Objective To compare the Occurrence rate of unplanned extubation(UEX)and anastomotic leakage by two different gastric tube for gastrointestinal decompression in patients after the operation of esophageal carcinoma.Methods Three hundred and eighty patients were randomly divided into two groups,the experimental group(n=90),ballonet gastric tubes were used;the control group(n=90),general gastric tubes were used.The occurTence rate of unplanned extubation(UEX)and anastomotic leakage were investigated.Results There was a remarkable difference(P＜0.01)in the rate of UEX between the experimental group and the control group.Though no statistical difference was seen in the rate of anastomotic leakage(P＞0.05),lower incidence of anastomofic leakage was seen in the experimental group.Conclusions BalIonet gastric tube for gastrointestinal decompression in patients after the operation of esophageal carcinoma can reduce the rate of UEX,improve the nursing qualiy and also successfully reduce the rate of anastomotic leakage.

Objective To investigate the expression of β-catenin and Oct-4 in colonal carcinoma and explore the relationship with recurrence and metastasis after operation. MethodsImmunohistochemical analysis was used to evaluate the expression of β-catenin and Oct-4.The correlation of β-catenin and Oct-4 expression with tumor cell differentiation,T stage,N stage and metastasis was analyzed.The gene expression of Oct-4 was examined by RT-PCR in 20 frozen tumor tissues and normal tissues adjacent to tumor.Results Thirty-five patients had metastasis. The positive rates of β-catenin and Oct-4 expression were significantly higher in metastasis group than in the non-metastasis group (65.71％ vs 31.11％,51.43 ％vs 13.33 ％,x2 =9.843,P =0.002,x2 =13.605,P =0.001).Expression of β-catenin and Oct-4 was not associated with differentiation,T stage or N stage.The positive expression rate of Oct-4 in colonal carcinoma tissues was significantly higher than that in normal tissues.Metastatic rates in patients with positive expression of β-catenin and Oct-4 was higher than that in negative expression.The survival analysis showed that time of metastasis was significantly different in two groups of patients (P ＜0.05).Conclusion The expression of β-catenin and Oct-4 in tumor tissues is related to metastasis of colonal cancer after surgery and might be used to predict metastasis of colonal cancer after operation.

BACKGROUND: In post-menopausal women, the reduction of estrogen level is followed by gradual increase of bone absorption, accompanied by increased cytokine synthesis and bone metabolism disorder. Observation of serum interleukin-6(IL-6), osteocalcin(OC), estradiol(E2)and urinary pyridinoline (PYD) in women with osteoporosis may help understand role of these factors in the onset and development of osteoporosis.OBJECTIVE: To investigate the relationship of serum IL-6, OC, E2, and urinary PYD levels with bone metabolism in women with osteoporosis, so as to identify the factors responsible for the occurrence and development of osteoporosis.DESIGN: A case-controlled clinical observation.SETTING: Central Laboratory of Orthopedics, Nanshan People's Hospital of Shenzhen City.PARTICIPANTS: Between January 1999 and December 2001, 25 post-menopausal women with osteoporosis aged 42 -69 years were selected from the Department of Orthopedics, Nanshan People' s Hospital of Shenzhen to constitute the experimental group, with 10 healthy women from the same hospital serving as control group.METHODS: Two milliliters of fasting venous blood and 2 mL urine samples were collected from women in both groups in the morning to determine the contents of IL-6, OC, PYD and E2, respectively.MAIN OUTCOME MEASURES: Serum IL-6, OC, E2 and urinary PYD levels in the subjects.RESULTS: In the experimental group, the IL-6 level was(201.0±79. 9) ng/L, OC(25.5 ± 16.2) μg/L, and PYD(41.3 ±9.7) nmol/mmol (creatinine), all significantly higher than those in control group( t = 2. 159 -2. 953, P < 0.05-0.01) . Serum E2 level in the experimental group (79. 8 ± 73.2) ng/L, however, was significantly lower than that in control group ( t = 2.071, P < 0.05).CONCLUSION: IL-6, OC, PYD and E2 may play important roles in the occurrence and development of osteoporosis, and adjustment of the levels of these factors can be necessary in the treatment of women with osteoporosis.

Based on the surgical model using transforaminal lumbar interbody fusion (TLIF) to treat lumbar spondylolisthesis, this paper presents the investigations of the biomechanical characteristics of cage and pedicle screw in lumbar spinal fusion implant fixed system under different combinations with finite element method. Firstly, combining the CT images with finite element pretreatment software, we established three dimensional nonlinear finite element model of human lumbar L4-L5 segmental slight slippage and implant under different fixed combinations. We then made a comparison analysis between the biomechanical characteristics of lumbar motion range, stress distribution of cage and pedicle screw under six status of each model which were flexion, extension, left lateral bending, right lateral bending, left axial rotation and right axial rotation. The results showed that the motion ranges of this model under different operations were reduced above 84% compared with those of the intact model, and the stability of the former was improved significantly. The stress values of cage and pedicle screw were relatively larger when they were fixed by single fusion device additional unilateral pedicle screw, but there was no statistically significant difference. The above research results would provide reference and confirmation for further biomechanics research of TLIF extracorporal specimens, and finally provide biomechanical basis for the feasibility of unilateral internal fixed diagonal intervertebral fusion TLIF surgery.
Biomechanical Phenomena ; Finite Element Analysis ; Humans ; Lumbar Vertebrae ; Models, Anatomic ; Motion ; Pedicle Screws ; Posture ; Range of Motion, Articular ; Rotation ; Spinal Fusion

In the present study, a finite element model of L4-5 lumbar motion segment was established based on the CT images and a combination with image processing software, and the analysis of lumbar biomechanical characteristics was conducted on the proposed model according to different cases of flexion, extension, lateral bending and axial rotation. Firstly, the CT images of lumbar segment L4 to L5 from a healthy volunteer were selected for a three dimensional model establishment which was consisted of cortical bone, cancellous bone, posterior structure, annulus, nucleus pulposus, cartilage endplate, ligament and facet joint. The biomechanical analysis was then conducted according to different cases of flexion, extension, lateral bending and axial rotation. The results showed that the established finite element model of L4-5 lumbar segment was realistic and effective. The axial displacement of the proposed model was 0.23, 0.47, 0.76 and 1.02 mm, respectively under the pressure of 500, 1 000, 1 500 and 2 000 N, which was similar to the previous studies in vitro experiments and finite element analysis of other people under the same condition. The stress distribution of the lumbar spine and intervertebral disc accorded with the biomechanical properties of the lumbar spine under various conditions. The established finite element model has been proved to be effective in simulating the biomechanical properties of lumbar spine, and therefore laid a good foundation for the research of the implants of biomechanical properties of lumbar spine.
Biomechanical Phenomena ; Finite Element Analysis ; Humans ; Intervertebral Disc ; anatomy & histology ; Lumbar Vertebrae ; anatomy & histology ; Models, Anatomic ; Pressure ; Prostheses and Implants ; Range of Motion, Articular ; Rotation

Objective: To investigate the clinicopathological features of gangliocytic paraganglioma(GP). Methods: Clinical data and pathological diagnosis of the 4 cases of GP were obtained through the medical record inquiry from January 2011 to December 2017 at the First Affiliated Hospital of Zhengzhou University. Routine HE staining and immunohistochemistry of CKpan, Syn, CgA, CD56, NSE and NF were performed. Clinical follow-up of the patients was obtained through telephone communication. Results: All 4 patients, including 2 male and 2 female patients, presented with intermittent abdominal pain and distention. The median age was 56 years. Preoperative CT showed local thickening of the duodenum wall with slight enhancement in all four cases. Endoscopic ultrasonography showed low level echo in the mucous layer and submucosa involved by the tumor in 3 of 4 cases. The maximal diameter of the tumor ranged from 0.6 to 1.8 cm with an average of 1.2 cm. Microscopically, the tumors consisted of epithelioid, spindle and ganglion-like cells, and the proportion of the three cell types was different among cases. Epithelioid cells expressed CKpan, Syn, CgA and CD56. Spindle cells expressed S-100 protein and SOX-10 and ganglion-like cells expressed NF, Syn, CgA and CD56.All tumour cells expressed NSE. All 4 patients had no recurrence a post-surgery follow-up period of 3 to 30 months. Conclusions GP of the duodenum is a benign tumor with excellent prognosis after endoscopic excision. Although its incidence is very low, its diagnosis should be considered for any mass lesion of the duodenum, especially involving mucosa and submucosa of the second dudenal segment.

ObjectiveTo observe the effect of Nd∶YAG laser combined with enamel cement on dentine hypersensitiveness (DH).Methods120 DH cases (totally 182 teeth) were randomly divided into two groups. The experiment group (92 teeth) was treated with Nd∶YAG laser and enamel cement. The control group (90 teeth) was only treated with Nd∶YAG laser.ResultsEffective rates of the experiment group at the moment of treatment, 3 months and 6 months after treatment were 97.8%, 96.7% and 90.2 % respectively, and that of the control group were 95.6%, 91.1% and 84.4%. There was a significant difference between two groups (P<0.05).ConclusionNd∶YAG laser combined with enamel cement has an obvious effect on DH.

Objective To evaluate the efficacy and toxicity of the combination of oxaliplatin and S-1 in the treatment of patients with advanced breast cancer.Methods A total of 72 patients with advanced breast cancer after the treatment failuer of anthracycline and taxane were treated with oxaliplatin and S-1.The first day,they were given oxaliplatin,135 mg/m2,with the 5％ glucose injection 500 ml,the time of intravenous drip should be more than 2 hours.And the S-1 was taken after breakfast and dinner,the dose was 40-60 mg,and the time of duration was 2 weeks,then they had 7 days to rest.The cycle was 21 days.Every 2 cycles,we estimated the efficacy.Patients who were effective and stable kept that chemotherapy regimens,the maximum duration was 6 cycles.The efficacy and toxicities were evaluated after cycles of chemotherapy.Results Two cases (2.8％) had complete response (CR),26 cases (36.1％) had partial response (PR).The response rate (RR) was 38.9％ and the disease control rate (DCR) was 69.4％.The median progress free survival (PFS) was 7.7 months and the median overall survival (OS) was 12.3 months.Subgroup analysis showed that the OS of patients who belong to stage Ⅳ,had two or more metastases or with failure treatment after being treated with anthracycline and taxane was notably shorter than the patients who belong to stage Ⅲ C,only one metastasis,with effective treatment after being treated with anthracycline and taxane,and the differences were statistically significant (10.5 months vs.15.0 months,x2 =4.469,P =0.035;9.3 months vs.15.0 months,x2 =8.297,P=0.004;10.0 months vs.14.0 months,x2 =4.077,P=0.043).The main side effects were neutropenia (19.4％),nausea (8.3％) and nerve toxicity (2.8％),mainly 3-4 degree,and could be welltolerated.The others were diarrhea,impaired liver function,stomatitis,anemia and hand-foot syndrome,mainly 1-2 degree.Conclusion Oxaliplatin combined with S-1 is effective and tolerable in treatment of patients with advanced breast cancer,the adverse reactions can be tolerated.

Objective: To investigate the clinicopathological features, diagnosis and differential diagnosis of gastrointestinal glomus tumors (GIGT). Methods: Totally 15 cases of GIGT were collected at the First Affiliated Hospital, Zhengzhou University, from January 2011 to June 2018. The clinicopathological features, immunophenotype, BRAF V600E mutation and prognosis were retrospectively analyzed. Results: The 15 patients′ age ranged from 37 to 59 years(median 49 years, mean 50 years). Eleven patients presented with intermittent abdominal pain and distention, three showed antral space-occupying lesions at physical examination, and one had abdominal pain accompanied by fecal blood. Fourteen tumors were located in the stomach, and one was in the ileum. Imaging showed the gastric glomus tumors were located in the submucosal layer with obvious enhancement in the arterial phase, and the ileum glomus tumor involved the whole layer of intestinal wall causing luminal obstruction. The maximum diameters of the tumors ranged from 1.5 to 3.0 cm (mean 2.3 cm). Grossly, the gastric glomus tumors were solid. Microscopically, the gastric glomus tumors were mostly located in the muscularispropria layer and were vascular. The tumor boundary was distinct but without capsule formation. The tumor cells were round or oval, and showed perivascular hemangiopericytoma-like or solid nest-like structures. The tumor cells were mildly pleomorphic, with rare mitosis and no necrosis. Two tumors had focal calcification, two showed mucosal invasion, two showed vascular invasion and five showed perineural invasion. The ileum glomus tumor was cellular, with prominent cellular atypia, and the mitotic count in hot spots was about 5-6/HPF. Immunohistochemistry showed that SMA and collage Ⅳ were strongly expressed in all the tumor cells; caldesmon and calponin were moderately expressed in some regions, and syn was weakly expressed in 12 cases. The Ki-67 proliferation index in the gastric glomus tumors ranged from 1% to 30% (mean 6%); and that in the ileum glomus tumor was about 70%. BRAF V600E mutations were not detected in any of 15 GIGTs. All patients did not receive radiotherapy or chemotherapy post operatively. Thirteen patients were followed up by telephone for 18-90 months (mean 42 months). Twelve patients with gastric glomus tumors survived without recurrence and metastasis, and the patient with ileum glomus tumor had liver metastasis 15 months after operation. Conclusions Glomus tumors is a rare mesenchymal tumor of the gastrointestinal tract. It should be differentiated from gastrointestinal stromal tumors, neuroendocrine tumor, leiomyoma, solitary fibrous tumor and paraganglioma. Most GIGTs are benign and have good prognosis. More experience is needed to understand the biologic behavior and prognostication of GIGTs.

BACKGROUND:Hepatic fibrosis in chronic liver disease can be reversed. Studies have shown that Periplaneta americana extract has anti-fibrosis effect, and has protective effect on the experimental hepatic fibrosis rats.
OBJECTIVE:To observe the effect of Periplaneta americana extract sticky sugar amino acid on hepatic fibrosis, and to primarily explore the mechanism of sticky sugar amino acid against hepatic fibrosis.
METHODS:Rat models of immune hepatic fibrosis were induced by pig serum and intragastricaly administered 0.5, 0.25, 0.10 g/kg sticky sugar amino acid. Four indexes of hepatic fibrosis were detected by radioimmunoassay. Immunohistochemical staining wasused to measure transforming growth factor beta 1, tissue inhibitor of metaloproteinase protein expression intensity and positive cel rate, to determine the correlation of different concentrations of sticky sugar amino acid, transformation growth factorbeta 1 and tissue inhibitor of metaloproteinase.
RESULTS AND CONCLUSION:(1) The Periplaneta americana extract sticky sugar amino acid reduced the levels of laminin, type III procolagen, type IV colagen and hyaluronidase (P< 0.01) and reduced the expression of transformation growth factor beta 1 and tissue inhibitor of metaloproteinase 1 in liver tissue (P< 0.01). (2) Sticky sugar amino acid concentration and transformation growth factor beta 1 and tissue inhibitor of metaloproteinase 1 protein expression showed a significant negative correlation (|r| > 0.9). (3) Results confirmed that the Periplaneta americana extract sticky sugar amino acid can change the reversal of hepatic fibrosis. Its mechanism of action is associated with expression of transforming growth factor beta 1 and tissue inhibitor of metaloproteinase 1 inhibited by sticky sugar amino acids.