Several reconstruction techniques are available after gastrectomy. Roux-en-Y reconstruction following distal gastrectomy is the reference in terms of long-term functional and endoscopic outcomes. It is the preferred reconstruction for benign lesions and early gastric cancer. In patients with advanced gastric cancer, BillrothII (reconstruction is an acceptable alternative. After total gastrectomy, Roux-en-Y reconstruction is the simplest solution, with satisfactory functional outcome. Addition of a jejunal reservoir seems to improve long-term outcome after total gastrectomy and could be of benefit to patients with good prognosis. After distal or total gastrectomy, hand-sewn anastomoses should be preferred because of lower costs. Mechanical sutures can facilitate transhiatal esophagojejunostomy. After proximal gastrectomy, esophago-gastric anastomosis is the basic reconstruction method. Gastric remnant is made into gastric tube in the operation. The effect of pyloroplasty remains controversial, and further study is needed to improve the quality of life after operation.
Anastomosis, Roux-en-Y ; methods ; Gastrectomy ; Gastroenterostomy ; methods ; Humans ; Reconstructive Surgical Procedures ; methods ; Stomach Neoplasms ; surgery

OBJECTIVE: Study the clinical characteristics, treatment results and prognostic factors of hypopharyngeal carcinoma. MMETHOD: A retrospective analysis was performed of 97 hypopharyngeal cases that were treated in Department of Dtolaryngology of our hospital from January 2008 to December 2012. 93 cases of them are male patients, and 4 cases are female patients. The tumors are originated from pyriform sinus(75 cases), posterior pharyngeal wall (16 cases) and post-cricoid area (6 cases). Of the 97 patients,21 patients were treated with partial hypopharynx resection (21. 6%), 7 were treated with partial laryngectomy+ partial hypopharynx resection (7. 2%), 53 were treated with total laryngectomy+partial hypopharynx resection (54. 6%), 12 were treated with total laryngectomy and total hypopharynx resection, gastric-pharyngeal anastomosis (12. 4%) and 4 were treated with total laryngectomy and total hypopharynx resection, enteric-pharyngeal anastomosis (4. 1%). Sixty-one cases undergo postoperative radiotherapy in Oncology. Use Chi-square test to do enumeration data analysis, the survival rate is calculated with the life table method, survival analysis with Kaplan-Meier method, parallel Log-rank test. Cox regression multivariate analysis model is used to find the factors affecting prognosis. RESULT: The follow-up rate of this group was 90. 7%. All patients' 1-year survival rate is 76. 0% , 3-year survival rate is 56. 0%, pathological lymph node metastasis rate is 71. 1%, occult lymph node metastasis rate is 19. 6%. Local recurrence rate is 21. 6%. The main reasons of death in patients include : cervical lymph node metastasis in 7 patients (21. 9%), local recurrence in 12 cases (37. 5%), distant metastases in 10 patients (31. 3%) and so on. Univariate analysis showed that tumor size (P<0. 01) and tumor T stage (P<0. 05) have impact on survival prognosis, no risk factors was found with Cox regression multivariate analysis. CONCLUSION Hypopharyngeal carcinoma is difficult to be found early, prone to recurrence and metastasis after operation, carefully chosen surgical excision and neck dissection, adjuvant postoperative radiation therapy is the main treatment strategy. Posterior pharyngeal wall carcinoma tend to have higer recurrence and metastasis rate than the other two types of hypopharyngeal caocinom, and treatment would cause much larger injury, so more attention should be paid to this type of hypopharyngeal caocinom.
Carcinoma, Squamous Cell ; diagnosis ; surgery ; Female ; Head and Neck Neoplasms ; diagnosis ; surgery ; Humans ; Hypopharyngeal Neoplasms ; diagnosis ; surgery ; Hypopharynx ; surgery ; Laryngectomy ; Lymphatic Metastasis ; Male ; Neck Dissection ; Neoplasm Recurrence, Local ; Pharynx ; Prognosis ; Retrospective Studies ; Squamous Cell Carcinoma of Head and Neck ; Survival Rate ; Treatment Outcome

Objective: To search for effective volatile oil of Chinese crude drug for killing demodex in vitro. Methods: The demodex mites were collected by adhesive cellophane tape technique. The killing effects of different volatile oils against Df and Db were observed by microscope. Normal saline and Xinfu Manling Ointment were used as negative and positive controls, respectively. Skin irritation tests for normal and wounded skin and acute toxicity test were carried out using rabbit skin. Results: The volatile oils of 6 Chinese crude drugs, including clore, orange fruit, manchurian wildginger, cinnamon bark, rhizoma alpinae, and pricklyash peel, were highly potent in killing Df and Db in vitro; and the volatile oil of clore and manchurian wildginger had a better killing effect against Df than Db(P< 0.05). The scores for irritation to normal and wounded rabbit skin were 0.2 and 0.3, respectively, and acute toxicity test showed no obvious toxicity. Conclusion: The volatile oils of the 6 mentioned Chinese crude drugs have satisfactory anti-mite activities in vitro. The volatile oil of clore shows a remarkable activity against demodex in vitro, with good skin safety.

Objective: To study the influence of pre-operative disease course on the operation and post-operation quality of life of adolescents with idiopathic scoliosis (AIS). Methods: A total of 110 AIS patients who were treated with classic posterior correction, pedicle internal fixation were divided into two groups according to their disease courses (n=55): short course group with a pre-operation course <2 years (S group), long course group with a pre-operation course ≥2 years (L group). The gender, Lenke type, and major curve Cobb angle were matchable between the two groups. Various radiographic measurements and indices like fusion level, intraoperative blood loss and scores of SRS-22 scale were compared between the two groups before operation, immediately, and 2 years after operation. Results: The pre-operative Cobb angles of the major curve were similar between the two groups, but the flexibility of the major curve averaged (55.7±18.77)% in the S group and (48.1±18.24)% in the L group (P = 0.034). Pre-operative Cobb angles of the minor curve were larger in L group than those in S group ([30.1±12.10]° in the S group and [34.8±10.85]° in the L group, P = 0.035). The post-operative radiographic measurements and the blood loss/infusion were similar between the two groups. The number of fused vertebrae in the L group was significantly more than that in the S group (P = 0.027). The parameters in the SRS-22 scale, including function/activity, pain, self-image/appearance, and mental health were similar between the two groups during follow-up. And the L group had a significantly lower satisfaction rate of treatment compared with the S group ([4.0±0.70] vs [3. 7±0.78], P = 0.037). Conclusion: The flexibility of the curve in AIS decreases with the increase of disease course, and the disease course might be a risk factor for the scoliosis progression of the minor side. Patients with a disease course ≥2 years have more fused vertebrae than those with a disease course <2 years. The length of pre-operative disease course has influence on the quality of life of AIS patients after operation.

Animals ; Hypothyroidism ; physiopathology ; Learning ; Memory ; Mice ; Motor Activity

In this paper, we propose a new active contour algorithm, i. e. hierarchical contextual active contour (HCAC), and apply it to automatic liver segmentation from three-dimensional CT (3D-CT) images. HCAC is a learning-based method and can be divided into two stages. At the first stage, i.e. the training stage, given a set of abdominal 3D-CT training images and the corresponding manual liver labels, we tried to establish a mapping between automatic segmentations (in each round) and manual reference segmentations via context features, and obtained a series of self-correcting classifiers. At the second stage, i.e. the segmentation stage, we firstly used the basic active contour to segment the image and subsequently used the contextual active contour (CAC) iteratively, which combines the image information and the current shape model, to improve the segmentation result. The current shape model is produced by the corresponding self-correcting classifier (the input is the previous automatic segmentation result). The proposed method was evaluated on the datasets of MICCAI 2007 liver segmentation challenge. The experimental results showed that we would get more and more accurate segmentation results by the iterative steps and the satisfied results would be obtained after about six rounds of iterations.
Algorithms ; Humans ; Imaging, Three-Dimensional ; Liver ; diagnostic imaging ; Models, Theoretical ; Tomography, X-Ray Computed

Blast Injuries ; Deafness ; etiology ; Humans

AIM: To analyze the postoperative infection of pathological myopia with pocket scleral reinforcement. ·METHODS:The clinical data of 167 cases of pathological myopia treated with pocket scleral reinforcement in June to December 2014 were analyzed. The postoperative infection rate, the resistance of pathogenic bacteria were analyzed, and the related factors of infection were analyzed. ·RESULTS: A total of 286 eyes were obtained in 167 patients. The infection rate was 6. 3% in 10 patients ( 18 eyes) . There were 30 pathogenic bacteria isolated from the 18 infected eyes, in which were 10 Staphylococcus aureus, 10 Staphylococcus epidermidis, 6 Klebsiella pneumoniae, 4 Pseudomonas aeruginosa infection. Gram positive bacteria showed higher resistance to penicillin, ampicillin and ciprofloxacin, and were sensitive to vancomycin. The resistance rates of gram negative bacteria to cefotaxime were higher, but to imipenem was low. The two groups of patients age, culture level, operation time, the number of operation, intraoperative nursing staff seniority, postoperative medication compliance rate was statistically significant (P<0. 05), which related to the infection after pocket scleral reinforcement. ·CONCLUSION:The infection caused by Staphylococcus aureus is the most common after pocket scleral reinforcement, and it is sensitive to vancomycin, and gram negative bacteria is sensitive to imipenem. Shortening the operation time, using the experienced nursing staff to cooperate, reducing the number of operation and improving the compliance of the patients can reduce the postoperative infection.

Objective To observe the hemodynamic effects of open-loop target controlled infusion (OLTCI) and closed-loop target controlled infusion (CLTCI) of propofol and fentanyl for general anesthesia induction. Methods Twenty-four female patients with ASA grade I-II who were performed thyroidectomy were randomly allocated into two groups: OLTCI group and CLTCI group(n=12). In OLTCI group, anesthesia induction and maintenance were performed with propofol and fentanyl at the target concentrations of 3 ?g/mL and 3 ng/mL, respectively. In CLTCI group, double CLTCI were performed. Titrations of propofol and fentanyl were guided with bispectral index (BIS) and product of systolic pressure and heart rate (HR). Initiative concentrations of this closed-loop system were 3 ?g/mL and 3 ng/mL, step-up or step-down concentrations were 0.5 ?g/mL and 0.5 ng/mL, and the highest concentrations were 6 ?g/mL and 5 ng/mL, respectively. HR, mean arterial pressure (MAP), HR variability, BIS value and the dosages of propofol and fentanyl in various time of the two groups were recorded. Results One min after intubation and simulative incision stimulation, BIS value of both groups were increased, but the BIS value in CLTCI group was less increased than OLTCI group(P

This paper presents a high voltage generator for the defibrillator.Its principle and design method are introduced.The high voltage generator is the core part of the defibrillator which is necessary toany hospital.There is nodomestic-patented defibrillator by now and published paper specialized in the principle and design method of the high voltage generator for the defibrillator.