ObjectiveTo explore the operation effect and clinicopathologic characteristics of elderly patients with gastric carcinoma(GC) and the relationship between prognosis and age.MethodsThe clinical data and treatment outcomes of 112 elderly patients suffered from GC( elderly group≥70 years of age) and 135 younger patients (control group ＜50 years of age) were analyzed retrospectively.ResultsThe elderly GC patients had more preoperative comorbidities,and a well or moderately differentiated histology(P ＜0.05).And more young patients had a poorly differentiated histology and signet ring cell carcinoma,using the Borrmann classification,type Ⅳ was more frequent in the young patients(P ＜0.05 ) ; Whereas there were no significant differences beween the two groups in other factors ( including liver function,tumor invasion,nodal involvement,hepatic metastasis,peritoneal dissemination,tumor stage,type of surgery,post operation complication and 5-year survival rates of elderly patients and young patients) ( all P ＜0.05).ConclusionOutcomes in elderly patients with gastric carcinoma were comparable to young patients.The important prognostic factor was whether the patients undergo a curative resection.For the elderly patients without preoperative comorbidities or with controlled comorbidities,gastrectomy was a safe and effective treatment.

Lipoprotein-associated phospholipase A2(Lp-PLA2) can rapidly hydrolize and oxidize the oxidized phosphatidylcholine molecules produced in low density lipoprotein and atherogenic lipoprotein (a),generating the soluble proinflammatory and proapoptotic mediatorslyso-phosphatidylcholine and oxidized free fatty acids.It stimulates aggregation and activation of monocyte-macrophage system and induces apoptosis and damages the removal of dead cells.It plays an important role in the development of lipid necrotic core of atherosclerosis.Lp-PLA2 is not an independent risk marker of coronary artery disease and ischemic stroke,but also plays an important role in the development of atherosclerotic plaques.Selective Lp-PLA2 inhibitor reduces the development of necrotic cores.It may play a role in the stabilization of atherosclerotic plaques.At the same time,it may represent a novel target for the treatment of atherosclerosis.

Objective The aim of this study is to observe the effect of our surgical treatment method for abductor defects in hip revision cases. Methods We retrospectively evaluated a consecutive series of eight patients (eight hips) with a defect of the hip gluteus medius muscle from April 2012 to April 2014 who underwent revision and gluteus medius muscle reconstruction. 7 patients with loosening of components (2 periprosthetic joint infections), 1 repeated dislocation after hemiarthroplasty. There was one case with moderate pain and 7 cases with severe pain. 8 cases were severe limp, needed crutches or braces walking aids, glu?teal medius muscle strength was ≤3, and the Trendelenburg sign was positive in all patients. The average age was 50 years old (31-69 years old), 2 men and 6 women. One patient with a gluteus medius muscle completely disrupted from insertion at greater trochanter, which underwent knit suture. One patient had a greater trochanter fracture resulted in ascending of gluteus medius mus?cle. During revision, fracture was reducted and fixed by 2.0 Kirschner wire and cable. Three patients with defects of gluteus medi?us muscle;we applied gluteus maximus fascia lata muscle valvuloplasty. One patient with deficiency of both gluteus medius mus?cle and greater trochanter. Gluteus maximus was directly reattached to the proximal of femoral stem. Results All patients were followed up for an average of 18 months (range, 14-35 months). The mean Harris Hip score increased from 57 to 85, pain was remarkably relieved, ROM of hip and myodynamia was improved. Preoperative abductor strength ≤3, 6 months after surgery abductor strength was increased with average of 1-2 level. Conclusion Reconstruction of hip abductor tendon of gluteus medi?us muscle deficiency would be effective in hip revision surgery.

Objective To investigate the role of contrast-enhanced ultrasound (CEUS) on the diagnostic efficacy of ultrasound-guided percutaneous biopsy of peripheral lung lesions. Methods Ninty-six patients with pleural-based lesions underwent percutaneous ultrasound-guided biopsy. Of the 96 patients,54patients underwent CEUS before biopsy and enhancement information was referred for the selecting of tissue sampling site. The rest of 42 patients didn' t undergo CEUS before biopsy. The difference in the diagnostic accuracy between the two groups was analyzed to evaluate the value of CEUS before biopsy.Results Of the 52 patients in the CEUS group,48 were malignant,and 6 were benign. Of the 42 patients in the un-CEUS group,36 were malignant, and 6 were benign. Necrosis (areas lacking of enhancement) was demonstrated in 41.7％ (20/48) of the patients with malignant lesions in CEUS group, and necrosis incidence was increased with the increase of the dimension of the malignant lesions. No necrosis area was demonstrated in 6 benign lesions. The rate of successful initial biopsy in CEUS group (98.1 ％ ,53/54) was statistically higher than that in un-CEUS group ( 85.7％, 36/42 ) ( P ＜ 0.05 ). Tissue necrosis and denaturalization attributed to most of the inconclusive pathologic diagnosis. Conclusions CEUS before transthoracic peripheral lung lesion biopsy improved the diagnostic accuracy of the procedure by providing information for differentiating viable or necrotic tissue and consequently provide more accurate information about the site of biopsy.

The blocking action and selectivity of 1 - (? -naphthylmethyl)-2 - methyl - 6,7 - dimethoxy -1,2,3,4 -tetrahydroisoquinoline (86040) on a - a-drenoceptor have been investigated in isolated tissues. 86040 suppressed the inhibition of clonidine for the electrically stimulated twitch response of rat vas deferens ( - adre - noceptor), with pA2 value of 5. 85. 86040 could competitively inhibit anococcygeus muscle contraction (?1 -a-drenoceptor ) induced by phenylephrine with pA2 value of 7. 62. 86040 was found that the selectivity radio to block ?2 - and ?2 adrenoceptor(?1/?2)was 60. these results indicate that 86040 is a potentant relatively selective ?1 - adrenoceptor blocker.

Objective To evaluate the strategies and effect of surgical treatment for concomitant abdominal aortic aneurysm (AAA) and colorectal cancer (CRC). Methods Literatures on concomitant AAA and CRC published from January 1988 to December 2008 were retrieved from Pubmed, Sciencedirect, Ovid, CBMdisc, CNKI and et al, and correlated indexes were extracted for analysis. Differences among the groups were analyzed using the t test, chi-square test and fisher's exact test. Results A total of 367 cases of concomitant AAA and CRC treated by operation were retrieved. The length of operation delay of patients who received radical resection of CRC first was (115 ± 21 )days, which was significantly longer than (42 ± 8 )days of patients who received open abdominal aortic aneurysm repair (OAAR) first (t = 18. 9, P <0.05). The 30-day complication rate and accumulative length of hospital stay of patients who received one-stage radical resection of CRC + OAAR were 10.5% ( 12/114 )and (23 ±6) days, and 26.0% (47/181) and ( 16 ±4)days of patients who received two-stage radical resection of CRC + OAAR, with a significant difference ( χ2 = 10.42, t = 12. 01, P <0.05 ). The accumulative length of hospital stay of patients who received radical resection of CRC + endovascular aneurysm repair (EVAR) was (12 ±4) days, which was significantly shorter than that of patients who received radical resection of CRC + OAAR [ ( 19 ±5 ) days ] ( t = 9.48, P < 0. 05 ). The 4-year survival rate of patients who received two-stage radical resection of CRC + OAAR was 43.5% (27/62), which was significantly lower than that of patients who received two-stage radical resection of CRC + EVAR [69.2% (18/26) ] or one-stage radical resection of CRC + OAAR [73.7%(14/19) ] (χ2 =4.83, 5.28, P<0.05). Conclusions If the diameter of AAA is under 5 cm, radical resection of CRC should be firstly carried out; but if the diameter of AAA is above 5 cm, OAAR should be firstly carried out to prevent the rapture of tumors. One-stage surgery is better than two-stage surgery if patients could tolerate it.

An offline two-dimensional system combining a rat cardiac muscle cell membrane chromatography time-of-flight mass spectrometry (CMC-TOF/MS) with a high performance liquid chromatography time-of-flight mass spectrometry (HPLC-TOF/MS) was established for investigating the parent components and metabolites in rat urine samples after administration of the roots of Aconitum carmichaeli.On the basis of the analysis of the first dimension,retention components of the mine sample were collected into 30 fractions (one fraction per minute).Then offline analysis of the second dimension was carried out.34 compounds including 24 parent alkaloids and 10 potential metabolites were identified from the dosed rat urine,and then binding affinities of different compounds on cell membranes were compared and influences of some functional groups on activity were estimated with the semi-quantification and curve fitting method.As a result,binding affinities decreased along with the process of deacylation,debenzoylation and demethylation,which may be related to the alleviation of toxicity in the procedure of herb processing or metabolism.Moreover,some minor components in rat urine (Songorine,14-benzoylneoline,Deoxyaconitine,etc.) exerted relatively strong affinity on cell membranes are worth exploring.The results delivered by the system suggest that the CMC can be applied to in vivo study.

Objective To analyze imaging infarct patterns and features in patients with severe stenosis or occlusion of internal carotid artery (ICA) and middle cerebral artery (MCA)from the point of view of diffusion-weighted imaging (DWI) and to investigate the infarction related mechanism. Methods Eighty-eight patients with acute ischemic stroke who had moderate to severe ICA or MCA stenosis or occlusion confirmed by cerebral angiography were analyzed retrospectively. They were divided into ICA lesion and MCA lesion groups. The infarct patterns were classified as single and multiple according to DWI. The former were reclassified as perforating artery infarct (PAI), pial infarct (PI), watershed infarct, and large infarct. Results There were 11 types of infarct patterns in MCA territories. The DWI multi-infarct pattern accounted for 62.5% of all patients (55/88). PI with watershed infarction appeared more often in the ICA lesion group (11/45, P=0. 040), and PI with PAI appeared more often in the MCA lesion group (10/43, P = 0. 037). Conclusions In patients with cerebral infarction associated with ICA or MCA severe stenosis or occlusion, most of them showed multi-infarct pattern,which suggested the mixed mechanisms such as embolization, hypoperfusion/impaired clearance of emboli, and local perforating branch occlusion were the main mechanisms of the occurrence of cerebral infarction. The main mechanism of cerebral infarction in the ICA lesion group was embolization combined with hypoperfusion/impaired clearance of emboli, while in the MCA lesion group was embolization combined with local perforating branch occlusion.

Objective:To investigate the relevant factors on serum C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) which did not meet the 2011 Musculoskeletal Infection Society (MSIS) diagnostic criteria in patients with periprosthetic joint infection (PJI).Methods:During December 2011 to December 2019, a total of 328 patients with PJI were hospitalized for surgery or antibiotic administration, including 152 males and 166 females, aged 62.10±13.74 (range 24-87) years. All patients underwent CRP and ESR before the antibiotic administration or the revision surgery. PJI was diagnosed based on the 2011 MSIS diagnostic criteria. There were 172 knee PJIs (52.4%), 151 hip PJIs (46.0%), 4 elbow PJIs (1.2%) and 1 shoulder PJI (0.3%). Patients were classified according to Tsukayama type, pathogen and immune status. We, further, analyzed relevant factors on CRP and ESR levels in PJI patients.Results:There were 119 patients with CRP and ESR did not meet the MSIS diagnostic criteria, accounting for 36.3% (119/328). Furthermore, there was no significant difference in Tsukayama types among them (χ 2=7.224, P=0.065). In addition, the ratio was 46.4% in patients with negative culture results, which was higher than that in positive culture results (27.4%, χ 2=12.276, P<0.001). The ratio was 42.9% in patients with normal immune status (grade A), which was higher than that of immune grade B (30.6%) and of immune grade C (23.8%) (χ 2=6.586, P=0.037). Multivariate logistic regression analysis showed the negative association between positive culture results and immune grade B with nonconformity ( OR=0.420, P=0.001; OR=0.578, P=0.04). Conclusion:The serum tests level unmet the threshold in MSIS criteria usually present in PJI patients with normal immune status and negative culture results. Thus, we should utilize other methods for diagnosing PJI.