Objective To clarify the risk factors of postoperative recurrence of early gastric cancer (EGC)patients who underwent radical gastrectomy.Methods We investigated follow-up records of 336 EGC patients on whom curative operations were performed at the First Affiliated Hospital of Dalian Medical University between January 1994 and January 2008 with special reference to 12 cases of cancer recurrence.Results The 5-year survival rate of D1 was 89.0％,D1 + t was 91.4％,D1 + β was 91.8％,D2 was 92.5％,D3 was 90.0％(P =0.981).The recurrence rate was 3.6％(12/336).The recurrence time was 17-58 months,the survival time was 33-68 months.Six cases suffered from hematogenous recurrences,four cases from lymph node recurrences,two cases from remnant stomach recurrences.The recurrence rate of SM was higher than M(P =0.015),lymph node positive was high than negative(P =0.011),D1 was higher than D2(P =0.025).Conclusions The recurrence rate of EGC correlated with depth of invasion,lymph node metastasis and lymph node dissection.

Objective To discuss the effect of pylorus-preserving gastrectomy for early gastric cancer(EGC). Methods Between August 1995 and December 2005, 52 cases of EGC underwent pyloruspreserving gastrectomy(PPG) and 159 cases of EGC underwent distal gastrectomy(DG), Clinicopathlogic data and follow-up results of the two groups were analyzed retrospectively, and gastric emptying and gallbladder function of 15 cases PPG and 17 cases DG were compared at the same time.Results Compared with DG group, patients in PPG group maintain the body weight, gastric emptying and gallbladder function. There was no significant difference between PPG group (92. 3% ) and DG group (93.1% ) in overall 5-year survival rate ( P = 0. 881 ). The 5-year survival rate of the the PPG group with lymph node dissection was D1 100%, D1+α 92. 3%, D1+β 88.9%, D2 87. 5% respectively.Conclusions For early gastric cancer, the pylorus-preserving gastrectomy is effective for maintaining the postoperative function with similar long term survival as that of distal gastrectomy.

Adolescent ; Adult ; Angiography, Digital Subtraction ; Child ; Decompression, Surgical ; methods ; Female ; Humans ; Magnetic Resonance Angiography ; Male ; Middle Aged ; Optic Nerve Injuries ; diagnostic imaging ; pathology ; Young Adult

Cerebral Veins ; Female ; Humans ; Middle Aged ; Prosthesis Implantation ; Stents ; Tinnitus ; etiology ; surgery

Objective To investigate the effect of different Chinese herbs on cell proliferation and cartilage oligomeric matrix protein(COMP)expression in chondrocyte culture.Methods Chondrocytes isolated from rabbit knee cartilage were cultured for 3 generations with the density of 2?10~4/cm~2 and were verified by collagenⅡimmunohistochemical staining.Rabbit sera containing herbs were obtained after animals orally ad- ministrated herbs at the dosage equivalent to human.At 5% and 10% serum density,cells were cultured in the medium that contained liver-softening herbal compound sera.Subgroups setting at 1,3 and 5 hours after herb intervention were observed.Rabbit and bovine sera were control groups.Seven days after intervention,chon- drocytes proliferation was observed using the MTT assay kit.For the study of COMP expression,chondrocytes were isolated from human knee cartilage supematant.Superuatant COMP level was tested by enzyme-linked immunoabsorbent assays(ELISA)after directly adding compound and extract from liver-softening herbs to the culture at the final concentration of 10 mg/ml for 3 days.Results Liver-softening herbal compound group had significant effect on cell proliferation compared to control,of which,3-hour subgroup was more significant than 1-and 5-hour subgroups(P

We describe two cases in which a forceps imprintdeveloped in the AcrySof ReSTOR IOL optic whileinserting these IOLs into the cartridge with straightclamping forceps. In case 1 ,the AcrySof ReSTOR IOL wasexplanted and observed under scanning electronmicroscopy (SEM). The SEM showed that the stepdesign of ReSTOR Multifocal IOL was well maintained. Incase 2, visual acuity, contrast sensitivity and wavefrontmeasurements were performed and no specific changeswere found. Strong evidence does not exist that suggeststhe on-axis forceps imprint can significantly compromisevisual acuity.

OBJECTIVETo compare mid-term clinical outcomes between amputation and limb salvage in treating severe open tibial fractures with type Gustilo III B, III C.

METHODSFrom July 2007 to June 2010,68 patients with severe open tibial fractures with type Gustilo III B, III C treated by amputation and limb salvage were retrospectively analyzed. In amputation group, there were 26 males and 12 females with an average age of (44.9±16.3) years old; and 21 cases were type Gustilo (III B, 17 cases were Gustilo III C; amputation were performed in accordance with soft tissue injury degree of shank, fracture types and surgical exploration. In limb salvageg group, there were 21 males and 9 females with an average age of (43.5±14.7) years old; and 23 cases were type Gustilo III B, 7 cases were Gustilo III C; the method of internal fixation and and wound healing were performed in accordance with patients's specific condition. Operative time, blood loss, hospital stay and postoperative infection was compared between two groups; time of loading and rate of return to work was compared; VAS scoring was used to evaluate condition of pain; SF-36 health queationaire was used to assess postoperative life quality.

RESULTSTotally 60 patients were followed up (33 cases in amputation group and 27 cases in limb salvage group) with an average time of 49.1 months. Operative time, blood loss, hospital stay and postoperative infection in amputation and limb salvage group respectively was (109.0±25.7) min, (245.0±58.6) min; (168.0±49.0) ml, (311.0±137.0) ml; (13.8±2.7) d, (28.8±13.1) d; 7.9%, 36.7%. At the final following-up, there was no significance meaning between two groups in VAS scoring and rate of return to work, but time of loading in amputation group was shorter than that of in limb salvage group. Physiological function in amputation group was better than limb salvage group, while body pain was worse; and there was no signicance meaning in psychological health between two groups.

CONCLUSIONAmputation and limb salvage both can treat severe open tibial fractures, and mid-term clinical outcomes between two groups has equivalent efficacy.

Adolescent ; Adult ; Aged ; Amputation ; methods ; Case-Control Studies ; Female ; Humans ; Limb Salvage ; methods ; Male ; Middle Aged ; Tibial Fractures ; surgery

OBJECTIVETo evaluate the impact of lymph node metastasis on the prognosis of gastric cancer without serosal invasion.

METHODSFrom January 1994 to December 2005, 616 gastric cancer patients without serosal invasion and 162 gastric cancer patients with serosal invasion underwent D2 or D2(+) lymphadenectomy. Clinicopathologic data and long-term survival of the two groups were analyzed retrospectively.

RESULTSThe 5-year survival rate of patients with gastric cancer without serosal invasion was 77.9%, significantly higher than that of patients with gastric cancer with serosal invasion (37.3%) (P<0.01). The 5-year survival rates of T1a(M), T1b(SM), T2(MP), T3(SS), T4(SE,SI) were 95.6%, 92.5%, 73.5%, 62.7%, and 37.3%, respectively. As classified in the 13th edition of Gastric Cancer Treatment Guidelines in Japan, the 5-year survival rates of patients with gastric cancer without serosal invasion were 91.5% in N0, 75.3% in N1, 54.8% in N2, 14.7% in N3, and the differences were statistically significant (P<0.01). According to 7th edition of TNM classification, the 5-year survival rates of N0, N1, N2, N3a, N3b for the study group were 91.5%, 83.6%, 59.8%, 17.2%, 11.8%, respectively (P<0.01). Lymph node metastasis was an independent prognostic risk factor (P<0.01).

CONCLUSIONSIn patients with gastric cancer without serosal invasion, lymph node metastasis is an predictive factor regardless it is based on the extent or the number of lymph node metastasis.

Aged ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; pathology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; pathology ; surgery

BACKGROUND: The characteristics of cervical anatomy and pedicle screw, operational specification, and individual screw implantation are the key factors of a successful implantation treatment.OBJECTIVE: This study was designed to investigate the cervical pedicle screw and host response as well as the recovery of spinal nerve functions during the surgery and follow-up period of cervical spine fracture-dislocation.DESIGN: A case analysis.SETTING: Department of Orthopaedics, General Hospital of Shenyang Military Area Command of Chinese PLA, Shenyang, Lianning Province, China.PARTICIPANTS: A total of 41 patients with cervical spine fracture-dislocation, who have complete follow-up data, were admitted to the Department of Orthopaedics, General Hospital of Shenyang Military Area Command of Chinese PLA between February 2002 and February 2006. Of the included patients, 18 were complicated by spinal cord injury (according to Frankel classification system, 6 were graded as A, 1 as B, 4 as C, and 7 as D.METHODS: Forty-one patients with cervical spine fracture-dislocation were treated by implanting a screw through the cervical pedicle and fixing it. Prior to surgery, all patients were subjected to X-ray, CT and MRI examinations. According to measurements, each cervical pedicle screw was individually implanted. The entire surgery was accomplished by Xiang Liang-bi, chief physician, whose qualification corresponds to the responsibilities.MAIN OUTCOME MEASURES: Material and host response during and after screw implantation as well as in the follow-up period. Recovery of spinal nerve function after screw implantation.RESULTS: All patients were followed up for 6-12 months and all incisions were healed primarily. Material and host response during the process of screw implantation: A total of 218 screws were implanted. After initial implantation, 12 screws were loosened, and such a phenomenon disappeared in 11 screws by adjusting inserting point and inserting direction or/and increasing screw diameter or length. The remaining 1 screw was stabilized by increasing the fixed segments. After drilling, poles of 10 screws bled much and treated by hemostasis. C1-2 venous plexus hemorrhage was caused in 3 patients and stopped by compression, and Apofix internal fixation was used in 1 of 3 patients due to unclear surgical visual field. Material and host response after surgery and during the follow-up: A total of 218 screws were inserted. Of the 218 screws, 196 were in correct position, and 22 were deviated to different degrees. Deviation of 1 screw caused injury to nerve root and that of another screw led to injury to blood vessel. Thirty-eight patients acquired satisfactory reduction and bone union. Three patients presented with symptoms of nerve root irritation due to incomplete reduction in the old fracture-dislocation. Among the 3 patients, 1 was subjected to anterior approach due to screw removed, and neither injury to vertebral artery, spinal cord, and nerve root nor internal fixation destroy was found in any other patients. Recovery of spinal nerve function after implantation: Among the 18 patients complicated with spinal cord injury, 6 patients, who were assessed as grade A spinal cord injury, did not exhibit improvement in spinal cord function, while the remaining 12 presented with 1 or 2 grades of improvement.CONCLUSION: There is a lower probability for biocompatibility reaction, and spinal nerve function recovers better after implantation of cervical pedicle screw. So implantation of a cervical pedicle screw system is an effective and relatively safe method for treatment of cervical spine fracture-dislocation.

Objective To study the impact of enteral nutrition (EN) or parenteral nutrition (PN) in postoperative colorectal cancer patients on viscera organ function and "passing wind" time.Methods Totally 30 patients with colorectal cancer joined this study with informed consent.Patients were randomly divided into EN group and PN group.Both two groups were given nutritional support from the first post-operative day to the 7th post-operative day.The pre-operative and post-operative viscera organ functions and the recovery time of gastrointestinal functions are observed.Results Total bilirubin was significantly lower in EN group than in PN group (P ＜ 0.05).The length of post-operative hospital stay was significantly shorter in EN group than in PN group (P ＜0.01).The post-operative complications were not significantly different between two groups (P ＞ 0.05).Conclusion Postoperative EN support is beneficial for colorectal cancer patient in terms of lower bilirubin levels,shorter post-operative hospital stay,and lower cost.