Objective To investigate the therapeutic effect of percutaneous laser disc decompression on lumbar discogenic pain.Methods56 patients with lumbar discogenic pain were treated with percutaneous laser disc decompression with Nd:YAG laser(wavelength 1064 nm).They were followed up for more than 3 months with Macnab criteria.ResultsAll the patients were followed up.At the end point of postoperative 3 months,32 patients had an excellent outcome,20 were good,3 patients were fair,1 patient were poor.No complication(infection and nerve injury)had been observed.ConclusionPercutaneous laser disc decompression is a safe,little invasive and effective treatment modality for lumbar discogenic pain.

AIM: To explore the change of delayed rectifier potassium channel (K_V) activity in alveolar macrophages (AM) in chronic obstructive pulmonary disease (COPD) rats. METHODS: COPD model was established by exposure of the animals to cigarette smoke. With whole-cell voltage- or current-clamp techniques, K_V activity, membrane capacitance and resting membrane potential (Em) in AM from COPD model and control rats were compared. RESULTS: (1) Significant increases in total mononuclear cells and AM in bronchoal aveolar lavage fluid (BALF) were found in COPD group compared with in control group. (2) The AM K_V current altitude in COPD group [(520.5?38.7)pA, (+50) mV, n=30] was significantly lower than that in control group [(713.6?44.4)pA, (+50) mV, n=30, P0.05), but had more positive Em (P

Objective To compare the safety and effectiveness of duodenum-preserving pancreatic head resection (DPPHR) with pylorus-preserving pancreaticoduodenectomy (PPPD) in the treatment of chronic pancreatitis with a pancreatic head mass.Methods Medline,Biosis,Cochrane Library,Science Citation Index Database,CBM Database,Wan Fang and CNKI were searched systematically.The bias risk of the included trials was assessed according to the assessing tools as suggested by the Cochrane Handbook.Review Manage 5.2 was used to perform the statistical analysis.Results 7 RCTs with 226 patients were included in the meta-analysis which showed that there were no significant differences between PPPD and DPPHR in overall postoperative morbidity,postoperative hospital stay,complete pain relief,pancreatic fistula,exocrine insufficiency,symptom score at 5 to 7-year follow-up,and quality of life score at 14 to 15-year follow-up (P ＞ 0.05).While DPPHR had significant superiorities in operation time,blood replacement,delayed gastric emptying,occupational rehabilitation after the operations,weight gain,quality of life score at 1 to 2-year follow-up,symptom score at 5 to 7-year follow-up,and physical functioning score at 14 to 15-year follow-up.Conclusions DPPHR is more favourable than PPPD in reducing the use of blood replacement,shortening operation time,delayed gastric emptying,occupational rehabilitation after the operations,weight gain,physical functioning,and in improving quality of life of patients.

Objective To investigate the effects of sub-chronic arsenic poisoning on hyaluronidase activity of rat sperm.Methods Forty Sprague-Dawley (SD) rats in cleanliness grade,weighing 100-200 g,were randomly divided into four groups:control group,low-dose,middle-dose and high-dose arsenic exposure groups,10 in each group,and allotted to cages.Rats of arsenic groups were exposed to arsenic through drinking water (As2O3 was dissolved in distilled water).The concentrations of As2O3 in low-dose,middle-dose and high-dose groups were 25,50,and 100 mg/L,respectively.Body weight of each rat was weighed once a week.The rats in control group drank distilled water freely.All rats were fed for three months.After the experiment,all rats were killed and their sperms were collected.The positive rates and hyaluronidase activity intensities of the sperms in different groups were examined by the mature improved fixed-substrate film method.Results The positive rate of sperm hyaluronidase in control,low-dose,middle-dose and high-dose groups were (90.8 ± 13.2)％,(79.1 ± 15.6)％,(59.7 ± 20.3)％ and (33.8 ± 14.5)％,respectively.Compared with the control group,the positive rates of the middledose and the high-dose groups were significantly reduced(all P ＜ 0.05).The activity intensities of hyaluronidase in the sperms in control,low-dose,middle-dose and high-dose groups were (45.1 ± 24.0),(31.1 ± 21.3),(19.4 ± 15.3) and (9.8 ± 3.1)μm,respectively.Compared with the control group,the activity intensities of hyaluronidase of the middle-dose and the high-dose groups were significantly reduced(all P ＜ 0.05).Conclusion Sub-chronic arsenic poisoning reduces the activity intensities and positive rates of sperm hyaluronidase of rat,resulting in reduced sperm fertilizing capacity.

Objective To investigate the changes of estrogen receptor expression in mast cells of bronchial mucosa from female asthmatic patients.Methods 12 cases of female asthmatic patients and 9 cases of control female patients were enrolled in this study.The bronchial mucosa was obtained from the third grade bronchial by fiexible bronchofiberscope.Mast cells were marked by anti-mast cell tryptase monoclonal antibody,the expression of estrogen receptor(ER)were detected by anti-human estrogen receptor(ER)monoclonal antibodies.Results Mast cells and estrogen receptor positive cells of bronchial mucosa in female asthmatic patients were significantly higher than that in control group(P＜0.01).Coincident with the known features of bronchial asthma,the cells positive for estrogen receptor were morphologically similar to the mast cells.The cells stained for estrogen receptors by dual immunostaining coincided exactly with cells labeled as mast cells.Conclusion The result suggested the estrogen may be involved in the pathogenesis of female asthmatic patient through the changes of estrogen receptor expression in mast cells of bronchial mucosa.

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 discuss the significance of neoadjuvant chemotherapy followed by surgery in the treatment of local advanced esophageal cancer. Methods:A total of 272 cases of local advanced esophageal cancer were studied in retrospect. Out of the 272 cases, 112 were treated with neoadjuvant chemotherapy followed by surgery (CT-S), whereas the remaining 160 cases underwent surgical treatment (S) only. Complications and survival state after surgery were compared. Results: The rate of complications after surgery was as follows: CT-S: 34.8% (39/112); S: 29.4% (47/160), P=0.50. The five-year survival rate was 35.7% and 29.4%, respectively, P<0.05. The CT-S patients were divided into partial remission (PR) and stable disease (SD)/progressive disease (PD) groups according to the effect of the chemotherapy. The five-year survival rate was 38.5% and 30.1%, respectively, P<0.01. Conclusion: Neoadjuvant chemotherapy is available for local advanced esophageal cancer. Postoperative complications are not increased by chemotherapy, and the survival rate for local advanced esophageal cancer is improved by neoadjuvant chemotherapy. PR has better prognosis compared with SD/PD.

Objective:To study the use of three-dimensional computer reconstruction in diagnosis and treatment of hilar cholangiocarcinoma.Methods:A retrospective analysis of clinical data was conducted on patients with hilar cholangiocarcinoma admitted to the Department of General Surgery, the First Affiliated Hospital of the University of Science and Technology of China from January 1, 2017 to July 31, 2019. The classification of hilar cholangiocarcinoma, vascular invasion and surgical resectability were determined by preoperative three-dimensional reconstruction. These data were then compared with the findings obtained during operations, by comparing with the three-dimensional reconstruction technology findings in classification of hilar cholangiocarcinoma, vascular invasion, and hilar extent of biliary and vasculature involvement.Results:Of 65 patients included in this study, there were 35 males and 30 females, with an age of (60.35±10.70) years. After operation, these 65 patients were classified into type I ( n=7), type II ( n=4), type III ( n=14), and type IV ( n=40) using the Bismuth classification. The accuracy rates of preoperative three-dimensional reconstruction for hilar cholangiocarcinoma classification, portal vein invasion, hepatic artery invasion, and diagnosis of hilar cholangiocarcinoma vasculature involvement were 90.7% (59/65), 90.7% (59/65), 86.1% (56/65) and 80.0% (52/65) respectively. Conclusions:The three-dimensional computer reconstruction technology could visually and accurately display the shape and spatial extent of hilar cholangiocarcinoma. It has an important clinical use in accurately diagnosing hilar cholangiocarcinoma preoperatively.

Objective To investigate the anti-atherosclerosis effect of apocynum venetum(AV)by observing the influence of AV extract on early inflammatory factor TNF-αexpression.Methods Human U937 monocytes were differentiated to macrophages by the phorbol myristate acetate(PMA)induction and acted with 100 mg/L ox-LDL to form the foam cells for establishing the early atherosclerosis model(ox-LDL group).The different concentrations(0.2,0.4,0.8 mg/L)of AV were added to co-culture for 48 h (AV1,AV2,AV3 groups).The expression level of TNF-αin the supernate was detected by ELISA and RT-PCR respectively.Re-sults Compared with control group,the expression level of TNF-αin the ox-LDL group was significantly increased,the expression level of TNF-αin various AV medication groups(AV1,AV2,AV3 groups)was significantly decreased compared with the ox-LDL group(P<0.05).The AV concentration increase was negatively correlated with the TNF-αexpression level(P<0.05).Conclusion TNF-αis an important inflammatory factor in early atherosclerosis,AV could play the anti-atherosclerosis role by inhibiting the inflammatory factors.

Objective To study the use of a preoperative predictive scoring system established by the Beth Israel Deaconess Medical Center,Washington University School of Medicine and Hospital of the University of Pennsylvania for patients with clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy.Methods The clinical data of 394 patients who underwent pancreaticoduodenectomy at the Provincial Hospital Affiliated to Anhui Medical University from September 2007 to December 2015 were retrospectively analyzed.The four indexes including the gland texture,pathology,pancreatic duct diameter and intraoperative blood loss were calculated for the predictive score system using the logistic regression test.The factors associated with CR-POPF were analyzed.The sensitivity and specificity of the predictive scoring system were determined by the receiver operating characteristic (ROC) curve analysis.Results Of the 70 patients who were diagnosed to have postoperative pancreatic fistula (POPF),34 were CR-POPF,which included 36 with grade A,23 with grade B and 11 with grade C.Univariate analysis showed that male,preoperative serum total bilirubin level ≥ 170 mmol/L,pancreatitis or pancreatic cancer,portal vein invasion,soft pancreatic texture,main pancreatic duct diameter ≤ 3 mm,and pancreaticojejunostomy were significantly related to POPF after pancreaticoduodenectomy (P ＜ 0.05).Portal vein invasion,pancreatic texture and main pancreatic duct diameter were the risk factors of CR-POPF after pancreaticoduodenectomy (P ＜ 0.05).Multivariate analysis showed the independent risk factors associated with POPF were male,preoperative serum total bilirubin level ≥ 170 mmol/L,soft pancreatic texture and main pancreatic duct diameter ≤3 mm (P ＜ 0.05),while soft pancreatic texture and main pancreatic duct diameter ≤3 mm were the independent risk factors of CR-POPF (P ＜ 0.05).There were significant differences in the clinical relevant postoperative pancreatic fistula rates among the negligible risk,low risk,intermediate risk,and high risk patients with CR-POPF (P ＜ 0.05).The results of ROC curve analysis showed that the sensitivity and specificity of the Fistula Risk Scoring system were 76.5％ and 95.8％,respectively.The nomogram showed the area under the curve was 0.913 (95％ CI:O.858 ～ 0.968).Conclusion The preoperative predictive scoring system accurately predicted the occurrence of CR-POPF.