Objective Patients with chronic renal failure (CRF) are frequently malnourished, skeletal muscle atrophy and protein depleted. Insulin-like growth factor 1 (IGF-1) is an anabolic hormone. The actions of IGF-1 on protein turnover were examined in skeletal muscle of rats with CRF and sham operated (SO), pair-fed controls. IGF-1 was extracted from serum and skeletal muscle and then measured by radio-immunoassay (RIA). Total tyrosine in the supernatant from the medium was measured fluorometrically and then basal protein synthesis rate and degradation rate in skeletal muscle were calculated. The results showed that IGF-1 levels in serum and in skeletal muscle in the CRF rats were 170.3 ± 16.4 ng/ml and 4.22 ± 1.03ng/grams respectively. These values were significantly lower than in the SO rats (410.4 ± 49.3ng/ml in serum and 6.93 + 1.41ng/grams in muscle, respectively, P<0.001 for each comparison). The basal protein synthesis rate in epitrochlearis muscle of the CRF rats (24.0 ± 2.1 nmol Tyr/grams per hour ) was significantly lower, by 22%, than that of SO, pair-fed rats (30.8 ± 2.4nmol Tyr/grams per hour,P<0.05). In contrast, the basal protein degradation rate in the epitrochlearis muscle of the CRF rats (234.4 ± 13.8nmol Tyr/grams per hour) was increased by 78% in comparison to SO rats (131.7 ± 8.4nmol Tyr/grams per hour, P< 0.001). Dose response curves of rhIGF-1 showed that the effects of rhIGF-1 On muscle protein synthesis and degradation in CRF rats were markedly attenuated as compared to their SO pair-fed controls. The enhancement in protein synthesis induced by increasing concentrations of rhIGF-1 (ranging from 25 to 500ng/ml) in CRF rats was only 25 to 44% of that in SO rats. Similarly, the suppressive effects of the various concentrations of rhlGF-1 on protein degradation in muscle from CRF rats were only 15 to 42% of those found in SO rats. These data indicate that there are impaired actions of rhIGF-1 on protein synthesis and degradation in skeletal muscle of rats with CRF. These findings suggest that the decreased IGF-1 levels in serum and in skeletal muscle, the resistance to the anabolie effects of IGF-1 on protein metabolism may be the main causes of reduced protein synthesis and enhaneed protein degradation in muscle, muscle atrophy and malnutrition in patients with CRF.

Objective To explore the influence of peritoneal transport characteristics on nutritional status of peritoneal dialysis patients. Methods According to peritoneal equilibrium test (PET), 82 stable CAPD patients were divided into high transport group and low transport group. Total protein, albumin and amino acid in plasma and peritoneal effusive dialysate were measured, meanwhile GPI and nPCR were calculated synchronously. Nutritional status between two groups was compared and correlated factors were analyzed. Results There were no significant differences of remnant renal function, peritoneal dialysis time, daily dialysate dosage, ultrafiltration volume, glucose absorption, blood glucose, BUN, Scr and Kt/V between two groups. Total protein and multiple amino acids lost from daily effusive dialysate were significantly more in high transport group than those in low transport group, whereas nutritional indexes were poorer in high transport group than those in low transport group, including significant decrease of body weight and serum albumin. Levels of albumin and amino acid in blood and effusive dialysate were correlated with peritoneal transport characteristics. Conclusions The nutritional status of peritoneal high transport patients is worse as compared to low transport ones. Only elevating the dialysis sufficiency can not improve the nutritional status obviously. Nutritional management and guidance should be strengthened for the CAPD patients.

Objective:To explore the clinical effect of negative pressure wound therapy and to discuss the ethi-cal issues in this therapy and seek a solution. Methods:Sixty patients with negative pressure wound therapy in our hospital were invited to participate in this study. Patients were all with deep pressure ulcers or diabetic foot, of which the Wagner Scores were graded as three or four. They were divided into two groups randomly. The subjects in control group received standard treatment, while those in experimental group were treated by self -designed closed negative pressure drainage settings. The wound healing time, the cost of the treatment and comfort were compared between the two groups. Results:The cost of wound care in the experimental group was less than those in the control group (P<0. 001). There was no significant difference in comfort between two groups (P>0. 05). But the wound healing time was longer in the experimental group than those in the control group. Conclusion:Self-designed closed negative pressure settings can decrease the cost of patient care with the equal patient comfort and acceptance as the standard negative pressure, however, the wound healing time has been extended. So before using negative pressure technique, the medical staff should comprehensively analyze, be guided by medical ethics and choose the appropriate treatment for different patients.

Objective To explore the relationship between personality traits and facial emotion rec?ognition. Methods By opening recruitment,268 health undergraduates were measured using Eysenck Per?sonality Questionnaire and JACFEE facial emotion recognition test. Correlation analysis was administrated be?tween different gender,personality dimensions and facial emotion recognition ability. Results Female had better emotion recognition ability than male((44.18±5.83) vs (41.88±6.79), t=-2.976, P=0.003). There were significant differences among recognition frequency of no?expression picture to other basic facial emo?tions(χ2=37.877, P=0.004) . There were correlative relations between personality dimensions and facial e?motion recognition. Among choleric temperament personality,P dimension had negative correlation with fear emotion( r=-0.223, P=0.028). N dimension had negative correlation with fear emotion( r=-0.253, P=0.013) . Among sanguineous temperament personality,E dimension had negative correlation with contempt e?motion( r=-0.258, P=0.027) ,and P dimension had positive correlation with contempt emotion( r=-0.239, P=0.042).Among melancholic temperament,E dimension had positive correlation with fear emotion( r=0.283, P=0.023) ,and P dimension had positive correlation with amazing emotion( r=0.299, P=0.016) . A?mong phlegmatic temperament, there was no any correlation between personality dimension and emotion recognization. Conclusion Female has better emotion recognition ability than male. There is cognitive tend?ency between personality character and emotion recognition.

L-amino acid transporter 1 ( LAT1) is a member of L-amino transporter family and an important heterodi?meric amino acid transporter that belongs to subfamily of SLC7. LAT1 mainly mediates trans-membrane transportation of those neutral amino acids that had cyclobenzene or long side chains with high molecular mass such as L-Leu, L-Met and L-Phe as well as some amino acid analogues such as melphalan, L-DOPA and thyroxine in a Na+and ATP-independent diffu?sion. As LAT1 was abnormally overexpressed in various transformed cell lines, it might be related with tumor stage and prog?nosis. It is not only a biomarker that specifically expressed in some tumor cells but also plays an important role in tumor diag?nosis and therapy. Here we demonstrate the structure of LAT1 and its mechanism in transport peculiarity. We also reviewed the development of LAT1 in tumor diagnosis and treatment.

Objective To analyze the clinical effects of arthroscopic en masse repair with footprint ending shift using double-row suture-bridge technique for delaminated rotator cuff tears under tension.Methods A total of 58 patients with delaminated rotator cuff tears under tension from August 2013 to August 2016 who underwent arthroscopic en masse repair using doublerow suture-bridge technique were retrospectively analyzed.There were 33 males and 25 females with a mean age of 53.0±7.8 years (range 39-74) with 24 patients left side involved and 34 right side.They were divided into 2 groups to receive en masse repair either footprint ending shift or on the footprint.There were 28 patients with footprint ending shift and 30 patients on the footprint.Clinical effects were evaluated by University of California Los Angeles (UCLA) score,American Shoulder and Elbow Surgeons (ASES) score,visual analogue scale (VAS),Constant-Murley score and shoulder range of motion at preoperatively and postoperatively.Results The average follow-up duration was 23.2±0.8 months (range 21-24).The two groups were compatible with no significant difference in age,gender,tear size,follow-up duration,preoperative function and range of motion of the shoulder joint (P＞0.05).At the last follow up,the UCLA,ASES,VAS,Constant-Murley scores and shoulder range of motion in the group footprint ending shift were respectively 32.4±2.5,12.8±0.9,1.0±1.1,93.4±5.6,158.3°±9.3°,58.9°±5.0° with significantly differences compared with preoperative scores (P ＜ 0.05).The postoperative value in the group on footprint were respectively 31.6±2.9,12.8±0.9,0.7 ± 1.2,91.3±7.1,156.1°± 10.7°,59.6°±4.6° with significantly differences compared with the preoperative scores (P ＜ 0.05).There were no significant difference between the two groups (P ＞ 0.05).The operation duration in the group footprint ending shift was 100.9±6.0 min,while that in the group on footprint was 106.6±6.1 min.There was significantly difference in the operation duration between two groups (t=-3.600,P=0.001).Conclusion Arthroscopic en masse repair using double-row suture-bridge technique can successfully treat delaminated rotator cuff tears under tension.Compared with arthroscopic en masse repair on footprint using double-row suture-bridge technique,the footprint ending shift is easier and time saving without significant difference in function of the shoulder joint and the range of motion in repair of delaminated rotator cuff tear under tension.

Tendons and bones are connected at the tendon-bone interface to transmit force and exchange biological information. However, the formation of fibrous scars after injury to the tendon-bone interface makes it difficult to recover the original structure during surgery and thus reduces its performance. Therefore, the healing of the tendon-bone interface is a hotspot in sports medicine. Numerous studies have already demonstrated that a variety of molecules and cells participate in the tendon-bone interface reconstruction process, and yet the specific mechanism remains unclear. At present, a great number of studies have been carried out on treatment methods, but clinical treatment are varied with no unification. Therefore, the authors review the advances in the biology and mechanics of healing mechanisms of tendon-bone interface as well as the main methods promoting tendon-bone interface healing, so as to provide references and new ideas for further researches on tendon-bone interface healing.

Objective To evaluate the clinical efficacy of arthroscopic bursal layer-only double-row suture-bridge repair for delaminated rotator cuff tear which is difficult to reposit in comparison with separate double-layer repair and whole-layer repair.Methods From May 2013 through June 2016,82 patients with delaminated rotator cuff tear difficult to reposit were treated at Department of Joint Surgery,The Affiliate Hospital to Chengde Medical University.They were 47 males and 35 females with a mean age of 53.0 ± 7.9 years.They were divided into 3 groups according to their surgical procedures.In group A,28 cases were treated by arthroscopic whole-layer double-row suture-bridge procedure;in group B,29 cases were treated by arthroscopic separate double-layer double-row suture-bridge procedure;in group C,25 cases were treated by arthroscopic bursal layer-only double-row suture-bridge procedure.The 3 groups were compared in terms of University of California Los Angeles (UCLA) score,American Shoulder and Elbow Surgeons (ASES) score,visual analogue scale (VAS),Constant shoulder score,range of motion of shoulder joint and rotator cuff retear preoperatively and postoperatively.Results The patients in the 3 groups were comparable because their preoperative general data showed no significant significances (P ＞ 0.05).The operation time for groups A,B and C was respectively 105.5 ±5.6 min,117.4 ±6.9 min and 88.0 ±4.2 min,showing significant differences between the 3 groups (P ＜ 0.05).The 82 patients were followed up for 21 to 24 months (average,23.3 months).At 24 months postoperatively,UCLA,ASES,VAS,Constant score,shoulder anteflexion and lateral extorsion were respectively 32.4 ± 2.5,12.8 ± 0.9,1.0 ± 1.1,93.4 ± 5.6,158.3° ± 9.3°and 58.9°±5.0°in group A,32.2±2.5,12.9±1.0,0.9±1.0,92.8±6.0,156.4°±9.5°and 59.3°± 5.6° in groups B,and32.4±2.4,12.9±0.9,0.7±0.9,94.3±5.2,156.0°±9.5°and57.6°°5.4°in group C,showing no significant differences between the 3 groups (P ＞ 0.05).The occurrence of rotator cuff retear in groups A,B and C were respectively 17.9％ (5/28),13.8％ (4/29) and 12.0％ (3/25),showing no significant differences between the 3 groups (P ＞ 0.05).Conclusions In repair of delaminated rotator cuff tear difficult to reposit,although the arthroscopic bursal layer-only double-row suture-bridge repair is similar to conventional arthroscopic whole-layer double-row suture-bridge repair and arthroscopic separate double-layer double-row suture-bridge repair in functional recovery and range of motion of the shoulder and incidence of rotator cuff retear,it can reduce obviously operation time and make the operation easier.

OBJECTIVETo compare the short-term outcomes between robotic and laparoscopic radical total gastrectomy in gastric cancer patients with BMI index ≥24 kg/m.

METHODClinical data of 93 gastric cancer patients who underwent robotic and laparoscopic radical total gastrectomy at PLA General Hospital from April 2016 to April 2017 were retrospectively analyzed. The retrospective cohort study was adopted.

INCLUSION CRITERIApreoperatively definite diagnosis of primary gastric cancer by endoscopy and biopsy; preoperative BMI ≥24 kg/m; no previous abdominal surgery; no previous chemotherapy and radiotherapy; no distant metastasis or invasion into adjacent organs before operation or during operation; receiving radical gastrectomy; Roux-en-Y reconstruction of digestive tract in open procedure. According to approaches of minimally invasive surgery, 24 patients underwent robotic surgery and 69 underwent laparoscopic surgery. The intraoperative parameters (overall operative time, pneumoperitoneal time, open procedure time, intraoperative blood loss, transfusion rate, number of total retrieved lymph nodes and metastatic lymph nodes) and postoperative parameters (drainage in the first postoperative day, the first defecation time, morbidity of postoperative complication and hospital stay) were compared between two groups. Correlation of the above parameters were analyzed.

RESULTSOf 93 patients, 77 were male and 16 female with an average age of (60.0±10.6) years. The average BMI was (26.8±1.3) kg/m in whole patients, (26.9±1.6) kg/m in robotic group and (26.8±1.7) kg/m in laparoscopic group. No significant differences in age, gender, BMI, preoperative ASA class, postoperative pathological findings and clinical classification were observed between two groups, which made short-term parameters between two groups comparable. The robotic group had a significantly longer overall operative time [(301.2±68.9) minutes vs. (247.3±59.6) minutes, P=0.000], longer open procedure time [(141.5±26.3) minutes vs. (92.5±36.7) minutes, P=0.029] and higher cost than laparoscopy group[(17.5×10 ± 9.7×10) yuan vs. (10.0×10 ± 2.3×10) yuan, P=0.001]. Pneumoperitoneal operative time, intraoperative blood loss, transfusion rate, number of total retrieved lymph nodes, number of harvested metastatic lymph nodes and postoperative short-term efficacy were similar between the two groups (all P>0.05). In robotic group, pneumoperitoneal operative time was positively correlated with overall operative time (r=0.708, P=0.010); total cost was positively correlated with postoperative hospital stay (r=0.493, P=0.000) and open procedure time was negatively correlated with the first defecation time (r=-0.962, P=0.038). In laparoscopy group, total cost was positively correlated with overall operative time (r=0.411, P=0.046), drainage volume in the first postoperative day was positively correlated with the number of total dissected lymph node (r=0.540, P=0.006), postoperative hospital stay was positively correlated with intraoperative blood loss (r=0.574, P=0.003), total cost was positively correlated with intraoperative blood loss and hospital stay (r=0.609, P=0.002; r=0.865, P=0.000), drainage volume in the first postoperative day was positively correlated with BMI (r=0.533, P=0.007).

CONCLUSIONFor gastric cancer patients with BMI ≥24 kg/m, robotic radical total gastrectomy is associated with longer operative time and higher cost, but is less vulnerable to the change of BMI and more in favor of the realization of enhanced recovery after surgery (ERAS) than laparoscopic radical total gastectomy.

Aged ; Body Mass Index ; Female ; Gastrectomy ; methods ; Humans ; Laparoscopy ; Length of Stay ; Male ; Middle Aged ; Operative Time ; Retrospective Studies ; Robotic Surgical Procedures ; Stomach Neoplasms ; surgery ; Treatment Outcome