Objective To observe the treatment and outcomes of gastric stump cancer(GSC) after subtotal gastrectomy,and to analyse the possible related factors for the development of GSC. Methods The clinical data of 693 patients with subtotal gastrectomy were retrospectively analysed.The development,treatment and outcomes of GSC were observed,and the possible factors associated with the development of GSC were analysed. Results Seventy-six cases of GSC emerged in the 693 patients with subtotal gastrectomy.Fifty-one of the 76 cases were perfomed radical operations(n=36) or palliative resection(n=15).No death was found during the perioperative period,and the median survival time was 32.7 and 14.2 months,respectively.Those 25 without surgical management died 3 to 11 months after the development of GSC.Among the 76 cases with GSC,stomach was found as the original site of ulcer in 59(22.3%,59/259),and duodenal bulb in the other 17(3.9%,17/434)(P

ObjectiveTo evaluate 125I-labeled monoclonal antibody(McAb) CL58 in radioimmunoguided surgery(RIGS) for patients with colorectal cancer(CC).Methods 125I-McAb-CL58 was injected submucously into pericancerous site under endoscope in 29 CC patients. Intraoperative radioimmunodetection on targets(T) of tumors, regional lymph nodes and incisional margins, was carried out using a portable gamma-detecting probe. The T/NT ratio of 3∶1 was taken as the lowest threshold value of positivity for primary lesions, wall infiltration and lymph node metastasis. Lymph nodes were stained immunohistochemically for micrometastasis. Results The sensitivity for primary lesions was 93 1%. The specificity for tumor margin was 95 5%. For lymphatic metastasis, the sensitivity of RIGS was 92 0%, and the specificity was 87 8%(all P

Objective To discuss the therapy of cholelithiasis complicated with cirrhotic portal hypertension (CPH).Method In this study,clinical data were reviewed on 108 cases with cholelithiasis complicated with hepatic cirrhosis,including 78 cases who underwent surgery.Results Open cholecystectomy,subtotal cholecystectomy,laparoscopic cholecystectomy,open cholecystectomy plus spleectomy,splenectomy plus pericardial devascularization before biliary duct operation,leftlateral hepatectomy with biliary duct operation,and hepatic portal bile duct anaplasty with Roux-en-Y cholangiojejunostomy.10 patients received endoscopic treatment and 20 were treated conservatively.Results 73 patients were cured,with a cure rate of 67.6％; 32 patients were doing well (29.7％);3 patients died (2.8％) of massive hemorrhage and hepatic failure.The operative complications included ascites,jaundice,hemorrhage and hepatic insufficiency.Conclusions Before operation,the conditions of the patient should be accurately evaluated and a correct operative treatment option should be selected.Child C grade patients should be contraindicated for any surgery.

Sleep quality is closely related to human health. It is very important to correctly discriminate the sleep stages for evaluating sleep quality, diagnosing and analyzing the sleep-related disorders. Polysomnography (PSG) signals are commonly used to record and analyze sleep stages. Effective feature extraction and representation is one of the most important steps to improve the performance of sleep stage classification. In this work, a collaborative representation (CR) algorithm was adopted to re-represent the original extracted features from electroencephalogram sig- nal, and then the kernel entropy component analysis (KECA) algorithm was further used to reduce the feature dimension of CR-feature. To evaluate the performance of CR-KECA, we compared the original feature, CR feature and readied CR feature (CR-PCA) after principal component analysis (PCA). The experimental results of sleep stage classification indicated that the CR-KECA method achieved the best performance compared with the original feature, CR feature, and CR-PCA feature with the classification accuracy of 68.74 +/- 0.46%, sensitivity of 68.76 +/- 0.43% and specificity of 92.19 +/- 0.11%. Moreover, CR algorithm had low computational complexity, and the feature dimension after KECA was much smaller, which made CR-KECA algorithm suitable for the analysis of large-scale sleep data.
Algorithms ; Electroencephalography ; Entropy ; Humans ; Polysomnography ; Principal Component Analysis ; Sleep Stages ; Sleep Wake Disorders ; diagnosis ; Software

Objective:Nipple discharge is a common complaint in women.There were no accurate techniques in detecting ductal lesions in nipple discharge patients before the application of fiberoptic ductoscopy.The aim of this study was to evaluate fiberoptic ductoscopy in the diagnosis and treatment of nipple discharge.Methods: From June 2007 to November 2008,a total of 95 patients with nipple discharge were submitted to fiberoptic ductoscopy,and 50 of them underwent surgery and pathological examination.Results: Of the 95 cases,2 diagnosed as breast cancer,58 intraductal papilloma,23 mammary duct ectasia,and 10 inflammatory disease of the mammary duct.Compared with the results of pathological examination,the accuracy of the fiberoptic ductoscopy was 81% for intraductal papilloma and 100% for breast carcinoma.Conclusions:Fiberoptic ductoscopy,as a convenient,safe and accurate method for the diagnosis and treatment of nipple discharge,can be used to confirm etiological factors and locate the site of the complaint.

Objective To analyse the CT,MRI features of pleomorphic xanthoastrocytoma and improve the diagnosis.Methods Imaging feature of pleomorphic xanthoastrocytoma of 26 cases confirmed by surgery and pathology were analyzed retrospectively.Distribution,size,shape,signal,dense,peritumor edema and invasion of adjacent structures of lesion were summarized.Results The locations of lesions included:temporosphenoid lobe (19 cases),frontal lobe (2 cases),the lateral and three ventricles in 1 case,occipital lobe (1 case),medulla oblongata (1 case),and cervical cord (1 case).The tumor size:maximum:82 mm × 40 mm × 70 mm,minimum:16 mm × 13 mm × 14 mm.Solid lesions (3 cases),solid lesions with necrosis (7 cases),solid and cystic lesions (16 cases),lesion with calcification (4 cases).The solid lesions of the tumors showed equal signal intensity or slightly low signal intensity on T1WI,and equal signal intensity or slightly high signal intensity on T2WI.The equidensite and high density on CT,peritumor edema degree:mild (2 cases),moderate (5 cases),severe (1 case).Conclusion The characteristic imaging features can help in the understanding and diagnosis of pleomorphic xanthoastrocytoma.

Objective To investigate the effects of Dishevelled (DVL) on apoptosis of diffuse large B-cell lymphoma (DLBCL) cell line OCI-Ly10, and to explore its possible mechanism. Methods Lentivirus plasmid overexpressing DVL2 was constructed, and after virus was packaged, it was transfected into OCI-Ly10 cells. Flow cytometry was used to detect the apoptosis rate of OCI-Ly10 cells with or without the stimulation by TNF-α recombinant protein. Then the gene expression of anti-apoptotic genes, GADD45β and A20, in NF-κB pathway was detected by RT-PCR. Results The virus was sucessfully transfected into OCL-Ly10 cells which overexpressed DVL2. The apoptosis rate of OCL-Ly10 cells overexpressing DVL2 without the stimulation by TNF-α was increased compared with that of the negative control group [(15.46 ±2.37) % vs. (11.72±3.53)%, P=0.03], the A20 mRNA expression level was decreased compared with that of the negative control group [(0.66 ±0.01) vs. 1, P=0.04], and the relative expression level of GADD45β mRNA was not significantly decreased compared with that of the negative control group [(0.79 ±0.15) vs. 1, P=0.642]. The apoptosis rate of DVL2 overexpression OCI-Ly10 cells stimulated by TNF-α was significantly higher than that of the negative control group treated by TNF-α [(22.78±4.56)%vs. (12.79±2.89)%, P=0.007]. The gene expression of A20 and GADD45β in DVL2 overexpression cells stimulated by TNF-α was significantly increased, however, the magnitude of increase in DVL2 overexpression cells was less than that in the negative control group treated by TNF-α [A20: (3.75 ±0.14) times vs. (6.89 ±0.10) times, P=0.008; GADD45β:(4.750±0.21) times vs. (6.14±0.08) times, P=0.03]. Conclusion DVL can promote the apoptosis of OCI-Ly10 cells, and its mechanism may be related with anti-apoptotic genes that inhibits its downstream via NF-κB pathway.

ObjectiveTo evaluate the efficacy and safety of bepotastine besilate in the treatment of chronic urticaria.MethodsA randomized,double-blind,parallel-controlled clinical study was conducted in 5 centers.Patients were randomly assigned to 2 groups to be treated with bepotastine besilate 20 mg or loratadine 10 mg once a day,respectively,for 4 weeks.Visits were scheduled before and after 1,2 and 4 weeks of treatment.Itching degree,number of wheals and diameter of the largest wheal were recorded for efficacy evaluation.ResultsTotally,240 patients were enrolled and 227 patients completed the study.The response rate was 74.6％ and 77.9％ respectively in bepotastine besilate- and loratadine-treated patients,respectively(P ＞0.05).No significant difference was observed in the incidence of adverse reactions between bepotastine besilate- and loratadine-treated patients(12.8％ vs.17.9％,P ＞ 0.05).The main side effects were mild to moderate drowsiness,dry mouth,dizziness.ConclusionBepotastine besilate is effective and safe for the treatment of chronic urticaria,with an efficacy and safety profile similar to that of loratadine.

Objective To investigate the prevalence of integrons in A.baumannii isolates,analyze the correlation between inte- grons and resistance of A.baumannii,and study the resistance genes in integrons.Methods A total of 106 strains of A.bau- mannii were collected to test the antibiotic susceptibility by disk diffusion method.The classification of integrons was per- formed by analyzing the positive PCR products using restriction fragment length polymorphism (RFLP).The variable region of integrons was amplified by integron PCR.RFLP and DNA sequencing were used to analyze the resistance genes in integrons. Results About 52.8% (56/106) of the isolates showed integron positive.PCR-RFLP analysis revealed that they were all class I integrons.About 94.6%(53/56) of the positive strains with integrons owned the variable region,which was confirmed by integron PCR.The sizes of the amplicons ranged from 0.15 kb to 2.8 kb.All together 7 different cassette arrays were detec- ted,including genes coding resistance to aminoglycosides (aadA1,aadA2,aadA5,aadB,aacA4),sulphonamides (dfrⅫ, dfr17),?-lactam compounds (bla_(ara-10)),chloramphenicol (catB-like,catB8),and two open reading frames (orfF,orfI) with unknown function.A novel cassette array orfI-aadA1 was reported,and its GenBank accession number was DQ092497.Conclu- sions Class I integrons are widespread in A.baumannii isolates in Nanjing.The integrons are closely associated with the resist- ance and multidrug resistance in A.baumannii isolates.

ObjectiveTo explore effect of interleukin-10 (IL-10) on histopathologic scores of severe acute pancreatitis (SAP) and the level of serum amylase (AMY) in rats.Methods48 female and male adult Sprague Dawley rats (200—300g) were randomly allocated into three groups: OPgroup, SAP group and IL-10 group with 16 rats in each group. SAP was made with retrograde ductal infusion of 5% sodium taurocholate solution.ResultsIn SAP and IL-10 group, there were interstitial edema, necrosis, neutrophil infiltration and interstitial hemorrhage of pancreas, more or less. At 6h and 12h after models were made, the pancreatic histopathologic score in IL-10 group (4.00±0.33 and 6.25±0.25) were significantly lower than that in SAP group (6.13±0.35 and 9.50±0.50)(P<0.01). At 6 h after models were made, the serum AMY in IL-10 group was lower than that in SAP group (P<0.05), but at 12 h there were no differences.ConclusionIn earlier period of SAP in rats, IL-10 can lower the serum AMY level, and significantly reduced pancreatic histologic score (edema, inflammation, hemorrhage, and necrosis).