Objective To explore the clinical efficacies of laparoscopic distal pancreatectomy (LDP) with laparoscopic splenectomy (LS) for the treatment of malignant tumors in the body and tail of pancreas.Methods The clinical data of 37 patients with malignant tumors in the body and tail of pancreas who were admitted to the Third Affiliated Hospital of Guangzhou Medical University from June 2009 to December 2014 were retrospectively analyzed.LDP with LS was performed on all the patients under general anesthesia.The operation time,volume of intraoperative blood loss,postoperative complications,removal time of postoperative drainage tube,duration of hospital stay and results of pathological examinations were recorded.All the patients were followed up via outpatient examination and telephone interview up to May 2015.Results Thirty-seven patients received successful surgery without conversion to open surgery and perioperative death.Of 37 patients,19 received splenectomy due to splenic artery and vein surrounded by masses of pancreatic body and tail,splenic ischemia after clamping or amputating of splenic artery and vein;11 received splenectomy due to splenic hilum invasion,dense adhesions,unclear boundary and difficulty in preserving spleen;7 received splenectomy due to splenic cystic occupying lesion.The operation time,volume of intraoperative blood loss and removal time of drainage tube were (232 ± 42) minutes,(330 ± 160)mL and (5.0 ± 2.0)days,respectively.Four patients were complicated with pancreatic leakage without obvious discomfort and discharged from hospital with a placement of drainage tube,and then drainage tubes were removed after 2 weeks.The mean duration of postoperative hospital stay was 7.5 days (range,5.0-10.0 days).The results of pathological examination showed that resection margin was negative,moderate and low malignant intraductal papillary mucinous neoplasm (IPMN) was detected in 12 patients,mucinous cystic carcinoma in 9 patients,moderate and low malignant solid pesudopapillary neoplasm (SPN) in 7 patients,pancreatic ductal adenocarcinoma in 4 patients,pancreatic neuroendocrine cancer in 3 patients and acinic cell carcinoma in 2 patients.The number of detecting lymph node was (9 ± 3).All the patients were followed up for a mean time of 9 months (range,3-12 months) without recurrence of tumors.The platelet (PLT) of 37 patients was different levels of increasing.Of 21 patients with PLT ＞ 500 × 109/L,PLT was returned to normal range after aspirin and/ or clopidogrel were taken orally.Conclusion LDP with LS is safe and feasible for malignant tumors in the body and tail of pancreas.

ObjectiveTo study the protective effects of Qiqiong(QQJN) on focal cerebral ischemia/reperfusion injury and its mechanism. MethodsMiddle cerebral artery occlusion(MCAO) was used to make focal cerebral ischemia/reperfusion model by intravascular nylon filament occlusion. The protective effects of QQJN were evaluated by investigating neurological function score, percentage of cerebral infarction, pathomorphology of brain, the activity of SOD and the content of MDA in hrain tissue,thrombogenesis and platelet aggregation in vitro. ResultsCompared with model group, QQJN(4.4、8.8g/kg)could decrease the neurological score in 8 and 22h after reperfusion, reduce the percentage of cerebral infauction,improve pathomorphology of brain, decrease the length, wet weight and dry weight of thromb and inhibit platelet aggregation. ConclusionQQJN had protective effects on focal cerebral ischemia/reperfusion injury. The role of anti-injury of free radicals,inhibit thrombogenesis and platelet aggregation should contribute to its neuroprotective effects.

Objective To evaluate the effects of shRNA-TGF-β1 plasmid on Smads signal transduction of rat renal allograft.Methods A Sprague-Dawley to Wistar rat orthotopic transplant kidney-sclerosis accelerated model was constructed and transfected with short hairpin RNA-TGF-β1 based on the hydromechanics.The recipients were divided into three groups:group T(plasmid group)injected with shRNA-TGF-β1;group H(vacant plasmid group)injected with vacant plasmid;group Y(simply transplantation group)injected with no plasmid.In group J(sham-operated group)only right kidney was removed with no transplantation as control group.Transplanted kidneys and blood samples were collected at the first,second and third month after transplantation.The blood urea nitrogen(BUN)and serum Cr were tested by enzyme-linked immunoadsordent assay.The gene transcriptional level of TGF-β1 and Smad3/7 was detected by RT-PCR,and the protein variations of TGF-β1 and phosphorylated Smad3/7 were examined by Western blotting.Results At each test time point,the BUN and serum Cr were significantly higher in the plasmid group than in the sham-operated group(P<0.05 or P<0.01),but obviously lower than in the vacant plasmid group and simply transplantation group(P<0.05 or P<0.01).The expression of TGF-β1 as well as phosphorylated Smad3 was significantly higher in the plasmid group than in the sham-operated group(P<0.05 or P<0.01),but obviously lower than in the vacant plasmid group and simply transplantation group(P<0.05 or P<0.01).However,the expression of phosphorylated Smad7 was significantly lower in the plasmid group than in the sham-operated group(P<0.05 or P<0.01),but obviously higher than in the vacant plasmid group and simply transplantation group(P<0.05 or P<0.01).Conclusion Short hairpin RNA-TGF-β1 plasmid could significantly improve the renal function of rat renal allografts probably by downregulating phosphorylated Smad3 and upregulating phosphorylated Smad7,leading to the inhibition of TGF-beta 1 promoting fibrosis role and delay of the allograft fibrosis.

Objective To explore the mechanism of Niaochangshu capsule in the treatment of postmenopausal overactive bladder, through observing its influence on bladder weight and the expression of eNOS and AQP1 of ovariectomized female rats. Methods Female SD rats were divided into blank group, model group, Nilestriol group and Niaochangshu group. Rats were removed ovaries except the blank group. The treatment groups were given corresponding drugs, blank group and model group were given normal saline by gavage. After 4 weeks, the bladders' weight and thickness were detected, the expressions of eNOS and AQP1 in serum and bladder tissue were determined by ELISA, and NO by spectrophotometry. Results Ovariectomy resulted in decreased bladder weight, bladder mucosal and muscular atrophy, and opposite changes showed after given Niaochangshu. The expressions of eNOS and NO in bladder and serum were decreased significantly after ovariectomy, while increased by given Niaochangshu capsule or nylestriol (P<0.05), and there was significant difference between Niaochangshu group and Nilestriol group (P<0.05). The expression of AQP1 was decreased in the model group, and increased after given nylestriol or Niaochangshu capsule. While the expression of AQP1 in bladder had no significant difference among the four groups. Conclusion Niaochangshu capsule can reverse bladder mucosal and muscular atrophy caused by estrogen deficiency, and increase the content of eNOS in serum and bladder, thus play the role in the treatment of postmenopausal overactive bladder.

Objective To investigate the role of multi-disciplinary team (MDT) in the treatment of complex cholestatic liver injury after liver transplantation. Methods MDT consultation was conducted to clarify the causes and therapeutic strategies for one case of complex cholestatic liver injury after liver transplantation admitted to Liver Transplantation Center of the First Hospital of Jilin University on June 23, 2020. And the role of MDT in the treatment of complex cholestatic liver injury after liver transplantation was summarized. Results The patient presented with abnormal liver function after liver transplantation. The diagnosis of biliary stricture, rejection and biliary tract infection was confirmed successively. Endoscopic retrograde cholangiopancreatography (ERCP) stent internal and external double drainage, glucocorticoid shock and anti-infection therapy yielded low clinical efficacy. After MDT consultation, complex cholestatic liver injury after liver transplantation was confirmed. It was suggested to optimize the immunosuppressive regimen based on the exclusion of rejections by pathological examination, deliver targeted anti-infection interventions and prevent the potential risk of concomitant drug-induced liver injury. The patient was discharged after proper recovery. Conclusions The causes of complex cholestatic liver injury after liver transplantation are diverse, and the condition changes dynamically. MDT consultation are performed to deepen the understanding of this disease, strengthen the classification of diagnosis and treatment ideas and enhance the precision and efficacy of corresponding treatment.