1.Comparison of electroacupuncture and dexamethasone on lung development impairment in offspring rats induced by prenatal nicotine exposure
Tingting GUO ; Bo JI ; Yang FANG ; Yitian LIU ; Hewen LI ; Xiaoxuan LIU ; Liyu LIU ; Ling ZHANG ; Wenxuan LIU ; Ye QUAN ; Bohan MA ; Sakurai REIKO ; Virender Kumar REHAN
Journal of Beijing University of Traditional Chinese Medicine 2025;48(8):1167-1175
Objective To investigate and compare the effects of electroacupuncture and dexamethasone on lung function and histomorphology and behavior in the offspring of perinatal nicotine exposure(PNE)rats.Methods Twenty-four pregnant Sprague-Dawley rats were randomly divided into control,model,electroacupuncture shallow needling,and dexamethasone groups using the random number table method(n=6 rats per group).A pulmonary dysplasia model in offspring rats with PNE was prepared by cervicodorsal subcutaneous injection with nicotine,and successful establishment of the model was confirmed by demonstrating statistically significant differences in growth parameters,lung function,and lung morphology compared to the control group.From the sixth day of maternal conception,the control group received cervicodorsal subcutaneous injection with 0.9%sodium chloride solution(1 mg/kg once per day),and the remaining groups were similarly injected with nicotine(1 mg/kg once per day).Concurrent with the nicotine injections,the electroacupuncture shallow needling group received electroacupuncture interventions at the"Zusanli"(ST 36)acupoint on both sides once a day for 20 min.In contrast,the offspring rats in the dexamethasone group received intraperitoneal dexamethasone injections from postnatal day 8(1.5 mg/kg once per day for 3 days),with a later dose of 0.75 mg/kg once per day for 4 days.Following successful model establishment,four offspring per rat were retained in each group using the random number table method.Until the 21st day after the birth of the offspring,using the random number table method,one offspring randomly selected from the four retained offspring per rat in each group was assigned to growth parameter assessment including body weight,lung weight,and lung index;simultaneously,one offspring was randomly selected for pulmonary function which was detected by a small animal pulmonary function machine,with the parameters of forced vital capacity(FVC),functional residual capacity(FRC),dynamic lung compliance(Cdyn),peak expiratory flow(PEF),peak inspiratory flow(PIF),and airway resistance(RL);concurrently,one offspring was randomly selected for hematoxylin and eosin staining to observe the histomorphology of the lung tissue,alveolar numbers,and mean alveolar septal thickness;additionally,one offspring was randomly selected for Morris water maze testing to evaluate the effects of the two intervention methods on learning and memory capabilities in offspring rats with PNE.Results Compared with the control group,the body weight,lung weight,lung index,FVC,PEF,FRC,Cdyn,alveolar number,platform crossing times,target quadrant time percentage,and target quadrant path percentage in the Morris water maze experiment were significantly decreased in the offspring rats of the model group(P<0.01).In contrast,PIF,RL,average thickness of alveolar septa,and latency of the Morris water maze experiment were significantly increased in the offspring rats of the model group(P<0.01).Compared with the model group,both electroacupuncture shallow needling group and dexamethasone group exhibited significant increases in body weight,lung weight,lung index,FVC,PEF,FRC,Cdyn,and alveolar numbers(P<0.05,P<0.01),along with significant decreases in PIF,RL values,and mean alveolar septal thickness(P<0.01).However,in the Morris water maze experiment,compared with the model group,the electroacupuncture shallow needling group demonstrated significantly more platform crossing times and a higher target quadrant time percentage and target quadrant path percentage(P<0.01),coupled with reduced latency period(P<0.01),whereas the dexamethasone group showed no significant differences compared to the model group.Compared to the electroacupuncture shallow needling group,the dexamethasone group showed significantly less platform crossing times and a lower target quadrant time percentage and target quadrant path percentage,coupled with increased latency period(P<0.01).Conclusion Both electroacupuncture and dexamethasone demonstrated protective effects on lung development in PNE offspring rats by ameliorating lung histomorphology and pulmonary function.However,offspring receiving late,small-dose,short-course dexamethasone exhibited inferior learning and memory capabilities,whereas the electroacupuncture group showed significantly superior cognitive performance compared to the dexamethasone group.
2.Application of corticomuscular coherence in the field of rehabilitation medicine:a bibliometric analysis
Junfan SHEN ; Ayan GENG ; Wenxuan HU ; Chaojie KAN ; Tong WANG ; Chuan GUO
Chinese Journal of Rehabilitation Theory and Practice 2025;31(3):274-286
Objective To analyze the research status,development trends and hotspots in the field of corticomuscular coherence(CMC).Methods Relevant literatures on CMC from 1999 to 2024 were retrieved from the Web of Science Core Collection.CiteSpace 6.3R1 was ued to evaluate publications across multiple dimensions,including publication volume,countries/regions,institutions,authors,cited journals,cited references and keywords.Research hotspots and fron-tier dynamics were identified through keyword co-occurrence,clustering and bursting.Results A total of 447 articles were included.The overall publication trend for CMC research showed a fluctuating up-ward trajectory,peaking in 2023.China led in publication volume but exhibited relatively low centrality and inter-national collaboration.Germany led the way in academic influence.Aalto University and the University of Lon-don served as academic hubs for CMC research.The most influential research team,led by Mathieu Bourgui-gnon,focused on the physiological mechanisms and motor control applications of CMC.The Journal of Physiolo-gy-London was identified as the most impactful journal in the CMC field.CMC research spaned from molecular mechanisms to system-level behavior,delving into the interdisciplinary nexus of neuroscience and motor science while gradually extending to foundational studies in psychology and biology.High-interest keywords included synchronization,motor cortex and precision grip task.Current research hotspots encompassed connectivity,reor-ganization and activation.Future research was predicted to focus on advancements in CMC technology,interven-tions for neurological disorders,brain-muscle interaction mechanisms and signal processing.Conclusion CMC research has rapidly progressed in recent years,becoming a pivotal direction in motor function assess-ment and neurorehabilitation.Future studies should focus on optimizing CMC analytical techniques to enhance their application in brain-computer interfaces and personalized rehabilitation.Additionally,interdisciplinary col-laboration and international exchange should be strengthened to improve research quality and global impact.
3.Study on the prediction of cognitive impairment among older adults with depression by peripheral immune-inflammation markers
Yan CHEN ; Dansheng LE ; Wenxuan ZHANG ; Yufei GUO ; Zhengluan LIAO
Chinese Journal of Geriatrics 2025;44(9):1246-1251
Objective:To explore the clinical utility of peripheral immune-inflammatory markers in predicting late-life depression with cognitive impairment(LLD+ CI + ). Methods:A cross-sectional study was conducted between January 2020 and December 2021, collecting demographic data, peripheral blood inflammatory markers, and cognitive function scores from 40 patients with LLD+ CI + , 38 patients with late-life depression without cognitive impairment(LLD+ CI -), and 26 healthy controls(HCs). Logistic regression analysis and receiver operating characteristic(ROC)curve analysis were employed to assess the value of peripheral blood inflammatory markers in differentiating LLD+ CI + . Results:Patients with LLD+ CI + exhibited significantly different levels of lymphocytes, C-reactive protein(CRP), systemic immune-inflammation index(SII), systemic inflammation response index(SIRI), neutrophil-to-high-density lipoprotein cholesterol ratio(NHR), and neutrophil-to-lymphocyte ratio (NLR)compared with the LLD+ CI - group and the HGs group( F=4.000, 11.642, 13.541, 10.441, 6.623, 4.193; P=0.022, 0.003, 0.001, 0.005, 0.036, 0.018). The multivariate logistic regression analysis of factors influencing LLD+ CI + revealed that elevated levels of CRP( OR=4.933, 95% CI: 1.385-17.563, P=0.014), SII( OR=5.534, 95% CI: 1.336-22.927, P=0.018), and NLR( OR=3.386, 95% CI: 1.470-7.797, P=0.004)constitute risk factors for geriatric depression with cognitive impairment, while an increased lymphocyte count( OR=0.206, 95% CI: 0.058-0.725, P=0.014)serves as a protective factor.Further analysis identified CRP, lymphocytes, SII, and NLR as significant predictors for LLD+ CI + , with areas under the curve (AUC) values of 0.849(95% CI: 0.760-0.934), 0.847(95% CI: 0.761-0.933), 0.860(95% CI: 0.777-0.943), and 0.857(95% CI: 0.777-0.938), respectively, in distinguishing LLD with or without cognitive impairment. Conclusions:Peripheral immune-inflammatory markers represent an economical and effective approach for investigating the pathophysiological changes and predictive factors associated with LLD+ CI + .These findings provide valuable insights into the underlying mechanisms and potential therapeutic avenues.
4.Comparison of electroacupuncture and dexamethasone on lung development impairment in offspring rats induced by prenatal nicotine exposure
Tingting GUO ; Bo JI ; Yang FANG ; Yitian LIU ; Hewen LI ; Xiaoxuan LIU ; Liyu LIU ; Ling ZHANG ; Wenxuan LIU ; Ye QUAN ; Bohan MA ; Sakurai REIKO ; Virender Kumar REHAN
Journal of Beijing University of Traditional Chinese Medicine 2025;48(8):1167-1175
Objective To investigate and compare the effects of electroacupuncture and dexamethasone on lung function and histomorphology and behavior in the offspring of perinatal nicotine exposure(PNE)rats.Methods Twenty-four pregnant Sprague-Dawley rats were randomly divided into control,model,electroacupuncture shallow needling,and dexamethasone groups using the random number table method(n=6 rats per group).A pulmonary dysplasia model in offspring rats with PNE was prepared by cervicodorsal subcutaneous injection with nicotine,and successful establishment of the model was confirmed by demonstrating statistically significant differences in growth parameters,lung function,and lung morphology compared to the control group.From the sixth day of maternal conception,the control group received cervicodorsal subcutaneous injection with 0.9%sodium chloride solution(1 mg/kg once per day),and the remaining groups were similarly injected with nicotine(1 mg/kg once per day).Concurrent with the nicotine injections,the electroacupuncture shallow needling group received electroacupuncture interventions at the"Zusanli"(ST 36)acupoint on both sides once a day for 20 min.In contrast,the offspring rats in the dexamethasone group received intraperitoneal dexamethasone injections from postnatal day 8(1.5 mg/kg once per day for 3 days),with a later dose of 0.75 mg/kg once per day for 4 days.Following successful model establishment,four offspring per rat were retained in each group using the random number table method.Until the 21st day after the birth of the offspring,using the random number table method,one offspring randomly selected from the four retained offspring per rat in each group was assigned to growth parameter assessment including body weight,lung weight,and lung index;simultaneously,one offspring was randomly selected for pulmonary function which was detected by a small animal pulmonary function machine,with the parameters of forced vital capacity(FVC),functional residual capacity(FRC),dynamic lung compliance(Cdyn),peak expiratory flow(PEF),peak inspiratory flow(PIF),and airway resistance(RL);concurrently,one offspring was randomly selected for hematoxylin and eosin staining to observe the histomorphology of the lung tissue,alveolar numbers,and mean alveolar septal thickness;additionally,one offspring was randomly selected for Morris water maze testing to evaluate the effects of the two intervention methods on learning and memory capabilities in offspring rats with PNE.Results Compared with the control group,the body weight,lung weight,lung index,FVC,PEF,FRC,Cdyn,alveolar number,platform crossing times,target quadrant time percentage,and target quadrant path percentage in the Morris water maze experiment were significantly decreased in the offspring rats of the model group(P<0.01).In contrast,PIF,RL,average thickness of alveolar septa,and latency of the Morris water maze experiment were significantly increased in the offspring rats of the model group(P<0.01).Compared with the model group,both electroacupuncture shallow needling group and dexamethasone group exhibited significant increases in body weight,lung weight,lung index,FVC,PEF,FRC,Cdyn,and alveolar numbers(P<0.05,P<0.01),along with significant decreases in PIF,RL values,and mean alveolar septal thickness(P<0.01).However,in the Morris water maze experiment,compared with the model group,the electroacupuncture shallow needling group demonstrated significantly more platform crossing times and a higher target quadrant time percentage and target quadrant path percentage(P<0.01),coupled with reduced latency period(P<0.01),whereas the dexamethasone group showed no significant differences compared to the model group.Compared to the electroacupuncture shallow needling group,the dexamethasone group showed significantly less platform crossing times and a lower target quadrant time percentage and target quadrant path percentage,coupled with increased latency period(P<0.01).Conclusion Both electroacupuncture and dexamethasone demonstrated protective effects on lung development in PNE offspring rats by ameliorating lung histomorphology and pulmonary function.However,offspring receiving late,small-dose,short-course dexamethasone exhibited inferior learning and memory capabilities,whereas the electroacupuncture group showed significantly superior cognitive performance compared to the dexamethasone group.
5.Application of corticomuscular coherence in the field of rehabilitation medicine:a bibliometric analysis
Junfan SHEN ; Ayan GENG ; Wenxuan HU ; Chaojie KAN ; Tong WANG ; Chuan GUO
Chinese Journal of Rehabilitation Theory and Practice 2025;31(3):274-286
Objective To analyze the research status,development trends and hotspots in the field of corticomuscular coherence(CMC).Methods Relevant literatures on CMC from 1999 to 2024 were retrieved from the Web of Science Core Collection.CiteSpace 6.3R1 was ued to evaluate publications across multiple dimensions,including publication volume,countries/regions,institutions,authors,cited journals,cited references and keywords.Research hotspots and fron-tier dynamics were identified through keyword co-occurrence,clustering and bursting.Results A total of 447 articles were included.The overall publication trend for CMC research showed a fluctuating up-ward trajectory,peaking in 2023.China led in publication volume but exhibited relatively low centrality and inter-national collaboration.Germany led the way in academic influence.Aalto University and the University of Lon-don served as academic hubs for CMC research.The most influential research team,led by Mathieu Bourgui-gnon,focused on the physiological mechanisms and motor control applications of CMC.The Journal of Physiolo-gy-London was identified as the most impactful journal in the CMC field.CMC research spaned from molecular mechanisms to system-level behavior,delving into the interdisciplinary nexus of neuroscience and motor science while gradually extending to foundational studies in psychology and biology.High-interest keywords included synchronization,motor cortex and precision grip task.Current research hotspots encompassed connectivity,reor-ganization and activation.Future research was predicted to focus on advancements in CMC technology,interven-tions for neurological disorders,brain-muscle interaction mechanisms and signal processing.Conclusion CMC research has rapidly progressed in recent years,becoming a pivotal direction in motor function assess-ment and neurorehabilitation.Future studies should focus on optimizing CMC analytical techniques to enhance their application in brain-computer interfaces and personalized rehabilitation.Additionally,interdisciplinary col-laboration and international exchange should be strengthened to improve research quality and global impact.
6.Study on the prediction of cognitive impairment among older adults with depression by peripheral immune-inflammation markers
Yan CHEN ; Dansheng LE ; Wenxuan ZHANG ; Yufei GUO ; Zhengluan LIAO
Chinese Journal of Geriatrics 2025;44(9):1246-1251
Objective:To explore the clinical utility of peripheral immune-inflammatory markers in predicting late-life depression with cognitive impairment(LLD+ CI + ). Methods:A cross-sectional study was conducted between January 2020 and December 2021, collecting demographic data, peripheral blood inflammatory markers, and cognitive function scores from 40 patients with LLD+ CI + , 38 patients with late-life depression without cognitive impairment(LLD+ CI -), and 26 healthy controls(HCs). Logistic regression analysis and receiver operating characteristic(ROC)curve analysis were employed to assess the value of peripheral blood inflammatory markers in differentiating LLD+ CI + . Results:Patients with LLD+ CI + exhibited significantly different levels of lymphocytes, C-reactive protein(CRP), systemic immune-inflammation index(SII), systemic inflammation response index(SIRI), neutrophil-to-high-density lipoprotein cholesterol ratio(NHR), and neutrophil-to-lymphocyte ratio (NLR)compared with the LLD+ CI - group and the HGs group( F=4.000, 11.642, 13.541, 10.441, 6.623, 4.193; P=0.022, 0.003, 0.001, 0.005, 0.036, 0.018). The multivariate logistic regression analysis of factors influencing LLD+ CI + revealed that elevated levels of CRP( OR=4.933, 95% CI: 1.385-17.563, P=0.014), SII( OR=5.534, 95% CI: 1.336-22.927, P=0.018), and NLR( OR=3.386, 95% CI: 1.470-7.797, P=0.004)constitute risk factors for geriatric depression with cognitive impairment, while an increased lymphocyte count( OR=0.206, 95% CI: 0.058-0.725, P=0.014)serves as a protective factor.Further analysis identified CRP, lymphocytes, SII, and NLR as significant predictors for LLD+ CI + , with areas under the curve (AUC) values of 0.849(95% CI: 0.760-0.934), 0.847(95% CI: 0.761-0.933), 0.860(95% CI: 0.777-0.943), and 0.857(95% CI: 0.777-0.938), respectively, in distinguishing LLD with or without cognitive impairment. Conclusions:Peripheral immune-inflammatory markers represent an economical and effective approach for investigating the pathophysiological changes and predictive factors associated with LLD+ CI + .These findings provide valuable insights into the underlying mechanisms and potential therapeutic avenues.
7.Treatment strategy and prognostic analysis of nasopharyngeal necrosis after first radical radiotherapy for nasopharyngeal carcinoma
Dan ZONG ; Wenxuan HUANG ; Yesong GUO ; Jing WEN ; Lijun WANG ; Lanfang ZHANG ; Lirong WU ; Cheng CHEN ; Shengfu HUANG ; Xia HE ; Zhenzhang CHEN
Chinese Journal of Radiation Oncology 2024;33(9):797-803
Objective:To investigate the treatment strategy and prognostic factors of nasopharyngeal necrosis after the first radical radiotherapy for nasopharyngeal carcinoma.Methods:Clinical data of 1020 patients with nasopharyngeal carcinoma undergoing radical intensity-modulated radiotherapy in Jiangsu Cancer Hospital from January 2013 to January 2022 were retrospectively analyzed. Nasopharyngeal necrosis was confirmed by nasopharyngeal MRI, electronic nasopharyngoscopy and biopsy. Patients with nasopharyngeal necrosis were treated with electronic nasopharyngoscope irrigation debridement, combined with systemic anti-infection and nutritional support therapy. Kaplan-Meier method was used to calculate the survival, and Cox regression analysis was used to analyze the relationship between clinical factors and patients' survival.Results:Nasopharyngeal necrosis occurred in 20 cases of 1020 nasopharyngeal carcinoma patients after the first radical intensity-modulated radiotherapy, with an incidence rate of 1.96%. Odd smell and headache were common in nasopharyngeal necrosis patients. All patients had locally advanced nasopharyngeal carcinoma at initial treatment, including 2 (10%) cases of T 3 stage and 18 (90%) cases of T 4 stage. Nasopharyngeal necrosis occurred in the primary nasopharyngeal lesions. According to the stages of nasopharyngeal necrosis, there were 6 (30%) cases of stage I, 14 (70%) cases of stage II and no stage III. The occurrence time of nasopharyngeal necrosis was from 2 to 24 months after radiotherapy, and the median time was 5 months. All 16 cases of nasopharyngeal necrosis were cured clinically after debridement and irrigation under nasopharyngoscope, systemic anti-infection and symptomatic support treatment. Among them, 9 cases had no necrotic cavity and complete healing and 7 cases had residual necrotic cavity. Four patients died of massive nasopharyngeal hemorrhage or due to the inability to nasopharyngeal irrigation. The 5-year survival rates were 37.5% and 85.7% in patients with and without internal carotid artery involvement ( P=0.008), and 25.0% and 77.8% in patients with and without diabetes mellitus ( P=0.016). Univariate Cox regression analysis showed that necrotic lesions involving internal carotid artery ( HR=5.80, 95% CI=1.14-29.38, P=0.034) and diabetes mellitus ( HR=10.24, 95% CI=1.19-88.04, P=0.034) were the influencing factors of overall survival. Conclusions:Nasopharyngoscope irrigation debridement combined with anti-inflammation and nutritional support treatment are effective interventions for nasopharyngeal necrosis after the first radical intensity-modulated radiotherapy in patients with nasopharyngeal carcinoma. The necrosis involving the internal carotid artery and diabetes mellitus are important factors affecting the survival of patients. Vascular invasion caused by vascular rupture is the main cause of death.
8.The feasibility of individualized primary CTV for lateralized nasopharyngeal carcinoma
Siyu ZHANG ; Wenxuan HUANG ; Lijun WANG ; Juying LIU ; Lijun ZHAO ; Lirong WU ; Dejun WANG ; Wenjing XU ; Yesong GUO ; Pengwei YAN ; Lanfang ZHANG ; Zhenyu ZHAI ; Shengfu HUANG ; Xia HE
Chinese Journal of Radiation Oncology 2023;32(8):675-682
Objective:To investigate the feasibility of individualized primary clinical target volume (CTV) delineation in intensity-modulated radiotherapy for nasopharyngeal carcinoma (NPC).Methods:Clinical data of 87 consecutive patients newly diagnosed with lateralized NPC in Jiangsu Cancer Hospital between October 2016 and February 2018 were retrospectively analyzed. Lateralized NPC is defined as tumor invasion not exceeding the contralateral wall. According to the tumor spread, the primary CTV was optimized as follows: CTV2 only covered the medial part of the contralateral pterygopalatine fossa, whereas the contralateral foramen oval was not included; on the level of parapharyngeal space, the contralateral side of CTV only covered the posterior lateral lymph nodes, whereas the contralateral internal jugular vein was not regularly covered. Failure patterns and 5-year survival [local control rate (LCR), progression-free survival (PFS) and overall survival (OS)] were evaluated by Kaplan-Meier method. Paired t-test and rank-sum test were used to analyze the dose variation in the optimized region and adverse reactions. Results:The median follow-up time was 59.5 months. The 5-year LCR, PFS, and OS were 98.9%, 86.5% and 92.1%, respectively. There was no local recurrence in the optimized area of CTV. Dosimetric comparison results showed that the doses of parotid gland, temporal lobe, cochlea and middle ear on the contralateral side were reduced by 13.45%, 9.14%, 38.83%, and 29.36%, respectively. Four cases (4.6%) developed grade 3 hearing loss, all on the ipsilateral side. The optimized scheme significantly alleviated the hearing loss on the contralateral side compared to that on the ipsilateral side ( P<0.001). Other grade 3 late adverse reactions included cranial nerve injury, subcutaneous fibrosis in the neck and visual impairment, with 1 case each. Conclusion:Individualized primary CTV for lateralized NPC is feasible and safe, with obvious dosimetric advantages and reduced adverse reaction rate, which is worthy of clinical promotion.
9.Relationship between defense style and family environment among male prisoners of different terms of imprisonment
Yonghang LI ; Jinying QIN ; Wenxuan LI ; Jincai ZHU ; Huagui GUO ; Xuan GU ; Wei HUANG ; Xuesong LI
Sichuan Mental Health 2022;35(3):272-276
ObjectiveTo explore the psychological defense styles and family environment among male prisoners of different terms of imprisonment, and to analyse the relationship between their psychological defense styles and family environment. MethodsA total of 200 male prisoners in a prison in Guangdong were randomly selected from April to June 2015, and they were classified into less than 5 years of imprisonment group (n=108) and 5 years or more imprisonment group (n=92). Their defense style and family environment were evaluated by Defense Style Questionnaire (DSQ) and Family Environment Scale-Chinese Version (FES-CV). Pearson correlation analysis was used to test the correlation between each scale score. ResultsThe factor scores of immature defense mechanism and intermediate defense mechanism of DSQ in the group with less than 5 years of imprisonment were lower than those in the group with 5 years or more imprisonment, with statistically significant differences (t=4.198, 1.137, P<0.01). The scores of FES-CV family intimacy, emotional expression and organizational factors in less than 5 years of imprisonment group were higher than those in 5 years or more imprisonment group (t=3.122, 2.993, 2.203, P<0.01), and the scores of contradiction factors were lower than those in 5 years or more imprisonment group (t=-3.682, P<0.01). The scores of DSQ immature, intermediate defense mechanism and concealment factor of male prisoners were negatively correlated with the scores of FES-CV family intimacy and emotional expression factor (r=-0.428~-0.172, P<0.05 or 0.01), and the scores of 4 factors in DSQ were all positively correlated with the scores of contradiction factor in FES-CV (r=0.175~0.384, P<0.05 or 0.01). ConclusionCompared with male prisoners with less than 5 years of imprisonment, those with 5 years or more are prone to adopt immature and intermediate defense mechanisms, and their family environments are characterized by apparent contradiction and a lack of family intimacy, emotional expression and organization. Furthermore, the defects of psychological defense mechanism of prisoners are related to their family environment.
10.Impact of Roux-en-Y reconstruction with isolated pancreatic drainage on delayed gastric emptying after pancreaticoduodenectomy
Shaohong WANG ; Wenxuan ZHANG ; Shigang GUO ; Chunmin NING ; Aolei LI ; Xinliang KONG ; Xiangtao WANG ; Shangsheng LI ; Shan KE ; Jun GAO ; Jian KONG ; Qiang LI ; Wenbing SUN
Chinese Journal of Hepatobiliary Surgery 2021;27(6):415-420
Objective:To study the impact of Roux-en-Y reconstruction with isolated pancreatic drainage (RYR) on delayed gastric emptying (DGE) after pancreaticoduodenectomy (PD).Methods:The data of 203 patients who underwent PD at 5 clinical centers from January 2014 to June 2020 were collected. According to the method of reconstruction of the digestive tract, the patients were divided into the RYR group ( n=88) and the conventional loop reconstruction (CLR) group ( n=115). The incidence and severity of DGE were compared between groups. The risk factors of clinically relevant DGE (CR-DGE) after PD were analysed by univariate and multivariate analyses. Results:Of 203 patients, there were 124 males and 79 females, aged (61.6±10.2) years. The overall incidence of DEG was 27.6% (56/203). The incidence of CR-DGE in the RYR group was significantly lower than that in the CLR group [13.6%(12/88) vs 26.1%(30/115), P=0.030]. Patient age of more than 65 years ( OR=2.966, 95% CI: 1.162-8.842, P=0.024), clinically relevant pancreatic fistula ( OR=3.041, 95% CI: 1.122-8.238, P=0.029), ascites and abdominal infection ( OR=10.000, 95% CI: 2.552-39.184, P=0.001), and CLR ( OR=3.206, 95% CI: 1.162-8.842, P=0.024) were identified as independent risk factors for CR-DGE. The duration of hospitalization and hospital expenditure of patients were significantly increased in the CR-DGE group ( P<0.05). Conclusions:Patients over 65 years with clinically relevant pancreatic fistula, with ascites or abdominal infection after operation, had a higher evidence of CR-DGE. Roux-en-Y reconstruction with isolated pancreatic could helped to decrease the incidence of CR-DGE after PD.

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