Objective To explore the protective effect of polydatin and its mechanism on secondary liver injury in silicosis rats based on network pharmacology and animal experiments. Methods i) Network pharmacology study. Based on multiple databases, the targets of polydatin effect related to silicosis and liver injury were collected, and the common targets of polydatin-silicosis-liver injury were screened to construct a protein-protein interaction network. Enrichment analyses were performed to identify core targets involved in the effects of polydatin on silicosis-associated secondary liver injury. The mechanism of action of polydatin in relieving silicosis and silicosis-associated secondary liver injury was investigated, in which polydatin served as molecular docking ligand. ii) Animal experimental validation. Specific pathogen free male SD rats were randomly divided into three groups, with 10 rats per group. Rats in the model and intervention groups received 1 mL of a silica suspension at a mass concentration of 50 g/L for modeling using a one-time non-tracheal exposure method. Then rats in the intervention group were injected intraperitoneally with polydatin solution at 30 mg/kg body weight, once daily starting from the first day after silica exposure, whereas rats in the control group received no treatment. Lung and liver histopathology of rats, which were randomly sacrificed on days 28 and 56 post-exposure in both groups, were examined. Biomarkers of liver injury and hepatic oxidative stress were measured, and hepatic expression of nuclear factor erythroid 2-related factor 2 (NRF2) related proteins was detected by Western blotting. Results i) Network pharmacology study results. A total of 137 polydatin-related targets, 14 812 silicosis-related targets, and 3 038 liver injury-related targets were identified, among which 69 were common targets and 28 were key targets. Gene Ontology analysis indicated that the key targets were involved in 1 883 pathways. Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis identified 137 pathways related to the targets. Molecular docking showed good binding affinities between polydatin and B-cell lymphoma 2 (BCL2), interleukin 6 (IL-6), tumor necrosis factor (TNF), and NRF2. ii) Animal experimental validation results. Compared with the control group, rats in the model group showed increased collagen deposition in both lung and liver tissues, with hepatic degeneration, necrosis, and inflammatory cell infiltration on days 28 and 56 after silica exposure. The collagen in lung and liver tissues of rats on days 28 and 56 after silica exposure increased in the model group compared with the control group (all P<0.05). Meanwhile, serum alanine aminotransferase and aspartate aminotransferase activities, hepatic lactate dehydrogenase 5 activities and NADPH: quinone oxidoreductase 1 (NQO1) expression in liver tissue increased (all P<0.05), whereas hepatic superoxide dismutase activity and NRF2 expression were decreased (all P<0.05). The level of malondialdehyde and the relative expression of heme oxygenase-1 (HO-1) protein in liver tissue in rat of model group were higher than those in the control group (all P<0.05). These alterations were ameliorated in rats of the intervention group compared with the model group (all P<0.05). Conclusion Polydatin exerts protective effects against secondary liver injury in rats with silicosis. These effects may be mediated by regulation of core targets such as BCL2, IL6, TNF, and NRF2, modulation of inflammatory pathways including TNF and IL17 signaling, and activation of the NRF2/HO-1 pathway, thereby exerting synergistic anti-inflammatory, antioxidant, and antifibrotic effects via the "lung-liver axis".

Objective:To evaluate the short-term and long-term efficacy of Heidelberg triangle dissection in surgical treatment for pancreatic head cancer.Methods:The clinicopathological data of 97 patients with pancreatic head cancer who underwent pancreaticoduodenectomy at Cangzhou Central Hospital from Jan 2017 to Jan 2020 were retrospectively analyzed. After propensity score matching, 33 patients were included into the Heidelberg group and 36 patients in the control group.Results:There were no significant difference between Heidelberg group and control group in preoperative general conditions and postoperative major complications, while there were more cases with safe surgical margin > 1 mm (81.8% vs. 58.3%, P=0.034) and a significantly higher total number of lymph node dissection (11.24±2.35 vs. 9.50±2.76, P=0.006). In the survival analysis, the cumulative recurrence rate at 12 months (0.182±0.067 vs. 0.444±0.083, P=0.023) and 18 months (0.424±0.086 vs. 0.667±0.079, P=0.024) were better off in the Heidelberg group, and the local recurrence rate in the Heidelberg group was significantly lower than that in the control group (15.3 % vs. 36.1 %, P=0.037). However, there was no statistical difference in the overall survival time between the two groups. Conclusion:Dissection of Heidelberg triangle in radical resection of pancreatic head cancer reduces tumor local recurrence ,while fails to provide survival benefit.

Objective:To investigate the characteristics and risk factors of local recurrence in resected pancreatic cancer.Methods:The clinicopathological data of 190 patients in whom recurrent sites can be identified after radical resection of pancreatic cancer from Sep 2013 to Aug 2020 at the Cangzhou Central Hospital were retrospectively analyzed. The survival time and clinicopathological characteristics of local recurrence were compared with those of other recurrence types. Cox risk regression model was used to analyze the risk factors of local recurrence.Results:The recurrence sites were local (49 cases, 25.8%), liver (53 cases, 27.9%), lung (35 cases, 18.4%), peritoneal (25 cases, 13.2%) and multiple sites (28 cases, 14.7%). Patients mRFS and mOS were 17.8 months and 30.9 months respectively. The clinicopathological features of patients with local recurrence were compared with those of other recurrence types [tumor diameter ( P=0.023), preoperative CA199 level ( P=0.021), peripancreatic nerve plexus invasion ( P=0.031), lymphovascular invasion ( P=0.004), surgical margin state ( P<0.001) and postoperative adjuvant chemotherapy ( P=0.038)]. Tumor diameter ( P=0.018), peripancreatic nerve plexus invasion ( P=0.002) and postoperative adjuvant chemotherapy ( P=0.004) were independent factors for local recurrence in resected pancreatic cancer, and only peripancreatic nerve plexus invasion was not associated with other recurrence types. Conclusions:Local recurrence in resected pancreatic cancer has important impact on the prognosis of patients. Peripancreatic nerve plexus invasion is an independent factor affecting local recurrence.

Objective:To investigate the application value of susceptibility-weighted imaging (SWI) in the diagnosis of intracranial dural arteriovenous fistula (DAVF).Methods:Patients with DAVF confirmed by digital subtraction angiography (DSA) in Weihai Municipal Hospital from January 2014 to January 2021 were retrospectively included. All patients underwent conventional T 1-weighted imaging (T 1WI), T 2-weighted imaging (T 2WI) and SWI, and some patients also underwent 3D time-of-flight magnetic resonance angiography (3D-TOF-MRA). Results:A total of 36 patients with DAVF were enrolled, 29 of them received 3D-TOF-MRA. The fistula location of 24 patients (24/36, 66.7%) underwent SWI and 26 patients (26/29, 89.7%) underwent 3D-TOF-MRA were correctly judged, and the difference was statistically significant (Fisher's Exact Test, P=0.039). SWI showed that the proportion of patients with thickened supply arteries (7/36, 19.4%) was significantly lower than that on 3D-TOF-MRA (14/29, 48.3%; χ2=6.105, P=0.013). T 2WI, 3D-TOF-MRA and SWI showed no cerebral venous abnormalities in all 7 patients with DAVF without cortical venous reflux; in 29 patients with DAVF with cortical venous reflux revealed by DSA, SWI and T 2WI showed all patients (100%) and 26 patients (89.7%) had superficial venous dilatation respectively, but there was no significant difference ( χ2=0.693, P=0.405). SWI showed medullary vein dilation in 17 patients (47.2%), and only 2 patients (5.6%) had medullary vein thickening on T 2WI, and the difference was statistically significant ( P<0.001). The proportion of patients with venous cerebral infarction on T 2WI was significantly higher than that on SWI (22.2% vs. 0%; Fisher’s Exact Test P=0.005), and the proportion of patients with intracerebral hemorrhage on SWI was significantly higher than that on T 2WI (61.1% vs. 25.0%; χ2=9.574, P=0.004). Conclusion:SWI is helpful to evaluate the abnormal drainage vein of DAVF and the secondary changes in brain, especially intracerebral hemorrhage.

Tumor recurrence after surgery is the main cause of treatment failure. However, the initial stage of recurrence is not easy to detect, and it is difficult to cure in the late stage. In order to improve the life quality of postoperative patients, an efficient synergistic immunotherapy was developed to achieve early diagnosis and treatment of post-surgical tumor recurrence, simultaneously. In this paper, two kinds of theranostic agents based on gold nanorods (AuNRs) platform were prepared. AuNRs and quantum dots (QDs) in one agent was used for the detection of carcinoembryonic antigen (CEA), using fluorescence resonance energy transfer (FRET) technology to indicate the occurrence of

Objective:To investigate whether the combination of conventional axial and thin-layer sagittal diffusion-weighted imaging (DWI) can improve the detection ability of acute brainstem infarction (ABI).Methods:Patients with ABI diagnosed clinically and admitted to Weihai Municipal Hospital, Shandong University from January 2019 to July 2020 were enrolled retrospectively. All patients underwent conventional axial and thin-layer sagittal DWI examination after admission. Those who could not make a definite diagnosis were confirmed by DWI reexamination before discharge. The numbers of positive and negative cases of brainstem infarction at different sites detected by conventional axial and conventional axial+ thin-layer sagittal DWI were recorded.Results:A total of 65 patients with ABI were included. Conventional axial DWI was positive in 51 patients (78.5%) and was negative in 14 (21.5%); conventional axial+ thin-layer sagittal DWI were positive in 60 patients (92.3%) and was negative in 5 (7.7%). In 8 patients with medullary infarction, only 4 (50.0%) were positive on conventional axial DWI, and 6 (75.0%) were positive on conventional axial+ thin-layer sagittal DWI; in 50 patients with pontine infarction, only 44 (88.0%) were positive on conventional axial DWI, and 48 (96.0%) were positive on conventional axial+ thin-layer sagittal DWI; in 4 patients with midbrain infarction, only 1 (25.0%) was positive on conventional axial DWI, and 3 (75.0%) were positive on conventional axial+ thin-layer sagittal DWI; in 3 patients with pontine+ midbrain infarction, only 2 (66.7%) were positive on conventional axial DWI, and 3 (100.0%) were positive on conventional axial DWI+ thin-layer sagittal DWI. The detection rate of ABI on conventional axial+ thin-layer sagittal DWI was significantly higher than that on conventional axial DWI, and difference was statistically significant (92.3% vs. 78.5%; χ2=4.993, P=0.026). Conclusion:The combination of conventional axial and thin-layer sagittal DWI improved the detection rate of ABI. For ABI patients whose axial DWI did not find lesions or whose diagnosis was not clear, thin-layer sagittal DWI should be added.

Objective:To investigate the short-term outcome of Heidelberg triangle dissection in laparoscopic pancreaticoduodenectomy (LPD) for pancreatic cancer.Methods:The clinical data of 84 patients with pancreatic head cancer who underwent LPD from July 2015 to September 2020 in the Department of Hepatobiliary and Pancreatic Surgery of the Cangzhou Central Hospital were retrospectively analyzed. According to the scope of surgical dissection, the patients were divided into the control group ( n=45) and the Heidelberg group ( n=39). In the control group, routine lymph node dissection was performed, and in the Heidelberg group, all blood vessels, lymphatic tissue and nerve tissue in the Heidelberg triangle area were dissected on the basis of routine lymph node dissection. Operation-related indicators (operation duration, intraoperative blood loss, cases of patients with intraoperative blood transfusion, fasting time and hospitalization duration after operation), postoperative complications (pancreatic fistula, biliary fistula, lymphatic fistula, bleeding and delayed gastric emptying) and postoperative pathological parameters (surgical margin, degree of differentiation, tumor size, cases of nerve invasion, number of dissected lymph nodes, lymph node metastasis and TNM stage) were compared between the two groups. Results:Compared with the control group, the operation time of the Heidelberg group was longer [ (334.85±24.95)min vs (305.09±24.54)min], theincidence of lymphatic fistula was higher (15.4% vs 2.2%), the rate of >1 mm at surgical margin was higher (76.9% vs 53.3%), and the total number of lymph nodes dissection was more [ (11.31±2.46) vs (9.49±2.28)]. All the differences between the two groups were statistically significant ( P<0.05). However, there were no significant differences on the intraoperative blood loss, cases of patients with intraoperative blood transfusion, postoperative hospital stay and fasting time, incidence of pancreatic fistula and biliary fistula, bleeding, delayed gastric emptying, degree of differentiation, tumor size, cases of nerve invasion, lymph node metastasis and TNM stage between the two groups. Conclusions:LPD combined with Heidelberg triangle dissection for pancreatic cancer was feasible and safe, which can increase the R 0 resection rate, remove more lymph nodes, reduce the local recurrence of pancreatic cancer and improve the prognosis of patients.

With the development of laryngeal microsurgery, the requirements for the flexibility and convenience of surgical instruments are increasing. The research on related instruments has important value for the clinical application of laryngeal microsurgery. We have redesigned a gun-type tube-guide device of laser fiber by comparing the shortcomings of existing laser fiber introducers. The innovation of this design lies in its rotating nut device with adjustable laser angle and pre-bent tip. The corresponding
Humans ; Larynx/surgery* ; Laser Therapy/instrumentation* ; Lasers ; Microsurgery/instrumentation* ; Surgical Instruments

With the aging of the society, the number of stroke patients has been increasing year by year. Compared with the traditional rehabilitation therapy, the application of upper limb rehabilitation robot has higher efficiency and better rehabilitation effect, and has become an important development direction in the field of rehabilitation. In view of the current development status and the deficiency of upper limb rehabilitation robot system, combined with the development trend of all kinds of products of the upper limb rehabilitation robot, this paper designed a center-driven upper limb rehabilitation training robot for cable transmission which can help the patients complete 6 degrees of freedom (3 are driven, 3 are underactuated) training. Combined the structure of robot with more joints rehabilitation training, the paper choosed a cubic polynomial trajectory planning method in the joint space planning to design two trajectories of eating and lifting arm. According to the trajectory equation, the movement trajectory of each joint of the robot was drawn in MATLAB. It laid a foundation for scientific and effective rehabilitation training. Finally, the experimental prototype is built, and the mechanical structure and design trajectories are verified.

Objective To investigate if anesthetic sensitivity to propofol will be restored after biliary decompression.Methods Twenty-four adult male SD rats were randomly assigned into 3 groups:sham group (group S),irreversible obstructive jaundice group (group Ⅰ) and reversible obstructive jaundice group (group R).The serum total bilirubin (TBL) and total bile acid (TBA) concentratins were detected in the rat blood samples collected from the caudal vein before and after the operation,3,7,14,21 d respectively.Propofol was administered to measure the time of loss of righting reflex and recovery pre or 7th and 21th day post ligation.Results Serum TBL and TBA in group Ⅰ and serum TBA in group R were significantly higher than that in group S on 3rd,7th,14th,21th day post surgery(P＜0.05).Compared with group S,seum TBL in group R were significantly high on 3rd,7th,14th day post-surgery.Serm TBL and TBA in group R were significantly lower than group Ⅰ on 14th,21th day post-surgery (P＜0.05).Compared with group S,the time to loss of righting reflex in group I and group R were significantly shortened and the time to recovery were significantly increased on 7th day post-surgery (P＜0.05).Conclusion Obstructive jaundice could significantly potentiate the ability of propofol to induce a loss of righting reflex,and the increased anesthesia sensitivity will be restored after biliary decompression.