Progress on biliary flora and primary intrahepatic stone formation / 公共卫生与预防医学

Primary intrahepatic stone （PIS）is one of the intractable diseases in hepatobiliary surgery and an important cause of death from benign biliary tract diseases, and it has a high prevalence in the Yangtze River basin and southeastern coastal areas of China. At present, the mechanism of PIS occurrence has not been fully elucidated, but the role of biliary flora in the formation of PIS has been recognized by more and more studies. This article reviews the research progress of biliary flora in the formation of PIS with a view to strengthening the clinical understanding of mechanism of PIS, increasing the attention to the detection of biliary flora, and providing a reference for the prevention and treatment of PIS and the improvement of prognosis.

Application of Laparoscopic Surgery in Ileostomy Reversal / 肿瘤防治研究

In colorectal cancer surgery, loop ileostomy is sometimes necessary to prevent anastomotic leakage. Although ileostomy reversal is relatively simple, postoperative complication is inevitable. In recent years, laparoscopic surgery has been gradually applied in ileostomy reversal due to its small trauma, fast recovery, and low complications, exhibiting satisfactory short-term outcomes. This review analyzes the application of the laparoscopic technique in ileostomy surgery and explores the potential of total laparoscopic surgery, aiming to provide a new perspective for the clinical application of laparoscopic ileostomy reversal.

Application of constructivism teaching theory combined with PBL teaching mode in the training of new nurses in department of gastroenterology / 中华医学教育探索杂志

Objective:To explore the role of constructivism teaching theory combined with problem-based learning (PBL) teaching mode in the training of new nurses in the department of gastroenterology.Methods:A total of 27 newly recruited nurses in the Department of Gastroenterology in West China Hospital of Sichuan University from August 2018 to August 2019 were selected as the control group, and traditional teaching was adopted. In addition, 24 newly recruited nurses from September 2019 to September 2020 were selected as the research group, using constructivism teaching theory combined with PBL teaching mode. After the training, the teaching effect was compared between the two groups through the assessment results and the training method scores. SPSS 19.0 was used for t test. Results:The research group's newly recruited nurses' theoretical evaluation scores [(95.08±5.61) vs. (91.63±5.27)] and practical skills operation evaluation scores [(94.30±7.22) vs. (87.13±6.84)] were both higher than those of the control group, and the difference was statistically significant ( P<0.05). Compared with the control group, the newly recruited nurses of the research group believed that the combination of constructivism teaching theory and PBL teaching could improve clinical thinking ability, analysis and problem-solving ability, and the degree of integration of theory and practice, mobilize the enthusiasm of autonomous learning, enhance autonomous learning ability, and improve communication ability, cultivate teamwork ability, stimulate interest in learning, improve work confidence and training satisfaction, with statistical significance ( P<0.05). Conclusion:The combination of constructivism teaching theory and PBL teaching mode is beneficial to the training of newly recruited nurses in the department of gastroenterology to independently construct a theoretical framework of knowledge, improve comprehensive ability, and make a useful exploration for the training of newly recruited nurses.

Long-term oncological and functional outcomes of transanal full-thickness resection after non-curative local resection of early rectal cancer / 中华普通外科杂志

Objective:To explore the safety of transanal re-excision (TAR) after positive-margin local resection for early rectal cancer.Methods:A retrospective analysis was made data of 44 patients with rectal cancer after local excision from Mar 2006 to Oct 2018 at the Department of Colorectal Surgery, Cancer Hospital of Chinese Academy of Medical Sciences. All patients had positive margin or suspicious tumor remains after local excision, and subsequently salvage TAR surgery was performed after informed consent was given.Results:Forty-four patients after local excision were with pathologically showed residual condition, including 26 cases of positive margin and 18 cases of suspicious tumor remaining. The pathological types were all adenocarcinoma. Forty-one (93%) patients with pT1 and 3 (7%) patients with pT2. The median follow-up time after salvage TAR was 100 (11-164) months. During follow-up, 3 patients (7%) developed mild anal incontinence. One patient (2%) had local recurrence, 3 (7%) patients had distant metastases, and 3 patients (7%) died of non-tumor specific deaths. The overall 5-year survival rate and disease-free survival rate were 98% and 93 %, respectively.Conclusions:Transannal full thickness tumor re-excision is safe and reliable for the salvage treatment after non-complete local resection of early rectal cancer. The long-term follow-up results show that the 5-year survival rate is comparable to that of radical surgical resection, and with a good anal function.

Short-term outcomes of patients treated with enhanced recovery after surgery combined with laparoscopic colorectal cancer surgery / 中华普通外科杂志

Objective To investigate the safety and efficacy of enhanced recovery after surgery (ERAS) used in laparoscopic colorectal cancer surgery.Methods We conducted a retrospective analysis of the medical records of 99 cases treated with ERAS programed laparoscopic colorectal cancer surgery (ERAS group) and 103 cases treated with traditional perioperative care and laparoscopic colorectal cancer surgery (controlled group) from Mar 2017 to Sep 2017 in our center.Results There was no significant difference in age,gender,BMI,ASA classification,tumor location,operation time,pathological stage and the incidence of postoperative complications between ERAS group and controlled group (all P ＞ 0.05).Compared to control group,ERAS had less blood loss,shorter time to pass first flatus,stool and start diet and shorter hospitalization day,with all the difference statistically significant [(60 ± 63)ml vs.(112 ± 245)ml,(3.0±0.8)dvs.(4.3 ±1.2)d,(3.5 ±1.0)dvs.(4.6±1.3)d,(4.1 ±1.2)dvs.(5.4± 2.0)d,(5.8±2.1)dvs.(7.8±2.5)d,t=-2.021、-9.216、-6.887、-5.252、-6.163,allP＜ 0.05].No patients in both groups suffered from readmission or death within 30 days after surgery.Conclusion Patients treated with ERAS programed laparoscopic colorectal cancer surgery is safe and effective,with rapid recovery and reduced hospital stay.

The role of a workflow in diagnosing biliary causes for acute pancreatitis / 中华内科杂志

ObjectiveTo establish a practical and effective clinical pathway (CP) for the etiological diagnosis of acute biliary pancreatitis.MethodsA total of 2216 patients enrolled were randomly divided into control group (n =1120) and CP group (n =1096) according to different etiological diagnosis methods including following doctor's established experiences and habits and the designed CP in our study.ResultsThere was no significant difference in baseline data between the two groups.The etiology of acute pancreatitis was determined in 91.1％ (999/1096) of cases in the CP group which was significantly higher than the control group (65.5 ％,734/1120),P ＜ 0.05.The enhanced etiological determination of CP group was mainly consisted of the increased detection of biliary stones,duodenal diseases as well as pancreas divisum,P ＜ 0.05.The positive etiological determination of magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography in the CP group were 59.1％ (273/462) and 86.0％ (98/114),respectively.ConclusionsThe CP established in this study significantly enhances the biliary etiological determination of acute pancreatitis. It is easy to be conducted and may be of importance to improve the quality of etiological diagnosis of acute pancreatitis.

Transplantation of autologous peripheral blood stem cells accelerates ulcer cicatrisation in ischemic disease of lower limb arterial / 基础医学与临床

Objective To evaluate the clinical efficacy of transplantation of autologous peripheral blood stem cells(PBSC) for the treatment of toe or heel ulcer and of rest pain in patients with lower limb arterial ischemic diseases.Methods To mobilize patients' own stem cells with G-CSF for 5 days.At the sixth day,PBSC are collected with a blood-cells separator.The PBSC were then intramuscularly injected into ischemic areas of the lower limbs.Results After transplantation,all patients are followed up from 3 to 24 months.The rest pain disappeares in 12 patients,while toe or heel ulcers are cicatrized in 11 cases.However,4 patients lost in following up.ConclusionTransplantation of autologous peripheral blood stem cells is an effective method for the treatment of arterial ischemic disease.

TIPS with covered stents improved shunt insufficiency and portal hypertension:a systematic review / 中国实用内科杂志

Objective To evaluate the improved shunt insufficiency and clinical outcome using covered or bare stents for TIPS.Methods We searched all the main data base to identify trails of TIPS with covered or bare stents in improving shunt insufficiency and clinical outcome and evaluated the quality of included studies.Incidence of shunt insufficiency and clinical relapse relating to portol hypertension were analysed with Revman 4.2.Results Totally 1340 patients undergoing TIPS were included.Randomised controlled(12.8% vs 43.9%,P=0.004)trial and non-randomised controlled trials(11.6% vs 57.6%,P

Diagnosis and treatment of primary angitis of central nervous system / 中国神经精神疾病杂志

Objective 　To investigate methods for the diagnosis and treatment of primary angitis of central nervous system (PACNS). Methods　Radiological and clinical feature, operative resutls of 12 patients with mass lesion presentations of PACNS were analyzed retrospectively. Results　The lesions showed low density on CT and long T1 and long T2 signal on MRI. The ring-wall enhanced lesions on MRI were flowery in 7 patients. Gross total resection of the lesions were performed in 10 patients with excellent recovery postoperatively. Growth of lesions were observed in 2 patients who underwent subtotal resection. Conclusions　 Lesions of PACNS have special appearance on enhanced MRI. More patients with mass lesion presentations of PACNS could be diagnosed preoperatively according to radiological and clinical feature.For these patients, surgery is the optimal treatment at present.

Endovascular repair of aortic diseases:report of 64 cases / 中国普通外科杂志

Objective To explore the methods of the endovascular repair of aortic disease(aortic dissection and aortic aneurysm).Methods We retrospectively analysed 64cases of aortic diseases treated with endovascular repair,including 42cases of aortic dissection(38 were Stanford B,4 were Stanford A) and 22 cases of aortic aneurysms.The stent-grafts were set into the aorta cavity to cover the damaged aortic intima through the femoral artery under local or general anesthesia;4 cases also underwent by-pass vascular operations.In 6 cases the left subclavian artery(LSA) was covered by stent-graft at the endovascular therapy without by-pass operation.Results Eighteen cases of immediate inner-leak were found after the stent placement,a rate of 28.13 %(18/64).No other severe complications occurred,such as stent-graft shift or error placement,aortic rupture,conversion to open-operation or paraplegia.The blood flow of all the vital branches of aorta were obviously improved.The mortality in the perioperative period was 6.25 %(4/64),the time of follow-up was 1-78 months(mean 32 months).Reoperation was done in 2 cases of aortic aneurysm group and 2 cases of aortic dissection group.Conclusions The endovascular repair is a good method for aortic disease.The short and middle term result is satistactory,and the long term follow-up needs to be studied.

Fingerprint of Pogostemon cablin by pyrolysis-gas chromatography and its fuzzy cluster analysis / 中草药

Object To study comparatively the fingerprint of Pogostemon cablin (Blanco) Benth. in different producing area and investigate the effect of pyrolysis temperature and pyrolysis time on the fingerprint Methods Pyrolysis gas chromatography (PGC) and fuzzy cluster analysis were used Results Both similarity and charecteristics were found in the fingerprint of P. cablin in different producing area. The methodological evalulation showed that this method had a good reproducibility, RSD≤2.75% Conclusion This method is simple, rapid and accurate. It is suitable for the quality control of the Chinese materia medica with the important role of pyrolysis temperature and pyrolysis time

Determination of chromatographic fingerprint of Forsythia suspensa by pyrolysis-gas chromatography / 中草药

Object To study comparatively the chromatographic fingerprint of Forsythia suspensa (Thunb ) Vahl in different producing aeras Methods Pyrolysis gas chromatography (PGC) was used Results The similar fingerprint of 13 samples (PGC) appeared The chromatographic overlap of them was over 89%, RSD