Objective:To investigate clinical effects of a good control of blood sugar during perioperative period on surgical tolerance and postoperative recovery in elderly patients with gastric cancer and diabetes.Methods:A total of 92 elderly patients with gastric cancer and diabetes undergoing surgery in our hospital from August 2018 to March 2020 were randomly divided into a control group(taking conventional perioperative care, n=46)and an observation group(taking conventional perioperative care and good glycemic control, n=46). The changes of perioperative blood glucose level, surgical conditions and postoperative recovery in the two groups were observed and analyzed.Results:Fasting blood glucose level of observation group and control group was[(7.4±1.1)mmol/L vs.(7.9±1.3)mmol/L, t=-1.991, P=0.025]at 1 d before operation, [(7.2±0.9)mmol/L vs.(8.7±1.2)mmol/L, t=-6.782, P=0.000]during operation, and[(6.9±1.5)mmol/L vs.(8.5±1.1)mmol/L, t=-5.834, P=0.000]after operation.Anyway, fasting blood glucose level was lower in the observation group than in the control group.In observation vs control group, time of incision healing[(7.5±1.6)d vs.(9.7±2.2)d, t=-5.485, P=0.000], time to get out of bed[(3.3±0.8)d vs.(4.7±1.3)d, t=-6.221, P=0.000], length of stay in hospital[(10.5±2.7)d vs.(15.1±3.5)d, t=-7.058, P=0.000]were shorter in observation group than in control group.The incidence of postoperative complications was lower in the observation group than in the control group(8.70% vs.26.09%, χ2=4.484, P=0.028). Conclusions:The application of perioperative glycemic control can effectively maintain the perioperative blood glucose at a reasonable and stable level, improve the surgical tolerance and promote the postoperative recovery in elderly patients with gastric cancer and diabetes.And it plays a very positive role in ensuring the safety of surgery

Objective Through the investigation of 80 cancer operation patients' families,we would like to investigate further more the effect of their anxiety conditions for the patients' mental state and find out the corresponding strategy.Methods 80 cancer patients' families in our department were chosen to fill the anxiety scales between the 2nd to 5th day after their admission and some corresponding directions were given.Results Compared with the norm,the cancer patints' families' anxiety scores had significant difference(P

Intravenous preparations take more risk than oral preparation and externally applied agent.In phaseⅠtoler- ance trial of intravenous preparations of TCM on human subjects,minimum dose and maximum dose should be decided in light of data derived from preclinical pharmacodynamic and toxicological experiments,combined with practical situation in clinic.Dose-ascending coefficient of the should be reasonable.During the application of intravenous preparations of TCM in tolerance trial,clinical monitoring must be done to ensure the safety of subjects.Overall and integrated observa- tional indices should be designed on the basis of the features of preparation types,administration methods,the nature of medicine,etc.,so as to provide full-scale data for safe dose range,concentration of the preparation,dripping veloci- ty and possible adverse reactions,etc.

Objective:To summarize our clinical experience in the treatment of aortic root aneurysm by aortic valve sparing root replacement.Methods:From May 2017 to October 2019, a total of 20 patients with aortic root aneurysm underwent aortic valve sparing root replacement by reimplantation method. There were 17 males and 3 females, with an average age of(35.6±15.8) years(12-63 years). There were 11 cases of Marfan syndrome, 5 cases of bicuspid aortic valve, and 1 case of redo operation. The preoperative diameter of ascending aorta was(40.6±9.7)mm, the diameter of aortic sinus was(52.2±9.2)mm, and the diameter of aortic valve ring was(27.1±3.6)mm. There were 10 cases of no or mild regurgitation, 5 cases of moderate regurgitation and 5 cases of severe regurgitation. In the whole group of patients, the root replacement of aortic valve was retained by reimplantation, and the artificial graft were selected as: 26, 28 and 30mm straight vessels, 1, 3 and 6 cases, respectively, 26 and 28mm artificial graft with valsalva sinus, 4 and 6 cases, respectively. During the operation, aortic valve cusp repair was performed in 6 cases, such as plication of the free margin( 4 cases), decalcification(1 case) and raphe release(1 case).Results:None of the patients died in hospital or underwent rethoracotomy for hemostasis. During the operation, the duration of CPB time was(171.0±25.6) minutes and the duration of cross-clamp time was(134.0±23.2) minutes. There were 12 cases of aortic valve regurgitation and 8 cases of mild regurgitation. The mean follow-up was(15.1±9.8) months(4-33 months). During the follow-up period, there were 2 cases with moderate aortic regurgitation no need reoperation, while the rest of the patients had no or mild regurgitation. There are no patients undergoing reoperation. During the follow-up, 1 patient suffered coronary artery embolism in left circumflex artery and recovered after medicine treatment.Conclusion:Reimplantation with aortic valve sparing root replacement is safe and effective in the treatment of aortic root aneurysm, and the early and mid-term follow-up results are satisfactory, which can avoid anticoagulation-related complications and is suitable for young patients.

Objective To investigate the antibacterial properties and curative effects of a nanosilver-epidermal growth factor (NanoAg-EGF) sustained-release carrier.Methods First,in accordance with former method,sustained-release carrier of NanoAgEGF was prepared,with the design of the NanoAg-EGF group,NanoAg-alone group,EGF-alone group,control groups of normal saline-alone,and benzylpenicillin sodium.Contrasting detection on antibacterial properties of five kinds of common microbes (staphylococcus aureus,escherichia coli,pseudomonas aeruginosa,candida albicans,and streptococcus pneumonia) in each group was used to confirm their antibacterial properties.Then,wound models of diabetic rats were randomly divided into five groups,with the wound treatments by sustained-release cartier of NanoAg-EGF,combined application of NanoAg + EGF,EGF-alone,NanoAg-alone,and normal saline-alone control group,respectively.The observation on the healing situation of each group in different times was used to ensure the curative effect.Results In the antibacterial experiments,it was found that the NanoAg-EGF and NanoAg had strong antibacterial properties.Their antibacterial properties had no significant difference (P ＞ 0.05).The control group,penicillin sodium only had relatively weak antibacterial properties on staphylococcus aureus and streptococcus pneumoniae,with obviously weaker function compared to the NanoAg-EGF and NanoAg groups (P ＜ 0.05).The control groups,EGF-alone and normal saline-alone had no inhibitor function on each kind of pathogenic microorganisms.In the wound healing experiments on diabetic rats,it was found that NanoAgEGF shortened significantly the wound healing time of diabetic rats (P ＜ 0.05).On the 3rd day,the healing rate of each group had no difference (P ＞ 0.05).On the 7th day and 13th day,the healing rates of NanoAg-EGF [(61.71 ± 8.78)％ and (100 ± 2.60) ％] were significantly higher than the other four groups (P ＜ 0.05).Conclusions NanoAg-EGF not only has good antibacterial properties but also can promote rapidly the wound healing of diabetes.

Objective To explore the changes in expression of Klotho, an aging-suppression protein, and neutrophil gelatinase associated lipocalin ( NGAL) and their relationship with rat mesangial cells ( RMCs) cultured with high glucose in vitro, and to explore the role played by Toll-like receptor-4 (TLR4) / nuclear factor-kB(NF-kB) p65 pathways in this process. Methods Three NGAL-siRNA sequences were designed and synthesized. The effective sequence in subsequent experiments was chosen. RMCs were preincubated with pyrrolidinedithiocarbamate (PDTC)or exogenously added Klotho prior to high glucose treatment. Realtime PCR was used to analyze Klotho, TLR4, NGAL mRNA expressions. Western blot was used to observe Klotho, TLR4,NF-kB p65, NGAL,fibronectin (FN), and connective tissue growth factor ( CTGF) protein expression. ELISA assay was used to detect monocyte chemoattractant protein-1 ( MCP-1) and CXCL5 secretions. Results High glucose suppressed Klotho expression significantly(P<0. 05) and activated TLR4 / NF-kB p65 pathway. Meanwhile,the levels of NGAL,FN,CTGF, MCP-1, and CXCL5 were highly expressed ( P < 0. 01). NGAL gene silencing obviously down-regulated the increased expressions of FN, CTGF, MCP-1, and CXCL5 ( P < 0. 01). After PDTC treatment the overexpression of NGAL protein was markedly lowered(P<0. 01). In addition, Klotho treatment significantly inhibited the activity of TLR4 /NF-kB p65 pathways and down-regulated the expressions of NGAL, FN, CTGF, MCP-1 and CXCL5 stimulated by high glucose(P<0. 01). Conclusion Klotho inhibits the activity of TLR4 / NF-kB p65 pathways and thus inhibits NGAL expression in RMCs cultured with high glucose in vitro. And then it suppresses the expressions of FN, CTGF, MCP-1, and CXCL5. This provides a new basis to illustrate the protection mechanism of the anti-aging protein Klotho in diabetic nephropathy, and may provide new ideas and therapeutic targets for prevention and treatment.

Objective To identify the association of oxygen saturation of arterial hemoglobin (SaO2) with late-onset hypertension in the Chinese Han population located in the Daxinganling area.Methods A total participants were selected by convenience sampling methods from the Daxinganling area.All data were collected from each person by the questionnaire record of physical examinations as well as biochemical index measuring.SaO2 was noninvasively measured with finger pulse oxymetry,the reported SaO2 was the average of three readings taken 10 seconds apart.Results There were significant differences for SaO2 within the population of individuals,the mean SaO2 values was 97.71%±6.14%,with range from 88% to 100%.There was association of SaO2 with sex,BMI and age.SaO2 level declined with BMI and age increasing.Particularly,it was found that the risk increasing to hypertension was marked association with SaO2 rapid drop.During the period from 40-50 years of age,SaO2 declined from 97.85% to 97.64%,The risk to hypertension increased more than 10 times(P<0.001).That implicated hypoxia mightinvolve in the etiology of hypertension.Conclusions The preliminary results demonstrated the rapid decline of SaO2 with lapse of age may be one of the major risk factors to hypertension,it may be helpful to explain late-onset hypertension to some extent at least.

To investigate the effects of Jianpi Jiedu Formula (JPJDF), a compound Chinese herbal medicine, on vascular endothelial growth factor (VEGF) expression induced by Helicobacter pylori (Hp) in human gastric cancer cells, and to explore the possible mechanism.

Objective To evaluate the outcomes and complications of permanent brachytherapy combined with external beam radiotherapy and hormonal therapy for local high-risk or intermediated-risk prostate cancer.Methods There were 354 men with local high-risk or intermediated-risk prostate cancer were reviewed,including 111 men with local intermediated-risk prostate cancer and 243 men with local highrisk prostate cancer.The age of the patients were 48 to 84 years old (mean age 72.4 years old).The preoperative PSA levels were in a range of 3.8 to 99.8ng/ml (mean 29.6 g/ml) and the preoperative Gleason scores were 4 to 9 (mean 6.8).The prostate volume were 13.7 to 65.0 ml (mean 30.5 ml).All the patients were treated with brachytherapy combined with hormonal therapy,including 69 patients received additional external beam radiotherapy.All patients were followed up for biochemical progression-free survival (bPFS),distant disease free survival (DDFS),overall survival (OS),cause-specific survival (CSS) rate and complications.Results Among 354 cases,174 cases underwent brachytherapy after the diagnosis of prostate cancer,and 157 cases underwent brachytherapy after maximal androgen blockade (MAB) treatmentfor 3 months,while the other 23 patients with large prostate underwent brachytherapy after MAB treatment for 6 months.All 354 cases were treated with MAB after brachytherapy.One hundred and eleven cases in intermediated-risk group were treated with MAB for 6 months and 243 cases in high-risk group were treated with MAB for 6 months to 3 years.Another 69 patients received adjuvant external radiotherapy.All cases were followed up for 9 to 128 months (mean 91 months),including 135 cases having biochemical recurrence,and 63 cases having distant metastasis.There were 81 cases died,including 24 cases died of prostate cancer.The overall bPFS,DDFS,OS and CSS were 61.9％,82.2％,77.1％ and 93.2％ respectively.There were significant difference in the survival rate between the high-risk group and the intermediated-risk group(P ＜ 0.001).The incidence of urinary retention and long term urethral stricture were 6.8％ and 1.7％,respectively.No serious complications occurred.Conclusion Permanent brachytherapy combined with external beam radiotherapy and hormonal therapy treating local high-risk or intermediated-risk prostate cancer can be effective with few complications.

Objective To investigate the attitude toward and perception of the risk of nuclear power plant among the public residing in vicinity of nuclear power plant,as well as the related factors.Methods A face-to-face interview on perceived radiation risks was conducted among 1408 individuals in Liangyungang City, Jiangsu Province.where the Tianwan nuclear power plant was under construction.The four groups was defined according to the distance between the residence of the subjects and the Tianwan nuclear power plant:<4 km,4- 8 km,8-30 km and 30-50 km.A was used to collect information on education,working history,religion, perception of major industries hazards especially nuclear power plant,and major factors may influence their perceptions.Ordinal logistic regression model was used to analyze the data.Results About 91.18% of the interviewee heard about the nuclear power plant,35.36% of them had knowledge about Chernobyl nuclear power plant accident,71.05% of them believed that the nuclear power plant had no negative effects on environments, 37.03% of them believed that the nuclear energy was safe.74.27% of them believed that it was necessary for China to develop nuclear energy.63.29% of them supported the construction of the nuclear power plant in local area.Ordinal logistic regression analysis revealed that the higher education,higher family annual income,male, economic benefits from the nuclear power plant construction,and trust in local government having competency to handling emergencies were positive factors;otherwise,impression on nuclear power plant of bad influences on environment and health were negative factors.An inverted U-shaped with a right tailing relationship between negative attitudes toward nuclear power plant and distance to the plant was found.Conclusions Education, gender,family annual income and expectation of economic benefit returns were the major factors influencing the perception of and attitudes toward nuclear power plant.More works needed to be done to mitigate the negative attitude of the residents in vicinity of nuclear power plant and enhance the public acceptability .