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A total of 1 789 patients with gastric cancer underwent radical gastrectomy in our hospital from September 2015 to August 2017, internal hernia (IH) developed in 7 cases with a incidence rate of 0.4%. The general condition, the symptoms, imaging findings, treatment methods and prognosis as well as the types of digestive tract reconstruction of patients were retrospective analyzed. There were 4 cases of Petersen′s hernia, 2 cases of jejuno-jejuno mesenteric hernia and 1 case of diaphragm hernia. All patients developed mechanical obstruction. Imaging examination showed mesenteric vessels overriding sign and double whirl sign. Six patients recovered smoothly, 1 patient gave up treatment due to extensive small bowel infarction. It is indicated that the formation of abnormal channels in the abdominal cavity after radical gastrectomy may lead to IH. The mesenteric vessels overriding sign and the double whirl sign are the unique imaging findings of IH after radical gastrectomy. Closing the abnormal channel can prevent the occurrence of IH after gastrectomy.
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A total of 1 789 patients with gastric cancer underwent radical gastrectomy in our hospital from September 2015 to August 2017,internal hernia (IH) developed in 7 cases with a incidence rate of 0.4％.The general condition,the symptoms,imaging findings,treatment methods and prognosis as well as the types of digestive tract reconstruction of patients were retrospective analyzed.There were 4 cases of Petersen's hernia,2 cases of jejuno-jejuno mesenteric hernia and 1 case of diaphragm hernia.All patients developed mechanical obstruction.Imaging examination showed mesenteric vessels overriding sign and double whirl sign.Six patients recovered smoothly,1 patient gave up treatment due to extensive small bowel infarction.It is indicated that the formation of abnormal channels in the abdominal cavity after radical gastrectomy may lead to IH.The mesenteric vessels overriding sign and the double whirl sign are the unique imaging findings of IH after radical gastrectomy.Closing the abnormal channel can prevent the occurrence of IH after gastrectomy.
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Objective To investigate the clinical efficacy of middle segment pancreatectomy (MSP) in treatment for pancreatic neck and body tumors.Methods From Jan.2000 to Dec.2016,the clinicopathological data of 26 patients with pancreatic neck or body tumors were analyzed retrospectively.Results All of the 26 patients received middle segment pancreatectomy.14 cases had serous or mucinous cystadenomas.The tumor diameter was 2.3 to 5.6 cm (averaging from 3.8 cm).9 cases had solid pseudopapillary tumors.The tumor diameter was 3.3 to 5.0 cm(averaging from 3.6 cm);One case had insulinoma and the diameter was 2.0 cm.Two cases had nonfunctional pancreatic neuroendocrine tumors,and the diameter was 2.1 and 2.4 cm.The post-complication morbidity rate was 53.8％.The main post-complications of the group were pancreatic fistula (9 cases,34.2％),intra-abdominal infection(1 case,3.8％),delayed gastric emptying (2 cases,7.6％),lymphatic fistula (1 case,3.8％),and abdominal infection (1 case,3.8％).All of the 26 patients healed after surgery without undergoing surgery again.There were no mortality during perioperative period.All patients were followed up for 6 to 60 months.All of the 26 patients had good life quality,without new-onset diabetes or cancer recurrence during the follow-up period of 6 to 60 months after operation.Conclusion Middle segment pancreatectomy is safe and feasible in treatment of benign or low-graded malignant pancreatic neck and body tumors and is capable of preserving pancreatic endocrine and exocrine function.
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BACKGROUND:Some studies indicate that PI3K/Akt signaling pathway is associated with the expression of glucose transporter 4 (GLUT4) and the function of cAMP response element binding protein (CREB) in skeletal muscle. However, it is stil unclear whether PI3K/Akt signaling pathway has the effects on CREB and GLUT4 in skeletal muscle of the rats with high-fat diet and treadmil exercise. OBJECTIVE:To investigate whether PI3K/Akt signaling pathway has the effects on CREB and GLUT4 in gastrocnemius muscle of the rats with high-fat diet and treadmil exercise. METHODS:A total of 70 rats were fed with normal diet for 2 weeks, and randomly divided into common feed group (n=20) and high-fat feed group (n=50). Rats in both groups were respectively fed with common feed and high-fat feed for 8 weeks. The rats in the common feed group were equaly assigned to common feed quiet group and common feed exercise group. 20 rats from the high-fat feed group whose body weight was 1.4 times of common rats were randomly and equaly assigned to obese quiet group and obese exercise group. Rats in the quiet groups did not do exercises. Rats in the exercise groups received adaptive sports for 1 week and medium-intensity treadmil exercise for 8 weeks. RESULTS AND CONCLUSION:(1) Impairments of PI3K/Akt signaling pathway appeared in obese rats, however, the quantity of GLUT4 expression did not change obviously in gastrocnemius muscles of obese rats. The reasons for the decrease of the nuclear protein CREB level of gastrocnemius muscles of obese rats might be related to the decrease of pAkt-Ser473 level. (2) The increase of the quantity of GLUT4 expression was accompanied by significantly up-regulated pAkt-Ser473 level by exercise intervention in gastrocnemius muscles of obese rats. Exercise intervention significantly increased the expression of nuclear protein CREB in gastrocnemius muscles of chow-fed rats and obese rats, which was consistent with the changes of pAkt-Ser473. These findings suggest that pAkt-Ser473 can play an important role in the effects of high-fat diet and exercise intervention on GLUT4 and CREB protein expression in gastrocnemius muscles of obese rats.
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Objective To investigate the clinical outcomes of radical surgery for pancreatic body and tail tumors accompanied with sinistral portal hypertension (SPH).Method The clinicopathological data of 35 patients with pancreatic body and tail tumors accompanied with SPH operated from January 2004 to December 2014 were retrospectively analyzed.Results Of 35 patients,22 patients had body and tail pancreatic carcinomas,10 patients had malignant solid pesudopaillary tumors and 1 patients had a neuroendocrine tumor.All these patients developed splenomegaly and varices in the gastric fundus with normal hepatic function.The splenic vein pressure was (27.3 ±3.8)cmH2O (1 cmH2O =0.098 kPa),its average diameter was (1.3 ± 0.3) cm,and the speed of splenic vein blood flow was (8.9 ± 0.8) cm/s.Of the 35 patients with pancreatic body and tail tumors who underwent radical resectional operations,22 patients in addition underwent devascularization.There were 13 of these 22 patients who underwent pericardical devascularization and the remaining 9 underwent total or proximal gastrectomy.The main complications were pancreatic fistula (n =5,14.2％),intra-abdominal infection (n =4,11.5％),delayed gastric emptying (n =1,2.8％),lymphatic fistula (n =1,2.8％) and gastric perforation (n =1,2.8％).The post-complication morbidity rate was 34％.All these patients were followed-up for 6 to 60 months after operations.There was no upper gastrointestinal bleeding which occurred within 6 months of operation.Conclusion Multi-disciplinary treatment,complete preoperative evaluation,correct perioperative and individualized management enhanced efficacy in the surgical treatment of patients with pancreatic body and tail tumors with SPH.
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Objective To investigate the clinical efficacy of radical operation for gastric cancer with liver cirrhosis.Methods The clinicopathological data of 56 gastric caner patients with liver cirrhosis performed on between Jan 2000 and Dec 2013 were analyzed retrospectively.Results The morbidity rate was 71％.The main complications of the group with liver cirrhosis were postoperative ascites (7 cases),delayed gastric emptying(6 cases),pulmonary infection(8 cases),intra-abdominal infection (5 cases),anastomotic leakage (3 cases).wound infection (2 cases)and,astrointestinal bleeding(1 cases).Postoperative complications of gastric cancer with liver cirrhosis were associated with age (＞ 60 yrs),Child-pugh grade(B),lymph node dissection(D2).There were no mortality.The 1-,3-and 5-year survival rates of the 56 cases were 73.2％,41％ and 26.7％.Conclusion Multi-disciplinary treatment,complete preoperative evaluation,correct perioperative management,individualized principle were the best mode on effective treatment of the patients with liver cirrhosis.
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Objective To investigate the effect of the second resection for unsuspected gallbladder carcinoma discovered after cholecystectomy.Methods A retrospective clincopathological analysis was conducted for 45 cases of unsuspected gallbladder carcinoma receiving second operation at our hospital from January 2000 to December 2010.Result Of the 45 cases with unsuspected gallbladder carcinoma (33 pT2,12 pT3 ),40 cases received second radical reeection of the liver bed with lymph dissection; the remaining 5 cases received palliative operation.Amongst 45 patients lymph metastasis (4 pT2,6 pT3 ) was found in 10 cases,liver metastasis ( 2 pT2,1 pT3 ) in 3,parietal seeding in 1 ( pT3 ) and distant metastasis ( pT2 ) in one.The 5 patients receiving palliative operation died in 3 ～ 8 months and 40 patients receiving the radical operation achieved long-term survival ( 40.4 ± 2.7 months) after the operation.The effect of second operation which was done within 4 weeks after the first cholecystectomy was better than that of the operation done beyond 4 weeks ( survival time 37.1 ± 2.2 vs 22.4 ± 5.8months).Conclusions Radical resection for unsuspected gallbladder carcinoma discovered after the initial cholecystectomy helps improve prognosis and prolong patients survival time.
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OBJECTIVE@#To establish the 2-dimensional electrophoresis (2-DE) map in colonic mucosa in sub-healthy people with shapeless stool and healthy people, to identify the differential proteins by matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS), and to provide theoretical basis for the pathogenesis of intestinal mucosa in sub-healthy people with shapeless stool.@*METHODS@#Two-DE was used to separate the total proteins from the intestinal mucosa in sub-healthy people (the sub-health group) with the shapeless stool and healthy volunteers (the control group). ImageMaster 2D Elite soft was applied to analyze the 2-DE images, and the differentially expressed protein spots between the 2 groups were identified by MALDI-TOF-MS, protein bank and information technique.@*RESULTS@#We analyzed the average maps and obtained 517 protein spots in the sub-healthy group and 535 protein spots in the control group. Between the sub-healthy group and the control group, the mean of 366 protein spots was matched, and the matching rate was 70.79%. Ten differential protein spots were screened by MALDI-TOF-MS, and 8 were identified. Five out of the 8 spots were significantly decreased, while 3 out of the 8 were significantly increased.@*CONCLUSION@#The proteomic expression in colonic mucosa of people with shapeless stool is significantly different from that of healthy people. Eight differential proteins such as aldehyde dehydrogenase 1A1 isoform 1, 3-hydroxy-3-methylglutaryl-coenzyme A synthase 2 (mitochondrial), γ-actin, annexin A5 possibly involve in the pathogenesis of sub-healthy people with shapeless stool.
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Female , Humans , Male , Actins , Metabolism , Aldehyde Dehydrogenase , Metabolism , Aldehyde Dehydrogenase 1 Family , Annexin A5 , Metabolism , Case-Control Studies , Colon , Metabolism , Dyspepsia , Metabolism , Electrophoresis, Gel, Two-Dimensional , Hydroxymethylglutaryl-CoA Synthase , Metabolism , Intestinal Mucosa , Metabolism , Proteins , Genetics , Metabolism , Proteome , Proteomics , Methods , Retinal DehydrogenaseABSTRACT
Objective To investigate the predictive factors and prognosis of early intrahepatic recurrence after curative resection of hepatocellular carcinoma(HCC).Methods Clinicopathological dats of 184 HCC patients with intrahepatic recurrence after curative resection were collected.Thirteen clinicopathological factors and prognosis after recurrence were retrospectively analyzed. Results Univariate analysis showed that preoperative scrota alpha-fetoprotein(AFP)>100 ng/ml,tumour size>5 cm,venous invasion and intra-operative blood transfusion were predictive factors of early intrahepatic recurrence,and selum albumin<35 g/L was marginally predictive factor.Multivariate analysis showed that serum AFP>100 ng/ml,tumour size>5 cm and venous invasion were independent predictive factots of early intrahepatic recurrence.The survival of patients suffering from early recurrence was significantly shorter than those with late recurrence.with median survival period of 12 mos vs 18 mos(P=0.012).Conclusion Serum AFP,tumour size and venous invasion were independent predictive factors of early intrahepatic recurrence in HCC patients after radical resection of the primary tumor.Early intrahepatic recurrence implies poor prognosis.
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spectrum beta-lactamase genes:blaOXA-128 and blaOXA-129.
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OBJECTIVE:To observe the clinical efficacy and transdermal absorption of Suhong bone-penetrating massage drug for rheumatic arthralgia. METHODS:Suhong bone-penetrating massage drug(Chinese medicine) was applied in 300 cases with rheumatic arthralgia characterized by various symptoms such as bone spur, injury, scapulohumeral periarthritis, acute injury or chronic strain of articular surrounding soft tissue; Suhongtougu powder was used as control to treat another 120 cases with the same disease. The curative efficacies in two groups were compared. The effects of the effective components such as Muskone,Borneo Camphor,Menthol in Suhong bone-penetrating massage drug on the transdermal absorption of this preparation was investigated by transdermal test on mice. RESULTS:The total effective rate in the treatment group was 93.24% as compared with 80.00% in the control group, showing significant difference between two groups(P
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OBJECTIVE To invesigate the prevalence of SHV-producing Enterobacteriaceae isolates in Hunan Province and identify the subtype of SHV encoding gene and the epidemiological aspect of SHV-producing isolates. METHODS Isolates were collected and identified as well as subjected to ESBLs detection.PCR and DNA sequencing were used to determine the genotype of SHV enzymes.The homology of SHV-producing strains were detected by RAPD. RESULTS Twenty-six of 171 Enterobacteriaceae isolates were confirmed to produce blaSHV genes,and 5 subtypes of SHV-type ?-lactamases were determined,including 9 strains of SHV-28,7 strains of SHV-12,7 strains of SHV-1,2 strains of SHV-11 and 1 strain of SHV-5.There were 6 RAPD types in 19 isolates of SHV-producing Klebsiella pneumoniae,5 RAPD types in 5 isolates of SHV-producing Enterobacter cloacae. CONCLUSIONS SHV-12 is the predominant genotype of SHV ESBLs producing Enterobacteriaceae in Hunan Province,and clone spread has played a certain role in SHV-type ?-lactamase producing K.pneumoniae.SHV ESBLs are not found in Escherichia coli.
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6 hours). The APACHE Ⅱ and POSSUM scoring system during perioperative period was in positive correlation with postoperative morbidity and mortality. Conclusions Pancreatoduodenectomy for the treatment of periampullary carcinomas is with high risks. Postoperative mortality and morbidity were in close correlation with the risk factors.
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Objective To study the best preparation technique of compound Thallus laminaria granules volatile oil-?-cyclodextrin clathrate and examine the stability of the elathrate.Methods The orthogonal design method was used to optimize the formulation.The yeild of the volatile oil and the content of the clathrate were used as the test target.Results The best preparation process was as follows:?-cyclodextrin:compound Thallus laminaria=12:1(g?mL~(-1)),at 50～60℃for 2 hours.Making distillation twice while adding water to the first decoction, steaming 1h after boiling;A_2 B_1 was the best extraction scheme.Conclusion The preparation process can be a scheme to obtain the clathrate with high content of effective component,which can be used in the preparation of the clathrate.
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Objective To study the surgical treatment of the primary retroperitioneal sarcoma(RPS). Methods The treatment and prognosis of 63 patients with primary retroperitoneal sarcomas (liposarcomas and leiomyosarcomas) from Jan 1992 to Dec 2000 were analyzed retrospectively. Results The rate of complete tumor resection was 88.2%, and concomitant resection of involved adjacent organs was 21.6%. There was no operation death. The median survival time(MST) in liposarcomas that for was 36.5months, and leiomyosarcomas was 27.6 months. The MST in highly differentiated tumor was 34.7 months,and that of intermiade and low differtiated tumors was 18.1months(P