Objective: To explore the development of the pancreatic surgeon technique in a high-volume center. Methods: A total of 284 cases receiving pancreatic surgery by a single surgeon from June 2015 to December 2020 were retrospectively included in this study. The clinical characteristics and perioperative medical history were extracted from the medical record system of Zhongshan Hospital,Fudan University. Among these patients,there were 140 males and 144 females with an age (M (IQR)) of 61.0 (16.8) years(range: 15 to 85 years). The "back-to-back" pancreatic- jejunal anastomosis procedure was used to anastomose the end of the pancreas stump and the jejunal wall. Thirty days after discharge,the patients were followed by outpatient follow-up or telephone interviews. The difference between categorical variables was analyzed by the Chi-square test or the CMH chi-square test. The statistical differences for the quantitative data were analyzed using one-way analysis of variance or Kruskal-Wallis H test and further analyzed using the LSD test or the Nemenyi test,respectively. Results: Intraoperative blood loss in pancreaticoduodenectomy between 2015 and 2020 were 300,100(100),100(100),100(0),100(200) and 150 (200) ml,respectively. Intraoperative blood loss in distal pancreatectomy was 250 (375),100 (50),50 (65), 50 (80),50 (50),and 50 (100) ml,respectively. Intraoperative blood loss did not show statistical differences in the same operative procedure between each year. The operative time for pancreaticoduodenectomy was respectively 4.5,5.0(2.0),5.5(0.8),5.0(1.3),5.0(3.3) and 5.0(1.0) hours in each year from 2015 to 2020,no statistical differences were found between each group. The operating time of the distal pancreatectomy was 3.8 (0.9),3.0 (1.5),3.0 (1.8),2.0 (1.1),2.0 (1.5) and 3.0(2.0) hours in each year,the operating time was obviously shorter in 2018 compared to 2015 (P=0.026) and 2020 (P=0.041). The median hospital stay in 2020 for distal pancreatectomy was 3 days shorter than that in 2019. The overall incidence of postoperative pancreatic fistula gradually decreased,with a incident rate of 50.0%,36.8%,31.0%,25.9%,21.1% and 14.8% in each year. During this period,in a total of 3,6,4,2,0 and 20 cases received laparoscopic operations in each year. The incidence of clinically relevant pancreatic fistula (grade B and C) gradually decreased,the incident rates were 0,4.8%,7.1%,3.4%,4.3% and 1.4%,respectively. Two cases had postoperative abdominal bleeding and received unscheduled reoperation. The overall rate of unscheduled reoperation was 0.7%. A patient died within 30 days after the operation and the overall perioperative mortality was 0.4%. Conclusion: The surgical training of a high-volume center can ensure a high starting point in the initial stage and steady progress of pancreatic surgeons,to ensure the safety of pancreatic surgery.
Male ; Female ; Humans ; Pancreatic Fistula/surgery* ; Retrospective Studies ; Blood Loss, Surgical ; Pancreatectomy/methods* ; Pancreaticoduodenectomy ; Postoperative Complications ; Surgeons ; Postoperative Hemorrhage ; Pancreatic Neoplasms/surgery*

Objective: To introduce the construction idea and function for establishing China Cardiovascular Surgery Registry (CCSR)database and to provide a reference for domestic congener databases. Methods: Using peer database as reference, taking current status of cardiovascular surgery registry and hardware in our country with the necessity of international communication, we worked on a variables selection, metadata instruction, logic rules, case report form develpment and finally established a web-based, multi-functional database that enabled cross-database and international merging of data, forming a national intelligent data-exchanging platform for cardiovascular surgery. Results:CCSR database has over 300 variables of multiple topics including basic information, risk factors, medical procedures and endpoint events. Taking clinical and association data exchange standards as reference, it may conduct cross-discipline data connection, record important peri-operative information in relevant patients and meanwhile, it has the functions of automatic logic check, data report, statistical study, data export and importing the electronic medical records. Conclusion:CCSR database is a national platform accord with current status of Chinese cardiovascular surgery and characteristics, meanwhile it gives consideration to international communication and data exchange; which may play a important role in improving medical care and clinical investigation.

Objective To study the changes in red blood cells(RBCs),hemoglobin(Hb),hematocrit(HCT),mean corpuscular volume(MCV),RBC distribution width variation coefficient(RDW-CV)and RBC distribution width standard deviation(RDW-SD)of leukocyte-poor red blood cells preserved in navy ship force on a long voyage.Methods According to the Requirement of Health Examination for Blood Donors(GB 18467 -2011),red blood cells in additive solution leukocytes reduced were randomly collected from ten healthy voluntary blood donors one day before sailing.Each blood sample was preserved.The relevant parameters were detected as data before sailing.Each blood sample was divided into two parts,one in test group and the other in control group.Samples were taken from the two groups of leukocyte-poor red blood cells for the sampling detection after 21 days of sailing respectively.Results ①After sailing, the concentrations of RBCs and Hb declined in both groups,and the difference of RBC concentrations was not significant(P=0.319),but that of the concentrations of Hb was significant(P=0.002).②After sailing, the concentrations of HCT and MCV increased, but the change of HCT was significant(P=0.015),while that of MCV was insignificant(P=0.051).③After sailing,the concentrations of RDW-SD and RDW-CV were higher,but the change of RDW-SD was significant(P<0.001),while that of RDW-CV was not(P=0.528).Conclusion When leukocyte-poor red blood cells are preserved in navy ship force,the concentrations of RBC and Hb decrease,while the concentrations of HCT,MCV,RDW-SD and RDW-CV increase with the prolongation of preservation.A long voyage has some impact on the parameters of red blood cells in additive solution leukocytes reduced,as is the case with the conventional blood storage refrigerator(4 ±2)℃.

Objective To explore the influence on and changes in the biochemical indices of red blood cells(RBCs)in additive solution leukocytes reduced preserved in navy ship force on a long voyage.Methods According to the Requirement of Health Examination for Blood Donors(GB 18467 -2011),RBCs in additive solution leukocytes reduced were prepared from 10 healthy voluntary blood donators one day before sailing.Each blood sample was divided into two parts,one in test group and another in control group.All the groups had samples taken for the biochemical index detection after 1,3,5,7,14 and 21 days of sailing respectively.Results ①The change in total protein(P=0.235)and albumin (P=0.119)concentration was not obvious,and the difference between the two groups was not significant.②The change in total creatinine(P=0.001)and uric acid(P=0.001)concentration was obvious, but the difference between the two groups was not significant.③The change in total cholesterol(P=0.354)concentration was not obvious,but the change in triglycerides(P=0.005)concentration was significant.The difference between the two groups was not significant.④The concentration of lactate dehydrogenase, hydroxybutyrate dehydrogenase and creatine kinase increased with the time of preservation(P<0.001).The difference between the two groups was not significant.⑤The interaction between grouping effect and time effect had no significant influence on the concentration of osmolarity(OSM)(P=0.968)and glucose(Glu) (P=0.406).Between the two groups,the difference of concentrations of OSM(P=0.569)and Glu(P=0.115)was not significant.Conclusion Under the 4 class sea conditions, a long voyage has some impact on the storage of RBCs in additive solution leukocytes reduced,as in the conventional blood storage refrigerator(4 ±2)℃.The results of this study have important clinical implications for our further study of marine blood support.

In this paper, the potential distribution information and ecological suitability regionalization for Gastrodia elata in Zhaotong were studied based on the climate, terrain, soil and vegetation factors analysis by Maxent and ArcGIS. The results showed that the highly potential distribution (suitability index>0.6) mainly located in Zhaotong, Yunnan province（Zhenxiong,Yiliang and Daguan county, with an area of 2 872 km²）, and Bijie, Guizhou province （Hezhang,Bijie,Weining county, 1 251 km²）. The AUC of ROC curve was above 0.99, indicating that the predictive results with the Maxent model were highly precise. The main ecological factors determining the potential distribution were the altitude, average rainfall in November, average rainfall in October, vegetation types, average rainfall in March, average rainfall in April,soil types,isothermal characteristic and average rainfall in June. The environmental variables in the highly potential areas were determined as altitude around 1 450-2 200 m,annual average temperature around 18.0-20.4 ℃,annual average precipitation around 900 mm,yellow soil or yellow brown soil,and acid sandy loam or slightly acidic sandy loam.The results will provide valuable references for plantation regionalization and the siting for imitation wild planting of G. elata in Zhaotong.

Aged ; Computed Tomography Angiography ; Deep Brain Stimulation ; adverse effects ; Female ; Hematoma, Subdural, Intracranial ; diagnosis ; etiology ; surgery ; Humans ; Subthalamic Nucleus ; physiology

Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Meningioma ; diagnosis ; Middle Aged ; Retrospective Studies ; Young Adult

BACKGROUNDMeningioma is one of the most common primary tumors of the central nervous system, but there are not many detailed studies on the sex, age, subtypes and locations of large series. This study was a retrospective analysis of the characteristics of meningioma cases consecutively operated on at a single institution in China from 2001 to 2010.

METHODSThis study investigated the demographic background of 7084 meningioma cases, and the subtypes and locations of the tumors. Sex and age distributions were analyzed, and the pathological subtypes were classified according to the World Health Organization (WHO) classification. The location of the meningiomas was also categorized.

RESULTSThe female:male ratio of the 7084 cases was 2.34:1. The mean age was 51.4 years (range, 11 months-86 years). The mean age of cases of WHO grade I meningioma was significantly older than that of grade II or III meningiomas (P < 0.001, Fisher's Least Significant Digit test). There was a significantly higher female:male ratio in WHO grade I meningiomas than in grade II or grade III meningiomas (2.57, 1.03 and 0.76, respectively; P < 0.001, χ(2) test). Meningothelial (n = 2061) and fibrous meningiomas (n = 3556) were the most common subtypes, comprising 79.3% of all meningiomas. All meningioma cases were classified into 23 locations in this study, with the cerebral convexity the most common site (38.33%, n = 2722). Cases with uncommon locations such as extra-cranial and sylvian fissure meningiomas were also present in this series.

CONCLUSIONSFemale predominance was found for benign meningiomas, while malignant subtypes showed male predominance. The mean age of patients with WHO grade I meningiomas was older than that of patients with higher-grade tumors. Meningothelial and fibrous meningiomas were the most common subtypes. The cerebral convexity was the most common meningioma location.

Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Male ; Meningioma ; epidemiology ; Middle Aged ; Sex Distribution ; Young Adult

Objective To explore the clinical characteristics and treatment of cerebral arteriovenous malformations (AVMs) in elderly patients to improve their prognoses.Methods Such clinical data as clinical manifestations,angioarchitecture features,location and therapy of 28 elderly patients (≥60 years old) with AVMs,admitted to our hospital from January 2000 to December 2011,were retrospectively analyzed.Results The elderly patients had 5.4％ (28/511) morbidity of AVMs,with mean age of (62.25±3.46) years; the male patients were slightly more than the female patients.The clinical presentations included hemorrhage in 20 patients,seizure in 4,headache in 2,facial tic in 1 and tinnitus in 1.Supratentorial and infratentorial lesions were noted in 22 and 6,respectively.The maximum diameter of AVMs was smaller than 3 centimeters in 11 patients,ranged from 3 to 6 centimeters in 16,and larger than 6 centimeters in 1.Twenty-one AVMs were located in the functional areas and 7 in non-functional areas.Deep vein drainage was noted in 15,two-way drainage in 1 and superficial drainage in 11.Spetzeler-Martin grading showed grade Ⅰ in 1,grade Ⅱ in 7,grade Ⅲ in 13,grade Ⅳ in 6 and grade V in 1.After operation,endovascular embolization,27 patients had significantly improved symptoms; one patient had no effect on any treatments.Conclusion The elderly patients with cAVMs have low morbidity with hemorrhage as its most common symptom; and the lesions mostly locate in the supratentorial region; active intervention therapy (resection,endovascular embolization and radiotherapy)can obviously improve the prognosis and quality of lives.

OBJECTIVETo observe the effects of Angelica dahurica extracts on the biological characteristics of human dermal fibroblasts in vitro and to preliminary explore its possible therapeutic mechanism for wound healing.

METHODSThe optimal concentration of Angelica dahurica extracts was identified by analysing of proliferation activity of human normal fibroblasts (Fb) that treated with different concentration of Angelica dahurica extracts through thiazole blue (MTT) colorimetric assay. Cell cycle, collagen I and collagen III mRNA levels of the optimal Angelica dahurica extracts treated Fb were detected by flow cytometry (FCM) and real-time PCR techniques.

RESULTSAt concentrations of 5 × 10(-4) to 5 × 10(-2) g/L, the Angelica dahurica extracts significantly enhanced the proliferation of Fb. The most significant concentration was 5 × 10(-3) g/L (t = 5.79, P < 0.01), at which an increased percentage of G1 to S and S to G2 phase cells (t = 11.2, 5.69, 2.44, P < 0.05) as well as an increased level of collagen I (1.61 ± 0.26 vs. 1.00 ± 0.16) and collagen III mRNA (3.36 ± 0.40 vs. 1.00 ± 0.14) were obtained compared to the control group (t = 6.69, 7.64, P < 0.01).

CONCLUSIONSAngelica dahurica extracts can notably promote the proliferation of Fb and accelerating the cell cycle of Fb as well as up-regulating the expression of collagen I and collagen III, which may enhance the process of wound healing.

Angelica ; chemistry ; Cell Cycle ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Collagen ; metabolism ; Dermis ; cytology ; Fibroblasts ; cytology ; drug effects ; metabolism ; Humans ; Plant Extracts ; pharmacology