In recent years,laparoscopic total gastrectomy (LTG) with lymphadenectomy is increasingly utilized for the management of gastric cancer located in the middle or upper third of the stomach.However,esophagojejunostomy is the key technical difficulty in operation.Compared with conventional extracorporeal esophagojejunostomy via mini-laparotomy,pioneers are attempting to perform intracorporeal anastomosis in order to gain better manipulation and minimally invasive benefits,as well as reducing the difficulties in digestive tract reconstruction.

Objective To investigate the effective methods for the treatment of periprosthetic fracture after hip replacement.Methods The clinical data of 13 cases underwent the artificial total hip replacement (THR) with postoperative periprosthetic femur fractures were analyzed.Results The happening time was 12 days to 2 years after primary THR.According to Vancouver classification,there were 2 cases of type A,two cases of type B1,7 cases of type B3,and 2 cases of type C.The treatment included nonoperative treatment in 2 cases,3 cases received open reduction with memory alloy encircling fixer fixation,one case received wire binding with autologous iliac bone grafting,7 cases received revisions with modular revision implant combined with wire binding and autologous iliac bone grafting.The stem was loosened in one type B1 patient at 3 months after surgery.X-ray examination showed that the fractures were united and no infection occurred after operation in 12 patients.No migration or breaking of the instruments was observed.The average Harris hip score was 81 (70 ～ 86points).Conclusion The effective treatment method of periprosthetic fracture after THR should determined by Vancouver classification,degree of bone defect and economic situation of the patients.

Objective To study the chemical structure of a pure glycoprotein I_(1-2-1) from Irpex lacteus.Methods Based on chemical and spectral analysis,the structural characterization of I_(1-2-1) was investigated.Results I_(1-2-1) was composed of Ara,Xyl,Man,Gal,and Glu with its mean molecular weight of(40 000.) Methylation analysis showed that the main chain of I_(1-2-1)was all 1→2,1→6 linked Manp.Conclusion I_(1-2-1) is a complicated glycoprotein obtained for the first time from I.lacteus.

Objective To analyze the injury characteristics in 2004-2009 road traffic accidents (RTAS) of 0-25 years old adolescents treated in Beijing 120 Emergency Center so as to provide scientific basis for making effective measures in prevention and control of RTAs. Methods The data of all the adolescents with traffic injuries treated in Beijing 120 Medical Emergency Center were collected for a retrospective analysis on sex,age,traffic injury time,wound regions,injury characteristics and death condition of the injured adolescents. Results( 1 ) There were 17 232 injuries and 259 deaths according to the traffic reports from 2004 to 2009. Among the total injury cases,there were 4 229 cases of 0-25 years old adolescents (24.5％),at (20.13 ± 4.43 ) years of age.The injury number showed a significant rising trend with the increase of age and the injury number of 20 years old group were obvious more than that of other age groups.(2) There were 2 252 males and 1 677 females,with ratio of males to females for 1.5:1 ( P ＜ 0.05 ).( 3 ) Total number of patients was decreased yearly.The high incidence of adolescent RTAs could be seen in September,October and May in one year; Friday,Saturday and Sunday in one week; and between 8:00 am and 11:00 pm in one day.The low incidence of adolescent RTAs could be seen in Tuesday in one week,and 3:00-6:00 am in one day (P ＜0.05).(4) Cases of limb and arthrosis wounds (53.4％) were more than those of head and neck wounds (35％).Most of the cases were pedestrians (49.1％ ).(5) There were 38 deaths,including 28 males and 10 females,at ageof (19.29 ± 5.30) years.The death were mainly resulted from craniocerebral injuries (87％),which mainly concentrated in July ( 13.2％ ) and August ( 15.8％ ). Conclusions The present condition ofadolescent traffic injuries is not good enough.We should strengthen traffic security education,increase executive powers in the traffic rush and promote cooperation and communication in pre-hospital emergency,as may be beneficial for decreasing adolescent RTA.

AIM: To investigate the effects of IL-13 on expression of IL-1? in acute renal ischemia/reperfusion injury. METHODS: Fifty-seven male Wistar rats were randomly divided into 8 group: normal group,sham operation group, ischemia group, ischemia/reperfusion injury group(I/R), normal saline(NS)-treated group 1(C-1), NS-treated group 2(C-2),IL-13-treated group1(T-1)and IL-13-treated group 2(T-2).Rats were subjected to 45 min bilateral renal ischemia followed by reperfusion. rmIL-13 (1.5 ?g/50 g body weight )was injected into the renal arteries through the abdominal aorta before ischemia(T-1) or immediately afterischemia(T-2).The serum level of IL-1? and the renal expression of IL-1? were determined in each group at 24 h post-ischemia. In addition, BUN,Cr and renal histology were also measured. RESULTS: (1)The serum level of IL-1? [C-1to T-1: (27.13?5.51) ng/L to (14.05?3.82) ng/L, P

Objective:To study the influences of circular RNA ras homolog family member T1(CircRHOT1)on the prolifera-tion,apoptosis and immune escape of breast cancer cells by regulating the miR-187-3p/sex-determining region Y-box protein 4(SOX4)axis.Methods:Real-time quantitative PCR and Western blot were used to detect the expressions of CircRHOT1,miR-187-3p and SOX4 in human normal breast epithelial cells MCF-10A and breast cancer cells MCF-7,Hs-578T and MDA-MB-231 in vitro;MCF-7 cells cultured in vitro were randomly separated into control group,CircRHOT1 knockdown(transfected with CircRHOT1 siRNA plasmid)group,miR-187-3p mimics(transfected with miR-187-3p mimics)group,co-transfection negative control(transfected with empty plasmid and miR-187-3p inhibitor negative control)group,and CircRHOT1 knockdown+miR-187-3p inhibitor(transfected with CircRHOT1 siRNA plasmid and miR-187-3p inhibitor)group.After grouping and transfection,real-time quantitative PCR and Western blot were used to detect the expressions of CircRHOT1,miR-187-3p and SOX4 in each group;cell proliferation in each group was detected by EdU staining and plate colony formation assay;cell apoptosis in each group was detected by flow cytometry;im-munofluorescence staining was used to detect the ratio of apoptosis-related proteins Bax and Bcl-2(Bax/Bcl-2)expressions in each group.The cells of each group were co-cultured with human peripheral blood lymphocytes and transfected into groups,flow cytometry was used to detect the proportion of activated CD8+T cells in human peripheral blood lymphocytes in each group;the killing rate of human peripheral blood lymphocytes to MCF-7 cells in each group was detected by MTT assay.Dual-luciferase reporter assay was used to detect the targeted regulation of miR-187-3p and miR-187-3p on SOX4 by CircRHOT1 in MCF-7 cells.Results:Compared with human normal breast epithelial cells MCF-10A,human breast cancer MCF-7,Hs-578T and MDA-MB-231 cells had obviously higher protein and mRNA expression of CircRHOT1 and SOX4(P<0.05),and obviously lower expression of miR-187-3p(P<0.05).Com-pared with control group,the protein and mRNA expression of SOX4,EdU positive rate and colony formation rate of cells in Circ-RHOT1 knockdown group and miR-187-3p mimics group decreased(P<0.05),the expression of miR-187-3p,apoptosis rate,Bax/Bcl-2,the proportion of activated CD8+T cells in human peripheral blood lymphocytes and the killing rate on MCF-7 cells increased(P<0.05).Compared with CircRHOT1 knockdown group,there was no obvious difference in the expression of CircRHOT1 in the CircRHOT1 knockdown+miR-187-3p inhibitor group(P>0.05),the protein and mRNA expression of SOX4,EdU positive rate and colony formation rate of cells increased(P<0.05),the expression of miR-187-3p,apoptosis rate,Bax/Bcl-2,the proportion of activated CD8+T cells in human peripheral blood lymphocytes and the killing rate on MCF-7 cells decreased(P<0.05);there was no obvious difference in the indexes of cells in co-transfection negative control group(P>0.05).Conclusion:Knockdown of CircRHOT1 can reduce the expression of SOX4 by up-regulating miR-187-3p,thereby attenuating the proliferative activity of breast cancer cells and promoting their apoptosis.It can also inhibit the activation of CD8+T cells and enhance their cancer cell cytotoxicity,thereby weakening immune evasion of breast cancer cells.

Compared to that with laparoscopic assisted approach, intracorporeal anastomosis with totally laparoscopic radical total gastrectomy has the advantages of smaller incision, and better vision for operation, and may also be fit for patients with large size lesion, high-located lesions, or obesity. It remains controversial though several surgeons have reported the safety and feasibility of intracorporeal anastomosis with totally laparoscopic total gastrectomy. This review describes the recent technical advances in intracorporeal anastomoses with totally laparoscopic total gastrectomy, focusing on the reconstruction skills and indications. Current data on totally laparoscopic total gastric resection for gastric carcinoma revealed that all digestive tract reconstructions were performed with esophagus-jejunum Roux-en-Y anastomosis, and different reconstruction techniques of such Roux-en-Y anastomosis have certain advantages and disadvantages. Surgeons should make choice based on tumor location, esophageal diameter and personal skills in order to achieve maximal benefit to patients.
Anastomosis, Roux-en-Y ; methods ; Gastrectomy ; methods ; Humans ; Laparoscopy ; methods ; Stomach Neoplasms ; surgery

ObjectiveTo investigate the epidemiological features and risk factors of road traffic injury in Beijing.MethodsData of road traffic injuries of Beijing Changping Hospital in 2010 was collected for statistical analysis of the epidemiological features. ResultsA total of 990 cases of road traffic injuries were treated in Beijing Changping Hospital in 2010,with a male/female ratio of 2.57:1 and at average age of 45 yeats.There were 21 cases aged ＜ 18 years,703 cases aged 18-55 years and 266 cases aged ≥56 years.Self-employed individuals and fanning production staffs were the risky population that were easily subjected to road traffic injuries.Summer and autumn were the accident-prone seasons.The most common injury site was the lower limbs,next with the neck and head.The hospital stay was mainly in a range of 5-10 days (12.8 days on average).ConclusionsMale self-employed individuals and agricultural producers are the high-risk groups of road traffie accidents in the area,where shows a high occurrence of road traffic accidents in the summer and autumn.Thereby,traffic safety education and prevention-control measures based on these characteristics should be carried out to effectively reduce the number and severity of the local traffic injuries.

Voltage-gated sodium channels (VGSCs) in primary sensory neurons play a key role in transmitting pain signals to the central nervous system. BmK I, a site-3 sodium channel-specific toxin from scorpion Buthus martensi Karsch, induces pain behaviors in rats. However, the subtypes of VGSCs targeted by BmK I were not entirely clear. We therefore investigated the effects of BmK I on the current amplitude, gating and kinetic properties of Nav1.8, which is associated with neuronal hyperexcitability in DRG neurons. It was found that BmK I dose-dependently increased Nav1.8 current in small-sized (<25 μm) acutely dissociated DRG neurons, which correlated with its inhibition on both fast and slow inactivation. Moreover, voltage-dependent activation and steady-state inactivation curves of Nav1.8 were shifted in a hyperpolarized direction. Thus, BmK I reduced the threshold of neuronal excitability and increased action potential firing in DRG neurons. In conclusion, our data clearly demonstrated that BmK I modulated Nav1.8 remarkably, suggesting BmK I as a valuable probe for studying Nav1.8. And Nav1.8 is an important target related to BmK I-evoked pain.
Aniline Compounds ; pharmacology ; Animals ; Cell Size ; Cells, Cultured ; Electrophysiological Phenomena ; drug effects ; Furans ; pharmacology ; Ganglia, Spinal ; cytology ; Kinetics ; Male ; NAV1.8 Voltage-Gated Sodium Channel ; metabolism ; Rats ; Rats, Sprague-Dawley ; Scorpion Venoms ; antagonists & inhibitors ; pharmacology ; Scorpions ; Sensory Receptor Cells ; drug effects ; metabolism ; physiology ; Sodium Channel Blockers ; pharmacology ; Voltage-Gated Sodium Channel Agonists ; pharmacology

Objective To analyze the risk factors of gastrointestinal dysfunction in critically ill patients and provide reference for the prevention and treatment of gastrointestinal dysfunction. Methods A retrospective study was conducted, and the data of patients admitted to intensive care unit (ICU) of Jinghai District Hospital from September 2018 to March 2019 were collected. The data including sex, age, sequential organ failure score (SOFA), acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), diagnosis in ICU, application of special drugs, hemoglobin (Hb), blood glucose, albumin (Alb) levels and presence or absence of bacteremia were collected. The patients were divided into gastrointestinal dysfunction group and non-gastrointestinal dysfunction group according to whether gastrointestinal dysfunction occurred or not. The general data, related final outcome and prognosis were compared between the two groups. Logistic regression analysis was used to analyze the risk factors affecting gastrointestinal dysfunction in critical ill patients, and the possible existing complications were recorded. The receiver operating characteristic curve (ROC) was drawn to evaluate the predictive values of risk factors. Results One hundred and thirty-eight patients were enrolled in this study, and 86 patients had gastrointestinal dysfunction. The SOFA score and proportions of using catecholamine and bacteremia in the gastrointestinal dysfunction group were significantly higher than those in the non-gastrointestinal dysfunction group [SOFA score: 7.2±3.8 vs. 5.8±3.6, the proportion of using catecholamine: 57.0% (49/86) vs. 38.5% (20/52), the proportion of bacteremia: 32.6%(28/86) vs.17.3%(9/52), all P < 0.05], Alb level was significantly lower than that in the non-gastrointestinal dysfunction group (g/L: 24.15±5.75 vs. 26.55±5.68, P < 0.05). Logistic regression analysis showed that the use of catecholamine, Alb level, bacteremia and SOFA score in ICU were the risk factors for occurrence of gastrointestinal dysfunction in ICU patients [odd ratios (OR) were 1.128, 0.547, 1.645, 1.958, 95% confidence intervals (95% CI) were 1.052-1.219, 0.384-0.765, 1.143-2.597, 1.925-1.993, P values were 0.011, 0.017, 0.021, 0.016, respectively]. Compared with the non-gastrointestinal dysfunction group, the incidence of bedsore, the proportion of energy intake unable to reach the target, the length of stay in ICU and the mortality in gastrointestinal dysfunction group were significantly increased [the incidence of bedsore: 53.5% (46/86) vs. 30.8% (16/52), the proportion of intake unable to reach the target: 27.9% (24/86) vs. 5.8% (3/52), the length of stay in ICU (days): 22.5±17.8 vs. 16.0±11.5, mortality rate: 51.2% (44/86) vs. 34.6% (18/52), all P < 0.05]. ROC curve analysis showed that the use of catecholamine, bacteremia present or not, Alb level and SOFA score showed certain extents of predictive values for the occurrence of gastrointestinal dysfunction in critically ill patients the area under ROC curve (AUC) were 0.794, 0.712, 0.705 and 0.882, respectively, 95% confidence interval (95% CI) were 0.708-0.880, 0.609-0.816, 0.579-0.830, 0.801-0.962, sensitivity were 58.8%, 42.5%, 76.3%, 75.0%, specificity were 100%, 60%, 100%, 85%, all P < 0.05. Conclusions The use of catecholamine, Alb level, bacteremia and high SOFA score are the risk factors of gastrointestinal dysfunction in critically ill patients. Prevention of gastrointestinal motility disorder can improve the treatment success rate of critical patients.