BACKGROUND:Biliary stent is widely used in different biliary tract surgeries, and there are some defects in the use of biliary stent. OBJECTIVE:To explore the biodegradability and compatibility of polylactide/glycolide biliary stent. METHODS:The polylactide/glycolide biliary stent was prepared, and immersed in the bile. At 1, 2, 3, 4 and 5 weeks after soaking, eight experimental stents were dried and placed under the scanning electron microscope. In the sterile condition, the stent was implanted under the rat skin. At 1, 2, 3, 4, and 5 weeks after implantation, two rats were sacrificed. The stent was taken out. The appearance of the stent and muscle structure of experimental animals was observed. The gross appearance of stent was observed at different time by scanning electron microscopy. The rate of degradation was calculated. The muscle structure of experimental animal and the stent were understood. RESULTS AND CONCLUSION:At 1 week, stent shape remained almost intact, but the texture became soft;surface roughness and cracks gradual y appeared;stent wal col apse was visible. The stent was completely degraded at 5 weeks. Before degradation, the stent presented clear three-dimensional reticular structure observed by scanning electron microscopy. With the time extended, the stent surface and section corrosion became worsened. By gel permeation chromatography detection, at 1 week of implantation, the molecular mass of the stent declined rapidly, and then gradual y declined. At 2 weeks, the relative molecular mass decreased to 15 000. At 4 weeks, stent mass loss was approximately 40%. Al the experimental animals were survived, no poisoning, al ergy or heat source response. The operative wound was healed wel , and no infection occurred. By histological observation, at 5 weeks, the stent was completely degraded, with a degradation rate of 100%. Surrounding muscles recovered to a normal state. These results indicate that the polylactide/glycolide biliary stent has good degradation in vitro and biocompatibility.

ObjectiveTo investigate rational surgical approaches for Siewert type Ⅰ adenocarcinoma of the esophagogastric junction (AEG),and analyze the prognostic factors.MethodsThe clinical data of 103 patients with Siewert type Ⅰ AEG who were admitted to the Renji Hospital from January 2005 to December 2009 were retrospectively analyzed.All patients were divided into transthoracic approach group (61 patients) and thoracoabdominal approach group (42 patients).The incidences of numbers of lymph node dissected and postoperative complications of the 2 groups were compared using the chi-square test,Fisher exact probability or the t test.The survival curve was drawn by the Kaplan-Meier method and the survival was analyzed using the Log-rank test.Prognostic factors were analyzed using the one-way analysis of variance and Cox regression model.ResultsNo perioperative death was observed in the 2 groups.There were significant differences in the number of lymph node dissected and number of metastatic lymph node between the 2 groups (t =2.18,2.29,P ＜ 0.05 ).There was no significant difference in splenic injury between the 2 groups (P ＞ 0.05 ).There were no significant differences in postoperative bleeding,anastomotic fistula and stricture,esophagogastric reflux,pulmonary infection and esteomyelitis between the 2 groups (x2 =0.07,0.94,0.22,1.41,0.17,P＞0.05).Of the 103 patients,97(94.2％) were followed up.The mean postoperative survival time was 26 months.The median survival time was 26 months,and the 3-yearsurvival rate was 35.9％.The 3-year survival rates of transthoracic approach group and thoracoabdominal approach group were 32.8％ and 40.2％,with no significant difference between the 2 groups ( x2 =0.37,P ＞ 0.05).The results of univariate analysis showed that radical or palliative resection,TNM stage,lymph node metastasis stage,tumor diameter and metastasis rate,degree of radical resection were independent factors influencing the prognosis of patients with Siewert type Ⅰ AEG (x2 =21.07,26.04,22.42,6.26,32.20,20.80,P＜0.05).The results of multivariate analysis showed that degree of TNM stage,lymph node metastasis rate and radical resection were independent factors influencing the prognosis of patients ( Wald =12.01,8.75,10.03,P ＜ 0.05 ).Conclusions Thoracoabdominal approach is a reasonable selection for patients with Siewert type I AEG.Degree of TNM stage,lymph node metastasis rate and radical resection were independent risk factors influencing the prognosis of patients.

Objective To isolate and identify the chemical constituents of 95% alcohol extract in the fruits of Ailanthus altissima. Methods The compounds were prepared by repurification and their structures were identified by physicochemical properties and spectral analyses. Results Nine compounds were isolated and identified as ailanthone A [11?, 20-epoxy-1?, 2?, 12?-pentahydroxypicrasa-3, 13(21)-dien-16-one, Ⅰ], olean-9(11), 12-dien-3?-ol (Ⅱ), D-friedoolean-14-en-3-one (Ⅲ), ?-amyin (Ⅳ), cycloart-25-ene-3?,24?-diol (Ⅴ), hopane-3-one-22-ol (Ⅵ), n-tetratriacontane (Ⅶ), L-evonymitol (Ⅷ), D-mannitol (Ⅸ). Conclusion Among them Ⅱ- Ⅸ are isolated from the plants of Ailanthus Desf. nom. Conserv. for the first time.

OBJECTIVETo investigate the chemical constituents from the extract of the fruits of Ailanthus altissimrna.

METHODTwelve compounds were isolated by chromatography and identified by spectral data.

RESULTThe compounds obtained were identified as (+)-isolariciresinol (1), isolariciresinol 9-O-beta-D-glucopyranoside (2), gallic acid (3), D-sorbitol (4), vanillin (5), 6,7-dihydroxy-coumarin (6), stigmast-4-en-3-one (7), 5alpha, 8alpha-epidioxy-ergosta-6,9 (11), 22E-trien-3beta-ol (8), ergosta-4,6,8 (14), 22E-tetraen-3-one (9), cycloeucalenol (10), lupeol (11), betulinic acid (12).

CONCLUSIONCompounds 1-12 were isolated from this genus for the first time.

OBJECTIVETo investigate the chemical constituents of the extract of Galium verum.

METHODThe compounds were isolated by chromatography and identified by spectral data.

RESULTThe eleven compounds obtained were identified as (+)-pinoresinol 4,4'-O-bis-beta-D-glucopyranoside (1), epipinoresinol (2), (+) -medioresinol (3), isorhamnetin (4), isorhamnetin 3-O-alpha-L-rhamnopyranosyl-(1-6)-beta-D-glucopyranoside (5), diosmetin (6), diosmetin 7-O-beta-D-glucopyranoside (7), quercetin-3-O-beta-D-glucopyranoside (8), ursolic acid (9), ursolic aldehyde (10) and rubifolic acid (11).

CONCLUSIONCompounds 1-5 and 9-11 were isolated from this genus for the first time.

Objective To investigate the feasibility and clinical value of anteroposterior and lateral scout scan combined with Care Dose 4D and Care kV in chest CT scan.Methods A total of 60 patients of clinical diagnosis with lung tumor were enrolled.Those patients were randomly divided into test group and control group.Control group underwent a scan protocol with lateral scout scan combined with Care Dose 4D and Care kV,while anteroposterior and lateral scout scan combined with Care Dose 4D and Care kV were performed in test group.The signal-to-noise ration (SNR),contrast-to-noise ratio (CNR),and overall image quality of two groups of images and diseased tissues were analyzed and evaluated by two high-grade radiologists using double-blind method.Effective doses (E) were also calculated.Results All the 60 patients had successfully completed the chest CT scans.Test group overall image quality (4.57 ± 0.45) and control group overall image quality (4.73 ± 0.45) had no statistically significant difference (P ＞ 0.05).The control group image SNR,CNR and diseased tissue SNR,CNR compared with test group had no statistical significance difference (P ＞ 0.05).The difference of the volume CT dose index (CTDIvol),dose-length product (DLP) and effective dose (E) of test group and control group was statistically significant (t =8.514,8.464,8.464,P ＜ 0.001).Compared with control group,the effective dose of test group decreased by 33.3％.Conclusions Compared with lateral scout scan,the technology of anteroposterior and lateral scout scan combined with Care Dose 4D and Care kV can decrease radiation dose without reducing the image quality.This technology can therefore be considered as a regular imaging modality for chest CT scan.

Gastric cancer is one of the most common malignant tumors which is a great threat to human health. In recent years, the reform of surgical mordalities and the optimization of radiation and chemotherapy is still far from reducing morbidity and mortality of gastric cancer. As a new research pattern, translational medicine has emerged in various clinical subjects, which leads to remarkable effects. In this paper, the definition and development of translational medicine, molecular markers and drug treatment of gastric cancer will be discussed and the feasibility of translational medicine in the treatment of gastric cancer will be explained. In our opinion, the intervention of translational medicine could change the current situation that scientific researches is severely disconnected with clinical practice and increase the detection rate of gastric cancer and the effective rate of adjuvant therapy after surgery to improve the prognosis of patients with gastric cancer.
Chemotherapy, Adjuvant ; Combined Modality Therapy ; Humans ; Prognosis ; Stomach Neoplasms ; drug therapy ; Translational Medical Research

The surgical treatment of early gastric cancer (EGC) is undergoing the development of minimally invasive, precise and individualized treatment. The concept is changing from simple emphasis on radical treatment to giving consideration to both radical treatment and functional preservation. Combined laparoscopy-endoscopy local resection can achieve accurate resection of the lesions of EGC and solve the problem of lymph node dissection which cannot be performed in endoscopic mucosal dissection (ESD). At present, there are several methods of combined laparoscopy-endoscopy local resection for EGC, such as laparoscopy-assisted endoscopic full-thickness resection (EFTR), endoscopy-assisted wedge resection (EAWR), combined laparoscopic and endoscopic approach for neoplasia with a non-exposure technique (CLEAN-NET), and non-exposed endoscopic wall-inversion surgery (NEWS). These methods of local resection have the advantages of minimal invasion, shorter operation time, and less blood loss compared to conventional gastrectomy. Concerning the issue of lymph node dissection in combined laparoscopy-endoscopy surgery, sentinel node navigation can be the solution, although cumbersome intraoperative lymph node tracing, operative failure and false negative still exist. As a developing treatment for EGC, combined laparoscopy-endoscopy local resection will have a good application prospect in the future.

The surgical treatment of early gastric cancer (EGC) is undergoing the development of minimally invasive, precise and individualized treatment. The concept is changing from simple emphasis on radical treatment to giving consideration to both radical treatment and functional preservation. Combined laparoscopy-endoscopy local resection can achieve accurate resection of the lesions of EGC and solve the problem of lymph node dissection which cannot be performed in endoscopic mucosal dissection (ESD). At present, there are several methods of combined laparoscopy-endoscopy local resection for EGC, such as laparoscopy-assisted endoscopic full-thickness resection (EFTR), endoscopy-assisted wedge resection (EAWR), combined laparoscopic and endoscopic approach for neoplasia with a non-exposure technique (CLEAN-NET), and non-exposed endoscopic wall-inversion surgery (NEWS). These methods of local resection have the advantages of minimal invasion, shorter operation time, and less blood loss compared to conventional gastrectomy. Concerning the issue of lymph node dissection in combined laparoscopy-endoscopy surgery, sentinel node navigation can be the solution, although cumbersome intraoperative lymph node tracing, operative failure and false negative still exist. As a developing treatment for EGC, combined laparoscopy-endoscopy local resection will have a good application prospect in the future.

Under the premise of radical resection in the treatment, it is of great significance to preserve partial gastric function so that the early gastric cancer (EGC) patients' postoperative quality of life (QOL) can be improved. In the patients with EGC in the upper third of the stomach, the emphasis is on the prevention of reflux esophagitis caused by bile and gastric juice reflux. Pylorus-preserving gastrectomy (PPG) is applicable to the patients with EGC in the middle third of the stomach. In the patients with EGC in the lower third of the stomach, distal gastrectomy (DG) is performed in general. Various anastomosis ways are applied to reduce the negative impact of pylorus resection after DG. Furthermore, it should also be considered that reasonable vagal nerves preservation and lymph node dissection are both important for function preserving gastrectomy of EGC. Rational use of laparoscopy-assisted gastrectomy has advantages of lower invasiveness, faster recovery, etc. And the amplification effect of laparoscope can contribute to preserving nerves and gastric function.
Esophagitis, Peptic ; prevention & control ; Gastrectomy ; methods ; Gastroenterostomy ; Gastroesophageal Reflux ; prevention & control ; Humans ; Laparoscopy ; Lymph Node Excision ; Organ Sparing Treatments ; Postoperative Period ; Pylorus ; surgery ; Quality of Life ; Stomach Neoplasms ; surgery ; Vagus Nerve