Objective To study carbon nanoparticles lymphatic tracer to guide surgery for gallbladder cancer.Methods 120 patients with gallbladder cancer were randomized into two groups:the experimental group (n =60) and the control group (n =60).For the experimental group,0.1 ml carbon nanoparticles was injected at 4 ～ 6 locations subserosally around the cancerous site intraoperatively.Stained lymph nodes were used as markers to guide lymphadenectomy.The resected specimens were carefully dissected,and then the lymph nodes were studied according to their positions by histopathological examinations.Results Various degrees of stained lymph nodes were seen in the specimens.In the experimental group,the number of lymph nodes (12.0 ± 3.8),and metastatic lymph nodes (6.3 ± 3.3) per patient were obviously higher than those in the control group (9.2 ± 3.6、4.4 ± 2.8),respectively,(P ＜ 0.05).There were significant differences (P ＜ 0.05) in postoperative disease-free survival and overall survival.Conclusions Intraoperative injection of carbon nanoparticles enhanced lymph node clearance and increased the number of lymph nodes and metastatic lymph nodes dissected,which helped to guide pathological staging.There were significant improvements in disease-free survival and overall survival of these patients with gallbladder cancer after surgery.

Objective To investigate the environmental impact of the Japanese Fukushima No.1 nuclear power plant accident on radiation levels in some areas of Liaoning province.Methods The emergent monitoring was performed by detecting atmosphere aerosols,precipitations,drinking water,vegetables,milk and seafood by gamma spectrometry analysis and gross activity measurements.Results The fission radionuclides of 131I,134Cs and 137Cs were detected in atmosphere aerosols 20 d after nuclear accident.The rad ionuclides of 131I,134Cs and 137Cs were found existing in atmosphere for 25,4 and 6 d,respectively,with the highest concentrations of 4.6 × 10 3,2.9 × 10-4 and 4.2 × 10-4 Bq/m3,respectively.The man-made fission radionuclides could not be detected in vegetablcs,drinking water and milk from Shenyang city and seafood from Dandong city.Conclusions The atmosphere might be slightly contaminated in Liaoning province due to the nuclear accident,whereas the vegetables,milk and drinking water not contaminated.

Objective To compare the value of assessment with DWI and contrast-enhanced MRI (CE-MRI) in activity of sacroiliitis of patients with ankylosing spondylitis(AS).Methods Ninety-six patients conforming to modified New York criteria were prospectively collectedas the AS group, and twenty-one healthy volunteers were enrolled into the control group. According to the Bath AS disease activity index (BASDAI), erythrocyte sedimentation rate and C-reaction protein, AS patients were divided into the active AS group (n=60) and the chronic AS group (n=36) . All subjects were performed with conventional MRI, DWI and CE-MRI of bilateral sacroiliac joints. The MRI manifestations were reviewed and the ADC values and signal intensity enhancement rate (ΔSI) were measured.ANOVA was performed for the comparison ofΔSI and ADC values among active AS group, chronic AS group and control group with BASDAI and lab test results as the gold standards. ROC was analyzed with ΔSI and ADC values for activity of AS and paired
samples t test was obtained to comparethe areas under the ROC ofΔSI and ADC values.Results Among 96 cases of AS patients, MRI of sacroiliac jointsshowed that 62 cases had subchondral bone edema (57 cases of active group, 5 cases of chronic group), that 11 cases had bone surface erosion(4 cases of active group, 7 cases of chronic group), that 15 cases had bone sclerosis(6 cases of active group, 9 cases of chronic group) and that 58 cases had fat deposition on the sacroiliac joints (27 cases of active group, 31 cases of chronic group). The ΔSI values of the active group, the chronic group and control group were respectively (2.51 ± 1.69)%,(1.19 ± 0.67)%and(0.75 ± 0.21)%, and the ADCvalues were(1.33 ± 0.33)× 10-3,(1.00 ± 0.43)× 10-3 and(0.38±0.13)×10-3mm2/s. There were significant differences forΔSI and ADC values among three groups (F=18.375, 16.366. P<0.01), and statistical significance ofΔSI and ADC values were found between every two groups of three(P< 0.05).The area under the ROC between ΔSI and ADC to determine activity of AS patients were respectively 0.814 and 0.730, which had nostatistical significance(t=1.632, P=0.103). The sensitivity and specificity to determine activity of AS patients byΔSI=1.44%were 81.67%and 80.00%.The sensitivity and specificity to determine activity of AS patients by ADC=1.15 × 10-3/mm2 were 76.67% and 71.43%.Conclusion DWI and CE-MRI performed equally in detecting activity of AS patients.

Objective To investigate the influence of different pancreaticojejunostomy on the incidence of postoperative pancreatic (PF) fistula in pancreaticoduodenectomy (PD).Methods The clinical data of 343 patients undergoing radical PD from January 2011 to December 2015 were collected.343 patients were divided into 3 groups,including 124 cases of continuous lamellar duct-to-mucosa pancreaticojejunostomy (CL-DMP) (group A),111 cases of invaginated pancreaticojejunostomy (group B) and 108 cases of binding pancreaticojejunostomy (group C).The rates of postoperative PF and related complications,length of postoperative hospital stay,perioperative mortality and hospitalization costs were compared between the 3 groups.Results There was no statistical difference in the size of pancreatic duct between the 3 groups (P ＞ 0.05).The postoperative PF incidence of group A was 4.84％,significantly lower than 13.51％ in group B and 15.74％ in group C,respectively (P ＜0.05).The anastomosis took less time and postoperative hospital stay was shorter in group A than that in the other 2 groups (P ＜0.05).Conclusion CL-DMP is time-saving,safe and effective method of pancreaticojejunostomy during the process of pancreaticoduodenectomy.

Objective:To evaluate the impacts of radioactivity in foods since begining of the operation of the Hongyanhe Nuclear Power Plant (HNPP).Methods:The levels of radioactivity in foods collected within 30 km of HNPP from 2013 to 2020 were analyzed by comparison of the control samples and those collected before the operation. The impacts on the operation of the HNPP on foods were evaluated.Results:The man-made radionuclides such as 131I, 134Cs, 60Co, 58Co, 110Ag m were not found in food samples. The nautral radionuclides such as 238U, 226Ra, 232Th, 40K were at the normal levels, with the average levels of (0.088±0.053), (0.155±0.178), (0.314±0.388)and(81.3±18.1)Bq/kg(fresh weight)in foods, respectively. The average levels of man-made nuclide 137Cs in foods were (0.013±0.010) Bq/kg (fresh weight). There was no increase in radionuclide levels compared with the control samples and the samples before the operation. Conclusions:The impacts on foods due to the operation of HNPP was not found.

Objective To evaluate enhanced recovery after surgery (ERAS) in the treatment of cholecystolithiasis complicated with extra hepaticbile duct stones by laparoscopy and choledochoscopy.Methods Patients were divided into ERAS and control groups according to the inclusion and exclusion criteria.Patients in ERAS group received perioperative management according to enhanced recovery rehabilitation program.Clinical and laboratory results were compared between the two groups.Results 46 patients were enrolled into ERAS group and 40 patients into control group.The ERAS group had shorter time of first postoperative exhaust,first postoperative oral intake,getting out of bed,removal of abdominal drainage tube,postoperative hospital stay (respectively t =-3.658,-15.552,-8.864,-6.673,-6.036,all P ＜ 0.05),less pain in 6,12,24 and 48 hours after operation (F =8.284,P =0.000),and lower complication rate (x2 =4.172,P =0.043),lower C-reactive protein (CRP) level from pre-operation to postoperative day 1,3 and 5 (F =6.692,P =0.013),higher level of prealbumin (PA) from preoperation to postoperative day 1,3 and 5 (F =21.191,P =0.000),lower hospitalization costs (t =-0.592,P =0.004).Conclusion The application of ERAS in the treatment of cholecystolithiasis complicated with extrahepatic bile duct stones by laparoscopy combined with choledochoscopy is conducive to rapid postoperative recovery of patients.

Objective To investigate the food radioactivity levels in areas around the Xudabao nuclear plant before operation. Methods The food radioactivity levels were achieved by detecting samples collected within 30 km around the Xudabao nuclear power plant with a HPGe detector. Results The major radionuclides in food were ²³⁸U, ²²⁶Ra, ²³²Th, ⁴⁰K and the man-made radionuclide of ¹³⁷Cs. The average activity levels of natural ²³⁸U、²²⁶Ra、²³²Th、⁴⁰K were(1.2 × 10⁻¹¹ ± 2.6 × 10⁻¹¹)、(9.2 × 10⁻¹² ± 1.6 × 10⁻¹¹)、(3.6 × 10⁻¹¹ ± 6.5 × 10⁻¹²)、(9.0 × 10¹ ± 5.8 × 10¹)Bq/kg respectively. The average level of ¹³⁷Cs in food was (1.2 × 10⁻¹² ± 9.0 × 10⁻¹³)Bq/kg. Conclusion The man-made radionuclides were not detected except ¹³⁷Cs in the collected food. The radioactivity concentrations were lower than the national standards. The effective dose for local residents by ingestion of ¹³⁷Cs was around 6.0 × 10⁻¹² µSv/a.