Repeated stellate ganglion blockade for the treatment of ventricular tachycardia storm in patients with nonischemic cardiomyopathy: a new therapeutic option for patients with malignant arrhythmias / 中华心血管病杂志

Objectives: This study sought to describe our institutional experience of repeated percutaneous stellate ganglion blockade (R-SGB) as a treatment option for drug-refractory electrical storm in patients with nonischemic cardiomyopathy (NICM). Methods: This prospective observational study included 8 consecutive NICM patients who had drug-refractory electrical storm and underwent R-SGB between June 1, 2021 and January 31, 2022. Lidocaine (5 ml, 1%) was injected in the vicinity of the left stellate ganglion under the guidance of ultrasound, once per day for 7 days. Data including clinical characteristics, immediate and long-term outcomes, and procedure related complications were collected. Results: The mean age was (51.5±13.6) years. All patients were male. 5 patients were diagnosed as dilated cardiomyopathy, 2 patients as arrhythmogenic right ventricular cardiomyopathy and 1 patient as hypertrophic cardiomyopathy. The left ventricular ejection fraction was 37.8%±6.6%. After the treatment of R-SGB, 6 (75%) patients were free of electrical storm. 24 hours Holter monitoring showed significant reduction in ventricular tachycardia (VT) episodes from 43.0 (13.3, 276.3) to 1.0 (0.3, 34.0) on the first day following R-SGB (P<0.05) and 0.5 (0.0, 19.3) after whole R-SGB process (P<0.05). There were no procedure-related major complications. The mean follow-up was (4.8±1.1) months, and the median time of recurrent VT was 2 months. Conclusion: Minimally invasive R-SGB is a safe and effective method to treat electrical storm in patients with NICM.

Function of Polo-like kinase 1 and its research progress in tumor therapy / 国际外科学杂志

Protein kinases are key regulators of cellular function and constitute one of the largest and participate in orch estrating the vast majority of cellular activities, forming a criss-cross regulatong network. Kinases, which play a key role in regulating the activity of cellular proteins, are prime targets for anticancer drugs because their abnormal forms can promote the proliferation of tumor cells. Polo-like kinase-1 (Plk-1) is a member of the polo-like family of serine/threonine (Ser/Thr) kinases, which is involved in many aspects of the mitotic process that regulates cell proliferation, which is one of the key kinases of cell mitosis, whose overexpression is closely related to the occurrence and development of many human cancers. Drug development targeting Plk-1 may be one of the promising directions for the treatment of cancer. This review will summarize the structural features of Plk-1 and the cellular processes involved, as well as the rationale for anti-tumor therapy against Plk-1, the latest progress in inhibitor development and the latest strategies.

Influence of lymph node-related parameters on postoperative long-term prognosis of patients with distal cholangiocarcinoma / 国际外科学杂志

Objective:To analyse the correlation between the lymph nodes, the number of positive lymph nodes, the positive rate of lymph nodes and the long-term prognosis of patients with distal cholangiocarcinoma.Methods:The clinical data and follow-up results of 104 patients with distal cholangiocarcinoma admitted to Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 2015 to December 2021 were retrospectively analyzed using a retrospective cohort study. All patients underwent pancreaticoduodenectomy. According to the nature of the patients′ lymph nodes, the number of positive lymph nodes, and the positive rate of lymph nodes, the X-tile software was used to analyze data respectively, and the critical value of SUVmax were determined, and the patients were divided into low-risk group and high-risk group by critical values. Based on this critical value, the patients were divided into low-risk groups and high-risk groups. There were 37 patients in the lymph node positive group and 67 patients in the negative group. In the lymph node positive group, according to the number of positive lymph nodes (the cut-off value=2), they were divided into the low-risk group( n=14), the high-risk group( n=23); grouped according to the lymph node positive rate (the cut off=0.13), and divided into the low-risk group( n=15), and the high-risk group( n=22). After grouping according to different lymph node parameters, the preoperative general data such as age, gender, laboratory examination, etc., the correlation between perioperative complications and long-term prognosis were analyzed. The measurement data conforming to the normal distribution was expressed as mean ± standard deviation( ± s), and the t test was used for comparison between groups; the measurement data that was not normally distributed was expressed as M ( Q1, Q3), and the comparison between groups was performed by the rank sum test. The enumeration data were expressed by the number of cases, and the comparison between groups was performed using the chi-square test. If the total number of cases was less than 50, and Fisher′s exact test was used. The optimal cut-off values for different lymph node parameters were determined using the x-tile 3.6.1 software. Survival curves were calculated and drawn using the Kaplan-Meier method, and the survival rates were compared using the Log-rank test. Results:All patients successfully underwent the operation, 5 patients(4.8%) died during the perioperative period. The median postoperative survival time of lymph node-positive patients and lymph node-negative patients was 17 months and 36 months, respectively, and the overall survival rates at 1, 3, and 5 years were 64.9%, 23.9%, 23.9%, and 81.5%, 49.8%, 41.7%( P=0.003). Among the patients grouped according to the number of positive lymph nodes, the median postoperative survival time of patients in the low-risk group and the high-risk group was 21 months and 17 months, and the 1-, 3-, and 5-year overall survival rates of the two groups were were 77.1%, 42.9%, 42.9% and 58.2%, 13.8%, 13.8%( P=0.284), respectively. Among the patients grouped according to the positive rate of lymph nodes, the median postoperative survival time of the patients in the low-risk group and the high-risk group was 30 months and 15 months, and the 1-, 3-, and 5-year overall survival rates of the two groups were 85.6%, 42.7%, 42.7% and 51.3%, 10.3%, 0.3%( P=0.020), respectively. Conclusions:Radical pancreaticoduodenectomy is the standard procedure for patients with distal cholangiocarcinoma. The prognosis of patients with positive lymph nodes is worse. For patients with positive lymph nodes, the positive rate of lymph nodes is a better predictor of the long-term prognosis compared with the number of positive lymph nodes.

Revision of the non-suicidal self-injury behavior scale for adolescents with mental disorder / 中南大学学报(医学版)

OBJECTIVES@#Adolescents are at high risk of non-suicidal self-injury (NSSI). Currently, there is no clinical assessment tool for adolescent NSSI behaviors measurement with global consistency. The Ottawa Self-injury Inventory (OSI) is considered as a relatively comprehensive assessment tool for NSSI, but the questionnaire is discussed with excessive content and timecostly, which may affect the reliability of the measurement results for adolescent.Thus, this study, based on OSI, aims to revise the assessment tool for adolescent with NSSI that is suitable for both clinically and scientifically, referring to the diagnostic criteria for NSSI in the 5th Diagnostic and Statistical Manual of Mental Disorder (DSM-5).@*METHODS@#This study was led by the Second Xiangya Hospital of Central South University and collaborated with 6 mental health service institutions in China from August to December 2020. Adolescent aged from 12 to 24 years old who had self-injury behavior and met the DSM-5 diagnostic criteria for NSSI were continuously recruited in the psychiatric outpatient department or ward. After clinical diagnosis by an experienced attending psychiatrist or above, the general information and OSI were collected by questionnaires. SPSS 24.0 and AMOS structural equation model statistical softwares were used to conduct item analysis and exploratory factor analysis on the obtained data to complete the revision of the scale. Cronbach's alpha coefficient, split-half reliability, test-retest reliability, and content validity and structure validity were performed to analyze the reliability and validity and confirmatory factor analysis was carried out to test the structure validity for the revised scale.@*RESULTS@#A total of 234 adolescent with NSSI were enrolled, including 33 (14.1%) males and 201 (85.9%) females with the mean age of (16.2±2.6) years old. The most common clinical diagnoses were depression disorder (57.4%), bipolar disorder (20.9%), adolescent mood disorder (17.1%), etc. Nine items (item 2, 7, 11, 13, 23, 24, 10, 17, 18) in the functional scale of OSI were deleted according to extreme grouping method, correlation analysis, and principal component analysis in exploratory factor analysis. The revised functional scale for NSSI consisted of 15 items. The reliability analysis showed that the Cronbach's alpha coefficients of NSSI thought and behavior frequency, addiction characteristics, and function scales were 0.799, 0.798, and 0.835, respectively, and the split-half coefficients were 0.714, 0.727, and 0.852, respectively. The test-retest coefficients of the latter 2 scales were 0.466 and 0.560, respectively. The correlation coefficient between sub-items and total scores in each part of the scale showed good content validity. The exploratory factor analysis showed that a component was extracted from the frequency of thoughts and behaviors of NSSI, one component was extracted from the addictive characteristics, and three components were extracted from the functional part. The three functional subscales were social influence, external emotion regulation, and internal emotion regulation. The factor load of each item was >0.400.@*CONCLUSIONS@#The revised Chinese version OSI targeted the adolescent patients with mental disorders has relatively ideal reliability and validity. The scale shows high stability, dependability, and a reasonable degree of fit. It is a suitable assessment tool for clinical and scientific research on adolescent with NSSI.

Research progress in pharmacological effects of polyphenols in Areca catechu L / 中国药理学与毒理学杂志

Betel nut is the dry and mature seed of Areca catechu L., which is originated in Malaysia and cultivated in Yunnan, Hainan and Taiwan and other tropical areas of China. It is also known as big belly, binmen, olive seed, green seed and so on. Betel nut is a dual-use resource for medicine and food, which was first contained in LI Dang's Pharma?ceutical Record. Betel nut tastes bitter, pungent, warm in nature, and belongs to the stomach and large intestine meridian. It contains a variety of chemical components such as alkaloids, phenolic compounds, polysaccharides, fatty acids, amino acids, flavonoids, minerals, terpenoids, and steroids. It has the advantages of promoting digestion, lowering blood pres?sure, anti-depression, anti-oxidation, anti-inflammatory, and anti-parasites, antibacterial and other activities. The content of total phenols in fresh fruits of areca nut was 31.1％, mainly including catechin, isorhamnetin, chrysopanthoxanthin, luteolin, tannin and other polyphenols. The commonly used methods for determination of polyphenols in areca are vanil?lin titration potassium permanganate titration and potassium ferricyanide spectrophotometry. The main activities and mechanisms of areca polyphenols include: ① Antidepressant effect: polyphenols bind to monoamine oxidase type A (MAO-A) receptors that inhibit the production of neurotransmitters, thereby increasing the content of amine transmitters in the brain and playing a therapeutic effect on depression. ② Antioxidant effect: polyphenols contain multiple adjacent hydroxyl groups, which are easily oxidized and can effectively remove superoxide anion free radical, hydroxyl free radi?cal, 1,1-diphenyl-2-picrylhydrazyl radical, showing good antioxidant activity.③Bacteriostatic effect:polyphenols can spe?cifically bind to the surface of bacteria, thus achieving bacteriostatic effect. Studies have found that betel nut polyphenols have varying degrees of inhibitory effects on a variety of bacteria. ④ Inducing apoptosis of lymphocytes: polyphenols deplete the mercaptan in lymphocytes and make them unable to survive, thus inducing apoptosis of lymphocytes.⑤Anti-aging effect: polyphenols have the effect of anti-hyaluronidase and anti-elastase, so as to protect elastin fiber and pro?mote collagen synthesis.⑥Anti-allergic effect:studies have found that polyphenols can reduce ovalbumin induced aller?gic reactions.⑦Other functions:betel nut can freshen breath, eliminate bad breath, and resist the activity of cobra venom. At present, domestic and foreign scholars' research on betel nut mainly focuses on arecoline and its carcinogenicity, mutagenicity, effects on reproductive function, addiction and toxicity to the nervous system, and there are few studies on the positive effects of betel nut, especially on it. There is less research on phenolic ingredients. Therefore, this article reviews the polyphenolic chemical constituents of betel nut, and fully excavates its pharmacological activity to provide a reasonable basis for the scientific use of betel nut.

Progress in protective effect and mechanism of 6-gingerol on myocardial ischemia/reperfusion injury / 中国药理学与毒理学杂志

The morbidity and mortality of cardiovascular diseases are very high, which has attracted more and more attention all over the world. Common treatment methods for clinical treatment of acute myocardial infarction include direct percutaneous coronary intervention and coronary artery bypass grafting, which can quickly restore blocked coronary blood flow and reduce the infarct size. However, the inevitable ischemia/reperfusion injury will occur during the recovery of coronary blood flow, its pathological mechanism is complicated, and the Western medicine countermeasures are very limited. Among the current drugs for the treatment of cardiovascular diseases, traditional Chinese medicine has become a research hotspot due to its multiple targets, safety, and low side effects. Ginger is the fresh rhizome of Zingiber offici?nale Rosc., a perennial herbaceous plant in the ginger family. It is a dual-purpose resource of medicine and food. Ginger has the functions of relieving the appearance and dispelling cold, warming up and relieving vomiting, resolving phlegm and relieving cough, and relieving fish and crab poison. The chemical components of ginger mainly include volatile oil, gingerol, diphenylheptane, etc.. Among them, 6-gingerol, as the main active component of gingerols, has obvious phar?macological effects in myocardial protection, anti-oxidation, anti-inflammatory, etc.. Studies have shown that 6-gingerol protects myocardium mainly through anti-oxidative stress, anti-inflammatory, inhibiting cell apoptosis, and preventing cal?cium influx. ① Anti-oxidative stress: oxidative stress is a state where oxidation and anti-oxidation in the body are out of balance, and it is also an important factor leading to myocardial damage. Many studies have confirmed that 6-gingerol has an antioxidant effect, and it is considered a natural antioxidant. 6-gingerol can significantly reduce the degree of oxi?dative stress and the level of reactive oxygen species caused by cardiomyocyte damage, and has a significant cardiopro?tective effect. ② Anti-inflammatory: inflammation can cause substantial cell damage and organ dysfunction, which is another important cause of myocardial damage. 6-gingerol can reduce the levels of inflammatory factors such as inter?leukin-6, interleukin-1β, and tumor necrosis factor-αin cardiomyocytes, and at the same time inhibit the TLR4/NF-κB sig?naling pathway, an important regulatory pathway of inflammation, showing that it may improve myocardial damage through anti-inflammatory effects. ③ Inhibition of apoptosis: apoptosis is a complex and orderly process in the autono?mous biochemical process of cells, and one of the main mechanisms of myocardial injury. This process can be roughly divided into three pathways: mitochondria, endoplasmic reticulum, and death receptors. Among them, the mitochondrial pathway plays an important role, and Bcl-2 and Bax located upstream of this pathway can regulate the entire process of cell apoptosis by regulating the permeability of the mitochondrial membrane. Studies have found that the preventive application of 6-gingerol can reduce cell damage, reduce the number of apoptotic cells, reduce the activity of Bax and caspase-3, and increase the expression of Bcl-2. Therefore, 6-gingerol pretreatment can reduce the damage of cardio?myocytes, and its mechanism may be related to the inhibition of apoptosis.④Prevent calcium influx:calcium overload is involved in the pathogenesis of myocardial ischemic injury, which may be related to excessive contracture, arrhythmia, and mitochondrial Ca2+accumulation that impairs myocardial function. 6-gingerol inhibits the increase of intracellular Ca2+concentration by inhibiting L-type calcium current, thereby reducing extracellular Ca2+ influx, thereby avoiding calcium overload and playing a cardioprotective effect. In summary, 6-gingerol can effectively treat and improve myocardial isch?emia/reperfusion injury, and it has great development potential in the fields of medicine and health products.

Clinical observation on gastroesophageal reflux asthma treated with needling technique / 中国针灸

OBJECTIVE@#To compare the clinical effect on gastroesophageal reflux asthma between the needling technique of acupuncture (acupuncture for promoting the circulation of the governor vessel and reducing the reversed ) and omeprazole enteric capsules (OME).@*METHODS@#A total of 60 patients with gastroesophageal reflux asthma were randomized into an acupuncture group and a western medication group, 30 cases in each one. The basic treatment for anti-bronchial asthma was provided in both of the groups. Additionally, OME was prescribed for oral administration in the western medication group, twice a day, 20 mg each time, for 8 weeks. In the acupuncture group, the needling technique of acupuncture was added. The needles were inserted at the sites inferior to the spinous processes of T to T. Acupuncture was given once in the morning on Tuesday, Thursday and Saturday respectively, totally for 8 weeks. Separately, before and after treatment, the score of reflux disease diagnostic questionnaire (RDQ), the score of asthma control test (ACT) and the tenderness threshold at the sites inferior to the spinous processes of T to T were observed and the clinical effect was evaluated in the two groups.@*RESULTS@#①The remarkably effective and curative rate was 46.7% (14/30) in the acupuncture group, higher than 3.3% (1/30) in the western medication group (<0.01). The asthma control rate was 66.7% (20/30) in the acupuncture group, higher than 13.3% (4/30) in the western medication group (<0.01). ②RDQ score after treatment was lower than that before treatment in either group (<0.05). The decrease range of RDQ score in the acupuncture group was larger than that of the western medication group (<0.05). After treatment, ACT score was increased as compared with that before treatment in either group (<0.05) and the increase range of ACT score in the acupuncture group was larger than that of the western medication group (<0.05). ③The tenderness thresholds at the sites inferior to the spinous processes of T to T and T to T were all increased after treatment as compared with those before treatment in the acupuncture group separately (<0.05). In the western medication group, the thresholds were only increased at the sites inferior to the spinous processes of T, T and T after treatment as compared with those before treatment separately (<0.05). After treatment, the tenderness thresholds at T to T in the acupuncture group were all higher than the western medication group (<0.05).@*CONCLUSION@#The needling technique of acupuncture effectively relieves the symptoms of gastroesophageal reflux asthma and improves the quality of life in the patients and its effect is better than omeprazole enteric capsules.

Professor 's concept and experience in the diagnosis and treatment of gastroesophageal reflux disease / 中国针灸

In view of the five major misunderstandings in the clinical understanding of gastroesophageal reflux disease in traditional Chinese medicine, that is, wrong main symptoms, wrong position of the disease, wrong character of the disease, treating acid with acid, and attaching importance to drugs and neglecting acupuncture-moxibustion in treatment, Professor has proposed the corresponding solving strategies, which includes grasping the main disease, carefully examining the disease position, distinguishing the character of disease, and no acid suppression for acid regurgitation. In addition, Professor highly values the external treatment of traditional Chinese medicine. In particular, the acupuncture therapy of " (promote the circulation of the governor vessel and reduce the reversed )" based on many years of clinical experience provides new ideas and methods for the diagnosis and treatment of gastroesophageal reflux disease in traditional Chinese medicine.

Surgical treatment and prognosis analysis of hilar cholangiocarcinoma / 国际外科学杂志

Objective To analyse the experience and prognosis of surgical treatment of hilar cholangiocarcinoma.Methods Clinical data of 49 patients of hilar cholangiocarcinoma underwent surgical treatment were analyzed retrospectively from January 2011 to December 2017 in Department of Hepatobiliary Surgery,Beijing Chaoyang Hospital affiliated to Capital Medical University.Of the 49 patients,29 patients underwent R0 resection and 10 patients underwent R1 resection according to the patient's condition.The overwall prognosis and R0 resection rate were analyzed.All patients were followed up by outpatient or telephone.The follow-up deadline was December 2017.The long-term prognosis of R0 and R1 resection were compared.Normal distribution data were expressed as (Mean ± SD),while non-normal distribution data were expressed as M(P25,P75).Survival curve was depicted by Kaplan-Meier method,and survival rate was compared by Log-Rank test.Results All patients underwent surgical treatment.There were 5 complications (10.2％) during the perioperative period,and no deaths occurred.Radical resection was performed in 39 patients,with a radical resection rate of 79.6％.The overall median survival time was (27.0± 1.2) months.The survival rates in 6 months,1,3 and 5 years were 95.9％,85.6％,34.5％,6.6％ respectively.The total median survival time of R0 resection and R1 resection was (28.0 ± 6.5) months and (16.0 ± 0.7) months respectively.The 6 months,1,2,and 3 years survival rates were 94.9％,89.7％,43.5％,8.3 ％ and 80.0％,68.6％,0,0 respectively.Conclusion Surgical treatment is safe and effective,and it can improve the prognosis of patients.

Intraoperative frozen pathological diagnosis in radical resection of hilar cholangiocarcinoma / 中华普通外科杂志

Objective To evaluate rapid frozen pathology in the operation of hilar cholangiocarcinoma.Methods Clinical data of 49 patients of hilar cholangiocarcinoma undergoing surgical treatment were analyzed retrospectively from Jan 2011 to Dec 2017 at Department of Hepatobiliary Surgery,Beijing Chaoyang Hospital Affiliated to Capital Medical University to evaluate rapid frozen pathology on operative strategy of hilar cholangiocarcinoma and the prognosis of patients.Results All patients with hilar cholangiocarcinoma underwent intraoperative frozen pathological examination.5 patients adjusted the operation approach because of the discrepancy between frozen pathological examination and preoperative imaging results.47 intraoperative frozen pathological results were consistent with postoperative pathological diagnosis,and the accuracy rate was 95.9％,sensitivity 90％,specificity 97.4％,false positive rate 2.6％,false negative rate 10％.Frozen section margin negative patients had significantly longer survival time(P ＜ 0.05).Conclusions Intraoperative frozen pathological examination can guide the operation approach,greatly improve the resection rate of R0 and the prognosis of patients.

Prognosis and related risk factors in patients with primary liver cancer after liver transplantation / 中华肝胆外科杂志

Objective To evaluate the prognosis and related risk factors in patients with primary liver cancer after liver transplantation. Methods We retrospectively analyzed the clinical data of 298 patients who underwent liver transplantation between January 2013 and December 2017 at Beijing Chaoyang Hospital of Capital Medical University. 121 patients with primary liver cancer on postoperative pathological diagnosis were included into this study. The patients included 108 males and 13 females, aged from 31 to 70 years, with an average of (52. 7 ± 8. 7) years. The prognosis and the related risk factors on prognosis were analyzed. The survival curve was drawn by the Kaplan-Meier method, and the survival rate was compared by the log-rank test. Multivariate Cox regression was used to analyze the prognostic factors. Results Of the 121 patients who were enrolled in this study, 5 patients died during the perioperative period, making a perioperative mortality rate of 4. 1% (5/121). The remaining 115 patients were followed up and the followed up rate was 95. 0% (115/121). The overall 1-, 2- and 3-year survival rates were 81. 0% , 74. 6% and 70. 2% , respectively. The median survival was 41. 5 months. Multivariate analysis showed that preoperative Child grading (RR=3. 028, 95% CI: 1. 625～5. 643) and microvascular invasion (RR=7. 165, 95% CI: 2. 237～22. 951) were independent risk factors of prognosis. The worse the preoperative Child grading, the worse was the prognosis. The prognosis of patients with microvascular invasion was also poor. Conclusions The overall prognosis of patients with primary liver cancer after liver transplantation was good. Preoperative Child grading and pathological microvascular invasion were the main risk factors of prognosis after liver transplantation carried out for primary liver cancer.

Expression of CD147, MMP-9 and HER-2 in patients with gastric cancer and their correlation with clinicopathology and prognosis / 中国基层医药

Objective@#To investigate the correlation between the expression of extracellular matrix metalloproteinase-inducible factor (CD147), matrix metalloproteinase-9 (MMP-9) and human epidermal growth factor receptor-2 (HER-2) in gastric cancer tissues and clinical pathology and prognosis.@*Methods@#From June 2016 to June 2018, 80 gastric cancer specimens from the First People's Hospital of Taizhou were collected as observation group, and another 60 normal specimens of gastric mucosa adjacent to cancer were selected as control group.The expressions of CD147, MMP-9 and HER-2 were detected by SP immunohistochemical method.The positive rates of CD147, MMP-9 and HER-2 protein expression, the positive rates of CD147, MMP-9 and HER-2 protein expression in different pathological characteristics, and the positive rates of CD147, MMP-9 and HER-2 protein expression in different prognosis were compared between the two groups.@*Results@#The positive rates of CD147 (73.75%), MMP-9 (76.25%) and HER-2 (42.50%) in the observation group were higher than those in the control group (21.67%, 25.00%, 5.00%), the differences were statistically significant (χ2=37.233, 36.288, 24.797, all P<0.05). There were no statisticallysignificant differences in the positive expression rates of CD147, MMP-9 and HER-2 protein among different gender, age, tumor diameter and differentiation (all P>0.05). The positive rates of CD147 (93.88%), MMP-9 (95.92%) and HER-2 (61.22%) with lymph node metastasis were higher than those without lymph node metastasis (41.94%, 45.16%, 12.90%), the differences were statistically significant (χ2=26.462, 27.012, 18.142, all P<0.05). The positive rates of CD147 (96.15%), MMP-9 (92.31%) and HER-2 (69.23%) in the death group were higher than those in the survival group (62.96%, 68.52%, 29.63%), the differences were statistically significant(χ2=9.987, 5.484, 11.263, all P<0.05).@*Conclusion@#High expression of CD147, MMP-9 and HER-2 proteins in gastric cancer tissues is closely related to invasion and metastasis, which can become a new prognostic marker and therapeutic target of gastric cancer.

Non-penetrating vascular and tubular tissue closure system in radical resection of adenocarcinoma of pancreatic head combined with major venous resection and reconstruction / 中华普通外科杂志

Objective To analyze the application and effect of non-penetrating vascular and tubular tissue closure system in radical resection of adenocarcinoma of pancreatic head combined with venous resection and reconstruction.Methods A retrospective analysis was made on the clinical data of 78 patients with pancreatic head cancer who underwent radical resection of venous vessels from Feb 2014 to Feb 2018.According to the intraoperative venous resection and anastomosis,the patients were divided into vascular clip group (41 cases) and traditional suture group (37 cases).The preoperative data,intraoperative and postoperative recovery of the two groups were analyzed and compared.Results There were no perioperative deaths and no significant differences in perioperative complications between the two groups (P ＞ 0.05).The anastomotic time of the clip group was (18.6 ± 3.3) min,which was significantly shorter than that of the traditional suture group (39.7 ± 8.5) min,(P ＜ 0.05).There were no significant differences in operation time,intraoperative bleeding volume,ICU time,hospital stay and anastomotic stenosis between the two groups(P＞ 0.05).Conclusion It is safe and feasible to use vascular clip in venous vascular reconstruction in radical resection of carcinoma of the head of the pancreas combined with venous vascular resection.

Analysis on the application of vascular closure system in portal vein reconstruction of liver transplantation: report of 137 cases / 器官移植

Objective To analyze the application effect of non-penetrating vascular closure system in portal vein reconstruction of allogenic liver transplantation in adults. Methods Clinical data of 222 patients undergoing allogeneic liver transplantation were retrospectively analyzed. According to whether vascular closure system was used in portal vein reconstruction during operation, all patients were divided into vascular clip group (n=137) and traditional suture group (n=85). Perioperative conditions, clinical prognosis and complications were statistically compared between two groups. Results All patients successfully completed the surgery. The success rate of one-time portal vein anastomosis was 93.4% (128/137) in the vascular clip group. A total of 14 patients died during perioperative period in this study with a mortality rate of 6.3% (14/222). No portal vein-related complications occurred during perioperative period in both groups. The time of portal vein anastomosis in the vascular clip group was (5.6±1.7) min, which was significantly shorter than (10.7±3.6) min in the traditional suture group (P<0.05). The incidence and grade of perioperative complications did not significantly differ between two groups (all P>0.05). Conclusions It is safe and feasible to utilize vascular closure system to reconstruct the portal vein during liver transplantation. Compared with traditional suture, it can effectively shorten the time of portal vein anastomosis.

Diagnosis and treatment of persistent ascites after liver transplantation / 国际外科学杂志

Persistent ascites is a rare complication in the perioperative period after liver transplantation,it will seriously affect patients' prognosis.The reasons of persistent ascites may be associated with chyle leakage,abdominal infection,portal hypertension and so on.There are also some reasons still unclear.The related examination should be completed as soon as possible to find out the probable reasons.The key to successful treatment depends on the definite diagnosis of the reasons.The treatment strategy and prognosis of persistent ascites due to different reasons.This article focuses on the reasons,risk factors and treatment methods of persistent ascites after liver transplantation.

Application of vascular replacement technique with allogenic blood vessel in radical resection for pancreatic carcinoma: a report of 33 cases / 中华外科杂志

Objective@#To analyze the application of vascular replacement technique with allogenic blood vessel in radical resection for pancreatic carcinoma.@*Methods@#The clinical data of 33 patients with vascular invasion of pancreatic carcinoma who underwent radical resection from April 2013 to April 2017 in Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital were retrospectively analyzed. There were 14 males and 19 females with age of (62.5±10.6)years(ranging from 35 to 78 years). Vascular replacement technique with allogenic blood vessel was used on all patients who underwent radical resection for pancreatic carcinoma. The operation procedure was made according to the specific location of the carcinoma, and the allogenic blood vessel was selected according to the type of vascular invasion. The matching vessel was selected for replacement to the patient who was invaded only one vessel. And the "Y" type of iliac vein was selected for replacement to the patient who was invaded the confluence of portal vein, splenic vein and superior mesenteric vein. After the operation, the patients were followed up by telephone and outpatient review.@*Results@#All of 33 patients were successfully completed the operations. There were 28 patients underwent pancreaticoduodenectomy with vascular replacement, and 5 patients underwent total pancreatectomy with vascular replacement. All the patients were confirmed pancreatic carcinoma and R0 resection according to the postoperative pathology. There were 16 patients with the carcinoma invasion the confluence of portal vein, splenic vein and superior mesenteric vein, 12 patients with the carcinoma invasion the superior mesenteric vein, and 5 patients with the carcinoma invasion the portal vein. There was no perioperative death in this group and no complications related to allogenic blood vessel. The incidence of postoperative complications was 18.2% (6/33), and the incidence of pancreatic fistula was 6.1% (2/33), all of which were biochemical fistula. There were 32 patients were followed up, and the follow-up rate was 96.9%. The median survival time was 14.6 months. The half-year, 1-year and 2-year survival rates were 75.6%, 37.6% and 27.4%.@*Conclusion@#The application of vascular replacement technique with allogenic blood vessel for pancreatic carcinoma has a great significance for improving the R0 resection rate and the prognosis of patients.

Risk factors and treatment of pulmonary infection after liver transplantation / 中华肝胆外科杂志

Objective To investigate the clinical characteristics and the related risk factors of pulmonary infection in patients after liver transplantation.Methods The clinical data of 298 patients who underwent liver transplantation in the Beijing Chaoyang Hospital between January 2013 and December 2017 were retrospectively stndied.The patients were divided into the infection group (n =58) and the control group (n =240) according to whether they had pulmonary infection.The characteristics,diagnosis,treatment,prognosis and risk factors of pulmonary infection were analyzed.Results Pulmonary infection occurred in 58 patients (19.5％) after liver transplantation.Eight patients died in the infection group of pulmonary infection.The mortality rate was 13.8％.The most common pathogenic bacteria were Acinetobacter bauman,Pseudomonas aeruginosa and Klebsiella pneumoniae,which accounted for 28.8％,20％ and 13.8％,respectively for the pulmonary infection.Multivariate analysis showed that the neutrophil ratio,and intensive care unit (ICU) hospitalization time were independent risk factors of pulmonary infection (P ＜ 0.05).Conclusions Pulmonary infection was common after liver transplantation.The treatment strategy should be the use of rational antibiotics and intensive pulmonary management.The neutrophil ratio and ICU hospitalization time were the risk factors of pulmonary infection.

Significance of tumor pathological length in evaluation of prognosis of esophageal squamous cell carcinoma / 中国基层医药

Objective To explore the clinical significance of tumor pathological length in evaluation of prognosis of esophageal squamous cell carcinoma.Methods 421 patients with esophageal squamous cell carcinoma were selected as study subjects.Each patient's data of gender,age,pathological examination(tumor pathological length),survival time,cancer stage,operation mode were collected.The patients were divided into two groups:≤4 cm group(189 cases) and >4 cm group(232 cases), and the constituent ratios of gender,age,or operation mode and the survival rate between the two groups were analyzed.Results There were no significant differences in gender composition,age structure and operation mode between the two groups(x2=2.03,2.41,0.06,all P>0.05);There was positive correlation between tumor pathological length and TNM stage(CMH=68.07,P<0.01).The 25%,50% and 75% quantiles of survival period in the group whose tumor length was less than or equal to 4 cm were 28,40 and 58 months,respectively,which in the group whose tumor length was more than 4 cm were 19,31 and 61 months,and there was significantly difference between the two groups(x2=44.88,P<0.01), the group whose tumor length was less than or equal to 4 cm had higher survival rate than the group whose tumor length was more than 4 cm.In the further stratification analysis by TNM stage,the group whose tumor length was less than or equal to 4 cm had higher survival rate than the group whose tumor length was more than 4 cm in theⅠstage patients(x2=5.61,P<0.05);the group whose tumor length was less than or equal to 4 cm had higher survival rate than the group whose tumor length was more than 4 cm in theⅡstage patients(x2=4.62,P<0.05);the group whose tumor length was less than or equal to 4 cm had higher survival rate than the group whose tumor length was more than 4 cm in the Ⅲ stage patients(x2=4.88,P<0.05).Conclusion Tumor pathological length is an effective prognostic factor for esophageal squamous cell carcinoma,and the critical value can be determined as 4 cm.

Enhancing hRANKL production in Escherichia coli by optimizing culture conditions and lysing program / 生物工程学报

RANKL/RANK/OPG axis is important in bone metabolism regulation, and becomes a popular research area in bone diseases. RANKL is a critical part of RANKL/RANK/OPG axis, and widely required in bone metabolism research. However, the yield of recombinant soluble human RANKL (hRANKL) in Escherichia coli is much lower than mouse RANKL (mRANKL). In this study, by adjusting and stabilizing the pH value of LB medium at 7.5, lowering the inducing temperature to 16 ℃ and optimizing the lysis program, the yield of soluble hRANKL increased by approximately 5 to 12-fold over the non-adjusted group. Our experiment effectively enhanced soluble hRANKL expression in E. coli and might constitute a meaningful attempt to obtain soluble expression of recombinant protein in E. coli.

Propofol attenuates hydrogenperoxide-induced apoptosis in human umbilical vein endothelial cells via multiple signaling pathways / 대한마취과학회지

BACKGROUND: Propofol has been reported to protect vascular endothelial cells against oxidative stress. In this study we investigated its effect on hydrogen peroxide (H2O2)-induced apoptosis of human umbilical vein endothelial cells (HUVECs) and examined the possible signaling pathways. METHODS: HUVECs were pretreated with propofol (1, 5, 25, and 50 microM) for 30 min and then co-incubated with 0.4 mM H2O2 for 4 h. Cell viability was assessed using a Cell Counting Kit-8. Cell apoptosis was analyzed using flow cytometry with annexin V/propidium iodide staining, and evaluated by quantifying caspase-3, Bax, and Bcl-2 expression levels. The expression levels of p38 mitogen activated protein kinase (MAPK), phosphorylated (p)-p38 MAPK, cJun-N-terminal kinases (JNK), phosphorylated (p)-JNK, Akt and phosphorylated Akt [(p)-Akt] (Ser473) were measured by western blotting. RESULTS: H2O2 treatment induced the activation of caspase-3, downregulated Bcl-2 expression, and up-regulated Bax expression, all of which were dose-dependently attenuated by propofol pretreatment. Furthermore, propofol significantly ameliorated H2O2-induced phosphorylation of p38 MAPK, JNK, and Akt in HUVECs. CONCLUSIONS: Propofol can protect HUVECs against H2O2-induced apoptosis via a mechanism that may involve p38 MAPK, JNK, and Akt signaling pathways.