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Different timing for abdominal paracentesis catheter placement and drainage in severe acute pancreatitis complicated by intraabdominal fluid accumulation

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World Journal of Gastrointestinal Surgery 2024年第1期16卷 134-142页

作者： Rui Chen Hua-Qiang Chen Rui-Die Li Hui-Min Lu Department of General Surgery Chengdu Sixth People’s HospitalChengdu 610058Sichuan ProvinceChina West China Center of Exellence for Pancreatitis Institute of Integrated Traditional Chinese and Western MedicineWest ChinaDivision of Pancreatic SurgeryDepartment of General SurgeryWest China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina HospitalSichuan University

BACKGROUND Non-surgical methods such as percutaneous drainage are crucial for the treatment of patients with severe acute pancreatitis(SAP).However,there is still an ongoing debate regarding the optimal timing for abdominal paracentesis catheter place-ment and drainage.AIM To explore the influence of different timing for abdominal paracentesis catheter placement and drainage in SAP complicated by intra-abdominal fluid accumu-lation.METHODS Using a retrospective approach,184 cases of SAP complicated by intra-abdominal fluid accumulation were enrolled and categorized into three groups based on the timing of catheter placement:group A(catheter placement within 2 d of symptom onset,n=89),group B(catheter placement between days 3 and 5 after symptom onset,n=55),and group C(catheter placement between days 6 and 7 after symptom onset,n=40).The differences in progression rate,mortality rate,and the number of cases with organ dysfunction were compared among the three groups.RESULTS The progression rate of group A was significantly lower than those in groups B and groups C(2.25%vs 21.82%and 32.50%,P0.05).At postoperative day 3,the levels of C-reactive protein(55.41±19.32 mg/L vs 82.25±20.41 mg/L and 88.65±19.14 mg/L,P<0.05),procalcitonin(1.36±0.51 ng/mL vs 3.20±0.97 ng/mL and 3.41±0.98 ng/mL,P<0.05),tumor necrosis factor-alpha(15.12±6.63 pg/L vs 22.26±9.96 pg/L and 23.39±9.12 pg/L,P<0.05),interleukin-6(332.14±90.16 ng/L vs 412.20±88.50 ng/L and 420.08±87.65ng/L,P<0.05),interleukin-8(415.54±68.43 ng/L vs 505.80±66.90 ng/L and 510.43±68.23ng/L,P<0.05)and serum amyloid A(270.06±78.49 mg/L vs 344.41±81.96 mg/L and 350.60±80.42 mg/L,P<0.05)were significantly lower in group A compared to those in groups B and group C.The length of hospital stay in group A was significantly lower than

关键词： Abdominal paracentesis catheter drainage timing Severe acute pancreatitis Intra-abdominal fluid Application value

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Strengthening pharmacotherapy research for COVID-19-induced pulmonary fibrosis

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World Journal of Clinical Cases 2024年第5期12卷 875-879页

作者： Yan-Miao Liu Jing Zhang Jing-Jing Wu Wei-Wei Guo Fu-Shan Tang The First Clinical Institute Zunyi Medical UniversityZunyi 563006Guizhou ProvinceChina Key Laboratory of Clinical Pharmacy in Zunyi City Zunyi Medical UniversityZunyi 563006Guizhou ProvinceChina Department of Respiratory Medicine Central Hospital in Jinchang CityJinchang 737102Gansu ProvinceChina Department of Clinical Pharmacy Key Laboratory of Basic Pharmacology of Guizhou Province and School of PharmacyZunyi Medical UniversityZunyi 563006Guizhou ProvinceChina Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education Zunyi Medical UniversityZunyi 563006Guizhou ProvinceChina

The global spread of severe acute respiratory syndrome coronavirus 2 has resulted in a significant number of individuals developing pulmonary fibrosis(PF),an irreversible lung injury.This condition can manifest within a short inter-val following the onset of pneumonia symptoms,sometimes even within a few days.While lung transplantation is a potentially lifesaving procedure,its limited availability,high costs,intricate surgeries,and risk of immunological rejection present significant drawbacks.The optimal timing of medication administration for coronavirus disease 2019(COVID-19)-induced PF remains controversial.Despite this,it is crucial to explore pharmacotherapy interventions,involving early and preventative treatment as well as pharmacotherapy options for advanced-stage PF.Additionally,studies have demonstrated disparities in anti-fibrotic treatment based on race and gender factors.Genetic mutations may also impact therapeutic efficacy.Enhancing research efforts on pharmacotherapy interventions,while considering relevant pharmacological factors and optimizing the timing and dosage of medication administration,will lead to enhanced,personalized,and fair treatment for individuals impacted by COVID-19-related PF.These measures are crucial in lessening the burden of the disease on healthcare systems and improving patients'quality of life.

关键词： COVID-19 Pulmonary fibrosis Pharmacotherapy intervention Medication administration timing Dosage

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timing of endoscopic retrograde cholangiopancreatography in the treatment of acute cholangitis of different severity

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World Journal of Gastroenterology 2022年第38期28卷 5602-5613页

作者： Yao-Chi Huang Chi-Huan Wu Mu Hsien Lee Sheng Fu Wang Yung-Kuan Tsou Cheng-Hui Lin Kai-Feng Sung Nai-Jen Liu Department of Medicine College of MedicineChang Gung UniversityTaoyuan 333Taiwan Department of Gastroenterology and Hepatology Chang Gung Memorial HospitalTaoyuan 333Taiwan

BACKGROUND The optimal timing of endoscopic retrograde cholangiopancreatography(ERCP)in acute cholangitis(AC) is uncertain,especially in patients with AC of varying severity.AIM To report whether the timing of ERCP is associated with outcomes in AC patients with different severities.METHODS According to the 2018 Tokyo guidelines,683 patients who met the definite diagnostic criteria for AC were retrospectively identified.The results were first compared between patients receiving ERCP ≤ 24 h and>24 h and then between patients receiving ERCP ≤ 48 h and>48 h.Subgroup analyses were performed in patients with grade Ⅰ,Ⅱ or Ⅲ AC.The primary outcome was 30-d mortality.Secondary outcomes were intensive care unit(ICU) admission rate,length of hospital stay(LOHS) and 30-d readmission rate.RESULTS Taking 24 h as the critical value,compared with ERCP>24 h,malignant biliary obstruction as a cause of AC was significantly less common in the ERCP ≤ 24 h group(5.2% vs 11.5%).The proportion of cardiovascular dysfunction(11.2% vs 2.6%),respiratory dysfunction(14.2% vs 5.3%),and ICU admission(11.2% vs 4%)in the ERCP ≤ 24 h group was significantly higher,while the LOHS was significantly shorter(median,6 d vs 7 d).Stratified by the severity of AC,higher ICU admission was only observed in grade Ⅲ AC and shorter LOHS was only observed in grade Ⅰ and Ⅱ AC.There were no significant differences in 30-d mortality between groups,either in the overall population or in patients with grade Ⅰ,Ⅱ or Ⅲ AC.With 48 h as the critical value,compared with ERCP>48 h,the proportion of choledocholithiasis as the cause of AC was significantly higher in the ERCP ≤ 48 h group(81.5% vs 68.3%).The ERCP ≤ 48 h group had significantly lower 30-d mortality(0 vs 1.9%) and shorter LOHS(6 d vs 8 d).Stratified by AC severity,lower 30-d mortality(0 vs 6.1%) and higher ICU admission rates(22.2% vs 10.2%) were only observed in grade Ⅲ AC,and shorter LOHS was only observed in grade I and Ⅱ AC.In the multivariate analysis,cardiovascular dysfunction and time to ERCP were two

关键词： Acute cholangitis Endoscopic retrograde cholangiopancreatography severity timing Thirtyday mortality Length of hospital stay

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timing of surgical operation for patients with intra-abdominal infection:A systematic review and meta-analysis

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World Journal of Gastrointestinal Surgery 2023年第10期15卷 2320-2330页

作者： Shu-Rui Song Yang-Yang Liu Yu-Ting Guan Ruo-Jing Li Lei Song Jing Dong Pei-Ge Wang Department of Emergency Surgery The Affiliated Hospital of Qingdao UniversityQingdao 266000Shandong ProvinceChina Medical Complex Building Qingdao UniversityQingdao 266071Shandong ProvinceChina

BACKGROUND Intra-abdominal infections(IAIs)is the most common type of surgical infection,with high associated morbidity and mortality rates.In recent years,due to the use of antibiotics,various drug-resistant bacteria have emerged,making the treatment of abdominal infections more challenging.Early surgical exploration can reduce the mortality of patients with abdominal infection and the occurrence of complications.However,available evidence regarding the optimal timing of IAI surgery is still weak.In study,we compared the effects of operation time on patients with abdominal cavity infection and tried to confirm the best timing of surgery.AIM To assess the efficacy of early vs delayed surgical exploration in the treatment of IAI,in terms of overall mortality.METHODS A systematic literature search was performed using PubMed,EMBASE,Cochrane Central Register of Controlled Trials,Ovid,and ScienceDirect.The systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses method.Based on the timing of the surgical operation,we divided the literature into two groups:Early surgery and delayed surgery.For the early and delayed surgery groups,the intervention was performed with and after 12 h of the initial surgical intervention,respectively.The main outcome measure was the mortality rate.The literature search was performed from May 5 to 20,2021.We also searched the World Health Organization International Clinical Trials Registry Platform search portal and ClinicalTrials.gov on May 20,2021,for ongoing trials.This study was registered with the International Prospective Register of Systematic Reviews.RESULTS We identified nine eligible trial comparisons.Early surgical exploration of patients with IAIs(performed within 12 h)has significantly reduced the mortality and complications of patients,improved the survival rate,and shortened the hospital stay.CONCLUSION Early surgical exploration within 12 h may be more effective for the treatment of IAIs relative to a delayed operation.

关键词： Intra-abdominal infection Surgical exploration timing Infection Surgical operation Systematic review Metaanalysis

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Surgery for Crohn’s disease:upfront or last resort?

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Gastroenterology Report 2022年第1期10卷 188-194页

作者： U.Ahmed Ali Ravi P.Kiran Division of Colorectal Surgery New York–Presbyterian/Columbia University Medical CenterNew YorkUSA

Crohn’s disease(CD)can involve the entire gastrointestinal tract from the mouth to the anus and can lead to a constellation of symptoms.With the advancement of effective medical treatments for CD,a tendency has emerged to consider surgical treatment as a last resort.This potentially has the disadvantage of delaying surgery and if it fails might leave patients sicker,less well nourished,and with more severe complications.As with most non-malignant diseases,the choice of surgery vs medical treatment is a patient’s personal preference under the guidance of the treating physician,except in extreme situations where surgery might be the only option.In this article,we will discuss the available evidence regarding the optimal timing of surgery in CD,focusing on whether early surgery can bring benefits in terms of disease control,symptom relief,and quality of life.

关键词： surgery timing Crohn’s disease outcome

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timing of surgery after neoadjuvant chemotherapy for gastric cancer: Impact on outcomes

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World Journal of Gastroenterology 2018年第2期24卷 257-265页

作者： Yi Liu Ke-cheng Zhang Xiao-hui huang hong-qing Xi Yun-he Gao Wen-quan Liang Xin-Xin Wang Lin chen Department of General Surgery & Institute of General Surgery Chinese People's Liberation Army General Hospital

AIM To evaluate whether the neoadjuvant chemotherapy(NAc T)-surgery interval time significantly impacts the pathological complete response(pc R) rate and longterm survival.METHODS One hundred and seventy-six patients with gastric cancer undergoing NAc T and a planned gastrectomy at the chinese p LA General hospital were selected from January 2011 to January 2017. Univariate and multivariable analyses were used to investigate the impact of NAc T-surgery interval time( 6 wk) on pc R rate and overall survival(OS).RESULTS The NAc T-surgery interval time and clinician T stage were independent predictors of pc R. The interval time > 6 wk was associated with a 74% higher odds of pc R as compared with an interval time of 4-6 wk(p = 0.044), while the odds ratio(OR) of clinical T3 vs clinical T4 stage for pc R was 2.90(95%c I: 1.04-8.01, p = 0.041). In cox regression analysis of long-term survival, postneoadjuvant therapy pathological N(yp N) stage significantly impacted OS(N0 vs N3: h R = 0.16, 95%c I: 0.37-0.70, p = 0.015; N1 vs N3: h R = 0.14, 95%c I: 0.02-0.81, p = 0.029) and disease-free survival(DFS)(N0 vs N3: h R = 0.11, 95%c I: 0.24-0.52, p = 0.005; N1 vs N3: h R = 0.17, 95%c I: 0.02-0.71, p = 0.020). The surgical procedure also had a positive impact on OS and DFS. The hazard ratio of distal gastrectomy vs total gastrectomy was 0.12(95%c I: 0.33-0.42, p = 0.001) for OS, and 0.13(95%c I: 0.36-0.44, p = 0.001) for DFS.CONCLUSION The NAc T-surgery interval time is associated with pc R but has no impact on survival, and an interval time > 6 wk has a relatively high odds of pc R.

关键词： Gastric cancer timing of surgery Neoadjuvant chemotherapy

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timing of convalescent plasma therapy-tips from curing a 100-yearold COVID-19 patient using convalescent plasma treatment: A case report

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World Journal of Clinical Cases 2021年第12期9卷 2890-2898页

作者： Bo Liu Kang-Kang Ren Nian Wang Xin-Ping Xu Jue Wu Department of Laboratory Hospital No.967 of PLADalian 116000Liaoning ProvinceChina Department of Laboratory Guanggu Branch of Hubei Maternal and Child Health HospitalWuhan 430073Hubei ProvinceChina Gaoxin Hospital The First Affiliated Hospital of Nanchang UniversityNanchang 330006Jiangxi ProvinceChina GrandOmics Diagnostics Co. LtdWuhan 430073Hubei ProvinceChina Translational Medicine Research Center Medical Innovation Research Division of Chinese PLA General HospitalBeijing 100853China

BACKGROUND Convalescent plasma therapy is used for the treatment of critically ill patients for newly discovered infectious diseases,such as coronavirus disease 2019(COVID-19)pneumonia,under the premise of lacking specific treatment drugs and corresponding vaccines.But the best timing application of plasma therapy and whether it is effective by antiviral and antibiotic treatment remain unclear.CASE SUMMARY We describe a patient with COVID-19,a 100-year-old,high-risk,elderly male who had multiple underlying diseases such as stage 2 hypertension(very high-risk group)and infectious pneumonia accompanied by chronic obstructive pulmonary disease and emphysema.We mainly describe the diagnosis,clinical process,and treatment of the patient,including the processes of two plasma transfusion treatments.CONCLUSION This provides a reference for choosing the best timing of convalescent plasma treatment and highlights the effectiveness of the clinical strategy of plasma treatment in the recovery period of patients with COVID-19 pneumonia.

关键词： COVID-19 Convalescent plasma therapy Treatment Elderly timing Case report

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Conserved Spatiotemporal Dynamics with Millisecond Precision During Reverberatory Activity in a Self-organized Neuronal

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Neuroscience Bulletin 2023年第5期39卷 808-812页

作者： Dong-Qing Shi Fang Xu Guo-Qiang Bi Pak-Ming Lau Division of Life Sciences and Medicine University of Science and Technology of ChinaHefei 230026China Interdisciplinary Center for Brain Information The BrainCognition and Brain Disease InstituteShenzhen Institute of Advanced TechnologyChinese Academy of SciencesShenzhen 518055China

Dear Editor,The timing of spiking activity across neurons is believed to play an important role in information coding in brain circuits1[1].At the cellular level,neurons can fire spikes with millisecond precision and the relative timing of pre-and postsynaptic spikes can determine the direction and extent of synaptic modification[2].When such spike-timing-dependent plasticity(STDP)and other physiological and anatomical properties are implemented in theoretical models,the simulated networks of interconnected spiking neurons exhibit neuronal groups with stereotypical time-locked spatiotemporal firing patterns with millisecond temporal precision[3].

关键词： second organized timing

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Determinants of timing and amplitude in the plant general stress response

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Journal of Integrative Plant Biology 2016年第2期58卷 119-126页

作者： Marta Bjornson Abhaya Dandekar Katayoon Dehesh Department of Plant Sciences University of California Department of Plant Biology University of California

Plants have evolved intricate signaling cascades to rapidly and effectively respond to biotic and abiotic challenges. The precise timing of these responses enables optimal resource reallocation to maintain the balance between stress adaptation and growth. Thus, an in-depth understanding of the immediate and long-term mechanisms regulating resource allocation is critical in deciphering how plants withstand environmental challenges. To date however, understanding of this tradeoff has focused on the amplitude of long-term responses, rather than the timing of rapid stress responses. This review presents current knowledge on kinetics of secondary messengers involved in regulation of rapid and general stress responses, followed by rapid stress responsive transduction machinery, and finally the transcriptional response of a functional general stress responsive cis-element. Within this context we discuss the role of timing of initial peak activation and later oscillating peak responses, and explore hormonal and stress signaling crosstalk confounding greater understanding of these cascades.

关键词： Calcium general stress response mitogen-activated protein kinase rapid stress response element reactive oxygen species nitric oxide timing

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Regulation of the timing of oligodendrocyte differentiation:mechanisms and perspectives

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Neuroscience Bulletin 2013年第2期29卷 155-164页

作者： Hao Huang Xiao-Feng Zhao Kang Zheng Mengsheng Qiu Institute of Developmental and Regenerative Biology College of Life SciencesHangzhou Normal University Department of Anatomical Sciences and Neurobiology University of Louisville

Axonal myelination is an essential process for normal functioning of the vertebrate central nervous system. Proper formation of myelin sheaths around axons depends on the timely differentiation of oligodendrocytes. This differentiation occurs on a predictable schedule both in culture and during development. However, the timing mechanisms for oligodendrocyte differentiation during normal development have not been fully uncovered. Recent studies have identified a large number of regulatory factors, including cell-intrinsic factors and extracel- lular signals, that could control the timing of oligodendrocyte differentiation. Here we provide a mechanistic and critical review of the timing control of oligodendrocyte differentiation.

关键词： oligodendrocytes differentiation timing remyelination

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