Objective To investigate the effect of perineural invasion (PNI) on evaluating the prognosis of patients with gastric cancer.Methods The clinical data of 116 patients who underwent gastric resection were analyzed retrospectively,all of the paraffin sections were stained with S-100 albumen,the association between PNI with clinicopathological features and prognosis were analyzed.Results PNI was positive in 41 of all the 116 patients (35.3％,41/116).The occurrence of PNI related with depth of invasion,histological type,lymph node metastasis (P ＜0.05),unrelated with gender,tumor size,Borrmann classification,TNM stage (P ＞0.05).One hundred and five patients completed follow-up,the median follow-up time was 49 months,the median life span and 5-year survival of the PNI-positive patients were significantly worse than that of PNI-negative patients [23.6 months vs.43.8 months,30.6％(ll/36) vs.53.6％ (37/69),P ＜ 0.05].Univariate and multivariate analysis were prompted PNI with perineural invasion (P ＜ 0.05).Conclusions The PNI-positive tumor cell may have more power in invasiveness,and it could serve as an independent predictor of prognosis of gastric cancer.

Colorectal cancer is a kind of common malignant tumor,the incidence of which appears to increase with the developments of social economy and change of life style.Liver metastasis occurred in about 50％ of patients with colorectal cancer,as an important cause of death.In recent years,radiofrequency ablation (RFA) has been used clinically to damage the hepatic metastatic carcinoma.With the characteristics of accuracy,micro-invasive trauma and repeatability,RFA has been extensively used as an effective local treatment.This paper discusses the indications of RFA for colorectal liver metastasis (CRLM),current status of RFA in unresectable and resectable CRLM,application of RFA in combine therapy for CRLM.

Objective To study the dependablity of clinical characteristics and prognosis in patients with endometrial cancer,so as to apply the basis for the treatment. Methods The clinical and pathological data of 92 patients with endometrial cancer were analyzed retrospectively, 5-year survival rate was followed and observed. Using Cox proportional hazard regression analysis to evaluate the factors related to overall survival. Results The overall 5-year survival rate was 72.41%. Using univariate analysis, the survival time was correlated with histologic type, pathological staging, histologic grade, myometrium invasion,cervical invasion and lymph node metastasis (P＜0.05).Using multivariate analysis, the survival time was correlated with histologic type,histologic grade and myometrium invasion. Conclusions Histologic type, histologic grade and myometrium invasion are independent prognostic factors for survival time of patients. In order to improve the prognosis of the patients, they should be treated by individual therapies.

Objective:To investigate the effect of ultrasound-guided transverse abdominal plane block combined with dexmedetomidine on cesarean section.Methods:Eighty pregnant women undergoing elective cesarean section under general anesthesia in Binzhou Central Hospital from October 2017 to October 2019 were included in this study. They were randomly assigned to undergo either cesarean section under general anesthesia followed by patient- controlled intravenous analgesia (control group, n = 40) or ultrasound-guided transverse abdominal plane block combined with intravenous dexmedetomidine administration (observation group, n = 40). Analgesic efficacy and the analgesic effect on puerperas and their newborns were compared between the observation and control groups. Results:At 2, 4 and 12 hours after surgery, the Visual Analogue Scale score in the observation group was (2.1 ± 0.9) points, (2.2 ± 0.7) points, (3.0 ± 0.6) points, respectively, which was significantly lower than (4.4 ± 1.3) points, (4.9 ± 1.2) points, (3.9 ± 0.8) points in the control group, respectively ( t = 8.946, 7.854, 6.246, all P < 0.05). At 2, 4 and 12 hours after surgery, the comfort score in the observation group was (3.4 ± 0.8) points, (3.2 ± 0.7) points, (3.3 ± 0.7) points, respectively, which was significantly higher than (2.1 ± 0.7) points, (2.2 ± 0.9) points and (2.5 ± 0.8) points respectively in the control group ( t = 7.235, 6.130, 5.953, all P < 0.05). After surgery, the number of times the demand button of the anesthesia pump in the observation group was pressed was (8.4 ± 2.9), with the rate of patient satisfaction of 97.50% (39/40), which was significantly higher than that in the control group [13.1 ± 3.7, 77.50% (31/40), t = 7.036, χ2 = 9.347, both P < 0.05). At 1 and 2 days after surgery, the cumulative amount of anesthetics used for patient-controlled intravenous analgesia was (52.1 ± 1.9) mL and (121.7 ± 4.1) mL respectively, which were less than (63.6 ± 2.4) mL and (146.5 ± 5.3) mL in the control group, respectively ( t = 6.240 and 8.842, both P < 0.05). The score of extubation quality in the observation group was significantly lower than that in the control group [(1.3 ± 0.3) points vs. (3.2 ± 0.5) points, t = 6.664, P < 0.05]. There was statistically significant difference in cortisol content between the two groups at 10 minutes after extubation and at the time points of fetus removal, skin incision and intubation (all P < 0.05). In the observation group, the partial pressure of carbon dioxide in the umbilical cord blood was significantly reduced, the partial pressure of oxygen and the oxygenation index in the umbilical cord blood were significantly increased, and Apgar score at 1 minute after birth was significantly increased (all P < 0.05). Conclusion:Ultrasound-guided transverse abdominal plane block combined with dexmedetomidine can enhance the anesthetic effect on cesarean section, prolong analgesic time, reduce the amount of analgesics, improve the operation effect, reduce maternal stress responses, and improve maternal and infant health.

Objective To investigate the expression of CYP2W1 in gastric cancer and its effect on proliferation and invasion.Methods CYP2W1 protein expression in 326 gastric cancertissues and in the corresponding normal gastric mucosa was measured by immunohistochemstry.The expression of CYP2W1 mRNA in 10 randomly chosen gastric cancer tissues and its corresponding normal gastric mucosa was tested by semi-quantitative RT-PCR.4 groups pairs of gastric cancer and normal gastric mucosa cell lines were constructed.CYP2W1 expression in each of the cell line was tested.The effect of CYP2W1 expression on the proliferation and invasion capacity of the gastric cancer cells was studied by MTT experiment and transwell cell experiment.Results Expression of CYP2W1 protein in the gastric cancer tissues is higher than that in normal gastric mucosa (26.7％ vs.0,x2 =100.396,P ＜ 0.05).CYP2W1 mRNA in the gastric cancer tissues is higher than that in normal gastric mucosa [(0.413 ± 0.026) vs.(0.074 ± 0.005),t =28.115,P ＜ 0.05].CYP2W1 protein expression in the gastric cancer cell lines is higher than that in normal gastric mucosa cell lines [(0.481 ± 0.024) vs.0,t =49.097,P ＜ 0.05].The growth capacity of CYP2W1 positive gastric cancer cell is stronger than that of CYP2W1 negative cells (P ＜ 0.05),and CYP2W1 positive gastric cancer cells are also more of invasiveness,[(63 ±8) vs.(18 ±3),t =24.134,P ＜0.05].Conclusions CYP2W1 is only expressed in the gastric cancer tissues,hence it is closely related to the growth multiplication,and invasiveness of gastric cancer cells.

Objective To compare endoscopic stenting with surgery for pyloric obstruction caused by unresectable gastric cancer.Methods Between June 2002 and June 2012,6 patients underwent endoscopic stenting and 70 did surgery for gastric outlet obstruction caused by gastric cancer.Results There were no significant difference in technical success rate and clinical success rate between the stenting and surgery groups (P ＞ 0.05).The stenting group had shorter time to oral intake,and shorter length of hospital stay [(2.5-± 3.1) d vs.(6.6 ± 3.5) d,t =-7.0,P ＜ 0.001].The incidence of early complications was significantly higher in the surgery group.However,the rates of late complications were significantly lower in the surgery group.Moreover,the surgery group was significantly associated with a longer patency duration [(295.8 d,95％ CI:260.7-330.8) vs.(168.2 d,95％ CI:134.7-201.7 d),P ＜0.001] and overall survival [(307.6 d,95％ CI:272.4-342.8 d) vs.(229.6 d,95％ CI:195.1-264.3 d),P =0.003].Conclusions Both endoscopic stenting and surgery are effective palliative therapy for gastric outlet obstruction caused by gastric cancer.Endoscopic stenting is associated with better shortterm outcomes.Surgery is preferable to ES in longer patency duration.

OBJECTIVETo prepare insulin-loaded polymeric nanoparticles based on polyethyleneimine-polycaprolactone- polyethylene glycol-polycaprolactone-polyethyleneimine pentablock copolymers and evaluate its in vitro release of insulin.

METHODSPolycaprolactone-polyethylene glycol-polycaprolactone (PCL-PEG-PCL) triblock copolymer was synthesized by ring-opening polymerization method, and the pentablock copolymer was prepared by Michael addition reaction. The copolymers obtained were characterized by Fourier-transform infrared (FT-IR) spectroscopy and (1)H-NMR and their critical aggregation concentration (CAC) was measured by fluorescence technique with pyrene as the probe. Insulin-loaded polymeric nanoparticles based on the pentablock copolymers were prepared by solvent evaporation method that exploited the cationic nature of PEI-PCL-PEG-PCL-PEI to allow the formation of ionic complexes with anionic biomolecules such as insulin. The prepared nanoparticles were further characterized by Malvern laser particle sizer and transmittion electron microscopy (TEM). The drug loading, encapsulation efficiency and in vitro release profile of the nanoparticles were analyzed using Bradford method.

RESULTSUsing copolymer PEI10K-PCL4K-PEG2K-PCL4K-PEI10K as the drug carrier, the spherical nanoparticles prepared with an optimal insulin-coplymer mass ratio of 40% allowed the maximum insulin loading of (18.63∓0.07)% and had an average particle size of 175.30∓19.51 nm. The prepared nanoparticles was capable of sustained release of insulin for as long as 48 h in vitro, and the burst release could be minimized by incorporation of PEI in the triblock copolymer.

CONCLUSIONThe insulin-loaded polymeric nanoparticles based on the pentablock copolymers allow sustained release of insulin in vitro, and PEI can enhance sustained drug release and reduce burst drug release.

Delayed-Action Preparations ; Drug Carriers ; chemistry ; Drug Liberation ; Insulin ; pharmacokinetics ; Nanoparticles ; chemistry ; Particle Size ; Polyesters ; chemistry ; Polyethylene Glycols ; chemistry ; Polymers ; chemistry ; Spectroscopy, Fourier Transform Infrared

Objective To summarize the surgery nursing cooperation points of liver procurement of brain death contributions (DBD) donor in the uninterrupted blood flow way . Methods Complete the following preoperativepreparation such as personnel,brain death donation donor,environment ,surgical content,multiple organ repair system and other related equipments;intraoperative preparation includes surgical instruments and related equipments ,assisting intubation of arteria lienalis ,portal vein and the choledochus and the organ procurement . Result About 3 cases of donor liver procurement were successfully implemented in the interrupt blood flow way, operation time was 3~4 h,bleeding was 200~400 mL,an average of 300 mL. Conclusions Uninterrupted flow liver transplantation can protect liver function to the greatest extent , thus greatly avoids the common complication of organ transplantation.The tacit understanding surgery cooperation improves the rate of surgery successfully.

Objective: To explore the consumption of sugar sweetened beverages (SSBs) and its association with behavioral problems in Chinese preschool children, and to provide a scientific basis for the prevention of behavioral problems of children. Methods: A total of 7 634 children aged 3-6 years were chosen from kindergartens in 3 cities (Yangzhou, Xuzhou, Zhenjiang) in the lower reaches of Yangtze River using method of cluster sampling during October to November in 2017. Parental or guardian questionnaires were used to obtain information regarding child consumption of SSBs. The Strengths and Difficulties Questionnaire (SDQ) was used to assess children s emotional and behavioral problems. Multivariate Logistic regression model was used to explore the association between different SSBs intake frequency and children s behavioral problems. Results: A total of 5 509(72.2%) consumed SSBs less than once a day, 830(10.9%) reported SSBs consumption once a day, and 1 295(16.9%) had 2 times or more intake of sugar sweetened beverages per day. After adjusting for confounding factors including age, sex, BMI, family financial status, parental education, screen time, sleep duration, and physical activities duration, multiple Logistic regression model revealed that intake of SSBs once a day was associated with an increased risk of hyperactivity disorder ( OR =1.26, 95% CI =1.01-1.57) and SDQ total difficulties ( OR =1.44, 95% CI =1.14-1.82) in boys and with an increased risk of emotional symptoms ( OR=1.34, 95%CI =1.02-1.76), conduct problems ( OR=1.53, 95%CI =1.18-2.00), hyperactivity disorder ( OR=1.79, 95%CI =1.42-2.27) and prosocial behavior ( OR=1.48, 95%CI =1.14-1.91) in girls. Intake of SSBs≥2 times per day was associated with an increased risk of emotional symptoms ( OR=1.28, 95%CI =1.02-1.59) and SDQ difficulties ( OR=1.30, 95%CI =1.07-1.58) in boys and not with behavioral problems in girls. Conclusion Sex differences are observed with respect to the association between SSBs intake and behavioral problems in preschoolers, but no significant dose response relationship was observed. More longitudinal studies are needed to further explore the association between SSBs intake and behavioral problems in preschool children as well as the underlying physiological mechanisms in future.

Objective To study the effect of remote limb isehemic postconditioning (RLIPC) on posterior circulation ischemia vertigo (PCIV). Methods Seventy patients with PCIV, admitted to our hospital from January 2013 and June 2014, were randomly divided into control group and therapy group (n=35). The patients of control group were treated with routine medicine, and those of therapy group were treated with RLIPC and routine medicine. Before and after treatment, dizziness assessment rating scale (DARS) and dizziness handicap inventory (DHI) scale were used to evaluate the changes of manifestations; peak systolic velocity (PSV) and end diastolic velocity (EDV) of vertebra artery (VA) were evaluated by colour doppler ultrasound. Results Before treatment, no significant differences on DARS and DHI scores were noted between the two groups (P>0.05); after treatment, , the DARS and DHI scores in the therapy group were 26.03±4.24 and 60.91±10.15, respectively, which were significantly decreased as compared with those in the control group (28.80±5.16 and 68.11±12.44, t=2.388 and 2.584, P=0.000); PSV and EDV of VA in the therapy group were 49.97±7.69 and 16.90±2.80, respectively, which were significantly increased as compared with those in the control group (47.31±7.47 and 15.12± 2.74, t=-2.505 and-2.631, P=0.015 and 0.011). Conclusions RLIPC could alleviate the symptoms of PCIV, which might be related to increased blood flow of VA. RLIPC is simple and safe, and can be used in the treatment of PCIV.