Objective To evaluate the safety,feasibility,and clinical outcome of anterior percutaneous endoscopic cervical discectomy (PECD).Methods The study involved 28 patients undergone PECD.Visual analogue scale (VAS) and MacNab scale were recorded before operation and at 3 days,1,3,6,12 and 18 months after operation.In addition,MRI examination was conducted at postoperative l month,3 months and 12 months.After data collection,single-factor T test with SAS software was performed.Results Follow-up (range,18-24 months,mean 19 months) was achieved in 25 patients.When compared to the preoperative score,VAS and MacNab scale presented improvement at postoperative 3 days (P ＞ 0.05) and great improvement at postoperative 1,3,6,12,18 and 24 months (P ＜ 0.01).VAS and MacNab scale at postoperative 3 days presented statistical differences as compared to those at postoperative 3,6,12 and 18 months (P ＜0.05),but the differences were not statistically insignificant at postoperative 3,6,12,and 18 months (P ＞ 0.05).Moreover,VAS and MacNab scale showed significant improvement at postoperative 24 months as compared to those before operation (P ＜0.01) and those at postoperative day 3 (P ＜ 0.01).Conclusion Anterior PECD is effective in treatment of cervical soft or partial hard disc herniation.

Objective To evaluate the influence of brachytherapy with 125Ⅰ seeds on celiac ganglia in porcine models. Methods Twelve pigs were randomly assigned into 3 groups to accept celiac plexus block by bilateral injection with 2 non-radioactive seeds in group A (n = 4), 0.4 mCi seeds in Group B (n = 4) and 0.8 mCi seeds in Group C (n = 4), respectively. Prophylactic antibiotics were administered postoperatively. Enhanced CT and three-dimensional reconstruction of blood vessels were performed to confirm the proper placement of the seeds. The animals were sacrificed 14 days and 60 days after the procedure, and TUNEL assay was employed to study neuron apoptosis in ediac ganglia. Results The procedure was succossfully performed in,10 pigs(83.3%)and failed in two others. The rescue procedure was performed on the day after and succeeded in both pigs. Apoptosis of neurons significantly increased in brachytherapy groups than in the control group and it was positively correlated with dose and time of radiation. Conclusion Brachytherapy can cause apoptosis of neurons of celiac ganglion, which could be the basis of its clinical application.

ObjectiveTo assess the safety of celiac plexus brachytherapy with 125Ⅰseeds placementguided by endoscopic ultrasound in porcine model, and to evaluate its effect on surrounding vessels and organs.MethodsFourteen pigs were randomly divided into 4 groups to accept celiac plexus block by bilateral injection with 2 non-radioactive seeds in group A (n=4),0.4 mCi seeds in Group B (n=4),0.8 mCi seeds in Group C (n=4) and one lateral injection with 5 ml dehydrated alcohol,respectively.Abdominal X-ray,Enhanced CT and three-dimensional reconstruction of blood vessels were performed to confirm the proper placement of the seeds in group A,B and C.Routine blood test,liver and renal function,serum amylase and CD4+/CD8+ratio were examined preoperatively and at the end of the follow-up in all groups.Animals were euthanized in batch to observe the position of the implanted seeds.Tissues and organs around the seeds were dissected for pathological examination.ResultsThe procedure succeeded in 12 pigs (85.7%)and failed in two others (1 in group A,and 1 in C) due to inappropriate position.Rescue procedures were performed on another day and succeeded.No significant difference was found in routine blood test,liver and renal func-tion,serum amylase and CD4+/CD8+ratio,except WBC elevation and small abcesses were found 7 days after the procedure in one pig of group C.In the radiated area, there was degeneration,necrosis and mild in-flammation at the outer membrane of blood vessels,with fibrosis around,which was positively correlated with the radiation dosage and duration.There was no change at the muscular layer and the innermost membrane of blood vessels,and no thrombosis was found.In group D,the celiac trunk became slightly brown and wider with obvious hemorrhage,necrosis and infiltration of inflammatory cells in the outer membrane of blood vessles and connective tissues around.ConclusionBrachytherapy has little negative effect on the organs a-round. It does not harm immunnity but induces lesions in blood vessels. Compared with dehydrated alcohol,this negative effect is limited.Therefore,celiac plexus brachytherapy with125Ⅰseeds guided by endoscopic ultrasound is safe.

Objective To explore the feasibility of establishing porcine model for training of endoscopic ultrasound (EUS) guided celiac plexus paracentesis.Methods A total of 6 healthy pigs were sedated with an intramuscular injection of Ketamin at 10 mg/kg,followed by intravenous injection of 3% pentobarbital at 0.8 ml/kg.EUS was then performed and empty seeds were implanted into celiac plexus.Enhanced CT scan was performed to confirm the location of the implanted seeds.Results No animal died after the procedure.All seeds were accurately distributed on both sides of the celiac trunk except in one pig the seed was found in stomach by CT scan and was re-implanted another day.Conclusion Pigs are similar to human in anatomic structure and they can be excellent models for beginner endoscopy physicians to acquire the skill of EUS guided celiac plexus paracentesis.

Objective To assess the safety of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA)of pancreatic lesions.Methods Patients who underwent EUS-FNA of a pancreatic lesion between January 2005 and June 2007were studied retrospectively.Possible risk factors were assessed by using logistic analysis.Results In 119 patients who underwent pancreatic EUS-FNA,mild acute pancreatitis were observed in 1(0.84%)patient after the operation.No complication occurred in 12 patients with regional portal vein hypertension.Nine patients(7.6%)showed hyperamylasemia 3 h after the procedure,rangeing from 197 to 835 U/L,with an average of(327±200)U/L.Blood amylase level kept increasing 24 h postoperatively in 6 cases of the 9.Logistic regression analysis showed past history of acute pancreatitis,gender,needle size,number of puncture,cystic foci,preoperative blood amylase level and location of foci would not possibly be the risk factors of hyperamylasemia.Conclusion Incidence of complications after EUS-FNA is 0.84%,and the occurrence rate of hyperamylasemia is 7.6%,indicating,EUS-FNA is a safe procedure.

Objective To investigate the risk factors for failure of percutaneous catheter drainage (PCD) for patients with infective pancreatic necrosis (IPN).Methods A retrospective review of medical records of patients with IPN who received PCD at Pancreatic Intensive Care Unit (PICU) of Changhai Hospital from April 2010 to June 2014 was performed.The patients were divided into 2 groups:(1) PCD success group (n =48) and (2) PCD failure group (n =12).The potential parameters for failure of PCD were recorded,which included age,sex,etiology,length of hospital stay,outcome,MCTSI,APACHE Ⅱ scores,number of organ failure,duration of use of antibiotics,duration of use of PPIs,if delayed fluid resuscitation occurred,start of enteral nutrition,nutrition status,etc,and univariate and multivariate logistic regression analysis was used.Results Univariate analysis showed MCTSI,number of organ failure,malnutrition,use of PPIs (more than two weeks),delayed enteral nutrition,delayed fluid resuscitation,the number of drainage catheter,number of aspiration,multi-drug resistant infections of drainage fluid were risk factors for failure of PCD;while multivariate logistic regression analysis showed that MCTSI (OR =3.33;95％ CI 1.52 ～ 7.29;P =0.003);multi-drug resistant infections of drainage fluid (OR =8.62;95 ％ CI 1.11 ～ 67.19;P =0.040) were risk factors for failure of PCD.Conclusions MCTSI and multi-drug resistant infections of drainage fluid can significantly influence the success rate of PCD.PCD should be carefully considered for patients with high score of MCTSI and multi-drug resistant infections of drainage fluid.

Objective To synthesize phenoxybutyric acid derivatives as 5α-reductase inhibitors and test their biological activities in vitro. Methods Eight analogues as nonsteroidal 5α-reductase inhibitors were designed and synthesized by substitution reaction of 6-(4-phenyl-piperazine-1-yl)-3(2H)-pyridazinone with phenoxybutyric acid derivatives. Results and Conclusion The structures of the compounds were characterized by 1H-NMR and MS. Biological evaluation indicated that 7 out of the 8 compounds exhibited moderate 5α-reductase inhibitory activities, especially the compounds A1 and A7 with inhibition rates reaching 12.50%and 19.64%at the concentration of 3.3×10-5 mol/L, respectively.

Objective To synthesize phenoxybutyric acid derivatives as 5α-reductase inhibitors and test their biological activities in vitro. Methods Eight analogues as nonsteroidal 5α-reductase inhibitors were designed and synthesized by substitution reaction of 6-(4-phenyl-piperazine-1-yl)-3(2H)-pyridazinone with phenoxybutyric acid derivatives. Results and Conclusion The structures of the compounds were characterized by 1H-NMR and MS. Biological evaluation indicated that 7 out of the 8 compounds exhibited moderate 5α-reductase inhibitory activities, especially the compounds A1 and A7 with inhibition rates reaching 12.50%and 19.64%at the concentration of 3.3×10-5 mol/L, respectively.

BACKGROUND:Abdominal incision healing is not only related with the patient’s own situation, but also closely related with the surgeon's suture technique, suture method, choice of stitches. ＜br> OBJECTIVE:To compare the absorbable sutures and silk sutures for abdominal incision. ＜br> METHODS:Total y 153 colorectal cancer patients, including 91 males and 62 females, aged 30-82 years, were randomly divided into observation group (n=78) and control group (n=75). An abdominal midline incision was made in al patients receiving radical surgery of colorectal cancer. The Vicryl suture and silk suture were respectively used in the observation and control groups for abdominal incision closure. Suturing time, length of hospital stay, incision infection, disruption of wound, fat liquefaction of wound and rejection were compared between two groups. ＜br> RESULTS AND CONCLUSION:The suturing time and length of hospital stay were less in the observation group than the control group (P＜0.05). In the observation group, there were three cases of incision infection, but no incision dehiscence and rejection occurred;in the control group, there were 10 cases of incision infection, 4 cases of incision dehiscence, and 5 cases of rejection. A significant difference was found in the incision infection, dehiscence and rejection between the two groups (P＜0.05). Hospitalization expenses and fat liquefaction of incision had no difference between the two groups. these findings indicate that the Vicryl plus as an absorbable suture is simple, effective and safe that can promote wound healing and reduce complications.

OBJEVTIVETo synthesize phenoxybutyric acid derivatives as 5α-reductase inhibitors and test their biological activities in vitro.

METHODSEight analogues as nonsteroidal 5α-reductase inhibitors were designed and synthesized by substitution reaction of 6-(4-phenyl-piperazine-1-yl)-3(2H)-pyridazinone with phenoxybutyric acid derivatives.

RESULTS AND CONCLUSIONThe structures of the compounds were characterized by 1H-NMR and MS. Biological evaluation indicated that 7 out of the 8 compounds exhibited moderate 5α-reductase inhibitory activities, especially the compounds A1 and A7 with inhibition rates reaching 12.50% and 19.64% at the concentration of 3.3 × 10⁻⁵ mol/L, respectively.