosis and treatment were observed to the guidelines for cardiopulmonary resuscitation and emergency cardiovasculat care set by the American Heart Association in 2005, and ECMO was applied in addition. The study was a self-comparison trial. The biomarkers including heart rate (HR), mean arterial pressure (MAP), central venous pressure( CVP) , arterial partial oxygen pressure (PaO2), arterial partial pressure of carbon dioxide ( PCQ2), oxygen saturation (SaO2), hydrogen power (PH), and concentration of lactic acid were taken and assayed before and 10 min, 1 h,6 h, 12 h, and 24 h after treatment. Differences between the results of measurements were analysed by t -test for matched pairs using SPSS version 10.0 software package. Neurological sequelae was also observed and described. Results Ten minutes after ECMO treatment, MAP rose dramatically (P < 0.01) and got to further higher level one hour later ( P < 0.05). On the other hand, CVP dropped off 10 minutes after ECMO treatment and further lowered one hour later, and PaO2 and SaO2 were improved apparently ( P < 0.01), and pH was increased significantly (P < 0.01), while a derease in concentration of arterial LA of significantly (P < 0.01). Of the 15 cases, 11 patients got well,including completely recovered without sequelae in 5,memory disorders in 2 and hemipleggia in 2 patients. Conclusions ECMO provides effective blood flow to hearts, and therefore, improves oxygenation and oxygen consumption greatly. Moreover, it provides stable oxygenated blood to brain and therefore, it is a good approach to cardiopulmonary cerebral resuscitation.
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Objective To explore the effective countermeasures for treatment of multiple trauma. Methods The clinical data of 135 cases with multiple trauma admitted into the emergency center of Zhongshan City from June 2002 to June 2003 were applied to study the mode and the key point of integrated treatment for multiple trauma. Results Of 135 cases,107 survived with a success rate of 79.3% and 28 died with a mortality of 20.7%. Conclusions (1)The integrated treatment in the emergency center is an effective way to improve the curative rate of multiple trauma as well as a development trend in treatment of multiple trauma. (2) The mode to make integrated diagnosis and treatment includes the following parts: set up wound center in emergency center,build a united rescue system and train high quality professional personnel. The diagnosis and treatment of multiple trauma must be organized and carried out by doctors in the emergency center. (3)The key treatment points for serious multiple trauma include firstly,active pre-hospital medical care and in-hospital medical care to save the lives;secondly,timely surgical operation to repair the damaged organ and eliminate the factors of lethality and cripples;and thirdly,necessary intensive care to treat the original damage further,protect various function of organs,promote recovery of body and prevent the complications.