Objective To investigate the relationship between preoperative anemia,low albumin,low body mass index and the prognosis of advanced gastric cancer.Methods Three hundred and seventeen patients diagnosed with advanced gastric cancer as well as complete clinical pathology data from January 2006 to January 2008 were retrospectively analyzed.The clinical pathologic factors including age,gender,tumor size,type of Borrmann,hemoglobin,serum albumin,body mass index,type of histology,blood vessels and lymphatic invasion,infiltration depth,lymph nodes metastasis.The single factor and multiple factors were analyzed.Results Tumor size,type of Borrmann,hemoglobin,serum albumin,body mass index,type of histology,blood vessels and lymphatic invasion,infiltration depth and lymph node metastasis were identified as influencing factors of the prognosis,while independent factors associated with the prognosis of gastric cancer were serum albumin (OR =1.546,95％ CI:1.069-2.237),infiltration depth (OR =1.933,95％ CI:1.182-3.162) and lymph nodes metastasis (OR =1.586,95％ CI:1.358-1.853).Conclusion Anemia and low body mass index are the influence factors but not the independent factors in the prognosis of gastric cancer,while low albumin concentration is the independent factor in the prognosis of gastric cancer.

Vitamin D deficiency is common among the elderly,which may be an important pathogenic factor in Alzheimer's disease(AD).Vitamin D has multiple functions including immune regulation,anti-oxidation,regulation of neurotrophic factors/acetylcholine neurotransmitters,and clearance of amyloid beta peptide; meanwhile,it may be helpful to avoid hyperparathyroidism.Vitamin D supplementation among the elderly may prevent the loss of neurons and slow down the AD-related cognitive decline,and therefore may play a role in the multi-targeted therapies for AD.

[Objective]To analyze the early diagnosis and treatment of the popliteal artery injury associated with the dislocation and fracture of the knee.[Method]A total of 71 cases of popliteal artery injury associated with the dislocation and fracture of the knee were treated from March 1998 to May 2005.Properative(vascular examization) and operative(methods of arterial repair,venous repair-ligation,anticoagulation-thrombolytic therapy,fracture reduction and internal fixation,fasciotomy) treatment were studied.[Result]Totally 15 cases were primary amputation and 56 cases were performed vascular repair and the fractures and dislocations were reduced and fixed by internal or external fixation.Two cases had thrombosis at the repaired site confirmed by Doppler and had to perform second operation to remove thrombus and repair the popliteal by autograft of the saphena magna vein.At the follow-up,2 cases had chronic osteomyelitis and 2 cases had traumatic arthritis.[Conclusion]It is postulated that a rational and prompt diagnosis and treatment of popliteal artery injury associated with dislocation and fracture around the knee would decrease the adverse effects of ischemia and reduce the overall morbidity.

Four cases of primary malignant fibrous histiocytoma of the thorax, arising from the mediastinum, trachea, esophagus and lung respectively are reported. Primary malignant fibrous histiocytoma is rare in those regions, but more commonly in deep fascia and skeletal muscles of the extremities and in the retroperitoneum. It is a distinct form of sarcoma and has been considered to be of primitive mesenchy-mal cell origin. Most of the tumors contain both fibroblast-like and histiocyte-like cells; some contain pleomorphic giant cells and inflammatory celts. They are often confused with other sarcomas. It is impossible to make correct diagnosis preoperatively. Excision is the treatment of choice for malignant fibrous histiocytoma. Radiation and chemotherapy appear to be useful adjuncts to surgical therapy.

Objective To observe the therapeutic effect of injection of consciousness promoted drug through carotid artery on persistent vegetate state (PVS).Methods33 PVS cases were divided into the treatment group (n=15) and control group (n=18). All patients were treated with routine therapy, but the treatment group added with injection of consciousness-promoted drug through the carotid artery. The therapeutic effects of two groups were evaluated.ResultsAfter the treatment, the therapeutic effects of patients in two groups were better than that of before treatment (P<0.05), and the treatment group was better than control group(P<0.05).ConclusionInjection of consciousness-promoted drug through the carotid artery is effective to PVS patients.

Objective To investigate the clinical significance of PRL-3 expression in sinonasal squamous cell cancer(SNSCC).Meth-ods The immunohistochemical method and RT-PCR were adopted to detect the PRL-3 protein expression level in 62 cases of SNSCC tissue (SNSCC group),30 cases of nasal polyps(NP group)tissue and 25 cases of normal nasal mucosa tissue(control group).The obtained results were compared.Results Both in the protein level and gene level detection,the expression of PRL-3 in the SNSCC group was higher than that in the NP group and control group,the difference was statistically significant (P <0.05).The expression of PRL-3 had no significant differences among different ages and between different genders(P >0.05),but with TNM stage increasing,differentiation degree decreasing and complicating lymph node metastasis,the expression of PRL-3 was significantly increased(P <0.05).Conclusion The PRL-3 expression can serve as good reference for the proliferation activity of SNSCC,its expressing intensity can obviously reflect the SNSCC cell proliferation activity,PRL-3 probably is an independent prognostic index of SNSCC,indicating poor prognosis.

Objective To study the local recurrence,distant recurrence and survival rate of anastomotic leak after surgery in patients with colorectal cancer.Methods Chinese and English related studies published from January 1970 to June 2011 were searched in PubMed/Medline,Excerpta medica database (EMBASE),Springger,Google scholar,China national knowledge infrastructure (CNKI),China biomedical literature database (CBM),Wanfang data.All controlled trials related to anastomotic leak after surgery in patients with colorectal cancer were retrieved.Outcomes were evaluated including local recurrence,distant recurrence and survival rate,then Mate-analysis was performed using RevMan 5.0 software provided by the Cochrane network.Results Fifteen studies were included,including a total of 18 225 patients.There were 1 425 patients with anastomotic leak and 16 800 patients without anastomotic leak.The patients with anastomotic leak were compared with patients without anastomotic leak.The OR value of local recurrence was 2.47 (95％ CI 1.72-3.55,P ＜ 0.01),the OR value of distant recurrence was 1.18 (95％ CI 0.98-1.43,P =0.08),and the OR value of 5-year survival rate was 1.68 (95％ CI 1.36-2.07,P ＜ 0.01).Conclusions Anastomotic leak after surgery is a bad prognosis factor in patients with colorectal cancer.It can increase the local recurrence rate,and decrease survival rate.

Objective To investigate the efficacy and safety of tranexamic acid on bleeding in rheumatoid arthritis (RA) patients undergoing total hip arthroplasty (THA). Methods A retrospective study was performed in 197 RA patients (Steinbrock?er III-IV) following primary unilateral THA from June 2012 to June 2014. The patients were divided to three groups based on the regimen of tranexamic acid:68 patients received a single intravenous dosage of 15 mg/kg tranexamic acid 20 min prior to opera?tion (single dose group);74 patients received an intravenous dosage of 15 mg/kg preoperatively and a second dosage of 10 mg/kg 3 hours postoperatively (repeated dose group);the other 55 patients didn't receive tranexamic acid (control group). The primary out?comes were total blood loss, transfusion rate, the incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE). The sec?ondary outcomes were postoperative drainage, hemoglobin (Hb) drop on third day postoperatively and other wound related compli?cations. Results There was less total blood loss (816.80 ± 245.09 ml vs 975.15 ± 216.33 ml vs 1 295.68 ± 263.85 ml), drainage (221.60 ± 70.05 ml vs 337.20 ± 113.10 ml vs 479.74 ± 120.66 ml), transfusion requirement (5.41%vs 10.29%vs 25.45%) and Hb drop (2.71±0.74 g/dl vs 3.18±0.62 g/dl vs 3.83±0.70 g/dl) in experimental group when compared with control group. And the effect was better in repeated dose group, with less total blood loss (816.80 ± 245.09 ml), less transfusion requirement (5.41%) and less postoperative drainage (221.60±70.05 ml). No episode of DVT or PE occurred in either group. There were 8 wound complications in single dose group, 6 in repeated group, and 8 in control group, and there were no statistically difference. Conclusion Intrave?nous administration of tranexamic acid was effective and safe on decreasing blood loss and transfusion requirement in RA patients following THA. Compared with a single dosage of tranexamic acid preoperatively, a second dosage of tranexamic acid 3 hours post?operatively was recommended.

Objective To explore the magnetic resonance spectroscopy characteristics of prefrontal white matter in bipolar Ⅱ disorder and its relation with executive function.Methods Thirty bipolar Ⅱ disorder patients and twenty healthy controls were evaluated with Multi-Voxel proton magnetic resonance spectroscopy (1H-MRS)scans on prefrontal white matter to assess the N-acetyl-aspartate (NAA),Choline (Cho),Creatine (Cr) and myoinositol (MI),and then the ratios of NAA/Cr,Cho/Cr,MI/Cr,NAA/Cho and NAA/Cho + Cr were calculated.All subjects were assessed for executive function using the Wisconsin Card Sorting Test (WCST).Results NAA/Cr in right prefrontal white matter(1.43 ± 0.26) and NAA/Cr,NAA/Cho,NAA/Cho + Cr in left prefrontal white matter (separatelyl.40 ± 0.29,1.13 (1.53,0.24),0.62 ± 0.12) were lower than healthy controls (separately 1.58 ±0.18,1.59,0.23,1.30 (0.53 ± 0.29),0.71 ± 0.08) (P ＜ 0.05).The correct trials and the number of categories of WCST in Bipolar Ⅱ disorder (separately 26.97 ± 8.97,3(6,3)) were less than in healthy controls(separately 36.35±4.85,5 (3,2)),and perseverative errors and random errors were more in patients (separately 12.77 ±5.73,7 (21,5)) than healthy controls (separately 7.35 ± 3.01,4 (13,2)).NAA/Cho and NAA/Cho + Cr in left prefrontal white matter were positively correlated with correct trials,number of categories,and negatively related with perseverative errors (P＜0.05).Conclusions Bilateral prefrontal white matter fiber damage occurs to bipolar Ⅱ disorder.And left prefrontal white matter fiber damage in bipolar Ⅱ disorder may lead to executive impairment.

BACKGROUND:To date, rivaroxaban has been a clinical y common anticoagulant in China;however, effective prophylaxis for venous thrombosis is associated with a markedly higher incidence of perioperative hemorrhagic complications. Although it has been reported that aspirin effectively prevents deep vein thrombosis and pulmonary embolism, the use of aspirin as a routine drug for venous thrombosis after total knee arthroplasty is stil controversial.
OBJECTIVE:To compare the efficacy and safety of aspirin and rivaroxaban for prevention of deep vein thrombosis after total knee arthroplasty.
METHODS:Total y 324 patients with osteoarthritis who underwent primary unilateral total knee arthroplasty were randomly divided into three groups. Twelve hours after the surgery, three groups were given aspirin, rivaroxaban and low-molecular-weight heparin respectively. Al three groups were treated for 14 days, and al of the patients were fol owed for 4 weeks.
RESULTS AND CONCLUSION:Compared with the low-molecular-weight heparin group, the incidence of deep vein thrombosis was lower (P<0.05), but hidden blood loss and wound complications were more common (P<0.05) in the rivaroxaban group. There were no significant differences between the low-molecular-weight heparin group and aspirin group in the incidence of deep vein thrombosis, hidden blood loss, wound complications or incidences of lower limb swel ing and subcutaneous ecchymosis (P>0.05). The results confirmed that rivaroxaban has a positive anticoagulation effect but leads to increases in wound complications in patients;there are no differences in efficacy and safety between aspirin and low-molecular-weight heparin, so aspirin as part of a multimodal anticoagulation therapy after total knee arthroplasty has good clinical safety and efficacy.