OBJECTIVETo investigate the optimal reconstruction technique after total gastrectomy.

METHODSA total of 159 patients with gastric cancer undergoing total gastrectomy in Tianjin Cancer Hospital between January 2005 and December 2007 were divided into 4 groups according to the reconstruction technique: group A(functional jejunal interposition with a pouch, n=46), group B(modified Braun type II(, n=38), group C (P pouch with Roux-en-Y esophagojejunostomy, n=25), group D(Roux-en-Y esophagojejunostomy, n=50). Quality of life(QOL), nutritional status 1 year after surgery, and perioperative complications were analyzed.

RESULTSThere were no significant differences in perioperative complications(P>0.05). One year after operation, QOL(Visick index) was better in group A than that in group B, C and D(P<0.05), and group D was inferior to group A, B and C(P<0.05). The increase in food intake, weight gain, hemoglobin and total protein were better in group A than those in group B, C and D(P<0.05) and group D was inferior to group A, B and C(P<0.05). The prognostic nutrition index ratio of the four groups were 1.21±0.15, 1.14±0.97, 1.15±0.16, and 1.10±0.16, respectively. Group A was better than that in group B, C and D (P<0.05) and group D was inferior to group A, B and C(P<0.05). The incidences of dumping syndrome, reflux esophagitis, Roux-en-Y stasis syndrome in group A were 4.3%(2/46), 2.2%(1/46) and 2.2%(1/46), respectively, which were significantly lower than those in other groups (P<0.05).

CONCLUSIONSFunctional jejunal interposition with a pouch is associated with improved nutritional condition and quality of life, and less perioperative complications. It is a reasonable reconstruction method after total gastrectomy.

Adult ; Aged ; Anastomosis, Roux-en-Y ; methods ; Anastomosis, Surgical ; methods ; Esophagus ; surgery ; Female ; Follow-Up Studies ; Gastrectomy ; methods ; Humans ; Jejunum ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Stomach Neoplasms ; surgery ; Treatment Outcome

BACKGROUNDDespite recent reports on the molecular epidemiology of cryptococcal infections in China, clinical isolates have been mostly reported from human immunodeficiency virus (HIV)-negative patients, and environmental isolates from China have rarely been included. The aim of this study was to investigate the ecological profile of Cryptococcus (C.) neoformans and C. gattii in China.

METHODSA survey was performed in 10 cities from 20°N (North latitude) to 50°N and in a Eucalyptus (E.) camaldulensis forestry farm at the Guixi forestry center, China.

RESULTSSix hundred and twenty samples of pigeon droppings from 10 cities and 819 E. camaldulensis tree samples were collected and inoculated on caffeic acid cornmeal agar (CACA). The brown-colored colonies were recultured to observe their morphology, growth on canavanine-glycine-bromothymol-blue (CGB) medium, phenol oxidase and urease activities, serotype and mating type. There were obvious differences in the positive sample rates of C. neoformans in pigeon droppings collected from the different cities, ranging from 50% in the cities located at latitudes from 30°N - 40°N, 29% at 20°N - 30°N and 13% at 40°N - 50°N.

CONCLUSIONSThere were no differences in positive bevy rates (approximately 80%) among the three grouped cities. Mycological tests of 101 isolates purified from pigeon droppings revealed that they were C. neoformans var. grubii. We also observed variable capsular size around the C. neoformans cells in colonies with variable melanin production and the bio-adhesion of the natural C. neoformans cells with other microorganisms. One urease-negative C. neoformans isolate was isolated from pigeon droppings in Jinan city. No C. gattii was isolated in this study.

Animals ; China ; Columbidae ; microbiology ; Cryptococcosis ; microbiology ; Cryptococcus ; isolation & purification ; Cryptococcus gattii ; isolation & purification ; Cryptococcus neoformans ; isolation & purification ; Eucalyptus ; microbiology ; Feces ; microbiology

OBJECTIVETo compare the correlation of prognosis with UICC or JGCA lymph node staging criteria for gastric cancer and evaluate the value of application of those two TNM staging systems in prognosis prediction.

METHODSFrom January 1996 to December 2005, 395 gastric cancer patients who underwent D2 or D2 plus radical gastrectomy with > or = 15 lymph nodes removed were enrolled into this study. The data were analyzed by both UICC and JGCA lymph node staging criteria, respectively. Kaplan-Meier method was applied to analyze the survival rates, and Log-rank test was performed to assess the statistical significance among groups.

RESULTSCompared with the survival curve based on JGCA lymph node staging criteria, UICC lymph node staging system showed a much more significant difference among N subgroups, and similar result was also found in the patients with T3 disease. The N subgroups stratified by UICC criteria were re-staged with JGCA, while the N subgroups by JGCA criteria with UICC. Though the difference among subgroups were not statistically significant in either group, it was greater based on UICC criteria than that based on JGCA. No significant difference was found in the 5-year survival rates of stage I , II, III and IV based on either UICC or JGCA TNM staging criteria.

CONCLUSIONOur results show that UICC staging system is more predictive and relevant to prognosis than JGCA staging system for gastric cancer, and D2 or D2 plus radical gastrectomy with at least or more than 15 lymph nodes removed is required when UICC-TNM gastric cancer staging criteria is applied.

Adenocarcinoma ; pathology ; surgery ; Adenocarcinoma, Mucinous ; pathology ; surgery ; Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Gastrectomy ; methods ; Humans ; International Agencies ; Lymph Node Excision ; Lymph Nodes ; pathology ; surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; methods ; Prognosis ; Stomach Neoplasms ; pathology ; surgery ; Survival Rate

OBJECTIVETo analyze the clinical and pathologic influencing factors of early recurrence in patents with gastric cancer after radical gastrectomy.

METHODSClinicopathological data of 141 patients with recurrence after curative gastrectomy for gastric cancer from January 2001 to December 2004 were analyzed retrospectively. Risk factors correlated with tumor early recurrence and survival difference between early recurrence group (< 1 year, 82 cases) and control group (1 year after, 59 cases) were assessed.

RESULTSThe 1- and 3-year survival rates of in early recurrence group and control group were 36.6%, 2.4% and 100%, 45.8%, respectively (P < 0.05). The median survival time after recurrence in the two groups was 3, 5 months, respectively (P < 0.05). Univariate analysis showed that the age, tumor Borrmann type, tumor site, invasive depth, lymph node metastasis, pTNM stage, metastatic lymph node ratio, surgical procedure and intraperitoneal hyperthermic perfusion chemotherapy (IHPC) were significant factors associated with early recurrence after curative gastrectomy for gastric cancer (P < 0.05). Lymph node metastasis, metastatic lymph node ratio and IHPC were independent factors associate with early recurrence after curative gastrectomy on multivariate analysis (P < 0.05).

CONCLUSIONSThe patients with early recurrence after the radical gastrectomy have a poorer survival compared with cases recur later. Lymph node metastasis, metastatic lymph node ratio and IHPC are independent factors associate with early recurrence after curative gastrectomy for gastric cancer.

Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Kaplan-Meier Estimate ; Logistic Models ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; etiology ; pathology ; Postoperative Period ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms ; pathology ; surgery

OBJECTIVETo compare post-operative long-term complications and quality of life of two digestive reconstruction procedures after total gastrectomy.

METHODSA total of 109 gastric cancer patients in Tianjin Medical University Cancer Hospital from March 2012 to February 2013 were prospectively enrolled and randomly divided into functional jejunal interposition (FJI) group (52 cases) and Roux-en-Y (R-Y) group (57 cases). The post-operative complications, nutritional status, and the quality of life were compared between two groups.

RESULTSOne, 3 and 6 months after operation, the incidence of R-S syndrome in FJI group was lower as compared to R-Y group[13% (6/45) vs. 37% (18/49), 3% (1/30) vs. 42% (14/33), 5% (1/21) vs. 48% (11/23), all P<0.01], while 3 months after operation, the incidence of reflux and heartburn in FJI group was higher[53% (16/30) vs. 21% (7/33), P<0.01; 37% (11/30) vs. 12% (4/33), P<0.05]. There were no significant differences in quality of life questionnaire QLQ-C30 between R-Y and FJI groups. QLQ-STO22 stomach module revealed in FJI group, the eating score was better, but reflux score was worse as compared to R-Y group 3 months after operation (all P<0.01).

CONCLUSIONSFunctional jejunal interposition keeps intestinal continuity preserving and food duodenal passing, which is a reasonable digestive reconstruction procedure.

Anastomosis, Roux-en-Y ; Female ; Gastrectomy ; Humans ; Male ; Middle Aged ; Prospective Studies ; Quality of Life ; Reconstructive Surgical Procedures

Objective To evaluate the effectiveness of a whole-process health education model among inpatients with ascites type of advanced schistosomiasis. Methods A “admission-hospitalization-discharge” whole-process health education model was created, 101 inpatients with ascites type of advanced schistosomiasis were given the whole-process health education. The scores of schistosomiasis control knowledge, attitudes towards schistosomiasis control and healthy behaviors, and awareness of schistosomiasis control knowledge, correct rate of attitudes towards schistosomiasis control and correct rate of healthy behaviors were compared among inpatients with ascites type of advanced schistosomiasis before and after implementation of the whole-process health education. Results The scores of schistosomiasis control knowledge, schistosomiasis control attitudes and healthy behaviors were all significantly higher among inpatients with ascites type of advanced schistosomiasis after implementation of the whole-process health education than before implementation (Z = −7.688, −3.576 and −4.328, all P values < 0.01). In addition, the awareness of schistosomiasis control knowledge increased from 54.3% to 82.7% (χ² = 188.886, P < 0.01), and the correct rate of attitudes towards schistosomiasis control increased from 88.4% to 98.0% (χ² = 22.001, P < 0.01), while the correct rate of healthy behaviors increased from 48.2% to 59.7% (χ² = 11.767, P < 0.01). Conclusions The whole-process health education model may remarkably improve the awareness of schistosomiasis control knowledge and promote the formation of positive attitudes towards schistosomiasis control and correct behaviors among inpatients with ascites type of advanced schistosomiasis, which is of great significance to facilitate patients’ cure.