Clinical analysis of intraabdominal unicentric Castleman disease:report of 8 cases / 中华普通外科杂志

Objective:To summarize the clinical characteristics of patients with unicentric Castleman disease(UCD).Method:The clinical data of 8 abdominal UCD patients who received surgical resection at the Second Hospital of Hebei Medical University from Oct 2019 to Oct 2022 were analyzed, and the imaging characteristics, pathological types and prognosis were summarized.Result:There were 2 males and 6 females. The average age of patients was (33.0±13.7) years old, and their BMI was (23.2±4.5) kg/m 2. The median maximum diameter of the tumor was 4.5 (3.0-4.9) cm. The average postoperative hospital stay was 6.5 (3.3-12.0) days. One was lost during follow up, there was no recurrence or other postoperative complications in the remaining 7 patients. Conclusion:The incidence of unicentric Castleman disease is rare. Complete resection of the tumor is the main treatment for UCD patients, and the prognosis of UCD is good.

Treatment and prevention of frontal sinusitis after cerebral frontal sinus surgery / 中国医师进修杂志

Objective:To study the cause of frontal sinusitis and the prevention methods after opened frontal sinus in the trans-frontal approach surgery.Methods:Retrospectively analyze 18 cases of frontal sinusitis secondary to the trans-frontal approach surgery in Sanbo Brain Hospital, Capital Medical University from January 2016 to December 2020. The main symptoms include headache, stuffy nose, skin redness and skin abscess in frontal. The mean history was 3.2 years, all the patients were performed surgical treatment, including 5 patients undergone trans-nasal trans-sphenoid sinus operation, 14 patients undergone debridement surgery following the original surgical approach. The cause of frontal sinusitis were analyzed statistically.Results:All the patients were totally cured post operation, the standard included no frontal sinus inflammation symptoms, no imaging characters of frontal sinusitis.Conclusions:Proper management of opened frontal sinus in trans-frontal approach is very important for preventing the frontal sinusitis. Completely remove the frontal sinus mucosa, avoid using bone wax, chemical glue stuffing, which can effectively prevent the frontal sinusitis.

Craniopharyngioma and anterior central space of brain base / 中国医师进修杂志

Objective:To analyze the surgical (anatomical) approach of craniopharyngioma based on the concept of anterior central space of brain base.Methods:The clinical data of MRI images of 10 cases of craniopharyngioma who treated in Sanbo Brain Hospital, Capital Medical University from January 2021 to December 2021 were analyzed retrospectively. The brain cisterns involved in the growth of craniopharyngioma were analyzed from the perspective of anterior central space of brain base. Meanwhile, the surgical approach and the basis of selection were discussed.Results:Among all the surgical approaches that can reach the anterior central space of the brain base, the fronto-basal interhemispheric approach was the best.Conclusions:The concept of anterior central space of the brain base is a new observation and interpretation of the anatomy of the brain base from a new perspective, and then create a new concept of brain base surgery. As a new method to analyze the surgical anatomy of this area, its inclusion has important clinical significance.

The surgical method and curative effect of resection of craniopharyngioma through sub-frontal longitudinal fissure duramater-keyhole approach / 中国医师进修杂志

Objective:To investigate the surgical method and curative effect of resection of craniopharyngioma through sub-frontal longitudinal fissure duramater-keyhole approach.Methods:The clinical data, imaging data of 179 patients with craniopharyngioma treated by sub-frontal longitudinal fissure duramater-keyhole approach from January 2017 to January 2021 in Sanbo Brain Hospital Capital Medical University were studied retrospectively.Results:Through this approach, total resection in 175 cases (97.77%), near total resection in 2 cases (1.12%), partial resection in 2 cases (1.12%); drilling of the tuberculum sellae in 31 cases (17.32%); the pituitary stalk was reserved in166 cases (92.74%), preserved in 13cases (7.26%); papillary craniopharyngioma in 27 cases (15.08%), ameloblastic craniopharyngioma in 152cases (84.92%); postoperative visual acuity improved in 65 cases (36.31%), not improved in 53 cases (29.61%), decreased in 6 cases (3.35%); electrolyte disorder in 101 cases (56.42%), polydipsia and polyuria in 65cases (36.31%), cerebrospinal fluid rhinorrhea in 3 cases (1.68%), hydrocephalus in 6 cases (3.35%). Postoperative hematoma in 2 (1.12%) cases and cerebral infarction in 6 cases (3.35%), intracranial infection in 8 cases (4.47%), postoperative disturbance of consciousness in 4 cases (2.23%) and death in 3cases (1.68%).Conclusions:Sub-frontallongitudinal fissure duramater-keyhole approach is an effective combination of minimally invasive and delicate surgery principle. It is a safe and effective method for the treatment of craniopharyngioma.

The use of the single purse-string parachute suturing technique for pancreaticojejunostomy in laparscopic pancreaticoduodenectomy / 中华肝胆外科杂志

Objective:To study the single purse-string parachute suturing technique for pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy, and to determine its feasibility and safety.Methods:The clinical data of 71 patients who underwent laparoscopic pancreaticoduodenectomy using the single purse-string parachute suturing technique for pancreaticojejunostomy from October 2018 to October 2021 at the Second Hospital of Hebei Medical University were retrospectively analyzed. There were 41 males and 30 females, with age (59.1±9.7) years old. The operative time, intraoperative blood loss, complication rate and other data were analyzed.Results:All 71 patients successfully underwent total laparoscopic pancreaticoduodenectomy, with 5 patients who underwent 2D laparoscopic surgery and 66 patients 3D laparoscopic surgery. There were additional vascular resection and reconstruction in 2 patients. The operative time was (388.9±92.9) min, the intraoperative blood loss was (411.3±176.9) ml, and the postoperative hospital stay was (14.1±5.8) d. The operation time of 71 patients who underwent the single purse-string parachute technique of pancreaticojejunostomy was (26.9±6.8) min. Postoperative complications occurred in 18 patients (25.4%). Grade B pancreatic fistula occurred in 2 patients (2.8%), and the longest time for removal of abdominal drain was 17 days after operation. Among the 71 patients, complications including biliary fistula occurred in 6 patients (8.5%), delayed gastric emptying in 5 patients (7.0%), pulmonary infection in 4 patients (5.6%), non-pancreatic fistula-related abdominal infection in 4 patients (5.6%), non-pancreatic fistula-related abdominal bleeding in 1 patient (1.4%), biliary tract bleeding in 1 patient (1.4%), and chylous leakage in 2 patients (2.8%).Conclusion:The single purse-string parachute technique of pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy had the advantages of being safe and reliable. The procedure is worthy of furthers promotion.

Application value of three dimensional imaging fusion navigation system in laparoscopic pan-creatic surgery / 中华消化外科杂志

Objective:To investigate the application value of three dimensional (3D) imaging fusion navigation system (hereinafter referred as navigation system) in laparoscopic pan-creatic surgery.Methods:The retrospective and descriptive study was conducted. The clinical data of two volunteers, including volunteer 1 undergoing laparoscopic pancreaticoduodenectomy for cholangiocarcinoma and volunteer 2 undergoing laparoscopic pancreaticotomy + splenectomy for pancreatic cancer, who were admitted to the Second Hospital of Hebei Medical University from December 2020 to May 2021 were collected. The 2 volunteers were females, aged 68 years and 40 years, respectively. The self-developed navigation system was applied in laparoscopic simulator model test, including in rigid-body model and prosthesis model, and clinical test. Observation indicators: (1) results of model test; (2) results of clinical test. Measurement data with normal distribution were represented as Mean± SD. Results:(1) Results of model test. The rigid-body model or prosthesis model with occlusion can be seen in the laparoscopic visual field of the initial laparoscopic simulator. The rigid-body model or prosthesis model with occlusion and rigid-body model or prosthesis model without occlusion can be seen in the 3D visual reconstruction image of enhanced computer tomography (CT) examination. The rigid-body model or prosthesis model with occlusion can be seen in the laparoscopic visual field of the initial laparoscopic simulator after the 3D visual reconstruction image was superimposed and fused with the real-time laparoscopic image. Both of the rigid-body model and prosthesis model were in high consistency, with the distance error of marker points were (0.26±0.11)mm and (0.29±0.18)mm, respectively. (2) Results of clinical test. The abdominal organs and blood vessels with occlusion of the 2 volunteers can be seen in the initial laparoscopic visual field. The location of tumor, important organs and blood vessels can be seen in the navigation system using the 3D visual reconstruction image of enhanced CT examination. The location of tumor, important organs and important blood vessels can be seen in the laparoscopic visual field after the 3D visual reconstruction image was superimposed and fused with the real-time laparoscopic image. The distance error of marker points of the volunteer 1 was (1.36±0.57)mm and the distance error of marker points of the volunteer 2 was (1.24±0.33)mm.Conclusions:The self-developed navigation system can integrate the preoperative 3D visual reconstruction image of enhanced CT examination and the intraoperative real-time laparoscopic image with a good effect. The relationship between deep tissue and blood vessels which is not clarified in conventional laparoscopy can be shown in the navigation system assisted laparoscopic pancreatic surgery.

Puerarin inhibits the proliferation and ossification of fibroblasts in ankylosing spondylitis / 西安交通大学学报(医学版)

Objective: To explore the effect and underlying mechanism of puerarin on cell proliferation and ossification of fibroblasts in ankylosing spondylitis (AS). Methods: Fibroblasts were isolated from the hip capsule tissue of AS patients or femoral neck fractures. The cells were treated with puerarin at different concentrations (25, 50, 100, 150, and 200 mg/L). Cell proliferation was measured by CCK-8 method. Protein expressions of IL-6, TNF-α, OCN and OPN were measured by Western blot. ALP activity was detected and the mRNA expression of Col I was evaluated by qRT-PCR. Results: Puerarin of 150 and 200 mg/L significantly inhibited the proliferation of normal fibroblasts, while puerarin of 100, 150 and 200 mg/L significantly inhibited the proliferation of AS fibroblasts. Puerarin significantly inhibited protein expressions of pro-inflammatory cytokines IL-6 and TNF-α, decreased ALP activity, inhibited mRNA expression ofCol, and attenuated protein expressions of OCN and OPN. Conclusion: Puerarin inhibits cell proliferation and fibroblast ossification of normal and AS fibroblasts.

Durability of neutralizing antibodies and T-cell response post SARS-CoV-2 infection / 医学前沿

The ongoing pandemic of Coronavirus disease 19 (COVID-19) is caused by a newly discovered β Coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). How long the adaptive immunity triggered by SARS-CoV-2 can last is of critical clinical relevance in assessing the probability of second infection and efficacy of vaccination. Here we examined, using ELISA, the IgG antibodies in serum specimens collected from 17 COVID-19 patients at 6-7 months after diagnosis and the results were compared to those from cases investigated 2 weeks to 2 months post-infection. All samples were positive for IgGs against the S- and N-proteins of SARS-CoV-2. Notably, 14 samples available at 6-7 months post-infection all showed significant neutralizing activities in a pseudovirus assay, with no difference in blocking the cell-entry of the 614D and 614G variants of SARS-CoV-2. Furthermore, in 10 blood samples from cases at 6-7 months post-infection used for memory T-cell tests, we found that interferon γ-producing CD4

Clinicopathological features, diagnosis and treatment of primary and metastatic hepatic neuroendocrine neoplasm originating from digestive tract / 中华消化杂志

Objective@#To explore the clinicopathological characteristics of primary hepatic neuroendocrine neoplasm (HNEN) and metastatic HNEN from digestive tract, to screen the risk factors of hepatic metastasis of gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN) and to analyze the differences between primary and metastatic HNEN in clinical features, diagnosis, treatment and prognosis.@*Methods@#From January 2010 to June 2017, the clinical data of 182 patients with HNEN admitted at The First Affiliated Hospital of Zhengzhou University were retrospectively analyzed, including 39 cases of primary HNEN, 129 cases of metastatic HNEN and 14 cases of HNEN with unknown primary lesions. Chi-square test and t test were performed to analyze the pathologic characteristics among groups. Logistic regression method was used to analyze the risk factors of hepatic metastasis. Kaplan-Meier method and log-rank test were used for survival analysis. Cox model was used for the prognostic multivariate survival analysis.@*Results@#Metastatic HNEN from digestive tract was more common in male (70.5%, 91/129). The case number of serological tumor biomarkers neuronspecific enolase and alpha-fetoprotein positive in primary HNEN were two cases and one case, respectively, and the positive rates in metastatic HNEN were 37.2% (32/86) and 6.4% (7/110). Most primary HNEN was single lesion (61.5%, 24/39), while multiple lesions were more common in metastatic HNEN (78.3%, 90/115). Primary HNEN mainly occurred in the right lobe of the liver (44.7%, 17/38), while metastatic HNEN located simultaneously in the left and right lobes of the liver (68.4%, 78/114). There were significant differences between primary HNEN and metastatic HNEN in tumor number, pathological grading, location of tumors and maximum diameter of tumors (χ2=21.264, 11.696, 19.461 and 4.547, all P<0.05). The median survival time of patients with primary HNEN and metastatic HNEN were 17.0 months and 10.0 months, and there was a significant difference in survival curves between the two groups (χ2=7.235, P=0.007). The type of hepatic tumors (primary or metastatic)(P=0.002), pathological grading of hepatic tumors (P=0.044), lymph node metastasis (P=0.024), the growth pattern of tumors (P<0.01) and treatment methods (P=0.018) were the independent factors for the prognosis of patients.@*Conclusions@#There are significant differences between primary HNEN and metastatic HNEN in tumor number, size and location. The type of hepatic tumors, pathological grading, lymph node metastasis, growth pattern of tumors and treatment methods are the independent factors for the prognosis of patients. Early topical treatment and combination treatment can help to prolong survival time of HNEN patients.

Clinicopathological features, diagnosis and treatment of primary and metastatic hepatic neuroendocrine neoplasm originating from digestive tract / 中华消化杂志

Objective To explore the clinicopathological characteristics of primary hepatic neuroendocrine neoplasm (HNEN) and metastatic HNEN from digestive tract ,to screen the risk factors of hepatic metastasis of gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN) and to analyze the differences between primary and metastatic HNEN in clinical features , diagnosis, treatment and prognosis.Methods From January 2010 to June 2017, the clinical data of 182 patients with HNEN admitted at The First Affiliated Hospital of Zhengzhou University were retrospectively analyzed , including 39 cases of primary HNEN, 129 cases of metastatic HNEN and 14 cases of HNEN with unknown primary lesions .Chi-square test and t test were performed to analyze the pathologic characteristics among groups .Logistic regression method was used to analyze the risk factors of hepatic metastasis .Kaplan-Meier method and log-rank test were used for survival analysis . Cox model was used for the prognostic multivariate survival analysis .Results Metastatic HNEN from digestive tract was more common in male ( 70.5%, 91/129 ).The case number of serological tumor biomarkers neuronspecific enolase and alpha-fetoprotein positive in primary HNEN were two cases and one case , respectively, and the positive rates in metastatic HNEN were 37.2%( 32/86) and 6.4%(7/110).Most primary HNEN was single lesion (61.5%, 24/39), while multiple lesions were more common in metastatic HNEN (78.3%, 90/115).Primary HNEN mainly occurred in the right lobe of the liver (44.7%, 17/38), while metastatic HNEN located simultaneously in the left and right lobes of the liver (68.4%, 78/114).There were significant differences between primary HNEN and metastatic HNEN in tumor number , pathological grading, location of tumors and maximum diameter of tumors ( χ2 ＝21.264, 11.696, 19.461 and 4.547, all P?0.05).The median survival time of patients with primary HNEN and metastatic HNEN were 17.0 months and 10.0 months, and there was a significant difference in survival curves between the two groups (χ2 ＝7.235, P＝0.007).The type of hepatic tumors (primary or metastatic) ( P＝0.002), pathological grading of hepatic tumors (P＝0.044), lymph node metastasis ( P ＝0.024), the growth pattern of tumors ( P ?0.01) and treatment methods (P＝0.018) were the independent factors for the prognosis of patients .Conclusions There are significant differences between primary HNEN and metastatic HNEN in tumor number , size and location. The type of hepatic tumors, pathological grading , lymph node metastasis, growth pattern of tumors and treatment methods are the independent factors for the prognosis of patients .Early topical treatment and combination treatment can help to prolong survival time of HNEN patients .

Comparision of perioperative cerebrovascular events through different surgical approaches for severe bilateral carotid artery stenosis / 中华普通外科杂志

Objective To explore the feasibility and safety of carotid endarterectomy (CEA) and carotid artery stenting (CAS) in patients with severe bilateral carotid stenosis.Methods From Jul 2003 to Sep 2017,unilateral CEA or CAS were performed in 1 046 patients,213 of which were with severe bilateral carotid stenosis.These 213 patients were divided into CEA group and CAS group according to procedures taken.The perioperative outcomes of 213 patients were analyzed retrospectively.Results The incidence of typical cerebral ischemia symptoms of CEA group was higher than that in CAS group (25.3％ vs.13.3％,P =0.029).The incidence of perioperative death or stroke in CEA group was 5.63％ (4/71),which had no significant difference with that in CAS group (2.82％,4/142) (P =0.524).Conclusion Based on adequate preoperative assessment and reasonable surgical selection,CEA and CAS are both safe and feasible for the unilateral lesion during one-stage operation for patients with severe bilateral carotid stenosis

Study on the impact of hyperthyroidism on pregnancy outcome / 中国基层医药

Objective To discuss the impact of hyperthyroidism on pregnancy outcome.Methods Clinical data of 80 pregnancy patients with hyperthyroidism(hyperthyroidism group)were retrospectively analyzed,in accordance with the norms of treatment during pregnancy is divided into treatment group(61 cases)and untreated group(19 cases);At the same time,in accordance with the ratio of 1:2 160 cases of healthy pregnant women were randomly selected as control group.childbirth,the maternal and perinatal outcome in three groups were compared.Results Graves disease group the incidence of pregnancy-induced hypertension 10.0%,3.8% incidence of heart failure,cesarean section rate of 61.4%,7.6% incidence of prematurity,asphyxia incidence of 7.6%,a low incidence of 3.8%,the mortality rate 3.8%,and 1.3% of the control group,41.3%,1.3%,0.6%,0,0,the differences were statistically significant(P＜0.05),the incidence of neonatal abnormalities in two groups is not different(P＞0.05);the treatment group of diseases of pregnancy-induced hypertension,heart failure,premature birth,asphyxia,such as the incidence were 3.3%,3.3%,3.3%,0,0 mortality,with non-governing group of 31.6%,15.8%,21.1%,15.8%,10.5%.The differences were statistically significant(P＜0.05),and a low incidence of the two groups,the cesarean section rate,incidence of deformities such as no difference.Conclusion Hyperthyroidism can increase the incidence of pregnancy complications,and standardize the treatment can improve pregnancy outcome.

Expression of Exogenous r-Interferon Genes in Human HepatoceUuIar Carcinoma Cells Following Retroviral Transduction / 中国肿瘤生物治疗杂志

Retroviral vector pLXSN was employed to introduce human r-Interferon (IFN-?) gene into four human hepa-tocellular carcinoma cell lines (HCC). The G418-resistant colonies were isolated and cloned. PCR and RT-PCR analysis indicated that the integration and expression of IFN-? gene was shown only in the transduced cells. Using a bioassay method, we found that all genetically modified HCC cells can secrete varied amount of IFN-?. The results of flow cytome-try showed that the cell surface expression of HLA class I molecules significandy increased following transduction. Moreover , we firsdy indicated that the increase in the expression of one specific HLA class I antigen, HLA-A2, was almost in the same magnitude as that of the total HLA class I molecules after transduction with IFN-r gene.

Study on Anti-Tumor Effect of Vaccination with Irradiated Tumor Cells Engineered to Secrete TNF-? / 中国肿瘤生物治疗杂志

We compared the ability of tumorigenicity of TNF-? gene-modified and unmodified H22 tumor cells, and therapeutic functions of the irradiated cells. Results indicated that H22-TNF-? cells were less tumorigenic as compared to H22 and H22-LXSN cells. In case of treatment groups, injected with irradiated tumor vaccine in 3 or 6 days after inoculation of H22 cells, the tumor growth was suppressed.

Studies on the Apoptotic Cell Death of Interleukin-2 Gene Modified Mouse Hepatoma Cells / 中国肿瘤生物治疗杂志

Retroviral vector was used to introduce the interleukin - 2 (IL -2) gene into H22 cells, a BALB/c mouse hepatoma cell line. The IL-2 gene and marker gene (NeoR) were assessed by using PCR and RT-PCR methods. FACS analysis demonstrated that the cells with low DNA content in IL-2 gene modified H22 cells were more than these in control H22 cells. Electron microscopic morphological structure showed that some cells in IL-2 gene modified H22 went into apoptotic cell death. The study demonstrated that apoptotic cell death of H22 - IL-2 cells was induced by the IL-2 gene modification. It may be one of mechanisms of decreased tumorigenicity of IL - 2 gene modified tumor cells.

STUDY ON INTERFERON-? GENE-MODIFIED HUMAN TUMOR CELLS / 中国免疫学杂志

The whole length cDNA of human interferon-?(IFN-?) gene including signal peptide was constructed to retroviral vector pLXSN and then packaged with PA317. A Human Hepetoma Cell Line(HHCL) and a human gastric cancer cell line (MKN-45) were infected by using supernatant containing retroviral vector with IFN-?. the gene-modified tumor cell. were isolated by G418 selection. Some changes were found in cell cycle, expression of HLA class Ⅰ and classⅡ, and tumorigenecity. Elevated immunogenecity and abrogated rumerigenecity suggest a means for generating gene-modified tumor cell vaccine. for the treatment of cancer.