Hydroxychloroquine is widely used in the treatment of autoimmune diseases and skin diseases, mainly for the treatment of diseases such as systemic lupus erythematosus, rheumatoid arthritis and other diseases. Hydroxychloroquine has many benefits to patients, but long-term use of the drug may lead to retinal chronic toxicity changes, seriously affect the patient’s vision and quality of their lives. However, there are few studies on retinal toxicity of hydroxychloroquine in the world, easy to miss diagnosis and misdiagnosis clinically. ophthalmologists should increase the knowledge with the etiology and pathology of hydroxychloroquine retinal toxicity, through relevant auxiliary check early detection of the drug to the retina and timely suggest patients to stop. This can effectively reduce the risk of vision loss caused by retinal toxicity, and reduce the adverse effects of hydroxychloroquine on the retina while patients get a good treatment effect.

Hydroxychloroquine is widely used in the treatment of autoimmune diseases and skin diseases, mainly for the treatment of diseases such as systemic lupus erythematosus, rheumatoid arthritis and other diseases. Hydroxychloroquine has many benefits to patients, but long-term use of the drug may lead to retinal chronic toxicity changes, seriously affect the patient’s vision and quality of their lives. However, there are few studies on retinal toxicity of hydroxychloroquine in the world, easy to miss diagnosis and misdiagnosis clinically. ophthalmologists should increase the knowledge with the etiology and pathology of hydroxychloroquine retinal toxicity, through relevant auxiliary check early detection of the drug to the retina and timely suggest patients to stop. This can effectively reduce the risk of vision loss caused by retinal toxicity, and reduce the adverse effects of hydroxychloroquine on the retina while patients get a good treatment effect.

OBJECTIVETo compare the short-term safety and costs between laparoscopic assisted or totally laparoscopic uncut Roux-en-Y and Billroth II((BII() + Braun reconstruction after radical gastrectomy of distal gastric cancer.

METHODSClinical data from our prospective database of radical gastrectomy were systematically analyzed. The patients who underwent laparoscopic gastrectomy with uncut Roux-en-Y or BII(+ Braun reconstruction between March 1st, 2015 and June 30th, 2017 were screened out for further analysis. Both the reconstructions were completed by linear staplers. Uncut Roux-en-Y reconstruction was performed with a 45 mm no-knife linear stapler (ATS45NK) on the afferent loop below the gastrojejunostomy. Continuous variables were compared using independent samples t test or Mann-Whitney U. The frequencies of categorical variables were compared using Chi-squared or Fisher exact test.

RESULTSEighty-one patients were in uncut Roux-en-Y group and 58 patients were in BII(+Braun group. There were no significant differences between uncut Roux-en-Y group and BII(+Braun group in median age (56.0 years vs. 56.5 years, P=0.757), gender (male/female, 52/29 vs. 46/12, P=0.054), history of abdominal surgery (yes/no, 10/71 vs. 4/54, P=0.293), neoadjuvant chemotherapy (yes/no, 21/60 vs. 11/47, P=0.336), BMI (thin/normal/overweight/obesity, 2/49/26/3 vs. 3/39/14/2, P=0.591), NRS 2002 score (1/2/3/4, 58/15/5/3 vs. 47/5/3/3, P=0.403), pathological stage (0/I(/II(/III(, 3/41/20/17 vs. 1/28/13/16, P=0.755), median tumor diameter in long axis (2.5 cm vs. 3.0 cm, P=0.278), median tumor diameter in short axis (2.0 cm vs. 2.0 cm, P=0.126) and some other clinical and pathological characteristics. There were no significant differences between uncut Roux-en-Y group and BII(+Braun group in morbidity of postoperative complication more severe than grade I([12.3% (10/81) vs. 17.2% (10/58), P=0.417], morbidity of anastomotic complication [1.2%(1/81) vs. 0, P=1.000] or hospitalization costs [(94000±14000) yuan vs.(95000±16000) yuan, P=0.895]. The median first time to liquid diet (57.1 hours vs. 70.8 hours, P=0.017) and median postoperative hospital stay (9 days vs. 11 days, P=0.003) of the patients in uncut Roux-en-Y group were shorter than those in BII(+Braun group.

CONCLUSIONLaparoscopic assisted or totally laparoscopic uncut Roux-en-Y reconstruction after radical gastrectomy of distal gastric cancer is safe and feasible with better recovery than BII(+Braun reconstruction.

Anastomosis, Roux-en-Y ; Databases, Factual ; Female ; Gastrectomy ; Gastroenterostomy ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Prospective Studies ; Stomach Neoplasms ; surgery ; Treatment Outcome

Objective:To investigate the predictive value of preoperative and postoperative serum tumor markers, namely, carcinoem-bryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and CA72-4, in the diagnosis of gastric cancer recurrence at different stag-es. Methods:Analysis was performed in 564 patients who underwent curative resection for gastric cancer between January 2002 and March 2007, received no chemotherapy at our hospital, and received complete follow-up according to the schedule determined pro-spectively. The values of CEA, CA19-9, and CA72-4 were evaluated before and after surgery. Results:In the pTNM-Ⅰ and pTNM-Ⅱ stage groups, patients with positive preoperative serum CEA, CA19-9, and CA72-4 levels showed recurrence rates of 50.0%, 24.1%, and 22.6%, respectively. Similarly, the recurrence rates of patients with positive postoperative serum CEA, CA72-4, and CA19-9 levels were 42.9%, 21.7%, and 14.3%, respectively. Multivariate analysis showed that the positive preoperative serum CEA level could be an inde-pendent factor of recurrence. In the pTNM-Ⅲ stage group, the recurrence rates of patients with positive preoperative serum CEA, CA19-9, and CA72-4 levels were 50.0%, 55.2%, and 47.6%, respectively. The recurrence rates of patients with positive postoperative se-rum CEA, CA19-9, and CA72-4 levels were 75.0%, 66.7%, and 66.7%, respectively. Multivariate analysis showed that high postoperative serum CA72-4 levels could be an independent factor of gastric cancer recurrence. Conclusion:Serum tumor markers exhibited differ-ent predictive values in different pTNM stages. Preoperative CEA level could be used to predict recurrence in patients with pTNM-Ⅰ and pTNM-Ⅱ stages of gastric cancer. Moreover, postoperative CA72-4 level could be used to predict recurrence in patients with pTNM-Ⅲ stage gastric cancer.

Objective:To investigate the efficacy, safety, and overall survival of advanced upper gastric cancer patients who received preoperative chemoradiation therapy. Methods:A total of 62 patients who received preoperative chemotherapy or chemoradiation therapy in the Department of Gastrointestinal Surgery of Beijing Cancer Hospital&Institute were retrospectively observed to determine the efficacy and safety and to perform survival analysis of preoperative chemoradiation therapy. Results:Results of the postoperative pathology showed that the number of patients with T4 and N3 stages was significantly lower in the preoperative chemoradiation therapy group than in the preoperative chemotherapy group (P<0.05). In addition, the differences between the two groups in terms of safety and toxicity were not significant (P≥0.05). Analysis also showed that the differences between the two groups in terms of survival were not significant (P≥0.05). Conclusion:Patients with advanced upper gastric cancer can gain a potential survival advantage from preoperative chemoradiation therapy. Compared with preoperative chemotherapy, preoperative chemoradiation therapy was performed without increased risk of toxicity and insecurity. Preoperative chemoradiation therapy can also improve the local control ratio, especial y the control ratio of lymphatic metastasis. However, the final results of survival analysis depend on long-term follow-up of patients.

Objective To understand the characteristics of High-density lipoprotein cholesterol (HDL-C) distribution through analyzing serum HDL-C levels in healthy checkup subjects among local urbanese.Methods The checkup results of 36 454 cases were collected from 2009 to 2013 in Tangshan Gongren hospital (male:n =20 343,female:n =16 111).The cases with liver injury,abnormal blood glucoses,kidney injury and defined cerebrovascular diseases and metabolic disease were excluded.25 197 cases were analyzed as normal subjects including 11 114 males and 14 083 females.Kolmogorov-Smimov test,kruskal-wallis test,and Dunn multiple comparison test was performed using Bioconductor software 3.0.2 for testing normality distribution and comparing the difference of two or multiple groups,respectively.Results were analyzed statistically with R 3.0.2.Results The results showed that the average level (1.22-± 0.31) mmol/L of HDL-C among the overall population is lower than that of national average level(1.30 mmol/L).The median serum HDL-C level in female is higher than in male (1.27 and 1.08,x2 =2 606.34,P ＜0.01).HDL-C levels in male continuously increase from 1.06 mmol/L to 1.11 mmol/L with aging,especially in groups of over 50 years old than in groups of below 50 years old (x2 =75.19,P ＜ 0.01).Conclusions Based on 2007 guidance on prevention and treatment by national health bureau,this study showed that there are 29.69％ of the apparent healthy subjects,especially about 42.94％ of the male,representing low HDL-C level under the low limit of 1.04 mmol/L.These results showed that serum HDL-C level in Tangshan urbanese is lower than that of national average level,and HDL-C level in male is tended to increase with aging.

Objective:To explore the influence of counseling methods of different groups on college students mental health.Methods:Two counseling groups were formed,each group having six people.Two counseling methods were adopted:long intensive training marathon group and brief group.The effect was assessed with SCL-90.Result:Group members had a rather high satisfaction;SCL90 test scores after testing had significant differences,P=0.001