Objective:To investigate the practical value of pancreatic duct bind with supporting tube combined with single-needle suture for pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy (LPD).Methods:The clinical data of 65 patients with pancreatic head or periampullary tumors who underwent LPD at the First Affiliated Hospital of Kunming Medical University between January 2021 and June 2024 were retrospectively analysed. Among them, 31 were male and 34 were female, aged (57.7±13.3) years. The patients were divided into two groups based on the method of pancreaticojejunostomy: 22 patients who underwent pancreatic duct bind with supporting tube single-needle suture pancreaticojejunos-tomy were included in the study group, 43 patients who underwent traditional pancreatic duct-to-mucosa pancreaticojejunostomy were included in the control group. The clinical data of the patients, including gender, age, operation time, pancreaticojejunostomy time, and postoperative complications, etc. were recorded.Results:Compared with the control group, the pancreaticojejunostomy time [(25.3±2.4) min vs. (47.0±3.9) min] and operation time [(425.2±52.1) min vs. (453.7±30.8) min] of the study group were both shortened, and the differences were statistically significant (both P<0.05). There was no statistically significant difference in the postoperative complication rate between the study group and the control group [18.2% (4/22) vs. 34.9% (15/43), P=0.161]. The incidence of clinically relevant pancreatic fistula in the study group was lower than that in the control group [4.5% (1/22) vs. 30.2% (13/43)], and the difference was statistically significant ( P=0.024). Conclusion:Pancreatic duct bind with supporting tube combined with single-needle suture pancreaticojejunostomy is safe and effective in LPD. Compared with traditional pancreatic duct-to-mucosa pancreaticojejunostomy, pancreatic duct bind with supporting tube combined with single-needle suture pancreaticojejunostomy has advantages in terms of clinically relevant pancreatic fistula rate, operation time, and pancreaticojejunostomy time.

Objective:To investigate the practical value of pancreatic duct bind with supporting tube combined with single-needle suture for pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy (LPD).Methods:The clinical data of 65 patients with pancreatic head or periampullary tumors who underwent LPD at the First Affiliated Hospital of Kunming Medical University between January 2021 and June 2024 were retrospectively analysed. Among them, 31 were male and 34 were female, aged (57.7±13.3) years. The patients were divided into two groups based on the method of pancreaticojejunostomy: 22 patients who underwent pancreatic duct bind with supporting tube single-needle suture pancreaticojejunos-tomy were included in the study group, 43 patients who underwent traditional pancreatic duct-to-mucosa pancreaticojejunostomy were included in the control group. The clinical data of the patients, including gender, age, operation time, pancreaticojejunostomy time, and postoperative complications, etc. were recorded.Results:Compared with the control group, the pancreaticojejunostomy time [(25.3±2.4) min vs. (47.0±3.9) min] and operation time [(425.2±52.1) min vs. (453.7±30.8) min] of the study group were both shortened, and the differences were statistically significant (both P<0.05). There was no statistically significant difference in the postoperative complication rate between the study group and the control group [18.2% (4/22) vs. 34.9% (15/43), P=0.161]. The incidence of clinically relevant pancreatic fistula in the study group was lower than that in the control group [4.5% (1/22) vs. 30.2% (13/43)], and the difference was statistically significant ( P=0.024). Conclusion:Pancreatic duct bind with supporting tube combined with single-needle suture pancreaticojejunostomy is safe and effective in LPD. Compared with traditional pancreatic duct-to-mucosa pancreaticojejunostomy, pancreatic duct bind with supporting tube combined with single-needle suture pancreaticojejunostomy has advantages in terms of clinically relevant pancreatic fistula rate, operation time, and pancreaticojejunostomy time.

For Perihilar cholangiocarcinoma (pCCA), surgical resection is the only effective way to cure this disease. However, it has high postoperative mortality and high recurrence rate. Domestic and foreign scholars have constructed statistics-based evaluation methods to predict patients′ postoperative survival and complications, such as nomogram, scoring system and other prognostic models. Based on these methods, clinicians can better select patients who can benefit from surgery and choose the optimal? treatment for more severe patients. Through the adoption of other treatments or some ways to ameliorate some preoperative condition, to improve the patient′s mortality and survival. This article reviews the prognostic risk factors and prognostic models of pCCA in order to provide a reference for clinicians to predict the prognosis about the surgery.

Objective To reveal the correlation between follistatin-like protein 1(FSTL1)level and severity of ventricular arrhythmia.Methods A total of 107 patients treated in our department from October 2019 to September 2020 were recruited and divided into control group(40 cases),accidental premature ventricular contraction(PVC)group(35 cases),frequent PVC group(20 cases)and ventricular tachycardia(VT)group(12 cases)according to the Lown's grading.The blood content of FSTL1 was determined by ELISA,and its expression level was detected by RT-qPCR.Electrocardiographic indicators,blood FSTL1 content and relative level of FSTL1 were compared among the four groups.Results The FSTL1 content was significantly higher in the fre-quent PVC group and the VT group than the control group[(39.62±14.29)ng/L and(50.66±21.37)ng/L vs(24.58±10.15)ng/L,P＜0.05],so was the content in the frequent PVC group and the VT group than the accidental PVC group[(39.62±14.29)ng/L and(50.66±21.37)ng/L vs(31.83±9.54)ng/L,P＜0.05].The VT group had significantly higher FSTL1 than the frequent PVC group[(50.66±21.37)ng/L vs(39.62±14.29)ng/L,P＜0.05].The mRNA level of FSTL1 was significantly higher in the frequent PVC group and the VT group than the control group and the accidental PVC group(P＜0.05),and in the VT group than the frequent PVC group(P＜0.05).Conclusion To a certain extent,the blood FSTL1 content is positively correlated with the severity of ventricular arrhythmia,which may be a new target for disease warming.

Objective To reveal the correlation between follistatin-like protein 1(FSTL1)level and severity of ventricular arrhythmia.Methods A total of 107 patients treated in our department from October 2019 to September 2020 were recruited and divided into control group(40 cases),accidental premature ventricular contraction(PVC)group(35 cases),frequent PVC group(20 cases)and ventricular tachycardia(VT)group(12 cases)according to the Lown's grading.The blood content of FSTL1 was determined by ELISA,and its expression level was detected by RT-qPCR.Electrocardiographic indicators,blood FSTL1 content and relative level of FSTL1 were compared among the four groups.Results The FSTL1 content was significantly higher in the fre-quent PVC group and the VT group than the control group[(39.62±14.29)ng/L and(50.66±21.37)ng/L vs(24.58±10.15)ng/L,P＜0.05],so was the content in the frequent PVC group and the VT group than the accidental PVC group[(39.62±14.29)ng/L and(50.66±21.37)ng/L vs(31.83±9.54)ng/L,P＜0.05].The VT group had significantly higher FSTL1 than the frequent PVC group[(50.66±21.37)ng/L vs(39.62±14.29)ng/L,P＜0.05].The mRNA level of FSTL1 was significantly higher in the frequent PVC group and the VT group than the control group and the accidental PVC group(P＜0.05),and in the VT group than the frequent PVC group(P＜0.05).Conclusion To a certain extent,the blood FSTL1 content is positively correlated with the severity of ventricular arrhythmia,which may be a new target for disease warming.

OBJECTIVE To study the protective effects of ligustrazine-scutellarein twin drug ST-11 on rat adrenal medullary pheochromocytoma PC12 cell injury induced by oxygen-glucose deprivation/reperfusion （OGD/R） and its mechanism. METHODS PC12 cells were divided into blank group， model group， nimodipine group （positive control， 5 μmol/L） and different concentration groups of ST-11 （5， 10， 20 μmol/L）. After 24 hours of pre-administration intervention， all the other groups except the blank group were cultured in glucose-free DMEM culture medium containing 10 mmol/L Na2S2O4 for 4 hours with glucose deficiency and hypoxia. After 4 hours of glucose and oxygen re-introduction， the survival rate of cells in each group， the contents of lactate dehydrogenase （LDH）， catalase （CAT）， glutathione （GSH）， malondialdehyde （MDA） and superoxide dismutase （SOD） in cell supernatant， apoptosis rate， the levels of reactive oxygen species （ROS） and mitochondrial membrane potential （MMP）， the protein expressions of B-cell lymphoma 2 related X protein （Bax）， B-cell lymphoma 2 （Bcl-2） and caspase-3 were all detected in each group. RESULTS Compared with blank group， the cell survival rate， the contents of CAT， GSH and SOD in cell supernatant， MMP level， relative expression of Bcl-2 and Bcl-2/Bax ratio in model group decreased significantly （P＜0.05）， while the contents of LDH and MDA， ROS level， apoptosis rate， relative expressions of Bax and caspase-3 were significantly increased （P＜0.05）. Compared with model group， above indexes of ST-11 groups （except for the protein expression of caspase-3 in 5 μmol/L ST-11 group） were reversed signifi-cantly （P＜0.05）. CONCLUSIONS ST-11 has a certain protec-tive effect on OGD/R-injured PC12 cells， and its effects may be related to reduction of oxidative stress and inhibition of cell apoptosis.

Objective:To correlate neutrophil/lymphocyte ratio and platelet/lymphocyte ratio with diabetic nephropathy (DN).Methods:A total of 160 patients with type 2 diabetes mellitus (T2DM) who received treatment between January 2017 and October 2020 in People's Hospital of Suzhou National New & Hi-Tech Industrial Development Zone were included in this study. These patients were randomly divided into DN [urinary albumin-to-creatinine ratio (UACR) ≥ 30 μg/mg, n = 85) and non-DN (UACR < 30 μg/mg, n = 75)] groups according to UACR values. A total of 150 healthy controls who concurrently received health examination were included in the control group. The clinical data and biochemical indicators were collected in each group and their clinical characteristics were compared. The factors that affect DN were analyzed using a logistic regression model. Results:Neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) in patients with T2DM were (2.14 ± 1.12) and (175.00 ± 56.21), respectively, which were significantly higher than those in the healthy controls [(1.53 ± 0.29), (142.70 ± 37.25), t = 3.584, 5.642, both P < 0.05). NLR and PLR in the DN group were (2.64 ± 1.22) and (278.00 ± 72.23), respectively, which were significantly higher than those in the non-DN group [(1.80 ± 0.90), (193.00 ± 62.40), t = 2.738, 3.166, both P < 0.05)]. Logistic regression analysis showed that NLR and PLR are the risk factors of DN ( OR = 5.981, 1.807; 95% CI = 2.104-15.563, 1.327-2.795). Conclusion:Combined detection of NLR and PLR in the clinic may help early prediction of DN.

Objective: To study the value of unmethylated cytosine guanine dinucleotide oligodeoxynucleotide (DSP30) and IL-2 in the conventional cytogenetic (CA) detection of the chromosomal aberrations in chronic lymphocytic leukemia (CLL) . Methods: Bone marrow or peripheral blood cells of CLL patients were cultured with DSP30 plus IL-2 for 72 h, following which R-banding analysis was conducted. Fluorescence in situ hybridization (FISH) was performed in 85 patients. CA results were compared with data obtained by FISH. Results: Among 89 CLL patients, the success rate of chromosome analysis was 94.38% (84/89) . Clonal aberrations were detected in 51 patients (51/84, 60.71%) . Of them, 27 (27/51, 52.94%) were complex karyotype. Among 85 CLL patients tested by FISH, chromosomal abnormalities were detected in 74 (74/85, 87.06%) patients, of which 2 (2/74) patients were complex karyotypes, accounting for 2.70%. Of the 85 CLL patients examined by FISH, 50 had abnormal karyotype analysis, 30 had normal karyotype, 5 failed to have chromosome analysis. Among them, 25 cases showed clonal aberrations by FISH assay but normal by CA, and 4 cases were normal by FISH but displayed aberrations in chromosome analysis, and totally 78 (91.76%) cases with abnormality detected by the combination of the two methods. The frequency of 13q- abnormality detected by FISH was significantly higher than that by CA analysis (69.41%vs 16.67%, P<0.001) , while the frequency of 11q-,+12 and 17p- detected by two methods showed no significant difference (P>0.05) . The detection rate of complex abnormalities in conventional karyotype analysis was higher than that in FISH (50.98%vs 2.70%) . In addition, 11 low-risk and 9 intermediate-risk patients according to FISH results showed complex karyotype by cytogenetics, and were classified into high-risk cytogenetic subgroup. Conclusion DSP30 and IL-2 are effective in improving the detection rate of CA in CLL patients (60.71%) and CA is more effective to detect complex karyotype. However, FISH had a higher overall abnormality detection rate (87.06%) than CA, especially for 13q-. The combination of CA and FISH not only enhanced the detection rate of clonal aberrations to 91.76%, but also provided more precise prognosis stratification for CLL patients, thus to provide more information for clinical implication.

OBJECTIVE： To investigate the characteristics and regularity of hepatotoxicity induced by quinolones， and to provide reference for clinical use of drug safely. METHODS： Using “quinolone” “floxacin” “hepatotoxicity” “hepatic injury”as retrieval words， relevant literatures about hepatotoxicity induced by quinolones were retrieved from domestic and foreign databases as CNKI， Wanfang， VIP， PubMed （during database establishment to 31th， Dec. 2017）. Those literatures were summarized and analyzed. RESULTS： A total of 59 valid literatures were collected， including 61 cases of hepatotoxicity induced by quinolones， 8 types of drugs as ciprofloxacin， moxifloxacin， ofloxacin， lomefloxacin， norfloxacin， levofloxacin， gatifloxacin and enoxacin. Ciprofloxacin， levofloxacin， moxifloxacin and ofloxacin were the most common drugs that caused hepatotoxicity， involving 19， 13， 11， 7 cases， respectively； accumulative constitute ratio was 81.97％. The ratio of male to female was 1.54 ∶ 1， and hepatotoxicity always happened at the age of 61 to 80 （30 cases， 49.18％）. Primary diseases of 46 cases were single disease （75.41％）， and mainly were infection of respiratory system and urogenital system. There were 15 cases of combined disease （24.59％）. Thirty-one cases used quinolones alone， most of which was ciprofloxacin. There were 30 cases of drug combination. Thirty-four cases were given drug intravenously and mainly were domestic cases. The hepatotoxicity first occurred within 10 minutes after administration and at the latest 8 weeks after administration. Forty-nine patients suffered from hepatotoxicity within 10 days after medication， accounting for 80.33％. Besides general fatigue， nausea and vomiting， clinical symptoms also included abnormal elevation of alanine aminotransferase， aspartate aminotransferase and total bilirubin，etc. Fifty-four patients were improved after withdrawal or symptomatic treatment， while 7 patients died. The results of causality evaluation of drug-induced hepatic injury showed that there were 4 probably association cases， 45 likely association cases and 12 possible association cases. CONCLUSIONS： The hepatotoxicity caused by quinolones is related to drug variety， patient’s age， primary disease， drug combination and route of administration， and mostly occurs within 10 days after administration. Great importance should be attached to patient’s liver function indexes， strengthen medication monitoring， and carefully combined use of drugs.

OBJECTIVE: To explore the clinical and laboratory characteristics of 5 patients with myeloid leukemia and t(12;22)(p13;q12). METHODS: Bone marrow cells were cultured for 24 h and analyzed by standard R-banding. Rearrangement of the MN1 gene was detected by fluorescence in situ hybridization (FISH) using dual color break-apart MN1 probes. MN1-ETV6 and ETV6-MN1 fusion genes were detected by reverse transcription polymerase chain reaction (RT-PCR). And the products were subjected to direct sequencing. RESULTS: Among the 5 patients, 2 had AML-M0, 2 had AML-M4, and 1 had CMML at the initial diagnosis. t(12;22)(p13;q12) was the primary abnormality among all patients. Rearrangements of MN1 gene were detected by FISH in all patients. MN1-ETV6 and ETV6-MN1 fusion genes were detected respectively in 4 and 3 patients. CONCLUSION t(12;22)(p13;q12) is a rare but recurrent chromosomal abnormality in myeloid leukemia, and is related to poor prognosis. allo-SCT is valuable for patients with t(12;22)(p13;q12).
Chromosome Banding ; Chromosomes, Human, Pair 12 ; Chromosomes, Human, Pair 22 ; Cytogenetics ; Humans ; In Situ Hybridization, Fluorescence ; Leukemia, Myeloid ; genetics ; Oncogene Proteins, Fusion ; Translocation, Genetic