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Less than a year after its emergence, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected over 22 million people worldwide with a death toll approaching 1 million. Vaccination remains the best hope to ultimately put this pandemic to an end. Here, using Trimer-Tag technology, we produced both wild-type (WT) and furin site mutant (MT) S-Trimers for COVID-19 vaccine studies. Cryo-EM structures of the WT and MT S-Trimers, determined at 3.2 [A] and 2.6 [A] respectively, revealed that both antigens adopt a tightly closed conformation and their structures are essentially identical to that of the previously solved full-length WT S protein in detergent. These results validate Trimer-Tag as a platform technology in production of metastable WT S-Trimer as a candidate for COVID-19 subunit vaccine.
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Objective:To compare the short-term outcomes of patients undergoing laparoscopic pancreaticoduodenectomy (LPD) and those with open pancreaticoduodenectomy (open pancreatiloduodenectomy, OPD).Methods:The clinical data of 85 patients with LPD and 103 patients with OPD at our hospital from Jun 2017 to Jun 2019 were analyzed retrospectively.Results:There was no significant difference in clinical data and between the two groups ( P>0.05). Compared with OPD group, the operation time in LPD group was longer [(407.6±117.4) min vs. (220.8±23.9) min]( P<0.05), but the intraoperative blood loss was less [(285.1±21.9) ml vs. (550.5±65.5) ml]( P<0.05). There was more lymph node dissection (13.5±1.4 vs. 8.8±0.6) ( P<0.05), earlier feeding per month ( P<0.05), shorter time for the use of analgesia and hospital stay ( P<0.05). There was no significant difference in the incidence of postoperative complications such as pancreatic fistula, biliary fistula, gastroparesis and intra abdominal bleeding ( P>0.05). Conclusions:LPD is as safe and reliable as OPD, LPD has the advantages of more precise display during operation, while less traumatic and quicker recovery after operation.
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BACKGROUND: Pancreatic cavernous hemangioma is an extremely rare benign tumor that is difficult to diagnose on an imaging examination, and its histopathological examination has rarely been reported. CASE PRESENTATION: Herein, we present the case of a 63-year-old man who was admitted to the hospital due to left upper abdominal pain and defecation unformed for more than 2 years. None of the positive results obtained from the physical examination could explain his symptoms. The imaging examination indicated a multilocular cyst with septa in the head of the pancreas. The patient underwent a pancreaticoduodenectomy, and the pathologic diagnosis was pancreatic cavernous hemangioma. The histopathological examination showed that the lesion was positive for benign vascular markers, such as CD31, CD34 and F8, and negative for lymphocyte markers, such as D2-40. Moreover, it was also positive for ERG and cytokeratin markers, CAM5.2 and AE1/AE3, indicating the complexity of its components, and Ki-67 negativity revealed its benign nature. CONCLUSIONS: Pancreatic cavernous hemangioma has a complex composition that may be reflected not only in the imaging examination but also in the immunohistochemical detection, and it may achieve a good outcome by surgical excision.
Subject(s)
Hemangioma, Cavernous/pathology , Pancreatic Neoplasms/pathology , Biomarkers, Tumor/analysis , Endosonography , Hemangioma, Cavernous/diagnostic imaging , Hemangioma, Cavernous/surgery , Humans , Immunohistochemistry , Male , Middle Aged , Pancreatic Neoplasms/diagnostic imaging , Pancreatic Neoplasms/surgery , Pancreaticoduodenectomy , Tomography, X-Ray ComputedABSTRACT
Objective To evaluate the feasibility and safety of laparoscopic choledochoscopy for common bile duct exploration in patients of common bile duct stones with a history of previous abdominal surgery.Methods From March 2015 to May 2016,100 cases were divided into laparoscopic and open common bile duct exploration in our department.Hospital stay,costs and complications were compared.Results The blood loss,cost,fasting time and hospital stay in the laparoscopy group were less than those in the open group.There were no significant differences in alanine aminotransferase,total bilirubin,albumin,prothrombin time,leukocyte,C-reactive protein,operative time and complications between the two groups.Conclusion Laparoscopic choledochoscopy for common bile duct exploration is an effective and safe method for the treatment of common bile duct stones in patients with previous history of abdominal surgery.
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Objective To investigate the clinical application value of fluorescence laparoscopy in radical resection of hepatocellular carcinoma (HCC).Methods Data of totally 113 patients with HCC in Henan Provincial People's Hospital between June 2016 to June 2018 were retrospectively analyzed.Among the 113 patients,46 patients underwent laparoscopic hepatectomy (LLR),and 67 patients underwent fluorescence guided laparoscopic hepatectomy (FLLR).Results No significant differences were observed between LLR group and FLLR group in terms of age,male proportion,liver function classification,surgical resection methods,and operation time (P＞0.05).The positive ratio of specimen surgical margin in LLR group was significantly higher than that in FLLR group,13.0％ vs.3.0％,and the difference was statistically significant (P＜0.05).In the FLLR group,22 patients received fluorescence guided anatomic hepatectomy with indocyanine green (ICG),10 with positive staining and 12 with negative staining,and fluorescence imaging was observed 2 minutes after ICG injection.There was no significant difference in operation time,hospitalization cost and length of stay between positive and negative staining (P＞ 0.05).Conclusion Fluorescence laparoscopy has certain advantages in hepatectomy,and can display the boundary of hepatocellular carcinoma in real time to ensure the safe margin of tumor resection.
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Objective@#To study the use of different techniques of pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy (LPD) for patients with slim pancreatic ducts.@*Methods@#The clinical data of 45 patients with slim pancreatic ducts (<3 mm) who underwent LPD in People's Hospital of Zhengzhou University from May 2017 to March 2019 were studied. These patients were divided into 2 groups: Chen's suturing technique (group A, n=31), and the imbedding pancreaticojejunostomy (group B, n=14). The postoperative pancreatic fistula (PF) rates, complication rate, pancreaticojejunostomy time, and length of postoperative hospital stay were compared between the 2 groups.@*Results@#There was no significant difference in the general data between the two groups (P>0.05). The incidence of postoperative pancreatic fistula in group A (4 cases) was significantly lower than that in group B (6 cases) (12.9% vs. 42.9%, P<0.05). The operation time of pancreaticojejunostomy in group A was significantly shorter than that in group B [(26.5±0.8) min vs. (28.0±2.4) min, P<0.05]. There was no significant difference in the length of postoperative hospital stay between the 2 groups (P>0.05).@*Conclusion@#Chen's suturing technique was a safe and effective pancreaticojejunostomy technique in LPD carried out in patients with slim pancreatic duct patients.
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Objective To evaluate fusion indocyanine green fluorescence imaging in laparoscopic anatomical hepatectomy.Methods The clinical data of 75 liver cancer patients undergoing laparoscopic anatomic hepatectomy (LAH) at the Department of Hepatobiliary and Pancreatic Surgery,Henan Provincial People's Hospital from Apr 2017 to Sep 2018 were retrospectively analyzed.Patients were divided into the indocyanine green fluorescence fusion imaging technique (FIGFI-LAH) group (35 cases) and laparoscopic anatomical hepatectomy (LAH) group (40 cases).Results Pathologically positive margin was found in 1 case in FIGFI-LAH group and 9 cases in LAH group (x2 =4.649,P =0.031).There were no significant differences in the mean operative time,intraoperative blood loss,blood transfusion rate,and rate of conversion to open surgery (P ＞ 0.05).Conclusion The use of FIGFI technique in laparoscopic anatomical hepatectomy for liver cancer effectively reduces the positive rate of surgical margin.
