Objective To evaluate the risk factors of gallstone occurrence after gastrectomy for gastric cancer.Methods Relevant documents published from 1990 to 2014 were retrieved through Pubmed,Cochrane Library,Embase,Web of Science CNKI,Wan Fang and VIP databases search.The Meta-analysis was applied with RevMan 5.3 software for Odds ratio and 95％ CI.Results 24 studies were selected for this Meta-analysis which included 3 randomized controlled trials,13 cohort studies and 8 case-controlled studies.These 24 studies included patient number which ranged from 32 to 893.The pooled OR (95％ CI) and P values of OR (95 ％ CI) for physiologic digestive tract reconstruction were 0.53 (0.44 ～ 0.65,P ＜ 0.05) ;amount of resection of stomach,1.98 (1.29 ～ 3.04,P ＜ 0.05) ; lymphadenectomy,0.38 (0.21 ～ 0.72,P ＜ 0.05) ; vagotomy,0.24 (0.13 ～ 0.45,P ＜ 0.05) ; and pylorus preservation,0.70 (0.48 ～ 1.02,P ＞ 0.05).Conclusions Physiologic digestive tract reconstruction and vagus nerve preservation reduced occurrence of gallstones after gastrectomy.On the other hand,total gastrectomy and extensive lymph node dissection increased the occurrence.There was no significant difference in the occurrence of gallstones whether there was pylorus preservation or not.

Objective:To investigate the relationship between telomerase activity and the biological behavior of prostate cancer.Methods:The telomerase activity in prostate cancer tissues was detected by TRAP (telomeric repeat amplification protocol) ELISA which is based upon amplification of the initial telomerase product and detected by ELISA.Results:None of the 10 samples from normal prostates expressed telomerase activity.The thirteen of fifteen cases (86.0%) with prostate cancer presented telomerase activity.The activity of telomerase was associated with the pathological differentiation of prostate cancer.The two of twelve cases (17.0%) with benign prostatic hyperplasia (BPH) expressed telomerase activity,and the activity of telomerase was lower than prostate cancer.Conclusion:The telomerase acitivity may be related to the biological behavior of prostate cancer and can evaluate the malignant potential of prostate cancer.The presence of telomerase acitivity in some cases of BPH may indicate the presence of a minority of malignant cells,as yet clinically undetected,within the population of BPH cells.

BACKGROUND: Poly(glycerol sebacate) holds excellent and good biocompatibility, flexibility and degradability, which is widely used in soft tissue replacement and tissue engineering, drug delivery carrier, wound dressing, and bone-cartilage regeneration. OBJECTIVE: To summarize the research progress in the optimal synthesis and medical application of poly(glycerol sebacate) and its composites. METHODS: PubMed, Elsevier, CNKI and WanFang databases were retrieved. The key words were “poly(glycerol sebacate), synthesis, cardiac muscle, blood vessels, nerves, skin, drug delivery carrier, wound dressing, bone regeneration” in English and Chinese, respectively. Finally, 43 articles eligible for the inclusion criteria were obtained. RESULTS AND CONCLUSION: In recent years, poly(glycerol sebacate) has attracted much attention because of its many excellent properties. Many basic scientific studies and animal experiments have confirmed that it is suitable for tissue engineering. Conventional poly(glycerol sebacate) curing process requires high temperature, high vacuum and long duration, which prevents the polymer from binding directly to cells or temperature-sensitive molecules, resulting in some limitations in its application. The composite scaffold material synthesized with a variety of other materials can make up for the corresponding shortcomings of its application in myocardial and vascular tissue engineering, drug delivery carrier, nerve guiding materials, skin and wound dressing, and bone-cartilage tissue engineering. At present, most of the studies on poly(glycerol sebacate) composites focus on the cytobiology level, and few studies focus on the mechanism of action in vivo. Further study may develop an important material for tissue replacement.

In recent years, the systematic treatment of liver cancer has made significant progress, but surgical resection remains as main treatment to obtain long-term survival for patients with liver cancer. With the rapid development of liver surgery, the complexity of liver anatomy and surgical operation are no longer the main obstacles to liver surgery. The insufficient future liver remnant (FLR) after hepatectomy has become the main limit of liver surgery. In clinical practice, most patients with liver cancer cannot undergo one-stage radical resection and can only receive non-surgical treatment, with poor long-term prognosis. The associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) provides hope for the treatment of liver cancer patients with insufficient FLR. ALPPS can induce significant hypotrophy of the FLR in a short period of time, and the radical tumor resection rate is as high as 90% to 100%, which significantly improves the prognosis of patients. However, in the early stages of the practice, there were considerable controversies on the safety of the operation. In recent years, with the continuous advancement of technology, the safety of ALPPS has been greatly improved. The authors synthesize the latest literatures and elaborate on the latest progress of ALPPS.

The optic nerve disease is a kind of diseases that seriously affect the visual function. In recent years, magnetic resonance diffusion tensor imaging ( DTI ) technology has been widely applied in the field of optic nerve diseases. Compared with the ophthalmic testing, such as optical coherence tomography imaging, visual evoked potential, field of vision, this method has obvious advantages. It not only can directly show the morphology changes of the optic nerve, visual pathway and visual cortex, but also can quantitatively analyze the morphological and pathological changes of the optic nerve, visual pathway and the visual cortex. This article reviews the imaging principle of diffusion tensor imaging, the progress and development prospect of diffusion tensor imaging in the study of the optic nerve diseases.

Objective To compare the esophageal acid and alkaline exposure characteristics of patients with cardia carcinoma after proximal gastrectomy or total gastrectomy.Method A total of 77 patients of cardia carcinoma who underwent radical resection from Sep 2007 to Sep 2011 in our hospital were retrospectively reviewed.24 hour esophageal pH monitoring were performed in all patients.Result Patients were divided into three groups:group TG had total gastrectomy (n =25),group PP had proximal gastrectomy with pyloroplasty (n =33),group NP had proximal gastrectomy (n =19).It revealed that indicators of acid reflux including the overall time length of acid episodes,＞ 5 min times of acid episodes,duration of longest acid episodes,time length of pH ＜ 4.00 and the DeMeester Scores in group NP were significantly higher than in group PP(U =32,P ＜ 0.01 ; U =35,P ＜ 0.01 ; U =23,P ＜ 0.01 ; U =39,P ＜0.01 ;U =49,P ＜0.01 respectively).Only alkline reflux was observed in group TG.The total times of alkaline episodes in PP group was significantly lower than in group TG(U =52,P ＜0.01) and group NP (U =182,P ＜0.01).＞5 min times of alkaline episodes in group TG was larger than in group PP,and that in group PP was larger than in group NP(P ＜0.01).Duration of longest alkaline episodes and total period of pH ＞7.00 in group PP was significantly higher than in group TG(U =125,P ＜ 0.01 ; U =143.5,P ＜ 0.01),and that in group TG was higher than in group NP(U =23.5,P ＜ 0.01 ; U =14,P ＜ 0.01).Conclusions Alkaline reflux deserves more attention in evaluating esophageal reflux in patients with cardia carcinoma after resection.Pyloroplasty is not helpful to relieving esophageal acid episodes while causing severe alkaline reflux.

Research on osteoporosis diagnosis has always been a critical isuue in the field of international academia and medicine. Recent progress in quantitative ultrasound (QUS) has suggested that ultrasound, due to its obvious advantages, be considered as an effective and noninvasive tool for assessment of bone status and diagnosis of osteoporosis. This paper presents the principle and recent development in the ultrasonic assessment of bone status and osteoporosis including assessment with through-transmission and backscattering measurement, and also introduces the latest progress in ultrasonic axial transmission technique.Limitations of current research are discussed and suggestions are proposed for future research.

Objective To explor the operative method of modified pericardial devascularization and compare the effects of modified pericardial devascularization and traditional pericardial devascularization on esophageal gastric varices of liver cirrhosis with portal hypertension. Methods The clinical data of 35 patients receiving modified pericardial devascularization (MED group) and 35 patients receiving traditional pericardial devascularization (ED group) were retrospectively analyzed . Results The operating time in MED group was significantly lower than that in ED group:(182 ± 30)min vs.(220 ± 30) min, P<0.05. The blood loss in MED group was significantly lower than that in ED group:(200 ± 15) ml vs. (300 ± 100) ml, P<0.05. Early complication rate in MED group was significantly lower than that in ED group:5.7%(2/35) vs. 22.9%(8/35), P<0.05. The esophageal gastric varices of patients who were followed up in MED group and ED group were almost equal (P>0.05). Conclusions The operating time, blood loss and early complication rate in modified pericardial devascularization is better than traditional pericardial devascularization. There is no significant difference in long-term efficacy between two methods.

Background and purpose:With the widespread use of screening of prostate-specific antigen (PSA) levels, prostate cancers at organ-conifned stage are increasing in newly diagnosed cases. However, some defects remain in conventional monoexponential diffusion-weighted imaging (DWI) for differentiating organ-conifned prostate cancer from benign lesions. Therefore, the aim of this study was to obtain biexponential apparent diffusion parameters of prostate organ-conifned cancer, chronic prostatitis in peripheral zone (PZ) and normal PZ tissue, and to compare with monoexponential apparent diffusion coeffcient (ADC) for differentiating prostate cancer from prostatitis lesions. Methods:Sixteen patients with pathologically confirmed prostate organ-confined cancer in PZ, 14 with prostatitis underwent conventional (b-factors 0, 1 000 s/mm2) and 10b-factors (0-3 000 s/mm2) diffusion-weighted imaging (DWI).The monoexponential ADC value and biexponential parameters fast ADC (ADCf), fraction of ADCf (f), slow ADC (ADCs) value for prostate cancer, prostatitis and normal tissues were calculated and compared. Receiver operating characteristic analysis was performed for those parameters.Results:Biexponential and monoexponential parameters were obtained for 18 prostate cancers, 18 prostatitis and 37 normal PZ tissues. The ADC value of prostate cancer tissues was remarkably lower [(0.83±0.11)×10-3 mm2/s] than that of other tissues (P<0.01), while the ADC value of prostatitis [(1.45±0.19)×10-3 mm2/s] was lower than that of PZ [(1.67±0.31)×10-3 mm2/s] (P<0.01). Prostate cancer tissues had low-er ADCf [(1.54±0.23)×10-3 mm2/s],f [(45.8±5.4)%] and ADCs [(0.52±0.15)×10-3mm2/s] than the other tissues (P<0.01). The ADCf,f and ADCs were higher in PZ [(3.90±0.40)×10-3, (67.3±8.2)% and (1.51±0.36)×10-3 mm2/s] than prostatitis [(3.06±0.49)×10-3, (47.9±3.9)% and (0.91±0.29)×10-3 mm2/s) (P<0.01). The area under the curve (AUC) of ADCf and ADC were similar in differentiating cancer and prostatitis (0.96vs 0.94) (P>0.01), but the AUC off and ADCs in differ-entiating cancer from prostatitis (0.83 and 0.80) were signiifcantly lower than that of ADC (P<0.01).Conclusion:The biexponential DWI provided additional tissue characterization parameters for different prostate tissues. ADCf yielded comparable accuracy with ADC in identiifcation of prostate organ-conifned cancer. The biexponential parameter could further improve the diagnostic effcacy.

Objective To discuss the clinical efficacy of internal fixation assisted by thoracoscope in treatment of rib fractures.Methods The study enrolled 180 patients with rib fractures associated with thoracic deformity hospitalized from July 2010 to June 2013.Ninety out of the patients were operated on by thoracoscope-assisted internal fixation (operation group),and the remaining 90 fractures were treated non-operatively (non-operation group).Clinical markers recorded were duration of pain,time of ventilator use,hospital length of stay and complications.Patient mental health was measured with self esteem scale (SES).Patient mobility was evaluated at follow-up.Results Between operation and non-operation groups differences were observed in duration of pain [(3.1 ± 1.0)d vs (8.9 ± 1.2) d],time of ventilator use [(3.0 ± 1.0) d vs (4.8 ± 1.0) d] and hospital length of stay [(10.0 ± 1.1) d vs (15.8 ± 1.0) d] (P ＜ 0.01).SES in operation group was (28.3 ± 2.1) versus (24.4 ± 3.3) points in non-operation group (P ＜ 0.01).No major complications occurred in operation group,but there were 20 pleural effusion,15 severe thoracic collapse or deformity,14 lung infection,10 refractory chest pain and 2 upper limb dysfunction in non-operation group (P ＜0.01).Two patients presented mobility limitation in operation group,but 12 had evident loss of mobility in non-operation group (P ＜0.01).Conclusions Thoracoscope-assisted internal fixation is effective to accelerate the pace of recovery,relieve pains,reduce complications and thus can be a priority method for treatment of rib fractures.