Objective To evaluate the clinical characteristics and surgical risks for elderly patients with gastric cancer. Methods The clinical data from 607 patients, who received surgical therapy for gastric cancer between January 2006 and December 2009, were retrospectively analyzed.Among them, 267 patients were over 65 years of age, and the other 340 patients (≤65 years of age)were served as control. Complete surgical resection was done by doctors in same group. The preoperative complications such as cardiopulmonary disease and post-operative complications as well as pathologic patterns were compared between two groups. Results Coexisted diseases were found more in elderly patients than in controls (68.91% vs 31.63 %, P＜0.01). Whereas there was no significant difference between two groups with respect to post-operative complication [28. 19% (75/267)vs 25.59 % (87/340)]. However, the incidence of cardiopulmonary complications, especially pulmonary infection, was higher in elderly patients than in controls (17.23% vs 5.29% ,P＜0.01). The digestive tract complications were related to the pattern of radical operation. Post-operative complication occurred less in patients treated with D1 radical operation than those with D2 and D3 radical operation.Conclusions The incidence of post-operative complication in elderly patients with gastric cancer was closely related to the surgical method. The elderly patients may has less complications if they were operated with D1 radical method which can reduce risk of complication and improve the quality of life.

BACKGROUND:In consideration of skin as the largest organ al over the body and its abundant vessels and vessel plexuses, there would be sufficient adult stem cels for tissue engineering. OBJECTIVE:To investigate the osteogenic potential of dermis-derived bone morphogenetic protein receptor subtype IB (BMPR-IB) positive cels. METHODS:In current study, histochemical analysis was adopted to study the localization and expression of BMPR-IB+ cels in skin. Fresh skin samples were digested into single cel suspension. Then, the surface marker BMPR-IB was used to isolate cel subpopulation by magnetic activated cel sorting from freshly prepared single cel suspension. After that, the osteogenic potential in vitro andin vivo was tested. Alkaline phosphatase staining and alizarin red staining were performed after osteogenic inductionin vitro. The BMPR-IB+ cels were seeded onto coral scaffolds, and the scaffolds were used to repair critical-sized calvarial defects of mice. Histochemical analysis was performed at 6 weeks postoperatively and micro-CT analysis was carried out at 24 weeks postoperatively to evaluate the ability of bone repairment. RESULTS AND CONCLUSION:We localized BMPR-IB cels in situ by immunohistochemistry that turned out to be expressed in the reticular layer of dermis and by single cels. Cel subpopulation which expressed BMPR-IB could be sorted by magnetic activated cel sorting. Alkaline phosphatase staining was obviously positive and lots of calcium modules were confirmed by alizarin red staining after osteogenic induction, indicating that BMPR-IB+ cels had the osteogenic potentialin vitro. Histochemical analysis demonstrated that plenty of new bone formation was found in BMPR-IB+ cels group after 6 weeks in vivo. Micro-CT analysis revealed that BMPR-IB+ cels-coral scaffold complex could repair calvarial defects successfuly after 24 weeksin vivo. These results indicated that dermis-derived BMPR-IB+ cels possessed adequate osteogenic potential. Moreover, they might be promising seed cels for bone tissue engineering.

This article was aimed to rapidly analyze chemical composition in A loe Barbadensis Mill, and to compare the chemical composition of commercial aloe vera medicinal materials with that of fresh aloe yellow exudate. An opti-mized liquid chromatography-mass spectrometry-ion trap-time-of-flight (LCMS-IT-TOF) method was applied for the analysis of commercial aloe vera medicinal materials and fresh aloe yellow exudates. The Agilent TC-C18 column (4.6 í 250 mm, 5 m) was used. The gradient elution was a solvent system of water(A)-methanol(B). ESI source was operated in both positive and negative ion modes. The results showed that chromones, pyrones, naphthalene deriva-tive, anthrones and anthraquinones were separated successfully, 30 compounds were characterized by the comparison of characteristic MS/MS fragment ions data with the literature. The diagnostic fragmentation patterns of different chemical compositions were also discussed on the basis of EST-IT-TOF MS data. It was concluded that the chemical composition of commercial aloe vera medicinal materials were significantly different from that of fresh aloe yellow ex-udate in terms of types and contents: the former one mainly contains isoaloeresin D and aloin, and few aloesin; but the latter is mainly composed of aloesin and aloin, and the content of aloesin is the highest. The LCMS-IT-TOF analysis can be used to rapidly obtain rich structural information of different chemical compositions, which improves the efficiency of qualitative analysis of chemical composition, and is of great significance to the quality control, eval-uation and the utilization of A loe Barbadensis Mill.

Acute gangrenous cholecystitis is a histologic diagnosis,mostly diagnosed by intraoperative or postoperative pathology.In China,as the aging population increases,the incidence of the disease increases steadily.AGC is still an indication of surgical treatment for acute cholecystitis(AC),but the diagnosis and treatment of AGC remains a challenge for clinical surgeons.However,preoperative clinical data such as age, gender,hypertension,diabetes,coronary heart disease,cholelithiasis disease history,laboratory examination and radiographic results are helpful in early diagnosis and reasonable surgical timing selection.

OBJECTIVELooking for an objective biomedical index to distinguish types and phases of hemangioma in order to provide an objective basis for selecting clinical treatment to hemangioma.

METHODSELISA (enzyme-linked immunosorbent assay) was used to determine serum VEGF concentration of 15 patients with proliferative hemangioma, 6 with involuted hemangioma, 6 with vascular malformation and 8 infants of the control group.

RESULTSThe serum VEGF concentrations of 15 proliferative hemangioma patients were significantly higher than those of involuted hemangioma patients, vascular malformation patients and control group infants. The serum VEGF concentrations of involuted hemangioma patients were a little bit higher than those of vascular malformation patients and control group infants, but without statistic significance.

CONCLUSIONSELISA could easily and accurately determine the serum VEGF concentration of different types and different phases of hemangioma. The determination of serum VEGF concentration could provide guidance for selecting a protocol of systemic corticosteroid treatment for proliferative hemangioma. Combined with gene expression and distribution of VEGF and its receptors and some other cytokines, the determination of serum VEGF concentration could help elucidate the mechanism of proliferative hemangioma.

Endothelial Growth Factors ; blood ; Enzyme-Linked Immunosorbent Assay ; Hemangioma ; blood ; Humans ; Infant ; Lymphokines ; blood ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factors

Objective To summarize experience in the treatment of chronic refractory empyema with autologous myocutaneous flap implantation.Methods From January 2004 to December 2017,26 patients had been treated with autologous myocutaneous flap implantation in Shanghai Pulmonary Hospital for chronic refractory empyema.Among them,24 were men and 2 were women.The mediam age was 50.1 years(14-74 years).21 of them had medical histories of lung resection because of basic diseases(most of which accepted surgeries in other hospitals).Complications appeared after surgeries.15 of them had bronchopleural fistula while windowing,which could not be cured by conservative treatments such as drainage.Then we performed open-window thoracostomy and long-time dressing.6 of 21 had experienced pneumonectomy.Other 5 patients did not have primary operational histories.They experienced dressing by windowing because of chronic refractory empyema after the in effective conservative treatments like drainage without pulmonary re-expansion.Results No respiratory complications occurred in these patients.The catheters were successfully removed within 5 days and the patients were discharged within 3-6 weeks after the operations.The median follow-up period was 9 months.24 cases were successful with no recurrence of empyema or flap necrosis,the other 2 cases underwent recurrence of empyema.Conclusion The application of autologous myocutaneous flaps for the treatment of chronic refractory empyema is an effective and continuously improving method.

Objective: To investigate the clinical effects of immediate nipple reconstruction with a local mastectomy flap in secondary breast reconstruction by deep inferior epigastric artery perforator (DIEP) flap. Methods: A free bipedicle DIEP flap was raised and folded upward to form the breast. Meanwhile, a deepithelialized lower mastectomy flap with a distant skin paddle was elevated and pulled throughout the reconstructed breast. The skin paddle was carefully sutured to the position of future nipple. Three weeks later, the pedicle of mastectomy flap was divided, and the paddle was modeled to form the new nipple. Results: From February 2011 to June 2016, 42 patients who had previously undergone unilateral modified mastectomies underwent the breast reconstructions and immediate nipple reconstructions. All flaps survived postoperatively. The average projection of the reconstructed nipple was measured as (16.3±2.4) mm immediately after the operation and gradually decreased to (8.4±1.3) mm by one year follow up. 35 patients ranked the aesthetic appearance of the reconstructed nipple and breast very good or good. Conclusions The immediate nipple reconstruction with a local mastectomy flap and breast reconstruction by DIEP flap could achieve a good breast shape and maintain a long term residual nipple projection, which results in considerable patient satisfaction.

Objective:To explore how to enhance the strength of science and technology of research-oriented hospital using goal management, thereby effectively promoting the construction and development of research hospitals.Methods:This paper studies the goal management measures and their effectiveness through data analysis, analyzes the problems of scientific research, goal management measures and changes in scientific research before and after the implementation measures over the years.Results:The goal management significantly enhances the scientific and technological strength. Total amount of research funding kept increasing year by year. Goal accountability management effectively improve the participation in individual scientific research activities. The implementation of high-quality papers goal management has a significant role in promoting the researchers to publish their achievements in domestic journals with international influence.Conclusions:Goal management plays an important role in the improvement of the scientific and technological strength of the hospital, which can effectively promote the construction and development of the research-oriented hospitals connotation. Goal management can serve as a powerful grasper for the research-oriented hospital to improve the scientific research capacity.

Objective:This study intends to explore the clinical outcomes of liposuction combined with a vacuum-assisted biopsy device in the treatment of Simon grade Ⅰ or Ⅱ gynecomastia (GYN) caused by glandular proliferation and excrescent fat deposition.Methods:The clinical data of Simon grade Ⅰ or Ⅱ GYN caused by glandular proliferation and excrescent fat deposition treated by liposuction and vacuum-assisted biopsy device in the Department of Plastic and Reconstructive Surgery of the Ninth People’s Hospital Affiliated to Medical College of Shanghai Jiao Tong University from June 2016 to June 2019 were analyzed retrospectively. Surgical procedures: A 5-mm skin incision was made at the lower outer margin of the breast, through which the excrescent fat deposition was removed by liposuction. In addition, a vacuum-assisted biopsy device was applied to remove the residual glandular tissue. The operation time, liposuction volume, removed glandular tissue weight, blood loss, drainage volume, drainage duration, patient satisfaction, and complications were observed and recorded. The patients were followed up from June to December 2020. Patients were asked to grade the cosmetic outcome between 0 and 5 (0 was extremely dissatisfied, 5 was extremely satisfied). The data were sorted out and analyzed by SPSS 19.0, and the data were expressed as Mean±SD or M ( P25, P75). Results:A total of 27 patients with 51 breasts were enrolled in this study. Unilateral operation time, liposuction volume, removed glandular tissue weight, blood loss, drainage volume, drainage duration were (45.3±11.1) min, (206.0±66.7) ml, (28.9±9.5) g, (10.0±4.3) ml, (78.8±33.9) ml and (2.3±0.4) d respectively. Bruising occurred in 9 breasts. No other complications were observed. The postoperative follow-up time was 21.0 (17.0, 28.0) months, and the score of patient satisfaction was 4.98±0.14.Conclusions:Liposuction combined with vacuum-assisted biopsy device can be used as a feasible and minimally invasive approach to treat the Simon grade Ⅰ or Ⅱ GYN caused by glandular proliferation and excrescent fat deposition, which is safe and reliable with few complications, excellent cosmetic results, and high patient satisfaction. However, it has some shortcomings, such as hemostasis under the indirect vision.