Objective To investigate the management experience of type Ⅱ endoleak originating from inferior mesenteric artery (IMA) after endovascular abdominal aortic aneurysm repair (EVAR). Methods The clinical data of patients with type Ⅱ endoleak originating from IMA after EVAR treated in the Department of Vascular Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University from October 2016 to November 2021 were collected and analyzed. Results There were 12 males and 3 females at age of 57-89 (68.00±7.84) years. Eleven patients received embolization of the abdominal aortic aneurysm lumen and initial segment of the IMA via the superior mesenteric artery-middle colic artery-Riolan arch-left colic artery-IMA route. Three patients received embolization of the initial segment of the IMA by the above route. One patient underwent open dissection of the abdominal aortic aneurysm, and orifice of IMA was sutured in the aneurysm cavity while stents were retained. All 15 patients were successfully treated by surgery. The symptoms of back pain, abdominal pain and abdominal distension disappeared in 6 patients after surgery. Neither perioperative deaths nor complications happened during the treatment and follow-up period. The median follow-up time was 11.00 (9.00, 18.00) months. Two patients with typeⅡendoleak recurred during the follow-up period and were admitted to hospital for secondary embolization. No recurrence was observed at 12 months postoperative follow-up. Conclusion Type Ⅱ endoleak is one of the most common complications after EVAR. IMA is the most common criminal origin of typeⅡendoleak. TypeⅡendoleak that lead to persistent expansion of the aneurysm cavity requires aggressive intervention.
ObjectiveTo review the latest advances in diagnosis and treatment of gallbladder carcinoma.MethodsThe recent literatures on diagnosis and treatment of gallbladder carcinoma at home and abroad were reviewed, and the diagnosis, staging and treatment progress of gallbladder carcinoma were systematically reviewed.ResultsThere are many methods to diagnose gallbladder carcinoma, among which imaging methods are commonly used, as well as various tumor markers and gallbladder carcinoma-related genes. Surgical resection is still the only possible cure for gallbladder carcinoma, but the scope and timing of surgical resection are still controversial. Radiotherapy, chemotherapy and gene therapy also play an important role in the treatment of gallbladder carcinoma.ConclusionsImaging examination is still the first choice for the diagnosis of gallbladder carcinoma. The tumor markers and gene diagnosis has broad prospects. Gallbladder carcinoma is mainly treated by surgery. Gene intervention and precise targeted therapy are the future development direction.
【摘要】 目的 探討老年糖尿病患者血清胱抑素C與血脂及高敏C反應蛋白的關系。 方法 2008年5月-2009年10月糖尿病患者共141例，其中糖尿病合并癥組68例，單純糖尿病組73例；另選取對照組51例。對入選者的血清胱抑素C、血脂及高敏C反應蛋白進行分析。 結果 老年男女糖尿病合并癥組血清胱抑素C、高敏C反應蛋白、總膽固醇、甘油三酯及低密度脂蛋白膽固醇最高、高密度脂蛋白膽固醇最低，與對照組比較有統計學意義（Plt;0.05）、與單純糖尿病組比較，無統計學意義（Pgt;0.05）。老年男女單純糖尿病組高敏C反應蛋白、總膽固醇、甘油三酯高于對照組，組間比較，有統計學意義（Plt;0.05）。老年男女單純糖尿病組血清胱抑素C與對照組比較，無統率學意義（Pgt;0.05）。老年女性單純糖尿病組低密度脂蛋白膽固醇與對照組比較，有統計學意義（Plt;0.05）。老年男性糖尿病二組與對照組血清胱抑素C低于老年女性糖尿病二組與對照組，組間比較，無統計學意義（Pgt;0.05）。老年男性糖尿病患者血清胱抑素C與高敏C反應蛋白及血脂不相關。老年女性糖尿病合并癥組血清胱抑素C與空腹血糖正相關；單純糖尿病組血清胱抑素C與高密度脂蛋白膽固醇負相關、與低密度脂蛋白膽固醇正相關、與高敏C反應蛋白不相關。 結論 老年糖尿病患者高脂、高糖及低度炎癥狀態下，血清胱抑素C水平較高。血脂對血清胱抑素C的影響可能存在性別差異。隨著動脈粥樣硬化的加重，血清胱抑素C有升高趨勢。【Abstract】 Objective To investigate the relationship between serum cystatin C concentration and lipid, hs-C reactive protein in the elderly with diabetes. Methods A total of 192 senile people form May 2008 to October 2009 were investigated. There were 141 patients with diabetes, in whom 68 were with cardiovascular and cor, cerebrovascular diseases, 73 were with diabetes only.There were 51 control subjects. The data of serum cystatin C, hs-CRP, TC, TG, HDL-C and LDL-C were analyzed. Results Serum cystatin C of elderly men was lower than that in elderly women, but no signifcant correlation between them was found (Pgt;0.05). Serum cystatin C, hs-CRP, TC, TG and LDL-C was higher, and HDL-C was lower in male and female diabetes subjects with cardiovascular and cor, cerebrovascullar diseases, than that in control subjects (Plt;0.05). Serum hs-CRP, TC and TG were higher in the elderly with diabetes only, than that in control subjects (Plt;0.05). LDL-C was higher in senile women with diabetes only, than that in female control subjects (Plt;0.05). Serum cystatin C with LDL-C in elderly women with diabetes only, with FPG in female diabetes subjects with cardiovascular and cor, cerebrovascular diseases had position correlation (Plt;0.05). No correlation were observed between serum cystatin C and hs-CRP in male and female diabetes subjects, and lipid in male diabetes subjects. Conclusions We speculate that high serum lipid, high glucose and low level of inflammation may result in increasing of serum cystatin C in senily people with diabetes. The influence of serum lipid on serum cystatin C may be different in male and female senile people.Along with atherosclerotic aggravating, the level of serum cystatin C was increasing.
Objective To explore the risk factors of chronic postoperative inguinal pain (CPIP) after transabdominal preperitoneal hernia repair (TAPP), establish and verify the risk prediction model, and then evaluate the prediction effectiveness of the model. Methods The clinical data of 362 patients who received TAPP surgery was retrospectively analyzed and divided into model group (n=300) and validation group (n=62). The risk factors of CPIP in the model group were screened by univariate analysis and multivariate logistic regression analysis, and the risk prediction model was established and tested. Results The incidence of CPIP at 6 months after operation was 27.9% (101/362). Univariate analysis showed that gender (χ2= 12.055, P=0.001), age (t=–4.566, P<0.01), preoperative pain (χ2=44.686, P<0.01) and early pain at 1 week after operation (χ2=150.795, P<0.01) were related to CPIP. Multivariate logistic regression analysis showed that gender, age, preoperative pain, early pain at 1 week after operation, and history of lower abdominal surgery were independent risk predictors of CPIP. The area under curve (AUC) of the receiver operating characteristic (ROC) of the risk prediction model was calculated to be 0.933 [95%CI (0.898, 0.967)], and the optimal cut-off value was 0.129, while corresponding specificity and sensitivity were 87.6% and 91.5% respectively. The prediction accuracy, specificity and sensitivity of the model were 91.9% (57/62), 90.7% and 94.7%, respectively when the validation group data were substituted into the prediction model. Conclusion Female, age≤64 years old, preoperative pain, early pain at 1 week after operation and without history of lower abdominal surgery are independent risk factors for the incidence of CPIP after TAPP, and the risk prediction model established on this basis has good predictive efficacy, which can further guide the clinical practice.
ObjectivesTo systematically review the prevalence of rosacea in China.MethodsPubMed, The Cochrane Library, EMbase, CNKI, WanFang Data and VIP databases were electronically searched to collect literature of the prevalence of rosacea in China from inception to September 5th, 2018. Two reviewers independently screened literature, extracted data and then meta-analysis was performed by using Stata 12.0 software.ResultsA total of 54 studies were included. The pooled prevalence of rosacea from 44 population-based or community-based studies was 0.27% (95%CI 0.22 to 0.32) and from 10 hospital-based studies was 1.47% (95%CI 1.08 to 1.86). Based on population-based or community-based studies, the highest prevalence was in the early 1980s (2.19%), followed by a gradual decline, to the lowest (0.17%) in the early 1990s, after that the prevalence increased to 1.24% till 2015. Based on hospital-based studies, the prevalence had a maximum of 4.64% in the past decade. The Northwest China and North China had higher prevalence of rosacea (population-based or community-based studies: 1.24% in Northwest China, 1.1% in North China; hospital-based studies: 6.03% in Northwest China, 2.83% in North China). The prevalence in East China and South China was relatively low (population-based or community-based studies: 0.02% in East China and 0.32% in South China; Hospital-based studies: 0.28% in South China). The prevalence of rosacea in female (0.36%) was higher than that of male (0.19%) in population-based or community-based studies.ConclusionsIn China, the pooled prevalence of rosacea is 0.27% in population-based or community-based studies and 1.47% in hospital-based studies. Rosacea is common in North China and Northwest China. Female has higher prevalence than male.
ObjectiveTo systematically evaluate the effect of single-port totally extraperitoneal (SPTEP) and conventional totally extraperitoneal (CTEP) inguinal hernia repair in treatment of inguinal hernia. MethodsPubMed, Cochrane Library, Embase, WanFang Data, VIP, and CNKI databases were electronically searched and the randomized controlled trial (RCT) and non-RCT studies on the efficacy and safety of SPTEP versus CTEP for patients with inguinal hernia from January 2010 to November 2019 were collected. Two reviewers independently screened literatures, extracted data, and assessed risk of bias of included studies, then the meta-analysis was performed by using RevMan5.3 software. ResultsA total of 17 clinical studies were included in the analysis, with 1 106 cases in the SPTEP group and 966 cases in the CTEP group. The results of meta-analysis showed that: the hospital stay [SMD=–0.12, 95%CI (–0.22, –0.02), P=0.01] and the time to resume normal activity [SMD=–1.17, 95%CI (–2.10, –0.23), P=0.01] were shorter, the satisfaction score of incision scars [SMD=0.92, 95%CI (0.31, 1.53), P<0.01] was higher in the SPTEP group as compared with the CTEP group. However, the operative time of SPTEP group was longer than that of the CTEP group both for unilateral inguinal hernia [MD=4.08, 95%CI (0.34, 7.83), P=0.03] and bilateral inguinal hernia [MD=5.53, 95%CI (0.39, 10.68), P=0.04]. There were no statistical differences in the postoperative pain score (24 h and 7 d), incidence of postoperative complications, the rate of patients satisfied with the incision, and hospitalization costs between the two groups (P>0.05). ConclusionsFrom the results of this meta-analysis, SPTEP has some certain advantages in shortening hospital stay and returning to normal activity time, and improving incision satisfaction. However, compared with CTEP, mean operative time of SPTEP is longer. Although SPTEP has developed for several years, it is difficult to replace CTEP.
