OBJECTIVE:The effect of a pre-operative biliary stent on complications after pancreaticoduodenectomy (PD) remains controversial.MATERIALS AND METHOD:We conducted a meta-analysis according to the preferred reporting items for systematic reviews and meta-analyses guidelines, and PubMed, Web of Science Knowledge, and Ovid's databases were searched by the end of February 2023. 35 retrospective studies and 2 randomized controlled trials with a total of 12641 patients were included.RESULTS:The overall complication rate of the pre-operative biliary drainage (PBD) group was significantly higher than the no-PBD group (odds ratio [OR] 1.46, 95% confidence interval [CI] 1.22-1.74; p < 0.0001), the incidence of post-operative delayed gastric emptying was increased in patients with PBD compared those with early surgery (OR 1.21, 95% CI: 1.02-1.43; p = 0.03), and there was a significant increase in post-operative wound infections in patients receiving PBD with an OR of 2.2 (95% CI: 1.76-2.76; p < 0.00001).CONCLUSIONS:PBD has no beneficial effect on post-operative outcomes. The increase in post-operative overall complications and wound infections urges the exact indications for PBD and against routine pre-operative biliary decompression, especially for patients with total bilirubin < 250 umol/L waiting for PD.

Video-assisted anal fistula treatment (VAAFT) is an innovative surgical approach enabling the direct visualization of the fistula tract structure. This study aims to assess the efficacy of VAAFT in comparison with that of traditional surgical methods and explore potential risk factors contributing to fistula recurrence to provide new recommendations for surgical selection. Information was collected from 100 patients with complex anal fistula (CAF) in our hospital who underwent surgical treatment from January 2021 to January 2023. We compared the baseline information and surgical outcomes of two groups, analyzed the risk factors for fistula recurrence by using logistic regression analysis, and conducted further exploration by using the body mass index. Equal numbers of patients underwent VAAFT and traditional surgeries, and no significant differences in baseline information were observed. Patients who received VAAFT experienced less intraoperative bleeding (15.5 (14.0–20.0) vs. 32.0 (25.0–36.0)), shorter hospital stays (2.0 (2.0–2.5) vs. 3.0 (3.0–3.5)), reduced postoperative pain and wound discharge, but longer operative times (43.3 ± 6.9 vs. 35.0 (31.5–40.0)) compared with patients who underwent traditional surgeries. No significant differences in recurrence rates were found three and six months after operation (the p-values were 0.790 and 0.806, respectively). However, the Wexner scores of the VAAFT group were significantly low in the first follow-up (0 (0–1.0) vs. 2.0 (1.0–2.0)). Postoperative recurrence of fistulas may be associated with obesity (p-value = 0.040), especially in patients undergoing traditional surgeries (p-value = 0.036). VAAFT offers advantages, such as less pain, less trauma, and faster recovery, compared with traditional surgical treatment. Obese patients with CAF are prone to recurrence, and we recommend that they undergo VAAFT treatment rather than traditional surgeries.

Abstract Background FBXL8 is a conserved F‐box protein, belonging to the ubiquitin ligase complex, which promotes the development and progression of tumours. However, the regulation function and mechanism of FBXL8's involvement in colorectal cancer (CRC) remain unclear. Methods RT–PCR is used to detect gene expression levels. Protein levels were determined by western blotting and flow cytometry. The bindings of FBXL8 and p53 and ubiquitination levels were detected by cell transfection and immunoprecipitation. The transwell assay was used to measure the ability of cells to migrate and invade. Animal studies were used to verify the function of FBXL8 in vivo. Results The expression of FBXL8 was up‐regulated in CRC tissues, and its overexpression was associated with poor prognosis in CRC patients. The up‐regulation of FBXL8 promoted the proliferation, invasion and migration of CRC tumour cells and maintained the stem‐cell characteristics of colorectal tumour cells. Further analysis demonstrated that FBXL8 targeted p53 and reduced its stability through ubiquitination. Knockout of FBXL8 down‐regulated the proliferation, migration and stem‐like properties of tumour cells. CRC mouse xenograft tumour model confirmed that FBXL8 gene knockout inhibited tumour formation and liver metastasis. Conclusion FBXL8 was highly expressed in CRC. Mechanism studies have shown that FBXL8 degraded tumour suppressor gene p53 by ubiquitination. FBXL8 knockout inhibited the proliferation and stem characteristics of CRC cells, so SCF‐FBXL8‐TP53 has potential to be used as a therapeutic target for CRC in subsequent studies.

Objective To study the value of perioperative application of geriatric nutritional risk index (GNRI) in elderly patients with gastrointestinal tumor. Methods GNRI or nutritional risk screening 2002 (NRS 2002) was used to eva-luate the nutritional risk in elderly patients (≥60 years old) with gastrointestinal tumor surgery. Both operative complications and postoperative hospital stay in elderly patients with geriatric nutritional risk or nutritional risk were compared with those without geriatric nutritional risk or nutritional risk. The effect of preoperative nutritional support on operative complications and postoperative hospital stay in two groups was studied. Results A total of 150 elderly patients were enrolled. Geriatric nutritional risk and nutritional risk in the patients was predicted at 60.00%(90/150) and 40.67%(61/150) respectively. The Kappa value was 0.062 (P=0.415). Operative complication rate in the patients with geriatric nutritional risk was 13.33% (12/90) and postoperative hospital stay (10.37±4.66) days without significant difference (P>0.05) when compared with those [23.33% (14/60), (11.80±6.36) days] in the patients without geriatric nutritional risk. Preoperative nutritional support decreased operative complications 6.38% (3/47) and length of postoperative stay (8.85±2.58) days in geriatric nutritional risk patients compared with those [20.93% (9/43), (12.02±5.78) days] without preoperative nutritional support (P<0.05). No significant difference was present between operative complications [13.11% (8/61)] and length of postoperative stay [(10.56±4.58) days] in the patients with nutritional risk and [20.22% (18/89), (11.20±5.95) days] in the patients without nutritional risk (P>0.05), and between [10.26% (4/39), (10.03±4.94) days] in nutritional risk patients with preoperative nutritional support and [18.19% (4/22), (11.50±3.78) days] in those without preoperative nutritional support (P>0.05). Conclusion GNRI could be used to screen the nutritional risk of the patients with gastrointestinal tumors before operation, and used as a reference for preoperative nutritional support.

Colorectal tumorigenesis is a heterogeneous disease driven by multiple genetic and epigenetic alterations. F-box and WD repeat domain containing 11 (FBXW11) is a member of the F-box protein family that regulates the ubiquitination of key factors associated with tumor growth and aggressiveness. Our study aimed to explore the role of FBXW11 in the development and metastasis of colorectal cancer (CRC). FBXW11 was overexpressed in colorectal tumor tissues and its overexpression was associated with a poor prognosis of CRC patients. The upregulation of FBXW11 not only promoted cell proliferation, invasion, and migration, but also contributed to maintaining stem-cell features in colorectal tumor cells. Further analysis revealed that FBXW11 targeted hypermethylated in cancer 1 (HIC1) and reduced its stability in CRC cells through ubiquitination. Moreover, the expression of sirtuin 1 (SIRT1), a deacetylase in tumor cells was upregulated by FBXW11 via regulating HIC1 expression. The mouse xenograft models of CRC confirmed that FBXW11 knockdown impeded colorectal tumor growth and liver metastasis in vivo. In summary, our study identified FBXW11 as an oncogenic factor that contributed to stem-cell-like properties and liver metastasis in CRC via regulating HIC1-mediated SIRT1 expression. These results provide a rationale for the development of FBXW11-targeting drugs for CRC patients.

In resource-limited countries, open appendectomy is still performed under general anesthesia (GA) or neuraxial anesthesia (NA). We sought to compare the postoperative outcomes of appendectomy under NA versus GA. We conducted a post hoc analysis of the International Patterns of Opioid Prescribing (iPOP) multicenter study. All patients ≥ 16 years-old who underwent an open appendectomy between October 2016 and March 2017 in one of the 14 participating hospitals were included. Patients were stratified into two groups: NA—defined as spinal or epidural—and GA. All-cause morbidity, hospital length of stay (LOS), and pain severity were assessed using univariate analysis followed by multivariable logistic regression adjusting for the following preoperative characteristics: age, gender, body mass index (BMI), smoking, history of opioid use, emergency status, and country. A total of 655 patients were included, 353 of which were in the NA group and 302 in the GA group. The countries operating under NA were Colombia (39%), Thailand (31%), China (23%), and Brazil (7%). Overall, NA patients were younger (mean age (SD): 34.5 (14.4) vs. 40.7 (17.9), p-value < 0.001) and had a lower BMI (mean (SD): 23.5 (3.8) vs. 24.3 (5.2), p-value = 0.040) than GA patients. On multivariable analysis, NA was independently associated with less postoperative complications (OR, 95% CI: 0.30 [0.10–0.94]) and shorter hospital LOS (LOS > 3 days, OR, 95% CI: 0.47 [0.32–0.68]) compared to GA. There was no difference in postoperative pain severity between the two techniques. Open appendectomy performed under NA is associated with improved outcomes compared to that performed under GA. Further randomized controlled studies should examine the safety and value of NA in lower abdominal surgery.

Background The long-term survival after vascularized composite allotransplantation (VCA) is often limited by systemic rejection as well as the adverse effects of immunosuppressants. The stromal vascular fraction (SVF) can be expanded to produce adipose-derived stem cells (ADSC) which represents a combination of endothelial cells, preadipocytes, immune cells, and ADSC. It has been demonstrated that ADSC possess consistently reliable clinical results. However, literature is scarce regarding SVF in VCA. This study seeks to determine the impact of ex vivo allograft pretreatment in combination with SVF cells in the ability to promote composite tissue allotransplantation immunotolerance. Methods A rat hind limb allotransplant model was used to investigate the influence of ex vivo pretreatment of SVF and ADSC on VCA survival. Intravascular cell-free saline, ADSC, or SVF was infused into the models with immunosuppressants. The histopathological examination and duration that the allografts went without displaying symptoms of rejection was documented. Peripheral T lymphocytes and Tregs were quantified with flow cytometry while allotissue expressions of CD31 were quantified with immunohistochemical staining (IHC). ELISA was used to detect vascular endothelial growth factor (VEGF)-A as well as anti- and pro-inflammatory cytokines. Results We demonstrated that ex vivo treatment of allografts with SVF or ADSC prolonged allograft survival in contrast to medium control cohorts. There were also enhanced levels of immunomodulatory cytokines and increased VEGF-A and CD31 expression as well as reduced infiltration and proliferation of T lymphocytes along with raised Treg expressions. Conclusion These studies demonstrated that adipose-derived cellular therapies prolong graft survival in an allogenic hind limb transplantation model and have the potential to establish immunotolerance.

Hepatocellular carcinoma (HCC) is a public health problem around the world, with the molecular mechanisms being still incompletely clear. This study was carried out to explore the role and mechanism of long-noncoding RNA (lncRNA) FEZF1-AS1 in HCC progression. RNA sequencing and quantitative real time polymerase chain reaction (qRT- PCR) were applied to identify differently expressed lncRNAs in HCC tissues and adjacent normal tissues. CCK8 assay was adopted to test cell proliferation and flow cytometry was taken to detect cell apoptosis. Wound healing assay and transwell experiment were performed to determine cell migration and invasion. To validate the function of lncRNA FEZF1-AS1 in vivo, tumor-burdened models were established. The results showed that lncRNA FEZF1-AS1 level was prominently enhanced in HCC tumor specimens and overexpression of FEZF1-AS1 promoted the proliferation, migration and invasion of HCC cells. In mechanism, overexpression of FEZF1-AS1 reduced the expression of miR-107 which inhibited the activation of Wnt/β-catenin signaling. Overexpression of β-catenin promoted cell proliferation, migration and invasion which were inhibited by FEZF1-AS1 downregulation. In conclusion, our study demonstrated that FEZF1-AS1 promoted HCC progression through activating Wnt/β-catenin signaling by targeting miR-107, which provided a novel target for the therapy of HCC.

目的 比较两种血培养直接药敏方法与常规药敏方法结果的一致性,评估两种前处理方法对血培养直接药敏的影响.方法 选取上海某三级教学医院2017年9月至2018年5月共241例血培养阳性样本,用分离胶管离心后分别使用直接检测法和TSB肉汤增菌法两种前处理方法获得细菌,并配置菌悬液,选择相应药敏卡进行药敏试验,得到的药敏结果与转种后获得菌落的常规药敏结果进行比较.结果 革兰阴性菌分离胶离心后直接检测法和增菌法与标准方法类别一致性分别为98.53％和98.74％(2753/2794、2759/2794),非常重大错误(VME)分别为0.21％和0.18％(6/2794、5/2794),重大错误(ME)分别为0.17％和0.21％(5/2794、6/2794),微小错误(MIE)分别为1.47％和1.25％(30/2840、24/2840).革兰阳性球菌(除链球菌)分离胶离心后直接检测法和增菌法与标准方法类别一致性为98.46％和99.13％(2048/2080、2061/2080),VME分别为0.34％和0.10％(7/2080、2/2080),ME分别为0.14％和0.19％(3/2080、4/2080),MIE分别为1.06％和0.63％(22/2080、13/2080).链球菌两种前处理方法与标准法类别一致性为100.00％(140/140).经过统计学分析,两种前处理方法直接体外药敏试验结果与标准法结果差异无统计学意义(P>0.05).结论 两种前处理直接药敏结果与标准法总符合率均为>98.00％,分离胶离心直接检测法操作简单无需繁琐的增菌过程,可以作为微生物实验室血培养替代直接药敏实验传统纸片法的一种方便又可靠的前处理方法.

目的:评价紫杉醇联合S-1方案的新辅助化疗治疗进展期胃癌的临床疗效及不良反应.方法:回顾性分析2014年7月至2017年7月在上海交通大学附属第六人民医院普外科接受治疗的55例进展期胃癌患者的临床资料.采用Kaplan-Meier法进行生存分析,Cox比例风险模型进行多因素预后分析.结果:新辅助化疗+手术组的R0切除率明显高于常规手术组(P<0.05);新辅助化疗+手术组的不良反应均可经对症处理后缓解,不影响治疗,停药后逐渐恢复.Cox比例风险模型显示:病理反应(P=0.002,RR=0.121,95％CI:0.014～0.453)、影像学疗效(P=0.009,RR=0.212,95％CI:0.076～0.478)和TNM分期(P=0.015,RR=1.712,95％CI:1.021～4.123)是影响新辅助化疗+手术组患者术后复发的独立因素.新辅助化疗+手术组的并发症发生率与常规手术组差异无统计学意义(P>0.05).结论:紫杉醇联合S-1方案是一个针对进展期胃癌新辅助化疗效果较好而不良反应较小的方案.

Objective: The International Patterns of Opioid Prescribing study compares postoperative opioid prescribing patterns in the United States (US) versus the rest of the world. Summary of Background Data: The US is in the middle of an unprecedented opioid epidemic. Diversion of unused opioids contributes to the opioid epidemic. Methods: Patients >= 16 years old undergoing appendectomy, cholecystectomy, or inguinal hernia repair in 14 hospitals from 8 countries during a 6-month period were included. Medical records were systematically reviewed to identify: (1) preoperative, intraoperative, and postoperative characteristics, (2) opioid intake within 3 months preoperatively, (3) opioid prescription upon discharge, and (4) opioid refills within 3 months postoperatively. The median/range and mean/standard deviation of number of pills and OME were compared between the US and non-US patients. Results: A total of 4690 patients were included. The mean age was 49 years, 47% were female, and 4% had opioid use history. Ninety-one percent of US patients were prescribed opioids, compared to 5% of non-US patients (P < 0.001). The median number of opioid pills and OME prescribed were 20 (0-135) and 150 (0-1680) mg for US versus 0 (0-50) and 0 (0-600) mg for non-US patients, respectively (both P < 0.001). The mean number of opioid pills and OME prescribed were 23.1 +/- 13.9 in US and 183.5 +/- 133.7 mg versus 0.8 +/- 3.9 and 4.6 +/- 27.7 mg in non-US patients, respectively (both P < 0.001). Opioid refill rates were 4.7% for US and 1.0% non-US patients (P < 0.001). Conclusions: US physicians prescribe alarmingly high amounts of opioid medications postoperatively. Further efforts should focus on limiting opioid prescribing and emphasize non-opioid alternatives in the US.

Prior work supports the hypothesis that ATP release through connexin hemichannels drives spontaneous Ca2+ signaling in non-sensory cells of the greater epithelial ridge (GER) in the developing cochlea; however, direct proof is lacking. To address this issue, we plated cochlear organotypic cultures (COCs) and whole cell-based biosensors with nM ATP sensitivity (ATP-WCBs) at the bottom and top of an ad hoc designed transparent microfluidic chamber, respectively. By performing dual multiphoton Ca2+ imaging, we monitored the propagation of intercellular Ca2+ waves in the GER of COCs and ATP-dependent Ca2+ responses in overlying ATP-WCBs. Ca2+ signals in both COCs and ATP-WCBs were inhibited by supplementing the extracellular medium with ATP diphosphohydrolase (apyrase). Spontaneous Ca2+ signals were strongly depressed in the presence of Gjb6-/- COCs, in which connexin 30 (Cx30) is absent and connexin 26 (Cx26) is strongly downregulated. In contrast, spontaneous Ca2+ signals were not affected by replacement of Panx1-/- with Panx1+/+ COCs in the microfluidic chamber. Similar results were obtained by estimating ATP release from COCs using a classical luciferin-luciferase bioluminescence assay. Therefore, connexin hemichannels and not pannexin 1 channels mediate the release of ATP that is responsible for Ca2+ wave propagation in the developing mouse cochlea. The technological advances presented here have the potential to shed light on a plethora of unrelated open issues that involve paracrine signaling in physiology and pathology and cannot be addressed with standard methods.

Systemic immunosuppression is indispensable for vascularized composite allotransplantation (VCA). Daily administration of standard triple therapy regimen of tacrolimus (FK506), mycophenolate mofetil (MMF), and steroid has severe side effects and reduces the compliance of VCA recipients. To overcome these hurdles, FK506/MMF/prednisolone (PDNN) was loaded into PLGA microspheres (PGLA MS). A single injection of FK506/MMF/PDNN-PLGA MS significantly prolonged the survival time of allograft in a rat hind limb transplantation model with a median survival time (MST) of more than 150 days compared to 34.5 days in the group treated orally with FK506/MMF/PDNN and 11 days in the nontreatment allograft and MS control groups. Analysis of showed that FK506/MMF/PDNN-PLGA MS could maintain relatively higher plasma and tissue drug concentrations for a long time. Moreover, histopathology and flow cytometry of circulating mononuclear cells revealed significantly prolonged immunosuppression by the FK506/MMF/PDNN-PLGA MS compared with the orally given FK506/MMF/PDNN. In conclusion, a single injection of FK506/MMF/PDNN-PLGA MS may provide a new approach for long-term prevention of immune rejection in VCA.

Full-thickness skin wounds are common and could be a heavy physical and economic burden. With the development of three dimensional (3D) printing technology, skin-like constructs have been fabricated for skin wound healing and regeneration. Although the 3D printed skin has great potential and enormous advantages before vascular networks can be well-constructed, living cells are not recommended for 3D skin printing for in vivo applications. Herein, we designed and printed a bilayer membrane (BLM) scaffold consisting of an outer poly (lactic-co-glycolic acid) (PLGA) membrane and a lower alginate hydrogel layer, which respectively mimicked the skin epidermis and dermis. The multi-porous alginate hydrogel of the BLM scaffolds promoted cell adhesion and proliferation in vitro, while the PLGA membrane prevented bacterial invasion and maintained the moisture content of the hydrogel. Skin regeneration using the bilayer scaffold was compared with that of PLGA, alginate hydrogel and the untreated defect in vivo. Tissue samples were analyzed using histopathological and immunohistochemical staining of CD31. In addition, mRNA expression levels of collagen markers [collagen type 1 alpha 1 (COL1a1) and collagen type 3 alpha 1 (COL3a1)] and inflammatory markers [interleukin-1β (IL-1β), as well as tumor necrosis factor (TNF-α)] were measured. Conclusively, the application of BLM scaffold resulted in highest levels of best skin regeneration by increasing neovascularization and boosting collagen I/III deposition. Taken together, the 3D-printed BLM scaffolds can promote wound healing, and are highly suitable for a wide range of applications as wound dressings or skin substitutes.

Limited evidence exists to precisely estimate efficacy and safety differences between parenteral nutrition (PN) prepared using olive-oil-based three-chamber bags (3CBs) and soybean-oil-based compounded bags (CoBs) in hospitalized adult patients. We designed a multicenter, randomized, prospective, open-label, noninferiority protocol to compare the efficacy, safety, and distribution of olive-oil-based 3CBs and soybean-oil-based CoB formulations in adult Chinese patients requiring PN during surgical intervention. Subjects were randomized to receive either one of the study treatments using an interactive voice or web-based recognition system in accordance with the randomization code. Randomization was further stratified based on the study site and surgical category. Both treatment groups received similar amounts of calories and protein. In addition, the two study treatments contained a similar composition of the amino-acid component. The only difference between the two PN formulations was the lipid constitution. The duration of administration of study treatments was a minimum of 5 days up to a maximum of 14 days after the surgical procedure. The primary efficacy endpoint was serum prealbumin levels on day 5 of the study. Noninferiority was proved if the anti-log of the lower bound of the 95% confidence interval (CI) of the treatment difference was at least 0.80. Other efficacy measures included treatment preparation time; duration to achieve tolerability of oral nutrition; associated infectious complications; length of hospitalization; and laboratory assessment of markers of nutrition, inflammation, metabolism, and oxidative stress. A total of 458 patients were enrolled in the study. The results showed that olive-oil-based 3CBs were non-inferior to soybean-based CoBs, besides being well tolerated. The infection rate was found to be significantly lower in the olive-oil-based 3CB group. Thus, this study may be used as a reference for future research on lipid emulsion and 3CBs.

为追溯新建水源库区污染物质的来源及变化,选取上海市金泽水库为研究区,利用三维荧光光谱结合平行因子分析法,研究金泽水库水体溶解性有机物(DOM)组成结构及空间分布特征.结果 表明:DOM由类蛋白质组分、类色氨酸组分、类富里酸组分组成;通过计算腐化指数(HIX)、生物源指数(BIX)和荧光指数(FI),得出水体DOM是腐化程度很低、具有强生物活性,主要受生物源作用;在3月和6月总荧光强度表现为前置库区＜深度净化区＜生态净化区,12月总荧光强度随水流方向升高,类富里酸在不同月份均随着水流方向降低;总荧光强度随时间的变化表现为3月＜12月＜6月.

目的 通过观察腹部术后患者的体表胃电图(electrogastrogram,EGG)波形变化,结合数字肠胃影像学、上腹部临床症状分度评分以及生化指标等多参数探讨腹部术后胃瘫发生的可能性.方法 47例腹部手术患者,根据其术后是否发生胃瘫分为胃瘫组和对照组.比较2组间术前24 h、术后72、96和120 h体表EGG的差异.同时对47例患者进行数字肠胃影像学检查、上腹部临床症状分度评分以及生化指标检测.结果 胃瘫组术后EGG波形中正常胃电慢波消失,呈胃电节律紊乱;胃电节律紊乱患者的数字肠胃影像学报告考虑胃瘫可能;胃瘫组在术后72 h的恶心、呕吐和反酸评分均较同阶段的对照组显著升高(均P<0.01);胃瘫组术前24 h的血红蛋白和总胆红素含量显著低于对照组(P<0.01和P<0.05),术后24 h的白细胞计数显著高于对照组(P<0.01).结论 EGG联合多参数对预测腹部术后胃瘫发生的可能性有一定参考.胃瘫发生可能与患者自控镇痛的耐受性有关.

Heterologous acellular dermal matrix (ADM) has good biocompatibility and sufficient strength for clinical use for the repair of defects, tissue filling, and resurfacing of deep wounds. However, ADM tissue has such a compact structure that it can easily result in delayed vascularization after implantation. Moreover, in spite of the low immunogenicity of heterologous ADM, it can still cause varying degrees of inflammation in the host. These two drawbacks limit the efficacy and scope of clinical applications for heterologous ADM. Adipose-derived stem cells (ADSCs) have multiple effects on promoting vascularization and regulating immunological responses through paracrine signaling. Pre-culturing heterologous ADM with ADSCs may address these problems; however, it is unknown if ADSCs can exert their paracrine functions within a heterologous ADM microenvironment. This study examined the effect of porcine ADM (PADM) on the paracrine function of rat ADSCs (rADSCs) and showed that the expression of genes associated with inflammatory regulation, pro-angiogenesis factors, and stemness increased when rADSCs were seeded on PADM compared to rADSCs seeded on microplates. This indicates that PADM can provide a beneficial microenvironment for ADSCs to exert their paracrine function. After pre-culture, in vivo implanted rADSC-PADM exhibited improved vascularization and mitigated inflammatory response compared to untreated PADM. This study is the first to report that ADM can provide a suitable microenvironment for ADSCs and that pre-culturing improved the ADM implantation quality in vivo. These results suggest that it could be possible to apply heterologous ADM more effectively and broadly for repair and reconstruction treatments.

目的:探讨胃电图在远端胃切除术后预测胃瘫发生中的临床意义.方法:47例远端胃切除患者根据术后是否发生胃瘫分为胃瘫组及对照组.比较两组术前及术后72 h、96 h、120 h体表胃电图的差异.同时对47例患者进行上腹部临床症状分度评分和生化指标检测.结果:与对照组相比,胃瘫组术后各阶段正常胃电慢波百分比均有升高趋势,手术前后各阶段胃电振幅均值均有不同程度减小;胃瘫组在术后72 h的恶心、呕吐和反酸评分均较对照组显著升高(P＜0.01);胃瘫组术前血红蛋白和总胆红素含量均显著低于对照组(P＜0.01和P＜0.05),术后的白细胞计数显著高于对照组(P＜0.01).结论:胃电图参数结合上腹部临床症状分度评分和生化指标对腹部术后发生胃瘫可能性有一定参考.