Objective We studied the clinical features and its significance of coal worker's pneumoconiosis combined with sleep apnea Methods In 40 patients with coal worker's pneumoconiosis combined with sleep apnea hospitalized from February 2006 to December 2009, polysomnography ( PSG) , blood routine, urine routine, blood pressure and biochemical indicators were measured and analyzed. Results Patients with coal worker' s pneumoconiosis combined with sleep apnea manifested mainly as duplicate hypoxemia and multi-organ dysfunction: high blood pressure, dysfunction of heart, lung and kidney, increase of serum glucose, blood lipids, blood uric acid and finally led a vicious cycle to aggravate the above mentioned damage. Conclusions In clinical, multiple-organ dysfunction resulted from severe hypoxemia and hypercapnia caused by coal worker's pneumoconiosis combined with sleep apnea, should be fully aware and give ational and effective treatment early to reverse or delay the further function damages of multiple organs, and therefore significantly improve the prognosis.

Objective To investigate the risk factors for group 14v lymph node metastasis in advanced gastric cancer.Methods The clinical data of 170 patients with advanced gastric cancer who were admitted to the Tianjin Cancer Hospital from January 2007 to December 2011 were retrospectively analyzed.All the patients received D2 gastrectomy + group 14v lymph node dissection.All the patients were with gastric adenocarcinoma.The general information of the patients,and the number of lymph node dissected and lymph node with positive expression were recorded.Univariate and multivariate analysis of clinicopathological factors influencing the group 14v lymph node metastasis were done using bivariate Logistic regression model.The correlation between the group 14v lymph node metastasis and regional lymph node metastasis was analyzed using the bivariate Logistic regression analysis.Results Of the 170 patients,459 group 14v lymph nodes were dissected,and 2.7 lymph nodes for each patient (range,1-17 lymph nodes) ; 55 positive lymph nodes were detected in patients with group 14v lymph node metastasis,and 1.7 lymph nodes for each patient (range,1-3 lymph nodes).The results of univariate analysis showed that group 14v lymph node metastasis was correlated with the degree of radical dissection of tumor,diameter of the tumor,lymph node metastasis (N stage) and distal metastasis (M stage).Compared with patients with advanced gastric cancer and with R0 resection of tumor,tumor diameter≤4 cm,N0 stages,and M0 stages,patients with R1 or R2 resection,tumor diameter ＞4 cm,N2 stages,N3 stages,and M1 stages had higher risk of group 14v lymph node metastasis (OR =3.899,2.646,19.231,33.929,5.000,95％ confidence interval:1.11113.677,1.075-6.516,2.333-158.548,4.310-267.112,1.617-15.464,P ＜ 0.05).The resnlts of multivariate analysis showed that N stage was the independent risk factor influencing the group 14v lymph node metastasis.Compared with patients in N0 stage,patients in N2 or N3 stage had higher risk of group 14v lymph node metastasis (OR =15.248,26.287,95％ confidence interval:1.811-128.386,3.244-213.034,P ＜ 0.05).Group 4sb,4d,5,6,7,8a,9,11p,12a and 16 lymph node mnetastasis were coxelated with group 14v lymph node metastasis (OR =3.923,3.335,2.693,5.641,3.100,4.203,3.655,3.660,3.838,17.400,95％ confidence interval:1.264-12.177,1.425-7.807,1.149-6.312,2.126-14.965,1.311-7.330,1.735-10.185,1.395-9.582,1.331-10.666,1.086-13.571,2.707-111.837,P ＜0.05).Conclusion N stage is an independent risk factor of group 14v lymph node metastasis,and the status of group 6 lymph node is the best indicator for group 14v lymph node metastasis.

Objective To evaluate the risk factors for recurrence of node-negative advanced gastric cancer(N0-AGC) after radical resection.Methods Data of 270 N0-AGC cases after curative intent resection were collected from 2001 to 2008 in Tianjin Cancer Hospital.There were 45 cases with postoperative recurrence.Univariate and multivariate analysis were applied to investigate risk factors for postoperative recurrence.Results The recurrence time was 2-68 months,the survival time was 5-87 months.Univariate analysis showed that tumor size,depth of tumor invasion,number of negative lymph nodes were associated with recurrence of N0-AGC.Multivariate analysis identified tumor size,depth of tumor invasion,number of negative lymph nodes as independent recurrence factors for entire cohort,depth of tumor invasion,number of negative lymph nodes were risk factors for locoregional recurrence.Tumor size,adjuvant chemotherapy for hematogenous metastasis.Conclusions For T4 stage,tumor diameter ＞4 cm advanced node-negative gastric cancer patients,extended lymphadenectomy was recommended to decrease locoregional recurrence,and adjuvant chemotherapy to reduce hematogenous spread.

Objective To compare the clinicopathological features of Borrmann type Ⅳ gastric cancer with other gastric cancer and explore prognostic factors of the patients with Borrmann type Ⅳ cancer.Methods We retrospectively reviewed the clinical data of 671 advanced gastric cancer patients.They were divided into 2 groups:Borrmann type Ⅳ (64 cases) and other macroscopic Borrmann types of cancer (607 cases).Their clinicopathologic characteristics and overall survival data were analyzed.Results Age,sex,tumor size,tumor location,lymph node metastasis,distant metastasis,TNM classification were discrepant between Borrmann type Ⅳ and other macroscopic Borrmann types of cancer.The 5-year survival rate of Borrmann type Ⅳ cancer patients was 20.1％,while it was 40.3％ for other types of cancer (P ＜ 0.05).The 5-year survival rate for Borrmann type Ⅳ gastric cancer and the other type gastric cancer was 50.0％ and 72.0％ at stage Ⅰ,30.0％ and 57.9％ at stage Ⅱ,18.0％ and 28.4％ at stage Ⅲ,and 16.4％ and 20.0％ at stage Ⅳ (all P ＜ 0.05),respectively.Multivariate analyses revealed age,histology differentiation type,tumor size,the Borrmann type carcinoma and tumor stage to be independent prognostic factors for survival.Conclusions Borrmann type carcinoma has unique clinicopathological features compared with other types of gastric carcinoma and is an important independent prognostic factor.

Objective To explore the genetic pathogen of patients with non-syndromic hearing impairment and to provide prenatal diagnosis for the families of hereditary deafness. Methods Mutation screening of GJB2, SLC26A4, GJB3 and mitochondrial 12 S rRNA genes was performed in 208 patients with non-syndromic hearing impairment by gene chip. Then direct sequencing was used in 41 patients who were found one mutation of GJB2 or SLC26A4 gene. And prenatal diagnosis was carried out in two families by direct sequencing. Results Eighty-six patients (41.35％) were found at least one mutation by gene chip. Among them, 40 patients were found to carry two mutations and 46 patients were found to carry one mutation. The most frequent mutation was 235delC, which was found in 46 patients. And 12 cases were found the second mutation through direct sequencing. A total of 52 (25.00％) patients were detected two mutations. Prenatal diagnosis showed that one fetus carried compound mutations of 299-300delAT and 235delC, and another one carried heterozygous mutation of IVS7-2A>G. Conclusion Patients with non-syndromic hearing impairment can be accurately diagnosed by gene chip and Sanger sequencing. The prenatal diagnosis is primary means for high-risk fetuses.

Objective:To investigate the clinical value of carbon nanoparticles zonal tracer technique in lymph node retrieval of gastric cancer (GC).Methods:A retrospective cohort study was carried out. Clinicopathological data of GC patients who underwent radical D2 resection with carbon nanoparticles tracer in The First Affiliated Hospital of Hainan Medical University and Hainan Cancer Hospital from December 2015 and February 2019 were collected. Those with postoperative pathology of T1-2, Borrmann IV type GC, distant metastasis, preoperative neoadjuvant chemotherapy and incomplete data were excluded. A total of 181 patients were enrolled in this study, including 113 cases from the First Affiliated Hospital of Hainan Medical University and 68 cases from Hainan Cancer Hospital. Patients were categorized into two groups based on the methods of carbon nanoparticles tracer: zonal tracer group and traditional tracer group. In the traditional tracer group, 0.1-0.3 ml of carbon nanoparticle was injected subserously at the upper, lower, left and right 4 injection points 0.5 cm away from the edge of the tumor in the normal serous membrane. In the zonal tracer group, on the basis of the traditional tracer group, 0.1-0.3 ml of carbon nanoparticle was injected subserously at the first branch of the suprapyloric right gastric artery into the stomach, the first branch of the subpyloric right gastroepiploic artery into the stomach, the first branch of the minor curvature left gastric artery into the stomach and the first branch of the greater curvature left gastroepiploic artery into the stomach, respectively. The display of lymphatic vessels in each location and lymph nodes in each group by the tracing method was observed. The number of black-stained lymph nodes, the black staining rate of lymph nodes, the total number of detected lymph nodes, the total number of positive lymph nodes, and the metastatic rate of lymph node were compared between the two groups.Results:Eighty-nine patients were assigned to zonal tracer group, and 92 patients to traditional tracer group. There were no significant differences in baseline information between the two groups (all P>0.05). The median number of black-stained lymph nodes (median: 25.0 vs. 13.5, Z=-7.158, P<0.001) and the black staining rate of lymph nodes [(70.8±12.0)% vs. (47.1±15.7)%, t=11.399, P<0.001) in the zonal tracer group were significantly higher than those in the traditional tracer group. The total detected number of lymph nodes (37.5±11.5 vs. 29.6±11.8, t=4.581, P<0.001) and the total number of negative lymph nodes (31.3±12.5 vs. 24.9±11.1, t=3.621, P<0.001) were significantly higher in the zonal tracer group than those in the traditional tracer group. There were no significant differences in the total number of positive lymph nodes (median: 4.0 vs. 3.0, Z=-1.485, P=0.137), lymph node metastatic rate [78.7% (70/89) vs. 72.8% (67/92), χ 2=0.834, P=0.361] and metastatic degree [median: 11% vs. 10%, Z=-0.483, P=0.629] between the two groups. Conclusion:The carbon nanoparticles zonal tracer method can increase the black-staining rate of lymph nodes and the detected number of lymph nodes, thus improving the accuracy of gastric cancer staging.

Objective:To investigate the clinical value of carbon nanoparticles zonal tracer technique in lymph node retrieval of gastric cancer (GC).Methods:A retrospective cohort study was carried out. Clinicopathological data of GC patients who underwent radical D2 resection with carbon nanoparticles tracer in The First Affiliated Hospital of Hainan Medical University and Hainan Cancer Hospital from December 2015 and February 2019 were collected. Those with postoperative pathology of T1-2, Borrmann IV type GC, distant metastasis, preoperative neoadjuvant chemotherapy and incomplete data were excluded. A total of 181 patients were enrolled in this study, including 113 cases from the First Affiliated Hospital of Hainan Medical University and 68 cases from Hainan Cancer Hospital. Patients were categorized into two groups based on the methods of carbon nanoparticles tracer: zonal tracer group and traditional tracer group. In the traditional tracer group, 0.1-0.3 ml of carbon nanoparticle was injected subserously at the upper, lower, left and right 4 injection points 0.5 cm away from the edge of the tumor in the normal serous membrane. In the zonal tracer group, on the basis of the traditional tracer group, 0.1-0.3 ml of carbon nanoparticle was injected subserously at the first branch of the suprapyloric right gastric artery into the stomach, the first branch of the subpyloric right gastroepiploic artery into the stomach, the first branch of the minor curvature left gastric artery into the stomach and the first branch of the greater curvature left gastroepiploic artery into the stomach, respectively. The display of lymphatic vessels in each location and lymph nodes in each group by the tracing method was observed. The number of black-stained lymph nodes, the black staining rate of lymph nodes, the total number of detected lymph nodes, the total number of positive lymph nodes, and the metastatic rate of lymph node were compared between the two groups.Results:Eighty-nine patients were assigned to zonal tracer group, and 92 patients to traditional tracer group. There were no significant differences in baseline information between the two groups (all P>0.05). The median number of black-stained lymph nodes (median: 25.0 vs. 13.5, Z=-7.158, P<0.001) and the black staining rate of lymph nodes [(70.8±12.0)% vs. (47.1±15.7)%, t=11.399, P<0.001) in the zonal tracer group were significantly higher than those in the traditional tracer group. The total detected number of lymph nodes (37.5±11.5 vs. 29.6±11.8, t=4.581, P<0.001) and the total number of negative lymph nodes (31.3±12.5 vs. 24.9±11.1, t=3.621, P<0.001) were significantly higher in the zonal tracer group than those in the traditional tracer group. There were no significant differences in the total number of positive lymph nodes (median: 4.0 vs. 3.0, Z=-1.485, P=0.137), lymph node metastatic rate [78.7% (70/89) vs. 72.8% (67/92), χ 2=0.834, P=0.361] and metastatic degree [median: 11% vs. 10%, Z=-0.483, P=0.629] between the two groups. Conclusion:The carbon nanoparticles zonal tracer method can increase the black-staining rate of lymph nodes and the detected number of lymph nodes, thus improving the accuracy of gastric cancer staging.

Objective:To explore the efficacy of breaking blood expelling stasis method accelerates hematoma resolution after intracerebral hemorrhage (ICH) and its potential mechanism.Methods:63 ICH patients confirmed by computer tomography (CT) scan from August 2019 to February 2020 were selected as the research objects and randomly divided into control group ( n=29, routine treatment plus placebo) and observation group ( n=34, routine treatment plus breaking blood expelling stasis granules). The changes of neurological function and hematoma volume were observed before and after treatment. At the same time, the ICH rat model was constructed to observe the changes of neurobehavior and hematoma volume after the intervention of breaking blood expelling stasis granules. The expressions of peroxidase proliferator-activated-receptor γ(PPARγ), CD11b and CD36 in the surrounding tissues of hematoma were detected by Western blot on the third day after the intervention. Results:After two weeks of treatment, the National Institutes of Health Stroke Scale (NIHSS) score and hematoma volume of the two groups decreased (all P<0.05), and the NIHSS score and hematoma volume of the observation group were significantly lower than those of the control group (all P<0.05). In addition, the changes of NIHSS score and hematoma volume in the observation group before and after treatment were significantly greater than those in the control group ( P<0.01). In animal experiments, the hematoma volume in the breaking blood expelling stasis group on the 14th day after ICH was significantly smaller than that in the ICH group [(9.8±4.9)mm 3 vs (17.6±6.4)mm 3,P<0.05], and the reduction of hematoma in the breaking blood expelling stasis group on the 7th and 14th day was significantly larger than that in the ICH group [(4.6±2.9)mm 3 vs (-2.1±1.6)mm 3, (14.3±3.8)mm 3 vs (4.2±2.8)mm 3, all P<0.01]. The percentage of right turn on 3rd, 7th and 14th day and the modified Neurological Severity Score (mNSS) on 7th and 14th day in the breaking blood expelling stasis group were lower than those in the ICH group (all P<0.05). Western blot analysis showed that the expressions of CD11b, CD36 and PPARγ in the breaking blood expelling stasis group on the third day after ICH were significantly higher than those in the ICH group (CD11b: 0.78±0.12 vs 0.49±0.11, P<0.05; CD36: 1.16±0.16 vs 0.80±0.11, P<0.05; PPARγ: 0.78±0.11 vs 0.37±0.10, P<0.01). Conclusions:Breaking blood expelling stasis can effectively accelerate intracerebral hematoma clearance and improve neurological outcome after ICH, and the mechanism maybe probably mediated by activating PPARγ and enhanced CD36, CD11b upregulation on microglia/macrophages, which resulting in facilitating erythrocyte endogenous phagocytosis.

OBJECTIVETo explore the clinicopathological characteristics and prognosis of familial gastric cancer(FGC) and to provide clinical evidence for rational treatment program.

METHODSClinicopathological data of 91 patients with FGC and 293 patients with sporadic gastric cancer(SGC) in our department from March 2003 to October 2007 were retrospectively analyzed and compared between the two groups.

RESULTSTumors with a diameter of less than or equal to 5 cm were more common in FGC patients than SGC patients [65.9%(60/91) vs. 52.6%(154/293), P=0.025]. Proportion of FGC patients with poor differentiation was significantly higher as compared to SGC patients [68.1%(62/91) vs. 55.6%(163/293), P=0.034]. The 5-year overall survival rate in FGC patients was significantly lower than that in SGC patients(25.6% vs. 38.9%, P=0.001). Further stratified analysis revealed that the 5-year survival rates of T4 FGC and T4 SGC patients were 14.5% and 30.5% respectively, the 5-year survival rates of N3 FGC and N3 SGC patients were 10.4% and 17.3% respectively, and the differences were statistically significant(all P<0.05), while other T stage and N stage between the two groups were not significantly different(all P>0.05). Univarite analysis showed that tumor size, tumor location, pathological type, operation method, infiltration depth and lymph node metastasis were influencing factors of prognosis of FGC. Multivariate analysis showed that tumor size(HR=2.271), pathology types(HR=1.449), lymph node metastasis(HR=1.748) and the infiltration depth(HR=1.487) were independent risk factors affecting the prognosis of patients with FGC.

CONCLUSIONCompared with SGC, FGC is associated with poor differentiation and poor prognosis.