[Thinking and strategy selection on the quality control of early gastric cancer].

With the developing technique of the diagnosis and treatment of early gastric cancer, the quality of early gastric cancer diagnosis and treatment is coming into focus, and is crucial to improve the overall management of gastric cancer. It is necessary to establish a quality control system to ensure the quality of diagnosis and treatment for EGC. Based on the summary of the diagnosis and treatment status and technological progress of early gastric cancer, this paper proposes the quality control strategy, content and plan for the diagnosis and treatment process of EGC from the aspects of multidisciplinary diagnosis and treatment, clinical diagnosis technology, endoscopic and surgical treatment, pathological diagnosis and follow-up, with a view to expound the rationality, standardization and quality guarantee of the diagnosis and treatment process for early gastric cancer.

[Influence of postoperative complications on prognosis of gastric cancer-The manifestation of gastric surgeon's skill, responsibility and empathy].

Radical gastrectomy combined with perioperative comprehensive treatment is the main curable strategy for gastric cancer patients, and postoperative complications are the issue that gastric surgeons have to face. Complications not only affect the short-term postoperative recovery, but also facilitate tumor recurrence or metastasis, thus resulting in poor prognosis. Therefore, unifying the diagnostic criteria for postoperative complications, bringing the surgeons' attention to complications, and understanding the potential mechanism of complications undermining long-term survival, will be helpful to the future improvement of the clinical diagnosis and treatment as well as prognosis for gastric cancer patients in China. Meanwhile, surgeons should constantly hone their operative skills, improve their sense of responsibility and empathy, and administer individualized perioperative management based on patients' general conditions, so as to minimize the occurrence of postoperative complications and their influence on prognosis.

[Combined laparoscopy-endoscopy local resection for early gastric cancer].

The surgical treatment of early gastric cancer (EGC) is undergoing the development of minimally invasive, precise and individualized treatment. The concept is changing from simple emphasis on radical treatment to giving consideration to both radical treatment and functional preservation. Combined laparoscopy-endoscopy local resection can achieve accurate resection of the lesions of EGC and solve the problem of lymph node dissection which cannot be performed in endoscopic mucosal dissection (ESD). At present, there are several methods of combined laparoscopy-endoscopy local resection for EGC, such as laparoscopy-assisted endoscopic full-thickness resection (EFTR), endoscopy-assisted wedge resection (EAWR), combined laparoscopic and endoscopic approach for neoplasia with a non-exposure technique (CLEAN-NET), and non-exposed endoscopic wall-inversion surgery (NEWS). These methods of local resection have the advantages of minimal invasion, shorter operation time, and less blood loss compared to conventional gastrectomy. Concerning the issue of lymph node dissection in combined laparoscopy-endoscopy surgery, sentinel node navigation can be the solution, although cumbersome intraoperative lymph node tracing, operative failure and false negative still exist. As a developing treatment for EGC, combined laparoscopy-endoscopy local resection will have a good application prospect in the future.

[The analysis of health effects of exposure to occupational hazards on works in gypsum mining enterprise].

Objective: To investigate the health of gypsum miners in Hubei province and analyze the health effects of occupational disease hazards exposure on gypsum miners. Methods: In April 2017, occupational disease hazard factors were tested on the site of a gypsum mine, and 500 workers were selected by random sampling to conduct questionnaires, relevant data such as occupational health examination was collected, and descriptive statistical analysis was performed. Results: The main occupational hazards of gypsum miners were gypsum dust and noise. The time-weighted average concentration of 8 h in the workplace was 4.32 to 9.34 mg/m(3), and the post pass rate was 69.2% (9/13) ; Respiratory dust 0.13-5.15 mg/m(3), post pass rate 75.0% (3/4). Gypsum miners had finger dysfunction and muscle numbness, joint pain (29.2%, 88/301) and chest pain and breathing difficulties (17.6%, 53/301). Followed by tinnitus, auricle pus, running water (4.7%, 14/301), abnormal muscle tension (2.7%, 8/301). The exposure of occupational disease hazards was associated with respiratory, auditory and neurological symptoms of gypsum miners. Conclusion: The long-term exposure of gypsum workers to gypsum dust, noise and other harmful factors may result in obvious symptoms of respiratory system and other health damage.

[Nested case-control study on risk factors of postoperative hyperactive-type delirium in geriatric orthopedic patients].

Objective: To investigate the risk factors of postoperative hyperactive-type delirium(PHTD) in geriatric orthopedic patients using nested case-control study. Methods: Seventy-four patients who underwent orthopedic surgeries in the Second Affiliated Hospital of Wenzhou Medical University from January 2008 to December 2013, aged 65 or above, American Society of Anesthesiologists (ASA) physical status Ⅰ-Ⅳ, with complete medical records and confirmed diagnosis of PHTD were selected as case group. A control group of 444 patients, on the basis of 1∶6 versus nested case group, from the same cohort but without PHTD was established. Data patterns such as patient age, gender, ASA classification, status of preoperative/postoperative electrolytes, preoperative blood glucose, preoperative/postoperative plasma albumin and preoperative/postoperative hematocrit(Hct), uses of non-steroidal analgesics, anticholinergic drugs and benzodiazepines drugs, type of anesthesia, anesthesia duration, difference in postoperative analgesia were collected and analyzed. Results: Univariate Logistic regression analysis showed that gender, age, ASA grade, preoperative electrolytes, anesthesia duration, operative duration, intraoperative hypotension and the difference of postoperative analgesia were risk factors for PHTD. Multiple Logistic regression analysis showed that gender (OR=2.562, 95%CI: 1.438-4.564, P=0.001), age (OR=3.929, 95%CI: 1.788-8.633, P=0.001), preoperative electrolytes(OR=3.714, 95%CI: 2.068-6.670, P<0.001)were the independent risk factors for PHTD. Conclusion: Male, elderly patients and abnormalities of preoperative electrolyte are the independent risk factors for PHTD in geriatric orthopedic patients.

Rationally designing S/Ti3C2Tx as a cathode material with an interlayer for high-rate and long-cycle lithium-sulfur batteries.

Lithium-sulfur batteries suffer from poor cycling stability and inferior rate capability, mainly caused by low conductivity and lithium polysulfide dissolution. To tackle these problems, this work demonstrates that Ti3C2Tx "clay", synthesized by selectively extracting the Al layers from the Ti3AlC2 phases with a mixture of HCl and LiF, is an effective host material for sulfur cathodes. To further enhance the rate performance and cycling stability of S/Ti3C2Tx composites, a single-walled carbon nanotube thin film was prepared by a simple vacuum filtration method and inserted between the cathode and the separator as an interlayer for Li-S batteries. The S/Ti3C2Tx composite with an interlayer could deliver a high initial discharge capacity of 1458 mA h g-1 at a current density of 0.1 A g-1 and an ultralow capacity decay of 0.04% per cycle at 0.8 A g-1 for over 1500 cycles was achieved. More importantly, a reversible capacity of 608 mA h g-1 was obtained at a high current density of 8.2 A g-1 (≈5C), demonstrating superior rate capability. These results suggest that the S/Ti3C2Tx composite is a promising sulfur cathode material and the introduction of the interlayer will pave the way for the future development and design of high-rate with long-cycle Li-S batteries.

Resistance of Castanea mollissima Shuhe-WYL strain to Dryocosmus kuriphilus and its molecular mechanism.

The resistance of Castanea mollissima Shuhe-WYL strain to Dryocosmus kuriphilus and its molecular mechanism were examined. The larvae of D. kuriphilus were inoculated on the Shuhe-WYL and Qingzha strains, and mortality was observed and compared; the relative mRNA content of the OsCDPK2, receptor-like protein, OsNAC6 protein, KH domain protein, RNA-binding protein, and the bHLH genes was detected using real-time polymerase chain reaction, and then compared between the Shuhe-WYL and Qingzha strains. Phenylalanine ammonia-lyase content was detected by western blotting and compared between the inoculated Shuhe-WYL, non-inoculated Shuhe-WYL, and inoculated Qingzha strains. The mortalities of larvae inoculated on the bud, bracteal leaf, and cardiac lobe were lower in Shuhe-WYL than Qingzha at 48 and 96 h after inoculation; the contents of OsCDPK2, receptor-like protein, OsNAC6 protein, and bHLH in the cardiac lobe were higher in Shuhe-WYL than in Qingzha at 96 h after inoculation, but KH domain protein and RNA-binding protein were not significantly different. The content of phenylalanine ammonia-lyase in the cardiac lobe was higher in inoculated and non-inoculated Shuhe-WYL compared to inoculated Qingzha at 15, 30, 45, and 60 days, and higher in inoculated Shuhe-WYL than in non-inoculated Shuhe-WYL at 15, 30, 45, and 60 days. The content of phenylalanine ammonia-lyase in the cardiac lobe of inoculated Shuhe-WYL had no significant difference between at 60 and at 45 days; and was higher at 60 and 45 days than at 30 and 15 days; and was higher at 30 days than at 15 days (60≈45˃30˃15 days). The C. mollissima Shuhe-WYL strain was resistant to D. kuriphilus; high expression of OsCDPK2, receptor-like protein, OsNAC6 protein, and bHLH and phenylalanine ammonia-lyase may explain the mechanism.

Influence of plasma exchange on transplantation related immune function in patients with liver failure.

This study aimed to evaluate the influence of plasma exchange (PE) treatment of patients with liver failure on the patient's immune function, including peripheral blood T lymphocytes and cytokines. Patients accepting PE for liver failure from October 2011 to February 2012 were included prospectively in the research group. Peripheral blood samples were collected at set time points. The percentages of T lymphocyte subtypes were detected by flow cytometry using different fluorescence labels including CD3-FITC, CD4-PerCP, CD8-PE, CD25-FITC, and Foxp3-PE. Changes in serum IL-17 concentration were followed by ELISA. In all fifteen patients who accepted PE, the percentages of CD3(+) and CD8(+) T cells increased immediately after the procedure and then reduced gradually. These significant changes were confirmed by statistical analysis (P < 0.05). The percentage of CD4(+) T cells also increased after PE to a certain extent, but failed to show statistical significance. The positive ratio of CD4(+)CD25(+)Foxp3(+) T cells (Treg) increased after the treatment with statistical difference (P < 0.05). The concentration of IL-17 in patient serum increased significantly following PE treatment (P < 0.05). These results demonstrated that T lymphocyte subgroups of patients with liver failure could be influenced after PE treatment, and that cellular immunity could be recovered. PE treatment, therefore, can be viewed as providing reliable protection for the reconstruction of the patient immune system.

Research of the Dispersity of the Functional Sericite/Methylphenyl- Silicone Resin.

In order to improve the homogeneity and dispersity of the sericite in methylphenyl-silicone resin, the agglomerate state of the sericites was controlled effectively. The dispersive model of the sericite in methylphenyl-silicone resin was designed also. First, the modified sericite was prepared using hexadecyl trimethyl ammonium bromide as the intercalating agent. Then, functional sericite was incorporated into methylphenyl-silicone by terminal hydroxyl. The structure and dispersive performance of the hybrid polymers was charactered by analytical instruments. Scanning electron microscopy and Transmission electron microscope, Laser scanning confocal microscope and X-ray diffraction analysis showed that functional sericite was dispersed homogeneously in methylphenyl-silicone resin matrix. X-ray photoelectron spectroscopy analysis showed that the absorption peaks of the Si-OH band of methylphenyl-silicone resin were decreased and the Si-O-Si band was increased. This change evidently showed a significant role to enhance the reaction degree of the functional sericite in methylphenyl-silicone resin.