Objective： After pancreaticoduodenectomy （PD）, the postoperative gastroduodenal artery stump （GDAS） hemorrhage is one of the most serious complications. The purpose of this study is to determine whether wrapping ...Objective： After pancreaticoduodenectomy （PD）, the postoperative gastroduodenal artery stump （GDAS） hemorrhage is one of the most serious complications. The purpose of this study is to determine whether wrapping the GDAS during PD could decrease the postoperative GDAS hemorrhage incidence. Methods： A retrospective review involving 280 patients who underwent PD from 2005 to 2012 was performed. Wrapping the GDAS during PD was defined as ＂Wrapping the GDAS using the teres hepatis ligamentum during PD＂. A total of 140 patients accepted the ＂wrapping＂ procedure （wrapping group）. The other 140 patients didn＇t apply the procedure （non-wrapping group）. Age, sex, preoperative data, estimated intraoperative blood loss, postoperative complications, pathologic parameters and hospitalization time were compared between two groups. ResultsI There were no significant differences in patient characteristics between two groups. After wrapping, the incidence of postoperative GDAS bleeding decreased significantly （1/140 vs. 9/140, P=0.01）. The rates of the other complications （such as intra-abdominal infection pancreatic fistula, billiary fistula, gastrointestinal bleeding, et aL） showed no significant differences. Conclusions： Wrapping the GDAS during PD significantly reduced the postoperative GDAS hemorrhage incidence. And the ＂wrapping＂ had no obvious influence on other complications.展开更多
Fxcessive forest exploitation significantly contributes to land degradation and the creation of human-made deadwood.Stumps are sometimes ignored in studies on the biodiversity of coarse woody debris.We investigated wh...Fxcessive forest exploitation significantly contributes to land degradation and the creation of human-made deadwood.Stumps are sometimes ignored in studies on the biodiversity of coarse woody debris.We investigated whether the type of stump,i.e.broken stumps(naturally created)and cut stumps(formed during forestry operations)had an impact on the species composition and species diversity as well as due to this fact they can be characterized by plant indicators.The research covered 728 spruce stumps(287 broken and 441 cut stumps)that were inhabited by lichens,liverworts,mosses and vascular plants in mountain forest belt(Karkonosze Mts.,Poland).The following types of microhabitats were included in the research:the upper surface and the lateral surface of a stump with both bark and wood.There are statistically significant compositional differences between the two types of stumps,which was demonstrated by ordination analyses and indicator species analysis.According to the generalized linear models,the probability of occurrence increases in cut stumps in case of liverworts and vascular plants and also along the decomposition stages.The generalized linear mixed-effects model showed that there was a higher species richness of liverworts,mosses and vascular plants on the cut stumps and less drier but the reverse situation was in lichens.The generalized additive models for their cover showed similar trends.Almost all of the taxonomic groups were affected by altitude both in terms of species composition and total cover on the stumps.We concluded that cut stumps are an important type of deadwood for biodiversity and provide a convenient habitat,especially for many lichens and bryophytes.展开更多
Background:and purpose:To share our single-center vertebral artery stump syndrome(VASS)treatment experience and assess the role of comprehensive classification based on anatomic development,proximal conditions,and dis...Background:and purpose:To share our single-center vertebral artery stump syndrome(VASS)treatment experience and assess the role of comprehensive classification based on anatomic development,proximal conditions,and distal conditions(PAD).Materials and methods:Data were retrospectively collected from patients who underwent endovascular thrombectomy(EVT)at the Stroke Center of the First Hospital of Jilin University between January 2016 and December2021.Among patients with acute ischemic stroke in the posterior circulation,those with acute occlusion of the intracranial arteries and occlusion at the origin of the vertebral artery confirmed by digital subtraction angiography were selected.The clinical data were summarized and analyzed.Results:Fifteen patients with VASS were enrolled in the study.The overall success rate of surgical recanalization was 80%.The successful proximal recanalization rate was 70.6%,and the recanalization rates for P1,P2,P3,and P4 were 100%,71.4%,50%,and 66.67%,respectively.The mean operation times for the A1 and A2 types were124 and 120 min,respectively.The successful distal recanalization rate was 91.7%,and the recanalization rates for types D1,D2,D3,and D4 were 100%,83.3%,100%,and 100%,respectively.Five patients experienced perioperative complications(incidence rate:33.3%).Distal embolism occurred in three patients(incidence rate:20%).No dissection or subarachnoid hemorrhage occurred in any patient.Conclusion:EVT is a technically feasible treatment for VASS,and comprehensive PAD classification can,to a certain extent,help initially estimate the difficulty of surgery and provide guidance for interventional procedures.展开更多
Gastric stump carcinoma,also known as remnant gastric carcinoma,is a malignancy arising in the remnant stomach following gastrectomy for a benign or malignant condition.Enterogastric reflux and preexisting risk factor...Gastric stump carcinoma,also known as remnant gastric carcinoma,is a malignancy arising in the remnant stomach following gastrectomy for a benign or malignant condition.Enterogastric reflux and preexisting risk factors in a patient with gastric cancer are the major contributors to the development of gastric stump carcinoma.The occurrence of gastric stump carcinoma is time-dependent and seen earlier in patients operated on for malignant rather than benign diseases.The tumor location is predominantly at the anastomotic site towards the stomach.However,it can occur anywhere in the remnant stomach.The pattern of lymph node involvement and the type of surgery required is distinctly different compared to primary gastric cancer.Gastric stump carcinoma is traditionally considered a malignancy with a dismal outcome.However,recent advances in diagnostic and therapeutic strategies have improved outcomes.Recent advances in molecular profiling of gastric stump carcinoma have identified distinct molecular subtypes,thereby providing novel therapeutic targets.Also,reports of gastric stump carcinoma following pancreatoduodenectomy and bariatric surgery highlight the need for more research to standardize the diagnosis,staging,and treatment of these tumors.The present review aims to provide an overview of gastric stump carcinoma highlighting the differences in clinicopathological profile and management compared to primary gastric carcinoma.展开更多
BACKGROUND Although the location of proximal cancer of the remnant stomach is the same as that of primary proximal cancer of the stomach,its clinical characteristics and prognosis are still controversial.AIM To evalua...BACKGROUND Although the location of proximal cancer of the remnant stomach is the same as that of primary proximal cancer of the stomach,its clinical characteristics and prognosis are still controversial.AIM To evaluate the clinicopathological features and prognosis factors of gastric stump cancer(GSC)and primary proximal gastric cancer(PGC).METHODS From January,2005 to December,2016,178 patients with GSC and 957 cases with PGC who received surgical treatment were enrolled.Patients in both groups underwent 1:1 propensity score matching analysis,and both clinical and pathological data were systematically collected for statistical purposes.Quality of RESULTS One hundred and fifty-two pairs were successfully matched after propensity score matching analysis.Of the 15 demographic and pathological variables collected,the analysis further revealed that the number of lymph nodes and positive lymph nodes were different prognostic and clinicopathological factors between PGC and GSC.Univariate and multivariate analyses showed that gender,differentiation degree and tumor-node-metastasis stage were independent risk factors for patients with GSC.Gender,vascular invasion,differentiation degree,depth of infiltration,positive lymph nodes,and tumor-node-metastasis stage were independent risk factors for patients with PGC.The 5-year overall survival and cancer-specific survival of patients with GSC were significantly lower than those in the PGC group,the scores for overall quality of life in the GSC-malignant group were lower than the GSC-benign,and the differences were statistically significant.CONCLUSION The differences in clinicopathological characteristics between GSC and PGC were clarified,and PGC had a better prognosis than GSC.展开更多
基金funded by A new round of the Shanghai Health System outstanding young talent training plan (XYQ2011030)
文摘Objective： After pancreaticoduodenectomy （PD）, the postoperative gastroduodenal artery stump （GDAS） hemorrhage is one of the most serious complications. The purpose of this study is to determine whether wrapping the GDAS during PD could decrease the postoperative GDAS hemorrhage incidence. Methods： A retrospective review involving 280 patients who underwent PD from 2005 to 2012 was performed. Wrapping the GDAS during PD was defined as ＂Wrapping the GDAS using the teres hepatis ligamentum during PD＂. A total of 140 patients accepted the ＂wrapping＂ procedure （wrapping group）. The other 140 patients didn＇t apply the procedure （non-wrapping group）. Age, sex, preoperative data, estimated intraoperative blood loss, postoperative complications, pathologic parameters and hospitalization time were compared between two groups. ResultsI There were no significant differences in patient characteristics between two groups. After wrapping, the incidence of postoperative GDAS bleeding decreased significantly （1/140 vs. 9/140, P=0.01）. The rates of the other complications （such as intra-abdominal infection pancreatic fistula, billiary fistula, gastrointestinal bleeding, et aL） showed no significant differences. Conclusions： Wrapping the GDAS during PD significantly reduced the postoperative GDAS hemorrhage incidence. And the ＂wrapping＂ had no obvious influence on other complications.
基金supported by the Statutory Funds of the Institute of Environmental Protection and Engineering of the University of Bielsko-Biala and the Department of Geobotany and Plant Ecologythe University of Lodz,Lodz,Poland。
文摘Fxcessive forest exploitation significantly contributes to land degradation and the creation of human-made deadwood.Stumps are sometimes ignored in studies on the biodiversity of coarse woody debris.We investigated whether the type of stump,i.e.broken stumps(naturally created)and cut stumps(formed during forestry operations)had an impact on the species composition and species diversity as well as due to this fact they can be characterized by plant indicators.The research covered 728 spruce stumps(287 broken and 441 cut stumps)that were inhabited by lichens,liverworts,mosses and vascular plants in mountain forest belt(Karkonosze Mts.,Poland).The following types of microhabitats were included in the research:the upper surface and the lateral surface of a stump with both bark and wood.There are statistically significant compositional differences between the two types of stumps,which was demonstrated by ordination analyses and indicator species analysis.According to the generalized linear models,the probability of occurrence increases in cut stumps in case of liverworts and vascular plants and also along the decomposition stages.The generalized linear mixed-effects model showed that there was a higher species richness of liverworts,mosses and vascular plants on the cut stumps and less drier but the reverse situation was in lichens.The generalized additive models for their cover showed similar trends.Almost all of the taxonomic groups were affected by altitude both in terms of species composition and total cover on the stumps.We concluded that cut stumps are an important type of deadwood for biodiversity and provide a convenient habitat,especially for many lichens and bryophytes.
文摘Background:and purpose:To share our single-center vertebral artery stump syndrome(VASS)treatment experience and assess the role of comprehensive classification based on anatomic development,proximal conditions,and distal conditions(PAD).Materials and methods:Data were retrospectively collected from patients who underwent endovascular thrombectomy(EVT)at the Stroke Center of the First Hospital of Jilin University between January 2016 and December2021.Among patients with acute ischemic stroke in the posterior circulation,those with acute occlusion of the intracranial arteries and occlusion at the origin of the vertebral artery confirmed by digital subtraction angiography were selected.The clinical data were summarized and analyzed.Results:Fifteen patients with VASS were enrolled in the study.The overall success rate of surgical recanalization was 80%.The successful proximal recanalization rate was 70.6%,and the recanalization rates for P1,P2,P3,and P4 were 100%,71.4%,50%,and 66.67%,respectively.The mean operation times for the A1 and A2 types were124 and 120 min,respectively.The successful distal recanalization rate was 91.7%,and the recanalization rates for types D1,D2,D3,and D4 were 100%,83.3%,100%,and 100%,respectively.Five patients experienced perioperative complications(incidence rate:33.3%).Distal embolism occurred in three patients(incidence rate:20%).No dissection or subarachnoid hemorrhage occurred in any patient.Conclusion:EVT is a technically feasible treatment for VASS,and comprehensive PAD classification can,to a certain extent,help initially estimate the difficulty of surgery and provide guidance for interventional procedures.
文摘Gastric stump carcinoma,also known as remnant gastric carcinoma,is a malignancy arising in the remnant stomach following gastrectomy for a benign or malignant condition.Enterogastric reflux and preexisting risk factors in a patient with gastric cancer are the major contributors to the development of gastric stump carcinoma.The occurrence of gastric stump carcinoma is time-dependent and seen earlier in patients operated on for malignant rather than benign diseases.The tumor location is predominantly at the anastomotic site towards the stomach.However,it can occur anywhere in the remnant stomach.The pattern of lymph node involvement and the type of surgery required is distinctly different compared to primary gastric cancer.Gastric stump carcinoma is traditionally considered a malignancy with a dismal outcome.However,recent advances in diagnostic and therapeutic strategies have improved outcomes.Recent advances in molecular profiling of gastric stump carcinoma have identified distinct molecular subtypes,thereby providing novel therapeutic targets.Also,reports of gastric stump carcinoma following pancreatoduodenectomy and bariatric surgery highlight the need for more research to standardize the diagnosis,staging,and treatment of these tumors.The present review aims to provide an overview of gastric stump carcinoma highlighting the differences in clinicopathological profile and management compared to primary gastric carcinoma.
文摘BACKGROUND Although the location of proximal cancer of the remnant stomach is the same as that of primary proximal cancer of the stomach,its clinical characteristics and prognosis are still controversial.AIM To evaluate the clinicopathological features and prognosis factors of gastric stump cancer(GSC)and primary proximal gastric cancer(PGC).METHODS From January,2005 to December,2016,178 patients with GSC and 957 cases with PGC who received surgical treatment were enrolled.Patients in both groups underwent 1:1 propensity score matching analysis,and both clinical and pathological data were systematically collected for statistical purposes.Quality of RESULTS One hundred and fifty-two pairs were successfully matched after propensity score matching analysis.Of the 15 demographic and pathological variables collected,the analysis further revealed that the number of lymph nodes and positive lymph nodes were different prognostic and clinicopathological factors between PGC and GSC.Univariate and multivariate analyses showed that gender,differentiation degree and tumor-node-metastasis stage were independent risk factors for patients with GSC.Gender,vascular invasion,differentiation degree,depth of infiltration,positive lymph nodes,and tumor-node-metastasis stage were independent risk factors for patients with PGC.The 5-year overall survival and cancer-specific survival of patients with GSC were significantly lower than those in the PGC group,the scores for overall quality of life in the GSC-malignant group were lower than the GSC-benign,and the differences were statistically significant.CONCLUSION The differences in clinicopathological characteristics between GSC and PGC were clarified,and PGC had a better prognosis than GSC.
