1.Reliability and reproducibility of three classification systems for distal humeral coronal fractures
Gang FU ; Changrun LI ; Ting LI ; Xiang YU ; Zhaoning LI ; Liang DING ; Zhijian SUN ; Meng MI
Chinese Journal of Orthopaedic Trauma 2023;25(9):799-804
Objective:To investigate the reliability and repeatability of 3 classification systems for coronal fractures of distal humerus.Methods:Included were the imaging data (X-ray and CT scan) of the 64 patients with distal humeral coronal fracture who had been admitted to the outpatient and emergency departments of Beijing Jishuitan Hospital from January, 2015 to December, 2021. Four orthopedic surgeons (1 chief surgeon, 1 associate chief surgeon, 1 attending surgeon, and 1 resident surgeon) served as observers who classified the fractures by their imaging data respectively according to the Bryan-Morrey, Ring and Dubberley classifications. Four weeks later when the imaging data of 64 patients were renumbered, the 4 orthopedic surgeons performed the same classifications again. Inter-observer and intra-observer Kappa values were calculated for the 3 classifications. Landis and Koch Kappa's Benchmark Scale was used to interpret the results.Results:Interobserver confidence: The average agreement of the Bryan-Morrey classification was 75.0%, and its Kappa value was 0.546, indicating moderate agreement. The average consistency of Ring classification was 74.7%, and its Kappa value was 0.702, indicating high consistency. The average consistency of Dubberley classification was 84.1%, and its Kappa value was 0.785, indicating high consistency. Intra-observer repeatability: The average consistency of Bryan-Morrey classification was 89.9% and its Kappa value was 0.824 for the same observer. The average consistency of Ring classification was 91.0%, and its Kappa value was 0.884. The average consistency of Dubberley classification was 91.8%, and its Kappa value was 0.888.Conclusions:The 3 classification systems for distal humeral coronal fractures all demonstrate high reproducibility. As the Dubberley classification system is relatively more reliable, it has a certain guiding value for the treatment of coronal fractures of the distal humerus. However, in clinical practice, an optimal surgical strategy should take into account various factors that may affect fracture typing.
2.ETCM v2.0: An update with comprehensive resource and rich annotations for traditional Chinese medicine.
Yanqiong ZHANG ; Xin LI ; Yulong SHI ; Tong CHEN ; Zhijian XU ; Ping WANG ; Meng YU ; Wenjia CHEN ; Bing LI ; Zhiwei JING ; Hong JIANG ; Lu FU ; Wenjing GAO ; Yanhua JIANG ; Xia DU ; Zipeng GONG ; Weiliang ZHU ; Hongjun YANG ; Haiyu XU
Acta Pharmaceutica Sinica B 2023;13(6):2559-2571
Existing traditional Chinese medicine (TCM)-related databases are still insufficient in data standardization, integrity and precision, and need to be updated urgently. Herein, an Encyclopedia of Traditional Chinese Medicine version 2.0 (ETCM v2.0, http://www.tcmip.cn/ETCM2/front/#/) was constructed as the latest curated database hosting 48,442 TCM formulas recorded by ancient Chinese medical books, 9872 Chinese patent drugs, 2079 Chinese medicinal materials and 38,298 ingredients. To facilitate the mechanistic research and new drug discovery, we improved the target identification method based on a two-dimensional ligand similarity search module, which provides the confirmed and/or potential targets of each ingredient, as well as their binding activities. Importantly, five TCM formulas/Chinese patent drugs/herbs/ingredients with the highest Jaccard similarity scores to the submitted drugs are offered in ETCM v2.0, which may be of significance to identify prescriptions/herbs/ingredients with similar clinical efficacy, to summarize the rules of prescription use, and to find alternative drugs for endangered Chinese medicinal materials. Moreover, ETCM v2.0 provides an enhanced JavaScript-based network visualization tool for creating, modifying and exploring multi-scale biological networks. ETCM v2.0 may be a major data warehouse for the quality marker identification of TCMs, the TCM-derived drug discovery and repurposing, and the pharmacological mechanism investigation of TCMs against various human diseases.
3.Impact of different diagnostic criteria for assessing mild micro-hepatic encephalopathy in liver cirrhosis: an analysis based on a prospective, multicenter, real-world study
Xiaoyan LI ; Shanghao LIU ; Chuan LIU ; Hongmei ZU ; Xiaoqing GUO ; Huiling XIANG ; Yan HUANG ; Zhaolan YAN ; Yajing LI ; Jia SUN ; Ruixin SONG ; Junqing YAN ; Qing YE ; Fei LIU ; Lei HUANG ; Fanping MENG ; Xiaoning ZHANG ; Shaoqi YANG ; Shengjuan HU ; Jigang RUAN ; Yiling LI ; Ningning WANG ; Huipeng CUI ; Yanmeng WANG ; Chuang LEI ; Qinghai WANG ; Hongling TIAN ; Zhangshu QU ; Min YUAN ; Ruichun SHI ; Xiaoting YANG ; Dan JIN ; Dan SU ; Yijun LIU ; Ying CHEN ; Yuxiang XIA ; Yongzhong LI ; Qiaohua YANG ; Huai LI ; Xuelan ZHAO ; Zemin TIAN ; Hongji YU ; Xiaojuan ZHANG ; Chenxi WU ; Zhijian WU ; Shengqiang LI ; Qian SHEN ; Xuemei LIU ; Jianping HU ; Manqun WU ; Tong DANG ; Jing WANG ; Xianmei MENG ; Haiying WANG ; Zhenyu JIANG ; Yayuan LIU ; Ying LIU ; Suxuan QU ; Hong TAO ; Dongmei YAN ; Jun LIU ; Wei FU ; Jie YU ; Fusheng WANG ; Xiaolong QI ; Junliang FU
Chinese Journal of Hepatology 2023;31(9):961-968
Objective:To compare the differences in the prevalence of mild micro-hepatic encephalopathy (MHE) among patients with cirrhosis by using the psychometric hepatic encephalopathy score (PHES) and the Stroop smartphone application (Encephal App) test.Methods:This prospective, multi-center, real-world study was initiated by the National Clinical Medical Research Center for Infectious Diseases and the Portal Hypertension Alliance and registered with International ClinicalTrials.gov (NCT05140837). 354 cases of cirrhosis were enrolled in 19 hospitals across the country. PHES (including digital connection tests A and B, digital symbol tests, trajectory drawing tests, and serial management tests) and the Stroop test were conducted in all of them. PHES was differentiated using standard diagnostic criteria established by the two studies in China and South Korea. The Stroop test was evaluated based on the criteria of the research and development team. The impact of different diagnostic standards or methods on the incidence of MHE in patients with cirrhosis was analyzed. Data between groups were differentiated using the t-test, Mann-Whitney U test, and χ2 test. A kappa test was used to compare the consistency between groups. Results:After PHES, the prevalence of MHE among 354 cases of cirrhosis was 78.53% and 15.25%, respectively, based on Chinese research standards and Korean research normal value standards. However, the prevalence of MHE was 56.78% based on the Stroop test, and the differences in pairwise comparisons among the three groups were statistically significant (kappa = -0.064, P < 0.001). Stratified analysis revealed that the MHE prevalence in three groups of patients with Child-Pugh classes A, B, and C was 74.14%, 83.33%, and 88.24%, respectively, according to the normal value standards of Chinese researchers, while the MHE prevalence rates in three groups of patients with Child-Pugh classes A, B, and C were 8.29%, 23.53%, and 38.24%, respectively, according to the normal value standards of Korean researchers. Furthermore, the prevalence rates of MHE in the three groups of patients with Child-Pugh grades A, B, and C were 52.68%, 58.82%, and 73.53%, respectively, according to the Stroop test standard. However, among the results of each diagnostic standard, the prevalence of MHE showed an increasing trend with an increasing Child-Pugh grade. Further comparison demonstrated that the scores obtained by the number connection test A and the number symbol test were consistent according to the normal value standards of the two studies in China and South Korea ( Z = -0.982, -1.702; P = 0.326, 0.089), while the other three sub-tests had significant differences ( P < 0.001). Conclusion:The prevalence rate of MHE in the cirrhotic population is high, but the prevalence of MHE obtained by using different diagnostic criteria or methods varies greatly. Therefore, in line with the current changes in demographics and disease spectrum, it is necessary to enroll a larger sample size of a healthy population as a control. Moreover, the establishment of more reliable diagnostic scoring criteria will serve as a basis for obtaining accurate MHE incidence and formulating diagnosis and treatment strategies in cirrhotic populations.
4.Analgesic effect of intravenous anesthesia induction combined anterior lumbar quadratus block and related hemodynamic changes in patients undergoing partial nephrectomy via retroperitoneal approach
Haijun YUAN ; Xiaoxia HUANG ; Zhijian LAN ; Li FU ; Wenyong PENG ; Yaming FU
Chinese Journal of General Practitioners 2022;21(11):1063-1068
Objective:To investigate the analgesic effect of intravenous anesthesia induction combined with anterior quadratus lumborum block (AQLB)and related hemodynamic changes in patients undergoing laparoscopic retroperitoneal partial nephrectomy (RPN).Methods:A total of 116 patients undergoing elective laparoscopic partial nephrectomy for renal tumors in Jinhua Central Hospital from August 2021 to February 2022 were randomly divided into two groups with 58 cases in each group. Patients in control group received intravenous anesthesia , while those in study group received intravenous anesthesia induction with AQLB. The analgesic effect was evaluated at 1, 6, 12, 24, and 48 h after the operation. The hemodynamics were monitored at the time of entering the operating room (T 0), 3 min after induction of anesthesia (T 1), at the beginning of the operation (T 2), after the operation (T 3), and leaving the operating room (T 4). Microcirculation was assessed at 1, 6, 12, 24, and 48 h after operation. Cognitive function was assessed 30min before anesthesia, 6 h, 24 h, and 72 h after operation. Results:At 1, 6, 12, 24 and 48 h after operation, the visual analogue scale (VAS) of the resting (quiet state) pain in the study group were 3.2±1.2, 2.6±0.3,2.0±0.4, 1.5±0.4 and 0.8±0.2, which were significantly lower than those in control group (4.0±1.7, 3.4±0.7, 2.9±0.5, 1.7±0.5 and 1.2±0.3) ( t=2.93, P=0.004; t=8.00, P<0.001; t=10.07, P<0.001; t=2.38, P=0.019; t=8.45, P<0.001). There was no significant difference in heart rate and mean arterial pressure (MAP) at T 0 between two groups ; no significant difference in the heart rate at T 1, T 2, T 3 and T 4. There were significant differences in MAP levels at T 1, T 2, T 3 and T 4 between study group [(80.0±8.0)mmHg (1 mmHg=0.133 kPa), (84.4±8.4)mmHg, (80.4±5.7)mmHg, (86.4±4.7)mmHg and control group (77.1±7.5)mmHg, (88.0±8.6)mmHg, (83.0±7.7)mmHg, (92.2±6.2) mmHg; t=2.01, P=0.046; t=2.28, P=0.024; t=2.07, P=0.041; t=5.68, P<0.001]. At 6, 12, 24 and 48 h after operation, the morphological scores of tube loops in the study group were 1.0±0.2, 0.8±0.2, 0.7±0.1 and 0.7±0.1, which were lower than those in the control group (1.1 ±0.2, 0.9±0.2, 0.8±0.2 and 0.8±0.1; t=2.69, P=0.008; t=2.69, P=0.008; t=3.41, P=0.001; t=5.39 , P < 0.001). The blood flow status scores of the study group were 1.1±0.2, 0.9±0.2, 0.8±0.2 and 0.6±0.1, which were lower than those of the control group (1.2±0.2, 1.0±0.2, 0.9±0.2 and 0.7±0.1; t=2.69, P=0.008; t=2.69, P=0.008; t=2.69, P=0.008; t=5.39, P<0.001). The cognitive function scores of the study group and the control group were 24.4±1.0, 27.1±0.9 and 23.5±0.9, 26.7±0.9 at 6 h and 24 h after operation ( t=5.10, P<0.001; t=2.39, P=0.018); while there were no significant at 72 h after operation between two groups (28.2±0.9 vs. 28.1±0.8, t=0.63, P=0.529). Conclusion:Intravenous anesthesia induction combined with anterior quadratus lumborum block has a good analgesic effect in patients undergoing RPN, with stable hemodynamics and microcirculation, and not affecting cognitive function of patients.
5.Clinical and genetic analyses of hereditary factor Ⅴ deficiency cases
Donglei ZHANG ; Feng XUE ; Xueqing DOU ; Xiaofan LIU ; Rongfeng FU ; Yunfei CHEN ; Wei LIU ; Yujiao JIA ; Yuhua WANG ; Zhijian XIAO ; Lei ZHANG ; Renchi YANG
Chinese Journal of Hematology 2021;42(4):302-307
Objective:To analyze the clinical phenotype and molecular pathogenesis of nine patients with hereditary factor Ⅴ (FⅤ) deficiency.Methods:Nine patients with hereditary FⅤ deficiency who were admitted to the Institute of Hematology and Blood Diseases Hospital from April 1999 to September 2019 were analyzed. The activated partial thromboplastin time, prothrombin time, and FⅤ procoagulant activity (FⅤ∶C) were measured for phenotypic diagnosis. High-throughput sequencing was employed for the F5 gene mutation screening, Sanger sequencing was adopted to confirm candidate variants and parental carrying status, Swiss-model was used for three-dimensional structure analysis, and ClustalX v.2.1 was used for homologous analysis.Results:The FⅤ∶C of the nine patients ranged from 0.1 to 10.6. Among them, eight had a hemorrhage history, with kin/mucosal bleeding as the most common symptom (three cases, 37.5%) , whereas one case had no bleeding symptom. There were five homozygotes and four compound heterozygotes. A total of 12 pathogenic or likely pathogenic mutations were detected, of which c.6100C>A/p.Pro2034Thr, c.6575T>C/p.Phe2192Ser, c.1600_1601delinsTG/p. Gln534*, c.4713C>A/p.Tyr1571*, and c.952+5G>C were reported for the first time.Conclusion:The newly discovered gene mutations enriched the F5 gene mutation spectrum associated with hereditary FⅤ deficiency. High-throughput sequencing could be an effective method to detect F5 gene mutations.
6.Effect of Hypericum Perforatum L Extracts on depression induced by chronic unpredictable mild stress in mice
Songnian FU ; Jiangtao WANG ; Fuxiang LUO ; Guirong ZENG ; Zhijian LI ; Li MA
Chinese Journal of Behavioral Medicine and Brain Science 2019;28(10):915-920
Objective To observe the improving effect of Hypericum Perforatum L Extracts (HPLES)on depression induced by chronic unpredictable mild stress in mice. Methods The depression model was established by the method of chronic unpredictable mild stress. Fifty depression model mice were divided into model control group,fluoxetine hydrochloride group (2. 6 mg / kg),Hypericum perforatum ex-tract low,medium and high (0. 2 g / kg,0. 4 g / kg,0. 8 g / kg) dose groups according to the random num-ber table method. Another 10 normal mice matched with body weight were taken as the normal control group. The mice in normal control group and the model control group were given pure water by gavage every day,and the mice in other groups were given corresponding solution by gavage for 4 weeks. In addition to the normal control group,the mice in other groups continued to undergo chronic unpredictable mild stress during gavage. The sugar water preference test and forced swimming test were performed after the last administration. Blood samples were collected from the posterior orbital venous plexus,and the levels of dopamine (DA) and brain-derived neurotrophic factor (BDNF) were measured by Elisa. The hippocampal tissues of mice were exam-ined by HE staining. Results Compared with the normal control group,the body mass of mice in the model control group decreased significantly at the first,second,third and fourth weeks ( t=2. 739,4. 162,4. 082, 3. 957;all P<0. 05). At the first,second,third and fourth weeks,the body mass of mice in the low,middle and high dose group of Hypericum perforatum extract were not significantly different from those in the model control group (all P>0. 05). Compared with the normal control group,the sugar water preference index of mice in the model control group was significantly reduced((61. 3± 4. 5)%,(52. 6± 5. 2)%; t=2. 721,P<0. 05),the swimming immobility time was prolonged(( 44. 3± 20. 00) s,(101. 8± 50. 8) s;t=2. 939,P<0. 05),the difference were statistically significant. Compared with the model control group,the sugar water preference index of mice in the low,middle and high dose group of Hypericum perforatum extract increased ((61. 8±4. 7)%,(65. 2±4. 1)%,(62. 6±5. 6)%,t=-3. 005,5. 073,-2. 928,all P<0. 05),the swimming immobility time decreased ((47. 2±17. 9) s,(54. 8±50. 3) s,(61. 3±44. 2) s; t=2. 803,1. 921,1. 903,all P<0. 05). The results of Elisa showed that compared with the normal control group,the levels of serum DA and BDNF of mice in the model control group were significantly lower (t=3. 031,8. 507,all P<0. 05); com-pared with the model control group,the levels of serum DA of mice in the low dose and high dose group of Hypericum perforatum were significantly higher (t=5. 025,3. 414,P<0. 05),and the serum BDNF of mice in the high dose group of Hypericum perforatum was also significantly higher (t=6. 098,P<0. 05),the differ-ence was statistically significant. HE staining showed that compared with the normal control group,the neu-rons in CA3 area of hippocampus in the model control group mice were seriously damaged,suggesting the es-tablishment of the mouse model. Compared with the model control group,the atrophy and degeneration of hippocampal CA3 cells in the three dose groups were significantly reduced. The atrophy and deformation of hippocampal CA3 neurons in the low,middle and high dose groups of Hypericum perforatum extract were re-lieved. Conclusion HPLES have obvious improving and antidepressant effects on the depression model mice induced by chronic unpredictable stress. The above effects may be related to the improvement of serum DA,DBNF level and reduce neuronal damage in CA3 area.
7. Effect of Hypericum Perforatum L Extracts on depression induced by chronic unpredictable mild stress in mice
Songnian FU ; Jiangtao WANG ; Fuxiang LUO ; Guirong ZENG ; Zhijian LI ; Li MA
Chinese Journal of Behavioral Medicine and Brain Science 2019;28(10):915-920
Objective:
To observe the improving effect of Hypericum Perforatum L Extracts (HPLES)on depression induced by chronic unpredictable mild stress in mice.
Methods:
The depression model was established by the method of chronic unpredictable mild stress. Fifty depression model mice were divided into model control group, fluoxetine hydrochloride group (2.6 mg / kg), Hypericum perforatum extract low, medium and high (0.2 g / kg, 0.4 g / kg, 0.8 g / kg) dose groups according to the random number table method. Another 10 normal mice matched with body weight were taken as the normal control group. The mice in normal control group and the model control group were given pure water by gavage every day, and the mice in other groups were given corresponding solution by gavage for 4 weeks. In addition to the normal control group, the mice in other groups continued to undergo chronic unpredictable mild stress during gavage.The sugar water preference test and forced swimming test were performed after the last administration. Blood samples were collected from the posterior orbital venous plexus, and the levels of dopamine (DA) and brain-derived neurotrophic factor (BDNF) were measured by Elisa. The hippocampal tissues of mice were examined by HE staining.
Results:
Compared with the normal control group, the body mass of mice in the model control group decreased significantly at the first, second, third and fourth weeks (
8.Influence of body shape on the short-term therapeutic effects of laparoscopic distal gastrectomy: a multicentre retrospective study (A report of 506 cases)
Hexin LIN ; Su YAN ; Zhijian YE ; Jian ZHANG ; Lisheng CAI ; Jinping CHEN ; Guoqiang SU ; Guowei ZHANG ; Jinbo FU ; Chuanhui LU ; Liang WANG ; Weiping JI ; Wencheng KONG ; Jiang GONG ; Ping CHEN ; Rongjie HUANG ; Hailin KE ; Xian SHEN ; Jun YOU
Chinese Journal of Digestive Surgery 2019;18(1):65-73
Objective To investigate the risk factors of perioperative complications of laparoscopic radical distal gastrectomy and influence of body shape on the short-term therapeutic effects.Methods The retrospective case-control study was conducted.The clinicopathological data of 506 patients (328 males and 178 females,average age 60 years with the range of 24-85 years) who underwent laparoscopic radical distal gastrectomy+D2 lymph nodes dissection in the 8 clinical centers between March 2016 and November 2018 were collected,including 143 in the First Affiliated Hospital of Xiamen University,66 in the Affiliated Hospital of Qinghai University,66 in the Second Affiliated Hospital of Wenzhou Medical University,64 in the Zhongshan Hospital of Xiamen University,54 in the Affiliated Hangzhou First people's Hospital of Zhejiang University School of Medicine,48 in the Zhangzhou Affiliated Hospital of Fujian Medical University,35 in the Affiliated Quanzhou First Hospital of Fujian Medical University,30 in the Second Affiliated Hospital of Xiamen Medical College.The maximum thickness of subcutaneous fat at the level of umbilicus (USCF),the maximum vertical distance between the anterior abdominal skin and the back skin at the level of the umbilicus (UAPD),the maximum horizontal distance between the anterior abdominal skin and the back skin at the level of the umbilicus (UTD),the maximum verticaldistance between the anterior abdominal skin and the back skin at the level of the xiphoid bone (XAPD),the maximum horizontal distance between the.anterior abdominal skin and the back skin at the level of the xiphoid bone (XTD),the distance between the anterior abdominal skin and the root of celiac artery (CAD) and the maximum horizontal distance at a right angle to CAD (CATD) were measured using preoperative imaging examinations.Observation indicators:(1) intraoperative and postoperative situations;(2) follow-up situations;(3) risk factors analysis of perioperative complications;(4) influence of body shape related indexes on intraoperative situations and postoperative recovery:① Pearson univariate correlation analysis,② liner regression model analysis.Followup using outpatient examination and telephone interview was performed to detect the postoperative survival and tumor recurrence or metastasis up to December 2018.Measurement data with normal distribution were represented as Mean±SD.Measurement data with skewed distribution were described as M (range).Comparisons of count data were analyzed using the chi-square test.Comparisons of ordinal data were analyzed by Mann-Whitney U nonparametric test.Risk factors of perioperative complications of laparoscopic distal gastrectomy were analyzed by Logistic regression model.Influence of body shape related indexes on intraoperative situations and postoperative recovery was analyzed by Pearson univariate correlation analysis and liner regression model.Results (1) Intraoperative and postoperative situations:all the 506 patients underwent successful laparoscopic distal gastrectomy,including 103 with Billroth Ⅰ anastomosis,140 with Billroth Ⅱ anastomosis,201 with Billroth Ⅱ + Braun anastomosis,62 with Roux-en-Y anastomosis.The operation time,volume of intraoperative blood loss,number of lymph nodes dissected,time to postoperative anal exsufflation,time for initial fluid diet intake,time for initial semi-fluid diet intake and duration of postoperative hospital stay were (233±44)minutes,(102±86)mL,34±13,(3.6±1.5)days,(5.8±3.3)days,(8.3±3.8)days,(12.2±5.7)days respectively in the 506 patients.Of 506 patients,196 were defined as pathological stage Ⅰ,122 were defined as pathological stage Ⅱ and 188 were defined as pathological stage Ⅲ postoperatively.Of 506 patients,93 had 106 times of perioperative complications,including 33 times of pulmonary and upper respiratory infection,12 times of incisional infection,11 times of anastomotic leakage,11 times of abdominal infection,8 times of intestinal obstruction,8 times of gastroplegia,6 times of abdominal hemorrhage,5 times of bacteremia,3 times of anastomotic hemorrhage,3 times of lymph fluid leakage,2 times of pancreatic leakage,1 time of urinary infection,1 time of anatomotic stenosis,1 time of deep venous thrombosis and 1 time of pulmonary embolism;the same patient can merge multiple complications.Eleven patients were in the Clavien-Dindo classification ≥ Ⅲ.(2) Follow-up situations:465 of 506 patients were followed up for 1-32 months with a median time of 12 months.During the follow-up,451 had postoperative survival and 38 had tumor recurrence or metastasis.(3) Risk factors analysis of perioperative complications.① Results of univariate analysis showed that age,body mass index (BMI),preoperative hemoglobin,preoperative serum albumin and XAPD were related factors affecting perioperative complications of laparoscopic distal gastrectomy (x2 =10.289,7.427,5.269,5.481,4.285,P< 0.05).② Results of multivariate analysis showed that age,BMI,preoperative serum albumin were independent related factors affecting perioperative complications of laparoscopic distal gastrectomy (odds ratio =1.033,1.118,0.937,95% interval confidence:1.011-1.057,1.025-1.219,0.887-0.990,P<0.05).(4) Influence of body shape related indexes on intraoperative situations and postoperative recovery.① Results of Pearson univariate correlation analysis showed correlations between UAPD,XAPD,CAD,CATD and volume of intraoperative blood loss (r=0.107,0.169,0.179,0.106,P<0.05),between UAPD,XAPD,CAD and the number of lymph nodes dissected (r=-0.137,-0.143,-0.173,P<0.05),between USCF,XAPD and time to postoperative anal exsufflation (r =0.122,0.109,P<0.05),between USCF,XAPD,CAD and time for initial fluid diet intake (r=0.132,0.108,0.132,P<0.05),between USCF,XAPD and duration of postoperative hospital stay (r=0.116,0.100,P<0.05).② Results of liner regression model analysis showed a positive correlation between CAD and volume of intraoperative blood loss (r =6.776),a negative correlation between CAD and the number of lymph nodes dissected (r =-0.841),with statistically significant differences (t =2.410,-1.992,P< 0.05);a positive correlation between USCF and time to postoperative anal exsufflation (r=0.170),between USCF and time for initial fluid diet intake (r=0.365),between USCF and duration of postoperative hospital stay (r=0.636) respectively,with statisticallysignificant differences (t =2.188,1.981,2.107,P< 0.05).Conclusions Abdominal shape can influence intraoperative situations and postoperative recovery of laparoscopic distal gastrectomy,but cannot increase risks ofperioperative complications.Age,BMI and preoperative serum albumin are independent related factors affecting perioperative complications of laparoscopic distal gastrectomy.
9.The effect of resolvin D2 on radicular pain caused by lumbar disc herniation
Lanyu ZHANG ; Ling ZUO ; Qing ZHU ; Zhihua LIU ; Shuang WEN ; Congxian YANG ; Zhijian FU ; Tao SUN
Chinese Journal of Physical Medicine and Rehabilitation 2018;40(12):886-890
Objective To explore the effect of resolvin D2 ( RvD2) on radicular pain induced by interver-tebral disc herniation. Methods Thirty-six male Sprague-Dawley rats were randomly divided into a sham opera-tion group, a model group and an RvD2 group, each of 12. Non-compressive lumbar disc herniation was induced in the rats in the model and RvD2 groups using the autologous nucleus pulposus filling method. Those in the sham group had the surgical site exposed without any other treatment. After the modeling, 10μl of phosphate-buffered sa-line solution was administered intrathecally to the rats in the sham and model groups for 3 days, while the rats in the RvD2 group received 10 ng/10 μl of RvD2 intrathecally as well. Paw withdrawal thresholds (50%PWT) were ob-served 1 day before modeling and 7 days afterward for the rats of all three groups. On the 7th day after modeling, the L4 to L6 spinal dorsal horns on the surgery side were resected to detect the protein expression of phosphorylated protein kinase B ( p-AKT) , protein kinase B ( t-AKT) , phosphorylated glycogen synthase kinase 3β( p-GSK-3β) and glycogen synthase kinase 3β( GSK-3β) using western blotting. The protein levels of tumor necrosis factor alpha ( TNF-α) , interleukin-6 ( IL-6) , transforming growth factor-β1 ( TGF-β1) and interleukin-10 ( IL-10) were de-termined using enzyme-linked immunosorbent assays. Results On the 1st and 7th day after modeling, significant differences were observed between the model and sham groups in terms of the 50%PWT. From the 3rd day the aver-age 50%PWT in the RvD2 group was significantly higher than that of the model group at the same time points. On the 7th day after the modeling the average p-AKT and p-GSK-3βprotein levels of the model and RvD2 groups were significantly different from that of the sham group, and the model group′s average was also of significantly different from that of the RvD2 group. The average protein levels of the pro-inflammatory cytokines TNF-αand IL-6, as well as of the anti-inflammatory factors TGF-β1 and IL-10 in the dorsal horns of the model group and the RvD2 group were also significantly different on the 7th day, and both were significantly different from the sham group′s average. Conclusion RvD2 can alleviate radicular pain in rats with non-compressive disc herniation. The mechanisms might involve inhibition of GSK-3β activity, down-regulation of pro-inflammatory factors and up-regulation of anti-inflammatory factors.
10.Efficacy of facial acupoint injection combined with nerve block in treating hemifacial spasm
Xuebin WEN ; Congxian YANG ; Qianqian XING ; Xu ZHAO ; Shulin MA ; Shunzhi GONG ; Zhijian FU
Chinese Journal of Anesthesiology 2018;38(1):44-47
Objective To evaluate the efficacy of facial acupoint injection combined with nerve block in treating hemifacial spasm. Methods Fifty?four patients of both sexes, aged 26-73 yr, with the course of disease 6 months-17 yr from February 2015 to January 2016, were included in this study accord?ing to diagnostic criteria for hemifacial spasm based on expert consensus in 2014. Patients were divided into 2 groups(n=27 each)using a random number table: facial acupoint injection combined with nerve block group(group A)and nerve block group(group B). In group A, the mixed injection 2 ml(2% lidocaine hydrochloride 5 ml, compound betamethasone 1 ml, mecobalamin 1 mg, diluted to 18 ml in normal sa?line)was given at facial Sibai, Jiachengjiang, Xiaguan and Yifeng acupoints once every 5 days, 3 times in total;facial nerve block was performed via the stylomastoid foramen with the mixed injection(5 ml) previously described once every 5 days, 3 times in total;stellate ganglion block was performed on the right and left side alternately once a day, 5 times on each side. In group B, patients received facial nerve block and stellate ganglion block, and no facial acupoint injection was applied. The Cohen rating and Shorr out?come were recorded before treatment and at 10th day, 3rd month and 1 yr after treatment, and the recur?rence was recorded at 3 months and 1 yr after treatment. Results Compared with group B, Cohen classifi?cation was significantly decreased, and the effective rate was increased at 10th day, 3rd month and 1 yr af?ter treatment, and the recurrence rate was decreased at 3 months and 1 yr after treatment in group A(P<0.05). Conclusion The facial acupoint injection combined with nerve block produces better long?term ef?ficacy in treating hemifacial spasm than nerve block alone.

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