Laparoscopic curative gastrectomy has been widely adopted because it is minimal invasiveness.The efficacy of laparoscopic gastrectomy is comparable to that of open gastrectomy for patients with early or advanced gastric cancer,but few studies of laparoscopic total gastrectomy combined with distal pancreatectomy and splenectomy for patients with advanced gastric cancer have been reported.Seven patients with advanced gastric cancer received laparoscopic total gastrectomy combined with distal pancreatectomy and splenectomy at the First Hospital of Jilin University from September 2010 to September 2011.The mean operation time,blood loss,postoperative hospital stay and the nunber of lymph nodes resected were (218 ± 24) minutes,(366 ± 174) ml,( 14.6 ± 2.8 ) days and 32 ± 15,respectively.Two patients were complicated by pancreatic juice leakage and were cured with drainage. No anastomotic leakage,abdominal bleeding or mortality was observed. With the development of techniques and equipments,laparoscopic total gastrectony combined with distal pancreatectomy and splenectomy is safe and feasible in selected patients.

Objective To evaluate the clinical significance of video-electroencephalogram(VEEG) in the diagnosis of paroxysmal events in children.Methods The VEEG and routine electroencephalogram(EEG) were used to inspect 262 cases of seizures respectively collected of outpatient clinic and admission department from Apr.2006 to Dec.2007,and VEEG monitoring results were analyzed and compared with primary diagnoses retrospectively.According to the characteristics of EEG and clinical observation to decide whether it be epilepsy or not and compare the difference between the results of EEG and VEEG to evaluate the application value of the 2 examination methods in children with NES.SPSS 13.0 software was used to analyze the data.Results Of all 262 cases,113 cases of clinical outbreak were recorded,meanwhile the diagnose of 4 patients of epileptic seizures(ES) group were changed to non-epileptic seizures(NES) and 3 patients of NES were rediagnosed to ES,69 cases couldn′t be confirmed according to VEEG or EEG and there was no outbreak recorded in the other 149 cases.In the period onset,79 children′s characteristics of EEG were captured which included 76 children in ES group,and 3 children in NES group.Thirty-six children′s characteristics of EEG were not captured which included 4 children in ES group and 30 children in NES group.The differences of the ratio of total detect and abnormity between EEG and VEEG were significant,improving the diagniosis rate and the control rate of symptom.VEEG had a clinical significance in differential diagnosis of ES and NES.Conclusions Compared with EEG,VEEG will be more helpful in diagnosing and differentiating seizures diseases,improving the diagnosis rate and the control rate of symptom.VEEG has a clinical in diffe-rential diagnosis for ES and NES.

The geographical distribution of C. botulinum type E and its associated disease, type E botulism in China, is different from that in other areas of the world. Cases of type E botulism generally arise in costal regions. In China, however, type E botulism is found primarily in the Qinghai-Tibet plateau of northwest China far from the ocean, at an altitude of approximately 4-5 km. The foods most commonly associated with the disease are fermented grain and beans as well as raw meat. A suspected outbreak of type E botulism poisoning in the central costal region of China in the 1990s prompted the collection and analysis of samples of mud, sand, and fish from the region. The toxin produced by type E botulinum was found in these samples. Surprisingly, though, upon further analysis, the strain isolated from the samples was identified not as type E C. botulinum, but as the neurotoxigenic bacterium Clostridium butyricum.
Botulism ; epidemiology ; China ; epidemiology ; Humans

OBJECTIVETo explore the effects and action mechanism of electroacupuncture (EA) pretreatment on rats with transient cerebral ischemia/reperfusion.

METHODSA total of 144 healthy SD male rats were randomly divided into a sham operation group (group S), an ischemia/reperfusion group (group I/R) and an EA pretreatment group (group EA), 48 rats in each one. The model of cerebral ischemia/reperfusion was established by using 4-vessel occlusion method in the group I/R; after 5 min of cerebral ischemia, the reperfusion was performed. The group EA was treated with EA at "Dazhui" (GV 14) and "Baihui" (GV 20) 5 days before model establishment, 30 min per time, once a day. In group S, bilateral foramen alares were exposed without burning on the vertebral arteries, and bilateral common carotid arteries were unfolded and not occluded. The rats in the group I/R and group EA were sacrificed 6 h, 12 h, 24 h and 48 h after reperfusion and those in the group S were sacrificed at corresponding time to collect hippocampus example. The Western-blot method was used to measure the expression of glucose-regulated protein 78 (GRP 78), and HE staining method was used to count the number of surviving neurons, and TUNEL method was used to measure the number of apoptotic neurons.

RESULTSCompare with the group S, the number of surviving neurons in hippocampus was reduced at each reperfusion time point and the number of apoptotic neurons was increased (all P<0.05) in the group I/R and the group EA; the expression of GRP 78 at each reperfusion time point in group I/R and group EA was increased (P<0.05). Compared with the group I/R, the number of surviving neurons in hippocampus was increased at each reperfusion time point and the number of apoptotic neurons was reduced in the group EA (P<0.05); the expression of GRP 78 at each reperfusion time point was further increased (P<0.05).

CONCLUSIONThe electroacupuncture pretreatment has obvious cerebral protection on rats with ischemia/reperfusion, which is related with further increasing the expression of GRP 78 in ischemia area, leading to relieved endoplasmic reticulum stress.

Animals ; Brain Ischemia ; genetics ; metabolism ; surgery ; therapy ; Electroacupuncture ; Heat-Shock Proteins ; genetics ; metabolism ; Hippocampus ; metabolism ; Humans ; Male ; Rats ; Rats, Sprague-Dawley ; Reperfusion

Objective To investigate clinical effect of local decompression and selective interbody fusion with pedicle screw fixation technique for the treatment of degenerative lumbar scoliosis. Methods Medical records of 122 degenerative lumbar scoliosis patients were retrospectively studied. All cases were treated by selective interbody fusion,local decompression and pedicle screw fixation. Group A(L5 fusion)and group B(S1 fusion)un?derwent imaging analysis,and Suk criteria was used to evaluate the fixation,decompression,bone graft fusion. JOA scores were used to evaluate curative effect of excellent and good rate. Results There were no significant difference in operating time,blood loss and postoperative drainage volume between two groups. Follow?up period for all patients is(16.2 ± 0.8)months. X?ray revealed that Cobb′s angle on the coronal plane,the correction rate of lor?dosis and sagittal Cobb′s angle after treatment,the correction rate of lordosis in group B were better than in group A (P<0.05). There were no significant differences in intervertebral fusion rate,low back pain score of JOA and the effective rate at final follow?up between two groups(P>0.05). There was no infection or screw breakage and pulling out. The incidence rate of adjacent vertebral body disease in group A was higher than that in group B(P < 0.05). Conclusions Local decompression and selective interbody fusion with pedicle screw fixation technique for the treat?ment of degenerative lumbar scoliosis can produce satisfactory short to mid?term clinical curative effect.

Objective To observe the seasonal changes in serum levels of interleukin-1 beta (IL-1β), interleukin-6 (IL-6) and melatonin (MT) in Bizheng rat model, and explore the relationship between MT and the pathogenesis of rheumatoid arthritis.
Methods One hundred and sixty Sprague-Dawley rats were randomly divided into four groups in summer (n=80) and winter (n=80) respectively:normal group, collagen-induced arthritis (CIA) model group, operation group, and sham-operation group (n=20 in each group). The CIA model group was injected with collagen emulsion at the base of the tail to induce arthritis. The rats in the operation group received pineal gland resection, and 7 days after the first operation, underwent testectomy or oophorectomy. The rats in the sham-operation group were operated to ligature the sagittal sinus, without extracting the pineal gland. After the operations, the operation group and the sham-operation group both were immunized as the CIA group was.The serum levels of IL-1β, IL-6 and MT in different groups were measured by radioimmunoassay.
Results Compared with the normal group, the serum levels of IL-1βand IL-6 increased in the CIA model, operation, and sham-operation groups both in summer and in winter (IL-1βin summer, P=0.008, P<0.01, P=0.012; IL-1β in winter, P=0.019, P<0.01, P=0.027; IL-6 in summer, P=0.028, P<0.01, P=0.024;IL-6 in winter, P=0.006, P<0.01, P=0.008). In the operation group, the serum levels of IL-1βand IL-6 in winter were higher than in summer, but with no statistically significant differences (P=0.844, 0.679). Compared with the normal group, the serum level of MT significantly increased in summer and winter in both the CIA model group (P=0.002, 0.008) and the sham-operation group (P=0.003, 0.007), while significantly decreased in the operation group (P=0.023, 0.003). There was no significant difference in MT level in the operation group between summer and winter (P=0.947).
Conclusions The increase of serum levels of IL-1β and IL-6 may exacerbate the inflammatory reaction and cause a more severe condition in the rheumatoid arthritis. The concentrations of IL-1β, IL-6, and MT correspond with the change of seasons, confirming that there are connections between nature and human body.

OBJECTIVETo evaluate the safety and effectiveness of GreenLight 120-W laser photoselective vaporization of the prostate (PVP) versus transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH).

METHODSWe searched PubMed, Medline, Embase, Cochrane Library, Wanfang, CNKI, and VIP for randomized control trials and their references addressing 120-W PVP versus TURP in the treatment of BPH. Based on the inclusion and exclusion criteria, two reviewers independently accomplished the screening, quality assessment, and data extraction of the identified studies and performed meta-analyses using RevMan 5.2.

RESULTSTotally, 6 randomized control trials were included in this analysis, involving 703 cases, 351 treated by PVP and 352 by TURP. Compared with TURP, PVP showed significantly decreased time of catheterization (by 32. 55 hours, 95% CI 15.3 -49.8, P < 0.01), hospital stay (by 1.85 days, 95% CI 1.2-2.5, P < 0.01), and intraoperative blood loss (by 15.6 g/L, 95% CI 10.0-21.2, P < 0.01), but increased time of operation (by 9.37 minutes, 95% CI 5. 1-13.6, P < 0.01). There was also a significant reduction in blood transfusion, TUR syndrome, and capsular perforation in the PVP group. At 12 months after surgery, no statistically significant differences were found between the two groups in the improvement of maximum urinary flow rate, IPSS, postvoid residual, and sexual function.

CONCLUSIONGreenLight 120-W laser PVP is a safe and effective procedure for the treatment of BPH, with similar effectiveness to TURP but less blood loss, shorter time of catheterization and hospital stay, and lower incidences of blood transfusion, TUR syndrome and capsular perforation.

Blood Loss, Surgical ; Humans ; Laser Therapy ; adverse effects ; methods ; Length of Stay ; Male ; Prostate ; surgery ; Prostatic Hyperplasia ; surgery ; Randomized Controlled Trials as Topic ; Treatment Outcome

To examine whether or not the regulatory sequence of chicken ovalbumin gene can drive transgene expression specifically in hen oviduct, the authors constructed an oviduct-specific expression vector (pOV), containing 3.0 kilobases (kb) of the 5'-flanking sequence and 3.0 kb of the 3'-flanking sequence of the chicken ovalbumin gene. Jellyfish green fluorescence protein (EGFP) reporter gene and bacterial LacZ reporter gene were respectively inserted into the downstream of the 5'-regulatory region.The recombinants were named as pOVEGFP and pOVLacZ. Two transfer systems, in vitro and in vivo, were used to verify the function of the vector. In vitro, the plasmid DNA pOVEGFP and pEGFP-N1 were transfected respectively by the polyethyleneimine procedure into the primary chicken oviduct epithelium (PCOE) and fibroblasts cells isolated from laying hens. In vivo, the recombinant vector pOVLacZ was injected into egg-laying hens via wing vein and the tissues were collected for RT-PCR analysis.The results showed that expression of pEGFP-N1 was achieved at low level in oviduct epithelial cells and at high level in fibroblasts, but that the recombinant vector was not expressed in both cells. RT-PCR analysis showed that the LacZ gene was transcribed in the oviduct, but not in the heart, liver, kidney and spleen of the injected hens. Accordingly, the ?-galactosidase activity was only detected in the oviduct magnum (116.7 mU/ml) and eggs (16.47 mU/ml). These results indicated that the cloned regulation regions of chicken ovalbumin gene could drive exogenous gene expression specifically in the oviducts of hens. In vivo gene injection via wing vein may serve as a rapid production system of recombinant proteins in chicken eggs. In addition, the cultured primary oviduct cells from laying hens were not efficient temporary expression systems for analyzing the function of regulating elements of ovalbumin gene.

Objective To investigate the clinical efficacy and safety of recombinant human brain natriuretic peptide (rhBNP) in older patients with acute decompensated heart failure. Methods A total of 86 aged patients with acute decompensated heart failure who admitted to our hospital were enrolled. First, they were given recombinant human brain natriuretic peptide (rhBNP) loading doses 1. 5 μg·kg-1,3-5 min, intravenous injection, then continuous intravenous pump 0. 015 kg-1 for 3-5 days. The brain natriuretic peptide(BNP) ,left ventricular ejection fraction(LVEF) and blood urea nitrogen(BUN) ,serum creatinine(SCr) ,urine output/ intake ratio and blood pressure were compared befor and after treatment one week. Result Before and after treatment,BNP was(2387. 50 ± 1030. 99) pg·mL-1 and (783. 57 ± 476. 71) pg·mL-1; LVEF was(40. 85 ± 8. 76) ％ and(44. 35 ± 0. 94) ％; the systolic blood pressure was (135. 21 ± 15. 58) mmHg and(127. 51 ± 16. 24) mmHg; the urine output/ intake ratio was (0. 81 ± 0. 50) and (1. 26 ± 0. 24). Statistically significant differences before and after treatment were found(all P < 0. 05). Conclusion The early application of rhBNP in older patients with acute decompensated heart failure is effective and safe. It can improve cardiac function,and has no adverse effect on renal function,and increases urine output.

Objective To assess the diagnostic value of combined testing of urinary bladder cancer antigen(UBC),hyaluronic acid(HA)and survivin in the detection of bladder cancer.Methods This study included 64 bladder cancer patients and 20 urinary benign disease patients.The examinations of urine UBC by enzyme-linked immunosorbent assay(ELISA),HA by radioimmunology assay,survivin by RT-PCR and urine cytology were performed in them.Results The sensitivity of UBC(85.9%,55/64),HA (89.1%,57/64)and survivin(93.8%,60/64)was significantly higher than that of urine cytology (40.6%,P＜0.01).The specificity of UBC,HA,survivin and urine cytology was 85.0%(17/20),80.0% (16/20),95.0%(19/20)and 95.0%(19/20),respectively;there was no significant difference among these 4 methods(P＞0.05).The sensitivity of UBC,HA and survivin was also significantly higher than that of urine cytology in different histologic stages and grades(P＜0.05).The sensitivity of UBC and survivin was not significantly different among different histologie stages and grades(P＞0.05).With regard to HA test, the sensitivity in G_2 and G_3 groups was significantly higher than G_1 group(P＜0.01),but there was no differ- ence between G_2 and G_3 groups(P＞0.05);and no difference among different histologic stages(P＞0.05). However,the sensitivity of cytology was improved with the higher grade of bladder cancer(P＜0.01);there was no difference among histologic stages(P＞0.05),By combined use of UBC,HA and survivin,both the sensitivity and specificity were 100%.Conclusions The study indicates that UBC,HA and survivin are better diagnostic markers for the early detection of urinary bladder cancer.These tests are simple,feasible and noninvasive with higher sensitivity and specificity.In addition,combined use of them can improve the diag- nostic sensitivity and specificity.