Objective To study the feasibility, safety and clinical effects of spleen and splenic vessel-preserving distal pancreatectomy. Methods A retrospective study was performed in 26 patients undergoing distal pancreatectomy for benign or low grade malignant disease with splenectomy (n = 13) or splenic preservation (n = 13 ) at the First Hospital of Sun Yat-sen University and Guangdong General Hospital from May 2002 to April 2009. Results All 26 pancreatectomy with splenectomy or splenic preservation were performed successfully. There was no statistically significant difference between two groups in average operative time[(172±47) min vs. (157±52) min, P ＞ 0.05 ], intraoperative estimated blood loss [( 183 ± 68 ) ml vs. ( 160 ± 51 ) ml, P ＞ 0.05 ], incidence of noninfectious and infection complication and postoperative hospital stay [(10.1±2.2) d vs. ( 12. 1 ± 4. 6 ) d, P ＞ 0.05 ]. The platelet counts examined one week after operation were significantly higher in the distal pancreatectomy with splenectomy group than that in spleen-preserving group [(37.3 ± 12.8)×109/L vs. (54.7 ± 13.2) × 109/L, P＜0.05 ]. Conclusions Spleen-preserving distal pancreatectomy appears to be a feasible and safe procedure in selected cases of benign or low-grade pancreatic malignant disease necessitating a distal pancreatectomy.

Intracranial pressure fluctuates due to heart beat, respiration, neuro-regulation, etc. Traditional intracranial pressure study focuses on the static pressure and related factors, putting emphasis on mean intracranial pressure, while paying little attention to the pulse components. This study was composed of two parts: animal experiment and theoretical analysis. The animal experiment was performed on 14 mongrel dogs, studying the variation of intracranial pressure wave form under different intracranial pressure level. The dogs were installed epidurally with latex sacculus to establish models of increased intracranial pressure. The degree of intracranial pressure and volume could be altered by changing the volume of fluid in the sacculus. During the process, pressure transducers were arranged to monitor and record the variations of the pressure of intracranial ventricle and lumbar subarachnoid cavity. The result demonstrated that, with the continual increase of intracranial pressure, intracranial pulse pressure increased correspondingly, showing a linear relationship with the change of intracranial pressure. After the sacculus was emptied and reinfused, the slope of the linear relationship was determined to be greater than the former slope. The same result was obtained in the lumbar cerebrospinal fluid pressure. Therefore, the lumbar cerebrospinal fluid pressure is consistent with the intracranial pressure. Intracranial pulse pressure is in linear relationship with mean pressure, and the slope of their linear relationship predicts the perform of intracranial autoregulation.
Animals ; Blood Pressure ; physiology ; Cerebrospinal Fluid Pressure ; physiology ; Dogs ; Female ; Intracranial Pressure ; physiology ; Male ; Monitoring, Physiologic ; methods ; Pulsatile Flow ; physiology ; Pulse

Purpose: The purpose of this study was to evaluate the diagnostic value of soluble Axl (sAxl) in hepatocellular carcinoma (HCC) in comparison with serum α-fetoprotein (AFP). Materials and Methods: Eighty HCC patients, 80 liver cirrhosis patients (LC), 80 patients with hepatitis B virus (HBV) infection, and 80 healthy controls (HC) were enrolled. sAxl levels were measured by an enzyme-linked immunosorbent assay, serum AFP levelswere measured by an electrochemiluminescence immunoassay. Receiver operating characteristic (ROC) curves were used to evaluate diagnostic performances. Results: The results show that levels of sAxl were high expression in patients with HCC (p < 0.05), varied with disease state as follows: HCC > LC > HC > HBV. Logistic regression and ROC curve analysis identified the optimal cut-off for sAxl in differentiating all HCC and non-HCC patients was 1,202 pg/mL (area under the receiver operating characteristic [AUC], 0.888; 95% confidence interval [CI], 0.852 to 0.924) with sensitivity 95.0%, specificity 73.3%. Furthermore, differential diagnosis of early HCC with non-HCC patients for sAxl showed the optimal cut-off was 1,202 pg/mL (AUC, 0.881; 95% CI, 0.831 to 0.931; sensitivity, 94.1%; specificity, 73.3%). Among AFP-negative HCC patients with non-HCC patients, the cut-off was 1,301 pg/mL (AUC, 0.898; 95% CI, 0.854 to 0.942) with a sensitivity of 84.6%, a specificity of 76.3%. The optimal cut-off for sAxl in differentiating all HCC and chronic liver disease patients was 1,243 pg/mL (AUC, 0.840; 95% CI, 0.791 to 0.888) with sensitivity 93.8%, specificity 61.9%. The combination of AFP and sAxl increased diagnostic value for HCC. Conclusion sAxl outperforms AFP in detecting HCC, especially in early HCC and in AFP-negative HCC. Combination sAxl with AFP improved the specificity for early HCC diagnosis. In summary, sAxl is a candidate serum marker for diagnosing HCC.

With the continuous in-depth study of minimally invasive cardiac surgery(MICS), minimally invasive cardiac surgery in children has also been developed in this period, but there is still a certain gap compared with adults. Because of the large difference in body size and the low tolerance of surgery in children, minimally invasive cardiac surgery in children still has a short board on complex cardiac diseases. This article reviews several commonly used minimally invasive techniques: (1) small incision cardiac surgery; (2) thoracoscopic and robot-assisted cardiac surgery; (3) minimally invasive cardiopulmonary bypass(MiECC) and cardiac surgery to avoid cardiopulmonary bypass; (4) hybrid surgery and enhanced cardiac rehabilitation surgery(ERACS) in pediatric cardiac surgery and their application and research progress.

Objective To explore the promoting effect of egg yolk oil combined with heat-clearing and detoxi-fying traditional Chinese medicine external washing on postoperative wound healing in patients with perianal abscesses based on growth factors in the wound granu-lation tissue.Methods Eighty patients with perianal abscesses admitted to our hospital from January 2023 to May 2023 were randomly divided into a control group and an observation group,with 40 patients in each group.Three days after surgery,the control group received routine treatment,such as external washing with heat-clearing and detoxifying Chinese herbal medicine and dressing changes with vase-line gauze.The observation group received additional treatment with egg yolk oil,and both groups were treated continuously for 7 days.The clinical efficacy,improvement in clinical symptoms,and wound recovery at different time points;serum inflammatory cytokines;and expression levels of wound granulation tissue-related factors were compared between the two groups.Results The total effective rate was higher in the observation group than the control group(95%vs.75%,P<0.05).The time of pruritus disappearance,decaying flesh,emer-gence of new epithelium,and healing were shorter in the observation group than in the control group(P<0.05).The pain degree,wound secretion,granulation morphology and surrounding tissue edema score of the observation group were significantly decreased at 7 and 10 days after surgery compared with the control group(P<0.05).Serum levels of interleukin(IL)-1β,IL-8,and tumor necrosis factor-α were lower in the observation group than the control group at 7 and 10 days after surgery(P<0.05).The levels of basic fibroblast growth factor,vascular endothelial cell growth factor,and transforming growth factor-βin wound granulation tissue were higher in the observation group than the control group at 7 and 10 days after surgery(P<0.05).Conclusion The external application of egg yolk oil combined with heat-clearing and detoxifying Chinese herbs can significantly improve the clinical symptoms of patients with perianal abscesses and promote wound healing,with significant therapeutic effects.This may be related to the inhibition of inflammatory cytokine expression and the promotion of wound granulation tissue growth factor expression.

OBJECTIVE: To investigate the epidemiological characteristics of allergic rhinitis (AR) in urban and rural areas of Ningbo and Yongzhou. METHOD: Fifteen fields in the two cities from October 2006 to June 2007 were randomly selected. Cases suspected with symptoms of AR by a self-administered and interview questionnaire were recommended to special examinations for confirmed diagnosis. RESULT: 1. A total of 9969 individuals from 3803 families were surveyed, of whom 303 suffered with AR. 2. The prevalence rate was 4.10% in Ningbo and 1.65% in Yongzhou (the sex-adjusted rate was 4.10% and 1.64% respectively, and the age-adjusted rate was 4.33% and 1.58%); the population of island inhabitants had the lowest prevalence rate of 0.73%. 3. The prevalence rate in patients with asthma and that with family genetic history was 8% and 12% respectively. CONCLUSION It demonstrates that the prevalence rate is higher in Ningbo than in Yongzhou, in urban than in rural and in adolescent than in other ages. Allergic rhinitis may be associated with asthma and related to genetic factors. Allergic rhinitis may be curable.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asthma ; epidemiology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Male ; Middle Aged ; Prevalence ; Rhinitis, Allergic, Perennial ; epidemiology ; Rhinitis, Allergic, Seasonal ; epidemiology ; Rural Population ; Surveys and Questionnaires ; Urban Population ; Young Adult

Spinocerebellar ataxias are a high clinically and genetically heterogeneous group of neurodegenerative disorders, usually belongs to autosomal dominant hereditary cerebellar ataxia. Spinocerebellar ataxia type 5 (SCA5) is one of the extremely rare subtypes and caused by heterozygous mutation of SPTBN2 gene. A case of infant-onset SCA5 patient is reported, mainly manifested as global developmental delay, ataxia and dysarthria, carrying the heterozygous missense variant c.1438C>T (p. Arg480Trp) in the SPTBN2 gene. This mutation may have an important impact on functional regions of the β-Ⅲ spectrin, leading to the occurrence of disease.

Objective:To analyze the clinical presentations and diagnostic and treatment process of one patient with autoimmune encephalitis(AE)with double positive anti-N-methyl-D-aspartate receptor(NMDAR)and anti-γ-aminobutyric acid B receptor(GABABR)secondary to herpes simplex virus encephalitis(HSVE),and to improve the clinicians'awareness of this disease.Methods:The clinical data of one AE patient with double positive anti-NMDAR and anti-GABABR secondary to HSVE were collected,the diagnostic and therapeutic processes were summarized,and the relevant literatures were reviewed.Results:The patient,a 36-year-old male,developed a headache followed by limb convulsions,and progressed to disturbed consciousness.After admission,the routine biochemistry of the cerebrospinal fluid(CSF)was abnormal,and the herpes simplex virus-1(HSV-1)IgG antibody showed positive in the CSF;both CSF and serum tests for NMDAR antibodies were positive;the head magnetic resonance imaging(MRI)results showed abnormal signals in the right occipital white matter,leading to the diagnosis of HSVE secondary to anti-NMDAR encephalitis.Several months later,the patient experienced psychiatric behavior abnormalities,cognitive dysfunction,and sleep disorders,and both the serum NMDAR and GABABR antibodies showed positive results,prompting the diagnosis of HSVE secondary anti-NMDAR encephalitis and anti-GABABR encephalitis.After treatment with steroid pulse therapy and intravenous immunoglobulin(IVIG),the patient's condition was improved and the patient was discharged.At one-year follow-up,the patient's psychiatric symptoms had completely resolved,leaving mild cognitive impairment.Conclusion:If the clinical symptoms of the patients recovering from antiviral treatment for HSVE is worsened,secondary AE should be highly suspected;it is important to complete autoimmunity antibody testing as soon as possible for the early diagnosis and treatment to improve the prognosis of the patient.

In order to investigate the effects of porin genes ompW,ompS and ompD on the biological properties and virulence of Salmonella typhimurium,the corresponding mutant strains were con-structed using the λ Red homologous recombination system,and the growth curves,motility,bio-chemical properties,in vitro genetic stability,biofilm-forming ability,drug resistance,and lethal dose at half capacity(LD50)between the standard strain and each mutant strain were detected by comparative assays for Salmonella typhimurium.The results showed that,compared with the standard strain,the ompD and ompW mutation had less effect on the growth rate and motility of the bacteria,while the ompS mutation significantly reduced the growth rate and motility;none of the three genetic mutation affected the biochemical characteristics of Salmonella typhimurium,nor the genetic stability,but affected its susceptibility to a variety of commonly used antibiotics to varying degrees and caused a highly significant decrease(P＜0.01)in the ability to form a biofilm,and the results showed that the three mutant strains had a significant reduction in the ability to form a biofilm.The result of LD50 virulence assay showed that all three genetic mutation led to a decrease in the virulence of Salmonella typhimurium,among which the ompS mutant strain showed the most obvious decrease in virulence,LD50 was 25 times that of the standard strain.In conclusion,mutations of the pore protein ompW,ompS,and ompD genes can affect some biological properties of Salmonella typhimurium.The results of this study laid an experimental foundation for further research on the biological functions of the pore protein ompW,ompS and ompD genes and Salmonella pathogenicity.

Incorporation of multiple functions into one nanoplatform can improve cancer diagnostic efficacy and enhance anti-cancer outcomes. Here, we constructed doxorubicin (DOX)-loaded silk fibroin-based nanoparticles (NPs) with surface functionalization by photosensitizer (N770). The obtained nanotheranostics (N770-DOX@NPs) had desirable particle size (157 nm) and negative surface charge (-25 mV). These NPs presented excellent oxygen-generating capacity and responded to a quadruple of stimuli (acidic solution, reactive oxygen species, glutathione, and hyperthermia). Surface functionalization of DOX@NPs with N770 could endow them with active internalization by cancerous cell lines, but not by normal cells. Furthermore, the intracellular NPs were found to be preferentially retained in mitochondria, which were also efficient for near-infrared (NIR) fluorescence imaging, photothermal imaging, and photoacoustic imaging. Meanwhile, DOX could spontaneously accumulate in the nucleus. Importantly, a mouse test group treated with N770-DOX@NPs plus NIR irradiation achieved the best tumor retardation effect among all treatment groups based on tumor-bearing mouse models and a patient-derived xenograft model, demonstrating the unprecedented therapeutic effects of trimodal imaging-guided mitochondrial phototherapy (photothermal therapy and photodynamic therapy) and chemotherapy. Therefore, the present study brings new insight into the exploitation of an easy-to-use, versatile, and robust nanoplatform for programmable targeting, imaging, and applying synergistic therapy to tumors.