Value of albumin-bilirubin grade in predicting liver function changes and prognosis of hepatocellular carcinoma patients undergoing transarterial chemoembolization: A Meta-analysis / 临床肝胆病杂志

Objective To investigate the value of albumin-bilirubin (ALBI) grade in evaluating liver function changes and prognosis of hepatocellular carcinoma (HCC) patients undergoing transarterial chemoembolization (TACE). Methods PubMed, the Cochrane Library, EMbase, Web of Science, OVID, CNKI, Wanfang Data, VIP, and CBM databases were searched for studies on ALBI grade for evaluating liver function changes and prognosis of HCC patients undergoing TACE published up to December 2020. After quality assessment and data extraction, RevMan 5.3 was used to perform a meta-analysis of the studies included. The chi-square test was used to evaluate heterogeneity between studies; hazard ratio ( HR )/odds ratio ( OR ) and corresponding 95% confidence interval ( CI ) were used to evaluate outcome measures; funnel plots were used to assess publication bias. Results A total of 18 articles were included, with 9940 patients in total. The meta-analysis showed that the HCC patients with higher ALBI grades after TACE had a shorter overall survival time than those with lower ALBI grades (2 nd vs 1 st : HR =1.48, 95% CI : 1.39-1.57, P < 0.000 01; 3 rd vs 1 st : HR =2.45, 95% CI : 1.92-3.13, P < 0.000 01; 3 rd vs 2 nd : HR =1.91, 95% CI : 1.71-2.13, P < 0.000 01). The degree of deterioration of ALBI caused by 2 times of TACE was higher than that caused by 1 time of TACE ( OR =1.91, 95% CI : 1.27-2.88, P < 0.05); the degree of deterioration of ALBI caused by 3 times of TACE was higher than that caused by 1 time of TACE ( OR =3.21, 95% CI : 1.95-5.28, P < 0.05); the degree of deterioration of ALBI caused by 3 times of TACE was higher than that caused by 2 times of TACE ( OR =1.70, 95% CI : 1.07-2.70, P < 0.05). In addition, ALBI grade could predict the onset of acute-on-chronic liver failure (ACLF) after TACE ( OR =4.57, 95% CI : 2.76-7.57, P < 0.000 01). Conclusion Repeated TACE treatment can cause continuous deterioration of liver function based on ALBI, and ALBI has an important clinical value in predicting prognosis and the risk of ACLF after TACE.

Risk factors for delayed gastric emptying after pancreaticoduodenectomy / 中华胰腺病杂志

Objective To analyze the related risk factors for delayed gastric emptying ( DGE) after pancreaticoduodenectomy .Methods Clinical data on 308 patients who underwent pancreaticoduodenectomy at Ningbo Lihuili hospital from January 2009 to December 2014 were retrospectively analyzed , and patients were divided into DGE group and non-DGE group.Univariate analysis and multivariate logistic regression analysis were used to study the risk factors associated with DGE during perioperative period .Results DGE occurred in 55 patients (17.9%).The incidences of grade A, grade B and grade C DGE were 7.1%(22/308), 6.2%(19/308) and 4.5%(14/308), respectively.The univariate analysis showed the method of pancreatic digestive tract reconstruction ( pancreaticogastrostomy or pancreaticojejunostomy ) , postoperative pancreatic fistula, postoperative biliary fistula and postoperative intraabdominal infection were risk factors for DGE after surgery. Multivariate analysis indicated that the method of pancreatic digestive tract reconstruction (OR=1.19, P=0.046), postoperative pancreatic fistula ( OR=1.33, P=0.014), postoperative biliary fistula (OR=1.43, P=0.047) and postoperative intraabdominal infection (OR=1.51, P=0.001) were independently associated with DGE . Postoperative pancreatic fistula (OR=3.692, P=0.021) and intraabdominal infection (OR=3.725,P=0.003)were also the independent risk factors for Grade B and Grade C DGE. Conclusions DGE after pancreaticoduodenectomy was strongly related to the postoperative complications .Postoperative pancreatic fistula , biliary fistula and intraabdominal infection were associated with increased risk of DGE , while pancreaticogastrostomy reduced the incidence of DGE by decreasing the incidence of pancreatic or biliary fistula .

Value and safety of the surgery with vascular resection and reconstruction for pancreatic cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the value and safety of the surgery with vascular resection and reconstruction during pancreatectomy for pancreatic cancer.</p><p><b>METHODS</b>The clinical data of 206 patients with pancreatic cancer who underwent radical resection were retrospectively analyzed from January 2009 to March 2014 in Lihuili Hospital, Medical center of Ningbo.All cases were divided into non-vascular resection group(132 cases), the combined vein resection group(66 cases) and the combined arterial resection group(8 cases). The peri-operation data, the incidence of postoperative complications and the survival were compared in pairs among three groups.All patients were followed up till September 2014.</p><p><b>RESULTS</b>There were no statistical differences for the preoperative data among three groups.The operation time and the blood loss (M(QR)) were (347±96)minutes and (500(400)) ml in non-vascular resection group, (425±91)minutes and (800(500))ml in combined vein resection group, (508±120)minutes and (1 750(2 075))ml in combined arterial resection group, with significant differences among three groups(all P<0.01). The incidence of postoperative complication was 16.7%(22/132) in non-vascular resection group, 28.8%(19/66) in combined vein resection group, and 6 cases in combined arterial resection group, respectively.There were significant differences between non-vascular resection group and combined vein resection group(P<0.05), non-vascular resection group and combined arterial resection group(P<0.05), as well as between combined vein resection group and combined arterial resection group(P<0.05). The median survival time was 15 months for non-vascular resection group, 15 months for combined vein resection group, and 12 months for combined arterial resection group.No significant difference was found among three groups(all P>0.05). The postoperative mortality was nil for all of groups.</p><p><b>CONCLUSIONS</b>Compared with non-vascular resection, combined vein resection can be performed safely with a similar prognosis. The surgery of combined arterial resection could only be justified when R0 resection for pancreatic cancer could be achieved for highly selected patients.</p>

Risk factors for pancreatic fistula after distal pancreatectomy / 中华普通外科杂志

Objective To find the potential risk factors for pancreatic fistula after distal pancreatectomy.Methods Clinical data of 125 cases of consecutive distal pancreatectomy in Ningbo Lihuili Hospital from January 2006 to June 2013 were retrospectively analyzed.Results In all the 125 patients with distal pancreatectomy,pancreatic fistula was the most common surgical complication (43/125,34.4％),including 27 cases of grade A fistula,16 cases of grade B pancreatic fistula.Multivariate analysis showed that the texture of the pancreas and main pancreatic duct ligation were the independent risk factors for pancreatic fistula (all P ＜ 0.05).Conclusions Pancreatic fistula was the most common surgical complication of distal pancreatectomy.The texture of the pancreas and main pancreatic duct ligation effect the occurrence of postoperative pancreatic fistula.

Left lower extremity venous thrombosis after operation of cyst in the jaw: a case report / 华西口腔医学杂志

Deep vein thrombosis is a common complication after orthopedic, gynecological, and obstetric operations. However, instances of this complication after oral and maxillofacial surgeries have been rarely reported. We report a case with odontogenic keratocyst in the jaw that gained left lower extremity venous thrombosis after operation, and discuss the risk factors and prevention of lower extremity venous thrombosis through literature review.

Transcatheter arterial chemoembolization after liver resection for hepatocellular carcinoma with portal vein tumor thrombus / 中华肝胆外科杂志

ObjectiveTo study the efficacy of transcatheter arterial chemoembolization (TACE) after liver resection for hepatocellular carcinoma (HCC) with tumor thrombus in the main trunk and/or first branch of portal vein,and to clarify prognostic factors affecting survival.Methods From 2005 to 2009,there were 358 consecutive patients with HCC who underwent surgical resection in our Department.In 55 patients (15 ％),portal vein tumor thrombus (PVTT) was found intraoperatively or postoperatively during histopathological examinations to involve the first portal branch,main portal trunk,or contralateral portal branch.In this retrospective study,these 55 patients were divided into two groups:Group A,29 patients received postoperative TACE,and Group B,26 patients who did not receive TACE.The clinical data and survivals were compared between the two groups.Prognostic factors were indentified using univariate analysis,followed by multivariate regression analysis using the Cox proportional hazards model.ResultsThere were no significant differences in the demographic clinical data between Group A and Group B.The overall 1-,2- and 3-year survivals for the 55 patients were 63.3 ％,51.4 ％ and 43.5 ％,respectively.The accumulative 1-,2- and 3-year survivals for group A were 71.4 ％,60.1 ％ and 50.1 ％,respectively.The corresponding figures for group B were 56.7％,21.7％ and 10.4％,respectively.Multiple tumors,intrahepatic metastases,hepatic vein thrombus,and invasive type of tumor thrombus were found to be risk factors for short-term survival on univariate analysis,while the latter 3 factors were further found to be significant prognostic factors in the Cox proportional hazards model.Postoperative TACE was shown to be a significant factor in both univariate and multivariate analyses.ConclusionLiver resection was beneficial for some patients with portal vein tumor thrombus.Postoperative TACE further improved the prognosis and prolonged survivals in these patients.

RELEASE OF COLONY-STIMULATING FACTOR INDUCED BY ENDOTOXIN FROM BACTEROIDES MELANINOGENICUS ATCC 25845 / 微生物学通报

Present study investigated the effect of endotoxin from Bacteroides melaninogenicus ATCC 25845 on release of colony-stimulating factor (CSF)in mice. The bone marrow cells were cultured in semisolid agar medium,the number of colonies was as a level index of CSF. The results showed that as much as 0.1?g endotoxin could induce the release of CSF,moreover, The level of CSF increased with dose of endotoxin untill 50 ?g. The colony-stimulatin factor level of B. melaninogenicus endotoxin was 66.6?8.5(CFU-C). This endotoxin showed significant effect on bone marrow cells of mice.

The preparation of matrine sustained-release tablet and the determination of its dissolution rate / 中成药

AIM:To prepare sustained release matrine tablet,and study its drug release test in vitro. METHODS: In combination with HPLC,we studied the cumulative matrine release using HPLC and EC as the sustained materials. RESULTS: The release of matrine was conformed to Higuchi equation. CONCLUSION: The drug release behavior could be well described in vitro,and meet the design criteria,it is easy to be produced.

R-fraction as a Biological Principle in the Natural S. abortus equi Endotoxin Preparation / 第二军医大学学报

A typical smooth-form lipopolysaccharide (LPS) isolated from Salmonella abortus equi was fractionated into a S (smooth)-and a R (rough)-fraction and their serological and biological properties were investigated. It was shown that S- fraction expressed an O-antigenicity while R-fraction predominately a Rb-antigenicity. The R-fraction was endowed with higher bioactivities than the S-fraction in lethal toxicity, local Shwartzman reaction and pyrogenicity. Both S-and R-fractions were active in inducing mitogenicity to murine spleen cells. A reconstituted LPS preparation with fractionated S-fraction and a trace amount of R-fraction (1% of the original preparation) exhibited a same extent of lethal toxicity as that of the original one. Antr-Ra and -Rb antiserum with a liter of 1?4096 showed a .highly effective protection against the lethal challenge of LPS, indicating that the R-fraction in the natural LPS preparations plays a critical role to the lethality of LPS.

Combined Lethal Toxicity of TNF and LPS in Tumor-Bearing Mice / 第二军医大学学报

Both TNF and LPS are toxic to host, especially to tumor - bearing host Intravenous administration at a dose of 5?g of TNF or 25?g of LPS could not result in death of mice transplanted with sarcoma 180 (S180) 10 d later, but 80% of S180-bearing mice died after iv injection of 5?g of LPS combined with 0.5?g of TNF. In contrast to TNF, combined toxicity was seriously LPS-dose dependent Combined mortality dropped from 80% to 14% when LPS dose reduced to 1?g, however, 50% of mice died of combined toxicity when only TNF dose dropped to 0.1?g. It suggested that TNF sensitized host response to toxic effect of LPS. Indomethacin could partially block the combined toxicity, demonstrating that combined toxicity of LPS and TNF was partially mediated by prostaglan-dins.