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1.
Article in Chinese | WPRIM | ID: wpr-906248

ABSTRACT

Objective:To study the clinical efficacy of Chaihu Shugansan on non-alcoholic fatty liver(NAFLD) patients with liver stagnation and spleen deficiency syndrome and its effect on intestinal flora. Method:The study was a single-center, randomized,single-blind, placebo-controlled clinical study involving 80 patients with NAFLD treated from January 2019 to January 2020 at our hospital. They were divided into two groups (Chaihu Shugansan group,<italic>n</italic>=40) and control group (placebo group,<italic>n</italic>=40). The two groups of patients were given lifestyle intervention as the basic protocol. The treatment group was orally given Chaihu Shugansan,and the control group was orally given placebo. The drugs were given twice in the morning and evening, 1 dose/time. Patients were followed up for 12 weeks. Before and after treatment,the efficady on liver steatosis was observed by abdominal ultrasound and transient elastography (Fibroscan), levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),glutamyl transpeptidase(<italic>γ</italic>-GT),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triglyceride(TG),interleukin(IL)-6,IL-1<italic>β</italic>,Toll-like receptor-4(TLR-4) in peripheral blood mononuclear cells(PBMCs) and intestinal flora were also detected. Result:There were 37 patients in the treatment group and 35 patients in the control group who finally completed the study protocol. The total effective rate of NAFLD in the treatment group(81.08%,30/37) was higher than that in the control group (68.57%,24/35)(<italic>Z</italic>=2.67,<italic>P</italic><0.05). The treatment group was superior to the control group in reducing the levels of BMI,ALT,AST,TC,LDL-C,TG,<italic>γ</italic>-GT and increasing the level of HDL-C(<italic>P</italic><0.05). The levels of pro-inflammatory cytokines(TNF-<italic>α</italic>,IL-1<italic>β</italic> and IL-6),the values of Controlled Attenuation Parameter(CAP),Liver Stiffness Measurement(LSM) and expression of TLR4 were down-regulated in the treatment group (<italic>P</italic><0.01). In addition,the treatment group showed increase in the abundance of beneficial bacteria (<italic>Bifidobacterium</italic> and <italic>Lactobacillus</italic>) and inhibited the abundance of pathogenic bacteria (<italic>Enterobacter </italic>and<italic> Enterococcus</italic>) in the gut(<italic>P</italic><0.01). Conclusion:In addition to the lifestyle intervention,Chaihu Shugansan can improve lipid metabolism and liver function,regulate intestinal flora and inhibit the level of inflammatory factors in patients with NAFLD.

2.
Article in Chinese | WPRIM | ID: wpr-878985

ABSTRACT

Two phloroglucinol compounds(1-2) were isolated and purified from 95% ethanol extract of Dryopteris fragrans through various column chromatographies on silica gel, Sephadex LH-20, medium pressure column chromatography, and preparative HPLC. Their structures were elucidated as 2',4',6'-trihydroxy-5'-methyl acetate-3'-methyl-1'-butyrophenone(1) and aspidinol B(2) based on their chemical and physicochemical methods and spectroscopic data. Compound 1 is a new phloroglucinol compound named "dryofraginol".


Subject(s)
Chromatography, High Pressure Liquid , Dryopteris , Ethanol , Phloroglucinol , Plant Extracts
3.
Article in Chinese | WPRIM | ID: wpr-872160

ABSTRACT

Objective:To explore the clinical application of autologous freezing fat granule injection grafting in facial rejuvenation.Methods:A total of 64 cases of facial skin soft tissues ageing atrophy were treated by transplantation of autologous purification freezing lipochondria. Autologous fat was obtained from patient's abdomen or thighs, centrifugated at low velocity and low pressure to remove the oil and fluid, then stored the lipochondria in -20℃. Rewarming the fat under 37 ℃ for 1 hour, we observed the integrity of the adipocyte and detected the vitality of the fat. Then the purified autologous fat was injected into the recipient site of the face.Results:The fat cell membrane and cell nucleus were clear and integrity after stored in -20℃ for 24 weeks, and the vitality of the fat was (88.89±1.23)%. 21 cases gained satisfactory clinical results by injecting once and 35 cases with 2 times injections, 8 cases with 3 times injections, the effects were satisfactory and there was no complication by follow-up from 6 to 24 months. 82.81% patients and doctors were satisfactory with the curative effect, and 1.56% patients and doctors were unsatisfactory.Conclusions:The effects are satisfactory of autologous purified freezing microparticle fat injected transplant. It has low absorptivity, can duplicate injection, and accept easily by people. It is a good method for facial rejuvenation and worth to spread in the clinical practice.

4.
Article in Chinese | WPRIM | ID: wpr-802045

ABSTRACT

Objective:To characterize and compare the chemical information of four extracts of Qingre Chushi (QRCS) decoction by liquid chromatography-mass spectrometry (LC-MS), and combine the chemical information of the four extracts with their results of anti-inflammatory effect for a multivariate statistical analysis, in order to identify the compounds directly relating to the anti-inflammatory effects of QRCS decoction. Method:Four extracts of QRCS decoction were characterized by UPLC-Q-TOF-MS:①ethanol extract+water extract,② ethanol extract+supernatant after water extraction and alcohol precipitation, ③ ethanol extract+precipitation after water extraction and alcohol precipitation,and ④ standard decoction. On the basis of the results of inhibition of the four above extracts on xylene-induced ear swelling in mice,multivariate statistical analysis[principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA)] were carried out to lock the chromatographic peaks with significant differences between group ① (the best pharmacological action group) and group ④ (standard decoction group). According to the accuracy of quasi-molecular ion and fragment ion data,and the reference materials and literature data,those chromatographic peaks were identified. Result:PCA could cluster the four extracts of QRCS decoction,and the differences between groups was reflected in the distance between groups. Group ④ (standard decoction) had the most significant differences with the other three groups, especially in the first principal component; group ① (ethanol extract+water extract),group ② (ethanol extract+supernatant after water extraction and ethanol precipitation) and group ③ (ethanol extract+precipitation after water extraction and ethanol precipitation) had certain differences in the second principal component. OPLS-DA was used to compare group ① (the best pharmacological action group) and group ④ (standard decoction group). Eleven chromatographic peaks with great contribution and high reliability to group differences,were identified as gentiopicrin,skimmin,baicalin,baicalin isomer,wogonoside,5,6,7-trihydroxy-8-methoxyflavone-7-O-glucurodonaldehyde,5,6-dihydroxy-6,8,2',3'-tetramethoxyflavone,salicin-6-C-arabinose-8-C-glucoside,plantamajoside and glycyrrhizic acid. Conclusion:In the mode of pectrum-effect combination, this study explores and identifies compounds relating to the anti-inflammatory effect of QRCS decoction,so as to provide the basis for screening the extraction and purification process and optimizing the formulation of preparation of Qingre Chushi decoction.

5.
Article in Chinese | WPRIM | ID: wpr-699183

ABSTRACT

Pancreaticoduodenectomy (PD) is a standard surgical method for periampullary cancer.The hemorrhage is a dangerous complication after PD,how to effectively prevent and treat hemorrhage is a difficult point of pancreatic surgery,and also a key for reducing postoperative mortality.Four famous experts and their teams in surgical fiell explored prevention and treatment of the hemorrhage after PD from different angles based on clinical experiences.Professor Shen Boyong has conducted a discussion on early and Date hemorrhage after PD combined with previous successful experiences and prospective research data.Professor Chen Yajin suggested preventing hemorrhage in the aspects of anatomical resection,anastomosis and reconstruction,peritoneal drainage-tube placement and postoperative management based on different causes of hemorrhage.Professor Peng Bing paid attention to hemorrhage after laparoscopic PD,and supposed that intraoperative careful hemostasis,precise anastomosis,reasonable peritoneal drainage-tube placement and optimal perioperative management can reduce incidences of postoperative pancreatic fistula,biliary fistula and intra-abdominal infection,thereby lowering the incidence of hemorrhage.Professor Tan Guang respectively proposed processing strategies of hemorrhagc for grading A (mild at early stage),B (severe at early stage and mild at late stage) and C (severe at late stage).

6.
Article in Chinese | WPRIM | ID: wpr-699070

ABSTRACT

Pancreatic cystic neoplasm is a general term for a large class of pancreatic tumors,including mucinous cystic neoplasm,serous cystic neoplasm,and pancreatic intraductal papillary mucinous neoplasm.Due to the limitations of the current techniques in differential diagnosis and disease staging,different centers have great discrepancies in their treatment.The 103rd annual meeting of American College of Surgeons (ACS)as a grand meeting in the field of surgery bringed together a large number of clinical research results every year.Therefore,authors selected and reviewed contents about pancreatic cystic neoplasm,with a view to provide new ideas in terms of its management and further research.

7.
Article in Chinese | WPRIM | ID: wpr-707027

ABSTRACT

Objective To control the quality of realgar in compound Huanglian Ointment.Methods As2O3which is the toxic component of realgar was carried limit test by Gutzeit's test; Potassium sulfate, ammonium sulfate and sulfuric acid were used to digest, and then titration method was used to determine the content of As2S2in compound Huanglian Ointment. Results The content of the soluble As in compound Huanglian Ointment was no higher than 15.6 μg/g. The content of As2S2in compound Huanglian Ointment was no less than 2.21 mg/g. Conclusion The method is simple and easy,which can be applied as the quantity control method of compound Huanglian Ointment.

8.
China Journal of Endoscopy ; (12): 85-89, 2018.
Article in Chinese | WPRIM | ID: wpr-702934

ABSTRACT

Objective To investigate the therapeutic effect and safety of ESE (endoscopic submucosalexcavation) as the derivative technology of ESD (endoscopic submucosal dissection) for intestinal Neuroendocrinetumor. Methods A total of 23 lesions diagnosed as Neuroendocrine tumor were treated by ESE. Pathologicaldiagnosis was performed. Reverse events were recorded.Patients were followed up for recurrence andmetastasis. Results Lesions, 0.4 ~ 3.0 cm (medium size 1.0 cm) in diameter,were all resected at one ESE procedure.The operation time was 20 ~ 75 min (medium 30 min). Postoperative bleeding occurred in one case .Initiative fullthickness resection was made in one case due to the violation of muscularis propria layer. 23 cases were histologicallydiagnosed as neuroendocrine tumor, with 21 as G1 and 2 as G2, none as G3. Within 3 gastric neuroendocrine tumors,2 were type 1 and 1 was type 2. All resected samples were free of residual tumor cell in the lateral and basalmargins. Conclusion ESE is safe and efficacious for the treatment of intestinal neuroendocrine tumor.

9.
Article in Chinese | WPRIM | ID: wpr-661464

ABSTRACT

Objective To investigate the safety of the laparoscopic pancreaticoduodenectomy (LPD) in 70 years of age or older patients.Methods The retrospective cohort study was conducted.The clinicopathological data of 40 patients (age ≥70 years old) who underwent pancreaticoduodenectomy in the West China Hospital of Sichuan University between January 2012 and December 2016 were collected.Twenty patients undergoing LPD were allocated into the LPD group,and 20 receiving open pancreaticoduodenectomy (OPD) who were selected by random number table during the same period were allocated into the OPD group.Observation indicators included:(1) intraoperative situations;(2) postoperative situations;(3) follow-up situation.Follow-up using outpatient examination and telephone interview was performed to detect the patients' survival after discharge and tumor recurrence and metastasis up to March 2017.Measurement data with normal distribution was represented as x±s,and comparison between groups were evaluated with the t test.Measurement data with skewed distribution were described as median (range) and comparison between groups was analyzed using the nonparametric test.Comparison of count data was analyzed using the chi-square test.Comparison of ranked data was analyzed by non parametric test.Results (1) Intraoperative situations:1 patient in the LPD group was converted to open surgery,with a conversive rate of 5.0% (1/20).Operative time and volume of intraoperative blood loss were (463 ± 10) minutes,210.5 mL (152.5-300.0 mL) in the LPD group and (332± 25) minutes,420.0 mL (350.1-493.8 mL) in the OPD group,showing statistically significant differences between the 2 groups (t =5.48,Z =-3.98,P<0.05).Cases with intraoperative blood transfusion and pylorus preservation were respectively 4,14 in the LPD group and 6,10 in the OPD group,showing no statistically significant difference between the 2 groups (x2=0.53,1.67,P>0.05).The results of intraoperative rapid frozen pathological examination showed negative margin of the 40 patients.(2) Postoperative situations:cases in ICU,cases with postoperative analgesia,time for out-of-bed activity,time to anal exsufflation and time for intake were 17,7,(2.2±0.7)days,(4.2± 0.9)days,(4.8±0.7)days in the LPD group and 6,15,(3.6±0.8)days,(5.7±0.9)days,(7.1 ± 2.7)days in the OPD group,showing statistically significant differences between the 2 groups (x2 =12.34,6.47,t=-6.18,-6.55,-3.65,P<0.05).Pancreatic fistula,delayed gastric emptying (Grade B),postoperative bleeding (Grade B),biliary fistula,pulmonary infection,intestinal obstruction,wound infection,reoperation and major complication were respectively detected in 2,3,1,1,3,1,0,2,3 patients of the LPD group and 2,4,1,1,4,1,2,3,4 in patients of the OPD group,showing no statistically significant difference between the 2 groups (x2 =0.00,0.17,0.00,0.00,0.17,0.00,2.11,0.23,0.17,P>0.05).Results of postoperative pathological examination showed that duodenal adenocarcinoma,ampullary carcinoma,lower bile duct carcinoma,pancreatic ductal adenocarcinoma and pancreatic cystic tumor were respectively detected in 8,2,5,3,2 patients of the LPD group and 10,2,4,2,2 patients of the OPD group,showing no statistically significant difference between the 2 groups (x2 =0.53,P>0.05).Duration of postoperative hospital stay in the LPD and OPD groups were (19± 13) days and (15±7) days,respectively,showing no statistically significant difference between the 2 groups (t =1.28,P> 0.05).Results of postoperative oncology showed that tumor diameter,number of lymph node dissected,number of positive lymph nodes,cases with negative margin,cases in T1N0M0,T2N0M0,T3N0M0,T3N1M0,T4N0M0,T4N1M0 of TNM staging were respectively (2.4±0.7)cm,15.4±2.3,2,20,2,7,8,2,1,0 in the LPD group and (2.8±0.9)cm,14.4±2.5,3,20,1,8,5,2,3,1 in the OPD group,with no statistically significant difference between the 2 groups (t =-1.64,1.32,x2 =0.23,0.00,Z =-0.69,P> 0.05).(3) Follow-up situation:1 patient died respectively in both groups within the postoperative 30 days.Thirty-eight patients were followed up for 1-26 months,with a median time of 14 months.During follow-up,2 patients had tumor recurrence and 1 died of myocardial infarction in the LPD group;3 had tumor recurrence and 1 died of tumor recurrence in the OPD group.Conclusion LPD in 70 years of age or older patients is not only safe and feasible,but also significantly reduce volume of intraoperative blood loss and demand of analgesia,as well as quickly resume normal diet and activities.

10.
Article in Chinese | WPRIM | ID: wpr-658545

ABSTRACT

Objective To investigate the safety of the laparoscopic pancreaticoduodenectomy (LPD) in 70 years of age or older patients.Methods The retrospective cohort study was conducted.The clinicopathological data of 40 patients (age ≥70 years old) who underwent pancreaticoduodenectomy in the West China Hospital of Sichuan University between January 2012 and December 2016 were collected.Twenty patients undergoing LPD were allocated into the LPD group,and 20 receiving open pancreaticoduodenectomy (OPD) who were selected by random number table during the same period were allocated into the OPD group.Observation indicators included:(1) intraoperative situations;(2) postoperative situations;(3) follow-up situation.Follow-up using outpatient examination and telephone interview was performed to detect the patients' survival after discharge and tumor recurrence and metastasis up to March 2017.Measurement data with normal distribution was represented as x±s,and comparison between groups were evaluated with the t test.Measurement data with skewed distribution were described as median (range) and comparison between groups was analyzed using the nonparametric test.Comparison of count data was analyzed using the chi-square test.Comparison of ranked data was analyzed by non parametric test.Results (1) Intraoperative situations:1 patient in the LPD group was converted to open surgery,with a conversive rate of 5.0% (1/20).Operative time and volume of intraoperative blood loss were (463 ± 10) minutes,210.5 mL (152.5-300.0 mL) in the LPD group and (332± 25) minutes,420.0 mL (350.1-493.8 mL) in the OPD group,showing statistically significant differences between the 2 groups (t =5.48,Z =-3.98,P<0.05).Cases with intraoperative blood transfusion and pylorus preservation were respectively 4,14 in the LPD group and 6,10 in the OPD group,showing no statistically significant difference between the 2 groups (x2=0.53,1.67,P>0.05).The results of intraoperative rapid frozen pathological examination showed negative margin of the 40 patients.(2) Postoperative situations:cases in ICU,cases with postoperative analgesia,time for out-of-bed activity,time to anal exsufflation and time for intake were 17,7,(2.2±0.7)days,(4.2± 0.9)days,(4.8±0.7)days in the LPD group and 6,15,(3.6±0.8)days,(5.7±0.9)days,(7.1 ± 2.7)days in the OPD group,showing statistically significant differences between the 2 groups (x2 =12.34,6.47,t=-6.18,-6.55,-3.65,P<0.05).Pancreatic fistula,delayed gastric emptying (Grade B),postoperative bleeding (Grade B),biliary fistula,pulmonary infection,intestinal obstruction,wound infection,reoperation and major complication were respectively detected in 2,3,1,1,3,1,0,2,3 patients of the LPD group and 2,4,1,1,4,1,2,3,4 in patients of the OPD group,showing no statistically significant difference between the 2 groups (x2 =0.00,0.17,0.00,0.00,0.17,0.00,2.11,0.23,0.17,P>0.05).Results of postoperative pathological examination showed that duodenal adenocarcinoma,ampullary carcinoma,lower bile duct carcinoma,pancreatic ductal adenocarcinoma and pancreatic cystic tumor were respectively detected in 8,2,5,3,2 patients of the LPD group and 10,2,4,2,2 patients of the OPD group,showing no statistically significant difference between the 2 groups (x2 =0.53,P>0.05).Duration of postoperative hospital stay in the LPD and OPD groups were (19± 13) days and (15±7) days,respectively,showing no statistically significant difference between the 2 groups (t =1.28,P> 0.05).Results of postoperative oncology showed that tumor diameter,number of lymph node dissected,number of positive lymph nodes,cases with negative margin,cases in T1N0M0,T2N0M0,T3N0M0,T3N1M0,T4N0M0,T4N1M0 of TNM staging were respectively (2.4±0.7)cm,15.4±2.3,2,20,2,7,8,2,1,0 in the LPD group and (2.8±0.9)cm,14.4±2.5,3,20,1,8,5,2,3,1 in the OPD group,with no statistically significant difference between the 2 groups (t =-1.64,1.32,x2 =0.23,0.00,Z =-0.69,P> 0.05).(3) Follow-up situation:1 patient died respectively in both groups within the postoperative 30 days.Thirty-eight patients were followed up for 1-26 months,with a median time of 14 months.During follow-up,2 patients had tumor recurrence and 1 died of myocardial infarction in the LPD group;3 had tumor recurrence and 1 died of tumor recurrence in the OPD group.Conclusion LPD in 70 years of age or older patients is not only safe and feasible,but also significantly reduce volume of intraoperative blood loss and demand of analgesia,as well as quickly resume normal diet and activities.

11.
Article in Chinese | WPRIM | ID: wpr-608217

ABSTRACT

Objective To study the safety and feasibility of laparoscopic total splenectomy (LTS) and laparoscopic partial splenectomy (LPS) in the diagnosis and treatment of benign splenic tumors by comparing the perioperative and follow-up data between these two operative approaches.Methods We retrospectively analyzed the clinical data of 57 patients who underwent laparoscopic surgery for benign splenic tumors from December 2009 to April 2016.These patients were divided into the LTS and the LPS groups.The clinical data including the preoperative,intraoperative,postoperative and follow-up data were analyzed.Results When compared with the LPS group,the LTS group had shorter operation time [(97.0 ± 22.1)min vs.(135.0 ± 24.6) min,P < 0.05] and less blood loss [(33.3 ± 19.5) min vs.(90.6 ± 55.1)min,P < 0.05],but there were no significant differences between the two groups in the length of hospital stay,the duration of drainage tube placement,the amount of postoperative analgesics as well as the incidences of pulmonary infection,postoperative pancreatic fistula and other complications after surgery.These incidences were low in the two groups.Conclusion Laparoscopic surgery,including LTS and LPS,were safe and feasible in treating benign splenic tumors.

12.
Article in Chinese | WPRIM | ID: wpr-506086

ABSTRACT

Objective To assess the surgical skills and clinical outcomes of selective splenic pedicle occlusion (SSPO) in laparoscoic partial splenectomy.Methods Between May 2011 and Nov 2016,40 patients undergoing laparoscopic partial splenectomy were devided into selective splenic pedicle occlusion group (14 cases) and conventional laparoscopic partial splenectomy group (26 cases).Results There were no significant differences in preoperative patient characteristics between the two groups.Significantly less intraoperative blood loss (82 ± 36) ml vs (178 ± 81) ml (t =-4.2,P =0.001) were observed in group of SSPD,There were no significant differences between the groups in operative time (111 ± 17) min vs (127 ±40) min(t =-1.4,P =0.19),transfusion rate (0/14,0/26) (P =1),conversion rate (0/14,0/26) (P =1),postoperative complications (1/14,2/26) (Fisher =0.063,P =0.80) and length of postoperative hospital stay (7.1 ± 2.3) d vs (6.0 ± 1.3) d (t =1.28,P =0.22).Conclusions SSPO is feasible and safe for patients receiving laparoscopic partial splenectomy.

13.
National Journal of Andrology ; (12): 912-916, 2017.
Article in Chinese | WPRIM | ID: wpr-812857

ABSTRACT

Objective@#To investigate the clinical effect of "3+1" bladder function restoration combined with holmium laser enucleation of the prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH) with acontractile detrusor (ACD).@*METHODS@#We treated 35 BPH patients with ACD by HoLEP followed by "3+1" bladder function restoration, that is, a 3-phase bladder function training plus simultaneous 1-drug medication after surgery. We recorded and analyzed the detrusor pressure, post-void residual urine volume (PVR), maximum urinary flow rate (Qmax), International Prognostic Scoring System (IPSS) scores, quality of life (QoL), voluntary micturition, satisfaction with the bladder function, hydronephrosis, ureterectasia, renal function, and urinary tract infection of the patients before and after treatment.@*RESULTS@#Compared with the base line, at 6 months treatment, the patients showed significantly increased detrusor pressure ([35.1±2.7]vs [50.2±2.3] cmH2O, P<0.05) and Qmax ([4.2±2.7]vs [21.1±4.1] ml/s, P<0.05) but decreases in PVR ([173.0±31.6] vs [30.5±12.9]ml, IPSS score (27.3±3.2 vs 5.1±1.4, P<0.05) and QoL (4.1±0.8 vs 0.8±0.1, P<0.05), elevated rates of voluntary urination (0% [0/35] vs 100% [35/35], P<0.05), regularurination (0% [0/35] vs 85.71% [30/35], P<0.05), grade Ⅰ satisfaction with bladder function (0% [0/35] vs 85.71% [30/35], P<0.05), reduced rate of overflowing urinary incontinence (28.57% [10/35] vs 5.71% [2/35], P<0.05), and increased percentages of normal renal function (34.29% [12/35] vs 85.71% [30/35], P<0.05) and non-infection of the urinary system (17.14% [6/35] vs 94.29% [33/35], P<0.05). After treatment, urination was markedly improved in 94.29% (33/35) of the patients.@*CONCLUSIONS@#"3+1" bladder function restoration combined with HoLEP produced a desirable effect on BPH with ACD, though its long-term effect remains to be further investigated.


Subject(s)
Aged , Holmium , Humans , Laser Therapy , Methods , Lasers, Solid-State , Male , Personal Satisfaction , Prostatic Hyperplasia , General Surgery , Quality of Life , Recovery of Function , Transurethral Resection of Prostate , Methods , Treatment Outcome , Urinary Bladder , Physiology , Urination , Physiology
14.
Article in Chinese | WPRIM | ID: wpr-614263

ABSTRACT

Objective To investigate the safety and feasibility of laparoscopic pylorus-preserving pancreaticoduodenectomy.MethodsThe data of 59 patients with laparoscopic pancreaticoduodenectomy in Shangjin hospital of West China hospital of Sichuan University from January 2014 to December 2015 were analyzed retrospectively.The general data,operative time,estimated blood loss,conversion rate,time to liquid diet,postoperative hospital stay and complications were analyzed.Results The laparoscopic pylorus-preserving pancreaticoduodenectomy were successfully performed in 56 cases,the successful rate was 94.9%,the other 3 patients were converted to laparotomy for superior mesenteric vein/portal vein involvement.The operative time was 255~510 minutes,with mean operative time (384±145) minutes,the intraoperatve blood soss was 50~800 mL,with mean estimated blood loss (148±28)mL,the time to liquid diet was 1.0~4.0 days,with average time (3.2±1.1)days,the postoperative hospital stay was 5.0~53.0 days,with average time (10.3±2.6)days.After surgery,16 cases suffered from complication,the rate was 27.1%.The most common complication was pancreatic fistula which occurred in 13 cases including 12 cases of grade A and 1 case of grade pancreatic fistula.No grade C pancreatic fistula occurred in this series.Six patients suffered from delayed gastric emptying.One patient suffered from bile leakage.Conclusion Laparoscopic pylorus-preserving pancreaticoduodenectomy was safe and feasible.Pylorus-preserving does not increase the incidence of delayed gastric emptying.

15.
Article in Chinese | WPRIM | ID: wpr-335878

ABSTRACT

This work was launched to explore the effect of habitat and growth year on the secondary metabolites contents of cultivated Polygala tenuifolia. The samples of cultivated P. tenuifolia were analyzed by ultra-high performance liquid chromatography(UPLC)-quadrupole time-of-flight mass spectrometry(Q-TOF MS), and the obtained data were analyzed using multiple statistical analysis and cluster analysis. The results showed that compared with growth year, habitat is a main influencing factor which affected the secondary metabolites contents of P. tenuifolia. The contents of sucrose esters and oligosacchride multi-esters are greatly dependent on the habitat (the sample-AG with high levels of components of tenuifoliside B and tenuifoliside C, and the sample-FY with high levels of 3,6'-disinapoyl sucrose, tenuifoliose S, tenuifoliose L, and tenuifoliose V). There is no obvious effect of habitat and growth year on xanthone. The contents of triterpene saponins are greatly dependent on the growth year, and the content of parts of triterpene saponins increased as time goes on.The result indicated that the effect of habitat and growth year on different types of secondary metabolites is not completely equivalent. This study will contribute to the breeding of P. tenuifolia and amendment of current commodity criteria.

16.
Article in Chinese | WPRIM | ID: wpr-498274

ABSTRACT

BACKGROUND:During degeneration of cervical spine, biochemical changes appeared in intervertebral disc cel s. During this process, a variety of inflammatory cytokines may lead to disc herniation, which stimulates the production of a variety of inflammatory factors from surrounding adjacent tissue. OBJECTIVE:To explore the expression and significance of interleukin-1β, interleukin-6 and cyclooxygenase 2 in patients with different clinical symptoms of cervical spinal cord oppression. METHODS:Protrusion of the intervertebral disc or disc of responsibility among patients with anterior disc resection and internal fixation were divided into three groups according to clinical symptoms:myelopathic symptom group, nerve root symptom group and cervical spine trauma group. Intervertebral disc received hematoxylin-eosin staining and immunohistochemical staining for morphological observation. Positive cel s were counted according to the result of immunohistochemical staining. RESULTS AND CONCLUSION:(1) Hematoxylin-eosin staining results showed visible inflammatory cel infiltration and new blood vessel formation in the myelopathic symptom group and nerve root symptom group. No remarkable inflammatory cel infiltration or new blood vessel formation was seen in cervical spine trauma group. (2) Immunohistochemical staining interleukin-1β-, interleukin-6-positive cel s were seen in the myelopathic symptom group. Cytoplasm was stained tan. Cyclooxygenase 2-positive cel s showed a low number. The numbers of interleukin-1β-, interleukin-6-and cyclooxygenase 2-positive cel s were significantly more in the nerve root symptom group than in the myelopathic symptom group. The numbers of interleukin-1β-, interleukin-6-and cyclooxygenase 2-positive cel s were smal in the cervical spine trauma group. (3) Expression rate and IA value of interleukin-1β, expression rate and IA value of interleukin-6 were significantly higher in the myelopathic symptom group and nerve root symptom group than in the cervical spine trauma group (P<0.05). Expression rate and IA value of cyclooxygenase 2 were significantly higher in the nerve root symptom group than in the cervical spine trauma group. (4) These results suggested that interleukin-1β, interleukin-6 and cyclooxygenase 2 expression could be found in the cervical intervertebral disc after protrusion, and played a role in early degeneration of cervical intervertebral disc. The expressions of these inflammatory factors were significantly different in patients with different clinical symptoms of cervical spinal cord compression.

17.
Article in Chinese | WPRIM | ID: wpr-497819

ABSTRACT

Objective To investigate the application value of enhanced recovery after surgery(ERAS) in laparoscopic pancreaticoduodenectomy (LPD).Methods The retrospective cohort study was adopted.The clinical data of 64 patients who underwent LPD from January 2014 to January 2016 in the Shangjin Hospital of West China Hospital of Sichuan University were collected.Of the 64 patients,41 patients managed with ERAS program between March 2015 and January 2016 were allocated into the ERAS group,23 patients managed with traditional perioperative treatment between January 2014 and Febuary 2015 were allocated into the traditional group.The following indexes were observed:(l) intraoperative status:operation time,volume of intraoperative blood loss,conversion to open surgery,pylorus preservation.(2) Postoperative status:the time to out-of-bed activity,time to postoperative flatus,time of drainage tube removal,postoperative complications (pancreatic leakage,bile leakage,hemorrhage,delayed gastric emptying,abdominal infection,cardiovascular complications),duration of postoperative hospital stay,death within the postoperative 30 days.(3) Follow-up status:incidence of complications after discharge and survival of patients.The follow-up including incidence of complications after discharge and survival of patients was conducted by outpatient examination and telephone interview up to March 2016.Measurement data with normal distribution were presented as (x) ± s and analyzed by t test.Count data were analyzed using the chi-square test or Fisher exact probability.Results (1) Intraoperative status:the operation time,volume of intraoperative blood loss,number of patients with conversion to open surgery and pylorus preservation were (377 ± 38) minutes,(164 ± 48) mL,1,40 in the ERAS group and (392 ± 53) minutes,(152 ±31)mL,2,21 in the traditional group,showing no statistically significant difference between the 2 groups (t =5.02,8.43,x2=1.29,1.29,P > 0.05).(2) Postoperative status:the time to out-of-bed activity,time to postoperative flatus,time of drainage tube removal and duration of postoperative hospital stay were (1.7 ± 0.6)days,(2.5 ± 0.6) days,(5.3 ± 1.7) days,(9.1 ± 1.3) days in the ERAS group and (2.1 ± 0.9) days,(3.8 ±1.2) days,(8.2 ± 2.6) days,(11.9 ± 1.8) days in the traditional group,showing statistically significant differences between the 2 groups(t =-5.28,-7.01,-16.20,-10.67,P < 0.05).The numbers of patients with pancreatic leakage in stage A,B and C,bile leakage,hemorrhage,delayed gastric emptying,abdominal inflection,cardiovascular complications and death in the postoperative 30 days were 8,0,0,0,1,3,0,1,1 in the ERAS group and 5,1,0,1,1,3,2,1,0 in the traditional group,respectively,showing no significant difference between the 2 groups (x2=0.37,1.81,0.18,0.57,3.68,0.18,P >0.05).(3) Follow-up status:the 64 patients were followed up for a median time of 11 months (range,1-25 months).During the follow-up,number of patients complicated with diabetes,local tumor recurrence,liver metastasis and death were 5,4,1,0in the ERAS group and 2,5,2,3 (2 died of tumor recurrence and 1 died of myocardial infarction) in the traditonal group.Conclusion Application of ERAS in the perioperative management of LPD is safe and effective,meanwhile,it can accelerate the recovery of patients who underwent LPD and shorten the duration of hospital stay.

18.
Acta Pharmaceutica Sinica ; (12): 1165-2016.
Article in Chinese | WPRIM | ID: wpr-779293

ABSTRACT

The content changes of chemical components in different phenological phase of the cultivated Polygala tenuifolia is one of the important factors for determination of the best harvest time in the production practice. In this study, the digital gene expression (DGE) profiles of the cultivated P. tenuifolia were analyzed in different phenological phase (flowering fruit bearing stage, wilting stage, dormancy stage). The differentially expressed genes were found in the biosynthesis of chemical composition in P. tenuifolia, and the representational ones were validated by RT-qPCR. Then, the key enzymes (CYP450s and UGTs) involved in the downstream of the triterpenoid saponins biosynthesis pathway in P. tenuifolia were predicted through the correlation analysis of gene expression. The number of down-regulated genes was more than that of up-regulated in P. tenuifolia from flowering fruit bearing stage to dormancy stage. Six differentially expressed genes (HMGS, PMK, FPPS, SQS, SE, β-AS) and five (PAL, C4H, 4CL, CAD, peroxidase) were annotated to the triterpenoid saponins and phenylpropanoid biosynthesis pathway in P. tenuifolia, respectively. Compared to wilting and dormancy stages, the saponins, xanthones, and lignins were largely synthesized at the flowering fruit bearing stage of P. tenuifolia. Furthermore, UGT83A1, CYP716B1, CYP98A3, CYP86B1, and CYP94A1 may be the part of key enzymes in the downstream of the triterpenoid saponins biosynthesis pathway in P. tenuifolia. This study provides evidence to support the correctness of traditional harvest time of P. tenuifolia at the level of transcription, and lays the scientific foundation for gene cloning and functional verification of CYP450s and UGTs in the downstream of the triterpenoid saponins biosynthesis pathway in P. tenuifolia in the future.

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Article in Chinese | WPRIM | ID: wpr-489936

ABSTRACT

BACKGROUND:The greatest risk of osteoporosis in total knee arthroplastyisperioperative and long-term periprosthetic fractures. However, limited by the traditional concept of osteoarthritis patientswhousualy not associated with osteoporosis, domestic clinical trials have not given enough attention to the osteoporosis before total knee arthroplasty. OBJECTIVE:To analyze the osteoporosis and its relative factors in osteoarthritis patients before total knee arthroplasty. METHODS:Data of 81 cases (81 knees) of knee osteoarthritiswhounderwenttotal knee arthroplasty in the Department of Joint Surgery of Tianjin People’s Hospital from January 2012 to November 2014 were retrospectively analyzed. They received lumbar spine and hip bone mineral density examination before surgery. The correlation of bone mineral density with age, body mass index, knee motion range,and knee deformity was analyzed before surgery. The independent risk factors for osteoporosis before replacement were analyzed. RESULTS AND CONCLUSION:(1) Of 81 patients, there were normal bone mineral density in 25 cases (31%), osteopenia in 35 cases (43%),andosteoporosis in 21 cases (26%). Al 10 males had no osteoporosis and 21 in 71 female cases suffered osteoporosis (30%). Theincidence of osteoporosis in females was significantly higher than in male patients (P=0.046). (2) There was a linear correlation of bone mineral density with age and body mass index (correlation coefficientr=-0.230, 0.225). (3) The age of≥65 years and body mass index≥25 kg/m2were independent risk factors of osteoporosis before replacement (P< 0.05). (4) Patients with knee osteoarthritis had higher incidence of osteopenia and osteoporosis before total knee arthroplasty. The degree of osteoporosis was negatively correlated with age, but positively correlated with body mass index. The age of≥65 years and body mass index < 25 kg/m2were independent risk factors for preoperative osteoporosis. Thus, bone mineral density examination is essential for those patients before total knee arthroplasty.

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Article in Chinese | WPRIM | ID: wpr-286846

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the effects of inspiratory muscle training followed by non-invasive positive pressure ventilation in patients with severe chronic obstructive pulmonary disease (COPD).</p><p><b>METHODS</b>This investigator-initiated randomized, controlled trial recruited 88 patients with stable GOLD stage IV COPD, who were randomized into 4 equal groups to continue oxygen therapy (control group) or to receive inspiratory muscle training followed by non-invasive positive pressure ventilation (IMT-NPPV group), inspiratory muscle training only (IMT group), or noninvasive positive pressure ventilation only (NPPV group) for at least 8 weeks. The outcomes of the patients were assessed including the quality of life (SRI scores), maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), dyspnea (MRC scores), 6-min walking distance (6MWD) and lung function.</p><p><b>RESULTS</b>s Compared to baseline values, SRI scores, 6MWT and MRC scores increased significantly after 8 weeks in IMT-NPPV, IMT and NPPV groups, and the improvements were significantly greater in IMT-NPPV group than in IMT and NPPV groups (P<0.05 for all). In IMT-NPPV and IMT groups, MIP and MEP increased significantly after the training (P<0.05), and the improvement was more prominent in IMT-NPPV group (P<0.05). No significant changes were found in pulmonary functions in the groups after 8 weeks of treatment (P>0.05).</p><p><b>CONCLUSION</b>Inspiratory muscle training followed by non-invasive positive pressure ventilation, compared with inspiratory muscle training or non-invasive positive pressure ventilation alone, can better enhance the quality of life, strengthen the respiratory muscles, improve exercise tolerance and relieve the dyspnea in patients with COPD.</p>


Subject(s)
Dyspnea , Therapeutics , Exercise Tolerance , Humans , Lung , Noninvasive Ventilation , Physical Conditioning, Human , Positive-Pressure Respiration , Pulmonary Disease, Chronic Obstructive , Therapeutics , Quality of Life , Respiratory Muscles
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