Objective To investigate the clinical application of pancreatic head resection with the second portion duodenectomy (PHRSPD). MethodsThe clinical data of 4 PHRSPD cases were analyzed retrospectively. ResultsThere were 3 benign and 1 low-grade malignant periampullary tumors. The mean surgical time was 417 min, mean blood transfusion was 533 ml, mean hospital stay was 28.6 days. Delayed gastric emptying was encounted in one case. There was no hospital morality or major surgical complications. All cases were alive in the follow-up ranging from 6 to 36 months. There was no newly developed diabetes mellitus or severe gastroenteral symptoms. No reccurrence was found in the case with low-grade malignant duodenal tumor after 26 months. ConclusionsPHRSPD is an efficient way to treat benign and low-grade periampullary neoplasm and accompanying massive bleeding episodes.

ObjectiveTo explore the effect of different properties and hemisphere of stroke on trunk control ability and the relationships between the trunk control and cognition, activities of daily living (ADL).Methods75 inpatient stroke patients were divided into the group A (right hemorrhages, n=15), group B (right infarcts, n=25), group C (left hemorrhages, n=14) and group D (left infarcts, n=21). All cases in four groups were assessed by Mini-Mental Status Examination (MMSE), Sheikh Trunk Control Evaluation and Modified Brathel Index (MBI) before and after rehabilitation therapy.ResultsThe scores of Sheikh and MBI of the group A and group C were significantly lower than that of the group B and group D before treatment ( P<0.05～0.001). After treatment, the scores of MMSE, Sheikh Trunk Control Evaluation and MBI of the patients in four groups all increased, but the scores of the patients in the group A and group C increased more than other groups. There was no significant difference in Sheikh scores between right and left hemisphere stroke. All groups had high relationship between Sheikh Trunk Control Evaluation and MBI before and after treatment. There was no relationship between Sheikh Trunk Control Evaluation and MMSE before treatment, but having part relationship after treatment.ConclusionThe trunk control of hemorrhage patients are damaged more severe than that of the infarct cases, but they resume also faster. There are no different between right and left hemisphere stroke in trunk control impairment. The ability of trunk control has high relationship with ADL before and after treatment, it has no relationship with cognize before treatment but has relationship after treatment.

Aim To examine the inhibitory effect of re-combinant cardiac troponin fusion protein composed of subunit I and artificial peptide which was called CIS on tumor growth. Methods The CIS ’ s effect on the growth of human umbilical vein endothelial cells ( HU-VEC) was examined using MTT assay in vitro. Chick chorioallantoic membrane model was applied to study the alteration of angiogenesis treated with purified re-combinant CIS protein. The effect of tumor growth trea-ted with CIS was observed using several in vivo mice xenograft models. Results There was a statistically significant reduction in HUVEC cell proliferative rate when the cells were treated with purified CIS fusion protein, which was also shown in a dose-dependent manner. A decreased amount of new blood vessel for-mation ( angiogenesis) on chick embryo chorioallantoic membranes was observed in recombinant CIS protein treated group compared to the untreated control group. A significant inhibition of tumor growth rate was a-chieved in CIS treated mice compared to CIS untreated control mice in 6 different mouse xenograft models. Conclusions The fusion protein CIS shows the inhibi-tory effect on the tumor growth in our in vivo mouse models, and such inhibition could be mediated by the mechanism of CIS’ s effect on the decrease of HUVEC cell proliferation and further the reduction of angiogen-esis in tumor tissues. This work could provide the foundation for the in-depth investigations on the phar-maceutical application of CIS targeting anti-tumor ther-apy.

2-methacryloyloxyethyl phosphorylcholine (MPC) polymer membranes are synthesized as biomaterials of the biomembrane structure. The MPC polymer membranes have excellent biocompatibility and blood compatibility, they can effectively reduce protein adsorption and denaturation and inhibit cell adhesion even when the polymer membranes are in contact with whole blood in the absence of any anticoagulants. So, the MPC polymer membranes are widely used in blood purification, artificial organs, membrane oxygenator, and other field of biomedicine. The paper mainly expounds the research advancement and the application prospect of MPC polymer membranes.
Artificial Organs ; Biocompatible Materials ; chemistry ; Humans ; Membranes, Artificial ; Methacrylates ; chemistry ; Oxygenators, Membrane ; Phosphorylcholine ; analogs & derivatives ; chemistry ; Polymers ; Polymethacrylic Acids

Osteosarcoma is a common primary malignant bone tumor with highly aggressive and distal metastasis and poor prognosis. Abnormal metabolism of iron, an essential nutrient with electron-exchange capacity and an important participant in cellular activities, is closely associated with the progression of osteosarcoma. Ferroptosis has been shown to regulate osteosarcoma progression and play an important role in the treatment of osteosarcoma. Exploring the application of relevant molecular mechanisms of ferroptosis in osteosarcoma and the current status of pharmacological intervention may provide new strategies for the treatment of osteosarcoma.

Objective:To systematically review the care experience of caregivers of burn children, so as to provide references for guiding the continuing care in hospitals, communities, and homes.Methods:Databases including Cochrane Library, PubMed, ScienceDirect, ProQuest, Web of Science, and CINAHL were retrieved with the search terms of " burn" , " care/caregivers/nursing/father/mother/relatives" , " needs/perceptions/exceptions/attitudes/feelings/demands/experiences" , " qualitative research" , and the Chinese Journals Full- text Database, China Biology Medicine disc, VIP Database, and Wanfang Data were retrieved with the search terms in Chinese version of "烧伤/烧伤患儿/烧伤幼儿" , "照顾者/照护者/照料者/照护/父亲/母亲/家属" , "需求/认知/期望/态度/感受/体验" , "质性研究" to search the qualitative researches on care experience of caregivers of burn children published from the establishment of the databases to November 2019. After screening and extracting the data, the quality evaluation criteria for qualitative research of the Australian Joanna Briggs Institute Evidence-Based Health Care Center and its integrative/aggregative synthesis method were used to assess the quality of the included literature and meta-integrate the research results respectively. Results:A total of 16 studies and 269 caregivers were enrolled. The quality of one included literature was grade A, and the quality of 15 included literature was grade B. A total of 65 research results were extracted with totally 6 categories formed after summarization, and 2 integrated results obtained as follows: (1) The caregivers experienced heavy psychological pressure and burden in the care process, which had a significant impact on family, social relations, and daily life. (2) With the care time lapsing, through the support of all sectors of society and self-adjustment, the caregivers gradually accepted the reality and actively took various countermeasures, but they still faced many challenges in disease care.Conclusions:The caregivers of burn children have many physical and mental health problems and face many care challenges. The government, medical and health institutions, and society should give a great attention to these issues, improve the social support system and security system, reduce the family-related pressure of burn children′s families, and improve the quality of family life.

Objective To explore variety of suture methods in the prevention or reduction of calcaneal fracture incision complications.Methods The data on 120 patients receiving open reduction and internal fixation of the calcaneus fractures in our hospital from January 2014 to December 2015 were collected.A lateral L-like incisionwas used.Allgower-Donati suture,interrupted vertical mattress suture,intradermal suture,and interrupted suture were applied to manage the incision.The incidence of tension blisters in the incision and its surrounding areas,skin flap necrosis,stitch-cutting edge in the skin,and plate exposure was statistically analyzed.The SPSS 18.0 was used for statistical analysis,and P ＜ 0.05 was statistically significant.Results Postoperative complication rate was 6.7％ for Allgower-Donati suture,13.3％ for interrupted vertical mattress suture,26.7％ for intradermal suture and 33.3％ for interrupted suture (P ＜ 0.05).Conclusions Allgower-Donati suture can prevent or reduce wound complications of calcaneal fractures effectively,and it is worthy of extensive clinical use.

Objective:To investigate the diagnostic efficacy of MRI-based or CT-based measurements and the combined evaluation methods for preoperative bone quality assessment in patients with cervical degenerative diseases.Methods:Patients who underwent spine surgery for cervical degenerative diseases at the Department of Orthopedics, Huashan Hospital, Fudan University from September 2020 to March 2022 with available preoperative X-ray, CT, MRI and dule energy X-Ray absorptiometry (DEXA) data were included in this study. Vertebral bone quality score (VBQ) based on MRI T1-weightedimages and CT Hounsfiled unit (HU) values of the cervical spine were measured, and a combined diagnostic formula based on the binary logistic regression was constructed. The patients were divided into normal bone mass (T≥-1.0) and osteopenia/osteoporosis groups (T<-1.0). The student's t-test and Chi-square test were performed for comparisons between groups. The Pearson correlation coefficient was also used to investigate the correlation between DEXA-T scores, cervical VBQ and CT HU values. In addition, receiver operating characteristic curve (ROC) were plotted to explore the diagnostic efficacy of VBQ, CT HU and their combined diagnosis. Meanwhile, the corresponding sensitivity and specificity were obtained. Results:A total of 71 patients were included in this study (17 in the normal group and 54 in the osteopenia/osteoporosis group). The student's t-test showed that VBQ (2.90±0.70 vs. 3.83±0.83, t=4.23, P<0.001) and CT HU values (370.26±85.38 vs. 295.20±67.96, t=3.73, P=0.002) were significantly different between the two groups. The area under the ROC curve (AUC) for VBQ and CT values of the cervical spine were 0.81 and 0.75, respectively, and the AUC for the combined diagnostic value constructed on the basis of both was 0.85. Applying VBQ scores alone had a diagnostic sensitivity of 80% and a specificity of 70%, and the combined diagnosis with VBQ and CT HU had a sensitivity of 90% and a specificity of 75%. Person correlation analysis showed a significant correlation between DEXA T value, cervical VBQ value and CT HU value. The detailed formula was: DEXA T score=-0.63×cervical VBQ+0.64 ( r=-0.55, P<0.001), CT HU value=-40.20×cervical VBQ+458.40 ( r=-0.45, P<0.001), DEXA T score=0.006×CT HU-3.47 ( r=0.45, P<0.001). Conclusion:This study confirmed the feasibility of using cervical VBQ values, CT HU values and combined diagnostics for preoperative bone density screening in patients with degenerative cervical spine diseases. This method allows surgeons to perform an initial preoperative bone density screening based on the patient's existing imaging data, and thus could aid in confirming the indication and scheme of surgery. The method could be a powerful tool for preoperative bone density assessment screening in patients with cervical degenerative diseases.

Fusion surgery has been an effective modality for the treatment of spinal disorders for more than 100 years. With the increasing understanding of the disease and the increasing maturity of surgical techniques, lumbar fusion has become more widely performed and its efficacy has been conclusively proven. However, fusion surgery inevitably disrupts the original physiologic motion of the spine and limits segmental motion, resulting in a significant increase in disc and joint protrusion stress in adjacent segments. When a newly identified degenerative change on imaging is present in an adjacent segment or an existing degeneration is more aggravated, this is known as adjacent segment degeneration. When clinical symptoms such as pain and numbness in the lower extremities are present that are consistent with degeneration, this is known as adjacent segment disease. Real world studies (RWS) have become a major focus in medical research in recent years. Since it is closer to clinical practice and more practical for decision-making compared with randomized controlled trail (RCT), it is gaining importance in clinical practice. By searching major national and international databases, this article provides a review of risk factors as well as advances in the treatment of lumbar adjacent segment disease in RWS. According to the retrieved literature, there are many factors that contribute to the development and progression of adjacent segment degeneration and disease, which are mainly divided into patient-related factors and surgery-related factors. In general, patient age, weight, spinal-pelvic sagittal parameters, and internal diseases influence the progression of adjacent segment degeneration. Surgery-related risk factors include the number of segments operated on, the surgical approach, interference with adjacent segments, and whether the spinal-pelvicsagittal imbalance is corrected. To prevent the development of adjacent segment disease, patients can slow the progression of adjacent segment degeneration by reducing their own weight and controlling their internal diseases. The physician can also avoid the influence of surgery-related factors through adequate surgical planning and careful intraoperative management. At the same time, surgeries may be performed in patients who have developed adjacent segmental disease and for whom conservative treatment has failed. The current revision surgical approaches include endoscopic simple decompression and posterior decompression with extended internal fixation.Short-term RWS revealed that the efficacy of endoscopic treatment of adjacent spondylosis might be equivalent to re-fusion internal fixation surgery. Studies with large samples and long-term follow-up are still needed to guide the treatment of adjacent segment disease in the future, in order to improve clinical decision-making.

Objective To observe the effects of electroacupuncture(EA)on the expression of central and peripheral cysteine aspartic acid protease-12 via JNK signal transduction pathway in rats with chronic stress depression and to explore anti-depression mechanism of electro-acupuncture.Methods SD rats were randomly divided into blank group,stress model group,acupuncture group,fluoxetine group,model+DMSO(dimethyl sulfoxide,soluble organic solvent)group, model+JNK pathway blocker SP600125 (hereinafter abbreviated as SP)group, acupuncture +SP group, and fluoxetine +SP group(n=9 in each group).The combination of chronic stress and solitary raising was used to establish chronic unpre-dictable mild stress model in seven groups except the control group.The investigated intervention was EA at"Neiguan(PC6)"and"Sanyinjiao(SP6)"points,20 min for each session,once a day,for 21 con-secutive days.The positive control group was treated with fluoxetine 5 mg/kg by oral gavage for 21 days. Open field test was used to observe the rats' behaviors.The expression of caspase-12 protein in hippo-campus and serum was measured by using ELISA.Results Before the experiment,there was no statistic difference in rat behaviors of all groups(P>0.05).At Day 21 of the experiment,the horizontal crossing lattice and frequency of vertical movements markedly decreased compared to the blank group(P <0.01).Compared with the model group,EA increased the horizontal crossing lattice(P<0.05).Com-pared with the blank group,the expression of caspase-12 protein in the model group increased significant-ly(P<0.01).Compared with the model group, the expression of caspase-12 protein in the model +DMSO group,fluoxetine group,fluoxetine+SP group,acupuncture group and SP group all decreased(P<0.05).Compared with the blank group,the expression of caspase-12 protein in the model group de-creased.Compared with the model group, the expression of caspase-12 protein in the model +DMSO group,model+SP group, fluoxetine group and acupuncture +SP group(P>0.05)decreased, while the expression of caspase-12 in fluoxetine+SP group and acupuncture group was higher than that in the control group,but all the differences were not statistically significant(P>0.05).Conclusion Acu-puncture treatment may reduce the expression of caspase-12 protein in the hippocampus of chronic stress rats by effectively inhibiting the JNK signal transduction pathway activity and reducing the apoptosis of hippocampal neuron,which contributes to its anti-depression mechanism.