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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.
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Objective:To compare the short-term efficacy of orthopedic robot-assisted and traditional fluoroscopy-guided sustentaculum talus screw fixation of Sanders type II and III calcaneal fracture with.Methods:A retrospective cohort study was conducted to analyze the clinical data of 54 patients with Sanders type II and III calcaneal fracture admitted to People′s Hospital of Nanchang County of Jiangxi Province from October 2020 to October 2021, including 30 males and 24 females; aged 29-57 years [(39.5±7.4)years]. Type of fracture was Sanders type II in 38 feet and Sanders type III in 22 feet. Sustentaculum talus screw fixation was performed using orthopedic robot-assisted technique in robot group (26 patients, 28 feet) and using intraoperative fluoroscopy-guided technique in freehand group (28 patients, 32 feet). The intraoperative fluoroscopy frequency, incision length, intraoperative blood loss and operation time were recorded. Calcaneus width, B?hler angle and Gissane angle were measured preoperatively and at 3-, 6-month postoperatively. Foot function was assessed using the Maryland scale at 6 months after operation. Postoperative complications were observed.Results:All patients were followed up for 6-8 months [(6.9±0.7)months]. The intraoperative fluoroscopy frequency and operation time were (2.8±0.7)times and (46.9±2.4)minutes in robot group, compared to (10.1±2.0)times and (75.6±3.1)minutes in freehand group (all P<0.01). There was no significant difference in the incision length and intraoperative blood loss between the two groups (all P>0.05). The calcaneus width, B?hler angle and Gissane angle in the two groups were improved at postoperative 3, 6 months when compared with preoperative ones (all P<0.05), and the improvement was much better in robot group than that in freehand group ( P<0.05 or 0.01). The excellent and good rate of Maryland score was 100% (28/28) (21 excellent, 7 good) in robot group at postoperative 6 months, compared to 78.1% (25/32) (19 excellent, 6 good, 7 fair) in freehand group ( P<0.05). The postoperative complication rate was 0% (0/28) in robot group and was 6.3% (2/32) in freehand group ( P>0.05). Conclusion:For Sanders type II and III calcaneal fracture, orthopedic robot-assisted sustentaculum talus screw fixation is superior to traditional fluoroscopy-guided internal fixation since it can significantly reduce intraoperative fluoroscopy frequency, shorten operation time, improve calcaneus width, B?hler angle and Gissane angle, and achieve better foot function.
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Objective To investigate the distribution situation of methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism among healthy Han population ,patients with primary hypertension and patients with hypertension complicating coro‐nary heart disease(CHD) in south China area .Methods MTHFR C677T gene polymorphism in 359 cases was detected by adopting the microarray method .The differences of genotypes frequencies were statistically compared between males and females .Results The wild type CC genotypes were common ,accounting for 54 .9% ,the mutation type CT accounted for 33 .1% and TT for 12 .0% . The distribution difference of wild type and mutation type had statistical difference between the male and female populations (P<0 .05);the TT frequency distribution had statistical difference among the patients with hypertension complicating CHD ,healthy population and patients with primary hypertension (P<0 .05) .Conclusion MTHFR C677T gene polymorphism distribution has difference between male and female populations ,and is related to the CHD occurrence in the patients with primary hypertension .
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Objective To investigate the correlation between IL‐6 ,hs‐CRP and blood lipids ,blood glucose in type 2 diabetes mel‐litus(T2DM) patients complicated with coronary heart disease .Methods 64 outpatients first diagnosed T2DM complicated with coronary heart disease were selected ,56 T2DM patients and 58 health examination were as compare from 2014 January to November in my courtyard .Interleukin‐6(IL‐6) ,high sensitivity C reactive protein(hs‐CRP) and total cholesterol(TC) ,low density lipopro‐tein‐C(LDL‐C) ,blood glucose and HbA1c were detected in 3 groups of person .Results T2DM group and T2DM complicated with coronary heart disease with fasting glucose ,HbA1c ,TC and LDL‐C was significantly higher than normal group ,the difference was statistically significant(P<0 .05);The level of IL‐6 ,hs‐CRP in patients T2DM with coronary heart disease complicated was signifi‐cantly higher than that of T2DM group ,and T2DM group was higher than that of healthy group ,the differences were statistically significant(P<0 .05) .Conclusion IL‐6 and hs‐CRP can be as a specific index to predict the disease process of T2DM complicated with coronary heart disease .
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Objective To evaluate T cell and CD4+ CD28-T in the development and progression of abdominal aortic aneurysms (AAAs).Methods Fifty Wistar rats were randomly divided into 5 groups (n =10 each).An AAA animal model is established by enhancing perfusing elastase to the infrarenal abdominal aorta of the rats.The levels of T cell,B cell and macrophage cell of abdominal aorta of the rats on days 3,7,14 and 28,were detected by enzyme linked immunosorbent assay(ELISA).CD4+ CD28-T cell of the peripheral blood were measured by flow cytometry.Result There was significant T-lymphocyte infiltration both in middle and outer membrane of the artery of the rats on day 7 after surgery.T-lymphocyte,B-lymphocyte and macrophage cell infiltration were on the peak in middle and outer membrane of the artery on day 14 after surgery.The ratio of CD4+ CD28-T cell in rat peripheral blood reached peak on day 7(P ＜0.05).Conclusions T cell and CD4+ CD28-T cell expression increased in peripheral blood and abdominal aorta in AAA rat model,suggesting a potential role of T cell and CD4+ CD28-T cells in the pathogenesis of AAAs,especially during the early development of AAAs.
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ObjectiveTo investigate the practicability and maneuverability of applying partical hydroxylaptite artificial bone to rehabilitate saddle nose as well as removing materials from the malposition of nasal implant.MethodsWe used the incision beside nasal columella and detached atunnel in deep of nasal aponeurosis.Then we put hydroxyapatite into the detached tunnel,at the same time press position of operation from skin to obtain a nice form.At last we sewed up the incision.Results In 15000 cases of nasal implant operations with follow-up within last 18 years,the successful cases were 94 ％,while the failing ones were 6 ％.ConclusionsApplying partical hydroxylaptite artificial bone to saddle nose and nasal implant can obtain a satisfactory,long-tcrm and stable result.It can he an optional surgical method in nasal augmentation.
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ObjectiveTo investigate the morning blood pressure surge(MBPS) and its relationship with 24-hour blood pressure variability and anti-hypertensive drugs in middle-aged and elderly hypertensive patients.Methods A total of 521 middle-age and elderly men were surveyed with ambulatory blood pressure monitoring and ambulatory electrocardiograms recordings as well as questionnaire investigation from January 2009 to December 2010.Subjects were divided into MBPS positive group and MBPS negative group according to the level of MBPS[ ＞35 mm Hg (1 mm Hg=0.133 kPa) or ≤35 mm Hg].ResultsIn all the cases,the prevalence of MBPS was 19.4％,of which the elderly and very elderly had higher prevalences ( 18.9％ and 21.8％,respectively) than the middle-aged (5.6％,both P ＜0.01 ).Significant differences could be found in age [ ( 81.6 ± 6.4 ) years vs ( 78.7 ± 9.7 ) years ],day mean systolic blood pressure [ ( 132.8 ± 13.3) mm Hg vs ( 128.8 ±13.3) mm Hg],fasting blood glucose [ (5.96 ± 1.59) mmol/L vs (5.68 ± 1.22) mmol/L] and 24-hour blood pressure variability between the two groups ( all P ＜ 0.05 ).Significant difference could be observed in the prevalence of MBPS between the diuretics-taking group and non-taking group (27.4％ vs 17.6％,P ＜0.05 ).ConclusionsThe elderly hypertensive patients are prone to appear MBPS phenomenon.Fasting blood glucose level,24-hour blood pressure variability may be associated with MBPS.Diuretic antihypertensive treatment may not be conductive for MBPS control.
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<p><b>INTRODUCTION</b>This study reports a case of bevacizumab administered to treat choroidal neovascularisation in a woman later discovered to be pregnant.</p><p><b>CLINICAL PICTURE</b>A 25-year-old pregnant woman developed myopic choroidal neovascularisation in both eyes.</p><p><b>TREATMENT</b>Both eyes were treated with a total of 3 intravitreal injections of bevacizumab sequentially.</p><p><b>OUTCOME</b>Vision improved significantly in both eyes. There were no evident pregnancy-related complications at 1 year postpartum.</p><p><b>CONCLUSION</b>Although anti-vascular endothelial growth factor (VEGF) therapy did not result in any detectable short-term adverse event in this mother and baby, the potential toxicity of these agents must be carefully considered in pregnant patients.</p>
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Adult , Female , Humans , Pregnancy , Angiogenesis Inhibitors , Pharmacology , Therapeutic Uses , Antibodies, Monoclonal , Pharmacology , Therapeutic Uses , Antibodies, Monoclonal, Humanized , Bevacizumab , Choroidal Neovascularization , Drug Therapy , Pregnancy Complications , Drug Therapy , Treatment OutcomeABSTRACT
<p><b>INTRODUCTION</b>We studied the automated intraretinal segmentation on Fourier domain optical coherence tomography (OCT).</p><p><b>MATERIALS AND METHODS</b>Thirty eyes from 30 normal subjects were studied using the RTVue-100. Both radial and raster scan protocol were performed 3 times on each subject. The OCT software performs automated intraretinal segmentation and provides macular thickness measurements.</p><p><b>RESULTS</b>Both scanning protocols provide reproducible inner, outer and full retinal thickness measurements. The inner, outer and full retinal thicknesses at the foveal central subfield were 67.31 +/- 12.27 microm, 151.67 +/- 12.96 microm, 219.33 +/- 23.19 microm, respectively by the raster scan, and 63.27 +/- 10.37 microm, 147.07 +/- 14.54 microm, 209.89 +/- 21.80 microm, respectively by the radial scan. Macular regional variations were consistently observed. The raster scan protocol gives greater retinal thickness measurements than the radial scan protocol (P <0.05), but the latter yields slightly more reproducible results.</p><p><b>CONCLUSIONS</b>Fourier domain OCT equipped with the ability to perform automatic intraretinal segmentation is a convenient tool in studying diseases that may differentially affect various parts of the retina. However, the establishment of normative values can be complicated by different scanning protocols, devices used, methods of data presentation and definition of intraretinal boundaries.</p>
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Adult , Humans , Middle Aged , Young Adult , Image Interpretation, Computer-Assisted , Methods , Macula Lutea , Reference Values , Retinal Diseases , Diagnosis , Tomography, Optical Coherence , MethodsABSTRACT
<p><b>INTRODUCTION</b>We report a case in which intravitreal bevacizumab and ranibizumab appeared to have effects in the contralateral, uninjected eye.</p><p><b>CLINICAL PICTURE</b>An 83-year-old man with macular oedema from branch retinal vein occlusion (BRVO) in the right eye developed neovascular macular degeneration in the left eye. Intravitreal bevacizumab in the left eye improved macular oedema in the right eye temporarily before it recurred. Subsequently, intravitreal ranibizumab in the left eye also resulted in significant reduction of macular oedema in the right eye.</p><p><b>OUTCOME</b>Vision and macular oedema in the right eye improved.</p><p><b>CONCLUSION</b>Bevacizumab and ranibizumab may have therapeutic effects in the uninjected eye, possibly because they may escape from the eye into the systemic circulation.</p>
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Aged, 80 and over , Humans , Male , Angiogenesis Inhibitors , Therapeutic Uses , Antibodies, Monoclonal , Therapeutic Uses , Antibodies, Monoclonal, Humanized , Bevacizumab , Eye , Injections , Macular Edema , Drug Therapy , Ranibizumab , Retinal Vein Occlusion , Treatment Outcome , Vitreous BodyABSTRACT
<p><b>INTRODUCTION</b>To evaluate whether eyes with longer axial lengths are associated more often with clinically significant cataracts than eyes with shorter axial lengths.</p><p><b>MATERIAL AND METHODS</b>Charts of consecutive patients who underwent cataract surgery by 4 resident surgeons at Los Angeles County Hospital from July 2001 through May 2002 were retrospectively reviewed. Those patients whose axial lengths were significantly different between the 2 eyes (>or=0.30 mm) and who had no pathology (other than cataracts) affecting visual acuity were included in the study. The 2 eyes in each patient were compared for preoperative best-corrected visual acuity and severity of cataracts.</p><p><b>RESULTS</b>Thirty-four of 353 patients had interocular axial length differences of at least 0.3 mm and were included in this study. Thirty-one patients had worse, 1 had equal, and 2 had better preoperative vision in the eye with longer versus the shorter axial length. Fourteen patients had more severe, 11 had the same, and 1 had less severe posterior subcapsular cataract (PSC) in the eye with longer axial length. In 8 patients, PSC severity could not be assessed due to obscuring nuclear sclerosis. Twenty-four patients had more severe, 7 patients had equal, and 3 patients had less severe nuclear sclerosis in the longer eye. Overall, longer axial lengths correlated with worse visual acuity, posterior subcapsular cataracts, and nuclear sclerosis. Diabetic status did not affect the correlation. The correlations were stronger with greater axial length asymmetry.</p><p><b>CONCLUSIONS</b>Eyes with longer axial lengths have a higher prevalence of cataracts.</p>
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Humans , Middle Aged , Cataract , Diagnostic Techniques, Ophthalmological , Eye , Pathology , Retrospective Studies , Risk FactorsABSTRACT
Objective To observe the effects of antihypertensive agents on renin angiotensin aldosterone system, blood pressure and myocardial hypertrophy induced by high salt diet plus cold stress. Methods Fifty male Wistar rats weighting 200～250 g were divided into 5 groups: control, saline, captopril, betaloc and nitrendipine. The rats treated with dugs or saline were fed with high salt diet(8% NaCl) and subjected to cold stress 4 hours a day. Blood pressure and body weight were measured once a week. Rats were sacrificed and then the gross weight of hearts was measured 8 weeks later. Renin activity(RA), angiotensinⅡ(AngⅡ) and aldosterone(Aldo) in the left ventricular wall were determined by radioimmunoassay. Results ① Levels of RA, AngⅡ and Aldo of rat left ventricular wall in betaloc group were significantly lower than those in saline, captopril and nitrendipine groups( P
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To study the effects of high salt intake together with cold stress on rat cardiac renin angiotensin aldosterone system (RAAS) in rats. Male Wistar rats were randomly divided into four groups: control, high salt (8%NaCl), cold stress (5 2℃) and compound group (8%NaCl+cold stress). Blood pressure and body weight were measured once a week. The experiment ran for 8 weeks. Renin activity (RA), angiotensinⅡ (AngⅡ), and aldosterone (Aldo) in plasma and left ventricle were determined with radioimmunoassay. Angiotensin II receptor mRNA was determined with RT PCR. The results showed that ①Rats in compound group had higher blood pressure than rats in the other three groups ( P