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Objective@#To assess the safety, feasibility and short-term outcome of totally laparoscopic distal gastrectomy(TLDG).@*Methods@#Seventy-five patients who underwent laparoscopic distal gastrectomy in Cancer Hospital of Chinese Academy of Medical Science between August 2015 and April 2018 were enrolled in this study. A total of 46 laparoscopy-assisted distal gastrectomy (LADG) cases and 29 TLDG cases were included. The Short-term outcomes and safeties of the two groups were compared.@*Results@#The operation time of TLDG group was significantly longer than that of LADG group (207±41 vs. 156±34 min, P<0.001), while the length of wound was shorter in the TLDG group (3.6±0.6 vs. 5.8±0.8 cm, P<0.001). The time to first flatus in TLDG group was (3.3±0.6) days, significantly shorter than (3.7±0.8) days in LADG group (P=0.034). There were no significant differences between the two groups in the estimated blood loss, intraoperative blood transfusion, extraction of gastric tube, drainage tube removal, interval of the first time to eat semi-liquid food, postoperative hospital stays, surgical complications, number of retrieved lymph nodes, proximal and distal resection margin lengths (all P>0.05). The white blood cell count at postoperative day 1 in the TLDG group was (10.96±1.96) ×109/L, significantly lower than (12.49±3.46)×109/L of the LADG group (P=0.017). While the CRP level at postoperative day 1 in the TLDG group were lower than that of LADG group, no statistical difference was observed (P=0.072).@*Conclusions@#Our study shows that TLDG is safe and feasible. TLDG has better cosmesis, less blood loss, and faster recovery compared to LADG.
ABSTRACT
The evaluation of the immunosuppression state in liver transplanted recipients is vital for a correct posttransplantation management and a major step towards the personalized treatment of the immunosuppression.To date,immunological monitoring after liver transplantation relies mainly on clinical judgment and pathological examination of the graft,without a proper assessment of the actual state.Previous studies have ever identified many markers for acute rejection(AR) and immune tolerance after liver transplantation.Many markers for AR are pro-inflammatory or immunoregulatory cytokines and other proteins related to inflammation.However,many markers have been proved to be also able to predict other diseases and only a few of the markers for AR have been validated.Standard liver tests cannot be used as markers for graft rejection due to the low sensitivity and specificity.This review summarized the potential markers for AR and immune tolerance after liver transplantation based on published literatures in recent years and to provide evidence for clinical application.
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Objective To analyze the relationships between body mass index (BMI), blood pressure and the cerebral vascular function in middle-aged population that underwent health checkup. Methods Participants from health management centers of Renmin Hospital of Hubei province, the Second Hospital Affiliated to Nanhua University, Hospital of Shandong Electric Power and Chinese People's Liberation Army No. 180 Hospital aged 45 to 64 years were selected from health checkup population by cluster sampling. Levels of height, weight and blood pressure as well as the cerebral hemodynamics were checked. Subjects were grouped according to age, BMI, systolic and diastolic blood pressure. The differences and distribution of cerebrovascular function scores (CVFS) between groups were compared and described. Moreover, the risk of stroke in the population was evaluated. Results Of the 17 258 individuals who met inclusion criteria, the abnormal rate (the score below 75 points) of CVFS was 20.9 percent. The CVFS in normal, overweight and obese groups were 91.0±15.4, 83.3±21.3, 70.3±26.5 and differences in all age groups were statistically significant (P<0.01). The CVFS in systolic blood pressure<120,120-139, 140-159,≥160 mmHg (1 mmHg=0.133 kPa) groups were 93.9±12.9, 86.5±18.9, 72.1±23.5, 56.2±25.7 and differences in all age groups were statistically significant (P<0.01). CVFS in normal diastolic pressure<80, 80-89, 90-99,≥100 mmHg groups were 91.0±16.1, 85.5±20.2, 75.4±23.6, 62.7±25.0 and the differences among all age groups were statistically significant (P<0.01). Conclusions The abnormal rate of cerebrovascular function integral and high risk stroke individuals in middle-aged health checkup people was approximately 21 percent. The overweight, obese and the high level of systolic and diastolic pressure may induce the injury of cerebrovascular function and the severity will increase with the level of BMI and blood pressure.