ObjectiveTo explore the significance of quantitative parameters of tissue diffusion included in the real-time ultrasound elastography (RTE), in diagnosing the degree of liver fibrosis. MethodFrom July 2012 to November 2014, liver biopsy being the gold standard for evaluating hepatic fibrosis stage, we performed RTE on 112 hepatitis patients and analyzed the elastogram we got. At the same time, we carried out quantitative analysis of tissue diffusion in these patients, and obtained the values of liver fibrosis index (LFI) of right liver parenchyma. Subsequently, we compared the biopsy pathological results with the values of LFI, and single-factor analysis of variance (ANOVA) was adopted to compare the LFI among patients with variant degrees of liver fibrosis. If there were any discrepancies, least significant difference method would be adopted in order to compare one with the other from different groups. Finally, critical value of LFI of different-stage liver fibrosis was obtained with the help of receiver operator characteristic (ROC)curve. ResultsChronological liver fibrosis was classified into stage 0, stage 1, stage 2, stage 3, and stage 4, and their LFI values were 2.36±0.46, 2.38±0.45, 2.84±0.54, 3.16±0.59, and 3.69±0.55, respectively. ANOVA showed that the LFI values of different-stage fibrosis had significant differences (F=29.959, P<0.001). However, there was no difference between stage 0 and stage 1 (P=0.920), or between stage 2 and stage 3 (P=0.076). The area under the ROC curve for stage 0-1 and stage 2-3, stage 2-3 and S4 was respectively 0.784 and 0.799, and their critical value was 2.83 and 3.69 respectively. ConclusionsThe real-time ultrasound elastography is a feasible and non-invasive method in diagnosing the degree of hepatitis fibrosis and LFI has advantage in distinguishing different stage of liver fibrosis.
The aim of this study was to investigate whether shear stress could promote function of endothelial progenitor cells (EPCs)with Shexiang Baoxin Pill (SBP) treatment in vitro, and to study whether shear stress contributed to vascular injury repair by EPCs. EPCs were isolated and characterized; EPCs' proliferation, migration, adhesion, tube formation and eNOS protein level in vitro were investigated by culturing confluent EPCs in 4 mg/mL SBP under physiological shear stress (15 dyne/cm2) for up to 24 hours. Afterwards, EPCs were transfused into rats after wire-induced carotid artery injury augmented re-endothelialization. The results showed that, compared to the SBP group, the shear stress+SBP group obviously enhanced EPCs proliferation, migration, adhesion, tube formation and eNOS protein expression in vitro (P<0.01). After one week, immunofluorescence staining showed that endothelial regeneration rate obviously enhanced in shear stress+SBP group (P<0.01). The present study demonstrates that shear stress can promote function of endothelial progenitor cells treated with SBP, which improves the vascular injury repair potentials of EPCs.
ObjectiveTo evaluate the effects of duct-to-mucosa pancreaticojejunostomy (dmPJ) and invagination pancreaticojejunostomy (iPJ) during pancreaticoduodenectomy (PD) on postoperative outcomes. MethodsPubmed, The Cochrane Library, Embase, Wanfang and CNKI database were searched to identify randomized controlled trials (RCTs) evaluating different type of pancreaticojejunostomy during PD. The literatures were screened according to inclusion and exclusion criteria. Quality assessment was conducted according to Jadad scoring system. ResultsNine RCTs were included, 1 032 patients were recruited, including 510 patients in dmPJ group and 522 patients in iPJ group. Meta-analysis indicated that there were no significant differences between two groups in terms of the incidence of pancreatic fistula in total (OR=0.95, P=0.78), clinical relevant pancreatic fistula (OR=0.78, P=0.71), overall morbidity (OR=0.93, P=0.60), perioperative mortality (OR=0.86, P=0.71), reoperation rate (OR=1.18, P=0.59), and length of hospital stay (WMD=-1.11, P=0.19). ConclusionDmPJ and iPJ are comparable in terms of pancreatic fistula and other complications.
ObjectiveTo explore the application value of MRS combined with VEEG on the surgical treatment of temporal lobe epilepsy. MethodsThere were 31 males and 20 females, age between 4 and 62 years.Their illness duration ranged from 4 to 10 years.The clinical manifestations showed complex partial seizure in 10 cases, secondary generalized seizure in 12 and generalized tonic-clonic seizure in 29. Based on their results of clinical manifestations, MRS and VEEG results, all the patients underwent anterior temporal lobectomy(including the most parts of the hippocampus and amydala). ResultsThe follow-up of 1~3 years after the operation showed seizure free in 36 cases(Engle Ⅰ), and significant improvement in 11(Engle Ⅱ), no improvement in 4 cases(Engle Ⅳ). The overall effective rate was 92.16%. ConclusionsMRS combined with VEEG has significant localization value for temporal lobe epilepsy. The prognosis of postoperative result is quiet good to the patient of typical temporal lobe epilepsy after anterior temporal lobectomy.
Objectives To identify the effect of procalcitonin (PCT) on the choice of operating time for severe acute pancreatitis and assessment of postoperative complications by monitoring the level of serum PCT and recording the incidence of postoperative complications. MethodsNinety-three patients who underwent debridement and drainage of infected necrosis from Sep. 2009 to Dec. 2011 were included. Serum PCT was tested on the day of admission (0 day), one week after admission, one day before surgery, one day after surgery, and one week after surgery. According to the level of serum PCT, all the 93 patients were divided into 3 groups:low level group (PCT < 2 ng/mL), middle level group (PCT 2-10 ng/mL), and high level group (PCT > 0 ng/mL). Postoperative complications were also recorded. ResultsThe incidence of postoperative complications was 19.4% (18/93). There were postoperative bleeding in 13 patients, intestinal fistula in 14 patients, pancreatic fistula in 18 patients, pulmonary infection in 4 patients, residual abscess in 10 patients; re-operation in 15 patients, and death in 8 patients (the death rate was 8.6%). Besides the pulmonary infection, and grade A and C of pancreatic fistula, the incidence of various complications in middle level group and high level group were lower than low level group (P < 0.05). Patients with complications had significantly higher PCT value in one week after admission than onset (P < 0.05). PCT value was higher in the patients with intestinal fistula and residual abscess on one day after operation than on one day before operation (P < 0.05). Patients who died or with re-operation had significantly higher PCT value in one week after operation than on one day after operation (P < 0.05). In the dead patients, the serum PCT sustained at a high level after operation. ConclusionsThe level of serum PCT is correlated with the incidence of postoperative complications. Dynamic monitoring the level of serum PCT can guide the choice of operative time and assessment of postoperative complications including intestinal fistula, pulmonary infection, and death, which can greatly improve the prognosis of SAP.
ObjectiveTo investigate the short-term effect of laparoscopic sleeve gastrectomy (LSG) in treatment of obesity in China. MethodsLiteratures about the effect of LSG in treatment of obesity were searched from WanFang, CNKI, PubMed, and Web of Science, then these literatures were filtered according to the inclusive and exclusive criteria and evaluated. Meta analysis was performed based on data extracted from these literatures. ResultsThree hundreds and eighty three cases of LSG were retrieved from 12 literatures. Compared with the preoperative, the body mass index (BMI) was lower in 6 months after LSG (MD=7.56, 95% CI: 5.77-9.34, P < 0.000 01), and compared with 6 months after LSG, the BMI was lower in 12 months after LSG (MD=3.19, 95% CI: 2.20-4.18, P < 0.000 01). Compared with 1 months after LSG, the excess weight loss (EWL%) was higher in 6 months after LSG (MD=-42.77, 95% CI:-45.77--39.77, P < 0.000 01), and compared with 6 months after LSG, EWL% was higher in 12 months after LSG (MD=-19.71, 95% CI:-25.54--13.87, P < 0.000 01). After the LSG, BMI decreased, but EWL% increased over time. ConclusionsIn China, LSG has obviously short-term curative effect in the treatment of obesity.
ObjectiveTo evaluate the influence of nicotine intake on bone microstructure, bone biomechanics, and oxidative stress state in rats. MethodsThirty-six 6-week-old male Sprague Dawley rats (weight, 160-180 g) were randomly divided into control group, low dose group, and high dose group, 12 rats each group. The rats in high dose group and low dose group were given respectively 6.0 mg/kg and 0.4 mg/kg nicotine gavage intervention for 12 months; no intervention was made in the control group. The survival of rats was observed during experiment, and the weight of rats was measured every month. At 12 months after modeling, the L1 vertebral body was harvested to measure the bone mineral density (BMD), bone volume fraction (BVF), trabecular thickness (TT), trabecular number (TN), and trabecular spacing (TS) by Micro-CT three-dimensional reconstruction; the left femur was harvested for biomechanical tests of maximal load, stiffness, and the maximal fracture energy; and arterial blood was extracted to measure the malonyldialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), and cotinine. ResultsDuring the experiment, two rats and one rat were added in the high dose group and the low dose group because of death, and no death in the control group. The body weight of the rats in the high and low dose groups gradually decreased with time when compared with one in the control group, and significant difference was found between two dose groups and the control group at 8-12 months (P < 0.05); the body weight of the high dose group was significantly lower than that of the low dose group at 11 and 12 months (P < 0.05). At 12 months after modeling, BMD, BVF, TT, and TN were significantly lower in the high dose group than the control group and the low dose group, but TS was significantly increased (P < 0.05). Difference in BVF, TN, and TS was significant between the low dose group and the control group (P < 0.05). The maximal load, stiffness, and maximal fracture energy of femoral shaft were significantly lower in the high dose group than the control group and the low dose group, and in the low dose group than the control group (P < 0.05). Compared with the control group, the levels of cotinine and MDA were significantly increased, and the levels of CAT and SOD were significantly decreased in the high and low dose groups (P < 0.05), and there were significant differences between the high and low dose groups (P < 0.05). ConclusionNicotine intake can cause micro-structural changes of the bone, decreased bone mechanical properties, and imbalance of oxidation-antioxidant levels in rats. High-dose nicotine intake may be one of the causes of osteoporosis.