Acute pancreatitis(AP) is mainly caused by gallstone disease and excessive alcohol consumption.Overall, about one fifth of patients develop into severe acute pancreatitis( SAP), which is still associated with a mortality rate exceeding 30%. This type of AP is usually accompanied by necrosis of the pancreas and/or organ failure. Treatment of SAP in several aspects, such as the application of antibiotics, nutritional support, surgical time, the method of operation, are still in dispute. In recent years, minimally invasive technique is increasingly used in the treatment of SAP, and some patients may benefit from the adoption of minimally invasive surgery.This article aims to review the current progress on the treatment of SAP.

Objective To investigate the treatment options of acute biliary pancreatitis.Methods A retrospective review was performed in 134 consecutive patients who presented to a single tertiary care institution from 2000 to 2010 with acute biliary pancreatitis.Results Of the 134 patients,30 had a persistent (commonbile duct,CBD)stone.Following multivariate analysis,at admission CBD size on ultrasound,alkaline phosphatase(ALP),total bilirubin(TB),significantly correlated with persistent CBD stone.Receiver operator curve analysis and linear regression were applied to obtain optimal and equitable predictive values,and variables combined.Optimal values were.,CBD≥10 mm;AP≥150 U/L;and TB≥51.3μmol/L.Presence of three variables had an associated odds ratio(OR)of29.5(P<0.001)for presence of persistent CBD stone.Zero variables conferred asignificantly decreased probability of CBD stone,OR 0.07(P<0.001).Conclusions Presence of three variables significantly correlated with persistent CBD stone.Biliary evaluation by endoscopic retrograde cholangiopancreatography(ERCP)is suggested.In the absence of any positive predictive variables,cholecystectomy may be sufficient.Decisions regarding patients with one to two be made vailables should occur on a case-to-case basis.

Objective To evaluate the therapeutic efficacy of transcather arterial chemoembolization for hepatic carcinoma and its influence on hepatic function. Methods Patients with HCC were divided into three groups according to repeated TACE times. The therapeutic efficacy was assessed with survival rate, car-cionma size and biologic response (AFP). Hepatic function was evaluated according to some hepatic param-eters(ALT,AST,ALB,DB,TB,PT). Results All three groups responses rates were 4.3%, 23.1% and 31.6% ;srespectively,liver function in group 1 and group 2 returned to its pretreatment level(P <0.05) ,but in group 3, liver function did not return to its pretreatment level associated with more repeated TACE times. The 1-,2-and 3-year survival rates of group 1 were 27.0%, 10.8%, 5.4% ; respectively, while those of group 2 were 57.1%, 33.3%, 19.0% ; respectively, which were not significantly different from those of Team 3 ,which was 62.5%, 37.5%, 18.8%, respectively. Conclusions (1) three to four repeated times TACE was an effective palliative treatment that prolongs survival of patients with HCC,while 1 to 2 re-peated times had a limited benefit; (2) Irreversible hepatic impairment induced by TAEC could affect its therapeutic efficacy.

Twenty five new beta-aminoalcohols containing nabumetone moiety were prepared via the reduction of potassium borohydride with a convenient and efficient procedure, starting from beta-aminoketones that have been synthesized by our group. Their chemical structures were determined by IR, MS, 1H NMR, 13C NMR, HR-MS and antidiabetic activities were screened in vitro. Preliminary results revealed that the antidiabetic activity of most beta-aminoalcohols were better than that of the corresponding beta-aminoketones. Although most compounds showed weak antidiabetic activity, the alpha-glucosidase inhibitory activity of compounds 5hd(1) and 5id(2) reached 74.37% and 90.15%, respectively, which were superior to the positive control. The relative peroxisome proliferator-activated receptor response element (PPRE) activity of five compounds were more than 60%, among them compound 5ca possessed the highest activity (112.59%). As lead molecules of antidiabetic agents, compounds 5hd(1), 5id(2) and 5ca deserve further study.

Objective To investigate the management and timing of operation in obstructive acute biliary pancreatifis.Methods A etrospective review was performed of seventy-six consecutive patients who presented to a single tertiary care institution from 2000 to 2010 with obstructive acute biliary pancreatitis.Results Of the seventy-six patients,thirty-six patients underwent operations,with early(after onset within 2 weeks)operations in twenty cases,delayed operationsin sixteen cases and one case dead,no one experienced recurrent pancreatitis during follow-up.Fifteen patients were treated by endoscopy,ERCP/EST in eleven cases,ERCP/ENBD in one case and ERCP only in three case.All patients were cured,only one patient experienced recurrent pancreatitis.Twenty-five patients received conservative treatment,one patient died,six patients experienced recurrent panereatitis.Conclusions Surgery is essential in the management of acute biliary pancreatitis.In cases of obstructive acute biliary pancreatitis,early operation or endoscopic therapy should be performed to remove biliopancreatic obstruction after aggressive conservative treatment.

Objective To evaluate the efficacy of lumbar sympathetic ganglion pulsed radiofrequency (PRF) in treatment of diabetic neuropathic pain.Methods Forty-eight patients of both sexes with diabetic neuropathic pain,aged 45-75 yr,with the course of disease 4-7 yr,were divided into 2 groups (n =24 each) using a random number table method:control group (C group) and PRF group (P group).Group C was treated with conventional drugs.Bilateral lumbar sympathetic ganglion PRF was performed on the basis of conventional drug therapy in group P.The serum concentrations of tumor necrosis factor-alpha and interleukin-6 were measured by enzyme-linked immunosorbent assay.The visual analogue scale score was recorded before treatment and at 1,2 and 4 weeks of treatment.The degree of efficacy was recorded at 4 weeks of treatment,and the total effective rate was calculated.Results Compared with group C,the visual analogue scale score and serum concentrations of tumor necrosis factor-alpha and interleukin-6 were significantly decreased,and the total effective rate and degree of curative efficacy were increased in group P (P＜0.05).No pulsed radiofrequency-related complications or drugs-related adverse reactions were found in two groups.Conclusion Lumbar sympathetic ganglion PRF can effectively relieve diabetic neuropathic pain in the patients.

Objective To evaluate the safety and feasibility of remote robot-assisted thoracoscopic surgery utilizing 5G technology. Methods Clinical data from five patients who underwent 5G remote robot-assisted thoracoscopic surgery at the Thoracic Surgery Center of Gansu Provincial People's Hospital from May to October 2024 were retrospectively analyzed. Results Finally, five patients were included. There were 2 males and 3 females at median age of 50 (42-63) years. All five surgeries (including 1 patient of lobectomy, 3 patients of partial lung resection and 1 patient of mediastinal lesion resection) were successfully completed without conversion to thoracotomy, complications, or mortality. The median intraoperative signal delay across the patients was 39 (37-42) ms. The median psychological load score for the surgeons was 9 (3-13). The median operation time was 100 (80-122) minutes with a median intraoperative blood loss of 100 (30-200) mL. Catheter drainage lasted a median of 4 (3-5) days, and the median drainage volumes on the first, second, and third postoperative day were 200 (100-300) mL, 150 (60-220) mL, and 80 (30-180) mL, respectively. The median postoperative hospital stay was 4 (3-7) days, and the median pain scores on the third postoperative day were 3 (1-4), 3 (0-3), and 1 (0-3), respectively. Conclusion 5G remote robot-assisted thoracoscopic surgery is safe and effective, with good surgical experience, smooth operation and small intraoperative delay.