Background and Aims:The incidence of intrahepatic cholangiocarcinoma(ICC)has been increasing in recent years.Due to its insidious onset and low rate of early diagnosis,radical resection remains the only potential curative treatment.Lymph node metastasis is a major adverse prognostic factor in ICC,but the scope and therapeutic value of lymphadenectomy remain controversial.Previous studies suggest that patients with central ICC may derive greater survival benefit from lymphadenectomy than those with peripheral ICC.Preoperative assessment of lymph node status mainly relies on imaging,but its accuracy is limited.This study aimed to investigate the prognostic impact of lymphadenectomy in ICC patients at different anatomical sites to inform surgical decision-making.Methods:A retrospective analysis was conducted on 220 ICC patients who underwent radical resection at the 904th Hospital of the Joint Logistic Support Force of the PLA from May 2016 to May 2021.The cohort included 126 males and 94 females,with a mean age of(56.76±13.15)years.Patients were categorized into peripheral ICC(n=144)and central ICC(n=76)groups.Clinical characteristics,albumin-bilirubin(ALBI)grade,preoperative risk of lymph node metastasis,number of lymph nodes dissected,lymph node metastasis status,and postoperative survival outcomes were compared.Subgroup analyses were conducted to assess the prognostic value of the number of lymph nodes dissected under different risk stratifications.Results:Significant differences were observed between peripheral and central ICC in ALBI grade(x2=9.952,P=0.002),preoperative lymph node metastasis risk(x2=6.166,P=0.014),number of lymph nodes dissected(x2=4.167,P=0.042),and lymph node metastasis rate(x2=7.331,P=0.007).The 3-year overall survival(OS)rate was higher in peripheral ICC(31.94％)than in central ICC(15.79％)(x2=13.890,P＜0.001).Among central ICC patients,those with ≥6 lymph nodes dissected had better 3-year OS than those with＜6(16.89％vs.13.04％,x2=3.894,P=0.048).In the high-risk subgroup of central ICC,≥6 lymph nodes dissected was also associated with improved 3-year OS compared with＜6(15.62％vs.11.11％,x2=3.962,P=0.047).In contrast,the number of lymph node dissections had no significant prognostic impact in peripheral ICC or in patients classified as low risk.Conclusion:Patients with peripheral ICC had a better prognosis than those with central ICC.Adequate lymphadenectomy(≥6 nodes)improved survival and enhanced staging accuracy in central ICC patients at high risk of lymph node metastasis,highlighting the importance of preoperative risk assessment for optimizing surgical strategies.

Background and Aims:The incidence of intrahepatic cholangiocarcinoma(ICC)has been increasing in recent years.Due to its insidious onset and low rate of early diagnosis,radical resection remains the only potential curative treatment.Lymph node metastasis is a major adverse prognostic factor in ICC,but the scope and therapeutic value of lymphadenectomy remain controversial.Previous studies suggest that patients with central ICC may derive greater survival benefit from lymphadenectomy than those with peripheral ICC.Preoperative assessment of lymph node status mainly relies on imaging,but its accuracy is limited.This study aimed to investigate the prognostic impact of lymphadenectomy in ICC patients at different anatomical sites to inform surgical decision-making.Methods:A retrospective analysis was conducted on 220 ICC patients who underwent radical resection at the 904th Hospital of the Joint Logistic Support Force of the PLA from May 2016 to May 2021.The cohort included 126 males and 94 females,with a mean age of(56.76±13.15)years.Patients were categorized into peripheral ICC(n=144)and central ICC(n=76)groups.Clinical characteristics,albumin-bilirubin(ALBI)grade,preoperative risk of lymph node metastasis,number of lymph nodes dissected,lymph node metastasis status,and postoperative survival outcomes were compared.Subgroup analyses were conducted to assess the prognostic value of the number of lymph nodes dissected under different risk stratifications.Results:Significant differences were observed between peripheral and central ICC in ALBI grade(x2=9.952,P=0.002),preoperative lymph node metastasis risk(x2=6.166,P=0.014),number of lymph nodes dissected(x2=4.167,P=0.042),and lymph node metastasis rate(x2=7.331,P=0.007).The 3-year overall survival(OS)rate was higher in peripheral ICC(31.94％)than in central ICC(15.79％)(x2=13.890,P＜0.001).Among central ICC patients,those with ≥6 lymph nodes dissected had better 3-year OS than those with＜6(16.89％vs.13.04％,x2=3.894,P=0.048).In the high-risk subgroup of central ICC,≥6 lymph nodes dissected was also associated with improved 3-year OS compared with＜6(15.62％vs.11.11％,x2=3.962,P=0.047).In contrast,the number of lymph node dissections had no significant prognostic impact in peripheral ICC or in patients classified as low risk.Conclusion:Patients with peripheral ICC had a better prognosis than those with central ICC.Adequate lymphadenectomy(≥6 nodes)improved survival and enhanced staging accuracy in central ICC patients at high risk of lymph node metastasis,highlighting the importance of preoperative risk assessment for optimizing surgical strategies.

OBJECTIVETo establish the method of high-performance liquid chromatography (HPLC) for the determination of N-isopropylaniline in workplace air.

METHODSN-isopropylaniline in the air was collected by silicone tube, and was then dissolved by acetonitrile and determined by HPLC-UV detector.

RESULTSThere was a linear relationship within the range of 0.0-100.0 µg/ml with the method, and the regression equation was y=22 863x+10 665(r=0.999 9); the detection limit was 0.005 µg/ml, and the minimum detectable concentration was 1.7x10(-3) mg/m3 (3.0 L sampling volume); the average recoveries of standard addition were 96.2%-101.3%. The within-run precision was 2.31%-2.99%, and the between-run precision was 3.21%-4.55%. The average desorption efficiency was 97.6%, the breakthrough volume was more than 8.12 mg, the sampling efficiency waE 100%, and the samples could be stored for at least 7 days at room temperature.

CONCLUSIONThe indicators ol the method all meet the requirements of GBZ/T 210.4-2008 (Determination methods of air chemicals in workplace), and can be used for the determination of N-isopropylaniline in workplace air.

Air Pollutants, Occupational ; analysis ; Aniline Compounds ; analysis ; Chromatography, High Pressure Liquid ; Limit of Detection ; Workplace

OBJECTIVETo establish a method for determination of chloropicrin in the air of workplace by gas chromatography with liquid absorption collection.

METHODSChloropicrin in sample air was collected by absolute ethyl alcohol in a porous glass plate absorption tube. Following direct sample loading, samples were separated by gas chromatography and detected with a micro-electron capture detector. The present method was compared with the national standard method.

RESULTSThe range of linearity was 0-3.0 µg/ml, and the regression equation was y = 3488.80x-57.84, with a correlation coefficient of 0.999 4. The detection limit was 0.003 µg/ml, with a minimum detectable concentration of 0.005 mg/m³ based on a 3.0 L sampling volume. The average recovery rate was 98.9%∼103.2%. The within-run precision was 0.96%-2.12%, and the between-run precision was 2.75%-4.59%. The sampling efficiency was 98.6%. Samples in porous glass plate absorption tube could be stored at 4 °C for at least 5 days. The result ratio of this method to the national standard method was 97.7%-108.0% .

CONCLUSIONThe present method meets the requirements of "Guide for establishing occupational health standards-Part 4: Determination methods of air chemicals in workplace" (GBZ/T 210.4-2008), and is feasible for determination of chloropicrin in the air of workplace.

Air ; analysis ; Air Pollutants, Occupational ; analysis ; Chromatography, Gas ; methods ; Hydrocarbons, Chlorinated ; analysis ; Workplace

Objective:To observe the clinical therapeutic effect of Rho kinase inhibitor-fasudil on no-reflow in pa-tients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI) .Methods :A total of 82 ACS patients ,who hospitalized and occurred no-reflow after PCI ,were randomly divided into fasudil group (n=30 , received fasudil 5mg) ,nitroglycerin group (n=25 ,received nitroglycerin 200μg) and tirofiban group (n=27 ,re-ceived tirofiban 10ml) .All patients received drugs via intracoronary injection ,and reviewed coronary angiography and coronary blood flow velocity evaluation after 10min .Thrombolysis in myocardial infarction (TIMI) flow im-provement ,ST segment elevation/depression extent ,left ventricular ejection fraction (LVEF) ,incidence rates of major adverse cardiovascular events (MACE) and complications were observed .Results:Compared with nitroglycer-in group ,there were significant rise in effective rate of TIMI flow improvement (40.0% vs .63.3% ,59.3% ) ,ST segment elevation and depression extent [ (0.15 ± 0.09) mm vs .(0.24 ± 0.11) mm ,(0.26 ± 0.15) mm] and LVEF level [(48.32 ± 5.67)% vs .(56.12 ± 7.11)% ,(55.78 ± 6.99)% ] ,and significant reduction in incidence rate of MACE in fasudil group and tirofiban group , P<0.05~ <0.01 ;for complications of hypotension ,hemorrhage and thrombocytopenia ,incidence rates of fasudil group (13.3% ,6.7% ,16.7% ) were significantly lower than those of nitroglycerin group (68.0% ,4.0% ,12.0% ) or tirofiban group (3.7% ,29.6% ,44.4% ) , P<0.05 all .Conclu-sion:Fasudil is safe and effective on no-reflow after PCI in ACS patients ,and it is worthy of extension .

Objective To evaluate the safety and efficacy of radical antithrombotic therapy(aspirin,clopidogrel and tirofiban) in the treatment of senile (≥ 75 years) non-ST-elevation acute coronary syndrome (NSTEACS).Methods A total of 146 senile patients with NSTEACS were divided into observation group (70 cases) and control group(76 cases) by random digits table method.The control group was given aspirin,low molecular weight heparin and clopidogrel,and the observation group was added tirofiban (intravenous loading dosage:0.4 μ g/ (kg· min) for 30 min and then maintaining 0.1 μ g/ (kg· min) for 48-72 h).The occurrence of major adverse cardiovascular events (MACE) within 30 d after treatment,7 d angina pectoris control rate and adverse reactions were observed in two groups.Results The occurrence rate of MACE within 30 d after treatment was 5.7％ (4/70) in observation group,and 14.5％ (11/76) in control group,and there was significant difference (P ＜ 0.05).The 7 d angina pectoris control rate was 92.9％ (65/70) and 76.3 ％ (58/76) in observation group and control group,and there was significant difference (P ＜ 0.05).The incidence of bleeding was 10.0 ％ (7/70) and 7.9 ％ (6/76) in observation group and control group,and there was no significant difference (P ＞ 0.05).There were no major bleeding events in two groups.One case had thrombocytopenia in observation group,but there was no significant difference compared with that in control group(P ＞ 0.05).Conclusion Triofiban on the basis of aspirin and clopidogrel in the treatment of senile NSTEACS is effective and safe.