Low-dose heparin for the prevention of post-ERCP pancreatitis: a randomized placebo-controlled trial

Background  As suggested by observational and animal studies, heparin has antiinflammatory effects that could prevent acute post–endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. Low-molecular-weight heparin did not reduce the incidence of post-ERCP pancreatitis in a controlled study. The current study aimed to determine whether prophylactic administration of low-dose unfractionated heparin, which has potentially more antiinflammatory capability, can prevent acute post-ERCP pancreatitis. Methods  Patients scheduled for ERCP in the authors’ department were randomized to receive unfractionated heparin (5,000 IU) or placebo (saline solution 0.5 ml) administered subcutaneously 20 to 30 min before the ERCP. Patients who had undergone endoscopic sphincterotomy in the past were excluded from the study. Post-ERCP pancreatitis was defined according to criteria established by Cotton: abdominal pain combined with a threefold elevation of blood amylase 24 h after the ERCP. Results  The study enrolled 106 patients. One patient was excluded from the analysis due to inaccessible papilla of Vater, leaving 51 patients in the heparin group and 54 in the placebo group, for a total of 105 patients (62 women and 43 men) with a mean age of 64.6 years. The rate of post-ERCP pancreatitis was not different between the groups (heparin, 4 patients, 7.8%; placebo, 4 patients, 7.4%). Two patients in each group experienced mild bleeding. Conclusions  The study did not demonstrate a significant effect of low-dose unfractionated heparin in the prevention of post-ERCP pancreatitis. A multicenter trial with a larger number of patients is needed to demonstrate a benefit from this drug.     

The use of tissue sealant to prevent fistula formation after laparoscopic distal pancreatectomy

Background Pancreatic fistula occurs in about 20% of patients undergoing laparoscopic pancreatectomy. A variety of techniques have been described to decrease this rate, with limited success. Fibrin sealants are products that promote the adhesion of tissue surfaces to each other. This report demonstrates the use of fibrin sealants to decrease the incidence of pancreatic fistula. Methods After completion of the laparoscopic or hand-assisted distal pancreatectomy, 5 ml of fibrin sealant (Tisseal; Baxter Healthcare, One Baxter Parkway, Deerfield, IL, USA) is applied to the cut edge of the pancreatic remnant. Omentum, which has been dissected to expose the raw surface, is then applied over the pancreatic remnant and fastened to the cut edge by the fibrin sealant. A drain is placed over the omentum in the left upper quadrant. Postoperative computed tomography (CT) scans are obtained on postoperative day 3 to determine whether any fluid collections are present. A pancreatic fistula is defined as any amylase-rich fluid found in the drain or any juxtaposed fluid collection next to the pancreatic remnant on postoperative day 3. Results A total of eight patients underwent laparoscopic distal pancreatectomy with the use of fibrin sealant. These were compared with the previous 13 patients who underwent laparoscopic distal pancreatectomy without fibrin sealant. No patients in the fibrin sealant group experienced pancreatic fistula, as compared with three patients (23%) in the no sealant group. Conclusions Although this series was small, it does suggest that the use of fibrin sealant may reduce the incidence of postoperative pancreatic fistula formation after laparoscopic distal pancreatectomy. Electronic supplementary material The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

Size matters: gastric pouch size correlates with weight loss after laparoscopic Roux-en-Y gastric bypass

Background Over the past 20 years, there has been an ongoing discussion about the importance of gastric pouch size as a key factor influencing weight loss after bariatric surgery. This analysis aimed to determine the relationship between initial gastric pouch size and excess weight loss (EWL) after laparoscopic Roux-en-Y gastric bypass (LRYGB). Methods Between August 2002 and March 2005, 320 LRYGB were performed at Yale New Haven Hospital. The patients’ demographics were entered into a longitudinal, prospective database. Upper gastrointestinal series were routinely performed on postoperative day 1. Pouch size was measured as area (cm²) on an anteroposterior radiograph at maximum pouch distention. Linear regression analysis was performed to determine the association between pouch size and weight loss at 6 and 12 months postoperatively. Adjustments were made for age, gender, and preoperative body mass index (BMI). Results The mean age of the patients was 41.2 years. Of the 320 study patients, 261 were women (81.6%) and 59 were men (18.4%). The mean preoperative BMI was 51.1 kg/m²; the mean 6-month EWL was 50.5%; the mean 12-month EWL was 62.5%; and the mean pouch size was 63.9 cm². A statistically significant, negative correlation between pouch size and EWL was found at 6 months (β = –0.241; p < 0.01) and at 12 months (β = –0.302; p < 0.02). The findings show that male gender (β = 0.147; p < 0.04) and preoperative BMI (β = 0.190; p < 0.01) are positively correlated with pouch size. Conclusion The analysis demonstrates that initial gastric pouch size is not the only significant component for successful weight loss after LRYGB. Male gender and increased preoperative BMI were identified as factors predicting pouch size. Efforts to standardize small pouch size for all patients seems important to the success of surgical therapy for morbid obesity.     

摘要的类型及英文摘要写作中常见的问题

本文列举了医学论文英文摘要的常见类型,并对目前国内中文医学期刊中英文摘要写作中存在的一些问题作了初步探讨。     

英文医学科技论文中副词的使用

简要总结了英文医学科技论文中副词的用法,对副词在句中的位置作了翔实阐述。     

桂枝汤的文献分析研究

采用文献计量分析法,选用中国医学科学院信息研究所建立的“中国生物医学文献数据库”为资料来源。以1992~2004年以来研究桂枝汤的文献为研究对象,对文献年代、期刊分布、副主题词、文献类型、疾病研究、药理实验等6个方面进行统计分析,揭示其分布特点,以求定量描述,有助于了解和加强对桂枝汤的研究。     

人口与健康领域国家"十一五"科技支撑计划中标人发表论文的计量分析

目的 了解人口与健康领域国家"十一五"科技支撑计划课题中标人中标前的学术积累情况.方法 使用文献计量方法查询相关数据并进行统计分析.结果 135个课题中标人共发表论文5154篇,高等级期刊发表论文占47.4%,高校及科研机构发文量占93%,作者论文署名居前三位比例较高,论文与其所中标课题研究领域的学科一致性达91.05%.结论 文献计量分析结果表明,课题中标人在本研究领域中确实具有相当高的科研积累和学术影响力.     

安徽某儿童医院2001-2010年间发表科技论文情况分析

目的 通过分析安徽某儿童医院2001 - 2010年间发表科技论文及著者情况,了解该院科研综合实力和趋势,为医院推进儿科科研工作提供决策依据.方法 汇总该院2001 - 2010年10年间发表科技论文数量、级别、论文发表专业人员的年龄、专业和职称结构以及学历（学位）等数据,并分析不同学历（学位）人员发表在统计源期刊以上专业杂志的差异性.结果 该院10年间论文发表总量呈逐年增长趋势,但统计源以上论文数量仍较少,核心著者群尚未完全形成;大内科发文量保持较大比重;30 - 50岁、中级职称、本科学历的作者是发表论文主力军;硕士以上学历作者发表统计源以上论文的比例,尤其在中华系列医学杂志发表比例显著较高.结论 继续支持鼓励高产作者群,加大对潜在作者的支持培养力度,以尽快形成稳定的核心著者群,扩大论文发表总量,并着力提升论文发表水平,是医院下一步科教工作的重点.     

Analysis by surface enhanced Raman spectroscopy on silver hydrosols and silver coated filter papers

Surface enhanced Raman spectrometry (SERS) is an analytical technique with a sensitivity comparable to that of conventional molecular absorption or fluorescence spectroscopy, with the additional major advantage of selectivity inherent in vibrational spectroscopies. The analytical application of flowing silver hydrosols is described. Under the controlled experimental conditions of flow injection analysis, it was possible to detect as low as 30 ng of p-aminobenzoic acid. The linear range was two orders of magnitude (1–100 μg ml⁻¹) with a signal reproducibility of 3.2%. Silver coated filter paper is another SERS active substrate that is simple to prepare and handle. The SERS spectra of several nitrogen-containing molecules were obtained on these substrates. The effects of laser power and paper hydration are described. The relative advantages of both substrates are compared.