ObjectiveTo discuss the current status and progress of delayed gastric emptying (DGE) after pancreaticoduodenectomy (PD).MethodThe related researches about DGE after PD in recent year were searched and reviewed.ResultsThe etiology and pathogenesis of DGE had not yet been fully elucidated. There were various risk factors, such as the surgical trauma, advanced age, diabetes, and with other abdominal complications. The pylorus preserving PD didn’t increase the risk of DGE. The pylorus ring resection, anterior colon, Braun anastomosis, and minimally invasive surgery were beneficial for reducing DGE. Although there was no obvious progress in the treatment of DGE at home and abroad, the majority of patients could be cured by the symptomatic conservative treatment.ConclusionsPrevention is a main strategy for DGE after PD. Application of enhanced recovery after surgery might be a key to solve problem in clinical, but further research is needed.
目的 探讨腹腔镜胆囊切除术(LC)同时同孔完成多脏器手术可能性及手术方法。方法 总结1993年3月至1999年4月完成LC 2 170例，其中LC同时同孔完成多脏器手术51例。结果 该51例手术全部成功，无1例术中中转开腹，除1例患者LC同时同孔行绝育手术后怀孕，其余无术中及术后并发症发生。结论 LC同时同孔完成多脏器手术实现了跨区域、多脏器同期手术，虽创伤范围增多，操作有一定的难度，仍具有微创外科的特点。一次完成多种手术，不明显增加患者的痛苦及费用，避免了患者在一种疾病治愈后再次住院手术治疗另一种疾病。
ObjectiveTo investigate the effectiveness of concealed penis correction surgery based on the principle of midline symmetry.MethodsBetween January 2016 and September 2018, 18 children with concealed penis were treated with correction surgery based on the principle of midline symmetry. All children were 3-12 years old, with an average age of 8.3 years. Physical examination showed that the penis was short; the penis body could not be exposed or be exposed too limited; the corpus cavernosum developed well. The pressure dressing was removed at 3 days after operation and the urethral tube was removed. The color of the glans, the swelling and congestion of penis and scrotum, and the blood supple of the prepuce flap were observed.ResultsThe operation time ranged from 47 to 54 minutes, with an average of 50 minutes. All children were followed up 3 months after operation. There was no hemorrhage and necrosis of the glans and no infection or ischemic necrosis of the flap. All patients had different degree of prepuce edema at 3 days after operation, 5 patients still had prepuce edema at 2 weeks, and the prepuce edema in all patients subsided at 3 months. All penises were exposed well after midline symmetric anastomosis with no bulky prepuce and scrotum.ConclusionThe correction surgery based on the principle of midline symmetry can be used to correct the appearance of the concealed penis effectively.
ObjectiveThis study aims to study the effects and mechanism of resveratrol on hepatocellular carcinoma (HCC) cells through phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) axis.MethodsHepG2 cells at logarithmic growth stage were treated with different concentrations (0, 12.5, 25.0, and 50.0 μmol/L) of resveratrol, respectively. Then the proliferation of HepG2 cells was detected by the CCK8 method and real time cell anaIysis (RTCA) system, the expressions of signal molecules associated with PI3K/Akt axis was detected by the Western blot method, including PI3K p58, phosphorylation protein kinase B (p-Akt), total protein kinase B (t-Akt), and CyclinA2 protein.ResultsResveratrol had a significant inhibitory effect on the growth of HepG2 cells in a time and dosage dependent manner. After 48 h treatment of resveratrol to HepG2 cells, 50.0 μmol/L resveratrol inhibited the growth of HepG2 cells most significantly. Further, the RTCA system studies also found that resveratrol had a time and concentration dependent effect on the reduction of normalized cell index (NCI) in HepG2 cells. Flow cytometry results showed that, apoptosis rates of 12.5, 25.0, and 50.0 μmol/L group were higher than that of 0 μmol/L group. Compard with 0 μmol/L group, the expressions of PI3K p85, p-Akt, and CyclinA2 protein in HepG2 cells of 12.5, 25.0, and 50.0 μmol/L resveratrol group was significantly higher (P<0.05), although there was no significant effect of resveratrol on the expression of t-Akt in HepG2 cells (P>0.05).ConclusionsResveratrol might have anti-proliferation effects on HepG2 cells through PI3K p85/Akt signaling axis. This study could provide a novel idea for the treatment to HCC.
ObjectiveTo review our experience of reoperations for pulmonary venous stenosis (PVS) after total anomalous pulmonary venous connection (TAPVC) repair for the past decade in Fuwai Hospital.MethodsNine patients underwent reoperation for PVS between 2009 and 2019 in Fuwai Hospital, including 4 males and 5 females with an average age of 5.10±5.00 years. The patients were divided into a sutureless group (n=3) and a non-sutureless group (n=6). Clinical data were reviewed and analyzed.ResultsFor primary TAPVC type, 4 patients were supracardiac, 2 patients were cardiac, 1 patient was infracardiac, and 2 patients were mixed-type anomaly. The median cardiopulmonary bypass time was 95 (63, 208) min, aortic clamping time was 58 (30, 110) min, ICU stay was 24 (24, 2 136) h. Early hospital death occured in 1 (11.1%) patient. One (11.1%) patient with single ventricle physiology had hospital comorbidity, who underwent hemofitration therapy. The follow-up time was 11.9 (2.2, 18.0) months, during which 1 patient died of restenosis of pulmonary vein and another patient died of stroke. No statistically significant difference was found between the sutureless group and non-sutureless group in postoperative or follow-up results (P>0.05). ConclusionSurgery is effective for treatment of PVS after repair of TAPVC, yet with a realatively high morbidity and mortality. The advantage of sutureless repair over conventional repair for this particular group of patients is yet to be verified.