Several reconstruction techniques are available after gastrectomy. Roux-en-Y reconstruction following distal gastrectomy is the reference in terms of long-term functional and endoscopic outcomes. It is the preferred reconstruction for benign lesions and early gastric cancer. In patients with advanced gastric cancer, BillrothII (reconstruction is an acceptable alternative. After total gastrectomy, Roux-en-Y reconstruction is the simplest solution, with satisfactory functional outcome. Addition of a jejunal reservoir seems to improve long-term outcome after total gastrectomy and could be of benefit to patients with good prognosis. After distal or total gastrectomy, hand-sewn anastomoses should be preferred because of lower costs. Mechanical sutures can facilitate transhiatal esophagojejunostomy. After proximal gastrectomy, esophago-gastric anastomosis is the basic reconstruction method. Gastric remnant is made into gastric tube in the operation. The effect of pyloroplasty remains controversial, and further study is needed to improve the quality of life after operation.
Anastomosis, Roux-en-Y ; methods ; Gastrectomy ; Gastroenterostomy ; methods ; Humans ; Reconstructive Surgical Procedures ; methods ; Stomach Neoplasms ; surgery

OBJECTIVE: Study the clinical characteristics, treatment results and prognostic factors of hypopharyngeal carcinoma. MMETHOD: A retrospective analysis was performed of 97 hypopharyngeal cases that were treated in Department of Dtolaryngology of our hospital from January 2008 to December 2012. 93 cases of them are male patients, and 4 cases are female patients. The tumors are originated from pyriform sinus(75 cases), posterior pharyngeal wall (16 cases) and post-cricoid area (6 cases). Of the 97 patients,21 patients were treated with partial hypopharynx resection (21. 6%), 7 were treated with partial laryngectomy+ partial hypopharynx resection (7. 2%), 53 were treated with total laryngectomy+partial hypopharynx resection (54. 6%), 12 were treated with total laryngectomy and total hypopharynx resection, gastric-pharyngeal anastomosis (12. 4%) and 4 were treated with total laryngectomy and total hypopharynx resection, enteric-pharyngeal anastomosis (4. 1%). Sixty-one cases undergo postoperative radiotherapy in Oncology. Use Chi-square test to do enumeration data analysis, the survival rate is calculated with the life table method, survival analysis with Kaplan-Meier method, parallel Log-rank test. Cox regression multivariate analysis model is used to find the factors affecting prognosis. RESULT: The follow-up rate of this group was 90. 7%. All patients' 1-year survival rate is 76. 0% , 3-year survival rate is 56. 0%, pathological lymph node metastasis rate is 71. 1%, occult lymph node metastasis rate is 19. 6%. Local recurrence rate is 21. 6%. The main reasons of death in patients include : cervical lymph node metastasis in 7 patients (21. 9%), local recurrence in 12 cases (37. 5%), distant metastases in 10 patients (31. 3%) and so on. Univariate analysis showed that tumor size (P<0. 01) and tumor T stage (P<0. 05) have impact on survival prognosis, no risk factors was found with Cox regression multivariate analysis. CONCLUSION Hypopharyngeal carcinoma is difficult to be found early, prone to recurrence and metastasis after operation, carefully chosen surgical excision and neck dissection, adjuvant postoperative radiation therapy is the main treatment strategy. Posterior pharyngeal wall carcinoma tend to have higer recurrence and metastasis rate than the other two types of hypopharyngeal caocinom, and treatment would cause much larger injury, so more attention should be paid to this type of hypopharyngeal caocinom.
Carcinoma, Squamous Cell ; diagnosis ; surgery ; Female ; Head and Neck Neoplasms ; diagnosis ; surgery ; Humans ; Hypopharyngeal Neoplasms ; diagnosis ; surgery ; Hypopharynx ; surgery ; Laryngectomy ; Lymphatic Metastasis ; Male ; Neck Dissection ; Neoplasm Recurrence, Local ; Pharynx ; Prognosis ; Retrospective Studies ; Squamous Cell Carcinoma of Head and Neck ; Survival Rate ; Treatment Outcome

Objective: To study the influence of pre-operative disease course on the operation and post-operation quality of life of adolescents with idiopathic scoliosis (AIS). Methods: A total of 110 AIS patients who were treated with classic posterior correction, pedicle internal fixation were divided into two groups according to their disease courses (n=55): short course group with a pre-operation course <2 years (S group), long course group with a pre-operation course ≥2 years (L group). The gender, Lenke type, and major curve Cobb angle were matchable between the two groups. Various radiographic measurements and indices like fusion level, intraoperative blood loss and scores of SRS-22 scale were compared between the two groups before operation, immediately, and 2 years after operation. Results: The pre-operative Cobb angles of the major curve were similar between the two groups, but the flexibility of the major curve averaged (55.7±18.77)% in the S group and (48.1±18.24)% in the L group (P = 0.034). Pre-operative Cobb angles of the minor curve were larger in L group than those in S group ([30.1±12.10]° in the S group and [34.8±10.85]° in the L group, P = 0.035). The post-operative radiographic measurements and the blood loss/infusion were similar between the two groups. The number of fused vertebrae in the L group was significantly more than that in the S group (P = 0.027). The parameters in the SRS-22 scale, including function/activity, pain, self-image/appearance, and mental health were similar between the two groups during follow-up. And the L group had a significantly lower satisfaction rate of treatment compared with the S group ([4.0±0.70] vs [3. 7±0.78], P = 0.037). Conclusion: The flexibility of the curve in AIS decreases with the increase of disease course, and the disease course might be a risk factor for the scoliosis progression of the minor side. Patients with a disease course ≥2 years have more fused vertebrae than those with a disease course <2 years. The length of pre-operative disease course has influence on the quality of life of AIS patients after operation.

Objective: To search for effective volatile oil of Chinese crude drug for killing demodex in vitro. Methods: The demodex mites were collected by adhesive cellophane tape technique. The killing effects of different volatile oils against Df and Db were observed by microscope. Normal saline and Xinfu Manling Ointment were used as negative and positive controls, respectively. Skin irritation tests for normal and wounded skin and acute toxicity test were carried out using rabbit skin. Results: The volatile oils of 6 Chinese crude drugs, including clore, orange fruit, manchurian wildginger, cinnamon bark, rhizoma alpinae, and pricklyash peel, were highly potent in killing Df and Db in vitro; and the volatile oil of clore and manchurian wildginger had a better killing effect against Df than Db(P< 0.05). The scores for irritation to normal and wounded rabbit skin were 0.2 and 0.3, respectively, and acute toxicity test showed no obvious toxicity. Conclusion: The volatile oils of the 6 mentioned Chinese crude drugs have satisfactory anti-mite activities in vitro. The volatile oil of clore shows a remarkable activity against demodex in vitro, with good skin safety.

OBJECTIVE: Explore the TGF-beta1 and collagen fibers in chronic nasal sinusitis each type and degree of expression of the normal control group and in the nasal mucosa epithelial tissue remodeling and the role of TGF-beta1 and collagen deposition relationship. METHOD: Sixty-two patients experimental group (CRSwNP of 21 cases. CRSs NP group of 15 cases. 11 cases of recurrent nasal polyps; control group 15 cases specimens for immunohistochemistry and masson collagen staining. Manual counting the number of positive cells by the Mann-Whitney U test to analyze the expression in experimental group and the control group. Experimental group and control group between the single-factor analysis of variance with a One-Way ANOVA analysis. RESULT: Experimental group and control group were expressed TGF-beta1 with collagen deposition. Which, TGF-beta1 in CRSsNP group was significantly lower than the control group (P < 0.05), CRSwNP group was significantly increased compared with CRSsNP group (P < 0.05); masson collagen staining, CRSsNP group was significantly lower than the control group (P < 0.01), recurrent nasal polyps group than in the control group was significantly increased (P < 0.05). TGF-beta1 and collagen staining masson positive correlation between (P < 0.01 ). CONCLUSION TGF-beta1 and collagen deposi tion and chronic nasal-sinusitis tissue remodeling has its relevance. Furthermore. TGF-beta1 expression increased with excessive deposition of collagen fibers also positively correlated.
Adult ; Case-Control Studies ; Chronic Disease ; Collagen ; metabolism ; Humans ; Middle Aged ; Nasal Mucosa ; metabolism ; Rhinitis ; metabolism ; pathology ; Sinusitis ; metabolism ; pathology ; Transforming Growth Factor beta1 ; metabolism ; Young Adult

Objective:To observe the clinical effects of acupuncture plus external medicine application for cervical radiculopathy.Methods:A total of 98 patients with cervical radiculopathy were randomly divided into an observation group and a control group based on the random digital table.The observation group (50 cases) was treated by acupuncture plus external medicine application and the control group (48 cases) was treated by acupuncture alone.The patients received the treatment every day.Ten sessions made a course.Cervical spondylosis symptom scale was used to assess the cases before and after the treatment.The clinical efficacy was compared between the two groups after the treatment.Results:The total effective rate was 98.1％ in the observation group versus 87.6％ in the control group with a statistically significant difference between the two groups (P＜0.05).The cure rate was 52.0％ in the observation group versus 18.8％ in the control group with a significant difference between the two groups (P＜0.05).There was no significant difference in the score of cervical spondylosis symptom scale between the two groups before the treatment (P＞0.05).It increased with a significant difference in both groups after the treatment (both P＜0.05),while a significant difference was found in the results between the two groups after the treatment (P＜0.05).Conclusion:Acupuncture plus external medicine application is more effective than acupuncture alone for treating cervical radiculopathy.The method also effectively improves the clinical symptoms.

Constipation has become a common clinical symptom in the elderly. Many factors can result in constipation, including diet,physiological aging, lack of exercise, inappropriate medication, psychological factors, perianal disease, and so on. If the individualized, targetedand comprehensive care interventions that consist of health education, psychological intervention, dietary intervention, medicationguide, functional exercise, passive attention to bowel training and abdominal massage etc. are done well, it can decrease the incidence ofconstipation, reduce a variety of complications and adverse effects caused by the constipation and improve the quality of life in the elderly.So it has important clinical significance.

Objective: To observe the clinical efficacy of acupuncture in treatment of chronic urticaria and the change in the content of serum immunoglobulin E (IgE), and to discuss the effect of acupuncture on the imbalance of T helper (Th)1/Th2 cell function via observing the changes in the contents of interferon-γ (IFN-γ) and interleukin-4 (IL-4). Methods: Ninety patients meeting the inclusion criteria of chronic urticaria were randomized into an acupuncture- medication group, an acupuncture group and a Western medication group by the random number table method. The acupuncture-medication group was intervened by acupuncture, cupping, collateral-pricking bloodletting and oral administration of cetirizine hydrochloride tablets; the acupuncture group was treated with acupuncture, cupping and collateral-pricking bloodletting; the Western medication group only received oral administration of cetirizine hydrochloride tablets. Before treatment and after 6-week treatment, the changes in the symptom scores and the contents of serum IgE, IFN-γ and IL-4 in the three groups were observed. Results: There were no significant differences in the total effective rate among the three groups (all P>0.05), but the cured and markedly effective rate was significantly higher in the acupuncture-medication group than that in the Western medication group (P<0.05). After treatment, the total symptom score decreased in the three groups (P<0.05), and the improvement of total symptom score in the acupuncture-medication group was more significant than that in the Western medication group (P<0.05). The component symptom scores all decreased after treatment in the three groups (all P<0.05); the improvements of the scores of itch intensity, and skin lesion size and number were more significant in the acupuncture-medication group than in the Western medication group (all P<0.05); the improvement of the skin lesion size score was more significant in the acupuncture group than in the Western medication group (P<0.01). The contents of IgE and IL-4 dropped (all P<0.05) and the content of IFN-γ increased (P<0.05) after treatment in the three groups; the post-treatment changes in the serum contents of IgE and IFN-γ were more significant in the acupuncture-medication group than in the Western medication group (both P<0.05). The incidence rate of adverse reactions was significantly lower in the acupuncture-medication group and acupuncture group than in the Western medication group (both P<0.05), and the relapse rate was significantly lower in the acupuncture-medication group than in the Western medication group (P<0.05). Conclusion: Combined acupuncture and medication can enhance the cured and markedly effective rate in treating chronic urticaria. Acupuncture is equivalent to cetirizine hydrochloride tablets comparing the clinical efficacy in treatment of chronic urticaria. Acupuncture plus medication and acupuncture alone both can effectively mitigate the clinical symptoms, with low incidence of adverse reactions. The relapse rate is low when using acupuncture together with medication. Acupuncture plus medication can work better in regulating the contents of IgE and IFN-γ and improving the imbalance of Th1/Th2 cell function.

Proper use of biochemical software is helpful for medial post-graduate students to establish scientific thinking behavior during research and to improve their creative capability.Exploration on curriculum of biomedical software application was made based on course objective and content,modern teaching methods and practical assessment methods.Results showed that this training course can enhance the students' understanding and practical skill of related software,which is fundamental for further research work.

Objective To study the feasibility of composite of human fibrinous gel and transgeneic MSCs aiming at replicating adenoviruses-bone morphogenetic proteins-2 (Ad-BMP-2) in repair of segmental bone defects. Methods Bone defects for 10 mm were created on the bilateral radius of 14 Japanese big ear rabbits and treated with four kinds of implantations (seven radii per group), ie, composite of transgeneic MSCs and fibrinous gel (Group A), composite of MSCs and fibrinous gel (Group B),fibrinous gel alone (Group C) and nothing as control group. The defects were observed radiologically and histologically and examined by biomechanical test at the 12th week after operation. Results The defects treated in the Group A were repaired and regenerated much more new bone, bridged earlier and stronger than those in the Group B 12 weeks after operation. The defects treated in the Groups C and D could not attain osseous tissue healing. Conclusions The composite of transgeneic MSCs and fibrinous gel can be used to effectively repair segmental bone defects.