Objective To exploring the expression of microRNA-93-5p(miRNA-93-5p)and neuregulin protein 1(NRG1)in thyroid cancer tissues and their relationship with clinicopathological characteristics and survival prognosis.Methods Frozen tissue specimens of 136 patients with thyroid diseases who underwent surgical treatment in the hospital from January 2018 to May 2020 were selected,including 84 cases of thyroid cancer(thyroid cancer group),52 cases of benign thyroid diseases(benign thyroid disease group),and another 40 cases of normal thyroid tissues(control group).The relative expression levels of miRNA-93-5p and the positive expression rate of NRG1 in the tissues of the thyroid cancer group,the benign thyroid disease group and the control group were compared,and the relationship between the expression of miRNA-93-5p and NRG1 in patients with thyroid cancer and the clinicopathological characteristics was analyzed.Multivariate Logistic regression was used to analyze the influencing factors of miRNA-93-5p and NRG1 expression.Kaplan-Meier survival curve was used to analyze the relationship between the expression of miRNA-93-5p and NRG1 and survival prognosis in patients with thyroid cancer.Results There were statistically significant differences in the relative expression levels of miRNA-93-5p and the positive expression rate of NRG1 among the thyroid cancer group,the benign thyroid disease group and the control group(P＜0.05).The relative expression level of miRNA-93-5p in thyroid cancer tissues was negatively correlated with the positive expression rate of NRG1(r=-0.216,P=0.013).The proportion of tumor maximum diameter＞1 cm,the rate of moderate and low differentiation,the rate of capsular invasion,the rate of lymphatic metastasis,and the proportion of TNM stage Ⅲ+Ⅳ in the miRNA-93-5p high-expression group were higher than those in the miRNA-93-5p low-ex-pression group(P＜0.05),and the above indicators in the NRG1 high-expression group were all lower than those in the NRG1 low-expression group(P＜0.05).Multivariate Logistic regression analysis revealed that the maximum diameter of the tumor,degree of differentiation,capsular invasion,lymphatic metastasis and TNM stage were all influencing factors for the expression of miRNA-93-5p and NRG1.The 3-year cumulative survival rate of the miRNA-93-5p high-expression group was lower than that of the miRNA-93-5p low-expres-sion group(P＜0.05),and the 3-year cumulative survival rate of the NRG1 high-expression group was higher than that of the NRG1 low-expression group(P＜0.05).Conclusion In thyroid cancer tissues,miRNA-93-5p is highly expressed and NRG1 is lowly expressed.Both can be used as biomarkers for evaluating the survival prognosis of patients.

Objective To reveal the prevalence and the related factors of hepatitis B (HepB) virus infection among HIV/AIDS patients.Methods We conducted a cross-sectional study in two HIV clinics,affiliated to local Centers of Disease Control and Prevention in Guangxi Zhuang Autonomous Regional.A face-to-face interview,with questionnaire was conducted to collect information on socio-demographic characteristics,drug use,and sexual behavior.Blood samples were used to test HBsAg.x2 test or Fisher's exact test and unconditional logistic regression models were used to identify the influencing factors.Results The prevalence of HBV and HIV co-infection was 13.85％ (113/816).Results from multivariate logistic regression analyses showed that age (25-45),family history of HBV and history of HepB vaccination were independent influencing factors for HBV and HIV coinfection,with OR (95％ CI) as 1.738 (1.031-2.931),2.898 (1.678-5.005) and 1.744 (1.052-2.892),respectively.Conclusion The prevalence of HBV among HIV/AIDS patients was significantly higher than that in general population.HIV/AIDS patients aged between 25 and 45 and with family history of HBV were more likely to be infected with HBV,while HepB vaccination was associated with the reduction of HIV/HBV coinfection.Specific comprehensive prevention and treatment programs on HIV/AIDS patients need to be set up.

Japanese gastric cancer treatment guidelines list options for treatment of each stage of early gastric cancer (EGC).The treatment of EGC is closely related to the lymph node metastasis, and the accurate prediction of lymph node metastasis is related to the choice of the treatment options and the prognosis of the patients.The lymph node metastasis of EGC is evaluated according to the clinicopathological factors, imaging,molecular markers and sentinel lymph node (SLN) tracer biopsy.A two-step method for the management of EGC treated with endoscopic mucosal resection/endoscopic submucosal dissection (EMR/ESD) is recommended.While for those EGC patients not suitable to receive EMR/ESD, imaging or molecular marker and SLN tracer biopsy technology are applied to determine lymph node status.

Objective:To investigate the cause, treatment, and prognosis of delayed hemorrhage in patients who underwent radical gastrectomy. Methods:The clinical data of 294 patients who underwent radical gastrectomy in the Second Hospital Affiliated from Nanchang University from January 2015 to October 2015 were retrospectively analyzed. Results:A total of 15 patients suffered from delayed hemorrhage and accounted for 5.1%of the gastric cancer cases in our hospital for the same period of radical gastrectomy. Of the 15 patients, 9 underwent laparoscopic radical gastrectomy and 6 received open radical gastrectomy resection. Large vascular hemorrhage was found in 7 cases. Anastomosis and anastomotic ulcer induced hemorrhage were observed in 3 cases. Duodenal stump rupture induced hemorrhage was detected in 2 cases. Hemorrhage was also observed in some parts in 2 cases. Likewise, hemorrhage occurred in 1 case, but the affected parts were unknown. Of the 11 patients who underwent a second operation, 2 were subjected to digital subtraction angiography (DSA) and transcathete arterial embolization (TAE) to stop hemorrhage. Endoscopic hemostasis was performed to stop hemorrhage in 1 case. Conservative treatment was administered to stop hemorrhage in 1 case. The secondary surgery rate was 73.3%(11/15) with mortality and curative rates of 40%(6/15) and 60%(9/15), respectively. Conclusion:For delayed hemorrhage after D2 of gastric cancer, a second radical surgery and death rates were high. Therefore, patients suffering from hemorrhage should be subjected to comprehensive clinical treatment and positive measures. Major vascular bleeding, anastomotic leakage, anastomotic ulcer, and duodenal stump rupture are relevant risk factors. Anastomotic fistula and celiac artery bleeding complications caused hemorrhage is the leading cause of death. Extensive bleeding and unstable vital signs should be checked. A second operation and abdominal drainage should also be timely conducted to as effective methods. Realistic and conservative treatment can be administered to patients with stable vital signs and low amount of blood loss. Endoscopic hemostasis can be applied to alleviate simple anastomotic ulcer bleeding. DSA can be initially performed to detect unknown bleeding sites. TAE can be subsequently used to treat hemorrhage.

D2 radical gastrectomy is widely accepted as surgical procedures for the resectable gastric cancer.However,cancer recurrence and five-year survival rate after radical resection are not satisfactory,and the surgical procedures should be further improved.En bloc mesogastric excision (EME) is one of the new attempts to change the status based on the embryoloical and anatomical understanding of mesogastrium.

Laparoscopic spleen-preserving splenic hilar lymphadenectomy (LSPL) is a operation conducted experimentally in the current. Current reports showed that it can be safely completed through different approach, such as the right, left, medial and retropancreatic approach. This paper summarized the steps and characteristics of different approaches LSPL and compared the differences between each other. The application status of LSPL in laparoscopy-assisted radical gastrectomy were reviewed. The security, feasibility and the problem to be solved of LSPL, improvement measure also be explored in this paper.
Gastrectomy ; methods ; Humans ; Laparoscopy ; Lymph Node Excision ; methods ; Lymph Nodes ; Spleen ; Stomach Neoplasms ; surgery

OBJECTIVETo evaluate the effect of body mass index (BMI) on postoperative short-term outcomes of laparoscopy radical gastrectomy by meta-analysis.

METHODSA literature search was performed in PubMed, EMBASE, Cochrane Library databases, CNKI, and CBM, Wanfang database to screen clinical trials published before October 2014 that compared short-term outcomes between high BMI and low BMI patients undergoing laparoscopy radical gastrectomy. RevMan 5.2 was used to perform the meta-analysis. Begg's and Egger's tests were carried out with Stata 12.0 software to evaluate the publication bias of enrolled literatures.

RESULTSTwelve studies involved a total of 4798 gastric cancer patients after laparoscopy radical gastrectomy. There were 1215 patients in high BMI group(BMI≥25 kg/m2) and 3583 patients in the low BMI group (BMI<25 kg/m2). Compared with the low BMI group, the high BMI group were associated with longer operation time (SMD=0.64, 95%CI:0.35-0.93, P=0.000), more intraoperative blood loss(SMD=0.63, 95%CI:0.24-1.03, P=0.002), less retrieved lymph nodes(SMD=-0.44, 95%CI:-0.72--0.17, P=0.002), and more postoperative complications(OR=1.44, 95%CI:1.19-1.74, P=0.000). There were no significant differences in postoperative hospital stay, the time to first flatus and initial complication(P>0.05).

CONCLUSIONThe higher BMI may result in a longer operation time, more intraoperative blood loss and a higher rate of postoperative complication after laparoscopy radical gastrectomy.

Blood Loss, Surgical ; Body Mass Index ; Gastrectomy ; Humans ; Laparoscopy ; Length of Stay ; Lymph Nodes ; Operative Time ; Postoperative Complications ; Postoperative Period ; Stomach Neoplasms ; Treatment Outcome

Objective To evaluate the effect of body mass index (BMI) on postoperative short-term outcomes of laparoscopy radical gastrectomy by meta-analysis. Methods A literature search was performed in PubMed, EMBASE, Cochrane Library databases, CNKI, and CBM, Wanfang database to screen clinical trials published before October 2014 that compared short-term outcomes between high BMI and low BMI patients undergoing laparoscopy radical gastrectomy. RevMan 5.2 was used to perform the meta-analysis. Begg′s and Egger′s tests were carried out with Stata 12.0 software to evaluate the publication bias of enrolled literatures. Results Twelve studies involved a total of 4798 gastric cancer patients after laparoscopy radical gastrectomy. There were 1215 patients in high BMI group (BMI≥25 kg/m2) and 3583 patients in the low BMI group (BMI <25 kg/m2). Compared with the low BMI group, the high BMI group were associated with longer operation time (SMD=0.64, 95%CI:0.35-0.93, P=0.000), more intraoperative blood loss (SMD=0.63, 95%CI:0.24-1.03, P=0.002), less retrieved lymph nodes (SMD=-0.44, 95%CI:-0.72--0.17, P=0.002), and more postoperative complications (OR=1.44, 95%CI:1.19-1.74, P=0.000). There were no significant differences in postoperative hospital stay, the time to first flatus and initial complication (P>0.05). Conclusion The higher BMI may result in a longer operation time, more intraoperative blood loss and a higher rate of postoperative complication after laparoscopy radical gastrectomy.

Objective To evaluate the effect of body mass index (BMI) on postoperative short-term outcomes of laparoscopy radical gastrectomy by meta-analysis. Methods A literature search was performed in PubMed, EMBASE, Cochrane Library databases, CNKI, and CBM, Wanfang database to screen clinical trials published before October 2014 that compared short-term outcomes between high BMI and low BMI patients undergoing laparoscopy radical gastrectomy. RevMan 5.2 was used to perform the meta-analysis. Begg′s and Egger′s tests were carried out with Stata 12.0 software to evaluate the publication bias of enrolled literatures. Results Twelve studies involved a total of 4798 gastric cancer patients after laparoscopy radical gastrectomy. There were 1215 patients in high BMI group (BMI≥25 kg/m2) and 3583 patients in the low BMI group (BMI <25 kg/m2). Compared with the low BMI group, the high BMI group were associated with longer operation time (SMD=0.64, 95%CI:0.35-0.93, P=0.000), more intraoperative blood loss (SMD=0.63, 95%CI:0.24-1.03, P=0.002), less retrieved lymph nodes (SMD=-0.44, 95%CI:-0.72--0.17, P=0.002), and more postoperative complications (OR=1.44, 95%CI:1.19-1.74, P=0.000). There were no significant differences in postoperative hospital stay, the time to first flatus and initial complication (P>0.05). Conclusion The higher BMI may result in a longer operation time, more intraoperative blood loss and a higher rate of postoperative complication after laparoscopy radical gastrectomy.

OBJECTIVETo systemically assess the feasibility and safety of complete mesocolic excision (CME) for colon cancer.

METHODSA computer-based online research of prospective, randomized or nonrandomized, controlled studies addressing CME versus traditional surgery published in the last five years was performed in electronic databases (Wanfang Database, China National Knowledge Infrastructure, Chinese Medical Current Contents, VIP, PubMed, Medline, Ovid, Elsevier, ISI Web of Knowledge, Cochrane Database of Systematic Reviews). With strictly screening according to the standard, the quality of studies was evaluated. Selective trials were analyzed by the Review Manager 5.1 software.

RESULTSA total of eight nonrandomized clinical trials, involving a total of 1209 patients (615 patients in CME group and 594 patients in control group), were identified. Meta-analysis showed that the intraoperative blood loss in CME group was less than that in control group [WMD=-13.05, 95%CI:-25.03 to -1.07, P=0.03]. No significant difference in the operation time was found [WMD=0.46, 95%CI:-26.50 to 27.41, P=0.97], and significant differences in the number of lymph node retrieved from postoperative pathologic specimens, the average length of large bowel resected, the area of mesentery resected, and the high vascular ligation were revealed between two groups. Besides there were no significant differences in the time to first flatus and the hospital stay between two groups (P=0.87, P=0.05). The postoperative complication morbidity did not increase in CME group as compared to control group (P=0.74).

CONCLUSIONCME is safe and effective in accordance with the concept of embryonic anatomy, oncological surgery and delicate surgery, and is expected to become a standardization operation method for colon cancer.

Clinical Trials as Topic ; Colonic Neoplasms ; surgery ; Feasibility Studies ; Humans ; Mesentery ; surgery