2.Pancreatic-duct hanging and continuous suturing maneuver in end-to-side anastomosis after pancreticoduedenectomy
Ke DONG ; Wei XIONG ; Xiaojiong YU ; Chun GU
Chinese Journal of Hepatobiliary Surgery 2012;(12):912-915
Objective To evaluate the impact of pancreatic duct hanging and continuous suturing maneuver in end-to-side pancreaticojejunostomy on the incidence of pancreatic fistula after pancreaticoduodenectomy (PD),and to study the feasibility,safety and efficacy.Method 165 patients who underwent pancreaticoduodenectomy were randomly selected and the incidences of pancreatic fistula for the different types of pancreaticojejunostomy were analyzed.Results The overall rate of pancreatic fistula was 13.9% (23/165).The incidences of pancreatic fistula after pancreatic duct hanging and continuous suturing maneuver in end-to-side anastomosis (3.1%,2/65,group C) was significantly lower than the traditional intussusception anastomosis (23.1%,12/52,group A,P<0.05) and the mucosa mucosa anastomosis (18.8%,9/48,group B).There was no significant difference between the traditional intussusception anastomosis and the mucosa mucosa anastomosis (P>0.05).In group C,the average operative time,intraoperative blood loss,and postoperative drainage was obviously superior to the A and B group (P<0.05).There was no significant difference between the A and B group (P>0.05).The other complications showed no significant differences among the three groups (P>0.05).Conclusion Pancreatic-duct hanging and continuous suturing maneuver in end-to-side anastomosis significantly reduced the rate of pancreatic fistula after pancreaticoduedenectomy.It was feasible,safe,convenient to use and should be popularized.
3.Application of laparoscopic-guided selective portal vein ligation in the two-stage hepatectomy for patients with primary hepatocellular carcinoma
Ke DONG ; Xiaojiong YU ; Wei XIONG ; Jun GONG ; Chun GU
Chinese Journal of Digestive Surgery 2013;12(8):620-623
Objective To investigate laparoscopic-guided selective portal vein ligation in the two-stage hepatectomy for patients with primary hepatocellular carcinoma (HCC).Methods Twenty-three patients with HCC who were not suitable for one-stage hepatectomy were admitted to the Sichuan Provincial People's Hospital from March 2009 to February 2012.Their clinical data were retrospectively analyzed.Laparoscopic-guided selective portal vein ligation was firstly performed,dynamic changes of hepatic volume and predicted volume of liver to be resected were detected by computed tomography.Two-stage open hepatectomy was performed after assessment of resectability of HCC.All data were analyzed using the analysis of variance or q test.Results Laparoscopic-guided selective portal vein ligation was successfully performed on 22 patients (2 patients received concomitant cholecystectomy because the right branch of portal vein was difficult to expose),1 patient was converted to open surgery because of hemorrhage during portal vein separation.Three patients with multiple lesions received transcatheter arterial chemoembolization at 1 week after selective portal vein ligation.Dull pain in the hepatic region,low fever,nausea and vomiting were observed in the 23 patients,while no severe complications including peritoneal hemorrhage,bile leakage,hepatapostema was observed.The levels of aspartate aminotransferase,alanine aminotransferase and total bilirubin were back to normal at 1 week after the surgery.The right liver volume at postoperative week 3 was (590 ± 154)cm3,which was significantly smaller than (698 ± 135)cm3 before surgery.Compared with right liver volume at postoperative week 1,2,3,the right liver volume before operation was significantly smaller (F=15.62,P <0.05).The left hepatic volume at postoperative week 3 was (408 ± 149)cm3,which was significantly bigger than (331 ± 68)cm3 before operation.The left liver volume before operation was significantly different from those at postoperative week 1,2,3 (F =17.48,P < 0.05).The predicted ratio of liver to be resected was 60% ± 18% at postoperative week 3,which was significantly smaller than 67% ± 15% before operation (F =12.35,P < 0.05).Two patients with insufficient hyperplasia of offside liver,2 patients with intrahepatic metastasis at postoperative week 3,2 patients were lost to follow up and 3 patients gave up hepatectomy,14 patients received hepatectomy at 2-4 weeks after laparoscopic-guided selective portal vein ligation.The resection rate was 60.9% (14/23).There were 2 patients received extended right hepatectomy,8 received right hepatectomy,4 received non-anatomical hepatectomy.All the 14 patients recovered well,and no hepatic failure,severe peritoneal effusion and infection was observed.Conclusion Laparoscopic-guided selective portal vein ligation is easy to perform,and it extends the indication of hepatectomy,increases the safety of two-stage hepatectomy.
4.Comparative study of 18F-FDG coincidence SPECT and 9gTcm-MDP bone scan for detecting malignancy
Yu-bo, MA ; Qi, YUAV ; Feng, XU ; Ai-chun, GU
Chinese Journal of Nuclear Medicine 2011;31(6):390-393
ObjectiveTo compare the diagnostic efficiency of 18F- FDG coincidence SPECT/CT and 99Tcm- MDP whole body bone scan (WBBS) in detecting malignancy.MethodsA total of 71 cases (male 45,female 26,mean age 59.2 ± 15.4 years) with clinically confirmed malignancy underwent both 99TcmMDP WBBS and 18F-FDG coincidence imaging within three weeks.The sensitivity,specificity,accuracy,positive and negative prediction value of these two imaging methods in detecting bone metastases were compared based on the results from pathology or clinical follow-up.x2test was used for data analysis.ResultsA total of 350 lesions (including primary,second malignancy and benign disease) in 71 patients were eval-uated.81.7% (286/350) malignant lesions were identified by either 99Tcm-MDP WBBS (209/350,59.7% ) or 18F-FDG coincidence imaging ( 141/350,40.3% ) (x2 =25.65,P < 0.01 ).The imaging findings of osteoblastic,osteolytic,mixed types of bone metastases by99Tcm-MDP WBBS and 18F-FDG coincidence imaging were significantly different (x2 =20.78,2.89 and 9.94,all P < 0.05 ).The sensitivity,specificity,accuracy,false-positive,false-negative,positive and negative predictive values for detecting bone metastases by 18 F-FDG coincidence study and 99Tcm-MDP WBBS were as follows:11.72% ( 15/128),91.67%(22/24),24.34% (37/152),8.33% (2/24),88.28% (113/128),88.24% (15/17),16.30% (22/135) ; and 53.91% (69/128),75.00% ( 18/24),57.24% (87/152),25.00% (6/24),46.09% (59/128),92.00% (69/75),23.38% ( 18/77 ).The sensitivity,accuracy,false-negative,positive-predicting value of the two methods had been significant different (x2 =32.70- 46.21,all P < 0.01 ).When two methods were combined,the diagnostic efficiency could been improved.ConclusionThe 99Tcm-MDP WBBS and 18F-FDG coincidence imaging has a complementary role in detecting bone metastases.
5.Neurotoxicity and biomarkers of lead exposure: a review.
Kang-sheng LIU ; Jia-hu HAO ; Yu ZENG ; Fan-chun DAI ; Ping-qing GU
Chinese Medical Sciences Journal 2013;28(3):178-188
Appropriate selection and measurement of lead biomarkers of exposure are critically important for health care management purposes, public health decision making, and primary prevention synthesis. Lead is one of the neurotoxicants that seems to be involved in the etiology of psychologies. Biomarkers are generally classified into three groups: biomarkers of exposure, effect, and susceptibility.The main body compartments that store lead are the blood, soft tissues, and bone; the half-life of lead in these tissues is measured in weeks for blood, months for soft tissues, and years for bone. Within the brain, lead-induced damage in the prefrontal cerebral cortex, hippocampus, and cerebellum can lead to a variety of neurological disorders, such as brain damage, mental retardation, behavioral problems, nerve damage, and possibly Alzheimer's disease, Parkinsons disease, and schizophrenia. This paper presents an overview of biomarkers of lead exposure and discusses the neurotoxic effects of lead with regard to children and adults.
Alzheimer Disease
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chemically induced
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metabolism
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pathology
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physiopathology
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psychology
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Animals
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Behavior
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drug effects
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Biomarkers
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metabolism
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Brain
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metabolism
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pathology
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physiopathology
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Brain Diseases
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chemically induced
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pathology
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physiopathology
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Environmental Exposure
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adverse effects
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Humans
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Lead
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pharmacokinetics
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toxicity
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Lead Poisoning
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etiology
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metabolism
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pathology
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physiopathology
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psychology
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Neurotoxicity Syndromes
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etiology
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metabolism
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pathology
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physiopathology
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psychology
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Parkinson Disease, Secondary
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chemically induced
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metabolism
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pathology
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physiopathology
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psychology
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Schizophrenia
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chemically induced
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metabolism
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pathology
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physiopathology
6.The effect of endostatin mediated by adenovirus on the inflammation and cytokines of arthritis rats
De-Qian MENG ; Yu ZHANG ; Wei-Gan SHEN ; Yong-Ji XUE ; Li-Chun XU ; Jian GU ;
Chinese Journal of Rheumatology 2003;0(12):-
Objective To investigate the effect of recombinant adenovirus mediatied human endostatin (rAD-GFP-ES)on rats with collagen typeⅡinduced arthritis(CIA),and explore the mechanism of inflamma- tion and cytokines inhibition on rats CIA.Methods The rAD-GFP-ES was amplified and purified.The model of rat CIA was induced by intradermal injection of typeⅡcollagen combined with complete Freund's adjuvant(CFA). On the second day after the injection,the therapeutic administration of rAD-GFP-ES(1?10~(11)pfu?kg~(-1)?week~(-1)?4 weeks)were performed to the rats.The mean arthritis index(AI)was scored every week since then.The relative concentrations of ES,IL-I?,TNF-?in sera collected at the fourth week were evaluated by western blotting. Results①The titer of the purified rAD-GFP-ES and rAD-GFP was 6.6?10~(12)pfu/ml and 4.8?10~(12)pfu/ml,re- spectively(A_(260nm)/A_(280nm)>1.3).②The concentration of ES in sera of the group treated with rAD-GFP-ES was 2.4-lold higher compared to the normal group.③The mean arthritis index of the group treated with rAD-GFP- ES was much lower than that of the model group.The administration of rAD-GFP-ES could significantly de- creas the production of IL-1?and TNF-?in sera.Conclusions①The rAD-GFP-ES is efficiently expressed in vivo.②The rAD-GFP-ES has an inhibitory effect on the arthritis index of rat CIA.③IL-1?and TNF-?are involved in the pathogenesis of RA.The rAD-GFP-ES has an inhibitory effect on the expression of IL-1?and TNF-?in rat CIA.
7.The study of macrophage colony-stimulating factor in the pathogenesis of spondyloarthropathy
Chun-Hua YANG ; Feng HUANG ; Jie-Ruo GU ; Han-Wei ZHANG ; De-En YU ;
Chinese Journal of Rheumatology 2003;0(12):-
Objective To study the macrophage colony-stimulating factor(M-CSF)expression levels of serum and synovial fluids from patients with spondyloarthropathy(SPA)and its contribution to the pathogen- esis of SpA.Methods Eleven SpA synovial tissue samples were compared to those from peripheral blood mononuclear cells(PBMC)of 10 normal subjects using a 1176 gene array.M-CSF was detected in both serum samples and synovial fluids by enzyme linked immunosorbent assay(ELISA).Two groups of AS subjects were tested.The first group consisted of 41 ankylosing spondylitis(AS)patients who had not been treated with bio- logics.The second group consisted of 13 subjects whose serum samples were collected before and 14 weeks af- ter initiation of infliximab.These were compared to serum samples from 28 normal subjects,and synovial fluid samples from 15 SpA patients.Results Expression of M-CSF could be detected in both serum samples and synovial fluids.The concentration of M-CSF in the group of 41 AS patients not treated with biologics correlated with the Bath Ankylosing Spondylitis Disease Activity Index(BASDAI)values(r=0.41,P=0.004).Treatment of infliximab in AS patients led to a significant decrease in the values of BASDAI(P=0.000 07),but no signif- icant change in the serum M-CSF values.Conclusion M-CSF is a promising candidate for research on the mechanisms of SpA and its signaling on pathway in SpA is different from tumor necrosis factor(TNF)-?,and it may provide new basis for developing new anti-biologics for SpA.
8.Studyies on the Breeding and Cultivation of L-Lactic Acid Producing Strain
Chun-Mei GE ; Shao-Bin GU ; Jian-Ming YAO ; Ren-Rui PAN ; Zeng-Liang YU ;
Microbiology 1992;0(05):-
In order to obtain higher L-lactic acid yield industrial strain, the original strain Rhizopus oryzae PW352 was mutated by means of N+ ions implantation and a mutant strain Rhizopus oryzae RE3303 was obtained. Its lactic acid yield was increased by 75% than that of the original one. The acid producing condition was optimized by orthogonal design. The concentration of L-lactic acid reached to 131~136g/L and the conversion rate of glucose was as high as 86%~90% under the optimum condition.
9.Antitumor screening of deep ocean water and sediment derived fungi and primary investigation of their secondary metabolites
Boyu ZHAO ; Tian-Jiao ZHU ; Yu FANG ; Gu CHUN ; Qun QIAN ; Wei-Ming ZHU ;
Chinese Journal of Marine Drugs 1994;0(04):-
Objective The cytotoxic microbial strains isolated from the deep ocean water and sediments were screened,and the secondary metabolites of bioactive fungus c2b were investi- gated.Methods Active bioactive microbial strains were screened using brine shrimp and chro- nic medulla leucocythemia leukocythemia(K562)cell line.The cytotoxic components of fun- gus c2b were isolated by bioassay-guided fractionation and solvent extraction,silica gel col- umn chromatography and preparative HPLC.Their structures were established by pbysico- chemical properties and spectral analyses.The cytotoxicities of compounds were evaluated by SRB method.Results and Conclusion Twenty-nine strains of fungi were isolated.Among them,seven strains showed cytotoxic activities.Six compounds(1~6)were isolated and i- dentified as N-acetyl histamine(1),chrysogine(2),ergosterol peroxide(3),5,8-epidioxy- 24-methylcholesta-6,22-dien-3?-ol(4)cerevisterol(5)and(4E,8E)-N-[(2'R,3'E)-2'-hy- droxy-3'-hexadecenoyl]-1-O-?-D-glycopyranosyl-9-methyl-4,8-sphingadiene(6),respective- ly.Compound 3 and 4 showed median cytotoxicity.
10.Analysis of polysomnography of normal tension glaucoma patients with mild cognitive impairment
Jieqiong LIU ; Liping WANG ; Yang SHEN ; Xuechuan DONG ; Chun ZHANG ; Yalan GU ; Chen DU ; Yu SONG
Chinese Journal of Nervous and Mental Diseases 2015;(9):536-541
Objective To assess the characteristic of normal tension glaucoma (NTG) patients with mild cogni?tive impairment (MCI). Methods This study included twenty-six cases of normal tension glaucoma patients who were diagnosed at ophthalmology department of Peking University Third Hospital. All the participants were examined by us?ing the scales of Montreal Cognitive Assessment (MoCA), mini-mental state examination(MMSE), clinical dementia rat?ing (CDR), activities of daily living (ADL), Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), Pitts?burgh Sleep Quality Index (PSQI) and polysomnography (PSG). The patients were then divided into Group with MCI (16 cases) and Group without MCI (19 cases). Results There was no difference between the two groups in gender, age, edu?cation, depression, anxiety and body mass index (BMI) (P>0.05), but significant difference in MoCA scores (P<0.05). The incidence rate of sleep disorder of PSQI in was 28.6%(10/35 patients) of total NTG patients, 43.8%(7/16 patients) in Group with MCI, and 15.8% (3/19 patients) in Group without MCI, respectively. The PSQI score was higher in Group with MCI than in Group without MCI (P<0.05). Sleep efficiency was higher in Group without MCI than in Group with MCI (P<0.05), but no difference was found between the two groups in six other indexes of PSQI (P>0.05). The in?cidence rate of sleep structure disorder of PSG in all the NTG patients was 85.7%(30/35 patients), 87.5%(14/16 pa?tients) in Group with MCI, and 84.2%(16/19 patients) in Group without MCI. Sleep time of NREM-N3 was significant?ly shorter in Group with MCI than in Group without MCI (P<0.05), but no difference was found between those groups in total sleep time, sleep efficiency, sleep latency and REM time (P>0.05). Conclusion NTG patients with mild cogni?tive impairment are more prone to sleep disorders, especially sleep structure disturbance and short NREM-N3 time may affect cognitive function.