Adult ; Female ; Humans ; Male ; Middle Aged ; Posterior Cruciate Ligament ; injuries ; surgery ; Tibial Fractures ; surgery ; Young Adult

OBJECTIVETo investigate the feasibility, safety and oncological effect of totally laparoscopic total gastrectomy (TLTG).

METHODSThe clinical data of TLTG cases and open total gastrectomy (OTG) patients between November 2007 and October 2011 were analyzed. Also compared the feasibility, safety and short-term outcomes of TLTG with OTG.

RESULTSNinty cases were analyzed. There were 18 cases in the TLTG group and 72 cases in the OTG group. Operation time was significantly longer in the TLTG group ((310 ± 86) minutes) than in the OTG group ((256 ± 57) min, t = 4.963, P = 0.002), However, the blood loss were significantly lower in the TLTG group ((136 ± 84) ml vs. (359 ± 141) ml, t = -11.734, P = 0.000). The post operative morbidity was similar between the TLTG and OTG group. First flatus time (t = -7.020), first diet time (t = -6.166 and -5.698), and post operative hospital stay (t = -4.610) were significantly shorter in the TLTG group than in the OTG group (P < 0.05).

CONCLUSIONSLTG is a safe and feasible procedure with quick post-operation recovery. The laparoscopic side-to-side esophagojejunal anastomosis is a safe and feasible method of alimentary reconstruction after laparoscopic total gastrectomy.

Adult ; Aged ; Female ; Gastrectomy ; methods ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Lymph Node Excision ; Male ; Middle Aged ; Stomach Neoplasms ; surgery ; Treatment Outcome

OBJECTIVETo explore the surgical technique and clinical value of treatment for posttraumatic large circular soft tissue defect in the lower extremities using a combination of posterior tibial vascular bridge flap in the unaffected leg and skin graft covered by vacuum sealing drainage (VSD).

METHODSFrom January 2008 to June 2010, 11 cases with posttraumatic large circular soft tissue defects with deep tissue exposed or partial necrosis in the lower extremities were treated by bridge flaps and combined with free skin graft covered by VSD. There are 7 males and 4 females, with an average age of 32.5 years (range from 15 to 52 years). The size of wound varied from 24 cm × 13 cm to 45 cm × 24 cm. After the wound were completely debrided, the external fixation or internal fixation was conducted for the patients with unstable fracture. Then VSD were used to covered the wound for 1-2 times with a period of 5 to 7 days according to the wound condition. After granulation tissue grew, bridge flap transplantation was performed to repair tissue defect and cover the exposed bone, which combined with skin graft covered by VSD was used to cover the residual wound. Survival rate and quality healing of the flaps were followed up postoperatively.

RESULTSThe granulation growth of 11 cases with large circular soft tissue defect in the lower extremities associated tissue exposure was good after the application of VSD. All the cases were covered by free flap transplantation and skin grafting except for 6 cases due to large defect. The wound was covered by skin re-grafting in 4 cases and frequently dressing change in 2 cases. All the flaps were successful with good infection control and no sinus. The average period of follow-up was 10.6 months (5 - 24 months). All the patients were satisfied with the good outline and good function of the affected limb.

CONCLUSIONPatients with posttraumatic large circular soft tissue defect in the lower extremities can be effectively treated with a combination of bridge flaps and free skin graft covered by VSD, which can shorten the course of treatment, and restore the function of affected extremities as much as possible.

Adolescent ; Adult ; Female ; Humans ; Lower Extremity ; injuries ; Male ; Middle Aged ; Negative-Pressure Wound Therapy ; Skin Transplantation ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; Treatment Outcome ; Young Adult

Objective To sequence and analyze the VP1 region of isolated enterovirus from different sources in Beijing,2006-2008.Methods 9 EV71 were selected from the isolates identified through the specimen of human hand foot mouth disease (HFMD),acute flaccid paralysis (AFP) and healthy children in Beijing,2006-2008.Reverse transcription-polymerase chain reaction (RT-PCR) method was used to amplify and sequence the whole VP1 gene of enterovirus.Phylogenetic tree was constructed,with the means of nucleotide homology and distance between/within groups analyzed.Results The 9 selected strains were clustered with C4 subgenotype reference strains in Phylogenetic tree and showed high nucleotide acid identity (92.1%-93.9% ) in nucleotide homology analysis,and had higher homology than C1,C2,C3 subgenotype reference strains (88.8%-89.5%,89.4%-90.0% and 88.4%-89.3%,respectively).High homologous (95.9%-100.0%) was noticed between the isolated stains from three different sources,but low homologous (93.3 %-93.9%,92.1%-92.9%,respectively) showed between the isolated stains and C4 reference strains isolated in 1998.There appeared larger variations between groups in C4 subgenotype when analyzing the distance between groups means,especially between the reference strains and isolated strains (D=0.052-0.071).Conclusion The EV71 isolated in Beijing,from 2006 to 2008 also appeared to be C4 subgenotype and there was no significant difference found in the whole sequence ofVP1 gene of the strains isolated from different regions,sources,or under different diseases occurred in the same period.There were more nucleotide variations and more chances for the presence of new subgenotype,suggesting that it is necessary to strengthen the surveillance program on EV71 isolates.

Objective To identify the etiology of 8 human hand-foot-mouth disease(HFMD)outbreaks in Beijing,during May to July 2007.Methods Reverse transcription-polymerase chain reaction(RT-PCR) method was used to directly type the specimens including fluid from the herpes and throat swabs from the HFMD patients.Using RD cell lines,the collected stool specimens were cultured followed by typing.Partial VP1 region of selected EV positive specimens and cultures were sequenced and both nucleic acid sequence and predicted amino acid sequence were analyzed.Results The two HFMD outhreaks in Daxing region in Beijing in 2007 were caused by enterovirus 71 type(EV71),and the others were caused by Coxsackie virus A16(Cox A16).Two EV71 strains caused epidemics in Daxing region in 2007 belonged to C4 subgenotype but on different branches in VP1 gene phylogenefic tree.The differences on nucleic acid sequence and amino acid sequence were 3.7% and 0.8% between the two EV71 stains.respectively.The Cox A16 strain in Shunyi region and the other strains were on different branches in phylogenetic tree,and the difference on nucleic acid and amino acid sequence were 3.7% and 0% respectively between the two Cox A16 shams.Conclusion The HFMD outbreaks occurred in Beijing in 2007 were caused mainly by EV71 and Cox A16, and there were two individual epidemic virus strains.Cox A16 seemed to spread more widely than EV71 in Beiiing,2007.

Objective To study balance function and surface electromyography (sEMG) activity of erector spinae (ES) and rectus ab-dominis(RA)in stroke patients.Methods From April,2015 to December,2016,17 stroke patients(test group)and 13 healthy subjects(con-trol group)were tested with balance platform:sitting with eyes open/close,with the platform swing of 10°,with trunk flexion and extension in maximum.The root mean square(RMS)of sEMG was recorded on both sides of ES and RA synchronously.The swing length and area of center of mass,the center of pressure on X and Y axes were also recorded as sitting with eyes open/close.Results For the test group,RMS of bilateral ES was significantly different as sitting with eyes open/close and with trunk flexion and extension in maximum (t>2.173, P<0.05).Compared with the control group,RMS of ES and RA in unaffected side increased as sitting with eyes open/close(t>2.175,P<0.05), as well as the swing length and area of center of mass(t>2.760,P<0.05).Conclusion The strength imbalance is found in ES in stroke pa-tients,which may associate with the balance function impairment,and need to be improved in rehabilitation.

Objective To explore the Fast Testing Sstrategy (FTS) for wild poliovirus Ⅰ (WP1).Methods Epidemiological investigations were carried out on 671 students from WP1 epidemic areas in China.A set of real time RT-PCR assays,including panenterovirus testings (PE) assay,poliovirus serotypings(PS) assay and the assay distinguishing wild strain from vaccine strain of poliovirus Ⅰ (DWV) were introduced into the screening program for WPV1 to replace the conventional RT-PCR,recommended by the China National Polio Laboratory (GNPL).Additionally,sensitivities of all the assays were assessed by poliovirus type Ⅰ to Ⅲ (Sabin stain) and the isolated WPV I.Results ( 1 ) 33 non-poliovirus enterovirus (NPEV) cases were detected,with 16 polio vaccinerelated cases including 5 polio Ⅰ,1 polio Ⅱ,3 polio Ⅲ,1 polio Ⅰ +Ⅱ,4 polio Ⅰ + Ⅲ and 2 polio Ⅰ + Ⅱ + Ⅲ.Three WPV 1 cases were also detected in this study and confirmed by GNPL.(2) For polio virus vaccine strain,sensitivities of the set of real time RT-PCR assays ranged from 1 to 100 times than that of the in-housc RT-PCR assay.The sensitivities of PE and PS assays for the detection of polio Ⅱ were 100 times than that of the RT-PCR assay and the sensitivity of DWV assay used for the detection of polio Ⅰ were 10 times than that of the RT-PCR assay.For WPV1,the sensitivity of three real time RT-PCR was 10 times higher than that of the RT-PCR assay.Conclusion The novel FTS for WPV I suggested by this study would include PE,PS and DWV.It not only could greatly shorten the testing time but also more sensitive than the RT-PCR and suited for emergency detection for WPV1.

OBJECTIVETo explore a new method for finding more HIV/AIDS.

METHODSIn September 2009, newly reported HIV-infected individuals from May to August, 2009 in Dehong prefecture were asked to participate in a survey which requested demographic characteristics, history of high-risk behaviors and contact information of individuals with whom they had high risky contacts. People with risky contacts with HIV-infected cases (index cases) were also approached to participate in this survey and HIV testing was provided.

RESULTSA total of 342 HIV-infected individuals were newly reported and served as index cases from May to August, 2009. Among them, 47.1% (161/342) were transmitted by regular sexual partners. Through three-round surveys, 218 contacts were traced and among them, 84.9% (185/218) were traced by regular heterosexual partners. HIV positive rate of the tested was 34.7% (60/173) in the first-round tracing and 12.5% (1/8) in the second one. Among the 560 individuals (index cases and their high-risk contacts), the proportions of having regular heterosexual partners, non-regular and non-commercial sexual partners, commercial sexual heterosexual partners and men having sex men were 87.9% (492/560), 18.9% (106/560), 22.3% (125/560) and 0.3% (1/318), respectively, while the proportion of having never used condoms when having sex with the above four types sexual partners were 73.8% (363/492), 72.6% (77/106), 63.2% (79/125) and 0.0% (0/1), respectively.

CONCLUSIONAs an epidemiological method for HIV/AIDS finding, contact tracing identified a large number of HIV infectors who were traced by newly reported HIV-infected individuals.

Acquired Immunodeficiency Syndrome ; epidemiology ; Adolescent ; Adult ; Child ; Child, Preschool ; China ; epidemiology ; Contact Tracing ; methods ; Female ; HIV Infections ; epidemiology ; Humans ; Infant ; Infant, Newborn ; Male ; Risk Factors ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo evaluate the combination chemotherapy regimen with floxuridine, dactinomycin, etoposide, and vincristine (FAEV) as primary treatment for gestational trophoblastic neoplasia (GTN).

METHODSClinical data and outcome of the patients with GTN from 1 January 2004 to 31 December 2009 were retrospectively reviewed. Totally 38 eligible patients had received at least one cycle of FAEV chemotherapy as primary treatment. The primary end points were response rate and toxicity of FAEV regimen.

RESULTSTotally 38 patients and 205 cycles of FAEV chemotherapy were included. Twenty-eight of these patients (73.6%) achieved serologic complete remission (SCR). Regimens were changed in 10 patients because of 5 with no response and 5 with intolerable toxicity. The most serious adverse events were greater than or equal to grade 3 neutropenia (31.6%), febrile neutropenia (7.9%), and greater than or equal to grade 3 thrombocytopenia (5.3%). During the follow-up, none relapsed.

CONCLUSIONFAEV is an effective regimen with manageable toxicity for patients with GTN as primary treatment, especially for patients with non-metastatic low or high risk GTN.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Dactinomycin ; administration & dosage ; Etoposide ; administration & dosage ; Female ; Floxuridine ; administration & dosage ; Gestational Trophoblastic Disease ; drug therapy ; Humans ; Middle Aged ; Pregnancy ; Retrospective Studies ; Treatment Outcome ; Vincristine ; administration & dosage ; Young Adult

OBJECTIVETo investigate the efficacy, safety and the life quality improvement of uroacitides injection in the treatment for patients with advanced malignant tumors.

METHODSA total of 160 patients with advanced stage cancers were enrolled into this multicenter, open and non-randomized phase II clinical trial, including cancers of the lung (33 cases), liver (45 cases), breast (17 cases), esophagus (11 cases), stomach (18 cases), colon (19 cases), pancreas (3 cases) and kidney (4 cases), and glioma (10 cases). Uroacitides was administrated in a dose of 300 ml daily via the superior vena cava catheter for consecutive 4-8 weeks.

RESULTSOf the 160 patients, 21 dropped out and one patient died during the trial. Efficacy could be evaluated in 138 patients and safety in 160. The total objective response rate (ORR, CR + PR)) and tumor control rate (CR + PR + MR + SD) of the 138 evaluable patients were 5.8% and 65.2%, respectively. Clinical benefit response (CBR) rate was 57.2%. Major adverse effects were grade I - II and reversible nausea/vomiting (21.9%) and pain (6.3%).

CONCLUSIONUroacitides injection is effective in the control for various kinds of advanced cancers with mild, reversible and tolerable adverse effects, and can also improve the patient's quality of life. It is worth being studied further.

Breast Neoplasms ; blood ; drug therapy ; pathology ; CA-19-9 Antigen ; blood ; Carcinoembryonic Antigen ; blood ; Carcinoma, Non-Small-Cell Lung ; blood ; drug therapy ; pathology ; Catheterization, Central Venous ; Colorectal Neoplasms ; blood ; drug therapy ; pathology ; Humans ; Liver Neoplasms ; blood ; drug therapy ; pathology ; Lung Neoplasms ; blood ; drug therapy ; pathology ; Methyltransferases ; administration & dosage ; adverse effects ; antagonists & inhibitors ; therapeutic use ; Nausea ; chemically induced ; Neoplasm Staging ; Peptides ; administration & dosage ; adverse effects ; therapeutic use ; Phenylacetates ; administration & dosage ; adverse effects ; therapeutic use ; Quality of Life ; Remission Induction ; Salvage Therapy ; Treatment Outcome ; Vomiting ; chemically induced ; alpha-Fetoproteins ; metabolism