Objective To study the expression of CD105 and CD31 and relationship with the biological behavior in gastric cancer tissue. Methods Immunochemical method was adopted to detect the microvessel density(MVD) of CD105 and CD31 in 63 cases of gastric cancer and 20 cases of chronic gastritis. Results The mean value of CD105-MVD and CD31-MVD were respectively 40.97?15.67 and 25.87?10.54 in gastric cancer, which was higher than those in chronic gastritis, the difference was significant (P 0.05). Conclusion CD105 was better than CD31 in staining gastric cancer tissue. Expression of CD105 was closely related to the biological behavior of gastric cancer; detection of CD105 was recommended to precisely assess tumor stage, direct cancer therapy and predict prognosis.

Objective To study the feasibility and safety of laparoscopy-assisted D2 radical gastrectomy for advanced gastric cancer. Methods From June, 2006 to July 2009, 11 patients with gastric cancer received laparoscopy-assisted gastrectomy for gastric cancer. According to UICC TNM classification of gastric cancer, 6 cases were with Stage Ⅱ, 2 cases with Stage Ⅲ A, 1 case with Stage Ⅲ B, and 2 cases with Stage Ⅳ. Under the assistance of laparoscope, dissociation of the stomach and lymph nodes clearance were performed first; then gastrectomy was performed on a 6 cm incision, samples were collected, and alimentary tract was inoculated. Results Among the 11 cases, 2 cases were performed radical total gastrectomy, 1 case was performed proximal partial gastrectomy, 7 cases were performed distal partial gastrectomy and 1 case with open surgery. The mean operation time: 350 min for total gastrectomy, 320 min for proximal partial gastrectom,266 min for distal partial gastrectomy. The mean number of harvested lymph nodes was 21.3 (11-38), incisal edge was 5.6 (4.0-9.6) cm. The mean time was 72 (36-110) hrs for gastrointestinal function recovery, 59 (26-86) hrs for patients to take general activity, and 76 (48-116) hrs to take liquid food. No complication was observed. Conclusion Laparoscopy-assisted D2 radical gastrectomy for advanced gastric cancer is safe and feasible. Compared with open surgery, it also has the advantages of small wound and fast recovery.

Objective To investigate neutrophil lymphocyte ratio (NLR) in early-stage diabetic nephropathy and its clinic significance. Methods The 145 subjects were divided into two groups:the healthy control group (n=54) and early stage diabetic nephropathy group (n=91). The numbers of neutrophils (N) and lymphocytes (L) as well as the NLR values of peripheral blood and other biochemistry index were examined. Factors of early stage diabetic nephropathy were calculated us?ing variance and logistic regression analysis. Results Creatinine(Cr), total cholesterol(TC), triglyceride(TG), LDL-C, neu?trophils number and CRP in DN group were significantly higher than those of the control group and lymphocytes numbers of DN group were significantly lower than that of the control group (P<0.05 respectively);NLR values were significantly higher in diabetic nephropathy group compared with those of healthy control group(2.52±0.57 vs 1.82±0.60,t=6.997, P<0.01). Lo?gistic regression analysis showed that the risk factors of DN include NLR, TG and total cholesterol. NLR ( P <0.001, OR=8.951, OR 95%CI:3.595-22.287) was significantly associated with DN. Conclusion High NLR values may be a predic?tive and reliable marker ofearly-stage DN.

Objective To investigate the impact of hepatitis B virus (HBV) infection on semen parameters,sperm DNA integrity,acrosin activity and sperm-nucleoprotein transition.Methods Semen samples from 527 subjects including 273 hepatitis B surface antigen (HBsAg) positive and 254 HBsAg negative,who sought medical attention and received in-vitro feritilization in reproductive medicine center of First Hospital of Wenzhou Medical University from Jan 2011 to Oct 2012 were collected.Semen parameters,sperm DNA fragmentation index (DFI),sperm-nucleoprotein transition and acrosin activity of both HBsAg-positive and HBsAg-negative subjects were analyzed.Results Semen parameters of both groups were within the normal range,but sperm concentration and percentage of forward moving sperms of HBsAg positive group were significantly lower than those of HBsAg negative group (P=0.000),while percentage of static sperms of HBsAg positive group were significantly higher than that of HBsAg negative group (P =0.000).DFI in HBsAg positive and negative group were (17.85 ± 0.70) ％ and (11.85 ± 0.50) ％,respectively,which was significantly different (t=6.951,P=0.000).Percentage of sperms with normal morphology in both groups were within the normal range,but sperms with neck and tail deformity in the HBsAg positive group was significantly higer than those in HBsAg negative group (all P＜0.05).Acrosin activity of sperms in HBsAg positive group was significantly lower than that in HBsAg negative group (t=3.756,P=0.000).Linear regression analysis indicated that serum HBsAg level was reversely correlated with sperm concentration (r=-0.140,P =0.021),but positively correlated to DFI (r =0.151,P =0.014).Conclusions HBV infection not only affects the routine semen parameters and sperm morphology,but also compromises sperm function including impaired DFI and acrosin activity.However,the impact of anti-HBV agents on sperm quality and male fertility requires further research.

Objective To investigate the feasibility and safety of delta-shaped anastomosis in totally laparoscopic distal gastrectomy digestive tract reconstruction of gastric cancer. Methods Clinical data of 26 patients with distal gastric cancer who received total laparoscopic distal gastrectomy with delta-shaped anastomosis from August 2013 to December 2014 were retrospectively analyzed. Results A total of 26 patients were successfully performed by laparoscopic distal gastrectomy with delta-shaped anastomosis. The operative time and delta-shaped anastomosis time was (186 ±28) min and (30 ±24) min respectively. The lengths of upper and lower segment of resection from gastric cancer were (4.9±1.2) cm and (3.5±1.5) cm respectively. Blood loss was (67±39) ml and the number of dissected lymph nodes was (27±11) for every patient. First time to ground activities, first flatus, time to fluid diet and hospital stay were respectively (1.7±0.8) d, (3.5±1.3) d, (4.2±1.6) d and (12±4 ) d. Pathological results showed upper and lower segment of resection cancers were not found. Only 1 patient had gastric small curved stump fistula and recovered after conservative treatment. There were no complications related to the anastomosis in all patients. Conclusion The delta-shaped anastomosis is safe and feasible for totally laparoscopic distal gastrectomy digestive tract reconstruction of gastric cancer with satisfactory short-term efficacy.

Objective To investigate the application value of vessel-guided lymph node dissection (LND) in the laparoscopic distal gastrectomy (D2) of distal gastric cancer.Methods The retrospective crosssectional study was conducted.The clinicopathological data of 157 patients who underwent laparoscopic distal gastrectomy (D2) of distal gastric cancer in the Affiliated Tumor Hospital of Shanxi Medical University from October 2012 to July 2015 were collected.Patients used vessel-guided LND that was divided into 4 steps:middle colic vessel-guided LND in the upper pyloric region,gastroduodenal artery-guided LND in the lower pyloric region,common hepatic artery-guided LND in the right upper margin of pancreas and splenic artery-guided LND in the left upper margin of pancreas.Observation indicators:(1) surgical and intraoperative situations,(2) postoperative pathological results,(3) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative 3-year survival rate up to June 2017.Measurement data with normal distribution were represented as xes.The survival rate was calculated using the Kaplan-Meier method.Results (1) Surgical and intraoperative situations:157 patients underwent successful laparoscopic distal gastrectomy (D2) of distal gastric cancer.Operation time,LND time,volume of intraoperative blood loss,time for initial out-of-bed activity,time to initial anal exsufflation and time of postoperative abdominal drainage-tube removal were (178± 38) minutes,(61 ± 27) minutes,(87 ± 40) mL,(1.2± 0.4) days,(2.8 ± 1.3) days and (7.5 ± 2.6) days,respectively.Of 157 patients,10 with postoperative complications were improved by conservative treatment,including 5 with intestinal obstruction,3 with anastomotic fistula and 2 dying of pulmonary infection;other patients didn't have complications.Duration of hospital stay of 157 patients was (9±3)days.(2) Postoperative pathological results:total number of LND,numbers of LND in the lower pyloric region and in the upper margin of pancreas were 34.6±11.0,4.8±2.1 and 12.3±4.7,respectively.TNM staging:26,33,18,24,37 and 19 patients were respectively detected in stage Ⅰ a,Ⅰ b,Ⅱa,Ⅱ b,Ⅲa and Ⅲb.(3) Follow-up situations:142 of 157 patients were followed up for 6-56 months,with a median time of 27 months,and postoperative 3-year survival rate was 67.6％.Conclusion The vessel-guided LND is safe and effective in the laparoscopic distal gastrectomy (D2) of distal gastric cancer,and the operation steps can be simplified.

Objective: To evaluate the clinical efficacy of two different digestive tract reconstruction methods in the Siewert Ⅱ or Ⅲ adenocarcinoma of esophagogastric junction underwent proximal gastrectomy and piggyback jejunal interposition. Methods: A total of 84 patients with Siewert Ⅱ or Ⅲ AEG who underwent proximal gastrectomy and interposition jejunal anastomosis were enrolled prospectively according to the exclusion criteria, from October 2015 to August 2017 at Department of Digestive Minimally Invasive Surgery, Shanxi Cancer Hospital. There were 61 male and 23 female patients, aged 48-69 years with an average age of 59.7 years. They were divided into single-tract reconstruction group (n=41) and double-tract reconstruction group (n=43) according to random number table. Both groups underwent proximal gastrectomy and piggyback jejunal interposition. After side-to-side anastomosis of the remnant stomach and jejunum was performed in the single-tract group, jejunum 3 cm below the anastomosis was ligated or closed. The jejunum in the double-tract group was not treated during the operation. Relevant nutritional indicators were collected at 3 months and 6 months after operation. The data were analyzed by repeated measurement of variance analysis to determine the nutritional status. Results: There was no significant difference in preoperative general condition between single-tract reconstruction group and double-tract reconstruction group (P>0.05). There was no significant difference in perioperative related indicators (P>0.05). Nutritional indicators in single-channel reconstruction group were higher than those in double-channel reconstruction group (hemoglobin: F=23.374, P=0.000; albumin: F=6.149, P=0.003; total protein: F=18.362, P=0.000; weight: F=74.255, P=0.000). The quality of life was compared half year after operation, there was no significant difference in the incidence of subjective symptoms such as reflux, heart burning, nausea and vomiting, dysphagia and sternum discomfort in the two groups (P>0.05), as well as the results of QLQ-STO22 score (27.0±3.8 vs. 27.6±3.3, t=-0.688, P=0.494). The results of gastroscopy showed that the incidence and degree of the two groups were almost the same whether in the incidence of reflux esophagitis (2/41 vs. 2/43, P=1) or in the contrast of reflux degree (Z=-1.528, P=0.127). Conclusion For patients with type Siewert Ⅱ or Ⅲ esophagogastric junction adenocarcinoma who underwent proximal gastrectomy and piggyback jejunal operation, single tract reconstruction is ideal.

Objective:To explore the effects of magnanimous therapy on the magnanimous and enterprising traits of lung cancer patients and the analysis of related factors.Methods:Totally 197 patients with lung cancer were divided into individual group ( n=62), team group ( n=75) and control group ( n=60). Comparison and correlation analysis were applied to the data before and after the electroencephalogram and the magnanimous questionnaire, the cancer response questionnaire, the T-type psychological scale, the cancer heart state questionnaire and the cancer patient's life function index scale. t test, analysis of variance and Pearson correlation analysis were processed by SPSS 23.0. Results:After treatment, the " enterprising" dimension and " magnanimous" dimension of individual group and the " enterprising" dimension of the team group ((3.035±0.309), (3.041±0.265), (3.173±0.371)) were higher than that before treatment((2.934±0.326), (2.908±0.315), (3.130±0.387), all P<0.05). There was negative correlation between " magnanimous" dimension of the magnanimous questionnaire and " subconscious" dimension of the T-type psychological scale in individual group( r=-0.280, P<0.05). In team group, the " enterprising" dimension of the magnanimous questionnaire was negatively correlated with " Psychological" and " Yield" dimension of the cancer heart state questionnaire( r=-0.279, -0.285, P<0.05), and positively correlated with " Facing" of the cancer response questionnaire, " Good physical condition and ability" and " Psychological well-being" dimension of the cancer patient's life function index scale( r=0.367, 0.402, 0.379, P<0.05). There was a negative correlation between the " enterprising" dimension of the magnanimous questionnaire and the beta wave value in individual group. Conclusion:The magnanimous therapy can improve enterprising and magnanimous level of patients with lung cancer, and the effects are related with the above-mentioned psychosomatic factors.

Objective:To understand the perceptions, attitudes and treatment selection of Chinese surgeons for proximal gastrectomy (PG) and digestive tract reconstruction.Methods:A cross-sectional survey was used in this study. Selection of subjects: (1) Domestic public grade IIIA (provincial and prefecture-level) tumor hospitals or general hospitals possessing the diagnosis and treatment qualifications for gastric cancer.(2) Surgeons with senior attending physician, associate chief physician and chief physician. The "Questionnaire Star" platform was used to design a questionnaire about cognition, attitude and treatment choice of "proximal gastrectomy and digestive tract reconstruction". The questionnaire contained 32 questions, such as the basic information of surgeons, the current status of gastric cancer surgery, the selection and management of surgical methods and related details for proximal gastric cancer, the choice of proximal gastrectomy and reconstruction of digestive tract, the related complications and nutritional status monitoring after proximal gastrectomy. A total of 76 questionnaires were linked to the respondents via WeChat between July 29 and August 25, 2019. Statistical analysis was performed using Chi-square test or Kruskal-Wallis test for categorical variables.Results:A total of 47 grade IIIA hospitals were included, and 76 questionnaires were sent out. The proportions of recovered and valid questionnaires were both 100%. For early and middle stage adenocarcinoma of esophagogastric junction (AEG), especially those smaller than 4 cm, 72.37% (55/76) of surgeons preferred proximal gastrectomy, while 22.37% (17/76) of surgeons chose total gastrectomy. For early AEG, 90.79% (69/76) of surgeons thought that endoscopic submucosal dissection (ESD) or proximal gastrectomy could be considered. For AEG below T3 stage and shorter than 4 cm, 60.53% (46/76) of surgeons gave priority to proximal gastrectomy, and 60.53% (46/76) of the surgeons believed that the advanced AEG with a higher radical cure should be treated with proximal gastrectomy, and the residual stomach should not be less than half stomach. Considering anti-reflux effect, postoperative weight recovery, clinical efficacy, wide application and easy popularization, surgeons preferred double-tract reconstruction. The surgeons in tumor hospitals had a higher approval rate for the application of proximal gastrectomy and the fact that the Kamikawa anastomosis was the most difficult to promote than the surgeons in provincial/municipal general hospitals. The surgeons with an annual surgical volume of more than 200 were more likely to choose proximal gastrectomy for early and middle stage AEG patients and the proportion was as high as 8/9. From the perspective of good clinical results, wide range of application, and easy popularization, the surgeons with a higher ratio (60.00%, 15/25) of double-tract reconstruction were those surgeons with 50-100 operations per year.Conclusions:The general level of cognition and acceptability of Chinese surgeons for proximal gastrectomy and reconstruction of digestive tract is suboptimal. In the future, it is urgent to promote the "Chinese consensus on digestive tract reconstruction after proximal gastrectomy" so as to guide and optimize treatment in proximal gastric cancer.

Objective:To understand the perceptions, attitudes and treatment selection of Chinese surgeons for proximal gastrectomy (PG) and digestive tract reconstruction.Methods:A cross-sectional survey was used in this study. Selection of subjects: (1) Domestic public grade IIIA (provincial and prefecture-level) tumor hospitals or general hospitals possessing the diagnosis and treatment qualifications for gastric cancer.(2) Surgeons with senior attending physician, associate chief physician and chief physician. The "Questionnaire Star" platform was used to design a questionnaire about cognition, attitude and treatment choice of "proximal gastrectomy and digestive tract reconstruction". The questionnaire contained 32 questions, such as the basic information of surgeons, the current status of gastric cancer surgery, the selection and management of surgical methods and related details for proximal gastric cancer, the choice of proximal gastrectomy and reconstruction of digestive tract, the related complications and nutritional status monitoring after proximal gastrectomy. A total of 76 questionnaires were linked to the respondents via WeChat between July 29 and August 25, 2019. Statistical analysis was performed using Chi-square test or Kruskal-Wallis test for categorical variables.Results:A total of 47 grade IIIA hospitals were included, and 76 questionnaires were sent out. The proportions of recovered and valid questionnaires were both 100%. For early and middle stage adenocarcinoma of esophagogastric junction (AEG), especially those smaller than 4 cm, 72.37% (55/76) of surgeons preferred proximal gastrectomy, while 22.37% (17/76) of surgeons chose total gastrectomy. For early AEG, 90.79% (69/76) of surgeons thought that endoscopic submucosal dissection (ESD) or proximal gastrectomy could be considered. For AEG below T3 stage and shorter than 4 cm, 60.53% (46/76) of surgeons gave priority to proximal gastrectomy, and 60.53% (46/76) of the surgeons believed that the advanced AEG with a higher radical cure should be treated with proximal gastrectomy, and the residual stomach should not be less than half stomach. Considering anti-reflux effect, postoperative weight recovery, clinical efficacy, wide application and easy popularization, surgeons preferred double-tract reconstruction. The surgeons in tumor hospitals had a higher approval rate for the application of proximal gastrectomy and the fact that the Kamikawa anastomosis was the most difficult to promote than the surgeons in provincial/municipal general hospitals. The surgeons with an annual surgical volume of more than 200 were more likely to choose proximal gastrectomy for early and middle stage AEG patients and the proportion was as high as 8/9. From the perspective of good clinical results, wide range of application, and easy popularization, the surgeons with a higher ratio (60.00%, 15/25) of double-tract reconstruction were those surgeons with 50-100 operations per year.Conclusions:The general level of cognition and acceptability of Chinese surgeons for proximal gastrectomy and reconstruction of digestive tract is suboptimal. In the future, it is urgent to promote the "Chinese consensus on digestive tract reconstruction after proximal gastrectomy" so as to guide and optimize treatment in proximal gastric cancer.