Standardized implementation of minimally invasive surgery for Siewert Ⅱ esophagogastric junction adenocarcinoma / 中华胃肠外科杂志

The incidence of Siewert type II adenocarcinoma of the esophagogastric junction (AEG) is increasing year by year. Due to its special anatomical location and biological behavior, the treatment of AEG is still controversial in terms of lymph node dissection, the esophageal resection margin, range of gastrectomy, and the choice of reconstruction modality for postoperative gastrointestinal tract. The advent of the minimally invasive era has brought the treatment of Siewert type II AEG to a stage of gradual improvement and standardization. Experts of China are also actively exploring the value of minimally invasive surgery in the treatment of AEG through multicenter trials (CLASS-10, etc.). It is believed that based on the active development of many clinical studies, basic experimental studies and large prospective clinical studies, the strengthening of communication and cooperation among various disciplines and the innovative application of new technologies can bring greater survival benefits to patients.

Effect of Wubi Shanyao Pills on sexual dysfunction in rats with adenine-induced kidney-Yang deficiency / 中国中药杂志

The aim of this paper was to study the effect of Wubi Shanyao Pills on sexual dysfunction in rats with kidney-Yang deficiency and to investigate its possible mechanism. Adenine(100 mg·kg~(-1)) was administered to male SD rats for 8 weeks to establish kidney-Yang deficiency model, and at the same time, Wubi Shanyao Pills(2, 1, 0.5 g·kg~(-1)) were administered to rats for 8 weeks. The syndrome manifestation of kidney-Yang deficiency was observed in rats and the scores of symptoms were evaluated. Sexual behavior indexes(incubation period and times of capture, straddle and ejaculation) were measured by mating experiment. The levels of serum testosterone(T), estradiol(E_2), follicle stimulating hormone(FSH), luteinizing hormone(LH), and gonadotropin releasing hormone(GnRH) were measured by radioimmunoassay. The wet weights of testis and seminal vesicle were measured. The content of fructose in seminal plasma was detected by UV spectrophotometry. The pathological changes of testis and epididymis were observed by HE staining. The expression levels of transforming growth factor(TGF-β1) and cytochrome P450 aromatase(CYP19) in testis were detected by immunohistochemistry and Western blot. The results showed that Wubi Shanyao Pills could significantly reduce the score of kidney-Yang deficiency syndrome, improve the symptoms of kidney-Yang deficiency syndrome, shorten capture, straddle and ejaculation latency, increase capture and straddle times, increase serum T, LH, FSH, E_2 and GnRH levels, increase the wet weight of testis and seminal vesicle and fructose content in seminal plasma, improve the pathological structure of testis and epididymis, and inhibit the expression of TGF-β1 and increase CYP19 in testis of the model rats. Therefore, Wubi Shanyao Pills can significantly improve sexual dysfunction in rats with kidney-Yang deficiency, and its mechanism may be related to regulating the low function of hypothalamus pituitary gonad(HPG) axis and improving the disorder of sex hormone secretion. In addition, it may be also related to inhibiting the expression of testicular TGF-β1, increasing the expression of CYP19 protein, and then regulating the amount of T converted to E_2.

Application of totally laparoscopic anastomosis in laparoscopic gastrectomy / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the safety and feasibility of the total laparoscopic anastomosis in laparoscopic gastrectomy.</p><p><b>METHODS</b>Clinical data of 36 patients who received totally laparoscopic anastomosis and another 47 patients who received anastomosis through small incision in our department from July 2012 to July 2013 were retrospectively analyzed. Clinical outcomes were compared between the two groups.</p><p><b>RESULTS</b>The operation was successfully carried out in all the 83 patients. The mean incision length was (7.1±0.9) cm in small incision group and (2.6±0.4) cm in totally laparoscopic group, while the mean time of anastomosis was (70.9±9.0) min and (29.1±4.9) min respectively. Six patients felt moderate pain and 41 felt severe pain in small incision group, while 29 patients felt moderate pain and 7 felt severe pain in totally laparoscopic group. Anastomotic leakage occurred in 1 case after operation in small incision group and there was no related anastomosis complication in totally laparoscopic group.</p><p><b>CONCLUSIONS</b>Total laparoscopic anastomosis is safe and feasible in laparoscopic gastrectomy for gastric cancer. Compared with small incision-assisted anastomosis, totally laparoscopic anastomosis is associated with shorter time and less pain.</p>

Value of radical dissection with vagus nerve preservation for proximal gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the feasibility and influence of vagus nerve preservation in radical operation for proximal gastric cancer.</p><p><b>METHODS</b>Thirty-two patients with early or T2 cardia cancer from May 2007 to May 2009 were enrolled and randomized into two groups, i.e. vagus nerve preservation group(n=16) and control group(n=16). Two groups were compared with regard to operative time, anastomotic fistula, digestive discomforts, body weight, survival rate, findings on gastroscope and abdominal ultrasonography.</p><p><b>RESULTS</b>There were no statistically significant differences between the two groups in operative time (2.8 vs. 2.5 h), postoperative complications rate (25.0% vs. 31.3%). No recurrence or mortality was observed after one-year follow-up. However, patients who underwent vagus nerve preservation had less postprandial discomforts(3 vs. 12 cases), bile reflux(3 vs. 10 cases), atrophic gastritis(1 vs. 9 cases), gallstones(1 vs. 8 cases), body mass index, and diarrhea(P<0.05).</p><p><b>CONCLUSION</b>For patients with early gastric cancer, preservation of the vagus nerve during radical gastrectomy results in less complications and does not compromise patient survival.</p>

Renal protection of rosiglitazone in hypertensive rats and its relationship with the expression of angiotensin Ⅱ receptors / 中华肾脏病杂志

Objective To observe the role of rosiglitazone in unclipped kidneys of two-kidney- one-clip hypertensive rats and examine its relationship to angiotensinⅡreceptors.Methods Two- kidney-one-clip hypertensive rats were divided randomly into 4 groups as follows:positive control group (CONT),traditional antihypertensive drugs group (TAHD,reserpine 50?g?kg~(-1)?d~(-1), dihydralazine 6.25 mg?kg~(-1)?d~(-1) and hydrochlorothiazide 6.25 mg?kg~(-1)?d~(-1),regular-dose rosiglitazone group (RRGL,rosiglitazone 5 mg?kg~(-1)?d~(-1)),and high-dose rosiglitazone group (HRGL, rosiglitazone 20 mg?kg~(-1)?d~(-1)).Sham operation rats were as negative controls.Each group had 8 rats. Animals were monitored and sacrificed at 10th week.Results Blood systolic pressure in TAHD group and HRGL group was significantly lower than that in CONT group [TAHD(137?27 ) mm Hg and HRGL (143?16) mm Hg vs CONT (191?25 ) mm Hg,P＜0.05],but no significant difference between the former two groups was found.Nor did the blood systolic pressure between RRGL group [(176?18) mm Hg] and CONT group.At 10th week,rats in SHAM group and treated groups had lower urinary urinary protein excretion rate,glomerular injury score and wall-to-lumen ratio of arteriole than those in CONT group [vs CONT urinary protein excretion rate (44.60?17.40) mg/24 h,P＜0.05; vs CONT glomerular injury score 60.85?33.05,P＜0.05;vs CONT wall-to-lumen ratio of arteriole 2.33?1.01,P＜0.01,except TAHD group].Though with the similar level of blood pressure,blood glucose and lipid,HRGL,compared with TAHD group showed lower urinary protein excretion rate [HRGL (16.78?3.50) mg/24 h vs TAHD (27.94?12.79) mg/24 h,P＜0.05],decreased glomerular injury score (HRGL 18.04?7.76 vs TAHD 27.92?6.39,P＜0.05) and wall-to-lumen ratio of arteriole (HRGL 1.75?0.38 vs TAHD 2.16?0.90,P＜0.05) in the cortexes of unclipped right kidneys.The expression of type 1 angiotensinⅡreceptor (AT1R) mRNA was no difference in HRGL group and TAHD group,but the expression of type 2 angiotensinⅡreceptor (AT2R) mRNA was more intensive in HRGL group.Conclusion Rosiglitazone can protect the kidneys from hypertensive injury,especially in high dose.The beneficial effects seem incompletely dependent on the metabolism modulating and reduction of blood pressure,but in relationship to the upregulation of AT2R mRNA.

Investigation of sub-clinical infection of hepatitis E virus in blood donors / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To understand the prevalence of sub-clinical infection of hepatitis E virus (HEV) among blood donors.</p><p><b>METHODS</b>A cluster sampling strategy was used to sample all blood donors from July to August in 2002 in Beijing. Their blood was tested for IgM and IgG antibody against HEV.</p><p><b>RESULTS</b>The prevalence of anti-HEV IgM among blood donors in Beijing was 1.74%. The rate of abnormal alanine aminotransferase (ALT) in anti-HEV IgM positive donors is significantly higher than anti-HEV IgM negative donors. Among all ALT abnormal donors, 2.68% can be associated with HEV sub-clinical infection. The percentage is similar with HBV but higher than HCV.</p><p><b>CONCLUSION</b>There are sub-clinical infection of HEV among blood donors, which is one of the cause of abnormal ALT in the donors.</p>