Objective To compare the clinical effect of proximal gastric malignant tumor treated by the total gastrectomy and the proximal gastrectomy.Methods 278 patients with gastric cancer were randomly divided into two groups by double blind method(1 ∶ 1).Patients in the two groups received total gastrectomy (TG)and proximal gastrectomy(PG) treatment,respectively.The surgery effect,postoperative complications,survival rate and tumor recurrence rate were compared between the two groups.Results In PG group,the average blood loss was (151.6 ± 26.4)mL,operation time was (124.5 ±36.2) min,hospital stay was(8.9 ± 3.1) days,which were significantly lower than those in TG group (231.5 ± 15.3) mL,(162.4 ± 24.8) min and (12.6 ± 6.2) days (t =45.352,36.521,11.243,all P ＜0.05).The lymph node excision rate of PG group was (13.2 ± 3.1)％,which was significantly lower than (16.4 ±4.6) ％ in TG group(t =9.654,P ＜ 0.05).The incidence rate of postoperative complications between the two groups had statistically significant difference(x2 =25.321,20.254,all P ＜ 0.05).The survival rates of 3 years,5 years in TG group were 62.16％,42.32％,those in PG group were 60.39％,34.23％.The 3 years survival rate had no significant difference between the two groups (x2 =6.321,P =0.079),5 years survival rate had statistically significant difference between the two groups (x2 =31.265,P =0.000).The recurrence rate in group TG was 22.30％,which was significantly lower than 34.53 ％ in PG group (x2 =29.365,P =0.000).Conclusion Average blood loss,operation time,hospitalization time and postoperative complications of PG group are less,,but the lymph node resection rate is low,tumor recurrence rate is high,the 5-year survival rate is lower than the TG after surgery.TG can be recommended for the proximal gastric malignancy.

Different types of cervical spondylosis treated by a vartiety of operative techniques were compared with the aim at improving quality of treatment for cervical spondylosis. 1780 operations including laminectomy, open door laminoplasty, subtotoal vertebrectomy, Cloward's technique, Smith's technique, "keyhole" decompression of the intervertebral foramina, discectomy with intervertebral fusion, intervertebral fixation with titanium cage, and fixation with titanium plate. The results showed:(1)Myelopathy in 363 cases: laminectomy on 4; subtotoal vertebrectomy on 136; Cloward's technique on 201; Smith's technique on 4; intervertebral fixed with titanium on 4; discectomy with fusion on 14. 104 cases were followed up, 82 7% of them showed good and excellent recovery. (2)Myeloradiculopathy in 1106 cases: laminectomy on 3; laminoplasty on 143; subtotoal vertebrectomy on 687; Cloward's technique on 263; Smith's technique on 2; discectomy with fusion on 8. 396 cases were fouowed up, 85 6% of them showed good and excellent recovery. (3)Radiculopathy in 35 cases: posterior approach key hole decompression of the intervertebral foramina on 19; lateral approach decompression of the intervertebral foramina on 9; anterior approach decompression of the intervertebral foramina on 7. Good and excellent results reached 100%. (4)Vertebral artery compression in 9 cases: resection of the osteophyte of the uncinate processes on 5; opening of the transverse foramen on 4. The results were good. (5)Esophagus compression in 18: after removing directly the osteophyte, the symptoms disappeared. (6)Ossification of the posterior longitudinal ligament in 93 cases: subtotal vertebrectomy on 39; laminoplasty on 45; laminectomy on 9. 41 cases were followed up, good and excellent recovery was seen in 85 3%. (7)Cervical stenosis in 156 cases: laminoplasty on 149 and laminectomy on 7. Good and excellent recovery was observed in 97 5%. All the results indicated that a variety of operative techniques could be selected depending on the site of the osteophytes. Direct resection of the lesion which produced compression and fixation or fusion of vertebral bodies were both important to achieve a satisfactory result

砄bjective:To study the absorption of porous block ? tricalcium phosphate(? TCP) implanted in the defects of rabbit calvarium.Methods:Twenty four rabbits were randomly divided into four groups with six in each,a round piece of bone with the diameter of 8 mm was removed on left and right sides in the calvarium of each animal.? TCP samples were implanted in the left defects and hydroxyapatite(HA)in the right.Rabbits were sacrificed at 2,4,8,12 weeks after operation respectively,The implanted materials were quantitatively measured by "Point Counting".Results:Twelve weeks after operation,the amount of ? TCP and HA remained in the transplants were 34.54% and 49.28%,while the bone tissue comprised 24.43% and 19.67% of ? TCP and HA transplants respectively.Conclusion:Porous block ? TCP is more absorbable and more feasible for new bone tissue regeneration than HA.

Objective: To evaluate the feasibility,the safety and the effect of early postoperative enteral nutrition in patients with esophageal cancer.Methods: On the first postoperative day,40 patients were randomly divided into two groups.One group was given isocaloric total parenteral nutrition through central vein(TPN group) and the other group was fed with enteral nutrition through nasoenteric tubes or jejunostomy tubes which were inserted during the operation(EEN group).All variables were measured before operation and on postoperative day 1 and 8.Blood was drawn at different time points to assess albumin,prealbumin and transferrin.Immune response was determined by immunoglobins,total lymphocytes,T-lymphocyte subsets and NK cells. Inflammatory response were determined by C-reactive protein,IL-6 and TNF-?.Morbidity,mortality and length of hospital stay were also evaluated. Results: Tolerance of enteral nutrition was excellent.Neither mortality nor serious morbidity occurred in all patients during the period of study.After the study,the levels of serum prealbumin,total lymphocytes,CD3,CD4 and CD4/CD8 ratio in the EEN group were significantly higher than the levels in the TPN group.The concentrations of IL-6 and the length of hospital stay in the EEN group were significantly lower than in the TPN group.Conclusion: Early postoperative enteral nutrition in patients with esophageal cancer is safe,and also has the benefit effects of enhancing the body status of nutrition and immune function,and reducing the inflammatory response and the length of hospital stay.

Objective To investigate the diagnostic value of ADC in the evaluation of small round cell malignant tumors(SRCMT) of nasal and paranasal sinus.Methods This study included 143 patients with surgically confirmed SRCMT and Non-SRCMT of nasal and paranasal sinus between 2008 and 2015, all patients underwent diffusion weighted MRI at 3.0 T with a b factor of 0 and 1 000 s/mm2.Quantitative analysis of ADC values was performed.Difference in ADC values between SRCMT and Non-SRCMT was evaluated using the independent samples t test.One-way analysis of variance(ANOVA) test was performed to compare the ADC values of SRCMT.Receiver operating curves (ROC) were developed to determine the cutoff points to differentiate SRCMT from Non-SRCMT.Results There were 98 SRCMT, of which 20 lesions were rhabdomyosarcoma(RMS), 19 lesions were non-Hodgkin's lymphoma(NHL), 4 lesions were malignant melanoma(MM), 14 lesions were neuroendocrine carcinoma(NEC), 12 lesions were Ewing sarcoma or primitive neuroectodermal tumor(EWS or PNET), 11 lesions were extramedullary plasmacytoma(EMP), and 8 lesions were olfactory neuroblastoma(ON).There were 45 Non-SRCMT, of which 28 lesions were squamous cell carcinoma(SCC) and 17 lesions were adenoid cystic carcinoma(ACC).The mean ADC value of SRCMT[(0.66 ± 0.12) × 10-3mm2/s] was significantly different (t=14.97, P＜0.01) from Non-SRCMT [(1.02± 0.16)× 10-3mm2/s].All of 7 kinds of SRCMT were divided into 3 groups according to ADC values: NHL,MM, NEC,EMP;RMS,EWS,PNET;ON.There was statistically significant difference among all 3 groups(F=39.743, P＜0.01), and the differences between any 2 groups were still statistically significant.The area under the ROC of ADC values diagnosing SRCMT was 0.975.Compared with pathological results, an ADC value of 0.82 × 10-3mm2/s was used as the threshold for diagnosing SRCMT with a sensitivity of 97.8％ (44/45),specificity of 89.8％(88/98), and accuracy of 92.3％ (132/143).ADC value had high correlations compared with pathological results (Kappa value was 0.831).Conclusion The ADC value is a non-invasive imaging parameter that can be used to effectively assess SRCMT of nasal and paranasal sinus.

Objective To study how to reduce the incidence rate of skin flap necrosis after the eradicative resection of breast cancer. Methods 45 patients with breast cancer underwent eradicative operation with new methods to prevent the necrosis of skin flap,and they were studied and compared with 1210 cases treated by traditional ways. Results With the new methods adopted, the necrosis rate of skin flap following eradicative operation of breast cancer was reduced from 45%(original)to 2%(present).Statistic analysis showed that there was outstanding difference between them. Conclusion In the eradicative operation of breast cancer,the key to prevent the necrosis rate of skin flap is:prevention of subaxillary lymphatic fistula, two tubular drainage set individually in subcostalis and subaxillaris, appropriate force of chest bandaging, proper thickness of skin flap and perfect suture without tension.

Objective To investigate the relationship between cross‐sectional area (CSA) and average CT value of posterior vertebral extensor group and bone mineral density(BMD) in postmenopausal women .Methods Totally 114 postmenopausal women being eligible for inclusion were enrolled .All the subjects ,ages range from 55 to 87 years old ,underwent quantitative computed tomography(QCT) scans from December 2015 to December 2016 in Beijing Jishuitan Hospital .The original image was transmitted to the image postprocessing workstation ,using Mindways QCT Pro software ,vertebral bone mineral density of L2-L4 were meas‐ured .CSA and average CT value of bilateral posterior vertebral muscles were measured by 2 diagnostic physicians in the L4 verte‐bral body horizontal axis CT images ,and analyzed respectively .Results Average CT values of posterior vertebral muscles between the left and the right side had a significant difference (P<0 .01) .The average CT value of bilateral posterior vertebral muscles was positively correlated with lumbar bone mineral density measured by QCT(P<0 .01) .There was no significant correlation between the CSA of posterior vertebral extensor group and BMD .Conclusion The loss of posterior vertebral muscle mass may be an impor‐tant risk factor for osteoporosis .The average CT value of posterior vertebral extensor group is more promising than CSA in the e‐valuation of the degenerative muscles .

目的探讨中西医结合在脑外伤反应治疗中的作用。方法将120例脑外伤反应患者分成两组:治疗组(80例)在综合措施治疗的基础上,使用理气开窍汤;对照组(40例)按综合措施治疗。观察治疗20d内患者头痛、头昏、耳鸣、恶心呕吐、失眠症状改善情况。结果临床症状有效率比较,两组有显著性差异(P<0.05)。结论理气开窍汤配以高压氧及营养神经类药物,可明显提高疗效。

Objective: To observe the clinical efficacy of Xingnao-Kaiqiao acupuncture("醒脑开窍"针法) on patients with cerebral infarction.Methods: Sixty-three patients with the disease were randomly divided into treatment group(n=32) treated with Xingnao-Kaiqiao acupuncture and control group(n=31) with(traditional) acupuncture.In addition,routine medicine therapies were given to the two groups(including(dehydration),(decrease) of intracranial pressure,enhancement of nerve nutrition and supportive treatment).(Xingnao-)(Kaiqiao acupuncture) was used and adjusted the number of points with different syndromes in the treatment group,main points were as follows: Neiguan(内关PC6),(Rengzhong)(人中GV26),Sanyinjiao((三阴交)SP6) and vice points were Jiquan(极泉HT1),Chize ((尺泽LU5)),Weizhong(委中BL40),Fengchi(风池GB20),Yintang (印堂EX-HN3),Shangxing((上星DU23)-through-Baihui)(百会GV20).Traditional acupuncture was used in the control group.Points at the upper limbs were Jianjing(肩井GB 21),Quchi(曲池LI 11),Waiguan(外关(S)51),Hegu(合谷LI 4) and at the lower limbs were Zusanli(足三里ST36),Yanglingquan(阳陵泉GB34),Huantiao(环跳GB30),Fenglong(丰隆ST40),Kunlun(昆仑BL60) etc..Acupuncture was given twice a day for 15 days in both groups.Before and after therapy,the hemorrheology,blood lipid,blood,urine,stool and biochemical routine examinations,white blood cell (WBC) count in(peripheral) blood and neurological deficit score(NDS) were(determined).Curative effects of two groups after treatment were observed.Results: After treatment,the total effective power was 93.75% in the treatment group,while it was 67.74% in the control group,the difference being significant (?~2=4.85,P

Livin,as a novel member of human inhibitor of apoptosis protein family,is highly expressed in many malignant tumors.Livin plays critical role in apoptosis inhibition,regulating the cell cycle,participating in tumor angiogenesis.Livin is also significant to chemoresistance.The majority of the current data suggests that Livin expression in cancer appears to be associated with unfavorable clinico-pathological parameters,such as disease relapse and shorter patient survival.In recent years,immunotherapy and gene therapy for the targeting of Livin have become a hot research field,which provides new strategy and direction for tumor therapy.