Objective To investigate the clinical efficacy of laparoscopic radical gastrectomy in elderly patients with advanced gastric cancer.Methods The clinical data of 85 elderly patients with advanced gastric cancer who were admitted to the Ningbo First Hospital from January 2012 to June 2014 were retrospectively analyzed.Laparoscopic radical gastrectomy was performed on 46 patients (LRG group) and open radical gastrectomy on 39 patients (ORG group).All the patients underwent primary tumor resection for gastric cancer + D2 lymph node dissection,and the postoperative recovery plans were done according to enhanced recovery program.The volume of blood loss,number of lymph node dissected,operation time,intraoperative arterial partial pressure of carbon dioxid (PaCO2),time to anal exsufflation,indwelling time of gastric tube,time for out-off-bed activity,time for fluid diet intake,postoperative hemoglobin,duration of hospital stay and occurrence of complications in the 2 groups were analyzed.The follow-up by outpatient examination and telephone interview was carried out on patients up to August 2014.The count data were analyzed by the chi-square test and Fisher exact probability.The measurement data with normal distribution were presented as x ± s and analyzed using the t test.The t' test was used if the data were deficient.Results Surgical procedures in the 2 groups were successfully carried out and no perioperative death occurred.There was no conversion to open surgery in the LRG group.The resection margins in all the patients were negative.The operation time and number of lymph node dissection in the LRG group were (239 ±68)minutes and 27 ± 10,compared with (227 ±50)minutes and 26 ± 10 in the ORG group,with significant differences (t =0.919,0.179,P ＞ O.05).PaCO2 in the LRG group was (41 ± 5) mmHg (1 mmHg =0.133 kPa),which was significantly higher than(36 ± 5) mmHg in the ORG group (t =4.745,P ＜ 0.05).The volume of blood loss was (102 ± 44)mL in the LRG group,which was significantly less than (200 ± 120) mL in the OPG group (t' =-4.807,P ＜ 0.05).The postoperative level of hemoglobin in the LRG was (110 ± 15) g/L,which was significantly higher than (98 ± 27)g/L in the ORG group (t' =2.471,P ＜ 0.05).The time to anal exsufflation,indwelling time of gastric tube,time for out-off-bed activity,time for fluid diet intake,duration of hospital stay in the LRG group were (2.6 ± 0.7) days,(2.1 ± 0.7) days,(1.1 ± 0.3) days,(4.1 ± 0.7) days and (11 ± 4) days,which were significantly different from (4.8 ± 1.5) days,(4.0 ± 1.8) days,(4.5 ± 0.6) days,(5.9 ± 1.8) days and (18 ± 3) days in the OR G group (t' =-8.415,-6.206,-33.831,-5.879,t =9.632,P＜0.05).Eight patients in the LRG group and 15 patients in the ORG group had complications,with the incidence of complications of 17.4％ (8/46) and 38.5％ (15/39),respectively,showing a significant difference (x2 =4.748,P ＜ 0.05).Forty-four patients in the LRG group and 36 patients in the ORG gorup were followed up for 2-25 months,1 patient in the LRG group and 2 patients in the ORG group died and others had full recovery.Conclusions Laparoscopic radical gastrectomy could provide a safe and complete tumor resection for elderly patients with advanced gastric cancer compared with open radical gastrectomy,meanwhile,it can improve postoperative recovery and reduce postoperative complications in elderly patients with advanced gastric cancer.

Objective To establish an effective qualitative discrimination method for Selaginella medicinal materials.Meth- ods Thin layer chromatography(TLC)method was used.Results The TLC method has a good specialization for identifying Selaginella medicinal materials and can distinguish Selaginella rnoellendorfii from other 10 familiar species in northern areas of Guangdong province.Conclusion The method can help to control the quality of Selaginella moellendorfii Tablet.

Clinical competence was estimated for grades 2011-2013 general practitioners (GPs)trained by the DxR Clinician software.Clinical cases were solved on computer.And the abilities of diagnosis,thinking and handling were assessed.The average score of all GPs was 61.68 ± 10.69.The average score of diagnostic ability was the highest at 71.82 ± 15.47 (weighted score of 25.1).The average score of thinking ability was 62.36 ± 10.40 (weighted score of 28.1).And the average score of handling ability was the least at 42.27 ± 18.22 (weighted score of 8.5).Significant differences in average scores existed between grades 2011 and 2013 (P ＜ 0.05).Significant differences in score of clinical thinking ability existed between grades 2011,2012 and 2013 (P ＜ 0.01) respectively.None of them passed the part of handling.The longer period of training,the higher scores the residents obtained.Since the ability of clinical handling fared the worst,targeted training should be strengthened.

In MAST (mRNA accessible site tagging),the DNA tags from synthesized library were employed for identifying mRNA accessible sites. A large number of tags were amplified and subcloned for sequencing to verify mRNA binding profiles. A PCR was designed by using one primer which bridges over the tag terminal sequences. In PCR reaction DNA tag fragments were concatemerized by a bridge primer in reaction cycles. The concatemerized tag fragments were subcloned and sequenced. Dozens of the concatemerized sequences contained thousands tags. The PCR was a simple,effective way which for sequencing tags in a high through put manner.

OBJECTIVEIt is demonstrated that excessive activation of NF-κB is central to the pathogenesis of inflammatory bowel disease (IBD). Zinc finger protein A20 (A20) is a key player in the negative feedback regulation of NF-κB signaling in response to multiple stimuli and has been described as central gatekeeper in inflammation and immunity. Mice genetically deficient in A20 develop severe intestinal inflammation and have increased susceptibility to dextran sodium sulfate (DSS)-induced colitis. Few studies have been done to explore the role of A20 in the pathogenesis of IBD. To clarify the relationship between intestinal inflammation and the expression level of A20 in IBD patients, the expression level of A20 and a series of inflammatory cytokines, such as NF-κB, IL-6, and IL-8, in children with IBD and controls were examined.

METHODTerminal ileal mucosal samples were obtained via endoscopy. Fifty-seven mucosal samples were divided into 4 groups: normal control group (n = 16), IBD remission group (n = 12), IBD active group (n = 13) and non-IBD enteritis group (n = 16). According to disease activity index scores, the IBD patients were divided into IBD remission group and IBD active group. Normal control group was consisted of patients with functional bowel disorders or intestinal polyps. Non-IBD enteritis was defined as changes in which endoscopy and histological examination showed inflammatory changes but could not be diagnosed as IBD. Real-time PCR was adopted for detecting the mRNA levels of A20, IL-6 and IL-8. Meanwhile immunohistochemistry was performed to measure the expression of A20 and NF-κB.

RESULT(1) The expression of A20 and NF-κB were very low in normal control group, but significantly up-regulated in IBD active group and non-IBD enteritis group (P < 0.01 for both); (2) Compared with normal control group, expression of NF-κB [(9.35 ± 4.84)% vs. (0.57 ± 0.44)%, P < 0.01], IL-6 (t' = 1.34, P > 0.05), IL-8 (t = 1.38, P > 0.05) increased in IBD remission group, while the expression of A20 in both mRNA (t = 1.03, P > 0.05) and protein levels [(0.36 ± 0.18)% vs. (0.87 ± 0.29)%, P < 0.01] decreased; (3) Compared with non-IBD enteritis group, although the expression of NF-κB [(24.17 ± 11.27)% vs. (55.29 ± 21.84)%, P < 0.01], IL-6 (t = 2.22, P < 0.05), IL-8 (t = 2.97, P < 0.01) were highly increased in IBD active group, the expression of A20 in both mRNA(t = 2.26, P < 0.05) and protein levels [(29.23 ± 11.70)% vs. (16.81 ± 5.90)%, P < 0.01]significantly decreased; (4) The expression of IL-6, IL-8 were similar in IBD remission group and non-IBD enteritis group (both P > 0.05), but the expression of A20 was much lower in both mRNA (t = 4.42, P < 0.01) and protein levels [(29.23 ± 11.70)% vs. (0.47 ± 0.25)%, P < 0.01] in IBD remission group.

CONCLUSIONThe results demonstrate that there is an excessive inflammatory response but insufficient up-regulation of A20 expression in IBD patients. Low levels expression of A20 may play an important role in the pathogenesis of IBD.

Case-Control Studies ; Child ; Endopeptidases ; metabolism ; Female ; Humans ; Inflammatory Bowel Diseases ; metabolism ; pathology ; Interleukin-6 ; metabolism ; Interleukin-8 ; metabolism ; Intestinal Mucosa ; metabolism ; pathology ; Male ; NF-kappa B ; metabolism

Based on analyzing image edge cloning theory and algorithms, a marginal clone algorithm is proposed with a combination of edge connectivity and noise removal algorithm. Simulation results show that the edge image detected by the algorithm has solved problems of traditional edge discontinuities and tsereve noise. Moreover, it has better edge recognition performance.
Algorithms ; Humans ; Image Enhancement ; methods ; Retinal Vessels

Objective To investigate the susceptibilities of HCMV clinical strains isolated to ganciclovir from the patients after hematopoietic stem cell transplantation.Methods Eight HCMV clinical isolates were isolated from the blood or the urine of hematopoietic stem cell transplantation recipients who had been treated with GCV.Tissue cell infection median dose(TCID50) were calculated by Reed-Muench method.Drug susceptibility was determined by MTT assay.Results TCID50 values of eight HCMV clinical strains were 10-4.12/0.1ml,10-4.29/0.1ml,10-4.3/0.1ml,10-4.4/0.1ml 10-4.42/0.1ml,10-4.5/0.1ml,10-4.52/0.1ml and 10-4.62/0.1ml respectively.50％ inhibitory concentration(IC50) to GCV of eight HCMV clinical strains were 0.638,1.438,0.965,0.698,0.482,1.167,1.519,1.511 mg/L respectively.Conclusion Our results suggest that resistant HCMV strains are not prevalent in Guangzhou.Continuous monitoring of HCMV is needed to understand the antiviral resistance status of the virus in patients after hematopoietic stem cell transplantation and guide its clinical management.

Objective To outline the research fronts of ten major sub-specialties in internal medicine.Methods Based on their impact factor scores and the proportion of the journals of 10 subspecialties (endocrinology & metabolism,cardiac & cardiovascular systems,hematology,infectious diseases,nephrology,gastroenterology & hepatology,respiratory system,rheumatology,critical care medicine,clinical neurology) in Journal Citation Report (JCR),and careful consulation of expert clinicians,we identified 50 journals.Their bibliographic records (including references) published in 2011 were downloaded,and the frequency of the references (citations) in each sub-specialty was counted and the highly cited records were extracted.We performed a clustering analysis according to the co-cited times among any pairs of the highly cited records.To tag each cluster of highly cited records,we browsed the titles and abstracts of all highly cited records in the same cluster,and concluded the main topics of each cluster.Finally,we extracted the current published papers devoted to particular cluster by some clustering analysis indicators.The clusters of highly cited records were considered as the intelligence base,and the main topics in current papers which citing these highly cited papers were considered as research fronts.Results Totally 50 journals on 10 sub-specialties in internal medicine were identified.A total of 202 highly cited papers,38 clusters (knowledge bases),and 152 corresponding current citing papers presenting the research fronts were selected.Conclusions We confirm and present research fronts in 10 major sub-specialties of internal medicine.This study provides a synchronic structure of contemporary research activities in internal medicine sub-specialties.

Objective To investigate the clinical features,prognosis and its influencing factors of cerebral venous sinus thrombosis (CVST).Methods The clinical data of 163 patients with CVST were analyzed retrospectively.The outcome was assessed with the modified Rankin Scale (mRS).The influencing factors on prognosis were analyzed by logistic regression model.Results Among the 163 CVST cases,headache was found in 140 cases,motor and (or) sensory deficits in 16 cases,coma in 6 cases,serious intracranial hypertension (＞ 350 mm H2O,1 mm H2O＝0.0098 kPa) in 68 cases,lateral sinus thrombosis in 129 cases,straight sinus thrombosis in 11 cases and intracranial hemorrhage in 21 cases.Follow-up data was obtained by telephone in 150 cases (92％).The mRS scores were 0-1 in 89 cases,2 in 13 cases,3-5 in 44 cases,and 6 in 4 cases respectively.Poor outcome (mRS score ＞ 2) was found in 29.4％(48/163) patients.The total mortality rate was 2.7％ (4/150).Univariate analysis identified factors associated with poor outcome were motor and (or) sensory deficits,straight sinus thrombosis,serious intracranial hypertension (＞ 350 mm H2O) and intracranial hemorrhage.In logistic regression analysis,serious intracranial hypertension(＞ 350 mm H2O; OR =0.169,95％ CI 0.053-0.541,P =0.003) and intracranial hemorrhage (OR =0.075,95％ CI 0.018-0.311,P =0.000) were identified as independent predictors of poor prognosis.Conclusions The clinical manifestations of CVST are complicated and nonspecific.It is still a disease that may lead to death or disability.Serious intracranial hypertension(＞ 350mm H2O) and intracranial hemorrhage were independent predictors of poor prognosis.

Objective: To study the influence of negative electrets on apoptosis of fibroblast cells and to probe its mechanism. Methods: Fibroblast cell were treated with -300, -500 and -1 000V PTFE electrets for 24, 48 and 72 h, respectively, and the influence of negative electrets on cell apoptosis was studied by means of flow cytometry and transmission electron microscope. Results: Compared with control group, apoptosis cells increased from 0.5% to 10% (some even to 15%) after 24，48 and 72 h action of -300, -500 and -1 000 V electrets. After action of -500 V PTFE electrets for 48-72 h, fibroblast cells showed characteristic morphological features of apoptosis. These features included chromatin aggregation, nuclear and cytoplasmic condensation and partition of cytoplasm and nucleus into membrane bound-vesicles (apoptotic bodies). The effect of negative electrets on apoptosis was in proportion to the time and electric field intensity. Conclusion: Negative electrets can enhance apoptosis of fibroblast cells.