BackgroundDistribution of regional lymph nodes (LNs) is decisive for the lymphadenectomy boundary in radical resection of a right-sided colon cancer (RCC). Currently, the data of LNs in central area remains ambiguous and scarce. Herein we aim to provide a more detailed anatomical research on LNs surrounding the superior mesenteric vessels for RCC and investigated the metastasis rate.MethodsCarbon Nanoparticles (CNs) or Indocyanine Green (ICG) were used as dye and we laparoscopically observed the stained LNs distribution pattern and analyzed the harvested LNs combined with pathology report. Lastly, 137 RCC patients who received a “superior mesenteric artery (SMA)-oriented” hemicolectomy from September 2016 to September 2020 were included to calculate the probability of LNs metastasis in our target area.Results20 patients diagnosed as RCC (mean age 55.55 years, 13 male) were included. 13 patients underwent CNs injection and 7 patients consented to the ICG, while 4 cases suffered from imaging failure. The unequal number of the regional LNs located between SMV and SMA was detected in 17 cases (85%), posterior to SMV area in 6 cases (30%), and anterior to SMA in 11 cases (55%), respectively. The presence of LNs posterior to SMV was associated with the crossing pattern of ileocolic artery (²= 5.38, p= 0.020). The probability of LNs metastasis in the above areas (target areas) was 2.19% (3/137). No dyed LNs occurred when the SMA sheath was exposed. What’s more, the number of total harvested LNs in patients with dye injection was significant more than dye-free RCC patients (22.44±13.78 vs 43.20±22.70, p<0.01). ConclusionRight-hemi colon-draining lymphatic vessels anteriorly/posteriorly traversed the SMV and arrived at the surface of SMA near the middle colonic artery (MCA) level, which highlights the potential need of CME to place the internal border anterior to SMA and the removal of mesenteric tissue in our target area on lymphatic resection.
A hydrostable anionic zinc-organic open framework with a bcu topology was synthesized based on 2,5-furandicarboxylate ligand by a solvothermal process and exhibited a 17.2 wt% 5-fluorouracil payload, constituting a negligible cytotoxicity effect.
Background:Patients with coronary heart disease (CHD) who undergo percutaneous coronary intervention (PCI) have a certain risk of vascular complications, including coronary restenosis and thrombosis. Many recent randomized controlled trials have reported that Danshen injection (DSI) combined with conventional Western medicine can significantly reduce the occurrence of major cardiovascular adverse events in patients with CHD after PCI. However, there are many types of DSIs, and no study has yet compared each type. Therefore, we propose a study protocol for the systematic evaluation of the efficacy of various DSIs in the treatment of CHD after PCI.Methods:We will search the following electronic databases for randomized controlled trials evaluating the effect of DSI in patients with CHD after PCI: PubMed, Embase, Web of Science, Cochrane Library, Scopus, Ovid Evidence-Based Medicine Reviews, China National Knowledge Infrastructure, and Chinese Biomedicine Literature Database. Each database will be searched from inception to April 2018. The entire process will include study selection, data extraction, risk of bias assessment, pairwise meta-analyses, and network meta-analyses.Results:This proposed study will compare the efficacy of different DSIs in the treatment of patients with CHD after PCI. The outcomes will include major cardiovascular adverse events and left ventricular ejection fraction.Conclusion:This proposed systematic review will evaluate the different advantages of various types of DSIs in the treatment of patients with CHD after PCI.Registration:PROSPERO (registration number: CRD42018092705).
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