Objective:To study the use of primary continuous single-layer pancreaticojejunostomy after linear stapler closure of pancreatic neck in pancreaticoduodenectomy (PD).Methods:The clinical data of 21 patients who were treated with primary continuous single-layer pancreaticojejunostomy after linear stapler closure of pancreatic neck in PD at Beijing Chaoyang Hospital Affiliated, West Campus, Capital Medical University, Rizhao Hepatobiliary-pancreatic-splenic Surgery Research Institute, Binzhou Second People’s Hospital, Chaoyang Central Hospital from February 2022 to May 2022 were retrospectively analyzed. There were 12 males and 9 females, with ages ranging from 31.0 to 82.0 years (median age 63.0 years). The success rates of linear stapling at pancreatic neck, time of pancreaticojejunostomy, postoperative complications, pancreatic fistula risk score, and length of hospital stay were studied.Results:Among the 21 patients, there were 3 patients who underwent open PD and 18 patients who underwent laparoscopic PD. Primary continuous single-layer pancreaticojejunostomy after linear stapler closure of pancreatic neck was successfully carried out in all these patients. The success rate was 100.0%. The success rate of finding pancreatic ducts at the pancreatic stumps and inserting an drainage tube was 100.0%(21/21). In the 3 patients who underwent open PD, the operation time were 230.0, 245.0 and 250.0 minutes respectively. The time for completing pancreaticojejunostomy were 12.0, 13.0 and 12.0 minutes respectively. The estimated blood loss were 300.0, 450.0 and 600.0 ml respectively. The length of hospital stay were 14.0, 15.0 and 21.0 days. In the 18 patients who underwent laparoscopic PD, the operation time was (295.9±14.5) min, the time for constructing pancreaticojejunostomy was (22.3±1.5) min, the blood loss was (180.0±40.0) ml, the length of hospital stay ranging from 8.0 to 16.0 days (median 10.5 days). Among all the 21 patients, the pancreatic fistula risk score was (4.7±1.5). Postoperative acute pancreatitis occurred in 3 patients (14.3%), delayed gastric emptying occurred in 4 patients (19.0%), and all of them recovered after conservative treatment. There was no postoperative bleeding, nosocomial infection, grade B and C postoperative pancreatic fistula or perioperative death.Conclusion:The continuous single-layer pancreaticojejunostomy after linear stapler closure of the pancreatic neck was safe, reliable, simple and technically easy. It has the potential to prevent clinical postoperative pancreatic fistula and pancreaticojejunostomy bleeding. It is worth to popularize this surgical procedure.

Objective:To investigate the effects of propofol and sevoflurane on post-traumatic stress disorder (PTSD) after emergency surgery in trauma patients.Methods:A total of 160 trauma patients undergoing emergency surgery under general anesthesia were randomly divided into the propofol group and the sevoflurane group. The perioperative clinical data of the two groups were collected. The incidence of PTSD was evaluated by PCL-5 score one month after the operation in the two groups. The relevance of the injury time and PCL-5 score was assessed by Spearman correlation analysis. Logistic regression analysis was used to analyze the risk factors of PTSD.Results:The incidence of PTSD in the propofol group was significantly higher than that in the sevoflurane group at postoperative 1 month (24.0% vs 10.8%, P=0.034). The injury time was negatively correlated with PCL-5 score in the propofol group ( r=0.229, P<0.01). There was no correlation between the injury time and the PCL-5 score in the sevoflurane group ( r=0.001, P=0.804). Logistic regression analysis showed that the use of propofol was an independent risk factor for PTSD ( P=0.004). Conclusions:Sevoflurane anesthesia is more effective than propofol anesthesia in reducing the occurrence of PTSD in emergency surgery for trauma patients.

Objective:To compare the simplicity, safety, efficacy, prognoses and economic burden of CAS-R-2 frameless stereotactic device and Leksell frame stereotactic device in assisting surgery for patients with hypertensive cerebral hemorrhage (ICH, hematoma volume: 20-40 mL).Methods:The clinical data of 120 patients with supratentorial ICH, admitted to our hospital from December 2012 to December 2019, were retrospectively analyzed; trepanation and drainage assisted by CAS-R-2 frameless stereotactic device was performed in 65 patients (frameless group), and trepanation and drainage assisted by Leksell frame stereotactic device was performed in 55 patients (frame group). The differences of surgery time, hematoma evacuation rate 7 d after surgery, incidences of recurrent hemorrhage and intracranial infection during hospitalization, length and expense of hospitalization, and modified Rankin scale (mRs) scores 6 months after surgery were compared between the two groups.Results:As compared with those in the frame group, patients from the frameless group had significantly shorter surgery time ([0.5±0.1] h vs. [2.2±0.5] h), significantly lower incidence of recurrent hemorrhage (0% vs. 9.1%) and significantly lower incidence of intracranial infection (1.5% vs. 9.1%) during hospitalization ( P<0.05). The hospitalization expense of patients from the frame group was significantly lower than that in the frameless group ( P<0.05). There were no significant differences in hematoma evacuation rate 7 d after surgery, length of hospital stays, and mortality and mRs scores 6 months after treatment between the two groups ( P>0.05). Conclusion:For patients with supratentorial ICH, trepanation and drainage assisted by CAS-R-2 frameless stereotactic device has the same curative effect and prognoses as Leksell frame stereotactic one; the former has higher simplicity and clinical safety, and the latter has lower economic burden.

Objective To investigate the role of microRNA-1 (miR-1) in cardiac fibroblasts induced by high glucose in rats. Methods The primary fibroblasts were cultured from the apical tissue of 1-3 day-old Sprague-Dawley (SD) rats. The cells which were passaged to generation 3 or 4, were randomly divided into normal glucose+lentivector-vehicle group (CON+Lv-Vehicle group), normal glucose+lentivector-miR-1 group (CON+Lv-miR1 group), high glucose+lentivector-vehicle group (HG+Lv-Vehicle group), high glucose+lentivector-miR-1 group (HG+Lv-miR1 group), high glucose+Lv-Vehicle+inhibitor group (HG+Lv-Vehicle+CC group), and high glucose+lentivector-miR-1+inhibitor group (HG+Lv-miR1+CC group). The myocardial fibroblasts were cultured in the concentration of 5.5 mmol/L glucose (normal glucose) or 25.0 mmol/L (high glucose) DMEM medium. Then lentiviral vector containing miR-1 silent sequence or the same volume of lentiviral vector was inoculated into the cells. The AMP activated protein kinase (AMPK) inhibitor Compound C (20 μmol/L) was added to the medium at 12 hours before sampling in inhibitor groups. The expression of phosphorylation of AMPK (p-AMPK), collagenⅠandⅢ, matrix metalloproteinase (MMP-2, MMP-9), and autophagy flux related protein LC3B-Ⅱ and p62/SQSTM1 were measured by Western Blot. Results The purity of rat myocardial fibroblasts in vitro was 97%. Compared with CON+Lv-Vehicle group, there was no significant difference in the expression of p-AMPK in CON+Lv-miR1 group, the expression of p-AMPK in HG+Lv-Vehicle group was significantly decreased (p-AMPK/t-AMPK: 44.72±3.29 vs. 100.00±7.77, 1 < 0.01). The expression of p-AMPK in HG+Lv-miR1 group was higher than that in HG+Lv-Vehicle group (p-AMPK/t-AMPK:60.52±5.16 vs. 44.72±3.29, 1 < 0.05). Compared with HG+Lv-Vehicle group, the expressions of collagen, MMP, LC3B-Ⅱand p62/SQSTM1 in HG+Lv-miR1 group were significantly decreased; after the treatment with AMPK inhibitor, the expressions of collagen, MMP, LC3B-Ⅱ, p62/SQSTM1 were significantly increased (HG+Lv-Vehicle+CC group vs. HG+Lv-Vehicle group: collagen Ⅰ/β-actin: 158.74±13.21 vs. 100.00±7.64, collagenⅢ/β-actin: 177.38± 17.31 vs. 100.00±5.18, MMP-2/β-actin: 130.09±14.31 vs. 100.00±10.47, MMP-9/β-actin: 215.54±20.92 vs. 100.00±11.28, LC3B-Ⅱ/β-actin: 159.34±13.83 vs. 100.00±6.44, p62/SQSTM1/β-actin: 201.01±24.02 vs. 100.00±8.62; HG+Lv-miR1+CC group vs. HG+Lv-miR1 group: collagenⅠ/β-actin: 108.69±9.93 vs. 80.83±7.24, collagenⅢ/β-actin: 127.68±10.46 vs. 81.56±9.97, MMP-2/β-actin: 106.66±10.21 vs. 74.80±7.43, MMP-9/β-actin: 145.65±11.56 vs. 74.63±10.55, LC3B-Ⅱ/β-actin: 150.15±13.28 vs. 22.98±2.87, p62/SQSTM1/β-actin: 130.48±10.74 vs. 49.90±2.27, all 1 < 0.05). Conclusion miR-1 gene silencing inhibits myocardial fibrosis induced by high glucose, its mechanism may be related to the up-regulation of p-AMPK, which can recover autophagy flux.

Objective To investigate the clinical value of platelet parameters in patients with acute myocardial infarction(AMI) in plateau.Methods A total of 72 patients diagnosed as acute myocardial infarction in our department from January 2016 to June 2017 were enrolled into this study.Clinical data and outcomes were analyzed.Platelet parameters were measured within 24 h after AMI occurrence.The relationship between platelet distribution width (PDW),mean platelet volume (MPV),and the severity of disease,infarct size as well as short-term prognosis were further investigated.Results Compared with control group,PDW and MPV were positively correlated with the severity of disease (PPDW=0.039,PMPV=0.038) and infarct size (rPDW=0.305,P=0.009;rMPV=0.263,P=0.025).The AUC of PDW was 0.827,optimal operating point (OOP) was 16.3％,the AUC of MPV was 0.813,OOP was 13.1 fl,the AUC of GRACE was 0.865,OOP was 145.Conclusions PDW and MPV could be regarded as laboratory index to evaluate the severity of disease,infarct size,pathological changes of coronary artery and short-term prognosis of acute myocardial infarction in plateau.

In order to provide substantial scientific information for exploring the mechanism of porcine liver injury caused by Taenia asiatica (T.asiatica),the expression of Cysteine aspartyl proteinase 3 (Caspase-3) from liver tissues of porkets that were experimentally infected by T.asiatica was examined.The T.asiatica adults were collected from the taeniasis patients in Duyun,Guizhou Province and identified biologically.The eggs were harvested from gravid proglottids and prepared by repeated washing and centrifugation.Twelve 20-days old Yorkshire and Seghers hybrid porkets were randomly divided into experimental and control groups as six pigs per group.The experimental group was orally administrated with 1.5 × 106 eggs per porket at day 0 post-infection.The porkets of both groups were sacrificed on the day 15 and day 75 post-infection (three pigs per time point) respectively,and liver samples were collected for further experiments.Quantitative real-time polymerase chain reaction method was employed to detect the mRNA levels of Caspase-3,and western blotting and immunohistochemistry methods were performed to detect the level of Caspase-3 expression in both groups.At the day 15 post-infection,the mRNA level and expression level of Caspase-3 of the experimental group were significantly decreased,comparison with the control group (P =0.011,P=0.008 and P=0.004 respectively).It was positive with Caspase-3 when yellow or brown signal appeared in the cytoplasm of liver cells by immunohistochemistry.However,at the day 75 post-infection,the mRNA level and expression level of Caspase-3 of the experimental group were dramatically similar to the control group.Furthermore,in the experimental group,the mRNA level and expression level of Caspase-3 were significantly increased at day 75 post-infection than day 15 post-infection (P--0.018,P=0.003 and P=0.002 respectively).These results suggested that Caspase-3 might be involved into the regulation of the damage of porcine liver induced by T.asiatica challenge at the early infection stage and have on effect to the hepatic injury because of the dramatic recovery of Caspase-3 at the consequent infection stage.

Objective To explore the expression of the CENP-W in gliomas and investigate the effects of its invasion. Methods The expression level of the CENP-W in gliomas with varied pathologic grade were detected by immunohistochemical analysis,RealTime PCR,and Western Blotting. U251 cells were transfected with the specific siRNA to repress the CENP-W expression level. The invasion ability of U251 cells were examined by Transwell Chamber assay ,while RAS mRNA and protein levels were detected at the same time. Results The expression levels of the CENP-W in glioma tissues were significantly high and the CENP-W gene could enhance the invasion of U251 cells . The expression of RAS was down-regulated when the expression of CENP-W was repressed. Conclusion The CENP-W has an oncogenic role in human brain gliomas and may regulate the invasion of gliomas by adjusting the RAS signaling pathways.

Objective To study the effect of SNORD47 over-expression on proliferation and invasion of U87-epidermal growth factor receptor (EGFR)vⅢ glioma cells. Methods U87-EGFRvⅢ glioma cells at logarithmic phase were assigned into lenti-SNORD47 group, lenti-NC group and blank control group. The recombinant lentiviruses containing lenti-SNORD47 or lenti-NC were transfected into U87-EGFRvⅢ glioma cells of the lenti-SNORD47 group and lenti-NC group, respectively. Forty-eight h after transfection, the SNORD47 expression in the three groups was measured by real time quantitative PCR. Western blotting was used to detect the protein expressions of matrix metalloproteinase (MMP) 2 and MMP9. The proliferation of U87-EGFRvⅢ cells 4, 24, 48, 72 and 96 h after transfection was evaluated by CCK-8 assay and colony formation assay. Transwell assay and wound-healing assay were used to examine the invasion and migration of these cells. Results The SNORD47 expression in the lenti-SNORD47 group was significantly higher than that in the lenti-NC group and control group (P<0.05). The protein expressions of MMP2 and MMP9 in the lenti-SNORD47 group were significantly decreased as compared with those in the lenti-NC group and control group (P<0.05). At 48, 72 and 96 h after transfection, the optical density and number of cloned cells in the lenti-SNORD47 group were significantly decreased as with those in the lenti-NC group and control group (P<0.05). The invasion and migration abilities of U87-EGFRvIII cells in the lenti-SNORD47 group were significantly suppressed as compared with those in the lenti-NC group and control group (P<0.05). Conclusion SNORD47 could inhibit the proliferative and invasive abilities of U87-EGFRvⅢ glioma cells.

Objective To study the effect of exsomes in SH-SY5Y cells after hypoxic ischemia/reperfusion injury.Methods Human umbilical vein endothelial cell hypoxic ischemia/reperfusion (HUVEC I/R) injury models were established,and the exosomes derived from HUVEC I/R were extracted and identified.SH-SY5Y cell hypoxic ischemia/reperfusion injury models (SH-SY5Y I/R) were established,and cells from SH-SY5Y I/R were divided into control group and exosomes-treatedgroup.The proliferation of SH-SY5Y cells was evaluated by CCK-8 assay 24,48and 72 h after cell inoculation.Transwell assay and wound-healing assay were used to examine the invasion and migration.Hochest33258 staining and Flow cytometry were used to monitor the changes of cell cycle and apoptosis.Expressions of Caspase-3,Bax and Bcl-2 were measured by real-time fluorescence quantificative-PCR and Western blotting.Results As compared with those in the control group,the proliferation abilities of SH-SY5Y cells in exosomes-treated group were significantly promoted (48 h:0.70±0.05 vs.0.94±0.08;72 h:0.83±0.05 vs.1.02±0.06),the cell cycle rate of S phase was significantly increased (14.39％±4.11％ vs.20.54％±3.46％),and G0/G1 phase was statistically decreased (71.26％± 5.24％ vs.66.87％±4.23％,P＜0.05).What's more,cell invasive was significantly promoted (44.00±6.56 vs.70.67±6.11),and relative wound injury area was significantly reduced in the exosomes treated group (0.61±0.07 vs.0.52±0.10);significant differences were noted between the two groups (P＜0.05).The mRNA expressions of Bax and Caspase-3 were significantly decreased and the mRNA expressions of Bcl-2 was significantly increased in the exosomes-treated group as compared with those in the control group (P＜0.05).Conclusion HUVEC I/R-derived exosomes play neuro-protective role in human SH-SY5Y cells after hypoxic I/R injury.