The delta-shaped anastomosis is an emerging operation method in digestive tract reconstruction following total laparoscopic distal gastrectomy (TLDG).With the advantages of small surgical trauma,short anastomosis time and simple manipulation,it has been gradually accepted by surgeons.However,restricted by small manipulation range,restrictive visual range and large anastomotic lumen,there are controversies in complete resection of tumor,intraoperative indexes,postoperative recovery and prevention and treatment of complications about TLDG with delta-shaped anastomosis.In this paper,the operative indications,intraoperative indexes and postoperative recovery of TLDG with delta-shaped anastomosis were reviewed.

Objective To evaluate objectively the traditional methods on the assessment of bladder outlet obstruction(BOO) due to BPH. Methods Correlation between the urodynamic findings and the traditional diagnostic parameters such as age,IPSS,Vp,Qmax z and PVRr was studied.The clinical prostatic score(CPS),derived from multiple regression of clinical parameters depending on URA,was evaluated. Results The parameters such as age,IPSS,Vp,Qmax z and PVRr were evaluated with reference to pressure flow study.Every parameter alone was not enough for BOO diagnosis. The regression equation was CPS=49.8-3.3 Qmax z+0.5 IPSS+0.2 Vp+7.5 PVRr.Correlation coefficient between CPS and urodynamic findings was 0.629 and was significantly higher than that of any clinical parameter alone.With CPS≥35,the sensitivity was 83.7% and specificity 85.8% for the diagnosis of BOO.With CPS

Objective To investigate the changes of urinary bladder structure and function of aging rats. Methods The aging group and the young adult group were composed of 24 month old rats and 6 month old rats, respectively. The urodynamic changes were studied with filling cystometry, structural changes by Masson stain and image analysis. Results Filling cystometry revealed that the maximum bladder capacity increased in the aging rats. No difference in leak point pressure was found in the two groups. The occurrence rate of the detrusor instability in aging group was higher than that in young adult group. In bladder structure, fibrous tissue increased significantly but smooth muscle decreased significantly in the detrusor of aging rats. Conclusion Aging may lead to changes of rat bladder structure and function, but its mechanism needs to be further studied.

Objective To explore the profiles of physical activity domains among professionals with different occupational activity patterns.Methods A cluster random sampling method was used to recruit employed adults aged 30-60 years in Beijing as well as Zhejiang province.The information on the physical activity domains was collected with a revised Global Physical Activity Questionnaire (GPAQ).Results Of 3 326 professionals,about 30.79％,50.75％ and 18.46％ adults had Class Ⅰ (mostly sedentary reading or writing during work time) ,Class Ⅱ (mostly working with arms or legs with little effort) ,and Class Ⅲ (working with effort)occupational activity patterns,respectively.The median volume of leisure time activity and bicycling were all 0 Met-min/week,and no significant difference of domestic activity volume was detected among all the three classes of professionals.Of all the non-occupational activity volume among three classes of adults,domestic activity accounted for the most proportion (58.87％) performed by adults of Class Ⅱ,traffic activity accounted for the most proportion (34.2％) by those of Class Ⅲ,and leisure time activity accounted for the most proportion (12.7％) by those of Class Ⅰ.Most time was spent in sedentary behaviors by those of Class Ⅰ after hours.Conclusions Besides the generally low level of moderate activity,the diversity of the domains of physical activity among this population was evident.It is necessary to develop appropriate technology to improve physical activity for professionals with different occupational activity patterns.

Objective To explore the feasibility of 256-slice whole-brain CT perfusion (CTP) in evaluate graft reperfusion after surgical revascularization and hemodynamic alterations before and after surgery in Moyamoya disease. Methods Twenty-five cases with Moyamoya disease were scanned on a 256-slice CT.CTP was performed pre- and post- surgical revascularization. The wolumetric CT angiographic ( CTA ) images were generated from volumetric data acquired at the arterial phase of CTP. CBF, CBV, TTP and MTT were measured in functional maps at the operated side within middle cerebral artery perfusion areas and contralateral mirroring areas. Relative CBF( rCBF), relative CBV (rCBV), relative TTP (rTTP), relative MTT (rMTT) were also obtained. Differences in perfusion CT values pre- and post operation were assessed with the paired t test or matched-pairs signed-ranks test. Data with normal distribution was present as : (x-)± s,while those with the non-normal distribution were present as M ( P25-P75 ). Results All the direct graft patencies were displayed on volumetric CTA. No significant differences were found between volumetric CTA and conventional CTA. Postoperative CBF, rCBF and rCBV values of the operated side [ 72. 86 (55.54-112. 19) ml · 100 g-1 · min-1 , 1. 31 ( 1.05-1.73), 1.45 ±0. 62] were significantly higher than those before operation [46.72(28.57-57.67) ml · 100 g-1 · min-1, 0.53(0.33-0.82), 1.01 ±0.36](Z=- 2.72, - 2. 98, t = - 2. 85, P ＜ 0. 05 ). Postoperative MTT, TTP and rTTP values of the operated side [ (3.98 ± 2. 36 ) s, ( 17.56 ± 4. 38 ) s, 1.01 ± 0. 09 ] were significantly lower than those before operation [(5.43±2.07) s,(19.40±3.87) s,1.14±0.28] (t=2.41,2.17,2.17, respectively, P＜0.05).However, no significant differences were detected for changes of CBV and rMTT after revascularization ( P ＞0. 05). Conclusion 256-slice CT has the potential value for the non-invasive assessment of both the graft patency and cerebral hemodynamics changes in moyamoya disease after surgery with administration of one contrast medium bolus in a single examination.

Objective:To investigate the changes of serum heme oxygenase 1 (HO-1) level and its correlation with clinical characteristics in patients with acute cerebral infarction (ACI) before and after successful recanalization.Methods:Twenty-nine ACI patients accepted mechanical thrombectomy and enjoyed successful vascular recanalization (Thrombolysis in Cerebral Infarction (mTICI) grading≥2B) in our hospital from November 2018 to September 2019 were enrolled as observation group; 22 patients suspected for carotid artery stenosis or cerebral aneurysm underwent DSA (DSA ruled out the intracranial and carotid artery lesions) were chosen as control group. The level of HO-1 was measured by ELISA before and one, three and 7 d after surgery in the observation group, and before and after DSA in the control group. Besides, the correlation of HO-1 expression level with clinical characteristics of patients in the observation group was analyzed.Results:(1) As compared with the control group before DSA, the serum HO-1 level in the observation group before surgery was significantly higher ( P<0.05); and the serum HO-1 level in the observation group 7 d after surgery was significantly higher than that before and one d after surgery ( P<0.05). (2) Preoperative serum HO-1 level in patients with preoperative scores of diffusion weighted imaging (DWI)-Alberta stroke program early CT (ASPECT)≤7 was significantly higher than that in patients with DWI-ASPECT scores>7 from the observation group ( P<0.05). Preoperative serum HO-1 level in patients with baseline National Institutes of Health stroke scale (NIHSS) score≤12 was significantly lower than that in patients with NIHSS scores>12 from the observation group ( P<0.05). The preoperative serum HO-1 level was negatively correlated with DWI-ASPECTS scores ( r=-0.560, P=0.002) and positively correlated with baseline NIHSS scores ( r=0.685, P=0.001). (3) There was no difference in serum HO-1 level between mTICI grading 2B patients and mTICI grading 3 patients from the observation group ( P>0.05); but for patients with mTICI grading 3, the serum HO-1 level 7 d after surgery was significantly higher than that one d after surgery ( P<0.05). (4) The serum HO-1 level in patients with hemorrhagic transformation 3 and 7 d after surgery was significantly higher than that in patients without hemorrhagic transformation from the observation group ( P<0.05); the serum HO-1 level in patients with hemorrhagic transformation 7 d after surgery was significantly higher than that one d after surgery ( P<0.05). Conclusion:The serum HO-1 level is increased in patients with ACI, and it will further increase after successful recanalization; the serum HO-1 level is related with early infarction degree and neurological deficit degree before surgery, recanalization level and hemorrhagic transformation after surgery.

Objective To analyze the patients′ psychological resilience level of postpartum pelvic floor dysfunction and to explore the influencing factors, in order to provide the scientific basis for patients′psychological intervention. Methods A cross-sectional survey was conducted on 208 patients of postpartum pelvic floor dysfunction by using the Connor-Davidson Resilience scale(CD-RISC), Positive and Negative Affective scales(PANAS) and Medical Coping Modes questionnaire(MCMQ, which includes "confrontation","acceptance-resignation"and"avoidance"). Results The score of psychological resilience of 208 patients was (53.64 ± 12.29)points, differences in age, family monthly income, living locations, delivery methods and delivery times reached a statistically significant level(F=15.287,5.731,t=-2.571,-15.911,-2.922,all P<0.05). Patients′psychological resilience level had significant positive correlation with positive emotions(P<0.01)and"confrontation",and it had negative correlation with"acceptance-resignation"(P<0.01).Age,living locations, delivery methods, positive emotions and "acceptance- resignation" are the forecast factors of psychological resilience, which can explain 69.6% of total variation. Conclusions Patients of postpartum pelvic floor dysfunction have low levels of psychological resilience, which associated with positive emotions and medical coping modes. Therefore, nursing staffs should pay attentions to the patients′ psychological status, develop individualized psychological guidelines,implement psychological intervention and health education,in order to improve the level of patients′resilience and improve their living quality.

Subjective well-being,a comprehensive psychological index for evaluating the quality of life,is closely related to the physical and mental health of the elderly.At present,the mainly Methods for measuring subjective well-being in the elderly is scale. Subjective well-being assessment scales include generic scales and specific scales.Domestic elderly subjective well-being scales commonly imported from abroad.Specific scales for elderly are less in mainland China.This article will review the current research status for subjective well-being assessment scales in the elderly, in order to strengthen the localization research of specific scales and further provides reference for the clinical research of this topic.

Objective To explore the application value of circulating tumor cell (CTC) counting in the diagnosis of patients with colorectal cancer.Methods From July to October in 2015,a total of 61 patients firstly diagnosed with colorectal cancer,at stagc] to Ⅳ were enrolled.At the same period,20 individuals (healthy volunteers or patients with benign colorectal diseases) were selected as controls.Peripheral blood (7.5 mL) was taken before therapy.Peripheral blood CTC were counted by immunomagnetic beads enrichment combined with fluorescent staining method in two hours.The positive detection rate of CTC for colorectal cancer,especially early colorectal cancer was analyzed.And the priority of combination it with carcino-embryonic antigen (CEA) was also investigated.Chi-square test,t test and rank-sum test were used for statistical analysis.Results Two patients could not be pathological staged,due to the lack of whole body imaging evaluation.There were 30 patients with colorectal cancer at early stage (stage Ⅰ to Ⅱ) and 29 patients at advanced stage (stage Ⅲ to Ⅳ).The difference in CEA level between patients at early stage and advanced stage ((3.3±1.1) μg/L vs (20.4±3.3) μg/L) was statistically significant (t=-2.74,P=0.008).The median cell number of CTC of colorectal cancer group and control group was 1 (interquartile range=4) and 0,respectively,and the difference was statistically significant (Z=2.721,P=0.007).Taken 0/7.5 mL and 5 μg/L as the cut-off value of CTC and CEA,the detection rates of CTC for colorectal cancer and early colorectal cancer were 65.6％ (40/61) and 63.3％ (19/30),respectively;the detection rates of CEA for colorectal cancer and early colorectal cancer were 29.5 ％ (18/61) and 13.3％ (4/30).When CTC combined with CEA,the detection rates for colorectal cancer and early colorectal cancer were 73.8％ (45/61) and 66.7％ (20/30),respectively.Conclusions CTC has certain detection value in colorectal cancer especially early colorectal cancer.If it combined with CEA,the detection rate is much higher.

Objective To observe the clinical effect of traditional Chinese medicine inflammatory mixture on vascular endothelial cell injury, mcrocirculation disorder and organ dysfunction in sepsis. Methods 73 patients with sepsis were randomly divided into two groups: Anti-inflammatory mixture-treated group (40 cases) and control group (33 cases). Routine medicine therapy was given in both groups.Additionally, in the Anti-inflammatory mixture-treated group, 100 ml Anti-inflammatory mixture was given By oral or nasal feeding, every 12 hours for consecutive 7 days. Vascular endothelial injury index (Soluble thrombomodulin,Vascular endothelial growth factor-2, endothelial specific molecule-1), mcrocirculation disorder index (arterial blood lactate, central venous oxygen saturation, total vessel density, perfused vessel density, proportion of perfused vessels, microcirculatory flow index) of two group patients before and after therapy were observed and the sequential organ failure score (SOFA) was recorded before and after treatment. Results After treatment, the indexes of vascular endothelial injury sTM (12.37 ± 5.08 μg/L vs. 18.77 ± 6.88 μg/L, t=3.448), VEGF-2 [45.6 ng/L (14.3, 112.5) vs. 52.4 ng/L (17.2, 123.6), Z=4.009], ESM-1 (15.54 ± 4.09 ng/ml vs. 17.64 ± 6.79 ng/ml, t=-1.551), Lac (2.6 ± 1.2 mmol/L vs. 3.7 ± 1.8 mmol/L, t=4.115) and SOFA (4.1 ± 1.7 vs. 6.1 ± 3.2, t=-2.118) in anti-inflammatory mixture group decreased significantly than those in the control group. but the ScvO2(0.719 ± 0.243 vs. 0.603 ± 0.201, t=-2.773), PVD (14.8 ± 5.8 mm/mm2 vs. 13.1±5.1 mm/mm2, t=-5.114), PPV (59.1% ± 22.5% vs. 53.9% ± 20.6%, t=1.779), MFI (9.4 ± 4.6 vs. 7.2 ± 2.2, t=4.339) in the anti-inflammatory mixture group were significantly higher than those in the control group. Correlation analysis showed that the sTM and PPV were significantly negatively correlated (r=-0.875, P＜0.01), ESM-1 was significantly negatively correlated with PVD, PPV and MFI (r=-0.877, P＜0.01; r=-0.799, P＜0.01; r=-0.821, P＜0.01) and ESM-1 and SOFA were significantly positively correlated (r=0.840, P＜0.01). Conclusions Anti-inflammatory mixture of Chinese medicine has a certain therapeutic effect on sepsis by protecting vascular endothelial cell function.