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BACKGROUND@#The results of studies comparing Billroth-I (B-I) with Roux-en-Y (R-Y) reconstruction on the quality of life (QoL) are still inconsistent. The aim of this trial was to compare the long-term QoL of B-I with R-Y anastomosis after curative distal gastrectomy for gastric cancer.@*METHODS@#A total of 140 patients undergoing curative distal gastrectomy with D2 lymphadenectomy in West China Hospital, Sichuan University from May 2011 to May 2014 were randomly assigned to the B-I group ( N = 70) and R-Y group ( N = 70). The follow-up time points were 1, 3, 6, 9, 12, 24, 36, 48, and 60 months after the operation. The final follow-up time was May 2019. The clinicopathological features, operative safety, postoperative recovery, long-term survival as well as QoL were compared, among which QoL score was the primary outcome. An intention-to-treat analysis was applied.@*RESULTS@#The baseline characteristics were comparable between the two groups. There were no statistically significant differences in terms of postoperative morbidity and mortality rates, and postoperative recovery between the two groups. Less estimated blood loss and shorter surgical duration were found in the B-I group. There were no statistically significant differences in 5-year overall survival (79% [55/70] of the B-I group vs. 80% [56/70] of the R-Y group, P = 0.966) and recurrence-free survival rates (79% [55/70] of the B-I group vs. 78% [55/70] of the R-Y group, P = 0.979) between the two groups. The scores of the global health status of the R-Y group were higher than those of the B-I group with statistically significant differences (postoperative 1 year: 85.4 ± 13.1 vs . 88.8 ± 16.1, P = 0.033; postoperative 3 year: 87.3 ± 15.2 vs . 92.8 ± 11.3, P = 0.028; postoperative 5 year: 90.9 ± 13.7 vs . 96.4 ± 5.6, P = 0.010), and the reflux (postoperative 3 year: 8.8 ± 12.9 vs . 2.8 ± 5.3, P = 0.001; postoperative 5 year: 5.1 ± 9.8 vs . 1.8 ± 4.7, P = 0.033) and epigastric pain (postoperative 1 year: 11.8 ± 12.7 vs. 6.1 ± 8.8, P = 0.008; postoperative 3 year: 9.4 ± 10.6 vs. 4.6 ± 7.9, P = 0.006; postoperative 5 year: 6.0 ± 8.9 vs . 2.7 ± 4.6, P = 0.022) were milder in the R-Y group than those of the B-I group at the postoperative 1, 3, and 5-year time points.@*CONCLUSIONS@#Compared with B-I group, R-Y reconstruction was associated with better long-term QoL by reducing reflux and epigastric pain, without changing survival outcomes.@*TRIAL REGISTRATION@#ChiCTR.org.cn, ChiCTR-TRC-10001434.
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Humans , Stomach Neoplasms/pathology , Anastomosis, Roux-en-Y/methods , Quality of Life , Treatment Outcome , Gastrectomy/methods , Postoperative Complications , Gastroenterostomy/methods , PainABSTRACT
Water solubility, stability, and bioavailability, can be substantially improved after glycosylation. Glycosylation of bioactive compounds catalyzed by glycoside hydrolases (GHs) and glycosyltransferases (GTs) has become a research hotspot. Thanks to their rich sources and use of cheap glycosyl donors, GHs are advantageous in terms of scaled catalysis compared to GTs. Among GHs, sucrose phosphorylase has attracted extensive attentions in chemical engineering due to its prominent glycosylation activity as well as its acceptor promiscuity. This paper reviews the structure, catalytic characteristics, and directional redesign of sucrose phosphorylase. Meanwhile, glycosylation of diverse chemicals with sucrose phosphorylase and its coupling applications with other biocatalysts are summarized. Future research directions were also discussed based on the current research progress combined with our working experience.
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Glucosyltransferases/metabolism , Glycoside Hydrolases/metabolism , Glycosylation , Glycosyltransferases/geneticsABSTRACT
Glycoside compounds are widely used in medicine, food, surfactant, and cosmetics. The glycosidase-catalyzed synthesis of glycoside can be operated at mild reaction conditions with low material cost. The glycosidase-catalyzed processes include reverse hydrolysis and transglycosylation, appropriately reducing the water activity in both processes may effectively improve the catalytic efficiency of glucosidase. However, glucosidase is prone to be deactivated at low water activity. Thus, glucosidase was immobilized to maintain its activity in the low water activity environment, and even in neat organic solvent system. This article summarizes the advances in glycosidase immobilization in the past 30 years, including single or comprehensive immobilization techniques, and immobilization techniques combined with genetic engineering, with the aim to provide a reference for the synthesis of glycosides using immobilized glycosidases.
Subject(s)
Catalysis , Enzymes, Immobilized , Glycoside Hydrolases/genetics , Glycosides/biosynthesis , HydrolysisABSTRACT
Evidence-based medicine (EBM) is an emerging subject which allows us to make health-related policy based on evidence, and is also an important course in medical colleges and universities. Given the current educational objectives and characteristics of evidence-based medicine, this paper proposed an online and offline integrated teaching model of evidence-based medicine based on online platform for medical undergraduates. Online teaching was conducted using online platform which focus on the cultivation of evidence-based thinking and scientific research quality. Offline teaching was in-classroom teaching which focus on basic knowledge and skill learning. Practice of this model not only enriches teaching methods, but also improves the learning effect, thus this model needs to be explored and perfected in the future.
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Objective To verify whether β-arrestin-2 inhibits autophagy by up-regulating PI3K/Akt signal to protect the liver from ischemia-reperfusion injury (IRI) in mice. Methods Twelve β-arrestin-2 knockout (KO) and twelve wild-type (WT) C57BL/6 mice were randomly divided into the KO+sham group, KO+IRI group, WT+sham group and WT+IRI group, six mice in each group. The mouse models with 70% liver IRI were established or sham operation was performed. Relevant experiments were carried out at 6 h after liver reperfusion or operation. The expression levels of apoptosis signal protein cleaved Caspase-3, proliferation signal protein Ki-67 and the PI3K/Akt signal protein p-Akt were detected by immunohistochemical staining. Results Immunohistochemical staining demonstrated that compared with the corresponding sham group, the positive cell count for cleaved Caspase-3, Ki-67 and p-Akt in liver tissues of mice was significantly increased in the KO+IRI and WT+IRI groups (all P < 0.01). Compared with the WT+IRI group, the positive cell count for cleaved Caspase-3 in liver tissues of mice was significantly increased, whereas the positive cell count forKi-67 and p-Akt was significantly decreased in the KO+IRI group (both P < 0.05). Conclusions β-arrestin-2 can mitigate the liver cell apoptosis and promote the repair of injury after IRI in mice. Moreover, β-arrestin-2 inhibits autophagy by up-regulating the PI3K/Akt signal to alleviate liver IRI in mice.
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@#Objective To study the safety of right vertical infra-axillary thoracotomy (RVIAT) in the repair of ventricular septal defect (VSD) and the optimal age for RVIAT. Methods Between June 2014 and June 2018, 441 children underwent VSD repair via RVIAT in our hospital. According to the age, they were divided into four groups: a 4 months to 1 year old group (R1 group, n=123), a 1-2 years old group (R2 group, n=106), a 2-5 years old group (R3 group, n=166), a >5 years old group (R4 group, n=46). The clinical effects of the patients were compared. Results All the operations were successfully performed and no serious complication was found in all groups. No statistical difference was observed in the operation time, blood loss during operation, thoracic drainage 24 h after operation among groups (P>0.05). The cardiopulmonary bypass time, aortic cross-blocking time and ICU stay time in the R1 and R2 groups were longer than those in the R3 and R4 groups (P<0.05). In the R1 group, the postoperative ventilating time and postoperative hospital stay time were longer, and the blood transfusion volume was more than those in the R3 and R4 groups (P<0.05). The incidence of postoperative complications was higher in the R4 group than that in the R1 and R3 groups (P<0.05). Conclusion VSD repair via RVIAT may be more effective in children >2 years old, and 2-5 years old may be the optimal age.
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Objective:To observe the correlation between the changes of area foveal avascular zone (FAZ), central foveal thickness (CFT), the thickness of the macular ganglion cell-inner plexiform layer (GCIPL) and the BCVA in type 2 diabetic mellitus patients with different fundus lesions.Methods:A prospective clinical study. Eighty-three eyes of 51 patients with type 2 diabetic mellitus were collected in Shengjing Hospital of China Medical University from January 2018 to January 2019, including 31 males and 20 females. The average age was 53.4±7.8 years. According to the diabetic retinopathy international clinical staging criteria, the patients were divided into the non-diabetic retinopathy (NDR) group with 17 patients (31 eyes), and the non-proliferative diabetic retinopathy (NPDR) group with 34 patients (52 eyes). And 13 control eyes of 8 age- and sex-matched healthy physical examination subjects (control group) were selected in this study. The BCVA examination was performed using the international standard visual acuity chart, which was converted intoIogMAR visual acuity. OCT was used to measure the CFT, the mean and the minimum thickness of GCIPL. OCT angiography (OCTA) examination was applied to obtain blood flow density scan images in macular area of 3 mm × 3 mm size. The superficial FAZ area was measured by Photoshop software. The differences of the superficial FAZ area, BCVA, CFT, the mean and the minimum thickness of GCIPL in each group were statistically analyzed, and to explore the correlation between the parameters. Analysis of variance was used to compare measurement data among three groups, and chi-square test was used for the comparison of counting data among three groups. The statistical correlation was evaluated using Pearson’s correlation coefficient.Results:The average area of superficial FAZ area in the control group, NDR group and NPDR group were 0.314±0.103, 0.349±0.102, 0.416±0.148 mm 2; the mean logMAR BCVA were 0.015±0.038, 0.029±0.059, 0.129±0.133; the mean CFT were 247.46±13.35, 244.13±25.09, 263.12±24.96 μm; the mean GCIPL thickness were 89.00±4.98, 86.06±4.43, 82.61±14.32 μm; the mean minimum GCIPL thickness were 84.85±3.18, 80.68±5.39, 71.19±19.94 μm, respectively. The superficial FAZ area, logMAR BCVA, CFT and the minimum thickness of GCIPL showed significant differences ( F=4.660, 11.708, 6.891, 6.333; P=0.012, 0.000, 0.002, 0.003) among these three groups. Correlation analysis showed that the logMAR BCVA was positively correlated with the superficial FAZ area ( r=0.335, P=0.001), negatively correlated with the mean GCIPL thickness ( r=-0.348, P=0.001) and the minimum GCIPL thickness (r=-0.416, P=0.000), no significant correlated with the CFT ( r=0.171, P=0.095). The superficial FAZ area was negatively correlated with the CFT ( r=-0.262, P=0.010) and the minimum GCIPL thickness ( r=-0.213, P=0.037), no significant correlated with the mean GCIPL thickness ( r=-0.179, P=0.081). Conclusions:With the aggravation of fundus lesions in patients with type 2 diabetic mellitus, the superficial FAZ area gradually expands, the minimum GCIPL thickness gradually becomes thinner and the BCVA gradually decreases. Both the superficial FAZ area and the GCIPL thickness are correlated with BCVA. The superficial FAZ area is correlated with CFT and the minimum GCIPL thickness.
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Objective To explore the CT features of gastrointestinal tract diospyrobezoar and its complications,to improve the recognition. Methods The plain CT scan of 36 patients with gastrointestinal tract diospyrobezoar confirmed by gastroscope and surgery were analyzed retrospectively.Results The number and location of diospyrobezoar showed by CT were consistent with the results of gastroscope and surgery.There were 1 1 cases of stomach diospyrobezoar,1 9 cases of small intestine diospyrobezoar,and 6 cases of stomach and small intestine diospyrobezoar.32 cases were solitary lesion,and 4 cases were multiple lesions.A total of 41 diospyrobezoars were removed, most of which were wel-l defined ovoid mass.3 1 lesions presented mottled internal gas bubbles with high-density encapsulating wall.6 lesions showed mottled gas pattern without encapsulating wall.4 lesions showed uneven high density.Over time,1 lesion moved in the digestive tract and the boundary and density were changed.Complications:gastric and duodenal diospyrobezoar accompanied by gastric retention,which manifested as a significant expansion of the gastric cavity effusion.Small intestine diospyrobezoar was accompanied by small bowel obstruction,which showed that the proximal intestinal tube of the diospyrobezoar was obviously dilated,and the distal intestine was suddenly collapsed.There was a focal transition zone between them.Conclusion Gastrointestinal tract diospyrobezoar has a variety of CT manifestations,of which oval shape,clear boundary,uneven mass composed of gas and soft tissue are common.
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Objective To evaluate the safety and efficacy of individualized treatment of splenorenal shunt during liver transplantation. Methods Clinical data of 2 recipients who underwent orthotopic liver transplantation and splenorenal shunt intraoperatively were retrospectively analyzed. According to the perfusion status after splenorenal shunt and donor liver reflow, the left renal vein ligation and splenorenal shunt vessel ligation were performed in two recipients during liver transplantation. The general postoperative conditions of the recipients were observed, including surgical related complications, peak portal blood flow velocity, liver and renal function indexs. The postoperative conditions of the recipients were monitored by abdominal ultrasound. Results No intraoperative or postoperative complications occurred in two recipients. The changes of peak portal blood flow velocity before and after splenorenal shunt in two recipients were 22.9-35.1 cm/s and 24.3-58.8 cm/s respectively. No delayed recovery of alanine aminotransferase (ALT) level was observed in two patients after operation. Case 1 experienced a transient increase in the serum creatinine (Scr), which was recovered to normal at postoperative 13 d. During the postoperative follow-up, ultrasound examination demonstrated that the direction and velocity of portal blood flow were normal and liver perfusion was excellent. Conclusions It is safe and effective to selectively ligate the left renal vein or splenorenal shunt vessels of the recipients with severe splenorenal shunt during liver transplantation.
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Drosophila neural development undergoes extensive chromatin remodeling and precise epigenetic regulation. However, the roles of chromatin remodeling in establishment and maintenance of cell identity during cell fate transition remain enigmatic. Here, we compared the changes in gene expression, as well as the dynamics of nucleosome positioning and key histone modifications between the four major neural cell types during Drosophila neural development. We find that the neural progenitors can be separated from the terminally differentiated cells based on their gene expression profiles, whereas nucleosome distribution in the flanking regions of transcription start sites fails to identify the relationships between the progenitors and the differentiated cells. H3K27me3 signal in promoters and enhancers can not only distinguish the progenitors from the differentiated cells but also identify the differentiation path of the neural stem cells (NSCs) to the intermediate progenitor cells to the glial cells. In contrast, H3K9ac signal fails to identify the differentiation path, although it activates distinct sets of genes with neuron-specific and glia-related functions during the differentiation of the NSCs into neurons and glia, respectively. Together, our study provides novel insights into the crucial roles of chromatin remodeling in determining cell type during Drosophila neural development.
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Objective To explore the CT manifestations of primitive neuroectodermal tumor (PNET) of adrenal gland,aiming to increase the cognition on this disease.Methods The CT manifestations of 7 patients who were pathologically diagnosed with adrenal gland PNET were analyzed retrospectively.Results The age of patients was 24-63 years old,with average age of (47.6±13.7) years,including 6 females and 1 male.Location of PNET:4 in left adrenal gland and 3 in right adrenal gland.Clinical manifestations:3 cases had upper abdominal distension,2 cases suffered from pain of waist and back,1 case was discovered in physical examination and another 1 had fever.No abnormality was found in laboratory and endocrinological examinations.After operation,4 cases had recurrence and 2 had distant metastasis.During follow-up,6 patients died and only 1 still alive.CT showed that the tumor,whose maximum diameter was 10.1-19.4 cm,was elliptic or lobulated in shape.The tumor was clear in boundary in 2 patients,but was unclear in boundary and involved adjacent organs in 5 patients.The plain scanning showed equidensity or slightly low density,complicated with necrosis and cystic lesions without calcification.The enhanced scanning suggested progressive uneven enhancement,with multiple interatrial septum-like changes and latticed enhancement inside.Conclusion CT manifestations of adrenal gland PNET can prompt the diagnosis,pathological examination is still required for confirmation.CT can accurately describe the internal structures,adjacent relationship and the metastasis of tumors.
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The pulmonary artery sling (PAS)is a rare congenital cardiovascular disease and usually associated with airway stenosis and cardiovascular anomalies. Abnormal left pulmonary artery oppress trachea and esophagus can cause respiratory tract obstruction or esophageal compression symptoms,such as recurrent wheezing,cough,lung infec-tions,difficulty of breathing or swallowing. Once diagnosed,the patients has surgical indications,but due to the lack of specific clinical manifestations,missed diagnosis or misdiagnosis for other respiratory diseases may occur. The surgical method of PAS is mainly the left pulmonary transplantation,whether perform tracheoplasty remains controversial.
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Congenital cystic adenomatoid malformation of the lung is a rare clinical lung disease.It is the deformity formed by abnormal embryo development of lung tissue.Its pathological morphology is very different from other types of pulmonary cyst.The main pathogenesis,clinical manifestation,diagnosis,differential diagnosis and treatment are described.
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Diabetic retinopathy (DR) is the most common microvascular complication of diabetes, which severely affects the visual function and quality of life of patients, and can lead to irreversible blindness in later stages. In recent years, some progress has been made in DR treatment, but the effect is limited. The effective prevention and treatment of DR is still the focus of current research. This article reviews the recent advances in DR auxiliary diagnosis, clinical treatment, emerging drugs, and new treatment strategies.
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@#Objective To investigate the effect of hyperbaric oxygen (HBO) on the behaviors, organizational morphology and the expression of protein kinase R-like ER kinase (PERK) in rats with spinal cord injury. Methods Thirty-six male Sprague-Dawley rats were randomly divided into normal group, sham group, model group and HBO group, with nine cases in each group. The normal group did not receive any treatment, the sham group received only laminectomy, and the other two groups were established spinal cord injury model with modified Allen's method. Six hours after operation, the model group was treated with regular air, and HBO group received HBO treatment for seven days. The recovery of locomotor function was evaluated by BBB (Basso Beattie and Bresnahan) on the day before operation and six hours, three days, seven days after operation. HE staining was used to observe the change of tissue morphology in injured spinal cord, and the expression of PERK in spinal cord was detected by Western blotting. Results There was no neurological deficit in the normal group and the sham group. The neurological score was lower in the model group than in the sham group three days and seven days after operation (P < 0.05), and was higher in HBO group than in the model group seven days after operation (P < 0.05). There was no obvious structural change in the normal group and the sham group, however, the model group showed swelling cells, condensed cytoplasm, and nucleus pycnosis hyperchromatic, and the HBO group showed slighter swelling cell compared with the model group. The expression of PERK was higher in the model group than in the sham group, and was lower in HBO group than in the model group seven days after operation (P < 0.05). Conclusion HBO could reduce the expression of PERK in the injured spinal cord, and improve the recovery of hind limb locomotor function in spinal cord injury rats.
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<p><b>OBJECTIVE</b>To establish the tissue response grading (TRG) system following neoadjuvant chemotherapy and to investigate its application in the gastric cancer patients who received neoadjuvant chemotherapy.</p><p><b>METHODS</b>Data of 30 cT3-4N0-3M0 gastric cancer cases who received neoadjuvant chemotherapy and operation from May 2017 to February 2018 at Department of Gastrointestinal Surgery, West China Hospital were analyzed retrospectively. The edema degree of gastrointestinal tract and perigastric tissues, intraoperative effusion, and fibrosis of tumor and lymph nodes bearing tissues which could be divided into 4 categories constituted the core parameters of the TRG system following neoadjuvant chemotherapy. Four categories of edema: grade 0, no obvious tissue edema; grade 1, slight tissue edema and swelling, no obvious effusion when dissecting the capsule of connective tissues; grade 2, moderate tissue edema and swelling, a few effusion when dissecting the capsule of connective tissues; grade 3, severe tissue edema and swelling with high tension on the capsule of connective tissues, tension blister could be observed in some patients, continuous effusion when dissecting the capsule of connective tissues. Four categories of intraoperative effusion: grade 0, no obvious effusion; grade 1, slight effusion and a few intraperitoneal exudation; grade 2, moderate effusion and continuous intraperitoneal exudation necessitating interrupted suction; grade 3, severe effusion and continuous intraperitoneal exudation necessitating constant suction. Four categories of fibrosis: grade 0, no fibrosis; grade 1, slight fibrosis with threadiness fibrous bands, clear dissecting space could be found between the fibrous tissues and adventitia/normal tissues; grade 2, moderate fibrosis with flaky fibrous tissues, the difficulty of tissue and lymph nodes dissection increased although dissecting space could be found between the fibrous tissues and adventitia/normal tissues; grade 3, severe fibrosis with hard and flaky fibrous membrane, the difficulty of tissue and lymph nodes dissection increased extremely and the fibrous tissues merges with adventitia/normal tissues without dissecting space. The relationships of TRG system with tumor response evaluation by computed tomography (CT), tumor regression score, surgical duration, number of retrieved lymph nodes, number of metastatic lymph nodes, number of enlarged lymph nodes seen in the preoperative CT scans as well as postoperative complications were analyzed using t test, χ² test and logistic regression model.</p><p><b>RESULTS</b>Nineteen male and 11 female patients with a mean age of(59.1±9.4) years were enrolled. There were 17 cases of grade 1, 12 cases of grade 2 and 1 case of grade 3 for tissue edema, while the corresponding number was 14, 15 and 1 for intraoperative effusion and 15, 14 and 1 for fibrosis respectively. There were no significant differences among the different degrees of tissue edema, intraoperative effusion and fibrosis in terms of the tumor response evaluation by CT and tumor regression score (all P>0.05). The results of logistics regression showed that tumor response evaluation by CT was related with the degree of tissue edema (P=0.012) and intraoperative effusion (P=0.007), rather than the degree of fibrosis (P=0.527). However, tumor regression score was not related with the degree of tissue edema(P=0.345), intraoperative effusion (P=0.159) and fibrosis (P=0.207). Surgical duration of one case with all grade 3 in tissue edema, intraoperative effusion and fibrosis was 408 minutes, which was longer than those with grade 1 and grade 2 patients [(295.9±40.1) minutes and (293.1±34.3) minutes, respectively]; the number of retrieved lymph nodes, metastatic lymph nodes, and enlarged lymph nodes seen in the preoperative CT scans of this case with all grade 3 were 25, 4 and 1, which were all less than those with grade 1 and grade 2 (42.3±11.9 and 38.5±18.2, 7.3±9.1 and 8.1±9.7, 1.8±1.6 and 2.3±1.3, respectively). There were no significant differences between grade 1 and grade 2 of tissue edema, intraoperative effusion and fibrosis in terms of surgical duration, retrieved lymph nodes, metastatic lymph nodes and enlarged lymph nodes seen in the preoperative CT scans(all P>0.05). Four patients suffered from pulmonary complications and 2 patients experienced slight lymphatic, and all leakage were cured by conservative therapies. There were no significant differences among the different grades of tissue edema, intraoperative effusion and fibrosis in terms of the operation-associated complications (all P>0.05).</p><p><b>CONCLUSION</b>The tissue response grading system can assist the judgment of operation difficulty and reflect the effectiveness of neoadjuvant chemotherapy to some extent, which has the possibility of applications.</p>
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Aged , Female , Humans , Male , Middle Aged , China , Lymph Node Excision , Lymph Nodes , Neoadjuvant Therapy , Retrospective Studies , Stomach Neoplasms , Drug Therapy , General SurgeryABSTRACT
Objective To investigate the imaging findings of giant cell glioblastoma(GCG).Methods Imaging findings of 8 cases with pathology-confirmed GCG were retrospectively reviewed and correlated with pathologic findings.Results All of the 8 cases were located in the cerebral hemisphere.On CT images, 1 lesion case was shown appeared as mixed density,4 lesions were shown as cystic and solid mass.Mural nodule were slightly hyperdense.On MRI images, all of 4 cases lesions were hypointensity on T1WI, mixed signal intensity or hyperintensity on T2WI and FLAIR, low signal intensity on DWI.The lesion showed nonuniform enhancement,with enhanced mural nodules and cyst walls,and mildmoderate or no peritumoral edema.Microscopically, the cells were arranged in perivascular pseudorosettes to form palisades.Cellular pleomorphism was a typical feature, including monstrous and multinucleated giant cells.Mitotic figures were usually numerous.Reticulin was abundant in the stroma.Immunohistochemistry showed staining for S-100, Vim, p53, GFAP.The proliferation rate determined by Ki-67 immunohistochemistry was 30%.Conclusion GCG has certain imaging characteristics,CT and MRI are effective in detecting the disease.
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Objective To investigate the efficacy of transabdominal ultrasound interventional puncture combined with medicine in the treatment of ovarian chocolate cysts. Methods According to the different treatment methods will be January 2015 to December 2016 in Yuyao People's Hospital 70 cases of patients with ovarian chocolate cyst group: the control group with washed cysts + ethanol sclerotherapy by transabdominal ultrasound interventional puncture + urokinase solution, the observation group in the control group based on the addition of triptorelin;observed the body hormone before and after E2 two patients in the treatment group, follicle stimulating hormone, serum luteinizing hormone, FSH/LH, antral follicles level changes, complications, clinical treatment, and the relevant data for comparative analysis. Results Abdominal ultrasound interventional puncture and drug treatment (observation group) treatment of ovarian chocolate cyst is better than transabdominal ultrasound interventional treatment (control group), the stability of the body hormone levels of patients than the control group, the complication rate was lower than the control group, the total efficiency of clinical treatment was higher than the control group, the difference was statistically significant (P <0.05). Conclusion The patients with ovarian chocolate cyst transabdominal ultrasound interventional puncture and drug treatment effect significantly, can effectively improve the patients body hormone level, low complication rate, the total effective rate of the treatment is high, it is worthy of widely used treatment of patients with ovarian chocolate cyst.
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<p><b>OBJECTIVE</b>To investigate the feasibility and efficacy of clockwise modularized lymphadenectomy in laparoscopic gastrectomy for gastric cancer.</p><p><b>METHODS</b>Clinical data of 19 cases who underwent the laparoscopic clockwise modularized lymphadenectomy for gastric cancer (clockwise group) from July 2016 to September 2016 were analyzed retrospectively. The clockwise modularized lymphadenectomy included the fixed operative order, detailed procedure and requirement of lymphadenectomy, which mainly reflected in assisting the exposure of operative field and dissection of lymph nodes through suspending the liver and banding the greater omentum, as well as proposing the requirements and attentions for the dissections of each station of lymph nodes to facilitate the quality control of lymphadenectomy. The operative time, intraoperative complications, intraoperative estimate blood loss, number of total harvested lymph nodes, morbidity and postoperative recovery, were compared with the data of another 19 cases who received traditional lymphadenectomy from January 2016 to June 2016 (control group).</p><p><b>RESULTS</b>The baseline data were comparable between two groups. All the patients were performed successfully by laparoscopy without conversion and intraoperative complications. The operative time, intraoperative estimated blood loss and number of total harvested lymph node were (278.4±29.9) min, (91.1±41.6) ml and 38.2±15.1 in clockwise group, and were (296.7±30.3) min, (102.2±32.2) ml and 37.0±12.3 in control group without significant differences (all P>0.05). However, the mean number of retrieved No.11p lymph nodes was 2.2±1.8 in clockwise group, which was significantly higher than that in control group (0.8±1.0) (P=0.013). Four patients in each group suffered from pulmonary infections, who were cured by conservative therapies. There was no anastomotic leakage, intraperitoneal hemorrhage, intraperitoneal infection or intestinal obstruction in each group.</p><p><b>CONCLUSION</b>The clockwise modularized lymphadenectomy can contribute to the facilitation of the retraction and exposure, decrease of the surgical duration and intraoperative blood loss, and radicalization of lymph node dissection, especially for the lymph nodes dissection around the celiac trunk.</p>
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Humans , Blood Loss, Surgical , Convalescence , Gastrectomy , Methods , Intraoperative Complications , Epidemiology , Laparoscopy , Methods , Lymph Node Excision , Methods , Lymph Nodes , General Surgery , Operative Time , Retrospective Studies , Stomach Neoplasms , General Surgery , Treatment OutcomeABSTRACT
Objective To establish male rat models for fertility following liver transplantation. Methods Male Sprague-Dawley (SD) rats were used as the donors and recipients of liver transplantation. The donor liver was transplanted with two-cuff technique. Liver transplantation was performed in 15 male SD rats. At 3 weeks after liver transplantation, 5 rats were randomly sacrificed for detection of sperm deformity rate. The remaining male rats were mixed bred and mated with healthy female SD rats at a ratio of 1︰2. General conditions of the rats undergoing liver transplantation were recorded. Liver function parameters were detected after liver transplantation. Postoperative sperm deformity rate was observed. The pregnant status of female rats and health situation of their offsprings was monitored. Results All 15 rats (100%) underwent liver transplantation successfully. Nine rats (9/10) survived longer than 8 weeks. Liver function parameters were normal in male rats following liver transplantation. The sperm deformity rate was ranged from 0.5% to 1.3%. Ten male rats undergoing liver transplantation were mixed bred with female rats at a ratio of 1︰2 for 1 week. All female rats were successfully mated and delivered their offsprings after 3 weeks. The offsprings had no evident physiological deformity. Conclusions Male rat models for fertility are successfully established after liver transplantation, which serve as an animal model to evaluate the fertility performance in male patients undergoing liver transplantation.