Nutritional support treatment strategies for sepsis / 中华消化外科杂志

Sepsis is divided into sepsis, severe sepsis and septic shock according to the severity. The severe sepsis and septic shock can lead to multiple organ dysfunction syndrome, which is life-threatening. In the early stage of sepsis, catabolism is obviously. Early enteral and parenteral nutrition should actively correct nutrients and vitamin deficiency, and provide the best low protein and moderate amount of non-protein calories. In the recovery period, the body needs enough protein and calories. In different periods of sepsis, patients have different nutritional needs. Therefore, mastering the nutritional support treatment for the sepsis is extremely important for the prognosis of patients.

Nutritional support treatment strategies for sepsis / 中华消化外科杂志

Sepsis is divided into sepsis,severe sepsis and septic shock according to the severity.The severe sepsis and septic shock can lead to multiple organ dysfunction syndrome,which is life-threatening.In the early stage of sepsis,catabolism is obviously.Early enteral and parenteral nutrition should actively correct nutrients and vitamin deficiency,and provide the best low protein and moderate amount of non-protein calories.In the recovery period,the body needs enough protein and calories.In different periods of sepsis,patients have different nutritional needs.Therefore,mastering the nutritional support treatment for the sepsis is extremely important for the prognosis of patients.

Expression of LncRNA TCONS_00023867 in pancreatic cancer and its roles in biological functions / 中华内分泌外科杂志

Objective To verify the expression of long non-coding RNA(LncRNA) TCONS_00023867 in pancreatic cancer tissue and cells,and to explore its effects on cell proliferation,invasion and migration in pancreatic cancer cells.Methods The expression of lncRNA TCONS_00023867 in human pancreatic cancer tissues,adjacent non-cancer tissues,pancreatic cancer cells(Capan-2,AsPC-1,BxPC-3,MIAPaCa-2,PANC-1) and pancreatic normal duct epithelial cell (HPDE6c-7) was detected by quantitative real-time PCR (qRT-PCR).LncRNA TCONS_00023867 over-expression plasmid and its control plasmid PEX-3 were transfected in Capan-2 and PANC-1 cells.Then,the abilities of cell proliferation,invasion and migration were determined by using clone formation assay,CCK-8 assay and Transwell assay,respectively.Furthermore,the expression of p53 protein was examined by Western blot.Results The expression of IncRNA TCONS_00023867 in pancreatic cancer tissues was significantly lower than that in the matched adjacent pancreatic cancer tissue(△Ct value 13.64±0.55vs 8.64± 0.38,P＜0.001).Over-expression of TCONS_00023867,the experimental plate clone count of Capan-2 and PANC-1 cells were respectively lower than that in the empty plasmid vector PEX-3 group (181.3±4.667 vs 227.3± 9.207,P=0.011 2),(86.0±4.933 vs 167.2±2.603,P=0.000 1).The proliferation ability of Capan-2 and PANC-1 was significantly reduced compared with that of the empty plasmid vector PEX-3 group.The migration ability of Capan-2 and PANC-1 was significandy reduces compared with that of the group of empty plasmid vector PEX-3 (57.6±6.809 vs 124.6±8.548,P=0.003),(47.40±7.061 vs 105.2±10.28,P=0.001 7).The invasion ability of Capan-2 and PANC-1 was significantly reduced compared with that of the empty plasmid vector PEX-3 group (46.0± 5.033 vs 120.7±7.055,P=0.001),(64±8.327 vs 118.0±11.53,P=0.019 2).Through western blot experiment,the expression of p53 in Capan-2 and PANC-1 was higher than that in the group of empty plasmid vector PEX-3 (2.192± 0.077 3 vs 1.007±0.018 8,P=0.000 1),(1.816±0.163 vs 0.988±0.012 16,P=0.007 2).Conclusions The level of TCONS_00023867 is decreased in pancreatic cancer tissues and cells.Overexpression of TCONS_00023867 decreases cell proliferation,invasion and migration in pancreatic cancer ceils through increasing the level of p53.

Study on SCARB1 mediated coagulation dysregulation in recipients after liver xenotransplantation / 器官移植

To investigate the changes in the expression levels of scavenger receptor class B member 1 (SCARB 1) in the liver tissues before and after liver xenotransplantation and analyze the relationship between the variations in the SCARB1 expression and coagulation regulating dysfunction in the recipients.Methods The Wuzhishan miniature pig with α-1,3-galactosyltransferase gene-knockout(GTKO) was utilized as the donor and Macaca thibetana was chosen as the recipient.Heterotopic auxiliary liver xenotransplantation models were established.The liver tissue specimen was collected before and after liver xenotransplantation.Primary hepatocytes were extracted from the pig using collagenase digestion method.Human peripheral blood mononuclear cells were obtained by immunomagnetic bead sorting.These two types of cells were co-cultured and supplemented with human plasma to establish cell models with coagulation regulating dysfunction following liver xenotransplantation.Quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) and Western blot were performed to quantitatively measure and statistically compared the expression levels of messenger ribonucleic acid (mRNA) and protein of SCARB1 in the tissue and cell samples.At the cellular level,the expression of SCARB 1 was interfered by lentiviral vector.The coagulation time was detected to validate the effect upon coagulation function.Results The expression levels of SCARB1 mRNA and protein were significantly down-regulated after liver xenotransplantation (both P＜0.05).In the cell models,the expression levels of SCARB1 mRNA and protein in the porcine hepatocytes co-cultured with human monocytes were significantly down-regulated compared with those in porcine hepatocytes without intervention (both P＜0.05).Compared with the non-intervention group,the coagulation time was significantly prolonged after the expression of SCARB1 was interfered by lentiviral vector (P＜0.05).Conclusions The down-regulated expression of SCARB1 in the liver graft is one of the main causes of mediating coagulation regulating dysfunction.Intervention of SCARB1 expression contributes to resolve the coagulation regulating dysfunction in the recipients after liver xenotransplantation.

Application of laparoscopic distal pancreatectomy for treatment of insulinoma / 中华内分泌外科杂志

Objective To evaluate the safety and efficacy of laparoscopic distal pancreatectomy in treatment of insulinoma.Methods Clinical data of 8 cases of insulinoma treated by laparoscopic distal pancreatectomy from Apr.2015 to Apr.2017 were retrospectively reviewed.Results Locations of the insulinoma in distal pancreas were all identified preoperatively by enhanced CT,MRI or somatostatin receptor scintigraphy (SRS).Laparoscopic distal pancreatectomy was applied to 8 cases,including combined splenectomy to 1 case.The operation time,bleeding volume,and postoperative hospital stay was (159±44) min,(125±119) ml and (5.5±1.4) days,respectively.Grade B fistula happened to one patient after surgery.The level of postoperative blood glucoses was normal in all cases.Conclusion Laparoscopic distal panreatectomy is safe,effective,and less invasive in treating insulinoma,with quick recovery and high efficacy in spleen preservation.

Surgical treatment of pancreatic neuroendocrine neoplasms / 中华内分泌外科杂志

Pancreatic neuroendocrine neoplasms (pNENs) are clinically rare,however,it shows an in creasing trend recent years.Surgical management,such as radical resection or debulking,plays an important role in this field.Different procedures can be applied to tumors with different types,locations,and developing stages.The optimal clinical management of pNENs involves a multidisciplinary approach in order to improve prognosis.

Missed diagnosis and misdiagnosis of carcinoma of gallbladder and bile duct in LC / 中华肝胆外科杂志

Objective To pay close attention to and reverse the increasing trend about missed diagnosis and misdiagnosis of carcinoma of gallbladder and bile duct in laparoscopic cholecystectomy(LC). Methods By using retrospective analysis of 17 cases of missed diagnosis and misdiagnosis of carcinoma of gallbladder and bile duct in LC, their Clinical features and proposing protective measures were summarized. Results Seventeen patients including 14 with carcinoma of gallbladder and 3 with carcinoma of bile duct received various therapeutic measures according to their own conditions or aspirations. Conclusion Rapid intraoperative frozen section diagnosis is required for the cases with suspected carcinoma in LC and second operation is performed for those who are pathologically diagnosed with malignant tumor after the first one. No pathological diagnosis is strictly prohibited.

Preparation and Certification of Reference Materials for 3-Amino-2-oxazolidinone Residue in Eel Muscle Lyophilisates / 分析化学

A methodology for preparing and certifying the reference material of 3-amino-2-oxazolidinone(AOZ) in eel muscle lyophilisates was presented. Furazolidone was accessed to eel by dipping fish in pond with furazolidone solution at a dosage of ca 0.16 mg/L. With the metabolism of furazolidone in eel, the muscles contain a certain concentration of AOZ as furazolidone metabolite was obtained. Lyophilization of the muscles was performed in one batch and 400 bags of samples were obtained by the procedure of homogenation, cryodesiccation and irradiation. The homogeneity and stability of the sample was examined. The value of the chemical constituent of the sample was certified through the collaborative analysis program participated by 11 laboratories using isotope dilution liquid chromatography-tandem mass spectrometry, and the uncertainty assessment was performed. The reference materials have been approved as certified reference materials by AQSIQ, China (State General Administration of the People′s Republic of China for Quality Supervision and Inspection and Quarantine) in 2009 after one year of trial period. The serial numbers is GBW(E)100180.

Treatment and prevention of residual gallbladder: a report of 56 cases / 中华肝胆外科杂志

Objective To explore methods for the treatment and prevention of residual gallbladder.Methods Clinical data of 56 patients with residual gallbladder were retrospectively analyzed.Results All 56 cases were diagnosed through clinical imaging examination and cured by selective operation of residual gallbladder resection.Conclusion The residual gallbladder can be diagnosed by repeated biliary symptoms in patients with a history of cholecystectomy and imaging examination.Residual gallbladder resection is an effective therapy for the treatment of residual gallbladder.

Emergency management of iatrogenic injury of portal vein and superior mesenteric vein / 中华肝胆外科杂志

Objective To explore the emergency management and prevention of iatrogenic injury of in-ferior vena cava. Methods A retrospective study was undertaken to investigate the operative procedure and post-operative outcome of 7 patients suffering from iatrogenic injury of inferior vena cava in the course of three nephrectomy, one fight adrenal gland tumor resection, one fight surgical kidney, one right upper retro-peritoneal tumor and one pancreaticoduodenectomy. The gross hemorrhage was controlled by local pressure. Then, abdominal incision was done. Firm pressure on the inferior vena cava was performed to right side for temporary control of hemorrhage. The bleeding part could be found when the hematocele was cleaned. And continuous suture should be done with 3-0 silk or absorbable suture after the crevasse was clamped. Results In these 7 cases, 1 died of hemorrhagic shock and the other 6 had significant effect postoperatively. The asso-ciated injuries were healed well except 1 case of slight edema of lower extremity. Conclusion Iatrogenic inju-ry of inferior vena cava can be treated successfully with correct procedure. Furthermore, the injury could be avoided with exactitude intraoperative procedure.

RhoA gene expression and clinicopathology parameters in HCC patients / 中华普通外科杂志

Objective To investigate the expression of RhoA gene in human hepatocellular carcinoma (HCC) and to discuss its significance during hepatocellular carcinogenesis. Methods Intratumor RhoA expression level was determined and compared with that in adjacent nontumorous hepatic tissues using quantitative real time reverse transcription polymerase chain reaction and Western blot in 64 HCC patients. Results The mRNA levels of RhoA were significantly higher in tumor tissues than that in the unaffected portions (t =3.445 ,P =0.0006). The expression of RhoA mRNA in the primary lesion was higher in patients with venous invasion (t = 2.667, P = 0.009), microscopic satellite lesions (t=2.172,P =0.038), and advanced pTNM stage (stage Ⅱ/Ⅳ; t=2.551,P=0.013) than in those without. There was a significant difference between high RhoA protein levels in the tumor tissues and noncancerous liver tissues in HCC patients (t = 3.532, P = 0.0002), and there was a significant association between high tumor RhoA protein levels and the presence of venous invasion (t = 2.087, P = 0.042), microscopic satellite lesions (t = 2.254, P = 0.031), and advanced pTNM stage (t = 2.812, P = 0.007). Conclusions There is a significant correlation between RhoA expression, tumor stage, and intrahepatic metastasis. The expression of RhoA could be used as a good tumor marker for invasive and advanced carcinoma as well as a prognosis predictor.

The characteristics and treatment of male breast cancer / 中国普通外科杂志

Objective To explore the diagnostic and therapeutic methods for male breast cancer. Methods Clinical data of 11 cases of male breast cancer treated in our hospital from 1992 were analyzed (retrospectively). Results 2 patients were diagnosed at advanced stage and survived 6 and 8 months (respectively) after biopsy. The other 9 patients received radical mastectomy. 3 were lost to follow-up, 1 was found to have pulmonary metastasis after 5 years and combined treatment of traditional Chinese medicine and western medicine was given. Nodules were found under the axillary fossa in another patient at five years after surgery and the nodules were recurrent carcinoma as confirmed by biopsy. The patient has survived for 7 years with radiotherapy and chemotherapy. The other 4 cases have survived 0.5 to 7 years respectively, and are undergoing treatment. Conclusions Early diagnosis of male breast cancer should be emphasized. Aggressive surgery combined with other auxiliary treatments are effective.

Value of MELD score system for the prediction of operative mortality in patients undergoing liver transplantation / 中国普通外科杂志

Objective This study was to evaluate the usefulness of the model of end-stage liver disease (MELD) score in comparison with the Child-Pugh classification to predict postoperative mortality and short-term survival in liver transplant patients. MethodsMELD score and Child-Pugh score were computed for each patient according to the original formula on admission day. Kaplan-Meier survival curves were made using the cut-off points calculated by Youden index. ResultsSix out of 40 patients died within three months, MELD scores and Child-Pugh scores for non-survivors (32.2?8.0, 12.3?2.0) were higher than those for survivors (13.4?6, 9.12?2.31) significantly (P