远端胃癌患者行微创手术结合三角吻合的长期预后研究

目的探讨全腹腔镜下远端胃癌根治术(TLDG)加三角吻合(DA)治疗远端胃癌的长期疗效。方法回顾性收集2014年1月-2016年4月于浙江衢化医院行腹腔镜远端胃癌根治术治疗的128例远端胃癌患者的临床资料。根据手术方式的不同,分为TLDG加DA治疗组(DA组,72例)和腹腔镜辅助下远端胃癌根治术(LADG)加管状吻合(TA)治疗组(TA组56例)。记录两组手术时间、术中出血量、拆线时间、术后排气时间、淋巴结清扫数目、住院时间和术后并发症情况。采用电话随访的形式每个月定期随访,随访截至2017年4月。结果 DA组术中出血量(55.6±12.5)ml和术后排气时间(2.5±1.0)d均明显低于TA组的(85.6±15.8)ml和(4.5±1.5)d,差异有统计学意义(P<0.05),两组手术时间、拆线时间、淋巴结清扫数目和住院时间比较差异均无统计学意义(P>0.05)。DA组吻合口狭窄(0.00%)、吻合口瘘(0.00%)和吻合口出血(0.00%)发生率明显低于TA组的7.14%、8.93%和7.14%,差异有统计学意义(P<0.05)。DA组全部获得有效随访,随访时间16~62个月,16例患者死于肿瘤复发或转移,累积生存率77.78%。TA组全部获得有效随访,随访时间15~61个月,14例患者死于肿瘤复发或转移,累积生存率75.00%。DA组和TA组累积生存率比较差异无统计学意义(P>0.05)。结论在远端胃癌的治疗中,与LADG加TA相比,采用TLDG加DA近期疗效存在一定的优势,但两者远期疗效相当。

Effect of temperature on antioxidant defense and innate immunity in Brandt’s voles

Ambient temperature is an importa nt factor in flue ncing many physiological processes, in eluding antioxidant defense and immunity. In the present study, we tested the hypothesis that antioxidant defense and immunity are suppressed by high and low temperature treatme nt in Bran dt's voles (Lasiopodomys brandtii). Thirty male voles were randomly assigned into different temperature groups (4, 23, and 32℃, n=10 for each group), with the treatment course lasting for 27 d. Results showed that low temperature in creased gross en ergy in take (GEI) and liver, heart, and kidney mass, but decreased body fat mass and dry carcass mass. With the decline in temperature, hydrogen peroxide (H2O2) concentration, which is indicative of reactive oxyge n species (ROS) levels, in creased in the liver, decreased in the heart, and was unchanged in the kidney, testis, and small intestine. Lipid peroxidation indicated by malonaldehyde (MDA) content in the liver, heart, kidney, testis, and small intestine did not differ among groups, implying that high and low temperature did not cause oxidative damage. Similarly, superoxide dismutase (SOD) and catalase (CAT) activities and total antioxidant capacity (TAOC) in the five tissues did not respond to low or high temperature, except for elevation of CAT activity in the testis upon cold exposure. Bacteria killing capacity, which is indicative of innate immunity, was nearly suppressed in the 4℃ group in contrast to the 23℃ group, whereas spleen mass and white blood cells were un affected by temperature treatment. The levels of testosterone, but not corticostero ne, were in flue need by temperature treatment, though neither were correlated with innate immunity, H2O2 and MDA levels, or SOD, CAT, and TAOC activity in any detected tissues. Overall, these results showed that temperature had different in flue nces on oxidative stress, an tioxida nt en zymes, and immunity, which depended on the tissues and parameters tested. Up-regulation or maintenance of an tioxida nt defe nse might be an importa nt mechanism for voles to survive highly variable environmental temperatures.

Luminosity of a radio pulsar and its new emission death line

We investigated the pulsar radio luminosity(L),emission efficiency(ratio of radio luminosity to its spin-down powerE),and death line in the magnetic field(B)versus spin period(P)diagram.We found that the dependence of pulsar radio luminosity on its spin-down power(L-E)is very weak,shown as L^E0.06,which deduces an equivalent inverse correlation between emission efficiency and spin-down power asξ~E-0.94.Furthermore,we examined the distributions of radio luminosity of millisecond and normal pulsars and found that for the similar spin-down powers,the radio luminosity of millisecond pulsars is about one order of magnitude lower than that of the normal pulsars.The analysis of pulsar radio flux suggests that these correlations are not due to a selective effect but are intrinsic to the pulsar radio emission physics.Their radio radiations may be dominated by the different radiation mechanisms.The cutoff phenomenon of currently observed radio pulsars in B-P diagram is usually referred as the"pulsar death line",which corresponds toE≈1030 erg s-1 and is obtained by the cut-off voltage of electron acceleration gap in the polar cap model of pulsar proposed by Ruderman and Sutherland.Observationally,this death line can be inferred by the actual observed pulsar flux S≥1 mJy and 1 kpc distance,together with the maximum radio emission efficiency of 1%.However,the observation data show that the 37 pulsars pass over the death line,including the recently observed two pulsars with long periods of 23.5 s and 12.1 s,which violate the prediction of the polar cap model.At present,the actual observed pulsar flux can reach0.01 mJy by FAST telescope.This will arise the observational limit of spin-down power of pulsars as low as E˙≈1028 erg s-1.This means that the new death line is downward shifted two orders of magnitude,which might be favorably referred as the"observational limit–line".Accordingly,the pulsar theoretical model for the cut-off voltage of gap should be heavily modified.

Exploring the Accretion Disk Structure and X-ray Radiation of GX 17+2 Based on kHz QPOs and Cross-correlations

Applying the timing tools of kilohertz quasi-periodic oscillations(k Hz QPOs)and cross-correlations,we study the influence of the magnetosphere-disk relation on the X-ray radiation process of GX 17+2.First,as the spectral state track of X-ray emission evolves along the horizontal branch(HB),the magnetosphere-disk radii of the source derived by k Hz QPOs shrink from r~24 km to r~18 km,while its average X-ray intensities in≤10 ke V and in≥10 ke V show the opposite evolutional trends.Moreover,this branch has been detected with the anti-correlations between the low-/high-energy(e.g.,2–5 ke V/16–30 ke V)X-rays.We suggest that in HB there may exist an X-ray radiation transfer process at the disk radii near the neutron star(NS),i.e.,~5–10 km away from the surface,which probably originates from the interaction between the corona or jet with high-energy X-rays and accretion disk with low-energy X-rays.Second,as the source evolves along the normal branch(NB)and along the flaring branch(FB),their average X-ray intensities in all~2–30 ke V show the monotonously decreasing and monotonously increasing trends,respectively.In addition,these two branches are both dominated by the positive correlations between the low-and high-energy(e.g.,2–5 ke V/16–30 ke V)X-rays.Moreover,the evolution along NB is accompanied by the shrinking of the magnetosphere-disk radii from r~18 km to r~16 km.We ascribe these phenomena to that as the shrinking of the accretion disk radius,the piled up accretion matter around the NS surface may trigger the radiation that produces both the low-and high-energy X-rays simultaneously,and then form the branches of NB and FB.

Statistical properties of fast radio bursts elucidate their origins:magnetars are favored over gamma-ray bursts

Fast radio bursts(FRBs) are extremely strong radio flares lasting several milliseconds,most of which come from unidentified objects at a cosmological distance.They can be apparently repeating or not.In this paper,we analyzed 18 repeaters and 12 non-repeating FRBs observed in the frequency bands of 400–800 MHz from Canadian Hydrogen Intensity Mapping Experiment(CHIME).We investigated the distributions of FRB isotropic-equivalent radio luminosity,considering the K correction.Statistically,the luminosity distribution can be better fitted by Gaussian form than by power-law.Based on the above results,together with the observed FRB event rate,pulse duration,and radio luminosity,FRB origin models are evaluated and constrained such that the gamma-ray bursts(GRBs) may be excluded for the non-repeaters while magnetars or neutron stars(NSs) emitting the supergiant pulses are preferred for the repeaters.We also found the necessity of a small FRB emission beaming solid angle(about 0.1 sr) from magnetars that should be considered,and/or the FRB association with soft gamma-ray repeaters(SGRs) may lie at a low probability of about 10%.Finally,we discussed the uncertainty of FRB luminosity caused by the estimation of the distance that is inferred by the simple relation between the redshift and dispersion measure(DM).

Pedicle complex tissue flap transfer for reconstruction of duplicated thumbs with unequal size

BACKGROUND Thumb polydactyly is one of the most common congenital hand deformities,and the Bilhaut-Cloquet procedure or a modified one is often used.However,controversy remains over the rare instances in which both thumbs are not of similar length or far apart in distance.AIM To evaluate the clinical outcomes of pedicle complex tissue flap transfer in the treatment of duplicated thumbs with unequal size.METHODS From January 2014 to December 2020,15 patients underwent duplicated thumb reconstruction by pedicle complex tissue flap transfer at our hand surgery center.The technique was used when it was necessary to combine different tissues from both severed and preserved thumbs that were not of similar length or far apart in distance.Subjective parents’evaluations and functional outcomes(ALURRA and TATA criteria)were obtained.The alignment deviation,instability,range of motion(percent of opposite thumb)of the interphalangeal and metacarpophalangeal joints,and the aesthetic aspects,including circumference,length,nail size,and nail deformity,were used to assess the clinical outcomes.RESULTS The average age of patients at the time of surgery was 13 mo,and the mean final follow-up occurred at 42 mo.An appropriate volume with a stable joint and good appearance was obtained in 14 reconstructed thumbs.An unstable interphalangeal joint occurred in one thumb.The flexion-extension arc at the metacarpophalangeal joint was good,while that at the interphalangeal joint was poor.Most of the parents were satisfied with the cosmetic and functional results of the reconstructed thumbs.The mean ALURRA score was 21.8(range:20-24),and the Tada score was 6.9(range:5-8).Compared with the non-operated side,the length of the operated thumb was approximately 95%,the girth was 89%,and the nail width was 82.9%.The mean ranges of motion were 62.1%of that of the unaffected thumb in the interphalangeal joint and 78.3%in the metacarpophalangeal joint.CONCLUSION Harvesting a pedicle flap from a severed thumb is a safe and reliable procedure.Defects of the preserved thumb,such as the skin,nail,and bone,can be effectively restored using the complex tissue flap.

Relatedness and spatial distance modulate intergroup interactions: experimental evidence from a social rodent

Kin selection theory predicts that individuals should generally behave less aggressively or more amicably towards relatives than nonkin.However,how individuals treat conspecifics depends on genetic relatedness but also on the ecological context,which influences the benefits and costs of their interactions.In this study,we used microsatellite DNA markers and behavioral tests to examine the influence of kinship and proximity on the social behavior of Mongolian gerbils Meriones unguiculatus living in different social groups,and whether these effects varied with sex and season.We recorded the duration of 4 behavioral categories(investigative,neutral,amicable,and agonistic)during a 10-min pairwise test.We found that genetic relatedness had significant effects on the duration of investigative,neutral,and amicable behavior,but not on agonistic behavior.We also found significant interaction effects of relatedness and distance between burrow systems(i.e.,spatial distance)on investigative,neutral,and amicable behavior,which suggests that the effects of kinship on social behavior were restricted by spatial proximity.The interaction effect between sex and relatedness on amicable behavior showed that male gerbils became more intimate with individuals of the same sex that had higher pairwise relatedness than females.Furthermore,both male and female gerbils enhanced their aggression during the food-hoarding season,but the intensity of these changes was significantly higher in females.Overall,our results suggest that the effects of kinship and spatial proximity on social behavior exhibit sexual or seasonal patterns,thereby implying ecological context-dependent responses to out-group individuals in Mongolian gerbils.