Objective Laparoscopy-assisted distal gsstrectomy (LADG) with D1 + β lymph node dissection has become the most popular treatment for early gastric cancer in Asian countries. However, no one has shown the same clinical advantages with this procedure as with LADG with D1 + α lymph node dissection. The aim of this study was to compare the outcome of LADG with D1 + β to that of LADG with D1 + α lymph node dissection. Methods During the period of June 2002 through June 2006, LADG with D1 + α lymph node dissection was performed in 54 patients, and LADG with D1 + β lymph node dissection was performed in 42 patients. Surgical findings, clinicopathologic data, postoperative course, complications, and blood analysis findings were compared between the two groups. Differences were analyzed with Mann-Whitney U test and chi-square test. Results Patients in the two groups were comparable with respect to age, sex, body mass index, and stage and pathologic characteristics of gastric cancer. A significantly greater number of N2 lymph nodes were harvested by D1 + β lymph node dissection than by D1 + α dissection (5.9vs. 2.7, P<0.01). However, no significanees in the total number of retrieved lymph nodes (24.7 vs. 22.2) or perigastric lymph nodes dissected (18.9 vs. 19.4) were identified between the D1 + β and D1 +α groups. There was also no significant difference between the D1 + α and D1 + β groups with respect to operation time, blood loss, complication rate, time to first walking, first flatus, first eating, and first defecation, frequency of analgesics, volume of oral intake on postoperative day 7, weight loss, and postoperative hospital stay. Blood analysis showed there were no significant differences in white blood cell count, levels of C-reactive protein, and serum albumin. Conclusion The short-term outcome of LADG with D1 + β lymph node dissection is comparable to that of LADG with D1 + α lymph node dissection.

OBJECTIVE To know the compliance and it′s impact factors of hand hygiene of healthcare workers.METHODS The wards and healthcare workers were sampled randomly.Survey the compliance,qualified rate and impact factors of hand hygiene of healthcare workers when they didn′t know to be observed by special training staffs.RESULTS The compliance and the qualified rate of hand hygiene was 30.2% bothly,and be affected by the time before or after operation,occupations and work post.The factors causing low qualified rate were anenough time and improper technique for washing hand,and drying hand wrong.CONCLUSIONS The hand hygiene for healthcare workers in hospitals should be strengthened.

Objective To study the risk factors for intra-abdominal infection after pancreaticoduodenecto-my. Methods Clinical data of 101 cases undergoing pancreaticoduodenectomy in our hospital from January 1994 to January 2008 were reviewed retrospectively. The risk factors were analyzed. Results The incidence of intra-abdomi-hal infection was 12.9% (13/101). Univariate analysis showed postoperative pancreatic,biliary and intestinal fistu-la,pulmonary infection,preoperative acute cholangitis and texture of the remnant pancreas were the risk factors for intra-abdominal infection(P<0.05). Multivariate Logistic regression revealed that postoperative pancreatic, biliary and intestinal fistula, pulmonary infection, preoperative acute cholangitis were independent risk factors (OR = 11.914,9.891 and 7.197 ) of intra-abdominal infection after pancreaticoduodenectomy. Conclusion Preventing and curing pancreatic ,biliary and intestinal fistula, pulmonary infection, preoperative acute cholangitis can decrease the incidence of intra-abdominal infection.

Objective To explore the value of hydrogen sulfide(H2S) in the evaluation of severity of acute pancreatitis(AP).Methods Fifty-one patients with AP from February 2013 to December 2015 in this hospital were divided into severe acute pancreatitis (SAP,n=21) group and mild acute pancreatitis (MAP,n 30) group.Thirty six non-pancreatitis abdominal patients and 9 healthy persons(NC) were chosen as compare groups.The peripheral venous blood samples from the four groups and the Ranson Score of AP group were obtained after admission,the venous blood samples of 12 h,24 h,48 h of AP group were also obtained.Blood samples were used to detect the concentrations of hydrogen sulfide with ELISA method.We compared the concentrations of H2S between the four groups with one way ANOVA,and post hoc;compared the differences of concentrations of H2S in AP group between after admission,12 h,24 h and 48 h with repeated measures data ANOVA;and explored the relationship between the concentrations of H2S after admission and the Ranson scores in AP group with Spearman correlation analysis.Results The concentra tions of H2S was significant higher in SAP group than MAP,abdominal,and NC group(P=0.000);the concentrations of H2S was also significant higher in MAP group than abdominal,and NC group(P=0.000);there is no significant difference between the abdominal and NC group(P =0.131).There is significant difference of H2S concentrations between the four times in AP group(P =0.000),decreasing gradually over time.The H2S concentrations in AP group after admission was significantly related with their Ranson scores(r=0.578,P=0.000).Conclusion There is certain value of the concentrations of H2S in the diagnosis of AP,the higher H2S level suggests the higher severity of the patients with acute pancreatitis.