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Background: Previous retrospective studies have shown that laparoscopic spleen-preserving D2 total gastrectomy (LSTG) for advanced upper third gastric cancer (AUTGC) is safe. However, all previous studies were underpowered. We therefore conducted a prospective, multicenter study to evaluate the technical safety and feasibility of LSTG for patients with AUTGC. Methods: Patients diagnosed with AUTGC (cT2-4a, N−/+, M0) underwent LSTG at 19 institutions between September 2016 and October 2017 were included. The number of No. 10 lymph node (LN) dissections, metastasis rates, intraoperative and postoperative complications were investigated. Results: A total of 251 patients were enrolled in the study, and 242 patients were eligible for the per protocol analysis. The average numbers of No. 10 LN dissections and metastases were 2.4 and 0.1, respectively. Eighteen patients (7.4%) had No. 10 LN metastases, and among patients with advanced gastric cancer, the rate of No. 10 LN metastasis was 8.1% (18/223). pN3 status was an independent risk factor for No. 10 LN metastasis. Intraoperative complications occurred in 7 patients, but no patients required conversion to open surgery or splenectomy. The overall postoperative complication rate was 13.6% (33/242). The major complication and mortality rates were 3.3% (8/242) and 0.4% (1/242), respectively. The number of retrieved No. 10 LNs, No. 10 LN metastasis and TNM stage had no significant influence on postoperative complication rates. Conclusion: LSTG for AUTGC was safe and effective when performed by very experienced surgeons, this technique could be used in patients who needed splenic hilar lymph node dissection.

Shaking table is an important component in rapid detection system of microorganisms. Based on the discussion regarding the advantage and shortage of the shaking table, this paper proposed a simple, reliable, and low-cost automatic shaking table. Three mechanisms were discussed with the achievement of reciprocating motion: slide-crank mechanism, follower-cam mechanism, and incomplete gear mechanism. The three mechanisms were compared in mechanical motion pair, motion form, component design, and manufacturing process. The slide-crank mechanism was finally determined. To overcome the strong oscillation of the liquid in the test tube along a single direction, this paper improved the slider-crank mechanism, and whose trajectory was modified into an irregular circle.