Objective:To study the effect of preoperative pancreatic duct stent placement in enucleation (EN) of pancreatic tumor adjacent to the main pancreatic duct (MPD).Methods:Clinical data of 56 patients with benign or borderline pancreatic tumor adjacent to the MPD undergoing EN in the Department of Hepatobiliary Surgery of the Second Hospital of Hebei Medical University from January 2022 to September 2024 were retrospectively analyzed, including 25 males and 31 females, aged (32.0±5.5) years. Among the patients, 35 (62.5%) were solid pseudopapillary neoplasm, 15 (26.8%) were neuroendocrine tumor, and 6 (10.7%) were serous cystic tumor. According to whether the pancreatic duct stent was placed through encoscopic retrograde cholangiopancreatography preoperatively, patients were divided into the stent group ( n=20, observation group) and no-stent group ( n=36, control group). The operation time, intraoperative pancreatic duct injury, tumor enucleation time and blood loss, grade B/C pancreatic fistula and postoperative hospital stay were compared between the two groups. Results:All patients underwent EN successfully. The operation time in the observation group was shorter than that in the control group [150.0 (143.5, 159.0) vs 158.0 (150.0, 180.0) min, Z=-2.08, P=0.031], and the rate of intraoperative MPD injury in the observation group was lower than that in the control group [10.0% (2/20) vs 38.9% (14/36), χ2=5.26, P=0.022]. The tumor enucleation time and blood loss were comparable between the two groups (both P>0.05). The rate of postoperative grade B/C pancreatic fistula in the observation group was lower than that in the control group [15.0% (3/20) vs 41.7% (15/36), χ2=4.19, P=0.041], and the postoperative hospital stay was also shorter in the observation group [(7.9±1.6) vs (9.3±2.1) d, t=-2.57, P=0.014]. Conclusion:Under the premise of matured endoscopic operation, preoperative pancreatic duct stent placement through ERCP in the EN of pancreatic tumor adjacent to the MPD can protect the MPD during operation, reduce the occurrence of postoperative grade B/C pancreatic fistula, and shorten the postoperative hospital stay.

Osteoarthritis (OA) is a prevalent degenerative joint disease predominantly affecting the elderly and is characterized by cartilage degradation, synovitis, and subchondral bone sclerosis. Despite its widespread occurrence, no effective pharmacological interventions currently exist to halt or reverse disease progression. Polyphenolic compounds, a diverse class of plant-derived substances, have attracted considerable attention for their potent anti-inflammatory and antioxidant activities. This review summarizes recent advances in understanding the multifaceted roles of polyphenols in OA. Specifically, polyphenols protect chondrocytes and preserve the extracellular matrix by mitigating oxidative stress, suppressing inflammation, regulating autophagy and cholesterol metabolism, and inhibiting programmed cell death pathways, including apoptosis, pyroptosis, and ferroptosis. Furthermore, they exert protective effects on synovial tissue by regulating macrophage polarization and inhibiting pathogenic fibroblast activation, while also contributing to the maintenance of subchondral bone homeostasis. Recent progress in nanotechnology-based delivery systems, designed to overcome the poor solubility and limited bioavailability of polyphenols, is also highlighted. Collectively, this review integrates mechanistic insights with emerging therapeutic strategies, underscoring the potential of polyphenolic compounds as disease-modifying agents for OA.

Objective:To study the effect of preoperative pancreatic duct stent placement in enucleation (EN) of pancreatic tumor adjacent to the main pancreatic duct (MPD).Methods:Clinical data of 56 patients with benign or borderline pancreatic tumor adjacent to the MPD undergoing EN in the Department of Hepatobiliary Surgery of the Second Hospital of Hebei Medical University from January 2022 to September 2024 were retrospectively analyzed, including 25 males and 31 females, aged (32.0±5.5) years. Among the patients, 35 (62.5%) were solid pseudopapillary neoplasm, 15 (26.8%) were neuroendocrine tumor, and 6 (10.7%) were serous cystic tumor. According to whether the pancreatic duct stent was placed through encoscopic retrograde cholangiopancreatography preoperatively, patients were divided into the stent group ( n=20, observation group) and no-stent group ( n=36, control group). The operation time, intraoperative pancreatic duct injury, tumor enucleation time and blood loss, grade B/C pancreatic fistula and postoperative hospital stay were compared between the two groups. Results:All patients underwent EN successfully. The operation time in the observation group was shorter than that in the control group [150.0 (143.5, 159.0) vs 158.0 (150.0, 180.0) min, Z=-2.08, P=0.031], and the rate of intraoperative MPD injury in the observation group was lower than that in the control group [10.0% (2/20) vs 38.9% (14/36), χ2=5.26, P=0.022]. The tumor enucleation time and blood loss were comparable between the two groups (both P>0.05). The rate of postoperative grade B/C pancreatic fistula in the observation group was lower than that in the control group [15.0% (3/20) vs 41.7% (15/36), χ2=4.19, P=0.041], and the postoperative hospital stay was also shorter in the observation group [(7.9±1.6) vs (9.3±2.1) d, t=-2.57, P=0.014]. Conclusion:Under the premise of matured endoscopic operation, preoperative pancreatic duct stent placement through ERCP in the EN of pancreatic tumor adjacent to the MPD can protect the MPD during operation, reduce the occurrence of postoperative grade B/C pancreatic fistula, and shorten the postoperative hospital stay.

Objective:To investigate the clinical value of gastroduodenal artery-stump pro-tection technology (GDAPT) in laparoscopic pancreaticoduodenectomy (LPD).Methods:The retro-spective cohort study was conducted. The clinical data of 288 patients who underwent LPD in The Second Hospital of Hebei Medical University from October 2021 to May 2024 were collected. There were 172 males and 116 females, aged (60±7)years. Of the 288 patients, 186 patients undergoing LPD with GDAPT were divided into the intervention group, including 78 cases with GDAPT using ligamentum teres hepatis and 108 cases with GDAPT using left-lateral lobe and hepatic caudate lobe, 102 patients undergoing LPD without GDAPT were divided into the control group. Observation indicators: (1) surgical situations; (2) postoperative complications and prognosis. Comparison of measurement data with normal distribution between groups was conducted using the independent sample t test. Comparison of measurement data with skewed distribution between groups was conducted using the Mann-Whitney U test. Comparison of count data between groups was conducted using the chi-square test. Results:(1) Surgical situations. All 288 patients completed LPD successfully. There was no significant differences in operation time, the volume of intraoperative blood loss and intraoperative blood transfusion between the two groups ( P>0.05). (2) Postoperative complications and prognosis. Cases with postoperative hemorrhage, duration of postoperative hospital stay, cases dead during postoperative 30 days were 7 in the control group, 15.0(14.0,18.0) days, 2 in the intervention group, respectively, versus 14, 17.5(15.0,19.0)days, 7 in the control group, respectively, showing significant differences between the two groups ( χ2=9.67, Z=-2.79, χ2=5.50, P<0.05). Conclusion:Compared with no GDAPT, application of GDAPT in LPD can significantly reduce the postoperative hemorrhage rate, mortality and shorten the postoperative hospital stay without increasing the surgical risk.

Objective:To investigate the clinical value of gastroduodenal artery-stump pro-tection technology (GDAPT) in laparoscopic pancreaticoduodenectomy (LPD).Methods:The retro-spective cohort study was conducted. The clinical data of 288 patients who underwent LPD in The Second Hospital of Hebei Medical University from October 2021 to May 2024 were collected. There were 172 males and 116 females, aged (60±7)years. Of the 288 patients, 186 patients undergoing LPD with GDAPT were divided into the intervention group, including 78 cases with GDAPT using ligamentum teres hepatis and 108 cases with GDAPT using left-lateral lobe and hepatic caudate lobe, 102 patients undergoing LPD without GDAPT were divided into the control group. Observation indicators: (1) surgical situations; (2) postoperative complications and prognosis. Comparison of measurement data with normal distribution between groups was conducted using the independent sample t test. Comparison of measurement data with skewed distribution between groups was conducted using the Mann-Whitney U test. Comparison of count data between groups was conducted using the chi-square test. Results:(1) Surgical situations. All 288 patients completed LPD successfully. There was no significant differences in operation time, the volume of intraoperative blood loss and intraoperative blood transfusion between the two groups ( P>0.05). (2) Postoperative complications and prognosis. Cases with postoperative hemorrhage, duration of postoperative hospital stay, cases dead during postoperative 30 days were 7 in the control group, 15.0(14.0,18.0) days, 2 in the intervention group, respectively, versus 14, 17.5(15.0,19.0)days, 7 in the control group, respectively, showing significant differences between the two groups ( χ2=9.67, Z=-2.79, χ2=5.50, P<0.05). Conclusion:Compared with no GDAPT, application of GDAPT in LPD can significantly reduce the postoperative hemorrhage rate, mortality and shorten the postoperative hospital stay without increasing the surgical risk.

In epidemic prevention and control,people from epidemic areas are easy to be stigmatized and discriminated,and the dignity of patients may be offended intentionally or unintentionally in the treatment process.In such a world where dignity is still generally ignored,ignored and discriminated against,how to maintain and promote human dignity in epidemic prevention and control has become a public ethical problem.There is no conflict between epidemic prevention and control and human digni-ty,but mutual promotion.The prevention and control measures and policies that fully respect human dignity can be better under-stood,supported and cooperated by individuals.From the perspective of dignity,special respect and care should be given to vul-nerable groups in the epidemic situation,so as to provide medical and health services to vulnerable groups in a dignified way.

Objective:To study the feasibility of a modified pancreatogastric anastomosis in laparoscopic duodenum preserving pancreatic head resection (LDPPHR).Methods:The clinical data of 25 patients with benign or low-grade malignant tumors of pancreatic head undergoing LDPPHR at the Second Hospital of Hebei Medical University from January 2019 to May 2023 were retrospectively analyzed, including 7 males and 18 females, aged (44.9±6.2) years old. According to the methods of pancreatic digestive reconstruction, patients were divided into the observation group ( n=10), who underwent the modified pancreatogastric anastomosis, and the control group ( n=15) who underwent conventional pancreaticojejunal anastomosis and jejuno-jejunal anastomosis. The general data, intraoperative pancreatic digestive reconstruction time, maximum levels of amylase in abdominal drainage within three days postoperatively, postoperative complications, and hospital stay were compared between the groups. Results:All procedures were performed successfully. The intraoperative pancreatic digestive reconstruction time was shorter in the observation group [(27.8±2.4) min vs. (45.8±3.6) min, P=0.010]. The intraoperative blood loss were comparable between the groups [(140.5±14.8) ml vs. (145.2±9.7) ml, P=0.843]. The maximum level of amylase in abdominal drainage within three days postoperatively was lower in the observation group [(809.1±185.5) U/L vs. (1 385.4±481.1) U/L, P=0.031]. No grade C pancreatic fistula or postoperative hemorrhage occurred in either group, and the incidence of grade B pancreatic fistula was lower in the observation group [20.0% (2/10) vs. 60.0% (9/15), P=0.048], with a shorter postoperative hospital stay [(7.9±1.3) d vs. (10.3±2.7) d, P=0.017]. No decrease of life quality or reoperation due to pancreatic fistula, hemorrhage or digestive tract malfunction occurred in either group within a median follow-up of 15.6 months. Conclusion:In LDPPHR, the modified pancreatogastric anastomosis could help shorten the pancreatic digestive reconstruction and lower the risk of postoperative pancreatic fistula.