Objective To investigate the inhibitory effect of Rhodiola total flavonoids on transforming growth factor (TGF)-β1-induced proliferation of cardiac fibroblasts (CFB) in the rats, and to explore its mechanisms of improving myocardial fibrosis.Methods 5 μg·L-1 TGF-β1 was used to induce the proliferation of CFB to build the cell models of myocardial fibrosis.The cultured CFB were divided into control group,model group,and low, medium,high doses (25,50 and 100 mg· L-1 )of Rhodiola total flavonoids groups.The cells were treated for 48 h,the vitalities of cells were detected by MTT,the levels of collagen proteinⅠ (ColⅠ)and collagen proteinⅢ(Col Ⅲ)in supernatant were measured by ELISA,and the activities of total superoxide dismutase (T-SOD)and glutathione peroxidase (GSH-Px)were detected,the levels of malondialdehyde (MDA)and glutathione (GSH) were also measured.Results The MTT results indicated that compared with control group,the cell vitality in model group was significantly increased (P < 0.01 ).compared with model group,the cell vitalities of CFB in Rhodiola total flavonoids groups were significantly decreased (P < 0.05 ). Compared with control group, the T-SOD activity in model group was decreased, while the MDA level was significantly increased (P <0.05);compared with model group,the T-SOD activities in 50 and 100 mg· L-1 Rhodiola total flavonoids groups were increased (P <0.01);the MDA levels in 25 and 50 mg· L-1 groups were decreased significantly (P < 0.05). Compared with control group,the GSH-Px activity and GSH level in model group were significantly decreased (P <0.01).Compared with model group,the GSH-Px activities and GSH levels in Rhodiola total flavonoids groups were increased (P <0.05).Compared with control group,the ColⅠand Col Ⅲ levels in model group were significantly increased (P <0.01);compared with model group,the ColⅠand Col Ⅲ levels in Rhodiola total flavonoids groups were significantly decreased (P <0.05).Conclusion Rhodiola total flavonoids can inhibit the proliferation of rat CFB.The development of myocardial fibrosis may be inhibited by Rhodiola total flavonoids through anti-oxidative stress pathway.

Objective: To discuss the methods, skills and experiences of dividing the neck of pancreas in laparoscopic pancreaticoduodenectomy(LPD). Methods: The clinical data of 58 patients with periampullary tumors who received LPD at the Union Hospital of Fujian Medical University from December 2014 to January 2017 were retrospectively analyzed.There were 26 males and 32 females, ranged from 18 to 65 years, with a mean age of (46±12)years. Results: All of the 58 patients underwent operation smoothly.Three cases underwent open anastomosis via an auxiliary incision after the total resection of specimen laparoscopically, due to the early learning curve of LPD.Two cases transformed into open operation as a result of tumor vascular invasion to portal vein(PV) or superior mesenteric vein(SMV). Fifty-three cases underwent laparoscopic or laparoscopic combined with robotic pancreaticoduodenectomy completely.Forty-two cases ligated gastroduodenal artery(GDA), fully penetrated the interspace between rear of pancreatic neck and SMV, suspended the pancreas and then divided the neck of pancreas from inferior to superior. Thirteen cases fully dissected the interspace between rear of pancreatic neck and SMV, divided the neck of pancreas from inferior to superior and then ligated GDA.Three cases ligated GDA, dissected PV and SMV at the superior and inferior margin of the neck of pancreas separately, and then divided pancreas from anterior to posterior.Mean time of dividing pancreas was (34.9±9.7)minutes, mean volume of blood loss while dividing pancreas was (30.1±8.2)ml.The main postoperative complications included pancreatic fistula(7 cases, Biochemical leak 2 cases, B grade 3 cases, C grade 2 cases), biliary fistula(3 cases), gastric fistula(1 case), delayed gastric emptying(1 case, C grade), abdominal infection(5 cases), hepatic failure (1 case), intra-abdominal hemorrhage(2 cases), reoperation(2 cases). One case died at the perioperative period while others recovered.The mean duration of postoperative stay was (14.2±5.1)days. Conclusions Dividing the neck of pancreas is one of the most important steps in LPD, which deserved sufficient attention.At the meantime, a suitable method of dividing the neck of pancreas should be chosen according to intraoperative exploration and preoperative imageological examinations.

Objective: To compare the short-term clinical outcomes and cost differences of robotic distal pancreatectomy (RDP) versus laparoscopic distal pancreatectomy (LDP). Methods: The retrospective descriptive study was adopted.The clinical data of 158 patients underwent minimally invasive distal pancreatectomy who were admitted to Fujian Medical University Union Hospital between January 2016 and July 2018 were collected.A 1∶1 matched propensity score (PSM) analysis was performed for the RDP group and the LDP group.Observed indexes included operative time, blood loss, spleen-preserving rate, postoperative hospital stay, morbidity, incidence of pancreatic fistula and hospital costs. T test or rank sum test was used to compare measurement data, χ² test or Fisher exact test was used to compare count data. Results: A well-balanced cohort of 41 patients was analyzed.There were 14 males and 27 females in the RDP group, aged (45.2±16.4)years. There were 15 males and 26 females in the LDP group, aged (47.4±14.9) years.The operation time was (209.7±52.9) minutes for the RDP group and (186.5±56.7) minutes for the LDP group (P=0.073). Median blood loss was less in RDP (50(15-175)ml) compared with LDP (100(50-350)ml) (Z=-2.689, P=0.007). Thirty-eight cases of non-malignant diseases were observed in each group and spleen-preserving rate was higher in RDP (76.3%) compared to LDP(44.7%) (χ²=7.930, P=0.005).Postoperative hospital stay was similar in the RDP group and the LDP group (RDP: 9.4 days vs. LDP: 10.6 days; P=0.372). The overall morbidity and incidence of pancreatic fistula major complication rates (RDP: 12.2% vs. LDP: 14.6%, P=0.746; RDP: 7.3% vs. LDP: 9.8%, P=1.000) were similar.Total cost of RDP group was higher than that of LDP group ((80 563.7±10 641.8) yuan vs. (57 792.8±8 943.0) yuan, t=4.515, P<0.01). Conclusions Both RDP and LDP are safe and feasible procedures. RDP is more expensive, but RDP is associated with significantly less blood loss and higher spleen-preserving rate, which is more suitable for the non-malignant diseases of pancreatic body and tail with an expectation of splenic preservation.

Objective To explore the clinical effects of laparoscopic combined with open mesh repair for abdominal wall incisional hernia.Methods The retrospective cross-sectional study was conducted.The clinical data of 41 patients with abdominal incisional hernia who were admitted to the Fujian Medical University Union Hospital between September 2011 and June 2017 were collected.All the patients underwent laparoscopic combined with open mesh repair,with the sequence from laparoscopic surgery to open surgery and then to laparoscopic surgery.Observation indicators:(1) intra-and post-operative situations;(2) follow-up situation.Follow-up using outpatient examination and telephone interview was performed to detect postoperative long-term complications and hernia recurrence up to November 2017.Measurement data with normal distribution were represented as (x)±s.Results (1) Intra-and post-operative situations:forty-one patients underwent successful laparoscopic combined with open mesh repair for abdominal wall incisional hernia.Diameter of hernia ring and defect area of abdominal wall were respectively (10±3)cm and (75±34)cm2.Among 41 patients,25 underwent laparoscopic combined with open mesh repair due to tight intestinal adhesion induced difficult laparoscopic separation;16 underwent laparoscopic combined with open mesh repair due to the larger diameter of the hernia ring induced difficulty of closing hernia ring under laparoscope.Operation time,cases with indwelling drainage-tube,time of drainage-tube removal and duration of postoperative hospital stay were respectively (188±71)minutes,33,(14±3)days and (4.5±2.6)days.Of 41 patients,2 with postoperative incomplete intestinal obstruction were cured by symptomatic treatment;2 with incisional infection were cured by antibiotic therapy,irrigation and dressing change.(2) Follow-up situation:41 patients were followed up for (29±17)months.The postoperative chronic pain of 2 patients was occasional and cannot affect the normal life.There was no occurrence of seroma,mesh infection,intestinal fistula,abdominal compartment syndrome and hernia recurrence during the follow-up.Conclusion The laparoscopic combined with open mesh repair has a better clinical effect for patients of incisional hernia with large hernia ring and tight intestinal adhesion,and surgical methods should be chosen seriously according to the condition of the patients in clinical application.

Objective To investigate the clinical efficacy of laparoscopic resection for retroperitoneal tumor via transabdominal approach.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 37 patients with retroperitoneal tumor who underwent laparoscopic resection via transabdominal approach at Fujian Medical University Union Hospital between January 2011 and August 2017 were collected.The surgical approach of resection for retroperitoneal tumor at the left hypochondriac region,left iliac region,right hypochondriac region and right iliac region referred to laparoscopic distal pancreatectomy,laparoscopic left hemicolectomy,laparoscopic pancreatoduodenectomy and laparoscopic right hemicolectomy respectively.Observation indicators:(1) intra-and post-operative recovery situations;(2) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect postoperative tumor recurrence,metastasis and survival of patients up to November 2017.Measurement data with normal distribution were represented as (x)±s.Measurement data with skewed distribution were described as M (range).Results (1) Intra-and post-operative recovery situations:37 patients underwent successfully laparoscopic resection for retroperitoneal tumor via transabdominal approach.Among 37 patients,4 were converted to open surgery,4 were completed surgery with assisted small incision,4 were combined with adjacent organ resection and other 25 underwent totally laparoscopic resection for retroperitoneal tumor.The operation time,volume of intraoperative blood loss,postoperative gastrointestinal recovery time,postoperative drainage-tube removal time and duration of postoperative hospital stay were respectively (181±73) minutes,(160±87) mL,(3.0± 1.0) days,(3.0±2.0) days and (7± 4)days.Of 37 patients,3 with postoperative complications including 2 of chylous fistula and 1 of delayed gastric emptying were improved by symptomatic treatment.There was no perioperative death.(2) Follow-up and survival situations:37 patients were followed up for 3-82 months,with a median time of 30 months.During the follow-up,1 patient with inflammatory myofibroblastic tumor had recurrence at 15 months postoperatively and underwent surgical resection,however,the patient had liver metastasis at 9 months after the second operation and underwent interventional therapy repeatly.One patient with Castleman and 5 with lymphoma underwent regular chemotherapy and achieved disease-free survival.The other patients had disease-free survival.Conclusion Laparoscopic resection for retroperitoneal tumor via transabdominal approach is safe and feasible.

BACKGROUND:Material biomechanics is the investigation of the mechanical microenvironment of biomaterials through a material science approach,which belongs to the frontier discipline of sustainable development. OBJECTIVE:To explore the current research hotspots and development trends of material biomechanics and provide theoretical references for subsequent research. METHODS:Based on CiteSpace bibliometric software,we generated keyword co-occurrence and clustering,emergent word detection,and other knowledge maps based on 3 182 material biomechanics literature in the Web of Science core database during 2012-2022 for visualization analysis. RESULTS AND CONCLUSION:The number of research articles on the biomechanics of materials has been increasing in the last decade,and the United States,China,and Germany are the top three countries in terms of the number of articles published,and the research is mainly concentrated on major universities and research institutions,with significant aggregation.Material biomechanics research mainly involves the disciplines of material science,biomedical engineering,and kinesiology.Finite element analysis,material properties,mechanical performance of biomaterials,and molecular biomechanics are the focus of scholars'attention and research.At present,the research in the field of material biomechanics focuses on the use of finite element analysis to calculate the mechanical response of different biomedical materials under different conditions of loading and mechanical properties for the prevention of sports diseases,surgical planning,and postoperative rehabilitation.The application of inorganic materials and the mode of transport of molecular signals may be the prospect of future research.