Objective To evaluate the postoperative complications and safety of pancreaticogastrostomy (PG) versus pancreaticojejunostomy (PJ) after pancreaticoduodenectomy (PD).Methods Medline,EMBASE,Science Direct,Springer link,CBM,Cnki,Wan fang and VIP database were retrieved by computer search between 1st January 2004 and 31st March 2014 to collect all the RCT articles on pancreaticojejunostomy versus pancreaticogastrostomy after pancreaticoduodenectomy.The quality of the included trials was studied by assessing the inclusive and exclusive criteria (the PRISMA statement) by 2 researchers independently,then the data were extracted and analyzed using the RevMan 5.2.10 software.Results A total of 6 prospective randomized controlled trials which involved 976 patents were included in the study.There were significant differences between PG and PJ in terms of postoperative pancreatic fistula (RR:0.51 ; 95 ％ CI:0.37-0.70 ; P ＜ 0.0001),intra-abdominal fluid collection (RR:0.55 ; 95 ％ CI:0.34-0.89; P =0.01),and postoperative biliary fistula (RR:0.14; 95％ CI:0.03-0.59; P =0.0008).There was no significant difference in postoperative complications,mortality,delayed gastric emptying,postoperative hemorrhage,reoperation and length of hospital stay (P ＞ 0.05).Conclusions Pancreaticogastrostomy after pancreaticoduodenectomy is superior to pancreaticojejunostomy in safety and practicability.However,large,multicenter prospective randomized controlled trials are still needed to confirm the findings of this meta-anlaysis.

Objective To study the method of gray-scale blood flow imaging and image processing in condition of high frequency ultrasound,and the implementation of the system.Methods On the base of research of scattered signals of red blood cells in high frequency ultrasound,20 MHz ultrasound mechanical and linear scanning probe was used to transmit a number of pulses on a scan line.Pulse-echo subtraction method was used to obtain the blood flow information.At the end,simulated blood vascular was used to conduct flow imaging,and the obtained images were analyzed.Results Experiment results showed that clear blood flow images were obtained using this system.The noise from perivascular tissue could be filtered and the signals from blood flow could be enhanced after image processing.Conclusions In the detection of superficial blood vessel,blood flow signals can be obtained even using single pulse emitting via high frequency ultrasound.The blood flow imaging system can be implemented after image processing.

BACKGROUND: As a new radiotherapy for malignant tumor, brachytherapy of radioactive seed implantation enables the inter-tissue implantation of radioactive seeds to be applied further with the appearance of seed implantation treatment planning system (TPS), and the gradual consummation of ultrasound and CT-guided precise positioning system.OBJECTIVE: To evaluate the methods, feasibility, safety and efficacy of CT-guided iodine-125 (125I) implantation for malignant tumors.DESIGN: A controlled observation before and after implantation.SETTING: The First People's Hospital of Hefei City.PARTICIPANTS: Twenty-one patients with malignant tumors, who were not suitable for surgical treatments of operation,were selected from the First People's Hospital of Hefei City from January 2004 to March 2005. There were 26 lesions, including 9 lesions of primary unresectable carcinoma and 17 lesions of metastasis tumors.METHODS: Under CT guidance, 125I seeds were implanted into malignant tumor according to TPS, the radioactivity quantum were 22, 26, 30 and 33 MBq per granule. Larger radiation 125I wes suitable for the implantation in the center of a lesion and smaller ones were for the margin of the lesion and the peripheral region of some important organisms such as vessels and nerves. The interval between larger seeds was about 1.5 cm whereas the interval between smaller ones was about 1.0 cm.MAIN OUTCOME MEASURES: The seed distribution, existence of complication and changes of the size of lesion after implantation were observed.RESULTS: ① The seeds were implanted successfully in all the 21 cases. No complication was observed. The practical distribution of the implanted seeds was basically the same as the scheduled scheme before implantation. All the 21 patients were involved in the analysis of results. ② The number of seeds implanted in one lesion was 5 to 40 (mean 14).Pain relief was obtained in all 10 cases of malignant tumors of bone after implantation. Follow-up CT reexamination demonstrated that 18 lesions were obviously diminished, necrosis was found in 4 lesions and remaining 4 lesions had no significant changes in size. ③ The average sizes of 14 lesions in 11 patients at 5-7 months after implantation were obviously smaller than those before implantation (1.84 cm vs 3.41 cm, t =5.7237, P ＜ 0.001). The average sizes of 12 lesions in 10 patients at 8-10 months after implantation were also obviously smaller than those before implantation (1.96 cm vs 3.43 cm, t =5.577 8, P ＜ 0.002).CONCLUSION: CT-guided 125I implantation is a safe, effective and feasible method for the treatment of malignant tumor.

To investigate the therapeutic effect and molecular mechanism of the main flavonoid components of Silybum marianum (S. marianum) on nonalcoholic fatty liver disease (NAFLD), we identified nine flavonoids in S. marianum through TCMSP, PubChem database and corresponding literatures. The potential therapeutic targets of NAFLD were predicted by SwissTargetPrediction, GeneCards and Venny 2.1.0 platform, while the protein-protein interaction (PPI) network of potential targets was analyzed using String platform and Cytoscape software. Then GO and KEGG pathway enrichment analysis were performed using David 6.8 database, followed by molecular docking verification using AutoDock software. In vitro, components with higher degree value in the "components-targets-pathway" network were chosen for further analysis. L02 cells were used to establish lipid accumulation model and treated with different components. Furthermore, the effects of four pure active compounds from S. marianum on lipid accumulation in hepatocytes were analyzed by oil red O staining. The results showed that the main nine flavonoids extracted from S. marianum contained 24 potential NAFLD targets. Several critical pathways closely related to NAFLD process were identified by GO and KEGG enrichment analysis, including phosphatidylinositol 3-kinase-protein kinase B (PI3K-Akt) pathway, type 2 diabetes pathway, tumor necrosis factor (TNF) pathway and insulin resistance pathway. The results of molecular docking further indicated that the core components displayed strong binding abilities with key targets respectively, and silandrin showed better binding activity as compared to other components. The results obtained from L02 cells showed that the lipid accumulation was reduced by treatment with isosilybin A, isosilybin B, silydianin and silychristin, while the activity of isosilybin B was better than that of isosilybin A. Taken together, we concluded that the main flavone components of S. marianum could improve lipid accumulation through multiple signaling pathway in hepatocytes, and this could be a potential new strategy for the treatment of NAFLD.

The medicinal fungi, which are of great importance in traditional medicine, are facing the problems of wild resources scarcity and low concentration of bioactive compounds. Velvet family and LaeA global regulator play a vital role in secondary metabolism and developmental programs, which are found in a wide variety of fungi ranging from Chytridiomycota to Basidiomycota. This review elaborates the structures and functions between Velvet family and LaeA protein. The Velvet family which shares the Velvet protein domain, including VeA (Velvet), VelB (Velvet like B), VosA (viability of spores A) and VelC (Velvet like C), acts on the regulation function is secondary metabolism and developmental programs such as asexual and sexual development. Furthermore, the function is affected by environmental factors such as light and temperature. LaeA protein which owns S-adenosylmethionine-dependent methyltransferase domain, coordinately regulates development and secondary metabolism by regulating and modifying the Velvet proteins. The regulation of LaeA is mediated by light receptor proteins. Therefore, clarifying the mechanism of Velvet and LaeA proteins in medicinal fungi will pave the way for nurturing medicinal fungi and improving production of bioactive compounds.
Fungal Proteins ; metabolism ; Fungi ; chemistry ; Gene Expression Regulation, Fungal ; Genes, Regulator ; Protein Structure, Tertiary ; Secondary Metabolism ; Structure-Activity Relationship

OBJECTIVETo study clinical effects of one-hole microplate internal fixation for the treatment of collateral ligament injuries of the metacarpophalangeal joint of the thumb combined with fracture.

METHODSTwenty-two patients (16 males, 6 females) with collateral ligament injuries of the metacarpophalangeal joint of the thumb combined fracture were treated with one-hole microplate internal fixation. The age of the patients ranged from 18 to 53 years old with a mean age of 28.5 years old. The duration from injury to surgery ranged from 2 hours to 2 months, and the mean time was 6 days. All the patients had collateral ligament injuries combined with fracture of the metacarpophalangeal joint of the thumb. Thirteen patients had injuries in the right hand and 9 patients had injuries in the left hand. There were 18 cases of closed wound and 4 cases of open wound. Eighteen patients had fresh injuries (< 2 weeks) and 4 had old injuries (> 2 weeks). Sixteen patients had injuries in the ulnar collateral ligament of the thumb combined with fracture, 6 patients had radial collateral ligament injuries of the thumb combined with fracture, 4 cases of which were complicated with injuries of abductor pollicis brevis and the end of the flexor pollicis brevis tender. The size of the avulsed fragment was about 3.0 mm x 4.0 mm to 6.0 mm x 7.0 mm.

RESULTSThe incisions of 22 patients healed by first intention. The follow-up periods ranged from 6 months to 5 years old,with an average of 2.5 years old. The thumb function was evaluated by Saetta and other evaluation criteria, and 20 patients got an excellent result and 2 good.

CONCLUSIONThe application of one-hole microplate internal fixation in treating collateral ligament injuries with fracture of the metacarpophalangeal joint of the thumb is an effective method.

Adolescent ; Adult ; Bone Plates ; Collateral Ligaments ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Metacarpophalangeal Joint ; injuries ; surgery ; Middle Aged ; Thumb ; injuries ; surgery ; Young Adult

Objective To evaluate the application value of dual-source CT coronary angiography in low tube voltage setting and the influence of heart rate on image quality and radiation doses.Methods 323 patients suspected of coronary artery disease received retrospective ECG-gating coronary angiography with dual-source CT scanner,who were divided into low tube voltage group (100 kVp,n =201) and conventional voltage group (120 kVp,E group,n =122).No beta-blockers were taken before CT scan.All patients in low tube voltage group were divided into four groups according to the heart rate (HR):group A,HR≤59 beats per minute (bpm),n =50; group B,60≤HR ＜69 bpm,n =64; group C,70≤HR ＜91bpm,n =62;group D,HR ≥ 91 bpm,n =25.All images were transferred to a workstation for further processing.The best R-R interval reconstruction images of all groups were evaluated.The value of pitch,CT volume dosage index(CTDIvol),dose length product(DLP) and effective dose(E)were recorded.The pitch,the score of imaging quality of coronary artery segments and the radiation dose were compared with One-Way ANOVA.The influence of heart rate on image quality and radiation doses of coronary artery was analyzed.Results The value of pitch in groups A-D was 0.24 ± 0.03,0.29 ± 0.04,0.33 ± 0.05,0.38 ± 0.06,respectively,with statistical difference (F =62.57,P ＜ 0.05).The value of CTDIvol in groups A-E was (21.59±7.97),(20.24±6.03),(18.23±7.55),(18.14 ±5.75),(38.62±16.21)mGy,respectively,with statistical difference (F =85.16,P ＜ 0.05).The value of E in group A-E was (5.31 ±2.18),(4.85 ±1.70),(4.49 ± 1.86),(4.37 ±1.50),(8.75 ± 4.07) mSv,respectively,with statistical difference(F =44.83,P ＜ 0.05).The image score was (4.65 ±0.46),(4.55 ± 0.53),(4.55 ±0.53),(4.47 ±0.72),(4.66 ± 0.44) (F =1.89,P ＞ 0.05).Conclusions No beta-blockers was taken before CT scan,and a high quality image could be acquired by using dual-source CT coronary angiography in low tube voltage setting(100 kVp).When the auto ECG-gating is selected,medium and low HR have little influences on radiation dose,while the radiation dose could be decreased significantly at higher HR,but the possibility to obtain the high quality image decreased.

The medicinal fungi, which are of great importance in traditional medicine, are facing the problems of wild resources scarcity and low concentration of bioactive compounds. Velvet family and LaeA global regulator play a vital role in secondary metabolism and developmental programs, which are found in a wide variety of fungi ranging from Chytridiomycota to Basidiomycota. This review elaborates the structures and functions between Velvet family and LaeA protein. The Velvet family which shares the Velvet protein domain, including VeA (Velvet), VelB (Velvet like B), VosA (viability of spores A) and VelC (Velvet like C), acts on the regulation function is secondary metabolism and developmental programs such as asexual and sexual development. Furthermore, the function is affected by environmental factors such as light and temperature. LaeA protein which owns S-adenosylmethionine-dependent methyltransferase domain, coordinately regulates development and secondary metabolism by regulating and modifying the Velvet proteins. The regulation of LaeA is mediated by light receptor proteins. Therefore, clarifying the mechanism of Velvet and LaeA proteins in medicinal fungi will pave the way for nurturing medicinal fungi and improving production of bioactive compounds.

OBJECTIVETo summarize the clinical effect of avulsed skin replantation of hand and foot via vacuum sealing drainage (VSD) combing low temperature technique.

METHODSFrom March 2012 to October 2013,13 cases with avulsed skin replantation of hand foot using combined technique included 8 males and 5 females with an average age of 32 years old ranging from 18 to 62 years. The time from injury to hospital was 1 to 4 hours (2.4 hour in average). The reasons of injury included machine injury in 7 cases and rolling over by cars in 6 cases. The parts of injuried involved finger in 2 cases,back of the hand in 5 cases and dorsum of foot in 6 cases. The area of avulsed skin was 5 cm x 6 cm to 12 cm x 16 cm,tendon and bone exposure was found in 4 cases. VSD was operated in all patients and the avulsed skin was refrigerated in the temperature of -4 °C or -80 °C. After 4 days, the skin stored in the -4 °C was replanted to the wounded place in 5 cases and in 3 cases the skin was planted to the donor site of flap. The skin stored in the -80 °C was replanted in 4 cases after 7 or 8 days, 1 case after 45 days.

RESULTSOf the 13 cases, 1 case of degloved injury from lower leg to dorsal foot,the replanted skin was necrosis completely; 1 case of degloving injury with fourth finger,the skin which replanted after 45 days survived approximately 30%,cured after skin-graft many times. In the other cases, the survival area of replanted skin was more than 85%, all cured after dressing. According to the standard of skin survival area evaluation by Jia et al, 11 cases showed excellent, 1 showed medium and 1 showed inferior. There were no complication about grafted skin rupture after the skin survived in 11 patients,after 4 to 22 months follow-up, the resiliency of grafted skin showed good. Sensation recovery was measured by BMRC standard: 3 cases of S3, 5 cases of S3, 3 cases of S2.

CONCLUSIONVSD combining lower temperature technique in skin replantation provides time and space for wound preparation and treatment plan for the patients who need second surgery, especially for the large area skin degloving,this method could utilize the degloved skin efficiently, decrease the donor site area, alleviate the pain and financial burden,reduce the scar formation of donor site and impediment.

Adolescent ; Adult ; Cryopreservation ; methods ; Drainage ; instrumentation ; methods ; Female ; Foot Injuries ; surgery ; Hand Injuries ; surgery ; Humans ; Male ; Middle Aged ; Replantation ; Skin ; injuries ; Skin Transplantation ; Young Adult

Humans ; Forensic Pathology