1.Clinical application of modified pancreaticogastrostomy based on the concept of " Hong's one-stitch method" in digestive tract reconstruction in pancreaticoduodenectomy
Jianhua LIU ; Xinbo ZHOU ; Xueqing LIU ; Shubin ZHANG ; Jianzhang QIN ; Zixuan HU ; Zhongqiang XING ; Guiying WANG
Chinese Journal of Hepatobiliary Surgery 2023;29(2):119-123
Objective:To study the safety and therapeutic effects of the modified pancreaticogastrostomy based on the concept of " Hong's one-stitch method" in digestive tract reconstruction in pancreatic surgery.Methods:The clinical data of 44 patients who underwent modified pancreaticogastresstomy at the Department of Hepatobiliary Surgery, the Second Hospital of Hebei Medical University from May 2022 to October 2022 were analyzed retrospectively. There were 23 males and 21 females , with a median age of 54 years old (range 18 to 70 years old). The operation time, intraoperative blood loss, postoperative condition and complications were analysed.Results:All the 44 patients completed the operation successfully. There were 29 patients who underwent laparoscopic pancreaticoduodenectomy, 11 patients laparoscopic duodenum-preserving pancreatic head resection, 1 patient laparoscopic central pancreatectomy, and 3 patients open pancreaticoduodenectomy. The time required for the pancreaticogastrostomy was (15.4±1.0) min in laparoscopic surgery, and (9.1±0.5) min in open surgery. There were 2 patients who developed grade A pancreatic fistula (4.55%, 2/44) and 7 patients gastric emptying disorder (15.91%, 7/44). There were no grade B or C pancreatic fistula, biliary fistula, gastrointestinal anastomotic fistula, abdominal infection, postoperative bleeding and perioperative death.Conclusion:The modified pancreaticogastrostomy for digestive tract reconstruction in pancreatic surgery was safe and reliable. It effectively reduced the incidence of postoperative pancreatic fistula and improved prognosis of patients.
2.Erratum: Author correction to 'Design, synthesis and biological evaluation of chalcone analogues with novel dual antioxidant mechanisms as potential anti-ischemic stroke agents' Acta Pharmaceutica Sinica B 9 (2019) 335-350.
Jiabing WANG ; Lili HUANG ; Chanchan CHEN ; Ge LI ; Jingwen XIE ; Mengya SHEN ; Qian CHEN ; Wulan LI ; Wenfei HE ; Peihong QIU ; Jianzhang WU
Acta Pharmaceutica Sinica B 2022;12(8):3451-3452
[This corrects the article DOI: 10.1016/j.apsb.2019.01.003.].
3.Study of sequential surgical guide assisting full arch immediate implant placement and provisionalization in patients with severe periodontitis
Jingwen YANG ; Jianxia HOU ; Jianzhang LIU ; Yu ZHANG ; Quan CHEN ; Yijiao ZHAO ; Yong WANG
Chinese Journal of Stomatology 2021;56(6):576-580
To explore the technical process and the therapeutic effect of using sequential surgical guide with independent intellectual property rights assisting immediate implantation and restoration of the full arch, with the support from the periodontal splint for mobile supporting teeth, patients with severe periodontitis who planned to undergo immediate full arch implantation were recruited from August 2019 to December 2020 at the Department of Prosthodontics, Department of Periodontology, Department of Implantology and First Clinical Division, Peking University School and Hospital of Stomatology. Through the procedure of collecting preoperative maxillofacial data, making systematic diagnostic design, making periodontal splints fixation, producing surgical guide, and carrying out guided surgery for full arch immediate implantation, eight cases were included. By registering the postoperative cone-beam CT (CBCT) with the preoperative data, the difference between the actual three-dimensional position of the implants and the virtual design was observed, and the accuracy of the implant placement position guided by the sequential guide was statistically analyzed using SPSS 25.0 software. Analysis indicators include coronal and apical global displacement, coronal horizontal and vertical displacement, apical horizontal and vertical displacement, and angular deviation. Results revealed that the 8 patients [2 males and 6 females, aged (49.0±9.3) years (38-65 years)] of recruited cases included 7 cases of maxilla and 1 cases of mandible. A total of 48 implants, of which 44 implants were placed upright and 4 were placed tilted, 16 implants in the anterior region and 32 implants in the posterior region. No guide plate fracture or damage to important anatomical structures were reported. The overall displacement at the coronal point [(0.83±0.48) mm] and the global displacement at the apical point [(1.36±0.57) mm] were within the clinically acceptable safety range, and the horizontal displacement and vertical displacement at the coronal point, horizontal displacement and vertical displacement at the apical point, and the angle deviation of implants axial have no statistic significant difference in the anterior and posterior region ( P>0.05). Periodontal splints combined with sequential surgical guides to assist patients with severe periodontitis for immediate full arch implantation and immediate restoration can expand the indications of guide assisted implant surgery. It meets the safety requirements in clinical applications.
4.Clinical application of a prefabricated interocclusal recording cap for making interocclusal records of implant-supported fixed prostheses
Qian DING ; Tingting PU ; Mingzhu HE ; Shimin WANG ; Wenjin LI ; Lei ZHANG ; Jianzhang LIU ; Dai TONG ; Yongsheng ZHOU
Chinese Journal of Stomatology 2021;56(12):1205-1210
Objective:To use a self-developed, prefabricated cap for making interocclusal records in implant-supported fixed prosthetic treatment, and to evaluate its effect of clinical application and accuracy of transferring intra-oral intercuspal position.Methods:Series of prefabricated caps for occlusal recording of implant-supported fixed prostheses were designed based on the healing abutments, and fabricated with three-dimensional (3D) printing. According to the inclusion and exclusion criteria, 12 partially edentulous patients who visited the Department of Prosthodontics, Peking University School and Hospital of Stomatology between November 2020 and September 2021, had lost no fewer than 2 contiguous teeth in distal extension (Kennedy Class Ⅰ or Ⅱ), and had received implant placement 3 months ago were enrolled. Self-control study design was used. Two occlusal records of each included case were obtained by the following 2methods:for the test group, appropriate prefabricated caps were used; and for the control group, polyvinyl siloxane occlusal record was directly set on the healing abutments. The working casts were mounted on the mechanical articulator using the 2 groups of occlusal records successively. Accuracy of occlusal relationship of the mounted casts was evaluated. Diagnostics test was performed to obtain the sensitivity and positive predictive value, which were determined in photographs by comparing the intra-oral occlusal contact points with those in the mounted casts, point-by-point. Virtual casts were taken by intraoral and extraoral scans in intercuspal position and imported to Geomagic Studio 2014. Then the root mean square values of occlusal clearance space between the upper and lower occlusal surfaces of remaining posterior teeth, and the deviations of the interocclusal position of the occlusal surfaces of the remaining teeth in the mandibular arches when superimposing the maxillary arches of the intraoral and extraoral scans were calculated. As a self-control design, paired t test was used. Results:Twelve participants were enrolled, including 3 men and 9 women aged (52.6±12.1) years, and 36 missing teeth. The prefabricated caps could fit on the healing abutments with good retention and stability. The sensitivity of the test group (0.73±0.14) was significantly better than that of control group (0.63±0.12, P<0.01), with no significant difference in positive predictive value between the 2 groups ( P>0.05). The deviations of the interocclusal position of the occlusal surfaces of the remaining teeth were (357.0±140.2) μm for the test group, and (399.4±206.3) μm for the control group, with no significant difference between them ( P>0.05). Conclusions:Interocclusal position record based on prefabricated cap in this study for implant-supported fixed prosthetic treatment can improve the consistency between the intra-oral occlusion and the occlusion in dental casts. This technique has good accuracy, clinical convenience and usability.
5.Clinical efficacy comparison of three methods for correction of moderate and severe upper eyelid skin laxity
Peng GUO ; Juan ZHANG ; Zhou YU ; Jianzhang WANG ; Chen HUANG ; Kuan YANG ; Zhe ZHANG ; Baoqiang SONG
Chinese Journal of Plastic Surgery 2020;36(2):185-192
Objective:To compare and analyze the clinical appplication and therapeutic effect of applying three methods for correction of moderate and severe upper eyelid skin laxity.Methods:From January 2017 to March 2019, retrospective analysis was performed to evaluate the therapeutic effect of applying three methods by Department of Plastic Surgery at Xijing Hospital of Air Force Medical University to correct moderate and severe upper eyelid skin laxity, such as subbrow blepharoplasty(SBB), double eyelid surgery(DES) and combination of subbrow blepharoplasty and double eyelid surgery(CSD). Patients were divided into the SBB group, DES group, and CSD group according to the different surgical methods, inclusion and exclusion criteria. The 6 month postoperative improvement of upper eyelid skin laxity, including marginal reflex distance 1(MRD1), medial corneal margin-fold distance (MCMFD), middle pupil margin-fold distance (MPMFD), lateral canthus margin-fold distance (LCMFD), the improvement of upper eyelid wrinkles and patient and surgeon visual analog scores (VAS) were compared. Measurement data were expressed as mean ± standard deviation, comparison between groups was performed by ANOVA, pairwise comparison between groups was performed by LSD- t test, P<0.05 was considered statistically significant. Results:Ninety female patients were included in this study. Thirty patients in each group, patients were between 35 and 62 years old. There was no significant difference in gender, age, and degree of upper eyelid skin laxity among the three groups ( P>0.05). All patients were followed up for 6 to 24 months. Upper eyelid skin laxity and upper eyelid wrinkles were obviously improved in all cases after operation. With the exception of 2 cases of vomiting and 1 case of scalp numbness of CSD group. The improvement of MRD1 in SBB group, DES group and CSD group was (0.14±0.09) mm, (0.34±0.11) mm, (0.43±0.15) mm, showing significant difference between three groups ( F=34.537, P <0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=6.418, 2.824, 9.236, P <0.001, 0.008, <0.001). The improvement of MCMFD in SBB group, DES group and CSD group was (0.32±0.15) mm, (0.92±0.21) mm, (0.97±0.24) mm, showing significant difference between three groups ( F=94.082, P <0.001). The differences between the SBB group and the DES group, the SBB group and the CSD group were statistically significant ( t=11.273, 12.404, P <0.001), and there was no significant difference between the DES group and the CSD group ( t=1.132, P=0.261). The improvement of MPMFD in SBB group, DES group and CSD group was (0.34±0.13) mm, (1.07±0.24) mm, (1.37±0.23) mm, showing significant difference between three groups ( F=193.935, P<0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=13.531, 5.628, 19.159, P <0.001). The improvement of LCMFD in SBB group, DES group and CSD group was (0.54±0.17) mm, (1.58±0.37) mm, (1.97±0.48) mm, showing significant difference between three groups ( F=121.405, P <0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=10.971, 4.097, 15.068, P <0.001). The improvement of upper eyelid wrinkles in SBB group, DES group and CSD group was 0.70±0.47, 0.50±0.51, 1.20±0.48, showing significant difference between three groups ( F=16.471, P <0.001). There was no significant difference between the SBB group and the DES group ( t=1.592, P=0.115), while the differences between the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=5.571, 3.979, P <0.001). The VAS patients score in SBB group, DES group and CSD group was 2.77±0.57, 2.17±0.38, 3.90±0.31, showing significant difference between three groups ( F=124.575, P<0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=5.379, 15.541, 10.161, P <0.001). The VAS surgeons score was 2.80±0.61, 2.27±0.58, 4.07±0.45, showing significant difference between three groups ( F=84.085, P<0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=3.740, 12.624, 8.883, P <0.001). Conclusions:Compared with subbrow blepharoplasty and double eyelid surgery, the combination of subbrow blepharoplasty and double eyelid surgery is an effective way to excise upper eyelid skin and reduce wrinkles, which has the best results in promoting upper eyelid rejuvenation. It should be considered as optimal method for correction of moderate and severe upper eyelid skin laxity.
6.Clinical efficacy comparison of three methods for correction of moderate and severe upper eyelid skin laxity
Peng GUO ; Juan ZHANG ; Zhou YU ; Jianzhang WANG ; Chen HUANG ; Kuan YANG ; Zhe ZHANG ; Baoqiang SONG
Chinese Journal of Plastic Surgery 2020;36(2):185-192
Objective:To compare and analyze the clinical appplication and therapeutic effect of applying three methods for correction of moderate and severe upper eyelid skin laxity.Methods:From January 2017 to March 2019, retrospective analysis was performed to evaluate the therapeutic effect of applying three methods by Department of Plastic Surgery at Xijing Hospital of Air Force Medical University to correct moderate and severe upper eyelid skin laxity, such as subbrow blepharoplasty(SBB), double eyelid surgery(DES) and combination of subbrow blepharoplasty and double eyelid surgery(CSD). Patients were divided into the SBB group, DES group, and CSD group according to the different surgical methods, inclusion and exclusion criteria. The 6 month postoperative improvement of upper eyelid skin laxity, including marginal reflex distance 1(MRD1), medial corneal margin-fold distance (MCMFD), middle pupil margin-fold distance (MPMFD), lateral canthus margin-fold distance (LCMFD), the improvement of upper eyelid wrinkles and patient and surgeon visual analog scores (VAS) were compared. Measurement data were expressed as mean ± standard deviation, comparison between groups was performed by ANOVA, pairwise comparison between groups was performed by LSD- t test, P<0.05 was considered statistically significant. Results:Ninety female patients were included in this study. Thirty patients in each group, patients were between 35 and 62 years old. There was no significant difference in gender, age, and degree of upper eyelid skin laxity among the three groups ( P>0.05). All patients were followed up for 6 to 24 months. Upper eyelid skin laxity and upper eyelid wrinkles were obviously improved in all cases after operation. With the exception of 2 cases of vomiting and 1 case of scalp numbness of CSD group. The improvement of MRD1 in SBB group, DES group and CSD group was (0.14±0.09) mm, (0.34±0.11) mm, (0.43±0.15) mm, showing significant difference between three groups ( F=34.537, P <0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=6.418, 2.824, 9.236, P <0.001, 0.008, <0.001). The improvement of MCMFD in SBB group, DES group and CSD group was (0.32±0.15) mm, (0.92±0.21) mm, (0.97±0.24) mm, showing significant difference between three groups ( F=94.082, P <0.001). The differences between the SBB group and the DES group, the SBB group and the CSD group were statistically significant ( t=11.273, 12.404, P <0.001), and there was no significant difference between the DES group and the CSD group ( t=1.132, P=0.261). The improvement of MPMFD in SBB group, DES group and CSD group was (0.34±0.13) mm, (1.07±0.24) mm, (1.37±0.23) mm, showing significant difference between three groups ( F=193.935, P<0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=13.531, 5.628, 19.159, P <0.001). The improvement of LCMFD in SBB group, DES group and CSD group was (0.54±0.17) mm, (1.58±0.37) mm, (1.97±0.48) mm, showing significant difference between three groups ( F=121.405, P <0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=10.971, 4.097, 15.068, P <0.001). The improvement of upper eyelid wrinkles in SBB group, DES group and CSD group was 0.70±0.47, 0.50±0.51, 1.20±0.48, showing significant difference between three groups ( F=16.471, P <0.001). There was no significant difference between the SBB group and the DES group ( t=1.592, P=0.115), while the differences between the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=5.571, 3.979, P <0.001). The VAS patients score in SBB group, DES group and CSD group was 2.77±0.57, 2.17±0.38, 3.90±0.31, showing significant difference between three groups ( F=124.575, P<0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=5.379, 15.541, 10.161, P <0.001). The VAS surgeons score was 2.80±0.61, 2.27±0.58, 4.07±0.45, showing significant difference between three groups ( F=84.085, P<0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=3.740, 12.624, 8.883, P <0.001). Conclusions:Compared with subbrow blepharoplasty and double eyelid surgery, the combination of subbrow blepharoplasty and double eyelid surgery is an effective way to excise upper eyelid skin and reduce wrinkles, which has the best results in promoting upper eyelid rejuvenation. It should be considered as optimal method for correction of moderate and severe upper eyelid skin laxity.
7.Design, synthesis and biological evaluation of chalcone analogues with novel dual antioxidant mechanisms as potential anti-ischemic stroke agents.
Jiabing WANG ; Lili HUANG ; Chanchan CHENG ; Ge LI ; Jingwen XIE ; Mengya SHEN ; Qian CHEN ; Wulan LI ; Wenfei HE ; Peihong QIU ; Jianzhang WU
Acta Pharmaceutica Sinica B 2019;9(2):335-350
Scavenging reactive oxygen species (ROS) by antioxidants is the important therapy to cerebral ischemia-reperfusion injury (CIRI) in stroke. The antioxidant with novel dual-antioxidant mechanism of directly scavenging ROS and indirectly through antioxidant pathway activation may be a promising CIRI therapeutic strategy. In our study, a series of chalcone analogues were designed and synthesized, and multiple potential chalcone analogues with dual antioxidant mechanisms were screened. Among these compounds, the most active not only conferred cytoprotection of HO-induced oxidative damage in PC12 cells through scavenging free radicals directly and activating NRF2/ARE antioxidant pathway at the same time, but also played an important role against ischemia/reperfusion-related brain injury in animals. More importantly, in comparison with mono-antioxidant mechanism compounds, exhibited higher cytoprotective and neuroprotective potential and Overall, our findings showed compound could emerge as a promising anti-ischemic stroke drug candidate and provided novel dual-antioxidant mechanism strategies and concepts for oxidative stress-related diseases treatment.
8. Laparoscopic duodenum-preserving subtotal pancreatic head resection: a clinical analysis of eight patients
Jianzhang QIN ; Xueqing LIU ; Le WANG ; Jiayue DUAN ; Jianhua LIU
Chinese Journal of Hepatobiliary Surgery 2019;25(11):846-849
Objective:
To summarize the clinical experience of laparoscopic duodenum-preserving subtotal pancreatic head resection (LDPPHR).
Methods:
The clinical data of 8 patients with LDPPHR performed at the Second Hospital of Hebei Medical University from November 2016 to February 2019 were analyzed retrospectively.
Results:
All the eight patients underwent LDPPHR successfully. The operation time was 207.0~540.0 minutes. The estimated blood loss was 50.0~200.0 ml. The postoperative hospital stay was 10.0~27.0 days. One patient developed pancreatic fistula of grade B, and one patient developed biliary fistula. Pathologic results showed pancreatic solid pseudopaillary neoplasm in 3 patients, intraductal papillary mucinous neoplasms in 1 patient, mucinous cystadenoma in 1 patient, serous cystadenoma in 1 patient, neuroendocrine neoplasm in 1 patient, and pancreatic true cyst in 1 patient.
Conclusion
LDPPHR is a safe and effective surgical method for treatment of pancreatic head inflammatory mass, pancreatic head benign or low-grade malignant tumors.
9.Laparoscopic pancreaticoduodenectomy for patients with pancreatic head cancer: an analysis of 57 patients
Xueqing LIU ; Zhaolong WANG ; Feng FENG ; Jianzhang QIN ; Zhongqiang XING ; Jiayue DUAN ; Wenbin WANG ; Haitao LYU ; Jiansheng ZHANG ; Jianhua LIU
Chinese Journal of Hepatobiliary Surgery 2019;25(7):521-525
Objective To study the feasibility of laparoscopic pancreaticoduodenectomy ( LPD) in the treatment of pancreatic head cancer, and to analyze the short-term postoperative outcomes. Methods The clinical data of 57 patients with pancreatic head cancer who underwent laparoscopic pancreaticoduode-nectomy from April 2015 to November 2017 in the Second Hospital of Hebei Medical University were retro-spectively analyzed. Results Of the 57 patients, conversion to open surgery was required in 2 patients, and major venous resection and reconstruction were performed in 9 patients, including 8 end-to-end anastomosis, and 1 synthetic graft interposition. Total pancreatectomy was carried out in 4 patients. For the remaining 53 patients, pancreaticojejunal mucosal anastomoses were carried out in 50 patients, and sleeve pancreaticojeju-nostomy in 3 patients. The mean operative time and operative blood loss were 497 (240~720) min and 435 (50~3 000 ) ml, respectively. The mean postoperative hospital stay was 17. 7 ( 6. 0 ~59. 0 ) days. Postoperative complications were detected in 26. 3% (15/57) of patients, which included delayed gastric emptying (DGE) in 4 patients, Grade B pancreatic fistula (PF) in 4 patients, biliary fistula ( BF) in 2 patients, postpancreatectomy hemorrhage ( PPH) in 2 patients, intraabdominal infection in 1 patient and pulmonary infection in 2 patients. All the patients with DGE recovered with conservative treatment and they were discharged home. Reoperation was only required in the two patients with PPH. One patient died after the operation. The postoperative pathological results revealed pancreatic duct adenocarcinoma in 53 patients, adenosscale carcinoma in 1 patient and neuroendocrine carcinoma in 3 patients. The maximum and minimum tumor sizes were 7. 0 cm×5. 0 cm×3. 5 cm and 2. 5 cm×1. 5 ×1. 0 cm, respectively. The mean lymph nodes harvest and positive lymph node retrieval were 14(1~60) and 0. 7(0~3), respectively. Negative resection margins were obtained in 84. 2% (48/57) of patients. This study was censored on December 31, 2017. The follow-up for these patients ranged between 1 to 32 months. Mortality occurred in 21 patients, including 1 patient with a ruptured aneurysm 2 months after operation, 2 patients with GI bleeding 2 and 9 months respectively after operation, 1 patient with severe pulmonary infection and 17 patients with cancer recurrence with survival varying from 2 to 21 months. 35 patients were still alive. Conclusion Laparoscopic pancreaticoduodenectomy is a safe and feasible procedure for pancreatic head cancer.

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