Cancer patients are often accompanied by serious psychosomatic symptoms such as depression,anxiety,insomnia and pain,which seriously affect the quality of life and prognosis of patients.However,these symptoms are ofte...Cancer patients are often accompanied by serious psychosomatic symptoms such as depression,anxiety,insomnia and pain,which seriously affect the quality of life and prognosis of patients.However,these symptoms are often under-appreciated and poorly treated.At present,the domestic consensus on the management of cancer lacks the content of psychosomatic symptoms.Therefore,this consensus systematically describes the clinical management methods of psychosomatic symptoms related to cancer patients,combining relevant literature and integrating practical management tools.It comprehensively answers the important questions of physician-patient communication.展开更多
Objective To determine the correlation between traditional Chinese medicine(TCM)inspec-tion of spirit classification and the severity grade of depression based on facial features,offer-ing insights for intelligent int...Objective To determine the correlation between traditional Chinese medicine(TCM)inspec-tion of spirit classification and the severity grade of depression based on facial features,offer-ing insights for intelligent intergrated TCM and western medicine diagnosis of depression.Methods Using the Audio-Visual Emotion Challenge and Workshop(AVEC 2014)public dataset on depression,which conclude 150 interview videos,the samples were classified ac-cording to the TCM inspection of spirit classification:Deshen(得神,presence of spirit),Shaoshen(少神,insufficiency of spirit),and Shenluan(神乱,confusion of spirit).Meanwhile,based on Beck Depression Inventory-II(BDI-II)score for the severity grade of depression,the samples were divided into minimal(0-13,Q1),mild(14-19,Q2),moderate(20-28,Q3),and severe(29-63,Q4).Sixty-eight landmarks were extracted with a ResNet-50 network,and the feature extracion mode was stadardized.Random forest and support vectior machine(SVM)classifiers were used to predict TCM inspection of spirit classification and the severity grade of depression,respectively.A Chi-square test and Apriori association rule mining were then applied to quantify and explore the relationships.Results The analysis revealed a statistically significant and moderately strong association be-tween TCM spirit classification and the severity grade of depression,as confirmed by a Chi-square test(χ^(2)=14.04,P=0.029)with a Cramer’s V effect size of 0.243.Further exploration us-ing association rule mining identified the most compelling rule:“moderate depression(Q3)→Shenluan”.This rule demonstrated a support level of 5%,indicating this specific co-occur-rence was present in 5%of the cohort.Crucially,it achieved a high Confidence of 86%,mean-ing that among patients diagnosed with Q3,86%exhibited the Shenluan pattern according to TCM assessment.The substantial Lift of 2.37 signifies that the observed likelihood of Shenlu-an manifesting in Q3 patients is 2.37 times higher than would be expected by chance if these states were independent-compelling evidence of a highly non-random association.Conse-quently,Shenluan emerges as a distinct and core TCM diagnostic manifestation strongly linked to Q3,forming a clinically significant phenotype within this patient subgroup.展开更多
BACKGROUND Single-nucleotide polymorphisms(SNPs)of the serotonin type 3 receptor subunit(HTR3)genes have been associated with psychosomatic symptoms,but it is not clear whether these associations exist in irritable bo...BACKGROUND Single-nucleotide polymorphisms(SNPs)of the serotonin type 3 receptor subunit(HTR3)genes have been associated with psychosomatic symptoms,but it is not clear whether these associations exist in irritable bowel syndrome(IBS).AIM To assess the association of HTR3 polymorphisms with depressive,anxiety,and somatization symptoms in individuals with IBS.METHODS In this retrospective study,623 participants with IBS were recruited from five specialty centers in Germany,Sweden,the United States,the United Kingdom,and Ireland.Depressive,anxiety,and somatization symptoms and sociodemographic characteristics were collected.Four functional SNPs—HTR3A c.-42C>T,HTR3B c.386A>C,HTR3C c.489C>A,and HTR3E c.*76G>A—were genotyped and analyzed using the dominant and recessive models.We also performed separate analyses for sex and IBS subtypes.SNP scores were calculated as the number of minor alleles of the SNPs above.The impact of HTR3C c.489C>A was tested by radioligand-binding and calcium influx assays.RESULTS Depressive and anxiety symptoms significantly worsened with increasing numbers of minor HTR3C c.489C>A alleles in the dominant model(F_(depressive)=7.475,P_(depressive)=0.006;F_(anxiety)=6.535,P_(anxiety)=0.011).A higher SNP score(range 0-6)was linked to a worsened depressive symptoms score(F=7.710,P-linear trend=0.006)in IBS.The potential relevance of the HTR3C SNP was corroborated,showing changes in the expression level of 5-HT3AC variant receptors.CONCLUSION We have provided the first evidence that HTR3C c.489C>A is involved in depressive and anxiety symptoms in individuals with IBS.The SNP score indicated that an increasing number of minor alleles is linked to the worsening of depressive symptoms in IBS.展开更多
BACKGROUND Mild cognitive impairment(MCI)has a high risk of progression to Alzheimer’s disease.The disease is often accompanied by sleep disorders,and whether sleep disorders have an effect on brain function in patie...BACKGROUND Mild cognitive impairment(MCI)has a high risk of progression to Alzheimer’s disease.The disease is often accompanied by sleep disorders,and whether sleep disorders have an effect on brain function in patients with MCI is unclear.AIM To explore the near-infrared brain function characteristics of MCI with sleep disorders.METHODS A total of 120 patients with MCI(MCI group)and 50 healthy subjects(control group)were selected.All subjects underwent the functional near-infrared spec-troscopy test.Collect baseline data,Mini-Mental State Examination,Montreal Cognitive Assessment scale,fatigue severity scale(FSS)score,sleep parameter,and oxyhemoglobin(Oxy-Hb)concentration and peak time of functional near-infrared spectroscopy test during the task period.The relationship between Oxy-RESULTS Compared with the control group,the FSS score of the MCI group was higher(t=11.310),and the scores of Pittsburgh sleep quality index,sleep time,sleep efficiency,nocturnal sleep disturbance,and daytime dysfunction were higher(Z=-10.518,-10.368,-9.035,-10.661,-10.088).Subjective sleep quality and total sleep time scores were lower(Z=-11.592,-9.924).The sleep efficiency of the MCI group was lower,and the awakening frequency,rem sleep latency period,total sleep time,and oxygen desaturation index were higher(t=5.969,5.829,2.887,3.003,5.937).The Oxy-Hb concentration at T0,T1,and T2 in the MCI group was lower(t=14.940,11.280,5.721),and the peak time was higher(t=18.800,13.350,9.827).In MCI patients,the concentration of Oxy-Hb during T0 was negatively correlated with the scores of Pittsburgh sleep quality index,sleep time,total sleep time,and sleep efficiency(r=-0.611,-0.388,-0.563,-0.356).It was positively correlated with sleep efficiency and total sleep time(r=0.754,0.650),and negatively correlated with oxygen desaturation index(r=-0.561)and FSS score(r=-0.526).All comparisons were P<0.05.CONCLUSION Patients with MCI and sleep disorders have lower near-infrared brain function than normal people,which is related to sleep quality.Clinically,a comprehensive assessment of the near-infrared brain function of patients should be carried out to guide targeted treatment and improve curative effect.展开更多
BACKGROUND The prevalence of coronary heart disease(CHD)is higher in patients with depression than in the general population.Recently,multiple novel biomarkers have been proposed to predict CHD risk,and these factors ...BACKGROUND The prevalence of coronary heart disease(CHD)is higher in patients with depression than in the general population.Recently,multiple novel biomarkers have been proposed to predict CHD risk,and these factors have been reported to be altered in patients with depression.AIM To explore whether these new biomarkers are associated with an increased risk of CHD in patients with depression.METHODS We recruited 279 healthy controls and 164 sex-and age-matched patients with depression and collected their clinical characteristics and laboratory values of novel cardiovascular biomarkers.The Framingham CHD risk score was used to assess the CHD risk of all individuals,and the cardiovascular markers related to the CHD risk in patients with depression were analyzed.RESULTS Patients with depression had an increased CHD risk of 5.3%(95%confidence interval:4.470-6.103)and altered novel cardiovascular biomarkers compared to healthy controls,which included lower levels of thyroid stimulating hormone,albumin,total bilirubin,total cholesterol,high-density lipoprotein cholesterol,and higher levels of triglyceride(TG)and uric acid.Further regression analysis showed that illness duration,family history of depression,serum TG,and urea acid levels were significantly correlated with the Framingham risk score in patients with depression.CONCLUSION Patients with depression had a higher CHD risk and that their illness duration,family history of depression,serum TG,and uric acid levels could play important roles in predicting CHD risk.Moreover,elevated CHD risk in patients with depression was not only related to physiological changes caused by depression but also to their genetic susceptibility.展开更多
BACKGROUND Adolescent depression manifests through diverse,interconnected symptoms,yet the clinical profile in patients treated with repetitive transcranial magnetic stimulation(rTMS)remains inadequately characterized...BACKGROUND Adolescent depression manifests through diverse,interconnected symptoms,yet the clinical profile in patients treated with repetitive transcranial magnetic stimulation(rTMS)remains inadequately characterized.While rTMS shows therapeutic potential,its efficacy may be overestimated due to limited research and symptom heterogeneity.Identifying key symptom clusters and evaluating their predictive value for treatment response is crucial for optimizing rTMS outcomes in this population.AIM To identify adolescent depression symptom clusters and assess their differential responses to rTMS treatment.METHODS One hundred adolescent patients with first-episode major depressive disorder were randomized into control and study groups.Both groups received sertraline treatment,while the study group additionally underwent 10 sessions of adjunctive rTMS.Depressive symptoms were evaluated using the 17-item Hamilton Depression Rating Scale(HAMD-17)at baseline,week 2,and week 4.RESULTS Hierarchical clustering revealed four distinct symptom clusters:Subjective mood,impaired activity,somatic concerns,and anxiety/insomnia.The main effect of treatment visit showed significant decreases in symptom severity across all clusters.In the study group,the effect size between baseline and week 4 was largest for the subjective mood cluster(Cohen’s d=2.41)and smallest for somatic concerns(Cohen’s d=0.59).In the control group,the largest effect size was observed in the anxiety/insomnia cluster(Cohen’s d=1.20),with the smallest effect in impaired activity(Cohen’s d=0.47).CONCLUSION This study identified four distinct symptom clusters with differential responses to rTMS treatment.The findings demonstrate that rTMS shows greatest efficacy for improving subjective mood symptoms,guiding targeted therapeutic approaches.展开更多
Depression is the most disabling disorder world- wide that accounts for the highest proportion of global burden attributable to mental disorders. Major depressive disorder （MDD） is characterized by deep sadness, red...Depression is the most disabling disorder world- wide that accounts for the highest proportion of global burden attributable to mental disorders. Major depressive disorder （MDD） is characterized by deep sadness, reduced energy, vegetative nervous system dysregulation, cognitive dysfunction, and even a high suicidal tendency. Although other treatment choices are available, antidepressant medication is the front-line treatment option for MDD. Regarding clinical efficacy, only - 50% of patients respond to frontline antide pressants, and 〈33% obtain remission. Currently, objective indexes to guide clinical decisions are still lacking. Further- more, knowledge about the neurobiological mechanisms underlying discrepant antidepressant outcomes is still also fragmentary. In the present review, we discuss the current research progress and clinical opinions on MDD in China.展开更多
This review describes the conceptual and clinical relations between irritable bowel syndrome (IBS), other functional, somatoform, and mental disorders, and points to appropriate future conceptualizations. IBS is consi...This review describes the conceptual and clinical relations between irritable bowel syndrome (IBS), other functional, somatoform, and mental disorders, and points to appropriate future conceptualizations. IBS is considered to be a functional somatic syndrome (FSS) with a considerable symptom overlap with other FSSs like chronic fatigue syndrome or fibromyalgia syndrome. IBS patients show an increased prevalence of psychiatric symptoms and disorders, especially depression and anxiety. IBS is largely congruent with the concepts of somatoform and somatic symptom disorders. Roughly 50% of IBS patients complain of gastrointestinal symptoms only and have no psychiatric comorbidity. IBS concepts, treatment approaches, as well as health care structures should acknowledge its variability and multidimensionality by: (1) awareness of additional extraintestinal and psychobehavioral symptoms in patients with IBS; (2) general and collaborative care rather than specialist and separated care; and (3) implementation of “interface disorders” to abandon the dualistic classification of purely organic or purely mental disorders.展开更多
治疗药物监测(Therapeutic Drug Monitoring,TDM)通过定量测定和解释血药浓度以优化药物治疗。TDM着眼于药代动力学的个体差异,使个体化药物治疗成为可能。在精神病学和神经病学领域中,有可能明显获益于TDM的主要患者群体包括少年儿童...治疗药物监测(Therapeutic Drug Monitoring,TDM)通过定量测定和解释血药浓度以优化药物治疗。TDM着眼于药代动力学的个体差异,使个体化药物治疗成为可能。在精神病学和神经病学领域中,有可能明显获益于TDM的主要患者群体包括少年儿童、孕妇、老年患者、智障患者、药物滥用者、涉法精神病患者、已知或怀疑药代动力学异常的患者以及合并躯体疾病影响药代动力学的患者。常规剂量下治疗无效,用药依从性难以判断,药物耐受性不佳,以及可能存在药代动力学方面的药物-药物相互作用等情况都是治疗药物监测的典型指征。然而,只有将TDM充分整合到临床治疗过程中,才能发挥其优化药物治疗的潜在优势。为了向临床医生和实验室提供有效的TDM信息,神经精神药理学与药物精神病学协会(Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie,AGNP)的TDM专家组在2004年发表了第一版《精神科治疗药物监测指南》。2011年进行了更新之后,现在再次更新。遵循新版指南,可能会改善神经精神药物治疗的效果,加快很多患者的康复,并降低医疗费用。展开更多
Over the last several years there has been a growing interest in placebo, not only as an inert control in clinical trials, but also in the placebo effect as a group effect as well as a reaction in individual subjects....Over the last several years there has been a growing interest in placebo, not only as an inert control in clinical trials, but also in the placebo effect as a group effect as well as a reaction in individual subjects. Methodological factors such as regression to the mean and natural history of the disease play a role in the evaluation of a possible placebo effect. In this report, we discuss several factors including PavIovian conditioning, beliefs outcome, expectations, and other factors as potential mediators of the placebo response. Placebo effects are common in gastrointestinal diseases and there seems to be no clear difference between placebo effects in functional gastrointestinal diseases （functional dyspepsia and irritable bowel syndrome） and organic gastrointestinal disease （duodenal ulcer and inflammatory bowel disease）.展开更多
AIzheimer＇s disease patients diagnosed with the Chinese Classification of Mental Disorders diagnostic criteria were selected from the community through on-site sampling. Levels of macro and trace elements were measur...AIzheimer＇s disease patients diagnosed with the Chinese Classification of Mental Disorders diagnostic criteria were selected from the community through on-site sampling. Levels of macro and trace elements were measured in blood samples using an atomic absorption method, and neurotransmitters were measured using a radioimmunoassay method. SPSS 13.0 was used to establish a database, and a back propagation artificial neural network for Alzheimer＇s disease prediction was simulated using Clementine 12.0 software. With scores of activities of daily living, creatinine, 5-hydroxytryptamine, age, dopamine and aluminum as input variables, the results revealed that the area under the curve in our back propagation artificial neural network was 0.929 （95% confidence interval： 0.868-0.968）, sensitivity was 90.00%, specificity was 95.00%, and accuracy was 92.50%. The findings indicated that the results of back propagation artificial neural network established based on the above six variables were satisfactory for screening and diagnosis of Alzheimer＇s disease in patients selected from the community.展开更多
AIM： To determine by brain functional magnetic resonance imaging （fMRI） whether cerebral processing of non-visceral stimuli is altered in irritable bowel syndrome （IBS） patients compared with healthy subjects. To...AIM： To determine by brain functional magnetic resonance imaging （fMRI） whether cerebral processing of non-visceral stimuli is altered in irritable bowel syndrome （IBS） patients compared with healthy subjects. To circumvent spinal viscerosomatic convergence mechanisms, we used auditory stimulation, and to identify a possible influence of psychological factors the stimuli differed in their emotional quality. METHODS： In 8 IBS patients and 8 controls, fMRI measurements were performed using a block design of 4 auditory stimuli of different emotional quality （pleasant sounds of chimes, unpleasant peep （2000 Hz）, neutral words, and emotional words）. A gradient echo T2＊weighted sequence was used for the functional scans. Statistical maps were constructed using the general linear model. RESULTS： To emotional auditory stimuli, IBS patients relative to controls responded with stronger deactivations in a greater variety of emotional processing regions, while the response patterns, unlike in controls, did not differentiate between distressing or pleasant sounds. To neutral auditory stimuli, by contrast, only IBS patients responded with large significant activations. CONCLUSION： Altered cerebral response patterns to auditory stimuli in emotional stimulus-processing regions suggest that altered sensory processing in IBS may not be specific for visceral sensation, but might reflect generalized changes in emotional sensitivity and affectire reactivity, possibly associated with the psychological comorbidity often found in IBS patients.展开更多
AIM: To study statements and recommendations on psychosocial issues as presented in international evidence-based guidelines on the management of inflammatory bowel diseases (IBD).
Photobiomodulation using light in the red or near-infrared region is an innovative treatment strategy for a wide range of neurological and psychological conditions.Photobiomodulation can promote neurogenesis and elici...Photobiomodulation using light in the red or near-infrared region is an innovative treatment strategy for a wide range of neurological and psychological conditions.Photobiomodulation can promote neurogenesis and elicit anti-apoptotic,antiinflammatory and antioxidative responses.Its therapeutic effects have been demonstrated in studies on neurological diseases,peripheral nerve injuries,pain relief and wound healing.We conducted a comprehensive literature review of the application of photobiomodulation in patients with central nervous system diseases in February 2019.The NCBI PubMed database,EMBASE database,Cochrane Library and ScienceDirect database were searched.We reviewed 95 papers and analyzed.Photobiomodulation has wide applicability in the treatment of stroke,traumatic brain injury,Parkinson’s disease,Alzheimer’s disease,major depressive disorder,and other diseases.Our analysis provides preliminary evidence that PBM is an effective therapeutic tool for the treatment of central nervous system diseases.However,additional studies with adequate sample size are needed to optimize treatment parameters.展开更多
AIM To provide an overview of the current research in the functional neuroanatomy of panic disorder.METHODS Panic disorder(PD)is a frequent psychiatric disease.Gorman et al(1989;2000)proposed a comprehensive neuroanat...AIM To provide an overview of the current research in the functional neuroanatomy of panic disorder.METHODS Panic disorder(PD)is a frequent psychiatric disease.Gorman et al(1989;2000)proposed a comprehensive neuroanatomical model of PD,which suggested that fear-and anxiety-related responses are mediated by a so-called"fear network"which is centered in the amygdala and includes the hippocampus,thalamus,hypothalamus,periaqueductal gray region,locus coeruleus and other brainstem sites.We performed a systematic search by the electronic database PubMed.Thereby,the main focus was laid on recent neurofunctional,neurostructural,and neurochemical studies(from the period between January 2012 and April 2016).Within this frame,special attention was given to the emerging field of imaging genetics.RESULTS We noted that many neuroimaging studies have reinforced the role of the"fear network"regions in the pathophysiology of panic disorder.However,recent functional studies suggest abnormal activation mainly in an extended fear network comprising brainstem,anterior and midcingulate cortex(ACC and MCC),insula,and lateral as well as medial parts of the prefrontal cortex.Interestingly,differences in the amygdala activation were not as consistently reported as one would predict from the hypothesis of Gorman et al(2000).Indeed,amygdala hyperactivation seems to strongly depend on stimuli and experimental paradigms,sample heterogeneity and size,as well as on limitations of neuroimaging techniques.Advanced neurochemical studies have substantiated the major role of serotonergic,noradrenergic and glutamatergic neurotransmission in the pathophysiology of PD.However,alterations of GABAergic function in PD are still a matter of debate and also their specificity remains questionable.A promising new research approach is"imaging genetics".Imaging genetic studies are designed to evaluate the impact of genetic variations(polymorphisms)on cerebral function in regions critical for PD.Most recently,imaging genetic studies have not only confirmed the importance of serotonergic and noradrenergic transmission in the etiology of PD but also indicated the significance of neuropeptide S receptor,CRH receptor,human TransM EMbrane protein(TMEM123D),and amiloride-sensitive cation channel 2(ACCN2)genes.CONCLUSION In light of these findings it is conceivable that in the near future this research will lead to the development of clinically useful tools like predictive biomarkers or novel treatment options.展开更多
The cancer-associated anorexia-cachexia syndrome is observed in 80% of patients with advanced-stage cancer, and is one of the major obstacles in chemo- therapy. Ghrelin is a orexigenic hormone that has been proposed t...The cancer-associated anorexia-cachexia syndrome is observed in 80% of patients with advanced-stage cancer, and is one of the major obstacles in chemo- therapy. Ghrelin is a orexigenic hormone that has been proposed to prevent anorexia. Aim of the study was to determine whether the addition of the ghrelin agonist growth hormone releasing peptide 2 (GHRP-2) to cytotoxic therapy with 5-fluoruracil (5-FU) prevents the anorexia associated with chemotherapy in cancer cachectic mice. Thirty-three BALB/c female tumourbearing mice were randomized to receive a solution containing: (a) placebo; (b) GHRP-2; (c) 5-FU; or (d) 5-FU + GHRP-2. Ten BALB/c no tumour-bearing mice received placebo solution. Food intake and survival were checked. Six hours after the drug injection the cumulative food intake was signifi cantly increased in mice treated with the combination of 5-FU + GHRP-2 versus the 5-FU alone (P = 0.0096). On day 3, the cumulative food intake of mice treated with GHRP-2,5-FU and 5-FU + GHRP-2 signifi cantly increased com- pared with naive and vehicle groups (P = 0.0007, P = 0.0038 and P = 0.0166, respectively). The median survival time was longer in 5-FU + GHRP-2 treated mice than in those with 5-FU, although it was not signifi cant (18 d versus 15.5 d, P = 0.7). For the fi rst time, we demonstrated that the addition of GHRP-2 to cytotoxic therapy with 5-FU improved appetite in tumour-bearing mice with anorexia/cachexia syndrome in early stage. These data suggest that GHRP-2 may improve the effi cacy of therapy and the quality of life of cancer patients thank to the amelioration of their nutritional state.展开更多
This study was conducted to verify the results of a preceding retrospective pilot study by means of a prospective controlled investigation including a larger sample size. Therefore, the aim of this clinical investigat...This study was conducted to verify the results of a preceding retrospective pilot study by means of a prospective controlled investigation including a larger sample size. Therefore, the aim of this clinical investigation was to analyze the relationship between sleep bruxism and several functional and occlusal parameters. The null hypothesis of this study was that there would be no differences among sleep bruxism subjects and non-sleep bruxism controls regarding several functional and occlusal parameters. Fifty-eight sleep bruxism subjects and 31 controls participated in this study. The diagnosis sleep bruxism was based on clinical criteria of the American Academy of Sleep Medicine. Sixteen functional and occlusal parameters were recorded clinically or from dental study casts. Similar to the recently published retrospective pilot study, with a mean slide of 0.77 mm （s.d., 0.69 mm） in the sleep bruxism group and a mean slide of 0.4 mm （s.d., 0.57 mm） in the control group, the evaluation of the mean comparison between the two groups demonstrated a larger slide from centric occlusion to maximum intercuspation in sleep bruxism subjects （Mann-Whitney U-test; P=O.O08）. However, following Bonferroni adjustment, none of the 16 occlusal and functional variables differed significantly between the sleep bruxism subjects and the non-sleep bruxism controls. The present study shows that the occlusal and functional parameters evaluated do not differ between sleep bruxism subjects and non-sleep bruxism subjects. However, as the literature reveals a possible association between bruxism and certain subgroups of temporomandibular disorders, it appears advisable to incorporate the individual adaptive caoacitv of the stomatognathic svstem into future investigations.展开更多
BACKGROUND Laparoscopic radical gastrectomy is currently the most common surgical approach for gastric cancer.The main difference between totally laparoscopic total gastrectomy(TLTG)and laparoscopic-assisted total gas...BACKGROUND Laparoscopic radical gastrectomy is currently the most common surgical approach for gastric cancer.The main difference between totally laparoscopic total gastrectomy(TLTG)and laparoscopic-assisted total gastrectomy(LATG)is the route of digestive tract reconstruction.However,TLTG is currently not widespread as the safety and feasibility of intracorporeal esophagojejunostomy is uncertain.AIM To compare the short-term efficacy of TLTG and LATG for radical gastrectomy of gastric cancer,and to determine the safety and feasibility of intracorporeal esophagojejunostomy.METHODS PubMed,EMBASE,and Web of Science databases were searched for all relevant articles regarding TLTG vs LATG for gastric cancer published up to October 1,2019.Inclusion and exclusion criteria were established.All the basic conditions of patients and important clinical data related to surgery were extracted,and a meta-analysis was performed with RevMan 5.3 software.RESULTS Eight studies involving a total of 1883 cases(869 cases in the TLTG group and 1014 cases in the LATG group)were included.Compared with the LATG group,reduced intraoperative blood loss(weighted mean difference=-35.37,95%CI:-61.69--9.06,P=0.008)and a larger number of retrieved lymph nodes(weighted mean difference=3.11,95%CI:-2.60-12.00,P=0.01)were found in the TLTG group.There were no significant differences in operating time,anastomotic time,tumor size,proximal resection margin length,postoperative pain score,time to first flatus,time to first oral intake,postoperative hospital stay,postoperative anastomosis-related complication rate and overall complication rate between the two groups(P>0.05).CONCLUSION Intracorporeal esophagojejunostomy is safe and feasible.TLTG has the advantages of being minimally invasive,reduced intraoperative blood loss and easier access to lymph nodes compared with LATG.Totally laparoscopic gastrectomy is likely to be the surgical trend for gastric cancer in the future.展开更多
文摘Cancer patients are often accompanied by serious psychosomatic symptoms such as depression,anxiety,insomnia and pain,which seriously affect the quality of life and prognosis of patients.However,these symptoms are often under-appreciated and poorly treated.At present,the domestic consensus on the management of cancer lacks the content of psychosomatic symptoms.Therefore,this consensus systematically describes the clinical management methods of psychosomatic symptoms related to cancer patients,combining relevant literature and integrating practical management tools.It comprehensively answers the important questions of physician-patient communication.
基金Research and Development Plan of Key Areas of Hunan Science and Technology Department (2022SK2044)Clinical Research Center for Depressive Disorder in Hunan Province (2021SK4022)。
文摘Objective To determine the correlation between traditional Chinese medicine(TCM)inspec-tion of spirit classification and the severity grade of depression based on facial features,offer-ing insights for intelligent intergrated TCM and western medicine diagnosis of depression.Methods Using the Audio-Visual Emotion Challenge and Workshop(AVEC 2014)public dataset on depression,which conclude 150 interview videos,the samples were classified ac-cording to the TCM inspection of spirit classification:Deshen(得神,presence of spirit),Shaoshen(少神,insufficiency of spirit),and Shenluan(神乱,confusion of spirit).Meanwhile,based on Beck Depression Inventory-II(BDI-II)score for the severity grade of depression,the samples were divided into minimal(0-13,Q1),mild(14-19,Q2),moderate(20-28,Q3),and severe(29-63,Q4).Sixty-eight landmarks were extracted with a ResNet-50 network,and the feature extracion mode was stadardized.Random forest and support vectior machine(SVM)classifiers were used to predict TCM inspection of spirit classification and the severity grade of depression,respectively.A Chi-square test and Apriori association rule mining were then applied to quantify and explore the relationships.Results The analysis revealed a statistically significant and moderately strong association be-tween TCM spirit classification and the severity grade of depression,as confirmed by a Chi-square test(χ^(2)=14.04,P=0.029)with a Cramer’s V effect size of 0.243.Further exploration us-ing association rule mining identified the most compelling rule:“moderate depression(Q3)→Shenluan”.This rule demonstrated a support level of 5%,indicating this specific co-occur-rence was present in 5%of the cohort.Crucially,it achieved a high Confidence of 86%,mean-ing that among patients diagnosed with Q3,86%exhibited the Shenluan pattern according to TCM assessment.The substantial Lift of 2.37 signifies that the observed likelihood of Shenlu-an manifesting in Q3 patients is 2.37 times higher than would be expected by chance if these states were independent-compelling evidence of a highly non-random association.Conse-quently,Shenluan emerges as a distinct and core TCM diagnostic manifestation strongly linked to Q3,forming a clinically significant phenotype within this patient subgroup.
基金results in part from collaboration and network activities promoted under the frame of the international network GENIEUR (Genes in Irritable Bowel Syndrome Research Network Europe),which has been funded by the COST program (BM1106, www.GENIEUR.eu)currently supported by the European Society of Neurogastroenterology and Motility (ESNM, www.ESNM.eu)
文摘BACKGROUND Single-nucleotide polymorphisms(SNPs)of the serotonin type 3 receptor subunit(HTR3)genes have been associated with psychosomatic symptoms,but it is not clear whether these associations exist in irritable bowel syndrome(IBS).AIM To assess the association of HTR3 polymorphisms with depressive,anxiety,and somatization symptoms in individuals with IBS.METHODS In this retrospective study,623 participants with IBS were recruited from five specialty centers in Germany,Sweden,the United States,the United Kingdom,and Ireland.Depressive,anxiety,and somatization symptoms and sociodemographic characteristics were collected.Four functional SNPs—HTR3A c.-42C>T,HTR3B c.386A>C,HTR3C c.489C>A,and HTR3E c.*76G>A—were genotyped and analyzed using the dominant and recessive models.We also performed separate analyses for sex and IBS subtypes.SNP scores were calculated as the number of minor alleles of the SNPs above.The impact of HTR3C c.489C>A was tested by radioligand-binding and calcium influx assays.RESULTS Depressive and anxiety symptoms significantly worsened with increasing numbers of minor HTR3C c.489C>A alleles in the dominant model(F_(depressive)=7.475,P_(depressive)=0.006;F_(anxiety)=6.535,P_(anxiety)=0.011).A higher SNP score(range 0-6)was linked to a worsened depressive symptoms score(F=7.710,P-linear trend=0.006)in IBS.The potential relevance of the HTR3C SNP was corroborated,showing changes in the expression level of 5-HT3AC variant receptors.CONCLUSION We have provided the first evidence that HTR3C c.489C>A is involved in depressive and anxiety symptoms in individuals with IBS.The SNP score indicated that an increasing number of minor alleles is linked to the worsening of depressive symptoms in IBS.
文摘BACKGROUND Mild cognitive impairment(MCI)has a high risk of progression to Alzheimer’s disease.The disease is often accompanied by sleep disorders,and whether sleep disorders have an effect on brain function in patients with MCI is unclear.AIM To explore the near-infrared brain function characteristics of MCI with sleep disorders.METHODS A total of 120 patients with MCI(MCI group)and 50 healthy subjects(control group)were selected.All subjects underwent the functional near-infrared spec-troscopy test.Collect baseline data,Mini-Mental State Examination,Montreal Cognitive Assessment scale,fatigue severity scale(FSS)score,sleep parameter,and oxyhemoglobin(Oxy-Hb)concentration and peak time of functional near-infrared spectroscopy test during the task period.The relationship between Oxy-RESULTS Compared with the control group,the FSS score of the MCI group was higher(t=11.310),and the scores of Pittsburgh sleep quality index,sleep time,sleep efficiency,nocturnal sleep disturbance,and daytime dysfunction were higher(Z=-10.518,-10.368,-9.035,-10.661,-10.088).Subjective sleep quality and total sleep time scores were lower(Z=-11.592,-9.924).The sleep efficiency of the MCI group was lower,and the awakening frequency,rem sleep latency period,total sleep time,and oxygen desaturation index were higher(t=5.969,5.829,2.887,3.003,5.937).The Oxy-Hb concentration at T0,T1,and T2 in the MCI group was lower(t=14.940,11.280,5.721),and the peak time was higher(t=18.800,13.350,9.827).In MCI patients,the concentration of Oxy-Hb during T0 was negatively correlated with the scores of Pittsburgh sleep quality index,sleep time,total sleep time,and sleep efficiency(r=-0.611,-0.388,-0.563,-0.356).It was positively correlated with sleep efficiency and total sleep time(r=0.754,0.650),and negatively correlated with oxygen desaturation index(r=-0.561)and FSS score(r=-0.526).All comparisons were P<0.05.CONCLUSION Patients with MCI and sleep disorders have lower near-infrared brain function than normal people,which is related to sleep quality.Clinically,a comprehensive assessment of the near-infrared brain function of patients should be carried out to guide targeted treatment and improve curative effect.
基金Supported by the National Natural Science Foundation of China,No.82301737.
文摘BACKGROUND The prevalence of coronary heart disease(CHD)is higher in patients with depression than in the general population.Recently,multiple novel biomarkers have been proposed to predict CHD risk,and these factors have been reported to be altered in patients with depression.AIM To explore whether these new biomarkers are associated with an increased risk of CHD in patients with depression.METHODS We recruited 279 healthy controls and 164 sex-and age-matched patients with depression and collected their clinical characteristics and laboratory values of novel cardiovascular biomarkers.The Framingham CHD risk score was used to assess the CHD risk of all individuals,and the cardiovascular markers related to the CHD risk in patients with depression were analyzed.RESULTS Patients with depression had an increased CHD risk of 5.3%(95%confidence interval:4.470-6.103)and altered novel cardiovascular biomarkers compared to healthy controls,which included lower levels of thyroid stimulating hormone,albumin,total bilirubin,total cholesterol,high-density lipoprotein cholesterol,and higher levels of triglyceride(TG)and uric acid.Further regression analysis showed that illness duration,family history of depression,serum TG,and urea acid levels were significantly correlated with the Framingham risk score in patients with depression.CONCLUSION Patients with depression had a higher CHD risk and that their illness duration,family history of depression,serum TG,and uric acid levels could play important roles in predicting CHD risk.Moreover,elevated CHD risk in patients with depression was not only related to physiological changes caused by depression but also to their genetic susceptibility.
基金Supported by the Hangzhou Medical and Health Science and Technology General Project,No.A20240472 and No.A20210156the Plan Projects of Zhejiang Provincial Department of Science and Technology,No.2025C01103the Major projects of Hangzhou Municipal Health Commission,No.Z20250275.
文摘BACKGROUND Adolescent depression manifests through diverse,interconnected symptoms,yet the clinical profile in patients treated with repetitive transcranial magnetic stimulation(rTMS)remains inadequately characterized.While rTMS shows therapeutic potential,its efficacy may be overestimated due to limited research and symptom heterogeneity.Identifying key symptom clusters and evaluating their predictive value for treatment response is crucial for optimizing rTMS outcomes in this population.AIM To identify adolescent depression symptom clusters and assess their differential responses to rTMS treatment.METHODS One hundred adolescent patients with first-episode major depressive disorder were randomized into control and study groups.Both groups received sertraline treatment,while the study group additionally underwent 10 sessions of adjunctive rTMS.Depressive symptoms were evaluated using the 17-item Hamilton Depression Rating Scale(HAMD-17)at baseline,week 2,and week 4.RESULTS Hierarchical clustering revealed four distinct symptom clusters:Subjective mood,impaired activity,somatic concerns,and anxiety/insomnia.The main effect of treatment visit showed significant decreases in symptom severity across all clusters.In the study group,the effect size between baseline and week 4 was largest for the subjective mood cluster(Cohen’s d=2.41)and smallest for somatic concerns(Cohen’s d=0.59).In the control group,the largest effect size was observed in the anxiety/insomnia cluster(Cohen’s d=1.20),with the smallest effect in impaired activity(Cohen’s d=0.47).CONCLUSION This study identified four distinct symptom clusters with differential responses to rTMS treatment.The findings demonstrate that rTMS shows greatest efficacy for improving subjective mood symptoms,guiding targeted therapeutic approaches.
基金supported by the National Natural Science Foundation of China(81371488 and 81571330)
文摘Depression is the most disabling disorder world- wide that accounts for the highest proportion of global burden attributable to mental disorders. Major depressive disorder （MDD） is characterized by deep sadness, reduced energy, vegetative nervous system dysregulation, cognitive dysfunction, and even a high suicidal tendency. Although other treatment choices are available, antidepressant medication is the front-line treatment option for MDD. Regarding clinical efficacy, only - 50% of patients respond to frontline antide pressants, and 〈33% obtain remission. Currently, objective indexes to guide clinical decisions are still lacking. Further- more, knowledge about the neurobiological mechanisms underlying discrepant antidepressant outcomes is still also fragmentary. In the present review, we discuss the current research progress and clinical opinions on MDD in China.
文摘This review describes the conceptual and clinical relations between irritable bowel syndrome (IBS), other functional, somatoform, and mental disorders, and points to appropriate future conceptualizations. IBS is considered to be a functional somatic syndrome (FSS) with a considerable symptom overlap with other FSSs like chronic fatigue syndrome or fibromyalgia syndrome. IBS patients show an increased prevalence of psychiatric symptoms and disorders, especially depression and anxiety. IBS is largely congruent with the concepts of somatoform and somatic symptom disorders. Roughly 50% of IBS patients complain of gastrointestinal symptoms only and have no psychiatric comorbidity. IBS concepts, treatment approaches, as well as health care structures should acknowledge its variability and multidimensionality by: (1) awareness of additional extraintestinal and psychobehavioral symptoms in patients with IBS; (2) general and collaborative care rather than specialist and separated care; and (3) implementation of “interface disorders” to abandon the dualistic classification of purely organic or purely mental disorders.
文摘治疗药物监测(Therapeutic Drug Monitoring,TDM)通过定量测定和解释血药浓度以优化药物治疗。TDM着眼于药代动力学的个体差异,使个体化药物治疗成为可能。在精神病学和神经病学领域中,有可能明显获益于TDM的主要患者群体包括少年儿童、孕妇、老年患者、智障患者、药物滥用者、涉法精神病患者、已知或怀疑药代动力学异常的患者以及合并躯体疾病影响药代动力学的患者。常规剂量下治疗无效,用药依从性难以判断,药物耐受性不佳,以及可能存在药代动力学方面的药物-药物相互作用等情况都是治疗药物监测的典型指征。然而,只有将TDM充分整合到临床治疗过程中,才能发挥其优化药物治疗的潜在优势。为了向临床医生和实验室提供有效的TDM信息,神经精神药理学与药物精神病学协会(Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie,AGNP)的TDM专家组在2004年发表了第一版《精神科治疗药物监测指南》。2011年进行了更新之后,现在再次更新。遵循新版指南,可能会改善神经精神药物治疗的效果,加快很多患者的康复,并降低医疗费用。
文摘Over the last several years there has been a growing interest in placebo, not only as an inert control in clinical trials, but also in the placebo effect as a group effect as well as a reaction in individual subjects. Methodological factors such as regression to the mean and natural history of the disease play a role in the evaluation of a possible placebo effect. In this report, we discuss several factors including PavIovian conditioning, beliefs outcome, expectations, and other factors as potential mediators of the placebo response. Placebo effects are common in gastrointestinal diseases and there seems to be no clear difference between placebo effects in functional gastrointestinal diseases （functional dyspepsia and irritable bowel syndrome） and organic gastrointestinal disease （duodenal ulcer and inflammatory bowel disease）.
基金supported by the National Natural Science Foundation of China,No.30760214
文摘AIzheimer＇s disease patients diagnosed with the Chinese Classification of Mental Disorders diagnostic criteria were selected from the community through on-site sampling. Levels of macro and trace elements were measured in blood samples using an atomic absorption method, and neurotransmitters were measured using a radioimmunoassay method. SPSS 13.0 was used to establish a database, and a back propagation artificial neural network for Alzheimer＇s disease prediction was simulated using Clementine 12.0 software. With scores of activities of daily living, creatinine, 5-hydroxytryptamine, age, dopamine and aluminum as input variables, the results revealed that the area under the curve in our back propagation artificial neural network was 0.929 （95% confidence interval： 0.868-0.968）, sensitivity was 90.00%, specificity was 95.00%, and accuracy was 92.50%. The findings indicated that the results of back propagation artificial neural network established based on the above six variables were satisfactory for screening and diagnosis of Alzheimer＇s disease in patients selected from the community.
文摘AIM： To determine by brain functional magnetic resonance imaging （fMRI） whether cerebral processing of non-visceral stimuli is altered in irritable bowel syndrome （IBS） patients compared with healthy subjects. To circumvent spinal viscerosomatic convergence mechanisms, we used auditory stimulation, and to identify a possible influence of psychological factors the stimuli differed in their emotional quality. METHODS： In 8 IBS patients and 8 controls, fMRI measurements were performed using a block design of 4 auditory stimuli of different emotional quality （pleasant sounds of chimes, unpleasant peep （2000 Hz）, neutral words, and emotional words）. A gradient echo T2＊weighted sequence was used for the functional scans. Statistical maps were constructed using the general linear model. RESULTS： To emotional auditory stimuli, IBS patients relative to controls responded with stronger deactivations in a greater variety of emotional processing regions, while the response patterns, unlike in controls, did not differentiate between distressing or pleasant sounds. To neutral auditory stimuli, by contrast, only IBS patients responded with large significant activations. CONCLUSION： Altered cerebral response patterns to auditory stimuli in emotional stimulus-processing regions suggest that altered sensory processing in IBS may not be specific for visceral sensation, but might reflect generalized changes in emotional sensitivity and affectire reactivity, possibly associated with the psychological comorbidity often found in IBS patients.
文摘AIM: To study statements and recommendations on psychosocial issues as presented in international evidence-based guidelines on the management of inflammatory bowel diseases (IBD).
文摘Photobiomodulation using light in the red or near-infrared region is an innovative treatment strategy for a wide range of neurological and psychological conditions.Photobiomodulation can promote neurogenesis and elicit anti-apoptotic,antiinflammatory and antioxidative responses.Its therapeutic effects have been demonstrated in studies on neurological diseases,peripheral nerve injuries,pain relief and wound healing.We conducted a comprehensive literature review of the application of photobiomodulation in patients with central nervous system diseases in February 2019.The NCBI PubMed database,EMBASE database,Cochrane Library and ScienceDirect database were searched.We reviewed 95 papers and analyzed.Photobiomodulation has wide applicability in the treatment of stroke,traumatic brain injury,Parkinson’s disease,Alzheimer’s disease,major depressive disorder,and other diseases.Our analysis provides preliminary evidence that PBM is an effective therapeutic tool for the treatment of central nervous system diseases.However,additional studies with adequate sample size are needed to optimize treatment parameters.
文摘AIM To provide an overview of the current research in the functional neuroanatomy of panic disorder.METHODS Panic disorder(PD)is a frequent psychiatric disease.Gorman et al(1989;2000)proposed a comprehensive neuroanatomical model of PD,which suggested that fear-and anxiety-related responses are mediated by a so-called"fear network"which is centered in the amygdala and includes the hippocampus,thalamus,hypothalamus,periaqueductal gray region,locus coeruleus and other brainstem sites.We performed a systematic search by the electronic database PubMed.Thereby,the main focus was laid on recent neurofunctional,neurostructural,and neurochemical studies(from the period between January 2012 and April 2016).Within this frame,special attention was given to the emerging field of imaging genetics.RESULTS We noted that many neuroimaging studies have reinforced the role of the"fear network"regions in the pathophysiology of panic disorder.However,recent functional studies suggest abnormal activation mainly in an extended fear network comprising brainstem,anterior and midcingulate cortex(ACC and MCC),insula,and lateral as well as medial parts of the prefrontal cortex.Interestingly,differences in the amygdala activation were not as consistently reported as one would predict from the hypothesis of Gorman et al(2000).Indeed,amygdala hyperactivation seems to strongly depend on stimuli and experimental paradigms,sample heterogeneity and size,as well as on limitations of neuroimaging techniques.Advanced neurochemical studies have substantiated the major role of serotonergic,noradrenergic and glutamatergic neurotransmission in the pathophysiology of PD.However,alterations of GABAergic function in PD are still a matter of debate and also their specificity remains questionable.A promising new research approach is"imaging genetics".Imaging genetic studies are designed to evaluate the impact of genetic variations(polymorphisms)on cerebral function in regions critical for PD.Most recently,imaging genetic studies have not only confirmed the importance of serotonergic and noradrenergic transmission in the etiology of PD but also indicated the significance of neuropeptide S receptor,CRH receptor,human TransM EMbrane protein(TMEM123D),and amiloride-sensitive cation channel 2(ACCN2)genes.CONCLUSION In light of these findings it is conceivable that in the near future this research will lead to the development of clinically useful tools like predictive biomarkers or novel treatment options.
基金Supported by (in part) A Grant-in-Aid for Scientic Research (B:16390208) from the Ministry of Education, Culture, Sports, Science and Technology of Japan (to A.I.)
文摘The cancer-associated anorexia-cachexia syndrome is observed in 80% of patients with advanced-stage cancer, and is one of the major obstacles in chemo- therapy. Ghrelin is a orexigenic hormone that has been proposed to prevent anorexia. Aim of the study was to determine whether the addition of the ghrelin agonist growth hormone releasing peptide 2 (GHRP-2) to cytotoxic therapy with 5-fluoruracil (5-FU) prevents the anorexia associated with chemotherapy in cancer cachectic mice. Thirty-three BALB/c female tumourbearing mice were randomized to receive a solution containing: (a) placebo; (b) GHRP-2; (c) 5-FU; or (d) 5-FU + GHRP-2. Ten BALB/c no tumour-bearing mice received placebo solution. Food intake and survival were checked. Six hours after the drug injection the cumulative food intake was signifi cantly increased in mice treated with the combination of 5-FU + GHRP-2 versus the 5-FU alone (P = 0.0096). On day 3, the cumulative food intake of mice treated with GHRP-2,5-FU and 5-FU + GHRP-2 signifi cantly increased com- pared with naive and vehicle groups (P = 0.0007, P = 0.0038 and P = 0.0166, respectively). The median survival time was longer in 5-FU + GHRP-2 treated mice than in those with 5-FU, although it was not signifi cant (18 d versus 15.5 d, P = 0.7). For the fi rst time, we demonstrated that the addition of GHRP-2 to cytotoxic therapy with 5-FU improved appetite in tumour-bearing mice with anorexia/cachexia syndrome in early stage. These data suggest that GHRP-2 may improve the effi cacy of therapy and the quality of life of cancer patients thank to the amelioration of their nutritional state.
基金supported in part by grants from the German Research Foundation (839/6-1,839/6-2)
文摘This study was conducted to verify the results of a preceding retrospective pilot study by means of a prospective controlled investigation including a larger sample size. Therefore, the aim of this clinical investigation was to analyze the relationship between sleep bruxism and several functional and occlusal parameters. The null hypothesis of this study was that there would be no differences among sleep bruxism subjects and non-sleep bruxism controls regarding several functional and occlusal parameters. Fifty-eight sleep bruxism subjects and 31 controls participated in this study. The diagnosis sleep bruxism was based on clinical criteria of the American Academy of Sleep Medicine. Sixteen functional and occlusal parameters were recorded clinically or from dental study casts. Similar to the recently published retrospective pilot study, with a mean slide of 0.77 mm （s.d., 0.69 mm） in the sleep bruxism group and a mean slide of 0.4 mm （s.d., 0.57 mm） in the control group, the evaluation of the mean comparison between the two groups demonstrated a larger slide from centric occlusion to maximum intercuspation in sleep bruxism subjects （Mann-Whitney U-test; P=O.O08）. However, following Bonferroni adjustment, none of the 16 occlusal and functional variables differed significantly between the sleep bruxism subjects and the non-sleep bruxism controls. The present study shows that the occlusal and functional parameters evaluated do not differ between sleep bruxism subjects and non-sleep bruxism subjects. However, as the literature reveals a possible association between bruxism and certain subgroups of temporomandibular disorders, it appears advisable to incorporate the individual adaptive caoacitv of the stomatognathic svstem into future investigations.
基金Supported by the Ethics Committee of Chongqing Three Gorges Central Hospitalthe Guiding Project of Science and Technology Plan for Social Development in Wanzhou District Chongqing,No.wzstc-z 201707
文摘BACKGROUND Laparoscopic radical gastrectomy is currently the most common surgical approach for gastric cancer.The main difference between totally laparoscopic total gastrectomy(TLTG)and laparoscopic-assisted total gastrectomy(LATG)is the route of digestive tract reconstruction.However,TLTG is currently not widespread as the safety and feasibility of intracorporeal esophagojejunostomy is uncertain.AIM To compare the short-term efficacy of TLTG and LATG for radical gastrectomy of gastric cancer,and to determine the safety and feasibility of intracorporeal esophagojejunostomy.METHODS PubMed,EMBASE,and Web of Science databases were searched for all relevant articles regarding TLTG vs LATG for gastric cancer published up to October 1,2019.Inclusion and exclusion criteria were established.All the basic conditions of patients and important clinical data related to surgery were extracted,and a meta-analysis was performed with RevMan 5.3 software.RESULTS Eight studies involving a total of 1883 cases(869 cases in the TLTG group and 1014 cases in the LATG group)were included.Compared with the LATG group,reduced intraoperative blood loss(weighted mean difference=-35.37,95%CI:-61.69--9.06,P=0.008)and a larger number of retrieved lymph nodes(weighted mean difference=3.11,95%CI:-2.60-12.00,P=0.01)were found in the TLTG group.There were no significant differences in operating time,anastomotic time,tumor size,proximal resection margin length,postoperative pain score,time to first flatus,time to first oral intake,postoperative hospital stay,postoperative anastomosis-related complication rate and overall complication rate between the two groups(P>0.05).CONCLUSION Intracorporeal esophagojejunostomy is safe and feasible.TLTG has the advantages of being minimally invasive,reduced intraoperative blood loss and easier access to lymph nodes compared with LATG.Totally laparoscopic gastrectomy is likely to be the surgical trend for gastric cancer in the future.
