Cardia ; Gastric Fundus ; Humans ; Stomach Neoplasms ; surgery

BACKGROUNDHereditary nonpolyposis colorectal cancer (HNPPC) is one of the most common genetic syndrome related with mutation of human mismatch repair genes. This study was to evaluate the clinical significance of suspected hereditary nonpolyposis colorectal cancer (sHNPCC) criteria I and the clinical and genetic features of International Collaborative Group-HNPCC (ICG-HNPCC) and sHNPCC families.

METHODSTwenty-nine ICG-HNPCC families fulfilling the Amsterdam criteria and 34 sHNPCC families fulfilling the sHNPCC criteria I were collected. PCR-SSCP and DNA sequencing analysis were employed to screen the germline mutations of the hMLH1 and hMSH2 genes in these families.

RESULTSThe ICG group had more colorectal cancer (CRC) patients per family than did the suspected group (P < 0.05). No statistical difference was observed in Lynch classification and familial tumor spectrum. In both groups of families, colorectal cancer was the most frequent malignancy, and carcinomas of the stomach, pancreas and uterus were the three most common extracolonic malignancies. Mutation screening showed that ICG-HNPCC and sHNPCC families had a similar mutation rate (31.0% vs 29.4%, P > 0.05), mutation type, and mutation distribution. Comparison of the families with and without mutation showed no significant difference in CRC patients per family, Lynch classification, and tumor spectrum.

CONCLUSIONSICG-HNPCC and sHNPCC families that have similar clinical manifestations and genetic basis indicate a similar nature for cancer development. The application of sHNPCC criteria I will facilitate clinical diagnosis and treatment of small families.

Adaptor Proteins, Signal Transducing ; Carrier Proteins ; Colorectal Neoplasms, Hereditary Nonpolyposis ; genetics ; DNA-Binding Proteins ; genetics ; Humans ; MutL Protein Homolog 1 ; MutS Homolog 2 Protein ; Mutation ; Neoplasm Proteins ; genetics ; Nuclear Proteins ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Proto-Oncogene Proteins ; genetics

Cold Temperature ; adverse effects ; Cold-Shock Response ; Humans ; Myocardial Infarction ; etiology ; physiopathology

Objective To explore the therapeutic effect and medication safety of low-dose erythromycin treatment on intractable allergic rhinitis(AR) associated with bronchus asthma.Methods Totally 173 cases of children received outpatient treatment because of AR associated with asthma,their ages ranging from 3 to 14 years.Among them,78 cases developed intractable AR with symptoms of asthma having been controlled or satisfactorily controlled after 2 courses of conventional treatment.Seventy-six children with intractable AR received full follow-up and were randomly divided into observation group and control group.The control group was given different second-generation antihistamines,when necessary,supplemented by nasal glucocorticoids.In the observation group,the same treatment as it was done in control group was continued,plus oral treatment with erythromycin enteric-coated capsules(10 mg?kg-1?d-1,which were taken 3 times a day for 1 month) to the observation group.Both observation group and control group were in accordance with the norms of the treatment of asthma.Results The improvement rate,inefficiency and the total efficiency were different between observation group and control group,and the diffe-rence was statistically significant(?2=12.629,8.412,8.412,Pa0.05).Their liver function was also monitored and was found normal before treatment and after the replacement of drugs for 1 month,including alanine ami-notransferase,aspartate aminotransferase,albumin,globulin,and were found normal.Conclusions On the basis of conventional treatment,low-dose erythromycin treatment of intractable AR is effective and safe.However,the treatment must be limited to the refractory cases,and the appropriate indications must be strictly observed.

Objective To investigate the changing pattern of antimicrobial resistance among gram-negative bacilli isolated from respiratory intensive care unit (RICU) for rational use of antimicrobial agents.Methods Antimicrobial susceptibility of 1 047 isolates of gram-negative bacilli from 2000 to 2004 was tested by disk diffusion method.WHONET 5.3 software was used to analyze the data.Results The most common pathogens were Pseudomonas aeruginosa (42.9%),Stenotrophomonas malto- philia (17.1%),Acinetobacter baurnannii (10.0%) and Klebsiella pneumoniae (6.5%).The susceptibility rate of P.aerug- inosa was relatively higher to ceftazidime (50%-74%),amikacin (33.3%-81.0%),piperacillin-tazobactam (30.4%-64.6%) and cefoperazone-sulbactam (33.5%-47.5%),while the susceptibility to imipenem decreased.The susceptibility rate of S. maltophilia was relatively higher to cefoperazone-sulbactam (47.2%-78.6%) and ticarcillin-clavulanic acid(28.3%-86.6%). More than 90% of Acinetobacter baumannii isolates were susceptible to imipenem.The susceptibility rates of K.pneumoniae to imipenem and cefepime were 92.9%-100% and 55.6%-80.0%,respectively.The susceptibility rate to piperacillin-tazobac- tam decreased from 58.3% to 21.7%.The prevalence of extended-spectrum?-lactamases (ESBLs) in K.pneumoniae increased from 11.1% in 2002 to 47.8% in 2004.Conclusions Most pathogens show significant resistance to the most commonly used an- tibiotics.It is very important to select antibiotics for the treatment of infections in ICU based on the results of susceptibility.

Diabetes surgery is a new concept in recent years, which means controlling blood sugar or curing diabetes through some surgical methods. From the commencement of bariatric surgery in the 1950s to the discovery of the special function of decreasing blood sugar after these surgeries in 1970s, and then the fast developing of diabetes surgery in the past 30 years, now there seems be a different answer to the question that if we can cure diabetes. In this article, we review the historical evolution, surgical procedure, potential mechanism and outlook of diabetes surgery.
Bariatric Surgery ; methods ; Diabetes Mellitus, Type 2 ; surgery ; Humans

OBJECTIVETo study genetic damage of mice caused by the volatile organic compounds (VOC) of decoration materials.

METHODSFifty-five hotel guest rooms newly decorated within 6 months and 18 hotel guest rooms not decorated within 3 years were selected to determine the concentrations of 6 main VOC (benzene, methylbenzene, dimethylbenzene, ethyl acetate, butyl acetate, formaldehyde) in the air. Mice were exposed to VOC with the concentrations of 5, 10, 20, 40 times respectively as high as those present in the newly decorated rooms in an exposure cabinet for 15 days. DNA damage of peripheral lymphocytes of the mice was determined by single cell gel electrophoresis (SCGE) and bone marrow micronucleus test.

RESULTSThe concentrations of benzene, methylbenzene, dimethylbenzene, ethyl acetate, butyl acetate and formaldehyde in the rooms newly decorated within 6 months (6.50, 3.00, 6.70, 41.33, 1.70 and 0.14 mg/m(3) respectively) were significantly higher than those in rooms not decorated within 3 years (0.08, 0.94, 1.38, 0.25, 0.25, 0.01 mg/m(3), P < 0.01). DNA damage rates of peripheral lymphocytes in the concentrations of 10, 20, 40 times of exposure groups were significantly higher than those in the control groups (P < 0.05 or P < 0.01), and the frequencies of micronucleus in the mice exposed to 40 times of concentration was significantly higher than that in control group.

CONCLUSIONHigh concentrations of the volatile organic chemical compounds may cause genetic damage in mice. SCGE test is more sensitive than micronucleus test.

Air Pollutants ; toxicity ; Air Pollution, Indoor ; adverse effects ; Animals ; DNA Damage ; drug effects ; Mice ; Micronucleus Tests ; No-Observed-Adverse-Effect Level ; Organic Chemicals ; toxicity ; Paint ; adverse effects

BACKGROUNDRecent studies have revealed that the reason for the low surgical resection rate of pancreatic carcinoma partly lies in its biological behavior, which is characterized by neural infiltration. This study aimed to investigate the clinical significance of radical pancreatoduodenectomy combined with retroperitoneal nerve, lymph, and soft-tissue dissection for carcinoma of the pancreatic head.

METHODSForty-six patients with pancreatic head cancer were treated in our hospital from 1995 to 2005. The patients were divided into two groups: radical pancreatoduodenectomy combined with retroperitoneal nerve, lymph and soft-tissue dissection (group A, n = 25) and routine Whipple's operation (group B, n = 21). There were no significant differences between the two groups in relation to age, gender and preoperative risk factors, and perioperative conditions, pathological data and survival rates were studied.

RESULTSThere were no significant differences in tumor size, surgical procedure time, postoperative complications, and time of hospitalization. However, the number and positive rate of resected lymph nodes in group A were significantly higher than those in group B (P < 0.05). The 1- and 3-year survival rate in group A were 80% and 53%, respectively, which was higher than those in group B (P < 0.05). There were significant differences in the survival rates between patients with and without nerve infiltration in group A (P < 0.05).

CONCLUSIONSRadical pancreatoduodenectomy combined with retroperitoneal nerve, lymph and soft-tissue dissection, can effectively remove the lymph and nerve tissues that were infiltrated by tumor. Meanwhile, this method can reduce the local recurrence rate so as to improve the long-term survival of patients.

Cause of Death ; Humans ; Lymph Node Excision ; Pancreatic Neoplasms ; pathology ; surgery ; Pancreaticoduodenectomy ; adverse effects ; methods ; mortality ; Retroperitoneal Space ; innervation ; pathology ; surgery ; Survival Rate

OBJECTIVETo investigate the efficacy of uncutted Roux-en-Y esophagojejunostomy with jejunal pouch (URYJP) after total gastrectomy.

METHODSTotal gastrectomy was performed on 168 patients of gastric cancer, and 3 methods were used for reconstruction: the uncutted Roux-en-Y esophagojejunostomy with a jejunal pouch was performed on 69 patients(group A),Roux-en-Y esophagojejunostomy with the P-type jejunal pouch on 50 patients(group B),and Roux-en-Y esophagojejunostomy with the Orr-type jejunal pouch on 49 patients (group C). The alimentary tract reconstruction time, morbidity and mortality were compared. The 121 cases that survived for more than 1 year were analyzed for quality of life(QOL),including body weight, intake quantity, prognosis nutritional index (PNI), and Visick scores 6 and 12 months after the operations.

RESULTSAll the patients recovered quickly and no anastomosis leakage or duodenal fistulas were found. It took (30+/-7) minutes to finish the reconstruction in group A, which was significantly shorter than that in group B [(57+/-6) minutes] or in group C [(48+/-6) minutes]. There were no significant differences among 3 groups in the incidence of alkaline reflux gastritis. The incidence of Roux stasis syndrome was 2.2% in group A, which was significantly lower than 17.9% and 19.4% in group B and C. Weight loss and food intake gain in group A was superior to those in group B and C 6 months and 12 months postoperatively. As compared with prognosis nutritional index(PNI) postoperatively, those of 3 groups decreased significantly 6 months postoperatively. At 12 months after operation, the PNI of group A returned to the level before operation, while PNI of both group B and C remained significantly lower than those before operation (both P < 0.05). The Visick score of group A was superior to those of group B and C 6 months and 12 months postoperatively.

CONCLUSIONSThe new uncutted Roux operation with jejunal pouch can prevent alkaline reflux gastritis and Roux-en-Y stasis syndrome. It may be a standard procedure for reconstruction after total gastrectomy.

Adult ; Aged ; Aged, 80 and over ; Anastomosis, Roux-en-Y ; methods ; Female ; Gastrectomy ; Humans ; Jejunum ; surgery ; Male ; Middle Aged ; Postoperative Period ; Stomach Neoplasms ; surgery

OBJECTIVETo compare the surgical outcomes between laparoscopic and open wedge resection for gastrointestinal stromal tumors of the stomach.

METHODSClinical data of 18 cases undergoing laparoscopic wedge resection from June 2000 to August 2009 at the Zhejiang Provincial People's Hospital were compared with 30 patients treated by open surgery. The perioperative parameters and prognosis data of the two groups were compared.

RESULTSCompared to the open group, laparoscopic group was found with longer operative time, less blood loss, less requirement of postoperative analgesia, earlier resumption of oral intake, earlier return of first flatus, and shorter postoperative hospital stay(all P<0.05). There were no postoperative deaths in both groups. Postoperative complication rate was significantly lower in the laparoscopic group(5.5% vs. 33.3%, P<0.05). The postoperative recurrence rates were 11.8%(2/17) and 10.7%(3/28); the 5-year survival rates were 78% and 63%, respectively, and the difference was not statistically significant(P>0.05).

CONCLUSIONLaparoscopic wedge resection is a feasible treatment option for GISTs of the stomach.

Adult ; Female ; Gastrectomy ; methods ; Gastrointestinal Stromal Tumors ; diagnosis ; pathology ; surgery ; Humans ; Laparoscopy ; Male ; Middle Aged ; Prognosis ; Retrospective Studies