Management of major vascular injury in laparoscopic urology

Objective:During the past three decades,laparoscopy has played a significant role in the management of urological disorders.This study aims to standardize the management of major vascular injury,which is a life-threatening complication in the laparoscopic urological procedures.Methods:A total of 8210 patients with the urological disorder,who underwent laparoscopic surgery at Sir Run Run Shaw Hospital from January 2000 to December 2018,were included in this retrospective study.Patients’data of the laparoscopic major vascular injury were collected and analyzed,and the basic principles of the procedure were summarized.Results:A total of 15(0.18%)cases of major vascular injury were found among the 8210 patients,and 2 of them were converted to open surgery.Although the type of laparoscopic surgery,causes,and management of major vascular injury among the patients were diverse,the main management strategies of major vascular injury in laparoscopic surgery were to keep the vision clear,control bleeding rapidly by clamping and compression,make full preparation for possibly needed liquid resuscitation,and try best to repair under laparoscope.If necessary,converse to open surgery.Conclusion:Although the reported incidence of major vascular injury in laparoscopic urological surgery is extremely low,such injury can result in high morbidity and mortality.It is important to rapidly identify the cause and strictly follow the standardized management for better outcomes.

基于网络药理学和代谢组学分析滁菊中潜在活性成分及其药理作用机制

“滁菊”是我国著名的传统中药材,它含有多种有效活性成分,可以治疗多种疾病,而且没有毒副作用。为了进一步探究“滁菊”中的有效活性成分及其作用靶点和药理机制,本研究采用代谢组学与网络药理学相结合的方法,构建了基于化学、药代动力学和药理学的可视化网络分析模型,对滁菊的潜在药理机制进行了预测。共鉴定出424个代谢产物,通过ADME筛选出21个具有潜在药用活性成分的化合物。对活性成分进一步的药理学分析发现,滁菊中的金合花素、β-谷甾醇通过作用于GSK3B、MAPK14、ADRA1R和NOS2等靶点蛋白来调控糖尿病、阿尔茨海默病、乳腺癌和炎症等疾病。这些结果成功地说明了“滁菊”潜在的有效活性成分具有多种药理作用机制。