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Gastric cancer is one of the most common malignant tumors in the world, and its incidence and mortality are among the top of malignant tumors in China. Since Kitano et al com-plete the first laparoscopic radical gastrectomy for gastric cancer in the world in 1992, the laparos-copic technology has developed rapidly. After more than 30 years of exploration and practice, the clinical diagnosis and treatment of gastric cancer in China has also made considerable progress. A large number of clinical studies at home and abroad have confirmed that laparoscopic radical gas-trectomy is no less effective than traditional open surgery in the short and long term. Laparoscopic radical gastrectomy has the characteristics of less trauma, faster recovery of gastrointestinal func-tion, less postoperative pain, and shorter average hospital stay. It has gradually replaced open surgery as the mainstream surgical method for gastric cancer. As the concept of surgical treatment for gastric cancer continues to update, emerging minimally invasive technologies continue to emerge, including robotic surgery systems and indocyanine green tracing technology, which are increasingly used in gastric cancer surgery, making gastric cancer surgery more minimally invasive and accurate, the quality of perigastric lymph node dissection and the domestic gastric cancer surgery technology further improving. Based on the relevant research at home and abroad, the authors review and summarize the latest progress in recent years with the topic of minimally invasive surgery for gastric cancer, aiming to systematically describe the current situation and future prospects of gastric cancer surgery. It is believed that in the future, the clinical diagnosis and treatment of gastric cancer in China will be more standardized, minimally invasive and accurate, more high-quality multicenter clinical research will be carry out and the diagnosis and treatment of gastric cancer will be further improved in China.
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Objective:To investigate the effect of gene polymorphism of β1 adrenergic receptor (β1-AR) G1165C and A145G locus on myocardial hypertrophy and the efficacy in patients with hypertension.Methods:Two hundred and twenty-seven cases of patients with hypertension admitted to Binhai County People′s Hospital from January to December 2019 were enrolled. Among them, there were 113 cases of hypertension with myocardial hypertrophy and 114 cases of hypertension without myocardial hypertrophy. In addition, 115 patients with normal physical examination during the same period were selected as the control group. DNA in the peripheral blood leukocytes was extracted, polymerase chain reaction-restriction fragment length polymorphism method was used to detect β1-AR G1165C and A145G locus gene polymorphism, and the differences in the efficacy of β blockers in hypertensive patients with different genotypes were compared.Results:There was no statistically significant differences in the distribution of β1-AR A145G genotypes among the three groups ( P>0.05). Compared with the healthy control group, the frequency of Gly/Gly genotype carrying β1-AR G1165C locus was higher in hypertension with myocardial hypertrophy group, and the frequency of Gly/Arg and Arg/Arg gene were lower; compared with hypertension without myocardial hypertrophy group, the frequency of Gly/Arg+Gly/Gly gene in hypertension with myocardial hypertrophy group was higher; taking Arg/Arg genotype as the control group, carrying Gly/Gly genotype could increase the risk of cardiac hypertrophy in hypertensive patients by 3.159 times ( OR = 3.159, 95% CI 1.240 - 7.412, P<0.05).The frequency of G1165C allele Arg in the hypertension with myocardial hypertrophy group was significantly lower than that in the control group and the hypertension without myocardial hypertrophy group ( P<0.05); the frequency of G1165C allele Gly was significantly higher than that in the control group and the hypertension without myocardial hypertrophy group ( P<0.05); taking Arg/Arg genotype as the control, carrying Gly/Gly genotype could increase the risk of cardiac hypertrophy in hypertensive ( OR = 3.417, 95% CI 1.357 - 7.965, P<0.05). The left ventricular mass index of Gly/Gly genotype patients was (120.38 ± 28.41) g/m 2, which was significantly higher than (99.76 ± 25.16) g/m 2 and (90.30 ± 19.54) g/m 2 of Gly/Arg and Arg/Arg, with statistically significant differences ( F = 10.89, P<0.01). After the treatment, the resting heart rate, systolic blood pressure, diastolic blood pressure and mean arterial blood pressure of patients with G1165C allele Arg hypertension with myocardial hypertrophy were lower than those with G1165C allele Gly, with statistically significant differences ( P<0.05). Conclusions:β1-AR G1165C gene polymorphism is related to the risk of myocardial hypertrophy in hypertensive patients. Carrying the G1165C allele Gly may increase the risk of susceptibility to cardiac hypertrophy, and β-blockers are more effective in hypertensive patients with myocardial hypertrophy who carry the G1165C allele Arg.
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Traditional depression research based on electroencephalogram (EEG) regards electrodes as isolated nodes and ignores the correlation between them. So it is difficult to discover abnormal brain topology alters in patients with depression. To resolve this problem, this paper proposes a framework for depression recognition based on brain function network (BFN). To avoid the volume conductor effect, the phase lag index is used to construct BFN. BFN indexes closely related to the characteristics of "small world" and specific brain regions of minimum spanning tree were selected based on the information complementarity of weighted and binary BFN and then potential biomarkers of depression recognition are found based on the progressive index analysis strategy. The resting state EEG data of 48 subjects was used to verify this scheme. The results showed that the synchronization between groups was significantly changed in the left temporal, right parietal occipital and right frontal, the shortest path length and clustering coefficient of weighted BFN, the leaf scores of left temporal and right frontal and the diameter of right parietal occipital of binary BFN were correlated with patient health questionnaire 9-items (PHQ-9), and the highest recognition rate was 94.11%. In addition, the study found that compared with healthy controls, the information processing ability of patients with depression reduced significantly. The results of this study provide a new idea for the construction and analysis of BFN and a new method for exploring the potential markers of depression recognition.
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Humans , Brain , Brain Mapping , Depression/diagnosis , Electroencephalography , Recognition, PsychologyABSTRACT
Objective@#To compare the weight loss and metabolic profile between a continuous energy-restricted diet and intermittent fasting diet in order to present an optimal nutritional weight reduction method for obese people in China.@*Methods@#Sixty overweight or obese adults were selected and divided into two groups as the continuous energy-restricted diet group and the intermittent fasting diet group. Height, weight, waist circumference, body mass index(BMI), body fat, change of visceral fatarea, fasting glucose(FPG), triglyceride(TG), total cholesterol(TC), high density cholesterol(HDL), low density cholesterol(LDL), glutamic pyruvicaminotransferase(AST), signglutamic pyruvic transaminase(ALT), gamma-glutamyltranspeptidase(GGT), alkalinephosphatase (ALP), fasting insulin level(FINS) and HOMA-IR were assessed at baseline and 8 weeks after weight loss methods carried.@*Results@#Both continuous energy-restricted diet and intermittent fasting diet resulted improvement on body shape indexes and a significant decrease in weight, waist circumference, BMI, body fat, visceral fat area and skeletal muscle(P<0.01)at 8 weeks. Both groups experienced improvements in biochemical outcomes and metabolic indicators at 8 weeks. A significant reduction in TC, AST, ALT, GGT, ALP, FINS and HOMA-IR(P<0.01 or P<0.05)were observed in continuous energy-restricted diet group. And a significant decline in TC, LDL, HDL, AST, ALT, GGT, ALP, FINS and HOMA-IR were observed in intermittent fasting diet group(P<0.01 or P<0.05). HDL was found significantly reduced in intermittent fasting diet group as compared with continuous energy-restricted diet group(P<0.01) at 8 weeks, however, there were no difference in weight loss, waist circumference, BMI, body fat, visceral fat area and other metabolic indicators at 8 weeks(P>0.05).@*Conclusion@#Both intermittent fasting diet and continuous energy-restricted diet have a similar effect on weight loss and metabolic indexes like blood glucose, HOMA-IR and blood lipid, but intermittent fasting diet can more significantly decrease HDL level.
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Objective To compare the weight loss and metabolic profile between a continuous energyrestricted diet and intermittent fasting diet in order to present an optimal nutritional weight reduction method for obese people in China. Methods Sixty overweight or obese adults were selected and divided into two groups as the continuous energy-restricted diet group and the intermittent fasting diet group. Height, weight, waist circumference, body mass index (BMI), body fat, change of visceral fatarea, fasting glucose (FPG), triglyceride (TG), total cholesterol ( TC), high density cholesterol ( HDL), low density cholesterol (LDL), glutamic pyruvicaminotransferase ( AST), signglutamic pyruvic transaminase ( ALT), gammaglutamyltranspeptidase (GGT), alkalinephosphatase (ALP), fasting insulin level (FINS) and HOMA-IR were assessed at baseline and 8 weeks after weight loss methods carried. Results Both continuous energy-restricted diet and intermittent fasting diet resulted improvement on body shape indexes and a significant decrease in weight, waist circumference, BMI, body fat, visceral fat area and skeletal muscle (P<0. 01) at 8 weeks. Both groups experienced improvements in biochemical outcomes and metabolic indicators at 8 weeks. A significant reduction in TC, AST, ALT, GGT, ALP, FINS and HOMA-IR (P<0. 01 or P<0. 05) were observed in continuous energy-restricted diet group. And a significant decline in TC, LDL, HDL, AST, ALT, GGT, ALP, FINS and HOMA-IR were observed in intermittent fasting diet group (P <0. 01 or P < 0. 05). HDL was found significantly reduced in intermittent fasting diet group as compared with continuous energy-restricted diet group (P<0. 01) at 8 weeks, however, there were no difference in weight loss, waist circumference, BMI, body fat, visceral fat area and other metabolic indicators at 8 weeks (P>0. 05). Conclusion Both intermittent fasting diet and continuous energy-restricted diet have a similar effect on weight loss and metabolic indexes like blood glucose, HOMA-IR and blood lipid, but intermittent fasting diet can more significantly decrease HDL level.
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To construct a competency model for junior caregivers for the elderly and to provide a reference for the selection, evaluation and training for the junior caregivers for the elderly. Methods: Firstly, we drafted the primary competency model for junior caregivers for the elderly through literature review. Then, we used Delphi method to carry out 2 rounds of questionnaire survey for 20 experts to optimize the indicators for primary model. The weight of each indicator is determined by analytic hierarchy process (AHP) and expert sequencing method. Results: The effective recovery rates of the two-round questionnaire were 87% and 100%, respectively. The expert authority coefficient was 0.70-0.93, and the average authority coefficient was 0.80. The final version of the competency model for junior caregivers for the elderly included 4 first-grade indexes, 11 second-grade indexes and 37 third-grade indexes. Conclusion: The competency model for the junior caregivers for the elderly is reliable and can be used as the reference standard for the selection, evaluation and training for the junior caregivers for the elderly.
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Aged , Humans , Caregivers , Reference Standards , Clinical Competence , Delphi Technique , Health Services for the Aged , Reference Standards , Medical Staff, Hospital , Reference Standards , Reference Standards , Surveys and QuestionnairesABSTRACT
Objective Pancreatic enzymes may spread into the injured intestine, bloodstream,and cause the cascade of inflammatory reactions. Our objective was to explore trypsin expression in serum and vital organs in septic rats. Methods Trypsin levels in serum, heart, lung and jejunum were tested and compared between Escherichia coli endotoxin injected rats(SS), SS treated with a protease inhibitor (ulinastatin) and control group(SHAM). The correlations between serum trypsin, intestinal proteins and inflammation indices were assessed.Two components of mucosal barrier, i.e. mucin-2 and E-cadherin,were measured to evaluate the intestinal mucosal barrier function. The levels of tumor necrosis factor alpha (TNFα), interleukin-6(IL-6) and neutrophil elastase(NE) were measured to determine the inflammation indices.Results Compared to SHAM group, trypsin levels in serum[(73.71±9.14) ng/ml vs. (12.12±2.36) ng/ml],heart[(51.60±15.06) ng/ml vs. (6.39±3.53) ng/ml],lung [(54.73±5.57) ng/ml vs. (5.24±3.08) ng/ml] and jejunum(1.19 ± 0.48 vs. 0.40 ± 0.12) were significantly higher in SS group (all P<0.05). The level of serum trypsin had negative correlation with mucin-2 and E-cadherin, and positive correlation with TNFα, IL-6 and NE (all P<0.05). In rats treated with ulinastatin, trypsin levels were significantly decreased compared with those in SS group including in serum [(65.79±4.88)ng/ml]], heart [(26.33±12.03)ng/ml], lung [(28.73±14.46) ng/ml] and jejunum (0.80±0.20) (all P<0.05).Serum TNFα[ (247.34±16.97)ng/L vs. (178.78±40.81)ng/L] revealed similar changes in ulinastatin and SS group, whereas mucin-2(0.58 ± 0.14 vs. 0.89 ± 0.17)and E-cadherin(0.11 ± 0.04 vs. 0.23 ± 0.06)were both significantly elevated after administration of ulinastatin (both P<0.05). Conclusion Serum and tissue trypsin is elevated in septic rats. Protease inhibitor ulinastatin protects intestinal function by reducing inflammatory reaction.
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Objective To study the value of Saccharomyces boulardii for the prevention of antibiotic-associated diarrhea in older inpatients.Methods A total of 163 older patients who were treated with wide-spectrum antibiotics at least three days during January 2014 to December 2015 were randomly divided into control and study group.In study group, 81 patients were administrated with oral Saccharomyces boulardii 500 mg twice a day for 21 days.The control group was of no intervention.Morbidity rate of antibiotic-associated diarrhea and Clostridium difficile-associated diarrhea, frequency and duration of diarrhea were recorded.Results The incidence of antibiotic-associated diarrhea in study group was significantly lower than that in control group [14.8%(12/81) vs 28.0%(23/82), P0.05] in two groups.The frequency and duration of diarrhea in the study group were significantly lower and shorter than those in control group[(4.3±1.7) times/day vs (6.9±2.0) times/day;(3.0±1.1) days vs (5.7±1.8) days, both P<0.01].Conclusion Saccharomyces boulardii may reduce the incidence of antibiotic-associated diarrhea therefore improving the symptom of diarrhea in older inpatients.
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Objective To analyze the characteristics of TCM syndromes of children abnormal sweating;To investigate the correlation between diseases and primary and secondary syndromes. Methods Through a multi-center epidemiology investigation, 400 cases were collected to statistically analyze the five TCM syndromes of children abnormal sweating, and characteristics of each syndrome were analyzed. Results In the 400 cases of children abnormal sweating, there were 129 cases (32.25%) of dysfunction of lung-wei pattern, 50 cases (12.50%) of nutrient qi and defensive qi discordance, 84 cases (21.00%) of qi and yin deficiency pattern, 57 cases (14.25%) of dampness heat forced steamed pattern, and 80 cases (20.00%) of qi and yang deficiency pattern. Spontaneous sweating and night sweating were found in the four patterns besides qi and yin deficiency pattern, and night sweating can be mainly found in qi and yin deficiency. Each type is consistent in the syndrome differentiation and cluster analysis. Conclusion Spontaneous sweating and night sweating, each has the certification of yin and yang. Spontaneous sweating can be caused by yin deficiency while night sweating can be caused by yang deficiency. Each pattern of children abnormal sweating has its own syndrome characteristic, which can provide the basis for clinical diagnosis and treatment.