Systematic review and Meta-analysis of incidence of oral feeding intolerance in acute pancreatitis / 国际外科学杂志

Objective To systemically review andquantify the incidence of oral feeding intolerance in acute pancreatitis. Methods Randomized controlled trials that reported the oral feeding intolerance rates of acute pancreatitis were searchedfrom PubMed, EMBASE, Medline, Cochrane Library, WanFang, CNKI, CMCC and VIP dal,abase wilh the" Acute pancreatitis " " Feeding intolerance" " Incidence" " Meta- analysis "from January 2002 to May 2017. Date were analyzed by using R 3. 4. 0 software. The heterogeneity of data were analyzed using 12test. Results Eleven randomized controlled trials including 658 cases were enrolled in Meta-analysis. The incidence of oral feeding of intolerance was 12. 2% . The result of subgroup analysis showed that there were no significant difference in the incidence of oral feeding intolerance when region, sample size and published year were taken into analysis (P > 0. 05). The oral feeding intolerance rate of mild acute pancreatitis was lower than that when moderately severe acute pancreatitis and severe acute pancreatitis were, included (8. 2% and 19. 9% , respectively; P = 0. 002 7). Conclusion Oral feeding intolerance affects approximately l in 8 patients with acute pancreatitis. The incidence of oral feeding intolerance of patients with severe acute pancreatitis is higher than that of patients with mild acute pancreatitis

Practice and its effects for reducing incidence of peritoneal dialysis related peritonitis for patients in rural area / 中华护理杂志

Objective To reduce the incidence of peritoneal dialysis related peritonitis for patients in rural area and to improve management quality of peritoneal dialysis center.Methods We established multidisciplinary collaborative research group involving departments of nephrology,nutrition,infection,and quality control.Risk factors of peritoneal dialysis related peritonitis in rural patients were analyzed,and prevention measures were designed.The rate of peritoneal dialysis related peritonitis in 89 patients after implementation was analyzed.Results The rate of peritoneal dialysis related peritonitis was decreased from 43 patient·month per time to 67 patient ·month per time.Conclusion The compound pathway can effectively reduce the rate of peritonitis,improve patient satisfaction,and prolong dialysis age.

Laparoscopic versus open D2 gastrectomy for advanced gastric cancer: A meta-analysis on long-term outcomes / 国际外科学杂志

Objective To evaluate the long-term clinical outcomes between laparoscopic gastrectomy and open gastrectomy with D2 lymph dissection for advanced gastric cancer.Methods Clinical studies that compared clinical outcomes of laparoscopic gastrectomy and open gastrectomy for advanced gastric cancer were searched from PubMed,EMBASE,Medline,Cochrane Library,WanFang,CNKI,CMCC and VIP database with the Gastric neoplasms Laparoscopy Gastrectomy Long-term outcomes Meta-analysis between Jan.2002 and Oct.2016.Data of long-term survival and recurrence were analyzed by using of RevMan 5.2 software.Survival data were present by the odds ratio(OR) and 95％ CI.The heterogeneity of the data was analyzed using the I2 test.Results Fifteen studies including 4,053 cases were enrolled.There were 2,091 patients in LG group and 1,962 patients in the open gastrectomy group.There was no significant difference in the 3-year overall survival rate(OR =1.00,95％ CI:0.83-1.20,P =0.98),5-year overall survival rate (OR =1.14,95％ CI:0.95-1.36,P =0.15),5-year disease-free survival rate(OR =1.13,95％ CI:0.93 ～ 1.39,P =0.22)and cancer recurrence rate (OR =0.96,95％ CI:0.79 ～ 1.18,P =0.71)between the patients treated with laparoscopic gastrectomy,or open gastrectomy (P ＞ 0.05).Conclusion Laparoscopic gastrectomy with D2 lymph dissection for advanced gastric cancer has similar long-term outcomes as compared to open gastrectomy.

Simultaneous determination of seven constituents in Sangqishouwu Tablets by HPLC / 中成药

AIM To establish an HPLC method for the simultaneous content determination of calycosin-7-glucoside,ononin,calycosin,formononetin,oxypaeoniflorin,alibiflorin and benzoylpaeoniflorin in Sangqishouwu Tablets (Talxilli Herba,Astragali Radix,Polygoni multiflori Radix Praeparata,etc.).METHODS The analysis of methanol extract of this drug was performed on a 25 ℃ thermostatic Diamonsil C18 colmn (250 mm × 4.6 mm,5 μm),with the mobile phase comprising of acetonitrile-0.02％ phosphoric acid flowing at 0.9 mL/min in a gradient elution manner,and the detection wavelengths were set at 230 nm and 254 nm.RESULTS Seven constituents showed good linear relationships within their own ranges (r ≥ 0.999 2),whose average recoveries were 97.13％-100.03％ with the RSDs of 0.69％-1.47％.CONCLUSION This sensitive,accurate and specific method can be used for the rapid quality control of Sangqishouwu Tablets.

Application of visible simulation surgery in the typeⅡB odontoid fractures / 局解手术学杂志

Objective Through the exploration of the reality technology to find the treatment of type Ⅱ odontoid fractures in anterior fixation of odontoid fractures with hollow screw .Methods Based on 64 row spiral CT continuous 2-dimensional images of akull ,atlas and axis were reconstructed by the Mimics software ,Mimics software reconstruction atlas ,the atlantoaxial 3D visualization structure in Mimics, simulated surgery was carried out in the MedCAD .Results The structure of three-dimensional reconstruction image was clear ,structure of hollow screw into pin-point was accurate in virtual simulation surgery ,the screw path is correct .Conclusion Mimics Software has great val-ues in the diagnosis of odontoid fractures ,preoperative risk evaluation ,place the hollow screw and clinical teaching ,which provides an objec-tive basis for choice of treatment program .

Efficacy comparison of laparoscopic versus open distal gastrectomy with D2 lymph dissection for advanced gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the long-term clinical outcomes between laparoscopic and open distal gastrectomy with D2 lymph dissection for advanced gastric cancer.</p><p><b>METHODS</b>Clinical data of 377 cases of laparoscopic distal gastrectomy and 301 cases of open distal gastrectomy with D2 lymph dissection at the Southwest Hospital, the Third Military Medical University from January 2004 to June 2010 were retrospectively analyzed. Patients were followed up until September 2015. Surgical outcomes, postoperative complications and long-term survival were compared between the two groups.</p><p><b>RESULTS</b>Compared with conventional open group, laparoscopic group was associated with lower intraoperative blood loss [(125±89) ml vs. (290±161) ml, t=-15.942, P=0.000], shorter time to oral intake [(2.9±0.7) days vs. (4.1±1.6) days, t=-12.120, P=0.000], quicker bowel function retum[(2.7±1.4) days vs. (3.6±1.6) days, t=-7.804, P=0.000], shorter postoperative hospital stay [(7.7±3.6) days vs. (10.1±4.1) days, t=-8.107, P=0.000]. In addition, there were no significant differences in the operative time[(207±57) minutes vs. (202±43) minutes, P>0.05], number of retrieved lymph nodes(33±13 vs. 31±15, P>0.05), resection margin length(P>0.05) between two groups. The postoperative complication morbidity in laparoscopic group was significantly lower than that in open group[7.2%(22/377) vs. 12.6%(38/301), χ(2)=5.762, P=0.016]. Within perioperative period, 7 patients underwent operation again due to complication and 1 case died of peritoneal bleeding in laparoscopic group; 6 patients underwent re-operation and 2 cases died of peritoneal infection with hepatic failure and lung infection with respiratory failure. During the median follow-up of 86 months (range from 3-140 months), relapse occurred in 171(45.4%) patients and 183(48.5%, among them, 156 cases died of primary disease) patients died in laparoscopic group; relapse occurred in 140(46.5%) patients and 151(50.2%, among them, 127 cases died of primary disease) patients died in open group. The difference in overall 5-year survival rate between two groups was not statistically significant (51.5% vs. 49.8%, χ(2)=0.142, P=0.706). No significant difference was seen in 5-year disease-free survival rate (49.1% vs. 47.8%, χ(2)=0.062, P=0.803). Stratified analysis based on TNM stage also showed no significant difference in 5-year overall or disease-free survival rate(both P>0.05).</p><p><b>CONCLUSION</b>Laparoscopic distal gastrectomy with D2 lymph dissection for advanced gastric cancer has better short-term efficacy and similar long-tern efficacy as compared to open surgery.</p>

Application of virtual simulation surgery in lumbar spinal metastases / 局解手术学杂志

Objective Through the exploration of virtual simulation surgery to find a way to treat lumbar spinal metastases. Methods Based on 64 row spiral CT continuous 2-dimensional images of lumbar segments, normal lumbar vertebral, destruction of disease, abdominal aorta and kidneys were reconstructed by the Mimics software. 3D visualization structure was contemplated by anterior lesions clear, titanium mesh of bone cement support, and posterior pedicle screw fixation. Results The three-dimensional reconstruction distinctly displayed the structures of lumbar and its adjacent organs, and the entire virtual simulation surgery was intuitive. Conclusion The application of virtual simulation surgery ensures more accurate 3D model of lumbar establishment and its adjacent organs, and it provides an objective basis for in-dividualized treatment programs.

Short-term efficacy of da Vinci robotic and laparoscopic radical gastrectomy for gastric cancer: a Meta analysis / 中华消化外科杂志

Objective To compare the short-term efficacy between da Vinci robotic and laparoscopic radical gastrectomy for gastric cancer.Methods Database including PubMed,EMBASE,the Cochrane Library,Medline,the China National Knowledge Infrastructure (CNKI),Wanfang Database,VIP and China Biomedicine were searched with the key words of gastric cancer,gastrectomy,da Vinci surgical system,laparoscopic,laparoscopy,胃癌,胃切除术,达芬奇机器人手术系统and腹腔镜.Literatures published between May 2002 and March 2014 were retrieved.Related controlled trials containing the clinical efficacy of da Vinci robotic and laparoscopic radical gastrectomy for gastric cancer were enrolled in the study,and then the literatures were screened and the data were extracted by 2 independent reviewers.The quality of the literatures was assessed,and the data were analyzed using the RevMan 5.2 software.Patients receiving da Vinci robotic surgery and laparoscopic surgery were allocated into the robotic group and laparoscopy group,respectively.The count data were analyzed using the relative risk (RR) and 95％ confidence interval (95％ CI),and the measurement data were analyzed using weighted mean difference (WMD) and 95％ CI.The heterogeneity of the data was analyzed using the I2 test.Results Eleven literatures including 3 698 cases were enrolled in the study.There were 953 patients in the robotic group and 2 745 patients in the laparoscopic group.There were significant differences in the operation time,volume of intraoperative blood loss,time of postoperative flatus,time of first oral intake and duration of postoperative hospital stay between the 2 groups (WMD =51.23,-36.96,-0.24,-0.26,-1.11,95％ CI:28.01-74.46,-61.28--12.65,-0.42--0.06,-0.39--0.14,-1.92--0.29,P ＜ 0.05).There was no significant difference in the number of lymph nodes resected,the distance to proximal and distal resection margin and overall incidence of postoperative complications (WMD =1.63,0.21,0.06,RR =1.11,95％ CI:-0.49-3.76,-0.65-1.06,-0.13-0.25,0.90-1.37,P ＞ 0.05).Conclusion Da Vinci robotic radical gastrectomy for gastric cancer is safe and feasible,with the advantages of minimal invasion and rapid postoperative recovery.

MR manifestation of lower extremity rhabdomyolysis caused by crush injury in earthquake / 中华放射学杂志

Objective Rhabdomyolysis (RM) is a common disorder resulting from a large variety of causes. Acute injury is one of the main reasons. The purpose is to describe the MRI manifestations of rhabdomyolysis caused by 5.12 Wenchuan earthquake in Sichuan province and to discuss their importance in diagnosis and treatment of rhabdomyolysison in clinic practice. Methods Three patients with rhebdomyolysis caused by earthquake were studied via 1.5 T MRI. In all the patients, T, and T2 weighted sequences with and without fat suppression, and short time inversion recovery (STIR) of both lower extremities were obtained in axial, coronal and sagittal planes. All patients were given contrast material during imaging, and MRA (magnetic resonance angiography) of both lower extremity vessels were performed. The MRI characteristics of damaged extremities in 3 cases were studied. Results MRI showed swelling of the affected muscles and subcutaneous fat tissue on both T1 and T2 weighted images. The margins of involved muscles were blurred. On T1 weighted images, swollen muscles showed equal or slightly decreased intensity with small patterns of increased intensity in some local areas. On T2 weighted and STIR sequences, the affected muscles showed inhomogeneons increased signal intensity with clearer margin. Slight fluid collection in spatium intermusculare was observed. Contrast-enhanced scanning showed nonhomologous intensification of damaged muscles, the enhancement inside the muscles was decreased when compared with normal muscles. The locations of all these abnormal intensity were correlated with the injury history and clinic physical examinations. MRA showed no lower extremity vessels were affected. Conclusion MRI has very high sensitivity in detecting the injury of muscles. It's very useful in evaluating the extent and severity of muscles affected in rhabdomyolysis caused by trauma. Also it's very valuable to evaluate the condition of blood vessels in involved extremity for predicting the prognosis of the disease. Therefore MRI possesses a very important role in the diagnosis and treatment of RM.

Preparation of GM-CSF Loaded Chitosan Nanoparticles / 中国药房

OBJECTIVE: To study the feasibility of using biodegradable chitosan nanoparticles as new type carriers for controlled GM-CSF delivery system. METHODS: GM-CSF and BSA loaded chitosan nanoparticles were prepared by ion cross linking method using tripolyphosphate as cross-linking agent with its morphology observed by transmission electron microscope. The encapsulating efficiencies of GM-CSF and BSA were determined respectively by fluorescence scanning and ultraviolet spectrophotometer. The in vitro drug release properties of chitosan nanoparticles were studied as well. RESULTS: Morphologically, the nanoparticles were spherical with mean particle size of 201nm. The encapsulating efficiencies of GM-CSF and BSA were 62.1% and 58.5%, respectively, and their in vitro accumulative drug release rates on the 3rd day were 69% and 82% respectively. CONCLUSION: The ion cross linking method is fit for the preparation of GM-CSF loaded chitosan nanoparticles.

Application of Estrogen Receptor Binding Assay in the Endocrine Disrupting Chemicals Screening Tests / 环境与健康杂志

Estrogen receptor binding assay is to assess the estrogenic activity of chemicals by determining the ability of competing with 17?-estradiol to bind with estrogen receptor.It has the strengths of simplicity,speediness with good reproducibility.This literature reviewed mainly the mechanism,the research progress,test method,influencing factors of this assay as well as its application.