Objective To investigate the indications and suitable surgical operation routes of total gastrectomy for gastric carcinoma and the reconstruction procedure of digestive tract following total gastrectomy.Methods The clinical data of total gastrectomy by abdominal incision in 170 patients with GC from 1991 to 2001 were reviewed.Results Radical total gastrectomy was prfomed in 132 cases,palliative total gastrectomy in 38 cases,total gastrectomy with combined re section of other organs in 18 cases,Roux en Y esophagojejunostomy in 110 cases following total gastrectomy.Interposition with jejunum in 60 cases following total gastrectomy.There are 20 cases with dumping syndrome and 6 cases with reflux esophagitis occurring in Roux en Y esophagojejunostomy,but none of cases occurs in those by interposition with jejunum.Conclusions (1)Transabdominal incision is the better choice for patients of GC,especially gastrocardiac carcinoma.(2)The total gastrectomy can raise the survival rate and quality of life of patients with GC,if the indications are stricted.(3)Interposition with jejunum following total gastrectomy is superior to Roux en Y esophagojejunostomy.

AIM: To study the influence on the expression of proliferation cell nuclear antigen(PCNA) in rectal carcinoma through retention -enema with FUDR and 5 -FU. METHODS: 80 cases of rectal carcinomas were randomized into three groups: the FUDR group(30 cases), the 5-FU group(30 cases) and normal control group(20 cases), treated with FUDR(500mg), 5-FU(500mg) and normal saline(20ml ) everynight through retention - enema separately for serven days- Mucosa of rectal car cinoma were sampled and PCNA protein were simultaneously detected by imrnunohistochemical method on the first and eighth day. RESULTS: The expression of PCNA was significantly decreased in both FUDR group and 5 - FU group after treatment(P 0. 1). CONCLUSION:The cell proliferation of rectal carcinoma could be inhibited by FUDR and 5-FU through retention-enema. The effects of FUDR was more obvious than that of 5-FU in the same concentration. so the treating method through retention-enema with FUDR should be used as a routine therapeutic scheme befOre operation.

Objective To study the spare demand rate and storage quantity probability model for military medical equipment in order to make a valuable reference to the decision-making of medical organization for the further medical support.Methods The reliability and maintainability of spare in the process of equipment maintenance were studied,and the signifi-cant factors which have influence on spare demand rate were analyzed.By using Passion theory,spare demand rate proba-bility model of medical equipment was deduced,especially for repairable components and un-repairable components spare.By calculating the probability of replaceable spare,a useful method to scientifically make out the storage quantity of mili-tary medical equipment was provided.Results The models of spare demand rate and storage quantity were made for mili-tary medical equipment maintenance.Conclusion The solution of the model is simple and convenient and the calculating results shows that the spare demand rate and storage quantity is close to the reality.It can meet the requirements of pre-diction of spare demand rate and determination of the storage quantity in maintenance support of medical equipment in peacetime.

Objective To investigate the reconstruction procedures of digestive tract following total gastrectomy.Methods The clinical data of pylorus ring preserving and jejunum interposition for the reconstruction of digestive tract following total gastrectomy in 17 cases of fundus and/or cardia carcinoma in past 3 years in our hospital were reviewed. Results There was no operative death,and no stomach fistula or constriction occurred in this series.All the 17 patients were discharged with recovery. Half a year after the operation, all the patients can eat about 200-300g each time, and 3-4 times a day. Patients′ subject feeling was good; no retrosternal burning pain occurred after meal; no symptoms of bile reflux or empty disorder happened. Conclusions The reconstruction of digestive tract following total gastrectomy using pylorus ring preservation and jejunum interposition should be effective if strict indications are adopted.

Objective To find out the methods for the reconstruction of digestive tract following subtotal gastrectomy. Methods The clinical data of 17 patients with carcinoma of gastric fundus and cardia carcinoma undergoing transabdominal pylorus preserving subtotal gastrectomy for the reconstruction of digestive tract with interposition of jejunum from March 1999 to July 2002 were analyzed retrospectively. Results No death, no stoma fistula, nor constriction were found after operation. All patients were discharged after recovery. Half a year later, patients could eat food of about 200-300 g at each meal (3 or 4 times a day). No burning pain in the postbreast bone, phenomenon of bile reflux, empty disorder, nor dumping syndrome were found after meal. No anemia was found in all patients, and their body weight restored to the preoperative normal level. Conclusion The pylorus reserving transabdominal subtotal gastrectomy for the reconstruction digestive tract with interposition of jejunum can result in satisfactory surgical outcomes if the indications are strictly controlled.

Objective To evaluate application feasibility of Array CGH in genetic diagnosis of clinical complex chromosomal abnormalities.Methods Two patients of genetic counseling and two patients of prenatal diagnosis were selected from Xiamen Maternity & Child Health Care Hospital during the period of December 2010 to December 2011.Under aseptic conditions 2-4 ml peripheral blood was collected in EDTA and 2-3 ml Cord Blood was collected through cordocentesis after genetic counseling and preoperative examination.G-banded chromosome analysis and genome DNA extraction were carried out on the four cases.The whole genome of four cases were scanned and analyzed by Array CGH.The results of Array CGH were confirmed by FISH.Results Array CGH detected different kinds of duplications and deletions in several chromosomes.Most of these duplications and deletions were not detected by karyotype analysis.The results of Array CGH showed duplication of 4p16.3-4p15.31,deletion of 4p16.3 in the first case,duplication of Xp11.22-Xq11.1 in the second case,duplication of 4p16.3-4p15.32,deletion of 2q37.3 in the third case and duplication of 2q21.2-2q32.1,deletion of 2q14.3-2q21.1 in the fourth case.These duplications and deletions were confirmed by FISH.Conclusions Compared with conventional cytogenetic analysis,Array CGH can not only accurately detect micro deletion and micro duplication with high resolution and sensitivity but also identify breakpoints precisely.Array CGH can provide the basis for clinical genetic diagnosis.

Objective To investigate the roles of ultrasound,laboratory methods,and genetic diagnostic techniques in screening and diagnosing fetuses with an unbalanced recombination of chromosome 18[rec(18)] due to parental pericentric inversion,and the relationship between rec(18) fetal phenotypes and their recombinant chromosomes.Methods We analyzed two pedigrees with pericentric inversion of chromosome 18 (including the fetuses and their parents) which received prenatal diagnosis and genetic counseling on March 2017 and March 2018 respectively at Xiamen Maternity and Children Health Care Hospital through karyotype analysis,chromosome microarray analysis(CMA) and fluorescence in situ hybridization (FISH).Literatures were retrieved from Scientific Citation Index,PubMed,China National Knowledge Infrastructure(CNKI) and Wanfang Data from 1970 to June 2018.The genetic counseling records,ultrasound and laboratory findings,pregnancy outcomes of families with pericentric inversion of chromosome 18 in this study and the included literatures were reported and analyzed.Results Non-invasive prenatal testing (NIPT) of one case indicated high risk of fetal trisomy 18 at 22 weeks of gestation.And the imaging examination indicated that fetus had interventricular septal defect and micrognathia at 24+2 weeks.Prenatal diagnosis confirmed that the fetal karyotype was 46,XY,rec(1 8)dup(18q) inv(18)(p1 1.32q12.1) pat,which was originated from his father whose karyotype was 46,XY,inv(1 8)(p1 1.32q12.1).In the other case,serum screening testing indicated high risk of fetal trisomy 18 at 12+3 weeks.Imaging examination indicated that fetus had thickened nuchal translucency at 13+3 weeks and bilateral choroid plexus cysts at 15+6 weeks.Prenatal diagnosis confirmed that the fetal karyotype was 46,XY,rec(18)dup(18q)inv(18) (p11.32q12.1) mat,which was originated from his mother whose karyotype was 46,XX,inv(18)(p11.32q12.1).Among the nine fetuses,including seven from five pedigrees reported in the literature retrieved and two from the two pedigrees we reported,seven showed abnormal soft markers or structures in ultrasound and three of the seven pedigrees had high risk of fetal trisomy 18.Conclusions Ultrasound screening is highly sensitive in detecting rec(18) fetuses,yet the association between ultrasound features and fetal karyotypes is not clear.The combination of multiple genetic analysis methods,including karyotype analysis,CMA and FISH,may be conducive to clarifying the types and sources of complex derived chromosomes.

OBJECTIVE: To carry out prenatal diagnosis for a fetus with absent nasal bone by using cytogenetic and molecular techniques. METHODS: Chromosomal karyotyping, single nucleotide polymorphism array (SNP-array) and fluorescence in situ hybridization (FISH) assays were applied for the diagnoses. Peripheral blood samples were also taken from the parents for chromosomal karyotyping and FISH analysis. RESULTS: The fetus was found to have a 46,XX,add(21)(p11.2) karyotype, and SNP-array has revealed a 11.3 Mb duplication at 21q22.12q22.3 (hg19: 36 762 648-48 093 361), which was confirmed by FISH. Both parents were found to be normal by chromosomal karyotyping and FISH analysis. The fetus was ultimately found to have a karyotype of 46,XX,der(21)t(21;21)(p11.2;q22.1), resulting a de novo partial trisomy of 21q22.1. CONCLUSION Combined use of various techniques has enabled accurate prenatal diagnosis and genetic counseling for the fetus.
Female ; Humans ; In Situ Hybridization, Fluorescence ; Karyotyping ; Nasal Bone ; Pregnancy ; Prenatal Diagnosis ; Trisomy/genetics*

OBJECTIVE: To carry out prenatal diagnosis for a fetus with increased nuchal translucency (NT) and another fetus with non-invasive prenatal testing (NIPT) suggested reduced sex chromosomes by cytogenetic and molecular techniques. METHODS: Chromosomal karyotyping, single nucleotide polymorphism array (SNP-array) and fluorescence in situ hybridization (FISH) were applied for the diagnoses. Peripheral blood samples were also taken from their parents for chromosomal karyotyping and SNP-array analysis. RESULTS: Both fetuses showed a 46,X,+mar/45,X karyotype. SNP-array has detected a 22.0 Mb duplication at Yp11.31q11.223 and a 3.9 Mb microdeletion at Yq11.223q11.23 in fetus 1, and a 16.9 Mb duplication at Yp11.31q11.221 and a 8.1 Mb deletion at Yq11.222q11.23 in fetus 2. The results were confirmed by FISH. The parents of both fetuses were normal by chromosomal karyotyping and SNP-array. CONCLUSION Combined use of various techniques can enable accurate prenatal diagnosis and genetic counseling.

OBJECTIVE: To carry out genetic testing for 3 fetuses with abnormal prenatal screening. METHODS: Fetal ultrasound, karyotype analysis, single nucleotide polymorphism (SNP) array and fluorescence in situ hybridization were performed. RESULTS: Abnormalities of chromosome 22 were found with all 3 fetuses. Fetus 1 harbored a 7.1 Mb deletion in 22q13.2q13.33 region, which involved 54 OMIM genes including SHANK3 and FBLN1. Fetus 2 had a mosaicism karyotype, with 12% of cells harboring a 6.6 Mb deletion in 22q13.31q13.33, covering 48 OMIM genes such as SHANK3 and PPARA, and 5% of cells harboring a 26.1 Mb duplication in 22q11.1q13.2 involving 285 OMIM genes. Fetus 3 carried a tandem duplication of 1.7 Mb in 22q11.1q11.21, which involved 10 OMIM genes including CECR1, CECR2 and ATP6V1E1. No abnormality was found in the three couples by chromosomal karyotyping and SNP array analysis. CONCLUSION The severity of diseases caused by chromosome 22 abnormalities not only depends on the range of the deletion or duplication, but is also closely related to chromosome structure, gene dose and genetic environment. Combined ultrasonography and various genetic testing techniques in prenatal diagnosis can greatly increase the detection rate of genetic diseases with substantial phenotypic variation.
Chromosome Aberrations ; Chromosome Deletion ; Chromosome Disorders ; diagnosis ; genetics ; Chromosomes, Human, Pair 22 ; genetics ; Female ; Fetus ; Genetic Testing ; Humans ; In Situ Hybridization, Fluorescence ; Karyotyping ; Pregnancy ; Prenatal Diagnosis ; Transcription Factors ; Ultrasonography, Prenatal