Background: Implementation of complete mesogastric excision in gastric cancer surgery, named D2 lymphadenectomy plus complete mesogastric excision (D2+CME), has been recently proposed as an optimal procedure. However, the safety and efficacy of D2+CME remain uncertain. Methods: A prospective, randomized, parallel-controlled trial was conducted at a tertiary referral teaching hospital. Participants were randomized to undergo either D2+CME or conventional D2 procedure. Results: 338 patients were included in the modified intention-to-treat analysis, which comprised 169 patients (102 men and 67 women; mean [SD] age, 54•8 [9•5] years) in D2+CME group and 169 patients (111 men and 58 women; mean [SD] age, 54•5 [9•3] years) in D2 group. Patients in D2+CME group showed less intraoperative blood loss (median [IQR]; 15 • 0 [23 • 0] ml in D2+CME vs. 37 • 0 [33 • 5] ml in D2, p<0 • 0001), more lymph node harvesting (median [IQR]; 34 [16] lymph nodes in D2+CME vs. 27 [13] lymph nodes in D2, p<0•0001) and earlier postoperative flatus (p=0•009) than those in D2 group. The overall postoperative complication rate was comparable between two groups (20•1% in D2+CME vs. 16•0% in D2, p=0•322), however, patients in D2+CME group were less likely to have severe complications (Clavien-Dindo Classification grade ≥IIIa: 4 in D2+CME vs. 9 in D2, p=0•041). Conclusion: D2+CME is associated with better short-term outcomes and surgical safety than conventional D2 dissection for patients with advanced gastric cancer. Trial Registration: ClinicalTrials.gov; NCT01978444

Several suction techniques have been developed recently to enhance tissue acquisition when sampling solid lesions using endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). The aim of this study is to determine whether a new modified wet suction technique (MWST) compared with the conventional dry suction technique (DRST) shall present better outcomes with respect to diagnostic yield and specimen quality of solid lesions in the intra-abdomen and mediastinum.

It often happens in longitudinal studies that some collected data are observed with the following issues. (i) Subjects may not sampled from homogeneous population with a common trajectory; (ii) longitudinal continuous measurements may suffer from a serious departure of normality in which normality assumption may cause lack of robustness and subsequently lead to invalid inference; (iii) some covariates of interest may be difficult to measure accurately due to their nature; and (iv) the response observations may be subject to left-censoring due to a limit of detection (LOD). Inferential procedures will become very complicated when one analyzes data with these features together. In the literature, there has been considerable interest in accommodating heterogeneity, non-normality, LOD or covariate measurement errors in longitudinal data modeling, but, no studies have done concerning all of the four features simultaneously. In this article, simultaneous Bayesian modeling approach based on a finite mixture of nonlinear mixed-effects Tobit joint (NLMETJ) models with skew distributions is developed to study impact of multiple data features together, and to estimate not only model parameters but also class membership probabilities at both population and individual levels. Simulation studies are conducted to assess the performance of the proposed method, and real data example is analyzed to demonstrate the proposed methodologies through comparing potential models with different specifications of error distributions and various scenarios.

To evaluate the efficacy and toxicity of induction chemotherapy followed by concurrent chemoradiotherapy vs. concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma (NPC).

Background: Three-dimensional (3D) strain analysis may help overcome the limitations of Doppler and two-dimensional strain analysis for the left ventricle and become the method of choice for left ventricular (LV) systolic function. The aims of this study were to evaluate the feasibility and reproducibility of LV global 3D systolic strain by real-time 3D speckle-tracking echocardiography (STE) in children and to establish their maturational growth patterns and normal values.Methods: A prospective study was conducted in 256 consecutive healthy subjects using real-time 3D echocardiography. Full-volume 3D data were acquired using a 3D matrix-array transducer. Three-dimensional LV peak systolic global strain (GS), global longitudinal strain (GLS), global radial strain (GRS), and global circumferential strain (GCS) values were determined using real-time 3D STE.Results: A total of 228 patients (89%) met the criteria for analysis; 28 (11%) were excluded. The correlations between age and strain variables by real-time 3D STE were poor (R-2 = 0.01-0.05, P < .05). The differences in GLS and GCS among the five age groups were statistically significant but clinically irrelevant. There were no statistical differences in GRS and GS values among the age groups, nor were there statistical differences between the genders for all 3D strain parameters. Intraobserver and interobserver variability ranged from 5.0 +/- 4.3% to 10.1 +/- 8.5% versus 6.9 +/- 6.1% to 17.0 +/- 16.2% for coefficients of variation, respectively. Interclass correlation coefficients ranged from 0.78 to 0.87 and from 0.75 to 0.79 for intraobserver and interobserver measurements for GS, GLS, GCS, and GRS, respectively.Conclusions: LV global 3D systolic strain analysis using the new 3D STE is feasible and reproducible in the pediatric population. There are small maturational changes in GLS and GCS, but not in GRS and GS, that are statistically significant but probably clinically irrelevant. Further investigation is warranted for potential clinical application of this new technology in a pediatric population.

Background: Doppler and 2-D strain provide less load-dependent and sensitive measures of global and regional left ventricular (LV) function; but these measures are highly dependent on the sampling ...

Objective: To evaluate the efficaey and safety of ibuprofen, pseudoephedrine hydrochloride and chlorphenamine maleate tablets for the treatment of adult common cold. Methods: Two hundred and twenty-five patients with cold symptoms were enrolled in a randomized, double blind, double-simulation, parallel controlled, multi-center study. The patients were randomized to orally receive either paracetamol pseudoephedrine hydrochloride and chlorphenamine maleate tablets 1 tablet × 4 times daily (control group, n = 113) or ibuprofen, pseudoephedrine hydrochloride and chlorphenamine maleate tablets 1 tablet × 4 times daily(test group, n = 112) for 3 ～ 5 days. The symptom score scale and the laboratory index were used to evaluate clinical efficacy and safety of the two groups. Results: The total effective rate of the control group and test group were 96.46% and 97.32% (P >0. 05), the total remarkable effective rate of the control group and test group were 96.46% and 96.43% (P >0. 05). After treatment, the first type symptoms (fever, headache) and the second type symptoms (stuffy nose, runny nose, sneezing) of both groups were significantly reduced, and the symptom score was improved significantly compared with the baseline(P < 0. 000 1), while there is no significant differences in the degree of improvement between two groups(P >0.05) ; All the major individual symptoms and signs of the patients were significantly reduced. The common adverse reactions included drowsiness, thirsty, the increase of transaminase and dizziness. The adverse reaction rate of the control group and test group were 7.08% (8/113)and 4.46% (5/112), respectively(P > 0.05), and the extents of these adverse reactions were mild. Conclusion: Ibuprofen, pseudoephedrine hydrochloride and chlorphenamine maleate tablets were safe and effective for the treatment of common cold, and its safety and efficacy was equal to paracetamol pseudoephedrine hydroehloride and chlorphenamine maleate tablets.