AIM: To study the effects of Ginkgo biloba extract (GbE) on cerebral ischemia-reperfusion injury. METHODS: Cerebral ischemia-reperfusion injury was produced by 10 min or 20 min occlusion of bilateral carotid arteries followed by 5 d or 1 d reperfusion in gerbils. Ninety-five gerbils were divided into 4 groups: sham-operation, ischemia-reperfusion, GbE 50 mg*kg-1 and GbE 100 mg*kg-1 groups. Drugs were given intragastrically 2 d prior to ischemia and during reperfusion. The effects of GbE on the contents of calcium, sodium, water in cortex, and lipid peroxide(LPO) in brain hemispheres, as well as the density of neuron in hippocampal CA1 sector were observed. RESULTS: GbE could reduce the increase of calcium, sodium, water content in a manner of dose-depedance. The dosage of GbE 100 mg*kg-1 could decrease the content of LPO and the mortality, increase the density of neuron in hippocampal CA1 sector. CONCLUSION: GbE has protective effects on cerebral ischemia reperfusion injury.

Objective To cultivate specialist nurses to perform preoperative stoma site marking in patients to receive enterostomy and improve the rate of preoperative stoma site marking and the ability of preoperative stoma site marking in specialist nurses. Methods The rate of preoperative stoma site marking in 148 patients from July 2016 to October 2016 was investigated and the reason of not receiving preoperative stoma site marking was analyzed. Nineteen primary nurses were trained to perform preoperative stoma site marking instead of the traditional pattern which was performed by enterostomy therapist and physician. The training included the criteria of preoperative stoma site marking, difficult preoperative stoma site marking, demonstration, group exercises, theoretical and operational assessment. The preoperative stoma site marking of 156 patients were performed by specialist nurses from November 2016 to February 2017.Then,the rate of preoperative stoma site marking,accuracy of stoma location,and knowledge of preoperative stoma site marking were compared between the traditional and new management pattern. Results The preoperative stoma site marking rate was 91.89%(136/148)and the accuracy rate was 94.12%(127/136)in traditional management pattern.The lack of enterostomy therapist, surgery performed on weekends and emergency surgery were the reasons that preoperative stoma site marking was not performed.After changing the management pattern,the preoperative stoma site marking rate was increased to 98.72%(154/156) and there was a significant difference between them (χ2=8.06, P <0.05).The accuracy of localization was decreased to 92.86%(143/154),but there was no significant difference between them(χ2=0.03,P>0.05).The rate of acquiring preoperative stoma site marking knowledge in nurses was increased from 8/19 to 18/19 with a significant difference(χ2=12.18,P<0.01). Conclusions The pattern of preoperative stoma site marking was changed and the new pattern improved the rate of preoperative stoma site marking,and didn′t affect the accuracy of preoperative stoma site marking.Meanwhile,we also improved the nurses′level of preoperative stoma site marking in our department.

Objective:To analyze the fail mode of neoadjuvant therapy combined with surgery for locally advanced esophageal squamous cell carcinoma (ESCC) after long-term follow-up.Methods:Clinical data of consecutive 238 patients with locally advanced resectable ESCC who underwent neoadjuvant therapy combined with surgery in Zhejiang Cancer Hospital from September 2012 to October 2019 were retrospectively analyzed. The failure mode in the whole cohort was analyzed after long-term follow-up. The overall survival (OS) and disease free survival (DFS) rates were analyzed by Kaplan-Meier method. Survival differences were determined by log-rank test.Results:The pathological complete response (pCR) rate was 42.0% in 238 patients. After a median follow-up of 46.1 months, tumor progression occurred in 96 patients (40.3%), including 25 patients (10.5%) with local recurrence, 61 patients (25.6%) with distant metastases, and 10 patients (4.2%) with simultaneous local recurrence and distant metastases. The median OS and DFS were 64.7 months and 49.9 months. And the 3-, 5-, and 7-year OS and DFS rates were 70.0%, 52.8%, 36.4% and 63.5%, 42.5%, and 30.0%, respectively. The 3-, 5-, and 7-year locoregional recurrence-free survival rates and distant metastasis-free survival rates were 86.0%, 71.4%, 61.2% and 70.6%, 55.9%, 43.0%. Compared with non-pCR patients, the overall progression rate and distant metastasis rate of pCR patients were lower (26.0% vs. 50.7%, 16.0% vs. 32.6%, both P<0.05). And the 3-, 5-, and 7-year OS (83.0% vs. 60.2%, 69.7% vs. 41.7%, 50.4% vs. 27.7%, all P<0.001) and DFS rates (80.4% vs. 51.4%, 63.9% vs. 31.2%, 45.9% vs. 20.3%, all P<0.001) were significantly better in pCR patients. Conclusions:Distant metastasis is the main failure mode of patients with locally advanced ESCC after neoadjuvant therapy. Patients with postoperative pCR can achieve better long-term survival.