Objective: To investigate the clinical effect of ω-3 polyunsaturated fatty acids (ω-3 PUFA) on elder patients after gastric cancer radical operation. Methods: Forty patients were randomly divided into experimental group (EG) and control group(CG). The patients of CG were treated with hypocaloric and lower nitrogen parenteral nutrition, and those in EG received ω-3 PUFA additionally. The nutrition index, immune function, liver function, inflammatory reaction and complications were compared. Results: The rate of complications significantly decreased in the EG (20% vs 5% , χ~2 = 3. 958, P < 0. 05). There were no significant differences in albumn and hemoglobin between the two groups (P > 0. 05). The level of prealbumin was significantly increased in the EG. The humoral immunity and cellular immunity were higher in the EG than those in the CG. IL-6, TNF-α and CRP levels on postoperative d5 were significantly depressed in the EG. Conclusion: Postoperative supplementation of ω-3 PUFA may have a favorable effect on the outcomes in elder gastric cancer patients.

Primary lesion removal and lymph node dissection are the main constituents of radical gastrectomy. However, the high recurrence rate after D2 radical gastrectomy for advanced gastric cancer has not improved. Recently, studies have found that discrete tumor deposits in the mesogastrium may be an important factor affecting the prognosis of gastric cancer after surgery. With the development of laparoscopic equipment, the ever-expanding "submicroscopic vision" makes it possible to completely remove the mesogastrium. Professor Gong Jianping advocated "membrane anatomy" to optimize the concept of radical gastrectomy: D2- based complete mesenteric resection (CME), namely D2+CME procedure. To prevent the leakage of tumor cells into the surgical field, as histological barrier, the intact mesogastrium should be located. The essential difference between D2+CME and previous D2/D2+systematic mesogastrium excision (SME), en-bloc mesogastric excision (EME) is as follow: double-factor guiding (lymph nodes and discrete tumor deposits) vs. single factor guiding (lymph nodes only). After practicing dozens of radical gastrectomy (D2+CME) authors believe that its conceptual connotation (double factor guiding) and operational extension (above mesentery bed) cover D2. In D2+CME surgery, depending on the anatomical identification under the magnified field of view, the conformal space between gastric mesentery and mesenteric beds is unique operational plane with repeatability. These findings and considerations address one problem: where is the precise boundary of en bloc principle in radical gastrectomy? In author′s opinion, with laparoscopy and "sub-microsurgery" progression and detection of discrete tumor deposit metastasis, survival benefit from definition of en bloc boundary in radical gastrectomy will be widely recognized. Meanwhile, D2+CME procedure is an appropriate way for study. Although the development of the "membrane anatomy" concept for gastric cancer still requires many further clinical and basic researches, it is reasonable to foresee that D2+CME surgery will guide a concept-optimized era for gastric cancer surgery.

Objective:To explore the safety and feasibility of the concept of enhanced recovery after surgery in the removal of catheters at different stages after laparoscopic gastric cancer surgery.Methods:A total of 219 patients who underwent laparoscopic radical gastrectomy in Harbin Medical University Cancer Hospital from December 2017 to January 2019 were selected as the research subjects. All patients were divided into groups A, B, and C according to the random number table with 73 cases each. One case in each group fell off, and 72 cases in each group finished the study. In group A, the ureter was removed 12 hours after operation; in group B, the ureter was removed 24 hours after operation; in group C, the ureter was removed 48 hours after operation. The urination-related indicators and rehabilitation indicators among the three groups of patients were compared.Results:There was no significant difference in the number of cases of urinary urination, the number of urinary retention and reinsertion cases, the number of urinary tract irritation, the number of urinary routine abnormalities, and the urination pain score after the first urinary extubation ( P> 0.05). The patients in group A got out of bed activity time, first ventilation time, postoperative hospital stays, total hospital stays, total hospitalization costs were (10.26 ± 4.51) h, (28.74 ± 8.04) h, (4.94 ± 1.73) d, (6.68 ± 1.93) d, (7.19 ± 0.31) ten thousand yuan, group B were (16.37 ± 5.13) h, (39.16 ± 11.52) h, (5.27 ± 1.97) d, (7.83 ± 1.88) d, (7.51 ± 0.36) ten thousand yuan, and group C were (24.19 ± 5.77) h, (54.37 ± 17.49) h, (6.48 ± 1.73) d, (8.16 ± 1.81) d, (7.98 ±0.42) ten thousand yuan. There were statistically significant differences among the three groups ( F values were 12.376 - 131.721, all P <0.01). Conclusions:It is safe and feasible to remove the catheter early after laparoscopic gastric cancer surgery under the concept of enhanced recovery after surgery. It can promote the early recovery of patients, reduce hospitalization time and reduce the overall economic burden of patients.

Primary lesion removal and lymph node dissection are the main constituents of radical gastrectomy. However, the high recurrence rate after D2 radical gastrectomy for advanced gastric cancer has not improved. Recently, studies have found that discrete tumor deposits in the mesogastrium may be an important factor affecting the prognosis of gastric cancer after surgery. With the development of laparoscopic equipment, the ever?expanding "submicroscopic vision" makes it possible to completely remove the mesogastrium. Professor Gong Jianping advocated "membrane anatomy" to optimize the concept of radical gastrectomy: D2-based complete mesenteric resection (CME), namely D2+CME procedure. To prevent the leakage of tumor cells into the surgical field, as histological barrier, the intact mesogastrium should be located. The essential difference between D2+CME and previous D2/D2+systematic mesogastrium excision (SME), en?bloc mesogastric excision (EME) is as follow: double?factor guiding (lymph nodes and discrete tumor deposits) vs. single factor guiding (lymph nodes only). After practicing dozens of radical gastrectomy (D2+CME) authors believe that its conceptual connotation (double factor guiding) and operational extension (above mesentery bed) cover D2. In D2+CME surgery, depending on the anatomical identification under the magnified field of view, the conformal space between gastric mesentery and mesenteric beds is unique operational plane with repeatability. These findings and considerations address one problem: where is the precise boundary of en bloc principle in radical gastrectomy? In author′s opinion, with laparoscopy and "sub?microsurgery"progression and detection of discrete tumor deposit metastasis, survival benefit from definition of en bloc boundary in radical gastrectomy will be widely recognized. Meanwhile, D2+CME procedure is an appropriate way for study. Although the development of the "membrane anatomy" concept for gastric cancer still requires many further clinical and basic researches, it is reasonable to foresee that D2+CME surgery will guide a concept?optimized era for gastric cancer surgery.

Primary lesion removal and lymph node dissection are the main constituents of radical gastrectomy. However, the high recurrence rate after D2 radical gastrectomy for advanced gastric cancer has not improved. Recently, studies have found that discrete tumor deposits in the mesogastrium may be an important factor affecting the prognosis of gastric cancer after surgery. With the development of laparoscopic equipment, the ever?expanding "submicroscopic vision" makes it possible to completely remove the mesogastrium. Professor Gong Jianping advocated "membrane anatomy" to optimize the concept of radical gastrectomy: D2-based complete mesenteric resection (CME), namely D2+CME procedure. To prevent the leakage of tumor cells into the surgical field, as histological barrier, the intact mesogastrium should be located. The essential difference between D2+CME and previous D2/D2+systematic mesogastrium excision (SME), en?bloc mesogastric excision (EME) is as follow: double?factor guiding (lymph nodes and discrete tumor deposits) vs. single factor guiding (lymph nodes only). After practicing dozens of radical gastrectomy (D2+CME) authors believe that its conceptual connotation (double factor guiding) and operational extension (above mesentery bed) cover D2. In D2+CME surgery, depending on the anatomical identification under the magnified field of view, the conformal space between gastric mesentery and mesenteric beds is unique operational plane with repeatability. These findings and considerations address one problem: where is the precise boundary of en bloc principle in radical gastrectomy? In author′s opinion, with laparoscopy and "sub?microsurgery"progression and detection of discrete tumor deposit metastasis, survival benefit from definition of en bloc boundary in radical gastrectomy will be widely recognized. Meanwhile, D2+CME procedure is an appropriate way for study. Although the development of the "membrane anatomy" concept for gastric cancer still requires many further clinical and basic researches, it is reasonable to foresee that D2+CME surgery will guide a concept?optimized era for gastric cancer surgery.

Cerebrovascular disease is one of the main diseases that threaten human health and life,and the age of onset become younger and younger. Research shows that Toll-like receptors (TLRs) express in brain, have effects on neurons, play an important role in the occurrence and development of cerebral ischemia and secondary cerebral injury.It is clear that TLR2, TLR3, TLR4, TLR7 and TLR9 have influence on occurrence and development of cerebral ischemia. This is crucial for understanding the relationship between immune inflammation and nerve regeneration, and improving clinical treatment.

Objective:To investigate the clinical and imaging characteristics of cervical spine hyperextension injury plus multilevel disco-ligamentous complex (MDLC) injury and the therapeutic effectiveness of their treatment.Methods:A total of 456 patients with cervical hyperextension injury were hospitalized between January 2010 and October 2020 at Department of Orthopaedics, The 909th Hospital, Dongnan Hospital Affiliated to Xiamen University. A retrospective study was conducted to analyze the clinical data of the 43 patients among them who had been diagnosed with MDLC injury and undergone surgical treatment and been fully followed up. They were 37 males and 6 females with an age of (50.6±10.7) years. According to the American Spinal Injury Association (ASIA) grading, there were 1 case of grade A, 8 cases of grade B, 18 cases of grade C, and 16 cases of grade D. The Japanese Orthopaedic Association (JOA) score was (7.9±1.6) points. Anterior cervical decompression, fusion and internal fixation were conducted for 42 patients, and posterior total laminectomy and internal fixation for 1 patient. The clinical and imaging manifestations of the patients, and the consistency between preoperative and intraoperative diagnosis of disco-ligamentous complex (DLC) injury were analyzed. ASIA grading and JOA score were used to assess the outcomes of surgical treatment and comparisons were made between preoperation and postoperation.Results:DLC injury existed at 99 levels (43 cases), with a high incidence at level C 5-6 (30 cases), and high-signal manifestations of cervical cord injury existed at 48 levels, with a high incidence at level C 3-4 (16 cases). Two-segment DLC injury was the most common [74.4% (32/43)], while three-segment DLC injury existed in 9 cases and four-segment DLC injury in 2 cases. There were 21 cases of jumping MDLC injury and 22 cases of continuous MDLC injury. At preoperation, DLC injury was suspected in 10 patients (at 11 levels), of whom 8 (at 9 levels) were diagnosed intraoperatively with DLC injury, and 2 (at 2 levels) were excluded from the DLC injury. All the 43 patients were followed up for (54.7±10.7) months. By the ASIA grading at the last follow-up, 3 cases were grade C, 13 cases grade D, and 27 cases grade E. The JOA score at the last follow-up was (15.1±2.2) points. Both the 2 outcomes showed significant improvements compared with the preoperative values ( P<0.05). Conclusions:The clinical incidence of cervical hyperextension injury combined with MDLC injury is low, but relatively higher in the middle-aged and elderly patients. As the level of DLC injury is often inconsistent with the likely level of cervical spinal cord injury, surgical exploration of the DLC structure with suspected injury can reduce the rate of missed diagnosis and misdiagnosis.

Animals ; Cellular Reprogramming ; genetics ; DNA Transposable Elements ; genetics ; Genetic Vectors ; genetics ; Genome ; genetics ; Humans ; Induced Pluripotent Stem Cells ; cytology ; metabolism ; Mutagenesis