Objective To explorer the safety of D2 lymphadenectomy in open distal gastrectomy for distal gastric cancer with the surgical approach from bottom to top,from left to right and from surrounding to middle.Methods 100 advanced distal gastric cancer patients selected from General Surgery Department of Chang Hai Hospital from December 2012 to November 2013 were analyzed retrospectively.All the patients were performed D2 lymphadenectomy in open distal gastrectomy with surgical approach from bottom to top,from left to right and from surrounding to middle.The operation time,amount of bleeding,the number of lymph nodes,postoperative complications and follow-up observation were recorded.Ruselts All patients had successful operation.The operation time was 90 to 190 mins,the average (125.00 ± 21.43) mins;intraoperative blood was 90 to 400 ml,the average (178.00 ± 73.74) ml;number of lymph node dissection was 17 to 41,the average (26.00 ± 6.72).One patient suffered from abdominal hemorrhage,recoverd and discharged after conservative treatment.Conclusions Surgical approach from bottom to top,from left to right and from surrounding to middle can improve the safety of D2 lymphadenectomy for distal gastric cancer.

Objective To investigate the changes of serum myelin basic protein (MBP) and S100B orotein (S100B) in premature infants with periventricular leukomalacia (PVL) and their outcomes.Methods Seventy-eight premature infants with PVL (PVL group)and 43 normal infants (control group)who were hospitalized in our hospital from Nov 2007 to Jul 2008 were enrolled in the study.The infants were sampled for MBP and S100B levels on 1st,3rd,7th and 14th d after birth.Thirty normal infants and 69 infants with PVL were followed up every three months as they discharged until they were one year corrected age and their development quotients(DQ) were measured using Gesell development schedules.Results ( 1 ) The serum MBP levels increased on day 1 [ (7.61 ± 1.78 ) μg/L ],peak on day 3 [ ( 14.53 ± 3.12 ) μg/L],and then decreased.The serum MBP levels in infants with PVL group were significantly higher than those of control group at 1st,3rd,7th and 14th d after birth ( P ＜ 0.05 ).(2) The serum S100B levels increased on day 1,day 3 and day 7 [ (3.82 ±0.68),(4.41 ±0.91,),(5.78 ± 1.54) μg/L],peaked on day 7,and then decreased.The S100B levels of infants in PVL group were significantly higher than those of control group at 1st,3rd and 7th d after birth (P ＜0.05) ;and decreased on day 14 (P＞0.05).(3) Infants whose MBP and S100B levels increased at 7th day after birth had significantly decreased DQ than those of normal infants ( P ＜0.05 ).Conclusion The serum MBP and S100B levels in infants with PVL are correlated with the severity of central nervous system injury.If the serum S100B and MBP levels of PVL infants continues to rise more than 7 d,the DQ are lower,and the outcomes are poor.

A sensitive determination method for sulfur mustard ( HD ) metabolites thiodiglycol ( TDG ) in rabbit urine was established and validated using isotope dilution negative ion chemical ionization ( NICI) gas chromatography-mass spectrometry ( GC-MS ) , in which deuterated thiodiglycol ( TDG-d8 ) was used as internal standard. Two solid-phase extraction ( SPE) steps were established and optimized in order to reduce the interfering backgrounds, one was used to extract thiodiglycol ( TDG ) from urine with self-assemblied Florisil SPE cartridges, another cleaning treatment of the by-products after pentafluorobenzoyl chloride (PFBZ) derivatization. The results showed that the limits of detection quantitation of this method were 0. 1 and 0. 3 μg/L, respectively. The exposure time-response relationship and exposure dose-response relationship of TDG in rabbit urine were studied after rabbit skin exposure to sulfur mustard (HD, 0. 02-0. 15 LD50). The TDG levels in the rabbit urine increased rapidly during the first day after application and then decreased over time for all dosage groups. A secondary release was also noted for the high-dose group, and the duration of high TDG excretion levels was correlated positively with the HD dosage levels. We thus concluded that abnormally high levels of TDG in urine could be used as a clear diagnostic indicator of HD exposure.

Objective To determine the effect of interferon-gamma (IFN-γ) on the phagocytosis and killing activity of a murine macrophage cell line RAW264.7 against T.asahii,and to estimate the possibility of treating T.asahii infection with IFN-γγ.Methods T.asahii was cultured with or without the presence of different concentrations (10,100,1000 U/ml) of IFN-γfor 18 hours followed by the incubation with RAW264.7 cells for different durations.After additional culture for 45 minutes,the number of T.asahii cells phagocytosed by RAW264.7 cells was counted under an inverted microscope,and the rate of phagocytosis was calculated.The number of colony forming units of T.asahii per milliliter (cfu/ml) was counted after 4-hour additional culture and the growth inhibition rate was determined.Data were processed by the SPSS 16.0 software,and comparisons of parameters between these groups were done by Bonferroni method and analysis of variance after homogeneity test of variance.Results The number of phagocytosed T.asahiicells was 25.12 ± 1.81,35.88 ± 3.56,52.12 ± 3.23,with the phagocytosis rate being 25.12％,35.88％ and 52.12％,respectively in RAW264.7 cells incubated with IFN-γ of 10,100,1000 U/ml,significantly different from that in untreated RAW264.7 cells (13.62 ± 2.39,13.62％,all P ＜ 0.01).The colony forming units of T.asahii per ml after incubation with untreated RAW264.7 cells differed significantly from those after incubation with IFN-γ (10,100,1000 U/ml)-treated RAW264.7 cells ((68.12 ± 3.39) × 500 vs.(58.62 ± 4.89) × 500,(45.50 ± 3.02) × 500 and (34.62 ± 4.24) × 500,all P＜0.01),with the growth inhibition rate being 25.21％,41.95％ and 55.83％ respectively for RAW264.7 cells incubated with IFN-γ of 10,100,1000 U/ml.Statistical differences were also observed in the killing activity between RAW264.7 cells incubated with different concentrations of IFN-γ (all P ＜ 0.01).Conclusion IFN-γ (10-1000 U/ml) may enhance the phagocytosis and killing activity of RAW264.7 cells against T.asahii in a concentration-dependent manner.

0.05).There was significant difference in lymph node metastatic rate between poorly-differentiated and undifferentiated adenocarcinoma(17.83%) compared with well-differentiated and middle-differentiated adenocarcinoma(1.58%)(P

Objective To investigate the therapeutic effect and prognostic significance of lateral lymph node dissection (LPLND) in patients with lateral lymph node (LPLN) metastasis. Methods The clinicopathological data of rectal cancer patients who underwent total mesorectal excision (TME) combined with LPLND and pathologically confirmed as LPLN metastasis after operation were retrospectively analyzed. The clinicopathological characteristics and metastasis rules of patients with LPLN metastasis were discussed, and the survival prognosis after LPLND was analyzed. Results A total of 102 rectal cancer patients with pathologically confirmed LPLN metastasis were included. The common sites of LPLN metastasis were internal iliac vessels lymph nodes (n=68, 66.7%), followed by obturator lymph nodes (n=44, 43.1%), and common iliac vessels or external iliac vessels lymph nodes (n=12, 11.8%). There were 10 patients (9.8%) with bilateral LPLN metastases, and the mean number of LPLN metastases was 2.2±2.4, among which 16 patients (15.7%) had LPLN metastases number≥2. The 3-year OS (66.8% vs. 7.7%, P < 0.001) and DFS (39.1% vs. 10.5%, P=0.012) of patients with LPLN metastases to the external iliac or common iliac lymph node were significantly lower than those with metastases to the internal iliac or obturator lymph node. The multivariate analysis showed that LPLN metastasis to external iliac or common iliac lymph node was an independent risk factor both for OS (HR=3.53; 95%CI: 1.50-8.31; P=0.004) and DFS (HR=2.40; 95%CI: 1.05-5.47; P=0.037). Conclusion LPLN mainly metastasizes to the internal iliac or obturator lymph node areas. The survival of patients with metastasis to the external iliac or common iliac lymph node cannot be improved by LPLND, and thus systemic comprehensive treatment is often the optimal treatment option.

Objective: To explore the clinical safety and feasibility of enterostomy using running suture of dermis and seromuscular layer in laparoscopic-assisted radical resection for rectal carcinoma. Methods: From May 1, 2017 to May 1, 2018, 46 patients who underwent laparoscopic-assisted radical resection for rectal carcinoma with enterostomy using running suture of dermis and seromuscular layer in Cancer Hospital, Chinese Academy of Medical Sciences were retrospectively enrolled in this study. Data regarding clinicopathologic characteristics, operation and postoperative outcomes, stoma-related complications and functions of stoma were collected and analyzed. Results: All of the 46 patients successfully underwent this operation. Among them, 30 patients underwent laparoscopic-assisted abdominoperineal resection for rectal cancer with sigmoidostomy and 16 patients underwent laparoscopic-assisted low anterior resection for rectal cancer with loop ileostomy. The mean operation time was 115.3 minutes and intraoperative blood loss was 86.1 ml. The mean time for enterostomy was 14.1 minutes. The average time to flatus, time to fluid diet intake and length of hospital stay were 1.8 days, 2.9 days and 6.5 days, respectively. During the follow-up period, three patients suffered from stomal edema, two patients suffered from parastomal hernia, and two patients suffered from skin inflammation surrounding stoma. None of re-operation related stoma and severe mobility such as stomal stenosis, stomal necrosis, stomal prolapse, stomal retraction and stomal mucocutaneous separation occurred. Thirty-five patients recovered with satisfactory stomal function, two with middle function and one with poor function. Conclusion Enterostomy using running suture of dermis and seromuscular layer in laparoscopic-assisted radical resection for rectal carcinoma is a safe and feasible procedure with a satisfactory short-term effect.