1.Discovery of a normal-tension glaucoma-suspect rhesus macaque with craniocerebral injury: Hints of elevated translaminar cribrosa pressure difference.
Jian WU ; Qi ZHANG ; Xu JIA ; Yingting ZHU ; Zhidong LI ; Shu TU ; Ling ZHAO ; Yifan DU ; Wei LIU ; Jiaoyan REN ; Liangzhi XU ; Hanxiang YU ; Fagao LUO ; Wenru SU ; Ningli WANG ; Yehong ZHUO
Chinese Medical Journal 2024;137(4):484-486
2.Changes of serum lipid profiles and the correlation analysis in clinic-pathological features of pancreatic cancer patients
Jian YANG ; Zhiyao FAN ; Yongzheng LI ; Shujie LIU ; Yufan MENG ; Jianwei XU ; Lei WANG ; Hanxiang ZHAN
Chinese Journal of Surgery 2022;60(7):680-687
Objective:To examine the characteristics of blood lipid profile and the correlation with clinic-pathological features of pancreatic cancer patients.Methods:The clinical and pathological data of 265 pancreatic cancer patients who received radical surgical treatment at Department of General Surgery,Qilu Hospital,Shandong University from January 2013 to September 2020 were collected and analyzed retrospectively. Among the 265 pancreatic cancer patients,there were 170 males and 95 females,with age of (61.0±9.6)years(range:28 to 86 years). General information,lipid indicators and clinic-pathological information were collected from electronic medical record system,and follow-up information gained by telephone. According to level of serum lipid in pancreatic cancer patients,265 patients were divided into dyslipidemia group( n=115) and normal lipid group( n=150). Pearson χ 2,Student′s t tests, variance analysis or univariate Logistic regression was used to analyze the correlation between dyslipidemia and clinico-pathological characteristics of pancreatic cancer,respectively. Kaplan-Meier survival curve was used to assessed the influence of dyslipidemia on prognosis of pancreatic cancer patients. Results:In 265 pancreatic cancer patients,115(43.4%)of them had dyslipidemias,and the most common form was increase of triglyceride(TG)(72.2%). In pancreatic cancer with dyslipidemias group,patients with body mass index ≥25 kg/m 2 had higher proportion than normal lipid group(36.1%(26/72) vs. 21.2%(21/99),χ2=4.643, P=0.031); The proportion of carcinoma located at head of pancreas(83.5%(96/115) vs. 40.7%(61/150),χ2=49.412, P<0.01), staging of T1/T2(79.1%(91/115) vs. 60.7%(91/150),χ2=10.316, P<0.01) and lymphatic metastasis(36.5%(42/115) vs. 22.7%(34/150),χ2=6.007, P<0.01) were higher. In patients of pancreatic cancer, dyslipidemias were closely associated with tumor location( OR=10.529, P<0.01)and body mass index( OR=3.671, P=0.008). Serum lipid profile results showed that TG,total cholesterol and high-density lipoprotein(HDL) disorders were associated with tumor location( P<0.05). TG disorder had association with body mass index( P<0.05), and HDL disorder had association with tumor stage( P<0.05). Moreover, the result of survival analysis showed that dyslipidemia was not a factor to impact the prognosis of pancreatic cancer patients underwent surgery( P>0.05). Conclusions:In pancreatic cancer patients,TG disorder was the most common type of dyslipidemia. Dyslipidemia has closely association with clinicopathologic features,including tumor location,body mass index,tumor stage. However,dyslipidemia had little effect on prognosis of pancreatic cancer patients.
3.Changes of serum lipid profiles and the correlation analysis in clinic-pathological features of pancreatic cancer patients
Jian YANG ; Zhiyao FAN ; Yongzheng LI ; Shujie LIU ; Yufan MENG ; Jianwei XU ; Lei WANG ; Hanxiang ZHAN
Chinese Journal of Surgery 2022;60(7):680-687
Objective:To examine the characteristics of blood lipid profile and the correlation with clinic-pathological features of pancreatic cancer patients.Methods:The clinical and pathological data of 265 pancreatic cancer patients who received radical surgical treatment at Department of General Surgery,Qilu Hospital,Shandong University from January 2013 to September 2020 were collected and analyzed retrospectively. Among the 265 pancreatic cancer patients,there were 170 males and 95 females,with age of (61.0±9.6)years(range:28 to 86 years). General information,lipid indicators and clinic-pathological information were collected from electronic medical record system,and follow-up information gained by telephone. According to level of serum lipid in pancreatic cancer patients,265 patients were divided into dyslipidemia group( n=115) and normal lipid group( n=150). Pearson χ 2,Student′s t tests, variance analysis or univariate Logistic regression was used to analyze the correlation between dyslipidemia and clinico-pathological characteristics of pancreatic cancer,respectively. Kaplan-Meier survival curve was used to assessed the influence of dyslipidemia on prognosis of pancreatic cancer patients. Results:In 265 pancreatic cancer patients,115(43.4%)of them had dyslipidemias,and the most common form was increase of triglyceride(TG)(72.2%). In pancreatic cancer with dyslipidemias group,patients with body mass index ≥25 kg/m 2 had higher proportion than normal lipid group(36.1%(26/72) vs. 21.2%(21/99),χ2=4.643, P=0.031); The proportion of carcinoma located at head of pancreas(83.5%(96/115) vs. 40.7%(61/150),χ2=49.412, P<0.01), staging of T1/T2(79.1%(91/115) vs. 60.7%(91/150),χ2=10.316, P<0.01) and lymphatic metastasis(36.5%(42/115) vs. 22.7%(34/150),χ2=6.007, P<0.01) were higher. In patients of pancreatic cancer, dyslipidemias were closely associated with tumor location( OR=10.529, P<0.01)and body mass index( OR=3.671, P=0.008). Serum lipid profile results showed that TG,total cholesterol and high-density lipoprotein(HDL) disorders were associated with tumor location( P<0.05). TG disorder had association with body mass index( P<0.05), and HDL disorder had association with tumor stage( P<0.05). Moreover, the result of survival analysis showed that dyslipidemia was not a factor to impact the prognosis of pancreatic cancer patients underwent surgery( P>0.05). Conclusions:In pancreatic cancer patients,TG disorder was the most common type of dyslipidemia. Dyslipidemia has closely association with clinicopathologic features,including tumor location,body mass index,tumor stage. However,dyslipidemia had little effect on prognosis of pancreatic cancer patients.
4.Tissue wasting and perioperative treatment strategies of pancreatic cancer patients
Hanxiang ZHAN ; Yongzheng LI ; Sanyuan HU
Chinese Journal of Digestive Surgery 2021;20(4):407-413
Pancreatic cancer is a highly malignancy of the digestive system, with low early diagnosis rate and poor prognosis. Cancer cachexia, muscle and adipose tissue wasting are important factors affecting surgical complications and long-term prognosis of patients with pancreatic cancer. On one hand, the occurrence and development of pancreatic cancer cachexia are associated with the decrease of food intake. On the other hand, the characteristic of tumor hypermetabolism, many inflammatory factors, fat and protein regulatory factors and many neuroendocrine pathways are also involved in pancreatic cancer cachexia. At present, the understanding of cancer cachexia and tissue wasting is not comprehensive, and the diagnostic methods are not unified. The main screening method is based on body mass index, but it is not applicable to obese patients. The detection of serum cytokines and determination of intramuscular fat content based on the abdominal computed tomography scan also play pivotal roles in the diagnosis of pancreatic cancer cachexia. Perioperative inhibition of tissue wasting can not only reduce surgical complications, but also improve the prognosis of pancreatic cancer patients. However, there is no effective method to completely reverse cancer cachexia. Multidisciplinary treatment is the routine therapy. Surgical treatment to remove the tumor is the fundamental measure to impede the development of cachexia. In addition, strengthening nutritional support, reducing inflammation and stress reaction, reducing the muscle wasting are also important in the treatment of cachexia during the perioperative period. Combined with self experience, the authors comprehensively analyze research advances, summarize the etiology, molecular mechanism, diagnosis and treatment of tissue wasting, in order to investigate tissue wasting and perioperative treatment strategies of pancreatic cancer patients.
5. Relationship Between Vitamin D Receptor Gene Polymorphisms and Risk of Ulcerative Colitis: A Meta-analysis
Jian LI ; Hanxiang ZHANG ; Hongliang GAO
Chinese Journal of Gastroenterology 2021;26(10):604-610
Background: Vitamin D receptor (VDR) is associated with the occurrence and development of ulcerative colitis (UC). The expression and function of VDR may be affected by its gene polymorphisms, and thus affecting the occurrence of UC. However, results of studies are still in controversary. Aims: To explore the relationship between VDR gene polymorphisms and UC. Methods: Studies on correlation of VDR gene (Apa, Bsm, Fok, Taq) polymorphisms with UC were retrieved from SinoMed, CNKI, Wanfang, VIP, Embase, PubMed, The Cochrane Library databases. Literatures were enrolled according to the inclusion and exclusion criteria, and the data were extracted. RevMan 5.3 was used to conducted meta-analysis. Results: A total of 11 studies involving 1 811 UC patients were included. Meta-analysis showed that VDR gene Fok polymorphism (FF + Ff vs. ff: OR=0.67, 95% CI: 0.49-0.92, P=0.01), allele (F vs. f: OR=0.81, 95% CI: 0.68-0.96, P=0.02) were significantly correlated with the susceptibility of UC. Among which, Fok polymorphism (FF+Ff vs. ff: OR=0.59, 95% CI: 0.37-0.94, P=0.03), allele (F vs. f: OR=0.76, 95% CI: 0.60-0.97, P=0.03) were significantly correlated with the susceptibility of UC in Asian, but not in Caucasian population (P>0.05). No significant association was observed between Apa, Bsm, or Taq polymorphisms and UC (P>0.05). Conclusions: Existing evidence shows that VDR gene Fok polymorphism might contribute to UC susceptibility, however, Apa, Bsm, and Taq polymorphisms might not be significantly correlated with UC.
6.Progress in diagnosis and treatment of chylous leakage following pancreatic resection
Yongzheng LI ; Jian YANG ; Sanyuan HU ; Hanxiang ZHAN
Chinese Journal of Surgery 2021;59(4):316-320
Compared with other postoperative complications following pancreatic resection, chylous leakage is rare in clinical, which could lead to serious morbidity, including malnutrition,immunosuppression and abdominal infection. The main risk factors for chylous leakage after pancreatic resection are the injury of cisterna chyli or lymphatic vessels caused by intraoperative lymph node dissection and early enteral nutrition. The clinical features of chylous leakage are not specific, and the diagnosis mainly depends on the composition analysis of the drainage fluid. The diagnostic criteria generally adopt the expert consensus of the international Study Group on Pancreatic Surgery,but it is only applicable to isolated chylous leakage and there is still no widely accepted diagnostic criteria in most complex cases. Abdominal fluid analysis and abdominal CT scan are the most applied diagnostic methods for chylous leakage after pancreatic resection,while lymphangiography can not only identify the site of leakage,but also has therapeutic value. For its treatment,the"step-up"treatment strategy is typically applied in most patients. Conservative treatments, including drainage,proper diet and applying octreotide, can benefit most patients. Surgical treatment is not commonly used,and its therapeutic value needs to be further verified. Optimizing perioperative management measures and personalized treatment strategies for different patients can effectively prevent postoperative chylous leakage and maximize the clinical benefits of patients who received pancreatic resection.
7.Well differentiated grade 3 gastroenteropancreatic neuroendocrine tumors:new insights into diagnosis and therapeutic strategy
Zhiyao FAN ; Ming SHI ; Jian YANG ; Yongzheng LI ; Peng SU ; Xiao WANG ; Hanxiang ZHAN
Chinese Journal of Surgery 2021;59(8):704-710
Gastroenteropancreatic neuroendocrine tumor G3(GEP-NET G3) is a novel subtype of neuroendocrine neoplasms proposed in 2019,which has unique biological behavior characteristics. However,there are still many challenges and controversies in its diagnosis and treatment. There are obvious differences between GEP-NET G3 and neuroendocrine carcinoma (NEC) in genetic alterations and molecular profiles. The most frequently mutated genes in NET G3 are MEN1,DAXX/ATRX,while in NEC,TP53 and Rb are the most frequently mutated genes. Currently,the mainstream view is that NET G3 and NEC are two distinct diseases with different genetic backgrounds,and NET G3 will not develop into NEC. Several clinical and pathological factors should be considered to distinguish GEP-NET G3 and NEC,which including patients′ medical history,histopathological morphology of neoplasms,Ki-67 index,immunohistochemical results of TP53,Rb,DAXX/ATRX and other markers. Multidisciplinary treatment,including radical resection,chemotherapy,targeted therapy,peptide receptor radionuclide therapy,immunotherapy should be applied in patients with GEP-NET G3. Overall,given its relatively indolent biological behavior,the therapeutic strategy should be more actively. Although the cure strategy of NET G3 has many similarities with NET G1/2,it is completely different from NEC.
8.Progress in diagnosis and treatment of chylous leakage following pancreatic resection
Yongzheng LI ; Jian YANG ; Sanyuan HU ; Hanxiang ZHAN
Chinese Journal of Surgery 2021;59(4):316-320
Compared with other postoperative complications following pancreatic resection, chylous leakage is rare in clinical, which could lead to serious morbidity, including malnutrition,immunosuppression and abdominal infection. The main risk factors for chylous leakage after pancreatic resection are the injury of cisterna chyli or lymphatic vessels caused by intraoperative lymph node dissection and early enteral nutrition. The clinical features of chylous leakage are not specific, and the diagnosis mainly depends on the composition analysis of the drainage fluid. The diagnostic criteria generally adopt the expert consensus of the international Study Group on Pancreatic Surgery,but it is only applicable to isolated chylous leakage and there is still no widely accepted diagnostic criteria in most complex cases. Abdominal fluid analysis and abdominal CT scan are the most applied diagnostic methods for chylous leakage after pancreatic resection,while lymphangiography can not only identify the site of leakage,but also has therapeutic value. For its treatment,the"step-up"treatment strategy is typically applied in most patients. Conservative treatments, including drainage,proper diet and applying octreotide, can benefit most patients. Surgical treatment is not commonly used,and its therapeutic value needs to be further verified. Optimizing perioperative management measures and personalized treatment strategies for different patients can effectively prevent postoperative chylous leakage and maximize the clinical benefits of patients who received pancreatic resection.
9.Well differentiated grade 3 gastroenteropancreatic neuroendocrine tumors:new insights into diagnosis and therapeutic strategy
Zhiyao FAN ; Ming SHI ; Jian YANG ; Yongzheng LI ; Peng SU ; Xiao WANG ; Hanxiang ZHAN
Chinese Journal of Surgery 2021;59(8):704-710
Gastroenteropancreatic neuroendocrine tumor G3(GEP-NET G3) is a novel subtype of neuroendocrine neoplasms proposed in 2019,which has unique biological behavior characteristics. However,there are still many challenges and controversies in its diagnosis and treatment. There are obvious differences between GEP-NET G3 and neuroendocrine carcinoma (NEC) in genetic alterations and molecular profiles. The most frequently mutated genes in NET G3 are MEN1,DAXX/ATRX,while in NEC,TP53 and Rb are the most frequently mutated genes. Currently,the mainstream view is that NET G3 and NEC are two distinct diseases with different genetic backgrounds,and NET G3 will not develop into NEC. Several clinical and pathological factors should be considered to distinguish GEP-NET G3 and NEC,which including patients′ medical history,histopathological morphology of neoplasms,Ki-67 index,immunohistochemical results of TP53,Rb,DAXX/ATRX and other markers. Multidisciplinary treatment,including radical resection,chemotherapy,targeted therapy,peptide receptor radionuclide therapy,immunotherapy should be applied in patients with GEP-NET G3. Overall,given its relatively indolent biological behavior,the therapeutic strategy should be more actively. Although the cure strategy of NET G3 has many similarities with NET G1/2,it is completely different from NEC.
10.A comparative study on the relationship between cerebral vascular hemodynamics and risk factors of stroke in Han and Hani nationality groups in south Yunnan
Xianwen WEI ; Hengye WANG ; Chengzhi XING ; Hanxiang LIU ; Meishuang LI ; Changyong DAO ; Nan YANG ; Ying GUO ; Deyun WANG ; Shihe ZHANG
Chinese Journal of Primary Medicine and Pharmacy 2018;25(1):39-43
Objective To investigate the difference between Han nationality residents and the Hani nationality residents in southern Yunnan about the effects of stroke risk factors on cerebral vascular hemodynamic indicators.Methods In the cohort crowds,Hani nationality outpatient patients were selected as the Hani nationality group,the Han nationality outpatient patients with the same gender and similar age were randomly selected as the Han nationality group with the ratio of nearly 1 ∶ 3.The risk factors of stroke and the differences of the hemodynamic indicators were compared between the two groups.Results The dyslipidemia proportion of the Hani nationality group was lower than that of the Han nationality group [48 cases (11.5 %) vs.257 cases (17.5 %),x2 =8.867,P =0.003],and the drinking proportion of the Hani nationality group was higher than that of the Han nationality group [79 cases (18.9%) vs.214 cases(14.6%),x2 =4.498,P =0.034],the other risk factors exposure rates had no statistically significant differences between the two groups (all P > 0.05).The ratio of numbers of cerebral vascular hemodynamic indicators below 75 points(optimum truncation points) in the Hani nationality group and the Han nationality group were 30.3% and 31.9%,respectively,the proportion of the two groups of integral value distribution had statistically significant difference (x2 =12.614,P < 0.01);Vmean (left:t =0.632,P =0.527;right:t =0.642,P =0.532),Vmin (left:t =-0.349,P =0.727;right:t =-0.540,P =0.589),Wv(left:t =0.297,P =0.767;right:t =1.119,P =0.263),Zcv(left:t =0.297,P =0.767;right:t =1.247,P =0.213),Rv(left:t =0.837,P =0.403;right:t =1.222,P =0.222),DR(left:t =0.720,P =0.482;right:t =0.396,P =0.692),Cp(left:t =0.614,P =0.539;right:t =1.486,P =0.138) and other indicators of the two groups had no statistically significant differences.Conclusion The Hani nationality residents'stroke risk factors and CVHI integral distribution in different age groups are different from Han people in southern Yunnan.

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