OBJECTIVETo explore the safety and short-term efficacy of laparoscopic transhiatal proximal gastrectomy in patients with adenocarcinoma of the esophagogastric junction.

METHODSFrom Aug 2008 to May 2011, 98 patients with adenocarcinoma of the esophagogastric junction underwent laparoscopic transhiatal proximal gastrectomy. Clinical data were analyzed retrospectively including operative time, estimated bleeding, length of resection, lymph node dissection, and short-term postoperative complications.

RESULTSNinety-six patients underwent laparoscopic transhiatal proximal gastrectomy successfully and 2 were converted to open operation (one for combined splenectomy and the other combined splenectomy and resection of the tail of the pancreas). The mean operative time was (224.1±33.7) min and the mean blood loss was (69.4±26.1) ml. The mean length of esophageal resection was (4.0±0.6) cm and the resection margin was negative. The number of lymph node removed was 16.4±5.7. Pleural laceration occurred in 14 cases and spleen injury occurred in 3 case during operation. There was one anastomotic leakage. There were no postoperative mortalities, bleeding, anastomotic stenosis and wound infection. After follow-up ranging from 3 to 30 months, the value of reflux diagnostic questionnaire (RDQ) was 9.9±4.4 at 1 month and 9.3±4.3 at 3 months postoperatively. No incision metastasis was found and 5 patients died.

CONCLUSIONLaparoscopic transhiatal proximal gastrectomy is safe for patients with adenocarcinoma of the esophagogastric junction and the short-term clinical outcomes are favorable.

Adenocarcinoma ; surgery ; Adult ; Aged ; Aged, 80 and over ; Esophagogastric Junction ; pathology ; Female ; Follow-Up Studies ; Gastrectomy ; methods ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

Objective: To evaluate the inhibitory effect of tumor vaccines in colon carcinoma model mice. Methods: Mouse bone marrow⁃derived dendritic cells（BMDCs）were stimulated by using CpG β⁃glucan nanoparticles（CNP）in vitro. The BMDCs were divided into PBS group，NP group（without CpG nanoparticles），Lysate group（MC38 cell lysate）and CpG group（CpG1826），which were determined for the expression of marker molecules on the surface by flow cytometry and for the contents of interleukin⁃6（IL⁃6）and IL⁃12p40 in the culture supernatant by ELISA. The tumor lysate nano⁃vaccine was pre⁃ pared by mixing 50 mg／mL tumor lysate（MC38 cell lysate）with 200 mg／mL CNP in a volume ratio of 1∶1，with which mice were subcutaneously immunized as Vaccine group. Vaccine group，PBS group，CNP group and Lysate group were im⁃ munized once a week，for three times in total. Mice were subcutaneously inoculated with MC38 cells，2 × 105 cells for each， in the right lower limb 1 h after the last immunization，and measured for tumor volume once every three days to plot the tumor growth curve. The ratios of CD3+ CD4+ T and CD3+ CD8+ T cells in the blood were analyzed by flow cytometry and the levels of tumor necrosis factor⁃α（TNF⁃α）and interferon γ（IFNγ）in the blood and spleen of mice were determined by ELISA. Results: CNP effectively increased the expression of CD11c+ CD80+，CD11c+ CD86+，CD11c+ MHC⁃Ⅱ+ and the secretion of IL⁃6 and IL⁃12p40 in BMDCs in vitro，which were significantly higher than those in other 4 groups（t = 4. 3 ~ 46. 2，each P < 0. 05）. Compared with that of the other three groups，the tumor volume of mice in Vaccine group decreased significantly（t =2.6~3.4，eachP <0. 05）；TherewasnosignificantdifferenceinCD3+ CD8+ TandCD3+ CD8+ Tcellratios（t = 0.5~ 1. 9，each P > 0. 05）；The content of IFNγ in blood increased significantly（t = 3. 8 ~ 4. 6，P < 0. 05），while thatof TNF⁃α showed no significant difference（t = 0. 4 ~ 2. 0，each P > 0. 05）；However，the contents of IFN γ and TNF⁃α in spleen increased significantly（t = 6. 3 ~ 13. 0，each P < 0. 001）. Conclusion The prepared nano⁃vaccine of tumor lysate improvedtheimmune level in mice and effectively inhibited the growth of colon carcinoma.

Objective To explore the relationship between psychological distress and T lymphocyte counts in HIV/AIDS patients. Methods A total of 102 HIV/AIDS patients were raeasured by symptom check list(SCL-90), self-rating depressive scale (SDS) and sclf-rating anxiety scale(SAS). Patients were divided into 2 groups based on CD4+ T lymphocyte counts < 0.2×109/L (group A) and ≥0.2×109/L(group B).Results 77cases (75.49%) had psychological problems, including depression, relationship problems, psychosis, force etc. The prevalence of depression and anxiety were 67.65 % (69/102)and 43.13 % (44/102)respectively. The symptom of depression and anxiety of patients in group A were severer than those in group B ( P < 0.05 ). The CD4+ T lymphocyte counts were significantly negatively correlated with the total score, depression score, paranoid score and psychosis score of SCL-90 (all P < 0.05 ). Conclusion Most of the HIV/AIDS patients were in an obviously abnormal psychological status. The psychological distress symptom of HIV/AIDS patients might had negative effects on the number of CD4+ T lymphocyte.

OBJECTIVEIn order to improve the diagnosis and treatment of the complex fracture of the orbit region and adjacent cranio-maxillofacial fracture.

METHODS73 cases with blowout fracture of the orbit and adjacent cranio-maxillofacial fracture in recent years were retrospectively analyzed and comparied with different methods of treatment. All cases had undertaken CT examinations.

RESULTSThe positive rate of the CT examinations with blowout fracture of the orbit and adjacent cranio-maxillofacial region were 100%. Operating repositioning, rigid fixation and artificial material placement were used to treat this kind of deformities.

CONCLUSIONSWith the progress of modern photographic methods, blowout fracture of the orbit and adjacent cranio-maxillofacial fracture can be diagnosed clearly and help the operation procedure. Operations with reduction, rigid fixation and filling materials can be used to restore this kind of fracture and appearance.

Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Male ; Maxillary Fractures ; surgery ; Maxillofacial Injuries ; surgery ; Middle Aged ; Orbital Fractures ; surgery ; Reconstructive Surgical Procedures ; Skull Fractures ; surgery

OBJECTIVE: To explore the growth status of epiphysis of sternal end of clavicle using thin-section computed tomography (CT) and to study the relationship between the status and the chronological age of Sichuan Han nationality youth. METHODS: According to the Schmeling's report and the age range of our samples, the ossification status of medial clavicle epiphysis was classified as four stages. CT films of 565 patients between 15 and 25 years were studied based on the classification and analyzed statistically. RESULTS: There was no statistical difference between the sexes (P > 0.05). The calculated empiric distribution function showed that 100% of stage 1 patients were under 18 years, 75% of stage 2 patients were under 18 years, 94.5% of stage 3 patients were over 18 years, and 100% of the stage 4 patients were over 20 years, respectively. CONCLUSION The ossification of medial epiphysis of the clavicle for those around 18 years has certain regular. These characteristics can be used for forensic identification of the skeletal age, especially 18 years, which is the criminal responsibility age.
Adolescent ; Adult ; Age Determination by Skeleton/methods* ; Age Factors ; Asian People/ethnology* ; China/ethnology* ; Clavicle/growth & development* ; Epiphyses/growth & development* ; Female ; Forensic Anthropology/methods* ; Humans ; Image Processing, Computer-Assisted ; Male ; Osteogenesis ; Sex Characteristics ; Tomography, X-Ray Computed/methods* ; Young Adult

OBJECTIVE: To estimate the chronological age of Han teenagers in Sichuan by the epiphyses development characteristics of iliac crest and ischial tuberosity in X-ray digital images. METHODS: According to TW2 classification principle, combining with the age range of our subjects and epiphyses development regularity, the degree of epiphyses development of iliac crest and ischial tuberosity had been divided into 8 grades (0-7) and 7 grades (0-6), respectively. Based on the degrees, the pelvic X-rays digital images of 691 samples of 16-20 aged teenagers were read and statistically analyzed by SPSS 19.0 software. The multiple linear regression equation was established by skeletal age (Y), development degree of iliac crest epiphyses (X1) and ischial tuberosity epiphyses (X2). RESULTS: There were no statistical differences between two sides of epiphyses development of iliac crest and ischial tuberosity (P>0.05). There were no statistical difference between genders (P>0.05). The re-substitution method of the samples showed that the accuracy of equation as Y=15.269+0.444X1+0.236 X2 was high. The result of the re-substitution method showed a high accuracy of the equation. CONCLUSION The multiple linear regression equation could be used to identify the skeletal age for providing the scientific basis to identify the 18-year-old Han population in Sichuan.
Adolescent ; Age Determination by Skeleton/methods* ; Age Factors ; Asian People/ethnology* ; Bone Development/physiology* ; China/ethnology* ; Epiphyses/diagnostic imaging* ; Female ; Forensic Anthropology/methods* ; Humans ; Ilium/diagnostic imaging* ; Ischium/diagnostic imaging* ; Linear Models ; Male ; Pelvis/diagnostic imaging* ; Tomography, X-Ray Computed ; Young Adult

Aim To explore the effect of gypenosides on proliferation and apoptosis of human gastric cancer cells SGC-7901 and AGS and its mechanism. Methods Different concentrations of gypenosides were cultured with human gastric cancer cells SGC-7901 and AGS. Cell viability assay was used to detect cell proliferation activity, and the IC

Objective To investigate the effect of different temperature on the susceptibility of Aedes albopictus for transmission of dengue 2 virus.Methods Mosquitoes were orally infected with dengue virus type 2 suspension,then fully blood-engorged mosquitoes were separated and transferred to new cartons and sustained at 18,21,26,31,33℃ and 36℃ with 10％ sucrose.Immunofluorescence assays were used to detect antigen of dengue virus type 2 in the head,salivary gland and thorax-abdomen,and calculated the disseminated infection rate of mosquitoes.Results For mosquitoes held at 18℃,the infection rate of thoraxabdomen was 8％,infection in head and salivary gland were not detected until 25d.Maximum infection rate of thorax-abdomen was attained at 31℃,the highest infection rate of head and salivary gland existed at 33℃,however,the infection rate of mosquitoes at 36℃ was significantly decreased compared with that at 33℃.The lowest disseminated infection rate was zero at 18℃,while the highest disseminated infection rate was 100％ at 36 ℃.Conclusion As the temperature went up,the infection rate showed a tendency of ascending first and descending later.Dengue virus might not be transmitted by Aedes albopictus when temperature was below 18℃.The disseminated infection rate increased gradually with the increase of temperature.

Objective To investigate the use of NBI (narrow band imaging) in early the diagnosis of nasopharyngeal carcinoma.Methods A total of 55 cases with nasopharyngeal lesions (including 9 cases of nasopharyngeal carcinoma after treatment) were examined and diagnosed by white and NBI endoscopy between October 2011 and March 2012,and their diagnosis efficacies were evaluated based on pathological diagnosis as a gold standard.Chi-square test was used to analyze data.Results Of 55 cases,12 cases were pathologically diagnosed as chronic mucosa inflammation and 43 as nasopharyngeal carcinoma including 6 recurrent cases,of 43 cases,40(93.0％) were diagnosed by NBI endoscopy and 18 (41.9％) by white endoscopy.Of 12 cases with early nasopharyngeal carcinoma (5 for stage Ⅰ and 7 for stage Ⅱ),5(100.0％) for stage Ⅰ,and 6 (85.7％) for stage Ⅱ were diagnosed by NBI endoscopy but only 1(14.3％) for stage Ⅱ by white endoscopy,with a statistically significant difference (x2 =10.000,P =0.008 ;x2 =7.143,P =0.029).Conclusion NBI endoscopy can be used in early diagnosis of nasopharyngeal carcinoma and check after treatment.

BACKGROUNDThin endometrium is associated with poor reproductive outcomes; estrogen treatment can increase endometrial thickness (EMT). The aim of this retrospective cohort study was to investigate the factors influencing the effectiveness of estrogen treatment and reproductive outcomes after the treatment in patients with thin endometrium.

METHODSRelevant clinical data of 101 patients with thin endometrium who had undergone estrogen treatment were collected. Possible factors influencing the effectiveness of treatment were analyzed retrospectively by logistic regression analysis. Eighty-seven infertile women without thin endometrium who had undergone assisted reproduction served as controls. The cases and controls were matched for age, assisted reproduction method, and number of embryos transferred. Reproductive outcomes of study and control groups were compared using Student's t-test and the Chi-square test.

RESULTSAt the end of estrogen treatment, EMT was ≥8 mm in 93/101 patients (92.1%). Effectiveness of treatment was significantly associated with maximal pretreatment EMT (P = 0.017) and treatment duration (P = 0.004). The outcomes of assisted reproduction were similar in patients whose treatment was successful in increasing EMT to ≥8 mm and the control group. The rate of clinical pregnancy in patients was associated with the number of good-quality embryos transferred in both fresh (P = 0.005) and frozen-thawed (P = 0.000) embryo transfer cycles.

CONCLUSIONSThinner EMT before estrogen treatment requires longer treatment duration and predicts poorer treatment outcomes. The effectiveness of treatment depends on the duration of estrogen administration. Assisted reproductive outcomes of patients whose treatment is successful (i.e., achieves an EMT ≥8 mm) are similar to those of controls. The quality of embryos transferred is an important predictor of assisted reproductive outcomes in patients treated successfully with exogenous estrogen.

Endometrium ; drug effects ; Estrogens ; therapeutic use ; Female ; Humans ; Infertility, Female ; drug therapy ; therapy ; Male ; Pregnancy ; Pregnancy Rate ; Retrospective Studies