Background Minimally invasive McKeown esophagectomy is an important surgical approach for esophageal cancer. Anastomotic leak is one of its common and serious complications. We assumed that the preoperative risk factors and postoperative indicators would predict or detect anastomotic leak. Methods Between December 2016 and July 2017, patients underwent minimally invasive McKeown esophagectomy were identified and their preoperative variables and postoperative test indicators were recorded. Fisher’s exact test, 2-tailed unpaired t test, nonparametric test and logistic regression were used to compare these datum between patients with or without anastomotic leak (AL). Receiver Operator Characteristic (ROC) curve was used to identify the best cut-off value of drainage amylase concentration for distinguishing anastomotic leak. Results In all the 96 patients included, 12 patients were diagnosed as anastomotic leak by the esophagram. No differences in preoperative variables were observed between patients with and without AL. Patients in AL group appeared to have a lower prealbumin concentration in AL group on POD (postoperative day) 4( P = 0.05), POD 5( P = 0.04), POD 6 ( P = 0.06). Prealbumin concentration cutoff value of 128 g/L on postoperative day 5 is 100.00% sensitive and 50.00% specific for predicting esophageal leaks. Drain amylases levels were higher in patients with anastomotic leak than those without anastomotic leak on POD 3( P = 0.03), POD 4( P = 0.01), POD 5( P < 0.001), POD 6( P < 0.001). The drain amylase cutoff value of 85 IU/L on postoperative day 4 was 75.00% sensitive and 84.00% specific for detecting esophageal leaks; the cutoff value of 65 IU/L on postoperative day 5 was 91.67% sensitive and 80.77% specific. The cutoff of 55/L on POD 6 is 100% sensitive and 86.96% specific. Conclusion Drainage amylase concentration on postoperative days may help to discover anastomotic leak in early stage after minimally invasive McKeown esophagectomy. Prealbumin concentration below 128 g/L on POD 5 might be potential risk factor for anastomotic leak.
Background For thoracic surgeons, three-dimensional computed tomography bronchography and angiography (3-DCTBA) is a convenient way to analyze pulmonary variations before segmentectomy. Mediastinal lingular artery (MLA) is one of the representative variations. Methods The 3-DCTBA data of left upper lobe (LUL) were collected from patients who underwent pulmonary surgery from January 2018 to December 2019. We reviewed the patterns of bronchi and pulmonary vessels and grouped them according to different classifications. Results Among all the 404 cases of 3-DCTBA, mediastinal lingular artery (MLA) was found in 107 cases (26.49%). The patterns of B3 and the vein in left upper division (LUD) are distinct between mediastinal (M-type) group and interlobar (IL-type) group. The patterns of bronchi and veins in lingular division, as well as the pattern of pulmonary artery in LUD, have no differences between M-type and IL-type groups. Conclusions Mediastinal lingular artery is speculated to originate from the variation of B3, and the MLA independently influences the venous pattern in LUD in turn.
Platinum-based chemotherapeutic drugs such as cisplatin, carboplatin and oxaliplatin are widely applied for the treatment of various types of tumors. However, poor solubility, serious side effects, and more importantly, the intrinsic and acquired resistance limit their clinical applications. These factors motivate scientists to design and synthesize novel and more potent analogues lacking disadvantages of clinical platinum drugs. Platinum (IV) complexes are one of representatives. In this review, we summarized the investigations undertaken into Platinum (IV) antitumor compounds since Rosenberg first noted their antitumor activity. The synthesis method and mechanism of action of Platinum (IV) complexes are outlined, as well as their chemical and pharmacological properties. Recent advances in Platinum (IV) anticancer agents that have been in clinical trials and photoactivatable Platinum (IV) complexes are also summarized, and the purpose here is to provide insight into the requirements for the antitumor activity of Platinum (IV) complexes and a basis for progressing in a new platinum compound.
The Lilium lancifolium Thunb. is a herb with multiple functions in both medicine and food in China, and its extracts have shown antidepressant effects. In this study, fresh bulbs of Lilium lancifolium Thunb. were processed to study the effects of different drying processes on changes in its main chemical components. We found that different drying methods can affect the chemical constituents of the herb. Among these components, Regaloside A has been found as the characteristic component. Here, Cell Counting Kit‐8 assay, and Western blotting were used to evaluate the neuroprotective antidepressant effects of Regaloside A. The results showed the cell survival rate was improved, the phosphorylation levels of brain‐derived neurotrophic factor, tyrosine kinase receptor B, phosphatidylinositol 3 kinase, protein kinase B, and mammalian target of rapamycin were increased after Regaloside A treatment. In general, different drying methods have a significant influence on the chemical composition of the herb, and Regaloside A may be the main chemical component of the herb. It can alleviate the damage of corticosterone in SH‐SY5Y cells, and phosphatidylinositol‐3‐kinase/protein kinase B/mammalian target of rapamycin signaling mediated by brain‐derived neurotrophic factor/tyrosine kinase receptor B may play an important role in the neuroprotective antidepressant effects of Regaloside A.
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