Objective To study the protective effects of human umbilical cord-derived mesenchymal stem cells (ucMSCs)against severe acute pancreatitis (SAP) in rats.Methods A total of 135 Sprague-Dawley male rats were randomly divided into Sham group,SAP group and SAP+ucMSCs group (45 each).SAP+ucMSCs group:Severe acute pancreatitis was induced by injecting 5％ sodium taurocholate (0.1ml/100g) into the common bilio-pancreatic duct and then CM-DiI-labeled ucMSCs at 1 × 107cells/kg were injected via the tail vein.All the rats were sacrificed 12,24 and 72 hours after SAP.The 72h death rate was counted.Pathological changes in the pancrease were detected by HE staining and pathological score was graded,ucMSCs colonization was observed by fluorescence microscopy.The serum levels of amylase,lipase,TNF-α,IL-1β,IL-4 and IL-10 were determined by ELISA.Results ucMSCs colonize the injured area of pancreatic tissue,the 72h death rate was reduced,and the serum amylase and lipase were also reduced significantly.Moreover,ucMSCs significantly reduced the pathological score of the pancrea and the level of proinflammatory cytokines (TNF-α and IL-1β),but the levels of anti-inflammatory cytokines were increased (IL-4 and IL-10).Conclusion Transplantation of ucMSCs can reduce the severity of pancreatic injury and inflammation in SAP rats.

Objective:To summarise the advantages and disadvantages of applying the method of retrograde replantation with an operative position of foot stepping and knee bending for replantation of rotational avulsed and fractured great toes.Methods:From January 2016 to June 2021, 11 rotational avulsed and fractured great toes were replanted with the method of retrograde replantation in an operative position of foot stepping and knee bending. Of the 11 patients, 10 were males and 1 was female, aged 18 to 50 years old with an average of 32 years old. Causes of injury: 5 of driving belt, 4 of machinery crush and 2 of car accident. Injury sites: 4 on left great toes and 7 on right great toes. All of the injuries were with fracture and exposure of proximal tendons of flexor and extensor. Seven patients had the follow-up reviews by outpatient clinic visiting, 2 over mobile phone and 2 via WeChat.Results:After surgery, 9 great toes completely survived and 2 great toes had necrosis. The survival rate of toe replantation was 81.8%(9/11). The operation time was 2 to 3 hours, with an average of 2.5 hours. Postoperative X-ray film showed that 8 to 12 weeks after the operation, the fracture and joint fusion were healed at first stage in the survived toes. All patients were entered in follow-up for 3 to 18 months with 10.5 months in average. The survived great toes were plump and the toenail grown well. At the final follow-up, the static TPD at the toes was 8-12 mm, with an average of 10 mm. There was no effect shown on either walking or running.Conclusion:The retrograde replantation method with an operative position of foot stepping and knee bending for great toe replantation has the characteristics of a good field of view and convenient in operation under microscope, a short operation time, and a high survival rate of replantation.

Surgical operation is the main treatment method for pancreatic cancer, and in clinical practice, radical surgery for pancreatic cancer is often combined with superior mesenteric-portal vein confluence pancreaticoduodenectomy to achieve R0 resection. However, severe left-sided portal hypertension (LSPH) may occur after splenic vein dissection, resulting in a series of pathological changes such as congestive splenomegaly, thrombocytopenia, backflow obstruction of splenic vein, and gastrointestinal varices, and in some cases, it can lead to fatal gastrointestinal hemorrhage and hemorrhagic shock. Therefore, in order to better manage LSPH in clinical practice, this article systematically analyzes and reviews the pathogenesis, treatment regimens, and control strategies of LSPH after combined superior mesenteric-portal vein confluence pancreaticoduodenectomy and put forward corresponding suggestions based on current studies.