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Objective:To investigate the region-specific characteristics of the gut microbiota and evaluate the association of speci?c gut microbes with type 2 diabetes mellitus (T2DM) from the Dongxiang Group in Gansu province, Northwest China.Methods:Fifty-three participants who was born in Dongxiang Autonomous County (Gansu Province) from April 2020 to January 2021 were enrolled, including 25 patients with T2DM recruited from the outpatient departments of internal medicine at The People′s Hospital of Dongxiang County(T2DM group) and 28 healthy controls recruited from the health screening center (HC group). Gut microbiome composition was analyzed using a 16S ribosomal RNA gene-based sequencing protocol.Results:A total of 936 operational taxonomic units (OTU) were obtained in the two groups. Of note, the HC and T2DM groups had 633 OTU in common. The alpha and beta diversity were different between the two groups ( P<0.05). Shannon index was significantly higher than that in the HC group, and Simpson index was significantly lower than that in the HC group, displacement multivariate analysis of variance was used to compare β diversity between the two groups, and the difference was statistically significant ( P<0.05). At the Phylum level, firmicutes and actinomycetes in T2DM group were significantly higher than those in the HC group (37.97% vs. 22.89%, 5.09% vs. 2.08%), and the differences were statistically significant ( P<0.05). The abundance of Bacteroidetes was significantly decreased (68.00% in T2DM group and 49.75% in HC group), and the difference was statistically significant ( P<0.05). At the genus level, there were 20 genera statistically significant differences between the two groups. The abundance of Bifidobacterium, Escherichia, Shigella, and Tyzzerella_4 levels were significantly increased in the T2DM group, but Prevotella_9, Erysipelotrichaceae_UCG-003, and Roseburia levels were significantly decreased in the T2DM group compared to those in the HC group. Conclusions:There is a significant difference in the gut microbiota between patients with T2DM and healthy individuals of the Dongxiang group in Northwest China. So as to preliminary exploration the intestinal flora characteristics of T2DM in the Dongxiang group.The findings of this study provide a theoretical basis for the prevention and control of T2DM in Dongxiang group in the future.
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Objective:To investigate the application value of modified Overlap esophago-gastric tube (MO-EG) reconstruction in totally laparoscopic radical proximal gastrectomy.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 7 patients with upper gastric cancer or adenocarcinoma of esophagogastric junction (AEG) who underwent totally laparoscopic radical proximal gastrectomy with MO-EG reconstruction in the Second Hospital of Jilin University from January 2019 to December 2020 were collected. There were 4 males and 3 females, aged 62(range, 55-72)years. The body mass index of the 7 patients was 21.5(range, 18.5-26.0)kg/m 2. Of the 7 patients, 2 cases had early upper third gastric cancer and 5 cases had Siewert Ⅱ AEG. All patients underwent totally laparoscopic radical proximal gastrectomy with MO-EG recons-truction using barbed sutures. Observation indicators: (1) surgical situations; (2) postoperative recovery situations; (3) postoperative histopathological examinations; (4) follow-up. Follow-up was conducted using outpatient examination and telephone interview to detect postoperative esophageal reflux, endoscopic classification of esophageal reflux, anastomotic complications, tumor recurrence and metastasis and survival of patients up to December 2021. Measurement data with normal distribution were represented as Mean±SD and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Surgical situations. All the 7 patients underwent totally laparoscopic radical proximal gastrectomy and D 1+ lymph node dissection with MO-EG reconstruction through abdominal transhiatal approach. None of the 7 patients underwent conversion to open surgery or additional thoracotomy. The operation time, time of digestive reconstruction, volume of intraoperative blood loss and length of esophagus dissected of 7 patients were (271±36)minutes, (44±10)minutes, (53±26)mL and (6.4±0.3)cm, respec-tively. (2) Postoperative recovery situations. The time to postoperative initial out-of-bed activities, time to postoperative first flatus, time to postoperative initial liquid food intake and duration of hospital stay of 7 patients were (21±5)hours, (2.9±0.9)days, (5.0±0.7)days and (10.1±1.9)days, respectively. None of the 7 patients had postoperative severe complications such as bleeding, anasto-motic leakage or mortality. One patient had postoperative pulmonary infection and recovered after anti-infection treatment. Two patients had pleural effusion and were improved after conserva-tive treatment. (3) Postoperative histopathological examinations. The tumor diameter of 7 patients was (2.5±0.7)cm. Histopathological examination of upper margins of 7 patients was negative. The distance between the esophagus margin and the superior margin of the tumor of patients with AEG was (1.8±0.6)cm. The number of lymph node dissected and the number of inferior mediastinum lymph node dissected of 7 patients were 26.0±3.6 and 3.7±1.1, respectively. Pathological TNM stages of 7 patients were 2 cases of stage ⅠB, 4 cases of ⅡA, 1 case of ⅡB. (4) Follow-up. All the 7 patients were followed up for 18(range, 12?36)months. Of the 7 patients, 4 cases reported asymptomatic, 2 cases had symptoms of reflux and 1 case had chocked feeling after eating. All the 7 patients underwent barium meal examination of gastrointestinal tract without anastomotic dysfunction or anastomotic stenosis. Six of the 7 patients underwent gastroscopy at postoperative 1 year and only 1 of them reported grade B reflux esophagitis according to Los Angeles classification, while the rest of 5 patients had no evidence of obvious reflux. None of the 7 patients had postoperative gastric cancer tumor recurrence, metastasis or death. Conclusion:Application of MO-EG reconstruction in totally laparoscopic radical proximal gastrectomy is safe and feasible, with satisfactory short-term effects.
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Adenocarcinoma of esophagogastric junction (AEG) has attracted more attention in recent years. Surgical method of Siewert type Ⅱ AEG is especially controversial, mainly focusing on the scope of lymph node dissection, safety of surgical margin, and digestive tract reconstruction. The abdominal transhiatal approach and right thoracoabdominal Ivor-Lewis approach are the main surgical approaches of totally laparoscopic or thoracoscopic surgery for Siewert type Ⅱ AEG, which not only need close teamwork, but also require rich experience in laparoscopic surgery. The authors has started to choose these two totally minimally invasive surgical approaches, the feasibility and safety of which are proved. The key surgical details are presented in this article for reference.
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Objective To explore the clinical efficacy of modified totally laparoscopic intra-gastric surgery for the treatment of submucosal tumors adjacent to the cardia or pylorus.Methods The retrospective crosssectional study was conducted.The clinicopathological data of 48 patients with gastric submucosal tumors adjacent to the cardia or pylorus between September 2014 and March 2018 were collected.There were 22 males and 26 females,aged from 38 to 78 years,with an average age of 58 years.Patients were performed multi-port or singleport modified laparoscopic intra-gastric surgery.Observation indicators:(1) surgical treatments;(2) postoperative recovery;(3) results of postoperative pathological examination;(4) follow-up.Patients were followed up by outpatient examination and telephone interview to detect the postoperative complications and tumor metastasis and recurrence up to June 2018.Measurement data with normal distribution were expressed as Mean±SD and measurement data with skewed distribution were described as M (range).Count data were represented as absolute number or percentage.Results (1) Surgical treatments:48 patients underwent modified totally laparoscopic intra-gastric surgery successfully,including one patient combined with proximal gastrectomy,without conversion to open surgery.Of the 48 patients,43 underwent multi-port modified laparoscopic intra-gastric surgery and 5 underwent single-port modified laparoscopic intra-gastric surgery.The operation time and volume of intraoperative blood loss were 68 minutes (range,45-110 minutes) and 20 mL (range,5-100 mL).The oncologic evaluation of 48 patients:48 patients had complete resection of tumors,without tumor rupture.The tumor diameter and distance from margin to tumor were 32 mm (range,20-40 mm) and 6 mm (range,5-10 mm).(2) Postoperative recovery:the time for initial oral intake and duration of postoperative stay were 2.8 days (rang,1.0-5.0 days) and 5.3 days(range,3.0-11.0 days).There were 4,3,1 and 1 patients complicated with surgical infection,delayed gastric emptying,sub-phrenic hydrops and digestive leakage respectively in the 48 patients.(3) Results of postoperative pathological examination:the distance from tumor margin to gastric cardia or pylorus,tumor diameter,circumferential resection margin were 15 mm (range,0-30 mm),24 mm (range,10-65 mm),6 mm (range,5-10 mm),respectively.Growth patterns of cancer in the 48 patents included 27 of intraluminal type,12 of intermural type,9 of mixed type.Pathological types of 48 patients:there were 26 patients with leiomyoma,9 with gastrointestinal stromal tumor,4 with other rare tumors,2 with carcinoid,2 with mucosa associated lymphoma,2 with inflammatory fibrous polyps,2 with gastritis cystica profunda,1 with ectopic pancreas.(4) Follow-up:41 of the 48 patients were followed up for 3-48 months,with a median follow-up time of 22 months.No tumor recurrence was detected in 37 of 41 patients by 3 times of gastroscopy and no stenosis or dysfunction of cardia or pylorus was detected in 39 patients by 2 times of upper gastrointestinal imaging (one patient undergoing two examinations).During the follow-up,there was no surgery-related complication or tumorspecific death.Conclusion Modified totally laparoscopic intra-gastric surgery is safe and feasible for the treatment of gastric submucosal tumors adjacent to the cardia or pylorus.
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Intraoperative hemorrhage is the most common complication of laparoscopic radical gastrectomy,which is also the main cause of conversion to open surgery.With the popularization of laparoscopic surgery technology worldwide,how to complete high-quality surgery and effectively avoid intraoperative or postoperative complications is the goal pursued by all surgeons.Intraoperative hemorrhage in the laparoscopic radical gastrectomy is mainly divided into parenchymal hemorrhage,perigastric vascular injury-induced hemorrhage,lymph node hemorrhage and anastomotic bleeding.Compression,electrocoagulation,vascular clipping and vascular suture repair are the most common treatments for intraoperative hemorrhage.It is necessary to use above methods in clinical work.Proficiency in laparoscopic operation skills,familiarity with perigastric vascular anatomy and variation,and improved teamwork to reduce complications are the key to laparoscopic surgery for gastric cancer.Combined with literature reports,the authors summarize experience in laparoscopic surgery for gastric cancer,discuss the prevention and treatment of hemorrhagic complications during laparoscopic radical gastrectomy.
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Intra-abdominal infection complicated with hypothyroidism is very common. It mostly featured decreased T3, with or without decreased T4, and without elevated thyroid stimulating hormone(TSH). This particular type of hypothyroidism was called "low T3 syndrome" or "thyroid illness syndrome", and is called "non-thyroid illness syndrome" increasingly in recent years. Its pathogenesis has not been fully understood, and probably is associated with abnormality of hypothalamic-pituitary-thyroid axis, disorder of peripheral thyroid hormone metabolism, change in thyroid hormone binding protein, regulation of triiodothyronine receptors, effect of cytokines, and lack of trace element selenium. Intra-abdominal infection complicated with hypothyroidism should be differentiated from primary hypothyroidism, which may be one cause of mental depression, insufficient anabolism, and poor tissue healing. Therefore, the changes of T3 and T4 levels should be actively monitored in patients with severe or prolonged intra-abdominal infection. Whether treatment is needed for intra-abdominal infection complicated with hypothyroidism remains controversial. T3 replacement therapy may improve prognosis. When low T3 syndrome presents as a disease-mediated hypothyroidism, we recommend the use of levothyroxine(L-T4) or liothyronine (L-T3) treatment to improve the prognosis of critical patients. Enteral nutrition can improve hypothyroidism and has good efficacy for enterocutaneous fistula patients with intra-abdominal infection.
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Humans , Hypothyroidism , Drug Therapy , Intraabdominal Infections , Diagnosis , Therapeutics , Thyroxine , Therapeutic Uses , Triiodothyronine , Therapeutic UsesABSTRACT
Objective To investigate the clinical efficacy of the superior pancreatic region approach guided by pancreatic capsule in laparoscopic radical gastrectomy of 438 patients.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 438 patients who underwent laparoscopic radical gastrectomy of gastric cancer in the Second Hospital of Jilin University between April 2013 and April 2017were collected.Patients were confirmed with stage T2 and above by postoperative pathological examination and then underwent adjuvant chemotherapy of XELOX regimen.Observation indicators:(1) surgical situation;(2)postoperative recovery situation;(3) postoperative pathological examination;(4) follow-up situation.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative adjuvant chemotherapy,postoperative long-term complications and tumor metastasis or recurrence up to May 2017.Measurement data with normal distribution were represented as x±s.Results (1) Surgical situation:all the 438patients underwent laparoscopic radical gastrectomy of gastric cancer through the superior pancreatic region approach guided by pancreatic capsule,including 295 undergoing distal gastrectomy and 143 undergoing total gastrectomy.There were no conversion to open surgery.Operation time and volume of intraoperative blood loss were respectively (178 ±32) minutes and (39± 11)mL.There were no intraoperative complications and death in perioperative period.(2) Postoperative recovery situation:time to anal exsufflation,time for fluid diet intake and duration of hospital stay were (32±6) hours,(26±3) hours and (8.7±2.3) days,respectively.Volume of amylase drainage was (157±35) U/L at postoperative day 1,(68±25) U/L at postoperative day 2 and (43±17) U/L at postoperative day 3,respectively.No pancreatic fistula occurred postoperatively.(3) Postoperative pathological examination:results of postoperative pathological examination showed that 218,209 and 11 patients were detected in T2,T3 and T4a staging,respectively.Numbers of lymph node dissected and lymph node metastases were respectively 27.0± 6.0 and 4.2-± 2.9.Pathological typing:high-or moderate-differentiated adenocarcinoma,lowdifferentiated adenocarcinoma and undifferentiated carcinoma or signet-ring cell carcinoma were detected in 67,279 and 92 patients,respectively.(4) Follow-up situation:of 438 patients,415 were followed up for 1-48months,with a median time of 33 months of 438 patients,293 received postoperative adjuvant chemotherapy of XELOX regimen,122 received unknown adjuvant chemotherapy or refused chemotherapy.During the follow-up,there was no oecurrence of tumor-related complications,13 patients had tumor metastases or recurrence and 5patients died of tumor recurrence or metastases.Conclusion The superior pancreatic region approach guided by pancreatic capsule is safe and feasible in laparoscopic radical gastrectomy.
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Objective To study the the feasibility of intestinal derotation maneuver in the resection of gastrointestinal neoplam localized in the vicinity of the ligament of Treitz.Method Intestinal derotation maneuver was applied in all the 9 case of gastrointestinal neoplasms near the ligament of Treitz,from January 2014 to January 2016,at the Second Hospital of Jilin University.The clinical date were retrospectively analyzed.Results Intestinal derotation maneuver were applied without failure in all the nine patients,the mean operation time were (195 ± 50) min,and the mean intestinal derotation maneuver time were (19 ±5) min;No derotation procedure-related injury occured,and the mean estimated blood loss were (132 ±94) ml.Early postoperative ileus developed in one case and gastroparesis in two cases.All were recovered by conservative treatment.The follow-up period were 3-24 month,tumor recurrence occurred in two cases and one case died.One case lossed to follow-up after postoperative 3 month.Conclusion The present data suggest that clinical use of intestinal derotation maneuver was feasible for surgical management of gastrointestinal neoplasms near the ligament of Treitz.
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<p><b>OBJECTIVE</b>To investigate the clinical advantage of the application of modified Roux-en-Y reconstruction after totally laparoscopic total gastrectomy.</p><p><b>METHODS</b>Clinical data of 36 patients who underwent totally laparoscopic total gastrectomy with Roux-en-Y reconstruction by one medical team for gastric adenocarcinoma between January 2014 and December 2014 in the Second Hospital of Jilin University were retrospectively analyzed. Patients were divided into classic Roux-en-Y group (CRY, 16 cases) and modified Roux-en-Y group (MRY, 20 cases) according to reconstructive methods. The data concerning the intraoperative and postoperative situation in two groups were compared.</p><p><b>RESULTS</b>Operation was successfully completed in all the cases without conversion to laparotomy. Compared to CRY group, MRY group had shorter mean operative time [(260.9 ± 21.2) min vs. (287.9 ± 19.0) min, P=0.000], shorter mean reconstruction duration [(32.4 ± 9.2] min vs. (45.4 ± 13.2) min, P=0.001] and less intraoperative bleeding [(50.9 ± 23.5) ml vs. (67.0 ± 20.5) ml, P=0.000]. Jejunum mesentery dissection and jejunum resection were not necessary in MRY group. However, there were no significant differences in lymph nodes harvested, time to flatus, hospital stay and postoperative complications between two groups.</p><p><b>CONCLUSIONS</b>As compared to classic Roux-en-Y reconstruction, the modified Roux-en-Y reconstruction can simplify the surgical procedures and achieve similar efficacy. It is feasible and safe, and worth further promotion in clinical practice.</p>
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Humans , Anastomosis, Roux-en-Y , Laparoscopy , Lymph Nodes , Mesentery , Operative Time , Postoperative Complications , Postoperative Period , Retrospective Studies , Stomach NeoplasmsABSTRACT
Objective To investigate the clinical efficacy of bronchoscopic MMC topical spraying for the treatment of tuberculous cicatricial stenosis of the central airway. Methods 45 patients with t tuberculous cicatricial stenosis of the central airway were randomly divided into a control group (14 patients), treatment group 1 (group1, 15 patients), or treatment group 2 (group 2, 16 patients), who received bronchial balloon dilatation alone, bronchial balloon dilatation combined with topical MMC spraying for one time, and for twice, respectively . The clinical efficacy was observed by using the MRC score and measuring airway diameter at the time points before treatment, end of treatment, and 3, 6, and 12 months after treatment, respectively. Results For the MRC scores at different time points, the MRC scores in group 2 (0.06 ± 0.25) and group 1 (0.33 ± 0.617) were significantly lower than those in the control group at 3 months after treatment (P 0.05). Conclusions Bronchial balloon dilatation combined with topical MMC spraying has certain short-term and long-term efficacy for improving dyspnea and maintaining the airway diameter after dilatation.
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Laparoscopic gastric cancer surgery, which has been gradually accepted by surgeons and popularized worldwide, is a less invasive alternative compared with an open procedure. However, the lack of cognition of the variation in perigastric vessels, and the difficulty to obtain a full-view image and to estimate the three-dimensional (3D) relationships between organs during laparoscopic procedures may lead to unexpected injuries of these vessels, causing massive bleeding, which would prevent surgeon from having access to a good view of the operative field. We retrospectively summarize the data of laparoscopic gastric cancer operation in our hospital, separate the perigastric vessels into three areas according to the procedure, respectively the inferior pylorus, superior pancreas, and hilum of spleen, and analyze the common anatomical variation of vessels and its characters. We propose that, following the right anatomical spaces, the familiarity of perigastric vessels and skills of treating its common anatomical variations, may contribute to the safe and effective operation, improve the level of lymph node dissection, and reduce the injury in the operation.
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Humans , Gastrectomy , Methods , Laparoscopy , Methods , Lymph Node Excision , Methods , Retrospective Studies , Stomach Neoplasms , General Surgery , Vascular Malformations , General SurgeryABSTRACT
Objective: To evaluate the therapeutic effect of gamma knife on patients with intracranial cavernous angioma (CA). Methods: The medical records of 122 patients (134 lesions) who underwent radiosurgery were reviewed retrospectively. Results: hT e average follow-up period was 43 months. No patient died. One patient underwent CA resection. In patients with epilepsy, 83% patients showed alleviation of seizures. About 44% of the lesions shrank in size after treatment with gamma knife radiosurgery (59/134). Seven cases had hemorrhage again after radiosurgery, and the overall annual hemorrhage rate was 1.6%. Edema was found in 11.5% patients (14/122) and all patients showed improvement atf er treatment. Conclusion: Gamma knife is a safe treatment for CA, which could obviously improve the symptoms of epilepsy. Gamma knife radiosurgery is the if rst option for the treatment of cavernous sinus angiomas.
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Chiari Ⅰ malformation is a congenital anomaly of posterior brain.There has been many theories for its pathogenesis.Recent years,researchers have sunmarized new theories about the pathogenesis of syringomyelia associated Chiari Ⅰ malformation.However,the exact pathogenesis of Chiari Ⅰ malformation has not been clarified.There are a lot of surgical treatments of Chiari Ⅰ malformation.Importantly,there remains no consensus about the best and generally applicable treatment.
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OBJECTIVE@#To explore the pathogenetic mechanism of cystic meningioma and the key to its diagnosis and operation.@*METHODS@#Clinical data of 8 patients with cystic meningioma were analyzed retrospectively. The occuring position and cure rate of cystic meningioma were compared with those of solid meningioma in the corresponding period.@*RESULTS@#All patients were subjected to total resection of tumor parenchyma and cystic wall. No operative death and severe complications occurred. The incidence of uppertentorial region of cystic meningioma was higher than that of solid meningioma, and the difference was significant (χ(2)=2.618, P0.05).@*CONCLUSION@#Removing tumor totally is the key to preventing its recurrence.
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Adult , Aged , Female , Humans , Male , Middle Aged , Arachnoid Cysts , Diagnosis , General Surgery , Meningeal Neoplasms , Diagnosis , General Surgery , Meningioma , Classification , Diagnosis , General Surgery , Retrospective StudiesABSTRACT
OBJECTIVE@#To explore the microsurgical techniques for insular glioma without damaging its surrounding normal structures.@*METHODS@#We retrospectively analyzed 54 patients with insular gliomas who underwent microsurgical operation by trans-syvian fissure approach between May, 2003 and August, 2008 in Xiangya Hospital. We discussed the techniques in the operation and summarized how to protect the key blood vessels, distinguish and protect the surrounding normal structures.@*RESULTS@#There were 36 complete removals,14 secondary complete removals, and 4 partial removals.Six patients had complications after the craniotomy who had temporal speech disorder (aphasia mostly began to recover about 10 days after the craniotomy),4 patients had opposite side paralysis worsening (3 recovered normally and 1 improved after 6 months),4 had light paralysis, and another 3 had paralysis and speech disorder.@*CONCLUSION@#The microsurgery by means of trans-syvian fissure approach can well expose the anatomical relation between tumor and its surrounding structures,so that we can remove the tumor and protect the surrounding normal tissues as much as we can.
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Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Brain Neoplasms , Pathology , General Surgery , Cerebral Cortex , Pathology , General Surgery , Glioma , Pathology , General Surgery , Microsurgery , Methods , Neurosurgical Procedures , Methods , Retrospective StudiesABSTRACT
Objective To evaluate the effectiveness of Moxifloxaein in treatment of multidrug-resistant(MDR)pulmonary tuberculosis.Methods 65 MDR pulmonary Mycobacterium tuberculosis patients were randomized divided into two groups,separately receiving the regimens of contained Moxifloxacin0.4 qd or Levofloxacin 0.6 qd six drugs treatment accompanying with aminoglycosides,prothionamide,pasiniazid,pyrazinamide,ethambutol and clarithromyein from 2003—2005y in Guangzhou chest hospital.The treatment outcomes were evaluated when study executed one and half year later.Results 35 patients in moxifloxacin group had 27 cases cured,and 30 patients in levofloxacin group had 19 cases cured.The success rates were 77.1% versus 63.3%(P=0.222).The time to sputum culture conversion were (1.9?0.7)months and 3.0?1.8 months(P=0.035).Bacillary susceptible to levofloxacin,good adherence,radi- ographic extent less than one lung,and use of moxifloxacin were independent predictors of favorable outcome(odds ratios,7.3 to 21.4).Conclusion Moxifloxacin was found have a better bactericidal activity in vivo and less side effects. Its efficacy was higher than levofloxacin when incorporated into muhidrug regimens used for treatment of MDR tuberculosis.
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Objective To study the methods and the effects of posterior peritoneoscope surgery in curing the disease of kindy,ureter and adrenal gland.Methods 92 patients with the disease of adrenal gland,kidney and urethra were conducted with the posterior peritoneoscope surgery,using the posterior auxiliary line puncturation and dilatation and posterior peritoneoscope technique.Results 88 cases(95.7%) were succeeded.4 cases(4.3%) which were changed into the operation on abdominal didn't use blood transfusion,1 case(1.1%) complicating with post-peritoneum abscess had satisfactory therapeutic effect.Conclusion Posterior peritoneoscope used in unroofing of cyst of adrenal gland,ectomy of the adrenal pheochromocytoma,nephrectomy,radical correction of renal carcinoma,unroofing of cyst of kidney,ureterolithotomy,pelvilithotomy,pyeloure-teroplasty shows the fortes such as wound is smaller,hemorrhage is less,recovery is faster,complication is also less.It also has reliable therapeutic effect and strong practicability.Posterior auxiliary line puncturation and dilatation has better close tightly,air leakage is also less,it may not damage peritoneum,it doesn't need dissociation adipose in extro-peritoneum,campus visualis is clear and anatomical layer is also distinct.
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Objective To study the correlation between the polymorphism of GSTM1 and GSTT1 genes and the susceptibility to the development of COPD. Methods Polymerase chain reaction (PCR) was used to detect the GSTM1 and GSTT1 genotypes in 91 cases of the patients with COPD (COPD group) and 44 cases of the subjects without COPD (control group), and their susceptibility to the development of COPD were analyzed according to their gender, age and smoking history. Results There was significant difference in the frequency of GSTM1 0/0 genotype between the two groups of male persons with more than 40 years old (P