BACKGROUND: Post-pancreaticoduodenectomy pancreatic fistula associated hemorrhage (PPFH) is one of the leading lethal complications. Our study was to analyze the risk factors and managements of hemorrhage associated w...BACKGROUND: Post-pancreaticoduodenectomy pancreatic fistula associated hemorrhage (PPFH) is one of the leading lethal complications. Our study was to analyze the risk factors and managements of hemorrhage associated with pancreatic fistula after pancreaticoduodenectomy, and to evaluate treatment options. METHOD: We analyzed 445 patients who underwent pancreaticoduodenectomy or pylorus-preserving pancreaticoduodenectomy and evaluated the relevance between clinical data and PPFH. RESULTS: The incidence of postoperative pancreatic fistula (POPF) was 27.42% (122/445), and the incidence of PPFH was 4.49% (20/445). Among the 20 patients with PPFH, 7 died and 13 were cured. Interventional angiographic therapy was performed for 10 patients and 5 were successfully treated. Relaparotomy was performed for 5 patients and 2 were successfully cured. Univariate logistic regression analysis indicated that several risk factors were related to PPFH: the nature of tumor (carcinoid/low-grade or high-grade malignancy), preoperative day 1. serum prealbumin, preoperative day 1 total bilirubin (TBIL), operative time, blood loss in the operation, operative method (vascular resection and revascularization), postoperative day 3 TBIL, biliary fistula, and the grade of POPF. The multivariate stepwise logistic regression analysis demonstrated that the nature of tumor and the grade of POPF were independently risk factors of PPFH. Receiver operating characteristic curve indicated that preoperative day 1 serum prealbumin level <173 mg/L and postoperative day 3 TBIL level.1.68.tmol/L were the risk factors of PPFH. CONCLUSIONS; The risk of PPFH was found to be increased with high potential malignancy and high grade of POPE Angiography-embolization is one of the major and effective therapies for PPFH. Extraluminal-intraluminal PPFH is more serious and needs more aggressive treatments.展开更多
Background The transseptal puncture technique has been widely used in therapeutic left atrium catheterization. But this technique may lead to some life-threatening complications. It can not be used widely because it i...Background The transseptal puncture technique has been widely used in therapeutic left atrium catheterization. But this technique may lead to some life-threatening complications. It can not be used widely because it is restricted by economy and deferring the transseptal puncture procedure. The aim of this study was to introduce a simple and safe transseptal puncture procedure. Methods The distal of coronary sinus （CS） electrode was positioned close to the lateral margin of heart, which was about at 3 o＇clock at left anterior oblique （LAO） 30° referred to whole cardiac profile. It was then used as the marker for the level of fossa ovalis at posterior-anterior projection to guide the pull of transseptal needle. The midpoint between the distal CS and the posterior margin of heart at right anterior oblique （RAO） 45° view was considered as the location of fossa ovalis. Once the puncture was succeeded, the guidewire was introduced to the left superior pulmonary vein via puncture sheath after the needle was retrieved. The end of outer sheath was introduced into left atrium with the protection of guidewire. It was applied in 539 patients （316 male, 223 female; （53±16） years old） who underwent catheter ablation of atrial fibrillation or left-sided atrioventricular accessory pathway. Results This transseptal approach reached 100.0% success and was succeeded in 98.9% with the first attempt. The first attempt puncture was aborted due to greater patients. However, the second attempts were all tamponade and embolism occurred. Conclusion The atrial septum puncture approach guidewire for protection when sending outer sheath resistance to needle advancement or smaller needle curve in six succeeded after the needle curve was reshaped. There was no using the location of distal CS electrode as important marker and the into left atrium is reliable and safe.展开更多
Litter uniformity, which is usually represented by within-litter weight coefficient of variation at birth （CVB）, could influence litter performance of sows and the profitability of pig enterprises. The objective of ...Litter uniformity, which is usually represented by within-litter weight coefficient of variation at birth （CVB）, could influence litter performance of sows and the profitability of pig enterprises. The objective of this study was to characterize CVB and its effect on other reproductive traits in Large White sows. Genetic parameters and genetic correlation of the reproductive traits, including CVB, within-litter weight coefficient of variation at three weeks （CVT）, total number born （TNB）, number born alive （NBA）, number born dead （NBD）, gestation length （GL）, piglet mortality at birth （Mo）, piglet mortality at three weeks （M3）, total litter weight at birth （TLW0）, and total litter weight at three weeks （TLW3） were estimated for 2 032 Large White litters. The effects of parity and classified litter size on CVB, CVT, TNB, NBA, NBD, GL, M0, M3, TLW0, and TLW3 were also estimated. The heritabilities of these reproductive traits ranged from 0.06 to 0.17, with the lowest heritability for CVB and the highest heritability for TLW0. Phenotypic and genetic correlations between these reproductive traits were low to highly positive and negative （ranging from -0.03 to 0.93, and -0.53 to 0.93, respectively）. The genetic correlations between TNB and CVB, and between M0 and CVB were 0.32 and 0.29, respectively. In addition, CVB was significantly influenced by parity and litter size class （P〈0.05）. All the results suggest that piglet uniformity should be maintained in pig production practices and pig breeding programs.展开更多
Selenium（Se） is commonly recognized as a protective element with an antagonistic effect against mercury（Hg） toxicity. However, the mechanisms of this Hg–Se antagonism are complex and remain controversial. To gain...Selenium（Se） is commonly recognized as a protective element with an antagonistic effect against mercury（Hg） toxicity. However, the mechanisms of this Hg–Se antagonism are complex and remain controversial. To gain insight into the Hg–Se antagonism, a type of unicellular eukaryotic protozoa（Tetrahymena malaccensis, T. malaccensis） was selected and individually or jointly exposed to two Hg and three Se species. We found that Se species showed different toxic effects on the proliferation of T. malaccensis with the toxicity following the order：selenite（Se（IV）） 〉 selenomethionine（SeMeth） 〉 selenate（Se（VI））. The Hg–Se antagonism in Tetrahymena was observed because the joint toxicity significantly decreased under co-exposure to highly toxic dosages of Hg and Se versus individual toxicity. Unlike Se（IV） and Se（VI）, non-toxic dosage of SeM eth significantly decreased the Hg toxicity, revealing the influence of the Se species and dosages on the Hg–Se antagonism. Unexpectedly, inorganic divalent Hg（Hg2＋） and monomethylmercury（MeHg） also displayed detoxification towards extremely highly toxic dosages of Se, although their detoxifying efficiency was discrepant. These results suggested mutual Hg–Se detoxification in T. malaccensis, which was highly dependent on the dosages and species of both elements. As compared to other species, SeM eth and MeHg promoted the Hg–Se joint effects to a higher degree. Additionally, the Hg contents decreased for all the Hg–Se co-exposed groups, revealing a sequestering effect of Se towards Hg in T. malaccensis.展开更多
文摘BACKGROUND: Post-pancreaticoduodenectomy pancreatic fistula associated hemorrhage (PPFH) is one of the leading lethal complications. Our study was to analyze the risk factors and managements of hemorrhage associated with pancreatic fistula after pancreaticoduodenectomy, and to evaluate treatment options. METHOD: We analyzed 445 patients who underwent pancreaticoduodenectomy or pylorus-preserving pancreaticoduodenectomy and evaluated the relevance between clinical data and PPFH. RESULTS: The incidence of postoperative pancreatic fistula (POPF) was 27.42% (122/445), and the incidence of PPFH was 4.49% (20/445). Among the 20 patients with PPFH, 7 died and 13 were cured. Interventional angiographic therapy was performed for 10 patients and 5 were successfully treated. Relaparotomy was performed for 5 patients and 2 were successfully cured. Univariate logistic regression analysis indicated that several risk factors were related to PPFH: the nature of tumor (carcinoid/low-grade or high-grade malignancy), preoperative day 1. serum prealbumin, preoperative day 1 total bilirubin (TBIL), operative time, blood loss in the operation, operative method (vascular resection and revascularization), postoperative day 3 TBIL, biliary fistula, and the grade of POPF. The multivariate stepwise logistic regression analysis demonstrated that the nature of tumor and the grade of POPF were independently risk factors of PPFH. Receiver operating characteristic curve indicated that preoperative day 1 serum prealbumin level <173 mg/L and postoperative day 3 TBIL level.1.68.tmol/L were the risk factors of PPFH. CONCLUSIONS; The risk of PPFH was found to be increased with high potential malignancy and high grade of POPE Angiography-embolization is one of the major and effective therapies for PPFH. Extraluminal-intraluminal PPFH is more serious and needs more aggressive treatments.
文摘Background The transseptal puncture technique has been widely used in therapeutic left atrium catheterization. But this technique may lead to some life-threatening complications. It can not be used widely because it is restricted by economy and deferring the transseptal puncture procedure. The aim of this study was to introduce a simple and safe transseptal puncture procedure. Methods The distal of coronary sinus （CS） electrode was positioned close to the lateral margin of heart, which was about at 3 o＇clock at left anterior oblique （LAO） 30° referred to whole cardiac profile. It was then used as the marker for the level of fossa ovalis at posterior-anterior projection to guide the pull of transseptal needle. The midpoint between the distal CS and the posterior margin of heart at right anterior oblique （RAO） 45° view was considered as the location of fossa ovalis. Once the puncture was succeeded, the guidewire was introduced to the left superior pulmonary vein via puncture sheath after the needle was retrieved. The end of outer sheath was introduced into left atrium with the protection of guidewire. It was applied in 539 patients （316 male, 223 female; （53±16） years old） who underwent catheter ablation of atrial fibrillation or left-sided atrioventricular accessory pathway. Results This transseptal approach reached 100.0% success and was succeeded in 98.9% with the first attempt. The first attempt puncture was aborted due to greater patients. However, the second attempts were all tamponade and embolism occurred. Conclusion The atrial septum puncture approach guidewire for protection when sending outer sheath resistance to needle advancement or smaller needle curve in six succeeded after the needle curve was reshaped. There was no using the location of distal CS electrode as important marker and the into left atrium is reliable and safe.
基金supported by the Agricultural Science and Technology Innovation Program, China (ASTIPIAS02)the National Key Technology R&D Program of China (2011BAD28B01)+2 种基金the National Natural Science Foundation of China (31201781)the Earmarked Fund for Modern Agro-Industry Technology Research System, China (2011ZX08006-003)the Chinese Academy of Agricultural Sciences Foundation (2014ZL006, 2011cj-5, 2012ZL069 and 2014ywf-yb-8)
文摘Litter uniformity, which is usually represented by within-litter weight coefficient of variation at birth （CVB）, could influence litter performance of sows and the profitability of pig enterprises. The objective of this study was to characterize CVB and its effect on other reproductive traits in Large White sows. Genetic parameters and genetic correlation of the reproductive traits, including CVB, within-litter weight coefficient of variation at three weeks （CVT）, total number born （TNB）, number born alive （NBA）, number born dead （NBD）, gestation length （GL）, piglet mortality at birth （Mo）, piglet mortality at three weeks （M3）, total litter weight at birth （TLW0）, and total litter weight at three weeks （TLW3） were estimated for 2 032 Large White litters. The effects of parity and classified litter size on CVB, CVT, TNB, NBA, NBD, GL, M0, M3, TLW0, and TLW3 were also estimated. The heritabilities of these reproductive traits ranged from 0.06 to 0.17, with the lowest heritability for CVB and the highest heritability for TLW0. Phenotypic and genetic correlations between these reproductive traits were low to highly positive and negative （ranging from -0.03 to 0.93, and -0.53 to 0.93, respectively）. The genetic correlations between TNB and CVB, and between M0 and CVB were 0.32 and 0.29, respectively. In addition, CVB was significantly influenced by parity and litter size class （P〈0.05）. All the results suggest that piglet uniformity should be maintained in pig production practices and pig breeding programs.
基金supported by the National Natural Science Foundation of China (Nos.41673118 and 41422306)the Strategic Priority Research Program of the Chinese Academy of Sciences (No.XDB14010400)the National Basic Research Program of China (No.2013CB430004)
文摘Selenium（Se） is commonly recognized as a protective element with an antagonistic effect against mercury（Hg） toxicity. However, the mechanisms of this Hg–Se antagonism are complex and remain controversial. To gain insight into the Hg–Se antagonism, a type of unicellular eukaryotic protozoa（Tetrahymena malaccensis, T. malaccensis） was selected and individually or jointly exposed to two Hg and three Se species. We found that Se species showed different toxic effects on the proliferation of T. malaccensis with the toxicity following the order：selenite（Se（IV）） 〉 selenomethionine（SeMeth） 〉 selenate（Se（VI））. The Hg–Se antagonism in Tetrahymena was observed because the joint toxicity significantly decreased under co-exposure to highly toxic dosages of Hg and Se versus individual toxicity. Unlike Se（IV） and Se（VI）, non-toxic dosage of SeM eth significantly decreased the Hg toxicity, revealing the influence of the Se species and dosages on the Hg–Se antagonism. Unexpectedly, inorganic divalent Hg（Hg2＋） and monomethylmercury（MeHg） also displayed detoxification towards extremely highly toxic dosages of Se, although their detoxifying efficiency was discrepant. These results suggested mutual Hg–Se detoxification in T. malaccensis, which was highly dependent on the dosages and species of both elements. As compared to other species, SeM eth and MeHg promoted the Hg–Se joint effects to a higher degree. Additionally, the Hg contents decreased for all the Hg–Se co-exposed groups, revealing a sequestering effect of Se towards Hg in T. malaccensis.
