Current status of lymph node dissection in pyloric-preserving gastrectomy for early gastric cancer / 中华胃肠外科杂志

With the gradual increase in the diagnosis rate of early gastric cancer, clinicians must consider prevention of gastric anatomical structure and physiological function while ensuring the radical treatment of the tumor. Pylorus-preserving gastrectomy is a function- preserving operation that preserves the pylorus, inferior pyloric vessel, and the vagus nerve in patients with early middle gastric cancer. One of the major controversies at present is the thoroughness of limited lymph node dissection for pyloric-preserving gastrectomy. Various studies have reported that the lymph node metastasis rate of early middle gastric cancer was low, especially in the suprapyloric region, inferior pylorus and the upper pancreatic region. Partial lymph node dissection is required for vascular and neurological protection, which is also safe and feasible in studies reported by major centers. Many clinical studies have been carried out in Japan and Korea, and postoperative follow-up has gradually increased evidence, providing the basis for the safety of lymph node dissection. In large case studies comparing pylorus- preserving gastrectomy with traditional distal gastrectomy, the incidence of postoperative morbidity, such as dumping syndrome, bile reflux esophagitis, weight loss, and malnutrition is low. Sentinel lymph node navigation technology is gradually applied to the diagnosis and treatment of early gastric cancer, and its clinical application value still needs further research.

Analysis of influencing factors of fingertip thermotactile perception threshold in healthy young adults / 中国职业医学

OBJECTIVE: To analyze the stability of test results of fingertip thermotactile perception threshold(TPT) among healthy individuals and the influencing factors of the TPT test. METHODS: Fifty healthy young volunteers aged 20-25 were selected as the study subjects using the convenience sampling method. The HVLab thermal aesthesiometer was used to perform the fingertip TPT test under the standard condition. Right index, middle, ring, little, left index and little fingers were tested. According to the method of random number table, we selected 25 subjects to receive second test after the interval of two weeks. RESULTS: Intraclass correlation coefficient(ICC) for cold threshold of right little finger was bigger than 0.75, suggesting the test-retest reliability was excellent. The ICC for hot threshold of six test fingers, cold threshold of right and left index fingers, right middle and left little finges was in the range of 0.60-0.74, indicating the test-retest reliability was good. However, the ICC for cold threshold of right ring finger was less than 0.40, and the test-retest reliability was poor. The hot threshold of right middle, ring and little fingers, and the cold threshold of left little finger of males were higher than those of females(all P<0.05). The cold threshold of right index and little fingers were lower than those of left hand in males(all P<0.05). The cold threshold of right middle and ring fingers were lower than that of the right index finger in females(all P<0.05). The cold threshold of right little finger was lower than those of right index, middle and ring fingers in females(all P<0.05). CONCLUSION: The stability of the fingertip TPT result is good in healthy young adults aged 20-25. The fingertip TPT test could be used for occupational health surveillance of workers exposed to hand-transmitted vibration. We should take into account the influence of gender, the right or left hand and different fingers when developing TPT reference values.

Analysis of the vibration reduction effect of three common protective gloves / 中国职业医学

OBJECTIVE: To test and analyze the vibration transmissivity of three common kinds of protective gloves, and to determine their actual protecting effect. METHODS: Three kinds of protective gloves were selected as test materials, and five healthy volunteers were selected as subjects using typical sampling methods. According to the ISO 10819:2013 Mechanical Vibration and Shock--Hand-arm Vibration--Measurement and Evaluation of the Vibration Transmissibility of Gloves at the Palm of the Hand(hereinafter referred to as ISO 10819:2013), investigation and measurement of basic parameters of protective gloves. The gloved vibration transmission(GVT) test system was used to test the vibration transmission of different protective gloves worn by the subjects, and the spectrum analysis of vibration reduction characteristics was carried out. RESULTS: The thickness of damping material of all the three kinds of protective gloves met the standard requirements. The mean value for the corrected frequency-weighted glove vibration transmissibility values at 25.0-200.0 Hz were 0.91, 0.75 and 0.94, and 1.05, 0.85 and 1.10 at 200.0-1 250.0 Hz, for the protective gloves A, B and C, respectively. The results of anti-vibration characteristic spectrum analysis show that there has no vibration reduction effect at the frequency of 25.0-200.0 Hz when wearing these three kinds of gloves. Wearing gloves A and B on part of the 200.0-1 250.0 Hz frequency vibration has an amplifying effect. Wearing glove C has a partial vibration reduction effect at the 200.0-1 250.0 Hz frequency, and the vibration reduction efficiency is the highest at the frequency of 1 250.0 Hz.CONCLUSION: According to the ISO 10819:2013 standard, the mean value of GVT measured when wearing the three kinds of protective gloves does not meet the relevant requirements, and the anti-vibration effect is poor. These gloves cannot be defined as anti-vibration gloves.

Current Understanding of Myeloproliferative Neoplasm-Related Gene Mutations and Cytokine -Review / 中国实验血液学杂志

Myeloproliferative neoplasm(MPN) is clonal hematopoietic stem cell disorder characterized by abnormal proliferation and expansion of one or more myeloid lineages. BCR-ABL-negative MPN includes polycythemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF). The mutations of JAK2, CALR and MPL genes are involved in the pathogenesis of MPN that provided a more complete molecular diagnostic standard for MPN. More and more new mutated genes related to prognosis of MPN were discovered in the past few years, at same time it was found that cytokines were also involved in the genesis and development of MPN. These provide a theoretical basis for the diagnosis, risk stratification and treatment management of MPN. In this article, the mechanisms of MPN-related cytokines and mutated genes in the genesis and development of disease and prognosis characteristics are summarized.

Clinical Analysis of Driver Mutations in Patients with Ph Negative Myeloproliferative Neoplasms / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the relationship between driver mutations and clinical characteristics in patients with Philadelphia chromosome (Ph) negative myeloproliferative neoplasms (MPN), so as to provide evidence for diagno-sis and treatment of the disease.</p><p><b>METHODS</b>The clinical data of 410 patients with classic Ph negative MPN including 150 cases of polycythemia vera (PV), 188 cases of essential thrombocythemia (ET) and 72 cases of primary myelofibrosis (PMF) from January 2013 to December 2016 in Fujian Medical University Union Hospital were retrospectively analyzed. The PCR or DNA sequencing were used for JAK2 V617F, JAK2 exon12, CALR and MPL W515L/K mutation analyses, and follow-up information on patients was updated by direct phone call or follow-up in outpatient.</p><p><b>RESULTS</b>Among the 410 patients with Ph negative MPN, 136 (33.2%) cases were asymptomatic at diagnosis. 389 cases were sequenced and JAK2 V617F was detected in 87.1% (122/140) of PV, 64.1% (118/184) of ET, 64.6% (42/65) of PMF; JAK2 exon 12 mutation in 1 case of PV; MPL W515L/K mutation in 1 case of ET and PMF, respectively; CALR mutation in 18(9.8%) cases of ET and 5 (7.7%) cases of PMF. JAK2 V617F mutated PV patients ocourred in older age: the white blood cell count, platelet count and incidence of splenomegaly were higher than JAK2-negative PV cases(P<0.05). Compared with JAK2 V617F mutated ET patients, CALR mutated ET cases displayed younger age, lower leukocyte count, higher platelet count and lower incidence of thrombosis; JAK2-negative ET cases had younger age, lower leukocyte count, lower hemoglobin level, higher platelet count and lower incidence of thrombosis(P<0.05). The incidence of splenomegaly in JAK2 V617F or CALR mutated PMF patients was both higher than that in JAK2-negative PMF cases, but the incidence of leukemia transformation in JAK2-negative PMF patients was higher than that in JAK2 V617F mutated cases (P<0.05).</p><p><b>CONCLUSION</b>The types of driver mutations are closely related with the clinical features and prognosis in Ph negative MPN patients.</p>