Objective To investigate the indications and suitable surgical operation routes of total gastrectomy for gastric carcinoma and the reconstruction procedure of digestive tract following total gastrectomy.Methods The clinical data of total gastrectomy by abdominal incision in 170 patients with GC from 1991 to 2001 were reviewed.Results Radical total gastrectomy was prfomed in 132 cases,palliative total gastrectomy in 38 cases,total gastrectomy with combined re section of other organs in 18 cases,Roux en Y esophagojejunostomy in 110 cases following total gastrectomy.Interposition with jejunum in 60 cases following total gastrectomy.There are 20 cases with dumping syndrome and 6 cases with reflux esophagitis occurring in Roux en Y esophagojejunostomy,but none of cases occurs in those by interposition with jejunum.Conclusions (1)Transabdominal incision is the better choice for patients of GC,especially gastrocardiac carcinoma.(2)The total gastrectomy can raise the survival rate and quality of life of patients with GC,if the indications are stricted.(3)Interposition with jejunum following total gastrectomy is superior to Roux en Y esophagojejunostomy.

Background Open-globe injury of zone Ⅱ is a severe eyeball wound in the sclera area near 5mm from the corneal limbus.To accurately evaluate the local tissue structure after the wounding is very important for lessening the complications of eye injury.Ultrasound biomicroscope (UBM) has been proven useful in examining eyeball wall and vitreous at the wound in order to offer the useful information about whether secondary operation is needed for the injured eyes and when is the optimal timing for surgery.Objective The present study is to explore the clinical application of UBM in open-globe injury of zone Ⅱ. Methods This is an observational study of clinical cases.UBM examination was performed on 38 eyes of 38 cases received emergency repair surgery of open-scleral injury.The restore status of sclera,ciliary body and vitreous of injuried zone (zone Ⅱ) were evaluated under the UBM in 3-5 days after the operation.The comprehensive results of UBM,B-scan and ophthalmoscope examinations were analyzed to determine the further treatment.The oral informed consent was obtained from each subject before this trial.Results Vitreous surgery were performed on 15 cases,and all wounds were found by UBM and were proven in the surgery.The other 23 cases were followed up in out-patient department and no obvious complications were found.Conclusion UBM is a valuable and atraumatic examination for open-globe injury of zone Ⅱ.It offers important and appraisal information about ocular injury.

Objective To report the effect of hormone replacement plus orthopedic surgery for 4 patients with female pseudohermaphroditism caused by congenital adrenal hyperplasia. Methods Four patients with female pseudohermaphroditism caused by congenital adrenal hyperplasia were included.On admission their ages were 11,15,14 and 20 years,respectively.The diagnoses were confirmed by medical histories,ultrasonography,serum levels of hormones and chromosome analysis.They all underwent clitoroplasty and vaginoplasty with perineal skin flap. Results After operation the patients received estrogen and progestogen for a short time to adjust the menstrual cycle and hydrocortisone replacement(10 to 20 mg,twice a day) for their lifetime.Normal menstruation and well-developed breasts were observed in all the patients.No constriction occurred in the reconstructed vaginas. Conclusions This disease can be easily misdiagnosed as hypospadias with bilateral cryptorchidism.Therefore,in addition to careful physical examination,the measurement of serum hormones,ultrasonography of the abdomen,and chromosome analysis are necessary.Proper utilization of the perineal skin flap for reconstruction of the clitoris and vagina as well as careful perioperative managements in combination with hormone replacement therapy can greatly contribute to satisfactory results.

Background and purpose:As a member of the catenin family, Delta-catenin protein could promote proliferation and invasion of tumor cells, but the accurate mechanism of Delta-catenin promoting cell proliferation is not clear. In the present study, we illustrated that Delta-catenin’s effect on cell apoptosis and their relationship with mitogen-activated protein kinase (MAPK) signaling pathway, and the possible mechanism was also explored for Delta-catenin promoting invasion and proliferation of tumor cells. Methods:The alterations of p38 and c-jun N-terminal rinasel JNK protein activity were detected in SPC and SK lung cancer cell lines with Delta-catenin overexpression or not, by Western blot method. At the same time, the apoptotic number of tumor cells was also examined by FCM method. Furthermore, the number of invasive tumor cells was examined by Matrigel invasive experiment. Results:Compared with untreated group and empty vector group, the activity of p38 protein was unchanged in lung cancer cell lines with Delta-catenin overexpressed (P>0.05), but the activity of JNK protein was decreased signiifcantly (P<0.05),meanwhile, apoptotic proportion of tumor cells were also reduced (P<0.05), and invasive ability of tumor cells was enhanced signiifcantly (P<0.05). Conclusion:Delta-catenin probably decreases apoptosis number of lung cancer cells via inhibiting the activity of JNK pathway, and then promotes invasive ability of tumor cells.

Objective To study the effects of the inopolysaccharide from Spirulina maxima (IPSⅡA) on tumor-bearing mice.Mothods The sarcoma 180(S 180) was transplanted in the abdominal cavity and armpit of mouse and then the survival time, the tumor weight, leukocyte count and the immunity index of the tumor-bearing mice treated with IPSⅡA were measured and compared with the control group. Results and ConclusionThe results showed that medication of IPS IIA ip in advance could obviously inhibit the tumor growth and prolong the survival time of the tumor-bearing mice.

Objective To observe the effects of selenium extracellular polysaccharide of Porphyridium sp(Se-PSP) on the growth and apoptosis of BEL-7402 tumor cell line.Methods The Se-PSP was obtained from a sort of culture medium with some selenous acid solution.In vitro,human tumor cells were cultured in sorts of PSP or Se-PSP liquors with different concentrations,and the result of which was determined by MTT,Focus apoptosis assay and DNA fragmentation.Results and Conclusion Se-PSP(80mg?L-1) displayed strong growth inhibitory effects against BEL-7402 human cancer cell line,and induced the apoptosis of BEL-7402 cells.

Objective To evaluate the impact of acute hyperglycemia on the short-term prognosis in patients with primary intracerebral hemorrhage (ICH) with meta-analysis. Methods The prospective or retrospective cohort studies or case-control studies of the relationship between baseline blood glucose levels and short-term prognosis (at least were followed up to discharge or 1 month) in patients with ICH within 24 hours were searched and reported. A meta-analysis software package (RevMan 4. 2) was used to pool data for the literatures in accordance with the inclusion criteria. The publication bias was analyzed and the sensitivity analysis was used to evaluate the stability of the results. Results The risk of mortality at the end of the follow up in the normoglycemia group was significantly lower than that in the hyperglycemia group (odds ratio 0. 24,95% CI 0. 19-0. 30; P <0. 000 01); the baseline plasma glucose level was significantly lower than that in the survival group (weighted mean difference -2. 30,95% CI -2. 36- -2.23; P< 0.000 01). Conclusions Acute hyperglycemia can significantly increase the risks of short-term mortality in patients with primary ICH. It is necessary to conduct a prospective randomized trial in order to investigate the effect of intensive glucose control on the prognosis of the patients with ICH.

Objective To analyze and compare the incidence of cerebral vasospasm (CVS) in patients with aneurismal subarachnoid hemorrhage(aSAH) in China and in Europe.Methods A literature search was performed for all the papers investigating the incidence,diagnosis, treatment or prognosis of CVS after aSAH using the MEDLINE and China Knowledge Resource Integrated Database (CNKI) from January 1, 1990 to December 31, 2010.The incidences of angiographic CVS, symptomatic CVS and CVS-related infarcts were recorded.The incidences of CVS between Chinese and white men in Europe were compared. Results A total of 237 articles were searched via CNKI and reference reviews, and 9 of the studies met the inclusion criteria. A total of 172 articles were searched via MEDLINE and reference reviews, and 18 of the studies met the inclusion criteria. The risk of occurring symptomatic CVS in patients with aSAH in Chinese was significantly higher than that in white men in Europe (relative risk,2. 063, 95％ confidence interval 1.816-2. 343, P ＜0. 001). Conclusions The incidence of CVS in patients with aSAH in Chinese was significantly higher than that in white men in Europe,indicating the pathogenesis of CVS may have genetic basis.

Objective: To investigate the ratios of peripheral blood CD4+CD25+,CD4+CD8+ regulative T cells of systemic lupus erythematosus(SLE) patients, and explore the association with disease active stage,nephropathy,serum anti-ds-DNA antibody,and both IgG and C3 levels. Methods: The percentage of CD4+CD25+T cells and CD4+CD8+T cells of peripheral blood from patients with systemic lupus erythematosus(SLE)(30 females and 7 males),30 rheumatism controls and 30 normal individuals were measured by flowcytometry. Results: Patients with active disease had statisitically lower levels of CD4+CD25+T cells than did normal controls(P

Objective To evaluate the value of circular anastomotic stapler for sigmoid colostomy in laparoscopy abdominoperi-neal resection .Methods 62 patients of low colorectal cancer treated in our hospital from October 2010 to February 2013 was retro-spectively analyzed .All the patients were treated by laparoscopy abdominoperineal resection ,34 patients received sigmoid colostomy with circular anastomotic stapler(group A) ,and the other 28 patients received sigmoid colostomy with conventional suturing tech-niques(group B) .The medical records including operation time ,the time of return of bowl function ,postoperative hospital stay and postoperative complication rate were analysed statistically .Results All patients received the operations successfully .No conversion to open procedure and no operative death occured in two groups .The result of statistical analysis showed that in group A ,the opera-tion time ,the time of return of bowl function ,postoperative hospital stay time were shorter than group B ,and the rate of edema of sigmoid in group A were lower than group B(P<0 .05) .Conclusion The application of circular anastomotic stapler for sigmoid co-lostomy in LAPR is a safe ,effective and minimally invasive technique ,which can shorten operation time ,postoperative hospital stay and reduce the related complications of colostomy .