Comparative analysis of endoscopic full-thickness resection and surgical resection of large gastric stromal tumors (with video) / 中华消化内镜杂志

Objective:To study the safety and effectiveness of endoscopic full-thickness resection(EFR) in the treatment of large gastric stromal tumors with diameter of 5-7 cm.Methods:Data of 36 patients with large gastric stromal tumors (5-7 cm) who received EFR or surgery (including laparoscopic and open surgery) in the First Affiliated Hospital of Zhengzhou University and confirmed by postoperative histopathology from January 2017 to October 2018 were retrospectively analyzed. Patients were divided into endoscopic group (9 cases) and surgical group (27 cases) according to different resection methods. The perioperative indicators and the total incidence of complications in the two groups were compared.Results:In terms of perioperative indicators, the median operation time of the endoscopic group was significantly longer than that of the surgical group (4.0 hours VS 2.0 hours, P<0.01), and the postoperative fasting time (4.55±0.88 days VS 6.22±2.24 days, t=-2.15, P=0.03) and hospital stay (6.88±1.26 days VS 10.03±2.90 days, t=-3.13, P<0.01) were significantly shorter than those of the surgical group. The median visual analogue scores (VAS) of abdominal pain of the endoscopic group on the first postoperative day (3 VS 6, P<0.01)and the third postoperative day (1 VS 3, P<0.01) were significantly lower than those of the surgical group. The hospitalization cost was significantly less than that of the surgical group (55±14.7 thousand yuan VS 73±24.3 thousand yuan, t=-2.11, P=0.04). In term of the total incidence of complications, the endoscopic group was 11.1% (1/9), which was higher than that of the surgical group [7.4% (2/27)], but there was no statistically significant difference( P=1.00). Conclusion:EFR is safe and effective in the treatment of large gastric stromal tumors (5-7 cm), and has the advantages of less invasiveness, rapid postoperative recovery, and lower hospitalization cost. But how to shorten the operation time is an urgent problem to be solved.

Preliminary results of endoscopic stent placement for treating benign pyloric stenosis (with video) / 中华消化内镜杂志

From June 2017 to September 2019, 5 patients who were diagnosed as having benign severe pyloric stenosis underwent fully covered stent placement using a new stenting method at the First Affiliated Hospital of Zhengzhou University. Five patients were performed successfully without serious complications. Postoperative barium meal radiograph revealed that the stents were in good location and the acontrast agent passed smoothly. The liquid diet was commenced 1-3 days after surgery. No vomiting, abdominal pain and diarrhea occurred. During the follow-up, all the patients had improved weight and nutritional status. Four patients underwent stent removal 3-4 months postoperatively. One patient was found that the stent had migrated to stomach 3 months after discharge. After removing the stent, balloon dilation and mucosal resection was performed for the mild pyloric stenosis. All 5 patients had an additional follow-up of 3 months, and no symptoms and restenosis occured. These preliminary results showed that the new stenting method of fully covered stent placement is feasible, safe and effective in the treatment of benign pyloric stenosis.

Curcumin inhibits the proliferation and induces the apoptosis of nephroblastoma through activating miR-192-5p/PI3K/Akt signaling pathway / 中华微生物学和免疫学杂志

Objective:To study whether curcumin inhibits the proliferation and promotes the apoptosis of nephroblastoma through activating the miR-192-5p/PI3K/Akt signaling pathway.Methods:CCK-8 assay was used to investigate the effects of curcumin on the proliferation of nephroblastoma SK-NEP-1 cells and the appropriate concentration. The apoptosis rate of SK-NEP-1 cells was detected by V-FITC/PI. Luciferase reporter assay was used to verify the binding activity between miR-192-5p and PI3K. RT-PCR was performed to detect the expression of miR-192-5p at mRNA level. Western blot was used to detect the expression of PI3K and Akt at protein level.Results:Curcumin could significantly inhibit the proliferation of SK-NEP-1 cells and induce cell apoptosis in a dose-dependent manner. RT-PCR results showed that curcumin could significantly increase the expression of miR-192-5p. In addition, miR-192-5p significantly inhibited cell proliferation, induced cell apoptosis, and enhanced the effects of curcumin on the proliferation and apoptosis of SK-NEP-1 cells. Luciferase reporter assay suggested that miR-192-5p could bind to PI3K. Western blot results showed that curcumin down-regulated the expression of PI3K and Akt at protein level by mediating the expression of miR-192-5p.Conclusions:Curcumin could inhibit the proliferation and induce the apoptosis of nephroblastoma cells through mediating the expression of miR-192-5p and further inhibiting the downstream PI3K/Akt signaling pathway.

Investigation of in-patient neonatal death at 18 hospitals in Henan Province / 中华围产医学杂志

Objective To investigate the situation and the causes of neonatal death in Henan Province.Methods This study retrospectively analyzed the clinical data of 277 neonates who died at 18 hospitals in Henan Province in 2017.Distribution and causes of neonatal deaths,differences between perinatal conditions of premature and term/post-term infants,causes of early (＜ 7 d) and late (7-28 d) neonatal deaths and the differences in neonatal death cases between Maternal and Child Health Care Hospitals and General/Children's Hospitals were analyzed.We used t,rank-sum and Chi-square test (or corrected Chi-square test,or Fisher's exact test) for statistical analysis.Results (1) A total of 50 993 newboms were admitted to the 18 hospitals in 2017,297 of which died with a mortality of 5.82‰.After excluding 20 cases with uncertain birth or maternal pregnancy history or clinical data,277 cases with complete data were analyzed.Among them,168 (60.6％) were preterm neonates and 109 (39.4％) were term/post-term ones.Early and late neonatal deaths accounted for 74.0％ (205 cases) and 26.0％ (72 cases),respectively.(2) The top five causes of neonatal deaths were infection (78 cases,28.2％),asphyxia (54 cases,19.5％),neonatal respiratory distress syndrome (NRDS,33 cases,11.9％),severe congenital malformations (26 cases,9.4％) including cyanotic congenital heart diseases,digestive malformations,airway malformations and neural tube defects and pulmonary hemorrhage (23 cases,8.3％).Among them,the top three causes of early neonatal deaths were asphyxia (48 cases,23.4％),infection (43 cases,21.0％) and NRDS (33 cases,16.1％),while the main causes of late neonatal deaths were infection (35 cases,48.6％),major congenital malformations (9 cases,12.5％) and chromosome abnormities/inherited metabolic diseases (7 cases,9.7％).(3) Maternal complications during pregnancy accounted for 79.1％ (219 cases) and the predominant types were pregnancy-induced hypertension (43 cases,19.6％),followed by infection (36 cases,16.4％),placental-related conditions (32 cases,14.6％),gestational diabetes mellitus (23 cases,10.5％),hypothyroidism (20 cases,9.1％),fetal distress (18,8.2％),twin-twin transfusion syndrome (10 cases,4.6％) and cholestasis syndrome (9 cases,4.1％).(4) Compared with the term/post-term cases,the preterm cases had higher proportions of multiple births [27.4％ (46/168) vs 6.4％ (9/109),x2=14.016,P ＜ 0.05],assisted reproduction [7.1％ (12/168) vs 0.9％ (1/109),x2=4.421,P ＜ 0.05] and maternal hypertensive disorders of pregnancy [21.4％ (36/1 68) vs 6.4％ (7/109),x2=11.353,P ＜ 0.05],infection [16.7％ (28/168) vs 7.3％ (8/109),x2=4.295,P ＜ 0.05] and twin-to-twin transfusion syndrome [6.0％ (10/168) vs 0.0％ (0/109),x2=6.707,P ＜ 0.05].(5) Among all the early neonatal deaths,preterm cases had a higher incidence of NRDS than term/post-term neonates [20.3％ (27/133) vs 8.3％ (6/72),x2=1 1.937,P ＜ 0.05],but lower incidence of meconium aspiration syndrome (MAS),severe congenital malformations and chromosome abnormalities/inherited metabolic diseases [0.8％ (1/133) vs 5.6％ (4/72),x2=4.508;3.8％ (5/133) vs 16.7％ (12/72),x2=10.233;1.5％ (2/133) vs 6.9％ (5/72),~=4.172;all P ＜ 0.05].Among the late neonatal deaths,the incidence of severe intracranial hemorrhage in preterm infants was higher than that in term/post-term neonates [7.1％ (3/42) vs 0.0％ (0/30),x2=2.205,P ＜ 0.05].(6) Compared with the cases in General/Children's Hospitals,those in Maternal and Child Health Care Hospitals showed a higher proportion of preterm neonatal deaths [67.3％ (105/156) vs 52.1％ (63/121),x2=6.010,P ＜ 0.05],younger gestational age [(32.8±5.3) weeks vs (34.6±4.9) weeks,t=3.072,P ＜ 0.05],lower birth weight [(2 132.6± 1 014.5) g vs (2 409.4±987.3) g,t=-2.513,P ＜ 0.05],and higher average age of death [M(P25-P75),3 (1-8) d vs 2 (1-4) d,Z=3.710,P ＜ 0.05].Conclusions Neonatal death occurs mainly within one week after birth in those with maternal complications.Late preterm deaths and term/post-term cases account for nearly half of total neonatal deaths.The causes of death for preterm and term/post-term newborns vary with postnatal age.Infection,asphyxia and severe congenital malformations are important causes of neonatal deaths.

Preparation-containing node of Lotus Rhizome, green tea and Panax notoginseng for obese adults / 中国组织工程研究

BACKGROUND: Obesity is a well-established risk factor for cardiovascular diseases, diabetes, hypertension, arteriosclerosis and stroke. Stimulants such as ephedrine and caffeine and their herbal counterparts have been proved effective in reducing body mass; however, their use is controversial due to the undesired effects. Therefore, it is necessary to find a tolerable and effective nutraceutical that can increase energy expenditure and/or decrease calorie intake to reduce weight.OBJECTIVE: To assess the effects of a preparation containing node of Lotus Rhizome, green tea, and Panax notoginsengin reducing body mass and fat in obese adults.DESIGN: Randomized, double blind, placebo-controlled study using the volunteers as the subjects.SETTING: Institute of Natural Drug of Yunnan Baiyao Group.PARTICIPANTS: The trial was conducted in the Institute of Natural Drug of Yunnan Baiyao Group from July 5 to August 23 in 2003. Altogether 82 obese volunteers[35 men and 47 women aged 26- 50 years, body mass index (BMI) ≥ 25 kg/m2 ] were randomly assigned to treatment and placebo groups with 41 in each group.METHODS: The treatment group received 9 g pill of a dietary supplement containing a proprietary blend of node of Lotus Rhizome, green tea and Panax notoginseng every day for 7 weeks, while the placebo group received 9 g pill of rice flour every day for 7 weeks. Their body mass, percentage of body fat,absolute fat mass, BMI, waist and hip circumference, and anthropometric measurements were recorded at the beginning and the end of the study. The subjects completed daily dietary intake records on days 1 to 3 and 47 to 49. They also completed weekly activity logs throughout the study.MAIN OUTCOME MEASURES: ① Final outcome indexes: body mass,percentage of body fat, BMI, waist and hip circumference; ② Replacement indexes: diet, heart rate, oxygen consumption and blood pressure; ③ Risk indexes: adverse events and side effects.RESULTS: Four subjects (1 from the treatment group and 3 from the placebo group) dropped out for personal reasons unrelated to the study. No significant changes were found in the consumption of total calories, percentage of calories ingested as carbohydrates, fat or protein, or activity levels in either group throughout the study. Body mass, percentage of body fat and BMI of the treatment group were(74.7 ± 11.4) kg, (33.0±4. 1)% and(28.5±2.7) kg/m2 before the experiment, and(73.6 ± 12.4) kg, (31.3 ±4.5)%and(27.9 ± 3.0) kg/m2 at week 7, with significant differences. Waist and hip circumference of the treatment group was obviously decreased, but did not differ significantly before and after the experiment in the placebogroup. There were no significant differences in heart rate, oxygen consumption and blood pressure between the two groups. No obvious side effects were observed in the two groups.CONCLUSION: The novel combination of node of Lotus Rhizome, green tea and Panax notoginseng can significantly reduce body mass and fat in obese adults.

Effect of postoperative epidural analgesia on erythrocyte immunity / 中华麻醉学杂志

0 05) , RCR and RFER were more higher , RICR and RFIR were greatly lower in analgesia group than those in control group 3d after operation(P0 05), RCR increased markedly 7d after operation(P0 05) Conclusions Postoperative analgesia can help stabilize erythrocyte immunity function

Influence of congenital cleft lip or cleft palate on total respiratary compliance in child / 中华麻醉学杂志

Objective To investigate the influence of congenital cleft lip or cleft palate on total respiratary compliance (C T) in child.Methods Sixty children without congenital malformation (control group) and 240 children with congenital cleft lip or cleft palate (test group), scheduled for selected operation, were divided into 5 subgroups according to the age range: 1 12 months,1 3 years,4 7 years and 8 12 years,respectively. With the mechnical ventilation following intratracheal intubation after anesthesia induction, P ET CO 2 was maitained at 4 4.6kPa. The C T was measured with Datex Ultima monitor.Results Compared with the control level in the same age subgroup, C T remained unsignificant changes in all subgroups of cleft lip and in 1 12 months and 1 3 years subgroups of cleft palate, but decreased significantly in 4 7 years and 8 12 years subgroups of cleft palate(P