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Objective To systematically evaluate the efficacy,safety and recent curative effects of delta-shaped anastomosis in totally laparoscopic distal gastrectomy (ICBI) for gastric carcinoma.Methods Literatures in English and Chinese comparing ECBI and ICBI published up to November 2015 were searched from international and national online databases.Meta-analysis was conducted by Review Manager 5.3 soft ware.Results There are eleven studies involved,with 2020 gastric cancer patients,including,1 169 ECBI cases and 851 ICBI cases.Meta-analysis showed that there was no significant statistical differences between ECBI group and ICBI group in operative time,resection margin length,overall postoperative complications and anastomosis-related complications.(all P ＞ 0.05).When compared to ECBI,the estimated blood loss was significantly less in ICBI,and ICBI with more retrieved lymph nodes,faster recovery of gastrointestinal function,less use of painkiller and shorter postoperative hospital stay (all P ＜ 0.05).Conclusion ICBI is safe and feasible in treatment of gastric cancer,and has a good short-term effect.
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Objective To compare the influence of visual endoscope and general laryngoscope under general anesthesia on postoperative sore throat , in order to provide reference for clinical surgery .Methods 320 patients under non-neck and non-throat surgeries were selected .They were randomly divided into the control group and obser-vation group,160 cases in each group.Same intubation was used in both the two groups ,general laryngoscope was used in the control group and visual endoscope was used in the observation group .Clinical indicators and pain score after surgery were compared between the two groups .Results The air pressure,time of anesthesia and operation time in the observation group were similar with the control group ,the differences were not significant (t =0.834,0.943, 1.034,all P>0.05); 2h,24h,48h,96h after surgery,the VAS scores in the observation group were (11.93 ± 2.04)points,(17.44 ±3.27)points,(3.88 ±0.83)points,(1.12 ±0.31)points,the incidence rate of throat bleed-ing within 96h was 7.50%,which were significantly lower than those in the control group [(18.43 ±3.21) points, (22.55 ±4.19)points,(6.33 ±0.64)points,(3.29 ±0.58)points,17.50%],there were significant differences (t=7.493,5.773,4.834,7.231,χ2 =8.221,all P<0.05).Conclusion Intubation with visual endoscope can decrease postoperative sore throat ,which can be a priority for clinical surgery .
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Objective To detect the expression of HER2 in clinical colon carcinoma tissue ,to investigate its correlation with the clinicopathological characteristics and to analyze its influence on the proliferation and cell cycle in colon carcinoma cell lines .Methods 108 specimens of colon carcinoma and corresponding paracancerous tissues were collected .The hybridization in situ and real-time quantitative polymerase chain reaction were used to detect the HER 2 expression in those specimens .The relationship between HER2 expression and the clinicopathologic features was analyzed .The expression of HER2 in colon carcinoma cells(SW480 and Lo-Vo) was reduced by using the antisense technology .The MTT assay and the flow cytometry were used to investigate the HER2 in-fluences on the cell proliferation and cell cycles .Results The hybridization in situ results showed that the HER2 positive expres-sion rate was 66 .67% in colon carcinoma and 10 .19% in the paracancerous tissues ,the difference between them was statistically significant(P<0 .05) .The real-time fluorescent quantitative PCR results further showed that HER2 was found to be overexpressed in 61 .11% of the colon carcinoma tissue(P<0 .05);the expression of HER2 was gradually increased with the progress of colon cancer .(P<0 .05);the expression of HER2 in the colon tissue with lymph node metastasis was also significantly higher than that without lymph node metastasis in colon carcinoma (P<0 .05);siRNA-HER2 could significantly reduce the expression of HER2 in colon cancer cell lines(SW480 and LoVo) ,the growth of colon carcinoma cell lines was also significantly inhibited and the propor-tion of cells in G0/G1 phase was increased ,while the proportion of cells in S phase and G2/M phase was decreased .Conclusion HER2 is closely related with the occurrence and development of colon carcinoma ,its mechanism could regulate the grow th of colon carcinoma cells via mediating the transition of G1/S phase ,which may provide a new target for the treatment of colon carcinoma .
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Objective To analyze clinical effects of gastric tube operation for treatment of esophageal cancer in elderly patients and evaluate its clinical efficacy and safety.Methods A total of 171 patients aged 60-72 years with esophageal cancer in our hospital were selected.They were randomly divided into treatment group and control group.Treatment group was treated with gastric tube operation,and control group was traditionally treated with complete replacement of esophagus with stomach.The quality of life,patient satisfaction and safety of operation were evaluated after 3 weeks,6 months and 12 months after operation,respectively.Results The operation for esophageal cancer in 171 patients were successful.At 3 weeks after the operation,the score of life quality in treatment group and control group were both low [(67.3±9.6) vs.(65.3±8.4)],and there were no significant differences between the two groups (P＞0.05).At 6 months and 12 months after operation,the scores of life quality were (89.2±8.3) and (90.3±9.6) in treatment group,and (66.5± 10.4) and (60.5 ± 11.2) in contol group,respectively.There were statistical differences between the two groups after 6 months and 12 months of operation (P＜0.05).The complication rate in treatment group (6.9％) was much lower than that in control group (30.6％),and there were significant differences between the two groups (x2 =18.43,P＜0.01).The patient satisfaction was in no differences between the two groups at 3 weeks after operation (P＞ 0.05),while there were statistically significant differences at 6 and 12 weeks after the operation (P＜0.05).Conclusions Gastric tube operation in treatment of elderly patients with esophageal cancer,can effectively improve the life quality,and prevent the occurrence of postoperative complications,which is worthy of clinical application.