Objective To find out the relationship between lymph node metastasis and clinical pathological specificity, the prognostic factors for the purpose of improving survival of early gastric cancer (EGC) and quality of life. Methods The clinical data of the 338 EGC patients from July 1999 to June 2009 was analyzed retrospectively, includirg the possible relationship of lymph node metastasis, the size of tumor,types of histopathology,depth of infiltration. Using Kaplan-Meier method to process suvival rate,immunohistochemistry method to detect the micrometastasis. Results Lymphnode metastasis was relative to the size of tumor, depth of infiltration (P < 0.05 or < 0.01). Total 5-year survival rate was 92.1%, intramucosa 5-year survival rate 97.1%, submucosa 5-year survival rate was 85.7% in 63 followed up patients, the survival rate of EGC was related with depth of infiltration and size of tumor (P = 0.043,0.004). Conclusion By precisely estimating depth of infiltration, the size of tumor and correct estimating the state of lymph node metastasis, choosing right 5-year surgical protocol can improve EGC survival rate and prognosis.

Objective To analysis the plague monitoring results on plague of rats in Lasiopodomys brandti plague natural foci of Xilin Gol Plateau in Inner Mongolia from 2001 to 2013,to master the dynamics of the plague epidemic,and to provide a basis for developing countermeasures.Methods Plague monitoring data from 2001 to 2013 in Lasiopodomys brandti plague natural foci were collected,main host density,rate of dye fleas,flea body index,bacteriology,serology and epidemic situation were studied.Results Within 13 years,10 153 Lasiopodomys brandti were captured overlapping a monitored area of 2 919.25 hm2,the average rat density was 3.48/hm2;other small rodents were captured 43 632 times,and 1 631 mice were captured,capture rate was 3.74％.Totally 22 752 host animals were checked by etiology,104 animals were infected with epidemic diseases,79 fleas of 31 groups positive fleas were checked from cultured 27 702 fleas of 6 437 groups.Totally 2 237 serum samples of Lasiopodomys brandti were checked using indirect hemagglutination (IHA),2 copies were found positive,the positive rate was 0.09％.Conclusion In Lasiopodomys brandti plague natural foci of Inner Mongolia,the plague bacteria infected host animals are still existed,future outbreak is possible;the monitoring and health education should be strengthened,in order to prevent the plague spreading to human being.

Objective To investigate the predictive values of P-selectin (P-sel),thrombus precursor protein (TpP) and D-dimer (D-D) in the early diagnosis of portal vein thrombosis (PVT) in patients submitted to splenectomy (or to devascularization).Methods The clinical data of 48 patients with portal hypertension (the PVT group,n=26; and the non-PVT group,n=22) who received operation in our hospital from 2009 to 2011 were retrospectively analyzed.Detecting the P-sel,TpP and D-D levels in the two groups of patients were done on preoperative day 1 and postoperative day 1,3,5,7,14.The SPSS software was used for statistic analysis.Results There were no significant differences on the preoperative day 1 levels of P-sel,TpP and D-D in the two groups (P＞0.05).The postoperative day1 levels of the three indicators in the PVT group were significantly higher than the non-PVT group (P＜0.05).Receiver operating characteristic (ROC) curves showed the area under curve (AUC) of P-sel was largest (0.893),followed by D-D,and TpP.The combined detection of the 3 indicators was highest,with the AUC up to 0.977.Conclusions Combined detection of P-sel,D-D and TpP levels were useful in the early diagnosis of PVT after splenectomy in patients with portal hypertension.

Objective To analyze the monitoring results on plague in Meriones unguiculatus plague natural foci in Inner Mongolia from 2010 to 2014,to master the epidemic dynamics of the plague and to provide a basis for developing countermeasures.Methods The plague monitoring data in Meriones unguiculatus plague natural foci from 2010 to 2014 were collected;main host density,rate of dye fleas,flea body index and bacteriology were counted;serology detection was done and the epidemic situation was analyzed.Isolation and identification of Yersinia pestis were carried out through a 4-step test (microscopic examination,isolation and culture,phage lysis test and animal experiment).Serum samples were tested by indirect hemagglutination test.Results Within 5 years,21689 Meriones unguiculatus were captured overlap monitored areas of 7116 hm2 totally,the average rat density was 3.05/hm2;other small rodents were clipped 144352 times,3947 mice were captured,capture rate was 2.73％.Totally 26500 Meriones unguiculatus were checked,91 Meriones unguiculatus were infected with epidemic diseases,227 of 59 groups positive fleas were checked from cultured 51262 fleas of 13268 groups.Totally 5426 serum samples of Meriones unguiculatus were checked,5 copies were found positive,the positive rate was 0.09％.Conclusions Inner Mongolia Meriones unguiculatus plague is still active and spreading.We must enhance propaganda of the plague.Surveillance and emergency management should be strengthened to prevent a outbreak of the plague in human being.

Objective:To determine the microvessel density (MVD) in laryngeal carcinoma and its clinical significance.Method:Thirty-eight tumor specimens were selected from laryngeal cancer patients from January,1994 to March,1996.Histological sections of the tumors were stained immunohistochemically for factor Ⅷ.Using light microscopy,we counted microvessels per 400×field in the most active areas of tumor angiogenesis.Result:①The tumor blood vessels,composed of only one layer of endothelium were mainly distrbuted heterogenously in the interstitial tissue of laryngeal carcinoma with irregular lumen,poorly developed structure.②The MVD in the cancer tissues were statistically higher than that in peritumoral tissues (P＜0.01).③The MVD in the cancer tissues in group of patients with metastasis to cervical lymphonodes were statistically higher than in group without metastasis (P＜0.01),the MVD in the cancer tissues in group of advanced cases (Ⅲ,Ⅳ stages) were statistically higher than that in group of early cases (Ⅰ,Ⅱ stages,P＜0.01).④There was no statistically difference in MVD in the cancer tissue between supraglottic and glottic laryngeal carcinoma patients (P＞0.05).⑤There was no statistically difference in MVD in the cancer tissue among the G1,G2 and G3 group (P＞0.05).Conclusion:The laryngeal cancer blood vessels have some characteristics that don′t appear in normal vessels.It is suggested that tumor angiogenesis can promote tumor growth and metastasis and MVD may be a new prognostic indicator of laryngeal carcinoma.

Objective:To introduce the experience of repairing the defect of cervical trachea wall by using the sternocleidomastoid myoperiosteal flap after the anterior or posterior wall of cervical trachea was invaded by cervical neoplasm. Method:Between 1989 to 1998 the sternocleidomastoid myoperiosteal flap was applied in 12 patients with different diseases, among which 3 cases were thyroid carcinoma, 5 cases were laryngeal carcinoma, 4 cases were cervical esophageal carcinoma. Result:The operation was successful. 12 patients were decannuated and had normal exercise tolerance. The time from reconstruction to decannulation was ranging from 20 days to 6 months. Conclusion: The sternocleidomastoid myoperiosteal flap is an ideal transplant for cervical tracheal reconstruction.

OBJECTIVETo investigate the relationship between polymorphism of N-acetyltransferase (NAT2) gene and genetic susceptibility to laryngeal carcinoma.

METHODSA case-control study on 62 laryngeal carcinoma patients and 56 controls was conducted. NAT2 alleles were differentiated by polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP) methods using originally created PCR primers and genomic DNA extracted from peripheral white blood cells. Genetic risk for NAT2 genotype was analyzed by smoking index (SI, cigarettes smoked per day x years of smoking).

RESULTSThe frequency of NAT2 slow genotype was 80.6% in patients with laryngeal carcinoma and 60.7% in the controls, the difference of which was statistically significant (chi(2) = 5.70, P = 0.017). The odds ratios were 2.70 (95% CI 1.19 approximately 6.11). Among the individuals with NAT2 slow genotype at high level of cigarette smoking, there was a significantly higher risk of 5.64 (95% CI 1.77 approximately 17.92), while those at low level were considered the reference group (OR 1.38, 95% CI 0.42 approximately 4.52).

CONCLUSIONNAT2 slow genotype increases the risk of susceptibility to laryngeal carcinoma. The combined effect of NAT2 slow genotype and exposure to smoking is observed during the development of laryngeal cancer.

Aged ; Alleles ; Arylamine N-Acetyltransferase ; genetics ; DNA, Neoplasm ; genetics ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; genetics ; Genotype ; Humans ; Laryngeal Neoplasms ; genetics ; pathology ; Male ; Middle Aged ; Polymorphism, Genetic ; Smoking ; Statistics as Topic

OBJECTIVETo study the feasibility, surgical technique and results of laryngeal function preservation in surgical treatment for medial wall pyriform sinus cancer.

METHODSFrom 1992 to 1999, 31 patients with medial wall pyriform sinus cancer including stage I 1, II 4, III 14 and IV 12 lesions were treated. Partial resection of pyriform sinus and partial laryngectomy were performed, then, the remains of epiglottis and uni-pedicled sternohyoid myofascial flap were used to restore the defects of larynx. At last, the remaining hypopharyngeal mucosa was sutured to cover the wound of hypopharynx and for artificial rebuild-up. All patients received postoperative radiotherapy.

RESULTSThe 3- and 5-year survival rates were 62.1% and 43.6% respectively, with 77.4% patients having laryngeal functions (voice, respiration and deglutition) completely restored and 32.6% partially restored (voice and deglutition).

CONCLUSIONConservative surgery so introduced is feasible for selected medial wall pyriform sinus cancer patients with the lesion completely resected.

Adult ; Aged ; Feasibility Studies ; Female ; Humans ; Hypopharyngeal Neoplasms ; mortality ; surgery ; Laryngectomy ; methods ; Male ; Middle Aged ; Pharyngectomy ; methods

Objective :To explore influence of ticagrelor on levels of serum high sensitive C reactive protein (hsCRP) and plasma homocysteine (Hcy) in patients with acute coronary syndrome (ACS).Methods :A total of 135 ACS pa‐ tients hospitalized in our department from Jan 2016 to Feb 2017 were selected .Based on routine treatment ,Patients were randomly and equally divided into routine group ,clopidogrel group and ticagrelor group (based on routine treatment respectively received clopidogrel or ticagrelor ) for four weeks .Levels of serum hsCRP and plasma Hcy were measured and compared among all groups before and after treatment .Results :Compared with before treat‐ment ,after four‐week treatment , there were significant reductions in levels of serum hsCRP and plasma Hcy in three groups (P＜0. 05 or ＜0.01).Compared with routine group and clopidogrel group after four‐week treatment , there were significant reductions in levels of serum hsCRP [ (12.95 ± 1.99) mg／L , (8. 56 ± 1. 24) mg／L vs.(4. 47 ± 1. 92) mg／L] and plasma Hcy [ (13.48 ± 2.12) μmol／L , (9.55 ± 0. 94) μmol／L vs.(6. 61 ± 1. 15) μmol／L] in ticagrelor group ( P＜0.05 or ＜0.01).Conclusion :Ticagrelor can significantly reduce levels of serum hsCRP and plasma Hcy while effective antiplatelet therapy ,then significantly inhibit inflammatory response ,improve vascular endothelial function ,contribute to stabilizing atherosclerotic plaques ,improve prognosis in ACS patients .

Objective:To study the risk factors and microbial spectrum for infectious complications for patients with biliary tract cancer after major hepatectomy with cholangiojejunostomy.Methods:Enrolled into this study were 78 consecutive patients (57 patients with perihilar cholangiocarcinoma, 17 with intrahepatic cholangiocarcinoma and 4 with gallbladder cancer), who underwent major hepatectomy with cholangiojejunostomy at Nanjing Drum Tower Hospital between September 2010 and March 2019. The clinical data were reviewed using multivariate analysis to find independent risk factors for postoperative infectious complications. Microorganisms isolated from bile and infected sites were determined to study the microbial spectrum.Results:A total of 45(57.7%) patients suffered from postoperative infectious complications. Male sex ( OR=7.765, 95% CI=1.895-31.815, P<0.05) was the independent risk factor, whereas increased preope-rative red blood cell (RBC) ( OR=0.151, 95% CI=0.038-0.592, optimal cut-off value=3.7×10 12/L) and increased total cholesterol (TC) on postoperative day (POD) 1 ( OR=0.227, 95% CI=0.083-0.626, optimal cut-off value=3.5 mmol/L) were protective factors (both P<0.05). The area under the receiver operating characteristic (ROC) curve was 0.805 (95% CI=0.707-0.902, P<0.05). 205 and 230 microorganisms were cultured respectively from 286 and 681 specimens which were collected from pre-/intraoperative bile and potentially infected sites. Staphylococcus, enterococcus, acinetobacter, klebsiella and pseudomonas were the most common pathogens on bile culture. The first 5 most frequently isolated microorganisms from the infected sites were enterococcus, staphylococcus, klebsiella, candida and xanthomonas. Sixteen (61.5%) of 26 patients had at least one pathogen being isolated from the infected sites with the pathogen being previously isolated in bile culture. Conclusions:Male sex were independent risk factors of infectious complications. Increased preoperative RBC and inreased TC on POD were proteetive factors. For patients without a positive bile culture, a third-generation cephalosporin can be considered as a prophylactic antibiotic. It is important to identify high-risk patients and monitor perioperative pathogens actively to prevent and to cure postoperative infectious complications.