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Objective To systematically evaluate the short-term efficacy and safety of robotic pancreaticoduodenectomy (RPD) versus traditional laparoscopic pancreaticoduodenectomy (LPD), and to provide a reference for clinical research and practice. Methods Chinese and English databases such as PubMed, Embase, the Cochrane Library, CNKI, Wanfang Data, and VIP were searched to include the cohort studies comparing the clinical efficacy of robot-assisted laparoscopy and traditional laparoscopy in pancreaticoduodenectomy. The quality of included articles was evaluated based on Cochrane systematic review, and Stata15.1 software was used to perform a meta-analysis of related outcome measures extracted. Results A total of 12 cohort studies were included, with 1630 patients in total, and there were 683 patients in the RPD group and 947 patients in the LPD group. The meta-analysis showed that there were significant differences between the RPD group and the LPD group in postoperative bleeding rate (odds ratio [ OR ]=0.66, 95% confidence interval [ CI ]: 0.48-0.91, P < 0.05), rate of conversion to laparotomy ( OR =0.41, 95% CI : 0.30-0.56, P < 0.05), estimated intraoperative blood loss (weighted mean difference [ WMD ]=-0.77, 95% CI : -1.33 to -0.22, P < 0.05), and length of postoperative hospital stay (WMD=-0.45, 95% CI : -0.80 to -0.11, P < 0.05). Country of publication might be one of the sources of heterogeneity in the incidence rate of postoperative complications between subgroups ( P < 0.05). Conclusion Compared with traditional LPD, da Vinci RPD can reduce postoperative bleeding rate, intraoperative blood loss and rate of conversion to laparotomy and shorten postoperative hospital stay, and meanwhile, it does not increase the operation time and the incidence rate of postoperative complications. Both surgical procedures are safe and feasible.
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Ischemic-type biliary lesion (ITBL) refers to biliary tract injury caused by insufficient blood supply of hepatic artery, which is one of the main factors affecting the long-term survival and quality of life of liver transplant recipients. The incidence of ITBL is associated with cold and warm ischemia, acute and chronic rejection, cytomegalovirus infection and the bile effect, etc. The occurrence of ITBL is a complicated process involving with multiple factors and steps. The therapeutic option of ITBL is extremely limited. A large proportion of ITBL patients should undergo repeated liver transplantation. ITBL has become one of the most critical factors preventing further advancement of liver transplantation. Hence, it is of significance to strengthen prevention and explore more effective modalities. Recent studies have found that toxic injury of bile salts plays a central role in ITBL. Active regulation of bile components, regulation of bile acid-related receptor expression and blockage or activation of bile acid-related signaling pathways probably have potentials in the prevention and treatment of ITBL. In this article, the cytotoxicity of bile salts and the mechanism of bicarbonate umbrella in the incidence and progression of ITBL after liver transplantation were reviewed, aiming to provide reference for the diagnosis and treatment of ITBL.
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Objective@#To explore the imaging characteristics and related influencing factors of in-stent neoatherosclerosis (ISNA) in patients with restenosis after drug-eluting stent(DES) implantation with optical coherence tomography(OCT).@*Methods@#A total of 25 cases of coronary heart disease patients(DES placement time ≥8 months) with coronary artery angiography showing DES in-stent restenosis (ISR) in Zunyi medical college affiliated hospital from July 2013 to December 2015 were included in this study and patient's data were retrospectively analyzed.In these patients with ISR, OCT images were acquired before percutaneous coronary intervention. Patients were divided into the ISNA group (12 patients and 12 lesions) and non-ISNA group(13 patients and 13 lesions) according to the result of OCT. ISNA on OCT was defined as neointima formation with the presence of lipids or calcification.@*Results@#(1) The incidence of chronic kidney disease and increased low-density lipoprotein cholesterol level in ISNA group were significant higher than that in non-ISNA group(all P<0.05). The stent implantation time in ISNA group was longer than that in the non-ISNA group(53.0(14.0, 81.0) months vs. 15.0(8.5, 32.5) months, P<0.01). In addition, clinical manifestation of acute coronary syndrome was present in 8 out of 12 patientsin ISNA group, and stable angina pectoris was found in 10 out of 13 casesin non-ISNA group(P<0.01). (2) Quantitative analysis of OCT showed that the lumen area was less in ISNA group than in non-ISNA group((3.45±1.82)mm2 vs. (4.17±1.68)mm2, P<0.01), and neointimal area(3.89(2.26, 5.52)mm2 vs. 2.96(1.99, 4.22)mm2, P<0.01), neointimal load (53.15(40.18, 67.30)% vs. 41.54(32.08, 56.91)%, P<0.01), neointimal thickness(0.98(0.63, 1.36)μm vs. 0.72(0.51, 1.03)μm, P<0.01) were higher in ISNA group than in non-ISNA group.(3)Qualitative analysis of OCT showed that the prevalence of homogeneous intima was less in the ISNA group than in the non-ISNA group ((41.42±22.56)% vs.(72.06±18.68)%, P<0.05), on the contrary, the heterogeneous intima was more common in the ISNA group ((58.57±22.56)% vs. (27.94±18.68)%, P<0.05). There was no significant difference between two groups in the peri-stentmicrovessels (9/12 vs. 5/13,P>0.05), and prevalence of intraintimalmicrovessels was higher in the ISNA group than in non-ISNA group (7/12 vs. 2/13, P<0.05). In addition, thin cap fibrous plaque(7/12 vs. 0, P<0.01), disrupted intima with visible cavity (7/12 vs. 1/13, P<0.05),andintraluminal red thrombus(7/12 vs. 1/13, P<0.05) were significantly higher in ISNA group than in non-ISNA group.@*Conclusions@#Results of OCT show that ISNA occurs frequently in patients with ISR after DES implantation. The stent implantation time, incidence of chronic kidney disease and higher low-density lipoprotein cholesterol level are associated with the formation of ISNA in these patients.
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Objective:To understand the characteristics and practice of standardized training for resident in psychiatric department,providing a reference for other hospitals in the similar situation.Methods:Using qualitative method,in-depth interview and focus group interview were carried out with clinical teaching and teaching management experts of a tertiary hospital,to understand the characteristics,practice,and deficiencies of resident doctors standardized training for psychiatrists.Results:Focusing on clinical operation,psychotherapy,and communication capability were the major characteristics of resident doctors' standardized training for psychiatrists in this hospital.Though this hospital did positive trials on guarantee system improvement,outpatient and inpatient training combination,and training content expansion,it was not perfect enough in united training and training pattern.Conclusions:The psychiatry resident's standardized training for psychiatrists should establish complete standards of performance for united training,strengthen training mechanism and training mode,and make full use of modem distance education resources to further improve quality of the psychiatric residency training.
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Symbolic dynamics may be a new research direction for electroencephalogram (EEG) signal analysis. Symbolic entropy can reflect the degree of complexity of nonlinear signal simply and reliably. In this paper, we propose a new method to symbolize the EEG signal, namely difference symbolization, by which we can analyze the characteristics of dynamics on the tangent space of observation data. Furthermore, we compare and analyze the value of symbolic entropy by choosing difference symbolization parameter. The comparative analyses on different physiological state of EEG data sets show that this method can clearly distinguish the EEGs' complexity between normal and epilepsy, between eyes open and eyes closed, and so on. And it is of significance to the establishment of objective criteria for evaluation and fine quantitative analysis of EEG.
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Humans , Algorithms , Electroencephalography , Methods , Entropy , Nonlinear Dynamics , Signal Processing, Computer-AssistedABSTRACT
Objective To summarize the experiences of tension-free method in inguinal hernia recurrence.Methods Using the PHS Ethicon Ine,42 patients with recurrent hernia were performed tension-free hemioptasty.Results The operation time was from 40 to 150 minutes.The patients could walk up within 1 d after the procedure.No incision infection was found.The eomplicatiom included 4 retention of urine.3 large serotal hematoma requiring surgical drainage.The follow-up period ranged from 6 months to 3 years,no recurrence and foreign body sensation in inguinal region were observed.Conclusion PHS call be anatomically adapted to repairing and augmenting the myopectineal orifice.It is suitable to the patients with recurrent inguinal hernia.
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OBJECTIVE: To establish HPLC method for the determination of the contents of atenolol, hydrochlorothiazide and nifedipine in xueyaan sustained release tablets. METHODS: The determination was performed on ZORBAX SB C18 column with column temperature at 35℃ . The mobile phase consisted of 0. 01mol? L- 1 sodium dihydrogen phosphate solution- methanol- acetonitrile ( 6∶ 3∶ 1) . The UV detection wavelength was set at 272nm and the sample size was 20? L. RESULTS: The liner ranges of atenolol, hydrochlorothiazide and nifedipine were 10～ 250? g? mL- 1 ( r=0. 999 4) , 6～ 150? g? mL- 1( r=0. 999 6) , and 5～ 125? g? mL- 1( r=0. 999 2) respectively. The average recovery rates of the three constituents were ( 98. 51? 0. 98) % ～ ( 99. 12? 0. 98) % , ( 98. 87? 1. 10) % ～ ( 99. 69? 1. 43) % , and( 98. 80? 1. 27) % ～ ( 99. 38? 1. 13) % , respectively, with RSD at 1. 00% , 1. 17% , and 1. 25% , respectively. CONCLUSION: The established method is simple, sensitive and reproducible, and suitable for the quality control of xueyaan sustained release tablets.
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OBJECTIVE: To prepare lincomycin hydrochloride glycerol paint and to determine its content. METHODS: Lincomycin hydrochloride glycerol paint was prepared using lincomycin hydrochloride and dyclonine hydrochlorideas as main components; the contents of the two main components were determined by HPLC. RESULTS: The linear ranges of lincomycin hydrochloride and dyclonine hydrochloride were 20～200 ?g?mL-1(r=0.999 8) and 10～100 ?g?mL-1(r=0.999 9),respectively. The average recoveries(n=5) were 99.61% and 99.28%,with RSD stood at 0.439% and 0.818%,respectively. CONCLUSION: Both the preparative method and determination method for lincomycin hydrochloride glycerol paint are simple and feasible.
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We adopted the linear combination method of absorbances to assay the contents of compound alcoholic solution of benzoic acid directly without isolation of its components. The recovery rates of benzoic acid and salicylic acid were 100.97％ (cv=0.86％)and 100.29％(cv=0.82％)respectively.