Gastrectomy with D2 lymphadenectomy is considered as the standared operation to treat gastric cancer by the major of experts at home and abroad.Laparoscopic gastrectomy with D2 lymphadeneetomy is safe,feasible, minimally invasive and can achieve the same result of abdominal opening.This article is a review to summarize the overview,necessity and feasibility,the indication,the points for attention in operation,preoperative evaluation, complication,the result and the perspect about lapamscopie gastrectomy with D2 lymphadenectomy.

Objective To investigate the relationship between metabolism syndrome (MS) and fatty liver. Methods Plasma lipids, plasma glucose, liver function, blood pressure, body height and body weight were determined in 666 leaders receiving physical examination. Their livers were also examined by ultrasound. Whit analysis of variance and chi-square test, the effect of plasma lipids, plasma glucose, blood pressure, and weight index on fatty liver, and the relation between MS and fatty liver were analyzed. Results The weight index, systolic pressure, diastolic pressure, and the levels of total cholesterol, triglyceride, apolipoprotein B and plasma glucose in the patients with fatty liver were higher than those in healthy subjects. The levels of high-density lipoprotein and apolipoprotein A were lower in patients with fatty liver than those in healthy subjects. The morbidity of fatty liver in the patients with MS was higher than that in healthy subjects. Conclusion There was a close relation between MS and fatty liver. It was necessary to early treat MS.

Aim To search the effective malaria mixed gene vaccine and to explore the immune response of vaccinated host. The recombinant pcDNA3-EBA175/HRP Ⅱ was injected alone or mixed with pcDNA3-Pfs25 of Plasmodium falciparum into mice by intramuscular route. The muscle of injected parts were treated previously, e.g. injecting 50μl of 0. 5％bupivacaine into the muscle of left latter leg, with 2mm depth. To observed the changes of IgG antibody value, the splenic lymphocyte proliferation, the ratio of CD4+/CD8+ subgroups and NK cell killing activity. After injecting recombinant pcDNA3-EBA175/HRP Ⅱ alone or mixed with pcDNA3-Pfs25 into mice by intramuscular route, it showed that sera IgG value increased, the splenic T lymphocyte proliferation stimulated by specific antigen of Plasmodium falciparum increased, the ratio of CD4+/CD8+ decreased and NK cell activity increased. Enhanced immune injection could improve host's immune reaction.It is suggested intramuscular injection is an effective immune route, and mice inoculated with coding two gene recombinant alone or that mixed with sexual stage gene recombinant could all induce increased humoral and cellular immune response, and NK cell activity.

Objective To investigate hemodynamie change in uremia complicating heart failure of elderly patients. Methods Totally 241 cases with uremia complicating heart failure received measurement of circulation dynamic detection(CD).The volume load,myocardial contractility and blood pressure were analyzed in the elderly group aged(71±6)years (n=116) and young and middleaged group aged(38± 10)years(n =125). Results The central venous pressure(CVP)[(26.7±11.3)cmH2O vs.(23.6 ± 10.7) cm H2O,t=2.410,P =0.010],effective circulation volume (ECV)[(4362± 1340)ml vs.(3085 ± 1001 ) ml,t =7.674,P =0.000],stroke volume(SV) [(185 ± 52) ml vs.(114±41)ml,t=7.803,P=0.000],cardiac output (CO)[( 13.9±4.3)L/min vs.(11.2±3.6)L/min,t=4.802,P=0.000],left ventricular end diastolic volume (LVD)[(388± 145)ml vs.(258±98)ml,t =7.673,P =0.000],left ventricular end systolic volume ( LSV ) [( 223 ± 95 ) ml vs.( 135 ± 59) ml,t =7.186,P=0.000] were significantly higher group than in young and middle-aged group.The ejection pressure (EP)[(178±29)mm Hg vs.(183±24)mm Hg,t=2.323,P=0.012],myocardium negative inotropic(MNC) [(0.609±0.149)vs.(0.683±0.188),t=3.113,P=0.002],ejection fraction (EF) [(0.433± 0.034) vs.(0.445 ± 0.031 ),t =2.451,P =0.010],diastolic blood pressure (DBP) [( 87 ±14)mm Hg vs.(1.08±22)mm Hg,t=8.141,P=0.000],systematic vascular resistance(SSR)[(952±207)gcm-4 s-2 vs.(1217± 308) gcm-4 s-2,t =7.143,P=0.000],ejection resistence(ER) [( 178± 29)vs.( 183 ± 24),t =2.323,P =0.012] were lower in elderly group than in young and middle-aged group.DBP(x2 =16.474,P=0.000,OR=0.752,95％CI:0.714-0.790),SBP(x2 =11.913,P=0.000,OR=1.148,95％CI:1.091-1.205),ER(x2 =17.892,P=0.000,OR=0.906,95％CI:0.861-0.951),CVP(x2 =14.672,P=0.000,OR=0.698,95％CI:0.663-0.733) and LDV(x2 =21.080,P=0.000,OR=0.942.95％ CI:0.895-0.989) were dangerous factors of uremia complicating heart failure.Conclnsions The increased volume load,decreased myocardial contractility and cardiac afterload may appear in the elderly patients with uremia complicating heart failure.

Surgical resection and liver transplantation are still the preferred treatments for patients with hepatocellular carcinoma (HCC).For the patients with advanced HCC which are not suitable for surgical resection,traditional chemotherapy can not improve the prognosis.Molecular targeted therapy is a new method and tendency in the treatment of HCC.Multiple targets inhibitors,vascular endothelial growth factor inhibitors and monoclonal antibodies for HCC are widely researched and applied.

Objective:To evaluate the effects of surface modification with different concentration silica sol through sol-gel processing on bond strength between dental zirconia ceramic and resin cement. Methods:Silica coating was prepared by colloidal silica sol with concentrations of 20%,30%,40% on dental Zirconia ceramic. 32 discs zirconia ceramic specimens were fabricated and randomly divided into four groups respectively after polishing and sandblasting.The ceramic surfaces of different groups were received different treatments:(1)silane couple agent;(2)20% silica coating and silane couple agent;(3)30%silica coating and silane couple agent;(4) 40% silica coating and silane couple agent. Each ceramic block was bonded to light curing composite resin. All samples were stored in distilled water at 37 degrees for 24 h before a shear bond test to measure the bond strength of the resin cement to the ceramic surface. Scanning electrical microscopy (SEM) and energy depressive spectrum (EDS) were used to analyze the silica coating. Results:Contents of surface silicon increased after modification with silica coating prepared by sol-gel method. Bond strengths of groups with silica coating were significantly higher(P

Objective To analysis the effect of compound betamethasone injection combined with radiation on keloid in frontal facial region. Methods 60 cases of keloid patients in zhejiangprovincial people's hospital from January 2014 to January 2016 were selected,all patients were treated with surgery,the patients were randomly divided into observation group and control group,30 cases in each group,radiotherapy was used in the control group,the observation group was treated with local injection of compound betamethasone on the basis of the control group,the therapeutic effects, pain scores, adverse reactions and complications were compared between the two groups. Results The recurrence rate of the observation group was 3.33% which was significantly lower than that of the control group 10%,the improvement rate of the observation group 93.33% was significantly higher than the control group 80%,the difference was statistically significant (P<0.05).one,two and three months after operation,the pain scores in the observation group were significantly lower than those in the control group at the same time point,the difference was statistically significant (P<0.05).The adverse reaction rate was 6.66% (2/30) in the observation group and 23.33% (7/30) in the control group, there was no significant difference between the two groups.The incidences of skin sag, pigmentation, incision delayed union and telangiectasia in the observation group were significantly lower than those in the control group (P<0.05). Conclusion Compound betamethasone injection combined with radiation on the frontal facial keloid patients with significant effect,can significantly reduce the recurrence rate,improve the rate of improvement,reduce pain and complications in patients.

Objective To investigate the relationship between nuclear factor(NF)-κB activity and lactacystin induced prostate cancer cell apoptosis.Methods Two prostate cancer cell were divided into two groups:blank control group treated with culture solution,lactacystin group treated with different concentration of lactacystin(0.5,1.0,2.0,4.0 μ mol/L),the action time were 8,16 and 24 hours.The cell survival rate was measured by MTT assay.NF-κB DNA binding activity was measured by enzyme-linked immunosorbent assay,the expression of NF-κB P65 nuclear protein was detected by Western blot assay,and caspase-3 activity was analyzed by enzyme analysis assay.Results On basal condition,the NF-κ B DNA binding activity was much higher in DU145 cell than that in LNCaP cell(t=4.728,P=0.001).Compared with blank control group,different concentration of lactacystin groups'NF-κ B DNA binding activity in both the LNCaP and DU145 cell were reduced.The expression of NF-κB p65 nuclear protein decreased along with raising of lactacystin concentration in LNCaP cell,but it did not change in DU145 cell.On basal condition,caspase-3activity in DU145 cell was higher than that in LNCaP cell(t=4.519,P=0.001).After lactacystin acting of 24 hours,caspase-3 activity increased along with raising of lactacystin concentration in both the LNCaP and DU145 cell(2.0 μmol/L lactacystin group compared with 1.0 μmol/L lactacystin group,DU145 cell P=0.000,LNCaP cell P=0.000).Conclusions Lactacystin has different killing effects on prostate cancer cell.The mechanism may be related to inducing the apoptosis by down-regulation of NF-κB activity.There may be additional cell survival/death pathway in androgen-independent prostate cancer cell.

Malaria vaccines are being developed against different stages in the parasite's life cycle. Although not directly protective ,the sexual stage vaccines would induce antibodies that would prevent infection of mosquitoes when ingestedin a bloodmeal containing sexual stage parasites. pfs25 has been tested to be an important candidate antigen for malarial transmission blocking vaccine . In this report we analyzed the complete code of pfs25 gene of Plasmodium falciparum PFD-3/YN isolate. The result shows that the gene encoding pfs25 of PED-3/YN isolate has a mutant which generates a PstI endonuclease restriction site and shares 99.2％ nucleotide homology with that of NF4 isolate.

Objective To investigate the role of ileocecal valve in children patients with intussus-ceptions by colonoscopy after pneumatic air enema reduction. Methods A total of 106 intussusceptions chil dren patients, who recovered with pneumatic air edema reduction, were recruited to the study. They underwent colonoscopy within 12 hours after reduction. The control group was composed of 103 children patients with both diarrhea and hematochezia. There was no significant difference in age, sex or weight between the two groups.Colonoscopic findings were recorded in terms of slack, swelling, prolapsus, lymphoid hyperplasia and mucosal lesions in ileocecal valve. Results In patients with intussusceptions, the rates of ileocecal valve slack, swelling including prolapsus, lymphoid hyperplasia and mucosal lesions were 61.3%, 33. 9%, 100. 0% and 31.1%, respectively, which were significantly different with those of the control group (P ＞ 0. 05 ). When further divided intussusceptions patients into groups with age more than 1 yr or less, significant differences were also observed in regarding of these features. Conclusion There is a close relationship between morphological and functional changes in ileocecal valve and intussusceptions in children. Ileocolic intussusceptions in patients younger than 1yr is more likely to be due to slack of ileocecal valve, while that in patients older than 1yr is mainly due to swelling or prolapse of ileocecal valve, represented by ileocecal intussuception.