Pancreaticoduodenectomy (PD) stands as one of the most challenging landmark procedures in general surgery. Postoperative pancreatic fistula (POPF), a common complication following PD, predisposes patients to secondary pathologies and remains difficult to avoid. Reducing its incidence and mitigating its impact have become focal points in pancreatic surgical research. This article comprehensively reviews domestic and international literature to systematically analyze key factors influencing POPF across three phases: preoperative, intraoperative, and postoperative management. By gaining deeper insights into the pathogenesis of POPF, this review aims to enhance clinical understanding among healthcare professionals, facilitate the implementation of preventive strategies, and offer novel perspectives for minimizing postoperative fistula risks.

Pancreaticoduodenectomy (PD) stands as one of the most challenging landmark procedures in general surgery. Postoperative pancreatic fistula (POPF), a common complication following PD, predisposes patients to secondary pathologies and remains difficult to avoid. Reducing its incidence and mitigating its impact have become focal points in pancreatic surgical research. This article comprehensively reviews domestic and international literature to systematically analyze key factors influencing POPF across three phases: preoperative, intraoperative, and postoperative management. By gaining deeper insights into the pathogenesis of POPF, this review aims to enhance clinical understanding among healthcare professionals, facilitate the implementation of preventive strategies, and offer novel perspectives for minimizing postoperative fistula risks.

Objective: To analyze the correlation between the age and the cone-beam CT (CBCT) images of the third and fourth cervical vertebrae in female skeletal class Ⅰ patients aged between 9 and 17 years, and to establish a quantitative evaluation method for calculating the age. Methods: CBCT images of 108 female skeletal class Ⅰ patients aged between 9 and 17 years were collected from Qingdao Stomatological Hospital from September, 2017 to March, 2019. The two-dimensional linear values (AH: height of anterior edge of vertebral body; H: height of middle part of vertebral body; PH: height of posterior edge of vertebral body; AP: width of vertebral body), the two-dimensional linear ratio values (AH/PH, AH/AP, AH/H, H/AP, H/PH, PH/AP) and the three-dimensional volume values of the third vertical vertebrae (C3) and the fourth vertical vertebrae (C4) were measured. By Exponential transformation of measurements and multiple linear regression analysis, the optimal index for evaluating age were screened, and the fitting degree of multiple linear regression equation (R²) and the accuracy of age estimation (SEE) were compared. CBCT images of 27 female skeletal class Ⅰ patients aged from 9 to 17 years were added from Qingdao Stomatological Hospital between April, 2019 and July, 2019, by which the accuracy of the regression equation was verified. Results: Multiple linear regression equation for age estimation based on two-dimensional linear indexes was as follows: Y=-113.928+33.743×e^AH₃^/100+58.844×e^PH₄^/100+20.590×e^AP₄^/100( "e" was a natural constant, e≈2.718), R²=0.745, SEE=1.31. Multiple linear regression equation for age estimation based on two-dimensional linear ratio indexes was as follows: Y=-0.076-2.284×e^AH₃/PH₃+3.227×e^AH₃/AP₃+2.149×e^AH₃/H₃+1.961×e^AH₄/H₄, R²=0.576, SEE=1.70. Multiple linear regression equation of age estimation by the volume index was as follows: Y=-16.828+22.184×e^V₃^{/10 000}, R²=0.555, SEE=1.71. The data of 27 new patients were tested. The CBCT measurement index of C3 and C4 vertebral bodies inferred the fitting degree (R²) and accuracy (SEE) of the equation of the age estimation. The two-dimensional linear value was superior to the two-dimensional linear ratio and the latter was superior to the three-dimensional volume value. The standard error of the estimate about them was 1.74, 2.00 and 2.37, respectively. Conclusions The two-dimensional linear index of CBCT images of C3 and C4 could be used to estimate the age of 9 to 17-year-old female skeletal class Ⅰ patients, and the accuracy of the method was higher than that of two-dimensional ratio index and three-dimensional volume index.

OBJECTIVE: The purpose of this research was mainly two-fold: first, to get an understanding of current researches conducted on Alzheimer disease in China; second, to systematically evaluate and compare Alzheimer's treatment delivered by traditional Chinese medicine (TCM) and Western medicine. METHODS: Two steps were employed in this research. They were data collection and cleaning, followed by systemic review and qualitative analysis. The data were selected from the following two databases: CNKI (http://www.cnki.net) and Wanfang Data (http://www.wanfangdata.com.cn). Inclusion criteria were: (1) Chinese literature; (2) Published between year 1994 and year 2004; (3) Using TCM as treatment and Western medicine as control; (4) Similar research purposes and methodology; (5) Subjects were diagnosed as Alzheimer disease. Descriptive analysis, homogeneity test, meta analysis, sensitivity analysis and subgroup analysis were performed in the second step. RESULTS: Supposing all qualified studies were of high quality, we got the following conclusion: the advantage of TCM was losing because of the newly-developed acetylcholinesterase inhibitors came in market. Moreover, the studies conducted after year 2002 were more homogeneous in comparison with those conducted in early years. Those studies using mini-mental status examination (MMSE) as outcome measurement were also more homogeneous than non-MMSE measurement groups. Combined odds ratio in comparative studies was 1.5 fold higher than that in experimental studies. Regarding to different outcome measurement, those studies using TCM assessment profile were 2.58(4.79/1.86) fold higher than those using MMSE as outcome measurement. CONCLUSIONS: After systemic literature search, we found that only 40 out of 2,403 studies met our inclusion criteria. Moreover, those qualified studies were of low quality. Therefore, the external validity of this study would be compromised. The solution to this would be to improve study quality by strengthening study design and carefully select more homogeneous subjects in terms of syndrome differentiation, by so doing, the results of meta analysis will be more convincing and easily recognized by international society.

AIM: To study the protective effect of mese nt eric lymph duct ligation on the functions of liver, kidney and heart, and morpho logy in multiple organ dysfunction syndrome (MODS) rats subjected to two-hit. METHODS: Male Wistar rats were divided into three groups: the me senteric lymph duct ligation group, the non-ligation group and sham group. The M ODS model of two-hit was established by bleeding and LPS administration in both ligation group and non-ligation group. After 24 h, all rats were cannulated to f acilitate blood withdrawal for serum sample, then all rats were killed and organ s including kidney, liver, lung and heart were collected for making microscopic sectio ns. The biochemical indexes of hepatic and renal functions and myocardial enzyme in s erum were determined before and after experiment. RESULTS: After two-hit, the serum contents of AST, ALT, TBA, BUN , Cr and LDH-1 in both non-ligation group and ligation group, and UA content in non-ligation group were obviously increased than those in pre-experiment and sh am group (P