To investigate the differences in postoperative short-term complications and long-term prognosis of pancreatic cancer(PC) patients after total pancreatectomy(TP) and pancreaticoduodenectomy(PD).

Atrial septal defect（ASD）is one of the most common congenital heart diseases in children. Although most children with this condition may not exhibit clinical symptoms，persistent left-to-right shunting can increase the burden on the right heart and compromise cardiac function as they age. Therefore，early intervention is crucial for these children. Percutaneous intervention has superseded conventional surgery as the primary mode of treatment for secondary atrial septal defect in children. The procedure has a low rate of postoperative complications，but carries a substantial risk. Serious complications include unsatisfactory device position or embolization，cardiac erosion，atrioventricular block，thrombosis or thromboembolism，air embolism，and hemolysis. Common complications include headache or migraine，residual shunt，and vascular-related complications. This review focuses on the pathogenesis，clinical presentations，prevention and treatment of complications related to percutaneous intervention of atrial septal defect in children.

Objective To observe the value of feature pyramid network(FPN)for automatic segmentation and semantic feature classification of spontaneous intracerebral hemorrhage(sICH)hematoma showed on non-contrast CT.Methods Non-contrast CT images of 408 sICH patients in hospital A(training set)and 103 sICH patients in hospital B(validation set)were retrospectively analyzed.Deep learning(DL)segmentation model was constructed based on FPN to segment the hematoma region,and its efficacy was assessed using intersection over union(IoU),Dice similarity coefficient(DSC)and accuracy.Then DL classification model was established to identify the semantic features of sICH hematoma.Receiver operating characteristic curves were drawn,and the area under the curves(AUC)were calculated to evaluate the efficacy of DL classification model for recognizing semantic features of sICH hematoma.Results The IoU,DSC and accuracy of DL segmentation model for 95％sICH hematoma in training set was 0.84±0.07,0.91±0.04 and(88.78±8.04)％,respectively,which was 0.83±0.07,0.91±0.05 and(88.59±7.76)％in validation set,respectively.The AUC of DL classification model for recognizing irregular shape,uneven density,satellite sign,mixed sign and vortex sign of sICH hematoma were 0.946-0.993 and 0.714-0.833 in training set and validation set,respectively.Conclusions FPN could accurately,effectively and automatically segment hematoma of sICH,hence having high efficacy for identifying semantic features of sICH hematoma.

The first rate-limiting enzyme of the serine synthesis pathway (SSP), phosphoglycerate dehydrogenase (PHGDH), is hyperactive in multiple tumors, which leads to the activation of SSP and promotes tumorigenesis. However, only a few inhibitors of PHGDH have been discovered to date, especially the covalent inhibitors of PHGDH. Here, we identified withangulatin A (WA), a natural small molecule, as a novel covalent inhibitor of PHGDH. Affinity-based protein profiling identified that WA could directly bind to PHGDH and inactivate the enzyme activity of PHGDH. Biolayer interferometry and LC-MS/MS analysis further demonstrated the selective covalent binding of WA to the cysteine 295 residue (Cys295) of PHGDH. With the covalent modification of Cys295, WA blocked the substrate-binding domain (SBD) of PHGDH and exerted an allosteric effect to induce PHGDH inactivation. Further studies revealed that with the inhibition of PHGDH mediated by WA, the glutathione synthesis was decreased and intracellular levels of reactive oxygen species (ROS) were elevated, leading to the inhibition of tumor proliferation. This study indicates WA as a novel PHGDH covalent inhibitor, which identifies Cys295 as a novel allosteric regulatory site of PHGDH and holds great potential in developing anti-tumor agents for targeting PHGDH.

Objective:To compare the clinical efficacy between the pressing tendon suture with a lateral anchor and the knotted suture with a lateral anchor in the treatment of severe rotator cuff tear under shoulder arthroscopy.Methods:A retrospective study was conducted of the 42 patients who had been treated at Department of Orthopedic Sports Medicine, Affiliated Hospital to Qingdao University from December 2018 to December 2019 for severe rotator cuff tear. They were 13 males and 29 females, with an age of (58.3±10.1) years (from 32 to 74 years). The injury was on the right side in 26 cases and on the left side in 16 cases. Of them, 22 received pressing tendon suture with a lateral anchor under shoulder arthroscopy and 20 knotted suture with a lateral anchor under shoulder arthroscopy. The flexion, abduction and external rotation of the shoulder, Visual Analog Scale (VAS) pain score, University of California-Los Angeles (UCLA) score, Constant-Murley shoulder score, American Shoulder and Elbow Surgeons (ASES) score and imaging MRI Sugaya grading were compared between the 2 groups 12 months after operation.Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability between them ( P>0.05). At 12 months after operation, the pressing tendon suture group had better abduction and flexion of the shoulder, a lower VAS pain score and a higher ASES score than the knotted suture group, but the differences were insignificant ( P>0.05). At 12 months after operation, the pressing tendon suture group achieved significantly better external rotation (39.2°±11.7°) and significantly higher UCLA score (28.1±4.7) and Constant-Murley shoulder score (77.0±9.3) than the knotted suture group (29.8°±14.6°, 22.1±5.7 and 66.4±11.0) ( P<0.05). At 12 months after operation, the imaging MRI Sugaya grading was significantly lower for the pressing tendon suture group than that for the knotted suture group ( P<0.05). Conclusion:In the treatment of patients with severe rotator cuff tear under shoulder arthroscopy, the pressing tendon suture with a lateral anchor may lead to better clinical prognosis than the knotted suture with a lateral anchor.

This paper reviews the clinical research on the treatment of chronic prostatitis with traditional Chinese medicine in recent years. It is believed that the core of the etiology and pathogenesis of this disease lies in the deficiency of spleen and kidney, dampness heat, phlegm turbid and blood stasis toxin. If the disease lasts for a long time, the spleen and kidney become to the deficiency from excess. The internal treatment of traditional Chinese medicine includes syndrome differentiation, disease differentiation or single prescription, while the external treatment mainly includes herbal bathing, enema, anal administration and acupuncture. Traditional Chinese medicine has advantages in the treatment of this disease. We should continue to study the the mechanism of traditional Chinese medicine for this disease, standardize the syndrome differentiation and treatment and outocmes evaluation, and carry out research on famous prescriptions on prostatitis.

Objective To investigate the early clinical efficacy of Masquelet membrane induction technique in the treatment of traumatic long bone defects.Methods A retrospective case series study was conducted to analyze the clinical data of 41 patients with traumatic long bone defects admitted to the General Hospital of the Northern Theater Command from January 2012 to April 2017.There were 36 males and five females,aged 15-70 years,with an average of 38.2 years.There were 20 patients with bone defect at the femur,19 at the tibia,one at the fibula,and one at the ulna.All patients received staged treatment using the Masquelet membrane induction technique.In stage Ⅰ surgery,thorough debridement was first performed,and the secretions were taken for bacterial culture.The average bone defect length after debridement was 6.9 cm (2.0-18.5 cm).The bone defect was filled with antibiotic bone cement to induce the biofilm formation.If the postoperative bacterial culture showed positive results,debridement surgery was performed again.Stage Ⅱ surgery was performed after 6-12 weeks.The white blood cell count,C-reactive protein (CRP),procalcitonin (PCT),erythrocyte sedimentation rate (ESR) were measured before the operation.During the operation,bone biopsy was performed,and the bone cement placeholder was completely removed.The autologous cancellous bone and artificial bone were implanted in the bone defect areas,and the induced membrane was sutured.The healing time of bone defects was recorded,and the Paley fracture healing scoring criteria were used to evaluate the limb function.The complications were observed.The inflammatory markers were reviewed at the last follow-up.Results All patients were followed up for 7-36 months with an average of 13.6 months.A total of 37 patients obtained bone healing.The fracture healing rate of stage Ⅰ was 90％,and the healing time was 6-13 months,with an average of 9 months.According to the Paley fracture healing scoring criteria,the results were excellent in 25 patients,good in 10,and fair in two patients,with the excellent and good rate of 85％.In terms of complications,one patient with superficial infection recovered after dressing change,three patients had deep infection,of which one patient was treated with amputation and two received other treatments,and three patients were treated with membrane induction again because of bone resorption.At the last follow-up,there were significant differences between preoperative and postoperative White blood cell count,CRP,PCT and ESR(P ＜ 0.05).Conclusion For traumatic long bone defects,Masquelet membrane induction technique can promote fracture healing,restore limb function and reduce complications.

Objective To compare the safely between 3 ways of inserting the anteroinferior iliac spine channel screws using computer simulation.Methods The spiral pelvic CT data of 100 patients were collected who had sought medical treatment at General Hospital of The Northern Theater Command from October 2017 to October 2018.They were 61 males and 39 females,aged from 20 to 60 years (average,47.5 years).The data were imported into Mimics (Materi-alise,Belgium) software to create three-dimensional models of the pelvis.The pelvic modeling data were then imported into 3-Matic (Materi-alise,Belgium) software for post-processing.Three cylinders with a diameter of 6.7 mm were created,taking the anteroinferior iliac spine as the entry point and taking the posterosuperior iliac spine,the posteroinferior iliac spine and the midpoint between the 2 spines as the 3 exit points.The insertion of anteroinferior iliac spine channel screws was simulated to observe the screw penetration.Results In the channel from the anteroinferior iliac spine to the posterosuperior iliac spine,penetration occurred in 41 cases out of the medial ilium and in 2 cases out of the lateral ilium,giving a penetration rate of 43％ (43/100);in the channel from the anteroinferior iliac spine to the midpoint between the 2 spines,penetration occurred in 16 cases out of the medial ilium and in 2 cases out of the lateral ilium,giving a penetration rate of 18％ (18/100);in the channel from the anteroinferior iliac spine to the posteroinferior iliac spine,penetration occurred in 6 cases out of the medial ilium,in 2 cases out of the lateral ilium,in 60 cases out of the greater sciatic notch and in 8 cases out of both the medial ilium and greater sciatic notch,giving a penetration rate of 76％ (76/100).There were significant differences between the 3 ways of insertion in the screw penetration (x2 =68.219,P ＜ 0.001).The rate of screw penetration in the channel from the anteroinferior iliac spine to the posteroinferior iliac spine was significantly higher than that in the channel from the anteroinferior iliac spine to the posterosuperior iliac spine which was significantly higher than that in the channel from the anteroinferior iliac spine to the midpoint between the 2 spines (P ＜ 0.05).Conclusions The channel from the anteroinferior iliac spine to the midpoint between the posterosuperior iliac spine and the posteroinferior iliac spine may lead to a lower rate of screw penetration while the channel from the anteroinferior iliac spine to the posteroinferior iliac spine may lead to a higher rate of screw penetration.

Objective To study the relationship between juxtapapillary duodenal diverticulum (JPDD) and pancreaticobiliary diseases, and the effect of JPDD on the diagnosis and treatment of ERCP. Methods A retrospective analysis was performed on data of 1230 patients who had received ERCP in general surgery departments of Shengjing Hospital of China Medical University from January 2012 to January 2017. The patients were divided into JPDD group ( n=360) and non-JPDD group ( n=870) according to whether JPDD was found. Patients with JPDD were divided into intradiverticular papilla group ( n=41) and non-intradiverticular papilla group ( n=319) according to whether the papilla located in diverticulum. The incidence of pancreaticobiliary diseases, success rate of cannulation, success rate of stones removal, and incidence of postoperative complications among each group were compared by using chi-square test or Fisher's exact probability. P < 0. 05 was statistically significant. Results The incidence of choledocholithiasis, primary choledocholithiasis and recurrent choledocholithiasis were 87. 78％ (316/360), 31. 11％ (112/360), and 6. 67％ (24/360), respectively, in the JPDD group, and 75. 52％ (657/870),19. 08％ (166/870), and 4. 02％ (35/870), respectively, in the non-JPDD group. There were significant differences between the two groups (χ2=23. 158, P<0. 001; χ2=21. 068, P<0. 001; χ2=3. 897, P=0. 048) . No significant differences were observed in the success rate of cannulation and complete stones removal during the first ERCP session, as well as the incidence of postoperative hemorrhage, pancreatitis and hyperamylasemia between the two groups ( all P>0. 05) . The incidence of recurrent choledocholithiasis in the intradiverticular papilla group and the non-intradiverticular papilla group were 14. 63％ ( 6/41) and 5. 64％ (18/319), respectively, with significant difference (χ2 =4. 721, P=0. 030). There were no significant differences between the two groups in the incidence of choledocholithiasis and primary choledocholithiasis, the success rate of cannulation and complete stones removal during the first ERCP session, as well as the incidence of postoperative hemorrhage, pancreatitis and hyperamylasemia ( all P>0. 05) . Conclusion JPDD is associated with the occurrence of primary choledocholithiasis. JPDD patients, especially the patients with intradiverticular papilla, are more likely to have recurrent choledocholithiasis after ERCP treatment.

Objective: To investigate the effect of thapsigargin (TG) which can induce endoplasmic reticulum stress (ERS) on the replication of coxsackievirus B 3 (CV-B3). Methods: After 10 MOI CV-B3 infected HeLa cells were exposed 0.25 μmol/L TG for 3 h, 6 h and 9 h, virus RNA of HeLa cells were extracted and viral replication was evaluated by real time PCR. After 0.25 μmol/L、0.08 μmol/L and 0.025 μmol/L TG exposed, the plaque of CV-B3 was used to confirm further replication of CV-B3. To verify TG induced ERS through three signal pathway, one of among PERK, ATF6 and IRE1 inhibitors GSK2656157, AEBSF and STF-083010, and 0.25 μmol/L TG were used in HeLa cells infected with 10 MOI CV-B3, replication of CV-B3 was evaluated by qRT-PCR. Results: The stimulation of TG did not induce increase of virus replication after post-infection 3 h. However, TG induced replication of virus to increase 2.5 times after post-infection 6 h and 158.6 times after post-infection 9 h. And, the area of viral plaque was significantly increased. ATF6 inhibitors AEBSF significantly inhibited promotion of virus replication from TG. Conclusions TG can promote the replication of CV-B3 through ATF6 signal pathway.