Objective To investigate the mRNA expression of survivin, livin and XIAP gene in peripheral blood of patients with gastric cancer and its relationship with clinico-pathological features.Methods This study included 50 patients with gastric cancer and 20 healthy donors. The expression of survivin, livin and XIAP gene was detected by reverse transcription-quantitative polymerase chain reaction (RT-QPCR) using a molecular beacon probe, while recombination plasmid containing the sequence of survivin, livin and XIAP was standard. The relationship between copies of survivin, livin and XIAP gene expression in peripheral blood with gastric cancer and clinical data was analyzed. Results A linear standard curve was obtained between 103 ～ 1010 copies. The copies of survivin, livin and XIAP mRNA in peripheral blood of patients with gastric cancer did not correlate with gender, age, and histological types ( P ＞ 0.05). There were positive relationships between copies of survivin, livin and XIAP gene with lymph node metastasis and TNM stage (P ＜0.05 ). The expression of survivine, livin and XIAP was all negative in peripheral blood of healthy people. 52% (17/33) of patients suffered from recurrence or metastasis who had positive expression of survivin and/or livin and/or XIAP mRNA, while it was 18% (3/17)among the negative survivin and/or livin and/or XIAP mRNA caces ( P ＜ 0.05). Conclusions The expression of survivin, livin and XIAP mRNA can be used to detecte micro-metastasis in peripheral blood circulation of gastric cancer.

Objective To observed the expression of serum TNF-α and IL-10 in rats with severe acute pancreatitis (SAP) at different altitudes,and to explore the relationships between TNF-α and IL-10,the pathological changes of the pancreas,and the experimental basis for clinical diagnosis and treatment of SAP.Methods 72 specific pathogen free (SPF) Wistar male rats were divided randomly into three groups:1 500 meters altitude (group L),3 300 meters altitude (group M),and 4 300 meters altitude (group H).These three groups were then each divided randomly into four subgroups:control (group n),6 hours after pancreatitis (group p 6 h),12 hours after pancreatitis (group p 12 h),and 24 hours after pancreatitis (group p 24 h).Pancreatitis was induced by intraductal administration of 5％ sodium taurocholate hydrate (NaTc).The rats were killed at 6,12,and 24 hours after NaTc injection in groups p.The group n rats were killed after 6 hours of pancreas observation.Blood samples and pancreatic tissues were collected post mortem and enzyme-linked immunosorbent assay (ELISA) measured serum TNF-α and IL-10.Results Compared with the control (group n),histopathological scores,IL-10,and TNF-α in the same altitude had a significant difference (P ＜ 0.05) in group p at each time point.In the same altitude of group p,histopathological scores and IL-10 were increased with time elapsed (P ＜ 0.05),while TNF-α was decreased with time elapsed (P ＜ 0.05).There was a significant difference between group Mp and Lp in histopathological scores,IL-10,and TNF-α (P ＜ 0.05),and the same result between group Hp and Lp (P ＜ 0.05),but there was no significant difference between group Hp and Mp (P ＜ 0.05).Meanwhile,IL-10 had a positive relationship with histopathological score,but TNF-α had a negative relationship with histopathological score.Conclusions The level of TNF-α increased with increasing altitude but significantly reduced with elapsed time.The level of IL-10 increased with both increasing altitude elapsed time.These results suggested that TNF-o and IL-10 might play a important role at different times in severe acute pancreatitis.

Objective To compare the clinical therapeutic effect of radical resection of esophageal carcinoma under combination of thoracoscopy and laparoscopy (RECTL) with traditional radical resection of esophageal carcinoma(TREC).Methods 80 patients receiving RECTL and 80 patients receiving TREC were chosen in our hospital.The general conditions during operation,pathologic data,postoperative complications and recurrence or metastasis rates were compared between two groups.Results Compared with TREC group,RECTL group had longer operation time 、less bleeding、less postoperative chest drainage liquid amount and less postoperative morphine administration (P ＜ 0.05 or P ＜ 0.01).The postoperative hospital stays were not statistically different between the two groups(P ＞0.05).The length of resected esophagus specimen and tumor near end cutting edge length in RECTL group are longer than that in TREC group,but with the former no statistically different(P ＞0.05) and the latter statistically different(P ＜ 0.05).There were no statistical differences about the number of dissected lymph nodes and the incidence of complications and local recurrence by cut plant between the two groups(P ＞ 0.05).The incidence of postoperative reflux gastritis was 7.1％ in RECTL group and 45 ％ in TREC group,with significantly statistical difference(P ＜0.01).The two groups had similar recurrence or metastasis rate(P ＞ 0.05).Conclusion Radical resection of esophageal carcinoma under combination of thoracoscopy and laparoscopy,with small wound and early recovery,has the same effect as traditional operational resection of esophageal carcinoma.

Objective To study and analyze the CT and MRI findings of hepatic eosinophilic infiltration. Methods Twenty nine patients of hepatic eosinophilic infiltration who were confirmed by biopsy or clinical diagnosis were retrospectively analyzed. All the patients underwent CT and/or MRI scan. Twenty seven cases underwent upper abdominal CT plain scan and three phase enhanced scan, and 5 cases underwent upper abdominal MR plain scan and three phase enhanced scan, of which 3 cases underwent CT and MRI scan. Evaluations were made regarding to the numbers of lesion, distribution, size, shape, margin, density or signal characteristic, enhancement parttern and other special features. Pearson correlation analysis was used to analyze the correlation between the number of hepatic lesions and the number of eosinophils in peripheral blood. Results A total of 108 lesions of eosinophilic hepatic infiltration were observed in 29 cases, including 2 cases with single lesion and 27 cases with multiple lesions. Ninety five of the lesions were located in subcapsular parenchyma or surrounding the portal vein. Most subcapsular lesions were wedge-shaped(n=28). Lesions surrounding portal vein were round-shaped(n=32), while the hepatic parenchymal lesions were irregular or round-shaped(n=13). The mean size of lesion was 34 mm, ranging from 3 to 61 mm. The margin of all the lesions were obscure. The lesions showed slightly low density or isodensity on CT pre-contrast images. On MR pre-contrast images, lesions showed slightly low signal or isointense on T1WI, and hyperintense on T2WI. Branches of portal vein were found infilrated by all lesions. Tueleve cases showed“stripe sign”along the portal vein branches, 16 cases showed“halo ring sign”around the portal vein. Pearson analysis indicated a significant correlation between the number of eosinophilic hepatic infiltrated lesions and the increase of eosinophils in peripheral blood (r=0.783, P<0.05). Conclusion The imaging features of EHI had certain characteristics, especially in the three phase dynamic enhanced scanning, from which we can mainly find“progressive enhancement”,“portal vein sign”,“stripe sign”and“halo ring sign”.

ObjectiveTo study the relationship between plasma riboflavin levels and esophageal squamous cell carcinoma.Methods We detected and compared plasma concentrations of riboflavin in patients with esophageal squamous cell carcinoma (ESCC) and immigrants of Linzhou living in Changzhi.Plasma riboflavin levels were quantified in 445 ESCC patients,689 healthy control subjects and 347 immigrants of Linzhou living in Changzhi by using enzyme-linked immunosorbent assay.ResultsThe plasma riboflavin levels in patients with ESCC were significantly lower than those in the healthy controls and immigrants of Linzhou living in Changzhi [ (731.69 ± 330.67 ) μg/L vs ( 1090.43 ± 445.08 ) μg/L,(731.69 ± 330.67) μg/L vs ( 897.58 ± 177.78) μg/L,respectively,all P ＜ 0.05 ],and the plasma riboflavin levels of the healthy controls were higher than those in the immigrants of Linzhou living in Changzhi (P ＜ 0.05).ConclusionPatients with ESCC have decreased plasma riboflavin levels as compared with the healthy controls and immigrants of Linzhou living in Changzhi,there exists a lack of riboflavin in ESCC patients,but the specific mechanism needs further study.

Objective To explore the association of C20orf54 gene rs3746804 position single nucleotide polymorphism and susceptibility to esophageal squamous cell carcinoma (ESCC).Methods Purification of genomic DNA from whole blood was used the Maxwell(R) 16 System.rs3746804 in C20ort54 was detected by direct sequencing in 434 ESCC patients from Changzhi (Shanxi province) and Linzhou (Henan province) and 554 healthy controls from Changzhi,Linzhou and including immigrators from Linzhou to Changzhi.Results For rs3746804,the genotypic frequencies of CT(37.5％ vs 51.0％,37.5％ vs 52.0％),CC (44.2％ vs 34.8％,44.2％ vs 33.0％) in Changzhi ESCC patients showed significant differences with healthy Changzhi controls and the healthy immigrator controls (all P ＜ 0.05),and the frequencies of TT(18.3％ vs 4.1％) and CC (44.2％ vs 54.6％) in Changzhi ESCC patients showed significant differences with Linzhou ESCC patients (all P ＜0.05).The genotypic frequencies of TT (4.1％ vs 15.0％),CT (41.2％ vs 52.0％) and CC(54.6％ vs 33.0％) showed significant differences between Linzhou ESCC patients and the healthy immigrator controls (all P ＜ 0.05),and the frequencies of TT (4.1％ vs 14.1％) and CC (54.6％ vs 34.8％) showed significant differences between Linzhou ESCC patients and Changzhi healthy controls (all P ＜ 0.01).Meanwhile,there were significant differences between ESCC patients (including Changzhi and Linzhou ESCC patients) and healthy controls (including the healthy Changzhi,Linzhou and immigrator controls) in genotypic frequencies of CT(39.2％ vs 48.7％) and CC (48.8％ vs 38.2％) (all P ＜ 0.01).CT and CT + TT genotype could decrease the risk of ESCC compared with the CC genotype (OR =0.630,95％ CI0.481-0.826 ; OR =0.654,95％ CI 0.507-0.844).Conclusion There is a closed relationship between SNP rs3746804 in C20orf54 and susceptibility to ESCC.

Objective To evaluate endoscopic surgical treatment of synchronous esophageal squamous cell carcinoma and adenocarcinonm at the esophagogastric junction.Methods The clinical data of 17 patients with synchronous esophageal squamous cell carcinoma associated with adenocarcinoma of esophagogatric junction between Jan 2010 and Jan 2017 were analyzed retrospectively.Results Among these 17 patients,9 patients underwent thoracoscopy and laparoscopy with partial resection of esophagus and proximal stomach,and gastroesophageal and neck anastomosis.3 patients underwent thoracoscopy and laparoscopy with partial resection of esophagus and proximal stomach,gastroesophageal intrathoracic anastomosis.Laparoscopic radical total gastrectomy combined with radiotherapy for esophageal cancer was performed in 5 cases.There was not perioperative death or serious complications.The cumulative survival rates of 1,3 and 5 years after surgery were 100％,42％ and 24％,respectively.Conclusion Thoracolaparscopic surgery combined with local radiation therapy is a safe and effective treatment for patients with synchronous esophageal squamous cell carcinoma and adenocarcinoma at esophagogastric junction.

Objective:To investigate the effect of the replantation in situ of donor skin graft with perforation and expansion in small and medium-sized skin transplantation. Methods:Patients were selected as group A with skin and soft tissue defects caused by various reasons treated in the Plastic and Aesthetic Surgery Department of Henan Provincial People’s Hospital from January 2002 to December 2019. A medium thick skin piece was harvested from the donor area with a drum dermatome, covering an area of 200-220 cm 2. The skin piece at the root of the drum dermatome was not broken, but the free skin piece of the drum dermatome was removed to the required area, transplanted to the wound surface, stitched intermittently and dressed with packing heap. The remaining skin graft in the donor area was punctured evenly with No. 15 surgical blade, then covered all the wounds in the donor area, sutured intermittently, and bandaged under pressure. The same kind of patients treated in other medical groups in our department in the same time were selected as group B. The skin donor area was not covered with skin graft in situ, but wrapped with traditional gauze. The patients were followed up in the outpatient department after operation, when the healing of the donor skin area and the degree of local scar was evaluated for data statistical analysis. The scars were scored according to Vancouver Scar Scale. The quantitative data were expressed in M( Q1, Q2), and were analyzed by Mann-Whitney U test. The qualitative data were analyzed by Chi-square test. P< 0.05 was statistically significant. Results:Group A had 63 cases, except for 1 case of graft avulsion, 2 cases of hematoma under the skin with partial survival of skin graft, 1 case of poor survival of infected skin graft after operation, the other skin grafts in the recipient area survived well. Group B included 59 patients, 38 males and 21 females, aged from 4 to 78 years old, with a skin defect area of 40 to 80 cm 2. The patients in both groups were followed up for 7-12 months. The healing time in group A was 11.1(10.2, 12.2) days. There were no skin pigmentation, severe hypertrophic scar and delayed healing of donor area. Four cases had mild scar hyperplasia and no keloid. The score of Vancouver Scar Scale was 3(2, 4). The healing time of group B was 15.8(13.9, 17.5) days with 23 cases of hypertrophic scar and 2 cases of keloid after healing. The score of Vancouver Scar Scale was 17(17, 17). There was significant difference in healing time between group A and group B ( P<0.01); there was significant difference in Vancouver Scar Scale scores between the two groups( P<0.01); what’s more, there was significant difference in the number of cases of hypertrophic scar between the two groups ( P<0.01). Conclusions:Compared with the traditional skin transplantation, the improved technology of the replantation in situ of donor skin graft with perforation and expansion has the advantages of intact skin, uniform thickness, timely blood circulation establishment after transplantation, no wound exposure in the donor area, natural skin color after primary healing, less scar and more in line with the skin function and aesthetic requirements of human body.

Objective:To investigate the effect of the replantation in situ of donor skin graft with perforation and expansion in small and medium-sized skin transplantation. Methods:Patients were selected as group A with skin and soft tissue defects caused by various reasons treated in the Plastic and Aesthetic Surgery Department of Henan Provincial People’s Hospital from January 2002 to December 2019. A medium thick skin piece was harvested from the donor area with a drum dermatome, covering an area of 200-220 cm 2. The skin piece at the root of the drum dermatome was not broken, but the free skin piece of the drum dermatome was removed to the required area, transplanted to the wound surface, stitched intermittently and dressed with packing heap. The remaining skin graft in the donor area was punctured evenly with No. 15 surgical blade, then covered all the wounds in the donor area, sutured intermittently, and bandaged under pressure. The same kind of patients treated in other medical groups in our department in the same time were selected as group B. The skin donor area was not covered with skin graft in situ, but wrapped with traditional gauze. The patients were followed up in the outpatient department after operation, when the healing of the donor skin area and the degree of local scar was evaluated for data statistical analysis. The scars were scored according to Vancouver Scar Scale. The quantitative data were expressed in M( Q1, Q2), and were analyzed by Mann-Whitney U test. The qualitative data were analyzed by Chi-square test. P< 0.05 was statistically significant. Results:Group A had 63 cases, except for 1 case of graft avulsion, 2 cases of hematoma under the skin with partial survival of skin graft, 1 case of poor survival of infected skin graft after operation, the other skin grafts in the recipient area survived well. Group B included 59 patients, 38 males and 21 females, aged from 4 to 78 years old, with a skin defect area of 40 to 80 cm 2. The patients in both groups were followed up for 7-12 months. The healing time in group A was 11.1(10.2, 12.2) days. There were no skin pigmentation, severe hypertrophic scar and delayed healing of donor area. Four cases had mild scar hyperplasia and no keloid. The score of Vancouver Scar Scale was 3(2, 4). The healing time of group B was 15.8(13.9, 17.5) days with 23 cases of hypertrophic scar and 2 cases of keloid after healing. The score of Vancouver Scar Scale was 17(17, 17). There was significant difference in healing time between group A and group B ( P<0.01); there was significant difference in Vancouver Scar Scale scores between the two groups( P<0.01); what’s more, there was significant difference in the number of cases of hypertrophic scar between the two groups ( P<0.01). Conclusions:Compared with the traditional skin transplantation, the improved technology of the replantation in situ of donor skin graft with perforation and expansion has the advantages of intact skin, uniform thickness, timely blood circulation establishment after transplantation, no wound exposure in the donor area, natural skin color after primary healing, less scar and more in line with the skin function and aesthetic requirements of human body.

Objective:To explore the clinical and pathological characteristics and prognostic factors of gastric neuroendocrine carcinoma(G-NEC)and gastric mixed adenoendocrine carcinoma(G-MANEC).Methods:Retrospective analysis was conducted on the clinical data of 67 patients with G-NEC and G-MANEC who underwent surgical treatment at Heping Hospital Affiliated to Changzhi Medical College from May 2015 to May 2023.The study included an analysis of the pathological characteristics distinguishing G-NEC from G-MANEC.Results:Com-pared to gastric adenocarcinoma,patients with G-NEC and G-MANEC in the stomach showed a higher incidence of gastric cancer in the male gastric cardia and were diagnosed at a later age.Tumors with larger diameters increase susceptibility to anemia,low albumin levels,and in-vasion of nerves and vasculature.Deeper tumor infiltration is associated with increased local lymph node metastases,later TNM staging,and a higher likelihood of distant metastasis post-surgery.The prognosis of G-NEC and G-MANEC is worse than that of gastric adenocarcinoma(P=0.001).However,there is no statistically significant difference in the pathological characteristics(P>0.05)and prognosis analysis(P=0.212)between G-NEC and G-MANEC.Univariate survival analysis identified age,preoperative albumin,preoperative CEA,number of lymph node metastases,TNM staging,and postoperative distant metastasis as risk factors affecting patient's overall survival(OS).In the multivariate ana-lysis,age,preoperative albumin,TNM staging,and postoperative distant metastasiswere identified as independent risk factors for OS.Con-clusions:There is a significant difference in clinical characteristics between G-NEC,G-MANEC,and gastric adenocarcinoma,often diagnosed at an advanced stage,which is prone to distant metastasis post-surgery.Poor prognosis is observed in patients aged over 60 years,with pre-operative albumin<40g/L,TNM stage Ⅱ/Ⅲ,and postoperative distant metastasis.