Objective To investigate the endurance or resistance of different bacteriophages to bubbling stress in different sampling solutions,to select the optimum sampling solution from three different ones and to select relatively stress-resistant bacteriophages from five different ones.Methods AGI-10(all glass impinger)was used as the representative for all the impingers that would bubble during operation to fulfill the bubbling experiment.Three different sampling solutions used,such as distilled water(DW),phosphatic buffer solution(PBS),and suspension medium(SM),were divided into two groups by adding olive oil(50 μl) or otherwise(0 μl).The impingers were operated 30 min at a flow rate of 7.0 L/min.The titers of bacteriophages and the volume of final sampling solutions were determined before the corrected survival probability was used to evaluate the stress resistance of several different bacteriophages.Results It was found that the survival probability of the same bacteriophage bubbling with different sampling solutions was different except for bacteriophage F2.The use of SM as the collection fluid was related to a high survival probability which remained unchanged between 50 μl and 0 μl olive oil.The corrected survival probability was 79%,77%,86%,50% and 71% for phage SM701,SM702,PhiX174,EcP1 and F2 respectively after 60 minutes of impingement at a flow rate of 7.0 L/min.Conclusion The endurance or resistance of different kinds of bacteriophages in the same sampling solution is different.SM might be an optimum sampling solution for phages.Bacteriophage SM701,SM702 and PhiX174 are more resistant to bubbling stress than EcP1 and F2.

OBJECTIVETo summarize the experience and short-term clinical outcomes of hand-assisted laparoscopic surgery (HALS) in sphincter-preserving surgery for low and ultralow rectal cancer.

METHODSData of 49 patients with rectal cancer who underwent HALS for low or ultralow anterior resection between January 2010 and January 2011 were analyzed retrospectively.

RESULTSThe proximal resection margin was (14.3±6.9) cm and the distal margin was(4.3±1.9) cm. The mean operative time was(128.3±70.9) min. On postoperative macroscopic evaluation, the mesorectum was intact in 42 cases, nearly intact in 7 cases. The circumferential resection margin was more than 2 mm in 42 cases, and less than 2 mm in 7 cases. Forty-six patients underwent R0 resection, and 3 cases underwent R1 resection. The median retrieved lymph node (LN) was 16.20±9.23, and the median positive LN was 1.12±2.19. Postoperative pathological examination showed TNM stage was I( in 12 patients, II(A in 18, II(B in 1, III(A in 2, III(B in 8, III(C in 5, IIII( in 3. The median postoperative hospital stay was (6.25±3.87) d. There were no anastomotic leakage, ileus, intra-abdominal or anastomotic bleeding. There were two wound infections.

CONCLUSIONLow and ultralow anterior resection for rectal cancer using HALS approach is safe and feasible with favorable short-term outcome.

Adult ; Aged ; Aged, 80 and over ; Anal Canal ; surgery ; Female ; Hand-Assisted Laparoscopy ; methods ; Humans ; Male ; Middle Aged ; Rectal Neoplasms ; surgery ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo compare the nutritional status between pancreaticojejunostomy(PJ) and pancreaticogastrostomy(PG) following pancreaticoduodenectomy.

METHODSA retrospective clinical analysis was performed on 37 patients undergoing pancreaticoduodenectomy(PD) for duodenal carcinoma and pancreatic non-epithelial tumor with PG(n=19) and PJ(n=18) in the First Hospital of Sun Yat-sen University from April 2006 to December 2010. All the patients had a needle catheter jejunostomy inserted at the conclusion of laparotomy. Postoperative early enteral nutrition and parenteral nutrition was performed for all the patients. Nutritional status of two groups was compared in body mass index (BMI), serum nutritional parameters such as albumin, transferrin and prealbumin before surgery and on 1, 3, and 6 months postoperatively.

RESULTSThere were no significant differences between PG and PJ groups in operative time, blood loss, pancreatic fistula, perioperative death, or postoperative length of hospital stay. One month after surgery, there were no significant differences in BMI [(17.1±7.0) vs. (19.0±4.8) kg/m(2), P>0.05], albumin [(30.1±0.5) vs. (32.1±1.3) g/L, P>0.05], transferrin [(1.89±0.57) vs. (2.01±0.61) g/L, P>0.05] and prealbumin[(0.18±0.05) vs. (0.18±0.09) g/L, P>0.05]. These parameters were decreased at 1 month after surgery, and gradually recovered to baseline or higher than the preoperative levels at 6 months after surgery. However, the differences were still not statistically significant between two groups.

CONCLUSIONSThe influence of PJ and PG on the postoperative nutritional status are comparable.

Adult ; Aged ; Female ; Gastrostomy ; Humans ; Male ; Middle Aged ; Nutritional Status ; Pancreas ; surgery ; Pancreaticoduodenectomy ; Pancreaticojejunostomy ; Postoperative Period ; Retrospective Studies

OBJECTIVETo analyze the relationships between smooth-muscle tumors of gastrointestinal (GI) tract and gastrointestinal stromal tumors (GISTs), and the efficacy of surgical management.

METHODSThe clinical and pathological data of 135 cases of GISTs were collected, including cases of leiomyomas/leiomyosarcoma between 1993 and 2003 and GIST between Jan. 2000 and Jul. 2005. The surgical outcomes were analyzed retrospectively.

RESULTS82.1% of former leiomyomas/leiomyosarcomas was corrected to GISTs. Overall 5-year survival rate was 79.7%. Univariate analysis revealed preoperative metastasis, tumor size, mitotic index, and postoperative metastasis or recurrence were correlated with overall survival in patients with completed resection. Multivariate analysis showed that only postoperative metastasis or recurrence were the indicators of poor prognosis, but without statistical significance (P=0.064). However, multivariate analysis for disease-free survival showed that preoperative metastasis and mitotic index were two independent predictors of poor prognosis (P=0.001 and P<0.001).

CONCLUSIONSMost former leiomyomas/leiomyosarcomas of GI tract should be corrected to the diagnosis of GISTs. Complete surgical resection is the choice of treatment for GISTs. Preoperative metastasis and mitotic index are two independent predictors of poor prognosis.

Female ; Gastrointestinal Stromal Tumors ; diagnosis ; surgery ; Humans ; Male ; Prognosis ; Survival Rate

Objective To investigate the value of ultrasound-guided liver biopsy for infantile hepatitis syndrome regarding diagnosis,treatment and prognosis.Methods Fifty children with infantile hepatitis syndrome hospitalized in Guiyang Maternal and Child Hospital during Aug.2010 to May 2012 were involved in this study.Ultrasoundguided liver biopsies were performed to evaluate the inflammation grade and fibrosis stage.Immunohistochemical staining was used for pathogen diagnosis.The clinical outcomes were followed-up.Results Thirty-four cases (68％)were CMV infection,6 cases(12％) were vanishing bile duct syndrome,4 cases(8％) were chronic intrauterine infection,4 cases(8％) were congenital anomaly of bilirubin metabolism,and 2 cases (4％) were obstructive cholangitis.All 50 cases showed mild inflammation at portal area(G1-G2 grade).All 50 cases exhibited liver fibrosis.Sixteen cases were S1 stage,20 cases were S2 stage,8 cases were S3 stage and 6 cases were S4 stage.Pathogen analysis:all 50 cases showed intrahepatic cholestasis:38 cases were diffuse cholestasis,and 12 cases were moderate cholestasis.Treatment:all cases were treated using 2-week heteropathy; antivirus was used for CMV infected cases,thus 39 cases were finally cured,9 cases were relieved,and 2 cases were ineffective.Conclusion Liver biopsy is valuable for diagnosis,treatment and prognosis infantile hepatitis syndrome.

Akkermansia ; Colitis ; Colorectal Neoplasms ; Humans ; Inflammatory Bowel Diseases ; Verrucomicrobia

Objective To evaluate the population health for disease prevention and control in Shanghai Minhang District of Shanghai the data of mortality from 1993 to 2015 and communicable diseases from 2002 to 2015.Methods We adopted descriptive epidemiological method to analyze the trends of average life expectancy (ALE),specific death rate and causes of death cis-position from 1993 to 2015,and the incident rates of communicable diseases,incidence trends in Minhang District from 2002 to 2015.Results Overall,the ALE of population in Minhang District increased 11.80 years from 1993 to 2015 (from 71.78 years in 1993 to 83.58 years in 2015),including the ALE of male population increased 14.03 years (from 67.43 years in 1993 to 81.37 years in 2015) and the ALE of female population elevated 9.67 years (from 76.22 years in 1993 to 85.89 years in 2015).In 2015,Crude death rate (CDR) was 755.35/105,which was 21.45％ higher than in 1993 and 2.71％ higher than in 2014,respectively.In the same year,standardized mortality rate (SMR) was 196.07/105,which was 54.17％ lower than in 1993 and 0.51％ lower than in 2014.The top five leading causes of death were circulatory system diseases,tumors,respiratory diseases,endocrine and metabolic diseases,and injury and poisoning,which contributed 91.33％ of the population death.From 2002 to 2015,a total of 23 kinds of notifiable infectious diseases were reported in Minhang District,including 62 845 cumulative cases and 152 cases died.The total reported incidence rate of communicable diseases sharply elevated by 291.98％ during 14 years (Z=10 943.83,P＜0.001),and it increased after standardized.The top five communicable diseases were hand foot and mouth disease (HFMD),scarlet fever,syphilis,tuberculosis and hepatitis B in 2015.Conclusions Over the years,Minhang District of Shanghai comprehensive implemented "health in all policies" by integrating the resources of all levels of regional healthcare institutions.The ALE of the residents was at a high level.The control and prevention of chronic non-communicable diseases and major communicable diseases will continue to be the priority of public health.

OBJECTIVETo compare the clinicopathological characters and operative prognosis of gastric cancer complicated with Krukenberg tumor and with pelvic peritoneal dissemination.

METHODSThirty-nine female cases of gastric carcinoma with pelvic metastasis were treated operated on between August 1994 and March 2006. Among them, 18 cases were complicated with Krukenberg tumor and 21 cases with pelvic peritoneal dissemination. The clinicopathological characters in the two groups were recorded and compared and the operative prognosis were analyzed.

RESULTSThere was no significant difference in age, tumor location and size, hepatic metastasis, organic encroachment, infiltration degree, positive lymph nodes, differentiated degree, tissue typing, Borrmann typing, value of carcinoembryonic antigen between the two groups (P > 0.05). The rate of P3 (peritoneal dissemination) in the cases of Krukenberg tumor (44.4%) was significantly lower than that in pelvic peritoneal dissemination group (85.7%) (P < 0.01), whereas the focal resection rate (77.8%) and multi-organ dissection rate (55.6%) were significantly higher than in pelvic peritoneal dissemination (38.0%, 23.8%) (P < 0.05). The mean survival of all cases was 12.6 months. The mean survival in the patients with Krukenberg tumor and pelvic peritoneal dissemination was 20.5, 15.0 months, respectively (P < 0.05). The mean survival of total focal resection, palliative focal resection, non-focal resection was 19.9, 12.5 and 5.7 months, respectively (P < 0.01). Non-focal resection, pelvic peritoneal dissemination, P3 of peritoneal implantation, hepatic metastasis, organic encroachment, total gastric cancer were unfavorable prognosis factors for all cases.

CONCLUSIONSCompared with pelvic peritoneal dissemination, the gastric cancer with Krukenberg tumor is associated with more limited peritoneal dissemination, higher resection rate and better prognosis. Focal resection can improve the prognosis.

Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Krukenberg Tumor ; pathology ; surgery ; Middle Aged ; Neoplasm Seeding ; Pelvic Neoplasms ; pathology ; secretion ; surgery ; Peritoneal Neoplasms ; pathology ; secondary ; surgery ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; pathology ; surgery

OBJECTIVETo investigate the clinical importance of palliative gastrectomy for late-staged gastric cancer.

METHODSFrom June 1994 to October 2001, 95 patients with late-staged gastric cancer underwent palliative operation. Clinicopathological and prognostic parameters between 64 patients with palliative gastrectomy (PG group) and 31 patients with unresectable operation (UO group) was compared retrospectively.

RESULTSThe age and gender ratios were not different between the two groups. The incidence of large volume (diameter > or = 8 cm), serosal invasion (T(4)) and late TNM stage (IV stage) were significantly higher in the UO group than that in the PG group. There was no difference in peritoneal dissemination, distant lymph node and hepatic metastasis, and tumor location between the two groups. The one- and two-year survival of the patients in the PG group was 48.1% and 23.1%, and significantly better than 13.5% and 0 in the UO group.

CONCLUSIONSPalliative gastrectomy, compared with unresectable operation, can improve the prognosis of the patients with late-staged gastric cancer even with peritoneal dissemination, distant lymph node and hepatic metastasis, and surrounding organ invasion.

Adult ; Aged ; Female ; Gastrectomy ; Humans ; Male ; Middle Aged ; Neoplasm Invasiveness ; Palliative Care ; Stomach Neoplasms ; mortality ; pathology ; surgery ; Survival Rate

OBJECTIVETo investigate the feasibility and clinical effects of titanium elastic nails (TEN) for adolescent clavicular fracture.

METHODSFrom October 2008 to November 2009, 17 adolescent patients with clavicular fracture were treated with internal fixation, including 11 males and 5 females who ranged in age from 12 to 18 years (mean 15.3 years). The mean time from injury to surgery was 3.5 days (2-7 days). Constant function score before surgery and that 3 months after surgery and shoulder ROM before surgery and that 2 months after surgery were compared. Fracture reduction and healing were followed up by X-rays to analyze internal fixation with the TEN technique.

RESULTSAll patients were followed up for a mean of 6.5 months (range 3-8 months), during which no infection, TEN fracture or skin bursting was observed. The Constant score rose from preoperative (45.3 +/- 6.1) to (85.6 +/- 4.3) at 3-month follow up (t = 22.164, P < 0.01),and the shoulder activity degree at 2-week follow up was improved obviosly from preoperative (P < 0.01). X-ray at 12-16 weeks after surgery showed good bone healing and recovery of shoulder function.

CONCLUSIONInternal fixation with TEN in the treatment of adolescent clavicular fracture is safe, minimally invasive,reliable and cosmetic. This technique provides a liable ption for the treatment of adolescent clavicular fractire

Adolescent ; Bone Nails ; Child ; Clavicle ; injuries ; surgery ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Range of Motion, Articular