Clinical effects of robot-assisted esophageal hiatal hernia repair and laparoscopic esophageal hiatal hernia repair: a retrospective comparative study / 中华外科杂志

Objective: To analyze the short-term clinical effects of robot-assisted and laparoscopic repair of the hiatal hernia. Methods: The clinical data of 56 patients underwent minimally invasive hiatal hernia repair from January 2021 to January 2022 in the Department of Minimally Invasive Surgery, Hernias and Abdominal Wall Surgery, People's Hospital of Xinjiang Uygur Autonomous Region were retrospectively analyzed. There were 32 males and 24 females, aging (59.7±10.7) years (range: 28 to 75 years). All patients were divided into laparoscopy group (n=27) and robot group (n=29) according to surgical procedures. Perioperative conditions, hospital stay, and improvement in symptoms before and after surgery were compared between the two groups by the t test, Wilcoxon rank-sum test and χ2 test. Results: All surgical procedures were successfully completed, without conversion to laparotomy or change in operation mode. There were no serious complications related to the operation. The intraoperative blood loss of the robot group was less than that of the laparoscopic group (M (IQR)): (20 (110) ml vs. 40 (80) ml, Z=-4.098, P<0.01). The operation time ((111.7±33.6) minutes vs. (120.4±35.0) minutes, t=-0.943, P=0.350) and hospitalization time ((3.9±1.4) days vs. (4.7±1.9) days, t=-1.980, P=0.053) of the robot group and the laparoscopic group were similar. Follow-up for 12 months after the operation showed no postoperative complications and recurrence. The score of the health-related quality of life questionnaire for gastroesophageal reflux disease in the robot group decreased from 10.8±2.8 before the operation to 6.5±0.6 after the operation, and that in the laparoscopic group decreased from 10.6±2.1 before the operation to 6.3±0.6 after the operation. There was no difference in the influence of different surgical methods on the change in score (t=0.030,P=0.976). Conclusion: Compared with laparoscopic repair of the hiatal hernia, robot-assisted hiatal hernia repair has the advantages of less bleeding, rapid postoperative recovery and good short-term effect.

Clinical target volume [CTV] in postoperation radiotherapy of esophageal squamous cell carcinoma could benefit from the detection of telomere length in lymph node

Background: This study evaluated the relation between telomere length in lymph node [LN] and prognosis of esophageal squamous cell carcinoma [ESCC]

Materials and Methods: LNs collected from 50 patients were assessed by pathological examination and quantitative reverse transcription polymerase chain reaction [qRT-PCR], which was used for detecting telomere length. The relation between clinical factors and the number of lymph node metastasis [LNM] identified were analyzed by the x2 test. The comparison of the pattern of LNM identified by pathological examination and detection of telomere length was assessed by Wilcoxon signed-rank test. Overall survival was assessed using the Kaplan-Meier method, and Cox proportional hazard regression analysis was used to evaluate the relationship between survival and the number of LNM

Results: The best threshold values, which could define the positive metastasis by detecting the telomere length, were 1.50, using the critical value method of statistic. Length of tumor, depth of tumor invasion and differentiation of tumor correlated closely with LNM were identified by detecting telomere length. The rates of LNM identified by detecting telomere length were 34.4%, 22.4%, 22.9%, 5.0% in 108,107, 7, and 3 LN station, respectively. The number of LNM identified by detecting telomere length was more closely related to the prognosis of ESCC than that of pathological examination [HR: 1.23 VERSUS 1.04]

Conclusion: The change of telomere length in LN was closely related to the prognosis of ESCC. Delineation of clinical target volume [CTV] may benefit from the detection of telomere length in regional LN

Seroprevalence and risk factors for Toxoplasma gondii in sheep and goats in Jinzhou, Northeastern China

In the present study, serum samples from 402 sheep and 216 goats were collected from 5 counties in Jinzhou from August to October 2012 and antibodies to Toxoplasma gondii were detected by modified agglutination test (MAT). Overall, 104 (16.8%) had antibodies to T. gondii with antibody titres of 1:25 to 1:800. Seropositive samples were distributed in all the 5 counties and seroprevalences of T. gondii varied significantly with flock size, age and rearing system, but not with breed, gender and farm location. The seroprevalences in small farms (18.3%, 95/518, 95% confidence interval [CI], 15.0-21.7%) were statistically higher than that in large farms (9%, 9/100, 95% CI, 3.4-14.6%) (P < 0.05), older animals were statistically higher than that in younger animals (P < 0.01). The prevalence in extensively and semiintensively raised samples was statistically higher than that in intensively raised animals (P < 0.01). Small flock size and extensive rearing system are the potential risk factors for the prevalence of Toxoplasma infection in sheep and goats in Jinzhou. This is the first report of T. gondii infection in sheep and goats in Jinzhou, northeastern China, and of an association of seropositivity to T. gondii and the risk factors.

Changes and their relationship of aquaporin-9 mRNA expression and Ca~(2+) concentration after cerebral ischemic in rats / 临床神经病学杂志

Objective To investigate the changes and their relationship of aquaporin-9(AQP9) mRNA expression and Ca2+ concentration of brain tissue after cerebral ischemic.Methods The models of cerebral ischemic in the rats were made by occluding unilateral middle cerebral artery with the suture method.The expression level of AQP9 mRNA was assessed by RT-PCR at interval times of 6 h,1 d,2 d,3 d,5 d after cerebral ischemic,respectively.Fura-2/AM fluoremetry technique was used to determine the cellular Ca2+ concentration of brain tissue.The results were compared with control group.Results Compared with control group,the expression level of AQP9 mRNA and the concentrations of Ca2+ significantly increased at 6 h in ischemic edema tissue,and reached a peak at 2 d,3 d after cerebral ischemic(P