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.

In this paper, we propose a new active contour algorithm, i. e. hierarchical contextual active contour (HCAC), and apply it to automatic liver segmentation from three-dimensional CT (3D-CT) images. HCAC is a learning-based method and can be divided into two stages. At the first stage, i.e. the training stage, given a set of abdominal 3D-CT training images and the corresponding manual liver labels, we tried to establish a mapping between automatic segmentations (in each round) and manual reference segmentations via context features, and obtained a series of self-correcting classifiers. At the second stage, i.e. the segmentation stage, we firstly used the basic active contour to segment the image and subsequently used the contextual active contour (CAC) iteratively, which combines the image information and the current shape model, to improve the segmentation result. The current shape model is produced by the corresponding self-correcting classifier (the input is the previous automatic segmentation result). The proposed method was evaluated on the datasets of MICCAI 2007 liver segmentation challenge. The experimental results showed that we would get more and more accurate segmentation results by the iterative steps and the satisfied results would be obtained after about six rounds of iterations.
Algorithms ; Humans ; Imaging, Three-Dimensional ; Liver ; diagnostic imaging ; Models, Theoretical ; Tomography, X-Ray Computed

Blast Injuries ; Deafness ; etiology ; Humans

Objective To investigate the role of CT three-dimensional reconstruction (3D-CT) in the diagnosis of bronchial foreign body.Methods Thirty-seven suspected pediatric cases of bronchial foreign bodies underwent CT scanning and 3D-CT reconstruction,whose accuracy was defined by bronchoscopical or surgical findings.Results For all the 37 cases,chest X-ray showed 8 cases (group A) had bronchial foreign body,while 29 cases(group B) were negative.In group A,CT findings suggested lung infection in 5 cases,congenital pulmonary dysplasia-lung lobe absence in 2 cases and tracheo-esophageal fistula in 1 case.In group B (29 patients),25 cases with bronchial foreign bodies were suspected by CT scanning and further bronchoscopical examination confirmed the existence of 24 cases of vegetable foreign body,one case of the tracheal tumor.For the four cases with negative result of bronchial foreign bodies after CT scanning,lung infection and laryngitis were confirmed in two cases respectively.Among the 24 surgically-confirmed cases of vegetable foreign bodies,CT scanning showed tracheobronchial foreign body in fourteen positive results,irregular tracheal stenosis in six cases and obstructive atelectasis,emphysema,pneumonia in seven each.Tracheobronchial foreign body and irregular tracheal stenosis were direct signs,accounting for 74%(20/27).Obstructive atelectasis,emphysema and pneumonia were indirect signs,accounting for 26%(7/27).Conclusion 3D-CT plays an important role in diagnosis and differential diagnosis of bronchial foreign body.

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.

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 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.