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Background Intracorporeal esophagojejunostomy via a transorally inserted-anvil method during laparoscopic total gastrectomy (LTG) for upper gastric cancer has been demonstrated to be feasible, but the use of this assessment exclusively for Siewert type 2 adenocarcinoma of the esophagogastric junction (AEG) has not been reported. Methods A total of 428 consecutive gastric-cancer patients who underwent LTG in Nanfang Hospital from January 2008 to December 2016 were reviewed. Among these patients, 98 were classified as Siewert type 2 AEG. The patients underwent intracorporeal esophagojejunostomy through either a transorally inserted-anvil method (n  =   27) or extracorporeal anastomosis usinga circular stapler (n  =   71). After generating propensity scores with covariates that were associated with developing anastomotic leakage, 26 patients who underwent esophagojejunostomy via the transorally inserted-anvil method (transoral group) were 1:1 matched with 26 patients who underwent the procedure via extracorporeal anastomosis using a circular stapler (extracorporeal group). The safety after 30 days post-operatively was compared between the two groups. Results The transoral group and extracorporeal group were balanced regarding the baseline variables. The operative time, reconstruction duration, number of dissected lymph nodes, length of the proximal resection margins, estimated blood loss, intra-operative complication rate, and post-operative recovery course were not significantly different between the two groups. The mean anvil-insertion completion time (9.7 ± 3.0 vs 13.4 ± 2.0   minutes, P  <   0.001) and the median incision length (5.5 vs 7.0   cm, P  <   0.001) in the transoral group were shorter than those in the extracorporeal group. The incidence of post-operative complications (26.9% vs 23.1%, P  =   0.749) and the classification of complication severity (P  =   0.939) were similar between the two groups. Conclusions Intracorporeal esophagojejunostomy through a transorally inserted-anvil method may be a potentially safe approach to simplify and optimize the procedure during LTG for Siewert type 2 AEG. [ABSTRACT FROM AUTHOR]

Site contamination has caused serious harm to human health and the ecological environment, so understanding its spatial and temporal distribution patterns is the basis for contamination assessment and site remediation. For this reason, this study analyzed the spatial-temporal distribution patterns of organic pollutants and their driving factors in the Yangtze River Delta based on site sampling data using the optimal-scale geographical detector. The analysis results showed that:① There was a significant scale effect in the spatial distribution of organic pollutants in the Yangtze River Delta, and its optimal geographic detection scale grid was 8 000 meters. ② The main control factor of the spatial distribution of pollutants in the Yangtze River Delta originated mostly from the biological field, followed by the chemical field. ③ At the depth of 0-20 cm of soil, the explanatory power of sucrase content, urease content, microbial nitrogen amount, total nitrogen content, and cation exchange amount were stronger for the spatial distribution of organic pollutants. At the soil depth of 20-40 cm, the factors with stronger explanatory power on the spatial distribution of organic pollutants were soil moisture, population, and total nitrogen content. With the deepening of soil depth, the explanatory power of the factors of the hydrodynamic field increased. ④ Population, total nitrogen content, and polyphenol oxidase content had stronger explanatory power for the spatial distribution of organic pollutants in the spring. The spatial distribution of organic pollutants was more complex in autumn, and the factors showed stronger enhanced-nonlinear and enhanced-bi phenomena.

Objective: To study the effects of combinative therapy of tumor necrosis factor related apoptosis-inducing ligand (TRAIL) and PI3-K-Akt inhibitor on the growth and apoptosis of nasopharyngeal carcinoma (NPC) cells and underlying mechanisms., Methods: With cell growth assay, flow cytometric analysis and Western blotting, the effects of TRAIL and PI3-K-Akt special inhibitor (LY294002) on cell growth, apoptosis and related proteins expressions in CNE-2 cell lines were studied., Results: When concentrate of TRAIL>1 ng/ml, viability rate of cells in combinative treatment group with TRAIL and LY294002 was higher than that in the single treatment group with TRAIL (all P<0.05). When concentrate of TRAIL were 10 ng/ml and 100 ng/ml, the combinative treatment induced CNE-2 apoptosis more obviously than single treatments (t were 7.167 and 7.206, all P<0.05). The combination group showed more cleavage of Caspase-8, Caspase-3, Caspase-9 than single treatment groups., Conclusions: Combinative application of TRAIL and PI3-K-Akt pathway inhibitor inhibits the growth of CNE-2 and induces apoptosis. The mitochondrial dependent pathway is implicated for the underlying mechanism.

Objective: To investigate the distribution and projective feature of cat olivocochlear neurons., Methods: Eleven adult cats were divided into two groups randomly. The experimental group of eight cats was injected of 1% cholera toxin B (CTB) to the left cochlea, while injected of 5% fluoro gold (FG) to the right cochlea. The control group of three cats was injected of saline to bilateral cochlea. After a survival time of 7 days, serial frozen sections were cut in the cat brainstem. All the sections were processed by immunofluorescent procedure for CTB and FG, and the labeled olivocochlear neurons were observed by fluorescent microscope., Results: In the experimental group, the mean total of olivocochlear neurons labeled by CTB and FG was 3210 +/- 168, including lateral olivocochlear neurons (LOC, 2298 +/- 120) and medial olivocochlear neurons (MOC, 913 +/- 64). The labeled neurons were divided into three different types according to their feature of projection: neurons which only projected to the ipsilateral cochlea, neurons which only projected to the contralateral cochlea, and double-labeled neurons which projected both to the ipsilateral and contralateral cochlea, but the double-labeled neurons comprised 3.9% and 15.1% in the LOC and MOC system respectively. No labeled neurons were found in the control group., Conclusions: There are three types of neurons in the cat olivocochlear system. The neurons which projected to the bilateral cochlea may distribute both in the LOC and MOC system.