Objective To evaluate the advantage of transabdominal modified Sugiura procedure Methods We retrospectively analyzed 45 cases undergoing transabdominal modified Sugiura procedure from May 1997 to May 2003 The procedure included devascularization of near half gastric and inferior part of esophagus after splenotomy The left and right vagus nerves, the anterior and posterior Latarjet nerves and paraesophageal collateral veins were left intact The gastric submucous vasculature was sutured on the plane 3～5 cm distal to cardia (suture group); or the esophagus 3 cm above cardia was cut and reanastomosed with pipe anastomat Results There was no inhospital mortality Free portal veinous pressure and portal vein flow speed did not change significantly The flow volume of portal vein decreased ( P

Objective ToevaluatethereportingqualityofChineseimagingdiagnosticaccuracystudiesbyStandardsforReporting DiagnosticAccuracyStudies (STARD)2015.Methods AticalspublishedinChina,whichoriginatedfrom ChinaBiology Medicine (CBM),ChinaNationalKnowledgeInfrastructure(CNKI)andWanfangDatabasefromJanuary12014toApril82016wereretrievedfor statisticalanalysis.Keywordswereasfollows:"Ultrasound","CT","MRI","X-ray"and"diagnosticstudy".Tworeviewersindependently screenedtheliteraturesandassessedtheincorporatedstudies.Excel2016wasusedtofigureouttheaccordancerateandSPSS (version 17.0)wasusedtoanalyzethedata.Results 152studieswerefinallyincluded.Thenumberandproportionofstudiesonimagingdiagnostic methodswere84 (55.26%)ultrasound,29 (19.08%)CT,16 (10.53%)MRI,and23 (15.13%)withthecombinationoftwoand moremethods.Thecoincidencerateandcorrespondingnumberofsingledocumentreportswereasfollows:0%－10%,1report;11%－20%,4reports;21%－30%,45reports;31%－40%,74reports;41%－50%,24reports;51%－60%,3reports;and61%－70%,1 report.Therewasnosignificantdifferenceofcoincidencerate (P＝0.09)betweendifferentimagingdiagnosticmethods.Also,there wasnosignificantdifferenceofcoincidenceratebetweentheoldentriesinSTARD2003andnewentriesinSTARD2015(P＝0.34). Conclusion ThisstudyprovidesareferencebaselinefortheresearchersandthecliniciansonthequalityofChinesetestreportson imagingdiagnosticaccuracy.Itisshowedthat,thereportsondiagnosticaccuracyofUltrasound,CT,MRIandX-raypublishedbetween January1,2014andApril8,2016aregenerally middleandlow level.

Objective:To study the effect of microsurgery for parasellar menningiomas and to analyze the impact factors of recurrence. Methods:Clinical and follow-up data in a consecutive series of 134 patients with parasellar meningiomas were retrospectively analyzed. Results:A total of 109 patients (81.3%) had radical removal (Simpson grade I and II), and 116 patients were followed up for an average period of 81.6 months. The mean quality of life score (KPS) was 91.9, 90 patients regained full daily activity and 16 patients were able to take care of themselves. Oculomotor paralysis occurred in 7 patients, epilepsy in 8, and another 9 patients suffered hemispheral paralysis. Tumor recurred atfer the radical removal in 12 out of the 96 follow-up patients (12.5%). Tumor progressed atfer subtotal removal in 12 out of the 20 follow-up patients (60%). Tumor with cavernous sinus (CS) invasion had significantly higher risk of recurrence campared with non-CS invasion (P=0.043). The recurrence rate increased with the pathological grade (P<0.01). Conclusion:Patients with parasellar meningiomas undergoing microsurgical resection may have a good long-term function outcome. For most patients, total removal by microsurgery is the ifrst choice. Careful follow-up is needed if tumor invaded the CS and radiosurgery is proposed for WHO grade 1 and 2.

OBJECTIVE: To discuss the clinical features of chronic subdural hematoma (CSDH) in different age groups. METHOD: A total of 417 patients with CSDH were divided into 3 groups: 0 to 39, 40 to 59 and elder than 60 years. We analyzed the clinical features in different groups, including sex, trauma history, potential hemorrhage factors, trauma to symptoms interval, encephalatrophy, onset symptom and hematoma volume. RESULTS: The incidence of trauma, potential hemorrhage factors, encephalatrophy, consciousness disorders and paralysis increased with age, while the incidence of intracranial hypertension symptoms and seizures decreased with age (P<0.001). The trauma to symptom interval in the group elder than 60 was longer than in other groups (P<0.05) and the hematoma volume increased with age(P<0.05). CONCLUSION The clinical features of CSDH including onset symptoms, trauma history, potential hemorrhage factors, encephalatrophy, trauma to symptoms interval and hematoma volume vary in different age groups.
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Diagnosis, Differential ; Female ; Hematoma, Subdural, Chronic ; diagnosis ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Young Adult

Adult ; Arm Injuries ; drug therapy ; surgery ; Drugs, Chinese Herbal ; therapeutic use ; Elbow Joint ; drug effects ; injuries ; surgery ; External Fixators ; Female ; Fracture Fixation ; Humans ; Internal Fixators ; Male ; Middle Aged

OBJECTIVETo evaluate the effect and safety of L-carnitine in the treatment of idiopathic oligoasthenozoospermia based on current clinical evidence.

METHODSWe searched the Cochrane Library, PubMed, MEDLINE, EMBASE, CNKI, VIP, CBM and Wanfang Database from the establishment to April 2014 for the published literature on the treatment of idiopathic oligoasthenozoospermia with L-carnitine. We conducted literature screening, data extraction, and assessment of the methodological quality of the included trials according to the inclusion and exclusion criteria, followed by statistical analysis with the RevMan 5. 2 software.

RESULTSSeven randomized controlled trials involving 751 patients with idiopathic oligoasthenozoospermia met the inclusion criteria, and 678 of them were included in the meta-analysis. L-carnitine treatment achieved a significantly increased rate of spontaneous pregnancy as compared with the control group (RR = 3.2, 95% CI 1.74 to 5.87, P = 0.0002). After 12-16 and 24-26 weeks of medication, total sperm motility (WMD = 5.21, 95% CI 2.78 to 7.64, P < 0.0001 and WMD = 9.29, 95% CI 1.28 to 17.29, P = 0.02) and the percentage of progressively motile sperm (WMD = 12.44, 95% CI 4.58 to 20.31, P = 0.002 and WMD = 9.76, 95% CI 3.56 to 15.97, P = 0.002) were remarkably higher than those in the control group, but no statistically significant differences were observed in sperm concentration between the two groups (WMD = 4.91, 95% CI -2.63 to 12.45, P = 0.2 and WMD = 0.93, 95% CI -3.48 to 5.34, P = 0.68). After 12-16 weeks of treatment, the percentage of morphologically abnormal sperm was markedly decreased in the L-carnitine group as compared with the control (WMD = -2.48, 95% CI -4.35 to -0.61, P = 0.009), but showed no significant difference from the latter group after 24-26 weeks (WMD = -4.38, 95% CI -9.66 to 0.89, P = 0.1). No statistically significant difference was found in the semen volume between the two groups after 12-16 or 24-26 weeks of medication (WMD = -0.13, 95% CI -0.43 to 0.18, P = 0.42 and WMD = 0.28, 95% CI -0.02 to 0.58, P = 0.07). No serious L-carnitine-related adverse events were reported in 4 of the randomniized controlled trials.

CONCLUSIONThe current evidence indicates that L-carnitine can improve spontaneous pregnancy and semen parameters in the treatment of idiopathic oligoasthenozoospermia, with no serious adverse reactions.

Asthenozoospermia ; drug therapy ; Carnitine ; adverse effects ; pharmacology ; Female ; Humans ; Male ; Pregnancy ; Pregnancy Rate ; Randomized Controlled Trials as Topic ; Semen Analysis ; Sperm Count ; Sperm Motility

OBJECTIVE: To determine the clinical value of arterial blood lactic acid monitoring in patients after cardiac surgery. METHODS: Relationship between dynamic blood lactic acid level and the prognosis of 200 patients (9 patients in the dead group, and 191 patients in the healing group) was analyzed after cardiac operation. RESULTS: The level of blood lactic acid was (1.2+/-0.3) mmol/L in the healing group,and (5.6+/-0.9) mmol/L in the death group. The level of blood lactic acid in the healing group descended to normal in 24 hours, while that in the death group rose persistently. The dynamic change of lactic acid indicated more sensitively the prognosis of the disease than pH and BE. CONCLUSION The higher the arterial blood level of lactic acid, the longer the duration, the more critical the condition, the higher the mortality rate. Blood lactic acid level can be used as an excellent prognosis index for patients after cardiac surgery.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Heart Defects, Congenital ; blood ; surgery ; Humans ; Infant ; Lactic Acid ; blood ; Male ; Middle Aged ; Monitoring, Physiologic ; methods ; Postoperative Period ; Prognosis ; Radial Artery ; Rheumatic Heart Disease ; blood ; surgery ; Thoracic Surgery ; Young Adult

Objective To investigate the effects of selenium supplement on atherogenesis and endothelial function in ApoE-knockout mice fed high fat diet.Methods ApoE-knockout mice fed with selenium-deficient and high fat diet were randomly allocated into 3 groups based on random number table including control group (not supplied with sodium selenite,n =10),low dosage selenium supplement group (supplied water with 0.1 mg/L sodium selenite,n =10) and high dosage selenium supplement group (supplied water with 0.2 mg/L sodium selenite,n =10).After 15 weeks,the following values were measured:the concentrations of selenium in heart and liver,the levels of serum lipid,the parameters of antioxidant function including activities of superoxide dismutase(SOD) and glutathion peroxidase (GSH-Px) and malondialdehyde (MDA) level in serum,the parameters of endothelial function including serum nitric oxide (NO),endothelin 1(ET-1),and vascular endothelial growth factor (VEGF) levels,and ET-1 and VEGF levels in aorta roots.The atherosclerotic lesions in aorta roots were analyzed with oil red O staining.Results (1) The selenium concentrations in heart and liver were significantly higher in high dosage and low dosage selenium supplement groups compared to control group (both P ＜ 0.05).(2) The levels of triglyceride,total cholesterol,low density lipoprotein cholesterol,very low density lipoprotein cholesterol and high-density lipoprotein cholesterol were similar among groups (all P ＞ 0.05).(3) The activity levels of serum SOD were significantly higher in low dosage ((113.8 ± 12.5) U/ml) and high dosage selenium supplement group ((152.3 ± 11.3) U/ml) compared to control group ((90.7 ± 10.7) U/ml,all P ＜ 0.05).The activity levels of serum GSH-Px were significantly higher in low dosage ((53.9 ± 7.2) U/ml) and high dosage ((69.6 ± 8.7) U/ml) selenium supplement groups than that of control group ((36.4 ± 5.6) U/ml,all P ＜0.05).The serum MDA levels in low dosage ((4.73 ± 1.05) nmol/ml) and high dosage ((4.13 ± 1.21)nmol/ml) selenium supplement groups were significantly lower than that of control group ((5.97 ± 1.08) nmol/ml,all P ＜ 0.05).(4) The serum NO concentrations in low dosage ((61.5 ± 12.8) μmol/L) and high dosage ((79.0 ± 14.6) μmol/L) selenium supplement groups were significantly higher than that of control group((42.7 ± 9.1) μmol/L,all P ＜ 0.05).The concentrations of serum ET-1 in low dosage ((52.8 ±6.3)ng/L)and high dosage ((46.3 ±4.7)ng/L)selenium supplement groups were significantly lower than that of control group((72.2±6.3)ng/L,P ＜ O.05).The concentrations of serum VEGF in low dosage ((97.4 ± 16.5) ng/L) and high dosage ((83.5 ± 22.0) ng/L) selenium supplement groups were significantly lower than that of control group((125.8 ± 18.6) ng/L,P ＜0.05).The expression levels of ET-1 and VEGF in aorta roots among low dosage and high dosage selenium supplement groups were significantly lower compared to control group (all P ＜ 0.05).(5) The plaque area of aorta roots in low dosage ((0.95 ± 0.19)× 105 μm2) and high dosage selenium supplement ((0.75 ± 0.15) × 105 μm2) groups were significantly smaller than that of control group ((1.13 ± 0.23) × 105 μm2),and the plaque area in high dosage selenium supplement group was significantly smaller than in low dosage selenium supplement group (P ＜ 0.05).Conclusion Supplement of selenium can attenuate atherogenesis in ApoE-knockout mice fed high fat diet,which is possibly mediated via reducing lipid peroxidation and improving endothelial functions.

OBJECTIVETo investigate the expression of vascular endothelial growth factor C (VEGF-C) and survivin protein in human gastric carcinoma,and to evaluate their clinical implications.

METHODSThe expressions of VEGF-C and survivin protein in tumor tissues,matched para- tumor tissues from 97 cases with gastric cancer and normal tissues form 20 normal controls,were determined by immunohistochemistry. Their relationships with clinicopathological parameters were analyzed.

RESULTSThe positive rate of VEGF-C and survivin protein in tumor tissues (66.0% and 57.2%) was significantly higher than those in matched para-tumor tissues normal tissues (P< 0.05). There were no significant differences in VEGF-C expression considering tumor size,localization,histological grade,venous invasion,and distant metastasis (P > 0.05), while its expression was correlated with serosal infiltration, lymphatic invasion, lymph node metastasis and TNM stage III-IV (P< 0.05). The survivin expression was significantly related with serosal infiltration,lymphatic invasion, regional lymph node metastasis,distant metastasis, and TNM stage III- IV (P< 0.05), but not with histological grade, localization,venous invasion,and tumor size (P > 0.05). The 1, 3 and 5-year survival rates of the patients with positive VEGF-C or survivin protein were significantly lower than those of the patients with negative VEGF-C or survivin (P< 0.05), respectively. In additional,the expression of VEGF-C was positively correlated with survivin expression in gastric carcinoma (P< 0.01).

CONCLUSIONThe expressions of VEGF-C and/or survivin may be indicators for poor prognosis of gastric carcinoma.

Adult ; Aged ; Carcinoma ; metabolism ; pathology ; Female ; Follow-Up Studies ; Humans ; Inhibitor of Apoptosis Proteins ; Male ; Microtubule-Associated Proteins ; biosynthesis ; Middle Aged ; Neoplasm Staging ; Prognosis ; Stomach Neoplasms ; metabolism ; pathology ; Vascular Endothelial Growth Factor C ; metabolism

OBJECTIVETo investigate the efficacy of uncutted Roux-en-Y esophagojejunostomy with jejunal pouch (URYJP) after total gastrectomy.

METHODSTotal gastrectomy was performed on 168 patients of gastric cancer, and 3 methods were used for reconstruction: the uncutted Roux-en-Y esophagojejunostomy with a jejunal pouch was performed on 69 patients(group A),Roux-en-Y esophagojejunostomy with the P-type jejunal pouch on 50 patients(group B),and Roux-en-Y esophagojejunostomy with the Orr-type jejunal pouch on 49 patients (group C). The alimentary tract reconstruction time, morbidity and mortality were compared. The 121 cases that survived for more than 1 year were analyzed for quality of life(QOL),including body weight, intake quantity, prognosis nutritional index (PNI), and Visick scores 6 and 12 months after the operations.

RESULTSAll the patients recovered quickly and no anastomosis leakage or duodenal fistulas were found. It took (30+/-7) minutes to finish the reconstruction in group A, which was significantly shorter than that in group B [(57+/-6) minutes] or in group C [(48+/-6) minutes]. There were no significant differences among 3 groups in the incidence of alkaline reflux gastritis. The incidence of Roux stasis syndrome was 2.2% in group A, which was significantly lower than 17.9% and 19.4% in group B and C. Weight loss and food intake gain in group A was superior to those in group B and C 6 months and 12 months postoperatively. As compared with prognosis nutritional index(PNI) postoperatively, those of 3 groups decreased significantly 6 months postoperatively. At 12 months after operation, the PNI of group A returned to the level before operation, while PNI of both group B and C remained significantly lower than those before operation (both P < 0.05). The Visick score of group A was superior to those of group B and C 6 months and 12 months postoperatively.

CONCLUSIONSThe new uncutted Roux operation with jejunal pouch can prevent alkaline reflux gastritis and Roux-en-Y stasis syndrome. It may be a standard procedure for reconstruction after total gastrectomy.

Adult ; Aged ; Aged, 80 and over ; Anastomosis, Roux-en-Y ; methods ; Female ; Gastrectomy ; Humans ; Jejunum ; surgery ; Male ; Middle Aged ; Postoperative Period ; Stomach Neoplasms ; surgery