Objective To explore the effect of lung protective ventilation strategy in artificial pneumothorax in full laparoscopic radical resection of esophageal cancer.Methods 88 patients were selected from January 2021 to March 2023 for the treatment of artificial pneumothorax with full laparoscopic radical resection of esophageal cancer.They were randomly divided into two groups.44 patients underwent conventional ventilation as the control group,and 44 patients underwent lung-protective ventilation strategy as the experimental group,and the different effects produced by the above different ventilation modes were analyzed.Results There were no significant differences in pH and partial pressure of carbon dioxide(PCO2)between the experimental group and the control group at the 10 min after endotracheal intubation(T1),1 h after single lung ventilation(T2),after surgery(T3),and 24 h after surgery(T4)(P＞0.05).The oxygenation index at the time points of T1,T2,T3 and T4,there were significant differences between the two groups(P＜0.05).The experimental group and the control group had significant differences in static lung compliance(Cs),plateau pressure(Pplat),and peak airway pressure(Ppeak)at the T1,T2,and T3 time points(P＜0.05).At T1,there were no significant differences in the levels of C-reaction protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-8(IL-8),and interleukin-6(IL-6)between the experimental group and the control group at the time points(P＞0.05).There were significant differences of the above indicators between the two groups at T2,T3,and T4 time points(P＜0.05);The incidence of pulmonary complications was 25.00％in the control group compared with 9.09％in the experimental group,there was a significant difference(P＜0.05).Conclusion Tidal volume(VT)6 mL/kg+100.00％inhaled oxygen concentration+positive end-expiratory pressure 5 cmH2O+recruitment lung protective ventilation strategy used in artificial pneumothorax for full laparoscopic radical resection of esophageal cancer can significantly reduce intraoperative airway pressure and inhibit inflammatory reaction and increase ventilation safety.

Objective:To evaluate the application value of transabdominal wall suspended laparoscopic appendectomy (LA) in patients with acute suppurative appendicitis or concurrent periappendiceal abscess.Methods:The clinical data of 107 patients with acute suppurative appendicitis or concurrent periappendiceal abscess in Hexi University, Zhangye People′s Hospital from September 2019 to December 2022 were retrospectively analyzed. Among them, 53 patients underwent open appendectomy (OA) (OA group), and 54 patients underwent transabdominal wall suspended LA (LA group). The operation time, postoperative pain score, postoperative hospitalization time, recovery time of gastrointestinal function, postoperative complications and hospital cost were compared between two groups.Results:In the LA group, 2 cases were transferred to OA due to heavy abdominal adhesion and unclear anatomy, and 3 cases could not undergo transabdominal wall suspended LA due to perforation of the root of the appendix or gangrene of the appendix. There was no statistical difference in operation time between two groups ( P>0.05); the postoperative hospitalization time, recovery time of gastrointestinal function, postoperative pain score and total incidence of postoperative complications in LA group were significantly lower than those in OA group: (4.92 ± 1.70) d vs. (7.51 ± 3.96) d, (20.64 ± 7.37) h vs. (35.32 ± 10.13) h, (5.62 ± 1.12) scores vs. (6.83 ± 0.93) scores and 5.56% (3/54) vs. 24.53% (13/53), the hospital cost was significantly higher than that in OA group: (8 325.47 ± 856.22) yuan vs. (6 458.64 ± 2 085.93) yuan, and there were statistical differences ( P<0.05). Conclusions:Transabdominal wall suspended LA has the advantages of wide indications, easy operation, minimal trauma, fast recovery, and fewer complications, but with relatively high hospitalization cost.

Objective:To observe the development of elevated body temperature during surgical correction under different general anesthesias in the pediatric patients with congenital ptosis.Methods:Sixty American Society of Anesthesiologists Physical Status classification Ⅰ pediatric patients with blepharoptosis of both sexes, aged 2-10 yr, undergoing elective surgery for blepharoptosis correction, were divided into total intravenous anesthesia group(TIVA group) and combined intravenous-inhalational anesthesia group(CIIA group) using a random number table method, with 30 cases in each group. Anesthesia was induced with intravenous propofol 1-2 mg/kg, cisatracurium 0.15-0.25 mg/kg and fentanyl 2-3 μg/kg in both groups, and then the patients were endotracheally intubated. Anesthesia was maintained with intravenous infusion of propofol 50-200 μg·kg -1·min -1 and remifentanil 0.2-0.05 μg·kg -1·min -1 in TIVA group and with intravenous infusion of propofol 25-75 μg·kg -1·min -1 and remifentanil 0.2-0.5 μg·kg -1·min -1 and inhalation of 1%-1.5% sevoflurane in CIIA group. After completion of anesthesia induction, the nasopharyngeal temperature was continuously monitored until the end of surgery, and the occurrence of elevation in intraoperative body temperature (≥37.5 ℃) was recorded. Results:The incidence of elevated body temperature was 20% and 40% in TIVA group and CIIA group, respectively. Body temperature ≥39.0 ℃ did not occur in two groups. There was no significant difference in the incidence of elevated body temperature and constituent ratio of degree of elevation in body temperature between the two groups ( P>0.05). Conclusions:When total intravenous anesthesia and combined intravenous-inhalational anesthesia are used in the surgery for blepharoptosis correction in the pediatric patients with congenital ptosis, concurrent mild hypothermia is a non-small probability event, but it is safe to evaluate it in terms of the occurrence of malignant hyperthermia.

Resection is one of the most important treatments for esophageal squamous cell carcinoma, and routine postoperative follow-up is an effective method for early detection and treatment of recurrent metastases, which can improve patients' quality of life and prognosis. This consensus aims to provide a reference for colleagues responsible for postoperative follow-up of esophageal squamous cell carcinoma patients in China, and further improve the standardization of the diagnosis and treatment of esophageal squamous cell carcinoma.

Covalent organic frameworks(COFs)are a novel type of crystalline porous organic polymer materials recently developed.It has several advantages in chromatographic separation field,such as high thermal stability,porosity,structural regularity,and large specific surface area.Here,a novel spherical COF 1,3,5-tris(4-aminophenyl)benzene(TAPB)and 2,5-bis(2-propyn-1-yloxy)-1,4-benzenedicarboxaldehyde(BPTA)was developed as an electrochromatographic stationary phase for capillary electro-chromatography separation.The COFTTAPB-BPTA modified capillary column was fabricated via a facile in situ growth method at room temperature.The characterization results of scanning electron microscopy(SEM),Fourier transform infrared(FT-IR)spectroscopy,and X-ray diffraction(XRD)confirmed that COF TAPB-BPTA were successfully modified onto the capillary inner surface.The electrochromatography separation performance of the COF TAPB-BPTA modified capillary was investigated.The prepared column demonstrated outstanding separation performance toward alkylbenzenes,phenols,and chlorobenzenes compounds.Furthermore,the baseline separations of non-steroidal anti-inflammatory drugs(NSAIDs)and parabens with good efficiency and high resolution were achieved.Also,the prepared column possessed satisfactory precision of the intra-day runs(n=5),inter-day runs(n=3),and parallel columns(n=3),and the relative standard deviations(RSDs)of the retention times of tested alkylbenzenes were all less than 2.58％.Thus,this new COF-based stationary phase shows tremendous application potential in chromatographic separation field.

Animals ; Carrier Proteins/metabolism* ; Histidine/metabolism* ; Humans ; Methylation ; Methyltransferases/metabolism* ; Neoplasm Proteins/metabolism* ; Neoplasms/metabolism* ; Protein Processing, Post-Translational

Objective:To investigate the epidemiological characteristics and current status of surgical management for esophageal cancer in China.Methods:A national database was setup through a network platform. The clinical data of esophageal cancer treated by surgery was collected from 70 major hospitals in China between January 2009 and December 2014.Results:Complete data of 8 181 cases of esophageal cancer patients who underwent surgery were recorded in the database and recruited in the analysis. Among them, 6 052 cases were male and 2 129 were female, the average age was 60.5 years.The epidemiological investigation results showed that 148 cases (1.8%) had history of psychological trauma, 7 527 cases (92.0%) were lower social economic status, 5 072 cases (62.0%) were short of fresh vegetables and fruits, 6 544 cases (80.0%) ate rough food frequently, 3 722 cases (45.5%) drank untreated water directly from lake or river or shallow well, 3 436 cases (42.0%) had a unhealthy eating habit, including habits of eating food fast (507 cases, 6.2%), eating hot food or drinking hot tea/soup (998 cases, 12.2%), eating fried food (1 939 cases, 23.7%), 4 410 cases (53.9%) had the habits of smoking cigarettes and 2 822 cases (34.5%) drank white wine frequently.The pathological results showed that 7 813 cases (95.5%) were squamous cell carcinoma, 267 cases were adenocarcinoma (3.3%), 25 cases were adenosquamous cell carcinoma (0.3%) and 50 cases were small cell carcinoma (0.6%). A total of 1 800 cases (22.0%) received preoperative neoadjuvant therapy due to locally advanced disease or difficulty of resection. The esophagectomies were performed through left thoracotomy approach in 5 870 cases (71.8%), through right chest approach in 2 215 cases (27.1%), and the remain 96 cases (1.2%) received surgery though other approaches.A total of 8 001 cases (97.8%) underwent radical resection, the other 180 cases (2.2%) received palliative resection. The 30-day postoperative mortality rate was 0.5%, the overall ≥ grade Ⅱ postoperative complication rate was 11.6% (951 cases). The 1-yr, 3-yr, and 5-yr overall actual survival rates were 82.6%, 61.6%, and 52.9%, respectively.Conclusions:The data analysis of the national database for esophageal cancer shows that bad eating habits or eating rough food without enough nutrients, lower social and economic status, drinking white wine and smoking cigarettes frequently may be correlated with tumorigenesis of esophageal cancer. However, strong evidences produced by prospective observation studies are needed. Overall, the long-term survival of esophageal cancer patients has been improved gradually due to the application of advanced surgical techniques and reasonable multimodality treatment.

Objective:To investigate the epidemiological characteristics and current status of surgical management for esophageal cancer in China.Methods:A national database was setup through a network platform. The clinical data of esophageal cancer treated by surgery was collected from 70 major hospitals in China between January 2009 and December 2014.Results:Complete data of 8 181 cases of esophageal cancer patients who underwent surgery were recorded in the database and recruited in the analysis. Among them, 6 052 cases were male and 2 129 were female, the average age was 60.5 years.The epidemiological investigation results showed that 148 cases (1.8%) had history of psychological trauma, 7 527 cases (92.0%) were lower social economic status, 5 072 cases (62.0%) were short of fresh vegetables and fruits, 6 544 cases (80.0%) ate rough food frequently, 3 722 cases (45.5%) drank untreated water directly from lake or river or shallow well, 3 436 cases (42.0%) had a unhealthy eating habit, including habits of eating food fast (507 cases, 6.2%), eating hot food or drinking hot tea/soup (998 cases, 12.2%), eating fried food (1 939 cases, 23.7%), 4 410 cases (53.9%) had the habits of smoking cigarettes and 2 822 cases (34.5%) drank white wine frequently.The pathological results showed that 7 813 cases (95.5%) were squamous cell carcinoma, 267 cases were adenocarcinoma (3.3%), 25 cases were adenosquamous cell carcinoma (0.3%) and 50 cases were small cell carcinoma (0.6%). A total of 1 800 cases (22.0%) received preoperative neoadjuvant therapy due to locally advanced disease or difficulty of resection. The esophagectomies were performed through left thoracotomy approach in 5 870 cases (71.8%), through right chest approach in 2 215 cases (27.1%), and the remain 96 cases (1.2%) received surgery though other approaches.A total of 8 001 cases (97.8%) underwent radical resection, the other 180 cases (2.2%) received palliative resection. The 30-day postoperative mortality rate was 0.5%, the overall ≥ grade Ⅱ postoperative complication rate was 11.6% (951 cases). The 1-yr, 3-yr, and 5-yr overall actual survival rates were 82.6%, 61.6%, and 52.9%, respectively.Conclusions:The data analysis of the national database for esophageal cancer shows that bad eating habits or eating rough food without enough nutrients, lower social and economic status, drinking white wine and smoking cigarettes frequently may be correlated with tumorigenesis of esophageal cancer. However, strong evidences produced by prospective observation studies are needed. Overall, the long-term survival of esophageal cancer patients has been improved gradually due to the application of advanced surgical techniques and reasonable multimodality treatment.

Incidence of adenocarcinoma of esophago-gastric junction (AEG) in China presents an obviously increasing trend. Due to the particular anatomic site, its definition, classification, staging, surgical approach, resection pattern, extent of lymphadenectomy, and neoadjuvant therapy, etc. remain controversial. The goal of this expert consensus is to improve the homogeneity in understanding and practice among Chinese thoracic and gastrointestinal surgeons, and to further standardize surgical treatment of AEG. This consensus was generated based on the best available clinical evidence, the latest global guidelines or consensuses, and the agreement from the Chinese expert panel. The panel composed of 19 thoracic surgeons and 20 gastrointestinal surgeons nationwide. Delphi technique was used to generate agreement rates and revision details. In the fields of aforementioned controversies, the present consensus produced 27 statements on surgical treatment-related recommendations for AEG, as well as 9 issues as investigational surgical concerns. The present consensus consists of 7 parts:(1) definition and classification of AEG; (2) surgical approach; (3) minimally invasive surgery; (4) pattern and extent of resection; (5) combined organ resection; (6) lymph node group and lymphadenectomy standard; and(7) neoadjuvant therapy. Pending issues in this consensus need further high-quality clinical research.
Adenocarcinoma ; surgery ; China ; Consensus ; Esophageal Neoplasms ; surgery ; Esophagogastric Junction ; Humans ; Lymph Node Excision ; Neoplasm Staging ; Stomach Neoplasms

Objective To study the feasibility,effectiveness and safety of temporary pacing at the right ventricular outflow tract area in patients with inferior acute myocardial infarction(AMI)and two or three degree atrioventricular block(AVB). Methods Ninety-five patients with inferior AMI and two or three degree AVB admitted into Cangzhou People's Hospital were randomly divided into right ventricular apex pacing group(47 cases) and right ventricular outflow tract region pacing group(48 cases). Seldinger method was used to perform the right femoral vein puncture in which a 6F sheath tube was placed,and a diode temporary pacing electrode was introduced into it in the two groups. Under the X-ray guidance,in the right ventricular apex pacing group,the electrode was pushed from the inferior vena cava to enter into the right atrium,then cross the tricuspid and finally reach the right ventricular apical portion pacing. In the right ventricular outflow tract region pacing group,under the X-ray guidance, after the electrode was withdrawn and rotated slightly clockwise,it was sent forward to the right ventricular outflow tract region pacing. The duration from the puncture at the right femoral vein to the implanted electrode reaching the pacing region,the pacing threshold,the un-favorable pacing,the incidence of ventricular arrhythmia and prognosis were observed in the two groups. Results The pacing time and pacing threshold in right ventricular apex pacing group were obviously higher than those in the right ventricular outflow tract region pacing group〔pacing time(s):336±150 vs. 354±152,pacing threshold(V):0.9±0.4 vs. 0.7±0.3,both P<0.05〕. The mortality in intensive care unit (ICU)〔0(0/48)vs. 2.13%(1/47)〕,the incidence of bad pacing〔10.42%(5/48)vs. 17.02%(8/47)〕and ventricular fibrillation(VF),sustained ventricular tachycardia,contraction of non-sustained ventricular tachycardia or frequent ventricular premature beat(VPB)and other arrhythmia incidence of complications〔10.42%(5/48)vs. 12.77%(6/47)〕in the right ventricular outflow tract region pacing group were all lower than those in the right ventricular apex pacing group. Conclusion The application of right ventricular outflow tract pacing in patients with inferior AMI and two or three degree AVB is safe and effective,and its stability is fine.