Diagnostic Techniques and Procedures ; standards ; Humans ; Infant, Newborn ; Jaundice, Neonatal ; diagnosis ; Reference Standards

Diabetic macular edema(DME)and age-related macular degeneration(ARMD)are the leading causes of visual impairment and blindness worldwide, and their common pathological features are increased vascular permeability and abnormal neovascularization, in which cytokines such as vascular endothelial growth factor(VEGF)and angiopoietin-2(Ang-2)play an important role. Intravitreal injection of anti-VEGF agents significantly changed the clinical management of DME and ARMD, but limitations such as the non-responsive cases, the treatment burden and risks caused by frequent injections need to be overcome. Faricimab, a novel bispecific monoclonal antibody that simultaneously targets VEGF-A and Ang-2, can effectively reduce vascular permeability, decrease the number of neovascularization and alleviate retinal edema. Registered clinical studies have shown that Faricimab is effective in improving vision and reducing retinal edema, which is non-inferior to Aflibercept and Ranibizumab, maintains a long dosing interval, and has a high safety profile. This article reviews the latest advances in the treatment of DME and ARMD with Faricimab.

Objective To investigate the correlation between cerebral artery stenosis (MCAS) and mild cognitive impairment (MCI).Methods Continuous selected 636 cases of 50-80 years old inpatients or outpatients who examined by transcranial color Doppler ultrasound (TCD) in April 2012 to April 2013 in our hospital.Keep the mini-mental state examination (MMSE) and clinical dementia rating (CDR) as the evaluation of cognitive function.Results Detected 124 cases of MCAS patients (MCAS group) and 512 cases of non-MCAS patients (non-MCAS group).Forty-four cases MCI were detected in MCAS group with the prevalence rate was 35.5％(44/124),and 114 cases of patients with MCI were detected in non-MCAS group with the prevalence rate was 22.3％ (114/512),the difference was statistically significant (P ＜ 0.05).Single factor analysis showed that there were no significant difference between two groups in waist circumference,hypertension,coronary heart disease,hyperlipidemia,smoking,diastolic blood pressure and total cholesterol,uric acid,fasting glucose,C-reactive protein (P ＞ 0.05); There were significantly different between two groups in age,gender,education level,MCAS,history of diabetes,systolic blood pressure and triglyceride,low density lipoprotein-cholesterol,high-density lipoprotein-cholesterol(P ＜ 0.05).Multiple factors analysis showed that the MCAS (OR =1.899,95％ CI 1.224-2.946),history of diabetes (OR =1.764,95％ CI 1.191-2.612),systolic blood pressure(OR =1.012,95％ CI 1.003-1.022),gender (OR =0.558,95％ CI 0.380-0.821),and age (OR =1.029,95％ CI 1.010-1.049) was the independent risk factor for MCI.Conclusion The MCAS related with MCI occurrence and development.

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.

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.

Objective To evaluate a modified liver hanging maneuver(retrohepatic tunnel of the IVC) in patients undergoing hemihepatectomy.Methods Twenty-four patients undergoing hemihepatectomy were divided into two groups:modified liver hanging maneuver group(n=12)and Pringle's maneuver group(n=12).The amount of intraoperative bleeding,operation time,postoperative liver function,liver function recovery and complications were compared between the two groups.Reset All operation were performed successfully and there were no difference in the time of operation etween the two groups.There was a difierence in the amount of mean intraoperative blood loss between the two groups.It was(160±40)ml in liver hanging group and(560±120)ml in Pringle's group(P＜0.01).Liver function recovery measured on postoperative day 3 and day 7 was better in liver hanging groupthan that in Pringle's group(P＜0.01).The volume of postoperative peritoneal serous fluid dranage was significantly less in liver hanging group(P＜0.01).Conclusion The modified liver hanging maneuver is useful for hemihepatectomy.

Alimentary tract duplications are rare congenital anomalies that usually present in childhood and occasionally in adults. They are most common in the ileum, but can occur anywhere along the alimentary tract from the mouth to the anus. We report a 24-year-old woman who presented with a giant chylous ileum cyst duplication. To our knowledge, there is only one other report of a patient with a giant chylous cyst in the literature.
Abdominal Pain ; Adult ; Cysts ; diagnosis ; pathology ; surgery ; Female ; Humans ; Ileum ; surgery ; Magnetic Resonance Imaging ; Tomography, X-Ray Computed

Animals ; Evoked Potentials, Motor ; physiology ; Male ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; Spinal Cord ; physiology

Autophagy is an important homeostatic cellular recycling mechanism responsible for degrading injured or dysfunctional cellular organelles and proteins in all living cells. Aging is a universal phenomenon characterized by progressive deterioration of cells and organs due to accumulation of macromolecular and organelle damage. Growing evidences indicate that the rate of autophagosome formation and maturation and the efficiency of autophagosome/lysosome fusion decline with age. Dysfunctional autophagy has also been observed in age-related diseases. Autophagy disruption resulted accumulation of mutated or misfolded proteins is the essential feature of neurodegenerative disorders. However, in cancers, fibroproliferative diseases or cardiovascular diseases, autophagy can play either a protective or destructive role in different types of disease, and even in different stages of the same disease. The review will discuss the cellular and molecular mechanisms of autophagy and its important role in the pathogenesis of aging and age-related diseases, and the ongoing drug discovery strategies for therapeutic intervention.
Aging ; Autophagy ; Drug Discovery ; Humans ; Lysosomes ; metabolism ; Neurodegenerative Diseases ; Phagosomes ; metabolism ; Protein Folding

Asthma is a common disease with recurrent onset which severely affects patients' quality of life.Acupuncture can improve pulmonary functions in asthma patients and thus treat this disorder.To summarize the status of acupuncture treatment for asthma,we have collected clinical literatures published in the recent 10 years and analyzed the influence of acupuncture on pulmonary functions in asthma patients from the aspects of frequently used points,needling techniques,manipulation and mechanisms to provide references for treating asthma with acupuncture.