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Objective:To explore the clinical characteristics and prognosis of newly diagnosed CD5-positive diffuse large B-cell lymphoma (DLBCL).Methods:The clinical data of 19 newly diagnosed CD5-positive DLBCL patients in Tenth People's Hospital of Tongji University and Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine between January 2015 and December 2018 were retrospectively analyzed. Their clinical characteristics and laboratory indexes were observed; Kaplan-Meier method was used for survival analysis, and Cox proportional risk model was used to make multifactor analysis of the prognostic factors.Results:The median age of 19 newly diagnosed CD5-positive DLBCL patients was 63 years (34-76 years). All 19 patients included 13 cases with Ann Arbor Ⅲ-Ⅳ stage; 12 cases with lactate dehydrogenase higher than the normal value limit, 9 cases with international prognostic index scores ≥ 4, 13 cases with B symptoms, 10 cases with Ki-67 positive index ≥ 80%, 15 cases with more than 1 lymph extra nodal organ involvement and 8 cases with tumor mass (mass diameter ≥ 7 cm). The 2-year progression-free survival (PFS) rate was 47.4% and 2-year overall survival (OS) rate was 63.2%. Univariate analysis showed that Ann Arbor stage, tumor mass, lymph extra nodal involvement and ≥ 4 courses of intrathecal injection were associated with OS (all P < 0.05). Multivariate analysis showed that Ann Arbor stage (stage Ⅰ-Ⅱ vs. stage Ⅲ-Ⅳ: HR = 0.158, 95% CI 0.031-0.803, P = 0.026), tumor mass (tumor diameter < 7 cm vs. tumor diameter ≥ 7 cm: HR = 0.076, 95% CI 0.009-0.637, P = 0.018)and ≥ 4 courses of intrathecal injection (yes vs. no: HR = 9.130, 95% CI 1.062-78.157, P = 0.044) were independent influencing factors for OS. Conclusions:Newly diagnosed CD5-positive DLBCL is highly aggressive and susceptible to extra nodal infiltration. Ann Arbor stage Ⅲ-Ⅳ, tumor mass, and not receiving ≥ 4 courses of intrathecal injection are independent risk factors affecting the prognosis of CD5-positive DLBCL patients.
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Objective To observe the effect of Xiaochaihutang on ammonia-induced edema of astrocytes in rats and explore the mechanism of Xiaochaihutang in the treatment of cerebral edema based on NF-κB signaling pathway.Methods Astrocytes were isolated from the cerebral cortex of SD rats 1-2 days old.When the cell content was more than 95%,the cells could be subcultured and divided into three groups:Vehicle group(10%blank control group serum,Vehicle),Model group(10%blank control group serum+5 mmol·L-1 ammonium chloride,Model),and Xiaochaihutang group(10%serum+5 mmol·L-1 ammonium chloride,XCHT).The expression of AQP4 was detected by immunofluorescence.The levels of AQP4,GFAP,and TNF-α were detected by RT-PCR and Western blot.NF-κB P65 was measured by Western blot.Results ① Ammonium chloride increased the expression of AQP4 in astrocytes(P<0.01)and decreased the expression of GFAP(P<0.05,P<0.01),however,the expression of AQP4 in astrocytes decreased(P<0.01)while GFAP increased(P<0.05)after the intervention of serum containing Xiaochaihutang.② Compared with the Vehicle group,the expression level of TNF-α and phosphorylation of NF-κB P65 in the Model group was significantly increased(P<0.05),while after Xiaochaihutang serum medicated treatment,TNF-α and phosphorylation of NF-κB P65 content lower(P<0.05).Conclusion Xiaochaihutang can improve the edema of astrocytes induced by ammonia and enhance the activity of astrocytes.Its mechanism may be related to inhibition of NF-κB signaling pathways,and reduce inflammation medium(especially TNF-α)produced and released.
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Inflammation is the basic pathological process of a variety of diseases, which involved in the occurrence and development of female infertility-related diseases, especially in bacteria and viruses infection of reproductive system, resulting in infertility. However, inflammatory reactions and factors also exist in normal physiological processes, such as endometrial morphologic changes in menstrual cycles, follicle genesis, ovulation, luteinization, pregnancy, etc. In addition, inflammation is also involved in the occurrence of some reproductive endocrine and metabolic diseases, such as obesity, endometriosis, polycystic ovary syndrome and so on. In the past, the understanding to inflammation in reproductive system was mostly limited to the inflammatory diseases and resulted in fertility decline or sterility, infertility, and other problems, which was not comprehensive. This review summarized the normal physiological inflammation and disease-related inflammation in the reproductive system, and described the evaluation of inflammatory state, as well as relevant prevention and treatment suggestions.
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Retinoic acid (RA) is a metabolic intermediate of vitamin A, which plays an important role in embryonic development and cell growth and differentiation. Cellular retinoic acid-binding proteins 2 (CRABP2) are a group of low-molecular weight intracellular proteins whose primary physiological function is to transport RA to the nucleus. Generally, CRABP2 binds to the retinoic acid receptor (RAR), then regulates specific downstream signaling pathways to function. Abnormal expression of CRABP2 was closely related to several human malignant tumors, and could affect the tumor occurrence and development through regulating multiple growth or apoptosis associated pathways or key biological molecules. Therefore, CRABP2 may be considered as a new diagnostic and prognostic marker for cancer, and a new therapeutic target for malignant tumors. Our present article summarizes the relationship between CRABP2 and tumor progression, drug resistance and prognosis, so as to provide reference for the future research.
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Objective:To explore the effectiveness of self-assisted couple communication program(SACCP)onprenatal depression and marital quality in pregnant women.Methods:Totally 90 pregnant women receiving ante-natal checkup in Air Force Medical Center with the Edinburgh Postnatal Depression Scale(EPDS)scores of ≥10 were voluntarily recruited and randomly allocated in routine caring and SACCP groups.Thirty-nine pregnant women in SACCP group and 37 pregnant women in routine caring group ultimately completed the study.In addition to rou-tine caring,the SACCP group completed a 10-week self-assisted family communication program once a week.The EPDS and Olson Marital Quality Questionnaires(ENRICH)were used as outcomes,and covariance and independ-ent t-teat were adopted to evaluate intervention effectiveness.Statistical analysis was conducted using the full analy-sis set and the per protocol set respectively.Results:Totally 76(84.4％)pregnant women received allocation and end-point revaluation.Covariance analysis revealed that EPDS adjusted means were higher in the SACCP group than in the routine caring group(P＜0.05)in both sets.T-test showed that marital satisfaction and couple communica-tion scores were higher in the SACCP group than in the routine caring group(Ps＜0.01)in the full analysis set.Conclusion:The self-assisted couple communication program(SACCP)could effectively alleviate clinical symptoms of prenatal depression of pregnant women and improve marital quality.
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Objective@#To describe the current status of the prevalence of co-morbid myopia and obesity among 7-18 years students in the Inner Mongolia Autonomous Region in 2021 and to analyze the moderating effect of lifestyle in this association ，so as to provide scientific basis for the establishment of the mechanism of Co-morbidity，Shared Etiology，and Shared Prevention of common diseases in children and adolescents.@*Methods@#A total of 139 630 primary and secondary school students aged 7-18 years from Inner Mongolia Autonomous Region were selected by stratified random cluster sampling method in September,2021. Myopia was determined using distance visual acuity examination and refractive error examination, and obesity was determined according to the BMI classification criteria for overweight, obesity screening of Chinese school age children and adolescents. Used a questionnaire, healthy lifestyles were determined according to the American Heart Association s Healthy Lifestyle Score by totaling the six scores for smoking, alcohol consumption, diet, exercise, screen time, and sleep duration.The χ 2 test was used to compare the association between group differences in the co-morbidity rate of myopia and obesity. The multivariable Logistic regression model was used to explore the influencing factors of the co-morbidity of myopia and obesity, and the stratified analysis was used to analyze the moderating effect of lifestyles on the prevalence of the co-morbidity.@*Results@#The prevalence of myopia and obesity co-morbidity among students aged 7-18 years old in the Inner Mongolia Autonmous Region in 2021 was 13.7%, higher among boys than girls ( 15.5 % vs. 11.8%), higher among those aged 10-12 years old than 7-9,13-15,and 16-18 years old (14.7%,13.7%, 13.3%, 12.0%), higher among other ethnic minorities than Han Chinese and Mongolians (15.3%, 14.0%, 12.5%), higher in urban areas than that in suburban areas(15.3%, 13.0%), and middle economic level tracts were higher than poor and good tracts (14.8%, 12.9 %, 12.6%) ( χ 2=392.37，115.73，62.80，119.02，121.60, P <0.05). Multivariable Logistic regression modeling showed that unhealthy lifestyles ( OR=1.24, 95%CI=1.19-1.29 ) and middle level of lifestyle score ( OR=1.15, 95%CI=1.10-1.19 ) students had higher prevalence of co-morbidity, and the results were statistically significant among both boys and girls, the age groups of 10- 12, 13-15, and 16-18 years old, as well as the Han and Mongolian ethnic groups (all P <0.05).@*Conclusion@#In 2021, the current situation of myopia and obesity co-morbidity and unhealthy lifestyles among primary and secondary school students in the Inner Mongolia Autonomous Region are not optimistic.
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Objective:To understand the mastery of disaster nursing knowledge of clinical nurses in tertiary general hospitals, so as to provide reference basis for formulating disaster nursing training program.Methods:A total of 374 clinical nurses in tertiary general hospitals in Xi ′an, Shaanxi Province from September to October 2020 were investigated by Nursers Disaster Nursing Emergency Knowledge Scale. Results:The score of the included 374 clinical nurses on disaster nursing emergency knowledge was 2.74±0.98 points. The "accident command system" score was 2.55±1.04 points and the "special care and isolation decontamination" score was 2.93±1.00 points which was the lowest and highest respectively. The followings were important factors which influence the score of emergency knowledge: age, education background, working years, professional title, department, post, hearing of disaster nursing or not, participating in disaster rescue training or not, and participating in disaster rescue or not ( F values were 22.093-2 103.285, P<0.001). Conclusions:The disaster nursing knowledge of clinical nurses in tertiary general hospitals is at a relatively low level. It is necessary to strengthen the training of junior nurses and encourage clinical nurses to actively participate in disaster nursing relevant work to enhance disaster nursing capabilities.
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Objective:To explore the cognitive processing characteristics of semantic emotion Stroop and memory recognition in pilots with depression, and to systematically reveal the cognitive processing characteristics of attention and memory.Methods:The semantic emotional Stroop task and memory recognition test were performed in 36 depressed pilots and 36 healthy pilots.The results of attention and memory in cognitive processing were analyzed by repeated measurement analysis of variance using SPSS 18.0 software.Results:In the semantic emotion Stroop, the response time of the depression group was longer than that of the control group ( F(1, 70)=7.03, P=0.008), and the response time of the depression group(579.55±141.62)ms ) was longer than that of the neutral words (565.66±132.60)ms, P=0.003) and positive words (563.09±138.88)ms, P<0.01). In memory recognition, the accuracy of response to emotion words in the depressed group was higher than that in the control group ( F(1, 70)=23.15, P<0.01). The accuracy of response to negative words was higher in the depressed group than that to positive words ((0.50±0.32) vs (0.32±0.21), P=0.006) and neutral words ((0.50±0.32) vs (0.33±0.23), P=0.007). The depression group showed a conservative bias towards negative words ((1.46±0.40), P<0.01), and negative words compared with neutral words ((0.63±0.24), P<0.01) and positive words ((0.57±0.27), P<0.01) were cautious and conservative. Conclusion:Patients with depression have attention bias toward the negative information in semantic information processing, and negative memory bias in memory recognition.
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OBJECTIVES@#To analyze the effect of hyperlipoproteinemia (α) on immediate expansion after coronary stent implantation guided by intravascular ultrasound (IVUS).@*METHODS@#A total of 160 patients (175 lesions) with coronary heart disease diagnosed by coronary artery angiography, who were performed percutaneous intervention guided by IVUS in the Department of Cardiology, Third Xiangya Hospital, Central South University, were enrolled retrospectively.According to the concentration of lipoproteina, the patients were divided into 2 groups: a hyperlipoproteinemia (α) group and a control group. Cardiac ejection fraction was measured with echocardiography. Logistic regression was used to analyze the influential factors for hyperlipoproteinemia (α). The target vessel was examined by IVUS to analyze the immediate expansion effect of hyperlipoproteinemia (α) after stent implantation.@*RESULTS@#The mean stent expansion index, lesion length, stent number, stent symmetry index and posterior balloon diameter were (94.73±18.9)%, (52.92±29.1) mm, (2.11±0.85), (83.62±13.07)%, and (9.46±2.00) mm in the hyperlipoproteinemia (α) group, respectively. Compared with the control group, there were significantly difference (all @*CONCLUSIONS@#Hyperlipoproteinemia (α) appears to be a predictor of stent underexpansion, and the decreased creatinine clearance rate is an independent risk factor for hyperlipoproteinemia (α).
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Humans , Coronary Angiography , Coronary Artery Disease/surgery , Lipoproteins , Percutaneous Coronary Intervention/adverse effects , Retrospective Studies , Risk Factors , Stents/adverse effects , Treatment Outcome , Ultrasonography, InterventionalABSTRACT
Laparoscopic subtotal gastrectomy has become the main treatment of early gastric cancer. The 4K laparoscopic system has the advantage of enhancing the operator′s recognition of various anatomical levels and blood vessels in radical gastrectomy. The authors discussed the reconstruction of digestive tract with Billroth Ⅱ anastomosis in totally laparoscopic distal radical gastrectomy with the aid of 4K laparoscopic technique.
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Laparoscopic subtotal gastrectomy has become the main treatment of early gastric cancer. The 4K laparoscopic system has the advantage of enhancing the operator′s recognition of various anatomical levels and blood vessels in radical gastrectomy. The authors discussed the reconstruction of digestive tract with Billroth Ⅱ anastomosis in totally laparoscopic distal radical gastrectomy with the aid of 4K laparoscopic technique.
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Objective@#To understand epidemiological characteristics of human rabies in China in 2017 and provide evidence for the development of strategy of human rabies control and prevention.@*Methods@#The descriptive epidemiological analysis was conducted based on the epidemic data from Chinese Infectious Disease Surveillance Reporting System, sentinel surveillance system in 6 provinces (Hunan, Guangxi, Anhui, Guizhou, Jiangsu and Shandong) and National Bureau of Statistics in 2017.@*Results@#A total of 516 human rabies cases, including 502 deaths, were reported by 27 provinces in 2017 with the morbidity rate and mortality rate of 0.037/100 000 and 0.036/100 000, respectively. The case number and death number decreased by 19.88% (128/644) and 15.20% (90/592) respectively compared with 2016. Rabies epidemics were mainly found in southern and central areas. The first 5 provinces reporting high case numbers were Hunan (71 cases), Henan (52 cases), Guangxi (41 cases), Anhui (39 cases) and Hubei (39 cases), their cases accounted for 46.90% (242/516) of the total reported cases in China. Rabies mainly occurred in summer and autumn, and the majority of patients were farmers, students and children outside child care settings. The male to female ratio of the cases was 2.46 ∶ 1 (367 ∶ 149). Cases was reported in all age groups, and more cases occurred in middle aged and old adults than in adolescents. Questionnaires survey was conducted for 186 cases, the results indicated that 94.89% (167/176) of exposures were caused by dog bites. The exposure degree was mainly category Ⅲ, accounting for 68.86% (115/167), and only 6.02% (10/166) of cases were immunized after exposure. The median of latent period of these cases was 72 days.@*Conclusions@#By 2017, the human rabies incidence in China had declined consecutively for ten years, more cases were reported in southern area than in northern area. The case number showed downward trends in provinces with high incidences and fluctuant increase in provinces with low incidence. Rabies cases mainly occurred in rural areas, and most cases were men and farmers. Low rate of post exposure prophylaxis, low rates of vaccination and passive immunization product injection were main causes for the onset of human rabies. It is necessary to strengthen the surveillance for human rabies, especially in rural areas, health education about treatment after rabies exposure and expend the coverage of canine immunization.
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Objective@#To investigate the safety and feasibility of laparoscopic operation in thetreatment of gastric gastrointestinal stromal tumor (GIST) at unfavorable positions.@*Methods@#A retrospective cohort study was conducted to analyze the clinical data of patients with gastric GIST at unfavorable positions confirmed by pathology after surgery (laparoscopy or laparotomy) at the Southwest Hospital of the Army Medical University and the Minda Hospital of Hubei Minzu University from June 2008 to June 2018. The unfavorable positions of stomach are defined as the esophagogastric junction, the proximal cardia of gastric lesser curvature, the pylorus of stomach, the posterior wall of stomach and the antrum of stomach.Exclusion criteria:(1) preoperative chemotherapy or imatinib therapy; (2) diameter of tumor > 10 cm; (3) tumor metastasis or concurrence of other malignant tumors. A total of 244 patients (238 in Southwest Hospital and 6 in Minda Hospital) were enrolled, including 122 males and 122 females with age of 41-70years. Operative methods should be adopted according to patients' wishes. There were 146 cases in the laparoscopic surgery group and98 cases in the open surgery group. The intraoperative blood loss, operative time, postoperative first flatus time, postoperative firstfeeding time,average hospital stay, morbidity of postoperative complication,1-,3-,and 5-year recurrence free survival(RFS) and overall survival (OS)rate were compared between the two groups.@*Results@#There were no significant differences in sex, age, tumor size, tumor risk grade or growth pattern between the laparoscopic and the open surgery groups (all P>0.05),and these two groups were comparable. Compared with open group, laparoscopic group had less intraoperative blood loss [(31.4±2.3) ml vs. (143.9±3.7) ml, t=292.800, P<0.001], shorter postoperative first flatus time [(2.1±0.7) days vs.(3.8±0.8) days, t=17.550,P<0.001], shorter postoperative first feeding time [(2.1±0.5) days vs.(2.3±1.7) days, t=1.339,P=0.020], shorter hospital stay [(8.6±2.6) days vs. (13.6±3.2) days, t=13.410, P<0.001], and lower morbidity of postoperative complication [16(11.0%) vs. 21(21.4%),χ2=4.996,P=0.025], whose differences were statistically significant. While the operation time was similar in two groups [(124.7±15.8) minutes vs. (120.9±14.5) minutes, t=1.903,P=0.058]. The median follow-up of all the patients was 43 (1 to 119) months.In laparoscopic group and open group, the 1-, 3- and 5-year RFS were 94.5% vs. 93.9%, 91.1% vs. 90.8%,and 82.2% vs. 81.6%, respectively, and 1-, 3- and 5-year OS were 98.6% vs. 95.9%, 95.9% vs. 94.9%,and 91.1% vs. 88.8%, respectively, whose differences were not statistically significant (all P>0.05).@*Conclusion@#In the experienced gastrointestinal surgery center, laparoscopic resection of gastric GIST at unfavorable position is safe and feasible, achieving the same efficacy of open surgery.
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Objective@#To compare the clinical efficacy of proximal gastrectomy with double tract reconstruction (PG-DT) and total gastrectomy with Roux-en-Y reconstruction (TG-RY) for proximal gastric cancer.@*Methods@#The retrospective study was conducted. Clinicopathological data of 132 patients with proximal gastric cancer confirmed by pathology who underwent PG-DT (n=51) or TG-RY (n=81) by the same surgeon team in Southwest Hospital of Army Military Medical University between January 2006 and December 2016 were collected. Patients with preoperative neoadjuvant therapy, non-R0 resection and non-adenocarcinoma confirmed by pathology were excluded. Observation indicators included intraoperative (operation time and blood loss); postoperative (time to flatus, hospital stay, total complications, metastasis of lymph nodes around distal side of stomach from cases undergoing TG-RY), follow-up (long-term hemoglobin level, incidence of anemia, and survival) parameters. Survival analysis was conducted using the Kaplan-Meier method, and Log-rank test was used to compare survival difference between two groups.@*Results@#No statistically significant differences were found between two groups in the baseline data, including age, gender, BMI, hemoglobin level before operation, postoperative TNM stage, tumor size and histological differentiation between two groups (all P>0.05). There were no significant differences between PG-DT and TG-RY in intraoperative blood loss [200 (200) ml vs. 200 (195) ml, Z=-1.860, P=0.063], time to flatus [(2.7±1.0) days vs. (2.6±1.1) days, t=0.225, P=0.823], postoperative hospital stay [10(3) days vs. 10 (4) days, Z=-0.449, P=0.654] and morbidity of perioperative complications [5.9% (3/51) vs. 8.6% (7/81), χ2=0.081, P=0.775]. Compared with the TG-RY group, PG-DT group had longer total operative time [294 (97) minutes vs. 255 (71) minutes, Z=–3.148, P=0.002]. The hemoglobin data of 42 patients with PG-DT and 56 patients with TG-RY were collected 1 year after operation. The incidence of anemia in PG-DT group was lower than that of TG-RY group [64.2%(27/42) vs. 82.1% (46/56), χ2=4.072, P=0.045], and PG-DT group had higher level of hemoglobin than TG-RY group [(114.4±16.3) g/L vs. (106.6±15.0) g/L, t=2.435, P=0.017]. There were 4 cases (4/81, 4.9%) with metastasis of lymph nodes around distal side of stomach in TG-RY group. All of these 4 tumors were T4 in depth and were more than 5 cm in diameter. The median follow-up period was 26 (1 to 110) months. One-year, 3-year and 5-year survival rates were 93.2%, 65.3% and 55.0% in PG-DT group, and 85.8%, 63.8% and 47.2% in TG-RY group, respectively without significant difference (χ2=0.890, P=0.345).@*Conclusions@#Compared with TG-RY, PG-DT has the same safety and feasibility for proximal gastric cancer. Although the operative time is a little longer than TG-RY, PG-DT has advantages in improving the postoperative hemoglobin level.
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Diabetes mellitus can cause a wide variety of complications.A large number of studies have shown that microRNA plays an important role in diabetic complications, and its expression regulation is closely related to the occurence, development and treatment of diabetic complications.In this article, several major complications of diabetes mellitus and their related microRNAs were reviewed, and we hoped to provide some theoretical basis for the diagnosis and treatment of these diseases.
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OBJECTIVE@#To explore the feasibility and safety of robotic surgical system for radical gastrectomy after liver transplantation.@*METHODS@#A 65-year-old male patient with gastric cancer after liver transplantation underwent radical distal subtotal gastrectomy using Da Vinci surgical system at the General Surgery Department of Southwest Hospital Affiliated to the Army Military Medical University on October 23,2018. The placement of Trocars was arranged using five-hole method. No metastatic tumors were found during intraperitoneal exploration and the first hepatic hilum was found to be wrapped with omentum majus. The tumor located at gastric antrum near the lesser curvature. Then the first and the second station lymph nodes were dissected successively. Distal gastrectomy, Billroth II and Brown anastomosis were performed. The anatomical changes of upper abdomen and gastric lymph reflux after liver transplantation were analyzed.@*RESULTS@#Radical distal gastrectomy with D2 lymphadenectomy was successfully performed under the whole robotic surgical system. The operative time was 315 minutes,and blood loss was 145 ml. A total of 19 lymph nodes were dissected, of which 11 were metastatic lymph nodes. The operative difficulty was to separate the adhesion around the hepatic hilum precisely so as to avoid the damage of hepatic surface, as well as the colon hepatic flexure and duodenum which were closely adhered to hepatic hilum. Meanwhile,it was necessary to pay attention to protetion for the common bile duct and portal vein. The endoscopic wrist joint of the robot surgical system was flexible and delicate, which had obvious advantages in the process of anatomical separation of the adhesions among organs and adhesions around denuded common hepatic artery without normal vascular sheath. Semi-liquid diet was provided on the third day after operation. The immunosuppressants were resumed on the third day after operation. The patient was discharged on the 7th day postoperatively without any complications. There were no abdominal bleeding, incision infection,anastomotic leakage, anastomotic stenosis and other complications. Two months after operation, the patients diet and daily life is normal.@*CONCLUSION@#The robotic surgical system is safe and feasible for gastric cancer surgery after liver transplantation.
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Aged , Humans , Male , Feasibility Studies , Gastrectomy , Methods , Laparoscopy , Liver Failure , General Surgery , Liver Transplantation , Lymph Node Excision , Robotic Surgical Procedures , Stomach Neoplasms , General SurgeryABSTRACT
Vascular endothelial cell glycocalyx is a layer of glycoprotein complex located on the surface of endothelial cells, forming a selective permeation barrier on the surface of endothelial cells. In the present review, after a brief introduction of glycocalyx, the relationship between glycocalyx and mass transport under fluid sheer stress (FSS), especially the relationship between glycocalyx and macromolecules such as low density lipoprotein (LDL) has been discussed. This relationship was reflected as following: on the one hand, the thickness and integrity of the glycocalyx affects the concentration polarization of LDL and its transendothelial transport and heparan sulfate proteoglycan (HSPG) participates in the whole process of residual lipoproteins metabolism. On the other hand, ox-LDL, an oxidized product of LDL, destroys heparan sulfate (HS) which is a major component of the endothelial cell glycocalyx. The study on relationship between vascular endothelial glycocalyx and lipoproteins will provide a new clue to elucidate the pathogenesis of atherosclerosis and provide more evidence to view the glycocalyx as a new control target.
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<p><b>OBJECTIVE</b>To explore the surgical techniques and feasibility of robotic surgery for carcinoma in the remnant stomach(CRS).</p><p><b>METHODS</b>Clinicopathological data of 20 CRS patients undergoing robotic surgery at the Minimally Invasive Center for Gastrointestinal Surgery, Army Medical University Southwest Hospital from November 2012 to October 2017 were retrospectively collected. The surgical methods, procedures, main difficulties, and key techniques were analyzed, and the clinical efficacy was evaluated.</p><p><b>RESULTS</b>Among 20 CRS patients, 14 were male and 6 were female with mean age of 59.9 years and mean BMI of 19.7 kg/m. For the primary diseases, 17 patients underwent laparotomy, 3 underwent laparoscopic radical resection of gastric cancer; 18 cases received distal subtotal gastrectomy plus Billroth II( anastomosis, 2 received distal subtotal gastrectomy plus Billroth I( anastomosis. CRS located in anastomotic stoma in 15 cases and in the gastric fundus and cardiac part in 5 cases. Preoperative staging revealed 2 cases of T2NxM0, 1 of T3NxM0, 2 of TxNxM0 and 15 of T4aNxM0. Sixteen patients received robotic surgery with Roux-en-Y reconstruction successfully, and 4 patients were converted to laparotomy for palliative total gastrectomy, including 1 case with diaphragm invasion, 1 case with transverse colon invasion, and 2 cases with tight adhesions. The mean surgery time was (255±35) minutes, mean blood loss was (230±50) ml, mean number of dissected lymph nodes was 19.5±3.0, mean recovery time to gastrointestinal function was (2.3±1.0) days, mean time to feeding was (2.3±1.0) days, and mean time to ambulatory activity was (2.5±0.5) days. Pathological examinations revealed 12 patients with poorly differentiated adenocarcinoma, 6 patients with moderately differentiated adenocarcinoma, and 2 patients with mucinous adenocarcinoma. Postoperative pTNM staging was identified as follows: stage I(B for 1 patient, stage II(A for 2 patients, stage II(B for 5 patients, stage III(A for 5 patients, stage III(B for 4 patients, and stage III(C for 3 patients. One patient died 2 weeks after operation due to multiple organ failure. One patient received another hemostasis operation due to hemorrhage of splenic artery and recovered postoperatively. Two patients experienced anastomotic leakage, 1 patient developed duodenal stump fistula and 1 patient experienced incision site infection postoperatively, and all of them recovered after conservative treatment. During 5-60 months follow-up, 10 cases died and 10 cases survived, including 1 case for 6 years.</p><p><b>CONCLUSIONS</b>Robotic surgery for CRS is feasible with satisfactory short-term efficacy. However, the long-term efficacy requires further study.</p>
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Female , Humans , Male , Middle Aged , Gastrectomy , Gastric Stump , General Surgery , Laparoscopy , Retrospective Studies , Robotic Surgical Procedures , Stomach Neoplasms , General SurgeryABSTRACT
Objective To explore the significance of changes of serum adiponectin and testosterone levels in old male patients with type 2 diabetes mellitus(T2DM) and coronary heart disease(CHD).Methods A total of 122 male patients(more than 60 years old)were enrolled into this study,T2DM patients without CHD(T2DM group,n =40);T2DM patients with CHD (CHD group,n=38);control group(n=44,44 cases of physical healthy men over the age of 60 in Qinghai Provincial People's Hospital from November 2014 to September 2015).The serum of fasting blood-glucose,glycosylated hemoglobin(HbAlc) and blood lipid were detected by Roche cobas 800 full automatic biochemical analyzer,the serum concentration of testosterone(T) was determined by the chemiluminesent immunoassay,serum adiponectin(APN)levels were determined by the enzyme linked immunosorbent assay,the serum insulin(FINS)levels were evaluated by chemiluminescence method,according to the steady-state model evaluation method for calculation of insulin resistance (HOMA-IR),the difference among the three sets of the above indexes indicators were compared,and the correlation between APN and other indicators above were analyzed.Results Compared with control group,the serum T and APN levels in the T2DM group and CHD group were significantly decrease,and the CHD group was the most obviously (P＜0.05).Compared with control group,the FPG,FINS,triglycerides(TG),low density lipoprotein cholesterol(LDL-C)and homeostasis model assessment-insulin resistance (HOMA-IR) levels in T2DM group and CHD group were apparently higher,and the CHD group was the most obviously (P＜ 0.05).The serum adiponectin was negative correlated with TG (r=-0.363),LDL-C(r=-0.417),HOMA-IR(r =-0.602),while positively correlated with HDL-C(r=0.485),T(r=0.624).The serum T was negative correlated with LDL-C(r=-0.457),HOMA-IR(r-0.643),while positively correlated with HDL-C(r=0.478),P＜0.05.Conclusion The level of the serum APN and the serumtin T2DM patients with CHD are significantly lower than the patients without CHD,the serum adiponectin and the serum testosterone may promote the development of T2DM with CHD.
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Objective To observe the change in IL-1β,IL-13mRNA expression in drowning rat lungs and serum,so as to investigate the significance of IL-1β and IL-13 mechanism in the development of drowning.Methods SD rats were randomly divided into control group,drowning group.Then using TaqMan probe method to determine the expression of IL-1β and IL-13 mRNA in Right lower lobe of lung tissue and the serum of right ventricle,which were extracted respectively from each group of rats.Results (1) The lung tissue morphological changes:Typical appearance signs and anatomy of drowning group meet ante-mortem drowning feature.(2) The expression of IL-1β,IL-13 in lung tissue:compared with the control group,the expression of IL-1β and IL-13 were slightly decreased,which has no statistical significance.(3) The expression of IL-1β and IL-13 in serum:compared with the control group,the expression of IL-1β and IL-13 were significant increased,both of which has statistical significance.Conclusion (1)The expression of IL-1β and IL-13 were decreased in lung tissue may be due to drowned rats present compensatory anti-inflammatory response syndrome which causes immune incompetent performance.(2) The expression of IL-1β and IL-13 were significant increased in serum may be relate to drown stress and drowning associated acute lung injury after traumatic stress.