Robotic-assisted versus open total pancreatectomy: a propensity score-matched study

BackgroundTotal pancreatectomy (TP) is a complex surgical procedure with significant postoperative morbidity. Despite the narrowed range of indications for TP, the introduction of neoadjuvant chemotherapy and the increasing complexity of surgical resections performed in high-volume centers has increased the number of annually performed TPs, especially regarding malignant disease. The introduction of robotic-assisted pancreatic surgery has provided a novel and minimally invasive approach for TP, yet the feasibility of this technique is still unknown. This study assessed the safety and efficacy of robotic-assisted total pancreatectomy (RTP) compared to conventional open total pancreatectomy (OTP).MethodsAll patients who underwent TP between March 2015 and July 2019 in a high-volume institution for pancreatic surgery were included in this retrospective study. Clinical data and perioperative outcomes were derived from the prospectively maintained institutional database. A 1:1 propensity score matching (PSM) method was utilized to compare the RTP and OTP cohorts to minimize bias.ResultsA standardized surgical protocol was utilized for RTP following a learning curve of RPD and RDP. The median operative time for patients who underwent RTP was significantly decreased compared to those who underwent OTP [300 (IQR, 250–360) vs. 360 min (IQR, 300–525), P=0.031]. Additionally, en bloc resection and spleen-preserving rates were also higher in the RTP cohort. Major 30-day morbidity (Clavien-Dindo > IIIa) and 90-day mortality were similar between the two cohorts. After a median follow-up time of 15 (IQR, 8–24) months, both the RTP and OTP cohorts had a comparable quality of life regarding exocrine and endocrine insufficiency.ConclusionsRTP appears to be safe and feasible when utilized in high-volume centers for the indicated management of benign and highly selected malignant pancreatic disease. However, further prospective randomized studies are needed to assess the feasibility of this approach.     

A humanized TCR retaining authentic specificity and affinity conferred potent anti‐tumour cytotoxicity

The affinity of T‐cell receptor (TCR) determines the efficacy of TCR‐based immunotherapy. By using human leucocyte antigen (HLA)‐A*02 transgenic mice, a TCR was generated previously specific for human tumour testis antigen peptide MAGE‐A3_112–120 (KVAELVHFL) HLA‐A*02 complex. We developed an approach to humanize the murine TCR by replacing the mouse framework with sequences of folding optimized human TCR variable domains for retaining binding affinity. The resultant humanized TCR exhibited higher affinity and conferred better anti‐tumour activity than its parent murine MAGE‐A3 TCR (SRm1). In addition, the affinity of humanized TCR was enhanced further to achieve improved T‐cell activation. Our studies demonstrated that the human TCR variable domain frameworks could provide support for complementarity‐determining regions from a murine TCR, and retain the original binding activity. It could be used as a generic approach of TCR humanization.     

体外电磁冲击波碎石治疗膀胱结石的体会

我院2003年1月-2005年12月使用科达ESWLNE-VB型电磁冲击波体外碎石机治疗膀胱结石61例，临床疗效满意，现报告如下。 1资料与方法 1．1一般资料本组病例61例，男54例，年龄30-87岁，平均67岁，女7例，年龄23-75岁，平均46岁。     

Ferroptosis Markers Predict the Survival,Immune Infiltration,and Ibrutinib Resistance of Diffuse Large B cell Lymphoma

Inflammation - Diffuse large B cell lymphoma (DLBCL) is the most common hematological malignancy in adults. Ferroptosis is an iron-dependent programmed cell death caused by lipid peroxidation....     

脂质体包封血红蛋白体外对血液流变性影响的研究

本文对脂质体包封血红蛋白（LEH）体外对血液流变性影响进行初步研究。观察了几种不同磷脂组成和配比的脂质体与 LEH对体外血栓形成、血液粘度和红细胞聚集指数的影响。研究发现，ＬＥＨ能使血液粘度降低，并可改善红细胞聚集指数，ＬＥＨ加入到血液中不会导致血栓形成，尚有轻微减缓体外血栓形成作用。     

血清ALP和LDH两种同工酶在不同组织学类型胃癌时的变化

本文对不同组织学类型的胃癌的血清标本进行了碱性磷酸酶（ALP）同工酶实验研究。结果表明：管状腺癌和乳头状腺癌患者血清有异常的碱性磷酸酶同工酶表达，并发现血清中乳酸脱氢酶（LD）同工酶的LD3和LD5的升高与胃癌的淋巴结转移和肝转移密切相关。