OBJECTIVETo discuss the application of right-inferior-posterior "artery first" approach in laparoscopic pancreaticoduodenectomy.

METHODSClinical data of 17 patients who underwent laparoscopic pancreaticoduodenectomy through right-inferior-posterior "artery first" approach in our department from February 2014 to April 2015 were retrospectively analyzed. The operation began at the inferior flexure of duodenum. After entering the Toldt's space, the left renal vein (LRV) was revealed and the root of superior mesenteric artery (SMA) was exposed just above the LRV. SMA was dissected along its trunk till the horizontal part of duodenum.

RESULTSOf these 17 cases, adenocarcinoma of pancreatic head was observed in 5 cases, adenosquamous carcinoma in 2 cases, mucinous cycstic neoplasm in 1 case, adenocarcinoma of lower common bile duct in 4 cases, and duodenal papilla cancer in 5 cases. Fifteen cases were accomplished successfully with laparoscopy and 2 cases were converted to open approach. The average operating time was (320 ± 85) min and mean intraoperative blood loss was (305 ± 175) ml. The cutting margins were tumor negative in all the patients. The average number of harvested lymph node was 15.4 ± 6.5. Postoperative complication occurred in 5 cases. Two cases of bile leakage and 2 cases of pancreatic fistula were cured with conservative treatment. One case of delayed abdominal hemorrhage was resolved with reoperation.

CONCLUSIONRight-inferior-posterior "artery first" approach is safe and feasible in laparoscopic pancreaticoduodenectomy.

Adenocarcinoma ; Duodenal Neoplasms ; Duodenum ; Humans ; Laparoscopy ; Mesenteric Artery, Superior ; Operative Time ; Pancreas ; Pancreaticoduodenectomy ; Postoperative Complications ; Retrospective Studies

OBJECTIVEThe objective of this paper is to investigate the pharmacokinetics of Chlorogenic acid (CA)and CA-Baicalin compound after intravenous injection (iv) in rabbits.

METHODTen rabbits were randomly divided into two groups. One group were administered CA (6 mg x kg(-1)) by iv, while the other were treated with CA (6 mg x kg(-1))-baicalin (90 mg x kg(-1)) compound by iv. administration. The concentration of CA in plasma was determined by HPLC. The key parameters of pharmacokinetics were calculated and analyzed by kinetic software.

RESULTBoth Concentration-time courses of CA alone and CA-Baicalin compound were consistent with a two-compartment model after administration. The key pharmacokinetic parameters of CA alone were significantly different from that of CA-Baicalin compound (P < 0.05). Compared with the group treated with CA alone, the group treated with CA-Baicalin compound had dramatic increased in AUC(0-infinity), MRT and T1/2alpha.

CONCLUSIONThere are significant difference between the pharmacokinetics of CA and CA-Baicalin compound in rabbits. Baicalin has impact on the pharmacokinetics of CA in rabbits.

Animals ; Calibration ; Chlorogenic Acid ; administration & dosage ; pharmacokinetics ; Flavonoids ; pharmacology ; Injections, Intravenous ; Linear Models ; Male ; Rabbits ; Tissue Distribution ; drug effects

Objective:To explore the effect of intervention of E-cadherin (E-cad) and B-lymphoma Moloney murine leukemia virus insertion region-1 (Bmi-1) mediated by transcription activator-like effector nuclease (TALEN) on the biological behaviors ofnasopharyngeal carcinoma cells.Methods:Multi-locus gene targeting vectors pUC-DS1-CMV-E-cad-2A-Neo-DS2 and pUC-DS1-Bmi-1 shRNA-Zeo-DS2 were constructed,and the E-cad and Bmi-1 targeting vectors were transferred with TALEN plasmids to CNE-2 cells individually or simultaneously.The integration of target genes were detected by PCR,the expressions of E-cad and Bmi-1 were detected by Western blot.The changes of cell proliferation were detected by cell counting kit-8 (CCK-8) assay.T-he cell cycle and apoptosis were detected by flow cytometry.The cell migration and invasion were detected by Transwell assay.Results:The E-cad and Bmi-1 shRNA expression elements were successfully integrated into the genome of CNE-2 cells,the protein expression level of E-cad was up-regulated,and the protein expression level of Bmi-1 was down-regulated.The intervention of E-cad and Bmi-1 didn't affect the proliferation,cell cycle and apoptosis of CNE-2 cells,but it significantly inhibited the migration and invasion ability of CNE-2 cells.Furthermore,the intervention of E-cad and Bmi-1 together significantly inhibited the migration ability of nasopharyngeal carcinoma cells compared with the intervention of E-cad or Bmi-1 alone (all P＜0.01).Conclusion:The joint intervention of E-cad and Bmi-1 mediated by TALEN can effectively inhibit the migration and invasion of nasopharyngeal carcinoma cells in vitro,which may lay the preliminary experimental basis for gene therapy of human cancer.

Objective:To analyze the application of indocyanine green (ICG) fluorescence imaging in laparoscopic resection of pancreatic cancer.Methods:Data of 15 patients undergoing laparoscopic surgery for pancreatic cancer in the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Wannan Medical College from June 2022 to March 2023 were retrospectively analyzed, including 13 males and 2 females, aged (67.0±8.6) years. ICG were intraoperatively injected to visualize the lesion and guide surgical resection. The surgical methods, postoperative pathology, ICG fluorescence imaging and tumor margins were reviewd.Results:Among the patients, seven underwent laparoscopic pancreaticoduodenectomy, seven underwent laparoscopic radical antegrade modular pancreaticosplenectomy, and one conversed to open pancreaticoduodenectomy due to combined superior mesenteric vein reconstruction. Postoperative pathology confirmed pancreatic moderately differentiated adenocarcinoma in nine cases, pancreatic moderately-low differentiated adenocarcinoma in four cases, pancreatic follicular cell carcinoma in one case, and inflammatory lesion in one case. Negative surgical margins were confirmed in all cases. Pancreatic lesion were visualized in 14 cases (fluorescent delineation of the tumor capsule) but not well visualized in one case (with moderately differentiated adenocarcinoma). In the case of inflammatory disease, the lesion parenchyma were visualized.Conclusion:ICG injection in laparoscopic surgery enables visualization of pancreatic tumor, which facilitates tumor localization and margin determination.