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Objective:To explore the efficacy and safety of laparoscopic technology in the treatment of gastric cancer which using proximal subtotal gastrectomy and distal subtotal gastrectomy.Methods:A retrospective analysis was conducted on the clinical data of 98 gastric cancer patients admitted to the Department of General Surgery, General Hospital of Huainan Eastern Hospital Group from January 2016 to January 2020, including 71 males and 27 females with an average age of (62.03±10.6) years old(ranged from 32 to 80 years). All cases were divided into proximal group ( n=28) and distal group ( n=70) according to different surgical methods. The proximal group was treated with laparoscopic proximal subtotal gastrectomy, while the distal group was treated with laparoscopic distal subtotal gastrectomy. SPSS 20.0 software was used to analyze the differences in surgical related clinical indicators, postoperative complications, nutritional status, quality of life, and survival rate between two groups. Kaplan-Merier was used to draw survival curves, and Log-rank test was used to compare the survival differences between the two groups. Results:The number of lymph node dissection in the proximal group was less than that in the distal group, and the difference was statistically significant ( t=2.02, P=0.045). The incidence rate of reflux esophagitis in the proximal group was higher than that in the distal group (57.14% vs 4.29%, χ2=35.75, P<0.001), the incidence rate of reflux gastritis was lower than that of the distal group, the difference was statistically significant(3.57% vs 22.86% P=0.035). The levels of red blood cells, hemoglobin, and albumin in the proximal group were lower than those in the distal group after surgery, and the differences were statistically significant ( t=2.62, P=0.010; t=2.12, P=0.036; t=3.54, P=0.001). One month after surgery, the Karnofsky functional status score in the proximal group was lower than that in the distal group, and the difference was statistically significant ( t=2.27, P=0.025). The postoperative 1, 3, and 5-year survival rates of the proximal group were 85.71%, 64.29%, and 46.43%, respectively, while the postoperative 1, 3, and 5-year survival rates of the distal group were 88.57%, 71.43%, and 57.14%, respectively. There was no statistically significant difference in the survival curves between the two groups ( P>0.05). Conclusions:The incidence rate of reflux esophagitis after laparoscopic proximal subtotal gastrectomy is higher than that of distal subtotal gastrectomy, and the number of lymph nodes cleared during operation is less than that of distal subtotal gastrectomy. Compared with laparoscopic distal subtotal gastrectomy, the nutritional status of patients after proximal subtotal gastrectomy is significantly worse, but there is no significant difference in long-term survival rate between the two groups.
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Objective:To investigate the imaging features of iris fluorescein angiography (IFA) combined with fluorescein fundus angiography (FFA) in diabetic iridopathy.Methods:A cross-sectional study was conducted.Sixty-five eyes of 44 patients with proliferative diabetic retinopathy (PDR) combined with diabetic iridopathy (DI) were enrolled in Henan Eye Hospital from May 2013 to May 2020.Patients were divided into non-proliferative diabetic iridopathy (NPDI) group and rubeosis iridis group according to the imaging results.Ophthalmic examinations including visual acuity, intraocular pressure, slit lamp miacroscopy, IFA and FFA were carried out in all patients.IFA was used to detect the iris imaging characteristics and the regression time of fluorescein in anterior chamber, and FFA was used to observe the retinal image characteristics and the incidence of optic disc neovascularization.To avoid the statistical error of recording the IFA examination time of the contralateral eye, only the relevant data of the affected eyes were analyzed.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Henan Eye Hospital (No.HNEECKY-2020[06]). Written informed consent was obatined from all patients before any medical examination.Results:Among the patients, 30 cases (50 eyes) were with NPDI and 14 cases (15 eyes) were with rubeosis iridis.The fluorescein regression time in anterior chamber of NPDI group was (3.37±0.11) minutes, which was significantly shorter than (6.02±0.29) minutes of rubeosis iridis group ( t=8.541, P<0.001). Strong fluorescence of retinal neovascularization was observed in both groups.The incidence of optic disc neovascularization in NPDI group was 20% (6/30), which was significantly lower than 50% (7/14) in rubeosis iridis group ( P=0.04). Conclusions:Diabetic rubeosis iridis can be diagnosed by the imaging features of IFA and the fluorescein regression time in anterior chamber.PDR combined with optic disc neovascularization should be evaluated by FFA combined with IFA.
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Objective:To observe the incidence of diabetic iridopathy and optic disc neovascularization in the contralateral eyes of proliferative diabetic retinopathy (PDR) with proliferative diabetic iridopathy (PDI).Methods:A retrospective case-control study. From February 2014 to May 2020, 72 eyes of 36 patients with PDR and PDI who underwent iris fluorescein angiography (IFA) combined with fluorescein fundus angiography(FFA) at the Henan Eye Institute were enrolled in the study. Among them, there were 34 eyes in 17 males and 38 eyes in 19 females; the average age was 62.3±4.7 years. All patients underwent best corrected visual acuity(BCVA), intraocular pressure, IFA combined with FFA examination. The BCVA examination was performed using the international standard visual acuity chart, which was converted into logarithm of the minimum angle of resolution BCVA for statistic analysis. According to PDI staging, patients were divided into early rubeosis iridis(RI) group and neovascular glaucoma (NVG) group, with 28 and 8 cases respectively. Compared with NVG group, RI group had better BCVA and intraocular pressure, and the difference was statistically significant( t=6.433, 10.619; P=0.000, 0.011). The incidence of PDI and the incidence of binocular optic disc neovascularization in the two groups were compared, and Fisher's exact probability method was used for comparison. Results:The results of the IFA examination showed that in the RI group, the pupil border and the iris surface of the iris of the affected eyes had strong neovascular bud-like or patchy fluorescence; the pupil border and the middle of the iris of the patients in the NVG stage had strong neovascular cluster-like fluorescence. Among the contralateral eyes in the RI group, 6 eyes (21.4%, 6/28) were with PDI (stage RI), 21 eyes (75.0%, 21/28) were with non-PDI (NPDI), and 1 eye (1/ 28, 3.6%) were absence of diabetic iris disease. Among the contralateral eyes in the NVG group, there were 5 eyes with PDI (62.5%, 5/8), including 4 eyes with RI stage, 1 eye with NVG stage (12.5%, 1/8); 3 eyes with NPDI. The image of IFA in patients with NPDI early showed as punctate fluorescence in the local small blood vessels of the iris itself. The incidence of PDI in the contralateral eye of the RI group was lower than that of the NVG group, and the difference was statistically significant ( P=0.040). The results of FFA examination showed that 9 (32.1%, 9/28) and 8 (28.6%, 8/28) eyes of the affected eye and the contralateral eye in the RI group were combined with optic disc neovascularization. In NVG group, there were seperately 6 eyes (75.0%, 6/8) in the affected eyes and the contralateral eyes with optic disc neovascularization. The differences in the incidence of optic disc neovascularization between the two groups of the affected eyes and the contralateral eye were statistically significant ( P=0.046, 0.040). Conclusion:The incidence of PDI and optic disc neovascularization in the contralateral eye of PDR and PDI, RI is lower than that of NVG.
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Objective@#To investigate the prognosis and influencing factors of postoperative low anterior resection syndrome (LARS) for rectal cancer patients undergoing laparoscopic sphincter-preserving radical resection.@*Methods@#A retrospective case-control study was used in this study. Clinical data of 268 rectal cancer patients undergoing laparoscopic sphincter-preserving radical resection at Department of Gastrointestinal Surgery of The First Affiliated Hospital of Bengbu Medical College from January 2016 to January 2018 were retrospectively collected. Inclusion criteria: (1) operation procedure was total mesorectal excision (TME) and sphincter-preserving radical resection; (2) rectal cancer was confirmed by postoperative pathology; (3) age of patient was ≥ 18 years old. Exclusion criteria: (1) patient who had history of pelvic surgery and pelvic fractures, which would affect the anorectal function; (2) patient who had history of preoperative chronic constipation and irritable bowel syndrome, which would affect defecation; (3) patient who developed postoperative complications, such as anastomotic leakage, which would affect defecation function; (4) patient who received long-term use of drugs, which would affect the function of gastrointestinal tract or anus; (5) patient suffered from mental illness, who was unable to communicate properly; (6) patient who was lack of clinical data or had incomplete clinical data. Patients were followed up at 3, 6 and 12 months postoperatively, and LARS was diagnosed and graded according to the LARS score scale. The LARS score ranged from 0 to 42 points, and 0 to 20 was difined as no LARS, 21 to 29 was mild LARS, and 30 to 42 was severe LARS. LARS score >20 points at any time point was defined as postoperative LARS. Severe LARS transferring into mild LARS and mild LARS transferring into no LARS was defined as symptom improvement. Incidence and outcomes of LARS were evaluated. The factors associated with LARS outcomes were analyzed using χ2 test and logistic regression model.@*Results@#A total of 268 patients were enrolled. The incidence of LARS was 42.9% (115/268), 32.5% (87/268) and 20.1% (54/268) at 3, 6, and 12 months postoperatively respectively, and no new case of LARS was found after 3 months postoperatively. The incidence of mild LARS was 25.7% (69/268), 17.2% (46/268) and 8.6% (23/268) at 3, 6, and 12 months postoperatively respectively, and mild LARS incidence at 6 months was significantly lower than that at 3 months (χ2=5.857, P=0.016), and was significantly higher than that at 12 months (χ2=8.799, P=0.003). The incidence of severe LARS was 17.2% (46/268), 15.3% (41/268) and 11.6% (31/268) at 3, 6, and 12 months postoperatively respectively, without significant difference among 3 time points (all P>0.05). The improvement rate within one year after surgery in patients with mild LARS diagnosed at 3 months was significantly higher than that in patients with severe LARS (88.4% vs. 32.6%, χ2=38.340, P<0.001). Univariate analysis showed that female, distance from anastomosis to anal verge < 5 cm and tumor diameter ≥ 5 cm were associated with unsatisfied LARS outcomes (all P<0.05). Logistic regression analysis showed that distance from anastomosis to anal verge <5 cm was an independent risk factor for LARS outcome (OR=3.589, 95% CI: 1.163 to 2.198, P<0.001).@*Conclusions@#The incidence of LARS after laparoscopic sphincter-preserving radical resection decreases with time. The improvement rate within postoperative 1-year of severe LARS is lower than that of mild LARS. Low anastomotic position may lead to impaired improvement of LARS.
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Objective@#To evaluate the feasibility of PKH26 marked human adipose derived mesenchymal stem cells (hADSCs) in vitro and intraocular.@*Methods@#HADSCs were cultured in vitro and marked with PKH26.Eighteen C57BL/6J mice were divided into normal control group (6 mice), labeled cell group (9 mice) and unlabeled cell group (3 mice) by using sortition randomization method, labeled cells were injected intravitreally in C57BL/6J mice as labeled cell group, and the unlabeled cells were injected intravitreally in C57BL/6J mice as unlabeled cell group.After 1 month, retinal slab was checked to contrast the results of intraocular labeling.The retina was taken out for hematoxylin-eosin staining and electron microscopy to observe the toxicity.The use and care of the animals complied with Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.@*Results@#In vitro, red fluorescent was found in the cytomembranes after hADSCs were labeled by PKH26.Retinal patch of labeled cell group showed red fluorescence of hADSCs were in front of the retina.Hematoxylin-eosin staining of retinal tissue and optic ganglion cells showed that cell degeneration and proliferation were not found in labeled cell group.The hADSCs in vivo and in vitro marked enhancement results showed that, no fluorescent was found in the unlabeled cell group, the color positive rate were both 0, while red fluorescence was found in the labeled cell group, the color positive rate were both 100%.@*Conclusions@#PKH26 can be used to mark and intraocular trace of hADSCs.Also, it has no morphology toxic reaction.
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Objective@#To evaluate the feasibility of differentiation of human adipose mesenchymal stem cells (hADSCs) into endothelial-like cells and the safety of induced cells intraocular application.@*Methods@#HADSCs were induced to endothelial-like cells in vitro.The experimental group was added with streptomycin, vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF), and the control group was added with the same amount of phosphate buffered saline (PBS), the expression of von Willebrand factor (vWF), a marker of endothelial cells, was observed in the two groups.Six C57BL/6J mice were randomly divided into experimental group and control group by using the random number method, 3 mice for each group, the induced cells were injected intravitreally into C57BL/6J mice as experimental group, and the same amount of PBS buffer was injected intravitreally into C57BL/6J mice as control group.The changes of retinal cells were observed by electron microscopy.The use and care of the animals complied with Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.@*Results@#After induction of hADSCs in vitro, the endothelial cell marker was expressed.VWF immunofluorescence of the experimental group showed strong green fluorescence, and the color rendering rate was 100%.The control group showed no coloration of vWF immunofluorescence, and the color positive rate was 0.After 1 month of intravitreal injection, the retinal ganglion cells and rod cells were not degraded and necrotic.@*Conclusions@#HADSCs can differentiate into endothelial-like cells in vitro, and there is no retinal toxicity in a short-term.
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Objective To evaluate ocular surface changes following minimal vitreoretinal surgery in postmenopausal women patients with proliferative diabetic retinopathy (PDR).Methods Sixty-one women PDR patients (61 eyes) underwent vitreous microsurgery were recruited in this prospective study,including 31 postmenopausal women (PMW group) and 30 non-postmenopausal women (non-PMW group).The contralateral eyes were considered as the control group.Corneal fluorescein (FL) staining,tear break-up time (TBUT),Schirmer I test (SIT),central corneal sensitivity and ocular surface disease index (OSDI) were estimated.All tests were carried out 1 day preoperatively and 1 day,10 days,1 month and 3 months postoperatively.The student's t test or Mann-Whitney U and ANOVA for repeat measurements test were used.Results Preoperatively,TBUT of surgery and non-surgery eyes in PMW were shorter than non-PMW (t=-2.115,-2.035;P＜0.05),but higher OSDI scores were found in PMW (t=2.482,2.208;P＜ 0.05).TBUT reduction rate (Z=-2.771,-1.993;P＜0.05) and OSDI rising rate (Z=2.539,2.157;P＜0.05) of surgery eyes in PMW were higher than non-PMW 1 day and 10 days postoperatively.The lower SIT of surgery eyes in PMW were observed at 1 day and 10 days (t=-2.403,-2.029;P＜0.05) after surgery.At 10 days after surgery,FL and OSDI scores of surgery eyes in non-PMW returned to preoperative level (Z=-0.447,-0.513;P＞0.05),but in PMW,the recovery process experienced 1 month (Z=-1.500,-0.853;P＞0.05).TBUT and SIT of surgery eyes in two groups both reached preoperative level at 1 month following surgery (Z=-0.715,-1.266,-1.531,-0.522;P＞ 0.05).Conclnsions PMW with PDR had ocular surface dysfunction,which resulted in aggravated dry eye after minimal vitreoretinal surgery.
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Objective To analyze the application effects of endoscopic optic nerve decompression in patients with traumatic optic neuropathy and its effect on visual acuity.Methods From January 2014 to January 2016,100 patients (100 eyes) with traumatic optic neuropathy in our hospital were selected as observation objects.According to different treatment methods,the patients were divided into observation group and control group,50 cases in each group.The control group was treated with drugs,and the observation group with endoscopic sinus decompression of optic nerve on the basis of the control group after the stability of the disease.The patients in two groups were followed up at least 1 year.The clinical efficacy,visual acuity,VEP findings and incidence of adverse reactions were compared between the two groups.Results The effective rates in the observation group and control group were 76.0％ and 36.0％,there was significant difference between two groups (P ＜ O.05).In the observation group,the visual acuity of 16 eyes were improved in 22 eyes with no light perception,9 eyes in 13 eyes with light perception,9 eyes in 11 eyes with hand movement,and 4 eyes with finger counting were all improved;In the control group,the visual acuity of 6 eyes were improved in 20 eyes with no light perception,6 eyes in 14 eyes with light perception,5 eyes in 12 eyes with hand movement,1 eye in 4 eyes with finger counting.After treatment,the incubation period and amplitude of P1O0 in the observation group were (116.85 ±7.96) ms and (5.11 ± 1.16) μV,which were better than the control group (105.62 ±6.82) ms,(4.31 ± 1.25) μV.The incidence of adverse reaction in the observation group was significantly lower than that in the control group (P =O.000).Conclusion The endoscopic optic nerve decompression has a good application effect and safety in patients with traumatic optic neuropathy,can effectively improve the patient's visual acuity,help to improve the quality of life of patients,is worthy of clinical application.
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Objective To study the influence of Qingzao Runfei Huazhuo Xingxue decoction on pulmonary tissue and lung function in mouse model of lung injury induced by PM2.5, and to provide an idea of clinical prevention and treatment of respiratory diseases induced by PM2.5. Methods Totally 30 clean level male ICR mice were randomly divided into three groups: normal control group, model group and Qingzao Runfei Huazhuo Xingxue decoction intervention group, with 10 mice in each group. Model of PM2.5-induced respiratory disease in mice was reproduced by instilling nasal cavity drip PM2.5 suspension 40 mg/kg once a day for 6 weeks. In the treatment group, the mice were fed with the Qingzao Runfei Huazhuo Xingxue decoction twice a day from the 4th week of instilling PM2.5 suspension until the end of experiment. In the normal control group, the mice were fed as usual. At the end of the experiment, the total protein content in bronchoalveolar lavage fluid (BALF), and lung wet/dry weight (W/D) ratio was determined. Hematoxylin-eosin (HE) staining was used to observe the histopathological changes in lung tissue under light microscope. The inflammatory mediators levels in lung tissue were determined by antibody-sandwich enzyme linked immunosorbent assay (ELISA). Results Respiratory system damage model was successfully reproduced by dripping of PM2.5 suspension in nasal cavity. Compared with normal control group, inflammatory changes and inflammatory cell infiltration in model group were significant, and lung W/D ratio (4.71±0.33 vs. 3.13±0.12), total protein content in BALF (mg/L: 363.98±18.24 vs. 82.13±12.78), tumor necrosis factor-α [TNF-α (ng/L): 185.72±0.23 vs. 31.03±0.16], interleukin-8 [IL-8 (ng/L): 531.85±37.83 vs. 72.64±16.72], and leukotriene B4 [LTB4 (ng/L): 931.74±48.64 vs. 483.81±41.74] in lung tissue were significantly increased (all P < 0.05). Compared with the model group, the inflammatory changes of lung tissue in Qingzao Runfei Huazhuo Xingxue decoction intervention group were significantly reduced, lung W/D ratio (3.92±0.41 vs. 4.71±0.33), total protein content in BALF (mg/L: 213.21±19.62 vs. 363.98±18.24), TNF-α (ng/L: 124.15±0.27 vs. 185.72±0.23), IL-8 (ng/L: 238.42±35.82 vs. 531.85±37.83) and LTB4 (ng/L: 582.85±31.00 vs. 931.74±48.64) levels in lung tissue in Qingzao Runfei Huazhuo Xingxue decoction intervention group were significantly decreased (all P < 0.05). Conclusion Qingzao Runfei Huazhuo Xingxue decoction can improve PM2.5-induced damage and pathological inflammatory changes in lung tissue, which provided some new ideas for the treatment of PM2.5-induced respiratory diseases.
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Background Neovascular glaucoma (NVG) is secondary to retinal ischemia and hypoxia.Iris fluorescein angiography (IFA) can be used for early detection of NVG,but it can not reflect the condition of retinal blood vessels comprehensively.IFA combined with fundus fluorescein angiography (FFA) can detect the condition of retina and iris neovascularization comprehensively,but its application on diabetic retinopathy(DR) with NVG was rare in China.Objective This study was to evaluate the clinical application of IFA combined with FFA in proliferative diabetic retinopathy (PDR) patients with NVG.Methods A retrospectively study was designed.One hundred and thirty-three eyes with PDR were enrolled in Henan Eye Hospital from February 2013 to January 2016,including 100 eyes with no iris diseases,21 eyes with rubeosis iridis,and 12 eyes with NVG.All eyes underwent ophthalmic examinations that included best-corrected visual acuity,intraocular pressure,slit lamp,IFA and FFA.The differences of IFA examination and slit lamp examination in the eyes with rubeosis iridis were compared and statistical analyzed by McNemar nonparametric test.Results In this study,100 eyes with no iris leakage were identified by IFA,32 eyes with panretinal photocoagulation (PRP) treatment history had no retinal neovascularization and 68 eyes had retinal neovascularization;21 rubeosis iridis eyes with iris leakage at pupillary border or on iris surface were observed at the early stage of IFA,and all the eyes were identified having retinal neovascularization according to FFA images;12 NVG eyes were observed having iris neovascular leakage on iris surface at the early stage of IFA,and all the eyes were identified having retinal neovascularization according to FFA images.The detection rate of IFA examination on rubeosis iridis was 100％ (21/21),which was higher than 71.43％ (15/21) of slit lamp examination,and there was a significant difference between the two detection methods (P =0.03).Conclusions IFA combined with FFA can detect PDR with rubeosis iridis early,and it is helpful to guide the treatment timely.
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Objective To investigate the morphological characteristics of superior sagittal sinus (SSS) and bridging vein (BrV) with virtual reality (VR) technology and their clinical significances.Methods Forty-three patients with parasagittal meningioma (PSM group) and 21 patients with trigeminal neuralgia or hemifacial spasm who had no intracranial venous system diseases (normal group),admitted to our hospital from October 2011 to March 2013,were chosen.The morphological characteristics of SSS and parasagittal BrV of patients from the 2 groups were observed,which was finished in the VR workstation.The number and diameter differences of cortical veins between the 2 groups,and bilatelal side and the first,middle and third 1/3 of SSS of normal group were analyzed.Results Among the patients from the 2 groups,4 having SSS extremity with morphological variation were observed firstly.The direction of BrV entering the SSS mainly was retrograde,which concentrated in the middle and third 1/3 of SSS.There were many directions of BrV entering the SSS in the first 1/3 of SSS,and the direction mostly was perpendicular.In normal group,there were no statistical differences of number and diameter in the bilatelal cortical veins (P＞0.05); in the first,middle and third 1/3 of SSS,there was statistical difference of cortical veins number (P＜0.05),but no difference of diameter (P＞0.05).The number and diameter of cortical veins of PSM group were under the normal group,with statistically significant difference (P＜0.05).With the growth of PSM,violations of SSS and cortical venous gradually aggravated,affecting venous return,which resulted in increase number and complication of collateral veins.Conclusions There is certain variability of SSS and related BrV.The direction of BrV entering the SSS may be associated with intracranial venous system hemodynamic.It is clear and three-dimensional to observe SSS and cortical veins in the help of VR,and to analyze the venous circulation changes caused by PSM.