Objective:To compare the perioperative conditions of open pancreaticoduodenectomy (OPD), laparoscopic pancreaticoduodenectomy (LPD) and LPD conversion OPD, and analyze the short-term prognosis and risk factors for LPD conversion OPD.Methods:The clinical data of 167 patients undergoing pancreaticoduodenectomy (PD) in the Beijing Friendship Hospital, Capital Medical University from February 2020 to March 2023 were retrospectively analyzed. Of 167 patients, 63 patients underwent OPD surgery (OPD group), 91 patients underwent LPD surgery (LPD group), and 13 patients were converted to OPD during LPD surgery (LPD conversion OPD group). The measurement data with non-normal distribution were expressed as median (interquartile range) [ M( Q1, Q3)], and comparison between groups was analyzed using the Kruskal-Wallis H test. The count data were expressed as the number of cases and percentage, and the Chi-square test was used for ordered categorical variable, Kruskal-Wallis H test was used for un-ordered categorical variable. The risk factors of LPD conversion OPD were analyzed by multivariate Logistic regression. Results:The intraoperative blood loss [600(350, 1 000) mL], bilio-intestinal drainage stay time [10(8, 15) d] and bilio-intestinal drainage volume [995(505, 1 502) mL] in the LPD conversion OPD group were significantly higher than those in the LPD group [200(100, 300) mL, 7(6, 6) 10) d, 450(175, 874) mL], the differences were statistically significant ( P<0.05). The operation time of the LPD conversion OPD group [335(293, 385) d] was significantly longer than that of the OPD group [230 (195, 290)d], and the difference was statistically significant ( P<0.05). Multivariate Logistic regression analysis revealed that preoperative complications of chronic pancreatitis ( OR=19.714) and maximum diameter of the lesion ( OR=5.583) has a significant impact on the LPD conversion OPD ( P<0.05). Conclusions:Patients who plan to undergo PD should prefer LPD if the technology and physical condition permit. Preoperative complication of chronic pancreatitis, maximum diameter of lesion > 3.5 cm are the risk factors for LPD conversion OPD, which may significantly increase intraoperative blood loss, prolong the indwelling time of biliary drainage tube, and increase the drainage volume of biliary drainage tube. Therefore, the surgical method should be carefully selected.

Objective To investigate whether the effects of venlafaxine on major depression disorder is associated with ankyrin G.Methods Breed Synapsin-Cre1 and Ankyrin3-floxed mice(Ank3 cKO mice).Ank3 cKO mice and wild type mice were randomly divided into model and control groups.All mice in model group and control group were orally administrated with venlafaxine(1 g/L)or the solvent(normal saline,NS)with the volume of 200 μL,respectively.Depression-related behaviors were examined by sucrose preference test(SPT)and Y maze test.The level of ankyrin G and PSD95 in the cortex of four groups were detected by Western blot.The level of ankyrin G and MAP2 in the in hippocampus of four groups were detected by immunohistochemistry method.Results Compared with wt-saline group,the cKO mice in saline showed a significantly decreased preference of sucrose(P＜0.001)and low spontaneous alteration(P＜0.05).Compared with cKO control ones,the venlafaxine model cKO mice showed remarkably increased preference of sucrose(P＜0.001)and more spontaneous alteration(P＜0.05).The level of ankyrin G and PSD-95 in the cortex of venlafaxine cKO mice was much higher than that in control mice(P＜0.01)The level of ankyrin G and MAP2 in the hippocampus of venlafaxine cKO mice were much higher than those of control mice(P＜0.05).Conclusions Venlafaxine alleviates the depression symptoms caused by knocking down Ank3.The mechanism of depression treatment by venlafaxine is potentially associated with levita-ting ankyrin G level in prefrontal cortex and hippocampus.

Cryoablation (CRA) and microwave ablation (MWA) are two main local treatments for hepatocellular carcinoma (HCC). However, which one is more curative and suitable for combining with immunotherapy is still controversial. Herein, CRA induced higher tumoral PD-L1 expression and more T cells infiltration, but less PD-L1^highCD11b⁺ myeloid cells infiltration than MWA in HCC. Furthermore, CRA had better curative effect than MWA for anti-PD-L1 combination therapy in mouse models. Mechanistically, anti-PD-L1 antibody facilitated infiltration of CD8⁺ T cells by enhancing the secretion of CXCL9 from cDC1 cells after CRA therapy. On the other hand, anti-PD-L1 antibody promoted the infiltration of NK cells to eliminate PD-L1^highCD11b⁺ myeloid cells by antibody-dependent cell-mediated cytotoxicity (ADCC) effect after CRA therapy. Both aspects relieved the immunosuppressive microenvironment after CRA therapy. Notably, the wild-type PD-L1 Avelumab (Bavencio), compared to the mutant PD-L1 atezolizumab (Tecentriq), was better at inducing the ADCC effect to target PD-L1^highCD11b⁺ myeloid cells. Collectively, our study uncovered the novel insights that CRA showed superior curative effect than MWA in combining with anti-PD-L1 antibody by strengthening CTL/NK cell immune responses, which provided a strong rationale for combining CRA and PD-L1 blockade in the clinical treatment for HCC.

Objective To compare the detection results of three kinds of automated nucleic acid purifiers, and to evaluate the detection performance of the domestic 2019-nCoV RNA purifier. Methods Three automated nucleic acid purifiers, namely A (imported), B (domestic), and C (domestic) automated nucleic acid extraction instruments, were used to purify nucleic acid. The Conchestan 2019-nCoV RNA (Liquid) quality control product S5 (batch number 202007002, reference level 1000cp/ml) was chosen as the experimental object. The quality control product was diluted in a series of 10 to 1000 times to prepare experimental samples of different concentrations. Among them, the A nucleic acid purifier used its own matching reagents, and the B and C purifiers belonged to a same manufacturer with different models and used their own supporting reagents as well as third-party reagents, to evaluate the anti-pollution ability, precision, accuracy, repeatability, detection limit and linear correlation. Results Using the imported brand A as a reference standard for comparison, when using reagents from B, the linear correlation between the two domestic nucleic acid purifiers and the imported equipment were 0.999, 0.915 (N-terminal), and 0.997, 0.825 (ORF1ab-terminal), respectively; when using the third-patty reagents, the linear correlation between the two domestic nucleic acid purifiers and the imported equipment were 0.999, 0.915 (N-terminal) and 0.997, 0.825 (ORF1ab-terminal), respectively. Conclusion The extraction of 2019-NCOV RNA by domestic nucleic acid purifiers can be fully automated with good correlation. The system performance is comparable to international standards. Moreover, the extraction time of the domestic nucleic acid purifiers is shorter than the imported one, which offers obvious advantages when the number of samples is large.

Purpose: This study aimed to investigate the clinicopathologic features and mutational landscape of patients with hepatitis B virus (HBV)–related advanced hepatocellular carcinomas (HCC) undergoing transcatheter arterial chemoembolization (TACE). Materials and Methods: From January 2017 to December 2018, 38 patients newly diagnosed with HBV-related advanced HCC were enrolled in the final analysis. Their pathological tissues and corresponding blood samples before TACE treatment were collected for whole-exome sequencing. Response to TACE was evaluated at 1-3 months after two consecutive use of TACE. Predictive factors were analyzed by univariate and multivariate analyses in a bivariate Logistic regression model. Enrichment of related pathways of all driver genes were acquired using the gene set enrichment analysis (GSEA). Results: Among 38 patients, 23 (60.5%) exhibited TACE failure/refractoriness. Patients with TACE failure/refractoriness showed higher frequency of TP53 mutation than their counterparts (p=0.020). Univariate and multivariate analyses showed that only vascular invasion and TP53 mutation were significantly correlated with TACE failure/refractoriness in HBV-related advanced HCC. Of the 16 patients without vascular invasion, eight (50.0%) had TP53 mutations, and TP53 mutation was associated with TACE failure/refractoriness (p=0.041). Moreover, GSEA showed that mitogen-activated protein kinase and apoptosis pathways induced by TP53 mutation were possibly associated with TACE failure/refractoriness. Conclusion Our study suggested that TP53 mutation was independently related with TACE efficacy, which may work via mitogen-activated protein kinase and apoptosis pathways. These findings may provide evidence to help distinguish patients who will particularly benefit from TACE from those who require more personalized therapeutic regimens and rigorous surveillance in HBV-related advanced HCC.

Objective To develop a new method for the rapid determination of lomefloxacin,gatifloxacin,ciprofloxacin and oflox-acin in plasm and urine by solid phase extraction(SPE)and capillary electrophoresis.Methods The capillary was fused silica capil-lary with id/od of 75/365 μm and effective/total length of 40/47 cm.The running buffer was 40 mmol/L borate buffer at pH 9.0. Separation voltage was 13 kV.Temperature was 20 ℃.Detection wave-length was set at 280 nm.The sample was analyzed after the pretreatment of SPE.Results The analysis of lomefloxacin,gatifloxacin,ciprofloxacin and ofloxacin was completed in 6 minutes with satisfied accuracy and precision.Good linearity was found within the range of 1-40 μg/mL,and the r was 0.998 7,0.997 6, 0.998 3 and 0.994 2 respectively.The recoveries of four quinolones in plasm and urine ranged from 80.1% to 107.6%,and the rel-ative standard deviations(RSD)ranged from 2.1% to 6.2%.Conclusion This method is fast,simple,precise and it might be feasi-ble for the determination of lomefloxacin,gatifloxacin,ciprofloxacin and ofloxacin in plasm and urine samples.

AIM:To evaluate the safety and feasibility of using vascular endothelial growth factor (VEGF) in the establishment of Walker-256 transplanted liver cancer model .METHODS: SD rats ( n =45) were divided into 3 groups:via the caudal vein, the rats in normal saline (NS) group were injected with 0.9%sodium chloride (0.1 mL/d), the rats in 20 mg/L VEGF group were injected with 20 mg/L VEGF (0.1 mL/d), and the rats in 40 mg/L VEGF group were injected with 40 mg/L VEGF (0.1 mL/d).All the injection began 1 week before transplantation of liver cancer , and stopped on the day the cancer model was established .Prepared tumor tissue was transplanted into the subcapsular space of the liver.Three days, 1 week and 2 weeks after the transplantation, magnetic resonance imaging (MRI) was performed for analyzing the tumor growth and the characteristics .The overall survival of the rats was also recorded .RESULTS:Success-ful establishment of Walker-256 transplanted liver cancer model was achieved .Among 45 rats, 1 rat died 1 d after implan-ting the tumor both in NS group and 20 mg/L VEGF group, while 3 rats died in 40 mg/L VEGF group 1 week after building the model, mainly because of the progression of tumors .Three days after modeling,the numbers of the rats in which the tumor was positively detected by MRI in 3 groups were 0, 7 and 10, respectively;1 week after modeling, those were 3, 13 and 13, respectively;2 weeks after modeling,those were 12, 13 and 10, respectively.Between NS group and 20 mg/L VEGF group, the statistical significance existed in the number of the rats in which the tumor was positively detected by MRI after 3 d of implanting, so did the NS group and 40 mg/L VEGF group.No statistical significance in the overall survival time between NS group and 20 mg/L VEGF group (P>0.05) was observed, but the significance existed between 40 mg/L VEGF group and NS group (P<0.01).CfONCLUSION:The application of VEGF at dose of 20 mg/L and 0.1 mL/d shortens the time to establish the transplanted liver cancer model without influence on the overall survival , which is a safe, feasible and efficient way, and is more suitable for anti-VEGF drug investigation.

Objective To investigate the red blood cell in urine after kidney puncture and know the best detection method.Methods Collected three urines of 31 patients after kidney puncture and detected the red blood cell by UF-100 and the hemoglobin by urine dipstick test.At the same time,detect the conductivity of the urine by UF-100.Results Both the UF-100 and urine dipstick test could reflect the decrease of red blood cell after kidney puncture.But both of them had some limits.Sometimes the results of the two method were not relative(κ=0.148).The agreement of two methods was 0.538.Neither of them could reflect the bleeding of the kidney accuracy.Conclusion By the best,we should use both the UF-100 and the urine dipstick test to detect the red blood cell in urine after kidney puncture,at the same time we should consider the conductivity of the UF-100.

Objective To investigate the role of alprostadil on hepatic perfusion after transarterial chemoembolization(TACE) for hepatocellular carcinoma. Methods Sixty-four consecutive patients with HCC were randomized to either treatment with PGE_1 after TACE (treatment group, 32 cases) or no additional treatment after TACE (control group, 32 cases). In PGE_1 group, Lipo-PGE_1 was administered intravenously once a day for total of seven days, once after completion of TACE. The dosage of Lipo-PGE_1 was 0.4μg/kg and rote 0.05 μg·kg~(-1)·min~(-1). In control group, regular TACE was used. All patients underwent hepatic CT perfusion within 1 week before TACE and 4 weeks after TACE. The parameters of hepatic perfusion, including hepatic arterial perfusion value (HAP), portal vein perfusion value (PVP), total liver perfusion value (TLP) , and hepatic arterial perfusion index (HPI) were measured and compared. Chi-Square test was used for comparison of CT perfusion parameters in different stage, and t test was used for comparison of each CT porfusion parameter between two groups. Results In control group, HAP of pre-TACE, 4 weeks after first TACE, and 4 weeks after second TACE was (0.18±0.08), (0.22±0.09), (0.32±0.10) ml·min~(-1)·ml~(-1), respectively. Likewise, PVP was (1.11±0.31)、(0.82±0.27)、(0.59±0.25) ml·min~(-1)·ml~(-1), respectively, and TLP was (1.29±0.33), (1.04±0.28), (0.91±0.24) ml·min~(-1)·ml~(-1), respectively, and HPI was (14.31±6.36)%, (21.37±9.07)%, (36.67±13.42)%, respectively. The perfusion parameters at different stages of TACE were statistically different (F=19.71,27.47,14.75,41.41, P<0.05). In PGE1 group, HAP before TACE, after first TACE, and after second TACE was (0.17±0.08), (0.20±0.08), (0.26±0.08) ml·min~(-1)·mi~(-1) respectively, and PVP was (1.09±0.36), (1.03±0.40), (0.91±0.41) ml·min~(-1)·ml~(-1), respectively, and TLP was (1.26±0.38), (1.23±0.40), (1.17±0.44) ml·min~(-1)·ml~(-1) respectively, and HPI was (14.04±6.71)%, (17.26±7.86)%, (23.93±8.96)%, respectively. The difference of HAP and HPI at different stage of TACE was significant (F = 10.78, 13.05, P < 0.05), but there was no significant difference both PVP and TLP (F = 1.73,0.39, P > 0.05). The difference of PVP and TLP between the control and PGE1 group was significant after first TACE(t = -2.37, -2.14, P <0.05)and second TACE (t = 2.55, - 4.49, P < 0.05) In addition, after the second TACE, the HAP and HPI were also significantly different (t = - 3.41,5.09, P < 0.05). Conclusions PVP and TLP decrease while HAP and HPI increase after TACE. Lipo-PGE1 improves hepatic peffusion after TACE, exerting its greatest effect by increasing portal vein perfusion. Consequently, treatment with Lipo-PGE1 appears to increase liver tissue perfusion and thereby alleviate injury induced by TACE.

alterations on liver hemodynamics on IR injury following administration of medication.