Objective:To analyze the effect of rapid division of left Glisson pedicle and Arantius tube plane in laparoscopic anatomical left hemihepatectomy (LALH).Methods:Clinical data of 25 patients (15 with intrahepatic bile duct calculus and 10 with liver tumor) undergoing LALH in the Department of Hepatobiliary and Pancreatic Surgery, Jiangyin Hospital Affiliated to Nantong University from June 2020 to November 2024 were retrospectively analyzed, including 14 males and 11 females, aged (66.6±11.9) years. Among the patients, 15 received LALH with rapid division of left Glisson pedicle and Arantius tube plane in " one-clamp" fashion, and the others received LALH after traditional dissection of left Glisson pedicle. Age, sex, body mass index, time of left Glisson pedicle dissection, whether the MHV exposure, the time of liver transection, whether MHV and its important branches or bile duct injury occurred, intraoperative blood loss, the incidence of postoperative biliary leakage, the time of abdominal drainage remove, the hospital stay, and alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, albumin 3 days after postoperative were compared between the groups.Results:The times of left Glisson pedicle dissection in the new-fasion and traditional group were (6.1±1.6) min and (13.8±3.0) min, and the time of liver transection was (24.9±3.5) min and (33.4±3.3) min, respectively ( t=-8.34, 6.08, P<0.001 for both). After division of left Glisson pedicle, the MHV was well exposed in 14 cases of new-fashion group and none of traditional group ( P<0.001). All the patients successfully completed the operation without conversion to laparotomy. Intraoperative blood loss, incidence of postoperative bile leakage, time of peritoneal drainage tube removal, postoperative hospital stay, AST, ALT, total bilirubin and albumin 3 days after surgery between the two groups were no significant differences (all P>0.05). Conclusion:LALH using the rapid division of left Glisson pedicle and Arantius tube plane in " one-clamp" fashion could be safe and feasible, the time of left Glisson pedicle and liver transection was short.

Objective:To analyze the effect of rapid division of left Glisson pedicle and Arantius tube plane in laparoscopic anatomical left hemihepatectomy (LALH).Methods:Clinical data of 25 patients (15 with intrahepatic bile duct calculus and 10 with liver tumor) undergoing LALH in the Department of Hepatobiliary and Pancreatic Surgery, Jiangyin Hospital Affiliated to Nantong University from June 2020 to November 2024 were retrospectively analyzed, including 14 males and 11 females, aged (66.6±11.9) years. Among the patients, 15 received LALH with rapid division of left Glisson pedicle and Arantius tube plane in " one-clamp" fashion, and the others received LALH after traditional dissection of left Glisson pedicle. Age, sex, body mass index, time of left Glisson pedicle dissection, whether the MHV exposure, the time of liver transection, whether MHV and its important branches or bile duct injury occurred, intraoperative blood loss, the incidence of postoperative biliary leakage, the time of abdominal drainage remove, the hospital stay, and alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, albumin 3 days after postoperative were compared between the groups.Results:The times of left Glisson pedicle dissection in the new-fasion and traditional group were (6.1±1.6) min and (13.8±3.0) min, and the time of liver transection was (24.9±3.5) min and (33.4±3.3) min, respectively ( t=-8.34, 6.08, P<0.001 for both). After division of left Glisson pedicle, the MHV was well exposed in 14 cases of new-fashion group and none of traditional group ( P<0.001). All the patients successfully completed the operation without conversion to laparotomy. Intraoperative blood loss, incidence of postoperative bile leakage, time of peritoneal drainage tube removal, postoperative hospital stay, AST, ALT, total bilirubin and albumin 3 days after surgery between the two groups were no significant differences (all P>0.05). Conclusion:LALH using the rapid division of left Glisson pedicle and Arantius tube plane in " one-clamp" fashion could be safe and feasible, the time of left Glisson pedicle and liver transection was short.

Objective:To analyze the clinical characteristics of acute pancreatitis (AP) in Wuxi city based on multi center data from four tertiary hospitals.Methods:A retrospective analysis was conducted on the clinical data of 1 254 AP patients treated at Affiliated Hospital of Jiangnan University, Yixing People's Hospital, Jiangyin Hospital of Traditional Chinese Medicine, and Jiangyin People's Hospital from January 1, 2006 to December 30, 2009 and January 1, 2020 to December 30, 2023, including 743 males and 511 females, aged 53 (40, 67) years. The patients were divided into two groups based on the time period of inclusion: the 2006-2009 group ( n=456) and the 2020-2023 group ( n=798). Clinical data such as general clinical characteristics, etiology, laboratory parameters, imaging parameters, complications and prognosis were collected. Results:Compared with the 2006-2009 group, the 2020-2023 group had an increased proportion of biliary AP [60.6%(484/798) vs. 46.5%(212/456)], hyperlipidemic AP [11.2%(89/798) vs. 4.2%(19/456)], comorbid diabetes mellitus [22.1%(176/798) vs. 7.2%(33/456)], and hypertension [32.1% (256/798) vs. 13.6%(62/456)], all of which were statistically significant (all P<0.05). Compared with the 2006-2009 group, the interval between symptom onset and admission to the hospital became longer in the 2020-2023 group [2.0(1.0, 4.0)d vs. 1.0(0.5, 3.0)d], the length of hospitalization was shorter [10(8, 13)d vs.13(8, 19)d], and the proportion of the number of people who got better was increased [85.6%(683/798) vs. 56.4%(257/456)] but the proportion of the number of people who were cured was decreased [12.2%(97/798) vs. 39.7%(181/456)], and the proportion of patients with postoperative complications of ketoacidosis increased [1.90%(15/798) vs. 0.22%(1/456)], with the differences statistically significant (all P<0.05). In both groups, the season with the highest number of AP cases was spring. Conclusion:The incidence of biliary AP in Wuxi City is on the rise, hypertension, meanwhile diabetes mellitus and hyperlipidemia emerge as the predominant etiologic factors, and spring is the high incidence season of AP.

Porcine circovirus type 2(PCV2)mainly damages the immune cells of pigs,causing lym-phocyte depletion and immune suppression.Interleukin(IL)-15 regulates immune functions wide-ly,and plays an important regulatory role in the survival,proliferation,differentiation and immune function of a variety of immune cells such as natural killer(NK),CD8+T cells and NKT cells.In this study,in order to determine the effect of PCV2 on IL-15 expression,4-week-old piglets(n=4)were infected with PCV2 and the negative control group(n=4)was set up.On day 7 post-infec-tion,the inguinal lymph nodes of the infected and control groups were collected,and porcine cyto-kine antibody microarray(QAP-CYT-1)was employed to quantify the expression of cytokines in the tissues,screen for differential cytokines,and GO and KEGG enrichment analysis for IL-15 were conducted.Real-time quantitative fluorescent PCR(qPCR)and ELISA were used to verify the level of IL-15 mRNA and protein,and those in porcine peripheral blood mononuclear cells(PBMC)and serum were simultaneously detected.Compared with the negative control group,the expression lev-el of IL-15 was significantly reduced in the infected group(P＜0.05);IL-15 was mainly involved in cytokine-cytokine receptor interactions,immune responses,cellular activation,and the regulation of JAK-STAT and TNF signaling pathways.The levels of IL-15 mRNA and protein in inguinal lymph nodes in the infected group were significantly lower than those in the control group(P＜0.05),which was consistent with the detection results of QAP-CYT-1.However,there was no significant difference in IL-15 mRNA and protein levels in PBMC and serum.These results indicate that PCV2 can inhibit IL-15 in the inguinal lymph node microenvironment of piglets.This study can provide important information for further revealing the immunosuppressive mechanism of PCV2.

Objective:To analyze the clinical characteristics of acute pancreatitis (AP) in Wuxi city based on multi center data from four tertiary hospitals.Methods:A retrospective analysis was conducted on the clinical data of 1 254 AP patients treated at Affiliated Hospital of Jiangnan University, Yixing People's Hospital, Jiangyin Hospital of Traditional Chinese Medicine, and Jiangyin People's Hospital from January 1, 2006 to December 30, 2009 and January 1, 2020 to December 30, 2023, including 743 males and 511 females, aged 53 (40, 67) years. The patients were divided into two groups based on the time period of inclusion: the 2006-2009 group ( n=456) and the 2020-2023 group ( n=798). Clinical data such as general clinical characteristics, etiology, laboratory parameters, imaging parameters, complications and prognosis were collected. Results:Compared with the 2006-2009 group, the 2020-2023 group had an increased proportion of biliary AP [60.6%(484/798) vs. 46.5%(212/456)], hyperlipidemic AP [11.2%(89/798) vs. 4.2%(19/456)], comorbid diabetes mellitus [22.1%(176/798) vs. 7.2%(33/456)], and hypertension [32.1% (256/798) vs. 13.6%(62/456)], all of which were statistically significant (all P<0.05). Compared with the 2006-2009 group, the interval between symptom onset and admission to the hospital became longer in the 2020-2023 group [2.0(1.0, 4.0)d vs. 1.0(0.5, 3.0)d], the length of hospitalization was shorter [10(8, 13)d vs.13(8, 19)d], and the proportion of the number of people who got better was increased [85.6%(683/798) vs. 56.4%(257/456)] but the proportion of the number of people who were cured was decreased [12.2%(97/798) vs. 39.7%(181/456)], and the proportion of patients with postoperative complications of ketoacidosis increased [1.90%(15/798) vs. 0.22%(1/456)], with the differences statistically significant (all P<0.05). In both groups, the season with the highest number of AP cases was spring. Conclusion:The incidence of biliary AP in Wuxi City is on the rise, hypertension, meanwhile diabetes mellitus and hyperlipidemia emerge as the predominant etiologic factors, and spring is the high incidence season of AP.

Background: Enteritis is one of the most frequently reported symptoms in piglets infected with porcine circovirus type 2 (PCV2), but the immunopathogenesis has not been reported. Objectives: This study examined the effect of a PCV2 infection on the intestinal mucosal immune function through morphological observations and immune-related molecular detection. Methods: Morphological changes within the ileum of piglets during a PCV2 infection were observed. The expression of the related-molecules was analyzed using a gene chip. The immunocyte subsets were analyzed by flow cytometry. The secretory immunoglobulin A (SIgA) content was analyzed by enzyme-linked immunosorbent assay. Results: The PCV2 infection caused ileal villus damage, intestinal epithelial cells exfoliation, and an increase in lymphocytes in the lamina propria at 21 days post-infection.Differentially expressed genes occurred in the defense response, inflammatory response, and the complement and coagulation cascade reactions. Most of them were downregulated significantly at the induction site and upregulated at the effector site. The genes associated with SIgA production were downregulated significantly at the induction site. In contrast, the expression of the Toll-like receptor-related genes was upregulated significantly at the effector site. The frequencies of dendritic cells, B cells, and CD8 + T cells were upregulated at the 2 sites. The SIgA content decreased significantly in the ileal mucosa. Conclusions PCV2 infections can cause damage to the ileum that is associated with changes in immune-related gene expression, immune-related cell subsets, and SIgA production.These findings elucidated the molecular changes in the ileum after a PCV2 infection from the perspective of intestinal mucosal immunity, which provides insights into a further study for PCV2-induced enteritis.

Objective To compare the efficacy and safety of three different methods of laparoscopic common bile duct exploration (LCBDE).Methods The clinical data of patients with LCBDE treated in our hospital by the same surgeon from January 2010 to December 2012 were retrospectively analyzed.These patients were divided into three groups according to the 3 surgical methods:Group A:15 patients were treated with laparoscopic transcystic common bile duct exploration (LTCBDE).Group B:85 patients were treated with laparoscopic common bile duct exploration followed by primary duct closure (LCBDEPDC).Group C:20 patients were treated with laparoscopic common bile duct exploration and T tube drainage (LCBDE-TD).The study measured the TBIL,inner diameter of common bile duct,costs,length of operation,postoperative hospital stay,peritoneal drainage time,and operation-related complications.Results The operations were successfully carried out in the 3 groups of patients.When compared with group C,group A and group B had significantly shorter operative time,shorter postoperative hospital stay,shorter peritoneal drainage time,lower hospital costs,and earlier return to work (P＜0.05).The only significant difference between group A and group B was the peritoneal drainage time.There was no significant difference in the incidences of postoperative complications between the 3 groups (P＞0.05).Conclusions The three different methods of LCBDE had their own indications.LTCBDE was better than primary suture,and LCBDEPDC was better than T-tube drainage after laparoscopic common bile duct exploration.

Objective To investigate the preventive effect of postoperative pancreatic leakage by continuous invaginated pancreaticoenterostomy in pancraticoduodenectomy. Methods Twenty-twopancraticoduodenectomy procedures were performed by continuous invaginated pancreaticoenterostomy with 4-0 absorbable suture and the results were compared with those of 12 end-to-side invagination interrupted suture procedures and 23 pancreatic duct jejunum anastomosis procedures. Results All continuous invaginated pancreaticoenterostomy cases were performed successfully with the average time of 13 minutes, and one biliary leak occurred postoperatively; and there was no pancreatic anastomotic leak and no death. The mean hospital stay of the patients was 15 days. While the mean time of end-to-side invagination interrupted suture procedures was 20 minutes, one biliary leak and one abdominal infection occurred, and one patient died of abdominal bleeding. The mean time of pancreatic duct jejunum anastomosis procedures was 18 minutes, and one pancreatic leak and one upper gastrointestinal bleeding occurred. The mean postoperative hospital stay of these patients was 19 days. Conclusions Continuous invaginated pancreaticoenterostomy is applicable to any situation in the residual pancreas, and has the advantages of easy to operate, time saving and less complications, thus it is an effective improvement of pancreaticoenterostomy.