Outcomes Based on Risk Assessment of Anastomotic Leakage after Rectal Cancer Surgery

Gong, Jian-Ping,Yang, Liu,Huang, Xin-En,Sun, Bei-Cheng,Zhou, Jian-Nong,Yu, Dong-Sheng,Zhou, Xin,Li, Dong-Zheng,Guan, Xin,Wang, Dong-Feng Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.2

Purpose: Anastomotic leakage (AL) is associated with high morbidity and mortality, high reoperation rates, and increased hospital length of stay. Here we investigated the risk factors for AL after anterior resection for rectal cancer with a double stapling technique. Patients and Methods: Data for 460 patients who underwent primary anterior resection with a double stapling technique for rectal carcinoma at a single institution from 2003 to 2007 were prospectively collected. All patients experienced a total mesorectal excision (TME) operation. Clinical AL was defined as the presence of leakage signs and confirmed by diagnostic work-up according to ICD-9 codes 997.4, 567.22 (abdominopelvic abscess), and 569.81 (fistula of the intestine). Univariate and logistic regression analyses of 20 variables were undertaken to determine risk factors for AL. Survival was analysed using the Cox regression method. Results: AL was noted in 35 (7.6%) of 460 patients with rectal cancer. :Median age of the patients was 65 (50-74) and 161 (35%) were male. The diagnosis of AL was made between the 6th and 12th postoperative day (POD; mean 8th POD). After univariate and multivariate analysis, age (p=0.004), gender (p=0.007), tumor site (p<0.001), preoperative body mass index (EMI) (p<0.001), the reduction of TSGF on 5th POD less than 10U/ml (p=0.044) and the pH value of pelvic dranage less than or equal to 6.978 on 3rd POD (p<0.001) were selected as 6 independent risk factors for AL. It was shown that significant differences in survival of the patients were AL-related (p<0.001), high ASA score related (p=0.036), high-level EMI related (p=0.007) and advanced TNM stage related <p<0.001). Conclusions: AL after anterior resection for rectal carcinoma is related to advanced age, low tumor site, male sex, high preoperative EMI, low pH value of pelvic drainage on POD 3 and a significant reduction of TSGF on POD 5. In addition to their high risk of immediate postoperative morbidity and mortality, AL, worse physical status, severe obesity and advanced TNM stage have similarly negative impact on survival.

论民法上处分行为之独立性

朱建農(Zhu, Jian-nong),权,承文(Quan, Cheng-wen) 조선대학교 법학연구원 2011 法學論叢 Vol.18 No.1

The concept of “Verfügungsgeschäfte” in German law is similar with the “act of disposition”. The establishment of the concept of “Verfügungsgeschäfte” and the doctrine of independence of Verfügungsgeschäfte reflecting the characteristics of German law are the great achievements of legislative practice of civil law and the success of law study in Germany. The rules and the concept related to the Verfügungsgeschäfte represent the principle of private autonomy in the market economy. In China, it is more than decade that the theory of Verfügungsgeschäfte has been argued since the beginning of the drafting of the Civil Code, but this result is still ambiguous now. In this essay, the authors holds an idea that the essential and original meaning of Verfügungsgeschäfte and the doctrine of independence of Verfügungsgeschäfte in Chinese civil law should be rediscovered and upheld. This essay consists of four parts. The first part presents a brief introduction to the concept of Verfügungsgeschäfte in Geman civil law and its exact meaning, and reveals its origin of Roman law through describing the evolution of the concept. Up to the end of 19th century when German Civil Law was drown up, the doctrine of distinction between Verfügungsgeschäfte and Verpflichtungsgeschäfte was accepted. But until the beginning of the 20th century that the precise interpretation of the Verfügungsgeschäfte was not brought to light. Later, this doctrine spreaded wide in the countries of civil law system such as Switzerland and previous ROC, etc. The concept of Verfügungsgeschäfte is attached importance in Japanese academy too, although it does not appear in Japanese Civil Law. But, what is the base or reason of distiguishing Verfügungsgeschäfte from Verpflichtungsgeschäfte? Some people think that it’s the distiction between real rights and claims, and other people think the difference of the effects of the lagel acts. This essay holds the latter, as both claims rights and dominance rights may be the objects of Verfügungsgeschäfte. So we can say that the distiguishing between real rights and claims cannot directly lead to that between Verfügungsgeschäfte and Verpflichtungsgeschäfte. In the second part, the authors discuss the relation between Verfügungsgeschäfte and right of disposition(Zuständigkeit des Verfügenden) and, further, various types of Verfügungsgeschäfte. The authors divide the Verfügungsgeschäfte into four types in accordance with the effects of Verfügungsgeschäfte. The third part is the main body of this essay. In this part, the authors introduce the present situation of Chinese legislation of civil law. There are three types of rules related to Verfügungsgeschäfte in Chinese law. The first, Real Right Law and Contract Law of China have set some rules about the legal acts which have substantial nature of Verfügungsgeschäfte, such as the transfering of earnest money and borrowing materials, giving up of rights and offsetting of debts, and performing obligation by third party, ect.. The second, there is a great number of rules in laws with the concept of Verfügungsgeschäfte. The third, there are some rules about legal acts analogous with the Verfügungsgeschäfte. The last part of the essay is the conclusion: the doctrine of independence of Verfügungsgeschäfte should beaccepted in China civil law. This conclusion is based on some reasons. The first reason is that the objective differences of the intention expressions should be recognized, and the second one, the principle of private autonomy, including the freedom of disposition of rights, as a legal ethic and legislative policy in market economy should be respected. What’s more, the recognition of the independence of “처분행위”의 개념과 “처분행위독립”원칙은 독일에서의 오랜기간 민법학 연구와 입법실무의 성과이며 독일민법의 특색을 체현하고 있다. 처분행위의 개념과 유관 제도는 시장경제체제하의 민법의식 자유원칙 방면에서 강력한 도구적인 작용을 한다. 이 개념과 제도는 대륙법계민법에 중요한 영향을 일으켰으며 현대 모든 대륙법계민법학에서 중시를 돌리지 않으면 안될 위치에 이르렀다. 중국에선 지난세기 말부터 민법전 입법작업을 시작 처분행위의 이론문제에 관하여 십여년의 토론을 지속하여 왔지만 여러 가지 원인으로 이 이론에 관한 연구는 중국에서 기로에 들어설 위험에 봉착하였는바 그로 인한 입법도 불명확한 현상이 출현하였는데 이런 현상은 법학이론계의 응당한 중시를 일으켜야 하는 바이다. 비록 주도적인 이론은 물권행위의 독자성을 승인하지 않지만 입법은 “처분”개념을 대량적으로 사용하고 있으며 이미 대량적인 실제적인 “처분행위”성질의 법률행위를 규정하고 있다. 이런 상황에서 법학은 제도구조 본신의 합리성을 진지하게 검토해야 하며 의도적인 법률개념 곡해를 통해 입법상의 모순과 결함을 해석하려 해서는 안된다. 이로써 아직도 중국의 민법이론과 입법과정에는 일부 위기가 잠재해 있음을 알 수 있다. 혹은 이런 위기가 중국법학자들의 실무과정에서 이미 나타가고 있는데도 그것을 인정하지 않을 뿐이다. 물론 독립처분행위의 개념이 실제 판결과정에서 승인을 받고 이론상의 혼란을 수정하는데 관하여 입법 혹은 사법기관의 공식적인 법률문서가 필요할 뿐만 아니라 명확한 문자설명으로 새롭게 규범화 하여야만 비로소 민법체계의 완정성과 조화로움을 유지할수 있다. 이글에서는 주로 중국민법의 처분행위 독립원칙에 대한 합리적인 태도를 논하는바 사실기초, 논리의 정책기초, 체계상의 논리요구 등 세 가지 측면에서 중국민법학에서 처분행위의 독립성 응당한 의의를 회복하고 중국민법학에서 처분행위와 부담행위의 분리를 승인할 것을 제시 하는바 이는 현실적인 의의 뿐만 아니라 현행입법의 기초이기도 하기 때문이다.

论民法上处分行为之独立性

朱建農(Zhu, Jian-nong) , 权 , 承文(Quan, Cheng-wen) 조선대학교 법학연구원 2011 法學論叢 Vol.18 No.1

“처분행위”의 개념과 “처분행위독립”원칙은 독일에서의 오랜기간 민법학 연구와 입법실무의 성과이며 독일민법의 특색을 체현하고 있다. 처분행위의 개념과 유관 제도는 시장경제체제하의 민법의식 자유원칙 방면에서 강력한 도구적인 작용을 한다. 이 개념과 제도는 대륙법계민법에 중요한 영향을 일으켰으며 현대 모든 대륙법계민법학에서 중시를 돌리지 않으면 안될 위치에 이르렀다. 중국에선 지난세기 말부터 민법전 입법작업을 시작 처분행위의 이론문제에 관하여 십여년의 토론을 지속하여 왔지만 여러 가지 원인으로 이 이론에 관한 연구는 중국에서 기로에 들어설 위험에 봉착하였는바 그로 인한 입법도 불명확한 현상이 출현하였는데 이런 현상은 법학이론계의 응당한 중시를 일으켜야 하는 바이다. 비록 주도적인 이론은 물권행위의 독자성을 승인하지 않지만 입법은 “처분”개념을 대량적으로 사용하고 있으며 이미 대량적인 실제적인 “처분행위”성질의 법률행위를 규정하고 있다. 이런 상황에서 법학은 제도구조 본신의 합리성을 진지하게 검토해야 하며 의도적인 법률개념 곡해를 통해 입법상의 모순과 결함을 해석하려 해서는 안된다. 이로써 아직도 중국의 민법이론과 입법과정에는 일부 위기가 잠재해 있음을 알 수 있다. 혹은 이런 위기가 중국법학자들의 실무과정에서 이미 나타가고 있는데도 그것을 인정하지 않을 뿐이다. 물론 독립처분행위의 개념이 실제 판결과정에서 승인을 받고 이론상의 혼란을 수정하는데 관하여 입법 혹은 사법기관의 공식적인 법률문서가 필요할 뿐만 아니라 명확한 문자설명으로 새롭게 규범화 하여야만 비로소 민법체계의 완정성과 조화로움을 유지할수 있다. 이글에서는 주로 중국민법의 처분행위 독립원칙에 대한 합리적인 태도를 논하는바 사실기초, 논리의 정책기초, 체계상의 논리요구 등 세 가지 측면에서 중국민법학에서 처분행위의 독립성 응당한 의의를 회복하고 중국민법학에서 처분행위와 부담행위의 분리를 승인할 것을 제시 하는바 이는 현실적인 의의 뿐만 아니라 현행입법의 기초이기도 하기 때문이다. The concept of “Verfügungsgeschäfte” in German law is similar with the “act of disposition”. The establishment of the concept of “Verfügungsgeschäfte” and the doctrine of independence of Verfügungsgeschäfte reflecting the characteristics of German law are the great achievements of legislative practice of civil law and the success of law study in Germany. The rules and the concept related to the Verfügungsgeschäfte represent the principle of private autonomy in the market economy. In China, it is more than decade that the theory of Verfügungsgeschäfte has been argued since the beginning of the drafting of the Civil Code, but this result is still ambiguous now. In this essay, the authors holds an idea that the essential and original meaning of Verfügungsgeschäfte and the doctrine of independence of Verfügungsgeschäfte in Chinese civil law should be rediscovered and upheld. This essay consists of four parts. The first part presents a brief introduction to the concept of Verfügungsgeschäfte in Geman civil law and its exact meaning, and reveals its origin of Roman law through describing the evolution of the concept. Up to the end of 19th century when German Civil Law was drown up, the doctrine of distinction between Verfügungsgeschäfte and Verpflichtungsgeschäfte was accepted. But until the beginning of the 20th century that the precise interpretation of the Verfügungsgeschäfte was not brought to light. Later, this doctrine spreaded wide in the countries of civil law system such as Switzerland and previous ROC, etc. The concept of Verfügungsgeschäfte is attached importance in Japanese academy too, although it does not appear in Japanese Civil Law. But, what is the base or reason of distiguishing Verfügungsgeschäfte from Verpflichtungsgeschäfte? Some people think that it’s the distiction between real rights and claims, and other people think the difference of the effects of the lagel acts. This essay holds the latter, as both claims rights and dominance rights may be the objects of Verfügungsgeschäfte. So we can say that the distiguishing between real rights and claims cannot directly lead to that between Verfügungsgeschäfte and Verpflichtungsgeschäfte. In the second part, the authors discuss the relation between Verfügungsgeschäfte and right of disposition(Zuständigkeit des Verfügenden) and, further, various types of Verfügungsgeschäfte. The authors divide the Verfügungsgeschäfte into four types in accordance with the effects of Verfügungsgeschäfte. The third part is the main body of this essay. In this part, the authors introduce the present situation of Chinese legislation of civil law. There are three types of rules related to Verfügungsgeschäfte in Chinese law. The first, Real Right Law and Contract Law of China have set some rules about the legal acts which have substantial nature of Verfügungsgeschäfte, such as the transfering of earnest money and borrowing materials, giving up of rights and offsetting of debts, and performing obligation by third party, ect.. The second, there is a great number of rules in laws with the concept of Verfügungsgeschäfte. The third, there are some rules about legal acts analogous with the Verfügungsgeschäfte. The last part of the essay is the conclusion: the doctrine of independence of Verfügungsgeschäfte should beaccepted in China civil law. This conclusion is based on some reasons. The first reason is that the objective differences of the intention expressions should be recognized, and the second one, the principle of private autonomy, including the freedom of disposition of rights, as a legal ethic and legislative policy in market economy should be respected. What’s more, the recognition of the independence of

DIAGNOSIS OF COOLING FAN FAILURE OF TRACTION MOTORS OF INTERCITY CARS

Nong Zhang,Sergei Kasian,Jianing He 한국소음진동공학회 1997 한국소음진동공학회 국제학술대회논문집 Vol.1997 No.1

Diagnosis of Cooling Fan Failure of Traction Motors of Intercity Cars : A Case Study

Nong Zhang,Sergei Kasian,Jianing He 대한기계학회 1997 Asia-Pacific Vibration Conference Vol.1 No.1

Clinical Observations on Treatment for Chinese Patients with Gastrointestinal Stromal Tumors

He, Zhan-De,Huang, Xin-En,Zhou, Jian-Nong Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.12

Background: To investigate the diagnostic and treatment methods for Chinese patients with gastrointestinal stromal tumor (GIST). Materials and Methods: From January 2004 to June 2014, patients diagnosed with primary GIST and treated by a single medical team in the Department of Digestive Disease of XuYi Hospital of Traditional Chinese Medicine were retrospectively recruited. Re-examination and follow-up was conducted regularly and abdominal enhanced CT, blood biochemistry and responses to surgery or imatinib were recorded. Results: A total of 15 patients were enrolled, including 9 male and 6 female patients, with an average age of 54 years (ranging from 32-81 years). The primary symptoms were abdominal uncomfortable in 5 patients, abdominal pain in 6 patients as well as nausea and vomiting in 4 patients. One patient was diagnosed with bowl obstruction at the first visit. All patients were treated with surgery, and tumor site was confirmed 1 esophagus, 6 stomach, 4 small bowel, and 4 colorectal and all patients were pathologically diagnosed with GIST. Immunochemical test positive for CD 117 was found 12 patients, and positive for CD 34 in7 patients. The median follow-up time was 24 months (range of 3-63). Three metastasis were confirmed 1.5, 2 and 2.6 years postoperatively. Three patients were treatment by imatinib postoperatively. Conclusions: Surgery remains the main treatment method for Chinese patients with GIST and imatinib could be feasible and safe for treating Chinese patients with GIST.

Comparative Study on the Value of Anal Preserving Surgery for Aged People with Low Rectal Carcinoma in Jiangsu, China

Yu, Dong-Sheng,Huang, Xin-En,Zhou, Jian-Nong Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.5

Objective: To compare the efficacy of anal preserving surgery for aged people with low rectal carcinoma. Methods: Clinical data for a consecutive cohort of 98 rectal cancer patients with distal tumors located within 3cm -7cm of the anal verge were collected. Among these, 42 received anal preserving surgery (35 with Dixon, 3 with Parks and 4 with transanal operations). The local recurrence and survival rates in the above operations were compared with those of the Miles operation in another 56 patients with rectal cancer. Results: The local recurrence and 3-, 5-year survival rates of anal preserving surgery were 16.7%, 64.3% and 52.4%, those of Miles operations were 16.1%, 67.9% and 51.8% respectively (P>0.05). Conclusion: Anal preserving surgery for aged people with low rectal cancer is not inferior to conventional operations in China, with satisfactory long term survival and comparable local recurrence rates.

Risk Assessment on Anastomotic Leakage after Rectal Cancer Surgery: An Analysis of 753 Patients

Yang, Liu,Huang, Xin-En,Zhou, Jian-Nong Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.7

Purpose: To investigate the risk factors for anastomotic leakage (AL) after anterior resection for rectal cancer with a double stapling technique. Patients and Methods: Between January 2004 and December 2011, 753 consecutive patients in Jiangsu Cancer Hospital and Research Institute diagnosed with rectal cancer and undergoing anterior resection with a double stapling technique were recruited. All patients experienced a total mesorectal excision (TME) operation. Additionally, decrease of postoperative tumor supplied group of factors (TSGF), which have not been reported before, was proposed as a new indicator for AL. Univariate and multivariate analysis were performed to determine risk factors for AL. Results: AL was detected in 57 (7.6%) of 753 patients with rectal cancer. The diagnosis of anastomotic leakage was confirmed between the 6th and 12th postoperative day (POD; mean 8th POD). After univariate analysis and multivariate analysis, age (p<0.001), gender (p=0.002), level of anastomosis (p<0.001), preoperative body mass index (BMI) (p=0.001) and reduction of TSGF in 5th POD was less than 10 ${\mu}/ml$ (p<0.001) were selected as 5 independent risk factors for AL. It was also indicated that a temporary defunctioning transverse ileostomy (p=0.04) would decrease the occurrence of AL. Conclusion: AL after anterior resection for rectal carcinoma is related to elderly status, low level site of the tumor (below the peritoneal reflection), being male, preoperative BMI and the decrease of TSGF in $5^{th}$ POD is less than 10 ${\mu}/ml$. Preventive ileostomy is advisable after TME for low rectal tumors to prevent AL.

Analysis of Small Fragment Deletions of the APC gene in Chinese Patients with Familial Adenomatous Polyposis, a Precancerous Condition

Chen, Qing-Wei,Zhang, Xiao-Mei,Zhou, Jian-Nong,Zhou, Xin,Ma, Guo-Jian,Zhu, Ming,Zhang, Yuan-Ying,Yu, Jun,Feng, Ji-Feng,Chen, Sen-Qing Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.12

Background: : Familial adenomatous polyposis (FAP) is an autosomal dominant inherited disease mainly caused by mutations of the adenomatous polyposis coli (APC) gene with almost complete penetrance. These colorectal polyps are precancerous lesions that will inevitable develop into colorectal cancer at the median age of 40-year old if total proctocolectomy is not performed. So identification of APC germline mutations has great implications for genetic counseling and management of FAP patients. In this study, we screened APC germline mutations in Chinese FAP patients, in order to find novel mutations and the APC gene germline mutation characteristics of Chinese FAP patients. Materials and Methods: The FAP patients were diagnosed by clinical manifestations, family histories, endoscope and biopsy. Then patients peripheral blood samples were collected, afterwards, genomic DNA was extracted. The mutation analysis of the APC gene was conducted by direct polymerase chain reaction (PCR) sequencing for micromutations and multiplex ligation-dependent probe amplification (MLPA) for large duplications and/or deletions. Results: We found 6 micromutations out of 14 FAP pedigrees, while there were no large duplications and/or deletions found. These germline mutations are c.5432C>T(p. Ser1811Leu), two c.3926_3930delAAAAG (p.Glu1309AspfsX4), c.3921_3924delAAAA (p.Ile1307MetfsX13), c3184_3187delCAAA(p.Gln1061AspfsX59) and c4127_4126delAT (p.Tyr1376LysfsX9), respectively, and all deletion mutations resulted in a premature stop codon. At the same time, we found c.3921_3924delAAAA and two c.3926_3930delAAAAG are located in AAAAG short tandem repeats, c3184_3187delCAAA is located in the CAAA interrupted direct repeats, and c4127_4128 del AT is located in the 5'-CCTGAACA-3', 3'-ACAAGTCC-5 palindromes (inverted repeats) of the APC gene. Furthermore, deletion mutations are mostly located at condon 1309. Conclusions: Though there were no novel mutations found as the pathogenic gene of FAP in this study, we found nucleotide sequence containing short tandem repeats and palindromes (inverted repeats), especially the 5 bp base deletion at codon 1309, are mutations in high incidence area in APC gene,.

Advanced Modeling and Services Based Mathematics for Ubiquitous Computing

Park, Jong Hyuk,Shen, Hong,Cao, Jian-nong,Xhafa, Fatos,Jeong, Young-Sik Hindawi Limited 2015 Mathematical problems in engineering Vol.2015 No.-