Objective To observe the effects of restricted and high-fat diets on behavioral changes of wild-type(Adrb1+/+)and transgenic mice carrying Adrb1-A187V mutation(Adrb1+/m)with short sleep durations.Methods Adrb1+/+and Adrb1+/m C57BL/6 mice were randomized into normal chow group(25 Adrb1+/+and 26 Adrb1+/m mice for behavioral monitoring),odor retention fasting group(17 Adrb1+/+and 19 Adrb1+/m mice for behavioral monitoring;6 Adrb1+/+mice and 6 Adrb1+/m mice for EEG/EMG monitoring),absolute fasting group(6 Adrb1+/+and 4-5 Adrb1+/m mice for behavioral monitoring;6 Adrb1+/+and 6 Adrb1+/m mice for EEG/EMG monitoring),and high-fat diet group(6 Adrb1+/+and 7 Adrb1+/m mice for behavioral monitoring;6 Adrb1+/+and 6 Adrb1+/m mice for EEG/EMG monitoring).Electrodes for EEG and muscle activity monitoring were implanted on the skulls of the mice.After 24 h of odor retention fasting,absolute fasting,or high-fat feeding,the mice were observed for behavioral changes adapted to diet changes.Results In odor retention fasting experiment,Adrb1+/m mice exhibited more stable fluctuations of activities with mildly reduced movement and prolonged sleep duration,indicating enhanced starvation resistance.In absolute fasting experiment,Adrb1+/m mice showed significantly increased nighttime water intake,improved rhythmicity in water intake(frequent intakes in small amounts),and increased duration of non-rapid eye movement sleep(NREM).In the high-fat diet experiment,Adrb1+/m mice showed higher levels of activity with increased instances of nighttime rearing,longer movement distances,and increased rapid eye movement sleep during daytime.Conclusion Adrb1+/m mice can quickly respond to environmental changes and under restricted dietary conditions,they can conserve energy by increasing sleep to maintain energy homeostasis but show higher levels of activity under high-fat dietary conditions.

Objective To observe the effects of restricted and high-fat diets on behavioral changes of wild-type(Adrb1+/+)and transgenic mice carrying Adrb1-A187V mutation(Adrb1+/m)with short sleep durations.Methods Adrb1+/+and Adrb1+/m C57BL/6 mice were randomized into normal chow group(25 Adrb1+/+and 26 Adrb1+/m mice for behavioral monitoring),odor retention fasting group(17 Adrb1+/+and 19 Adrb1+/m mice for behavioral monitoring;6 Adrb1+/+mice and 6 Adrb1+/m mice for EEG/EMG monitoring),absolute fasting group(6 Adrb1+/+and 4-5 Adrb1+/m mice for behavioral monitoring;6 Adrb1+/+and 6 Adrb1+/m mice for EEG/EMG monitoring),and high-fat diet group(6 Adrb1+/+and 7 Adrb1+/m mice for behavioral monitoring;6 Adrb1+/+and 6 Adrb1+/m mice for EEG/EMG monitoring).Electrodes for EEG and muscle activity monitoring were implanted on the skulls of the mice.After 24 h of odor retention fasting,absolute fasting,or high-fat feeding,the mice were observed for behavioral changes adapted to diet changes.Results In odor retention fasting experiment,Adrb1+/m mice exhibited more stable fluctuations of activities with mildly reduced movement and prolonged sleep duration,indicating enhanced starvation resistance.In absolute fasting experiment,Adrb1+/m mice showed significantly increased nighttime water intake,improved rhythmicity in water intake(frequent intakes in small amounts),and increased duration of non-rapid eye movement sleep(NREM).In the high-fat diet experiment,Adrb1+/m mice showed higher levels of activity with increased instances of nighttime rearing,longer movement distances,and increased rapid eye movement sleep during daytime.Conclusion Adrb1+/m mice can quickly respond to environmental changes and under restricted dietary conditions,they can conserve energy by increasing sleep to maintain energy homeostasis but show higher levels of activity under high-fat dietary conditions.

Object:To explore surgical treatments for duodenal fistula with intra-abdominal infection.Methods:The data of 19 patients with duodenal fistula treated at the Affiliated Tumor Hospital of Zhenzhou University between Jan 2015 and Dec 2021 were analyzed retrospectively. Surgery is performed with duodenostomy or modified duodenal shunt procedures.Result:All patients were accompanied by intra-abdominal infection, including 9 duodenal stump fistulas. All patients successfully completed the operation,11cases underwent duodenostomy, 8 case underwent modified duodenal shunt procedures. operating time was 110(60-140)min, postoperative hospitalization time was 29(9-103)d. Two patients died postoperatively. Fistula heals in other patients.Conclusion:Surgical intervention for duodenal fistula should focus on controlling the source of infection, strengthening intestinal and abdominal drainage, and reducing postoperative complications.

Objective:To evaluate the strategy and skills of reoperation for recurrent carcinoma at the stoma of esophagojejunostomy after total gastrectomy.Methods:The management experience in 18 patients at the Department of General Surgery, Tumor Hospital of Zhengzhou University from Oct 2016 to Jul 2021 were analyzed retrospectively.Results:Thirteen patients underwent left thoracoabdominal combined incision to completely remove the tumor.One patient developed anastomotic leakage, two patients developed pulmonary infection, one patient developed costochondritis, all were cured and discharged after conservative treatment; Nine patients had no postoperative complications. Two patients abandoned surgery due to high position of the tumor, 3 patients due to poor cardiopulmonary function, and were given radiotherapy and chemotherapy.The postoperative follow-up period was 4.6 to 42.9 months. Four patients died of tumor recurrence, and the remaining patients survived until the end of the follow-up. The overall 1-and 3-year recurrence-free survival rates were 100% and 20%, respectively.Conclusion:Surgery on recurrent carcinoma at esophagojejunostomy stoma after total gastrectomy, although difficult and challenging,could still benefit most patients when at the hands of expertise.

Objective:To evaluate a nano-carbon lymphatic tracing method for patients with rectal cancer after neoadjuvant radiotherapy and chemotherapy .Method:Retrospective analysis was made on 88 patients of rectal cancer undergoing neoadjuvant chemoradiation at the Department of General Surgery, He′nan Cancer Hospital from Jan 2016 to May 2020.According to whether nano-carbon lymph node was used or not, patients were divided into nanocarbon tracer group (study group) and non-nanocarbon tracer group (control group).Results:There was statistically significant in the number of havested lymph nodes between the two groups [15(11-19) vs.9(5-12), Z=5.227, P<0.001], There was no statistically significant in the number of positive lymph nodes between the two groups [0(0-0.25) vs.0(0-1), Z=1.199, P=0.231]. There were significant differences in the ratio of patients with less than 7 lymph nodes(0/34 vs.18/54, χ 2=14.248, P<0.001) and patients with less than 10 lymph nodes (4/34 vs.29/54, χ 2=15.657, P<0.001). Conclusions:The injection of nanocarbon after neoadjuvant chemoradiotherapy can increase the number of harvested postoperative lymph nodes and the ratio of patients with lymph nodes ≥7 and ≥10, which is more beneficial for prediction of the prognosis of patients.

Objective:To explore the prognostic value of combined fibrinogen/albumin ratio (FAR) and CA724 in patients with stage Ⅱ/Ⅲ gastric cancer after radical resection.Methods:A total of 932 patients were enrolled in the study, and the best cut-off values of CEA, FAR, NLR and other variables were obtained through ROC curve analysis. According to the FAR-CA724 score, patients were divided into 3 groups: FAR-CA724=0 (CA724<3.43 ng/ml and FAR<0.083), FAR-CA724=1 (CA724≥3.43 ng/ml and FAR≥0.083) and FAR-CA724=2 (CEA≥3.43 ng/ml and FAR≥0.083).Results:After FAR-CA724 grouping, the patient's age (χ 2=12.02, P=0.002), gender (χ 2=15.91, P<0.001), tumor size (χ 2=18.22, P<0.001), hypertension (χ 2=6.35, P=0.042), tumor location (χ 2=26.09, P<0.001), degree of differentiation (χ 2=12.46, P=0.002) and pTNM staging (χ 2=6.68, P=0.035) are significantly different. Survival analysis showed that there were significant differences in OS between the three groups of patients (FAR-CA724=0, 1, and 2: 88.2%, 64.3% and 37.8%, respectively, P<0.001). By multivariate analysis FAR-CA724 is an independent risk factor affecting OS in patients with stage Ⅱ/Ⅲ gastric cancer after radical surgery. Conclusions:Preoperative FAR-CA724 may be a potential blood marker for predicting the prognosis of GC patients.

Objective:To investigate the effects of preoperative endoscopic mucosal injection of carbon nanoparticle tracer and intraoperative serosa injection of carbon nanoparticle tracer on the acquisition of lymph nodes in total gastrectomy for gastric cancer.Methods:The retrospective cohort study was conducted. The clinical data of 118 patients with gastric cancer who underwent total gastrectomy in the Affiliated Tumor Hospital of Zhengzhou University between May 2017 and April 2018 were collected. There were 79 males and 39 females, aged from 26 to 81 years, with an average age of 59 years. Of 118 patients, 56 patients undergoing preoperative endoscopic mucosal injection of carbon nanoparticle tracer were divided into observation group and 62 patients undergoing intraoperative serosa injection of carbon nanoparticle tracer were divided into control group. Observation indicators: the total number of lymph node dissected, the number of positive lymph node dissected, the number of lymph node dissected at the first station and the number of lymph node dissected at the second station. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the independent-sample t test. Measurement data with skewed distribution were represented as M (range), and comparison between groups was analyzed using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Comparison of ordinal data was analyzed using the rank sum test. Results:The total number of lymph node dissected, the number of positive lymph node dissected, the number of lymph node dissected at the first station, the number of lymph node dissected at the second station of the observation group were 48±16, 3(range, 0-25), 26±9, 23±7, respectively. The above indicators of the control group were 41±13, 4(range, 0-28), 25±8, 16±5, respectively. There were significant differences in the total number of lymph node dissected and the number of lymph node dissected at the second station between the two groups ( t=2.494, 6.588, P<0.05), and there was no significant difference in the number of positive lymph node dissected and the number of lymph node dissected at the first station between the two groups ( Z=0.747, t=1.689, P>0.05). Conclusions:Carbon nanoparticle labeled lymph node staining using preoperative endoscopic mucosal injection of carbon nanoparticle tracer or intraoperative serosa injection of carbon nanoparticle tracer is safe and effective in total gastrectomy for gastric cancer. Compared with intraoperative serosa injection of carbon nanoparticle tracer, preoperative endoscopic mucosal injection of carbon nanoparticle tracer can increase the total number of lymph node dissected, especially the number of lymph node dissected at the second station of gastric cancer.

Objective To explore the safety and efficacy of middle line approach identified with superior mesenteric vein in the right hemicolectomy combined with pancreaticoduodenectomy for colonic carcinoma involing liver and duodenun.Methods Clinical data of 13 patient's with right colonic cancer (T4b) undergoing right hemicolectomy combined with pancreaticoduodenectomy from Jan 2016 to Jul 2019 in He'nan Provincial Tumor Hospital were retrospectively analyzed.The superior mesenteric vein was used to mark the medial border of tumor resection.Vertical cutline was made to transverse mesocolon and all the way done to the root of superior mesenteric vein,the pancreas was cut in front of superior mesenteric vein,superior mesenteric artery and the affiliated lymph nodes were dissected.The stomach and pancreas were transected,the specimen was removed.Then the GI tract was reconstructed.Results Surgery was successful in all 13 patients.The operation time was (249 ± 27) min,blood loss was (442 ± 129) ml,2 cases suffered pancreatic fistula,there was no biliary fistula,and 1 case of delayed gastric emptying.There were no other major complications.The number of lymph node dissection was (20 ± 4) and hospital stay was (23.2-± 9.4) d.Conclusions It is safe and feasible to use the superior mesenteric vein-identified middle line approach in patients of right colonic cancer undergoing right hemicolectomy plus pancreaticoduodenectomy.

Objective:To evaluate a new nano-carbon lymphatic tracing method to increase the number of lymph nodes acquired in patients with neoadjuvant chemotherapy for gastric cancer.Method:From Jan 2015 to Mar 2016, 159 patients with gastric cancer were recruited including 66 cases in study group receiving nano carbon injection under the mucosa layer one day before the operation, and 93 cases with intraoperative subserosal layer injection as control.Results:The average number of lymph nodes obtained in the study group was 47.0±14.7, while that in control was 38.0±14.5, P<0.05. The number of fibrotic lymph nodes obtained in the study group was 3.1 ± 1.9, compared with 3.0±1.8 in control, P>0.05. The number of black-stained lymph nodes in the former was 22.3±4.4, and the later was 14.7±4.8, P<0.05. The lymph nodes harvested in the first station in study group was 26.6±8.5, while that in the control group was 24.1±9.9, P>0.05. The lymph nodes obtained in the second station was 20.4±6.9 in study group, while in control was 13.8±5.7, P<0.05. Conclusions:The submucosal injection of nanocarbon one day before surgery increase the number of lymph nodes obtained in gastric cancer patients with neoadjuvant chemotherapy.

Objective:To investigate the expression of annexin A9(ANXA9)in gastric cancer tissues and cells and its effect on the proliferation of gastric cancer cells and the ability of subcutaneous tumorigenesis in nude mice.Methods:Immunohistochemistry and qPCR were used to detect the relationship between the expression of ANXA9 and clinicopathological parameters and prognosis in gastric cancer and paired adjacent tissues.Lentivirus transfection was used to inhibit the expression of ANXA9 in gastric cancer cell line SGC-7901. Cell counting kit-8 (CCK-8) and clone formation were used to detect the changes of proliferation of SGC7901, flow cytometry to detect the changes of SGC-7901 cell cycle, and nude mouse model bearing subcutaneous gastric cancer xenograft was established using SGC-7901 cells with stable ANXA9 knockdown to assess the effect of low expression of ANXA9 on xenograft growth.Results:Immunohistochemistry showed that the expression level of ANXA 9 was 67.1% and 30.7% in gastric cancer tissues and adjacent tissues, respectively. qPCR showed that the expression levels of ANXA 9 mRNA in gastric cancer tissues and adjacent tissues were 0.142±0.107 and 0.819±0.191, respectively. The difference was statistically significant ( P<0.05). The high expression of ANXA9 was different from the low expression group in the degree of tissue differentiation ( P<0.05), and the median survival time was 50 and 59 months, respectively. OD values of the transfected cells were 0.285±0.025, 0.386±0.031, 0.711±0.032, 1.007±0.084, 1.552±0.055 and 0.274±0.026, 0.380±0.049, 0.714±0.035, 1.106±0.081, 1.561±0.060, respectively, compared with 0.294±0.011, 0.445±0.046, 1.076±0.096, 1.588±0.095, 2.286±0.110 in NC group ( P<0.05). Cell clone formation in the transfection group was 207±12 and 225±14, lower than that in the NC group (412±14, P<0.05). After inhibiting the expression of ANXA9, the proportion of G 0/G 1 phase cells in the transfection group was 62.80% and 55.87%, respectively, significantly increased compared with 44.37% in the NC group. The proportions of S-phase cells in the transfected group were 22.74% and 21.44%, respectively, which were significantly lower than that in the NC group 29.19% ( P<0.05), after stable interference with ANXA9, the growth rate of transplanted tumors was significantly slower than that of the control group. On the 23rd day, the average volume of transplanted tumors in the two groups were (625±49) mm 3 and (303±157) mm 3, respectively, and the mass of tumor tissues in the two groups were (1.60±0.11) and (0.57±0.09) g ( P<0.05). Conclusions:Down-regulation of ANXA9 expression can inhibit the proliferation of gastric cancer cells and the ability of subcutaneous tumor formation in nude mice.