PURPOSE: Postpancreatectomy hemorrhage (PPH) is a life-threatening complication after pancreatoduodenectomy. Stent-graft implantation is an emerging treatment option for PPH. This study reports the outcome of PPH treated with stent-graft implantation. METHODS: This was a single-center, retrospective study. Between April 2020 and December 2023, 1723 pancreatectomy cases were collected while we screened 12 cases of PPH after pancreatoduodenectomy treated with stent-graft implantation. Patients' medical and radiologic images were retrospectively reviewed. Technical and clinical success, complications, and stent-graft patency were evaluated. Continuous data are reported as means ± standard deviation when normally distributed or as median (Q₁, Q₃) when the data is non-normal distributed. Categorical data are reported as n (%). A p < 0.05 was considered statistically significant. Kaplan-Meier estimates were used for stent patency and patients' survival. RESULTS: Pancreatic fistula was identified in 6 cases (50.0%), and pseudoaneurysm was identified in 3 cases (25.0%), including pancreatic fistula together with pseudoaneurysm in 1 case (8.3%). All pseudoaneurysm or contrast extravasation sites were successfully excluded with patent distal perfusion, thus technical success was achieved in all cases. The overall survival rate at 6 months and 1 year was 91.7% and 78.6%, respectively. One patient had herniation of the small intestine into the thoracic cavity, which caused a broad thoracic and abdominal infection and died during hospitalization. Rebleeding occurred at the gastroduodenal artery stump in 1 case after stent-graft implantation for the splenic artery and was successfully treated with another stent-graft implantation. Two cases of asymptomatic stent-graft occlusion were observed at 24.6 and 26.3 after the operation, respectively. CONCLUSIONS With suitable anatomy, covered stent-graft implantation is an effective and safe treatment option for PPH with various bleeding sites and causes.
Humans ; Pancreaticoduodenectomy/adverse effects* ; Stents ; Male ; Retrospective Studies ; Female ; Middle Aged ; Postoperative Hemorrhage/surgery* ; Aged ; Adult

Objective:To explore the subtypes of professional quality of life for Operating Room nurses from an "individual centered" perspective, so as to compare the differences in negative emotions and turnover intentions among different subtypes of nurses.Methods:This article was a cross-sectional survey study. Using the convenient sampling method, a total of 409 Operating Room nurses from three tertiary hospitals in Shandong Province were selected as the research objects in November 2021. The survey was conducted using General Information Questionnaire, Professional Quality of Life Scale, Depression Anxiety Stress Self-assessment Scale and single item of resignation intention. The latent profile analysis was used to explore the potential categories of professional quality of life for operating room nurses.Results:Finally, 350 valid questionnaires were collected, and the effective recovery rate was 85.57% (350/409). 350 operating room nurses scored (50.35±9.82) in the dimension of compassionate satisfaction, (49.01±10.43) in the dimension of burnout, and (49.18±9.53) in the dimension of secondary trauma, all of which were at a moderate level. The professional quality of life of operating room nurses was divided into three potential categories, namely good type (25.14%, n=88), contradictory type (17.43%, n=61) and low satisfaction type (57.43%, n=201). The scores of depression dimension were (3.89±7.69), (14.39±11.13) and (13.18±9.50) in good, contradictory and low-satisfaction class nurses, respectively, and the differences were statistically significant ( P<0.01). The scores of anxiety were (5.82±8.45), (16.92±10.87) and (14.45±9.29), respectively, and the difference was statistically significant ( P< 0.01). The scores of stress dimension were (5.64±8.27), (17.18±11.36) and (15.01±9.10), respectively, and the difference was statistically significant ( P<0.01). The scores of turnover intention were (1.45±0.52), (2.07±1.09), and (2.42±1.06), respectively, and the differences were statistically significant ( P<0.01) . Conclusions:There are different characteristic groups of professional quality of life in operating room nurses, and the population distribution is closely related to negative emotion and turnover intention. Nursing managers should pay attention to the identification and intervention of contradictory and low-satisfaction operating room nurses and give accurate and classified policies.

Objective: To explore the effect and mechanism of DMDAI-L in inducing the HL-60 cells apoptosis. Methods:Caspase-3 activity in HL-60 cells was measured with the enzymatic visible substrate DEVD-pNA. The fluorescence changes of mito-chondrial membrane potential (△Ψm) in HL-60 cells were investigated with the fluorescent probe JC-1. Results:The caspase-3 activ-ity was significantly increased in HL-60 cells after the DMDAI-L treatment at the concentration of 1. 25, 2. 5, 5, 10 and 20μg·ml-1 for 24h(P<0. 05). DMDAI-L could significantly reduce the mitochondrial membrane potential in HL-60 cells. Conclusion: The mechanism of DMDAI-L in inducing HL-60 cells apoptosis may involve the activation or regulation of caspase-3 activity as well as the reduction of mitochondrial membrane potential in HL-60 cells within certain concentration and time range.

Objective To detect the changes of CD4 + CD25 + CD127low/-regulatory T (Treg) cells in peripheral blood in patients with portal hypertension and hepatitis B virus infection before and after splenectomy,and to study the effects of splenectomy on the immune function of patients with portal hypertension.Methods The clinical data of 20 patients with portal hypertension,hepatitis B virus infection and hypersplenism who were admitted to the Third Hospital of Hebei Medical University from May 2012 to May 2013 were retrospectively analyzed.The dynamic levels of CD4 + CD25 + CD127low/ Treg cells in the peripheral blood of the 20 patients (portal hypertension group) at 1 day before splenectomy and at postoperative week 1,month 1 and month 3 were detected by flow cytometry,and the dynamic levels of CD4 + CD25 + CD127low/ Treg cells in the peripheral blood of 10healthy individuals (control group) from the same hospital were also detected by flow cytometry.The effects of changes of Treg cells on the immune function were analyzed.All data were analyzed using the t test or repeated measures analysis of variance.Results The proportions of CD4 + CD25 + CD127low/-Treg cells before operation were 5.1％ ± 3.5％ in the portal hypertension group and 1.4％ ± 0.2％ in the control group,with significant difference between the 2 groups (t =2.573,P ＜ 0.05).The proportions of CD4 + CD25 + CD127low/ Treg cells in the portal hypertension group at postoperative week 1,month 1 and month 3 were 9.2％ ±2.7％,5.6％ ± 1.7％and 2.5％± 2.1％,respectively.There was significant difference in the proportion of CD4+ CD25 + CD127low/-Treg cells between postoperative week 1 and that before operation (F =9.814,P ＜ 0.05),while there was no significant difference in the proportion of CD4 + CD25 + CD127low/-Treg cells between postoperative month 3 and that before operation (F =2.364,P ＞ 0.05).Conclusion The proportion of Treg cells increases in a short period after splenectomy,and then it decreases as time passed by,which indicates that splenectomy has slight influence on the immune system from the perspective of Treg cells.

Objective Objective To explore the reasons of lung hypervolemia after liver transplantation and the corresponding treatment strategies.Method 291 patients received liver transplantation,in which 35 cases underwent pulmonary edema at early stage (pulmonary hypervolemia group),and the rest without pulmonary hypervolemia served as control group.Average central venous pressure (CVP) was recorded pre-,intra-and post-operatively.Total intake,total discharge and fluid balance were also recorded intraoperatively and 3 days post-operatively.Result In pulmonary hypervolemia group,CVP was (12.33 ± 5.08),(14.33 ± 3.03) and (16.50 ± 4.57) mmHg pre-,intra-and post-operatively,significantly higher than that in control group (P＜0.05 for all).Total intake,total discharge and fluid balance in pulmonary hypervolemia group were significantly higher than those in control group intraoperatively and 3 days post-operatively (P＜0.05 for all).After diuretic therapy and hemodialysis,30 cases in pulmonary hypervolemia group recurred,and 5 cases died of infection.Conclusion Pulmonary hypervolemia at early stage after liver transplantation is related to fluid balance.The reasonable control of total intake,total discharge and fluid balance is necessary.

Objective To establish a RP-HPLC method for determining the content of puerarin in Xinkeshu Tablets. Method The analysis was carried on a column of Zorbax Eclipse XDB-C_(18)(4.6 mm?150mm,5?m)at 25℃,with methanol-water-phosphoric acid(23:77:0.5)as mobile phase.The flow rate was 1.0 mL?min~(-1),and the detection wavelength was 250 nm.Result A good linearity was found in the range of 27.1～271.0 ng.The average recovery rate was 100.5 %,and RSD was 1.8%(n=5).Conclusion The method is simple,rapid,accurate,reproducible,and can be used to control the quality of Xinkeshu Tablets.