Objective To investigate the prognosis and recurrent factors of primary retroperitoneal liposarcoma (PRPLS).Methods The retrospective case-control study was conducted.The clinicopathological data of 51 patients with PRPLS who were admitted to the Southwest Hospital of the Third Military Medical University from January 2005 and March 2015 were collected.Observation indicators:(1) follow-up institution.(2) Analysis of prognostic factors:gender,age,tumor diameter,combined organs resection,pathological type,cancer risk and local recurrence.(3) Analysis of recurrent risk factors:gender,age,tumor diameter,combined organs resection,pathological type and cancer risk.(4) Stratified analysis:the independent risk factors of recurrence were done by the stratified analysis.(5) Correlation between cancer risk and tumor diameter or number of organs invaded.(6) Correlation between adjacent organ invasion and tumor diameter.Follow-up using outpatient examination and telephone interview was performed to detect the survival of patients and tumor recurrence up to October 2015.The survival rate and curve were respectively calculated and drawn by KaplanMeier method.The univariate analysis and survival analysis were done using the Log-rank test.The multivariate analysis was done by the COX regression model.The correlation analysis was done using the Pearson test.Results (1) Follow-up institution:51 patients were followed up for 3-114 months,with a median time of 43 months.The 3-year survival rate of 51 patients was 70.6％.Twenty-two patients had the first local recurrence,with a recurrent time of 3-60 months and a median time of 29 months.(2)Analysis of prognostic factors:the results of univariate analysis showed that tumor diameter,combined organs resection,pathological type,cancer risk and local recurrence were the related factors affecting prognosis of patients with PRPLS (x2 =5.926,4.936,17.856,17.279,14.568,P ＜ 0.05).The results of multivariate analysis showed that combined organs resection,pathological type and cancer risk were the independent factors affecting prognosis of patients with PRPLS [OR =0.538,0.645,9.620,95％ confidence interval (CI):0.238-0.997,0.458-1.058,1.692-18.714,P ＜ 0.05].(3) Analysis of recurrent risk factors:the results of univariate analysis showed that pathological type and cancer risk were the related factors affecting recurrence of patients with PRPLS (x2 =12.375,12.364,P ＜ 0.05).The results of multivariate analysis showed that cancer risk was an independent factor affecting recurrence of patients with PRPLS (OR =6.234,95％ CI:1.419-27.377,P ＜ 0.05).(4) Stratified analysis:the 3-year survival rates of 11 patients with low risk of recurrence of PRPLS and with high risk of recurrence of PRPLS were 63.6％ and 9.1％,respectively,with a statistically significant difference (x2 =12.364,P ＜ 0.05).(5)Correlation between cancer risk and tumor diameter or number of organs invaded.Tumor diameter and number of organs invaded were respectively (17 ±8)cm,1 ± 1 in 33 patients with low risk of PRPLS and (19 ±5)cm,2 ± 1 in 18 patients with high risk of PRPLS,with no statistically significant difference in tumor diameter (r =0.222,P ＞ 0.05) and with a statistically significant difference in number of organs invaded (r =0.666,P ＜ 0.05).(6)Correlation between adjacent organ invasion and tumor diameter.Tumor diameter was (16 ± 8) cm in 19 patients without adjacent organ invasion and (19 ± 7)cm in 32 patients with adjacent organ invasion,respectively,showing no statistically significant difference (r =0.225,P ＞ 0.05).Conclusions The combined organs resection,pathological type and cancer risk are independent factors affecting prognosis of patients with PRPLS,and cancer risk is an independent factor affecting recurrence of patients with PRPLS.The prognosis of patients with low risk of PRPLS is better than that with high risk of PRPLS.The organ invaded is much likely to occur in patients with high risk of PRPLS.

Objective To study the association between transforming growth factor-β1 (TGF-β1) polymorphism and type 2 diabetes mellitus in Han population of Shanghai. Methods In this case-control study , 1 234 cases of T2DM patients were recruited and 1 272 healthy individuals were selected as control. Five ml of blood sample was collected from each subject ,from which the whole genomic DNA was extracted.The polymorphism was detected by the Taqman technology. Result Significant association was observed in TGF-β1 T896C genotypes and alleles with T2DM (P = 0.0001 and P = 0.004, OR = 1.18 [1.05 ~ 1.33], respectively). Conclusion The polymorphism of T896C in TGF-β1 gene may be associated with T2DM in Han population from Shanghai.

Objective To develop a rotatable scalp acupuncture to enhance success rate of arteriovenous puncture during hospital treatment, field firstaid and evacuation.Methods The acupuncture was composed of a pinhead, a neilsbed, wings and a soft tube. The wings connected with each other to form a hole to hold the intermediate section of the neilsbed rotating in it. There was an index point in the middle of the head of the neilsbed, whose direction corresponded linearly with that of the inclined plane of the pinhead in the vessel.Results Clinical trials proved that the acupuncture could eliminate the failure of puncture due to tremble hands, incoordination of the patient and etc.Conclusion The acupuncture structured well is easy to operate for all conditions, and thus is worth popularizing practically.

Objective To establish blood purification system for rats and provide a safe and reliable experimental platform for further research of blood purification. Methods The right carotid artery and the contralateral jugular vein of adult male Sprague?Dawley rats were cannulated to creat vascular access for blood purification, by which continuous arteriovenous hemofiltration blood purification system was established. Blood flow, substitution fluid flow and ultrafiltration rate were regulated by rotary mini?pumps. Blood purification therapy continued for 4 hours on the basis of maintained anesthesia and effective anticoagulation. The safety of continuous arteriovenous hemofiltration blood purification systems was evaluated by comparing the arterial blood gas, electrolyte indexes and blood glucose during the blood purification therapy. Closely monitoring the vital signs of rats, such as blood pressure and heart rate, and observing whether there were any side effects, such as massive haemorrhage, thrombogenesis and gas embolism in the therapeutic process. Results There were no obvious changes of arterial blood gas, electrolyte indexes and blood glucose during the blood purification therapy (P>0.05). The vital signs did not fluctuate acutely before and after the blood purification therapy (P>0.05). The incidence rate of side effects was very low. Conclusions
Continuous arteriovenous hemofiltration blood purification system had no obvious adverse effects on healthy rats. Our blood purification system for rats appears to be safe and reliable.

Objective To explore the possible mechanism of Jianyi Recipe for improving the function of islet cells from the aspects of synthesis,secretion and inactivation of glucagon-like peptide-1 (GLP-1).Methods The diabetic rat model was established by feeding with high-lipid food combined with injection of streptozotocin (STZ).The rats were randomly divided into model group,Jianyi Recipe group,and normal group.The treatment for the rats lasted for 4 weeks.The blood glucose level was detected by the rapid blood glucose meter.The plasma levels of GLP-1 and insulin were detected by Luminex liquid phase protein chip technology.Pancreatic duodenal homeobox-1 (PDX-1) mRNA expression level was detected by quantitative real-time fluorescence polymerase chain reaction (PCR).The level of GLP-1 in ileum L cells was detected by immunohistochemistry,and dipeptidyl peptidase Ⅳ (DPP-Ⅳ)level was detected by enzyme-linked immunosorbent assay.Results Jianyi Recipe could decrease the levels of fasting blood glucose and postprandial glucose (P ＜ 0.05),promote the secretion of insulin (P ＜ 0.05),and increase PDX-1 mRNA expression level in the pancreas of the diabetic rats.Compared with the model group,plasma GLP-1 level,and ileal GLP-1 positive expression area and integrated optical density were increased (P ＜ 0.05) in Jianyi Recipe group,while the differences of serum DPP-Ⅳ levels were insignificant between the two groups (P＞ 0.05).Conclusion Jianyi Recipe maybe regulate the synthesis and secretion of GLP-1 to promote PDX-1 gene expression and insulin secretion,so as to reduce blood glucose in diabetic rats.

Objective:To explore the use of internet-based continuous visual recognition task (MemTrax test, MTX) as a rapid screening tool for amnestic mild cognitive impairment (aMCI).Methods:Sixty-four patients with aMCI and 64 individuals with normal cognition as healthy controls were enrolled respectively from Department of Neurology and Health Examination Center of the First Affiliated Hospital of Kunming Medical University from August 2018 to December 2019. Montreal Cognitive Assessment (MoCA) scale and MTX were adopted to assess the cognitive function of all subjects. The total adjusted MoCA scale score, correct rate of MTX, reaction time of MTX and MTX score were obtained and statistically analyzed.Results:The adjusted MoCA scale scores of aMCI patients and healthy controls were 19 (14, 24) and 26 (24, 27; Z=6.795), the correct rate of MTX of aMCI patients and healthy controls were 74% (60%, 80%) and 88% (84%, 94%; Z=8.359), and the MTX score of aMCI patients and healthy controls were 51.11±14.07 and 70.56±14.91 ( t=7.590), respectively, all with statistically significant difference ( P<0.001). Reaction time of MTX of aMCI patients and healthy controls was 1.401 (1.253, 1.590) s and 1.277 (1.163, 1.410) s, respectively ( Z=3.083, P<0.01). After adjustment for age, physical or mental occupation, exercise, hypertension, hyperlipidemia, stroke, sleep time, as well as smoke, the linear regression showed that the aMCI patients had a significant decrease of adjusted MoCA score, correct rate of MTX and MTX score ( P<0.001), and an extension of reaction time of MTX ( P=0.071), compared with the controls. By MTX and MoCA scale assessment, the best cutoff value was 81% for correct rate of MTX and 23 for adjusted MoCA scale score respectively for the prediction of aMCI (with sensitivity of 79.7%, 93.8% respectively, and specificity of 68.8%, 82.8% respectively). The area under the curve (AUC) of correct rate of MTX was 0.93 (95% CI 0.89-0.97, P<0.001), and the AUC of adjusted MoCA score was 0.85 (95% CI 0.78-0.91, P<0.001). There was a statistically significant difference in paired comparison of the two AUCs (χ2=4.620, P<0.05). Conclusion:MTX acts better for the detection of aMCI than MoCA scale, and correct rate of MTX<81% can be considered as the existence of MCI.

Objective To explore the effect of giving sedatives according to the circadian rhythm in prevention of occurrence of delirium and the prognosis of patients undergoing mechanical ventilation in intensive care unit (ICU). Methods A prospective double-blinded randomized controlled trial (RCT) was conducted. The patients admitted to Department of Critical Care Medicine of the Second Hospital of Lanzhou University from July 2014 to February 2015, undergoing invasive mechanical ventilation over 12 hours were enrolled. All the patients were given fentanyl for analgesia, and they were randomly divided into simulated circadian clock group (study group, n = 35) and non-simulated circadian clock group (control group, n = 35). The patients in each group were subdivided into three subgroups according to the kinds of sedative drugs, namely dexmedetomidine group (n = 8), propofol group (n = 14), and dexmedetomidine combined with propofol group (combination group, n = 13). Visual analogue scale (VAS) standard and Richmond agitation-sedation scale (RASS) were used to control the analgesic and to quantify the depth of sedation by titrating the dose of sedative drugs, the simulated circadian clock was set to control the RASS score at 0-1 during the day, and -1 to -2 at night in study group. The RASS score in the control group was set at -1 to -2 day and night. The urine 6-hydroxy acid melatonin (aMT6s) levels at different time points in the first diurnal rhythm (06:00, 12:00, 18:00, 24:00) were determined by enzyme linked immunosorbent assay (ELISA). The incidence of delirium, severe hypotension, severe bradycardia and other adverse reactions, duration of mechanical ventilation and the time of extubation, length of ICU stay, amount of sedative and analgesic drugs used were recorded. The correlation between delirium and other indexes was analyzed by using Spearman correlation analysis. Results ① There were no significant differences in gender, age, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score among groups. ② Urine aMT6s levels did not show circadian rhythm in both groups, aMT6s level at 06:00 in study group showed an increasing tendency as compared with the control group, but the difference was not statistically significant. ③ Compared with the control group, the incidence of delirium was significantly lowered in the study group (14.3% vs. 37.1%, P = 0.029), but no significant differences were found in the incidence of severe hypotension or severe bradycardia (20.0% vs. 25.7%, 11.4% vs. 20.0%, both P > 0.05). In simulated circadian clock group, the incidence of delirium in dexmedetomidine group was significantly lower than that of the propofol group (6.3% vs. 32.1%, P < 0.05). ④ Compared with control group with the same sedative, the duration of mechanical ventilation, extubation time, length of ICU stay were significantly shortened, and the dosage of sedative drugs used was reduced in study group (all P < 0.05). In simulated circadian clock group, the duration of mechanical ventilation in dexmedetomidine group was significantly shorter than that of propofol group and combination group (hours: 75.75±26.78 vs. 102.00±26.31 and 100.31±25.38, both P < 0.05), and the length of ICU stay was significantly shorter than that of propofol group (days: 5.75±1.04 vs. 7.00±1.52, P < 0.05). ⑤ The occurrence of delirium was positively correlated with duration of mechanical ventilation (r = 0.705), extubation time (r = 0.704), length of ICU stay (r = 0.666, all P = 0.000), and no correlation was found between the occurrence of delirium and aMT6s level at 06:00, 12:00, 18:00, and 24:00 (r = -0.135, r = 0.163, r = 0.269, r = -0.077, all P > 0.05). Conclusions Administration of sedatives according to simulating circadian time could decrease the duration of mechanical ventilation, extubation time, and the length of ICU stay, decrease the dosage of sedative drugs, and reduce the incidence of delirium. Dexmedetomidine could reduce the incidence of delirium, and improve the prognosis of patients. Trial registration Registration of clinical trials in China, ChiCTR-IPR-15006644.

Objective: To compare the clinical efficacy of proximal gastrectomy with double tract reconstruction (PG-DT) and total gastrectomy with Roux-en-Y reconstruction (TG-RY) for proximal gastric cancer. Methods: The retrospective study was conducted. Clinicopathological data of 132 patients with proximal gastric cancer confirmed by pathology who underwent PG-DT (n=51) or TG-RY (n=81) by the same surgeon team in Southwest Hospital of Army Military Medical University between January 2006 and December 2016 were collected. Patients with preoperative neoadjuvant therapy, non-R0 resection and non-adenocarcinoma confirmed by pathology were excluded. Observation indicators included intraoperative (operation time and blood loss); postoperative (time to flatus, hospital stay, total complications, metastasis of lymph nodes around distal side of stomach from cases undergoing TG-RY), follow-up (long-term hemoglobin level, incidence of anemia, and survival) parameters. Survival analysis was conducted using the Kaplan-Meier method, and Log-rank test was used to compare survival difference between two groups. Results: No statistically significant differences were found between two groups in the baseline data, including age, gender, BMI, hemoglobin level before operation, postoperative TNM stage, tumor size and histological differentiation between two groups (all P>0.05). There were no significant differences between PG-DT and TG-RY in intraoperative blood loss [200 (200) ml vs. 200 (195) ml, Z=-1.860, P=0.063], time to flatus [(2.7±1.0) days vs. (2.6±1.1) days, t=0.225, P=0.823], postoperative hospital stay [10(3) days vs. 10 (4) days, Z=-0.449, P=0.654] and morbidity of perioperative complications [5.9% (3/51) vs. 8.6% (7/81), χ²=0.081, P=0.775]. Compared with the TG-RY group, PG-DT group had longer total operative time [294 (97) minutes vs. 255 (71) minutes, Z=–3.148, P=0.002]. The hemoglobin data of 42 patients with PG-DT and 56 patients with TG-RY were collected 1 year after operation. The incidence of anemia in PG-DT group was lower than that of TG-RY group [64.2%(27/42) vs. 82.1% (46/56), χ²=4.072, P=0.045], and PG-DT group had higher level of hemoglobin than TG-RY group [(114.4±16.3) g/L vs. (106.6±15.0) g/L, t=2.435, P=0.017]. There were 4 cases (4/81, 4.9%) with metastasis of lymph nodes around distal side of stomach in TG-RY group. All of these 4 tumors were T4 in depth and were more than 5 cm in diameter. The median follow-up period was 26 (1 to 110) months. One-year, 3-year and 5-year survival rates were 93.2%, 65.3% and 55.0% in PG-DT group, and 85.8%, 63.8% and 47.2% in TG-RY group, respectively without significant difference (χ²=0.890, P=0.345). Conclusions Compared with TG-RY, PG-DT has the same safety and feasibility for proximal gastric cancer. Although the operative time is a little longer than TG-RY, PG-DT has advantages in improving the postoperative hemoglobin level.

Objective To compare the clinical efficacy of proximal gastrectomy with double tract reconstruction (PG?DT) and total gastrectomy with Roux?en?Y reconstruction (TG?RY) for proximal gastric cancer. Methods The retrospective study was conducted. Clinicopathological data of 132 patients with proximal gastric cancer confirmed by pathology who underwent PG?DT (n=51) or TG?RY (n=81) by the same surgeon team in Southwest Hospital of Army Military Medical University between January 2006 and December 2016 were collected. Patients with preoperative neoadjuvant therapy, non?R0 resection and non?adenocarcinoma confirmed by pathology were excluded. Observation indicators included intraoperative (operation time and blood loss); postoperative (time to flatus, hospital stay, total complications, metastasis of lymph nodes around distal side of stomach from cases undergoing TG?RY), follow?up (long?term hemoglobin level, incidence of anemia, and survival) parameters. Survival analysis was conducted using the Kaplan?Meier method, and Log?rank test was used to compare survival difference between two groups. Results No statistically significant differences were found between two groups in the baseline data, including age, gender, BMI, hemoglobin level before operation, postoperative TNM stage, tumor size and histological differentiation between two groups (all P>0.05). There were no significant differences between PG?DT and TG?RY in intraoperative blood loss [200 (200) ml vs. 200 (195) ml, Z=-1.860, P=0.063], time to flatus [(2.7±1.0) days vs. (2.6±1.1) days, t=0.225, P=0.823], postoperative hospital stay [10(3) days vs. 10 (4) days, Z=-0.449, P=0.654] and morbidity of perioperative complications [5.9% (3/51) vs. 8.6% (7/81), χ2=0.081, P=0.775]. Compared with the TG?RY group, PG?DT group had longer total operative time [294 (97) minutes vs. 255 (71) minutes, Z=–3.148, P=0.002]. The hemoglobin data of 42 patients with PG?DT and 56 patients with TG?RY were collected 1 year after operation. The incidence of anemia in PG?DT group was lower than that of TG?RY group [64.2%(27/42) vs. 82.1% (46/56), χ2=4.072, P=0.045], and PG?DT group had higher level of hemoglobin than TG?RY group [(114.4 ± 16.3) g/L vs. (106.6±15.0) g/L, t=2.435, P=0.017]. There were 4 cases (4/81, 4.9%) with metastasis of lymph nodes around distal side of stomach in TG?RY group. All of these 4 tumors were T4 in depth and were more than 5 cm in diameter. The median follow?up period was 26 (1 to 110) months. One?year, 3?year and 5?year survival rates were 93.2%, 65.3% and 55.0% in PG?DT group, and 85.8%, 63.8% and 47.2% in TG?RY group, respectively without significant difference (χ2=0.890, P=0.345). Conclusions Compared with TG?RY, PG?DT has the same safety and feasibility for proximal gastric cancer. Although the operative time is a little longer than TG?RY, PG?DT has advantages in improving the postoperative hemoglobin level.

Objective To compare the clinical efficacy of proximal gastrectomy with double tract reconstruction (PG?DT) and total gastrectomy with Roux?en?Y reconstruction (TG?RY) for proximal gastric cancer. Methods The retrospective study was conducted. Clinicopathological data of 132 patients with proximal gastric cancer confirmed by pathology who underwent PG?DT (n=51) or TG?RY (n=81) by the same surgeon team in Southwest Hospital of Army Military Medical University between January 2006 and December 2016 were collected. Patients with preoperative neoadjuvant therapy, non?R0 resection and non?adenocarcinoma confirmed by pathology were excluded. Observation indicators included intraoperative (operation time and blood loss); postoperative (time to flatus, hospital stay, total complications, metastasis of lymph nodes around distal side of stomach from cases undergoing TG?RY), follow?up (long?term hemoglobin level, incidence of anemia, and survival) parameters. Survival analysis was conducted using the Kaplan?Meier method, and Log?rank test was used to compare survival difference between two groups. Results No statistically significant differences were found between two groups in the baseline data, including age, gender, BMI, hemoglobin level before operation, postoperative TNM stage, tumor size and histological differentiation between two groups (all P>0.05). There were no significant differences between PG?DT and TG?RY in intraoperative blood loss [200 (200) ml vs. 200 (195) ml, Z=-1.860, P=0.063], time to flatus [(2.7±1.0) days vs. (2.6±1.1) days, t=0.225, P=0.823], postoperative hospital stay [10(3) days vs. 10 (4) days, Z=-0.449, P=0.654] and morbidity of perioperative complications [5.9% (3/51) vs. 8.6% (7/81), χ2=0.081, P=0.775]. Compared with the TG?RY group, PG?DT group had longer total operative time [294 (97) minutes vs. 255 (71) minutes, Z=–3.148, P=0.002]. The hemoglobin data of 42 patients with PG?DT and 56 patients with TG?RY were collected 1 year after operation. The incidence of anemia in PG?DT group was lower than that of TG?RY group [64.2%(27/42) vs. 82.1% (46/56), χ2=4.072, P=0.045], and PG?DT group had higher level of hemoglobin than TG?RY group [(114.4 ± 16.3) g/L vs. (106.6±15.0) g/L, t=2.435, P=0.017]. There were 4 cases (4/81, 4.9%) with metastasis of lymph nodes around distal side of stomach in TG?RY group. All of these 4 tumors were T4 in depth and were more than 5 cm in diameter. The median follow?up period was 26 (1 to 110) months. One?year, 3?year and 5?year survival rates were 93.2%, 65.3% and 55.0% in PG?DT group, and 85.8%, 63.8% and 47.2% in TG?RY group, respectively without significant difference (χ2=0.890, P=0.345). Conclusions Compared with TG?RY, PG?DT has the same safety and feasibility for proximal gastric cancer. Although the operative time is a little longer than TG?RY, PG?DT has advantages in improving the postoperative hemoglobin level.