Objective To investigate the feasibility,safety and clinical efficacy of three-port laparoscopic sleeve gastrectomy (TLSG).Methods The retrospective cross-sectional study was conducted.The clinical data of 104 obese patients who were admitted to the Beijing Friendship Hospital of Capital Medical University between September 2016 and March 2017 were collected.TLSG was performed to all the 104 patients by the same surgical team.The surgical situations,conversion situations (port-site increased or conversion to open surgery),operation time,volume of intraoperative blood loss,surgery-related complications,duration of postoperative hospital stay and follow-up situations were observed.Patients were followed up by Wechat,telephone interview and inpatient examination once at month 3,6,9 and 12 postoperatively and once every year after 1 year postoperatively up to April 2017.Follow-up included weight-loss efficacy and postoperative long-term complications.Measurement data with normal distribution were represented as x±s or average (range).Results All the 104 patients underwent successful TLSG,without port-site increased or conversion to open surgery.Operation time and volume of intraoperative blood loss were (121±25)minutes and (9±6)mL,respectively.There was no severe intraoperative collateral damage.All the 104 patients with complications were cured by symptomatic treatment,including 1 with port-site infection,1 with peritoneal effusions causing secondary infection,3 with improper eating-induced acute delayed gastric emptying,6 with fat liquefaction around port-site and 9 with delay healing of port-site.There was no occurrence of severe complications,such as gastrointestinal bleeding,intra-abdominal bleeding and gastrostoma.Duration of postoperative hospital stay was (2.4±0.8)days.Eighty-two patients were followed up for 3 months (range,3-6 months),including 59 with 3-month follow-up,23 with 6-month follow-up and 22 with under 3-month follow-up.During the follow-up,there was no port-site hernia.Excess weight loss (EWL) was 37％± 11％ in 59 patients with 3-month follow-up and 45％± 13％ in 23 patients with 6-month follow-up.Of 59 patients with 3-month follow-up,14 patients with diabetes mellitus stopped taking antidiabetic drugs,10 of 14 patients had complete remission (CR) of hemoglobin Alc (HbAlc) and 4 of 14 patients had partial remission (PR) of HbAlc.Of 23 patients with 6-month follow-up,6 patients with diabetes mellitus had CR of HbAlc.Of 18 patients with obstructive sleep apnea hypopnea syndrome (OSAHS),4 had 3-month follow-up,including 3 with CR and 1 was improved to mild OSAHS.Other 14 patients were not evaluated due to inadequate follow-up time.Conclusion TLSG for obese patients with specific indications cannot increase operation time and risk,meanwhile,it can reduce port-site,with a good cosmetic effect.

Objective: To investigate the molecular mechanism of isofebrifuzine in the treatment of esophageal cancer by observing the effects of isofebrifuzine on proliferation, apoptosis, cycle, energy metabolism and protein expression related to energy metabolism pathway in EC9706 cells. Methods: ECC9706 cells were routinely cultured, cell activity was detected by MTT method, drug concentration was screened, and two concentrations of 1 μg/mL and 2 μg/mL were selected, the effect of isofebrifuzine on apoptosis and cycle of esophageal cancer cells EC9706 was detected by flow cytometry. The effect of isofebrifuzine on energy metabolism of EC9706 cells was detected by energy metabolism detection system, and the protein expressions of mTOR, p-mTOR, p-ACC and AMPK in cells were detected by Western blotting. Results: The proliferation of EC9706 cells was effectively inhibited in a dose-dependent manner (P < 0.01) after 48 h of treatment with different concentrations of isofebrifuzine, which could arrest EC9706 cells in S phase and G2/M phase (P < 0.05), effectively promote cell apoptosis (P < 0.05), and significantly inhibit cell glycolysis and mitochondrial metabolism (P < 0.01). Compared with the control group, AMPK expression was increased and mTOR, p-mTOR, p-ACC expression was decreased in the treatment group (P < 0.05). Conclusion: These results indicated that isofebrifuzine may regulate the cycle and apoptosis of EC9706 cells and inhibit the proliferation of EC9706 cells in esophageal cancer through energy metabolism.

OBJECTIVETo study the value of multislice spiral computed tomography (CT) in the diagnosis of ovarian fibroma.

METHODThe CT findings of 9 cases with pathologically confirmed ovarian fibroma were retrospectively analyzed by two radiologists.

RESULTSAll of the 9 cases showed unilateral adnexal mass with demarcated boundary. There were three different types of ovarian fibroma according to the CT appearances simple type(n=4), degeneration type(n=3) and the ovarian fibroma with ascites(n=2). The simple type showed homogeneous-density solid tumor with no enhancement; two of them diagnosed as uterine leiomyomas and the other two as benign tumor originated from the ovary. The degeneration type showed irregular or round hypodensity inside the tumor with no enhancement; one of them was diagnosed as malignant tumor and the other two as intrapelvic mass. The ovarian fibroma with ascites showed homogeneous density with no enhancement; one with ascites and pelvic effusion and the other one with pleural effusion, ascites and pelvic effusion, both of whom were diagnosed as malignant tumor that possibly originated from the ovary.

CONCLUSIONSThe ovarian fibroma has diverse CT findings. They often appear as a unilateral adnexal solid tumor without obvious enhancement. A diagnosis of Meigs's syndrome may be made when it is accompanied with ascites and pleural effusion.

Adult ; Aged ; Female ; Fibroma ; diagnostic imaging ; Humans ; Middle Aged ; Ovarian Neoplasms ; diagnostic imaging ; Retrospective Studies ; Tomography, X-Ray Computed ; methods

OBJECTIVETo explore the high-risk factors and analyze the clinical characteristics of massive pulmonary hemorrhage (MPH) in infants with extremely low birth weight (ELBW).

METHODSTwo hundred and eleven ELBW infants were included in this study. Thirty-five ELBW infants who were diagnosed with MPH were labelled as the MPH group, and 176 ELBW infants without pulmonary hemorrhage were labelled as the control group. The differences in clinical characteristics, mortality rate, and incidence of complications between the two groups were analysed. The high-risk factors for MPH were identified by multiple logistic regression analysis.

RESULTSThe MPH group had significantly lower gestational age, birth weight, and 5-minute Apgar score than the control group (P<0.05). The MPH group had significantly higher rates of neonatal respiratory distress syndrome, patent ductus arteriosus (PDA), early-onset sepsis (EOS), intracranial hemorrhage, pulmonary surfactant utilization, and death compared with the control group (P<0.01). The multiple logistic regression analysis showed that 5-minute Apgar score was a protective factor for MPH (OR=0.666, P<0.05), and that PDA and EOS were risk factors for MPH (OR=3.717, 3.276 respectively; P<0.01). In the infants who were discharged normally, the MPH group had a longer duration of auxiliary ventilation and a higher incidence rate of ventilator-associated pneumonia (VAP) compared with the control group (P<0.05).

CONCLUSIONSA higher 5-minute Apgar score is associated a decreased risk for MPH, and the prensence of PDA or EOS is associated an increased risk for MPH in ELBW infants. ELBW infants with MPH have a prolonged mechanical ventilation, a higher mortality, and higher incidence rates of VAP and intracranial hemorrhage compared with those without pulmonary hemorrhage.

Female ; Hemorrhage ; etiology ; Humans ; Infant, Extremely Low Birth Weight ; Infant, Newborn ; Logistic Models ; Lung Diseases ; etiology ; Male ; Pneumonia, Ventilator-Associated ; epidemiology ; Respiratory Distress Syndrome, Newborn ; epidemiology ; Risk Factors

OBJECTIVETo explore the diagnosis, treatment, and prognosis of prostatic malignant mesenchymal tumors (PMMT).

METHODSWe retrospectively analyzed the clinical and follow-up data about 20 cases of PMMT and reviewed the literature relevant to the diagnosis, treatment, and prognosis of the disease.

RESULTSBased on the results of pathology and immunohistochemistry, the 20 PMMT cases included leiomyosarcoma (n = 7), rhabdomyosarcoma (n = 5), prostatic stromal sarcoma (n = 3), chondrosarcoma (n = 1), and undifferentiated PMMT (n = 4). Twelve of the patients were treated by radical prostatectomy (3 concurrently by sigmoid colostomy and 1 by cystostomy), 2 by pelvic tumor resection following arterial embolization, 1 by total pelvic exenteration, 1 by colostomy with pelvic lymph node biopsy, and 4 by conservative therapy because of metastasis to the lung, pelvis and bone. Of the 20 patients, 9 died of systemic metastasis within 3 months after treatment, 3 died at 6, 7, and 14 months, respectively, 3 survived with tumor for 5, 11, and 12 months, respectively, 2 survived without tumor for 12 and 24 months so far, all subjected to periodic chemotherapy postoperatively, and 3 lost to follow-up.

CONCLUSIONPMMT is a tumor of high malignancy and rapid progression, for which transrectal ultrasound-guided biopsy remains the main diagnostic method. The clinical stage of the tumor is an important factor influencing its prognosis and the survival rate of the patients can be improved by early diagnosis and combined therapy dominated by radical prostatectomy.

Combined Modality Therapy ; methods ; Humans ; Immunohistochemistry ; Male ; Mesenchymoma ; mortality ; pathology ; therapy ; Prognosis ; Prostatectomy ; Prostatic Neoplasms ; mortality ; pathology ; therapy ; Retrospective Studies

HPLC-ELSD was applied to explore the absorption mechanism of pulchinenosides (B3, BD, B7, B10, B11) in rats. The experimental results showed that the absorption rate constant, Ka value (B3, BD) and Permeability coefficient, Peff value (B3, B7) displayed significant difference (P <0.05) in various intestinal segments, The Ka value and Peff value of PRS was different from each other with the highest absorption in duodenum (duodenum > jejunum > colon > ileum); The PRS displayed excessive satuation as the concentration increased over 0.05-2.5 g · L(-1). There were no obvious linear correlations between Peff values and concentrations in duodenum (0.6007 ≤ R2 ≤ 0.7727); Ka and Peff value declined when the PRS was perfused with P-glycoprotein promoter digoxin, on the other hand, inclined when perfused with P-glycoprotein inhibitor verapamil with significant difference among PRS B3, BD, B7, B11 (P <0.05). All the above results demonstrated that B3, BD, B7 were greatly influenced by absorption sites, duodenum was the main absorption site; PRS didn't entirely transported in a concentration dependent manner, and the transporter-protein involved the transportation, so the intestinal absorption of the five pulchinenosides was not entirely passive diffusion; and PRS might be the substrates of P-glycoprotein.
ATP-Binding Cassette, Sub-Family B, Member 1 ; physiology ; Animals ; Intestinal Absorption ; Male ; Oleanolic Acid ; pharmacokinetics ; Pulsatilla ; chemistry ; Rats ; Rats, Wistar ; Saponins ; pharmacokinetics

OBJECTIVETo investigate the effects and the mechanisms of cell growth inhibition in hepatocellular carcinoma cells after induction with antisense survivin-liposome (LIP) complex, and to provide evidence in treatment for hepatocellular carcinoma and tumors expressing survivin.

METHODSSurvivin ODNs was transfected into HepG2 cells mediated by LiP reagent. The expression of survivin mRNA and protein was detected by RT-PCR and Western blot. MTT assay was applied to determine cell proliferation in HepG2 cells. Active caspase-3 and apoptosis rate were evaluated by flow cytometric analysis. The morphological changes were assessed by electron microscopy. Cell cycle was analyzed by flow cytometry in the cell cycle-synchronized hepatocellular carcinoma cells treated with the antisense compound.

RESULTSAntisense compound efficiently down-regulated survivin expression (mRNA and protein) in a dose-dependent manner with an IC(50) of 250 nmol/L. Its maximal effect was achieved at a concentration of 600 nmol/L, when expression levels were down-regulated by 80%, as revealed by gradually increase of caspase-3-like protease activity and apoptosis rate in a time-dependent manner. Morphological apoptotic changes such as membrane blebbing, loss of microvilli, cytoplasmic vasculization, condensation of cytoplasm and nucleus, chromatin fragmentation, and apoptosis and cell growth inhibition were observed. In the cell cycle-synchronized hepatocellular carcinoma cells, antisense compound induced cell cycle arrest followed by apoptosis. After treated with low concentration of compound, the cell cycle was arrested at S phase or G2/M phase; while at high concentration, the cell cycle was mainly arrested at S phase. Apoptosis was obviously observed and the rate of apoptosis was increased in a time and concentration-dependent manner.

CONCLUSIONAntisense survivin has significant inhibitory effect on growth of hepatocellular carcinoma cells in vitro. This is associated with cell cycle arrest and apoptosis.

Apoptosis ; drug effects ; Carcinoma, Hepatocellular ; pathology ; Caspase 3 ; Caspases ; metabolism ; Cell Cycle ; drug effects ; Cell Proliferation ; drug effects ; Humans ; Inhibitor of Apoptosis Proteins ; Liposomes ; Liver Neoplasms ; pathology ; Microtubule-Associated Proteins ; metabolism ; pharmacology ; Neoplasm Proteins ; metabolism ; pharmacology ; Oligonucleotides, Antisense ; pharmacology

OBJECTIVETo investigate the angiographic feature and its diagnostic value in gastrointestinal stromal tumor (GIST).

METHODSTwelve patients with pathologically proved GIST underwent angiography using PUCK and DSA one week before operation. The origin, size, morphology and angiographic appearance of the lesion were retrospectively analyzed.

RESULTSIt was found that two tumors originated from stomach, eight from jejunum, and two from ileum. Seven cases were benign but five malignant. Obviously thickened and enlarged feeding artery was detected in eight tumors, and early-developed vein was found in three. Two types of angiographic changes of GIST were observed: 1) twisted irregular neoplastic vessels with partially coarse and indistinct margin were found in four cases, which were all malignant; 2) ball-like neoplastic vessels with homogeneous stain in tumor were found in eight cases, seven of them were benign but one was malignant.

CONCLUSIONAngiography may be helpful in localization and diagnosis as well as defining the size of GIST, and especially in patients with melena of unknown origin.

Adult ; Aged ; Angiography ; methods ; Female ; Gastrointestinal Stromal Tumors ; blood supply ; diagnostic imaging ; Humans ; Jejunal Neoplasms ; blood supply ; diagnostic imaging ; Male ; Mesenteric Arteries ; diagnostic imaging ; Middle Aged ; Stomach Neoplasms ; blood supply ; diagnostic imaging

Objective Toanalyzethestatusofeducationandhealthservicerelatedtosexualandreproductivehealthamong early adolescent students in Zhejiang Province and to provide scientific evidence for puberty education and health service. Methods Across-sectionalsurveywasconductedamong1312primarystudentsfromgrade4to6inZhejiangProvince, with stratified cluster sampling method.A self-made questionnaire was used to collect the information of their demographic characteristics and the utilization and demand situation of education and health service related to sexual and reproductive health.Results Amongthestudents,37.33percentofthestudentshadnevergotthesexualandreproductivehealth knowledge from school,and only 32.92 percent of them said that their school had provided adolescent health care service, and 34.32 percent of them was not satisfied with this service.And 48.75 percent of them said that their parents had never communicated SRH topics with them,meanwhile,35 .94 percent of them had never asked their parents SRH questions,and only 16.96 percent of them felt easy when they communicate SRH topics with their parents,and only 23.69 percent of them hope to communicate SRH topics with their parents.Meanwhile,59.65 percent of them had never communicated SRH topics with their peers,and 10.67 percent of them had gone to hospital due to pubertal development and reproductive health problems,and 59.41 percent of them thought it necessary to open adolescent reproductive health clinics in society. Conclusion Schooleducation,familyeducation,peereducationandsocialhealthservicerelatedtosexualand reproductive health among early adolescent students is relatively backward,and there is a big gap between the existing service and the demand of adolescents.

Objective The aim of the present study was to estimate the quantitative contributions of carbonated beverages consumption to bone loss.Methods We pedormed computer searches of PubMed,Cochrane Library,EBSCO,CALIS to search for studies investigating the relationship between carbonated beverages and bone loss.For carbonated beverages investigated in a comparative way,we use random effect model to compute pooled odds ratios (ORs) and Cochran Q statistic to estimate the heterogeneity.Results A total of 10 studies met the inclusion criteria and the relationships between carbonated beverages and bone loss were considered,including colas and bone loss.The following associations were found for carbonated beverages and low bone density (OR =1.28,95％ CI =1.02-1.60),carbonated beverages and bone fractures (OR =1.53,95％ CI =1.04-2.26),colas and bone fractures (OR =2.00,95％ CI =1.24-3.24).Condusion The present results indicate that carbonated beverages were associated with bone loss.This meta-analysis may have important public health implications given the widespread use of carbonated beverages.