Objective To compare the perioperative efficacy berween laparoscopic and open gastrectomy for the treatment of advanced gastric cancer.Methods Literatures on the comparison of the efficacy between laparoscopic and open gastrectomy were searched in the PubMed,EMBASE,the Cochrane Library,CNKI and CMCC.Articles were selected according to the inclusion criteria,and data were extracted from these trials by 2 reviewers independently and analyzed by Review Manager 5.0 software.The heterogeneity of the literatures was analyzed using the I2 test.Data were integrated by fixed or random effect model.The count data were presented by odds ratio (OR) and 95％ confidence interval (95％ CI).Results Twelve literatures were retrieved,including 1 published in Chinese and 11 in English,1 randomized controlled study and 11 retrospective non-randomized controlled studies.A total of 2 079 cases of advanced gastric cancer were included in this study,including 882 in the laparoscopic gastrectomy group and 1 197 in the open gastrectomy group.There were significant differences in the operation time,intraoperative blood loss,time to first flatus,time to first diet and duration of hospital stay between the 2 groups (WMD =41.33,-106.00,-0.55,-0.76,-2.62,95％ CI:25.44-57.21,-120.71--91.29,-0.80--0.29,-1.29--0.23,-4.05--1.18,P ＜ 0.05).There were no significant difference in the number of lymph nodes harvested and incidence of complications between the 2 groups (WMD =0.22,OR =0.82,95％CI:-1.48-1.93,0.62-1.08,P ＞ 0.05).Conclusion Laparoscopic gastrectomy can be safely performed for the treatment of advanced gastric cancer,and it brings benefits to patients in perioperative period than open gastrectomy.

The treatment of diabetic nephropathy (DN) currently extent to control the occurrence and development of it and delay renal failure on a certain stage.However,the effect is not satisfactory.Some traditional hypoglycemic,antihypertensive,lipid and anticoagulant drugs in DN patients with renal protective effect.And some have been in clinical use of drugs such as vitamin D,aldose reductase inhibitors,tripterygium wilfordii glycoside has proved to have the effect of the slow progress in DN,could be used more widely.For new drugs,such as renin inhibitors,phosphodiesterase inhibitors and methyl bartholomew sauron,while partialy was confirmed in a role in the treatment of DN,but before the clinical promotion,its effectiveness and safety still need further study to verify.

Objective: : To investigate whether development of the sph e noid sinus affect the surgical approach via saddle area. Methods: The pneumatization of sphenoid sinus of 50 cadaver heads was studied through t hinner CT scanning of coronal, sagittal and axial position. The sphenoid sinus w as classified according to the degree of pneumatization of sphenoid sinus toward s sphenoid bone, small wing of sphenoid bone and epippium. Results: There were 4% conchal, 18% pre-sellar, 18% semi-sellar, 14% sellar, 46% sellar -occipital in 100 sphenoid sinus cases. The transversal diameter of left and ri ght was 18.48 mm and 17.58 mm; The sagittal diameter of left and right was 2 2.20 mm and 20.82 mm, The vertical diameter of left and right was 21.02 mm and 2 0.38 mm. The distance between centre track and the later wall of sphenoid sinus was 14.78 mm in left side and 15.18 mm in right side. Conclusion: Thinner CT scanning with coronal and sagittal position can clearly show pneum atization of sphenoid sinus on both sides. Different pneumatization of sphenoid sinus provide anatomical basis for choosing operation approach.

Objective To evaluate the clinical effect of Wy 10 whitening combined with enamel microabrasion on bleaching dental fluorosis.Methods Forty patients with dental fluorosis were in-cluded and divided into two groups (20 each):group A was treated with Wy 10 whitening and enamel microabrasion,and group B only with Wy 10 whitening.Efficacy was measured according to the Vita classical shade guide before and after treatment.Sensitivity between groups was also tested.Results The effective rate of group A was significantly higher than that of group B (x2 =5.096,P＜0.05).The sensitive rates were 20.0％ (4/20) and 15.0％ (3/20) in group A and group B,respectively.No significant difference was found between the two groups in sensitivity (P＞0.05).Conclusions Wy 10 whitening combined with enamel microabrasion is an effective and safe method for bleaching dental fluorosis.

Objective To investigate the relationship between sonic hedgehog(SHH)signaling pathway and chronic pancreatitis.Methods Thirty Wistar rats were randomly divided into the model group,experimental control group and blank control group,and there were 10 rats in each group.Trinitrobenzene sulfonic acid was infused into the pancreatic duct of the rats to induce pancreatitis in the model group.The pancreatic duct of the rats in the experimental control group were infused with 0.9％ sodium chloride solution.No treatment was performed on rats in the blank control group.The serum levels of bilirubin and amylase of the 3 groups were determined,and the histopathological alterations were studied.Expressions of patched-1(PTCH-1),smoothened (SMO)and SHH were detected by immunohistochemistry.All data were analyzed using the analysis of variance or Student's t test.Results The levels of total bilirubin(TBil)in the model group,experimental control group and blank control group from day 1 to day 35 were(3.17 ±0.21)μmol/L-(9.28 ±2.15)μmol/L,(3.44 ±0.54)μmol/L-(3.76 ± 0.15)μmol/L,(2.45 ± 0.32)μmol/L-(3.27 ± 1.43)μmol/L,respectively.The levels of amylase in the model group,experimental control group and blank control group were(1124 ± 143)U/L-(1522 ± 169)U/L,(1123 ± 104)U/L-(1007 ± 141)U/L,(1014 ± 115)U/L-(1013 ± 142)U/L,respectively.Compared with the experimental group and the blank control group,the serum levels of TBil and amylase in the model group were increased significantly from day 7 to day 35(F =14.81,16.27,18.13,11.49,17.91;11.54,10.24,12.64,21.11,15.38,P ＜ 0.05),and fibrotic proliferation of pancreatic tissues were found at day 35;the expressions of PTCH-1,SMO and SHH in the pancreatic tissue was increased significantly in the model group.Conclusion SHH signaling pathway is activated in the tissue of pancreatitis in rats,it might play an important role in the genesis of pancreatitis.

OBJECTIVETo evaluate the clinical outcomes and complications of Triple-Endobutton plates in treating Tossy type III acromioclavicular joint dislocation.

METHODSFrom January 2011 to January 2013,45 patients with Tossy type III acromioclavicular joint dislocation were treated with Triple-Endobutton plates. There were 35 males and 10 females with an average age of 30.5 (ranged from 19 to 60) years old. At the final follow-up, VAS, DASH, Constant-Murley criterion were used to evaluate shoulder function.

RESULTSAll patients were followed up from 15 to 36 months. No neurovascular injury, wound infection and stress fractures were found,but 3 patients had a re-dislocation. At the final follow-up,the mean VAS score was decreased from (5.7±1.6) preoperatively to postoperative (0.2±0.1); DASH score was significantly decreased from (19.6±4.3) preoperatively to (0.3±0.1) postoperatively; Constant-Murley score was improved from (34.4±4.3) before operation to (94.8± 3.5) after operation.

CONCLUSIONClinical outcomes of treating Tossy type III acromioclavicular joint dislocation with Triple-Endobutton plates is satisfactory. However, re-dislocation is still the most common complication. Careful perioperative management is an important factor in preventing re-dislocation.

Acromioclavicular Joint ; injuries ; surgery ; Adult ; Bone Plates ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Shoulder Dislocation ; surgery ; Treatment Outcome ; Young Adult

Aged ; Anion Exchange Protein 1, Erythrocyte ; metabolism ; Brenner Tumor ; metabolism ; pathology ; surgery ; Carcinoma, Transitional Cell ; metabolism ; pathology ; surgery ; Chromogranin A ; metabolism ; Cystectomy ; Female ; Humans ; Hysterectomy ; Membrane Proteins ; metabolism ; Neoplasms, Multiple Primary ; metabolism ; pathology ; surgery ; Ovarian Neoplasms ; metabolism ; pathology ; surgery ; Urinary Bladder Neoplasms ; metabolism ; pathology ; surgery

Objective:To investigate the value of proton magnetic resonance spectroscopy (1H-MRS) on the diagnosis of SCA3/MJD,and to calculate the correlation between 1H-MRS ratio and the clinical score.Methods:Sixteen patients with SCA3/MJD and 19 healthy volunteers were scanned with 1H-MRS.The data of N-acetyl aspartate,creatine,choline-containing compounds,myoinositol,NAA/Cr,Cho/Cr,and mI/Cr ratio were collected,which were grouped for comparative study.The onset patients with SCA3/MJD were evaluated with the International Cooperative Ataxia Rating Scale and Scale for the Assessment and Rating of Ataxia,the correlation between NAA/Cr,Cho/Cr or mI/Cr ratio and the clinical score was calculated.Results:The NAA/Cr in the pons and cerebellar dentate nucleus from the onset patients with SCA3/MJD was significantly reduced compared to that in the normal control group.The NAA/Cr in the cerebellar dentate nucleus of onset patients with SCA3/MJD was obviously correlated with ICARS.Conclusion:SCA3/MJD lesions are mainly located in the cerebellum and brainstem,where gray and white mater are also involved.The cerebellar dentate nucleus may be the earliest involved area.There is a correlation between the ICARS and the cerebellar lesion degree.The ICARS reflects the severity of clinical manifestations.1H-MRS is useful in the diagnosis of SCA3/MJD.

Objective To explore the value of bedside ultrasound used by ICU doctor in the rapid diagnosis of traumatic abdominal,and to evaluate the advantage of bedside ultrasound in the treatment decision.Methods 60 patients with traumatic abdominal blood in our hospital admitted to the ICU were selected.All patients were checked through bedside ultrasonography by physicians with professional training of ICU,bedside ultrasound and abdominal CT and abdominal flat piece of traumatic hematocelia,and compared the diagnosis of the time of the bedside ultrasound,abdominal CT and abdominal X -ray and ultrasound physician ultrasound examination.Results The difference of abdominal blood detection rate between bedside ultrasonography and abdominal computed tomo-graphy (CT)had no statistical significance (P >0.05);bedside ultrasonography of abdominal blood detection rate was higher than plain film of the abdomen,the difference was statistically significant (χ2 =73.346,P <0.01);bed-side ultrasound received a preliminary diagnosis of time -consuming (4.37 ±2.1)min was significantly lower than that of the examination of ultrasound physicians (13.86 ±5.6)min,abdominal CT (22.13 ±6.9)min and abdominal plain film (28.19 ±7.32)min,the differences were statistically significant (t =3.947,14.607,21.139,26.338,all P <0.01 ).Conclusion By the professional training of ICU physicians for bedside ultrasound traumatic blood abdominal patients can make a more accurate diagnosis,time -shorten,more accord with the requirement of treating critically ill patients in ICU,which has important clinical value for trauma abdominal blood in early rapid diagnosis and treatment.