Objective To investigate the feasibility of laparoscopic radical gastrectomy for gastric cancer.Methods Laparoscopic radical gastrectomy was performed in 8 cases from Febrary 2005 to April 2005,including radical distal gastrectomy in 6 cases,radical total gastrectomy in 1 case,and radical proximal gastrectomy in 1 case.Results All the 8 patients underwent laparoscopic radical gastrectomy smoothly and no conversion to open surgery was required.The operation time was 340?62 minutes in radical distal gastrectomy,was 362 minutes in radical proximal gastrectomy,and 423 minutes in radical total gastrectomy.The intraoperative blood loss was 100～250 ml(mean,140 ml) in radical distal gastrectomy,300 ml in radical total gastrectomy,and 170 ml in radical proximal gastrectomy.No blood transfusion was needed.The number of havested lymph nodes was 18～37(mean,23).No surgical-related complications occurred.The time to first flatus was 38～56 hours(mean,42.4 hours),and the time to liquid diet was 2～5 days(mean,2.5 days).All the 8 cases were followed for 12～14 months postoperatively and no recurrence or metastasis was observed.Conclusions Laparoscopic radical gastrectomy is a feasible technique for patients with gastric cancer at early stage or early progressive stage.

Objective: To study the acceptable limitation of acute normovolemic hemodilution(ANHD) and its compensatory mechanisms in non-cardiac surgery. Method: In forty adults ASA classⅠ-Ⅱpatients undergoing non-cardiac surgery under general,anesthetic at normal body temperature ANHD was accomplished by exchanging whole blood for 4％ Gelofusine,The Hemotocrit (Hct) were hemodiluted approximately to 28％ (HD_1) preoperatively. Further hemodilution(HD_2,HD_3) was achieved due to intraoperative blood loss which was replaced by 4％ Gelofusine,Arterial and mixed venous blood gases,Plasma lactic acid(LA) were measured, Hemodynamic variables were determined using the thermodilution technique, Oxygen delivery/consumption (DO_2/VO_2) and oxygen extraction ratio (ERO_2)were calculated using standard formula. Results: (1)During the HD_1 (Hct29.16?1.31％ ),and HD_2 (Hct25.34％?1.58％), DO_2 decreased by 14％ and 20％, ERO_2 increased by 14％ and 25％, cardiac index (CI) increased by 9.9％ and 24％ ,respectively,(P

Objective To objectively quantitative assess the visual quality in patients with myopic foveoschisis (MF) using a double-pass optical quality analysis system (OQASⅡ).Methods Sixty-two subjects participated in this cross-sectional,observational study,who were divided into three groups based on the pathologic conditions including myopic fovcoschisis group (MFG),myopic control group (MCG) and normal control group (NCG).Measurements with OQAS Ⅱ were performed for the modulation transfer function cut off frequency (MTFcut-off),the Strehl ratio (SR) and the objective scatter index (OSI).Visual data were analyzed using ANOVA and Pearson's correlation accompanied by logMAR BCVA and axial length (AL).Results The mean values for MTFcut-off,SRand OSIof MFG,MCGand NCG were 18.18±4.81,0.13± 0.03,3.50±0.44;22.87±2.66,0.14±0.02,2.42±0.29;33.68±4.70,0.23±0.02,1.68±0.20 respectively,and statistical difference were proved except SR between MFG and MCG,or BCVA between MCG and NCG (P＜ 0.05).LogMAR BCVA and AL have negative correlations to MTF cut-off (r =-0.928,-0.658;P＜0.05) and SR (r=-0.577,-0.893;P＜0.05) with high coefficients in MFG.Log MAR BCVA has negative correlations to MTF cut-off and SR (r=-0.659,-0.806;P＜0.05) in MCG.Log MAR BCVA has negative correlations to MTF cut-off and SR (r=-0.606,-0.602;P＜0.05) and positively correlated to OSI (r=0.561,P＜0.05) in NCG.Conclusions The mean value of BCVA,MTF cut-off,SR,OSI of myopic foveoschisis patients were lower than those myopic patients without foveoschisis and normal people.there exists a significant negative correlation between Log MAR BCVA,AL to MTF cut-off and SR.Compared with myopic and normal subjects,myopic foveoschisis have lower BCVA,MTF cut off,SR but higher OSI.

Objective To evaluate the outcome of endovascular treatment with coarctation of aorta (CoA).Methods Between November 2007 and March 2012,11 patients,including 8 male and 3 female from 17 to 43 years old,with native CoA who were diagnosed by computed tomography angiography accepted the endovascular treatment.The arterial pressure difference between the femoral artery and the narrow segment was measured during the operation,and the stent was released by expanding the balloon.Results Endovascular treatment were successful in all cases without any major adverse events.Significant reduction of systohc blood pressure was observed from (64.09 ± 7.81) mmHg (1 mmHg =0.133 kPa) to (11.18 ± 3.37) mmHg.The mean CoA diameter pre-stent (4.000 ± 0.775) mm,post-stent (17.090 ± 2.427) mm.1 patient associated with patent ductus arteriosis had no persistent left-to-right shunt after covered stent implantation.The follow up range was 33 months.1 patient in simple balloon was retreatment by surgical because of restenosis.And no retraction was observed of 10 patients after stent implantation.Conclusion The early and midterm result of endovascular treatment with CoA is satisfactory,and longer follow-up is needed for its longterm outcomes.

Objective To summarize the experience in surgical treatment of Ebstein anomaly,and evaluate the therapeutic effect.Methods Thirty-five patients of Ebstein anomaly were treated by operation.New York heart association(NYHA)heart function classⅠ?was in 11 cases,classⅡ?was in 14 cases,class III-Ⅳ?was in 10 cases.The cue of echocardiogram about tricuspid valve regurgitation in 24 cases were severe,5 cases were moderate and 6 cases were mild.Two patients accepted tricuspid valve replacement.Thirty-three cases were accepted tricuspid valve repair and right ventricle folded,in which 2 cases accepted Danielson method,and 31 cases accepted Carpentier method,among them,9 cases accepted one and a half ventricular repair.Associated heart anomaly was corrected at the same time.Results One patient died.There were 2 cases with third degree atrioventricular block after tricuspid valve replacement,2 cases with low cardiac output syndrome and 2 cases with atrial fibrillation combined premature ventricular contraction.The heart was lower by chest X-ray and echocardiogram examination,tricuspid valve regurgitation in 22 cases were disappeared,9 cases were mild,3 cases were moderate.All patients were followed up from 1 month to 7years,tricuspid valve regurgitation in 21 cases were disappeared,12 cases were mild,heart function were class Ⅰ-Ⅱ.Because of heart function aggravation,1 patient was operated again 3 years after operation.Condusions Ebstein anomaly is a rare congenital heart disease,Carpentier method tricuspid valve repair can decrease regurgitation obviously and protect right ventricular function.One and a half ventricular repair should be adopted according to the function of tricuspid valve and right ventricle.

Objective To investigate the prognostic factors in patients with esophygectomy after oncologic esophagectomy by analyzing the long-term survival .Methods 104 patients underwent esophagectomy for cancer were retrospectively reviewed from 2007 to 2008 in this hospital ,and the investigation was carried on in questionnaire ,following up 3 years .Various ways ,such as Life Tables ,Kaplan-Meier and Cox regression analysis ,were used to evaluate long-term survival .Results (1)A total of 61 patients died in 3 years .The median survival time was 35 .23 months .The cumulative survival rates at 1 ,2 and 3 year after surgery were 87% , 62% ,and 48% respectively ,and death hazard in 24th month after surgery was the highest .(2)In univariate analysis :drinking ,pres-ence of lymph node metastasis and TNM staging were significant factors that influenced long-term survival .(3)Multivariate analy-sis :lymph node(RR = 2 .399 ,P= 0 .002 ,95% CI :1 .385 to 4 .154) ,drinking(RR = 0 .470 ,P = 0 .008 ,95% CI :0 .269 to 0 .882) ,di-gestive tract construction(RR= 1 .910 ,P= 0 .018 ,95% CI :1 .118 to 3 .262) were the isolated factor influencing the prognosis .Con-clusion Patients after oncologic esophagectomy generally suffer poor survival .The presence of lymph node metastasis ,drinking and different methods of reconstraction are statistically significant factors influencing long-term survival .

Objective To investigate the ipratropium bromide combined with Ambroxol Aerosol Inhalation on preventive effect of pulmonary complications after thoracotomy. Method 115 patients undergoing thoracic operation were randomly divided into 2 groups, 2 groups were given routine nursing before operation, the control group on the basis of Mucosolvan atomization inhalation, the observation group in the conventional nursing combined with ipratropium bromide and atomization inhalation of ambroxol. Results the curative effect of therapeutic group was signiifcantly better than the control group (P<0.05); lung infection in the observation group was significantly lower than that of the control group (P<0.05). Conclusion ipratropium bromide and Mucosolvan aerosol inhalation signiifcantly on the prevention of pulmonary complications after thoracotomy and effect, will help the patient restore.

Objective To explore the appropriately operative chance , method, and perioperative management of coronary arterybypass grafting (CABG) in the patients with severe left main artery (LMA) stenosis with three-vessel-disease.Methods A total of296 patients with severe LMA stenosis with three-vessel-disease who underwent CABG surgery was analyzed retrospectively from 2003through 2013.Of them, 276 patients underwent conventional coronary artery bypass surgery on pump ( CCABG)and 20 patients underwentoff-pump CABG( OPCAB); 172 Patients was over 60 years old (58.1%)and 246 patients (83.10%) had concomitant diseasesincluding valve lesion, hypertension, diabetes, myocardial infarction, left ventricular aneurysm with septal defect , stroke, renal failure,and cancer.Left internal mammary artery use was in 281 patients (95.1%); and 32 patients were implanted intra-aortic ballonpump(IABP) perioperatively.Results There were 7 cases(2.36 %) death of postoperative low cardiac output , ventricular fibrillation,cerebral infarction, renal failure, and multiple organ failure, respectively.Postoperative complications were low cardiac output ,respiratory failure , ventricular fibrillation, cereboembolism, cardiac tampomade, renal failure, stroke, and multiple organ failure.Afterfollow-up 2 to 84 months, there was 3 death in which 2 death of cardiac factors.Conclusions CCABG was a safe and effectivemethod in patients with severe LMA stenosis with severe three -vessel-disease.Preoperative insertion of IABP can certainly avoid the po -tential operative risk factor and significantly decrease the mortality and morbidity .

Objective To evaluate the surgical treatment for renal cell carcinoma with inferior vena cava tumor thrombus and the clinical significance of multidisciplinary treatment. Methods Two cases of renal cell carcinoma with inferior vena cava thrombus diagnosed by Doppler ultrasonography and CT were included in this retrospective analysis. The tumor thrombus was in level Ⅱ in one case and in level Ⅳ in the other. Coagulation test and complete blood count were done again before surgery. Human albumin, fibrinogen, prothrombin complex, plasma, platelet, UW and irrigating solution were prepared before the operation.Under general anesthesia, surgery was performed using abdomen inverted Y shaped incision. Right radical nephrectomy was finished by the urological surgeon; the vena cava was completely dissected from the renal vein level to the secondary porta of the liver by the hepatobiliary surgeon, the vena cava and the surrounding branch vein were blocked in the upper and lower vena cava tumor thrombus; tumor thrombus was removed completely by the vascular surgeon. In one case (patient with level Ⅳ thrombus ) where the tumour thrombus invaded the wall of the vena cava, the thrombus was found to be extending to the cavo-atrial junction but not into the right atrium. The left femoral venous-right atrial bypass was established, the cardiopulmonary bypass lasted for 241 mia, and the aorta was blocked for 18 min. Salvage autotransfusion was used during surgery, and the hepatic vein of the secondary liver porta was anastomosed to artificial vascular graft.The data for surgical indication, operation time, operative blood loss and postoperative hospital stay were analyzed. Results Right radical nephrectomy and inferior vena cava thrombectomy were performed successfully, and the two patients were discharged on the 15th and 27th day after surgery, respectively. The two patients were followed up for 1 and 16 months after surgery, respectively, and both survived without local recurrence and distant metastasis. Conclusion Radical nephrectomy and inferior vena cava thrombectomy is the preferred method for patients without metastasis, and multidisciplinary cooperation could shorten the operation time, reduce the tumor recurrence and increase the survival rate of patients.

OBJECTIVETo investigate the effect of 1,25-dihydroxyvitamin D(3) and 5-fluorouracil, either alone or in combination, on the expression of IGFBP-3 in human esophageal carcinoma 109 cell xenograft in nude mice.

METHODSIn vitro cultured esophageal carcinoma Eca-109 cells were inoculated subcutaneously in BALB/c mice. The tumor-bearing mice were randomly divided into control group (A), 1,25-dihydroxyvitamin D(3) group (B), 5-fluorouracil group (C), and 1,25-dihydroxyvitamin D(3) plus 5-fluorouracil group (D). 1,25-dihydroxyvitamin D(3) and 5-fluorouracil were administered at the doses of 2.5 ug/kg and 25 mg/kg via intraperitoneal injections, respectively, and the mice in the control group received saline injection only. The tumor growth was observed and the expression of IGFBP-3 in the tumor xenograft was detected using immunohistochemistry. An automatic biochemistry analyzer was used to determine serum calcium levels, and Von Kossa staining was utilized for observation of calcium deposition in the kidneys.

RESULTSCompared with that in group A, the xenograft in groups B, C, and D all showed a lowered growth rate with a smaller tumor volume, and presented with stronger IGFBP-3 positivity and significantly higher levels of IGFBP-3 protein expression (P<0.05). In group D, the protein expression of IGFBP-3 was significantly increased compared with that in groups B and C (P<0.05). Compared with that in group A, serum calcium level was slightly increased in groups B, C, and D, , but no obvious calcium deposition was found in the kidney tissue sections.

CONCLUSIONBoth 1,25-dihydroxyvitamin D(3) and 5-fluorouracil can inhibit the growth of the tumor xenograft in nude mice, and their combination is more effective. This effect is probably associated with increased protein expression of IGFBP-3 in the xenograft tumor. No calcium deposition occurs in the kidney tissue of the tumor-bearing mice.

Animals ; Cell Line, Tumor ; Fluorouracil ; pharmacology ; Humans ; Insulin-Like Growth Factor Binding Protein 3 ; metabolism ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Vitamin D ; analogs & derivatives ; pharmacology ; Xenograft Model Antitumor Assays