Objective To investigate the effect of great omentum combined with medical obturation glue on preventing thoracic cavity anastomotic leakage.Methods From August 2008 to September 2012,560 patients with esophageal gastric cardial carcinoma were enrolled and divided into two groups:the regular group (n =280) and the experimental group (n =280).In the regular group,anastomosis was reinforced with interrupted mattress sutures after esophageal gastric anastomosis was stapled.In the experimental group,anastomosis was covered with great omentum and medical obturation glue was sprayed to conglutinate after reinforced with interrupted mattress sutures.After that,gastric corpus was fixed upon the thoracic aorta and posterior chest wall.The clinical effects of the two groups were compared.Results Intrathoracic anastomotic leakage occurred in 8 cases (2.86％(8/280)) of the regular group,including 7 cases with symptomatic leakage and 1 case with asymptomatic loculate leakage.Seven patients were cured with conservative treatment and 1 patient with severe infection left hospital without cure.Average length of hospital stay was (55.6 ± 30.5) days postoperatively.Anastomotic stenosis occurred in 11 patients (3.93％,11/280).In the experimental group,one patient (0.36％,1/280) with asymptomatic loculate leakage was hospitalized for 20 days,and finally cured and discharged.8 cases with anastomotic stenosis occurred in the experimental group (2.86％,8/280).There was statistic difference in the rate of intrathoracic anastomotic leakage between the two groups (P =0.044),but there was no statistic difference in anastomotic stenosis between the two groups (P =0.484).Conclusion The technique of great omentum combined with medical obturation glue for preventing thoracic cavity anastomotic leakage,which is easy to perform,can obviously decrease the occurrence and attenuate the symptom of intrathoracic anastomotic leakage,and anastomotic stenosis increases unobviously.It also can shorten the length of hospital stay and is worthy of clinical promotion.

Objective To investigate the relationship between drug susceptibility of Salmonella bacteria and ion peak by mass spectrometry.Methods A total of 19 strains of Salmonella collected from the laboratory of Chengdu Center for Disease Control and Prevention from 2017 to 2020 were selected as the research objects.Serotyping and drug sensitivity tests were performed.The protein fingerprints of Salmonella were detected by matrix-assisted laser desorption ionization time-of-flight mass spectrometry.The relationship between drug sensitivity test and mass spectrometry in serotyping and drug resistance type identification was compared.Re-sults A total of 19 strains of Salmonella were generally resistant to β-lactam,and the antimicrobial resistance rate was above 50.00%except for cefepime,cefotetan and ertapenem.It was generally sensitive to non-β-lac-tam antibiotics,and the sensitivity rate was higher.The results of matrix assisted laser desorption ionization time-of-flight mass spectrometry showed that 3 128,3 158,5 144,6 094,64 84 m/z might be the specific pro-tein peaks of imipenem resistant Salmonella,5 772 m/z might be the specific protein peak of tobramycin re-sistant salmonella,3 046 m/z might be the specific protein peak of Salmonella resistant to levofloxacin,4 165 m/z might be the characteristic peak of Salmonella resistant to cefepime,10 957 m/z might be the common characteristic peak of Salmonella resistant to imipenem,cefazolin and ceftazidime,5 710 m/z might be the common characteristic peak of Salmonella resistant to tobramycin and cefotetan,4 165 m/z may be the com-mon characterstic peak of Salmonella resistant to imipenem and levofloxacin.Conclusion This study prelimi-narily explored the drug resistance spectrum of salmonella fingerprint results,which can provide reference for clinical drug use in time.

Objective:To explore the surgical outcomes and surgery-related complications of balanced orbital decompression and endoscopic transnasal inferomedial wall decompression for Grave's ophthalmopathy (GO).Methods:A cohort study was performed.The 56 GO patients who underwent balanced orbital decompression or endoscopic transnasal inferomedial wall decompression in the Tianjin Medical University Eye Hospital from December 2016 to December 2019 were enrolled.The follow-up time was 6 months.Patients were divided into two groups according to the operation modes.Thirty-three eyes of 24 subjects were given deep lateral wall rim-sparing orbital decompression and transcaruncular medial wall decompression, and 51 eyes of 36 cases were given endoscopic transnasal inferomedial wall decompression.The demographics, surgical details, imaging data, postoperative changes of exophthalmos, best corrected visual acuity (BCVA), orbital pressure and diplopia, surgery-related complications and further treatment were analyzed and compared.This study followed the Declaration of Helsinki and was approved by the Ethics Committee of Tianjin Medical University Eye Hospital [No.2020KY(L)-39]. All subjects signed informed consent.Results:The exophthalmos was (21.03±3.11)mm before operation, which was significantly higher than (17.06±2.55)mm after operation in the balanced orbital decompression group ( P<0.05). The exophthalmos was (20.51±3.53)mm before operation, which was significantly higher than (16.28±2.96)mm after operation in the endoscopic transnasal inferomedial wall decompression group ( P<0.05). No significant difference in the mean reduction of proptosis was found between the two groups ( P>0.05). All the subjects were accompanied with increase of intraorbital pressure before operation.The intraorbital pressure returned to normal at 6 months after operation.The postoperative BCVA of subjects with dysthyroid optic neuropathy (DON) were significantly higher than preoperative values ( Z=-3.524, -4.376; both at P<0.01). The postoperative improvement values of BCVA were 0.48 (0.25, 0.67) and 0.72 (0.40, 0.80) in the balanced orbital decompression group and the endoscopic transnasal inferomedial wall decompression group, respectively, with a significant difference between the two groups ( Z=-2.481, P=0.016). The incidence of complications in the balanced orbital decompression group was 21.2% (7/33), which was significantly lower than 47.0% (24/51) in the endoscopic transnasal inferomedial wall decompression group ( χ2=5.748, P=0.017). Conclusion:The two kinds surgical methods can effectively reduce the degree of exophthalmos and orbital pressure.Endoscopic transnasal inferomedial wall decompression can provide better improvement of visual function in patients with DON, but has a higher risk of surgery-related complications in comparison with the balanced orbital decompression.

Objective:To explore the therapeutic characteristics of population with gout achieving treat-to-target (T2T) indicators through real-world research and evaluate their safety.Methods:A total of 3 287 patients diagnosed with gout by rheumatologists in 21 first-class tertiary hospitals in 10 provinces, municipalities, and autonomous regions in China from January 2015 to December 2021 were included in this polycentric cross-sectional study. The database included patients′ general information, disease characteristics, and clinical application of traditional Chinese and Western medicine treatment measures. SPSS and Excel software were used for data analysis. Frequency analysis, cluster analysis, and factor analysis were used to summarize the characteristics and rules of treatment measures for patients with gout who achieved the target after treatment. The occurrence of adverse events (AE) was recorded during treatment.Results:After treatment, 691 visits (7%) achieved the serum urate (SUA) target, and the most frequent use of urate-lowering therapy (ULT) was febuxostat, followed by benzbromarone. The most common treatment options were following: GroupⅠ: traditional Chinese medicine (TCM) decoction-TCM external treatment-physical exercise-proprietary Chinese medicine; GroupⅡ: ferulic acid-nonsteroidal anti-inflammatory drugs (NSAIDs); Group Ⅲ: allopurinol-sodium bicarbonate-benzbromarone; Group Ⅳ: glucocorticoid-colchicine; Group Ⅴ: febuxostat. A total of 5 898 visits (60%) chieved manifestations of joint pain VAS scores target, and the most frequently used drug to control joint symptoms was NSAIDs. The frequency of use of drugs to control joint symptoms were 2 118 times (usage rate reached 35.9%), while the frequency of ULT were 2 504 times (usage rate reached 42.5%), which was higher than the joint symptom control drug. The most common treatment options were following: Group Ⅰ: proprietary Chinese medicine-TCM decoction-TCM external treatment-physical exercise; Group Ⅱ: NSAIDs-colchicine hormones; Group Ⅲ: allopurinol, Group Ⅳ: benzbromarone; Group Ⅴ: febuxostat. A total of 59 adverse events occurred during treatment.Conclusion:The proportions of gout patients who reach target serum urate level & good control of joint symptoms are both very low, and ULT and anti-inflammatory prescription patterns are very different from international guidelines, so it is necessary to strengthen the standardized management of gout patients. At the same time, life intervention measures account for a certain proportion of the treatment plans for the T2T population, and further exploration is needed.

Objective:To evaluate the influence of the clinical staging and different risk factors for the prognosis of ocular adnexal lymphoma.Methods:An ambispective cohort study was conducted.Seventy-four patients diagnosed with primary ocular adnexal lymphoma by pathology at Tianjin Medical University Eye Hospital from November 2010 to December 2018 were enrolled.TNM staging was performed according to local tumor extent, lymph node or systemic involvement.Ann Arbor staging was carried out according to lymph node involvement and extranodal extension.The pathological subtype was classified according to World Health Organization classification of lymphoma.The outcome of disease progression or death was analyzed.Kaplan-Meier method was used for univariate survival analysis.Cox proportional hazard model was employed for multivariate survival analysis to predict the risk factors affecting prognosis, hazard ratio ( HR) and 95% confidence interval ( CI) were estimated.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Tianjin Medical University Eye Hospital (No.2021KY[L]-32). Written informed consent was obtained from all patients before entering the cohort. Results:For TNM staging, there were 68 cases in stage