Postoperative complications and their influence on the prognosis factors in gastric cancer patients receiving neoadjuvant treatment / 中华胃肠外科杂志

Objective: To investigate postoperative complications of patients undergoing neoadjuvant therapy followed by radical gastrectomy, and to analyze their influence on the prognosis. Methods: A retrospective case-control study was used. Case inclusion criteria: (1) gastric adenocarcinoma confirmed by histopathology; (2) preoperative imaging examination showed no distant metastasis or peritoneal dissemination; (3) undergoing radical gastrectomy and D2 lymph node dissection after neoadjuvant therapy; (4) complete clinicopathological and follow-up data. According to the above criteria, clinical data of 490 gastric cancer patients who underwent radical gastrectomy in the Cancer Hospital of Chinese Academy of Medical Sciences, Peking Union Medical College from January 2008 to December 2018 were retrospectively collected, including 358 males and 132 females with mean age of (55.0±10.6) years. Neoadjuvant chemotherapy regimens included SOX (S-1+ oxaliplatin, n=151), XELOX (capecitabine+oxaliplatin, n=155), FLOT (docetaxel+oxaliplatin+fluorouracil, n=66), and DOS (docetaxel+ oxaliplatin+S-1, n=68). Preoperative concurrent chemoradiotherapy was performed in 100 patients. SOX regimen was used for 2-4 cycles as induction chemotherapy plus concurrent chemoradiotherapy (3D IMRT+S-1). Postoperative complications were defined as surgery-related complications, mainly including hemorrhage, anastomotic leakage, obstruction, anastomotic stenosis, pulmonary infection, abdominal infection, etc. Postoperative complications were graded according to Clavien-Dindo classification. Log-rank test and Cox regression model were used for univanriate multivariate prognostic analysis, respectively. Results: A total of 101 complications ocaured after operation in 87 (17.8%) patients, including 29 cases of major complications (Clavien-Dindo III to V), and 58 cases of minor complications (Clavien-Dindo I to II). Multivariate analysis showed that age > 65 years (HR=3.077, 95% CI: 1.827-5.184, P<0.001) and total gastrectomy (HR=1.735, 95% CI: 1.069-2.814, P=0.026) were independent risk factors for postoperative complications in patients with gastric cancer undergoing neoadjuvant therapy and radical gastrectomy (both P<0.05). The follow-up period was 0.7 to 131.8 months (median 21.5 months), and the 5-year overall survival rate was 47.4%. The 5-year overall survival rates of the complication group (87 cases) and the non-complication group (403 cases) were 33.2% and 50.9%, respectively (P=0.001). Multivariate analysis showed that age (HR=1.906, 95% CI: 1.248-2.913, P=0.003), ypTNM II to III stage (II stage: HR=5.853, 95% CI: 1.778-19.260, P=0.004; III stage: HR=10.800, 95% CI: 3.411-34.189, P<0.001), surgery time>3.5 h (HR=1.492, 95% CI: 1.095-2.033, P=0.011), total gastrectomy (HR=1.657, 95% CI: 1.216-2.257, P=0.001) and postoperative complications (HR=1.614, 95% CI: 1.125-2.315, P=0.009) were independent risk factors for prognosis, and postoperative adjuvant therapy (HR=0.578, 95% CI: 0.421-0.794, P=0.001) was an independent protective factor for prognosis. Conclusions: The occurrence of postoperative complications in gastric cancer patients undergoing neoadjuvant therapy is closely related to the age of the patients and the range of surgical resection. It is beneficial to improve the prognosis for these patients by paying more attention to the prevention of postoperative complications and the reinforcement of postoperative adjuvant therapy.

Bioinformatics analysis and systematic review of key genes and therapeutic traditional Chinese medicine of ulcerative colitis active stage / 中国中药杂志

Data GSE75214 and GSE48959 that contained ulcerative colitis(UC) in the active stage was download from GEO database. Differential genes of UC in the active phase were obtained by using adjusted P<0.05 and |log_2 FC|≥1.5, which was the screening criteria. PPI analysis was performed in the STRING database, and GO and KEGG pathway analysis was performed in DAVID database. Cytoscape was used to visualize differential genes, and calculate key genes in the active phase. Coremine Medical was used to analyze and systematically evaluate traditional Chinese medicines for treating key genes. Finally, 139 differentially expressed genes in the active phase were screened out, which included the 109 up-regulated genes and 30 down-regulated genes. DAVID analyzed that the biology and pathways of these differential genes were mainly concentrated in inflammatory response, immune response, chemokine activity, TNF pathway, NF-κB pathway, and Toll-like receptor pathway. Cytoscape software calculated that IL-6, CXCL8, IL-1β, MMP9, CXCL1, ICAM1, CXCL10, TIMP1, PTGS2 and CXCL9 were the key genes of UC in the active phase. According to Coremine Medical analysis, traditional Chinese medicines for UC in the active stage included Curcumae Longae Rhizoma, Scutellariae Radix, Curcumae Radix had clearing heat clearing damp, reducing fire and detoxifying effects, which was in line with the pathogenesis of UC active stage, and was often used in clinical treatment of dampness-heat diarrhea. Therefore, Huangqin Decoction, which Scutellariae Radix was the principal drug, was selected for systematic evaluation. The evaluation showed that Scutellariae Radix was superior to Western medicine in terms of improving clinical efficiency, reducing inflammatory factors and immunoglobulin levels, with statistically significant differences and fewer adverse reactions. This study provided a new idea for further research on the pathogenesis of UC in the active phase by analyzing the genes and their mechanism of action, and the systematic evaluation of Chinese medicine for the treatment of UC active stage provided a basis for the clinical prevention and treatment of UC by Chinese medicine.

Advances in Research of Cell Pyroptosis, Ulcerative Colitis and Regulation with Traditional Chinese Medicine / 中国实验方剂学杂志

Pyroptosis，which is different from cell necrosis， apoptosis and autophagy，is a new type of programmed cell death. It is characterized by the swelling of cells until the cell membrane rupture， resulting in the release of cell contents and the activation of a strong inflammatory response. Pyroptosis signaling pathway is divided into the classical pathway dependent on Caspase-1 and the non-classical pathway dependent on Caspase-4， 5 and 11. In classical pathway， activation Caspase-1 depends on inflammasome， whereas in non-classical pathway， Caspase-4， 5， and 11 are activated directly. All of these result in the cleavage of gasdermin D（GSDMD） protein， the formation of membrane pores， the maturation and release of interleukin-1β（IL-1β） and IL-18， and the rupture of the cell membrane， and then leads to pyroptosis. Ulcerative colitis （UC） is a common disease of the digestive system. The UC course is long， easy to relapse， and difficult to cure. The pathogenesis of UC is not completely clear. In recent years， it has been found that pyroptosis plays an important role in the development of UC. Traditional Chinese medicine（TCM） has a long history of preventing and treating UC， with significant clinical effects. It is found that the mechanism of TCM in the prevention and treatment of UC is closely correlated with inflammasome， IL-1β and IL-18. The mechanism of TCM in preventing and treating UC is correlated with cell pyroptosis. Therefore， this paper reviews the relationship between cell pyroptosis and UC and the regulatory effect of TCM.

Design of outpatient appointment system based on ASP.NET / 医疗卫生装备

Objective To design an outpatient appointment system based on ASP.NET which gains advantages over the existing system in database stability,functional module integrity and interface friendliness.Methods The ASP.NET-based system was developed with Microsoft Visual Studio 2010 as the platform,Microsoft SQL Server 2005 to create data and kinds of components to establish database and application interface.Results The system enhanced hospital registration and patient satisfaction.Conclusion The system is worthy promoting for outpatient appointment in the hospital.

Traversing the vertical pedicle flap for the treatment of severely buried penis in children / 中华男科学杂志

Objective@#To assess the effect of traversing the vertical pedicle flap (TVPF) for the treatment of severely buried penis in children.@*METHODS@#Totally 43 children with severely buried penis underwentTVPF (n = 21)or modifiedShiraki surgery (control, n = 22) in our hospitalfrom February to December 2014. Wecompared the operation time, intra-operation blood loss, foreskin swelling time, and parents' satisfaction with penile appearance between the two groups.@*RESULTS@#No statistically significant differences were observed between the TVPFand control groups in the operation time (［45.0 ±6.8］ vs ［42.0 ±5.3］ min, P>0.05) or intra-operation blood loss(［5.0 ±1.2］ vs ［6.0 ±0.8］ ml, P>0.05). The average foreskin swelling time was markedly shorter in the TVPFgroup than in the control (［9.0 ±2.3］ vs ［15.0 ±4.8］ d, P<0.05)and the parents' satisfaction with penile appearancewas higher in the former than in the latter (95.23vs31.81 %, P<0.05). The elastic bandages were removedfor all the patientsat 3 days postoperatively, and 3 to 6-month follow-up revealed no penile retraction or relapse.@*CONCLUSIONS@#The method of traversing the vertical pedicle flap is a feasible surgical option for the treatment of severely buried penis in children, which can make a rational use of the foreskin,remove the tight ring, and achieve a satisfactory appearance of the penis.

Quality safety of ultrasonic diagnostic apparatus during clinical application / 医疗卫生装备

Objective To study and analyze the quality safety of the ultrasonic diagnostic apparatus during clinical application to reduce the incidence of adverse events. Methods According to the actual use of ultrasonic diagnostic equipment and the data of quality control, the quality and safety factors of ultrasonic diagnostic apparatus during clinical application were studied by quantitative analysis of the ultrasonic source dose, image quality and etc. Results The factors affecting the quality safety of the ultrasonic diagnostic apparatus included the ultrasonic source dose, image quality, external environment and the operator's ability. Conclusion It is of great significance to understand the basic characteristics of the ultrasonic diagnostic apparatus and execute periodically preventive maintenance and quality control for increasing medical service quality while decreasing the incidence of adverse events.

Design of outpatient appointment system based on ASP.NET / 医疗卫生装备

Objective To design an outpatient appointment system based on ASP.NET which gains advantages over the existing system in database stability,functional module integrity and interface friendliness.Methods The ASP.NET-based system was developed with Microsoft Visual Studio 2010 as the platform,Microsoft SQL Server 2005 to create data and kinds of components to establish database and application interface.Results The system enhanced hospital registration and patient satisfaction.Conclusion The system is worthy promoting for outpatient appointment in the hospital.

nsory axonal neuropathy: a clinical and electrophysiological study / 中华神经科杂志

jective To study the clinical and electrophysiological characteristics of sensory axonal neuropathy (SAN). Methods Clinical data in 24 patients with SAN and 88 age-matched normal controls were examined. Sensory and motor nerve conduction were evaluated with supramaximal stimulation and surface electrodes in 180 nerves at different nerve segments of normal subjects, and compared with that of 90 nerves with sensory axonal neuropathy. Results Sensory symptoms of numbness and sensory ataxia were seen in 91. 6% of the patients, 70. 8% of them were mainly involved in the lower extremities. No weakness and fasciculation were found in our patients. Nerve conduction studies showed a normal MCV and CMAP amplitude, but the decreased amplitude of SNAP and slowed SCV in our patients had significant differences as compared with that of the normal subjects (P