Objective To detect the expression of p-STAT3 and survivin in primary gallbladder carcinoma (PGC) and explore its significance for the genesis and development of PGC.Methods The expression of p-STAT3 and survivin were determined with immunohistochemistry in samples from 45 PGC tissues and 20 chronic cholecystitis.The relationship between the expression of these proteins and various clinicopathological factors was evaluated.Results The expression rate of p-STAT3 and survivin in 45 PGC tissues was 55.6％ ( 25/45 ) and 64.4％ ( 25/45 ),respectively,which was significantly higher than those in 20chronic cholecystitis tissues 5.0％ ( 1/20),10％ ( 2/20 ) ( P ＜ 0.01 ).pSTAT3 expression was correlated with survivin ( r =0.830,P ＜0.01 ).p-STAT3 and survivin protein expression were significantly associated with histopathological grading,lymph node metastatis,nevin staging and 3-year survival rate.Conclusions p-STAT3 and survivin might play a vital role in the development of PGC.The expression of p-STAT3 or survivin was an independent prognostic factor in PGC.

38 ℃),while in the open group,3 patients showed complications,12 had the body temperature over 38 ℃.Conclusions Laparoscopic repair,which is feasible and safety for acute gastroduodenal ulcer perforation,should be the first choice in emergency,while non-surgical treatments and emergency subtotal gastrectomy can be two alternatives.

Objective To investigate the influence of fast track surgery (FTS) on insulin resistance indexes and inflammatory reaction in colorectal cancer patients who received laparoscopic surgery.Methods A total of 62 patients were randomly divided into control group (n=31) or FTS group (n=31).The postoperative first flatus and defecation time, postoperative hospital stay, hospitalization expenditure, and postoperative complications were recorded.Insulin resistance indexes and inflammatory reaction were measured before operation (T0) as well as on the 1st, 3rd, and 7th postoperative days (T1, T3, and T7), including fasting blood-glucose (FBG), fasting insulin (FINS), serum level of interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor (TNF-α).The insulin resistance index (HOMA-IR) was calculated at the same time points.Results The postoperative time of flatus and defecation in the FTS group was significantly shorter than that in the control group (t=3.088, P=0.003;t=4.227, P=0.000), the postoperative hospital stay and total hospitalization expenditure were significantly lower in FTS group (t=3.937, P=0.000;t=3.478, P=0.003).No significant difference was found in the complication rate between the two groups (χ2=0.267,P=0.605).The inflammatory indexes and insulin resistance indexes in the two groups at T1 and T3 time points were higher than those at T0 time points (P<0.05).Compared to the FTS group at T1 and T3 time points, the levels of IL-6, CRP, TNF-α, FINS, and HOMA-IR in the control group increased more obviously (P<0.05), but the elevation blood FBG was not obvious (T1: t=0.870, P=0.388;T3: t=0.870, P=0.388).There were no significant differences in IL-6 and TNF-α in the two groups between the T7 and T0 time points (P>0.05), but the levels of CRP, FBG, FINS, and HOMA-IR at T7 time points were significantly higher than those at the T0 time points in the two groups (P<0.05).The levels of IL-6, TNF-α, FBG, FINS, and HOMA-IR at T7 had no significant differences between the two groups (P>0.05), but the level of CRP in the control group was significantly higher than that in the FTS group (t=-4.527, P=0.000).Conclusion FTS may promote the early recovery of gastrointestinal functions, reduce stress reactions and postoperative insulin levels, thus being conducive to fast rehabilitation in colorectal cancer patients with laparoscopic surgery.

This paper analyzed international acupuncture and moxibustion literature cited in SCIE of web of science from 1970-2013,using bibliometric methods and visualization analysis tools,according to categories:publication years,countries,organization,authors,subjects and keywords,to explore the topic evolution process and development directions of acupuncture and moxibustion research.

No. Ⅱ fluorocarbon blood substitute in divided doses was infused into the rats in a 12-day-period. Pathomorphological changes of the various organs of the animals were observed dynamically in the first year after the completion of the infusion. Fluorocarbon particles mainly accumulated in the organs with abundant reticulo-endothelial tissue particularly the liver and spleen. The changes of the weight of the liver and spleen and the existence of foam cells could be considered as the criteria to indicate the severity of the accumulation. It was found that at the end of the first year after the completion of No. Ⅱ fluorocarbon blood substhue infusion, the liver and spleen essentially resumed their normal weight but a small number of foam cells still existed, However, accumulated fluorocarbon particles exerted no harmful effects on the functions and structures of the organs observed.

Objective:To investigate the effect of pelvic rotation around coronal axis on the placement angle of acetabular prosthesis after total hip arthroplasty.Methods:According to Murary's definition, the angle between the acetabular axis and the sagittal plane was defined as the acetabular abduction angle, and the angle between the acetabular axis and the coronal plane as the anterior inclination angle. A simple mathematical solid geometry model was established by using the mathematical software GeoGebra to simulate the dynamic changes of the acetabular prosthesis when it rotated around the coronal axis, and the calculation formula of the dynamic changes of the anterior inclination and abduction angle of the acetabular prosthesis was derived. MatLab software was used to generate the function graph of pelvis forward inclination and abduction angle and deduce the motion of acetabular prosthesis.Results:The dynamic changes of acetabular tilt angle and abduction angle when the pelvis rotated around the coronal axis were functionally related to the anterior-posterior tilt of the pelvis in a nonlinear pattern. When the pelvis rotates around the coronary axis, the anterior inclination angle formula is α 1=arcsin (sinβ 1×cosα×cosθ+cosβ 1×sinα); When the acetabulum axis faces downwards the abduction angle formula is θ 1=arccot (cosβ 1×cotθ-sinβ 1×tanα/sinθ); When the acetabulum axis faces upwards the abduction angle formula is θ 1=π-abs[arccot (cosβ 1×cotθ-sinβ 1×tanα/sinθ)] withα being the initial acetabular forward angle, θ being the initial acetabular abduction angle, α 1 being the forward angle of the acetabular prosthesis after pelvic rotation, θ 1 being the external expansion angle of the acetabular prosthesis after pelvic rotation and β 1 being the rotation angle of the pelvis around the coronal axis. When the pelvis is tilted backward, the anterior inclination angle of the acetabular prosthesis increases first and then decreases, and the abduction angle continues to increase. When the pelvis is tilted forward, the abduction angle decreases first and then increases, and the anterior inclination angle continues to decrease to negative. Conclusion:When the initial anterior inclination angle and abduction angle of acetabular prosthesis change, the curve of anterior inclination and abduction angle change accordingly. The larger the initial anterior inclination angle is, the faster it reaches its peak value, and the larger the peak value is, the faster the abduction angle changes. The larger the initial abduction angle is, the slower the initial anterior inclination angle and the abduction angle change.

Objective To explore the correlation between hyponatremia at admission and all-cause mortality within one year after discharge in elderly patients with intestinal obstruction.Methods The 331 cases of elderly patients with intestinal obstruction(aged ≥ 60 years)who visited the General Surgery Department of Nanjing Meishan Hospital from January 2017 to December 2020 were selected as the research objects for retrospective cohort study analysis.According to the patient's blood sodium level at admission,they are divided into two groups:the hyponatremia group(Na＜135 mmol/L)and the non hyponatremia group(Na≥135 mmol/L).Divided into death group and survival group based on whether death occurred within one year after discharge.SPSS 25.0 software was used for statistical analysis.Independent sample t test,x2 test,Kaplan Meier method,and multivariate Cox regression analysis were used to observe the correlation between admission hyponatremia and all-cause mortality within one year after discharge in elderly patients with intestinal obstruction.Results A total of 331 patients were enrolled.The incidence of hyponatremia was 32.3％,and 56 deaths occurred within one year,accounting for 16.92％.The one-year mortality rate in the hyponatremia group was 23.4％(25/107),which was higher than 13.8％(31/224)in the non hyponatremia group.The difference was statistically significant(P＜0.05).The survival analysis(Kaplan Meier)results showed that the survival rate of the hyponatremia group was lower than that of the non hyponatremia group(Log Rank P＜0.05).After adjusting for other confounding factors in multivariate Cox regression analysis,hyponatremia(HR=1.88,95％CI:1.07-3.29)was an independent risk factor for one-year all-cause mortality in elderly patients with intestinal obstruction(P＜0.05).Conclusion Hyponatremia at admission is an independent risk factor for all cause mortality in elderly patients with intestinal obstruction within one year after discharge.

Objective:To investigate the efficacy of different laparoscopic surgeries for gastrointestinal stromal tumors (GIST) of gastric cardia and fundus.Methods:The retrospective cohort study was conducted. The clinicopathological data of 251 patients with GIST of gastric cardia and fundus who underwent laparoscopic radical resection in 14 medical centers, including Guangdong Provincial People′s Hospital et al, from December 2007 to December 2021 were collected. There were 123 males and 128 females, aged 58(24,87)years. Observation indicators: (1) treatment; (2) clinicopathological data of patients undergoing different laparoscopic surgeries; (3) subgroup analysis for special laparoscopic techniques. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test or ANOVA. Measure-ment data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test or Kruskal-Wallis H test. Count data were described as absolute numbers or percentages. Comparison of ordinal data was conducted using the rank sum test. Results:(1) Treatment. Of the 251 patients,202 cases underwent gastric wedge resection, 26 cases underwent special laparoscopic techniques including 10 cases with serotomy and dissection and 16 cases with transluminal gastrectomy, 23 cases underwent structural gastrectomy including 6 cases with total gastrectomy and 17 cases with proximal partial gastrectomy. There were 24 patients had postoperative complications after surgery. (2) Clinicopathological data of patients undergoing different laparoscopic surgeries. The gender (male, female), age, tumor diameter, operation time, volume of intraoperative blood loss, length of incision, time to postoperative initial whole liquid food intake, time to postoperative initial semi-liquid food intake, duration of postoperative hospital stay, cases with perioperative complications, cases with mitotic count as ≤5/50 high power field, 6?10/50 high power field, >10/50 high power field, cases be classified as very low risk, low risk, medium risk, high risk according to the National Institutes of Health risk classification, cases with tumor located at fundus and gastric cardia were 93, 109, (59±11)years, 3.50(0.40,10.00)cm, 88.00(25.00,290.00)minutes,20.00(25.00,290.00)mL, 4.00(2.00,12.00)cm, 3.00(1.00,9.00)days, 4.00(1.00,16.00)days, 5.00(1.00,18.00)days, 14, 164, 31, 7, 47, 83, 50, 22, 30, 172 in patients undergoing gastric wedge resection, respectively. The above indicators were 19, 7, (49±14)years, 2.55(0.20,5.00)cm, 101.00(59.00,330.00)minutes, 27.50(2.00,300.00)mL, 4.50(0,6.00)cm, 2.50(1.00,10.00)days, 4.00(1.00,16.00)days, 6.00(1.00,18.00)days, 3, 20, 5, 1, 15, 5, 2, 4, 24, 2 in patients undergoing special laparos-copic techniques, and 11, 12, (52±10)years, 5.00(0.80,10.00)cm, 187.00(80.00,325.00)minutes, 50.00(10.00,300.00)mL, 6.00(4.00,12.00)cm, 4.00(2.00,8.00)days, 6.00(3.00,14.00)days, 8.00(2.00,18.00)days, 7, 11, 5, 7, 2, 6, 6, 9, 13, 10 in patients undergoing structural gastrectomy. There were significant differences in the above indicators among the three groups of patients ( χ2=6.75, F=10.19, H=17.71, 37.50, 35.54, 24.68, 16.09,20.20, 13.76, χ2=13.32, Z=28.98, 32.17, χ2=82.14, P<0.05). (3) Subgroup analysis for special laparoscopic techniques. The time to postoperative initial whole liquid food intake, time to postoperative initial semi-liquid food intake, classification of tumor location (endophytic type, exophytic type, parietal type) were 4.50(1.00,10.00)days, 8.00(3.00,12.00)days, 0, 8, 2 in patients undergoing serotomy and dissection, versus 2.00(1.00,4.00)days, 3.00(1.00,6.00)days, 16, 0, 0 in patients undergoing transluminal gastrectomy. There were significant differences in time to postoperative initial whole liquid food intake, time to postoperative initial semi-liquid food intake between them ( Z=-2.65, -3.16, P<0.05); and there was a significant difference in classification of tumor location between them ( P<0.05). Conclusions:Gastric wedge resection is the most commonly used laparoscopic technique for GIST of gastric cardia and fundus. The application of special laparoscopic techniques is focused on the GIST of cardia to preserve the function of the cardia.