Initial suction drainage decreases severe postoperative complications after pancreatic trauma:A cohort study

BACKGROUND Few studies have addressed the question of which drain types are more beneficial for patients with pancreatic trauma(PT).AIM To investigate whether sustained low negative pressure irrigation(NPI)suction drainage is superior to closed passive gravity(PG)drainage in PT patients.METHODS PT patients who underwent pancreatic surgery were enrolled consecutively at a referral trauma center from January 2009 to October 2021.The primary outcome was defined as the occurrence of severe complications(Clavien-Dindo grade≥Ⅲb).Multivariable logistic regression was used to model the primary outcome,and propensity score matching(PSM)was included in the regression-based sensitivity analysis.RESULTS In this study,146 patients underwent initial PG drainage,and 50 underwent initial NPI suction drainage.In the entire cohort,a multivariable logistic regression model showed that the adjusted risk for severe complications was decreased with NPI suction drainage[14/50(28.0%)vs 66/146(45.2%);odds ratio(OR),0.437;95%confidence interval(CI):0.203-0.940].After 1:1 PSM,44 matched pairs were identified.The proportion of each operative procedure performed for pancreatic injury-related and other intra-abdominal organ injury-related cases was comparable in the matched cohort.NPI suction drainage still showed a lower risk for severe complications[11/44(25.0%)vs 21/44(47.7%);OR,0.365;95%CI:0.148-0.901].A forest plot revealed that NPI suction drainage was associated with a lower risk of Clavien-Dindo severity in most subgroups.CONCLUSION This study,based on one of the largest PT populations in a single high-volume center,revealed that initial NPI suction drainage could be recommended as a safe and effective alternative for managing complex PT patients.

Serum magnesium level as a predictor of acute kidney injury in patients with acute pancreatitis

BACKGROUND Decreased serum magnesium(Mg2+)is commonly seen in critically ill patients.Hypomagnesemia is significantly more frequent in patients with severe acute pancreatitis.Acute kidney injury(AKI)in patients with acute pancreatitis(AP)is associated with an extremely high mortality.The association underlying serum Mg2+and AKI in AP has not been elucidated.AIM To explore the association between serum Mg2+on admission and AKI in patients with AP.METHODS A retrospective observational study was conducted in a cohort of patients(n=233)with AP without any renal injury before admission to our center from August 2015 to February 2019.Demographic characteristics on admission,severity score,laboratory values and in-hospital mortality were compared between patients with and without AKI.RESULTS A total of 233 patients were included for analysis,including 85 with AKI.Compared to patients without AKI,serum Mg2+level was significantly lower in patients with AKI at admission[OR=6.070,95%CI:3.374-10.921,P<0.001].Multivariate logistic analysis showed that lower serum Mg2+was an independent risk factor for AKI[OR=8.47,95%CI:3.02-23.72,P<0.001].CONCLUSION Our analysis indicates that serum Mg2+level at admission is independently associated with the development of AKI in patients with AP and may be a potential prognostic factor.

Lentivirus-mediated Persephin overexpression in Parkinson's disease rats

Persephin, together with glial cell line-derived neurotrophic factor and neurturin, has a neurotrophic effect and promotes the survival of motor neurons cultured in vitro. In this study, dopaminergic neurons in the substantia nigra of rats were transfected with the Persephin gene. One week later 6-hydroxydopamine was injected into the anterior medial bundle to establish a Parkinson＇s disease model in the rats. Results found that the number of dopaminergic neurons in the substantia nigra increased, tyrosine hydroxylase expression was upregulated and concentrations of dopamine and its metabolites in corpus striatum were increased after pretreatment with Persephin gene. In addition, the rotating effect of the induced Parkinson＇s disease rats was much less in the group pretreated with the Persephin gene. Persephin has a neuroprotective effect on the 6-hydroxydopamine-induced Parkinson＇s disease through protecting dopaminergic neurons.