The surgical intervention and criteria of severe acute pancreatitis has significantly changed in the last several years with the advent of enhanced imaging techniques and minimally invasive surgery.Many kinds of minimally invasive technologies which take laparoscopy as a representative are constantly applied to the treatment of severe acute pancreatitis and make its mortality and postoperative complication rate decrease obviously.However,there are many different ways using laparoscopic techniques to treat severe acute pancreatitis.In this review,the author will discuss the current status of the different approaches.

Objective Surgical treatment of lung cancer needs to follow strict quality control standard for the aims of accuracy of pathological staging and potentially improved prognosis.However,there are short of studies related to surgical quality analysis.Methods One hundred and twelve patients were enlisted with the diagnosis of lung cancer and received surgical intervention in 2007.Surgical quality of these cases were retrospectively analyzed in compliance with three international standards,National Comprehensive Cancer Network (NCCN),American College of Surgeons’ Oncology Group (ACOSOG),and International Association for the Study of Lung Cancer (IASLC).Results No surgical death was reported in this group.According to NCCN,ACOSOG and IASLC standards,qualified operations were 82 cases (80.4％),73 cases (71.6％),45 cases (44.1％) in 102 cases with R0 resection,respectively.The median total lymph nodes,median mediastinal nodes,and N1 nodes were 27 (range 0-63),16.5 (range 0-43),and 10.5 (range 0-26),respectively.The median mediastinal node stations resected were 4 (range 0-6).In the mediastinum,stations of 4R,5,6 and 7 presented the highest frequency of receiving lymph node dissection.For N1 stations,10 and 12 were among the top list.For the whole group,1-year survival,3-year survival and 4-year survival were 92％ (95％ CI,89-95),67％ (95％ CI,62-72),57％ (95％ CI,52-62),respectively.Conclusion Quality control is the essential part of surgical treatment of lung cancer,which will facilitate the baseline standardization of clinical research.Since IASLC provides the strictest standard for lung cancer surgery,we suggest that all thoracic surgeons need to follow this standard to secure the accuracy of pathological diagnosis and for a potential better prognosis.

Multi-target drugs attract increasing attentions for the therapy of complicated neurodegenerative diseases. In this study, a computer-assisted strategy was applied to search for multi-target compounds by the pharmacophore matching. This strategy has been successfully used to design dual-target inhibitor models against both the acetylcholinesterase (AChE) and poly (ADP-ribose) polymerase-1 (PARP-1). Based on two pharmacophore models matching and physicochemical properties filtering, one hit was identified which could inhibit AChE with IC50 value of (0.337 +/- 0.052) micromol x L(-1) and PARP-1 by 24.6% at 1 micromol x L(-1).
Acetylcholinesterase ; metabolism ; Cholinesterase Inhibitors ; pharmacology ; Computer-Aided Design ; Drug Discovery ; methods ; Poly(ADP-ribose) Polymerase Inhibitors

BACKGROUND:The mechanism underlying orthodontic-induced external root resorption is not yet clear, and it differs individual y. Kidney deficiency has been proved to be related to bone diseases which mediated by different cytokines. Interleukin-17 is an important cytokine involved in external root resorption. So figuring out whether kidney deficiency and interleukin-17 are related to root resorption wil be helpful for etiological research.
OBJECTIVE:To explore the relationship between kidney deficiency physique, interleukin-17 and root resorption during orthodontic treatment in rats.
METHODS:Thirty-six Wistar rats were selected and equivalently randomized into two groups, fol owed by modeled into kidney deficiency (kidney deficiency group) or injected with normal saline (control group), respectively. Afterwards, the right maxil ary of each rat served as an orthodontic force model, and the left maxil ary as a non-orthodontic force model. Al rats were respectively sacrificed under general anesthesia at the 3, 7 and 14 days after given orthodontic force. Then, the mesial surface of the root of maxil ary first molars and the expression level of interleukin-17 were observed through hematoxylin-eosin staining and immunohistochemical method.
RESULTS AND CONCLUSION:Histological observation showed that significantly increasing root resorption in a time-dependent manner could be observed, and there were various absorbed lacunae of osteoclasts on the enamel in the kidney deficiency orthodontic force group. The alveolar bone resorption and widened periodontal membrane appeared in the control orthodontic force group. While no remarkable root and alveolar bone resorptions were found in the other two non-orthodontic force groups. The expression level of interleukin-17 in the kidney deficiency orthodontic force group was higher than that in the control orthodontic force group;the expression level of interleukin-17 in the kidney deficiency non-orthodontic force group was higher than that in the control non-orthodontic force group. In conclusion, kidney deficiency patients are easy to develop root resorption, the mechanism of which is maybe relevant to the upregulation of interleukin-17.

OBJECTIVETo explore and compare the clinical effects of three immuno-potentiators and their influence on immune function in preventing and treating recurrent respiratory tract infection (RRI).

METHODSSeventy-two children with RRT were assigned to three groups, the 23 patients in the M group treated with milkvetch extract oral liquid, the 23 in the P group treated by P-transfer factor and the 26 in the U group treated by Utilins injection. Clinical effect was compared among three groups after treatment, and changes of T cell subgroups as well as immune antibodies were detected before and after treatment.

RESULTSThe markedly effective rate in the M, P, and U group was 69.6%, 65.2%, and 73.0% respectively, and the total effective rate 87.0%, 82.6%, and 92.3%, showing an insignificant difference among them (all P>0.05). After treatment, the levels of CD3+, CD4+ and CD4+/CD8+ rose obviously in the three groups (all P<0.05); levels of CD8+ in the M group and the P group lowered significantly (P<0.05, P<0.01), but with no significant difference among three groups in the changes of T cell subgroups (all P>0.05). Serum levels of IgG in all the three groups, IgA in the P group and the M group, and IgM in the M group and the U group rose significantly (P<0.05 or P<0.01), with statistical difference presented in comparing of IgA level in the P group with that in the other two groups (P<0.01).

CONCLUSIONThe clinical effects and the outcomes of immunological indexes' changing are similar in RRI patients treated by the three immuno-potentiators. They all can enhance the immunological function of the organism, strengthen the disease-resistant ability of patients, and reduce the incidence of RRI. Among them, the milkvetch extract oral liquid is worthy of spreading due to its lower cost, simple administration, exemption from painful injection, and good compliance.

Administration, Oral ; Astragalus Plant ; chemistry ; Child ; Child, Preschool ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; therapeutic use ; Female ; Humans ; Immunoglobulins ; blood ; Infant ; Male ; Respiratory Tract Infections ; blood ; drug therapy ; immunology ; prevention & control ; Retrospective Studies ; Secondary Prevention ; T-Lymphocyte Subsets ; drug effects ; immunology ; Treatment Outcome

Objective To study the application of a new magnetic beads made in China in DNA extraction of forensic biological samples with automation workstation.Methods DNA was extracted from common forensic biological samples by QIAGEN Bio-Robert Universal System and a new magnetic beads made in China,and then typed with Identifiler system in ABI3130XL Genetic Analyzer.210 of these samples were also quantitated by ABI7500 Real Time System.Results Total of 9100 genomic DNA was extracted from various forensic biological samples by the new magnetic beads made in China and automation workstation methods,and most of them were successfully typed for STR analysis.In these biological samples,oral swabs and muscles were of the highest Success rate of STR typing(100%),and the lowest was touched cell samples (50.0%).Conclusion The new magnetic beads made in China with automation workstation methods can be applied to DNA extraction of most forensic biological samples.

Objective This study is to analyse the clinical feature and risk factors of morbidity after pulmonary resection for lung cancer in patients older than 70 years. Methods The clinical records of 222 patients older than 70 years who had undergone pulmonary resection for their lung cancer was reviewed. The patients were divided into 3 groups: group Ⅰ including the patients who had severe postoperative complications, group Ⅱ including the patients who had mild complications and group Ⅲ including the patients who had no complications. Moreover, the definitions were made that group A1 = group Ⅰ+ Ⅱ , group B1 = group Ⅲ, group A2 = group Ⅰ and group B2 = group Ⅱ + Ⅲ. Univariate analyses and multivariate binary logistic regressions relating postoperative morbidity to risk factors were performed between the group Al and Bl, A2 and B2, resulting in the identification of the independent risk factors for overall morbidity and major morbidity. Results Preoperative comorbidity was recorded in 161 patients (72.5%). Lobectomy (64.9% ) was the predominant surgical procedure. The median number of dissected LN was 14, with the range of 0 to 57. The overall morbidity was 63.5% , including major morbidity of 13.5%. Perioperative mortality was 1.8% (4 cases). The results of binary logistic regression analyses indicated that the independent risk factors for overall morbidity were preoperative weight loss (P =0.020), ASA score (P＜0.001), MVV (% predicted) (P=0. 020 ) and the number of dissected LN ( P = 0.004 ). The independent risk factors for major morbidity were ASA score ( P =0.003), MVV (% predicted) (P= 0.018) and the location of tumor (P=0.007). Conclusion Preoperative weight loss and numbers of dissected mediastinal lymph nodes were risk factor for lung cancer patients older than 70 years, Proper perioperative management for the elderly patients with high ASA score, low MVV (% predicted) or central tumor, could reduce the major postoperative morbidity.

ObjectiveTo investigate the effects of using spiral pedunculated bladder muscle flap ureteroplasty in the treatment of long ureteral segment defects ( ＞ 20 cm).MethodsA retrospective analysis was conducted on the clinical effects of five patients who encountered long ureteral segment defects caused during ureteroscopic lithotripsy.The five patients included three males and two females with an age range from 37 to 59 yrs ( average age 48 ).Four of the cases had defects on the left and one case on the right.Two cases had whole ureteral mucosal avulsion and three cases had whole ureteral ruptur from the pelvis to the bladder junction.Defect lengths measured from 21 to 25 cm( mean length 22.5 cm).All five patients underwent emergency surgery using spiral pedunculated bladder muscle flap ureteroplasty and 7 F double J stent placement in the repaired ureters which was fixed on psoas muscles.The average length of the new ureters using spiral pedunculated bladder muscle flap was 22.5 cm.ResultsAll the operations were successful and the operation time was 1 -2 hrs (average 1.5 hrs).Drainage tubes for four patients were removed three days after operation.IN the remaining case the drainage tube was removed 10 days after surgery due to urine leakage.All wounds healed uneventfully.Serum creatinine and blood urea nitrogen were normal two weeks after surgery.Double-J tubes were removed safely under cystoscope eight weeks after surgery.In following-up,one case was found to have mild hydronephrosis and ipsilateral ureter slight expansion six months after surgery,but renal function was normal.There was no abnomality found in the remaining four patients after 2 -4 years of follow-up.The IVU showed normal morphology and good developments in the ipsilateral ureter.ConclusionsSpiral pedunculated bladder muscle flap ureteroplasty is an ideal treatment method in repairing long ureteral segment defects.

Objective Surgical approech differs between China and western countries in the treatment of middle/lower aegment thoracic esophageal cancer. This study was designed to compare the effects of different surgical modalities on traumatic reaction, heal-ing process and lymph node dissection.Methods Fifty-nine petients,diagnosed with middle/lower segment of thoracic esophageal cancer, were enlisted and had undergone curative RO esophagectomy.The patients were categorized based on different approaches as the following three groups:group of Ivor-Lewis operation,group of McKeown operation and group of esophagectomy through left tran-sthoracic approach.Clinical data was summarized and malyzed.Results (1)No surgical death was reported in this study.(2)There were no statistical difference among the three groups in tenms of postoperative hospital stay,diration of systemic inflammatory re-sponse syndrome and total body fluid loes (P=0.287,0.641,0.355).(3) The number of total lymph nodes harvested from the above three groups was 22.5(11-39),26(14-56).and 17(7-44)(P=0.005),respectively.The number of abdominal lymph nodes harvested from the above three groups was 10(5-26),12(4-32),and 8(3-19)(P=0.021),respectively.No statistical difference was found to the number of thoracic lymph nodes among three groups.(4)Lymph node metastasis occurred most frequently in the station of pericardial lymph nodes,followed by middle thoracic paraesophageal nodes along the left gastric ar-tery.The range of metastasized lymph nodes dissected through left transthoracic approach was much limited compated with right tran-sthoracic approach.Conchuslon The was no difference between left and right transthoracic approach in terms of surgical trauma and overall rehabilitation.The number of lymph nodes harvested from right transthoracic approach surpassed that from the left approach, which might be due to the extent of abdoominal lymphadenectomy.Considering wide range of lymph node metastasis,We recommedn a more extended lymph node dissection for middle/lower segment of thoracic esophageal cancer for the purpose of better local control control and survival benefit.

Objective:To study the relationship between somatization symptoms and body mass index (BMI), sleep and cognitive function in patients with depression.Methods:A total of 119 patients with depression were selected from January to December in 2019.According to the score of patient health questionnaire-15(PHQ15), they were divided into mild somatization group ( n=75) and moderate severe somatization group ( n=44). Hamilton depression scale-24(HAMD-24), patient health questionnaire-15, Pittsburgh sleep quality index(PSQI) and Montreal cognitive assessment(MoCA) were used to evaluate all subjects.SPSS 23.0 software was used for data analysis.Independent sample t-test was used to compare BMI, sleep and cognitive function scores between the two groups.Pearson correlation analysis was used to study the correlation between somatization symptoms and sleep quality and cognitive function. Results:There were significant differences in BMI((21.70±3.09)kg/m 2, (23.31±3.51)kg/m 2), PSQI((12.56±4.37), (14.37±3.72)), sleep quality(1.87±0.86), (2.21±0.80)), sleep disorder ((1.24±0.59), (1.65±0.53))and daytime dysfunction((2.45±0.81), (2.77±0.48)) between the two groups ( t=-3.783--2.133, all P<0.05), but no difference was found in cognition ( P>0.05). Correlation analysis showed that after controlling HAMD, PHQ-15 was positively correlated with PSQI, sleep quality, sleep disorder, daytime dysfunction and language score in MoCA ( r=0.205-0.298, all P<0.05). Conclusion:The severity of somatization in patients with depression is related to BMI, sleep quality, sleep disorder, daytime dysfunction and language function, suggesting that they may play an important role in the pathogenesis of depression with somatization.