Comparison between endoscopic full-thickness resection and cap-assisted endoscopic full-thickness resection in the treatment of elderly patients with small gastric stromal tumors / 中华消化内镜杂志

Objective:To compare the safety and effectiveness of endoscopic full-thickness resection (EFR) and cap-assisted endoscopic full-thickness resection (EFR-C) in the treatment of small gastric stromal tumors (≤1.5 cm) in the elderly (≥60 years old).Methods:Data of elderly patients with small gastric stromal tumors who received EFR (41 cases) or EFR-C (25 cases) at Nanjing Drum Tower Hospital from May 2012 to August 2020 were analyzed retrospectively. The clinicopathological characteristics, the procedures, intraoperative and postoperative complications, postoperative efficacy and economic benefits were compared between the two groups.Results:The R0 resection rates of the EFR group and the EFR-C group were 95.1% (39/41) and 100% (25/25), respectively. The operation time [45.0 (32.5, 66.5) min VS 30.0 (20.0, 42.5) min, U=259.500, P=0.001] and resection time [30.0 (20.0, 50.5) min VS 9.0 (6.5, 16.5) min, U=127.000, P<0.001] of the EFR group were significantly longer than those of the EFR-C group. The rate of hot clamp use in the EFR group was higher than that in the EFR-C group [75.6% (31/41) VS 12.0% (3/25), χ ２=25.159, P<0.001]. The postoperative white blood cell count [8.3 (6.6,10.4)×10 9/L VS 6.3 (5.0,7.7) ×10 9/L, U=271.000, P=0.001] and postoperative neutrophil percentage (77.6%±8.8% VS 73.0%±6.8%, t=2.256, P=0.027) in the EFR group were higher than those in the EFR-C group. The postoperative antibiotic day in the EFR group was longer than that in the EFR-C group (2.8±2.0 days VS 1.0±2.0 days, t=3.625, P=0.001). The hospitalization costs in the EFR group were significantly higher than those in the EFR-C group (20 595.0±3 653.3 yuan VS 13 209.0±4 458.9 yuan, t=7.323, P<0.001). There was no recurrence or metastasis during the follow-up period. Conclusion:EFR and EFR-C are safe and effective for the treatment of small gastric stromal tumors in the elderly. Compared with EFR, EFR-C needs shorter operation time and lower medical costs, yields less postoperative inflammation, and is more suitable for the treatment of small gastric stromal tumors in the elderly.

Comparison of safety and efficacy of laparoscopy and laparotomy for 5-10 cm intermediate-risk primary gastric stromal tumors / 中华消化内镜杂志

Objective:To compare the safety and efficacy of laparoscopy and laparotomy for 5-10 cm intermediate-risk gastric stromal tumor, and to evaluate whether there was evident benefits of postoperative adjuvant treatment with imatinib.Methods:A retrospective study was conducted on 72 patients with moderate risk gastric stromal tumors (5-10 cm in diameter) who received operation in Nanjing Drum Tower Hospital from January 2010 to July 2020. There were 28 cases in the laparoscopy group and 44 cases in the laparotomy group. The clinical features, pathological data, perioperative results and hospitalization costs were compared between the two groups. The survival rates of postoperative adjuvant therapy with or without imatinib were analyzed and compared.Results:There was no significant difference in clinicopathological features between the two groups ( P>0.05). The incidences of postoperative complications in the laparoscopy group and the laparotomy group were 32.1% (9/28) and 52.3% (23/44) respectively, showing no significant difference ( P=0.094). Compared with the laparotomy group, both the hospital stay (12.5±3.2 days VS 15.0±3.5 days, P=0.004) and the median postoperative hospital stay (7.5 days VS 9.0 days, P=0.006) in the laparoscopy group were significantly shorter, and the first exhaust time was significantly shorter ( P=0.003). During the median follow-up period of 58 months (13-129 months), there was no tumor-related death. Two cases died of breast cancer and heart disease in the laparotomy group, and 1 case died irrelevant to gastric stromal tumor in the laparoscopy group. Of the 72 patients, 40 received postoperative imatinib adjuvant therapy, 22 cases (50.0%) in the laparotomy group and 18 cases (64.3%) in the laparoscopy group, with no significant difference in the proportion ( χ2=1.414, P=0.234). There was significant difference in the overall survival rate between the group treated with imatinib and the group without imatinib ( P=0.015). Conclusion:Laparoscopic resection is safe and effective for intermediate-risk gastric stromal tumor of 5-10 cm. Taking imatinib adjuvant treatment does not increase overall survival rate of patients with intermediate-risk gastric stromal tumors (5-10 cm), and there is no tumor-related death, recurrence or metastasis for those who did not accept imatinib adjuvant treatment after R0 resection.

Efficacy on visual display terminal syndrome treated withtherapy ofmedicine / 中国针灸

<p><b>OBJECTIVE</b>To observe the efficacy and explore the effect mechanism on visual display terminal syndrome treated withtherapy ofmedicine.</p><p><b>METHODS</b>Sixty-five patients of visual fatigue induced by the visual display terminal operation were treated withtrigeminy therapy ofmedicine, e.g. massage manipulation, acupuncture and cupping; acting on the specific stimulating areas inmedicine, relevant with orbit, temple, forehead, ear and Baihui (GV 20). Each treatment lasted 40 min, once every two or three days. Totally, 10 to 14 treatments were required. The scores of visual symptoms and the ocular hemodynamics before and after treatment were observed, and clinical effect were evaluated in the two groups.</p><p><b>RESULTS</b>After treatment, the scores of visual symptoms were reduced apparently as compared with those before treatment (all<0.05). The total effective rate was 84.6% (55/65). The peak systolic velocity (PSV), the end diastolic velocity (EDV) in anterior ciliary artery (ACA) and the central retinal artery (CRA) were improved obviously, indicating the significant differences before and after treatment (all<0.05).</p><p><b>CONCLUSIONS</b>Thetherapy ofmedicine alleviates the visual symptoms in patients of visual fatigue and improves visual quality. The effects are related to the improvement of ocular microcirculation.</p>

Influence of long-time video operation on hemodynamics of the retrobulbar arteries in operators / 中华劳动卫生职业病杂志

Objective@#To investigate the influence of long-time video operation on hemodynamics of the retrobulbar arteries in operators.@*Methods@#From March to October, 2015, a total of 120 soldiers for office work engaged in video surveillance were enrolled as study group, and 155 fire fighters were enrolled as control group. The incidence of eye discomfort was compared between the two groups. Color Doppler ultrasound was used to measure and compare the peak systolic velocity (PSV) , end-diastolic velocity (EDV) , and resistance index (RI) of the central retinal artery (CRA) and the short posterior ciliary artery (SPCA) , and the correlation of video operation time with the hemodynamic parameters of the retrobulbar arteries was analyzed.@*Results@#The study group had a significantly higher incidence rate of eye discomfort than the control group (P<0.05) . Compared with the control group, the study group had significant reductions in the PSV and EDV of the CRA and the SPCA and a significant increase in the RI of the CRA (P<0.05) . Video operation time was negatively correlated with the PSV and EDV of the CRA and the SPCA (r=-0.61, -0.54, -0.65, and-0.68, all P<0.05) and positively correlated with the RI of the CRA and the SPCA (r=0.56 and 0.63, P<0.05) .@*Conclusion@#Long-time video operation can increase the incidence of eye discomfort and lead to increased blood resistance of the CRA and the SPCA and reduced retinal perfusion.

Effects of video work on the ocular vascular hemodynamic and visual of the operators / 中华劳动卫生职业病杂志

Objective@#To investigate the effects of long time video display terminal (VDT) operation on the ocular vascular hemodynamic and visual acuity.@*Methods@#During March and October 2015, 120 cases of video monitoring warriors were selected as study group, another 155 cases of logistics personnel as the control group. The low vision of the two groups was calculated and compared, and the color Doppler flow imaging was used to measure the central retinal artery (CRA) , short posterior ciliary artery (SPCA) , anterior ciliary artery (ACA) , (peak systolic velocity, PSV) , end diastolic velocity (EDV) and (resistance index (RI) . The differences of hemodynamic parameters between these two groups were evaluated, and the relationship between the visual acuity and each hemodynamic parameter was analyzed.@*Results@#The visual acuity of the study group was[0.8 (0.4-1.2) ], much lower than the control group, and the rate of low version in the study group was 40.00%, much higher than that of the control group. Compared with the control group, both of ACA and CRA of SPCA, PSV and EDV in the study group were decreased, while RI of CRA, ACA were increased (P<0.05) ; Compared with the control group, no statistical significance was found in the RI of SPCA in the study group (P>0.05) . The PSV and EDV were negatively correlated with visual acuity (r value of PSV and visual acuity were -0.352, -0.265 and -0.304; r value of EDV and visual acuity were -0.324, -0.348 and -0.365, while RI was positively correlated with visual acuity (r value were 0.363, 0.326 and 0.344) .@*Conclusion@#Our data suggest that long time video operation may be associated with changes of ocular vascular hemodynamic parameters and raise the incidence of low vision.

Analysis of eye ultrasonography in patients with trinitrotoluene cataract / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To evaluate the diagnostic value of ultrasonography for trinitrotoluene (TNT) cataract.</p><p><b>METHODS</b>The morphology and internal echoes of 90 lenses of 45 TNT cataract patients and 120 lenses of 60 healthy adults were observed and compared using ultrasonography and slit lamp, and the hemodynamic parameters of the post-ophthalmic artery were also measured. The findings of the slit-lamp microscope were regarded as diagnostic criteria, and the sensitivity, specificity, and accordance rate of ultrasonography in the diagnosis of TNT cataract were calculated.</p><p><b>RESULTS</b>The sensitivity, specificity, and accordance rate of ultrasonography in the diagnosis of TNT cataract were 93.33%, 100.00%, and 97.14%, respectively; the positive and negative predictive values were 100% and 95.23%, respectively; the positive and negative likelihood ratios were 93.33 and 0.67, especuvey. With the progression TNT cataract, utrasonography showed that the lenses demonstrated morphological changes (spindle-shaped, spherical, and discoid morphologies), and the arc echoes of the posterior capsule were thickened and enhanced. The TNT cataract patients showed significantly lower peak systolic velocity and end-diastolic velocity of the ophthalmic artery (OA) and central retinal artery (P<0.01) and a significantly higher resistance index (P<0.05) than the healthy adults.</p><p><b>CONCLUSION</b>The sensitivity of ultrasonography in the diagnosis of TNT cataract is similar to that of slit lamp. Ultrasonography can demonstrate objectively the shape, range, and degree of lens opacity in an efficient manner, which is conducive to the diagnosis and staging of TNT cataract by slit lamp, and can also provide hemodynamic information of the OA, thus providing new ideas for clinical physicians in evaluating the disease and clinical efficacy as well as exploring therapies.</p>

Antibiotics Resistance of Escherichia coli / 中华医院感染学杂志

OBJECTIVE To investigate the drug-resistance status of Escherichia coli(ECO)from various kinds of specimens to provide the scientific evidence for reasonable use of antibiotics.METHODS ECO strains were isolated and identified according to the National Clinical Laboratory Operation Rules.Drug resistance profile was analyzed by K-B method recommended by CLSI.RESULTS Among 275 ECO strains,50.2%(the most highest isolating rate)were isolated from urine.Detection rate of extended spectrum ?-lactamases(ESBLs)producing ECO was 32.4%(89/275).Except for 100% susceptibility to carbopenems,the drug-resistance to 14 antibiotics in ESBLs producers was higher than in the nonproducers.CONCLUSIONS Laboratory department should think highly of the monitoring of ECO to prevent and control the occurrence and prevalence of the nosocomial infection with ECO.

The shortcomings and the solution in internal medicine education by standardized patient / 中华医学教育探索杂志

Standardized patient(SP) is playing an important role in medical education.Nevertheless this kind of medical education is not perfect.By use of analyzing the shortcomings in internal medicine education by SP.the effect of SP education will be greatly increased.

Influence of hosts on Hyperoside content in two kinds of Semen Cuscutae / 中华中医药杂志

Objective: To study the contents of hyperoside in Semen Cuscutae,which grew in different host and different environment.Methods: Hyperoside was determined by HPLC.Results: The content of hyperoside is 0.28%-0.65% in the semen Cuscutae growing in different conditions in Shandong.The content is higher in semen of C.chinensis in Linyi,whose host is Scutellaria baicalensis Georgi.The content of hyperoside is lower in semen of C.australia which grew in Humulus scandens(lour.) Merr.The content has no obvious difference between C.chinensis and C.australis.Conclusions: The content of hyperoside in semen Cuscutae has relation with the hosts.The content increased with the seed mature degree.

Discussion on pediatric characteristics of Complete Work on Children's Diseases written by CHEN Fu-zheng / 中华中医药杂志

In CHEN Fu-zheng's Complete Work on Children's Disease,s,there are many special viewpoints and experiences of pediatrics.In theory,he fighted against abusing medicine such as metals,stone,camphol,musk in treatment of infantile convulsion.In diagnosis,further developped the diagnostic methods of infants'feeling pulse and finger veinlet inspection.In treatment,proposed original ideas in syndrome differentiation and treatment of convulsion induced by febrile disease,and elucidated the Febrile theories of ZHANG Zhong-jing,WANG Hai-zang,ZHANG Jing-yue,YU Jia-yan,ZHOU Xu-zhong.There were many external therapies such as lamp,moxibustion,external application,sticking,fumigation,washing,as well as internal therapies,and there were many formulas of classic and convenient.