Objective To evaluate the feasibility of laparoscopic D2 radical gastrectomy for staging gastric carcinoma.Methods From January 2008 to August 2008,a series of 32 patients with staging gastric tumor underwent laparoscopic D2 radical gastrectomy in our hospital.For distal gastrectomy,groups 1,3,4,5,6,7,8,9,11p,12a,and 14v lymph nodes were resected,while for proximal gastrectomy groups 1,2,3,4,7,8,9,10,and 11 lymph nodes were excised.In the patients who received total radical gastrectomy,the groups 1,2,3,4,5,6,7,8,9,10,11,12a,and 14v were harvested.Reconstruction of the digestive tract was performed after the resected tumor was removed through a mini-incision on the upper abdomen.Results The procedure was completed in all of the patients without conversion to open surgery.The distal gastrectomy was performed on 18 patients,and the proximal surgery was carried out in 2.The operation time and intraoperative blood loss for the two surgeries was 250-390 minutes(mean,325) and 50-250 ml,respectively.Total radical gastrectomy was employed in 12 cases with a mean operation time of 347 min(300-450),and blood loss of 60-350 ml.None of the 32 patients needed blood transfusion.Postoperative pathological examination showed that the edge of the resected samples were negative in all of the cases.They had the gastrointestinal function recovered in 24 to 72 hours(mean,38),and began fluid diet in 2 to 5 days(mean,2.8).No patient had anastomotic leakage or other complications.Thirty of the cases were followed up for 1 to 8 months.During the period,no recurrence,metastasis,or implantations at the incision or puncture sites were found.Conclusion Laparoscopic D2 radical gastrectomy is a safe,feasible,effective and minimally invasive technique with good short-term outcomes for patients with staging gastric carcinoma.

Lumbar fusion is currently the major treatment of lumbar degenerative disease, spinal instability and discogenic disease etc. Transforaminal lumbar interbody fusion (TLIF) is a novel lumbar fusion technique in recent years, and with the progress of minimally invasive spinal surgery, minimally invasive TLIF (mini-TLIF) technique has also got access to rapid development, which has more advantages compared with traditional open TLIF. The authors review the indications and contraindications, surgical method, development and advantages and minimally invasive surgical assistant instruments of mini -TLIF.

The purpose of this study is to investigate the effects of multiple-trough sampling design and nonlinear mixed effect modeling (NONMEM) algorithm on the estimation of population and individual pharmacokinetic parameters. Oxcarbazepine and tacrolimus were used as one-compartment and two-compartment model drugs, respectively. Seven sampling designs were investigated using various number of trough concentrations per individual ranging from 1-4. Monte Carlo simulations were performed to produce state-steady trough concentrations. One-compartment model was used to fit simulated data from oxcarbazepine and tacrolimus. The accuracy and precision of the estimated parameters were evaluated using the median prediction error (PE), the median absolute PE and boxplot. The results indicated that trough concentrations could yield reliable estimates of apparent clearance (CL/F). For oxcarbazepine, as the number of trough concentrations per subject increased, the accuracy and precision of CL/F, between-subject variability (BSV) of CL/F and residual variability (RUV) tended to be improved. For tacrolimus, however, although no improvement were observed in the accuracy of CL/F and BSV of CL/F, the PE distribution ranges were significantly narrowed and the RUV estimates were less bias and imprecise. In terms of algorithm, Monte Carlo importance sampling (IMP) and IMP assisted by mode a posteriori estimation (IMPMAP) were consistently better than other methods. Additionally, the sampling design had no significant effects on the individual parameter estimates, which were only depended on the interaction between BSV and RUV in various algorithms. Decreased in BSV and RUV levels can improve the accuracy and precision of the estimation for both population and individual pharmacokinetic parameter estimates.
Algorithms ; Bayes Theorem ; Carbamazepine ; analogs & derivatives ; pharmacokinetics ; Humans ; Immunosuppressive Agents ; pharmacokinetics ; Models, Biological ; Monte Carlo Method ; Nonlinear Dynamics ; Regression Analysis ; Tacrolimus ; pharmacokinetics

Objective To investigate the effect of running exercise on cartilage in rats with an unstable knee joint.Methods Twenty 8-week-old Sprague-Dawley rats had their left anterior cruciate ligament cut to model an unstable knee.They were randomly divided into a control group and an experimental group,10 rats in each group.The control group was given no intervention,while the experimental group accepted running exercise training on na animal treadmill at a velocity of 15 m/min for an hour every day.After 3 and 6 weeks of training,5 rats were sacrificed and cartilage from the medial condyle of the femur was sampled,decalcificated,embedded and sliced on the sagittal plane.After hematoxylin-eosin staining,toluidine blue staining and immunohistochemical staining,the cartilage thickness,Mankin' score,the content of matrix collagen and the proteoglycan content of the cartilage matrix were assessed,and the shape and structure of the unstable knee joints were observed under a transmission electron microscope.Results The cartilage thicknesses and Mankin's scores at 6 weeks were significantly different from those at 3 weeks in both groups.In the experimental group the average thickness of cartilage was 154 ± 13 μm at 3 weeks and 131 ± 15 μm at 6 weeks.The corresponding Mankin's scores were 9.93 ± 1.36 and 11.23 ± 1.57,respectively.Both were significantly different from the control group averages at the same time points.There was also a significant difference in the positive rate of toluidine blue and collagen type Ⅱ staining between the experimental group and the control group at both time points,and in the experimental group between 3 and 6 weeks of training.After 3 weeks of training,fewer chondrocytes were observed under the transmission electron microscope in the experimental group,and fissures were seen on the surface of the cartilages.However,3 weeks later,quite a few ruptures and a lot of necrotic cells could be seen.Conclusions Running exercise can damage the cartilage of unstable knee joints and speed up the development of osteoarthritis.Even moderate exercise could aggravate damage to unstable joints and the cartilage matrix,and accelerate chondrocyte degeneration.

Objective To evaluate the efficacy of laparuseopic and open D_2 radical gastrectomy for gastric cancer. Methods From January 2008 to February 2009, 64 gastric cancer patients received laparoscopic radical gastrectomy (LAP group) and 60 gastric cancer patients received open gastrectomy (open group) at Changzhou No. 2 People's Hospital. Clinical parameters including operation time, blood loss, resection margin of gastric cancer, number of lymph nodes dissected, time for passage of flatus, time for out-of-bed activity, hospital stay and postoperative complications in the 2 groups were analyzed via t test and chi-square test. Results Gastrectomy was successfully performed on all patients. Mean operation time in LAP group was significantly longer than open group (t=5.56, P<0.05). There was no significant difference in the length of resection margin and number of lymph nodes dissected between the 2 groups (t=0.67, 0.86, 1.09, P>0.05). The mean blood loss, time for passage of flatus, time for out-of-bed activity and hospital stay in LAP group were significantly lesser than in open group (t=4.59, 5.56, 16.39, 4.79, P<0.05). Six patients in LAP group and 5 patients in open group had compli-cations postoperatively. All patients were followed up for 1-13 months, and no recurrence or death occurred. Conclusion Laparoscopic D_2 radical gastrectomy is safe and effective for gastric cancer.

To compare the difference of total phenol of magnolia solid dispersion prepared by different methods. Hot melt extrusion, solvent evaporation method, and fusion-cooling method were used to prepare total phenol of Magnolia accessory solid dispersion, Plastone S-630 and HPC. The drug dispersion state in the prepared solid dispersion was evaluated with DSC and X-ray diffraction; FT-IR method was used to analyze the possible connections between drug and accessories. Finally, accelerated stability-in vivo dissolution test was use to compare the stability differences between these three processes. The results of DSC and X-ray diffraction showed that all of the drug in solid dispersion processed by three processes can exist in amorphous form; FT-IR results also could not distinguish the difference between the three processes; accelerated stability-in vivo dissolution test showed the stability of solid dispersion prepared by HPC was better than Plastone S-630, and the same kinds of materials solid dispersion prepared by hot melt extrusion showed a better stability than the other two processes.
Chemistry, Pharmaceutical ; methods ; Drugs, Chinese Herbal ; chemistry ; Magnolia ; chemistry ; Phenol ; chemistry ; Spectroscopy, Fourier Transform Infrared ; X-Ray Diffraction

Absract: Objective To report the result of annual monitoring and analysis of nasopharyngeal virus in children with respiratory tract infections in Nanxiang, Shanghai District. Methods Nasopharyngeal secretions were collected from 4389 children with acute respiratory tract infection in outpatient department from January 2007 to September 2013, 9 common respiratory viruses were analyzed by Multiplex RT-PCR, including inlfuenza virus (FLU), parainlfuenza virus (PIV), respiratory syncytical virus (RSV) , adenovirus (ADV), human bocavirus(HBOV), human coronavirus(Cov), enterovirus(EV), human metapneumovirus(HMPV), and rhinovirus(HRV). The same analysis was done in 123 asymptomatic children during the same period. Results The positive rate of detected respiratory viruses in children with respiratory tract infections in nasopharyngeal secretions were 34.8% (1526/4389), including FLU 10.3% (453/4389), RSV 7.3% (320/4389), PIV 6.2%(274/4389), ADV 3.3%(146/4389), HBOV 2.7%(118/4389), EV 2.5%(110/4389), Cov 2.4%(105/4389), HRV 1.6%(72/4389), HMPV 1.5%(67/4389);two and more combined respiratory viral infection were found in 273 cases (6.2%). The virus detection
rate between age groups was signiifcantly different (χ2=41.91, P<0.001). The school-age group had the lowest positive rate of 23.4%and the positive rates in other three groups were all higher than 35.0%. The infant group had the higher positive rate of RSV and HRV. FLU detection rate in school-age group was 13.6%. Respiratory viruses in children with asthmatic disease has high detection rate. RSV infection rate was the highest 14.8%(30/204) in the asthmatic disease group, followed by HBOV 13.8% (28/204). In nasopharyngeal secretions of 123 asymptomatic children, virus-positive detection rate of 6.5% (8/123), which showed signiifcant difference from that in respiratory virus infection group (χ2=42.60, P<0.001). Conclusions In seven consecutive years of testing, the inlfuenza virus and respiratory syncytial virus play an important role in children with respiratory tract infections in this region. The detection rate of virus showed difference between different age groups and a higher detection rate of RSV in infants with respiratory tract infections was observed. The overall detection rate of virus was decreased with the increase of age excluding the inlfuenza virus.

Objective To summarize the clinical features and technical key points on brain death during decision-made process in children with suspected brain death.Methods Twenty-four coma children with Glasgow coma scale score 3 and no spontaneous respiration were collected from May 2015 to February 2017 in Beijing Children's Hospital,Capital Medical University to make the brain death determination.All children received at least one confirmatory test.According to the Chinese standards for determining brain death (pediatric),all patients were divided into brain death group and non-compliance group.The clinical features were analyzed.The sensitivity,specificity,false positive rate and false negative rate of electroencephalogram (EEG),short latency somatosensory evoked potential (SLSEP) and transcranial Doppler sonography (TCD) were calculated.Results Among these 24 cases,there were 16 males and 8 females,aged 5.6 (2.0,8.8) years old.Ten cases met the criteria of brain death.Twelve (50％,12/24 cases) cases received autonomic breathing test.A total of 25 tests were conducted,of which 21 were successful.The completion rates of EEG,TCD and SLSEP were 100.0％ (24/24 cases),83.3 ％ (20/24 cases) and 54.2％ (13/24 cases),respectively.EEG had the highest sensitivity (100％) and specificity (79％).SLSEP had good sensitivity (100％),but the specificity was only 40％.The combination of EEG with SLSEP had the highest specificity and sensitivity,both of which were 100％,and the false positive rate and false negative rate were 0.Conclusions The key to determine brain death successfully is to make adequate preparations,to receive formal training and to apply standard operation.In the determination of brain death in children,EEG has a good sensitivity and specificity in single confirmation test,which is the priority item.The combination of EEG with SLSEP is the most advantageous.

Mizoribine(MZR), as an orally prescribed immunosuppressive agent, has been applied in the prevention of rejection after kidney transplantation.MZR requires individual dosing due to the variation of bioavailability.However, therapeutic drug monitoring (TDM) of MZR is not well developed in China, as compared to other clinically used immunosuppressive agents.To our knowledge, this is the first TDM review of MZR.Pharmacokinetic characteristic, concentration determination methods and sample selection of MZR were summarized, also the rational therapeutic window was proposed.Furthermore, gene polymorphism and population pharmacokinetics of MZR were estimated.This review will provide reference for TDM-based individual dosing of MZR in renal transplant recipients.