Analysis for the short-term efficacy and long-term prognosis of laparoscopic and laparotomy radical resection for gallbladder cancer / 中华外科杂志

Objective: To compare the short-term efficacy and long-term prognosis of laparoscopic and laparotomy radical resection for gallbladder cancer(GBC). Methods: From January 2010 to December 2020,the clinical data and survival information for 133 patients who underwent radical resection of GBC at the Department of Hepatopancreatobiliary Surgery,Zhejiang Provincial People's Hospital,were retrospectively collected. Eighty patients(23 males and 57 females) underwent laparoscopic radical resection and had a median age(M(IQR)) of 66.0(12.8)years(range:28.0 to 82.0 years). Fifty-three patients(45 males and 8 females) who received laparotomy were 63.0(6.0)years old(range:45.0 to 80.0 years old). There were no significant differences in age,gender,body mass index,preoperative albumin,preoperative total bilirubin,N stages,vascular invasion,peri-neural invasion or tumor differentiation between the laparoscopic and laparotomy group(all P>0.05). But there were significant differences in preoperative CA19-9(Z=-2.955, P=0.003), preoperative ALT level(Z=-2.801,P=0.031) and T stage (χ2=19.110,P=0.007) between the two groups. A non-parametric test was used for quantitative data. χ2 test or Fisher exact probability method was used for count data. Results: Patients in the laparoscopic group did not differ from those in the laparotomy group in terms of length of operation,number of lymph node yield,number of positive lymph nodes,the incidence of intraoperative gallbladder rupture,incidence of postoperative bile leakage,abdominal bleeding or abdominal infection,30-day mortality,90-day mortality, the incidence of incision implantation or peritoneal cavity metastasis(all P>0.05). Patients in the laparoscopic group showed less intraoperative bleeding(100.0(200.0)ml vs. 400.0(250.0)ml)(Z=-5.260,P<0.01),fewer days with drainage tube indwelling(6.0(3.8)days vs. 7.0(4.0)days)(Z=-3.351, P=0.001), and fewer postoperative days in hospital(8.0(5.0)days vs. 14.0(7.5)days)(Z=-6.079,P<0.01) than those in the laparotomy group. Patients in the laparoscopic group displayed better overall survival (P<0.01) and progression-free survival (P<0.01). Subgroup analysis for GBC of T1b-T2 and T3 stages revealed comparable overall survival and progression-free survival between the laparoscopic and laparotomy groups (P>0.05). Conclusions: Laparoscopic radical resection can achieve long-term survival for GBC comparable to that with open surgery. Laparoscopic radical resection has advantages over open surgery regarding surgical trauma and postoperative recovery.

The mechanism underlying pathogenesis of Parkinson's disease and the progress in its therapeutics / 医学研究生学报

Parkinson′s disease (PD) is a neurodegenerative disorder, characterized by progressive loss of dopaminergic neurons in the substantia nigra. The clinical manifestations of PD include motor and non-motor symptoms. There are around 5 millions PD patients in China, accounting for half of the total PD cases in the world. The mechanisms underlying PD pathogenesis remain to be elucidated, but it is widely accepted that abnormal protein aggregation, mitochondria dysfunction, and oxidative stress are the key causative factors of PD. The regular treatment for PD includes medication of which L-dopa is the most commonly prescribed, surgical treatment, and physiotherapy. In recent year, with the progress in biotechnology and understanding of mechanisms underlying PD, novel therapeutics such as cell replacement, gene therapy, deep brain stimulation emerge, which substantially benefit the treatment of PD. In present review, based on the molecular mechanisms underlying PD pathogenesis, we summarized and discussed current therapeutic strategy on PD.

Selective exclusion of hepatic outflow and inflow in hepatectomy for huge hepatic tumor / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the effects of selective hepatic vascular exclusion (SHVE) on prevention of serious hemorrhage and air embolism during hepatectomy and on the liver function after operation.</p><p><b>METHODS</b>From January 2004 to March 2007, 29 huge hepatic tumors were resected in our department. Both SHVE and Pringle maneuver were used to control the blood loss during hepatectomy. They were divided into two groups: SHVE group (15 cases) and Pringle group (14 cases). Data regarding the intraoperative and postoperative courses of the patients were analyzed.</p><p><b>RESULTS</b>There was no significant difference between the two groups regarding the age, sex, tumor size, cirrhosis, HbsAg positive rate and operating time (P > 0.05). Intraoperative blood loss was reduced significantly in the SHVE group (P < 0.05). The serum prealbumin levels on the postoperative day 1, 3 and 7 in SHVE group were significantly higher than those in the Pringle group (P < 0.05). The serum ALT value in SHVE group was significantly lower than that in the Pringle group on postoperative day 1, 3 and 7. The mean drainage volume in SHVE group was significantly less than that in the Pringle group on postoperative day 1 and 2. Liver failure occurred in two cases of the Pringle group, while no one in the SHVE group. Rupture of hepatic vein with massive blood loss occurred in 3 cases and air embolism in one case of the Pringle group, but did not occur in any case of the SHVE group.</p><p><b>CONCLUSION</b>When the selective exclusion of hepatic outflow and inflow is applied in hepatectomy, the resection rate of huge hepatic tumors and operative tolerance of hepatectomy are improved. It is a safe and rational operation type, and provides an optimal choice for hepatectomy.</p>

Inhibiting effects of high intensity focused ultrasound on Echinococcus granulosus protoscolices in vitro / 中国地方病学杂志

Objective To evaluate the acute and delayed killing effect of high intensity focused ultrasound (HIFU) on Echinococcus granulosus(E. granulosus)protoscolices in vitro.Methods E. granulosus protoscolices were treated with different dosage of effective power(0,25,50,100,200,250 W)and time(5,10,20,30,40,50,60 s)of HIFU in vitro to obtain the dosage-effect curves.Then the survival pmtoscolices were incubated,and the mortality of each group was counted daily.The protoscolicidal effects were investigated by trypan blue exclusion assay.Results Compared with the untreated group,the Vitality of E.granulosus protoscolices significantly decreased immediately after treated by HIFU of different dosage(F=5201.59 vs 1865.65,P＜0.05),there were the interaction both different dosage and time(F=214.50,P＜0.05).The protoscolices were broken into pieces by HIFU of 250 W×40 s,whereas the growth of the surviving protoscolices after exposed to HIFU was obvious suppressed.Both the acute killing effect and the delayed inhibitory effect showed a dosage-dependant manner.The inhibitory effect increased along with the increased dosage of HIFU(P＜0.05).The inhibitory effect in 50 W×10 s group was stronger than 25 W×20 s group(P＜0.05).The mortality was increased in parallel with the increase of HIFU dosage.Conclusions HIFU show an effective immediately killing effect,as well as a growth-inhibiting effect on the E.granulosus protoscolices in vitro.

Diagnosis and treatment of benign duodenal tumor / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the diagnosis and treatment of benign duodenal tumor.</p><p><b>METHODS</b>Clinical data of 14 patients with benign duodenal tumor confirmed pathologically or by operation from Oct.1988 to Oct.2001 were analyzed retrospectively.</p><p><b>RESULTS</b>Of 14 patients, 5 had Brunner's grand adenoma, 4 mesenchymoma, 2 leiomyoma, 2 hemangioma, 1 lipoma. Upper abdominal discomfort (64% ), gastrointestinal bleeding(50% ) and abdominal pain(20% ) were common manifestations. All cases received gastroscopy and only one case was diagnosed. Five cases received duodenoscope and the diagnosis was confirmed in 4 cases. Nine cases received hypotonic duodenography and lesions were found in 8 cases. Digital subtraction angiography was performed in 3 cases and detected all lesions. Computed tomographic scan and B-ultrasound were performed in 2 cases and only one case was diagnosed. Eleven cases (79% ) got definite diagnosis before operation. Tumor resection was performed in all patients. Perioperative death occurred in one patient. No recurrence occurred in 13 cases after following up from 2 to 11 years.</p><p><b>CONCLUSION</b>Upper abdominal discomfort and gastrointestinal bleeding are common features in patients with benign duodenal tumor. Duodenoscopy and hypotonic duodenography are good diagnostic approaches. Surgical tumor resection is the first choice of treatment.</p>

Protecting effect of human-derived neurotrophin-6 on retrogradely degenerated motoneurons of facial nucleus of rats / 中国应用生理学杂志

<p><b>AIM</b>The protecting effect of human-derived neurotrophin-6 (NT-6) on injured neurons was investigated to test the neurobiological characteristics of human-derived NT-6.</p><p><b>METHODS</b>Adult SD rats were used and divided into two groups, normal control group and experiment group. The right facial nerve of the experimental rats was sectioned. The experimental animals were subdivided into three groups, blank control group, NT-6 group and saline control group. The rats were raised for two weeks. Brain stem of the rats was removed and transversely sliced. Nissle stain and ChAT immunohistochemical stain of the slices were carried out to observe the role of NT-6 in protecting facial motoneurons.</p><p><b>RESULTS</b>The number of the ChAT positive neurons and the intensity of Nissle stain in the facial nucleus of NT-6 group were significantly augmented compared with that of the blank and saline control groups.</p><p><b>CONCLUSION</b>The human-derived NT-6 could partially protect the facial motoneurons from retrograde degeneration induced by their axon damage.</p>

Effect of stimulation of the facial nucleus on discharge of respiratory neurons in the pre-Bözinger complex and its neurotransmitter mechanism in rats / 生理学报

The experiments were carried out on adult Sprague-Dawley rats. We investigated the discharge response of respiratory neurons (RNs) in the pre-Bözinger complex (PBC) to electrical stimulation of the facial nucleus in which the motor neurons were retrogradely degenerated and the antagonistic effects of microiontophoresis of CNQX, bicuculline (BIC), strychnine (Stry) and atropine on the discharge responses of the neurons. In 12 rats with retrograde degeneration of the facial motor neurons, 116 RNs in the PBC ipsilateral to the facial nerve sectioned were extracellularly recorded. The response of pre-inspiratory (Pre-I) (24 / 26) and inspiratory (I) (30 / 35) neurons to the electrical stimulation of the facial nucleus was mainly excitatory, and the response of expiratory (E) (20 / 22) and inspiratory-expiratory phase-spanning (I-E) (28 / 33) neurons was mainly inhibitory. CNQX partially or completely block the excitatory effect of the stimulation on Pre-I (18 / 24) and I (23 / 27) neurons. Stry could partially or completely block the immediate transient inhibition on Pre-I (12 / 18) and I (14 / 23) neurons and the inhibitory effect on I-E (20 / 28) and E (9 / 16) neurons induced by the stimulation. BIC partially or completely blocked the inhibitory effect on I-E (22 / 25) and E (9 / 9) neurons induced by the stimulation. Atropine did not have obvious influence on the response of RNs to the stimulation. These results suggest that non-motoneurons in the facial nucleus may participate in the modulation of respiration by affecting the activities of RNs in the PBC and that Glu, GABA and Gly serve as neurotransmitters or modulators to regulate the activities of the RNs in the PBC and hence the rhythmic respiratory movement.

Effects of medullary ischemia on respiratory and blood pressure induced by ligating basilar artery in cat / 中国应用生理学杂志

<p><b>AIM</b>Observations on medullary ischemia region, the morphology of neurons and changes of respiration and blood pressure were made, in order to give evidences on how medullary ischemia affects respiration and circulation and give some advices on how to protect from it.</p><p><b>METHODS</b>Using cats as the experimental animals, the different parts of the basilar artery trunk were ligated. The changes in the density of blood vessels, the morphology of neurons in the brainstem, the electromyogram (EMG) of the diaphragm and the blood pressure of the femoral artery were investigated.</p><p><b>RESULTS</b>The density of blood vessels notably decreased in the medulla after ligating the basilar artery trunk. The ischemic range induced by ligation of the different parts of the basilar artery trunk overlapped, mainly locating in the medulla rostral to the obex. The soma were swelled and the Nissl bodies decreased in some of neurons in the ischemic region of medulla. The duration of inspiration (T1) and expiration (TE) shortened, respiratory frequency (RF) increased, and mean blood pressure (MBP) decreased in the experimental groups (P < 0.05).</p><p><b>CONCLUSION</b>There is an obvious overlap of the areas in which blood supplied by different parts of the basilar artery trunk. Medullary ischemia can involve in changes of respiration and blood pressure. The ischemic damage of neurons in the medulla might be the structural basis of the changes in the respiratory and circulatory functions.</p>