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简介：Baseduponstudiesfromrandomizedclinicaltrials,theextended(D2)lymphnodedissectionisnowrecommendedasastandardprocedureforlocaladvancedgastriccancerworldwide.However,therationalextentlymphadenectomyforlocaladvancedgastriccancerhasremainedatopicofdebateinthepastdecades.Duetothelimitationoflowmetastaticrateinpara-aorticnodes(PAN)inJCOG9501,theclinicalbenefitofD2+para-aorticnodaldissection(PAND)forpatientswithstageT4and/orstageN3disease,whichisverycommoninChinaandothercountriesexceptJapanandKorea,cannotbedetermined.Furthermore,theroleofsplenectomyforcompleteresectionofNo.10andNo.11nodeshasbeencontroversial,andhowever,thefinalresultsfromtherandomizedtrialofJCOG0110haveyettobecompleted.GastriccancerwiththeNo.14andNo.13lymphnodemetastasisisdefinedasM1stageinthecurrentversionoftheJapaneseclassification.WeproposethatD2+No.14vand+No.13lymphadenectomymaybeanoptioninapotentiallycurativegastrectomyfortumorswithapparentmetastasistotheNo.6nodesorinfiltratetoduodenum.Theexaminedlymphnodeandextranodalmetastasisaresignificantlyassociatedwiththesurvivalofgastriccancerpatients.

简介：Background:Apreviousstudyhasreporteda50%reductionindisuseatrophyofthequadricepsduringthefirst14daysafteranteriorcruciateligament(ACL)reconstruction.Afollow-uptrialisneededtoconfirmthesepromisingresults.ThepresentstudyaimstoinvestigatetheeffectofanocclusionstimulusonquadricepsatrophyafterACLreconstruction.Methods:Atotalof24subjectsparticipatedinthestudy.Theywererandomizedintotwogroups.Startingthe2nddayaftersurgery,theocclusiongroupreceivedanocclusionstimulusfor5min,followedbyremovaloftheocclusivepressurefor3min.Thiswasrepeatedfivetimesinonetrainingsession,twicedaily.Duringtheperiodofocclusivestimulus,thesubjectsperformed20lowloadexercisesforthequadriceps.Thecontrolgroupfollowedthesameexerciseprotocol,butwithouttheocclusionstimulus.Changesinquadricepsanatomicalcrosssectionarea(ACSA)weremeasuredusingaxialmagneticresonance(MR)imagesat40%and50%ofthelengthofthefemur.Results:BothgroupshadasignificantreductionofquadricepsACSAfrom2daysbeforesurgeryto16daysaftersurgery.Duringtheinterventionperiod,theocclusiongrouplost13.8%±1.1%(mean±SEM)andthecontrolgrouplost13.1%±1.0%oftheirquadricepsACSA,respectively.Therewasnosignificantdifferencebetweentheocclusionandcontrolgroupswithregardstoatrophyofthequadricepsmuscles.Conclusion:Inconflictwithotherstudiesusingasimilarprotocol,applicationofbloodflowrestrictionthefirst14daysafterACLreconstructiondidnotreducequadricepsACSAmuscleatrophymeasuredbyMRinapopulationofathletes.