Objective To explore the feasibility and safety of laparoscopic total colectomy for familial adenomatous polyposis. Methods All 9 patients with familial adenomatous polyposis received laparoscopic total colectomy were analyzed. Results Laparoscopic total colecto-my was successfully performed in all the 9 patients. The operative time,blood loss,flatus and hospitalization were respectively 230~310 min, 80~210 mL,2~3 days and 12~14 days. All patients were followed up for 6~36 months. The postoperative recovery was good. Conclusion Total colectomy can be successfully perfomed with laparoscopic assisted in treating familial adenomatous poliposis. It is a feasible and safe surgical procedure and can significantly improve the quality life.

Objective To compare the differences in the use of effects of improved and traditional abdominal positioning locator card in the empty nest elderly diabetic patients with insulin pen injection. Methods 100 discharged cases of empty nest elderly diabetic patients with insulin treated were enrolled. They were divided into two groups by random digital table method, 50 cases in traditional positioning card injection group and 50 cases in improved positioning card injection group. Usage rate of two sets of locator cart, adverse reactions in local skin injection and blood glucose control were observed for 12 months. Results After 12 months, 44 cases occupied 88%in improved positioning card injection group were not about using positioning card while 30 cases occupied 60%in traditional positioning card injection group. The difference was statistical significance (P<0.05). After 12 months, only 3 cases in improved positioning card injection group appeared local injection site reactions which was significantly lower than 31 cases in the traditional positioning card injection group, and the difference was statistically significant (P<0.05);12 months later, fasting blood glucose (FBG), 2 hour postprandial blood glucose (2 h PBG), glycosylated hemoglobin (HbA 1c) of improved positioning card injection group and traditional positioning card injection group [(7.0 ±1.5) mmol/L and(7.8±1.9)mmol/L,(10.7±2.1)mmol/L and(12.3±2.2)mmol/L,(7.1±1.3)% and(7.7±1.5)%] were all decreased significantly than before. The difference was statistically significant (P<0.05). FBG,2 h PBG, HbA1c of improved positioning card injection group were decreased more significantly than that in traditional positioning card injection group and the difference was statistically significant (P<0.05). The standard rate of HbA1c [64% (32/50)] in improved positioning card injection group was higher than that in traditional positioning card injection group [42%(21/50)]. The difference was statistically significant (P<0.05). Conclusions The modified abdominal injection locator card can improve patients′positioning card usage rate, optimize insulin injection technique, reduce the occurrence of adverse reactions in local skin injection and improve the control of blood glucose.

Objective:Study on proliferation of gastric cancer cells (GCCs) and expressions of VEGF under the CO2 pneumoperitoneum environment,and effect of Bcl-2 specific inhibitor on the expression of VEGF in GCCs/TAMs co-culture system.Methods:TAMs induced by PMA and IL-4 in vitro.TAMs and MKN-45 cells were co-cultured in Transwell chamber,in pseudo CO2 pneumoperitoneum environment.Proliferation activity of GCCs was detected by MTT assay,and ELISA method was used to detect VEGF concentration in the cell culture supernatant.Results:Co-culture system was divided into CO2 pneumoperitoneum group and control group.Proliferation activity of MKN-45 cell and expression of VEGF of 5mmHg,10mmHg and 15mmHg groups are no difference with the control group;25 mmHg group is opposite to the former.The cells in co-culture group and CO2 pneumoperitoneum group (15 mmHg) were added to ABT-737,VEGF expression of co-culture + ABT-737 group was significantly lower than that of in the control group(P=0.001).Co-cultured cells VEGF expression in pneumoperitoneum group was significantly lower than the control group without inhibitor (P=0.000).Conclusion:Normal laparoscopic pneumoperitoneum is no stimulation of tumor cell proliferation defects,And higher pneumoperitoneum pressure might increase the hypoxia status of tumor microenvironment,promote tumor malignant progression.The interaction between tumor cells and TAMs may be achieved by paracrine Bcl-2-VEGF loop.

Objective:To analyze the clinical characteristics of intracranial infection caused by Mycobacterium lentiflavum. Methods:The clinical data of a patient with intracranial infection caused by Mycobacterium lentiflavum admitted to Tianjin Haihe Hospital in May 2023 were collected. Meanwhile relevant literatures in databases were searched. Only 1 English literature (1 patient) was obtained. The clinical characteristics of this patient and the case reported in the literature were analyzed and summarized. Results:Totally 2 patients, including this case, and the patient with meningoencephalitis caused by Mycobacterium lentiflavum reported in the literature, both are females, 42 and 55 years old respectively, both manifested a chronic course, without fever, and presented progressive headache and cognitive impairment. Clinical manifestations also included abnormal mental behavior, limb weakness, and seizure. At the early stage, only intracranial pressure increased, and cerebrospinal fluid tests were negative. As the disease aggravated, there was an elevation of cerebrospinal fluid cells and protein, with normal levels of glucose and chloride. Using brain tissue obtained by biopsy for polymerase chain reaction or next-generation sequencing examination, the pathogenic microorganism was confirmed, which made accurate diagnosis possible. Antibiotic treatment had good efficacy, with a long treatment course and a good prognosis. Conclusions:Central nervous system infection caused by Mycobacterium lentiflavum is very rare, and a chronic disease course makes diagnosis very difficult. The treatment effect is significant, and the prognosis is excellent.