Objective To investigate the risk factors of post-pancreaticoduodenectomy complications.Methods The clinical data of 207 patients with pancreatic carcinoma or peri-ampullary carcinoma who underwent pancreaticoduodenectomy at the Anhui Provincial Hospital from Dec.2007 to Dec.2012 were studied.Seventeen clinicopathologic factors to correlate with the postoperative mortality and methods were selected for univariate analysis and multivariate analysis using logistic regression.Results Univariate analysis showed the major risk factors of postoperative mortality and morbidity were a history of previous operation,pre-operative drainage,total serum bilirubin level,alanine aminotransferase level,serum albumin level,serum pre-albumin level,parenchyma texture and pancreatic duct diameter (P＜0.05).Multivariate analysis showed alanine aminotransferase level,parenchyma texture and pancreatic duct diameter were independent risk factors of postoperative complications.Pancreatic duct diameter was the independent risk factor of pancreatic fistula.Pancreatic fistula was the independent risk factor of hemorrhage.Conclusion The postoperative complications of pancreaticoduodenectomy was closely related to alanine aminotransferase level,parenchyma texture and pancreatic duct diameter.

Bronchi ; Diagnostic Errors ; Female ; Foreign Bodies ; Humans ; Middle Aged

BACKGROUND: Biliary tract complications are one of the most common postoperative problems after liver transplantation.Balloon dilation and percutaneous transhepatic biliary drainage (PTBD) has become an effective method to improve biliary complication after orthotopic liver transplantation (OLT).OBJECTIVE: To evaluate the balloon dilation and PTBD in the treatment of biliary stricture after OLT through case follow up.DESIGN, TIME AND SETTING: A total of 53 consecutive patients underwent interventional procedures to treat biliary stricture after OLT in the Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University from July 1999 to March 2007 and were recruited for this study. The series included 46 men and 7 women, with 17-64 years of age. After OLT transplantation, all patients had abnormally elevated serum bilirubin level, and confirmed to suffer from obstruction of biliary tract by CT or MRI examinations.METHODS: Of 50 patients who received PTBD treatment, 36 underwent PTBD through right bile duct, 14 underwent bilateral (right bile duct and left bile duct) PTBD with 6 patients through left bile duct in the second treatment. A total of 13 underwent balloon dilation, and 3 were subjected to balloon dilation alone.MAIN OUTCOME MEASURES: An averaged 9.6 months of follow up was performed in 53 patients to observe obstructive jaundice recurrence induced by abnormally elevated serum bilirubin level after percutaneous transhepatic biliary interventional procedures.RESULTS: Follow up results showed satisfactory clinical outcome with obstructive jaundice resolved in all patients, except one patient, who received treatment with T tube, died of acute rejection at month 1 during the follow up, and one patient with liver failure had extremely poor prognosis after discharge at month 1 during the follow up. Obstructive jaundice was recovered even healed and serum bilirubin level was decreased to normal level in 51 patients at the end of follow-up. Primary success rate was 79% (42 in 53 cases), and assisted success rate was 21%. The first interventional procedure failed to treat obstructive jaundice in 5 patients. Obstructive jaundice recurred after primary percutaneous procedure in other 6 cases. No procedure related severe complications happened.CONCLUSION: Balloon dilation and PTBD are safe to treat biliary tract complication after OLT, without complication.

Epidermal growth factor (EGF) is an epithelial cell growth factor that can stimulate intestinal development, repair the damage of epidermal cells as well as reduce the incidence of pathogen infection and diarrhea. In order to produce a recombinant Lactobacillus plantarum (L. plantarum) expressing porcine epidermal growth factor (pEGF), we constructed a recombinant vector stably expressing pEGF in L. plantarum strains. First, L. plantarum strain Lp-1 was isolated from intestinal contents of piglets. Then the functional domain of pEGF, M6 precursor protein signal peptide (SP) and super strong constitutive promoter (SCP) were connected with the backbone plasmid pIAβ8 to construct the recombinant vector that was transformed into Lp-1 by electroporation. Afterwards, pEGF was expressed in Lp-1 and detected by Tricine-SDS-PAGE and ELISA. After orally irrigated early-weaned BALB/c mice with the recombinant L. plantarum every morning and late afternoon for 10 consecutive days, body weight, villous height and crypt depth in the intestine were measured to examine the influence of the recombinant bacteria on the intestinal development of early-weaned mice in vivo. Finally, the results of our experiments demonstrated that pEGF was successfully expressed in Lp-1 and the molecular weight of pEGF was 6 kDa. In addition, the recombinant pEGF can enhanced the daily gain and exerted significance influence (P < 0.05) to the small intestinal morphology of early-weaned BALB/c mice. In conclusion, pEGF could be expressed in L. plantarum and the recombinant pEGF possesses good biological activity.
Animals ; Electrophoresis, Polyacrylamide Gel ; Epidermal Growth Factor ; biosynthesis ; Genetic Vectors ; Intestines ; microbiology ; Lactobacillus plantarum ; metabolism ; Mice ; Mice, Inbred BALB C ; Plasmids ; Promoter Regions, Genetic ; Protein Precursors ; Protein Sorting Signals ; Recombinant Proteins ; biosynthesis ; Swine

Adult ; Carbamazepine ; adverse effects ; therapeutic use ; Drug Eruptions ; etiology ; Female ; Humans ; Tinnitus ; drug therapy

Objective To systematically evaluate the safety and effectiveness of combined portal vein resection and reconstruction in the resection of hilar cholangiocarcinoma.Methods Literatures were researched using Cochrane Library,PubMed,Embase,China Biology Medicine disc,China National Knowledge Infrastructure,Wanfang database,VIP database from January 31,2006 to January 31,2016 with the key words including “hilar cholangiocarcinoma”“Klatskin tumor”“Bile duct neoplasm”“Vascular resection”“portal vein resection”“肝门部胆管癌”“血管切除”“门静脉切除”.The clinical studies of resection of hilar cholangiocarcinoma with portal vein resection and construction and without vascular resection and construction were received and enrolled.Two reviewers independently screened literatures,extracted data and assessed the risk of bias.Patients who underwent resection of hilar cholangiocarcinoma combined with portal vein resection and reconstruction were allocated into the portal vein resection group and patients who didn't undergo vascular resection were allocated into the no vascular resection group.Analysis indicators included (1) results of literature retrieval;(2) results of Meta-analysis:① incidence of postoperative complications (hepatic failure,biliary fistula,intra-abdominal hemorrhage),② postoperative mortality,③ patients' prognosis,④ related indicators of postoperative pathology (lymph node metastasis rate,moderate-and low-differentiated rate,nerve invasion rate,negative rate of resection margin).The heterogeneity of the studies was analyzed using the I2 test.The hazard ratio (HR) and 95％ confidence interval (CI) were used for assessing the prognostic indicators.The incidence of complications,mortality and pathological indicators were evaluated by the odds ratio (OR) and 95％ CI.Results (1) Results of literature retrieval:13 retrospective studies were eurolled in the meta-analysis,and the total sample size was 1 668 cases including 437 in the portal vein resection group and 1 231 in the no vascular resection group.(2) Results of Meta-analysis:① incidence of postoperative complications was respectively 39.86％ in the portal vein resection group and 35.27％ in the no vascular resection group,with no statistically significant difference between the 2 groups (OR =1.12,95％ CI:0.82-1.53,P ＞0.05).The results of subgroup analysis showed that hepatic failure,biliary fistula and intra-abdominal hemorrhage were postoperative main complications,and the incidences were 17.09％,8.79％,6.25％ in the portal vein resection group and 10.62％,9.69％,2.51％ in the no vascular resection group,respectively,with no statistically significant difference between the 2 groups (OR =0.48,1.13,0.82,95％ CI:0.23-1.02,0.45-2.83,0.21-3.12,P ＞ 0.05).② Postoperative mortality was respectively 5.38％ in the portal vein resection group and 3.88％ in the no vascular resection group,with no statistically significant difference between the 2 groups (OR =1.16,95％ CI:0.62-2.14,P ＞ 0.05).③ There was statistically significant difference in patients' prognosis between the 2 groups (HR =1.81,95％ CI:1.52-2.16,P ＜ 0.05).④ The related indicators of postoperative pathology:lymph node metastasis rate,moderate-and low-differentiated rate and negative rate of resection margin were 41.55％,76.42％,63.74％ in the portal vein resection group and 33.42％,66.75％,64.29％ in the no vascular resection group,respectively,with no statistically significant difference between the 2 groups (OR =1.45,1.59,0.67,95％ CI:0.95-2.21,0.97-2.61,0.37-1.20,P ＞ 0.05).The nerve invasion rate was 83.47％ in the portal vein resection group and 64.90％ in the no vascular resection group,with a statistically significant difference between the 2 groups (OR =2.61,95 ％ CI:1.45-4.70,P ＜ 0.05).Conclusion Combined portal vein resection and reconstruction is safe and feasible in the treatment of hilar cholangiocarcinoma,and the prognosis of patients with portal vein invasion is worse than that without portal vein invasion.

Objective To explore the clinical diagnosis and treatment of cyclic vomiting syndrome in children.Methods Thirty children proved with cyclic vomiting syndrome admitted from January,1998 to January,2003 were analyzed retrospectively.Results Cyclic vomiting syndrome was most likely to occur in 3-12 years old.The male to female ratio was 3∶2.The clinical manifestations were recurrent vomiting.Twenty-one cases had inducements,while 9 cases had not inducements.It was safe and efficient that curing cyclic vomiting syndrome with cyprohetadine and amitriptyline.Conclusions If these children with cyclic vomiting syndrome are inefficient to treatment,excluding metabolizable diseases,gastrointestinal,neurological diseases,they may be diagnosed cyclic vomiting syndrome,and cured with cyprohetadine and amitriptyline.

Objective To study the clinic effects and safety of budesonide suspension combined with tubertaline solution for nebulization therapy on infantile asthma.Methods Seventy-five cases with asthma were divided into 3 groups randomly,double-blinded and controlled,each group having 25 cases.Group A inhaling tubertaline solution(bricanyl),while group B inhaling pulmicort respules combined with bricanyl,group C inhaling budesonide suspension(pulmicort respules)only.Results In group A,16 cases was cure,3 cases was markedly improved,6 cases was failure,the total efficacy rate was 76 percent.In group B,22 cases was cure,2 cases was markedly improved,1 case failed,the total efficacy rate was 96 percent.While in group C,14 cases was cure,4 cases was markedly improved,7 cases failed,the total efficacy rate was 72 percent.The difference of efficacy rate between group A and group B was significant(P0.05).Conclusion Pulmicort respules combined with bricanyl for nebulising inhalation is effective and safety on infantile asthma and its effect is better than inhaling bude-sonide or tubertaline only.

Objective To research the efficacy and safety of sequential rivaroxaban use in reducing blood loss after applying tranexamic acid(TXA)in total hip arthroplasty(THA).Methods According to the design by the random control principle,150 pa tients undergoing unilateral primary THA from September 2012 to June 2015 were selected and randomly divided into the group A,B,C,D and E (n=30).The group A did not use TXA,the group B received intravenous drip of 10 mg/kg TXA at 10 min before skin incision,the group Creceived intravenous drip of 15 mg/kg TXA at 10 min before skin incision,the group D respectively received intravenous drip of 15mL/kg TXA at 10 min before skin incision and after 3 h,the group E received intravenous drip of 15 mL/kg TXA at 10 min before skin incision and articular cavity use of 1 g TXA before closing the incision.Oral 10 mg rivaroxaban was given at postoperative 6-12 h when the drainage volume was less than 30 mL/h and then the conventional dose was used until postoperative 35 d.The intraoperative blood loss,postoperative drainage volume,hidden blood loss,blood transfusion rate,postoperative anticoagulation time,time of removing drainage tube,postoperative prothrombin time on postoperative 1 d,activated partial thromboplastin time,descend value of hemoglobin,and occurrence rates of postoperative deep vein thrombosis (DVT) and pulmonary embolism (PE) were observed in the group A,B,C,D and E.Results The intraoperative blood loss,postoperative drainage volume,hidden blood loss,blood transfusion rate and descend value of hemoglobin on postoperative 1 d had statistical differences among 5 groups(P＜0.05).The are significant differences between the group D and A in the intraoperative blood loss,postoperative drainage volume,hidden blood loss,blood transfusion rate,descend value of hemoglobin on postoperative 1 d,postoperative anticoagulation time and removal drainage tube time(P＜0.05).All cases had no symptomatic DVT and PE during the perioperative period and postoperative 3-month outpatient or telephone follow-up.Conclusion Sequential rivaroxaban use after applying TXA during THA perioperative period is safe and effective.Moreover intravenous drip of 15 mL/kg TXA at 10 min before skin incision and after 3 h has most significant effect in reducing bleeding volume during THA perioperative period.

Objective To investigate the effects of SDY-08 isolated from Dasyatis akajei on tis-sue repair. Methods MTT assay was performed to measure the effect of SDY-08 on the growth of ECV-304 cells. The effect of SDY-08 on angiogenesis was detected in the chick embryochorioallantoic membrane (CAM). Mouse wound model was applied to investigate the effect of SDY-08 on tissue repair. Immunohistochemical staining assay and Western blotting were adopted to examine the expression changes of vascular endothelial growth factor (VEGF), Bcl-2 and Bax in wound tissues in response to SDY-08. Results The proliferation rates of SDY-08 at final concentration of 80 μg/ml promoting ECV-304 cells were 28.1%, 115.6% and 81.4% respectively at 12, 24 and 36 hours. The induction rate of angiogene-sis of CAM by SDY-08 at concentration of 1.6 mg/ml was 72.1%. SDY-08 at 0.5 mg/ml markedly in-duced acceleration of wound healing in mouse model two days in advance. SDY-08 up-regulated either ex-pressions of VEGF in trauma group or that of Bcl-2 and VEGF of ECV-304 cells, but down-regulated ex-pression of Box. Conclusions SDY-08 can significantly promote angiogenesis and tissue repair, which is closely correlated with its effect of up-regulating expressions of VEGF and Bcl-2 as well with that of down-regulating expression of Box.