Relationship between intestinal flora and brain development in premature infants / 中华实用儿科临床杂志

Preterm delivery caused by various reasons leads to intestinal flora dysplasia in premature infants.In the early stages of life, there is a parallel development window between the intestinal microflora and the nervous system.Premature infants represent a unique population, whose brain development can be influenced by early microbial colonization.Microbiota optimization can improve the development of the nervous system.In this article, factors affecting the intestinal flora of premature infants, the effects of intestinal flora imbalance on the nervous system development, and the impact of early addition of probiotics on the development of premature infants were reviewed.Understanding the role of early optimization of the microbiota in the brain development of premature infants is essential for developing specific treatments for intestinal microbiota imbalance and protecting premature infants from a series of neurodevelopmental disorders caused by preterm delivery.

Application value of totally laparoscopic transabdominal-hiatal approach in the radical resec-tion of Siewert type Ⅱ adenocarcinoma of esophagogastric junction / 中华消化外科杂志

Objective:To investigate the application value of totally laparoscopic trans-abdominal-hiatal approach in the radical resection of Siewert type Ⅱ adenocarcinoma of esophago-gastric junction (AEG).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 45 patients with Siewert type Ⅱ AEG who were admitted to the Affiliated Hangzhou First People′s Hospital, Zhejiang University School of Medicine from May 2017 to December 2020 were collected. There were 28 males and 17 females, aged from 35 to 85 years, with a median age of 64 years. All patients underwent radical resection of AEG by totally laparoscopic trans-abdominal-hiatal approach with gastrointestinal anastomosis using proximal gastrectomy with double-tract anastomosis or total gastrectomy with esophagojejunointestinal anastomosis and digestive reconstruction using transdiaphragmatic-hiatal superior overlap esophagojejunostomy. Observation indicators: (1) surgical and postoperative situations; (2) postoperative histopathological examination; (3) follow-up and survival situations. Follow-up using outpatient examination and telephone interview was performed to detect survival of patients and tumor recurrence and metastasis up to March 2021. Measurement data with normal distribution were presented as Mean± SD and measure-ment data with skewed distribution were presented as M(range). Results:(1) Surgical and post-operative situations: all 45 patients underwent radical resection of AEG by totally laparoscopic transabdominal-hiatal approach successfully, including 35 cases undergoing total gastrectomy with esophagojejunointestinal anastomosis and 10 cases undergoing proximal gastrectomy with double-tract anastomosis. The total operation time, time of lower mediastinal lymph node dissection, time of superior overlap esophagojejunostomy, volume of intraoperative blood loss, time for initial out-of-bed activities, time to first flatus, time to initial liquid diet intake, time to drainage tube removal of the 45 patients were (235±32)minutes, (25±8)minutes, (45±10)minutes, (70±13)mL, (20±8)hours, (2.3±0.2)days, (2.6±0.8)days and (6.2±1.1)days, respectively. Eleven of 45 patients under-went postoperative complications and none of patient died during perioperative period. The post-operative duration of hospital stay of 45 patients was (10±3)days. (2) Postoperative histopatho-logical examination: all 45 patients had negative upper surgical margin. The length of proximal margin, tumor diameter, total number of lymph lodes harvested and number of lower mediastinal lymph nodes harvested were (2.5±0.5)cm, (2.9±0.8)cm, 35.0±4.0 and 2.4±0.8, respectively. Patholo-gical examination showed adenocarcinoma in all 45 patients with pTNM staging as 5 cases of stage ⅠB, 8 cases of stage ⅡA, 21 cases of stage ⅡB and 11 cases of stage ⅢA. (3) Follow-up and survival situations: 45 patients were followed up for 3 to 46 months, with a median follow-up time of 26 months. During follow-up, 8 of 45 patients died. Of the 37 patients survived, 3 cases underwent liver metastasis and 3 cases underwent bone metastasis, lung metastasis or peritoneal metastasis respec-tively.Conclusion:Total laparoscopic transabdominal-hiatal approach is safe and feasible in the treatment of Siewert type II AEG with a satisfactory clinical efficacy.

Strengthen the quality of project completion management and promote the sustainable development of medical science and technology / 中华医学科研管理杂志

Objective To optimize the quality management of project completion,improve the quality of scientific research outcomes,as well as promote the sustainable development of medical science and technology.Methods Based on the statistical analysis of the completion and postponement of the 2016-2018 provincial basic research projects in a medical school,explored the potential factors of project postponement.Identified possible problems in project execution and management,and furtherly,proposed effective countermeasures and suggestions for improvement.Results The main factors identified causing the postponement of project completion include the technique bottleneck of the experiment,unsatisfied research outcomes,long term of manuscript review,not well organized process management and so on.To deal with those problems,proposals including enhancing the publicity and education,optimizing the incentive system,reinforcing the whole process management,improving the multi-level management and strengthening the construction of scientific research integrity were put forward.Conclusions The quality management of project completion requires an improvement in the delicacy management of scientific research projects and a more comprehensive enhancement in cognition,rules and regulations,management means and scientific research integrity construction.

Modified overlap esophagojejunostomy in digestive tract reconstruction after laparoscopic total gastrectomy for gastric carcinoma / 中华普通外科杂志

Objective@#To evaluate modified overlap esophagojejunostomy in digestive tract reconstruction of totally laparoscopie total gastrectomy(TLTG)in patients of gastric carcinoma.@*Methods@#The clinicalpathological data of 68 patients admitted to Hangzhou First People′s Hospital from Jun 2015 to Aug 2018 Undergoing totally laparoscopie total gastrectomy and modified overlap esophagojejunostomy were analyzed retrospectively.@*Results@#Procedures were successful in all 68 patients without conversion to open surgery and no perioperative death.The operation time, esophagojejunostomy time, volume of intraoperative blood loss and incision length were respectively (210±30)min, (25±12)min, (50±20)ml and(3.5±1.1)cm. Time for initial out of bed activity, time of initial anal exsufflation, time for postoperative fluid diet intake and duration of postoperative hospital stay were (24±8)h, (2.4±0.5)d, (3.1±0.8)d, and (8±3.6)d. There was anastomotic fistula in one and recovered by conservative treatment, total number of harvested LNs in 68 patients were (38.9±2.3). By pTNM staging: 6 cases in stage ⅠB, 10 cases in stage ⅡA, 20 cases in stage ⅡB , 15 cases in stage ⅢA, 12 cases in stage ⅢB, 5 cases in stage ⅢC. 59 patients were followed up from 3 to 42 months. One with liver metastasis after 22 months, others were all tumor-free.@*Conclusion@#The modified overlap esophagojejunostomy method is safe and feasible in digestive tract reconstruction of totally laparoscopie total gastrectomy for gastric carcinoma.

Application value of totally laparoscopic transabdominal-hiatal approach in the radical resection of Siewert type Ⅱ adenocarcinoma of esophagogastric junction / 中华消化外科杂志

Objective To investigate the safety and feasibility of totally laparoscopic transabdominalhiatal approach in the treatment of Siewert type Ⅱ adenocarcinoma of esophagogastric junction (AEG).Methods The retrospective and descriptive study was conducted.The clinicopathological data of 11 patients with Siewert type Ⅱ AEG who were admitted to Affiliated Hangzhou First People's Hospital of Zhejiang University School of Medicine from May 2017 to July 2018 were collected.There were 8 males and 3 females,aged 56-72 years,with an average age of 63 years.Patients underwent radical resection of AEG by totally laparoscopic transabdominalhiatal approach.Observation indicators:(1) surgical situations and postoperative recovery;(2) postoperative pathological examination;(3) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect postoperative adjuvant chemotherapy,complications,food intake,anastomosis patency,tumor recurrence and metastasis,and survival up to December 2018.Measurement data with normal distribution were presented as Mean±SD,measurement data with skewed distribution were presented as M (range),and count data were represented as absolute number or percentage.Results (1) Surgical situations and postoperative recovery:all the patients underwent totally laparoscopic radical resection of Siewert type Ⅱ AEG by transabdominal-hiatal approach,without conversion to open surgery or perioperative death.Of the 11 patients,8 underwent total gastrectony including 3 combined with splenic hilar lymph node dissection and 3 underwent proximal gastrectomy with double-tract reconstruction.Operation time,time of superior overlap esophagojejunostomy,volume of intraoperative blood loss,time for initial out-of-bed activities,time to first flatus,time to initial liquid diet intake,time of drainage tube removal were respectively (245± 39)minutes,(60± 12) minutes,(75±23) mL,(24± 8) hours,(2.4± 0.5) days,(3.5 ± 0.8) days,(8.2 ± 1.3) days respectively.There was no serious complication including postoperative hemorrhage,anatomotic fistula or death.Three patients had left pleural effusion,and were cured after thoracic drainage.The duration of postoperative hospital stay was (11.0±3.0) days.(2) Postoperative pathological examination:all the 11 patients had negative upper surgical margin.The length of proximal margin,tumor diameter,total number of lymph lodes harvested,and number of lower mediastinal lymph lodes harvested were (2.1 ±0.2) cm,(2.6±0.9) cm,(36.0±4.0)/case and (2.3± 0.8)/case.Pathological examination showed adenocarcinoma in all the 11 patients.pTNM staging:2 cases were in stage Ⅰ B,4 cases in stage Ⅱ A,3 cases in stage Ⅱ B and 2 cases in stage Ⅲ A.(3) Follow-up and survival situations:11 patients were follow-up for 6-19 months,with a median time of 9 months.Chemotherapy regimeus were formulated according to the pathological examination.Nine patients received postoperative adjuvant chemotherapy,and 2 in stage Ⅱ B received no postoperative adjuvant chemotherapy.During the follow-up,11 patients had no obvious reflux symptom or choking feeling,and the anastomosis was patent as evaluated by oral contrast agent and gastroscopy.There was no tumor recurrence and metastasis or death in the 11 patients.Conclusion Totally laparoscopic transabdominal-hiatal approach applied in the radical resection is safe and feasible for the treatment of Siewert type Ⅱ AEG,with good short-term outcomes.

Modified overlap esophagojejunostomy in digestive tract reconstruction after laparoscopic total gastrectomy for gastric carcinoma / 中华普通外科杂志

Objective To evaluate modified overlap esophagojejunostomy in digestive tract reconstruction of totally laparoscopie total gastrectomy (TLTG) in patients of gastric carcinoma.Methods The clinicalpathological data of 68 patients admitted to Hangzhou First People's Hospital from Jun 2015 to Aug 2018 Undergoing totally laparoscopie total gastrectomy and modified overlap esophagojejunostomy were analyzed retrospectively.Results Procedures were successful in all 68 patients without conversion to open surgery and no perioperative death.The operation time,esophagojejunostomy time,volume of intraoperative blood loss and incision length were respectively (210 ±30)min,(25 ± 12)min,(50 ±20)ml and(3.5 ± 1.1) cm.Time for initial out of bed activity,time of initial anal exsufflation,time for postoperative fluid diet intake and duration of postoperative hospital stay were (24 ± 8) h,(2.4 ± 0.5) d,(3.1 ± 0.8) d,and (8 ± 3.6) d.There was anastomotic fistula in one and recovered by conservative treatment,total number of harvested LNs in 68 patients were (38.9 ±2.3).By pTNM staging:6 cases in stage Ⅰ B,10 cases in stage ⅡA,20 cases in stage ⅡB,15 cases in stage ⅢA,12 cases in stage ⅢB,5 cases in stage ⅢC.59 patients were followed up from 3 to 42 months.One with liver metastasis after 22 months,others were all tumor-free.Conclusion The modified overlap esophagojejunostomy method is safe and feasible in digestive tract reconstruction of totally laparoscopie total gastrectomy for gastric carcinoma.

The effect of the activated hepatic stellate cells on proliferation and invasion of hepatocellular carcinoma cells / 中国医师杂志

Objective To investigate the effect of hepatic stellate cells (HSC) on proliferation and invasion of hepatocellular carcinoma cells and the possible mechanism involved.Methods The HSC was isolated by optiprep method.Methyl thiazolyl tetrazolium(MTT) assay was used to detect the proliferation of hepatocellular carcinoma cells.The effect of invasion was measured with transwell assay.Matrix metalloproteinase-2 (MMP-2) and nuclear factor-κB (NF-κB) were detected by Western blotting.Results HSC was isolated and cultured successfully.HSC promoted the proliferation and invasion of hepatocellular carcinoma cells (proliferation:0.571 ±0.024 vs 0.803 ±0.048,1.271 ±0.044,1.973 ±0.036; invasion:25.2 ± 1.9 vs 35.8 ±3.3,44.4 ±2.7,53.9 ±3.6) (P ＜0.05).MMP-2 (1.32 ±0.22 vs 2.46 ±0.39) and NF-κB(0.85 ±0.09 vs 1.44 ±0.21) were increased obviously in hepatocellular carcinoma cells stimulated by HSC.Conclusions HSC can promote the proliferation and invasion of hepatocellular carcinoma cells.The mechanism might be related to up-regulation of the expressions of MMP-2 and NF-κB.

Preparation and identification of Nogo-66 polyclonal antibodies / 中华检验医学杂志

Objective To prepare polyclonal antibodies of anti Nogo-66, the extracellular region of one central nervous system neurite regeneration inhibitor Nogo, which could be used to further identification and functional study of Nogo molecule.Methods Preparing rabbit anti rat Nogo-66 polyclonal antibodies with a purified Nogo-66 fusion protein expressed in E.coli system. Studying its specificity by Western-blot and immuno-histochemical techniques and identifying its biological activity in PC12 cells.Results The high titer (1∶[KG-*2]10 000) anti rat Nogo-66 polyclonal antibodies were obtained.This antibody could specifically recognize the Nogo protein expressed in E.coli system.Immuno-histochemical staining indicated that the Nogo was widely expressed in rat spinal cord neurons and oligodendrocytes.It could effectively block the neurite extensioninhibition of Nogo protein in PC12.Conclusion Successful preparation of anti rat Nogo polyclonal antibodies provides a useful tool in identification or further functional study of Nogo molecule.