Search

To investigate the correlation between serum immunoglobulin E (IgE) levels and severity of Vogt-Koyanagi-Harada (VKH) disease.The medical records of patients with VKH disease between 2015 and 2020 were reviewed. Serum immunoglobulins (IgA, IgE, IgG, and IgM), tumor necrosis factor α (TNFα) and C-reactive protein (CRP) were measured. Patients were divided into IgE-positive (IgE ≥ 100 IU/mL) and IgE-negative (IgE100 IU/mL) groups. The best-corrected visual acuity (BCVA) and macular morphologic characteristics including foveal thickness (FT), serous retinal detachment (SRD), sensory retinal thickness (SRT), central foveal thickness (CFT), cube volume (V), and cube average thickness (AT) were determined in patients in both groups.Of 128 patients included in the study, 35 (27.34%) patients were IgE-positive, BCVA (logMAR) was worse in the IgE-positive group. The mean CRP (Elevated serum IgE levels were associated with more severe macular changes in patients with VKH disease. These findings suggest that IgE may be involved in the progression of VKH disease.

Background The clinical effect of laparoscopic proximal gastrectomy (LPG) with piggyback jejunal interposition double-tract reconstruction (PJIDTR) is not clear yet. The purpose of this study was to compare the efficacy of LPG with PJIDTR versus laparoscopic total gastrectomy (LTG) with Roux-en-Y reconstruction (overlap method) for proximal EGC using propensity score matching. Methods We retrospectively collected data from the patients with proximal EGC who were treated in Shanxi Cancer Hospital between January 2012 and December 2015. Propensity score was used to match LTG patients with LPG patients. The patient characteristics, clinical outcomes, nutritional indicators, reflux esophagitis incidence and overall survival were compared between the two groups. Results Of the 424 patients, 200 were excluded and 50 of the remaining patients received LPG with PJIDTR. Fifty matched LTG patients were screened. Comparison of intraoperative indicators, operative time, blood loss and number of retrieved lymphnodes between the two groups showed no statistical significance (P > 0.05). There was no statistically significant differences in first anal exhaust time, postoperative hospital stay, and early complications between the two groups (P > 0.05). The nutrition indexes at one year after surgery in the LPG group were significantly better than LTG group (P p = 0.08). Conclusion The postoperative nutritional outcomes of LPG with PJIDTR were better than those of LTG. The incidence of reflux esophagitis, complications, and 5-year overall survival were similar between the two groups. LPG with PJIDTR may be suitable for proximal EGC.

Background The incidence of adenocarcinoma of esophagogastric junction (AEG) has recently risen worldwide, including in Eastern Asia. The aim of the study was to explore the short-term and long-term clinical efficacy of piggyback jejunal interposition reconstruction single-tract reconstruction (PJIRSTR), piggyback jejunal interposition reconstruction double-tract reconstruction (PJIRDTR), and total gastrectomy esophageal jejunal Roux-en-Y anastomosis (TGRY) for the treatment of Siewert II and III AEG patients. Methods A total of 300 Siewert II and III AEG patients admitted to Shanxi Tumor Hospital from June 2015 to December 2017 were prospectively selected. Patients were randomly divided into PJIRSTR group (n = 98), PJIRDTR group (n = 103), and TGRY group (n = 99) using the random number table method. Results There were no statistically significant differences in total operation time, intraoperative blood loss, time of first anal exhaust, and postoperative hospital stay among the three groups (F = 2.526, 0.457, 0.234, 0.453; P > 0.05). The reconstruction time of PJIRSTR group and PJIRDTR group was longer than that of TGRY group (P < 0.01). There were no significant differences in cases of anastomotic leakage, anastomotic bleeding, abdominal infection, incision infection, ileus, and dumping syndrome in three groups (P > 0.05). The incidence of reflux esophagitis at 3, 6, 12, and 18 months after surgery in the PJIRSTR group and the PJIRDTR group were significantly lower than TGRY group in the same period (P < 0.05). Compared with PJIRDTR group and TGRY group, PJIRSTR group had a small fluctuation range of postoperative nutrition indexes and had basically recovered to the preoperative level at 18 months. Four patients of Visick grade IV presented in TGRY group 18 months postoperatively, which was significantly higher compared with the other two groups. Conclusion Compared with PJIRDTR and TGRY, PJIRSTR can significantly reduce the incidence of postoperative reflux esophagitis and improve the long-term nutritional status of patients. Trial registration Chinese Clinical Trial Registry, ChiCTR-IIR-16007733. Registered 07 November 2015 – Retrospectively registered, http://www.chictr.org.cn/searchproj.aspx.

background IgE is an immune antibody involved in inflammatory response and serum IgE level elevated in some autoimmune diseases. VKH disease is autoimmune inflammatory disorder, IgE might be involved in VKH disease and high serum IgE level might related to the disease severity. Main body Retrospective study. Foveal thickness (FT), serous retinal detachment (SRD), sensory retinal thickness (SRT), central foveal thickness (CFT), cube volume (V), and cube average thickness (AT) were measured by OCT. According to SRD, the patients were divided into high detachment group (༞500µm) and low detachment group (≤ 500µm). Rate-scattering turbidimetry was used to measure the Immunoglobulins levels. Of 138 patients, 51 (36.96%) were included in the high detachment group. The proportion of males (2.122; 95% CI, 1.051–4.288; P = 0.035) was greater and best-corrected visual acuity (BCVA) ( -0.495; 95% CI, -0.620—-0.369; P P = 0.016) than that in the low detachment group (median: 53 IU/ml, IQR:32–80). FT, SRD, CFT, V, and AT were significantly greater in the high detachment group. IgE level was positively correlated with SRD, CFT, and AT. Multivariable binary logistic regression analysis showed that male (2.447; 95% CI, 1.004–5.964; P = 0.049) and serum IgE levels (0.997; 95% CI, 0.995–0.999; P = 0.014) were independent risk factors for severe SRD. Conclusion Male are more likely to have severe SRD, and the extent of detachment is associated with the serum IgE level. IgE may be involved in the progression of VKH disease.

The relationships between spatial production, urbanization and sustainable development are becoming a focus of the international academic cycle. Urbanization dominated by spatial production driven by capital and power often produces and enlarges uneven development, which leads to multiple eco-environmental problems. Thus, the key to development lies in whether the pattern of urbanization is in harmony with the ecological environment. However, previous researches mainly concentrate on spatial production in developed countries or regions. The urbanization and sustainable development of less-developed regions, with complex and fragile ecological environments, are often overlooked. It is a new idea to explain the relationships and interactions between spatial production, urbanization and sustainable development based on less-developed regions by the theory of spatial production. The paper chooses the Hexi Corridor as a typical case, puts forward a conceptual framework and explores the process of spatial production from 2000 to 2017. The results reveal that urbanization in the Hexi Corridor is a multidimensional socio-spatial process: power and capital gave birth to a higher urbanization and accelerated the process of urbanization, however, the urban-rural gap between regions has not narrowed accordingly. Driven by comprehensive interests, local governments often take some extreme measures to forcefully promote the urbanization process, thereby violating the goals and requirements of sustainable development. At present, there is an urgent need to coordinate the relationship between urban and rural regions on different scales and transform the urbanization model from traditional spatial production to a new-type of urbanization with people-oriented and sustainable development.

Background: The objective of this study is to identify independent risks and protective factors and to construct a mortality prediction model for gastrectomy in the Chinese population. Study design: This is a population-based prospective cohort at an institutional level. Seventy-two participating hospitals reported their annual gastrectomy data between 2014 and 2016, while 44 variables covering the institution and surgical information were included in the analysis. We used R software to encode and complete data pre-processing. The first difference model was applied to build the risk model. Data from 2014 and 2015 were assigned to risk model development, while data from 2016 was used for validation. Results: In the included centers with 94,277 gastric cancer cases, the in-hospital mortality rate was 0.32%. The regression model revealed that provinces with low-middle GDP, hospitals with annual gastrectomy volume between 100 and 500, greater volume of urgent surgeries performed, larger proportion of males, and a higher proportion of liver metastasis were independent risk factors for mortality following gastric surgeries, while higher laparoscopic resection volume, greater volume of distal gastrectomy with B2 reconstruction, and larger proportion of palliative surgery were independent protective factors (p < 0.05, respectively). In the prediction test, the mean square error of the training set was 0.948, while that of the test set was 0.728, demonstrating the effectiveness of this model. Conclusions: We constructed the first mortality risk prediction model for gastric cancer surgery in the Chinese population. The identified risk factors will help with the therapy selection, while further informing Chinese medical policy decision-makers.

Objective: To determine the ideal surgical approach for Siewert type II esophagogastric junction (EGJ) carcinomas, an open-label and randomized controlled trial was conducted. Background: Siewert type II EGJ carcinomas have dragged considerable interest for the choice of surgical approach because of a borderline location between esophagus and stomach. A JCOG 9502 RCT in Japan showed that abdominal-transhiatal approach is more recommended for EGJ carcinomas because of its less morbidity and equivalent survival after abdominal-transhiatal approach. Still, further concerns on selection either resection extent (total or proximal gastrectomy) or reconstruction methods remain elucidated. Methods: An open-label and randomized controlled trial was conducted in a single cancer center between January 1, 2014 and August 30, 2016. A total of 105 patients with Siewert type II EGJ carcinoma were randomly assigned via a computer-generated randomization to receive either proximal gastrectomy plus jejunal interposition (PG+JI) (n=35) or proximal gastrectomy plus esophagogastrostomy (PG+EG) (n=35) or total gastrectomy plus Roux-en-Y esophagojejunostomy (TG+RY) (n=35). The primary endpoint was patient clinical indices of perioperative and post-operative outcomes. The secondary endpoint was nutrition index, quality of life and 2-year overall survival. The study was registered at Chinese Clinical Trial Registry (no. ChiCTR-IIR-160077330). Results: A total of 14 patients were excluded during operation or follow-up, and therefore 29, 30 and 32 were available in PG+JI, PG+EG and TG+RY groups. PG+JI group took longest reconstruction time among the three groups (33.93±6.0 minutes vs 21.97±3.30 minutes vs 30.56±4.26; P

Highlights • The giant peritoneal body with a diameter >5 cm has rarely been described in the literature. • We report a case of two giant loose bodies(gPLB) which are simultaneously found in one patient. • Two gPLB lie respectively in the peritoneal cavity and in the pelvic cavity, measuring 10.4*8.3 cm and 7.6*6.0 cm, weight 182.5 g and 98.4 g., Introduction Peritoneal loose body(PLB) is usually small, therefore giant Peritoneal loose body(gPLB) with a diameter >5 cm has rarely been described in the literatures. We report a case of two gPLB simultaneously found in one patient. Presentation of case A healthy 79-year-old man palpated himself a solid mass with alternating localizations in his peritoneal cavity 6 months ago. It was not the complaint of frequency of urinatior until he saw the doctor a week ago. Surprisingly, two oval-shaped masses were simultaneously discovered by computed tomography (CT). One was in the peritoneal cavity, measuring 10.4*8.3 cm, weight 182.5 g, another was in the pelvic cavity, measuring 7.6*6.0 cm, weight 98.4 g. The case was confirmed by surgical operation. Discussion The gPLB is considered as uncommon. Two gPLB which were simultaneously discovered in one patient have never been reported in the literatures. The small PLB is usually asmptomatic, occasionally, the gPLB can cause symptoms with acute retention of urine or intestinal obstruction. It is crucial to diagnosis the peritoneal loose body. Conclusion Two gPLB that situated in one patient are rare findings. Clinically, if a solid mass alternating localizations cound be palpated in the Peritoneal cavity, CT or other imaging shows an oval-shaped mass with calcifications in the central region, PLB should be considered. Surgical removal is recommended for the patient with acute retention of urine or intestinal obstruction or unclear diagnosis.