1.Analysis of surgical situations and prognosis of pancreaticoduodenectomy in Jiangsu province (a report of 2 886 cases)
Zipeng LU ; Xin GAO ; Hao CHENG ; Ning WANG ; Kai ZHANG ; Jie YIN ; Lingdi YIN ; Youting LIN ; Xinrui ZHU ; Dongzhi WANG ; Hongqin MA ; Tongtai LIU ; Yongzi XU ; Daojun ZHU ; Yabin YU ; Yang YANG ; Fei LIU ; Chao PAN ; Jincao TANG ; Minjie HU ; Zhiyuan HUA ; Fuming XUAN ; Leizhou XIA ; Dong QIAN ; Yong WANG ; Susu WANG ; Wentao GAO ; Yudong QIU ; Dongming ZHU ; Yi MIAO ; Kuirong JIANG
Chinese Journal of Digestive Surgery 2024;23(5):685-693
Objective:To investigate the surgical situations and perioperative outcome of pancreaticoduodenectomy in Jiangsu Province and the influencing factors for postoperative 90-day mortality.Methods:The retrospective case-control study was conducted. The clinicopathological data of 2 886 patients who underwent pancreaticoduodenectomy in 21 large tertiary hospitals of Jiangsu Quality Control Center for Pancreatic Diseases, including The First Affiliated Hospital of Nanjing Medical University, from March 2021 to December 2022 were collected. There were 1 732 males and 1 154 females, aged 65(57,71)years. Under the framework of the Jiangsu Provincial Pancreatic Disease Quality Control Project, the Jiangsu Quality Control Center for Pancreatic Diseases adopted a multi-center registration research method to establish a provincial electronic database for pancrea-ticoduodenectomy. Observation indicators: (1) clinical characteristics; (2) intraoperative and post-operative conditions; (3) influencing factors for 90-day mortality after pancreaticoduodenectomy. Measurement data with skewed distribution were represented as M( Q1, Q3) or M(IQR), and comparison between groups was conducted using the Mann-Whitney U test. Count data were expressed as absolute numbers or constituent ratio, and comparison between groups was conducted using the chi-square test, continuity correction chi-square test and Fisher exact probability. Maximal Youden index method was used to determine the cutoff value of continuous variables. Univariate analysis was performed using the corresponding statistical methods based on data types. Multivariate analysis was performed using the Logistic multiple regression model. Results:(1) Clinical characteristics. Of the 2 886 patients who underwent pancreaticoduodenectomy, there were 1 175 and 1 711 cases in 2021 and 2022, respectively. Of the 21 hospitals, 8 hospitals had an average annual surgical volume of <36 cases for pancreaticoduodenectomy, 10 hospitals had an average annual surgical volume of 36-119 cases, and 3 hospitals had an average annual surgical volume of ≥120 cases. There were 2 584 cases performed pancreaticoduodenectomy in thirteen hospitals with an average annual surgical volume of ≥36 cases, accounting for 89.536%(2 584/2 886)of the total cases. There were 1 357 cases performed pancrea-ticoduodenectomy in three hospitals with an average annual surgical volume of ≥120 cases, accounting for 47.020%(1 357/2 886) of the total cases. (2) Intraoperative and postoperative conditions. Of the 2 886 patients, the surgical approach was open surgery in 2 397 cases, minimally invasive surgery in 488 cases, and it is unknown in 1 case. The pylorus was preserved in 871 cases, not preserved in 1 952 cases, and it is unknown in 63 cases. Combined organ resection was performed in 305 cases (including vascular resection in 209 cases), not combined organ resection in 2 579 cases, and it is unknown in 2 cases. The operation time of 2 885 patients was 290(115)minutes, the volume of intra-operative blood loss of 2 882 patients was 240(250)mL, and the intraoperative blood transfusion rate of 2 880 patients was 27.153%(782/2 880). Of the 2 886 patients, the invasive treatment rate was 11.342%(327/2 883), the unplanned Intensive Care Unit (ICU) treatment rate was 3.087%(89/2 883), the reoperation rate was 1.590%(45/2 830), the duration of postoperative hospital stay was 17(11)days, the hospitalization mortality rate was 0.798%(23/2 882), and the failure rate of rescue data in 2 083 cases with severe complications was 6.529%(19/291). There were 2 477 patients receiving postoperative 90-day follow-up, with the 90-day mortality of 2.705%(67/2477). The total incidence rate of complication in 2 886 patients was 58.997%(1 423/2 412). The incidence rate of severe complication was 13.970%(291/2 083). The comprehensive complication index was 8.7(22.6) in 2 078 patients. (3) Influencing factors for 90-day mortality after pancreaticoduodenectomy. Results of multivariate analysis showed that age ≥ 70 years, postoperative invasive treatment, and unplanned ICU treatment were independent risk factors for 90-day mortality after pancreaticoduodenectomy ( odds ratio=2.403, 2.609, 16.141, 95% confidence interval as 1.281-4.510, 1.298-5.244, 7.119-36.596, P<0.05). Average annual surgical volume ≥36 cases in the hospital was an independent protective factor for 90-day mortality after pancreaticoduodenectomy ( odds ratio=0.368, 95% confidence interval as 0.168-0.808, P<0.05). Conclusions:Pancreaticoduodenectomy in Jiangsu Province is highly con-centrated in some hospitals, with a high incidence of postoperative complications, and the risk of postoperative 90-day mortality is significant higher than that of hospitallization mortality. Age ≥ 70 years, postoperative invasive treatment, and unplanned ICU treatment are independent risk factors for 90-day motality after pancreaticoduodenectomy, and average annual surgical volume ≥36 cases in the hospital is an independent protective factor.
2.Artificial intelligence application in hospital pharmaceutical service:a bibliometric analysis
Suqin FU ; Chenye HAO ; Jun PENG
China Pharmacy 2024;35(4):494-499
OBJECTIVE To analyze the current status and trend in the application of artificial intelligence in pharmaceutical service in China and globally. METHODS The research literature on the application of artificial intelligence technology in the field of hospital pharmaceutical service from database establishment to June 16, 2023, was searched in Web of Science and CNKI. The authors, countries/regions, institutions and the co-occurrence, clustering, and emergence of keywords were visually processed and analyzed using tools including Endnote, CiteSpace, and Python. RESULTS & CONCLUSIONS Overall, 1 190 global literature and 178 Chinese literature were included. The number of publications issued in China and globally is increasing year by year, yet a gap remains in the quantity and quality of Chinese research compared with global research. Europe and the United States have built a close cooperation network in this field, while China’s regional development in this field remains imbalanced. Global research hotspots mainly focus on the development and application of high-end technologies such as machine learning, natural language processing, and deep learning; Chinese research concentrates more on actual medical services and medical policies, especially in promoting rational drug use, prescription review, and the development of traditional Chinese medicine.
3.Genomic and transcriptomic analysis unveils population evolution and development of pesticide resistance in fall armyworm Spodoptera frugiperda.
Furong GUI ; Tianming LAN ; Yue ZHAO ; Wei GUO ; Yang DONG ; Dongming FANG ; Huan LIU ; Haimeng LI ; Hongli WANG ; Ruoshi HAO ; Xiaofang CHENG ; Yahong LI ; Pengcheng YANG ; Sunil Kumar SAHU ; Yaping CHEN ; Le CHENG ; Shuqi HE ; Ping LIU ; Guangyi FAN ; Haorong LU ; Guohai HU ; Wei DONG ; Bin CHEN ; Yuan JIANG ; Yongwei ZHANG ; Hanhong XU ; Fei LIN ; Bernard SLIPPERS ; Alisa POSTMA ; Matthew JACKSON ; Birhan Addisie ABATE ; Kassahun TESFAYE ; Aschalew Lemma DEMIE ; Meseret Destaw BAYELEYGNE ; Dawit Tesfaye DEGEFU ; Feng CHEN ; Paul K KURIA ; Zachary M KINYUA ; Tong-Xian LIU ; Huanming YANG ; Fangneng HUANG ; Xin LIU ; Jun SHENG ; Le KANG
Protein & Cell 2022;13(7):513-531
The fall armyworm (FAW), Spodoptera frugiperda, is a destructive pest native to America and has recently become an invasive insect pest in China. Because of its rapid spread and great risks in China, understanding of FAW genetic background and pesticide resistance is urgent and essential to develop effective management strategies. Here, we assembled a chromosome-level genome of a male FAW (SFynMstLFR) and compared re-sequencing results of the populations from America, Africa, and China. Strain identification of 163 individuals collected from America, Africa and China showed that both C and R strains were found in the American populations, while only C strain was found in the Chinese and African populations. Moreover, population genomics analysis showed that populations from Africa and China have close relationship with significantly genetic differentiation from American populations. Taken together, FAWs invaded into China were most likely originated from Africa. Comparative genomics analysis displayed that the cytochrome p450 gene family is extremely expanded to 425 members in FAW, of which 283 genes are specific to FAW. Treatments of Chinese populations with twenty-three pesticides showed the variant patterns of transcriptome profiles, and several detoxification genes such as AOX, UGT and GST specially responded to the pesticides. These findings will be useful in developing effective strategies for management of FAW in China and other invaded areas.
Animals
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China
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Genomics
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Humans
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Male
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Pesticides
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Spodoptera/genetics*
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Transcriptome
4.Continuous transversus abdominis plane block versus patient-controlled intravenous analgesia after abdominal surgery: A systematic review and Meta-analysis
Dongming LI ; Yun YANG ; Yufan WANG ; Hao WANG ; Zhewen FENG ; Yingchi YANG ; Lan JIN ; Zhongtao ZHANG
International Journal of Surgery 2021;48(4):226-232,F3
Objective:To compare the safety and efficacy of continuous transversus abdominis plane (CTAP) block and patient-controlled intravenous analgesia (PCIA) in abdominal surgery postoperatively.Methods:PubMed, Embase, Web of Science, CNKI and other English and Chinese databases were searched since their establishment to February 2021 with "continuous/modified, transversus/transverse abdominis plane block, TAP block, patient controlled analgesia, patient-controlled analgesia, patient controlled intravenous analgesia, patient-controlled intravenous analgesia, PCA/PCIA/IV-PCA" as the search keywords. According to the analgesia treatment methods, patients were divided into continuous transversus abdominis plane block group (CTAP group) and patient-controlled intravenous analgesia group (PCIA group). Review Manager 5.4 software was used to conduct a Meta-analysis on outcome indicators such as postoperative nausea and (or) vomiting (PONV), dizziness, pain score and recovery status after abdominal surgery. Risk ratio ( RR) was calculated for counting data, Mean ± SD was calculated for measurement data. Heterogeneity was measured by I2, and related data were analyzed by using either a fixed effects model or a random effects model. Results:(1) The results of literature search: A total of 6 randomized controlled trials, including 2 published in English and 4 published in Chinese were analyzed, involving 479 patients. The results of the Meta-analysis: Compared with PCIA, CTAP block had lower incidence of PONV ( RR=0.22, 95% CI: 0.08-0.62, P<0.01), lower incidence of dizziness ( RR=0.27, 95% CI: 0.09-0.79, P=0.02), lower pain scores on movement at 24 h ( MD=-0.75, 95% CI: -1.42--0.08, P=0.03) and 48 h ( MD=-0.68, 95% CI: -1.05--0.31, P<0.001) postoperatively, and earlier time of first mobilization ( MD=-0.49, 95% CI: -0.69--0.30, P<0.001) and first exhaust ( MD=-10.47, 95% CI: -13.53--7.41, P<0.001), with statistically significant differences. However, there were no statistically significant differences in pain scores at rest at 24 h ( MD=-0.25, 95% CI: -0.57-0.08, P=0.14) and 48 h ( MD=-0.15, 95% CI: -0.39-0.09, P=0.22) postoperatively and postoperative length of hospital stay ( MD=-1.01, 95% CI: -2.28-0.26, P=0.12). Conclusion:CTAP block is a relatively safe and effective analgesic method, and it′s more consistent with the concept of enhanced recovery after surgery (ERAS) and can be recommended as an alternative method of PCIA.
5.Risk factors for surgical site infection after emergency abdominal surgery: a multicenter cross-sectional study in China
Ze LI ; Junru GAO ; Li SONG ; Peige WANG ; Jian'an REN ; Xiuwen WU ; Suming LUO ; Qingjun ZENG ; Yanhong WENG ; Xinjian XU ; Qingzhong YUAN ; Jie ZHAO ; Nansheng LIAO ; Wei MAI ; Feng WANG ; Hui CAO ; Shichen WANG ; Gang HAN ; Daorong WANG ; Hao WANG ; Jun ZHANG ; Hao ZHANG ; Dongming ZHANG ; Weishun LIAO ; Wanwen ZHAO ; Wei LI ; Peng CUI ; Xin CHEN ; Haiyang ZHANG ; Tao YANG ; Lie WANG ; Yongshun GAO ; Jiang LI ; Jianjun WU ; Wei ZHOU ; Zejian LYU ; Jian FANG
Chinese Journal of Gastrointestinal Surgery 2020;23(11):1043-1050
Objective:Surgical site infection (SSI) is the most common infectious complication after emergency abdominal surgery (EAS). To a large extent, most SSI can be prevented, but there are few relevant studies in China. This study mainly investigated the current situation of SSI occurrence after EAS in China, and further explored risk factors for SSI occurrence.Methods:Multi-center cross-sectional study was conducted. Clinical data of patients undergoing EAS in 33 hospitals across China between May 1, 2019 and June 7, 2019 were prospectively collected, including perioperative data and microbial culture results from infected incisions. The primary outcome was the incidence of SSI after EAS, while the secondary outcomes were postoperative hospital stay, ICU occupancy rate, length of ICU stay, hospitalization cost, and mortality within postoperative 30 days. Univariate and multivariate logistic regression models were used to analyze the risk factors of SSI after EAS.Results:A total of 660 EAS patients aged (47.9±18.3) years were enrolled in this study, including 56.5% of males (373/660). Forty-nine (7.4%) patients developed postoperative SSI. The main pathogen of SSI was Escherichia coli [culture positive rate was 32.7% (16/49)]. As compared to patients without SSI, those with SSI were more likely to be older (median 56 years vs. 46 years, U=19 973.5, P<0.001), male [71.4% (35/49) vs. 56.1% (343/611), χ 2=4.334, P=0.037] and diabetes [14.3% (7/49) vs. 5.1% (31/611), χ 2=5.498, P=0.015]; with-lower preoperative hemoglobin (median: 122.0 g/L vs. 143.5 g/L, U=11 471.5, P=0.006) and albumin (median: 35.5 g/L vs. 40.8 g/L, U=9452.0, P<0.001), with higher blood glucose (median: 6.9 mmol/L vs. 6.0 mmol/L, U=17 754.5, P<0.001); with intestinal obstruction [32.7% (16/49) vs. 9.2% (56/611), χ 2=25.749, P<0.001], with ASA score 3-4 [42.9% (21/49) vs. 13.9% (85/611), χ 2=25.563, P<0.001] and with high surgical risk [49.0% (24/49) vs. 7.0% (43/611), χ 2=105.301, P<0.001]. The main operative procedure resulting in SSI was laparotomy [81.6%(40/49) vs. 35.7%(218/611), χ 2=40.232, P<0.001]. Patients with SSI experienced significantly longer operation time (median: 150 minutes vs. 75 minutes, U=25 183.5, P<0.001). In terms of clinical outcome, higher ICU occupancy rate [51.0% (25/49) vs. 19.5% (119/611), χ 2=26.461, P<0.001], more hospitalization costs (median: 44 000 yuan vs. 15 000 yuan, U=24 660.0, P<0.001), longer postoperative hospital stay (median: 10 days vs. 5 days, U=23 100.0, P<0.001) and longer ICU occupancy time (median: 0 days vs. 0 days, U=19 541.5, P<0.001) were found in the SSI group. Multivariate logistic regression analysis showed that the elderly (OR=3.253, 95% CI: 1.178-8.985, P=0.023), colorectal surgery (OR=9.156, 95% CI: 3.655-22.937, P<0.001) and longer operation time (OR=15.912, 95% CI:6.858-36.916, P<0.001) were independent risk factors of SSI, while the laparoscopic surgery (OR=0.288, 95% CI: 0.119-0.694, P=0.006) was an independent protective factor for SSI. Conclusions:For patients undergoing EAS, attention should be paid to middle-aged and elderly patients and those of colorectal surgery. Laparoscopic surgery should be adopted when feasible and the operation time should be minimized, so as to reduce the incidence of SSI and to reduce the burden on patients and medical institutions.
6.Risk factors for surgical site infection after emergency abdominal surgery: a multicenter cross-sectional study in China
Ze LI ; Junru GAO ; Li SONG ; Peige WANG ; Jian'an REN ; Xiuwen WU ; Suming LUO ; Qingjun ZENG ; Yanhong WENG ; Xinjian XU ; Qingzhong YUAN ; Jie ZHAO ; Nansheng LIAO ; Wei MAI ; Feng WANG ; Hui CAO ; Shichen WANG ; Gang HAN ; Daorong WANG ; Hao WANG ; Jun ZHANG ; Hao ZHANG ; Dongming ZHANG ; Weishun LIAO ; Wanwen ZHAO ; Wei LI ; Peng CUI ; Xin CHEN ; Haiyang ZHANG ; Tao YANG ; Lie WANG ; Yongshun GAO ; Jiang LI ; Jianjun WU ; Wei ZHOU ; Zejian LYU ; Jian FANG
Chinese Journal of Gastrointestinal Surgery 2020;23(11):1043-1050
Objective:Surgical site infection (SSI) is the most common infectious complication after emergency abdominal surgery (EAS). To a large extent, most SSI can be prevented, but there are few relevant studies in China. This study mainly investigated the current situation of SSI occurrence after EAS in China, and further explored risk factors for SSI occurrence.Methods:Multi-center cross-sectional study was conducted. Clinical data of patients undergoing EAS in 33 hospitals across China between May 1, 2019 and June 7, 2019 were prospectively collected, including perioperative data and microbial culture results from infected incisions. The primary outcome was the incidence of SSI after EAS, while the secondary outcomes were postoperative hospital stay, ICU occupancy rate, length of ICU stay, hospitalization cost, and mortality within postoperative 30 days. Univariate and multivariate logistic regression models were used to analyze the risk factors of SSI after EAS.Results:A total of 660 EAS patients aged (47.9±18.3) years were enrolled in this study, including 56.5% of males (373/660). Forty-nine (7.4%) patients developed postoperative SSI. The main pathogen of SSI was Escherichia coli [culture positive rate was 32.7% (16/49)]. As compared to patients without SSI, those with SSI were more likely to be older (median 56 years vs. 46 years, U=19 973.5, P<0.001), male [71.4% (35/49) vs. 56.1% (343/611), χ 2=4.334, P=0.037] and diabetes [14.3% (7/49) vs. 5.1% (31/611), χ 2=5.498, P=0.015]; with-lower preoperative hemoglobin (median: 122.0 g/L vs. 143.5 g/L, U=11 471.5, P=0.006) and albumin (median: 35.5 g/L vs. 40.8 g/L, U=9452.0, P<0.001), with higher blood glucose (median: 6.9 mmol/L vs. 6.0 mmol/L, U=17 754.5, P<0.001); with intestinal obstruction [32.7% (16/49) vs. 9.2% (56/611), χ 2=25.749, P<0.001], with ASA score 3-4 [42.9% (21/49) vs. 13.9% (85/611), χ 2=25.563, P<0.001] and with high surgical risk [49.0% (24/49) vs. 7.0% (43/611), χ 2=105.301, P<0.001]. The main operative procedure resulting in SSI was laparotomy [81.6%(40/49) vs. 35.7%(218/611), χ 2=40.232, P<0.001]. Patients with SSI experienced significantly longer operation time (median: 150 minutes vs. 75 minutes, U=25 183.5, P<0.001). In terms of clinical outcome, higher ICU occupancy rate [51.0% (25/49) vs. 19.5% (119/611), χ 2=26.461, P<0.001], more hospitalization costs (median: 44 000 yuan vs. 15 000 yuan, U=24 660.0, P<0.001), longer postoperative hospital stay (median: 10 days vs. 5 days, U=23 100.0, P<0.001) and longer ICU occupancy time (median: 0 days vs. 0 days, U=19 541.5, P<0.001) were found in the SSI group. Multivariate logistic regression analysis showed that the elderly (OR=3.253, 95% CI: 1.178-8.985, P=0.023), colorectal surgery (OR=9.156, 95% CI: 3.655-22.937, P<0.001) and longer operation time (OR=15.912, 95% CI:6.858-36.916, P<0.001) were independent risk factors of SSI, while the laparoscopic surgery (OR=0.288, 95% CI: 0.119-0.694, P=0.006) was an independent protective factor for SSI. Conclusions:For patients undergoing EAS, attention should be paid to middle-aged and elderly patients and those of colorectal surgery. Laparoscopic surgery should be adopted when feasible and the operation time should be minimized, so as to reduce the incidence of SSI and to reduce the burden on patients and medical institutions.
7.Status of diagnosis and management of acute appendicitis in 2017: a national multi-center retrospective study.
Jie WU ; Xinjian XU ; Hao XU ; Gang MA ; Chi MA ; Xiaocheng ZHU ; Zeqiang REN ; Xudong WU ; Xudong WU ; Yingjie CHEN ; Yanhong WENG ; Liping HU ; Fei CHEN ; Yonggan JIANG ; Hongbin LIU ; Ming WANG ; Zhenhua YANG ; Xiong YU ; Liang LI ; Xinzeng ZHANG ; Zhigang YAO ; Wei LI ; Jianjun MIAO ; Liguang YANG ; Hui CAO ; Fan CHEN ; Jianjun WU ; Shichen WANG ; Dongzhu ZENG ; Jun ZHANG ; Yongqing HE ; Jianliang CAO ; Wenxing ZHOU ; Zhilong JIANG ; Dongming ZHANG ; Jianwei ZHU ; Wenming YUE ; Yongxi ZHANG ; Junling HOU ; Fei ZHONG ; Junwei WANG ; Chang CAI ; Hongyan LI ; Weishun LIAO ; Haiyang ZHANG ; Getu ZHAORI ; Qinjie LIU ; Zhiwei WANG ; Canwen CHEN ; Jianan REN
Chinese Journal of Gastrointestinal Surgery 2019;22(1):49-58
OBJECTIVE:
To analyze the current status of diagnosis and management of acute appendicitis (AA) in China.
METHODS:
Questionnaire survey was used to retrospectively collect data of hospitalized patients with AA from 43 medical centers nationwide in 2017 (Sort by number of cases provided: Jinling Hospital of Medical School of Nanjing University, The First Affiliated Hospital of Xinjiang Medical University, Lu'an People's Hospital, Tengzhou Central People's Hospital, Dalian Central Hospital, The Affiliated Hospital of Xuzhou Medical University, Dongying People's Hospital, Jinjiang Hospital of Traditional Chinese Medicine, Huangshan Shoukang Hospital, Xuyi People's Hospital, Nanjing Jiangbei People's Hospital, Lanzhou 940th Hospital of PLA, Heze Municipal Hospital, The First College of Clinical Medical Science of China Three Gorges University, Affiliated Jiujiang Hospital of Nanchang University, The Second People's Hospital of Hefei, Affiliated Central Hospital of Shandong Zaozhuang Mining Group, The Third People's Hospital of Kunshan City, Xuzhou First People's Hospital, The 81st Group Army Hospital of PLA, Linyi Central Hospital, The General Hospital of Huainan Eastern Hospital Group, The 908th Hospital of PLA, Liyang People's Hospital, The 901th Hospital of Joint Logistic Support Force, The Third Affiliated Hospital of Chongqing Medical University, The Fourth Hospital of Jilin University, Harbin Acheng District People's Hospital, The First Affiliated Hospital of Zhengzhou University, Nanjing Luhe People's Hospital, Taixing Municipal People's Hospital, Baotou Central Hospital, The Affiliated Hospital of Nantong University, Linyi People's Hospital, The 72st Group Army Hospital of PLA, Zaozhuang Municipal Hospital, People's Hospital of Dayu County, Taixing City Hospital of Traditional Chinese Medicine, Suzhou Municipal Hospital, Beijing Guang'anmen Hospital, Langxi County Hospital of Traditional Chinese Medicine, Nanyang Central Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University).The diagnosis and management of AA were analyzed through unified summary. Different centers collected and summarized their data in 2017 and sent back the questionnaires for summary.
RESULTS:
A total of 8 766 AA patients were enrolled from 43 medical centers, including 4 711 males (53.7%) with median age of 39 years and 958 (10.9%) patients over 65 years old. Of 8 776 patients, 5 677 cases (64.6%) received one or more imaging examinations, and the other 3 099 (35.4%) did not receive any imaging examination. A total of 1 858 (21.2%) cases received medical treatment, mainly a combination of nitroimidazoles (1 107 cases, 59.8%) doublet regimen, followed by a single-agent regimen of non-nitroimidazoles (451 cases, 24.4%), a nitroimidazole-free doublet regimen (134 cases, 7.2%), a triple regimen of combined nitroimidazoles (116 cases, 6.3%), nitroimidazole alone (39 cases, 2.1%) and nitroimidazole-free triple regimen (3 cases, 0.2%). Of the 6 908 patients (78.8%) who underwent surgery, 4 319 (62.5%) underwent laparoscopic appendectomy and 2589 (37.5%) underwent open surgery. Ratio of laparotomy was higher in those patients under 16 years old (392 cases) or over 65 years old (258 cases) [15.1%(392/2 589) and 10.0%(258/2 589), respectively, compared with 8.5%(367/4 316) and 8.0%(347/4 316) in the same age group for laparoscopic surgery, χ²=91.415, P<0.001; χ²=15.915,P<0.001]. Patients with complicated appendicitis had higher ratio of undergoing open surgery as compared to those undergoing laparoscopic surgery [26.7%(692/2 589) vs. 15.6%(672/4 316), χ²=125.726, P<0.001].The cure rates of laparoscopic and open surgery were 100.0% and 99.8%(2 585/2 589) respectively without significant difference (P=0.206). Postoperative complication rates were 4.5%(121/2 589) and 4.7%(196/4 316) respectively, and the difference was not statistically significant (χ²=0.065, P=0.799). The incidence of surgical site infection was lower (0.6% vs. 1.7%, χ²=17.315, P<0.001), and hospital stay was shorter [6(4-7) days vs. 6(5-8) days, U=4 384 348.0, P<0.001] in the laparoscopic surgery group, while hospitalization cost was higher (median 12 527 yuan vs. 9 342 yuan, U=2 586 809.0, P<0.001).
CONCLUSIONS
The diagnosis of acute appendicitis is still clinically based, supplemented by imaging examination. Appendectomy is still the most effective treatment at present. Laparoscopic appendectomy has become the main treatment strategy, but anti-infective drugs are also very effective.
Acute Disease
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Adolescent
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Adult
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Aged
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Anti-Bacterial Agents
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therapeutic use
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Appendectomy
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Appendicitis
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diagnosis
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therapy
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China
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Female
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Health Care Surveys
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Humans
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Laparoscopy
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Male
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Middle Aged
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Retrospective Studies
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Treatment Outcome
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Young Adult
8.Protective Effect of PARP Inhibitor on Cortical Neurons in Streptozotocin-induced Diabetic Rats
Xiaoli WU ; Zhimin WANG ; Hebin LIANG ; Ying HAO ; Dongming ZHENG ; Yang GUO
Journal of China Medical University 2015;(6):481-484
Objective To investigate the effect of PARP inhibitor 3?aminobenzamide(3?AB)on cortical neurons in streptozotocin?induced diabe?tes mellitus(DM)rats and the mechanism. Methods A total of 60 rats were divided into 3 groups randomly:sham?operated control group,DM group and DM+3?AB group,20 rats in each group. Morris maze was used to detect learning and memory abilities in each group. Spectrophotometer assay was used to detect the levels of superoxide dismutase(SOD),glutathione peroxidase(GSH?Px)and malondialdehyde(MDA)in cortex. West?ern blot was used to determine the expression of poly(ADP?ribose)polymerase 1(PARP1)in cortex. Immunohistochemical staining was used to de?termine the expression of caspase?3?immunoreactive neurons in cortex. Results DM rats showed significantly declined learning and memory abili?ties. Compared with the control group,the levels of SOD and GSH?Px were significantly reduced(P<0.01)and the level of MDA was significantly up?regulated(P<0.01)in the DM group. Compared with the DM group,the levels of SOD and GSH?Px were significantly higher(P<0.05)and the level of MDA was significantly lower in the DM+3?AB group(P<0.05). The expression level of PARP1 was significantly up?regulated in the DM group and was significantly decreased in the DM+3?AB group(P<0.01). The level of caspase?3 was significantly higher in the DM group than in the control group(P<0.01),and was significantly decreased in the DM+3?AB group(P<0.01). Conclusion 3?AB protected cortical neurons from apoptosis in DM rats by inhibition of PARP1 and alleviation of oxidative stress.
9.Digital anatomy of nucleus accumbens in the human brain
Yu CHEN ; Feng HAN ; Wei WANG ; Jianan HAO ; Dongming XU ; Falong YAN ; Xuecheng LIU ; Songqing NIU
Acta Anatomica Sinica 2014;(3):354-358
Objective To explore the locating, parameter measurement and 3D display of nucleus accumbens in human brain in terms of digital anatomy .Methods The raw data of the head specimen of a 45-year-old male adult with 0.5mm as the section spacing was collected by using digital milling machine .Three hundreds images of continual cross sections containing brain were chosen and the segmentation of the caudate nucleus , putamen and nucleus accumbens was accomplished with Photoshop CS .The nucleus accumbens on the images of continual coronal section reconstruction were distinguished according to Harvard Medical School ’ s segment method to calculate the volume of nucleus accumbens and collect the correlative location information .The caudate nucleus , putamen and nucleus accumbens were 3D visualize with the software of Amira 3.1.1.Results The nucleus accumbens , the adjoining structure and the lesion target of nucleus accumbens were all clearly visible .The left nucleus accumbens volume was 972.5mm3 , and the right was 830.6mm3 .The 3D coordinate value was the left ( -11.0, 24.4, 1.3) and the right (9.3, 23.9, 1.7).Conclusion The digital anatomy of nucleus accumbens can distinctly display the nucleus accumbens , form and confirm it ’ s volume, location and adjoining area , which is useful to clinician .
10.Expression of CXCR7 protein in human bladder cancer and its clinical significance
Kailin HOU ; Lianhua ZHANG ; Juanjie BO ; Mingang HAO ; Guoliang YANG ; Haifeng JIANG ; Dongming LIU ; Jianhua WANG ; Yiran HUANG
Chinese Journal of Urology 2011;32(1):42-46
Objective To explore the expression of CXCR7 in bladder cancer and analyze its clinical significance and relationship with bladder cancer recurrence. Methods The expressions of CXCR7 protein in 148 specimens of bladder cancer and 30 specimens of normal bladder tissues were detected by immunohistochemical staining and its clinical significance was then analyzed. Results The expression of CXCR7 protein was higher in bladder cancers than in the adjacent normal tissues (P<0.01). CXCR7 protein expression rates were 49. 4% and 71.2% in mutifocal tumors and unifocal tumors, while 34.0%, 65.8% and 78. 6% in G1, G2, and G3 tumors, respectively (P<0. 01). Expression of CXCR7 protein was higher in muscle invasive bladder cancers than in non-muscle invasive bladder cancers (72. 7% versus 51.9% ,P<0.05). In patients followed up for 2-95 months, CXCR7 protein expression was significantly higher in patients with recurrence than with non-recurrence (64. 1% versus 32.5%, P<0.01). Kaplan-Meier analysis and the log-rark test showed that the recurrence-free survival was significantly different between the group of lower CXCR7 expression group and the higher expression group (P<0.01). Conclusions The expression of CXCR7 protein is high in bladder cancer and the analysis of CXCR7 protein expression is potentially valuable in prognostic evaluation of bladder cancers. CXCR7 may play a role in the development of bladder urothelial cell cancer.

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