To resolve the agastric syndrome after total gastrectomy, researchers have performed varoius alimentary tract reconstruction procedures for patients. Meanwhile, because of controversial standpoints fol-lowing the total gastrectomy, more than eighty methods were published in the world. The highlight is focused on the discussion of whether a reservoir with the duodenal passage of foodstuff significantly beneficial to the patient's clinical and nutritional status after total gastrectomy. In this article, we reviewed and evaluated the progress of digestive tract reconstruction procedures after total gastrectomy in order to obtain a optimal opera-tion approach.

OBJECTIVE To investigate the expression and their clinical significance of uPA (urokinase type plasminogen activator) and integrin?4 in papillary thyroid cancer. METHODS The levels of uPA and integrin?4 were determined by Immunohistochemistry technique (S-P method) in 36 specimens from patients with papillary thyroid cancer, 30 specimens from benign thyroid tumor and normal thyroid tissues adjacent to benign thyroid tumor. RESULTS The levels of uPA and integrin?4 in benign thyroid tumor were significantly higher than that in normal tissue adjacent to benign thyroid tumor (P

Objective To investigate the effects of selenium-and zinc-enriched probiotics on the content of selenium and zinc in blood,antioxidation function and intestinal microflora in canine.Method Eight 18-month native canines,female and male in half,were randomly divided into the control and treatment groups on average.The control group received basal diet,the treatment group received basal diet supplemented with 2.0g selenium-and zinc-enriched probiotics everyday.To determine the experimental indices,the samples were collected on D0,D15 and D30,respectively.Results Compared with the control group,on D15,the content of selenium and zinc in blood,blood GPX,serum SOD,T-AOC and the amount of Lactobacillus in the experimental group were significantly increased,while the amount of Escherichia coli significantly decreased,but the serum MDA and the amount of Bifidobacterium,Staphylococcus and Enterococcus had no significant change.On D30,the content of selenium in blood,serum SOD,T-AOC and the amount of Lactobacillus were very significantly increased,while the content of zinc in blood,blood GPX and the amount of Bifidobacterium significantly increased;but serum MDA and the amount of Escherichia coli,Staphylococcus and Enterococcus very significantly decreased.Conclusion Selenium-and zinc-enriched probiotics could increase content of selenium and zinc in blood,enhance antioxidation function,improve and regulate the intestinal microflora.

Objective To compare the clinical outcomes of retroperitoneal laparoscopic and open radical nephrectomy in patients with T1 renal cell carcinoma (RCC). Methods 352 patients under-went radical nephrectomy for T1 RCC, 185 by retroperitoneal laparoscopic radical nephrectomy(group A) and 167 by open radical nephrectomy through an extraperitoneal flank incision(group B). The op-eration time, blood loss during operation, hospital stay and complication after surgery were analyzed and compared. All the cases were followed up for 6-42 months(median, 25 months) and the survival rates were recorded. Results The operation time of group A, B was 55-130(75.6±11.2)min vs. 50-140(68.0±10.6)min(P0.05). Blood loss was 50-1200(110.6±32.3)ml vs. 50-1500 (160.8±38.1)ml(P<0.05). Eight cases of group A and 132 cases of group B took analgesic after surgery(P<0.05). The fasting period was 1-2(1.3±0.5)day vs. 2-5(2.9±1.2)d of group B (P<0.05)ilengthof hospital stay was 3-7(4.6±1.2)d vs. 7-14(8.9±1.6)d(P<0.05). The survival rate was 85.4 % vs. 86.2% (P0.05). Conclusions Compared with open radical nephrec-tomy, retroperitoneal laparoscopic radical nephrectomy is associated with lower blood loss, narcotic requirement and complications, a shorter hospital stay and earlier resumption of routine activities. Retroperitoneal laparoscopic radical nrphrectomy has become a gold standard therapy in T1 renal cell carcinoma.

Objective To summarize the clinical features,diagnosis and treatment of autologous urologic neoplasms in renal transplant recipients.Methods A retrospective analysis on the clinical data of 25 renal transplant recipients was done in our center.The onset time of new neoplasms was between 29 to 72 months after transplantation,with an average of 48.2 months.Intermittent hematuria was the first symptom in 23 patients,and the rest two cases were diagnosed through routine examination. The pathological diagnoses of thee cases were renal carcinoma,which were treated by transperitoneal laparoscopic radical nephrectomy.Eight cases were diagnosed as having renal pelvic tumor,which was treated by radical resection for the renal pelvic carcinoma.Fourteen cases were diagnosed as having bladder cancer,which was treated by transurethral resection of bladder tumor (13 cases) or radical cystectomy (one case).All patients were subjected to surgical treatment.The dosage of MMF,CSA/Tacrolimus was decreased to 1/2-2/3 of their original dosage. Sirolimus was used in place of calcineurin inhibitors in four patients.Immunosuppressive regimes and adjuvant therapy were given after surgery treatment.Results Twenty-five patients were followed up for 12-84 months.Contralateral renal carcinoma combined with lung and chest multiple metastases occurred in one case after radical nephrectomy,who died after targeted therapy 6 months later.Two patients with lymph node metastasis died 14 months and 20 months after surgery respectively.The rest 22 patients were closely followed up,whose creatinine remained 98-163μmol/L.Conclusion More attention should be paid to patients with hematuria after renal transplantation to screen the autologous urinary neoplasms.Patients should be treated with surgical procedures,and immunosuppressive regimens should be adjusted postoperatively.

In the present study, we first report the seroprevalence of Dirofilaria immitis in dogs in Shenyang, northeastern China. Sera from 528 randomly selected dogs were examined for D. immitis antigen using SNAP(R)4Dx test kit; 12.7% tested showed seropositive. No significant difference of infection was observed in different genders and breeds (P>0.05), but the difference was significant in different age groups and rearing conditions (P<0.05). The result suggested that the risk of exposure to D. immitis in dogs is high in Shenyang, and should be given attention.
Animals ; China/epidemiology ; *Dirofilaria immitis ; Dirofilariasis/epidemiology/*parasitology ; Dog Diseases/epidemiology/*parasitology ; Dogs ; Seroepidemiologic Studies

OBJECTIVE:To investigate the influence of CYP3A5*3 (rs776746) genetic polymorphism on blood concentration of tacmlimus (TAC) and renal function in renal transplant recipients during the stable period.METHODS:A total of 98 renal transplant recipients during the stable period receiving TAC-based triple anti-rejection scheme (TAC + sodium mycophenol +predrnisone acetate) after surgery and regular follow-up were selected from our hospital during Jan.1995-Dec.2014.The follow-up information during Jan.-Dec.2016 was also collected.Trough concentration of TAC in renal transplant recipients was determined by chemiluminescence microparticle immuno assay.Standard blood concentration (C/D) was calculated after corrected with body weight and daily dose.Scr level was detected with dry chemistry method.CYP3A5*3 genotype was detected by PCR-RFLP and direct sequencing.The relationship of CYP3A5*3 genetic polymorphism with TAC C/D value and Scr level was determined by Kruskal Wallis H or Mann-Whitney U assay.RESULTS:Among 98 renal transplant recipients,there were 9 cases of CYP3A5*3 *1/*1(AA) genotype,37 cases of *1/*3 (AG) genotype and 52 cases of *3/*3 (GG)genotype.The gene frequencies were 9.18％,37.76％,53.06％,which were all in line with Hardy-Weinberg equilibrium (P＞0.05).There was no statistical significance in trough concentration of TAC among different genotypes (P＞0.05).There was statistical significance in TAC dose and C/D value among different genotypes (P＞0.05).TAC dose of CYP3A5*3 *3/*3 genotype recipients was significantly lower than those of *1/*3 and *1/*1 genotype recipients;that of *1/*3 genotype recipients was significantly lower than that of *1/*1 genotype recipients.C/D value of *3/*3 genotype recipients was significantly higher than those of *1/*3 and *1/*1 genotype recipients;that of *1/*3 genotype recipients was significantly higher than that of *1/*1 genotype recipients,with statistical significance (P＜0.05).There was no statistical significance in Scr levels among different genotypes (P＞0.05).CONCLUSIONS:CYP3A5*3 genetic polymorphism significantly influences blood concentration of TAC in renal transplant recipients during the stable period,and *3 allele carriers have higher C/D values and need smaller TAC daily dose.CYP3AS*3 genetic polymorphism may be not associated with Scr level.

Objective To investigate the influence of epidural analgesia on labor duration under the new partogram recommendations using quantile regression.Methods In this study,we recruited 300 nulliparous women at full term who were hospitalized in Department of Obstetrics and Gynecology,Tongji Medical College,Huazhong University of Science and Technology from May to September,2018.The participants who were willing to receive epidural analgesia during labor were assigned to the epidural group (n=150),and those who were not to the control group (n=150).Labor duration and delivery outcomes were analyzed by Student's t test,Mann-Whitney U test,Chi-square test and Fisher's exact test.Quantile regression models were also used to investigate the effect of epidural analgesia on labor duration.Results The median durations of first-and second-stage labor in the epidural group were 600(400-840) and 66(45-98) min,respectively,which were significantly longer than those of the control group [420(320-610) and 52(33-87) min] (Z=-4.273,P＜0.001;Z=-3.210,P=0.001).Quantile regression analysis showed that,for the first stage of labor,epidural analgesia was associated with labor prolongation,and had significant effects on all the percentiles (all P＜0.05).The regression coefficients increased (95.630-285.000) correspondingly as the percentiles of the labor duration (from 10th to 90th percentiles) increased.For the second stage of labor,epidural analgesia showed a significant impact on prolongation only between the 25th and 75th percentiles (coefficients:10.000～18.143;all P＜0.05).Although the epidural group had a significant higher episiotomy rate [46.8％(65/139) vs 33.3％(48/144),x2=5.318,P=0.021],more times of urine catheterization during labor [1(0-1) vs 0(0-1),Z=-0.974,P=0.001]and higher rate of oxytocin administration during labor [48.7％(73/150) vs 30.0％(45/150),x2=10.952,P=0.001],when compared with the control group,there was no significant difference in cesarean section rate,assisted vaginal delivery rate and neonatal outcomes between the two groups (all P＞0.05).Conclusions Epidural analgesia may associated with the prolongation of the first and second stage of labor,especially with the first stage of labor,but has no adverse effects on maternal and neonatal outcomes.

Surgical resection is the first choice for liver cancer therapy.In order to transform the unresectable part into resectable one,surgeons manage to ensure adequate liver reserves by making the wanted liver tissue become hypertrophy and let the unwanted one become atrophy.However,though ALPPS (associating liver partition and portal vein ligation for staged sepatectomy) as an alternative operation plan in its initial developing stage now becomes a hot topic,it is still under great controversy.The author believes that it is imperative to draw up a personalized plan and carry out a strict and reasonable multicenter-clinical trial for those patients to get an opportunity to conduct a safe and effective operation.

Objective:To compair the outcomes of repairing soft tissue defects of hand between a biodegrad- able repair patch—porcine small intestinal submucosa (SIS) and skin grafting.Methods:From December, 2017 to December, 2018, 36 cases of hand soft tissue defect were treated and analyzed retrospectively. According to the defect area and treatment methods, 36 cases were divided into 2 groups: SIS group (21 cases) and grafting group(15 cases). In SIS group, the area of soft tissue defects was 2.0 cm×1.5 cm-9.0 cm×3.5 cm with an average of 5.3 cm×2.1 cm, treat- ed with SIS; In grafting group, the area of soft tissue defects was 9.0 cm×4.0 cm-16.0 cm×9.0 cm with an average of 12.0 cm×8.5 cm, treated with autologous skin grafting after wet dressing. Wound healing was evaluated at 14, 21 and 28 days, and 3 months after the surgery according to the appearance of colour, elasticity, sensory recovery and prog- noses of partial tendon exposure.Results:All patients were followed-up for 3 to 10 months, with an average of 5 months. All wounds in both groups were completely healed; the appearance was normal, and the skin elasticity and sensation had recovered. Sensation recovery in SIS group: 14 cases were good (66.6%), 5 cases were fine (23.8%), and 2 cases were bad (9.6%); in grafting group: 9 cases were good (60.0%), 4 cases were fine (26.0%), and 2 cases were bad (14.0% ). Wound healing effect in SIS group: 14 cases were good, 5 cases were fine, and 2 cases were bad; in grafting group: 9 cases were good, 4 cases were fine, and 2 cases were bad.Conclusion:The SIS patch can be used in the reconstruction of soft tissue defects in hand. There was no significant difference in colour compared to the sur- rounding skin and left no scar. The patch is an ideal repair material for superficial skin defects.