Gastrectomy with D2 lymphadenectomy is considered as the standared operation to treat gastric cancer by the major of experts at home and abroad.Laparoscopic gastrectomy with D2 lymphadeneetomy is safe,feasible, minimally invasive and can achieve the same result of abdominal opening.This article is a review to summarize the overview,necessity and feasibility,the indication,the points for attention in operation,preoperative evaluation, complication,the result and the perspect about lapamscopie gastrectomy with D2 lymphadenectomy.

Objective To investigate the relationship between metabolism syndrome (MS) and fatty liver. Methods Plasma lipids, plasma glucose, liver function, blood pressure, body height and body weight were determined in 666 leaders receiving physical examination. Their livers were also examined by ultrasound. Whit analysis of variance and chi-square test, the effect of plasma lipids, plasma glucose, blood pressure, and weight index on fatty liver, and the relation between MS and fatty liver were analyzed. Results The weight index, systolic pressure, diastolic pressure, and the levels of total cholesterol, triglyceride, apolipoprotein B and plasma glucose in the patients with fatty liver were higher than those in healthy subjects. The levels of high-density lipoprotein and apolipoprotein A were lower in patients with fatty liver than those in healthy subjects. The morbidity of fatty liver in the patients with MS was higher than that in healthy subjects. Conclusion There was a close relation between MS and fatty liver. It was necessary to early treat MS.

Objective:To evaluate the effects of surface modification with different concentration silica sol through sol-gel processing on bond strength between dental zirconia ceramic and resin cement. Methods:Silica coating was prepared by colloidal silica sol with concentrations of 20%,30%,40% on dental Zirconia ceramic. 32 discs zirconia ceramic specimens were fabricated and randomly divided into four groups respectively after polishing and sandblasting.The ceramic surfaces of different groups were received different treatments:(1)silane couple agent;(2)20% silica coating and silane couple agent;(3)30%silica coating and silane couple agent;(4) 40% silica coating and silane couple agent. Each ceramic block was bonded to light curing composite resin. All samples were stored in distilled water at 37 degrees for 24 h before a shear bond test to measure the bond strength of the resin cement to the ceramic surface. Scanning electrical microscopy (SEM) and energy depressive spectrum (EDS) were used to analyze the silica coating. Results:Contents of surface silicon increased after modification with silica coating prepared by sol-gel method. Bond strengths of groups with silica coating were significantly higher(P

Aim To search the effective malaria mixed gene vaccine and to explore the immune response of vaccinated host. The recombinant pcDNA3-EBA175/HRP Ⅱ was injected alone or mixed with pcDNA3-Pfs25 of Plasmodium falciparum into mice by intramuscular route. The muscle of injected parts were treated previously, e.g. injecting 50μl of 0. 5％bupivacaine into the muscle of left latter leg, with 2mm depth. To observed the changes of IgG antibody value, the splenic lymphocyte proliferation, the ratio of CD4+/CD8+ subgroups and NK cell killing activity. After injecting recombinant pcDNA3-EBA175/HRP Ⅱ alone or mixed with pcDNA3-Pfs25 into mice by intramuscular route, it showed that sera IgG value increased, the splenic T lymphocyte proliferation stimulated by specific antigen of Plasmodium falciparum increased, the ratio of CD4+/CD8+ decreased and NK cell activity increased. Enhanced immune injection could improve host's immune reaction.It is suggested intramuscular injection is an effective immune route, and mice inoculated with coding two gene recombinant alone or that mixed with sexual stage gene recombinant could all induce increased humoral and cellular immune response, and NK cell activity.

Objective To analysis the effect of compound betamethasone injection combined with radiation on keloid in frontal facial region. Methods 60 cases of keloid patients in zhejiangprovincial people's hospital from January 2014 to January 2016 were selected,all patients were treated with surgery,the patients were randomly divided into observation group and control group,30 cases in each group,radiotherapy was used in the control group,the observation group was treated with local injection of compound betamethasone on the basis of the control group,the therapeutic effects, pain scores, adverse reactions and complications were compared between the two groups. Results The recurrence rate of the observation group was 3.33% which was significantly lower than that of the control group 10%,the improvement rate of the observation group 93.33% was significantly higher than the control group 80%,the difference was statistically significant (P<0.05).one,two and three months after operation,the pain scores in the observation group were significantly lower than those in the control group at the same time point,the difference was statistically significant (P<0.05).The adverse reaction rate was 6.66% (2/30) in the observation group and 23.33% (7/30) in the control group, there was no significant difference between the two groups.The incidences of skin sag, pigmentation, incision delayed union and telangiectasia in the observation group were significantly lower than those in the control group (P<0.05). Conclusion Compound betamethasone injection combined with radiation on the frontal facial keloid patients with significant effect,can significantly reduce the recurrence rate,improve the rate of improvement,reduce pain and complications in patients.

Objective To investigate hemodynamie change in uremia complicating heart failure of elderly patients. Methods Totally 241 cases with uremia complicating heart failure received measurement of circulation dynamic detection(CD).The volume load,myocardial contractility and blood pressure were analyzed in the elderly group aged(71±6)years (n=116) and young and middleaged group aged(38± 10)years(n =125). Results The central venous pressure(CVP)[(26.7±11.3)cmH2O vs.(23.6 ± 10.7) cm H2O,t=2.410,P =0.010],effective circulation volume (ECV)[(4362± 1340)ml vs.(3085 ± 1001 ) ml,t =7.674,P =0.000],stroke volume(SV) [(185 ± 52) ml vs.(114±41)ml,t=7.803,P=0.000],cardiac output (CO)[( 13.9±4.3)L/min vs.(11.2±3.6)L/min,t=4.802,P=0.000],left ventricular end diastolic volume (LVD)[(388± 145)ml vs.(258±98)ml,t =7.673,P =0.000],left ventricular end systolic volume ( LSV ) [( 223 ± 95 ) ml vs.( 135 ± 59) ml,t =7.186,P=0.000] were significantly higher group than in young and middle-aged group.The ejection pressure (EP)[(178±29)mm Hg vs.(183±24)mm Hg,t=2.323,P=0.012],myocardium negative inotropic(MNC) [(0.609±0.149)vs.(0.683±0.188),t=3.113,P=0.002],ejection fraction (EF) [(0.433± 0.034) vs.(0.445 ± 0.031 ),t =2.451,P =0.010],diastolic blood pressure (DBP) [( 87 ±14)mm Hg vs.(1.08±22)mm Hg,t=8.141,P=0.000],systematic vascular resistance(SSR)[(952±207)gcm-4 s-2 vs.(1217± 308) gcm-4 s-2,t =7.143,P=0.000],ejection resistence(ER) [( 178± 29)vs.( 183 ± 24),t =2.323,P =0.012] were lower in elderly group than in young and middle-aged group.DBP(x2 =16.474,P=0.000,OR=0.752,95％CI:0.714-0.790),SBP(x2 =11.913,P=0.000,OR=1.148,95％CI:1.091-1.205),ER(x2 =17.892,P=0.000,OR=0.906,95％CI:0.861-0.951),CVP(x2 =14.672,P=0.000,OR=0.698,95％CI:0.663-0.733) and LDV(x2 =21.080,P=0.000,OR=0.942.95％ CI:0.895-0.989) were dangerous factors of uremia complicating heart failure.Conclnsions The increased volume load,decreased myocardial contractility and cardiac afterload may appear in the elderly patients with uremia complicating heart failure.

Surgical resection and liver transplantation are still the preferred treatments for patients with hepatocellular carcinoma (HCC).For the patients with advanced HCC which are not suitable for surgical resection,traditional chemotherapy can not improve the prognosis.Molecular targeted therapy is a new method and tendency in the treatment of HCC.Multiple targets inhibitors,vascular endothelial growth factor inhibitors and monoclonal antibodies for HCC are widely researched and applied.

Objective To investigate the effect of hypertension and hyperuricemia (HUA) on renal function.Method Total 1 209 subjects undergoing health check up from December 2000 to December 2002 and 45 patients with renal disorders were enrolled in the study.The blood pressure,height,weight,renal function and liver function were measured; and the glomerular filtration rate (GFR) was calculated.The GFR in patients with hypertension,HUA and hypertension with HUA was compared.Results The incidence of hypertension in HUA group and non-HUA was 23.9％ (58/243) and 13.9％ (134/966),respectively (x2 =14.52,P =0.000).GFR in HUA with hypertension,HUA and hypertension groups were (69.1 ± 30.5),(82.8 ± 25.3) and (90.1 ± 21.7) ml · min-1 · (1.73 m2)-1,respectively (P ＜ 0.01).Logistic regression analysis showed that the risk factors for GFR were UA,systolic pressure and age.After 5 years of follow up,GFR in hypertension group was significantly decreased from (90.7 ± 18.1) to (85.6 ± 17.6)ml·min-1 · (1.73 m2)-1m,in HUA group from (86.3±10.9) to(62.1 ±8.2) and inHUAwith hypertension group from (77.9 ± 18.9) to (49.3 ±9.8) ml · min-1 · (1.73 m2)-1,UA and age were the long-term factors that affect GFR (P ＜ 0.05).Conclusions Both hyperuricemia and hypertension can impair the kidney function,if hypertension is complicated with hyperurecemia the effect is more marked.

Objective To investigate the clinical liver function protective effect of Shuganning injection for treatment of patients with drug poisoning.Methods One hundred and forty patients with drug poisoning consistent with thecriteria of enrollment into the study were admitted into the Department of Emergency Medicine in the First Hospital of Jilin University-the Eastern Division from January 2015 to August 2016, and they were randomly divided into observation group and control group by the computer generated random numbers, 70 cases in each group. After admission, all the cases were treated with routine treatment including detoxification, removal of toxin, organ protection, symptomatic and supporting treatment, etc. Based on the routine treatment, additionally, Shuganning injection 20 mL+ 10% glucose injection 250 mL, intravenous drip slowly, once a day was given in the observation group; the therapeutic course was 14 days in both groups. The changes of serum glutamic transaminase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBiL) levels were determined before and 7 and 14 days after treatment respectively to evaluate the situation of liver function in the two groups.Results Before treatment, there were no statistical significant differences in the levels of serum ALT, AST and TBil in the two groups (allP > 0.05); with the prolongation of treatment, the above-mentioned indexes of the two groups were gradually reduced, on the 14th day after treatment, they reached the lowest levels, and the degree of decrease in level on the 14th day in the observation group was more significant than that in the control group [ALT (U/L): 32.6±10.8 vs. 98.3±34.5, AST (U/L): 39.4±14.3 vs. 138.5±25.6, TBil (μmol/L): 4.8±1.7 vs. 13.2±2.3, allP < 0.05].Conclusion Shuganning injection has a protective effect on liver function in patients with drug poisoning.

Objective To study the value of microwave coagulation therapy for liver malignant tumors.Methods Under local anesthesia,19 cases with hepatic malignant tumors treated with microwave knife under CT-guided.Results There were totally 23 tumors in 19 cases,13 tumors with≤3.5 cm in diameters were destroyed absolutely after the first treatmet,10 tumors among them were followed-up for 6-12 months and no recurred.10 tumors with＞3.5 cm in diameters treated at multiple points or angle,3～6 months later,CT showed that the tumors were destroyed completely in 6 and mostly in 4,by the hot condensate treatment secondly,3 tumors of 4 were destroyed completely 3 months later.There were no obvious complications.Conclusion The therapeutic effect under CT-guided microwave coagulation therapy for liver tumor which are ≤3.5 cm in diameter of the tumors is very reliable,the tumors＞3.5 cm in diameter can be destroyed mostly or completely by microwave treatment.