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Objective To evaluate the clinical effect of modified Overlap method in digestive tract reconstruction of totally laparoscopic total gastrectomy(TLTG) for gastric cancer??Methods The data of 86 patients with gastric cancer who underwent TLTG from January 2014 and January 2017 were collected from the First Hospital of Lanzhou University??All the patients underwent D2 lymphadenectomy??Forty?four patients′digestive tracts were reconstructed with traditional Overlap method (control group),and 42 patients′digestive tracts were reconstructed with modified Overlap method ( modified group )??The intraoperative and postoperative conditions, postoperative tumor?free survival, tumor recurrence and metastasis were compared between the two groups??Follow up lasted as of February 2018??Results TLTG was successfully performed in both groups,and no case was converted to laparotomy??The time of esophagojejunostomy ((20??4±2??3) min vs??(46??5±4??4) min, t＝9??493), total operation time (( 253??3 ± 12??8) min vs??( 278??6 ± 14??9) min,t＝5??462) in the modified group were significantly shorter than those in the control group,and there were significant differences between the two groups ( all P＜0??05)??And there were no significant differences between the the modified group and control group in volume of intraoperative blood loss(( 71??5±12??9) ml vs??(73??2± 15??3) ml , t＝0??286), number of lymph node dissected (( 35??5 ± 4??8) vs??( 34??2 ± 5??6) , t＝0??618),first postoperative exhaust time (( 2??6 ± 0??9) d vs??( 2??7 ± 1??1) d, t＝0??348), postoperative hospitalization time((9??9± 1??6) d vs??( 9??8 ± 1??7) d,t＝0??229) and postoperative complications( 7??1%(3／42) vs??9??1%(4／44), χ2 ＝ 0??207) ( all P＞0??05)??The two groups were followed up for 12～25 months??No recurrence or metastasis occurred??Conclusion Compared with traditional Overlap method,the modified Overlap method can simplify the anastomotic procedures, shorten operation time and achieve an effective and reliable anastomosis effect after TLTG??
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Objective To explore the advantage of anterior cervical muscle group approach at sternal end transection in removal of bilateral huge thyroid neoplasm.Methods One hundred and seven patient underwent removal of bilateral huge thyroid neoplasm were selected.Fifty-two patients were given neck white line incision thyroid surgery (control group) and 55 patients were given anterior cervical muscle group approach at sternal end transection for thyroid surgery (observation group).The operative time,operation field exposure effect,amount of bleeding in operation,postoperative complications,and postoperative drainage volume were compared between two groups.Results The operative time [(88.53 ± 5.95) min],amount of bleeding [(18.58 ± 5.95) ml],and postoperative drainage volume [(47.58 ± 14.76) rnl] in observation group were less than those in control group [(113.98 ± 15.85) min,(39.27 ± 16.32) ml,(73.90 ± 14.40) ml] (P ＜ 0.05),the postoperative complication rate was lower than that in control group (P ＜ 0.05).Operation field exposure effect in observation group was better than that in control group (P ＜ 0.05).Conclusions Removal of bilateral huge thyroid neoplasm with the sternal end approach is feasible and simple.The operation field exposure is better than the neck white line incision,complications after operation is less.It is worthy of clinical application.
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Insulinoma is a rare tumor derives from pancreatic islet B cells,the cause of etiology is unknown with insidious onset.Its clinical manifestations are of diversification,the high misdiagnosis rate with the low cure rate owing to the complex of pancreatic anatomy and the lack of effective localization diagnosis and differential diagnosis method for benign and malignant lesions,the treatment of insulinoma is still one of challenge in clinical application considering that some patients unable to tolerate surgery or unwilling surgery.In recent years there have been some new treatments except surgery,this review will introduce the some treatment methods of insulinoma for the moment.
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Bupleurum chinense used in the study were cultivated in the experimental fields of Gansu agricultural University for three years. The seeds of B. chinense were collected every 3 days 10 d after the blossom. The result showed that the 1 000-grain fresh weight reached the maximum 43 d after the blossom and then decreased rapidly, at the mature period the fresh weight of seeds were falling to the same level of the dry weight. The dynamic change of the grain dry matter accumulation showed as an S-shape curve, the rapid increase stage was 25-34 d following the flower, and the grain filling was ended 46 d after blossom. Grain filling rate was under the law "fast-slow-fast-slow". And there were two peaks of grain filling rate appeared, after reached the second peak 28 d after the flower the filling rate decreased rapidly and stayed steadily 43 d after flowering. The dehydration rate was also measured at its maximum 43 d following flower. The indexes of seeds all reached the top 52 days following the blossom, when the germination rate reached the peak (34.33%) and water content of seeds was near 10%. The rate of germination and the 1 000-graid weight of seed showed significant positive correlation, while the water content of seeds was found significant negatively correlation with germination percentage. So the best time for harvest should be 52 d after flowering (9 month), the seeds collected at that time showed both high quality and germination rate.
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Bupleurum , Chemistry , Flowers , Germination , Seeds , Chemistry , WaterABSTRACT
Objective To discuss the management of solid-pseudopapillary tumor of the pancreas. Methods Four patients of solid-pseudopapillary tumor of the pancreas (SPT) were diagnosed by pathology. One patient was underwent magnetic resonance and two enhanced computer tomography scan. The mass was located in tuberculum (1 case), neck (1 case), and body-tail (2 cases) of pancreases respectively. Four cases were underwent duodenopancreatectomy, local resection of mass, resection of body-tail of pancreases respectively. The maximal diameter of tumor ranged from 5 cm to 16cm, averaged 10.3cm. The blood regular test and biochemistry were normal, and the tumor markers including AFP,CA19-9,CA125,CEA also were normal. The specimens were examined by pathology and immunohistochemistry. Results Four cases all were diagnosed solid-pseudopapillary tumor of the pancreas by pathology. At histologic analysis, the tumor was composed of uniform polygonal cells with moderate to abundant amphophilic cytoplasm and arranged in solid nests with areas of degeneration characterized by separation of the cells into pseudopapillary aggregates with intervening accumulation of mucopolysaccharide rich ground substance. The expressions of Vimentin, α-ACT, α-AAT were positive, and CgA negative. Four cases were followed up for six months and norecurred. Conclusions SPT of pancreases was a kind of tumor of low potential malignancy, and the magnetic resonance and computer tomography were often to be used. The effective therapy was thoroughly resection, and the prognosis in most patients is excellent.
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Tissue factor(TF)is the most important factor in the physiological coagulation process.TF also plays important roles in tumor growth,angiogenesis,invasion and metastasis by combining with factor VII.In recent years,targeted therapy for the TF has made remarkable progress,showing its significant inhibition of tumor tissue and metastasis.
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Objective To assess the efficency and safety of non-peritoneal drain versus peritoneal drain after appendectomy of severe appendicitis. Methods Randomized controlled trials (RCTs) or quasi-randomize controlled trials(QRCTs) were searched and identified from CNKI (1994 to Oct 2008) ,CBM (1978 to Oct 2008), VIP (1989 to Oct 2008), Wanfang Data (1997 to Oct 2008), MEDI.INE (1966 to Oct 2008), EMBASE (1974 to Oct 2008),The Cochrane Library (issue3, 2008) and SCI (1974 to Oct 2008), and related journals were also scanned. We evaluated the quality of the included studies by Jadad scale and analyzed the data by Cochrane Collaboration' s RevMan 5. 0. Results We included 15 randomized controlled trials or quais-randomized controlled trials (n = 2809). Meta analysis showed that there were statisticly differences between two groups on the incidence of wound infection [OR = 0.43,95%CI (0.29,0.65)], postoperative intestinal adhesion [OR = 0.26,95%CI(0. 18,0.37)]and the duration of hospital stay [WMD = - 0.38,95%CI(- 4.96, - 1.20)], but no difference was found on the incidence of abscesses [OR = 0. 77,95% CI(0. 39, 1. 51)]. Conclusions The current evidences show that contrast with peritoneal drain, the non-peritoneal drain can significantly reduce the incidence of wound infection and intestinal adhesion, and shorten the duration of hosipital stay. Before draw the conclution into clinical practice, further high-quality, large scale, double-blind randomized controlled trials are still needed.
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Objective To investigate the expression and significance of myeloperoxidase(MPO) in acute lungs injury of severe acute pancreatitis associated ascetic fluid. Methods Forty-five adult wistar rats were randomly assigned into the group of negative control (group C,n=15),the group of severe acute pancreatitis (group S,n=15) and the group of peritoneal injection (group E,n=15). The group C was cut peritoneum and flipped pancreases softly. In group S,3.5% sodium taurocholate was injected retrograde in pancreatic and bile duct to establish the model of severe acute pancreatitis,and the pancreatic homogenate and ascites of the group S was injected into abdominal cavity of group E rats. After animal model established,rats were killed at 3h,6h and 12h point. The blood of inferior vena cava was sucked for determination of amylase.The inferior lobe of left lung was cut for myeloperoxidase detection.And pathology was regularly done about pancreas and lungs. Results Interstitial edema,hemorrhage and infiltration of neutrophilic granulocyte and macrophage were observed in group S and E. At different time point,the amylase levels of blood and myeloperoxidase of lungs in group S and E were significantly higher than those of group C,and the increasing degree of group E was smaller than group S. Conclusion Acute lung injury can be induced by the severe acute pancreatitis associated ascetic fluid. The expression of myeloperoxidase of lungs was increased to induce acute lungs injury.The reason may be concerned with activation of granulocyte by severe acute pancreatitis associated ascetic fluid.
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Objective To evaluate the expression of CyclinD1 in gallbladder carcinoma and its relationship with clinlicopathological parameters.Method SABC immunohistochemistry was used to detect the expression of CyclinD1in 41carcinoma,15 chronic cholecystitis,10 normal tissue of gallbladder .Gallbladder carcinoma cell proliferation condition was detected by PCNA counting score .Results There were no positive signal of CyclinD1 deteted in chronic cholecystitis and in normal tissue,the positive rate of CyclinD1 in gallbladder carcinoma was 58.5%(24/41).The expression of CyclinD1 was related to tumor TNM stage, lymph node metastasis and cell differentiation (P