New trends in surgical treatment of gastric cancer / 中华消化外科杂志

Surgery is the cornerstone of gastric cancer treatment. Surgical treatment of gastric cancer has shown new trends in the context of precision surgery. From standardized D 2 radical surgery to function-saving surgery, minimally invasive surgery and enhanced recovery after surgery, the controlling of surgical trauma and improving life quality of patients are getting more and more attention under the premise of ensuring radical cure. At the same time, the comprehensive treatment including immunotherapy has broadened the boundaries of gastric cancer surgery. Combined with the relevant data at home and abroad, the authors elaborate the new trends in surgical treatment of gastric cancer oriented by stage of gastric cancer, in order to provide new ideas for clinical work.

Application of double thin tube chest drainage in enhanced recovery for teenagers with primary spontaneous pneumo-thorax after single-port thoracoscopic surgery / 中华胸心血管外科杂志

Objective To evaluate the efficacy and safety of using double thin tube drainage after single-port thoraco-scopic pulmonary bullae resection in the treatment of primary spontaneous pneumothorax ( PSP) in teenager.Methods From January 2015 to January 2018, 81 PSP teenage patients were prospectively enrolled and randomly divided into two groups ac-cording to the different indwelling drainage tubes.One group was drained by double thin tube( 6F, 16F )(41 cases) and the other group was drained by single 28F thick tube(40 cases).The postoperative recovery and pain scores and other indicators of the two groups were compared.Results The time of keeping drainage tube, length of hospital stay, poor healing of incision and the number of second puncture cases, rest and movement pain scores within 5 days in the double thin tube drainage group were all better than those in the single thick tube group, the difference was statistically significant(P<0.05).Conclusion Double thin tube drainage after single-port thoracoscopic pulmonary bullae resection in teenage PSP patients is more helpful to relieve postoperative pain than single thick tube drainage , and is more conducive for enhanced recovery after surgery .

O voyeurismo no cinema: uma análise de janela indiscreta / Voyeurism in movies: analysing rear window / El voyerismo en el cine: un análisis de la ventana indiscreta / Le voyeurisme au cinéma: une analyse de fenêtre sur cour

Este artigo propõe-se a pensar o voyeurismo no cinema, tomando como modelo o filme Janela indiscreta, de Hitchcock. Nessa obra, um magistral movimento de câmera nos situa como voyeurs antes que apareça o personagem que assumirá esse lugar na narrativa. Com base na identificação do espectador com o protagonista, perguntamos: 1) a posição voyeur implica a supressão de outra expressão erótica?; 2) a posição voyeur é mortífera? Nossa hipótese, sustentada no uso da câmera como defesa pelo protagonista, é que a linguagem cinematográfica permite ao espectador resistir ao gozo da imagem e inscrever-se como sujeito.

This paper proposes a reflection on voyeurism in movies by taking as model the movie Rear window, directed by Hitchcock. In this movie, a masterful camera movement puts us in the position of voyeurs even before the appearance of the character who is going to occupy that position in the narrative. Based on the audience's identification with the protagonist, we raise questions as follows, 1) Does the voyeur position imply the suppression of other erotic expression? 2) Is the voyeur position deadly? Our hypothesis, sustained by using the camera as the protagonist's defense, is that the film language enables the viewer to resist from enjoying the image, and allows him to inscribe himself as subject.

En este artículo se propone una reflexión acerca del voyeurismo en el cine, tomando como modelo la película La ventana indiscreta, de Hitchcock. En esa obra, un magistral movimiento de la cámara nos pone como voyeurs antes de que aparezca el personaje que tendrá ese lugar en la narrativa. A partir de la identificación del espectador con el protagonista, nos preguntamos: 1) la posición voyeur ¿implica la supresión de otra expresión erótica? 2) la posición voyeur ¿es mortífera? Nuestra hipótesis, apoyada en el uso de la cámara como defensa por parte del protagonista, es que el lenguaje cinematográfico permite al espectador resistir al goce de la imagen e inscribirse como sujeto.

Cet article propose de penser le voyeurisme au cinéma, en prenant comme modèle le film Fenêtre sur cour, d'Hitchcock. Dans cette œuvre, un magistral mouvement de caméra nous situe comme voyeurs avant l'apparition du personnage qui va prendre cette place dans le récit. À partir de l'identification du spectateur avec le personnage principal, on se demande: 1) la position voyeur, implique-t-elle une suppression de l'autre expression érotique?; 2) la position voyeur, est-elle meurtrière? Notre hypothèse, appuyée sur l'usage de la caméra comme défense par le personnage principal, c'est que le langage cinématographique permet au spectateur de résister à la jouissance de l'image et de s'inscrire comme sujet.

Cirugías ortognáticas: ortopedia de la imagen y pacificación de la mirada / Orthognathic surgery: imagen orthopedics and gaze pacification / Chirurgies orthognatiques: orthopédie de l'image et apaisement du regard

El presente trabajo surge como uno de los resultados de la investigación ―Función de la mirada en pacientes de cirugía ortognática‖, desarrollada en el grupo de investigación Psicoanálisis, Sujeto y Sociedad y financiada por el Comité para el Desarrollo de la Investigación (CODI) de la Universidad de Antioquia. 2 Nuestro interés en el ámbito de las cirugías ortognáticas surge de la participación en un servicio de cirugía maxilofacial en un hospital de la ciudad de Medellín. Allí, desde el año 2005, hemos escuchado en entrevistas pre y posquirúrgicas a pacientes de ambos sexos y de distintos rangos de edad, quienes se encuentran en el protocolo de cirugía ortognática. El aspecto estético que estas cirugías comportan, es el que llamó nuestra atención, en virtud de que muchos pacientes buscaban el procedimiento ortognático en aras de mejorar su estética facial, bien fuera en pos de conseguir un cierto ideal estético o bien para dejar de ser el centro de burlas y señalamientos por su aspecto. El psicoanálisis ofrece un campo teórico y clínico en el que se pueden pensar estos fenómenos concernientes a la imagen y a la mirada.

This work arises as one of the results of the research called "Function of the Gaze among Orthognathic Surgery Patients", funded by the Committee for the Development of Research – CODI– of the University of Antioquia. Our interest in the field of orthognathic surgery stems from participating in a maxillofacial surgery unit of a hospital in the city of Medellín, Colombia. Since2005, pre- and post-operative interviews have been carried out with patients of both genders and different age ranges who are in the orthognathic surgery protocol. The aesthetic aspect that these surgeries entail is striking inasmuch as many patients sought the orthognathic procedure in order to improve their facial aesthetics, either to get a certain aesthetic ideal or to stop being taunted and pointed to because of their aspect. Psychoanalysis offers a theoretical and clinical field where these phenomena concerning image and gaze can be thought.

Cet article est l'un des résultats de la recherche nommée "Fonction du regard chez les patients ayant subi une chirurgie orthognatique", financée par le CODI de l'Université d'Antioquia. La participation au service de chirurgie maxillo-faciale d'un hôpital de la ville de Medellín a suscité notre intérêt à ce sujet. Des interviews pré et postopératoires ont été réalisées depuis 2005 dans ce service auprès de patients des deux sexes et de différents âges se trouvant dans le protocole opératoire. Le caractère esthétique de cette chirurgie a attiré notre attention étant donné que beaucoup de patients avaient recours à la procédure orthognatique dans le but d'améliorer leur apparence faciale, soit à la recherche d'un idéal esthétique particulier, soit pour ne plus être la cible de moqueries à cause de leur aspect. La psychanalyse offre un cadre théorique et clinique qui permet de réfléchir aux phénomènes concernant l'image et le regard.

Ojo, mirada y pulsión: un recorrido metapsicológico Freudiano / Eye, gaze, and drive / Oeil, regard et pulsion

Este ensayo explora algunas de las bases metapsicológicas sobre el tema de la mirada y de la importancia de la función del ojo en la producción teórica freudiana, a sabiendas de que ojo y mirada no son lo mismo. El presente abordaje se realiza partiendo de la diferencia entre visión y mirada para luego, conceptualmente, rastrear la función del ojo y el impacto de la mirada en la constitución de la subjetividad, sobre todo al nivel de la pulsión. Muy especialmente refiere a la teoría de las pulsiones, y a su repercusión teórica posterior, para inmediatamente aproximarse a sus primeros escritos psicoanalíticos, empezando con “Tres ensayos de teoría sexual”. La sección substancial de este ensayo lleva al problema netamente metapsicológico de la “pulsión de ver” (Schautrieb) expuesto en textos como el mencionado de 1905 y “Pulsión y destinos de pulsión” de 1915.

This essay explores some of the metapsychological foundations about the gaze as well as the importance of the function of the eye in the Freudian theoretical production, aware that the eye and the gaze are not the same. The present approach starts from the difference between vision and gaze so that, conceptually, it can be traced the function of the eye and the impact of gaze in the first Freudian writings, especially at the level of the drive. It specifically refers to the theory of the drives and its later theoretical repercussion, to then immediately approach his first psychoanalytic writings, starting with Three Essays on the Theory of Sexuality. The substantial section of this essay brings the reader to the merely metapsychological issue of the “drive to see” (Schautrieb) exposed in texts such as Three Essays on the Theory of Sexuality from1905 and “Instincts and their Vicissitudes” from 1915.

Cet essai explore quelques-unes des bases méta-psychologiques sur le thème du regard et celui de l’importance de la fonction de l'œil dans la production théorique freudienne, tout en sachant que l'œil et le regard ne sont pas la même chose. Cette analyse est abordée à partir de la différence entre vision et regard, pour ensuite rechercher, de manière conceptuelle, la fonction de l'œil et l’impact du regard dans la constitution de la subjectivité, surtout au niveau de la pulsion. Ce travail vise de façon particulière la théorie des pulsions et sa répercussion théorique postérieure et, par la suite, aborde les premiers écrits psychanalytiques à ce sujet, en commençant par Trois essais sur la théorie sexuelle. La partie essentielle de cet essai développe le problème nettement méta-psychologique de la “pulsion de voir” (Schautrieb) exposé dans des textes tels que Trois essais sur la théorie sexuelle de 1905 et “Pulsions et destins des pulsions” de 1915.

Endoscopic therapy in undifferentiated early gastric cancer / 中国肿瘤临床

Objective:To investigate the clinicopathological factors predictive of lymph node metastasis (LNM) in undifferentiat-ed early gastric cancer (EGC) and to expand the possibility of endoscopic therapy for treating undifferentiated EGC.Methods:The re-searchers collected the data of 90 undifferentiated EGC patients who had undergone surgery at the Xingtai People's Hospital, Xingtai, China. The relationship between LNM and clinicopathological factors was retrospectively analyzed using univariate and multivariate lo-gistic regression analyses. Results:Univariate analysis showed that tumor size, lymphatic vessel involvement (LVI), and cancer inva-sion depth were the significant and independent risk factors for LNM. The LNM rate was 57.1%in patients with the three clinicopatho-logical risk factors. LNM was not found in patients without the three risk factors. Conclusion:Tumor size, LVI, and invasion depth are independently associated with the presence of LNM in undifferentiated EGC. Endoscopic therapy can be used to treat the patients with-out risk factors.

Le sujet entre sidération et jouissance: l'issue sublimatoire. À propos de l'œuvre de Francisco Brennand / O sujeito entre sideração e gozo: a sublimação como solução. Sobre a obra de Francisco Brennand / The subject between jouissance and total consternation: sublimation as a solution. Art of Francisco Brennand / El sujeto entre sideración y gozo: la sublimación como solución. Sobre la obra de Francisco Brennand

Cet article traite de l'univers inconscient des sculptures de l'artiste brésilien Francisco Brennand (1927) et des mécanismes archaïques qui sous-tendent leur création. Axée sur la thématique de l'origine, cette approche des œuvres de Brennand étudie les racines du désir sexuel et son rapport aux objets partiels, considérant la sidération du sujet face à la cruauté d'une sexualité archaïque et la jouissance de l'artiste comme défi à la mort et à l'énigme du néant. Elle s'intéresse alors au processus sublimatoire comme transmutation du matériel traumatique et au destin de la pulsion scopique et de cruauté dans la création artistique.

O presente artigo trata do universo inconsciente das esculturas do artista brasileiro Francisco Brennand (1927) e dos mecanismos arcaicos subjacentes à sua criação. Fundamentada sobre o tema da origem, esta pesquisa das obras de Brennand estuda as raízes do desejo sexual e sua relação aos objetos parciais, considerando a sideração do sujeito frente à crueldade de uma sexualidade arcaica e o gozo do artista como desafio à morte e ao enigma do nada. Ela se interessa então pelo processo da sublimação como transmutação do material traumático e pelo destino da pulsão escópica e de crueldade na criação artística.

This article deals with the unconscious universe of the sculptures by the Brazilian sculptor Francisco Brennand (1927) and the archaic mechanisms that underlie their creation. Focused on the theme of origins this approach to Brennand's works studies the roots of sexual desire and its relation to partial objects, considering the subject's total consternation toward the cruelty of the artist's archaic sexuality and jouissance as a challenge to death and to the enigma of nothingness. The study then focusses on the sublimation process as transmutation of traumatic material and on the fate of the scopic drive and the drive toward cruelty in artistic creation.

Este articulo trata del universo inconsciente de las esculturas del artista brasileño Francisco Brennand (1927) y de los mecanismos arcaicos subyacentes a su creación. Fundamentado en el tema del origen, este trabajo de investigación sobre las obras de Brennand estudia las raíces del deseo sexual y su relación con los objetos parciales, teniendo en cuenta la sideración del sujeto frente a la crueldad de una sexualidad arcaica y el goce del artista como desafío a la muerte y al enigma de la nada. La investigación se orienta para el proceso de la sublimación como una transmutación del material traumático y por el destino de la pulsión escópica y de crueldad en la creación artística.

Treatment of acute gastroesophageal variceal bleeding with combination of endoscopic cyanoacrylate injection and endoscopic variceal ligation / 中华消化内镜杂志

Objective To evaluate the efficacy of endoscopic cyanoacrylate injection combined with endoscopic variceal libation (EVL) in treatment of acute gastroosophageal variceal bleeding. Methods Twenty-three patients with acute esophagogastric variceal bleeding received endoscopic cyanoacrylate injec-tion combined with EVL within 12 hours of hemostssis. Somatostatin were given intravenously at the dosage of 250 μg/h postoperatively for 72 h. The patients received follow-up endoscopy at 2 weeks and 3 months after the procedure, respectively. The variants including the rate of re-bleeding, mortality, and degree of esopha-gogastric varices were evaluated. Results Success in immediate hemostasis was achieved in all cases and a second EVL was performed in 6 patients 2 weeks later. The effective rate of variceal alleviation in gastric fun-dus was 95.65% and 91.30% in esophageal varices. No recurrent bleeding or death was observed in follow-up of 3 months. Conclusion Endoscopic eyanoaerylate injection combined with EVL is a safe and effective technique in the treatment of patients with acute gastroesophageal variceal bleeding.

Endoscopic submucosal dissection for local residual and recurrent lesions in digestive tract after endoscopic mucosal resection / 中华消化内镜杂志

Objective To determine the efficacy and safety of endoscopic submucosal dissection(ESD) for local residual and recurrent lesions in digestive tract after endoscopic mucosal resection (EMR).Methods From June 2006 to November 2007, 15 patients with local residual and recurrent lesions of digestive tract after EMR underwent ESD. The procedures of ESD were as follows: normal saline was injected into the sub-to elevate the lesions from the muscle layer, and the mucosa around the lesions were pre-cut, then the connective tissue of the submucosa beneath the lesions was dissected, and the scar beneath the lesion was re-sected along the plane of the submucosa with a Hook-knife. Results The mean diameter of 15 residual and re-current lesions after EMR were 2. 3 era(0.8 ～ 3. 5 cm), of which 6 lesions were located in stomach, 3 in colon and 6 in rectunm. All cases showed negative lifting sign due to scar formation. Fourteen lesions were completely re-sected and the overall resection rate was 93.3%(14/15). It was pathologically confirmed that 13 cases showed no tumor involvement in lateral and basal resection margins, and the complete resection rate was 86.7% (13/15).The mean operation time was 87 min(ranging from 60 to 155 min). Minor bleeding occurred during ESD in all ca-ses, but there was no postoperative bleeding. Two cases had free air in abdominal cavity due to deep dissection,but recovered with conservative treatment after ESD without surgical involvement. The perforation rate was 13.3%(2/15). The mean follow-up period was 13 months and no recurrence was recorded. Conclusion ESD proves to be a novel, safe and effective procedure for local residual and recurrent lesions after previous EMR, which makes it possible to resect the lesions completely and provide precise pathological information.