Objective To compare the perioperative outcomes of laparoscopic liver resection (LLR) versus open liver resection (OLR) for hepatocellular carcinoma (HCC).Methods A total of 89 HCC patients undergoing liver resection between January 2012 and November 2016 were enrolled.Nonparametric tests were employed to compare the clinicalpathological characters and preoperative outcomes.Results No significant difference was observed in clinicalpathological features and postoperative morbidity.LLR group had shorter hospital stay (Z =4.642,P ＜0.01),lower serum ALT level in 1st,3rd and 5 day (Z =2.157,3.089,2.384,all P ＜0.05) and AST level in 1st-and 3rd-day postoperatively (Z =2.688,2.566,all P ＜0.05).The growth rate in serum total protein (TP) and albumin (ALB) postoperatively is higher for LLR group (y =2.348 4x + 51.696 vs.y =0.902 9 + 35.532),(y =1.539 9x + 29.68 vs.y =0.732 9x + 30.406).Conclusion LLR allows quicker liver function recovery and shortens patients' postoperative hospital stay.

Through a comprehensive evaluation of collateral circulation establishment in portal hypertension, endoscopic ultrasonography (EUS) not only helps to predict and evaluate the risks of first bleeding from esophageal and gastric varices and recurrence and rebleeding after treatment, but also guides and participates in the treatment of varices. This article introduces the unique advantages of EUS in the treatment and prognostic evaluation of esophageal and gastric varices and provides an important reference for individualized treatment of patients with liver cirrhosis complicated by esophageal and gastric varices. EUS also helps to improve treatment safety and response rate. EUS for the systematic treatment of portal hypertension has become a hot research topic in recent years.

OBJECTIVE: To investigate the morphological characteristics of the bridge tendon grafting in no man's land to reconstruct the tendon defect and the effect of passive mobilization on it. METHODS: A 2 cm defect was made in bilateral flexor digitorum profundus tendons of the middle chicken toes, and was then transplanted to the opposite site to serve as a segmental autograft tendon. Postoperatively, passive mobilization of the left and right middle toes began at 5 and 21 d separately. Specimens were studied by light, scanning and transmission electron microscopy at 5, 10, 21 and 35 d. RESULTS: Early repair of the tendon-graft of the left middle toes was made by proliferation and ingrowth of the epitenon cells intermingled with newly-formed collagen fibers. A gliding surface formed at 10 and 21 d. The tendon graft itself played an active role in the repair. In contrast, adhesions obliterated the surface and occupied the space between the tendon graft and surrounding tissues in the right middle toes. CONCLUSIONS: It indicates that the use of the segmental bridge tendon graft in no man's land coupled with early passive motion stimulates an intrisic repair process in both the tendon stump and the autogenous tendon graft and results in a functional healing.

Objective To compare the long-term effects and later period toxic reactions between preop-erative simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT) and 3-dimensional conformal radiotherapy RT (3D-CRT) for locally advanced rectal cancer.Methods A total of 130 patients with clinical stage cT3-4/N+M0 rectal adenocarcinoma receiving neoadjuvant chemoradiotherapy in this hos-pital from May 2010 to May 2015 were selected as the study subjects.The patients were divided into the SIB-IMRT group (66 cases) and 3D-CRT group (64 cases) according to the random number table method.The SIB-IMRT group took the irradiation 55 Gy/25 frequencies,irradiation 45 Gy/25 frequencies in the high risk recurrent region and regional lymphatic drainage area.The 3-DCRT group took the irradiation 45 Gy/25 fre-quencies in the high risk recurrent region and regional lymphatic drainage area.All patients orally took capecitabine (825 mg/m2) on 1-14 d and 22-35 d of radiotherapy (twice daily) in synchronized radiothera-py.The total mesorectal excision was performed in 6-8 weeks after radiotherapy end.The overall survival (OS) rate,disease free survival (DFS) rate,locoregional recurrence free survival (LRFS) rate,distant metas-tasis rate (DMR) and occurrence situation of advanced stage toxic reactions were observed and compared be-tween the two groups.Results The median follow-up time of all study subjects was 105(2,136) months.The 10-year OS rate,DFS rate,LRFS rate and DMR in the SIB-IMRT group was 67.8％,64.5％,91.8％ and 29.9％ respectively,which in the 3D-CRT group was 62.6％,61.2％,88.7％ and 34.5％ respectively,but the differences were not statistically significant (P>0.05).The grade 2 and 3 adverse reactions in the SIB-IMRT group were higher than those in the 3D-CRT group (34.48％ vs. 28.07％),but the difference was not statistically significant (P>0.05).Conclusion SIB-IMRT provides the acceptable long term effect and toxic results than 3D-CRT.

Objective To analyze long-term prognosis and influencing factors of thymoma after complete resection.Methods Clinical data of recurrence free survival(RFS)and disease specific survival(DSS)of 106 patients with thymoma after complete resection in Jinhua Central Hospital from August 2007 to January 2018 were retrospectively analyzed.Relevant prognostic and treatment failure factors of patients were analyzed.Results RFS for 5-year and 10-year of 106 cases were 86.9%and 77.9%respectively;DSS for 5-year and 10-year of 106 cases were 95.0%and 85.8%respectively.There was statistically significant difference in Masaok-Koga staging between recurrent and non-recurrent patients(P<0.05).There were statistically significant differences in gender,World Health Organization(WHO)histological classification,Masaok-Koga staging and tumor size between deceased and non-deceased patients(P<0.05).Univariate analysis showed that Masaokak-Koga stage,WHO histological classification and tumor size were risk factors affecting recrudescence in patients with thymoma after complete resection.Masaoka-Koga stage was risk factor affecting specific survival in thymoma.Multivariate analysis showed that Masaoka-Koga stage,tumor size and age were independent risk factors affecting RFS in patients with thymoma after complete resection.Masaoka-Koga stage was independent risk factor affecting DSS in patients with thymoma after complete resection.Conclusion Long-term prognosis of patients with thymoma after complete resection is good,and DSS can reach 85.8%in 10 years.Masaoka-Koga stage is independent prognostic factor for DSS.Advanced Masaoka-Koga stage,larger tumor size and younger age are risk factors for thymoma recurrence.

Objective To identify the Brucella strains isolated from sheep blood in Jingyuan County Gansu Province,and to provide scientific basis for Brucellosis control and prevention.Methods In 2016,blood samples from suspected cases of sheep were collected in the home of Brucellosis patient of Jingyuan County,and cultured with vaccination double blood bottles via the enrichment method,and the Brucella strains isolated from sheep were identified by traditional bio-typing,genus specific Brucella surface protein 31 PCR (BSCP31-PCR) and Brucella abortus,Brucella melitensis,Brucella ovis,Brucella suis species-specific PCR (AMOS-PCR),respectively.Results The isolated strain was identified using the traditional biological classification method,bacteria could grow in thionine and fuchsin dyes,A and M factors serum agglutination tests were positive,Bk2 phage lysis test was positive,but Tb and Wb phage lysis tests were negative;and the results of BSCP31-PCR of tested strain was 223 bp band same to Brucella;the results of AMOS-PCR was 731 bp band same to Brucella melitensis.Conclusion Conventional bio-typing test assisted with molecular techniques has confirmed that the isolated Brucella strain from sheep blood is Brucella melitensis type 3 in Jingyuan County Gansu Province.

Objective To evaluate preoperative three dimensional(3D)reconstruction techniques in perioperative patients of hepatocellular carcinoma (HCC) undergoing hepatectomy.Methods Fifty-eight HCC patients who had undergone hepatectomy between 2015 and 2017 were enrolled.Twenty-three patients underwent hepatectomy based on preoperative 3D reconstruction techniques,while other thirty-five patients were without using it.Results No significant statistical difference was found in clincopathological parameters of patients preoperatively.The patients who underwent hepatectomy based on 3D reconstruction techniques had less operation time (Z =-2.213,P =0.028),hepatic inflow occlusion rate,time (x2 =3.966,P =0.046;Z =-2.371,P =0.018) and blood loss (Z =-2.140,P =0.032) during operation.Totally 23 postoperative complications occurred which were Clavien-Dindo classification grade Ⅰ or Ⅱ.More complications occurred in the not using 3D technique group (x2 =6.061,P =0.014).Conclusion Preoperative 3D reconstruction technique improves the perioperative prognosis of hepatectomy in patients with hepatocellular carcinoma.

Objective To analyze the etiological characteristics of human Brucella strains isolated, and to improve the precision in control and prevention of brucellosis. Methods In 2016, blood samples were collected from patients in Jingyuan County Gansu Province, and tested via the Rose-Bengal Plate Agglutination Test (RBPT) and the tube agglutination test methods,and serological positive blood samples were inoculated to bidirectional blood culture bottle for culturing, and further identified by traditional biological classification method and the Brucella abortus, Brucella melitensis, Brucella ovis, and Brucella suis species-specific PCR (AMOS-PCR). Multiple-locus variable number tandem repeat sequence analysis (MLVA) -16 was used to detect molecular typing and do cluster analysis. Results The isolated strain was identified by the traditional biological classification method, bacteria could grow in thionine and reddened dye, A and M factors agglutination tests were positive, Bk2phage treatment of bacterial strain cracking, but Tb, Wb phages were not cracked. AMOS-PCR amplification result showed a 731 bp band, which was a strain of Brucella melitensis. The results of MLVA-16 showed that there was a difference in the number of repeats on some Variaable Number of Tandem Repeat(VNTR)sites of the isolated strain. Clustering analysis showed that, the isolated strain was clusted into the same clade with the clustering of Brucella melitensis type 3 from GS-201605 in Gansu. And the clustering was similar compared with that of Zhejiang, Guangdong, Fujian and Yunnan. Conclusion Human brucellosis is a inputting transmission in Gansu Province, there is a genetic variation of genotype 3 sheep Brucella between Gansu Province and other domestic provinces.

Methods:Clinical data of 187 patients with left-sided hepatolithiasis and underwent laparoscopically or open left-sided hepatectomy from October 2014 to October 2019 at the Second Affiliated Hospital of Anhui Medical University were retrospectively analyzed in this propensity score matching (PSM) study and were matched in terms of age, sex, body mass index, liver function, ASA score, comorbidities, history of biliary surgery, and smoking history on the ratio of 1∶1.There were 47 cases in each group and the mean age were (54.7±12.3)years old(range:34 to 75 years old) and (53.2±12.6) years old (range: 34 to 75 years old) in open and laparoscopically group respectively. The data of operation time, intraoperative blood loss, postoperative hospital-stay, complication rate, biliary fistula rate, stone clearance rate, and stone recurrence rate were compared. The quantitative data were compared using t-test or rank-sum test. Count data were analyzed with χ 2 test or Fisher test. Results:No significant difference was observed in the clinical characteristics of included 94 patients in this study(all P>0.05).The length of the postoperative hospital-stay after OLH was significantly higher than that in the LLH group((10.8±3.1) days vs.(8.5±2.2)days, t=4.085, P=0.000). LLR significantly decreased the incidence of postoperative biliary fistula compared with the OLH (6.3% vs.21.2%, χ 2=4.374, P=0.036) and the rates of postoperative complications in the OLH group was significantly higher than that in the LLH group (48.9% vs.27.6%, χ 2=4.502, P=0.034). Moreover, the stone recurrence rates in the LLH group was significantly lower than that after OLR (4.2% vs. 17.0%, χ 2=4.029, P=0.045). OLH (95 % CI: 1.55 to 10.75, P=0.004) and postoperative complications (95 % CI: 1.29 to 9.52, P=0.013) were independent risk factors for prolonged hospital stay. OLH (95 % CI: 1.428 to 44.080, P=0.018) and residual stones (95 % CI: 1.580 to 62.379, P=0.014) were independent risk factors for the occurrence of postoperative biliary fistula. Biliary fistula (95 % CI: 1.078 to 24.517, P=0.040) was an independent risk factor for the recurrence of stones. Conclusion:Compared with OLH, LLH is safe and effective for the treatment of the primary left-sided hepatolithiasis with the clinical benefits of shorter hospital stay, fewer morbidity and biliary fistula occurrence, and lower stone recurrence rates.

Objective:To investigate the incidence and determinants of vaccine hesitancy towards national immunization program in China and understand the current status of parents' hesitancy to different vaccines used in national immunization program.Methods:A cross-sectional survey was conducted in Beijing, Sichuan and Gansu. The methods of proportional probability sampling and convenience sampling were used to select the eligible study subjects for questionnaire surveys.Results:A total of 3 592 parents were enrolled in the study, in whom 38.22% fully accepted all the vaccines, 59.35% agreed to let their children to receive all the vaccines but showed slight concern, and 2.42% had hesitancy to the vaccines. The vaccine with the most hesitancy was polio vaccine (0.89%), followed by diphtheria pertussis tetanus vaccine (0.70%) and hepatitis A vaccine (0.64%). The dominant reason for vaccine hesitancy was the risk-benefit perception of vaccination (31.03%), followed by the low awareness of the parents (21.84%) and the inconvenience caused by distance and time (21.84%).Conclusions:The incidence of vaccine hesitancy towards national immunization program was low in parents in China, but over 50% of the parents showed concern to the vaccines. It is essential to improve the service quality of national immunization program and strengthen the health education about the vaccination to reduce the incidence of vaccine hesitancy in parents.