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Laparoscopic lysis of duodenum for superior mesenteric artery syndrome： how and why we do it？

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Chinese Medical Journal 2010年第15期123卷 2148-2150页

作者： WU Qing-hua WANG Ming-liang ZANG Lu ZHANG Tao ZHENG Min-hua Shanghai minimally invasive Surgery Center Rui Jin HospitalShanghai Jiao Tong University School of Medicine Shanghai 200023China

Superior mesenteric artery syndrome （SMAS） is a rare etiology of duodenal obstruction resulting from the compression of the third part of the duodenum between the superior mesenteric artery and the aorta. The typica... 详细信息

关键词： superior mesenteric artery syndrome laparoscopy operation duodenum

Safety of high-carbohydrate fluid diet 2 h versus overnight fasting before non-emergency endoscopic retrograde cholangiopancreatography: A single-blind, multicenter, randomized controlled trial

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中华医学杂志(英文版) 2024年第12期137卷 2023 Aug 24页

作者： Meng Wenbo Leung Joseph W. Wang Zhenyu Li Qiyong Zhang Leida Zhang Kai Wang Xuefeng Wang Meng Wang Qi Shao Yingmei Zhang Jijun Yue Ping Zhang Lei Zhu Kexiang Zhu Xiaoliang Zhang Hui Hou Senlin Cai Kailin Sun Hao Xue Ping Liu Wei Wang Haiping Zhang Li Ding Songming Yang Zhiqing Zhang Ming Weng Hao Wu Qingyuan Chen Bendong Jiang Tiemin Wang Yingkai Zhang Lichao Wu Ke Yang Xue Wen Zilong Liu Chun Miao Long Wang Zhengfeng Li Jiajia Yan Xiaowen Wang Fangzhao Zhang Lingen Bai Mingzhen Mi Ningning Zhang Xianzhuo Zhou Wence Yuan Jinqiu Suzuki Azumi Tanaka Kiyohito Liu Jiankang Nur Ula Weiderpass Elisabete Li Xun Department of Hepatobiliary Surgery The General Hospital of Ningxia Medical University Yinchuan Ningxia China Department of Hepatobiliary & Hydatid Digestive and Vascular Surgery Center Xinjiang Key Laboratory of Echinococcosis and Liver Surgery Research The First Affiliated Hospital of Xinjiang Medical University Urumqi Xinjiang China Department of Hepatobiliary and Pancreatic Surgery The First Hospital of Shanxi Medical University Taiyuan Shanxi China Department of General Surgery The Second Hospital of Lanzhou University Lanzhou Gansu China Department of Biliopancreatic Endoscopic Surgery The Second Hospital of Hebei Medical University Shijiazhuang Hebei China Gastrointestinal Surgery Department Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei China Department of Hepatobiliary Surgery The First Affiliated Hospital of Xi’an Jiaotong University Xi’an Shaanxi China Department of Hepatobiliary Surgery the Second Affiliated Hospital of Guangzhou Medical University Guangzhou Guangdong China division of Biliopancreatic Surgery Department of General Surgery Second Xiangya Hospital Central South University Changsha Hunan China Department of General Surgery The First Hospital of Lanzhou University Lanzhou Gansu China The First Clinical Medical College of Lanzhou University Lanzhou Gansu China Clinical Research Centre Scientific Research Centre The Seventh Affiliated Hospital Sun Yat-sen University Shenzhen Guangdong China Department of Gastroenterology Hamamatsu Medical Center Hamamatsu Japan Department of Gastroenterology Kyoto Second Red Cross Hospital Kyoto Japan Cardiovascular division Brigham and Women’s Hospital Harvard Medical School Boston MA USA Department of Public Health College of Health Sciences Qatar University Doha Qatar International Agency for Research on Cancer (IARC) Lyon France. Key Laboratory of Biological Therapy and Regenerative Medicine Transformation Gansu Province Lanzhou G

Background: Although overnight fasting is recommended prior to endoscopic retrograde cholangiopancreatography (ERCP), the benefits and safety of high-carbohydrate fluid diet (CFD) intake 2 h before ERCP remain unclear. This study aimed to analyze whether high-CFD intake 2 h before ERCP can be safe and accelerate patients’ recovery.Methods: This prospective, multicenter, randomized controlled trial involved 15 tertiary ERCP centers. A total of 1330 patients were randomized into CFD group (n = 665) and fasting group (n = 665). The CFD group received 400 mL of maltodextrin orally 2 h before ERCP, while the control group abstained from food/water overnight (>6 h) before ERCP. All ERCP procedures were performed using deep sedation with intravenous propofol. The investigators were blinded but not the patients. The primary outcomes included postoperative fatigue and abdominal pain score, and the secondary outcomes included complications and changes in metabolic indicators. The outcomes were analyzed according to a modified intention-to-treat principle.Results: The post-ERCP fatigue scores were significantly lower at 4 h (4.1 ± 2.6vs. 4.8 ± 2.8,t = 4.23,P <0.001) and 20 h (2.4 ± 2.1vs. 3.4 ± 2.4,t= 7.94,P <0.001) in the CFD group, with least-squares mean differences of 0.48 (95% confidence interval [CI]: 0.26–0.71,P <0.001) and 0.76 (95% CI: 0.57–0.95,P <0.001), respectively. The 4-h pain scores (2.1 ± 1.7vs. 2.2 ± 1.7,t = 2.60,P = 0.009, with a least-squares mean difference of 0.21 [95% CI: 0.05–0.37]) and positive urine ketone levels (7.7% [39/509]vs. 15.4% [82/533],χ2 = 15.13,P <0.001) were lower in the CFD group. The CFD group had significantly less cholangitis (2.1% [13/634]vs. 4.0% [26/658],χ2 = 3.99,P = 0.046) but not pancreatitis (5.5% [35/634]vs. 6.5% [43/658],χ2 = 0.59,P = 0.444). Subgroup analysis revealed that CFD reduced the incidence of complications in patients with native papilla (odds ratio [OR]: 0.61, 95% CI: 0.39–0.95,P = 0.028) in the multivariable models.Conclusion: Ingesting 400 mL of CFD 2 h before

关键词： Endoscopic retrograde cholangiopancreatography ERCP Carbohydrate Fasting Safety Complications Enhanced recovery after surgery Randomized controlled trial

Association of matrix metalloproteinase-9 C1562T polymorphism and coronary artery disease： a meta-analysis

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2014年第3期15卷 256-263页

作者： Xiao WANG Lei-zhi SHI Department of Emergency Zhejiang Hospital Hangzhou 310013 China Department of Thoracic minimally invasive Surgery Linyi People's Hospital Linyi 276000 China

OBJECTIVE:Many investigations have studied the associations between matrix metalloproteinase-9 (MMP-9) C1562T polymorphisms and coronary artery disease (CAD). However, the conclusions of these studies were inconsistent. Therefore, this study was aimed at clarifying the association between MMP-9 C1562T polymorphisms and CAD in a large-scale meta-analysis.;METHODS:The PubMed and Embase databases were retrieved to collect all publications on the association between MMP-9 C1562T polymorphisms and CAD. Then the odd ratios (ORs) and 95% confidence intervals (95% CIs) for C1562T TT+TC versus CC genotype between CAD and the control groups were evaluated. Subgroup analysis was also performed according to different races. The meta-analysis was performed by Stata 10.0.;RESULTS:Sixteen case-control studies were included in our meta-analysis, involving 11032 CAD patients and 4628 non-CAD controls. Compared with C allele carriers, East Asian T allele carriers TT+TC had a significantly higher risk of CAD (OR=1.43; 95% CI: 1.03-1.99; P=0.031); however, there were no significant associations in Western populations (OR=1.06; 95% CI: 0.96-1.18; P=0.240) or West Asians (OR=1.13; 95% CI: 0.75-1.70; P=0.565). When further analyzing the association between C1562T polymorphisms and myocardial infarction (MI, the most serious type of CAD), the risk of TT+TC genotype versus CC genotype for MI was significantly higher for the overall (OR=1.21; 95% CI: 1.04-1.40; P=0.012) and for East Asians (OR=1.58; 95% CI: 1.26-1.97; P=0.000) but not in Western populations (OR=1.12; 95% CI: 0.99-1.26; P=0.078).;CONCLUSIONS:Our meta-analysis suggested an obvious ethnic difference in the association between MMP-9 C1562T polymorphisms and CAD. MMP-9 C1562T polymorphism was significantly related to CAD in East Asians. However, no significant associations were observed in either West Asians or Western populations.

关键词： Coronary artery disease Matrix metalloproteinase-9 Polymorphism Meta-analysis R541.4

Effectiveness of bee venom acupuncture for patients suffering from periarthritis humeroscapularis

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中医杂志:英文版 2023年第4期43卷 795-800页

作者： Minh Duc Nguyen Thanh Van Tran Quoc Vinh Nguyen Cay Doan Ha Linh Vu Phuong Dang Senior Specialist Clinic National Hospital of AcupunctureHanoi 1000Vietnam Department of Senior Specialist National Hospital of Acupuncture Hanoi 1000Vietnam Department of Senior Specialist Military Institute of Traditional MedicineHanoi 1000Vietnam Department of minimally invasive spine National Hospital of AcupunctureHanoi 1000Vietnam Department of Medicine Dai Nam UniversityHanoi 1000Vietnam

OBJECTIVE:To evaluate the efficacy of bee venom acupuncture in humeroscapularis(PHS)patients.METHODS:One hundred and twenty patients diagnosed with PHS were assigned into four groups:BV1(0.01 mg/kg),BV2(0.005 mg/kg),BV3(0.0025 mg/kg),and control group(vitamin B1 plus novocain 3%injection)with 15 d of treatment.The outcomes of the study including visual analogue scale(VAS)score andβ-endorphin,inflammatory cytokines including interleukin-10(IL-10),IL-1βand tumor necrosis factorα(TNF-α)and shoulder function score were assessed at baseline,after 10 and 15 d of treatment.RESULTS:All four groups reported statistically significant improvement in VAS score,motion range,and shoulder function score(P<0.01),only the BV3 group showed significant increase of anti-inflammatory(IL-10)and decrease of pro-inflammatory(IL-1β,TNF-α)cytokines after treatment(P<0.05).The BV3 group presented a significant difference between all outcomes compared to the control and other groups.CONCLUSION:BV3 groups showed better recovery including reduced pain,improved motor function and normalized inflammatory cytokines than current therapy used in Vietnam and other groups.

关键词： periarthritis humeroscapularis bee venom acupuncture visual analogue scale range of motion articular shoulder function score inflammatory cytokines

Effects of seasonal changes on T-helper 1/T-helper 2 immune balance and eczema onset in rats

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Journal of Traditional Chinese Medical Sciences 2023年第1期10卷 64-72页

作者： Hairong Zhang Leilei Liu Yike Sun Wenna Li Ruochong Wang Xiao Sun Guangqin Zhu Shuran Ma School of Traditional Chinese Medicine Beijing University of Chinese MedicineBeijing 102488China Department of Acupuncture and minimally invasive Oncology Beijing University of Chinese Medicine Third Affiliated HospitalBeijing 100029China

Objective: To explore the impact of seasonal changes on the T-helper 1(Th1)/T-helper 2(Th2) immune balance of the body in order to elucidate the internal immunological mechanisms underlying seasonal eczema.Methods: Eighty 4-week-old male Sprague-Dawley rats were divided into 5 season groups kept in corresponding season simulation environments, and subdivided into the model group and the control group. The Eczema Area and Severity Index(EASI) and scratching frequency were evaluated. The serum levels of immunoglobulin E(IgE), interleukin-2(IL-2), interleukin-12(IL-12), and interferon-gamma(IFN-γ), interleukin-4(IL-4), interleukin-25(IL-25), and interleukin-31(IL-31), and melatonin(MT), as well as the MT receptor(MTR) levels in the spleen, were detected by enzyme-linked immunosorbent assay analysis. The mRNA expression levels of T-bet and GATA3 were detected by quantitative real-time polymerase chain reaction.Results: EASI scores and the scratching frequency of the model group were higher in the long summer than in the other 4 seasons. Meanwhile, the serum levels of IgE and the Th2 cytokines IL-4, IL-25, and IL-31, as well as GATA3 mRNA expression levels, were high during the long summer in both groups. However, the serum levels of the Th1 cytokines IL-2, IL-12, and IFN-γ, as well as MT, MTR, and T-bet mRNA levels, were lower during the long summer. In all 5 seasonal groups(spring, summer, long summer, autumn, and winter), the levels of all immune factors, especially IL-4 and IL-31, were higher in the model group than those in the control group,while the concentrations of MT and MTR were lower.Conclusion: Under long light, hot, and humid conditions in the long summer, the body is more likely to suffer from Th2-dominated immune imbalance. This is the internal mechanism behind the high incidence and severity of eczema during the long summer. MT and MTR play a key role in the seasonal onset of eczema.

关键词： Eczema Seasonality Long summer Immunization Th1/Th2 Melatonin Immunoglobulin E

An injectable curcumin-releasing organohydrogel with non-drying property and high mechanical stability at low-temperature for expe dite d skin wound care

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Journal of Materials Science & Technology 2023年第2期133卷 123-134页

作者： Kang Wu Qiang Yang Lin Zhang Pengcheng Xu Xiexing Wu Huilin Yang Huan Zhou Xiao Lin Lei Yang College of Chemistry Chemical Engineering and Materials ScienceOrthopaedic InstituteDepartment of Orthopaedic SurgeryThe First Affiliated HospitalSoochow UniversitySuzhou 215031China Center for Health Sciences and Engineering(CHSE) School of Health Sciences and Biomedical EngineeringHebei University of TechnologyTianjin 300130China Department of minimally invasive Spine Surgery Tianjin HospitalTianjin 300211China

Although hydrogels have demonstrated great potential as new wound dressing materials,their instability in shape and/or mechanical characteristics due to water loss or freezing remains a shortcoming for wound care application.Herein,a novel injectable organohydrogel(IOH)of physically crosslinked polyvinyl alco-hol/glycerol that possesses non-drying capability and high stability at low temperature was developed for wound care.IOH has a skin-like stiffness(G’,∼280 Pa),high injectability,self-healing capability,high water-vapor transmission rate,and bacterial inhibitory effect.IOH exhibits high shape and mechanical stabilities after curing at 37°C and 50%relative humidity for 7 days or after curing at-20°C for 1 day.In addition,glycerol in IOH enabled an efficient loading and release of water-insoluble curcumin,a well-known anti-bacterial and anti-inflammation drug.The curcumin-releasing IOH(Cur-IOH)demonstrated significantly enhanced anti-bacterial performance compared to IOH or curcumin-loading polyvinyl alco-hol hydrogel.More importantly,Cur-IOH could accelerate wound healing in a murine full-thickness skin defect wound model,revealing improved wound contraction,collagen deposition,angiogenesis,and epi-dermis formation.This study demonstrates the great potential of organohydrogel for the reparation of severe wounds and Cur-IOH as a new type of injectable wound healing material.

关键词： Wound dressing Organohydrogel Non-drying Stability Curcumin

Impact of pre- and peri-operative risk factors on length of stay and hospital readmission following minimally-invasive partial nephrectomy

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Asian Journal of Urology 2024年第1期11卷 72-79页

作者： Vanessa A.Lukas Rahul Dutta Ashok K.Hemal Matvey Tsivian Timothy E.Craven Nicholas A.Deebel David D.Thiel Ram Anil Pathak Brigham and Women's Hospital Division of UrologyDepartment of Surgery75 Francis StreetBostonMAUSA Atrium Health Wake Forest Baptist Medical Center Department of Urology1 Medical Center BlvdWinston-SalemNCUSA Mayo Clinic Florida Department of Urology4500 San Pablo RoadJacksonvilleFLUSA

Objective:We conducted an analysis of the American College of Surgeons National Surgical Quality Improvement Program database for minimally-invasive partial nephrectomy cases reported with the goal to identify pre-and peri-operative variables associated with length of stay(LOS)greater than 3 days and readmission within 30 days.Methods:Records from 2008 to 2018 for“laparoscopy,surgical;partial nephrectomy”for prolonged LOS and readmission cohorts were compiled.Univariate analysis with Chi-square,t-tests,and multivariable logistic regression analysis with odds ratios(ORs),p-values,and 95%confidence intervals assessed statistical associations.Results:Totally,20306 records for LOS greater than 3 days and 15854 for readmission within 30 days were available.Univariate and multivariable analysis exhibited similar results.For LOS greater than 3 days,undergoing non-elective surgery(OR=5.247),transfusion of greater than four units within 72 h prior to surgery(OR=5.072),pre-operative renal failure or dialysis(OR=2.941),and poor pre-operative functional status(OR=2.540)exhibited the strongest statistically significant associations.For hospital readmission within 30 days,loss in body weight greater than 10%in 6 months prior to surgery(OR=2.227)and bleeding disorders(OR=2.081)exhibited strongest statistically significant associations.Conclusion:Multiple pre-and peri-operative risk factors are independently associated with prolonged LOS and hospital readmission within 30 days of surgery using the American College of Surgeons National Surgical Quality Improvement Program data.Recognizing the risks factors that can potentially be improved prior to minimally-invasive partial nephrectomy is crucial to informing patient selection,optimization strategies,and patient education.

关键词： minimally-invasive partial nephrectomy The American College of Surgeons National Surgical Quality Improvement Program Lengthof stay Hospital readmission

Laparoscopic hepatectomy by curettage and aspiration:a new technique

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Chinese Medical Journal 2007年第20期120卷 1773-1776页

作者： CAI Xiu-jun LIANG Xiao WANG Yi-fan YU Hong ZHENG Xue-yong HUANG Di-yu PENG Shu-you Department of General Surgery,Sir Run Run Shaw Hospital,College of Medicine Institute of minimally invasive Surgery of Zhejiang University,Hangzhou 310016,China (Cai XJ,Liang X,Wang YF,Yu H,Zheng XY,Huang DY and Peng SY) Department of General Surgery Sir Run Run Shaw HospitalCollege of MedicineInstitute of Minimally Invasive Surgery of Zhejiang University Hangzhou 310016 China）

Background Laparoscopic surgery is advantageous for minimal invasiveness and rapid postoperative recovery. Since the use of laparoscopic hepatectomy in liver resection in the 1990s, it has been performed in a few institutions worldwide, Lack of efficient and safe techniques for liver transaction is the major obstacle preventing from its further development, We developed a new technique for laparoscopic hepatectomy by curettage and aspiration in 1998. In this paper we analyze the clinical outcomes of this technique after 7 years of practice.Methods Altogether 59 consecutive patients underwent laparoscopic hepatectomy by curettage and aspiration from August 1998 to January 2005 at our institution. These patients included 33 males and 26 females, with a mean age of 47 years. For liver transecsion laparoscopic Peng＇s multifunctional operative dissector （LPMOD） was used. Lesions included malignant liver tumors in 19 patients, benign liver tumors in 17, intrahepatic calculus in 18, and other liver lesions in 5. Procedures included local resections in 30 patients, left lateral segmentectomy in 28, and right hemihepatectomy in 1.Results Laparoscopic operation was completed in 57 patients. Two patients （3.4%） had the operation converted to laparotomy. The mean operating time was 143 minutes and the mean intraoperative blood loss was 456 ml. The mean length of postoperative hospital stay was 7 days. Complications occurred in 2 patients （3.4%）, and there was no pedoperative death.Conclusion Laparoscopic hepatectomy by curettage and aspiration is efficient and safe for liver resection.

关键词： laparoscopic liver resection hepatectomy Peng＇s multifunctional operative dissector curettage and aspiration

Eight-year follow-up on postoperative improvement protocol in extensive metoidioplasty transgenders:A case series

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中国整形与重建外科(英文) 2023年第3期5卷 115-119页

作者： Shahryar Cohanzad Pars Advanced and minimally invasive Medical Manners Research Center Pars HospitalIran University of Medical SciencesRastak St.Shahid Abdollahzade Ave.Keshavarz Blvd.Tehran ***Iran

Background:This study aimed to evaluate the long-term penile size among patients who underwent extensive metoidioplasty.Methods:An evaluation was conducted on 7 out of 14 patients(mean age:29.71±13.76 years)who participated in a 2015 study that introduced a postoperative protocol to improve penile size after extensive metoidioplasty.Five transsexual females(46XX karyotype)and two patients with 5-alpha reductase deficiency were retrospectively followed up in 2023 to assess the long-term efficacy of the protocol at a specialized clinic in a general hospital in Tehran,Iran.All participants were informed about the study and consented to participate.Results:Five patients achieved increased penile size from their 2015 measurements(mean,29.00±13.34 mm).Five patients requested a larger sized penile traction device to continue the protocol.Conclusion:The long-term implementation of this protocol can result in increased penile size.We advise highly motivated patients to continue practicing the protocol to achieve better results.

关键词： Gender identity disorder Metoidioplasty Sex reassignment surgeries Transsexualism Penile extender Penile traction device