Objective:To investigate the related factors of pancreatic fistula after laparoscopic-assisted distal gastrectomy (LADG).Methods:A retrospective analysis was performed of 189 patients who underwent LADG in Beijing Friendship Hospital, Capital Medical University from June 2017 to March 2018. Twenty-seven patients with postoperative pancreatic fistula and 27 randomly selected normal patients were included in the study. The preoperative characteristics and surgical data of all patients were recorded, including body mass index, visceral fat area, past history, preoperative tumor staging, operation time and bleeding volume, etc. The related factors of postoperative pancreatic fistula were analyzed. Measurement data were expressed as mean±standard deviation ( Mean± SD), and t-test was used for comparison between groups. Chi-square test was used to compare the count data between groups. Results:The patients with high body mass index ( t=3.956, P=0.003), high visceral fat area ( t=6.161, P=0.038), long operation time ( t=2.650, P=0.024), profuse hemorrhage ( t=1.887, P=0.042), complete lymphadenectomy ( t=2.092, P=0.001) were prone to postoperative pancreatic fistula, while there was no significant difference of visceral fat area/total abdominal fat area ( χ2=1.334, P=0.324), preoperative with pulmonary diseases ( χ2=0.750, P=0.379), coronary heart disease ( χ2=0.081, P=0.500), hypertension ( χ2=0.667, P=0.239), diabetes mellitus ( χ2=2.030, P=0.127), chronic kidney disease ( χ2=0.587, P=0.352), tumor stage( χ2=1.388, P=0.500) and other factors between the two groups. Conclusions:Obesity patients and LADG patients with long operation time are more likely to have postoperative pancreatic fistula. Comprehensive preoperative assessment and prudent intraoperative operation may be one of the effective methods to avoid postoperative pancreatic fistula.

Objective To investigate the activity changes of gelatinase in the formation of ascending aortic aneurysm.Methods Thirty five young Wistar rats were divided into two groups:the control group and the experiment group.The rat models induced by ascending aorta banding were made.The ascending aortas were taken after 3-5 months operation,changes of gelatinase activity was observed by gelatin zymography and film in situ zymography.Results Gelatinase activity of ascending aortic aneurysm was significantly increased compared with that of normal ascending aortic aorta.Conclusion Elevation of gelatinase activity may play a significant role in the formation of ascending aortic aneurysm.

Objective To investigate the expressions and significance of transforming growth factor-beta 1(TGF?1) and its typeⅡ receptor(TGF?RⅡ) in experimental rat ascending aortic aneurysm of rat model.Methods The rat ascending aortic aneurysm models were made by banding ascending aorta of young Wistar rats.The ascending aortas were taken 4 months after operation.Immunohistochemistry staining and Western blotting were used to investigate the expressions of TGF?1 and TGF?RⅡ.Result Immunohistochemistry staining results showed that TGF?1 expressed in all layers of the aortic aneurysm and the control.TGF?RⅡ was extensively located in the hyperplastic intima and tunica media smooth muscle cells in the aortic aneurysm,while there was only a little positive staining in the control group.Western blotting results indicated that the expression levels of TGF?1 and TGF?RⅡ in the aortic aneurysm were stronger than the control,P

Objective To put forward reasonable and feasible recommendations aiming at enhancing the application safety of afterloading unit, through studying the human reliability in the emergency response against the source blockage of afterloading unit.Methods Based on the human cognition reliability model, ten operation errors during the emergency response against the source blockage of afterloading unit were analyzed and permissible time widow of emergency response operation were determined.The human error probability was calculated with the execution time of emergency response operation obtained through simulation, observation and recording.Results The operation action, relevant permissible time window and execution time were obtained with the corresponding human error probabilities in the range 0.04 - 0.27.Conclusions The human error model in emergency response against the source blockage of afterloading unit based on HCRmodel is feasible, and provides important reference basis to reduce the occurrence of potential exposure and mitigate the consequence of potential exposure.

Background: There are obvious changes in neuropeptides from plasma and cerebrospinal fluid in patients with vascular dementia (VaD), and regulating the levels of neuropeptides is a key for prevention and treatment of VaD. Objective: To observe the clinical efficacy of moxibustion at head-points in treatment of vascular dementia (VaD), and assess its effects on memory-related neuropeptides. Design, setting, participants and interventions: A total of 65 VaD patients from Acupuncture Hospital, Anhui University of Traditional Chinese Medicine, were randomly divided into moxibustion group (33 cases) and Western medicine group (32 cases). Patients in the moxibustion group were treated with indirect moxibustion with common monkshood cake for 20 min. Patients in the Western medicine group were orally administered piracetam tablets, 0.8 g for three times a day. One treatment course was 4 weeks, and they were treated for 4 treatment courses. Main outcome measures: The scores of Hasegawa's Dementia Scale (HDS), Mini-Mental State Examination (MMSE), and Activity of Daily Living Scale (ADL), as well as the levels of learning and memory-related neuropeptides from cerebrospinal fluid such as somatostatin (SS) and arginine vasopressin (AVP) were measured before and after treatment in the two groups. Results: Total response rate was significantly higher in the moxibustion group than in the Western medicine group (P<0.01). There were significant differences in scores of HDS, MMSE and ADL between before and after treatment in the two groups(P<0.05 or P<0.01). After treatment, the scores of HDS, MMSE and ADL in the moxibustion group were more improved as compared with those in the Western medicine group (P<0.05 or P<0.01). The levels of SS and AVP after treatment were higher than those before treatment in the two groups(P<0.01). After treatment, the increased levels of SS and AVP were higher in the moxibustion group than in the Western medicine group (P<0.01). Conclusion: Moxibustion is effective in improving the clinical symptom scores and regulating the levels of neuropeptides associated with learning and memory in VaD patients.

Objective To study the effect of lipopolysaccharide(LPS)on the endo-pulmonary natrium channel(ENaC)expression in the lung of rats with acute lung injured.Method Sixteen rats were randomly divided into normal control group and LPS-group.Rats of normal control group and LPS-group were killed at 6 hours after intravenous injection of normal saline(8 ml/kg)or LPS(8 mg/kg).The extent of lung injury was assessed by arterial blood gas analysis and histological examination.At the same time,?-ENaC protein and???- ENaC mRNA expression in the lung tissue were analyzed by immunohistochemistry and RT-PCR.Results PaO_2 in LPS-group was noticeably lower than in normal control group(P

Objective To explore the value of F wave recording in evaluating facial nerve function and its pathological changes in the pressure-induced rat models of acoustic neurinoma. Methods 58 rats in different groups were conducted F wave recording and biotinylated dextran amine(BDA) retrograde tracing for their right facial nerve one week after establishing models. Their latencies, amplitudes and F/M rates were analyzed first. 72 hours after BDA was injected into right whisker muscle, the rats were infused with 4% polyoxymethylene, then pontines and facial nerves in the CPA cistern were obtained. Pontiues were cut into frozen sections for histochemical staining with avidin-horseradish peroxidase (HRP)-DAB and Nissl 's counterstaining, calculating the positive BDA neurons ratio(BDA+-N%)in facial nuclear. Facial nerves were cut and stained with toluidine blue for light-micrescope inspection, and/or stained for transmission electron microscope observation. Correlating F/M with BDA+-N% and the facial nerve pathological findings. Results F/M are 97.66 % and 97.48 % in normal and pseudo-operation group, respectively, when stimulus are 1.4 mA; while 77.13 %, 48.91% and 11.54 % in from small to large tumor model groups because F waves were delayed in latencies or increasinglylost (P <0.001). Similarly, BDA+-N% are 98.37 % and 97.96 % in the above two control groups, while 77.28 %, 48.28 % and 11.55 % in from small to large tumor model groups (P < 0.001). Thus F/M are positively correlated with their BDA+-N% in all groups (r =0.996,P <0.001). Facial nerve examinations under light and electron microscope show increasing pathological changes along with increasing "tumor" size. Conclusion The findings of F wave recording in facial nerve may reflect its functional status and pathological changes. Therefore, F wave detection may help electrophysiological monitoring during acoustic neurinoma resection and facial nerve function evaluation after surgery.

· AIM: To study the effects of topical anesthesia on corneal thickness in myopic eyes with Orbscan topography system and to assess the application prospect of this device in determining the corneal thickness for refractive surgery.and 5 minutes after administration of one drop of Benoxil (Oxybuprocaine) 4g/L solution (Santen, Japan) to 98 eyes (98 patients). The numeric value of the corneal thinness (THN) and the mean central corneal thickness (CCT) of 2mm in diameter were obtained before and after the instillation. The changes in anterior chamber depth (ACD) were also studied.P＜0.001) and CCT by 3.10±7.13μm (t=-4.310, P＜0.001) were found following the instillation of the topical anesthetic. There were no statistically significant changes in ACD (t=1.288, P=0.201).immediate effects on the corneal thickness in myopic eyes and this have implications for corneal refractive surgery and even for the accuracy of applanation tonometry.

To observe the reliability and short-term and mid-term efficacy of a new designed multi-functional lacrimal sac nasal drainage stent on the treatment of nasolacrimal duct obstruction after endonasal endoscopic dacryocystorhinostomy ( EES-DCR ) , and to evaluate its clinical application value. METHODS: A retrospective case series study was carried out. Seventy - six patients ( 79 eyes ) with nasolacrimal duct obstruction underwent EES-DCR and a new type of multi-functional lacrimal sac nasal drainage stent was implanted. The nasal lacrimal drainage stent was pulled out 2~3mo later after surgery and the patients received 3~6mo follow-up afterwards. RESULTS: ln 79 eyes, stents were successfully implanted in 77 eyes (97. 5%). All stents of 77 eyes could be pulled out successfully 2 ~ 3mo after the operation. Sixty eyes were cured with unobstructed lacrimal irrigation and symptom of epiphora disappeared;15 eyes were improved of epiphora and mild reflux during lacrimal irrigation were found, overall effective rate was 97. 4%, 2 eyes failed in stent implantation. ln 6mo follow-up, nocomplications such as stent displacement or slip was occurred, the epithelization of anastomotic stoma was good.CONCLUSlON: Surgical technique of using the multi-function nasolacrimal stent is simple and fast, and implantation of the new designed stents has a rapid recovery with fewer complications. The usage of the new stents not only improves the success rate but also broadens surgical indications of EES-DCR, it is a safe and effective method for the treatment of nasolacrimal duct obstruction.

Objective:To investigate the levels of dose to eye lens of interventional radiology workers in China from 2017 to 2019.Methods:The monitoring data on eye lens doses to the interventional radiology workers in 28 provinces across the country were collected from National Individual Dose Registry. Monitoring was carried out using TLDs on their left eyes and evaluated in terms of the personal dose equivalent Hp(3). By using Mann-Whitney U test and Kruskal-Wallis H test, statistical analyses were made of the average annual lens doses to interventional radiology workers in the hospitals of different types at different levels for different years. Results:From 2017 to 2019, the data on eye lens doses to 2 981 interventional radiology workers were collected, with doses ranging from below the minimum detectable level (MDL) to 64.48 mSv, the average annual eye dose of 1.38 mSv, and the annual doses incurred by 0.97% monitored workers exceeding the recently recommended dose limits, 20 mSv per year. The average annual lens dose monitored in general hospitals and in cancer hospitals were 1.33 and 1.77 mSv, respectively, without statistically significant difference ( P>0.05). The average annual lens dose in tertiary hospitals was 1.39 mSv, significantly higher than that in secondary hospitals where the value was 1.16 mSv ( Z=2.894, P<0.05). Conclusions:The estimated annual eye lens doses to the interventional radiology workers during 2017-2019 were in accordance with the current national standard GB 18871-2002, but with a few exceptions exceeding the current international standards. This means that there exists, to a certain degree, a potential risk for the eye lens in this work category to exceed the international limits. It is suggested to continue in effort to enhance the monitoring of eye lens dose for these workers and to increase risk awareness, and take effective protective measures so as to lower the level of eye lens doses.