Objective To investigate the long-term effects of modified Bristow-Latarjet operation for treatment of recurrent inferoanterior shoulder dislocation.Methods A retrospective case series study was done on 90 patients with recurrent inferoanterior shoulder dislocation treated by modified Bristow-Latarjct procedure from January 2001 to January 2016.There were 72 males and 18 females,with an average age of 36.8 years.There were 59 fight shouders and 31 left shoulders,with dislocation for 4-32 times (mean,13 times).Shoulder instability severity index score (ISIS) was 3-10 points (mean,6.4 points).The duration of disease was 6-26 months (mean,13 months).The operation methods were coracoid lateral incision with modification,rotator cuff interval approach,double hollow compression screw fixation,and bone congruent-arc technique in standing position.Clinical evaluation was done on postoperative recurrence of shoulder joint dislocation/subluxation,bone healing evaluated by X-ray and CT,Rowe score,simple shoulder function Test (SST) score,shoulder osteoarthritis score (Samilson-Prieto),bodv side shoulder external rotation angle and the subscapularis muscle strength.Results All patients were followed up for 1-15 years (mean,5.6 years).The rate of redislocation or subluxation during follow-up was zero.All transpositions of the coracoid got bone healing at postoperative 3-6 months.The Rowe score was increased significantly from (45.6 ± 9.4) points preoperatively to (92.6 ± 3.5) points postoperatively (P ＜0.01);SST score was increased significantly from (5.6 ± 1.2)points preoperatively to (9.6 ± 2.8) points postoperatively at final follow-up) (P ＜ 0.01).Samilson-Prieto score was mild in 2 patients (2％).The body side shoulder external rotation angles were (56.7 ± 13.9) ° preoperatively and (54.6 ±14.1) ° postoperatively (P ＞ 0.05).With regards to subscapularis strength,the lift-off and belly-press in injured side were (4.9 ± 0.9) kg and (4.4 ± 1.0) kg,respectively (P ＞ 0.05).Lift-off and belly-off in normal side were (5.1 ± 0.5) kg and (4.7 ± 1.1) kg,respectively (P ＞ 0.05).Conclusion The modified Bristow-Latarjet operation is a reproducible and effective technique that can restore shoulder stability,with advantages of sound bone healing,free shoulder external rotation,low incidence of shoulder joint osteoarthritis,remaining of myodynamia under scapula and hence has long-term effects and is worth of clinical applicaiton.

This study was aimed to evaluate the efficacy of Tiao-Bu Fei-Shen therapies (i.e., Bu-Fei Jian-Pi, Bu-Fei Y i-Shen, Y i-Qi Zi-Shen) on cardiac remodeling of chronic obstructive pulmonary disease (COPD) rats and its mechanisms according to the R-value comprehensive evaluation method. Based on the database of previous experiment of COPD rats, R-value comprehensive evaluation method was used to evaluate the indexes as fellows to discuss efficacy of Tiao-Bu Fei-Shen therapies on cardiac remodeling of COPD rats. ① Indicators of right ventricular morphologic indexes: right ventricular hypertrophy index (RVHI), cardiac muscle sarcomere lengths, bulk density of myocardial mitochondria (Vv), surface area (δ), membrane surface (δm), Vv, δ, δm of heart mitochondria;② Indicators of mechanisms: right ventricular endothelin-1 (ET-1), transforming growth factor-beta ( TGF-β) , vascular endothelial growth factor ( VEGF ) , basic fibroblast growth factor ( bFGF ) , matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1). The results showed that the sequence of improving effect of right ventricular remodeling at week 20 was Bu-Fei Jian-Pi, Bu-Fei Y i-Shen, aminophylline, and Y i-Qi Zi-Shen; at week 32 and the integrated week 20 and week 32, the sequence of effect was Bu-Fei Jian-Pi, Bu-Fei Y i-Shen, Y i-Qi Zi-Shen, and aminophylline. At integrated week 20 and week 32, Bu-Fei Jian-Pi had significant better intensity correcting effect than aminophylline (P< 0.01). There was no difference between week 20 and week 32. It showed that each treatment group had good long-term effect. For the mechanism of correcting effect on right ventricular remodeling, at week 20, the sequence of comprehensive effect was Bu-Fei Jian-Pi, Bu-Fei Y i-Shen, aminophylline, and Y i-Qi Zi-Shen. And Bu-Fei Jian-Pi had better effect compared with aminophylline and Y i-Qi Zi-Shen (P< 0.01); Bu-Fei Y i-Shen had better effect than Y i-Qi Zi-Shen (P< 0.05). At week 32, the sequence of effect was Y i-Qi Zi-Shen, aminophylline, Bu-Fei Jian-Pi, and Bu-Fei Y i-Shen. At the integrated week 20 and week 32, the sequence of effect was Bu-Fei Jian-Pi, and Bu-Fei Y i-Shen, Y i-Qi Zi-Shen, and aminophylline. Until week 32, the correcting effect of Tiao-Bu Fei-Shen therapies and aminophylline still maintained the same level as at week 20. It indicated that each treatment plan had good long-term effect. It was concluded that Tiao-Bu Fei-Shen therapies can improve the cardiac remodeling of COPD rats and expression of related factors in the cardiac remodeling through the R-value comprehensive evaluation method. And the effect of Bu-Fei Jian-Pi was obvious with good long-term effect.

A case of a 3-year-old child suffered with severe crush injury to the right forearm and right hand on June, 2017. A comprehensive treatment was conducted with limb salvage, free flap repair and the repair of nerve, vessel and tendon for functional reconstructions followed by rehabilitation therapies. The function and appearance of the injured limb and hand recovered well 3 years after surgery.

Objective:Use the droplet digital PCR (ddRCR) technology to establish, optimize and evaluate the method of EGFR-T790M mutation detection.Methods:The relevant probes and primers were designed for EGFR-T790M mutations. The ddPCR reaction system was established, the optimal annealing temperature was set and the basic performance of the method was tested. On this basis, from January 2019 to October 2019, 72 cell-free DNA (cfDNA) samples from NSCLC patients were collected from Shandong Cancer Hospital Affiliated to Shandong First Medical University, and clinically verified. The consistency of the gene mutation detections with Bole ddPCR products was analyzed using Kappa test.Results:The ddPCR reaction system was established and optimized. Linear evaluation showed the R2 value was greater than 0.99. Using ddPCR, the blank detection limit was determined to be the numbers of mutant droplets≥2, with excellent specificity. For the sensitivity analysis, the lower limit of mutation detection was determined to be at least 0.05%. In the repeatability and inter-assay precision tests, the results had a coefficient of variation( CV)<20%. The relative deviation of the results was within the range of±10% for the accuracy analysis. Using the established T790M mutation detection method, 72 samples from the NSCLC patients were tested for genetic mutation in cfDNA, and the overall agreement with the Bole ddPCR products was 91.67% (66/72, Kappa=0.749; P<0.001). Conclusion:Using ddPCR, the method of EGFR-T790M mutation detection for NSCLC was successfully established.

According to the current evidence-based medicine researches, the eastern and western countries have reached a consensus that D2 operation is a standardized procedure for advanced gastric cancer.However, the postoperative five-year survival rate is still not satisfactory. Professor Gong Jianping of Tongji Hospital, Tongji Medical Gollege of Huazhong University of Science and Technology proposed a theory of membrane anatomy (the third element of surgical anatomy) and the concept of cancer leakage—an epoch-making concept in surgical anatomy. The Department of Gastrointestinal Surgery, The Affiliated Hospital of Guizhou Medical University was honored to be selected as one of the first domestic replication units of 3D laparoscopic radical gastrectomy under membrane anatomy. Professor Gong Jianping has visited our hospital several times for surgical demonstration, explanation of membrane anatomy theory and replication training. Through the understanding of membrane anatomy theory, we found that 3D laparoscopic radical gastrectomy guided by membrane anatomy can achieve good results, e.g less bleeding, complete resection, complete lymph node dissection and avoidance of side damage, meanwhile the operation is simple and safe. At the same time, it can avoid the shedding of cancer cells, so as to reduce the iatrogenic leakage of cancer and improve the efficacy of radical gastrectomy. In addition, the standardized procedure of laparoscopic radical gastrectomy makes it scientific, reproducible and easy to be popularized.

According to the current evidence?based medicine researches, the eastern and western countries have reached a consensus that D2 operation is a standardized procedure for advanced gastric cancer. However, the postoperative five?year survival rate is still not satisfactory. Professor Gong Jianping of Tongji Hospital, Tongji Medical Gollege of Huazhong University of Science and Technology proposed a theory of membrane anatomy (the third element of surgical anatomy) and the concept of cancer leakage—an epoch?making concept in surgical anatomy. The Department of Gastrointestinal Surgery, The Affiliated Hospital of Guizhou Medical University was honored to be selected as one of the first domestic replication units of 3D laparoscopic radical gastrectomy under membrane anatomy. Professor Gong Jianping has visited our hospital several times for surgical demonstration, explanation of membrane anatomy theory and replication training. Through the understanding of membrane anatomy theory, we found that 3D laparoscopic radical gastrectomy guided by membrane anatomy can achieve good results, e.g less bleeding, complete resection, complete lymph node dissection and avoidance of side damage, meanwhile the operation is simple and safe. At the same time, it can avoid the shedding of cancer cells, so as to reduce the iatrogenic leakage of cancer and improve the efficacy of radical gastrectomy. In addition, the standardized procedure of laparoscopic radical gastrectomy makes it scientific, reproducible and easy to be popularized.

According to the current evidence?based medicine researches, the eastern and western countries have reached a consensus that D2 operation is a standardized procedure for advanced gastric cancer. However, the postoperative five?year survival rate is still not satisfactory. Professor Gong Jianping of Tongji Hospital, Tongji Medical Gollege of Huazhong University of Science and Technology proposed a theory of membrane anatomy (the third element of surgical anatomy) and the concept of cancer leakage—an epoch?making concept in surgical anatomy. The Department of Gastrointestinal Surgery, The Affiliated Hospital of Guizhou Medical University was honored to be selected as one of the first domestic replication units of 3D laparoscopic radical gastrectomy under membrane anatomy. Professor Gong Jianping has visited our hospital several times for surgical demonstration, explanation of membrane anatomy theory and replication training. Through the understanding of membrane anatomy theory, we found that 3D laparoscopic radical gastrectomy guided by membrane anatomy can achieve good results, e.g less bleeding, complete resection, complete lymph node dissection and avoidance of side damage, meanwhile the operation is simple and safe. At the same time, it can avoid the shedding of cancer cells, so as to reduce the iatrogenic leakage of cancer and improve the efficacy of radical gastrectomy. In addition, the standardized procedure of laparoscopic radical gastrectomy makes it scientific, reproducible and easy to be popularized.

0.05). Conclusion After heated, the physical stability of UAE and UAS is reduced, the viscosity become lower, ADM releasing rate is fell. The heated Lipiodol-Adriamycin pharmaceutics had advantage in the interventional embolization chemotherapy of the neoplasm.

The laparoscopic vision platform developed from the prototype of candlelight reflector device to HD, 3D and 4K ultra HD, which revolutionized surgery from open surgery to minimally invasive surgery. With the continuous application in gastric cancer surgery, the importance of laparoscopy in radical gastrectomy is gradually recognized. Radical gastrectomy mainly includes lymph node dissection and digestive tract reconstruction. The reconstruction of digestive tract after radical gastrectomy for distal gastric cancer has been a hot topic of discussion and research, which is directly related to the incidence of postoperative complications, nutritional status and quality of life. This paper mainly discusses the Roux-en-Y digestive tract reconstruction of radical gastrectomy for distal gastric cancer with 4K laparoscopic.

AIM:Using bioinformatics analysis methods to identify the hub genes involved in myocardial isch-emia-reperfusion injury(MIRI).METHODS:Firstly,the rat MIRI related dataset GSE122020,E-MEXP-2098,and E-GEOD-4105 were downloaded from the database.Secondly,differentially expressed genes(DEGs)were screened from each dataset using the linear models for microarray data(limma)package,and robust DEGs were filtered using the robust rank aggregation(RRA)method.In addition,the surrogate variable analysis(SVA)package was used to merge all datas-ets into one,and merged DEGs were screened using the limma package.The common DEGs were obtained by taking the intersection of the two channels of DEGs.Next,the protein-protein interaction(PPI)network of common DEGs was con-structed,and the hub genes were identified using the density-maximizing neighborhood component(DMNC)algorithm.The receiver operating characteristic curve(ROC)was plotted to evaluate the diagnostic performance of the hub gene.Then,the mRNA and protein expression levels of hub genes were detected in the rat MIRI model,and the literature re-view analysis was carried out on the involvement of hub genes in MIRI.Finally,the gene set enrichment analysis(GSEA)was performed on hub gene to further reveal the possible mechanism in mediating MIRI.RESULTS:A total of 143 robust DEGs and 48 merged DEGs were identified.After taking the intersection of the two,48 common DEGs were obtained.In the PPI network of common DEGs,5 hub genes were screened out,namely MYC proto-oncogene bHLH transcription fac-tor(MYC),prostaglandin-endoperoxide synthase 2(PTGS2),heme oxygenase 1(HMOX1),caspase-3(CASP3),and plasminogen activator urokinase receptor(PLAUR).The ROC results showed that the area under the curve values for all hub genes were greater than 0.8.MYC,PTGS2,CASP3,and PLAUR showed high mRNA and protein expression in rat MIRI,while there was no difference in mRNA and protein expression for HMOX1.The literature review revealed that among the 5 hub genes,only PLAUR has not been reported to be involved in MIRI.The GSEA results for PLAUR indicat-ed that its functional enrichment mainly focused on pathways such as NOD-like receptor signaling pathway,P53 signaling pathway,Toll-like receptor signaling pathway,apoptosis,and fatty acid metabolism.CONCLUSION:MYC,PTGS2,CASP3,HMOX1,and PLAUR are involved in the pathological process of MIRI.PLAUR is a potential hub gene that can mediate MIRI by regulating pathways such as NOD like receptor signaling,P53 signaling,Toll like receptor signaling,cell apoptosis,and fatty acid metabolism.The results can provide reference for further investigation into the molecular mechanisms and therapeutic targets of MIRI.