BACKGROUND: Cholinergic nervous system has a site which is affected by both blineurine and nerve growth factor receptor tyrosine kinase A (NGF-RTK-A). Whether cholinergic injury can affect the changes of tyrosine kinase A (TrKA) is significant to the application of nerve growth factor (NGF) to interfere cognitive disorder disease.OBJECTIVE: To observe the expressive variety of TrKA in different cerebral regions of rats with bilateral fimbria/fornix transection, and comprehend the effect of fimbria/fornix transection on nerve growth factor receptor system.DESIGN: A completely randomized and controlled study on the basis of animals.SETTING: Institute of Cerebrovascular Disease, Affiliated Hospital of Qingdao University Medical College.MATERIALS: The experiment was completed in the Institute of Cerebrovascular Disease, Affiliated Hospital of Qingdao University Medical College from March to December 2003. Totally 14 male Wistar rats were randomly divided into control group and model group with 7 in each group.METHODS: The bilateral fimbria/fornix transection was performed on rats in the model group, but rats in the control group were treated with the same methods except fimbria/fornix transection. Twenty eight days after operation, rats in the two groups were killed under anesthesia to take out brain tissues to stain with immunohistochemical staining.MAIN OUTCOME MEASURES: The number of positive TrKA cells in the hippocammpal CA1, cortex, amygdala and Meynert of the basal forebrain of rats in both groups.RESULTS: Totally 14 rats entered the final analysis. The numbers of positive TrKA cells in the hippocammpal CA1, cortex, amygdala and Meynert of the basal forebrain of rats in the model group were obviously smaller than those in the control group [(18.91 ±6.27), (15.17±5.23),(18.71±9.05), (8.03±2.33); (54.77±11.84), (59.69±10.40), (49.23±15.84),(21.49±15.54), t=4.17-10.00; P ＜ 0.01].CONCLUSION: The expression of TrkA positive neurons is decreased in many sections of the brain in the rats with fimbria/fornix transection.Possibly it is the cause leading to the cognitive disorder and senile dementia.

0.05). Conclusion The technique of PEP-MN-PCR from single-cell for simultaneous detection of HLA-A, B, DR types were efficient and accurate. It was possible to apply the techniques of PEP-MN-PCR to detect HLA-A, B, DR typing for preimplantational diagnosis, preliminary selection of HLA matching embryos and the patient sibling who needs cord blood stem cell transplantation.

In developing excellent courses on pediatrics,it is proved that improving teaching content and enhancing the building of the teaching staff,adopting effective theoretical and practical teaching and building a sound and guaranteed monitoring system of the teaching quality will have a better teaching effect.

0.05 ). It is indicated that both eight extra-meridians acupuncture therapy and Jin Sanzhen therapy can improve intelligence index of VD, and the possible mechanism is related to the regulation of central nervous system function, elimination of SOD and reduction of NE and NO secretion.

Objective. To evaluate the respective value of dual-phase helical CT arterial portography (CTAP) and conventional angiography in preoperative predicting resectability of pancreatic ductal adenocarcinoma. Subjects and methods. Tumor resectability was prospectively evaluated in 54 patients with pathologically proven pancreatic ductal adenocarcinoma who later underwent surgery. Both dual-phase helical CT scanning and selective angiography were obtained in each patient preoperatively. For optimal enhancement of pancreas and major peripancreatic vessels, two catheters connected to an automatic injector via a Y-shaped tube were placed after selective angiography,one in celiac trunk, the other in superior mesenteric artery. Then the patient underwent dual-phase helical CTAP of pancreas and liver. The criteria of irresectability for CTAP include: tumor diameter≥ 5 cm,extrapancreatic invasion, distant metastases and vascular involvement(occlusion, stenosis or semicircular encasement of superior mesenteric artery, hepatic artery, splenic artery, celiac axis; portal vein, superior mesenteric vein or splenic vein). The results of both modalities were correlated with findings from surgery or pathology. Results. Thirty-eight of 54 patients had nonresectable disease. In prediction the irresectability, sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy were 94.7％ ,100％ ,100％ ,88.9％ ,96.3％ respectively for helical CTAP and 63.2％ ,93.8％ ,96.0％ ,51.7％ ,72.2％ respectively for selective angiography. In assessing vascular involvements, dual-phase helical CTAP was also superior to selective angiography. Conclusion. Dual-phase helical CTAP is superior to angiography in assessing resectability of pancreatic ductal adenocarcinoma. The combination of the two modalities may further improve overall accuracy of assessment.

Background and Aims:In recent years,function-preserving proximal gastrectomy with reconstruction has become an important approach for the treatment of early gastric cancer.However,there is no standardized surgical technique,and the short-and long-term outcomes of various new procedures remain unclear.This study was performed to evaluate the safety and short-term efficacy of laparoscopic proximal gastrectomy plus esophagogastrostomy with single-flap technique for early gastric cancer. Methods:The clinical data and follow-up records of 7 patients who underwent laparoscopic proximal gastrectomy with single-flap esophagogastrostomy in the First Affiliated Hospital of Soochow University between December 2021 and December 2022 were retrospectively analyzed.Perioperative safety,postoperative reflux,anastomotic stricture at 6 months,and related nutritional parameters were assessed.The nutrition-related indicators of this group of patients were compared with those of 11 patients who underwent total gastrectomy with Roux-en-Y anastomosis for early gastric cancer during the same period. Results:All 7 patients successfully underwent laparoscopic proximal gastrectomy with single-flap esophagogastrostomy.The average operative time was(212.9±20.6)min,with anastomosis taking(54.7±10.5)min;the mean intraoperative blood loss was(28.6±9.0)mL.No Clavien-Dindo grade Ⅲ or higher complications were observed during hospitalization.None of the patients experienced significant reflux symptoms,although 1 patient developed anastomotic stricture 3 months after operation.There were no statistically significant differences in hemoglobin concentration,albumin level,prealbumin level,total protein concentration,and lymphocyte count between preoperative and 6-month postoperative measurements(all P＞0.05).Compared to patients who underwent total gastrectomy with Roux-en-Y anastomosis,those who had the proximal gastrectomy with single-flap esophagogastrostomy showed a lower percentage decrease in body weight,skeletal muscle area at the third lumbar vertebra(L3),visceral fat area at L3,and hemoglobin concentration at 1 year after operation(all P＜0.05). Conclusion:Laparoscopic proximal gastrectomy with single-flap esophagogastrostomy is a safe and feasible surgical option for early gastric cancer,offering effective anti-reflux outcomes while minimizing the risk of anastomotic stricture.This procedure has a lower impact on postoperative nutritional status compared to total gastrectomy.

Objective:To investigate the impact of neuroendocrine function on postoperative complications and nutritional status in gastric cancer patients.Methods:Clinical data of 102 gastric cancer patients who underwent radical gastrectomy at the Department of General Surgery, First Affiliated Hospital of Soochow University, from Aug 2021 to Jun 2022 were retrospectively analyzed.Results:Among the 102 gastric cancer patients, 18 (17.6%) suffered from postoperative complications. Univariate analysis indicated that age, BMI, preoperative plasma ghrelin concentration, and preoperative hemoglobin levels were associated with early postoperative complications following radical gastrectomy. Multivariate analysis revealed that age, BMI, and preoperative plasma ghrelin concentration ( P<0.05) were independent risk factors for postoperative complications in gastric cancer patients. Differential analysis of ghrelin concentration demonstrated correlations with hemoglobin levels, skeletal muscle index, albumin, and creatinine, and a positive correlation with the skeletal muscle index. Conclusions:Reduced preoperative neuroendocrine hormone ghrelin concentration is an independent risk factor for postoperative complications in gastric cancer patients. Ghrelin concentration is correlated with the skeletal muscle index in these patients.

BACKGROUND: Hemorrhoids are one of the most common conditions that lead to surgery, and until now surgical hemorrhoidectomy has been the major effective treatment. Post-operative pain from hemorrhoidectomy has been experienced by thousands of patients and remains a major inconvenience of the operation. OBJECTIVE: This study evaluates the clinical efficacy of the pestle needle therapy, an acupoint stimulation method, for relief of post-hemorrhoidectomy pain. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This was a single-center, patient-assessor-blinded and randomized controlled trial with 154 patients receiving Milligan hemorrhoidectomy surgery. Eligible patients were randomly assigned to either a treatment group or a control group at a ratio of 1:1. The treatment group received the pestle needle therapy, with manual stimulation at Yaoshu (DU2), Mingmen (DU4), Changqiang (DU1), Chengshan (BL57), Erbai (EX-UE2) and the perianal points (1, 3, 5, 7, 9, and 11o'clock around the lesion); while the control group received a sham treatment with very light pressure. Three sessions of treatment were performed at 30 min, 4 h and 12 h after the surgery, and each lasted for 15 min. MAIN OUTCOME MEASURES: The primary outcome was post-operative pain measured with the visual analogue scale (VAS) at 12 h after surgery. The secondary outcomes included the VAS scores measured at 0.5, 2, 4, 6, 8, 24 and 48 h after surgery, the analgesic dose, the time and the VAS score of the patients' first defecation after surgery, as well as the Hamilton Rating Scale for Anxiety (HAMA) evaluated before discharge. RESULTS: The mean pain score of the treatment group was significantly lower than that of the control group (3.10 ± 1.27 vs 4.82 ± 1.29; P < 0.001) at 12 h after surgery. Compared with the control group, patients in the treatment group needed a smaller dose of analgesic within the first 24 hours after surgery (P = 0.002); and their HAMA scores before discharge were lower (4.07 ± 2.40 vs 5.10 ± 2.45, P = 0.009). Compared to the treatment group, patients in the control group had a greater time to the first defecation after surgery ([52.34 ± 15.72] h vs [27.08 ± 13.68] h; P < 0.001), but there was no difference in their VAS scores at the first defecation (P = 0.092). CONCLUSION The pestle needle therapy was effective for relieving pain, reducing anxiety and improving bowel function after hemorrhoidectomy, and it is worthy of clinical application.