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.

OBJECTIVE To control the quality of cleaning and sterilization of rent instruments and to secure medical safety of patients undergoing operations.METHODS We randomly chose 60 pieces of rent instruments and divided them into two groups,machinery wash group and hand wash group.Occult blood test was performed before and after washing and rinsing.RESULTS Positive rate of occult blood tests was 86.67% before either machinery or hand wash.While after machinery wash and hand wash it was 0% and 6.67%,respectively.Both wash methods had significant effect on depleting occult blood(P0.05).CONCLUSIONS Hospitals must enhance the management of rent instruments cleaning which is of poor quality at present by regulating the procedure and monitoring methods so as to ensure the quality of rent instruments cleaning and secure patients safety.

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 investigate the chemical constituents of the roots of Aconitum taipaicum, silica gel column chromatography was used for the isolation and purification of compounds. A new norditerpenoid alkaloid, isodelelatine (1), along with five known alkaloids, atisine (2), delfissinol (3), liangshanine(4), hypaconitine (5) and delelatine (6) were isolated and identified. The structure of the new compound was elucidated on the basis of spectral data.

More than 85% of all cancers express telomeras e activity. Human telome rase has been proposed as a novel and potentially highly selective target for ca ncer therapy. Inducers of differentiation are involved in regulation of telomera se activity. In the present review, the effects of retinoids, vitamin D3 compo unds, tea catechins and matrine on telomerase activity in malignant cells were r eviewed.

Asian Continental Ancestry Group ; Hepatitis B virus ; Hepatitis B, Chronic ; immunology ; Humans ; Killer Cells, Natural ; immunology

Objective To realize the status in the implementation of three industry standards of central sterile sup-ply department (CSSD),and provide a scientific basis for carrying out of the standards. Methods According to three standards,investigation forms were designed by specialists,written survey on 365 hospitals in 9 provinces and field investigation on 1 5 hospitals in 3 provinces were performed,the implementation of three standards were investi-gated.Results Of 365 hospitals,the number of provincial and ministerial level,municipal level,and county level hospitals were 90,87 and 188 respectively. More than 94% of hospitals established CSSD management system and regulations,>90% of hospitals met the requirements of CSSD layout;All hospitals were equipped with pressure steam sterilizer,all levels of hospitals basically equipped with the necessary equipments and facilities;CSSD respon-sible officers of 94.52% (345/365)of hospitals participated in training on standards;69.61% (252/362)of hospi-tals were using or developing CSSD information systems;>92% of the CSSD responsible officers considered that three standards played an important role in facilitating centralized management,and improving the quality of clean-ing,disinfection and sterilization.Conclusion Hospitals need to strengthen the management and training on stand-ards of CSSD,management of loaner instruments and development of information system need to be standardized.

Objective To evaluate the postoperative efficacy and safety of dexmedetomidine for cardiac surgery patients in intensive care unit. Methods A total of 90 cardiac surgery patients in the intensive care unit (ICU)were randomly assigned into dexmedetomidine group(D group,45 cases)and propofol group(P group,45 cases)to receive dexmedetomidine or propofol respectively for post-operative sedation. The ratio of sedation satisfac-tion was evaluated and calculated by Riker sedation-agitation scale(SAS),and the duration of mechanical ventila-tion,24-hour consumption of sufentanil,ICU staying time,and the incidences of side-effects(such as hypoten-sion,bradycardia,delirium etc)were recorded during the observation period. Results No significant differences were found in the ratio of sedation satisfaction and the incidences of bradycardia and delirium between the two groups (P > 0.05). The duration of mechanical ventilation and ICU staying time were significantly shorter in D group than that in P group(P<0.01),while the 24-hour consumption of sufentanil and the incidences of hypoten-sion and delirium were significantly lower than that in P group(P<0.05). Conclusion Using the dexmedetomi-dine as a postoperative sedation drug for post cardiac surgical patients in ICU is clinically effective and safe ,and the postoperative recovery of patients may be enhanced by the drug using.

[Objective]To explore the potential alteration of their osteogenesis and adipocyte differentiation in bone marrow mesenchymal stems cells from mice with immune-mediated aplastic anemia.[Methods]Balb/c mice model of immune-mediated aplastic anemia was established by radiation with sublethal dose of 60Co following the intravenously infusion lymphocytes of DAB/2 mice.The culture of the MSC and CFU-F and pathological examination of bone marrow were carried out 15 days later.The amount of calcium node and the frequency of adipocyte differentiation were evaluated respectively by alizarin red and oil red O.[Result]The number of CFU-F and the number of calcium node in model mice decreased more greatly than normal mice,but the ferenqucy of adipocyte differentiation was more increased greatly in model mice than normal mice;the pathological examination showed in the model mice,the hematopoietic structure was destroyed and filled with abundant adipocyte.[Conclusion]The potention of osteogenesis and adipocyte differentiation was altered in the mice with immune-mediated aplastic anemia.

OBJECTIVE: To optimize the microwave-assisted extraction of total organic acids from Isatis indigotica. METHODS: With the dissolution rate of total organic acids as indexes, the content of total organic acids was determiend by acid-base titration and the three main factors including volume of solvent, microwave power and extraction time in the extraction process were optimized by orthogonal test. RESULTS: The optimal extraction process is to add 15 times amount of water and extract at a microwave power of 522 W for 20 minutes. Under the above condition, the extraction rate was 4.83%, close to the extraction yield achieved by water decoction for 2 h. CONCLUSION: The microwave-assisted extraction of total organic acids from Radix Isatidis is characterized by rapid, simple, efficient and energy-saving etc, thus deserving to be be popularized.