OBJECTIVE: To explore clinical effect of open reduction and internal fixation with Henry's approach butterfly plate in treating double-column Die-punch fractures of distal radius. METHODS: From January 2018 to June 2021, 26 patients with double-column Die-column distal radius were treated with open reduction and internal fixation through Henry's surgical approach and using distal radius volar column plate(butterfly plate), including 14 males and 12 females, aged from 20 to 75 years old with an average age of (44.2±3.4) years old. Postopertaive complications were observed, Gartland-Werley score at 12 months after opertaion was used to evaluate wrist joint function. RESULTS: All 26 patients were followed up from 10 to 18 months with an average of(13.4±0.8) months. All fractures were obtained fracture union, the time ranged from 8.5 to 15.8 weeks with an average of (11.4±0.5) weeks. All incisions healed at stageⅠwithout infection, nerve injury and internal fixation failure occurred. Postoperative Gartland-Werley score at 12 months was (3.65±0.36), and 16 patients got excellent result, 8 good and 2 moderate. CONCLUSION Open reduction and internal fixation with butterfly plate for the treatment of double-column Die-punch fractures of the distal radius through volar Henry approach could obtain satisfactory clinical outcomes.
Adult ; Aged ; Animals ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; Bone Plates ; Fracture Fixation, Internal/methods* ; Radius/surgery* ; Radius Fractures/surgery* ; Range of Motion, Articular ; Treatment Outcome ; Wrist Joint

Objective: To compare the short-term and long-term outcomes between robotic-assisted and laparoscopic-assisted radical right hemicolectomy in patients with adenocarcinoma of the right colon. Methods: Retrospective review of a prospectively collected database identified 288 right colon cancer patients who underwent either robotic-assisted (n=57) or laparoscopic-assisted right hemicolectomy (n=231) between October 2014 and October 2020 at Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University. There were 161 males and 127 females, aging (60.3±12.8) years (range: 17 to 86 years). After propensity score matching as 1∶4 between robotic-assisted and laparoscopic-assisted right hemicolectomy, there were 56 cases in robotic group and 176 cases in laparoscipic group. Perioperative outcomes and overall survival were compared between the two groups using t test, Wilcoxon rank sum test, χ² test, Fisher exact test, Kaplan-Meier method and Log-rank test, respectively. Results: The total operative time was similar between the robotic and laparoscopic group ((206.9±60.7) minutes vs. (219.9±56.3) minutes, t=-1.477, P=0.141). Intraoperative bleeding was less in the robotic group (50 (20) ml vs. 50 (50) ml, Z=-4.591, P<0.01), while the number of lymph nodes retrieved was significantly higher (36.0±10.0 vs. 29.0±10.1, t=4.491, P<0.01). Patients in robotic group experienced significantly shorter hospital stay, shorter time to first flatus, and defecation (t: -2.888, -2.946, -2.328, all P<0.05). Moreover, the overall peri-operative complication rate was similar between robotic and laparoscopic group (17.9% vs. 22.7%, χ²=0.596,P=0.465). The 3-year overall survival were 92.9% and 87.9% respectively and the 3-year disease-free survival rates were 83.1% and 82.6% with no statistical significance between the robotic and laparoscopic group (P>0.05). Conclusions: Compared to laparoscopic-assisted right hemicolectomy, robot-assisted right hemicolectomy could improve some short-term clinical outcomes. The two procedures are both achieving comparable survival.
Colectomy ; Colonic Neoplasms/surgery* ; Female ; Humans ; Laparoscopy ; Male ; Prognosis ; Propensity Score ; Retrospective Studies ; Robotic Surgical Procedures ; Treatment Outcome

BACKGROUND: We previously found that the intestinal epithelial chemokine (C-C motif) ligand 7 (CCL7) plays an important role in the development of toxin-induced acute liver damage. The detailed effects of intestinal epithelial CCL7 on chronic diseases; however, are still unclear. Here, we aimed to investigate the impact of intestinal epithelial CCL7 overexpression on high-fat diet (HFD)-induced obesity and steatohepatitis in mice. METHODS: Intestinal epithelial CCL7 overexpression (CCL7) mice and their wild-type (WT) littermates were fed with normal chow or HFD for 16 weeks to induce obesity and non-alcoholic fatty liver disease. Body weight gain, as well as adipose tissue index were assessed. Liver injury was monitored by histological analysis and real time polymerase chain reaction. Gut microbial composition was analyzed by 16S rRNA gene sequencing. RESULTS: We found that the CCL7 mice on a HFD had markedly decreased weight gain (8.9 vs. 17.0 g, P < 0.05) and a lower adipose tissue index that include mesenteric fat (1.0% vs. 1.76%, P < 0.05), gonadal fat (2.1% vs. 6.1%, P < 0.05), subcutaneous fat (1.0% vs. 2.8%, P < 0.05) compared to WT animals. HFD-induced glucose intolerance and insulin resistance were also significantly improved in CCL7 mice compared to WT. Furthermore, HFD-fed CCL7 mice displayed less hepatic lipid accumulation and lower expression of inflammatory factors than WT mice. 16S rRNA gene sequencing demonstrated that CCL7 overexpression in intestinal epithelial cells improved HFD-induced gut microbial dysbiosis. CONCLUSIONS Our study revealed that CCL7 overexpression in the intestinal epithelium protects mice against the progression of diet-induced obesity, hepatic steatosis, and enteric dysbiosis.

Objective:To explore the effect of early drinking and eating for gastric cancer patients with multimode health propaganda and education during postoperative Enhanced Recovery After Surgery (ERAS).Methods:Sixty patients who would received radical operation of gastric cancer were randomly divided into two groups:observation group (30 cases) and control group (30 cases).Patients in the observation group were employed the multi-mode health propaganda and education which were guided more detailed and quantitative regimens for early drinking and eating.Patients in the control group were carried out with routine methods.The compliance of postoperative drinking and eating,the rate of complications and patients satisfaction were compared between the two groups.Results:The compliance of postoperative drinking and eating of the observation group was significantly higher than that of the control group.Hospital patient satisfaction in health-education projects (19.50 ± 0.50) of the observation group was significantly higher than that (16.12 ± 3.21) of the control group (P ＜ 0.05).The rate of gastrointestinal complications in the observation patients was significantly lower,compared with that in the control patients (P ＜ 0.05).Conclusion:During the postoperative ERAS for gastric cancer patients,early drinking and eating guided by multi-mode health propaganda and education is safe and effective,for which could increase the postoperative compliance,decrease the rate of complication.It is worth promoting early quantitative drinking and eating after operation.

The central nervous system (CNS) plays a key regulatory role in glucose homeostasis. In particular, the brain is important in initiating and coordinating protective counterregulatory responses when blood glucose levels fall. This may due to the metabolic dependency of the CNS on glucose, and protection of food supply to the brain. In healthy subjects, blood glucose is normally maintained within a relatively narrow range. Hypoglycemia in diabetic patients can increase the risk of complications, such as heart disease and diabetic peripheral neuropathy. The clinical research finds that the use of traditional Chinese medicine (TCM) has a positive effect on the treatment of hypoglycemia. Here the authors reviewed the current understanding of sensing and counterregulatory responses to hypoglycemia, and discuss combining traditional Chinese and Western medicine and the theory of iatrogenic hypoglycemia in diabetes treatment. Furthermore, the authors clarify the feasibility of treating hypoglycemia on the basis of TCM theory and CNS and have an insight on its clinical practice.
Brain ; metabolism ; Central Nervous System ; metabolism ; Diabetes Mellitus ; metabolism ; therapy ; Hormones ; metabolism ; Humans ; Hypoglycemia ; metabolism ; therapy ; Medicine, Chinese Traditional

The aim of the present study was to investigate the effect of glucagon-like peptide-1 (GLP-1) on palmitate-induced apoptosis of human umbilical vein endothelial cells (HUVECs) and the underlying mechanism. HUVECs were cultured in vitro, and then treated by palmitate to induce apoptosis. Meanwhile, GLP-1 was added to explore its effect. After 24 h of the treatments, Caspase-3 activity and DNA fragmentation were measured using ELISA kits. Phospho-p38 mitogen-activated protein kinase (p-p38 MAPK) expression was detected by Western blot. The results showed that incubating HUVECs with 0.125 mmol/L GLP-1 increased Caspase-3 activity and DNA fragmentation. GLP-1 significantly inhibited palmitate-induced increases of Caspase-3 activity and DNA fragmentation in a concentration-dependent manner. Moreover, GLP-1 inhibited the up-regulation of p-p38 MAPK expression induced by palmitate in HUVECs. These results suggest GLP-1 protects HUVECs against lipo-apoptosis, and this effect may be mediated through inhibiting p38 MAPK pathway.
Apoptosis ; Caspase 3 ; metabolism ; DNA Fragmentation ; Glucagon-Like Peptide 1 ; metabolism ; Human Umbilical Vein Endothelial Cells ; cytology ; Humans ; MAP Kinase Signaling System ; Up-Regulation ; p38 Mitogen-Activated Protein Kinases ; metabolism

Objective To explore the relationship between quantitative coronary angiography (QCA) parameters and fractional flow reserve (FFR) for identifying ideal angiographic parameters predictive of myocardial ischemia.Methods The study included 121 lesions with QCA and FFR data from 106 patients [ mean age:(63 ± 10 ) years ].The lesions were grouped into FFR ＞ 0.75 group and FFR ≤0.75 group.Assessed parameters by QCA included percentage diameter stenosis,minimum luminal diameter ( MLD),percentage area stenosis,minimum luminal area (MLA),reference vessel diameter (RVD) and lesion length (LL).Correlation analysis was used to identify the relationship between QCA parameters and FFR value,and receiver operating characteristic (ROC) curve was used to determine parameters predictive of FFR≤0.75.Results LL was significantly higher[ ( 14.8 ±7.9)mm vs.( 10.7 ±5.4) mm,P=0.024]whileMLD [(1.47 ±0.31)mm vs.(1.82 ± 0.51) mm,P=0.028],RVD [(2.30 ±0.50) mm vs.(2.81 ±0.64) mm,P=0.036],andMLA [(2.30±1.50)mm2 vs.(3.60 ±2.30) mm2,P=0.038]were significantly lower in FFR≤0.75 group than in FFR ＞0.75 group.LL (r =-0.209,P =0.040) was negatively correlated with FFR,and MLD ( r=0.414,P=0.040),RVD ( r =0.303,P =0.000) and MLA (r =0.315,P =0.002) were positively correlated with FFR.ROC analysis showed that MLD ≥ 1.6 mm was the best cut-off value to predict FFR ＞ 0.75 with sensitivity 63％,specificity 82％,and positive predictive value 96％.Conclusions QCA derived anatomic parameters of intermediate coronary lesions correlate to FFR value in some extent.MLD ≥ 1.6 mm is the best cut-off value to predict FFR ＞ 0.75 in patients with intermediate coronary lesions.

Objective To study the variational features of the brainstem auditory evoked potential (BAEP) and the preservation of the facial and auditory nerves during the microsurgery in patients with acoustic neuromas (AN). Methods We retrospectively analyzed the data of 76 patients with AN, admitted to our hospital fi'om May 2006 to May 2009: preoperative BAEP were examined; the peak latency (PL) of Ⅰ, Ⅲ and Ⅴ waves and their interpeak latency (IPL) were noted and compared. The tumors were microsurgically removed under intraoperative electrophysiologic monitoring to preserve the facial and auditory nerves. The relationships between the preservation of facial and auditory nerves and both the tumor size and the utilization of intraoperative monitoring were discussed. Results Before the operation, the 100% abnormal rate of BAEP was showed on the diseased side with the disappearance of Ⅲ and Ⅴ waves as its main features, while 82.9% (63/76) of that was noted on the contralateral side with the IPL ratio of Ⅲ-Ⅴ / Ⅰ-Ⅲ greater than or equal to 1 as its main features; the BAEP features between the 2 sides had statistical significance (P<0.05). Seventy patients (92.1%) were found abnormal of BAEP on the contralateral side during the operation; the BAEP features of the contralateral side had statistical significance between preoperation and intraoperation (P<0.05). The tumors were totally removed in 69 (90.8%), subtotally removed in 6 (7.9%) and partially removed in 2 (1.3%). The preservation of facial and auditory nerves increased obviously through monitoring the response of BAEP during the surgery and a positive correlation was observed between the preservation of facial and auditory nerves and the response of BAEP in the contralateral side(r=0.912, P=0.000; r=0.613, P=0.000). However, an inverse correlation was observed between the preservation of facial and auditory nerves and the size of AN (r=-0.869, P=0.000; r=-0.738, P=0.000). Conclusion Preoperative BAEP can help to make an exact diagnosis on patients with AN and the preservation of facial and auditory nerves can increase obviously through monitoring the normal response of BAEP during the surgery. The anatomy preservation of facial and auditory nerves depends on the size of AN.

Objective To discuss the common complications of single-nostril transsphenoidal surgery for pituitary adenomas, and the prevention ofpostsurgical complications. Methods Clinical and follow-up (1-36 months) data of 241 patients with pituitary adenomas treated with single-nostril transsphenoidal surgery were collected and analyzed retrospectively by EXCEL software with regard to the patients' sex, age, tumor dimension and quality, postsurgical complications, and so on. Results Total removal of tumors was achieved in 171 (71%) cases, subtotal removal in 28 (11.6%), most removal in 26 (10.7%), and partial removal in 16 (6.6%). After the operation, 38 (15.8%) cases were found with transient diabetes insipidus, 12 (4.9%) cases with worse sight, 4 (1.6%) with cerebrospinal fluid rhinorrhea, 2 (0.8%) with unilateral oculomotor paralysis, and 2 (0.8%) with anterior pituitary insufficiency; during the operation, there were 2 (0.8%) cases with severe cavernous sinus hemorrhage, 2(0.8%) with nasoseptal perforation, no internal carotid artery injuries or death. Conclusions Though the damage of single-nostril transsphenoidal surgery for pituitary adenomas was small, there were a few complications. In order to prevent the complications and reduce the mortality, we should be familiar with the regional anatomy and better master the surgical skills, meanwhile, clinical experience is also very important in improving the therapeutic efficacy.

OBJECTIVETo study the chemical constituents from the whole plants of Polygala telephioides.

METHODCompounds were isolated by repeated silica gel and Sephadex LH -20 column chromatography, and their structures were determined by spectral analysis and physicochemical properties.

RESULTSix xanthones were isolated from P. telephioides, and their structures were identified as 1, 3, 7-trihydroxyxanthone (1), 1, 7-dihydroxy-3-methoxyxanthone (2), 1, 3-dihydroxyxanthone (3), 1, 7-dihydroxyxanthone (4), 1-methoxy-2, 3-methylenedioxyxanthone (5) and 1, 7-dimethoxyxanthone (6).

CONCLUSIONAll the compounds were obtained from this plant for the first time.