Objective To investigate the relations between radiological findings and pathological classification of superficial depressed(Ⅱc type)early gastric cancer.Methods Radiological features in subtonic double contrast barium examination and the endoscopic pictures of early gastric cancer compared with the global pathological specimens and micro-pathological features were prospectively studied.Combined with the gastric endoscopic pictures,the sharpness of margin of the lesions,the changes of converging mucosal folds and the changes of the depressed surface on the film of double contrast barium examination were analyzed.The correlation between the radiological features and histological classification of gastric cancer including well differentiated tubular adenocarcinoma(tub1),moderately differentiated tubular adenocarcinoma(tub2),poorly differentiated adenocarcinoma(por)and signet-ring cell carcinoma(sig) were studied.Results In 102 cases of Ⅱc type early gastric cancer,there were tubl 27 cases,tub2 11, por 26 and sig 38 cases histologically.The margin of the depressed lesions of tub1(24 cases)and tub2 (9 cases)cancers were mostly unsharply demarcated or with fine spicular border,while the margin of lesions of por(15 cases)and sig(31 cases)were mostly clearly and sharply demarcated,with statistical significance (P

OBJECTIVETo search all studies that had been published in the world with regarding to the effectiveness of the extent of intralesional curettage and wide excision for recurrence rate and complications and comparative functional outcomes in patients with giant cell tumours (GCT) of the distal radius and analyze them which were in high quality by means of Meta analysis, in order to give some evidences for the choice of method dealing with giant cell tumors GCT in surgery.

METHODSCochrane central register of controlled trials(Issue 8 2014), PubMed(1970-01-01/2013-01-01), Ovid (1970-01-01/2013- 01-01), Elsevier (1970-01-01/2013-01-01), CNKI (1970-01-01/2013-01-01) were searched. Including intralesional curettage and wide excision were performed to treat giant cell tumors (GCTs) of the distal radius in the literatures, selecting on meet eligibility in the standard literatures underwent strict quality assessment. The Meta-analysis was performed with software RevMan5.0 from the Cochrane collaboration. Additionally, the analysis checked the heterogeneity of data. The effectiveness of the extent of intralesional curettage and wide excision for recurrence rate and complication in patients with giant cell tumours of the distal radius were evaluated and Odds Ratio was calculated.

RESULTSSeven relevant articles were identified involving total 163 cases. Among them, 92 cases were intralesional curettage (PMMA, n = 54; bone graft, n = 33; no PMMA or bone grafts, n = 5) and 71 cases were wide excision. The patients in the intralesional curettage group had a higher recurrence rate [OR = 3.87, 95% CI (1.42, 10.53)],especially for Campanacci grade 3 GCTs [OR = 10.12, 95% CI (1.57, 65.27)], yet fewer major complications [OR = 0.13, 95% CI (0.04, 0.40)] than the wide excision group. The use of PMMA versus bone graft did not affect the recur- rence rate [OR = 0.96, 95% CI (0.26, 3.56)]. By selecting the system evaluation of MSTS, the VAS and dynamometer, the result showed that the intralesional curettage group was equivalent or preferable to wide excision in terms of function rehabilitation.

CONCLUSIONBased on data obtained from the limited number of studies available, intralesional curettage appears to be moreappropriate for the treatment of local lesions (Grade 1 and 2) than Grade 3 GCTs of the distal radius. Moreover, PMMA was not additionally effective as an adjuvant, the intralesional curettage group was found to be equivalent or preferable to wide excision in terms of function rehabilitation.

Bone Neoplasms ; surgery ; Curettage ; methods ; Giant Cell Tumor of Bone ; surgery ; Humans ; Radius ; surgery

Statistic-based experimental design was used to optimize the culture conditions for Pseudomonas aeruginosa ME16 strain which is capable of utilizing methane.Effects of inoculum volume,temperature,methane content,and initial pH of media on cell growth were studied with the medium of mineral salt and methane gas,and the response surface methodology(RSM) was then used to optimize culture conditions.The optimum conditions were as follows:temperature of 29.4℃,inoculum volume of 1.8% and methane content of 25%.Under the optimized culture conditions,the ME16 production was increased by 0.8 times and its cultivation time was reduced.The removal of methane gas by ME16 was preliminary investigated,and the removal rate of methane gas reached 65.7%.The results indicated that the strain was capable of removing of methane.

OBJECTIVETo investigate the effects and mechanism of postoperative insulin resistance in gastrectomy patients with preoperative oral carbohydrate.

METHODSFrom April to October 2011, 60 consecutive gastric cancer patients met inclusion criteria were divided into oral carbohydrate group and placebo group by randomized double-blind principles. Resting energy expenditure (REE), fasting blood glucose, insulin and triglyceride level were detected in 4 hours preoperatively. The 500 ml carbohydrate or placebo were administrated orally 2-3 hours before anaesthesia. Two group patients underwent radical distal subtotal gastrectomy under epidural compounded intravenous anesthesia. After laparotomy and before the abdomen was closed, a piece of rectus abdominis was taken and fixed in 3% glutaraldehyde. REE, fasting blood glucose, insulin and triglyceride level were detected immediately after surgery. The changes of insulin resistance index, blood triglycerides level, REE and respiratory quotient were compared pre- and post-operatively. The changes of rectus abdominis mitochondrial ultrastructure were observed by transmission electron microscopy respectively.

RESULTSThere were 48 patients (34 males and 14 females) completed the trial. The 24 and 24 patients in oral placebo and carbohydrate groups respectively. In oral placebo group, post-operative insulin resistance index, REE, respiratory quotient, serum triglyceride level and the rectus abdominis mitochondrial damage index were 12.68 ± 3.13, (1458 ± 169) kcal/d, 0.73 ± 0.42, (0.53 ± 0.24) g/L and 1.14 ± 0.33, respectively. And the above items were 5.67 ± 1.40, (1341 ± 110) kcal/d, 0.79 ± 0.22, (1.04 ± 0.97) g/L and 0.92 ± 0.19 in oral carbohydrate groups respectively. All difference was statistically significant (t = 6.646, 2.851, 6.546, 2.542 and 2.730, all P < 0.05). Oral placebo group showed a markedly swollen mitochondria, steep membrane was not clear, mitochondria appeared vacuolated changes.

CONCLUSIONSPreoperative oral carbohydrate could reduce the insulin resistance and REE, improve the material metabolism status in radical gastrectomy patients. The possible mechanisms should be related to promotion of insulin release and protection of mitochondrial function.

Administration, Oral ; Aged ; Basal Metabolism ; Carbohydrates ; administration & dosage ; therapeutic use ; Double-Blind Method ; Female ; Gastrectomy ; Humans ; Insulin Resistance ; Male ; Middle Aged ; Mitochondria ; ultrastructure ; Postoperative Complications ; prevention & control ; Stomach Neoplasms ; surgery

Transumbilical single-incision laparoscopic surgeries have attracted the attention of surgeon. Here we report a patient with multiple hepatic hemagiomas and symptomatic cholelithiasis who underwent laparoscopic left lateral hepatecomy and left hepatic hemangioma enucleation with single incision followed by cholecystectomy. The duration of the operation was 155 minutes and the blood loss was 100 ml. There were no complications during or after the treatment. This surgical treatment yields a good cosmetic effect and rapid recovery.
Female ; Hepatectomy ; methods ; Humans ; Laparoscopy ; methods ; Middle Aged ; Treatment Outcome

OBJECTIVE: Meta-analysis was used to compare the clinical efficacy of high tibial osteotomy(HTO) and unicondylar arthroplasty (UKA) in the treatment of medial compartment osteoarthritis (MIOA) and provide a better surgical choice for patients with MIOA. METHODS: The Cochrane Library (Issue 6, 2017), PubMed, Ovid, ELSIVE, CNKI and Wanfang databases were searched by a computer. Literatures on HTO and UKA for MIOA from January 1, 1970 to June 30, 2017, including complications, knee joint score, knee mobility, revision rate and excellent and good rate, were searched and screened out according to the inclusion criteria, and strict quality evaluation was carried out. RevMan 5.0 software provided by Cochrane collaboration network was used to conduct the meta-analysis of the included research results and to test the heterogeneity of the data. RESULTS: Total 13 articles met the inclusion criteria, and the total sample size was 1 043. Among them, 462 were HTO treatment group and 581 were UKA treatment group. By comparison between HTO treatment group and UKA treatment group, there were significant differences in the contralateral deterioration rate[WMD=3.21, 95%CI(1.13, 9.10)], pre-operative knee range of motion[WMD=6.55, 95%CI(1.44, 11.66)], Lysholm knee score[WMD=-3.15, 95%CI(-4.77, -1.53)], complications[WMD=2.78, 95%CI(1.52, 5.11], revision rate[WMD=1.81, 95%CI(1.17, 2.80)], the rate of excellent and good[WMD=0.49, 95%CI(0.30, 0.80)], and femorotibial angle changes[WMD=-2.37, 95%CI, (-3.63, -1.11)](<0.05). There were no significant differences between the HTO treatment group and the UKA treatment group in patellofemoral deterioration rate[WMD=1.59, 95%CI(0.65, 3.84)] and the free walking speed[WMD=-0.02, 95%CI(-0.09, 0.04)](>0.05). CONCLUSIONS Based on the limited data, high tibial osteotomy is a better choice for the treatment of medial compartment osteoarthritis in the comparison of short and medium-term clinical outcomes, and long-term clinical outcomes may need further study.
Arthroplasty, Replacement, Knee ; Humans ; Knee Joint ; Osteoarthritis, Knee ; Osteotomy ; Tibia ; surgery ; Treatment Outcome

Objective To evaluate the synergy effect of cefperazone -sulbactam and meropenem combination against 35 meropenem-resistant Acinetobacter baumannii isolated from clinical specimens in vitro.Methods The synergy effect of cefperazone -sulbactam and meropenem combination was evaluated through microdilution checkerboard method a-gainst 35 meropenem resistant A.baumannii were isolated from inpa-tients.The inhibitory concentration against antimicrobials was detected . The synergy effect of combination was assessed by fractional inhibitory concentration index ( FIC).Results The minimal inhibitory concentra-tion ( MIC) of 35 meropenem-resistant Acinetobacter baumannii against cefperazone-sulbactam and meropenem combined were decreased com-pared with single -use ( P<0.01 ).The checkerboard method with the combination of cefperazone -sulbactam and meropenem demonstrated 54.3%(19/35)synergism, 34.3%(12/35)partial synergism, 5.7%(2/35)additive, 5.7%(2/35)indifference, no antagonism in our study.Con-clusion Cefperazone -sulbactam and meropenem combination show syn-ergism or partial synergism against most Acinetobacter baumannii isolates.

Objective To evaluate the combined antibacterial effect of fosfomycin and imipenem against 60 carbapenem-resistant Enterobacteri-aceae ( CRE ) in vitro.Methods Experiment was designed by the checkerboard method , the minimal inhibition concentrations of single antibacterial drug or the combination of fosfomycin and imipenem at dif-ferent concentrations against 60 CRE isolated from inpatients were evalua-ted through agar double dilution method synergy effect of combination was assessed by fractional inhibitory concentration index ( FIC ) .Results Compared with single-use, the minimal inhibitory concentra-tion of thecombination of fosfomycin and imipenem decreased ( P<0.01).The combination of fosfomycin and imipenem demonstrated 23.3%( 14/60 ) synergism , 35.0%( 21/60 ) partial synergism , 1.7%(1/60) additive, 40.0%( 24/60 ) indifference, no antagonism in our study.Conclusion Combination of fosfomycin and imipenem showed synergism or partial synergism against most CRE isolates.

Objective:To search all studies that had been published in the world with regarding to the effectiveness of the extent of intralesional curettage and wide excision for recurrence rate and complications and comparative functional outcomes in patients with giant cell tumours (GCT) of the distal radius and analyze them which were in high quality by means of Meta analysis,in order to give some evidences for the choice of method dealing with giant cell tumors GCT in surgery. Methods:Cochrane central register of controlled trials(Issue 8 2014),PubMed(1970-01-01/2013-01-01),Ovid (1970-01-01/2013-01-01),Elsevier (1970-01-01/2013-01-01),CNKI (1970-01-01/2013-01-01) were searched. Including intralesional curettage and wide excision were performed to treat giant cell tumors (GCTs) of the distal radius in the literatures,selecting on meet eligibility in the standard literatures underwent strict quality assessment. The Meta analysis was performed with software RevMan5.0 from the Cochrane collaboration. Additionally ,the analysis checked the heterogeneity of data. The effectiveness of the extent of intralesional curettage and wide excision for recurrence rate and complication in patients with giant cell tumours of the distal radius were evaluated and Odds Ratio was calculated. Results:Seven relevant articles were identified involving total 163 cases. Among them,92 cases were intralesional curettage (PMMA,n=54;bone graft,n=33;no PMMA or bone grafts,n=5) and 71 cases were wide excision. The patients in the intralesional curettage group had a higher recurrence rate [OR=3.87,95%CI(1.42,10.53)],especially for Campanacci grade 3 GCTs [OR=10.12,95%CI(1.57,65.27)],yet fewer major complications [OR=0.13,95%CI (0.04,0.40)] than the wide excision group. The use of PMMA versus bone graft did not affect the recur-rence rate [OR=0.96,95%CI(0.26,3.56)]. By selecting the system evaluation of MSTS,the VAS and dynamometer,the result showed that the intralesional curettage group was equivalent or preferable to wide excision in terms of function rehabilitation. Conclusion:Based on data obtained from the limited number of studies available ,intralesional curettage appears to be more appropriate for the treatment of local lesions (Grade 1 and 2) than Grade 3 GCTs of the distal radius. Moreover,PMMA was not additionally effective as an adjuvant,the intralesional curettage group was found to be equivalent or preferable to wide excision in terms of function rehabilitation.

Background: Cervical cancer is the sixth most common cancer in Chinese women. A standard treatment modality for cervical cancer is the combination of surgery, chemotherapy, external-beam radiotherapy and intracavitary brachytherapy. The aim of this study was to retrospectively assess the long-term treatment outcomes of patients with cervical cancer who were treated with californium-252 neutron brachytherapy combined with external-beam radiotherapy plus concurrent chemotherapy.Methods: We retrospectively analyzed the medical records of 150 patients with primary stages IB-IVB cervical cancer who received neutron brachytherapy combined with external-beam radiotherapy concurrently with cisplatin chemotherapy.All patients were followed up. Using an actuarial analysis, patient outcomes and treatment-related adverse effects were evaluated and compared.Results: The median overall survival (OS) was 33.2 months. The 3-year progression-free survival rates for patients with stages Ⅰ—Ⅱ, Ⅲ, and Ⅳ diseases were 81.0% (68/84), 65.0% (39/60), and 0% (0/6), respectively; the 3-year OS rates were 90.5% (76/84), 85.0% (51/60), and 16.7% (1/6), respectively. Vaginal bleeding was controlled within the median time of 4.0 days. One month after treatment, 97.3% of patients achieved short-term local control. The local recurrence rates for patients with stages Ⅰ—Ⅱ, Ⅲ, and Ⅳ disease were 4.8% (4/84), 11.7% (7/60), and 33.3% (2/6), respectively, and the occurrence rates of distant metastasis were 16.7% (14/84), 25.0% (15/60), and 100.0% (6/6), respectively. Cancer stage,tumor size, and lymph node metastasis were identified as prognostic risk factors, but only lymph node metastasis was found to be an independent prognostic factor. The most common adverse effects during treatment were grades 1 and 2 irradiation-related proctitis and radiocystitis.Conclusion: For patients with cervical cancer, neutron brachytherapy combined with external-beam radiotherapy plus concurrent chemotherapy produces a rapid response and greatly improves local control and long-term survival rates with tolerable adverse effects.