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1.
Article in Chinese | WPRIM | ID: wpr-876307

ABSTRACT

Objective To ascertain the level and dynamic changes of environmental health hazards in the rural areas of Pukou, Nanjing, to objectively evaluate the situation of rural environmental sanitation, providing basis and support for formulating policies and measures by the higher authorities. Methods According to the requirements of the rural environmental sanitation monitoring program of Jiangsu Province in 2017, 5 streets, 20 administrative villages were selected as monitoring points and 100 families used as monitoring objects.The monitoring data were obtained through interviews, access data, field records and laboratory tests. Results Centralized water supply was realized by 20 monitoring points.The rate of collection and centralized disposal of domestic waste was 95.00%.The sewage disposal sites were mainly discharged into sewage treatment plants and harmless sanitary toilets, accounting for 41.00% and 42.00% respectively.The coverage rate of sanitary toilets was 95.54%.Those who did the work of killing rats, flies and mosquitoes accounted for 40.00% and those who did the work of killing cockroaches 25.00%.And 98.00% of the families used fuel for gas, 98.00% of the families never burned straw in the fields, 88.00% of the families did not use the film, and the membrane recycling rate was 91.67%.It was found that 100% of the households drank boiled water, and 90.00% of the respondents developed the habit of washing hands before and after meals.The detection rate of Ascaris eggs was 20.00% in 20 soil samples, and the contents of Pb, CD and Cr were all within the normal range. Conclusion Although some achievements have been made in the rural environmental sanitation in Pukou, the management of pollution of rural sewage, waste and feces should be further strengthened, and the dangerous factors that affect the health of rural residents should be decreased and four pests removal activities actively carried out.

2.
Article in Chinese | WPRIM | ID: wpr-876289

ABSTRACT

Objective To ascertain the level and dynamic changes of environmental health hazards in the rural areas of Pukou, Nanjing, to objectively evaluate the situation of rural environmental sanitation, providing basis and support for formulating policies and measures by the higher authorities. Methods According to the requirements of the rural environmental sanitation monitoring program of Jiangsu Province in 2017, 5 streets, 20 administrative villages were selected as monitoring points and 100 families used as monitoring objects.The monitoring data were obtained through interviews, access data, field records and laboratory tests. Results Centralized water supply was realized by 20 monitoring points.The rate of collection and centralized disposal of domestic waste was 95.00%.The sewage disposal sites were mainly discharged into sewage treatment plants and harmless sanitary toilets, accounting for 41.00% and 42.00% respectively.The coverage rate of sanitary toilets was 95.54%.Those who did the work of killing rats, flies and mosquitoes accounted for 40.00% and those who did the work of killing cockroaches 25.00%.And 98.00% of the families used fuel for gas, 98.00% of the families never burned straw in the fields, 88.00% of the families did not use the film, and the membrane recycling rate was 91.67%.It was found that 100% of the households drank boiled water, and 90.00% of the respondents developed the habit of washing hands before and after meals.The detection rate of Ascaris eggs was 20.00% in 20 soil samples, and the contents of Pb, CD and Cr were all within the normal range. Conclusion Although some achievements have been made in the rural environmental sanitation in Pukou, the management of pollution of rural sewage, waste and feces should be further strengthened, and the dangerous factors that affect the health of rural residents should be decreased and four pests removal activities actively carried out.

3.
Article in Chinese | WPRIM | ID: wpr-733553

ABSTRACT

Objective To investigate the risk factors of perioperative complications of laparoscopic radical distal gastrectomy and influence of body shape on the short-term therapeutic effects.Methods The retrospective case-control study was conducted.The clinicopathological data of 506 patients (328 males and 178 females,average age 60 years with the range of 24-85 years) who underwent laparoscopic radical distal gastrectomy+D2 lymph nodes dissection in the 8 clinical centers between March 2016 and November 2018 were collected,including 143 in the First Affiliated Hospital of Xiamen University,66 in the Affiliated Hospital of Qinghai University,66 in the Second Affiliated Hospital of Wenzhou Medical University,64 in the Zhongshan Hospital of Xiamen University,54 in the Affiliated Hangzhou First people's Hospital of Zhejiang University School of Medicine,48 in the Zhangzhou Affiliated Hospital of Fujian Medical University,35 in the Affiliated Quanzhou First Hospital of Fujian Medical University,30 in the Second Affiliated Hospital of Xiamen Medical College.The maximum thickness of subcutaneous fat at the level of umbilicus (USCF),the maximum vertical distance between the anterior abdominal skin and the back skin at the level of the umbilicus (UAPD),the maximum horizontal distance between the anterior abdominal skin and the back skin at the level of the umbilicus (UTD),the maximum verticaldistance between the anterior abdominal skin and the back skin at the level of the xiphoid bone (XAPD),the maximum horizontal distance between the.anterior abdominal skin and the back skin at the level of the xiphoid bone (XTD),the distance between the anterior abdominal skin and the root of celiac artery (CAD) and the maximum horizontal distance at a right angle to CAD (CATD) were measured using preoperative imaging examinations.Observation indicators:(1) intraoperative and postoperative situations;(2) follow-up situations;(3) risk factors analysis of perioperative complications;(4) influence of body shape related indexes on intraoperative situations and postoperative recovery:① Pearson univariate correlation analysis,② liner regression model analysis.Followup using outpatient examination and telephone interview was performed to detect the postoperative survival and tumor recurrence or metastasis up to December 2018.Measurement data with normal distribution were represented as Mean±SD.Measurement data with skewed distribution were described as M (range).Comparisons of count data were analyzed using the chi-square test.Comparisons of ordinal data were analyzed by Mann-Whitney U nonparametric test.Risk factors of perioperative complications of laparoscopic distal gastrectomy were analyzed by Logistic regression model.Influence of body shape related indexes on intraoperative situations and postoperative recovery was analyzed by Pearson univariate correlation analysis and liner regression model.Results (1) Intraoperative and postoperative situations:all the 506 patients underwent successful laparoscopic distal gastrectomy,including 103 with Billroth Ⅰ anastomosis,140 with Billroth Ⅱ anastomosis,201 with Billroth Ⅱ + Braun anastomosis,62 with Roux-en-Y anastomosis.The operation time,volume of intraoperative blood loss,number of lymph nodes dissected,time to postoperative anal exsufflation,time for initial fluid diet intake,time for initial semi-fluid diet intake and duration of postoperative hospital stay were (233±44)minutes,(102±86)mL,34±13,(3.6±1.5)days,(5.8±3.3)days,(8.3±3.8)days,(12.2±5.7)days respectively in the 506 patients.Of 506 patients,196 were defined as pathological stage Ⅰ,122 were defined as pathological stage Ⅱ and 188 were defined as pathological stage Ⅲ postoperatively.Of 506 patients,93 had 106 times of perioperative complications,including 33 times of pulmonary and upper respiratory infection,12 times of incisional infection,11 times of anastomotic leakage,11 times of abdominal infection,8 times of intestinal obstruction,8 times of gastroplegia,6 times of abdominal hemorrhage,5 times of bacteremia,3 times of anastomotic hemorrhage,3 times of lymph fluid leakage,2 times of pancreatic leakage,1 time of urinary infection,1 time of anatomotic stenosis,1 time of deep venous thrombosis and 1 time of pulmonary embolism;the same patient can merge multiple complications.Eleven patients were in the Clavien-Dindo classification ≥ Ⅲ.(2) Follow-up situations:465 of 506 patients were followed up for 1-32 months with a median time of 12 months.During the follow-up,451 had postoperative survival and 38 had tumor recurrence or metastasis.(3) Risk factors analysis of perioperative complications.① Results of univariate analysis showed that age,body mass index (BMI),preoperative hemoglobin,preoperative serum albumin and XAPD were related factors affecting perioperative complications of laparoscopic distal gastrectomy (x2 =10.289,7.427,5.269,5.481,4.285,P< 0.05).② Results of multivariate analysis showed that age,BMI,preoperative serum albumin were independent related factors affecting perioperative complications of laparoscopic distal gastrectomy (odds ratio =1.033,1.118,0.937,95% interval confidence:1.011-1.057,1.025-1.219,0.887-0.990,P<0.05).(4) Influence of body shape related indexes on intraoperative situations and postoperative recovery.① Results of Pearson univariate correlation analysis showed correlations between UAPD,XAPD,CAD,CATD and volume of intraoperative blood loss (r=0.107,0.169,0.179,0.106,P<0.05),between UAPD,XAPD,CAD and the number of lymph nodes dissected (r=-0.137,-0.143,-0.173,P<0.05),between USCF,XAPD and time to postoperative anal exsufflation (r =0.122,0.109,P<0.05),between USCF,XAPD,CAD and time for initial fluid diet intake (r=0.132,0.108,0.132,P<0.05),between USCF,XAPD and duration of postoperative hospital stay (r=0.116,0.100,P<0.05).② Results of liner regression model analysis showed a positive correlation between CAD and volume of intraoperative blood loss (r =6.776),a negative correlation between CAD and the number of lymph nodes dissected (r =-0.841),with statistically significant differences (t =2.410,-1.992,P< 0.05);a positive correlation between USCF and time to postoperative anal exsufflation (r=0.170),between USCF and time for initial fluid diet intake (r=0.365),between USCF and duration of postoperative hospital stay (r=0.636) respectively,with statisticallysignificant differences (t =2.188,1.981,2.107,P< 0.05).Conclusions Abdominal shape can influence intraoperative situations and postoperative recovery of laparoscopic distal gastrectomy,but cannot increase risks ofperioperative complications.Age,BMI and preoperative serum albumin are independent related factors affecting perioperative complications of laparoscopic distal gastrectomy.

4.
Article in Chinese | WPRIM | ID: wpr-777503

ABSTRACT

Eight C_(19)-diterpenoid alkaloids( 1-8) were isolated from the ethyl acetate soluble fraction of 95% ethanol extract of the ground roots of Aconitum austroyunnanense through various column chromatographies on silica gel,ODS,Sephadex LH-20 and MCI gel.Their structures were elucidated as 14α-benzoyloxy-13β,15α-dihydroxy-1α,6α,8β,16β,18-pentamethoxy-19-oxoaconitan( 1),N-deethylaconitine( 2),spicatine B( 3),leucanthumsine A( 4),acofamine B( 5),macrorhynine B( 6),aconitilearine( 7),and ambiguine( 8) based on their chemical and physicochemical properties and spectroscopic data. Compound 1 was a new compound and alkaloids 2-8 were isolated from this plant for the first time. Some isolated alkaloids were tested in vitro for cytotoxic potential by employing the MTT method. As a result,alkaloid 1 exhibited weak cytotoxic activity against three tested tumor cell lines( A-549,He La,and Hep G2) with IC_(50) values less than 20 μmol·L~(-1).


Subject(s)
Aconitum , Alkaloids , Diterpenes , Molecular Structure , Plant Roots
5.
Acta Pharmaceutica Sinica B ; (6): 484-495, 2019.
Article in English | WPRIM | ID: wpr-774961

ABSTRACT

Metastasis-associated drug resistance accounts for high mortality in ovarian cancer and remains to be a major barrier for effective treatment. In this study, SKOV3/T4, a metastatic subpopulation of ovarian cancer SKOV3 cells, was enriched to explore potential interventions against metastatic-associated drug resistance. Quantitative genomic and functional analyses were performed and found that slug was significantly increased in the SKOV3/T4 subpopulation and contributed to the high resistance of SKOV3/T4. Further studies showed that slug activated c-Met in a ligand-independent manner due to elevated levels of fibronectin and provoked integrin V function, which was confirmed by the significant correlation of slug and p-Met levels in 121 ovarian cancer patient samples. Intriguingly, c-Met inhibitor(s) exhibited greatly enhanced anti-cancer effects in slug-positive ovarian cancer models both and . Additionally, IHC analyses revealed that slug levels were highly correlated with reduced survival of ovarian cancer patients. Taken together, this study not only uncovers the critical roles of slug in drug resistance in ovarian cancer but also highlights a promising therapeutic strategy by targeting the noncanonical activation of c-Met in slug-positive ovarian cancer patients with poor prognosis.

6.
Article in Chinese | WPRIM | ID: wpr-694563

ABSTRACT

Objective To investigate the pharmacokinetics and pharmacokinetics of torsemide in children with acute heart failure.Methods Ninety cases of children with acute heart failure patients were randomly divided into three groups which were given different intravenous therapy doses of torsemide. Our goal is to provide the basis for clinical rational therapy by analyzing parameter of the pharmacokinetics and pharmacokinetics of torsemide which is acquired by detecting plasma concentration of torsemide with liquid chromatography and tandem mass spectrometry after a one-time medication. Result Average pharmacokinetic parameters of the three groups in addition to the peak concentration (Cmax) and medication in the area under the curve (AUC0-16) are different (P<0.01), the rest of the pharmacokinetic parameters had no significant difference (P>0.05) . The 24 hours urine volume of the experimental groupⅡand the experimental groupⅢwere obviously higher than that of the experimental groupⅠ, so the difference was statistically significant (P<0.01).The 24 hours urine volumes between the experimental group Ⅱ and the experimental group Ⅲ were no significant difference (P> 0.05).There was no significant change in blood pressure, weight, abdominal girth, blood potassium, blood sodium and blood chlorine in the three dose groups compared with those before the treatment. There was no significant difference between the three groups (P>0.05) . Conclusion The children with acute heart failure were well tolerated with torsemide. The recommended dose of torsemide is 1.0 mg/(kg.d) in the treatment of acute heart failure in children, based on pharmacokinetic and pharmacodynamic characteristics.

7.
Article in Chinese | WPRIM | ID: wpr-692828

ABSTRACT

Objective To understand the changes in the level of osteocalcin (OC) in patients with type 2 di-abetes mellitus (T2DM) and discuss the correlation between the changes and glycated hemoglobin (HbA1c), fasting blood glucose (FBG),thyroid globulin (TG),total cholesterol (TC),high-density lipoprotein (HDL C),low density lipoprotein (LDL C),fasting insulin (FINS),and fasting C peptide (FCP) and so on.Methods 108 cases of T2DM patients were collected from group T2DM and 92 healthy subjects as healthy control group.Fasting venous blood was taken from the subjects and serum levels of OC were detected by chemilumi-nescence.HbA1c,FBG,TG,TC,HDL-C,LDL-C,FINS and FCP levels were detected,and Pearson correlation and logistic regression were used to analyze the relationship between OC and other indicators.Results The level of OC in the T2DM group was significantly lower than that in the control group,and the difference was statistically significant [(14.98 ± 10.16)ng/mL vs.(18.20 ± 6.67)ng/mL,P<0.05].There was a signifi-cant negative correlation between OC and HbA 1c and FBG in T2DM patients (P< 0.01),and a significant positive correlation with HDL C(P< 0.01);Logistic regression analysis showed that HbA 1c was an inde-pendent influence factor of serum OC(P<0.01).Conclusion The level of OC in peripheral blood of T2DM patients was significantly decreased.OC level was closely related to blood glucose and blood lipids,and it had a certain effect on the prevention and evaluation of T2DM.

8.
Article in Chinese | WPRIM | ID: wpr-691305

ABSTRACT

Laparoscopy-assisted D2 radical distal gastrectomy has been acknowledged as standard procedure for local advanced gastric cancer. But due to the abundant blood vessels and complicated anatomy of the stomach, lymphadenectomy has been considered as one of the difficulties of the operation, especially in the supra-pancreatic area. This article is to share the experiences of this topic from Department of Gastrointestinal Oncology Surgery, The First Affiliated Hospital of Xiamen University with the following five aspects. (1) How to dissect No.11p lymph nodes thoroughly and whether the exposure of splenic vein is needed? (2) Is it necessary to reveal portal vein during the lymphadenectomy of supra-pylorus and supra-pancreatic areas?(3) During laparoscopic operation, where is the posterior boundary of No.9 lymph nodes at the right side of celiac artery?(4) How to make it easier, safer, and more complete for supra-pancreatic lymphadenectomy? (5) How to deal with the tandem enlarged lymph nodes at the right side of celiac artery? According to the authors' experiences of laparoscopic radical gastrectomy, the following points may be helpful to make the supra-pancreatic lymphadenectomy safe, complete, and standard: (1) Transection of vessels of duodenum, right stomach and left stomach in advance will make the lymphadenectomy at the right side of the celiac artery easier. (2) The exposure of splenic vein as far as possible is necessary during the dissection of No.11p lymph nodes, and it is necessary to dissect the lymph-adipose tissue at the posterior-superior border of splenic artery and pancreas in front of Gerota fascia. (3) The left side of portal vein must be revealed initiatively for dissection of No.12a lymph nodes. (4) The lymph-adipose tissue must be dissected at the included angle of common hepatic artery and celiac artery and the right wall of the celiac artery should be revealed during the dissection of No.8a and the right side of No.9 lymph nodes. (5) The exposure of portal vein and the transection of left gastric vein at the root will make the dissection of this area safer and complete. (6) En bloc D2 plus operation will be a better option, when comfronted with tandem enlarged lymph nodes at the right side of celiac artery.


Subject(s)
Gastrectomy , Methods , Humans , Laparoscopy , Lymph Node Excision , Stomach Neoplasms , General Surgery
9.
Article in Chinese | WPRIM | ID: wpr-690527

ABSTRACT

Three aporphine-type alkaloids (1-3), three lycorine-type alkaloids (4-6), two crinane type alkaloids (7, 8) and one phenanthridine-type alkaloid (9) were isolated from the chloroform soluble fraction of 70% ethanol extract of the bulbs of Lycoris radiata through various column chromatographies over silica gel, ODS, Sephadex LH-20 and MCI. Their structures were elucidated as (+)-N-methoxylcarbonyl-1,2-methylenedioxyl-isocorydione (1), isocorydione (2), 8-demethyl-dehydrocrebanine (3), (+)-3-hydroxy-anhydrolycorine N-oxide (4), vasconine (5), pancratinine D (6), yemenine A (7), 11-O-acetylhaemanthamine (8), and 5,6-dihydro-5-methyl-2-hydroxyphenanthridine (9) based on their chemical and physicochemical properlies and spectroscopic data. Compound 1 was a new compound and alkaloids 2-9 were isolated and identified from this plant for the first time.

10.
Article in Chinese | WPRIM | ID: wpr-815921

ABSTRACT

To evaluate the molluscicidal effects of various water-free formulations of niclosamide ethanolamine salt against Oncomelania hupensis in the field of marshlands along the Yangtze River.The river beach with O. hupensis snails were selected as the test field in the marshland along the Yangtze River in Pukou District, Nanjing City. A molluscicidal experiment was carried out by the mechanical dusting method with the dustable powder (DP), powder-granule (PG), granule (GR) of niclosamide ethanolamine salt respectively. The snail mortality, corrected mortality, and the reduced rate of snails’ density were parallel compared among DP, PG and GR.On the 3rd day after the dusting, the snail mortality rates were 66.67%, 67.24%, and 66.87% in the DP, PG, and GR groups respectively, on the 7th day after the dusting, the snail mortality rates were 75.36%, 79.73%, and 73.97% in the DP, PG, and GR groups respectively, and there was no significant difference among the groups (χ2 = 0.006, 0.895, both P > 0.05). On the 15th day after the dusting, the snail mortality rates were 86.92%, 72.86%, and 71.43% in the DP, PG, and GR groups respectively, and there was a significant difference among the groups (χ2 = 9.709, P < 0.01). The snail mortality in the DP group was significantly higher than that in the PG, and GR groups. The curves of the snail corrected mortality and reduced rate of snails’density presented steadily rising trends in the DP group, but presented falling trends in the PG and GR groups on the 15th day after the dusting.The molluscicidal effect of DP is stable and effective in the marshland along the Yangtze River, but the drift of the powder is still not effectively controlled. It is necessary that the different dosage forms are perfected.

11.
Article in Chinese | WPRIM | ID: wpr-707658

ABSTRACT

Objective To investigate the clinical value of the real-time shear wave elastography(RT-SWE) in the assessment of salivary gland lesions by measuring the hardness of parotid gland and submaxillary gland in patients with Sj?gren′s syndrome (SS). Methods Forty patients with SS were chosen as SS group,and 35 age and gender matched healthy volunteers were chosen as control group.The patients were divided into mild SS group ( n =18) and severe SS group ( n =22) according to the decrease of uptake and secretion of salivary gland in Salivary gland scintigraphy.The Supersonic AixPlorer real-time quantitative diagnostic shear wave elastography was used to detect the parotid gland and submaxillary gland in 35 healthy volunteers and 40 patients.The RT-SWE elasticity indices of mean(Emean) was obtained and draw the SWE technology in the diagnosis of mild and severe SS patients with parotid and submandibular glands of the ROC curves. Results ① There was no significant difference in the Emean of left and right glands among the three groups (all P > 0.05). The Emean of parotid gland and submaxillary gland in patients with SS was higher than that in control group,especially in the severe SS group(all P <0.05). ②The cutoff value,sensitivity,specificity and the area under ROC for Emean with SWE diagnosing the parotid gland lesions of mild SS were 7.75 kPa,94.4%,97.1% and 0.998,and those in severe SS were 10.65 kPa, 90.9%,97.1% and 0.999,respectively.The cutoff value,sensitivity,specificity and the area under ROC for Emean with SWE diagnosing the the submaxillary glands lesions of mild SS were 8.15 kPa,100%,91.4%and 0.998,and those in severe SS were 10.40 kPa,95.5%,88.6% and 0.994,respectively.Conclusions RT-SWE can be successfully applied to assess parotid gland and submaxillary gland′s hardness in patients with SS,and provide a new method for the clinical evaluation of salivary gland diffuse lesions.

12.
Article in Chinese | WPRIM | ID: wpr-699243

ABSTRACT

Objective To investigate the clinical efficacy of thoracoscopic and laparoscopic radical resection for adenocarcinoma of the esophagogastric junction (AEG) with side-to-side tubular gastroesophagostomy.Methods The retrospective and descriptive study was conducted.The clinicopathological data of 4 patients with AEG who were admitted to the First Affiliated Hospital of Xiamen University between November 2017 and June 2018 were collected.All the patients underwent thoracoscopic and laparoscopic radical resection for AEG using side-to-side tubular gastroesophagostomy and received 6 cycles of postoperative adjuvant chemotherapy with SOX regimen.Observation indicators:(1) surgical and postoperative recovery situations;(2) postoperative pathological examination;(3) follow-up and survival situations.The follow-up using outpatient examination and telephone interview was performed to detect postoperative adjuvant therapy situations and survival of patients up to Semptember 2018.Results (1) Surgical and postoperative recovery situations:4 patients successfully underwent thoracoscopic and laparoscopic radical resection for AEG using side-to-side tubular gastroesophagostomy,without conversion to thoracotomy,open surgery or perioperative death.Operation time,volume of intraoperative blood loss,time for postoperative fluid diet intake and postoperative drainage-tube removal time of case 1,2,3,4 were respectively 420 minutes,400 minutes,320 minutes,300 minutes and 100 mL,100 mL,150 mL,100 mL and 9 days,8 days,8 days,8 days and 11 days,10 days,10 days,10 days.Case 1 with mild pneumonia and hiccup and case 2 with mild pneumonia were improved by symptomatic treatment,case 3 and 4 didn't have complication.All the patients had postoperative patent anastomosis.Duration of postoperative hospital stay of case 1,2,3,4 were respectively 12 days,11 days,11 days,11 days.(2) Postoperative pathological examination:all the 4 patients had negative surgical margin.Number of lymph node dissected,number of positive lymph node,tumor diameter,Siewert type,depth of tumor infiltration,tumor histopathologic stage of case 1,2,3,4 were respectively 32,31,17,23 and 0,4,2,6 and 3.5 cm,5.0 cm,5.0 cm,4.0 cm and type Ⅱ,Ⅰ,Ⅱ,Ⅰ and subserosa,entire wall of the esophagogastric junction,subserosa,entire wall of the esophagogastric junction and Ⅱ A staging,Ⅲ B staging,Ⅱ B staging,Ⅲ A staging.Degree of tumor differentiation and pathological type were moderately differentiated adenocarcinoma in the 4 patients.(3) Follow-up and survival situations:4 patients were followed up for 3-10 months,with a median time of 5 months.During the follow-up,4 patients underwent chemotherapy and achieved disease-free survival.Conclusion Thoracoscopic and laparoscopic radical resection for AEG using side-to-side tubular gastroesophagostomy is safe and feasible.

13.
Article in Chinese | WPRIM | ID: wpr-699207

ABSTRACT

Objective To investigate clinical effects and prognostic factors of transabdominal laparoscopic-assisted and open radical resection for Siewert type Ⅱ and Ⅲ adenocarcinoma of the esophagogastric junction (AEG).Methods The retrospective cohort and case-control studies were conducted.The clinicopathologieal data of 84 patients with Siewert type Ⅱ and Ⅲ AEG who were admitted to the First Affiliated Hospital of Xiamen University from January 2014 to January 2017 were collected.Among 84 patients,42 undergoing transabdominal laparoscopic-assisted radical gastectomy (LARG) were allocated into LARG group and 42 undergoing transabdominal open radical gastectomy (ORG) were allocated into ORG group.Observation indicators:(1) comparison of intraoperative and postoperative recovery situations between groups;(2)comparison of follow-up and survival situations between groups;(3) prognostic analysis of patients with Siewert type Ⅱ and Ⅲ AEG undergoing transabdominal radical resection.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival situations,tumor recurrence and metastasis of patients up to January 2018.Measurement data with normal distribution were representde as-x±s,and comparison between groups was analyzed using the t test.Measurement data with skewed distribution were described as M (range).Comparison of count data were analyzed using the ehi-square test or Fisher exact probability.Ordinal data were compared between groups using the Mann-Whitney U nonparametric test.The survival rate and curve were respectively calculated and drawn by the Kaplan-Meier method,and Log-rank test was used for survival and univariate analyses.Multivariate analysis was done by COX proportional hazard model.Results (1) Comparison of intraoperative and postoperative recovery situations between groups:patients with Siewert type Ⅱ and Ⅲ AEG in the LARG and ORG group underwent successful transabdominal radical resection,without conversion to thoracotomy.All patients in the LARG group underwent esophagojejunostomy with circular stapler device,38 and 4 patients in the ORG group underwent esophagojejunostomy with circular stapler and linear cut stapler respectively.Operation time,volume of intraoperative blood loss,length of incision,time of postoperative analgesia,cases with anastomotic bleeding,anastomotic leakage,abdominal bleeding,incisional infection,pulmonary infection,abdominal infection and reflux esophagitis of grade Ⅰ ~ Ⅱ postoperative complications and duration of postoperative stay were respectively (261±50)minutes,(119±111)mL,(7.8±1.6)cm,(2.1±1.3)days,1,1,0,0,1,0,0,(12.8 ± 1.9) days in LARG group and (216 ± 52) minutes,(230± 178) mL,(17.3± 1.8) cm,(3.4±1.2)days,2,0,2,2,2,1,2,(18.4±15.3)days in ORG group,with statistically significances between groups (t =2.357,2.960,2.195,2.013,x2 =5.486,t =2.125,P<0.05).All patients with complications were improved by symptomatic treatment.(2) Comparison of follow-up and survival situations between groups:81 of 84patients including 41 in LARG group and 40 in ORG group were followed up for 6-48 months,with a median time of 29 months.The postoperative 2-year overall and tumor-free survival rates were respectively 85.1% and 82.1% of 41 patients in LARG group and 83.1% and 79.3% of 40 patients in ORG group,with no statistically significance between groups (x2 =0.013,0.049,P>0.05).(3) Prognostic analysis of patients with Siewert type Ⅱ and Ⅲ AEG undergoing transabdominal radical resection:results of univariate analysis showed that tumor diameter,tumor TNM staging,tumor T staging,tumor N staging and postoperative adjuvant chemotherapy were related factors affecting prognosis of patients with Siewert type Ⅱ and Ⅲ AEG undergoing transabdominal radical resection (x2 =8.349,14.376,9.732,17.250,8.012,P<0.05).Results of multivariate analysis showed that tumor TNM staging and postoperative adjuvant chemotherapy were independent factors affecting prognosis of patients with Siewert type Ⅱ and Ⅲ AEG undergoing transabdominal radical resection (risk ratio =4.305,0.031,95% confidence interval:1.858-9.977,0.004-0.246,P<0.05).Conclusions Transabdominal laparoscopicassisted radical resection for AEG is safe and feasible,with advantage of minimally invasiveness,having equivalent long-term effects compared to open surgery.Tumor TNM staging and postoperative chemotherapy are independent factors affecting prognosis of patients with Siewert type Ⅱ and Ⅲ AEG undergoing transabdominal radical resection.

14.
Article in Chinese | WPRIM | ID: wpr-699163

ABSTRACT

Objective To investigate the short-term clinical effects of selecting duodenal transection timing on laparoscopic-assisted distal gastrectomy (LADG).Methods The retrospective cohort study was conducted.The clinicopathological data of 239 gastric cancer (GC) patients undergoing LADG in the 5 medical centers between March 2016 and March 2018 were collected,including 104 in the First Affiliated Hospital of Xiamen University,45 in Zhangzhou Affiliated Hospital of Fujian Medical University,35 in Quanzhou Affiliated Hospital of Fujian Medical University,30 in the Second Affiliated Hospital of Xiamen Medical College,25 in Zhongshan Hospital of Xiamen University.Of 239 patients undergoing LADG + D2 lymph node dissection,107 receiving duodenal transection and then lymph node dissection in the upper region of pancreas after lymph node dissection in the lower region of pylorus and 132 receiving lymph node dissection in the upper region of pancreas and then duodenal transection were respectively divided into anterior approach group and posterior approach group.Sixty-four,8,16,14 and 5 patients in the anterior approach group and 40,37,19,16 and 20 patients in the posterior group respectively came from the First Affiliated Hospital of Xiamen University,Zhangzhou Affiliated Hospital of Fujian Medical University,Quanzhou Affiliated Hospital of Fujian Medical University,Second Affiliated Hospital of Xiamen Medical College and Zhongshan Hospital of Xiamen University.Observation indicators:(1) surgical and postoperative situations;(2) postoperative complications;(3) stratified analyses of surgical and postoperative situations in patients with different TNM staging,body mass index (BMI) and maximum tumor dimension;(4) follow-up and survival.Follow-up using outpatient examination and telephone interview was performed to detect postoperative overall survival and tumor recurrence or metastasis up to April 2018.Measurement data with normal distribution were represented as (-x)±s,and comparison between groups was analyzed using the independent-samples t test.Measurement data with skewed distribution were described as M (Q),and comparison between groups was analyzed using the nonparametric test.Comparisons of count data were analyzed using chi-square test or Fisher exact probability.Comparison of ordinal data was done by the rank-sum test.Results (1) Surgical and postoperative situations:all the patients underwent successful operation,without perioperative death.Number of lymph node dissection in the upper region of pylorus in the anterior and posterior approach groups were respectively 3.9±2.6 and 3.0±2.5,with a statistically significant difference between groups (t=2.778,P<0.05).Cases with Billroth Ⅰ,Billroth Ⅱ,Billroth Ⅱ +Bruan and Roux-en-Y of digestive tract reconstruction,operation time,dissected times of lymph nodes in greater curvature of stomach,lower region of pylorus,upper region of pancreas and lesser curvature of stomach,cases with visible port vein,volume of intraoperative blood loss,number of overall lymph node dissection,numbers of lymph node dissection in greater curvature of stomach,lower region of pylorus,upper region of pancreas and lesser curvature of stomach,time to postoperative anal exsufflation,time for postoperative fluid diet intake,time for postoperative semi-fluid diet intake,intraperitoneal drainage-tube removal time and duration of postoperative hospital stay were respectively 16,32,47,12,(233.0±41.0)minutes,(14.6±5.4)tninutes,(21.9±6.3)nminutes,(32.7±6.8) minutes,(7.4±2.9)minutes,74,(87±73)mL,35.0±10.0,8.5±4.1,4.8±4.2,13.3±5.2,4.3± 3.3,(4.1±2.6)days,(5.4±2.8) days,(7.9± 3.5) days,(8.9± 2.9) days,(11.7± 4.5) days in the anterior approach group and 17,47,61,7,(243.0±44.0) minutes,(15.7±5.2) minutes,(23.1±8.0) minutes,(34.2±7.1) minutes,(7.9±2.8)minutes,79,(93±57)mL,33.0±10.0,8.1±4.8,5.3±4.9,12.5±5.6,3.8±2.4,(3.8±3.3)days,(5.0±3.6)days,(7.5±4.0) days,(8.5±3.8)days,(11.3±5.7) days in the posterior approach group,with no statistically significant difference between groups (x2 =3.431,t =-1.836,-1.546,-1.324,-1.634,-1.228,x2=2.552,t=-0.684,1.630,0.797,-0.871,1.148,1.314,0.954,0.951,0.884,1.065,0.694,P>0.05).(2) Postoperative complications:cases with overall complications,anastomotic leakage,anastomotic stenosis,anastomotic bleeding,pancreatic fistula,postoperative gastroparesis,intra-abdominal hemorrhage,incision infection,pneumonia,intra-abdominal infection,bacteremia,intestinal obstruction,endolymphatic leakage,Clavien-Dindo grade Ⅰ,Ⅱ,Ⅲa,Ⅲb and Ⅳa of postoperative complications were respectively 15,1,1,1,0,3,1,2,3,0,1,3,0,3,9,1,2,0 in the anterior approach group and 25,3,0,1,2,2,2,5,7,3,2,3,1,6,14,1,2,2 in the posterior approach group,with no statistically significant difference between groups (x2=1.027,0.643,0.022,0.479,0.161,0.765,0.921,0.161,0.063,Z=-1.055,P>0.05).Patients in 2 groups with complications were cured by symptomatic treatment.(3) Stratified analyses of surgical and postoperative situations in patients with different TNM staging,BMI and maximum tumor dimension:operation time,dissected times of lymph nodes in upper region of pancreas,cases with visible port vein,number of overall lymph node dissection,numbers of lymph node dissection in upper region of pylorus and upper region of pancreas were respectively (236.0±41.0)minutes,(33.9±6.2) minutes,32,36.0±12.0,3.8±3.0,13.4±5.5 in patients of the anterior approach group with Ⅲ stage of TNM staging and (253.0± 45.0) minutes,(36.5 ±7.0) minutes,29,31.0±t9.0,2.5±2.0,11.4±4.6 in patients of the posterior approach group with Ⅲ stage of TNM staging,with statistically significant differences between groups (t =-1.988,-2.066,x2 =4.686,t =2.472,2.757,2.016,P<0.05).Numbers of overall lymph node dissection and number of lymph node dissection in upper region of pylorus were respectively 37.0± 12.0,3.6±3.1 in patients of the anterior approach group with BMI ≥ 25 kg/m2 and 30.0±7.0,2.0± 1.3 in patients of the posterior approach group with BMI ≥ 25 kg/m2,with statistically significant differences between groups (t =2.211,2.205,P<0.05).Volume of intraoperative blood loss and number of lymph node dissection in upper region of pylorus were respectively (80±45) mL,4.0±2.6 in patients of the anterior approach group with maximum tumor dimension ≥ 3.3 cm and (110±67)mL,2.8± 1.8 in patients of the posterior approach group with maximum tumor dimension ≥ 3.3 cm,with statistically significant differences between groups (t =-2.320,2.589,P < 0.05).(4) Follow-up and survival:of 239 patients,202 were followed up for 2-24 months,with a median time of 12 months,including 89 in the anterior approach group and 113 in the posterior approach group.During the follow-up,cases with overall survival,tumor recurrence and metastasis were respectively 85,3,8 in the anterior approach group and 109,3,11 in the posterior approach group,with no statistically significant difference between groups (x2=0.032,0.089,0.119,P>0.05).Conclusions Both of anterior approach and posterior approach are safe and feasible in LADG,with equivalent short-term efficacies.The anterior approach in LADG has an advantage of the lymph node dissection in the upper region of pylorus compared with posterior approach,and it also is better for patients with later tumor staging,higher BMI and bigger tumor.

15.
Article in Chinese | WPRIM | ID: wpr-699073

ABSTRACT

Objective To investigate the influence of body configuration on the therapeutic effects of totally laparoscopic and laparoscopy-assisted radical total gastrectomies.Methods The retrospective cohort study was conducted.The clinicopathological data of 677 patients with gastric cancer who underwent laparoscopic radical total gastrectomies in the 11 clinical centers [100 patients in the First Affiliated Hospital of Army Medical University (Third Military Medical University),98 in the First Affiliated Hospital of Nanjing Medical University,94 in the First Affiliated Hospital of Nanchang University,89 in the First Affiliated Hospital of Xiamen University,81 in the Affiliated Hospital of Qinghai University,81 in the First Affiliated Hospital of Xinjiang Medical University,42 in the First Affiliated Hospital of Xi'an Jiaotong University,39 in the Traditional Chinese Medicine Hospital of Guangdong Province,26 in the First People's Hospital of Hangzhou City,17 in the Second Affiliated Hospital of Jilin University and 10 in the Xijing Hospital of Air Force Medical University (Fourth Military Medical University)] from January 2015 to June 2017 were collected.Among 677 patients,305 [89 patients in the First Affiliated Hospital of Army Medical University (Third Military Medical University),28 in the First Affiliated Hospital of Nanjing Medical University,14 in the First Affiliated Hospital of Nanchang University,26 in the First Affiliated Hospital of Xiamen University,75 in the Affiliated Hospital of Qinghai University,14 in the First Affiliated Hospital of Xinjiang Medical University,10 in the First Affiliated Hospital of Xi'an Jiaotong University,10 in the Traditional Chinese Medicine Hospital of Guangdong Province,19 in the First People's Hospital of Hangzhou City,13 in the Second Affiliated Hospital of Jilin University and 7 in the Xijing Hospital of Air Force Medical University (Fourth Military Medical University)] undergoing totally laparoscopic total gastrectomy were allocated into the totally laparoscopic group,and 372 [11 in the First Affiliated Hospital of Army Medical University (Third Military Medical University),70 in the First Affiliated Hospital of Nanjing Medical University,80 in the First Affiliated Hospital of Nanchang University,63 in the First Affiliated Hospital of Xiamen University,6 in the Affiliated Hospital of Qinghai University,67 in the First Affiliated Hospital of Xinjiang Medical University,32 in the First Affiliated Hospital of Xi'an Jiaotong University,29 in the Traditional Chinese Medicine Hospital of Guangdong Province,7 in the First People's Hospital of Hangzhou City,4 in the Second Affiliated Hospital of Jilin University and 3 in the Xijing Hospital of Air Force Medical University (Fourth Military Medical University)] undergoing laparoscopy-assisted total gastrectomy were allocated into the laparoscopy-assisted group.All patients received laparoscopic radical total gastrectomy and D2 lymphadenectomy using routine five-port method.Roux-en-Y anastomosis was applied for digestive tract reconstruction,and digestive tract reconstruction was performed under laparoscopy in the totally laparoscopic group and via upper abdominal median incision in the laparoscopy assisted group.Observation indicators:(1) surgical and postoperative situations;(2) stratified analysis:surgical and postoperative situations of obese patients [body mass index (BMI) > 25.0 kg/m2,the maximum vertical distance between the anterior abdominal skin and the back skin at the level of the xiphoid bone (X-APD) > an average value of 22.7 cm and X-APD/the maximum horizontal distance of a plane at a right angle to X-APD (X-TD) >an average value of 0.8] between groups;(3) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative overall survival and tumor recurrence or metastasis up to July 2017.Measurement data with normal distribution were represented as x±s.Comparison between groups was analyzed by the t test.Measurement data with skewed distribution were described as M(Q),and comparison between groups was analyzed by Mann-Whithey test.Comparisons of count data were analyzed using the chi-square test.Results (1) Surgical and postoperative situations:all the patients in the 2 groups underwent successful operations,without perioperative death.Esophagojejunostomy methods of 305 patients in totally laparoscopic group:conventional circular stapler method were performed in 107 patients,antipuncture circular staplar method in 6 patients,OrVilTM method in 5 patients,functional end-to-end esophagojejunostomy method in 76 patients,peristalsis side-to-side esophagojejunostomy method in 106 patients and π esophagojejunostomy method in 5 patients.Three hundred and seventy-two patients in the totally laparoscopic group received conventional circular stapler method,including 361 with end-to-side esophagojejunostomy method and 11 with half end-to-end esophagojejunostomy method.Total operation time,time of esophagojejunostomy,length of assisted incision and using time of analgesics were respectively (235± 72)minutes,(33 ± 15)minutes,(5.6± 1.4) cm,(2.0 ± 1.2) days in the totally laparoscopic group and (223± 63) minutes,(29 ± 10) minutes,(8.0 ± 2.6) cm,(2.3 ± 1.6) days in the laparoscopy-assisted group,with statistically significant differences between groups (t =2.383,3.289,-15.236,-2.780,P < 0.05).The eases with postoperative overall complications,anastomosis bleeding,anastomosis stricture,anastomosis leakage were respectively 38,6,11,11 in the totally laparoscopic group and 35,7,10,13 in the laparoscopy-assisted group,with no statistically significant difference between groups (x2 =1.621,0.007,0.470,0.006,P>0.05).All the patients with postoperative complications were cured by symptomatic treatment.(2) Stratified analysis:length of assisted incision,using time of analgesics,time to postoperative anal exsufflation,time for initial fluid diet intake,time for initial semi-fluid diet intake,time of postoperative drainage-tube removal and duration of postoperative hospital stay in obese patients with BMI>25.0 kg/m2,X-APD>22.7 cm and X-APD/X-TD>0.8 were respectively (5.9±1.3)cm,(5.7±1.4)cm,(5.6±1.4)cn,(2.0±1.2) days,(2.2±1.1)days,(2.1±1.1)days,(3.4±0.9) days,(3.3±0.9)days,(3.3±0.8)days,(4.7±1.1)days,(4.1±2.0)days,(4.0±1.6)days,(6.6±1.5)days,(6.4±2.3)days,(6.3±1.9)days,(7.8±2.3)days,(7.8±2.7)days,(7.6±2.9)days,(9±4)days,(10±5)days,(10±5) days in the totally laparoscopic group and (8.7±3.1)cm,(8.9±3.0)cm,(8.8±2.8)cm,(2.4±1.3)days,(2.5±1.5)days,(2.5±1.6)days,(3.7±1.0)days,(3.8±1.1)days,(3.7±1.3)days,(5.3±1.7)days,(4.8±1.7)days,(5.0±1.9)days,(7.4±2.3)days,(7.8±2.0)days,(7.0±2.2)days,(8.7±2.4)days,(8.4±1.9)days,(8.1±1.5)days,(1 1±8)days,(11±5)days,(1 1±5)days in the laparoscopy-assisted group,with statistically significant differences between groups (t =-7.950,-2.246,-2.222,-2.500,-2.771,-2.404,-2.251,P<0.05).There were statistically significant differences in above indicators of patients with X-APD>22.7 cm between groups (t =-12.089,-2.064,-3.732,-3.220,-5.297,-2.074,-2.208,P<0.05),and in above indicators of patients with X-APD/X-TD>0.8 between groups (t =-13.451,-2.736,-3.354,-4.961,-3.280,-2.137,-2.127,P<0.05).(3) Follow-up and survival situations:of 677 patients,645 were followed up for 1-31 months,with a median time of 12 months,including 283 in the totally laparoscopic group and 362 in the laparoscopy-assisted group.During the follow-up,cases with overall survival,tumor recurrence and tumor metastasis were respectively 255,18 and 21 in the totally laparoscopic group and 327,25 and 20 in the laparoscopy-assisted group (11 and 10 patients in the totally laparoscopic and laparoscopy-assisted groups with simutaneous tumor recurrence and metastasis),showing no statistically significant difference between groups (x2 =0.009,0.076,0.959,P > 0.05).Conclusions Totally laparoscopic and laparoscopy-assisted radical total gastrectomies are safe and feasible in obese patients,with the equivalent time of esophagojejunostomy.Totally laparoscopic radical total gastrectomy is of benefit to short-term recovery of patients.

16.
Article in Chinese | WPRIM | ID: wpr-275132

ABSTRACT

Four iridoids (1-4), five iridoid glucosides (5-9), and three triterpenoids (10-12) were isolated from the ethyl acetate soluble fraction of 70% Me2CO extract of the aerial parts of Viburnum ternatum through various column chromatographies over silica gel, ODS, Sephadex LH-20 and MCI. Their structures were elucidated as ternatumin A (1), 2,9-dioxatricyclo[4.3.1.03,7]decanes (2), 7,10,2'-triacetylsuspensolide F (3), 7,10,2',3'-tetraacetylsuspensolide F (4), viburtinoside IV (5), viburtinoside II (6), viburtinoside B (7), luzonoside A (8), luzonoside B (9), 2α,3β,24-trihydroxy-12-ursen-28-oic acid (10), 6-hydroxy-20(29)-lupen-3-one (11), and pomalic acid (12) based on the their chromatographic properties, chemical and physicochemical methods, and spectroscopic data. Compound 1 was a new compound and compounds 3-12 were isolated from this plant for the first time. Furthermore, we note here the first isolation of compound 2 as a new natural product.

17.
Article in Chinese | WPRIM | ID: wpr-621173

ABSTRACT

Objective To compare the clinical efficacies of totally laparoscopic and laparoscopy-assisted radical total gastrectomies.Methods The retrospective cohort study was conducted.The clinicopathological data of 373 patients with gastric cancer who underwent totally laparoscopic or laparoscopy-assisted radical total gastrectomies from the 7 medical centers in China (82 patients in the Affiliated Hospital of Qinghai University,80 in the Traditional Chinese Medicine Hospital of Guangdong Province,60 in the First Affiliated Hospital of Xiamen University,51 in the Hangzhou First People's Hospital,46 in the First Affiliated Hospital of Xi'an Jiaotong University,30 in the Second Affiliated Hospital of Jilin University and 24 in the Xijing Hospital of the Fouth Military Medical University) between January 2015 and December 2016 were collected.Of 373 patients,the 183 and 190 patients were respectively divided into the totally laparoscopic group (undergoing totally laparoscopic radical total gastrectomy) and laparoscopy-assisted group (undergoing laparoscopy-assisted radical total gastrectomy),including 63 and 19 in the Affiliated Hospital of Qinghai University,36 and 44 in the Traditional Chinese Medicine Hospital of Guangdong Province,25 and 35 in the First Affiliated Hospital of Xiamen University,20 and 31 in the Hangzhou First People's Hospital,10 and 36 in the First Affiliated Hospital of Xi'an Jiaotong University,17 and 13 in the Second Affiliated Hospital of Jilin University,12 and 12 in the Xijing Hospital of the Fouth Military Medical University.Routine five-port method was applied for laparoscopic radical total gastrectomy and D2 lymphadenectomy.Roux-en-Y anastomosis was applied for digestive tract reconstruction,and digestive tract reconstruction was performed under laparoscopy in the totally laparoscopic group and via upper abdominal median incision in the laparoscopy-assisted group.Observation indicators:(1) operation and postoperative situations;(2) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative overall survival and tumor recurrence or metastasis up to March 2017.Measurement data with normal distribution were represented as x±s.Comparison between the groups was analyzed by the t test.Measurement data with skewed distribution were represented as M (range).Comparisons of count data were analyzed using the chi-square test and Fisher exact probability.Results (1)Operation and postoperative situations:all the patients in the 2 groups underwent successful operations,without perioperative death.Esophagojejunostomy methods of 183 patients in totally laparoscopic group:conventional circular stapler method were performed in 28 patients,anti-puncture circular staplar method in 6 patients,OrVilTM method in 5 patients,functional end-to-end esophagojejunostomy method in 65 patients and peristalsis side-to-side esophagojejunostomy method in 79 patients.Conventional circular stapler method was applied to 190 patients in the laparoscopy-assisted group.Operation time,time of esophagojejunostomy,length of assisted incision,using time of analgesics and expenses of digestive tract reconstruction were (238± 55)minutes,(29±9)minutes,(5.1 ± 1.1)cm,(2.2±l.0)days,(18 332±2 141)yuan in the totally laparoscopic group and (217±39)minutes,(26±7)minutes,(7.8 ±2.0)cm,(2.7± 0.9)days,(16 237 ± 1 923)yuan in the laparoscopy-assisted group,respectively,with statistically significant differences between the 2 groups (t =4.324,3.455,-16.835,-5.561,9.949,P<0.05).The cases with postoperative overall complications,anastomosis leakage,anastomosis stricture,anastomosis bleeding and expenses of esophagojejunostomy were respectively 24,9,7,5,(9 668±2 814)yuan in the totally laparoscopic group and 24,8,9,6,(9 331 ±2 067)yuan in the laparoscopy-assisted group,with no statistically significant difference between the 2 groups (x2 =0.036,0.107,0.189,0.059,t=1.322,P>0.05).All the patients with postoperative complications were cured by symptomatic treatment.(2) Follow-up and survival situations:of 373 patients,336 were followed up for 4-26 months,with a median time of 13 months,including 166 in the totally laparoscopic group and 170 in the laparoscopy-assisted group.During the follow-up,cases with overall survival,tumor recurrence and tunor metastasis were respectively 150,10,16 in the totally laparoscopic group and 154,9,16 in the laparoscopy-assisted group (10 and 9 patients in the totally laparoscopic and laparoscopy-assisted groups with simutaneous tumor recurrence and metastasis),showing no statistically significant difference between the 2 groups (x2 =0.075,0.010,P>0.05).Conclusions Total laparoscopic and laparoscopyassisted radical total gastrectomies are safe and feasible,with equivalent overall outcomes and effects of esophagojejunostomy.Compared with laparoscopy-assisted radical total gastrectomy,the postoperative pain time of patients in total laparoscopic radical total gastrectomy is less,but there are longer time of esophagojejunostomy and higher expenses of digestive tract reconstruction.

18.
Article in Chinese | WPRIM | ID: wpr-665522

ABSTRACT

Objective To evaluate the effect of the water conservancy schistosomiasis control projects combined with mollus-cicide to control Oncomelania hupensis snails in the rivers connecting with the Yangtze River. Methods The water conservancy schistosomiasis control projects of Zhujiashan River,Qili River and Gaowang River were chosen as the study objects in Pukou District,Nanjing City. The data review method and field investigation were used to evaluate the effect of the water conservancy schistosomiasis control projects combined with molluscicide to control O. hupensis snails. Results After the projects of the wa-ter level control and concrete slope protection and mollusciciding were implemented,the snails in the project river sections were completely eliminated. The snail diffusion did not happen in the inland irrigation area too. In the outside of the river beach , though the snails still existed,the snail densities plunged below 1.0 snail per 1.0 m2. Conclusion The comprehensive mea-sures of the combination of water level control,concrete slope protection and mollusciciding can effectively control and eliminate the snails,and prevent the snails from spreading.

19.
Article in Chinese | WPRIM | ID: wpr-665510

ABSTRACT

Objective To investigate the status of Cryptosporidium infection in the population in Nanjing City so as to pro-vide the evidence for the prevention and control of cryptosporidiosis. Methods A total of 100 fecal samples were collected from each of three districts(Liuhe,Qixia and Gaochun)and one hospital(Nanjing Zhongda Hospital)in 2015 and 2016 respective-ly. The fecal samples were detected for Cryptosporidium with microscopy(by using the gold amine phenol-modified acid-fast staining)and the positive samples were detected again for the molecular biology confirming by using the fluorescence quantita-tive PCR. Results During the two years,581 cases of normal population who lived in the city were surveyed and no Cryptospo-ridium infection was found. Among 202 cases of outpatients with chronic diarrhea,there were 9 Cryptosporidium positive cases with the microscope scanning method (4.46%),and among the 9 cases,7 cases showed obvious logarithmic amplification curves showing positive Cryptosporidium nucleic acid,but 2 cases without the obvious logarithmic amplification curves,and the Cryptosporidium nucleic acid positive rate was 3.47%. Conclusions Cryptosporidium infection is not found in the normal popu-lation of Nanjing City,but the Cryptosporidium infection is found in the chronic diarrhea patients. The results imply that we should strengthen the detection of Cryptosporidium in the chronic diarrhea patients,so as to provide the evidence for improving the diagnosis and treatment of cryptosporidiosis.

20.
Article in Chinese | WPRIM | ID: wpr-485731

ABSTRACT

BACKGROUND: Pedicle screw fixation is a common repair method for thoracolumbar fractures. Of them, pedicle screw placement into the injured vertebra is an important method. However, the long-term effects and the related biomechanical properties deserve further analysis. OBJECTIVE: To analyze the long-term effect and biomechanical characteristics of the internal fixation of thoracolumbar fractures by pedicle screw implantation. METHODS: A retrospective analysis was performed in 126 cases of thoracolumbar fractures. The patients were treated with pedicle screw implantation and the treatment was fol owed up regularly. Ten specimens of fresh calf chest and lumbar spines were obtained. Five specimens served as an experimental group to prepare models of anterior middle column fractures, and these specimens received pedicle screw fixation into the injured vertebra. The other five specimens served as the control group, and did not receive any treatment. In the two groups, along the sagittal axis, axial compression displacement, anterior flexion displacement, posterior extension displacement, torsion angle and pul -out strength were measured and recorded. RESULTS AND CONCLUSION: (1) Clinical trial results: 126 patients were fol owed up for 10-36 months. Compared with pre-treatment, compression ratio of the injured vertebra, the height of intervertebral space, vertebral slip distance, visual analogue score and Cobb angle were significantly improved at 1 month after treatment and during final fol ow-up (al P 0.05). At the end of fol ow-up, Frankel spinal cord injury grade was significantly improved (Z=-4.127, P 0.05). (3) Above findings showed that pedicle screw fixation into the injured vertebra for thoracolumbar fractures obtained good long-term effects, and had good biomechanical properties.

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