Application of concept of enhanced recovery after surgery in the training of hepatic surgery specialists / 中华医学教育探索杂志

Objective:To investigate the application effect of the concept of enhanced recovery after surgery (ERAS) in the training of hepatic surgery specialists.Methods:Sixty attending physicians who had received 6 months of specialist training in the Hepatopancreatobiliary Surgery of the First Affiliated Hospital, School of Medicine, Zhejiang University, China in 2017-2019 were randomly divided into the control group and research group. The control group adopted the traditional training mode of hepatic surgery specialists, and the research group adopted the training mode of hepatic surgery specialists integrating the concept of ERAS. At the end of the training, the two groups were evaluated through theoretical examination and clinical practice. SPSS 25.0 was used for t test and Chi-square test. Results:The scores in theoretical knowledge [(91.70±2.87) vs. (89.60±2.88), P = 0.006], clinical thinking [(93.17±2.78) vs. (86.33±3.70), P < 0.001], and surgical simulation [(92.83±2.84) vs. (89.50±3.31), P = 0.013] were significantly better in the research group than in the control group. The questionnaire results showed that the satisfaction of specialists in the research group was better than that in the control group [(91.50±3.26) vs. (84.67±3.46), P < 0.001]. The results of clinical practice assessment showed that the patients managed by the specialist in the research group had faster postoperative recovery compared with the control group (length of stay: 6.10±1.80 vs. 9.90±1.60, P < 0.001). Conclusion:The training mode of hepatic surgery specialists integrating the concept of ERAS enables specialists to better master the theoretical knowledge and practical operation skills of hepatic surgery, and ultimately benefits patients.

Progress of circulating tumor DNA in cervical cancer / 肿瘤研究与临床

Cervical cancer is a leading cause of cancer death in women. There are no reliable noninvasive indicators to predict the recurrence, metastasis and prognosis of cervical cancer. Circulating tumor DNA (ctDNA) is a kind of DNA fragment released from tumor cells into the blood circulation, which has the advantages of being non-invasive, real-time, and of reflecting the genetic characteristics of tumors. With the improvement of ctDNA detection technology and in-depth research on ctDNA, ctDNA has shown more obvious advantages in early diagnosis, tumor molecular typing, treatment monitoring and recurrence prediction of cervical cancer compared with traditional histological, serological and imaging detection methods. This paper reviews the detection methods of ctDNA and its latest research progress of ctDNA in cervical cancer.

Current status of surgery for portal hypertension in China: a national multi-center survey analysis / 中华器官移植杂志

Objective:To explore the current status of surgery for portal hypertension to grasp current status and future development of surgery in China.Methods:This study is jointly sponsored by China Hepatobiliary & Pancreatic Specialist Alliance & Portal Hypertension Alliance in China (CHESS).Comprehensive surveying is conducted for basic domestic situations of surgery for portal hypertension, including case load, surgical approaches, management of postoperative complications, primary effects, existing confusion and obstacles, liver transplantation(LT), laparoscopic procedures and transjugular intrahepatic portosystemic shunt(TIPS), etc.Results:A total of 8 512 cases of portal hypertension surgery are performed at 378 hospitals nationwide in 2021.Splenectomy plus devascularization predominated(53.0%)and laparoscopy accounted for 76.1%.Primary goal is preventing rebleeding(67.0%) and 72.8% of hospitals used preventive anticoagulants after conventional surgery.And 80.7% of teams believe that the formation of postoperative portal vein thrombosis is a surgical dilemma and 65.3% of hospitals practiced both laparoscopy and TIPS.The major reasons for patients with portal hypertension not receiving LT are due to a lack of qualifications for LT(69.3%)and economic factors(69.0%).Conclusions:Surgery is an integral part of management of portal hypertension in China.However, it is imperative to further standardize the grasp of surgical indications, the handling of surgical operation and the management of postoperative complications.Moreover, prospective, multi-center randomized controlled clinical studies should be performed.

Expert consensus on antiviral therapy of COVID-19 / 中华临床感染病杂志

COVID-19 is caused by a novel coronavirus-severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which has being spreading around the world, posing a serious threat to human health and lives. Neutralizing antibodies and small molecule inhibitors for virus replication cycle are the main antiviral treatment for novel coronavirus recommended in China. To further promote the rational use of antiviral therapy in clinical practice, the National Center for Infectious Diseases (Beijing Ditan Hospital Capital Medical University and the First Affiliated Hospital, Zhejiang University School of Medicine) invited experts in fields of infectious diseases, respiratory and intensive care to develop an Expert Consensus on Antiviral Therapy of COVID-19 based on the Diagnosis and Treatment Guideline for COVID-19 ( trial version 10) and experiences in the diagnosis and treatment of COVID-19 in China. The consensus is concise, practical and highly operable, hopefully it would improve the understanding of antiviral therapy for clinicians and provide suggestions for standardized medication in treatment of COVID-19.

Internal drainage tube versus T tube in laparoscopic common bile duct exploration / 中华肝胆外科杂志

Objective:To study the effect of internal drainage tube and T tube in laparoscopic common bile duct exploration.Methods:The data of 103 patients who underwent laparoscopic common bile duct exploration for the treatment of choledocholithiasis from January 2016 to April 2021 in Dongguan Kanghua Hospital were analyzed, including 50 males and 53 females, aged (50.3±17.2) years old, the age range was 15 to 90 years old. A total of 103 patients were randomly divided into T tube group ( n=60), who received laparoscopic cholecystectomy + choledocholithotomy and stone removal+ T tube drainage, and self-dropping stent group ( n=43), who received laparoscopic cholecystectomy + choledocholithotomy and stone removal + placed with self-dropping stent. The operation time, intraoperative blood loss, postoperative drainage, postoperative hospital stay and incidence of postoperative complications were compared between the two groups. Results:The operation time of self-dropping stent group was (107.2±26.1) min, intraoperative blood loss 10(5, 10) ml, and postoperative hospital stay (6.5±3.5) d, which were better than those of T tube group (143.5±52.7) min, 10(10, 20) ml, (8.8±3.8) d, the differences were statistically significant (both P<0.05). There were no significant difference in postoperative drainage volume and postoperative complications between the two groups (both P>0.05). Conclusion:The internal drainage tube in laparoscopic common bile duct exploration is a safe and reliable surgical method for the treatment of choledocholithiasis, which can significantly shorten the hospitalization time of patients.

Safety and clinical efficacy of invasive treatment for portal vein thrombosis after splenectomy or devascularization / 中华普通外科杂志

Objective:To analyze the safety and clinical efficacy of invasive treatment for portal vein thrombosis after splenectomy or devascularization.Methods:Invasive treatment was retrospectively analyzed from Jan 2016 to Jan 2020. In 319 cases who met the inclusion criteria.Result:There were complications in 41 cases and no death;The average portal vein pressure before and after thrombus clearance treatment was (25.6±4.9) mmHg and (14.7±4.1) mmHg respectively ( t=2.53, P<0.05); Thrombus decreased significantly in most patients. Conclusion:Invasive therapy is a safe and effective method for patients complicated with portal vein thrombosis after splenectomy or devascularization.

Development of a blocking ELISA based on a single-domain antibody target the S1 protein of porcine epidemic diarrhea virus / 生物工程学报

The aim of this study was to develop a blocking enzyme-linked immunosorbent assay (bELISA) based on a biotinylated nanobody target the S1 protein of porcine epidemic diarrhea virus (PEDV) for detecting the anti-PEDV antibodies and evaluating the immune effect of the vaccine. The gene encoding the single-domain antibody sdAb3 target the PEDV S1 protein was amplified and the Avitag sequence was fused at its 3'-end. The PCR product was cloned into the expression vector pET-21b for expression and purification of the sdAb3-Avitag protein. The purified sdAb3-Avitag fusion protein was biotinylated and its activity was determined. Using the recombinant S1 protein as a coating antigen, a bELISA was established and optimized. Serum samples were tested in parallel by the bELISA and a commercial kit. The recombinant vector pET21b-sdAb3-Avitag was constructed to express the tagged sdAb3. After induction for expression, the biotin-labeled sdAb3 (sdAb3-Biotin) with high purity and good activity was obtained. For the optimized bELISA, the coating concentration of the S1 protein was 200 ng/well, the serum dilution was 1:2 and incubated for 2 h, the dilution ratio of the biotinylated sdAb3 was 1:8 000 and incubated for 30 min, the dilution of the enzyme-labeled antibody was 1:5 000 and incubated for 30 min. The bELISA had no cross reaction with the sera of major porcine viruses including transmissible gastroenteritis virus, porcine reproductive and respiratory syndrome virus and showed good specificity and reproducibility. For a total of 54 porcine serum samples tested, the overall compliance rate of the bELISA with a commercial kit was 92.56%. This study developed a rapid and reliable bELISA method, which can be used for serosurveillance and vaccine evaluation for PEDV.

Cognition on diagnosis and treatments of bronchiectasis among respiratory specialists / 中华健康管理学杂志

Objective:To investigate the cognition of the diagnosis and management of bronchiectasis among respiratory specialists.Methods:Between May and June 2020, a questionnaire survey based on expert consensus and guidelines was conducted among respiratory specialists from 50 hospitals from Sichuan and Yunnan provinces. Total 691 questionnaires were distributed and 641 were received. 601 valid questionnaires were chosen for further analysis with an effective recovery rate of 87.0%. The respondents were required to finish the e-questionnaires independently in terms of cognition of diagnosing, severity assessment, treatments and Chinese medicines of bronchiectasis. The responses were collected online and the cognitive levels were evaluated by calculating the correct rates of corresponding questions.Results:540 (89.9%) of the respondents agreed that high-resolution computed tomography (HRCT) was the gold standard for diagnosing of bronchiectasis, but 318 (52.9%) had an incomplete understanding of common radiographic manifestations of bronchiectasis, and different cognitive degrees of common radiographic manifestations of bronchiectasis existed among respondents with different qualifications or working in different levels of hospitals ( P<0.05). Only 118 (19.6%) of the respondents were familiar with severity assessments of bronchiectasis, but 65 (55.1%) of the 118 respondents said they won′t apply these severity assessments to patient during their clinical works. For the treatment of patients with stable bronchiectasis, airway clearance techniques were most recommended by specialists surveyed [410 (68.2%)], among which, postural drainage was the most known method [559 (93.0%)]. For patients undergoing an acute exacerbation, most respondents recommended antibiotics [600 (99.8%)] as the primary treatment, and examinations such as sputum culture [544 (90.5%)], inflammatory markers [523 (87.0%)] should be performed as well. 504 (83.9%) thought that pseudomonas aeruginosa was the most common conditioned pathogen for bronchiectasis. For patients with frequent exacerbations (≥3 per year), 385 (64.1%) of the respondents supported the therapeutic effect of long-term antibiotics, however, among the 385 respondents supporting long-term antibiotics, only [113 (29.4%)] were willing to recommend long-term antibiotic treatment actively during their clinical practice. Besides, 304 (50.6%) respondents held a positive attitude to the clinical effect of traditional Chinese medicine therapies. Among 304 respondents holds the point of supporting, only 86 (28.3%) were willing to recommend traditional Chinese medicine to patients actively, differences about the attitude and clinical behaviors were found between respondents working in different levels of hospitals ( P<0.05). Conclusions:Respiratory specialists′ cognition on diagnosis and treatments of bronchiectasis remains inadequate, and cognitive levels differ among respondents working in different levels of hospitals. There is a gap between respondents′ cognition and clinical practice. Further education and trainings are necessary for improving respiratory specialists′ knowledge for timely diagnosis and standard treatment of bronchiectasis.

Application on different contrast media concentration in the pancreatic CT angiography scanning / 中国辐射卫生

Objective To compare the effects of the different contrast media concentration on the visualization of pancreatic arteries using 64-Detector Spiral CT. Methods 120 cases who underwent abdominal enhancement CT scanning were randomly divided into group A (n = 60) and B (n = 60). The contrast media concentration was 300 mgI/ml for group A and 370 mgI/ml for group B respectively, both groups shared the same contrast media dose algorithm and injection speed, with 0.5 gI/kg body weight and 4 ml/s respectively. Reformating the pancreatic arteries via MIP (maximum intensity projection), VR (volume rendering) and MPR (multi-planar reconstruction). Results The CT value of the abdominal aortic celiac opening of group B is significantly higher than A (P < 0.01). The visualization scores of pancreatic arteriesin Group B are significantly higher than A (P < 0.05). The visualization ratios of pancreatic arteriesin Group Bare higher than A, the differences of AIPDA、PIPDA、DPA、TPA、PMA、CPA between the 2 Groups have statistically significant (P < 0.05). Conclusion Pancreatic arteries could have a better visualization by using 370 mgI/ml contrast media in pancreatic artery scanning.

Experiment on Inhibiting NEK7 to Promote Apoptosis of Hepatocellular Carcinoma Cells / 肿瘤防治研究

Objective To use in vitro experiments to verify the changes of proliferation, senescence and apoptosis of hepatocellular carcinoma cells after inhibiting the expression of NEK7, and to explore the related molecular mechanism. Methods Western blot and RT-PCR were used to detect the expression of NEK7 in hepatocellular carcinoma cells and THLE-2 cells. A viral vector was designed to inhibit the expression of NEK7 based on the gene sequence. After hepatocellular carcinoma cells were transfected, we observed the changes of proliferation activity, cell senescence, cell apoptosis and cell cycle in vitro. Western blot was used to detect the expression of cell cycle-related factors. Results Compared with THLE-2 cells, NEK7 was highly expressed in hepatocellular carcinoma cells. After inhibiting the expression of NEK7 with shRNA, the proliferation of hepatocellular carcinoma cells was inhibited, the proportions of cell senescence and apoptosis were increased, meanwhile, the cell number in stage S and G2/M was significantly reduced, the cell cycle progression was blocked, the expression levels of C-myc, c-Fos, cyclin D1 and cyclin E were inhibited, P16 and P27 expression were increased, and CDK2, CDK4 and CDK6 expression were not significantly changed. Conclusion After inhibiting the expression of NEK7, the proliferation ability of hepatocellular carcinoma cells is reduced, cell senescence is promoted and apoptosis is induced; meanwhile, the cell cycle progress is blocked.

A tetravalent single-chain variable fragment antibody for the detection of staphylococcal enterotoxin A / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Staphylococcal enterotoxin A (SEA) synthesized by

Chlorophyll content for millet leaf using hyperspectral imaging and an attention-convolutional neural network / Estimativa do teor de clorofila para folhas de milheto usando imagens hiperespectrais e uma rede neural atenção-convolucional

ABSTRACT: Chlorophyll is a major factor affecting photosynthesis; and consequently, crop growth and yield. In this study, we devised a chlorophyll-content detection model for millet leaves in different stages of growth based on hyperspectral data. The hyperspectral images of millet leaves were obtained under a wavelength range of 380-1000 nm using a hyperspectral imager. Threshold segmentation was performed with near-infrared (NIR) reflectance and normalized difference vegetation index (NDVI) to intelligently acquire the regions of interest (ROI). Furthermore, raw spectral data were preprocessed using multivariate scatter correction (MSC). A correlation coefficient-successive projections algorithm (CC-SPA) was used to extract the characteristic wavelengths, and the characteristic parameters were extracted based on the spectral and image information. A partial least squares regression (PLSR) prediction model was established based on the single characteristic parameter and multi-characteristic parameter fusion. The determination coefficient (Rv 2) and the root-mean-square error (RMSEv) of the validation set for the multi-characteristic parameter fusion model were reported to be 0.813 and 1.766, respectively, which are higher than those obtained by the single characteristic parameter model. Based on the multi-characteristic parameter fusion, an attention-convolutional neural network (attention-CNN) (Rv 2 = 0.839, RMSEv = 1.451, RPD = 2.355) was established, which is more effective than the PLSR (Rv 2 = 0.813, RMSEv = 1.766, RPD = 2.167) and least squares support vector machine (LS-SVM) models (Rv 2 = 0.806, RMSEv = 1.576, RPD = 2.061). These results indicated that the combination of hyperspectral imaging and attention-CNN is beneficial to the application of nutrient element monitoring of crops.

RESUMO: A clorofila é um fator importante que afeta a fotossíntese e, consequentemente, o crescimento e o rendimento das culturas. Neste estudo, um modelo de detecção de conteúdo de clorofila é construído para folhas de milheto em diferentes estágios de crescimento, com base em dados hiperespectrais. As imagens hiperespectrais dos diferentes estágios de crescimento das folhas de milheto foram obtidas para 380-1000 nm, utilizando um gerador de imagens hiperespectrais. Uma segmentação de limiar foi realizada com refletância no infravermelho próximo (NIR) e índice de vegetação com diferença normalizada (NDVI) para adquirir de forma inteligente as regiões de interesse (ROI). Além disso, os dados espectrais brutos foram pré-processados usando o método de correção de dispersão multivariada (MSC). Um algoritmo de projeção de coeficiente de correlação sucessivo (CC-SPA) foi utilizado para extrair os comprimentos de onda característicos, e os parâmetros característicos foram extraídos com base nas informações espectrais e de imagem. O modelo de previsão de regressão parcial dos mínimos quadrados (PLSR) foi estabelecido com base nos parâmetros de característica única e na fusão de parâmetros de característica múltipla. O coeficiente de determinação (Rv2) e o erro quadrático médio da raiz (RMSEv) do conjunto de validação para o modelo de fusão de parâmetros com várias características foram obtidos como 0,813 e 1,766, sendo melhores do que os do modelo de parâmetro de característica única. Com base na fusão de parâmetros com várias características, foi estabelecida uma rede neural atenção-convolucional (atenção-CNN) (Rv2 = 0,839, RMSEv = 1,451, RPD = 2,355) mais eficaz que o PLSR (Rv2 = 0,813, RMSEv = 1,766, RPD = 2,167) e mínimos quadrados que suportam modelos de máquina de vetores (LS-SVM) (Rv2 = 0,806, RMSEv = 1,576, RPD = 2,061). Estes resultados indicam que o modelo atenção-CNN atinge uma previsão efetiva do teor de clorofila nas folhas de milheto usando os dados hiperespectrais. Além disso, esta pesquisa demonstra que a combinação de imagens hiperespectrais e a atenção-CNN se mostra benéfica para a aplicação do monitoramento dos elementos nutricionais das culturas.

Research updates on the mechanism and preogress of portal vein thrombosis prevention after splenectomy and esophagogastric devascularization / 中华肝胆外科杂志

At present,splenectomy and extensive esophagogastric devascularization is one of the effective treatments for relieving hypersplenism in patients with cirrhosis,relieving portal hypertension,and reducing upper gastrointestinal bleeding caused by rupture of esophagogastric varices.However,portal vein thrombosis is one of the most common serious complications of splenectomy and devascularization in patients with cirrhosis.Because of its high incidence and mortality of PVT,it has become the focus of disputes in the surgical field.In recent years,with the improvement of medical technology,many domestic and foreign scholars have conducted high-quality researches on the prevention of PVT in the perioperative period of splenectomy and devascularization.This paper summarized the research progress during recent years in combination with relevant literature.

Surgical diagnosis and treatment of portal vein thrombosis / 临床肝胆病杂志

Portal vein thrombosis refers to thrombotic lesions in the portal vein and is caused by various etiologies. Its clinical manifestations vary with location, extension, degree of vascular occlusion, and formation time, and severe thrombosis may cause gastrointestinal congestion and necrosis, liver insufficiency, esophagogastric variceal bleeding, and portal hypertensive biliary disease and even threatens patients’ life. Color Doppler ultrasound and contrast-enhanced abdominal computed tomography/magnetic resonance imaging are important auxiliary examinations for the diagnosis of portal vein thrombosis and play a vital role in early diagnosis and treatment, severity evaluation, and guidance for targeted treatment of this disease. Therapies of portal vein thrombosis depend on its severity and mainly target portal vein thrombosis and its complications. Surgical treatment should be performed for patients with intestinal congestion and necrosis, portal hypertension with esophagogastric variceal bleeding, splenomegaly, hypersplenism, portal hypertensive biliary disease, and end-stage liver disease. This article reviews the advances in the etiology, clinical manifestations, diagnosis, and surgical treatment of portal vein thrombosis.

Limonoids from seeds of A. Juss. and their cytotoxic activity

Four new limonoid-type nortriterpenoids, 1-detigloyl-1--methacryloylsalannin (), 28-deoxo-2,3-dihydronimbolide (), 12-acetoxy-3--acetyl-7--tigloylvilasinin () and 12-acetoxy-3--acetyl-7--methacryloylvilasinin (), along with five known ones, were isolated from seeds of A. Juss. Their structures were elucidated by various spectroscopic methods, including UV, IR, MS, NMR, X-ray crystallography, quantum chemical calculation, as well as by comparison of their spectroscopic data with those reported. In the cytotoxic assay, showed inhibitory activity against human breast cancer MDA-MB-231 cell line with IC value of 7.68±1.74 μmol/L, and inhibited growth of human cervical cancer Hela cell line, melanoma A375 cell line and promyelocytic leukemia HL-60 cell line, with IC 12.00±2.08, 17.44±2.11, and 13.95±5.74 μmol/L, respectively.

Postoperative complications and survival analysis of 1 118 cases of open splenectomy and azygoportal disconnection in the treatment of portal hypertension / 中华外科杂志

Objective@#To analyze the recent postoperative and long-term postoperative complications of open-splenectomy and disconnection in patients with portal hypertension.@*Methods@#There were 1 118 cases with portal hypertension who underwent open splenectomy and azygoportal disconnection from April 2010 to September 2015 at Department of Surgery, People′s Liberation Army 302 Hospital. Retrospective case investigation and telephone follow-up were conducted in October 2016. All patients had history of upper gastrointestinal bleeding before operation. Short-term complications after surgery were recorded including secondary laparotomy of postoperative abdominal hemostasis, severe infection, intake disorders, liver insufficiency, postoperative portal vein thrombosis and perioperative mortality. Long-term data including postoperative upper gastrointestinal rebleeding, postoperative survival rate and incidence of postoperative malignancy were recorded, too. GraphPad Prism 5 software for data survival analysis and charting.@*Results@#Postoperative short-term complications in 1 118 patients included secondary laparotomy of postoperative abdominal hemostasis(1.8%, 21/1 118), severe infection(2.9%, 32/1 118), intake disorders(1.0%, 11/1 118), liver dysfunction (1.6%, 18/1 118), postoperative portal vein thrombosis(47.1%, 526/1 118)and perioperative mortality(0.5%, 5/1 118). After phone call following-up, 942 patients′ long-term data were completed including 1, 3, 5 years postoperative upper gastrointestinal rebleeding rate(4.4%, 12.1%, 17.2%), 1, 3, 5-year postoperative survival rate(97.0%, 93.5%, 90.3%); the incidence of postoperative malignant tumors in 1, 3 and 5 years were 1.7%, 4.4% and 6.2%.@*Conclusions@#Reasonable choosing of surgical indications and timing, proper performing the surgery process, effective conducting perioperative management of portal hypertension are directly related to the patient′s short-term prognosis after portal hypertension. Surgical intervention can reduce the rates of patients with upper gastrointestinal rebleeding, improve survival, and do not increase the incidence of malignant tumors.

Technical advancement in surgical treatment of portal hypertension / 中华肝脏病杂志

Recently, there have been many developments and improvements in portal hypertension surgery, but there are still many controversies regarding the surgical indications, the timing of surgery, and the choice of surgical procedures. Minimally invasive laparoscopy and robotics are the leading direction for the development of surgical techniques for portal hypertension. Surgical selection procedures should be based on evidence-based, but guidelines should not be blindly followed. Surgical development needs to strengthen multidisciplinary cooperation, and surgical reform is the driving force for surgical development.

Analysis of peripheral blood lymphocyte subsets in multiple myeloma patients with different immunophenotypes / 肿瘤研究与临床

Objective To explore the clinical significance of peripheral blood lymphocytesubsets detection in multiple myeloma (MM) patients with different immunophenotypes. Methods A total of 40 MM patients in People's Hospital of Xinjiang Uygur Autonomous Region from January 2016 to June 2016 were selected as the research objects, and 20 healthy examinations were treated as the control group. Marrow and blood samples were collected to detect the expressions of antigens and peripheral blood lymphocytesubsets by using flow cytometry. Besides, immunophenotype and the differences of lymphocytesubsets between the two groups were analyzed. Results The expression rates of CD138, CD38, CD56, CD19, CD20, CD45 were 100 %(40/40),100 %(40/40),75 %(30/40),0,20 %(8/40),0 in MM group and 100 %(20/20),100 %(20/20), 0,100 %(20/20), 100 %(20/20),75 %(15/20)in the control group.There were two kinds of immunophenotypes in MM group including CD138+CD38+CD56-CD19- (10 cases) and CD138+CD38+CD56+CD19- (30 cases). The absolute value of CD3+[(924±341)/ml vs. (1 474±270)/ml], CD4+[(410±163)/ml vs. (871±214)/ml], CD4+/CD8+[(1.0±0.3)/ml vs. (1.6±0.5)/ml], CD19+[(72±26)/ml vs. (277±89)/ml] was lower in MM group compared with the control group(P <0.05). There was no statistical difference in the absolute values of peripheral blood lymphocytesubsets for the patients with different immunophenotypes in MM patients (all P > 0.05). Conclusions Flow cytometry could help to type accurately the different immunophenotypes, distinguish the benign and malignant of plasmocytes and assist the diagnosis for the MM patients. Peripheral blood lymphocytesubsets analysis can be used to reflect the immunity of MM patients.

Efficacy and safety of continuous regional arterial infusion to treat patients with severe acute pancreatitis / 中华肝胆外科杂志

Objective To investigate the efficacy and safety of continuous regional arterial infusion (CRAI) in patients with severe acute pancreatitis (SAP).Methods One hundred SAP patients (including 41 gallstone,26 alcoholism,13 hypertriglyceridemia,11 after heavy meals,and 9 unknown) who were admitted into our hospital from January 2013 to October 2017 were assigned to the CRAI group (n =58) and the control group (n =42).The levels of laboratory measurements,hospitalization time and costs,complications and outcomes were compared between the two groups.Results On the sixth and tenth day of treatment,the levels of white blood cell,hemodiastase,urine amylase,blood glucose,blood calcium and APACHE-Ⅱ score improved in both the 2 groups.The degrees of improvement in the CRAI group were better than that in the control group.The abdominal pain relief time [(3.3± 1.2)d vs.(5.9±2.3)d],hemodiastase recovery time [(7.9±1.8)d vs.(13.3±2.5)d],and hospitalization stay [(21.3±3.6)d vs.(32.4±4.3)d] were shorter in the CRAI group.The costs were similar in the two groups.Retroperitoneal infection,pancreatic pseudocyst,and pancreatic drainage were less in the CRAI group.The improved and cure rates were 94.8％ and 70.7％ in the CRAI group,which were higher than those in the control group (71.4％ and 47.6％,respectively).Moreover,the ineffective treatment and mortality rates were 5.2％ and 1.7％ in the CRAI group,which were lower than those in the control group (28.6％ and 14.3％,respectively).Conclusions CRAI was an efficacious and safe treatment for patients with SAP.It can be used as an alternative to other effective treatments.

Postoperative portal vein thrombosis and the liver function after splenectomy and pericardial devascularization / 中华肝胆外科杂志

Objective To study the impact of splenectomy and pericardial devascularization on the occurrence and development of portal vein thrombosis and the liver function in patients with cirrhosis complicated by portal hypertension.Methods 29 patients with cirrhosis and portal hypertension who underwent splenectomy and pericardial devascularization in the 302 Hospital of PLA from December 2012 to June 2013 were retrospectively studied.The incidences of PVT before and after operation were monitored.The liver function was assessed using the Child-Pugh classification.Results 29 patients with cirrhosis and portal hypertension underwent splenectomy and pericardial devascularization.The incidences of PVT in the preoperative period,12 days,3 months,6 months after operation were 10.3％,89.7％,51.7％,24.1％,respectively.The Child-Pugh scores in the preoperative period,12 days,3 months,6 months after operation were (5.2 ± 0.4),(5.6 ± 0.7),(5.2 ± 0.7),(5.3 ± 0.7),respectively.Conclusions The incidences of postoperative PVT increased after operation,but it decreased on long-term follow-up after operation.The liver function did not change.