Objective To evaluate the efficacy of circinal stapled suture and manual suture in cervical esophagogastric anastomosis in esophageal resection.Methods The clinical data of 187 patients with esophageal cancer who were admitted to the Cancer Hospital of Sichuan Province from January 2010 to January 2012 were retrospectively analyzed.All the patients were divided into the stapled suture group (98 patients) and manual suture group (89 patients).The time of anastomosis,operation time,time for dieting,duration of hospital stay,the incidence of postoperative complications and positive rate of esophageal remnant cancer cells of the 2 groups were compared.All data were analyzed using the t test or chi-square test.Results The time of anastomosis,operation time,time for dieting and duration of hospital stay were (7.8 ± 1.4) minutes,(227 ± 60) minutes,(6.3 ± 0.9) days and (14 ±4)days in the stapled suture group,which were significantly shorter than (28.5 ±2.3)minutes,(301 ±81)minutes,(8.4 ± 1.0)days and (22 ±9) days in the manual suture group (t =75.44,7.14,7.71,7.41,P ＜0.05).The incidence of anastomotic fistula was 1％ (1/98) in the stapled suture group,which was significantly lower than 8％ (7/89) of the manual suture group (P ＜ 0.05).The incidence of anastomotic stricture was 5％(5/98) in the stapled suture group,which was lower than 7％ (6/89) in the manual suture group,but no significant difference was detected (P ＞0.05).The positive rate of esophageal remnant cancer cells was 0(0/98),which was signifiantly lower than 4％ (4/89) in the manual suture group (P ＜0.05).Conclusion Circinal stapled suture in esophagogastric cervical anastomosis not only reduce the time of anastomosis,operation time and duration of hospital stay,but also decrease the incidence of anastomotic fistula and the positive rate of esophageal remnant cancer cells.

Objective: To compare the difference in somatic gene mutation of PTC subtypes between 114 patients with papillary thyroid carcinoma (PTC) and The Cancer Genome Atlas (TCGA) database. Methods: Totally 114 PTC patients admitted to The First Affiliated Hospital of Nanjing Medical University were recruited. The 18 hotspot genes associated with thyroid cancer were detected in thyroidectomy specimens were using next generation sequencing. PTC data were downloaded from the TCGA database in the cBioPortal website, and the difference in the somatic gene mutation was compared between 114 PTC patients and the TCGA database Results: The 114 PTC patients included 73 women (64.04%) and had a mean age of (39.23±13.18) years. The prevalence of BRAF V600E (66.67% vs. 48.68%), TERTp (3.51% vs. 0.41%), PDGFRA (1.75% vs. 0%), PTEN (3.51% vs. 0.41%) and TP53 gene mutations (4.39% vs. 0.61%) was significantly higher among the 114 PCT patients than in the TCGA database (P<0.05). The prevalence of BRAF V600E (80.88% vs. 54.99%), TP53 (7.35% vs. 0.57%) and TSHR gene mutations (2.94% vs. 0%) was significantly higher in classical PTC(CPTC) patients than in the TCGA database, and the prevalence of BRAF V600E (36.84% vs.13.86%) and TERTp gene mutations (10.53% vs. 0%) was significantly higher in follicular variant PTC (FVPTC) patients than in the TCGA database. According to the American Thyroid Association Risk Stratification of Thyroid Cancer Recurrence, the prevalence of BRAF V600E and TP53 gene mutations was 77.14% and 8.57% among moderate-risk CPTC patients, the prevalence of BRAF V600E gene mutation was 27.27% among low-risk FVPTC patients, and the prevalence of TERTp gene mutation was 33.33% among moderate-risk FVPTC patients, which were all higher than in the TCGA database (55.10%, 0%, 3.28%, and 0%, respectively; P<0.05). Conclusion There are significant differences in the type and rate of somatic gene mutations between 114 PTC patients and the TCGA database.

This article provides an overview of the severe acute respiratory syndrome (SARS) epidemics in mainland China and of what we have learned since the outbreak.The epidemics spanned a large geographical extent but clustered in two regions:first in Guangdong Province,and about 3 months later in Beijing and its surrounding areas.The resulting case fatality ratio of 6.4％ was less than half of that in other SARS-affected countries and regions,partly due to younger-aged patients and a higher proportion of community-acquired infections.Strong political commitment and a centrally coordinated response were most important for controlling SARS.The long-term economic consequence of the epidemic was limited.Many recovered patients suffered from avascular osteonecrosis,as a consequence of corticosteroid usage during their infection.The SARS epidemic provided valuable experience and lessons relevant in controlling outbreaks of emerging infectious diseases,and has led to fundamental reforms of the Chinese health system.Additionally,the epidemic has substantially improved infrastructures,surveillance systems,and capacity to response to health emergencies.In particular,a comprehensive nationwide internet-based disease reporting system was established.

OBJECTIVETo observe the differential effect of joint ultrasound on the syndrome differentiation of rheumatoid arthritis (RA) by observing the high frequency ultrasound performances among inactive stage and different syndromes in active stage.

METHODSTotally 83 RA patients in the active stage were assigned to the dampness heat syndrome group (DHS, 59 cases)and the cold dampness syndrome group (CDS, 24 cases) according to Chinese medicine (CM) syndrome typing. Besides, 20 RA patients in the remission stage were recruited as the control group (abbreviated as the remission group). By using high frequency ultrasound and power Doppler ultrasound technology, a comparative observation of synovitis, tenosynovitis, synovial blood flow, and bone erosion in the 2nd-5th metacarpophalangeal (MCP) joints, proximal interphalangeal (PIP) joints, wrist joints, knee joints, the second and the fifth metatarsophalangeal (MTP) joints (a total of 24 joints) was performed in all patients. Correlation analyses were performed between the ultrasound performance, laboratory indices, and the disease activity. Ultrasound data of each RA patient were analyzed by their total scores. Χ2 test was used for enumeration data. The measurement data was expressed as x ± s. One-way ANOVA was used for data of normal distribution, while non- parametric test was used for data of non-normal distribution. Correlation analysis of two variables was performed for clinical indicators and ultrasound indicators. Its significance was detected using Pearson correlation.

RESULTSCompared with the remission group, the severity degree of synovitis, tenosynovitis, synovial blood flow, and bone erosion significantly increased in the DHS group (P < 0.01). There was statistical difference in ESR, CRP, anti-CCP, DAS28 score, and the positive rate of RF (P < 0.05, P < 0.01). There was statistical difference in the severity degree of synovitis and synovial blood flow, and DAS28 score in the CDS group (P < 0.05). Compared with the CDS group, there was statistical difference in the four ultrasound indices (P < 0.05, P < 0.01), ESR, CRP, anti-CCP, DAS28 score, and the positive rate of RF in the DHS group (P < 0.05, P < 0.01). There was no statistical difference in G, IgG, IgA, or IgM among the three groups (P > 0.05). There existed positive correlation between ESR and the synovitis degree, synovial blood flow, and bone erosion in the DHS group (r = 0.444, 0.397, 0.486, P < 0.05).There existed positive correlation between ESR and the synovitis degree, bone erosion, and synovial blood flow in the DHS group (r = 0.378, 0.270, P < 0.05). There existed positive correlation between the DAS28 score and the synovitis degree and synovial blood flow in the DHS group (r = 0.304, 0.351, P < 0.05).

CONCLUSIONSThe inflammation degree was the most severe in RA patients of DHS. High frequency ultrasound could provide better evidence for Chinese medical syndrome differentiation of RA patients.

Arthritis, Rheumatoid ; diagnostic imaging ; Humans ; Medicine, Chinese Traditional ; Metacarpophalangeal Joint ; ultrastructure ; Syndrome ; Synovitis ; diagnostic imaging ; Ultrasonography

BACKGROUND: Classic isolation method of bone marrow mesenchymal stem cells (BMSCs) is Percoll density gradient centrifugation. Blood cell component was removed. However, this method is complicated. Preparation density was needed when isolating dog bone marrow. Moreover, centrifugation was frequent, which had a great damage to cells. OBJECTIVE: To establish methods of the isolation, proliferation, culture and osteoinduction of canine BMSCs, and observe the in vitro proliferation and ability to osteoinduction differentiation. METHODS: 10 mL bone marrow was extracted from dog posterior superior iliac spine, heparin anticoagulation, diluted using Hanks juice, treated with 1.077 g/mL Ficoll solution 3 mL, and centrifuged at 2 000 r/min for 20 minutes. Karyocytes were absorbed to form white cloudlike layering interface, and then centrifuged twice using DMEM supplemented with fetal bovine serum, incubated at 12×10~4/cm~2 at 37 ℃ in a 5% CO_2 incubator. Following subculture, cells were incubated in DMEM containing dexamethasone, β-sodium phosphoglycerol and ascorbic acid 2-phosphate. Immunocytochemical staining and immunofluorescence staining were utilized to detect osteocalcin, osteopontin and type Ⅰ collagen expression in osteoblasts. Alkaline phosphatase staining and alizarin red staining were performed. RESULTS AND CONCLUSION: 1.077 g/mL Ficoll density gradient centrifugation was used to isolate karyocytes that were significant compared with Percoll solution. Obtained BMSCs had high purity, good growth and the mean doubling time was 24 hours. Following in vitro osteogenic incubation of dog BMSCs, osteocalcin, osteopontin and type Ⅰ collagen showed positive expression. Alkaline phosphatase staining demonstrated bluish-green cytoplasm. Alizarin red staining showed red nodes in extracellular matrix, and could differentiate into osteoblasts in vitro.

OBJECTIVETo summarize and analyze the compatibility laws for acupoint selection of acupuncture in treating diabetic gastroparasis (DGP) in modern literatures of clinical researches.

METHODSRetrieved were literatures related to treating DGP by acupuncture or acupuncture combined other therapies from PubMed, CNKI, and WF from 1982 to 2014. Analyzed were frequency of acupoint use, meridians selected acupoints belonged to, regions selected, association laws of selected compatible acupoints.

RESULTSRetrieved were 35 with compatibility frequencies more than 15 listed as follows: compatibility frequency of Zusanli (ST36) and Zhongwan (CV12) was 33 (94.29%); compatibility frequency of Zusanli (ST36) and Neiguan (PC6) was 23 (65.71%), compatibility frequency of Zhongwan (CV12) and Neiguan (PC6) was 22 (62.86%), compatibility frequency of Zusanli (ST36), Zhongwan (CV12), and Neiguan (PC6) was 22 (62.86%); compatibility frequency of Zusanli (ST36) and Sanyinjiao (SP6) was 16 (45.71%); compatibility frequency of Zhongwan (CV12) and Sanyinjiao (SP6) was 16 (45.71%); compatibility frequency of Zusanli (ST36), Zhongwan (CV12), and Sanyinjiao (SP6) was 15 (42.86%). Meridians selected acupoints belonged to were sequenced as Foot Yangming Stomach channel, Ren channel, Foot Taiyang Bladder channel, and so on. Acupoints selected were mainly in lower limbs, chest and abdomen, waist and back. The compatibility of Zusanli (ST36) and Zhongwan (CV12) was the most often used with the highest frequency.

CONCLUSIONSThe compatibility laws for acupoint selection of acupuncture in treating DGP were mainly dominated as upper-lower selection, three regions selection, local selection, anterior-posterior selection. The compatibility laws for acupoint selection of acupuncture along meridians were mainly dominated as the convergence points and exterior-interior meridian points.

Acupuncture Points ; Acupuncture Therapy ; Diabetes Complications ; drug therapy ; Diabetes Mellitus ; drug therapy ; Humans ; Meridians ; Stomach ; physiopathology ; Stomach Diseases ; drug therapy

Adult ; Comet Assay ; DNA Damage ; drug effects ; Female ; Humans ; Lipid Peroxidation ; drug effects ; Male ; Peracetic Acid ; toxicity

Background Diabetic complication is associated with lipid peroxidation.Aldehyde dehydrogenases (ALDH) catalyze the irreversible oxidation of a variety of biological aldehydes,including lipid-derived aldehydes (LDAs),and thus protect organs and tissues from toxic LDAs.Understanding the activity of ALDH in different ocular tissues in diabetic subjects is very important for prevention and treatment of diabetic ocular complications.Objective This research aimed to investigate the activity and expression of ALDH in different ocular tissues in diabetic rats and to explore the mechanism of ALDH in diabetes-induced eye disease.Methods Twenty-eight healthy SPF male Sprague-Dawley(SD) rats weighted 170-180 g were randomly divided into the normal control group and diabetic group.The diabetic animal model was established by intraperitonial injection of 4％ streptozotocin at 65 mg/kg.Isometric citric acid buffer was injected in the rats of the normal control group.The rats were sacrificed in each group 2 and 4 months after the establishment of the diabetic models,and eyeballs were obtained for the preparation of corneal,lens and retinal homogenates.ALDH activity was detected using a multifunctional microplate reader SpectraMax M5,and ALDH content was measured by ELISA at the wavelength of 450 nm with the SpectraMax M5 ELISA reader.Results The blood glucose level in diabetic rats was significantly elevated at various time points compared with the normal control group(P=0.000),and body weights were evidently lower in the diabetic group than in the normal group (P =0.000).The activities of ALDH (A340) in corneal,lens and retinal tissues in the diabetic group were increased in comparison with the normal control group (F =396.601,P=0.000),and showed an enhancement with the lapsing of time (F =53.139,P =0.000).In addition,the highest level of ALDH was found in the cornea and the lowest level in the lens(F =6973.000,P=0.000).The expression level of ALDH in the corneal,lens and retinal homogenates was significantly higher in the diabetic group compared with the normal control group (F=312.985,P =0.000) and showed a considerable increase over the course (F =19.203,P=0.000).The highest expression level was seen in the cornea and the lowest was in the lens,with a significant difference among these three kinds of tissues (F =3243.000,P =0.000).Conclusions ALDH can protect ocular tissue from the damage of lipid peroxidation.Thess results suggest that ALDH plays a role in preventing diabetes-related ocular complications.

Objective To investigate the perioperative characteristics and changing trends of gastric electrical activity of thoracic (tube) stomach in patients with esophageal cancer.Methods The clinical data of 30 patients with esophageal cancer who were admitted to the Sichuan Cancer Hospital between March 2013 and November 2013 were prospectively analyzed.All the eligible patients underwent esophageal cancer resection by Ivor-Lewis according to the inclusion criteria.The electrogastrograms of patients were recorded at preoperative day 1 and at postoperative day 3,7, 11 and 30.The electrogastrograms of patients at preoperative day 1 were used as the control.The parameters of electrogastrogram were analyzed including main frequency, coefficient of dominant frequency instablility, main power, postprandial/preprandial power ratio, percentage of normal gastric slow wave,percentage of slow gastric slow wave and percentage of tachycardia gastric slow wave.Measurement data with normal distritution were presented as x ± s, and measurement data with skew distritution were presented as M (Qn).The postoperative time and pre-and post-prandial electrogastrograms were compared by the repeated measures two-way ANOVA.The comparison between groups were evaluated with the LSD test and analysis of variance.Results Thirty patients were screened for eligibility with a mean age of 62 years (range, 49-75 years), including 26 males and 4 females.The pre-and post-prandial main frequencies were changed from 2.83 ± 0.13 and 3.01 ± 0.17 before operation to 2.66 ± 0.10 and 2.82 ± 0.10 at postoperative day 30 with coherent changing trend.The main frequencies at postoperative each time points were significantly lower than those before operation while postprandial above indicators were higher than preprandial those, showing a significant increasing trend with the passage of postoperative time (F =285.62, P ＜ 0.05).There was no interaction between the time and meal (F =0.22, P ＞ 0.05).The pre-and post-prandial coefficients of dominant frequency instablility were changed from 0.133 ±0.031 and 0.045 ±0.019 before operation to 0.150 ±0.043 and 0.115 ±0.010 at postoperative day 30 with coherent changing trend, and coefficients of dominant frequency instablility at postoperative each time points were significantly higher than those before operation while postprandial above indicators were lower than preprandial those, showing a significant reducing trend with the passage of postoperative time (F =16.51, P ＜ 0.05).The pre-and post-prandial main powers were changed from (85 ± 15) μV and (149 ± 23) μV before operation to (74 ± 9) μμV and (98 ± 10) μV at postoperative day 30, and main powers at postoperative each time points were significantly lower than those before operation, showing a significant increasing trend with the passage of postoperative time (F =48.45, P ＜ 0.05).There was interaction between the time and meal (F =7.39, P ＜ 0.05).The postprandial/preprandial power ratio was changed from 3.00 ± 0.35 before operation to 2.52 ± 0.25 at postoperative day 30, and postprandial/preprandial power ratios at postoperative each time points were significantly lower than those before operation, showing a significant increasing trend with the passage of postoperative time (F =26.66, P ＜ 0.05).The pre-and post-prandial percentages of normal gastric slow wave were changed from 81％ ± 6％ and 94％ ± 5％ before operation to 57％ ± 5％ and 70％ ± 5％ at postoperative day 30 with coherent changing trend, and percentages of normal gastric slow wave at postoperative each time points were significantly lower than those before operation while postprandial above indicators was lower than preprandial those, showing a significant increasing trend with the passage of postoperative time (F =49.36,P ＜0.05).There was no interaction between the time and meal (F =0.24, P ＞ 0.05).The pre-and postprandial percentages of slow gastric slow wave were changed from 17％ ± 7％ and 4％ ± 4％ before operation to 32％±4％ and 21％±4％ at postoperative day 30 with coherent changing trend, and percentages of slow gastric slow wave at postoperative each time points were significantly higher than those before operation while preprandial above indicators were higher than postprandial those, showing a significant reducing trend with the passage of postoperative time (F =46.54, P ＜ 0.05).There was interaction between the time and meal (F =18.12, P ＜ 0.05).The pre-and post-prandial tachycardia gastric slow wave percentages were changed from 1.55％ (1.04％,2.21％) and 1.95％ (1.74％, 4.22％) before operation to 8.97％ (5.76％, 12.02％) and 12.41％ (8.04％,16.85％) at postoperative day 30 without completely coherent changing trend, and percentages of tachycardia gastric slow wave at postoperative each time points were significantly higher than those before operation while postprandial above indicators were higher than preprandial those, showing a significant difference between before operation and postoperative day 3 (Z =11.47, 13.28, P ＜ 0.05) and no significant difference among the postoperative day 7, 11, 30 (Z =1.88, 0.31, 0.03, P ＞ 0.05).There was no interaction between the time and meal (F=0.85, P＜0.05).Conclusions After the esophagectomy, gastric electrical activity of thoracic (tube) stomach is also retained before and after the meal.There are significant differences among the main frequency, main power, coefficients of dominant frequency instablility, postprandial/preprandial power ratio,percentage of normal gastric slow wave, percentage of slow gastric slow wave, percentage of tachycardia gastric slow wave of thoracis (tube) stomach, they have changed dynamically in the perioperative period.

Objective To evaluate the value of CT perfusion imaging (CTP)for solitary pulmonary nodule (SPN)by Meta-analysis.Methods Literatures about SPN diagnosed by CTP were filtered.PubMed,EMBASE,CNKI,VIP and WANFANG databases were searched for the relevant articles.The retrieved studies were screened according to the criteria for diagnostic research published by the cochrane methods group on screening and diagnosis.The quality of the articles was accessed and the basic data in the articles was extracted.Review Manager 5.3 software was used to compare the blood volume (BV)among different nodules,to perform heterogeneity test and analyze publication bias.Results A total of 1 7 studies with 877 lesions were included in the study.The random effect model was used for the existence of heterogeneity.The result showed the BV value of malignant SPN was higher than that of benign ones.Conclusion The result indicates that there exists significant difference in BV between malignant and benign SPN.The BV value,as one of the hemodynamic parameters of CTP,can be used as the diagnostic basis of SPN.