Objective To explore reasonable application of antibiotics in the peri-operative period of the general surgery.Methods 121 cases who were admitted from Nov. 1998 to Jun. 2000 were divided into three groups including deep-vein group, biliary culture group and drainage-rube group. The antibiotics were Cefradine, Cefuroxime, Cefoperazone, Ceftriaxone, Imipenem, Ciprofloxacin and Metronidazole. We recorded the dosages and applying-time of the antibiotics. We also carried out the culture of the blood, cut-secreta and drainage tube at the same time.Results The clinical doctors applied the antibiotics with excess of indications and applying-time. That brought about more and more drug-fast bacteria, even multiple drug-fast bacteria.Conclusion We must apply the antibiotics reasonable in the peri-operation.

The first few cases of colonic surgery using Da Vinci surgical system were reported in 2002;since then,Da Vinci surgical system has gradually been used in several centers for rectal cancer and with favorable outcomes.Laparoscopy has opened a new era in modern surgery,however,the inherent limitations of traditional laparoscopic surgery may cause certain difficulties during manipulation,especially in the demanding field of colonic laparoscopic surgery,which prolonged the learning curve.The advantages of Da Vinci surgical system include stable camera platform,three-dimensional imaging,excellent ergonomics,tremor elimination,ambidextrous capability,motion scaling,and instruments with multiple degrees of freedom.Low rectal region was regarded as the"forbidden zone"for laparoscopy,so we applied the Da Vinci surgical system in low anterior resection for rectal cancer.Because of mulyiquadrant operations in low anterior resection of rectal cancer,moving the robotic cart twice during the operation is necessary,which increased the operation time.In order to solve the problem,many surgeons use conventional laparoscopy for vessel ligation and flexure mobilization,and adopt the Da Vinci surgical system only in the lower quadrant of the abdomen.We present a technique that allows for the complete isolation of the mesorectum from the same position of the robotic cart,during the process,the enhanced dexterity and precise dissection offered by the Da Vinci surgical system were fully utilized.

OBJECTIVETo investigate the predictors of local recurrence and survival in primary retroperitoneal leiomyosarcoma (PRLS).

METHODSA retrospective analysis was conducted on 46 cases of PRLS between August 2006 and April 2012. There were 9 male and 37 female patients, and they were 30-79 year old (median 49 year old). Kaplan-Meier estimations and Cox regression analyses were performed.

RESULTSThe tumor size were 5-36 cm, and 29 cases (63.1%) of this group was more than 10 cm. Local 3- and 5-year control rates after complete resection were 47% and 30%. FNCLCC (Fédération Nationale des Centres de Lutte Contre le Cancer) grading (RR = 3.10, 95%CI: 1.59-6.04), gender (RR = 5.30, 95%CI: 1.64-17.13) and blood loss (RR = 3.12, 95%CI: 1.28-7.60) were independent prognostic factor of local recurrence in multivariable analysis (P < 0.05). The 5-year disease-free survival rates after complete resection of PRLS was 26%; and the 5-year disease-specific survival (DSS) rates after complete resection was 48%. The median DSS was 60 months in negative margin of resection and 50 months in positive margin. However, by multivariate analysis, only FNCLCC grading was significant independent predictors of DSS (RR = 2.01, 95%CI: 1.16-3.49, P = 0.013).

CONCLUSIONSGender, FNCLCC grading and blood loss were independent prognostic factor of local recurrence. The disease-specific survival in PRLS varied significantly according to FNCLCC grading.

Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Leiomyosarcoma ; pathology ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; pathology ; Prognosis ; Retroperitoneal Neoplasms ; pathology ; Retrospective Studies ; Survival Rate

BACKGROUND:Differences exist between the action execution of the dominant hand and the nondominant hand during daily lives. With the increasing of the age, the dominant hand and the nondominant hand play an equaly important role in the action execution and implementation during daily lives. Previous studies mainly focus on the muscle strength of upper limbs. However, studies on the influence of joint dynamic characteristics and trajectory deviation on the occupational activities have been increased gradualy. The three-dimension motion capture and analysis have become the reliable and valid standard of the assessment of the upper limb movement. OBJECTIVE:By using the three-dimensional kinematic analyze method, to colect the data of the healthy elderly people using the upper limbs to drink water respectively with the cups of different weights and to investigate whether there is a difference between dominant and nondominant hands under different weight-bearing conditions based on upper limb kinematics METHODS: Sixteen right-handed elder people were chosen to be the experimental subjects. The upper limb motion of drinking water with different weight was captured by Vicon Nexus. By Data modeling and trajectory filtering with pipeline and data normalizing with the Matlab, the three-dimensional angle and peak value of the velocity of the should, elbow and wrist joint in the bilateral upper limbs were analyzed and compared when lifting the cups of 100, 200 and 500 g. RESULTS AND CONCLUSION:The most significant difference could be found in the three-dimensional movement angle of the elbow joint when holding the weights: there were significant differences in 100 g horizontal plane (X axis) and sagittal plane (Z axis), 200 g frontal plane (Y axis) and sagittal plane (Z axis), and 500 g three-dimensional plane (P < 0.05). Difference could be found in the peak value of three-dimension angular velocity in the shoulder, elbow and wrist joints: 100 g (shoulder jointPx=0.01; elbow jointPy=0.048,Pz=0.007), 200 g (elbow jointPy=0.033,Pz=0.005; wrist joint Py=0.035), 500 g (elbow jointPy=0.027,Pz=0.006) had significant differences (P < 0.05). There was no significant difference in the movement angle and angular velocity when holding different weights with the ipsilateral upper limb (P > 0.05). These results show that there is a difference in the movement angle and angular velocity between the dominant hand and the nondominant hand when drinking water. A great change of movement angle could be found in the X axis of the elbow joint in the dominant hand, and a great change of the movement angle could be found in the Z axis of the elbow joint in the nondominant hand. The angluar velocity in the Y axis has better changes than in the Z axis. The size of the weights has no effect on the movement of bilateral upper limbs.

Objective:To investigate the expression and clinical application value of exosomal circRPS6 in serum of colorectal cancer (CRC) patients.Methods:Peripheral serum samples were collected from 115 CRC patients admitted to Henan Provincial People′s Hospital from January 2019 to December 2020. There were 68 males and 47 females, aged (63.0±9.5) years. Meanwhile, one hundred and twenty healthy subjects from the same period wereenrolled, with 70 males and 50 females, aged (61.0±10.7) years. In addition, sixty pairs of tumor and adjacent tissue specimens from CRC patients undergoing surgical treatment were collected. The circRPS6 expression in serum exosome and tissue of CRC patients were detected via real-time fluorescence quantitative PCR (RT-qPCR), and its relationship with clinicopathological features and prognosis of CRC patients were also investigated. The levels of CEA and CA19-9 in serum were detected by electrochemiluminescence assay. The ROC curve and AUC were used to estimate the diagnostic capacity. Univariate and multivariate regression analysis was performed using Cox proportional hazard analysis.Results:The expression level of circRPS6 in CRC tissue was significantly higher than that in adjacent tissue( Z=5.38, P<0.001). Compared with healthy control, the expression of serum exosomal circRPS6 was significantly upregulated in the CRC group( t=14.52, P<0.001). ROC curve analysis results showed that the AUC of exosomal circRPS6 was 0.882, which had a higher diagnostic efficacy in CRC patients than CEA and CA19-9 detection. There was a positive correlation between the expression level of exosomal circRPS6 with TNM stage and lymph node metastasis and distant metastasis( P<0.05). Kaplan-Meier survival analysis revealed that CRC patients with low exosomal circRPS6 levels had a much longer average survival time compared with those in high group. Moreover,multivariate analysis results indicated that exosomal circRPS6 was an independent prognostic factor in colorectal cancer. Conclusion:Exosomal circRPS6 is highly expressed in the serum of CRC patients and correlated with malignant progression and poor prognosis, which is expected to be a potential marker for the diagnosis and prognosis evaluation of CRC patients.

OBJECTIVETo establish a nude mouse model of orthotopic engineered gastric tumor for in vivo fluorescence imaging studies.

METHODSAn engineered gastric tumor was constructed in vitro using collagen as the scaffold and the human gastric cancer cell line BGC823-EGFP cells expressing enhanced green fluorescence protein (EGFP) as the seed cells. The engineered tumor was then implanted into the stomach of nude mice, and the tumor growth was observed with in vivo fluorescence imaging. The nude mice were sacrificed 6 weeks after the transplantation to assess the tumor growth and metastasis, and the tumor histology was evaluated.

RESULTSThe tumor cells in the engineered tumor model grew well in three-dimensional culture. The success rate of orthotopic gastric tumor implantation was 100% (10/10) in nude mice with metastasis in the abdominal organs. The isolated tumor mass, weighing 1.719∓0.349 g, showed a histological characteristic of poorly differentiated adenocarcinoma. In vivo fluorescence imaging detected EGFP-expressing tumors in the abdominal cavity of the nude mice, but not accurately.

CONCLUSIONThe nude mouse model bearing orthotopic engineered gastric tumor provides a simple animal model for the study of gastric cancer, but a stronger fluorescence than green fluorescence is more desirable for more effective observation in in vivo fluorescence imaging.

Animals ; Cell Line, Tumor ; Disease Models, Animal ; Female ; Fluorescence ; Green Fluorescent Proteins ; analysis ; Humans ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Transplantation ; Optical Imaging ; Stomach Neoplasms ; Tissue Engineering

OBJECTIVETo evaluate the impact of preoperative platelet-lymphocyte ratio (PLR) on the prognosis in patients with operable colorectal cancer.

METHODSThe clinical data of 140 patients with operable colorectal cancer were analyzed retrospectively. According to preoperative PLR, the patients were divided into low PLR group (PLR<250) and high PLR group (PLR≥250). The overall 5-year survival rates and the clinicopathological factors in the two groups were analyzed using univariate analysis and COX regression model.

RESULTSThe patients with a high PLR had a significantly lower overall 5-year survival rate than those with a low PLR (71.4% vs 51.5%, P=0.045). Univariate analyses identified tumor location, the depth of tumor invasion, lymph nodes metastasis, TMN stage, and PLR as significant risk factors for reduced overall 5-year survival. In COX regression model, a high PLR was identified as an independent risk factor for poorer prognosis in patients with resectable colorectal cancer (RR: 2.213; 95%CI: 1.007-4.863, P=0.0048).

CONCLUSIONPreoperative PLR can be a clinically significant factor for assessment of prognosis of resectable colorectal cancer.

Adult ; Aged ; Blood Platelets ; cytology ; Colorectal Neoplasms ; diagnosis ; mortality ; Female ; Humans ; Lymphocyte Count ; Lymphocytes ; cytology ; Male ; Middle Aged ; Platelet Count ; Prognosis ; Retrospective Studies ; Survival Rate

Objective:To study the application of scenario simulation teaching combined with modular training in nursing education of medical rescue in manned space flight.Methods:Twenty nurses from the medical rescue team of Strategic Support Force Characteristic Medical Center were selected as the research objects. The research objects were randomly divided into the scenario simulation combined with practical training group (practical training group, n=10) and traditional teaching group (control group, n=10). Scenario simulation teaching combined with modular training and traditional teaching were used to carry out nursing training. After the training, theoretical assessment, operation assessment and satisfaction survey were organized. Results:The scenario simulation teaching combined with modular training group was significantly better than the traditional training group in theory assessment, operation assessment and satisfaction survey of nursing staff (all P<0.05). Conclusions:Scenario simulation teaching combined with modular training has obvious teaching effect, which can improve the ability and quality of nursing staff, and help to complete the manned space medical rescue mission efficiently.

Objective:To explore the module of the construction and application of medical first-aid at the door of the space capsule and the air evacuation.Methods:According to the purpose, principle, and method set by the module, it was divided into two sub-modules: medical first-aid at the door of the space capsule and the air evacuation. During the comprehensive first-aid training, independent training and combined training were carried out respectively according to different mission stages of launch and recovery and different recovery terrain. Meanwhile, research was performed to ensure that medical carrying equipment was lightweight, modular, and portable, and the efficiency of modularization construction was tested in the comprehensive training.Results:The module of medical first-aid at the door of the space capsule and the air evacuation obviously shortened the rescuing time during the comprehensive training, the saving effect was remarkable, and the overall saving efficiency was significantly improved.Conclusions:The module of medical first-aid at the door of the space capsule and the air evacuation meet the requirements that the emergency support system of aerospace medicine should function on an immediate basis, ensuring accurate treatment and air evacuation without any delay, so that to achieve the aim of aerospace medicare.

Objective:To review the characteristics and coping strategies of the rescue and landing medical support mission of Shenzhou-14 manned spacecraft.Methods:The characteristics of rescue and landing medical support mission of Shenzhou-14 manned spacecraft was analyzed, and the coping strategies and experience were discussed.Results:(1) The characteristics of rescue and landing medical support mission of Shenzhou-14 manned spacecraft included: long time in space station and high-intensity space missions; high-density space medical support mission in short term; special environmental factors in severe cold night; complex terrain of landing site; and the young medical support team. (2) The main coping strategies of rescue and landing medical support mission of Shenzhou-14 manned spacecraft included: strengthened the organization and leadership and improved the training model; reinforcement learning the medical treatment plan and strengthened the medical rescue skills training; optimized the carrying equipment and added the heat preservation and lighting measures; improved the medical rescue process and perfected the emergency plan; emphasized on the scientific research as important as mission; and strengthened the physical exercise and cold resistance exercise.Conclusions:The characteristics and coping strategies of rescue and landing medical support mission of Shenzhou-14 manned spacecraft are summarized to provide the experience for space medical rescue and offer the support for China's manned space industry.