OBJECTIVETo elucidate the clinicopathological features of solid pseudopapillary tumor (SPT) of the pancreas.

METHODSEight patients with SPT of the pancreas admitted from August 1996 to March 2005 were retrospectively analyzed.

RESULTSAll the 8 patients were female with an average age of 25.3 (13-41) years. The primary clinical manifestations included abdominal mass (n = 3), vague abdominal pain (n = 3), and duodenal obstruction (n = 1). SPT was occasionally found in one patient during physical examination. Six tumors located at the head and the other two in the body and tail of the pancreas. Pancreaticoduodenectomies were performed in 4 patients, tumor enucleations in 2, distal pancreatectomies in 1, and palliative internal drainage with a cystoenterotomy in the other one with an unresectable huge cystic lesion. All patients were alive on an average follow-up of 37.8 (8-103) months.

CONCLUSIONSPT occurs mainly in adolescent and young females, and satisfactory outcome may be achieved with active and appropriate surgeries.

Adolescent ; Adult ; Carcinoma, Papillary ; diagnosis ; pathology ; Female ; Humans ; Pancreas ; pathology ; Pancreatic Neoplasms ; diagnosis ; pathology ; Prognosis

OBJECTIVETo evaluate the hemocompatibility of a small-caliber expanded polytetrafluoroethylene vessel with silk fibroin coating sulfonated by low temperature plasma treatment.

METHODSThe composite blood vessel was prepared by first coating the small-caliber expanded polytetrafluoroethylene vessel with silk fibroin followed by sulfonation by low temperature plasma treatment. After hemolysis test in vitro, dynamic coagulation time test, blood platelet adhesion test, and recalcification time test were performed to evaluate the hemocompatibility of the composite blood vessel.

RESULTSScanning electronic microscopy revealed obvious platelets adhesion on the conventional artificial (control) vessel, which seldom occurred on the composite vessel. The curve of absorbance-clotting time of the composite vessel declined more slowly than that of the control vessel. The recalcification time of the composite blood vessel averaged 603 s, significantly longer than that of the control vessel (480 s, P = 0.000).

CONCLUSIONThe composite blood vessel has good antithrombotic activity and hemocompatibility as a promising vascular prosthesis.

Blood Vessel Prosthesis ; Coated Materials, Biocompatible ; chemistry ; Cold Temperature ; Fibroins ; chemistry ; Humans ; Materials Testing ; Plasma Gases ; Polytetrafluoroethylene ; chemistry ; Sulfonic Acids ; chemistry

Anterior cervical fusion surgery is the first choice for spine surgeons in the treatment of cervical spine diseases. It has significant effects in treating cervical degenerative diseases, trauma and tumors and other cervical diseases. In anterior cervical fusion, it is necessary to use a distractor to properly distract the intervertebral space, so as to fully expose and relieve the compressive factors, restore the physiological height, curvature and stability of the lesion segment, and achieve the best surgical effect. However, there is currently no consensus on the standard distraction height for the intervertebral space during anterior cervical surgery. This article reviewsed the progress of intervertebral space height in anterior cervical fusion from three dimensions:the relationship between intervertebral space height and cervical disc degeneration mechanism, the selection of intervertebral space height during operation, the recovery of intervertebral space height and the postoperative effect, so as to provide theoretical basis and reference for spinal surgeons when performing intervertebral distraction during operation.
Cervical Vertebrae/surgery* ; Humans ; Intervertebral Disc/surgery* ; Intervertebral Disc Degeneration ; Neck ; Spinal Fusion ; Treatment Outcome

Objective:To investigate the clinical significance of excessive inlet view in fluoroscopy-assisted placement of sacroiliac screws.Methods:Included for this prospective study were 47 patients with unstable pelvic fracture who had been admitted to Department of Orthopaedic Trauma, Xi'an Honghui Hospital between January 2020 and January 2021. There were 30 males and 17 females, with a mean age of 39.4 years (from 25 to 66 years). By the Tile classification, 21 fractures were type B and 26 ones type C. The inlet view and the angle of excessive inlet view were measured before operation. The intraoperative placement of sacroiliac screws was assisted by C-arm fluoroscopy navigation in the excessive inlet view. The positions of sacroiliac screws were verified by CT or O-arm fluoroscopy after operation. The screw placement time, fracture reduction quality, fracture healing time, and pelvic function at the last follow-up were recorded.Results:A total of 67 screws were implanted in the 47 patients, including 56 sacroiliac screws. The insertion time for each screw averaged 19.9 min (from 9 to 31 min); the angle of excessive inlet view averaged 17.38° (from 12.1° to 24.8°). Verification by O-arm fluoroscopy or CT revealed that all sacroiliac screws were located in the sacral canal without dislocation or breaking through the cortical bone. By the postoperative Matta scoring, the reduction was excellent in 22 cases, good in 17, acceptable in 6, and poor in 2, giving an excellent to good rate of 83.0%(39/47). The average follow-up time for the 47 patients was 9.5 months (from 5 to 15 months); fracture healing time averaged 10.5 weeks (from 7 to 16 weeks). By the Mejeed scoring at the last follow-up, the pelvic function was excellent in 26 cases, good in 15 and acceptable in 6, giving an excellent to good rate of 87.2% (41/47).Conclusions:Fluoroscopy in the excessive inlet view is a simple and easy intraoperative technique. It can improve accuracy and safety of sacroiliac screw placement because it allows clear identification of the posterior border of the sacrum and effectively avoids iatrogenic injury to the sacral nerve caused by screws breaking through the bone cortex.

OBJECTIVETo evaluate metabolic abnormalities in patients with mesial temporal lobe epilepsy (MTLE) with proton magnetic resonance spectroscopy (MRS) using a 3. 0T MR scanner.

METHODSSixty-three patients (32 women and 31 men) with diagnosed MTLE underwent diagnostic MR imaging (MRI) and proton MRS using a 3. 0T MR scanner. The clinical history and interictal epileptiform discharges (IEDs) were recorded. Sixteen healthy volunteers served as control. The results of proton MRS were compared with the findings of electroencephalogram and structural MRI findings.

RESULTSTwenty-seven of the 63 patients with MTLE showed unilateral hippocampal sclerosis, and 9 showed bilateral hippocampal sclerosis. The concentration ratio of N-acytelaspartate (NAA)/[creatine (Cr) + choline (Cho)] in the hippocampal region of MTLE patients (0.64 +/- 0.07) was significantly lower than control (0.80 +/- 0.05, P = 0.023). In the patients with unilateral hippocampal sclerosis, NAA/(Cr + Cho) in the hippocampal region ipsilateral to the sclerotic hippocampus (0.56 +/- 0.06) was significantly lower than the ratio in the contralateral hippocampal region (0.69 +/- 0.07, P < 0.001). There was significant difference in hippocampal NAA/(Cr + Cho) between the refractory patients and the non-refractory patients (0.64 +/- 0.05 vs. 0.71 +/- 0.07, P = 0.04). Forty-five patients were lateralized by IEDs, while 49 patients were lateralized by metabolite ratio. And lateralization determined by proton MRS and IEDs was concordant in 33 patients.

CONCLUSIONSMRS as a noninvasive tool adds helpful metabolite information to routine MRI in evaluation of MTLE. The method is well established and should be a routine clinical application in the investigation of epilepsy.

Adult ; Aspartic Acid ; analogs & derivatives ; metabolism ; Choline ; metabolism ; Creatine ; metabolism ; Electroencephalography ; Epilepsy, Temporal Lobe ; metabolism ; Female ; Hippocampus ; metabolism ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; instrumentation ; methods ; Male ; Protons

Objective:To analyze the functions and indications， formulation， dosage form and medication characteristics of Chinese patent medicines in the 2020 edition of Chinese Pharmacopoeia （part Ⅰ） for treating cough of children， and to provide ideas for the clinical rational application and provide reference for the research and development of new cough medicines for children. Method:The name， dosage form， formulation， functions and indications， usage and dosage， and other information of Chinese patent medicines for cough were collected from the 2020 edition of Chinese Pharmacopoeia （part Ⅰ）， then relevant information was input into Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine v2.0， and data analysis and mining were carried out through the analysis module of prescription medication rule， VOSviewer 1.6.14 was used to make drug clustering network view of Chinese patent medicines for the treatment of exogenous wind cold， exogenous wind heat and phlegm heat cough. Result:In the 2020 edition of Chinese Pharmacopoeia （part Ⅰ）， a total of 75 kinds of Chinese patent medicines for treating cough of children were collected， including 34 kinds of Chinese patent medicines for adults and children， 41 kinds of Chinese patent medicines for children only. There were 7 types of traditional Chinese medicine syndromes， such as wind-cold attacking the lung， wind-heat invading the lung and phlegm-heat obstructing the lung. There were 45 Chinese patent medicines for treating exogenous cough， accounting for 60%， among which 35 kinds were used for exogenous wind-heat cough and 10 kinds were used for wind-cold cough. There were 30 kinds of Chinese patent medicines for treating internal injury cough， including 19 kinds of medicines for phlegm heat obstructing the lung， 4 kinds of medicines for phlegm dampness containing the lung and phlegm food stagnation， 2 kinds of medicines for Yin-deficiency lung heat， 1 kind of medicine for the lung and spleen Qi-deficiency. The formulation analysis showed that Glycyrrhizae Radix et Rhizoma， Platycodonis Radix， Scutellariae Radix， Armeniacae Semen Amarum and Citri Reticulatae Pericarpium appeared frequently， which were mainly cold， bitter and sweet herbs， mainly belonged to the lung and stomach meridians. According to the analysis of administration and dosage forms， 71 kinds of Chinese patent medicines were administered through gastrointestinal tract， including 20 kinds of granules， 15 kinds of oral liquids， others included syrups， pills， capsules， tablets， powers， etc. Only 2 suppositories and 2 injections were administered by nongastrointestinal tract. The usage and dosage of most Chinese patent medicines were not clear. Conclusion:In the 2020 edition of Chinese Pharmacopoeia （part Ⅰ）， the main syndromes of Chinese patent medicines for cough of children are exogenous wind-heat and phlegm-heat obstruction in the lung. Most of the Chinese medicines are cold， bitter and sweet， and their meridians are mainly lung and stomach meridians. Scutellariae Radix， Lonicerae Japonicae Flos and Forsythiae Fructus are the most common medicines of exogenous wind heat syndrome. Perillae Folium， Citri Reticulatae Pericarpium and Ephedrae Herba are the most common medicines of exogenous wind cold syndrome. Meanwhile， Scutellariae Radix， Platycodonis Radix and Armeniacae Semen Amarum are the most common medicines of phlegm heat obstructing the lung syndrome. At present， the dosage forms of Chinese patent medicines used for treating cough of children are too few and the dosage labeling is not comprehensive， so it is necessary to further strengthen the research and development of new Chinese medicines suitable for characteristics of children.

Case reports are valuable clinical evidence in traditional Chinese medicine (TCM). However, the general reporting quality is suboptimal. A working group comprising 20 members was set up to develop systematic recommendations on case report in Chinese medicine (CARC). The working group (CARC group) developed a primary checklist based on reviewing the general reporting quality of case reports in TCM and thorough internal discussion. Two-round consensus process had been carried out among clinical experts, evidence-based medicine methodologists, medical journal editors and clinical practitioners with designated questionnaire embedded with the primary checklist. In total, 118 participants from 17 provinces of China and Korea completed the questionnaires. Their feedback was analyzed and discussed by the CARC group. The checklist was amended accordingly, and the final version, comprising 16-item, is presented here. Under the framework of CARC recommendations, the reporting quality of case reports in TCM can be improved.
Consensus ; Female ; Health Planning Guidelines ; Humans ; Male ; Medical Records ; Medicine, Chinese Traditional ; Research Report

OBJECTIVE: To investigate the value of preoperative three-dimensional image reconstruction in the treatment of ureteropelvic junction obstruction (UPJO). METHODS: We reviewed data on 40 patients (22 male cases, and 18 female cases) diagnosed with UPJO in Peking University First Hospital from May 2017 to April 2019. The median age was 26.5 years (IQR 23.25-38.75) years. There were 11 patients complicated with ectopic vessels, 14 patients with kidney stones, 3 patients with horseshoe kidney, and 6 patients with obstruction after pyeloplasty. All the patients underwent preoperative enhanced CT scan, and the CT data were reconstructed into three-dimensional image models. The obstruction position of ureteropelvic junction and the relationship between ureteropelvic junction and blood vessels and organs were observed by three-dimensional models to assist planning surgery. Thirty-seven patients underwent laparoscopic pyeloplasty (including 3 cases combined with pyelolithotomy with flexible cystoscope, 1 case combined with pyelolithotomy by sun-style cystoscope, 1 case with laparoscopic ureter resection and anastomosis, 3 cases of laparoscopic pyeloplasty of horseshoe kidney), 2 patients underwent laparoscopic ventral onlay lingual mucosal graft ureteroplasty, and 1 patient underwent robot-assisted laparoscopic pyeloplasty. RESULTS: Three-dimensional CT image clearly showed the relationship between the obstruction of ureteropelvic junction and blood vessels and organs after three-dimensional reconstruction. The type, diameter, position and direction of the ectopic vessels could be observed clearly before operation according to the three-dimensional reconstruction model, and the number, size, location and shape of renal calculi or other masses, the number of involved renal calyces and the anatomical distribution in the renal pelvis and calyces could be also evaluated preoperatively. After comprehensive analysis of the above information, individualized operation plans were performed on the patients, all the 40 cases were successfully completed with the surgery without any transfer to open surgery. The average operative time was (129.91±37.90) min (range: 75 to 273), the average blood loss was (48.1±78.0) mL (range: 10 to 400), the average hospitality was (5.04±1.99) d (range: 2 to 10), and the average postoperative drainage time was (3.8±1.4) d (range: 2 to 8). CONCLUSION The preoperative three-dimensional image reconstruction has a high clinical value in the treatment of ureteropelvic junction obstruction, and it is of great help to assist surgery planning and is worthy of further clinical promotion and application.
Adult ; Female ; Humans ; Imaging, Three-Dimensional ; Kidney Pelvis ; Laparoscopy ; Male ; Retrospective Studies ; Treatment Outcome ; Ureteral Obstruction/diagnostic imaging* ; Urologic Surgical Procedures ; Young Adult

Objective: To evaluate the main triggers of recurrent cardiac events in patients with symptomatic congenital long QT syndrome (cLQTS). Methods: In this retrospective case analysis study, clinical characteristics were reviewed from 38 patients with recurrent cardiac events after first visit out of 66 symptomatic cLQTS patients. General clinical data such as gender, age, clinical presentation, family history and treatment were collected, auxiliary examination results such as electrocardiogram and gene detection were analyzed. LQTS-related cardiac events were defined as arrhythmogenic syncope, implantable cardioverter defibrillator (ICD) shock, inappropriate ICD shock, aborted cardiac arrest, sudden cardiac death or ventricular tachycardia. Results: A total of 38 patients with recurrent symptoms were enrolled in this study, including 30 females (79%) and 14 children (37%). The average age of onset was (15.6±14.6) years, and the recurrence time was (3.6±3.5) years. Subtype analysis showed that there were 11 cases (29%) of LQT1 (including 2 cases of jervel-Lange Nielson syndrome), 19 cases (50%) of LQT2, 5 cases (13%) of LQT3 and 3 cases (8%) of other rare subtypes (1 LQT5, 1 LQT7 and 1 LQT11) in this patient cohort. LQT1 patients experienced recurrent cardiac event due to drug withdrawal (6 (55%)), specific triggers (exercise and emotional excitement) (4 (36%)) and medication adjustment (1 (9%)). For LQT2 patients, main triggers for cardiac events were drug withdrawal (16 (84%)), specific triggers (shock, sound stimulation, waking up (6 (32%)). One patient (5%) had recurrent syncope after pregnancy. One patient (20%) had inappropriate ICD shock. For LQT3 patients, 4 (80%) patients developed syncope during resting state, and 1 (20%) developed ventricular tachycardia during exercise test. One LQT5 patients experienced syncope and ICD shock under specific triggers (emotional excitement). One LQT11 patient had repeated ICD shocks under specific inducement (fatigue). One LQT7 patient experienced inappropriate ICD shock. Left cardiac sympathetic denervation (LCSD) significantly alleviated the symptoms in 2 children with Jervell-Lange Nielson syndrome (JLNS) post ineffective β-blocker medication. Nadolol succeeded in eliminating cardiac events in one patient with LQT2 post ineffective metoprolol medication. Mexiletine significantly improved symptoms in 2 patients with LQT2 post ineffective β-blocker medication. Conclusions: Medication withdrawal is an important trigger of the recurrence of cardiac events among patients with symptomatic congenital long QT syndrome.
Adolescent ; Adult ; Child ; Child, Preschool ; Death, Sudden, Cardiac ; Electrocardiography ; Female ; Heart ; Humans ; Infant ; Long QT Syndrome ; Retrospective Studies ; Young Adult

OBJECTIVETo survey the reporting quality of traditional Chinese medicine (TCM) case reports published in recent years and understand the common problems. The assessment results would lay the foundation for the development of recommendations for case report in Chinese medicine.

METHODSThis survey determined the reporting quality of cases with Chinese herbal decoction, Chinese proprietary medicine, acupuncture, moxibustion and other traditional therapies published in 20 core medical journals of China by searching the China Academic Journals Full-text Database from 2006 to 2010. Fifty survey items in 16 domains were used to determine the reporting quality. One point was assigned to each item (Yes=1 point; No=0 point), and total score was 50 points. The domain of treatment was assessed independently, ranging from 2 to 9 items for different TCM interventions.

RESULTSThe total of 1,858 case reports, covering 3,417 cases were included to analyze from 13 out of 20 core medical journals of China. There were 74.8% of them did not identify the nature of study in title, while 73.9% did not comprise an abstract. Incomplete reporting was found in discussions/ comment, and only 38.9% had made recommendations or take-away messages. Figures and tables were infrequently used. Three cases cited the full names of patients, but without declaring that any consent was obtained. Over 90% reported the symptoms and signs of TCM, and characteristics on tongue and pulse, but less than 50% did mention other medical history and diagnostic rationale. More than 90% treatments of the included cases were herbal decoction, with clear reporting on the ingredients and dosages. However, the reporting rate of the dosages of each ingredient was just 48.4%. Almost none reported the quality control of crude herbs, manufacturers and lot numbers of herbal proprietary medicine. Besides, advices and precautions on diet, emotions and living were rare to be illustrated.

CONCLUSIONSystematic reporting recommendations are urged to develop for improving the contents and format of case reports in TCM.

Humans ; Medicine, Chinese Traditional ; Outcome Assessment (Health Care) ; Periodicals as Topic ; Quality Assurance, Health Care ; Research Report ; standards