Middle segmental pancreatectomy: A safe and organ-preserving option for benign and low-grade malignant lesions

AIM: To study the feasibility and safety of middle segmental pancreatectomy (MSP) compared with pancreaticoduodenectomy (PD) and extended distal pancreatectomy (EDP). METHODS: We studied retrospectively 36 cases that underwent MSP, 44 patients who underwent PD, and 26 who underwent EDP with benign or low-grade malignant lesions in the mid-portion of the pancreas, between April 2003 and December 2009 in Ruijin Hospital. The perioperative outcomes and long-term outcomes of MSP were compared with those of EDP and PD. Periop-erative outcomes included operative time, intraoperative hemorrhage, transfusion, pancreatic fistula, intraabdominal abscess/infection, postoperative bleeding, reoperation, mortality, and postoperative hospital time. Long-term outcomes, including tumor recurrence, newonset diabetes mellitus (DM), and pancreatic exocrine insufficiency, were evaluated. RESULTS: Intraoperative hemorrhage was 316.1 ± 309.6, 852.2 ± 877.8 and 526.9 ± 414.5 mL for the MSP, PD and EDP groups, respectively (P < 0.05). The mean postoperative daily fasting blood glucose level was significantly lower in the MSP group than in the EDP group (6.3 ± 1.5 mmol/L vs 7.3 ± 1.5 mmol/L, P < 0.05). The rate of pancreatic fistula was higher in the MSP group than in the PD group (42% vs 20.5%, P = 0.039), all of the fistulas after MSP corresponded to grade A (9/15) or B (6/15) and were sealed following conservative treatment. There was no significant difference in the mean postoperative hospital stay between the MSP group and the other two groups. After a mean follow-up of 44 mo, no tumor recurrences were found, only one patient (2.8%) in the MSP group vs five (21.7%) in the EDP group developed new-onset insulin-dependent DM postoperatively (P = 0.029). Moreover, significantly fewer patients in the MSP group than in the PD (0% vs 33.3%, P < 0.001) and EDP (0% vs 21.7%, P = 0.007) required enzyme substitution. CONCLUSION: MSP is a safe and organ-preserving option for benign or low-grade malignant lesions in the neck and proximal body of the pancreas.

Diurnal brooding behavior of long-tailed tits （Aegithalos caudatus glaucogularis）

Brooding is a major breeding investment of parental birds during the early nestling stage, and has important effects on the development and survival of nestlings. Investigating brooding behavior can help to understand avian breeding investment strategies. From January to June in 2013 and 2014, we studied the brooding behaviors of long-tailed tits （Aegithalos caudatus glaucogularis） in Dongzhai National Nature Reserve, Henan Province, China. We analyzed the relationships between parental diurnal brooding duration and nestling age, brood size, temperature, relative breeding season, time of day and nestling frequencies during brooding duration. Results showed that female and male long-tailed tit parents had different breeding investment strategies during the early nestling stage. Female parents bore most of the brooding investment, while male parents performed most of the nestling feedings. In addition, helpers were not found to brood nestlings at the two cooperative breeding nests. Parental brooding duration was significantly associated with the food delivered to nestlings （F=86.10, dr=l, 193.94, P〈0.001）, and was longer when the nestlings received more food. We found that parental brooding duration declined significantly as nestlings aged （F=5.99, dr=-1, 50.13, P=0.018）. When nestlings were six days old, daytime parental brooding almost ceased, implying that long- tailed tit nestlings might be able to maintain their own body temperature by this age. In addition, brooding duration was affected by both brood size （F=12.74, dr=-1,32.08, P=0.001） and temperature （F=5.83, df=-l, 39.59, P=-0.021）, with it being shorter in larger broods and when ambient temperature was higher.

Network pharmacology research of mechanism of Maxing Shigan Decoction in treating COVID-19

Background:The COVID-19 has a huge negative impact on people’s health.Traditional Chinese Medicine(TCM)has a good effect on viral pneumonia.It is of great practical significance to study its pharmacology.Methods:The ingredients and targets of each herb in Maxing Shigan Decoction which obtained from Traditional Chinese Medicine Systems Pharmacology(TCMSP)database,and the related targets of COVID-19 were screened by GeneCards database based on the network pharmacology.Venn was used to analyze the intersection target between active ingredients and diseases.Cytoscape software was used to construct an active ingredient-disease target network.The protein-protein interaction network was constructed by STRING database and Cytohubba was used to screen out the key targets.Gene Ontology(GO)functional enrichment analysis and KEGG pathway analysis were performed by DAVID database.Results:In this study,a total of 134 active ingredients and 229 related targets,198 targets of COVID-19 and 48 common targets of drug-disease were chosen.Enrichment items and pathways were obtained through GO and KEGG pathway analysis.The predicted active ingredients were quercetin,kaempferol,luteolin,naringenin,glycyrol,and the key targets involved IL6,MAPK3,MAPK8,CASP3,IL10,etc.The results showed that the active ingredients of Maxing Shigan Decoction acted on multiple targets which played roles in the treatment of COVID-19 by regulating inflammation,immune system and other pathways.Conclusions:The main contribution of this paper is to use data to mine the principles of the treatment of COVID-19 from the pharmacology of these prescriptions,and the results can be provided theoretical reference for medical workers.