Objective To explore the clinical significance and the impact on prognosis of blood micrometastasis in the patients with pN0 esophageal squamous cell carcinoma. Methods Total RNA was extracted with TRIzol and mRNA was transcribed reversely into cDNA. RT-PCR was used to detect MMP-7 mRNA and hTERT mRNA in blood. △△Ct sample values were calculated with post-operative follow-up of 3 month, 6 month, 12 month. Results Statistical results suggested that blood micrometastasis was related to differentiation grade and pTNM staging (P=0.000, P=0.000 respectively), but not to age, sex, length of turnout (P0.05). Follow-up results suggested that the degree of invasion and tumor metastasis (recurrence) was no correlation; follow-up to 6 month and 12 month, tumor metastasis (recurrence) was associated with blood micrometastasis, and follow-up to 12 month, compared with the tumor metastasis (recurrence) probability of blood micrometastasis-positive patients and negative patients, the former was as 6.44 times as the latter. (OR=6.440, 95 % CI 1.547-26.822). Conclusion Blood micrometastasis testing is of great significance to early diagnosis and prognosis judgment in pN0 esophageal squamous cell carcinoma patients.

Objective To observe the therapeutic effect of scleral buckling procedure on old retinal detachment. Methods The clinical data of 42 patients (46 eyes), including 24 males (27 eyes) and 18 females (19 eyes), with old retinal detachment treated by scleral buckling procedure in our department were retrospectively reviewed. The duration of the disease ranged from 1 month to 2 years. All the patients were with rhegmatogenous retinal detachment and combined with mainly predominantly-subretinal proliferative vitreoretinopathy (PVR) (stage C), including stage C1 of PVR in 16 eyes (34.8%), stage C2 in 19 eyes (41.3%), and stage C3 in 11 eyes (23.9%). Scleral buckling was performed on 13 eyes (283%) and cerclage combined buckling on 33 eyes (71.7%). Sterile air was injected into 36 eyes (78.3%) during the operation, and C3F8 was introvitreal injected into 7 eyes (15.2%) after the operation. Results The follow-up duration was from 6 months to 1 year (mean 7.3 months). Retina was completely reattached in 31 eyes (67.4%), and was alleviated obviously in 12 eyes (26.1%). The subretinal fluid increased after the operation with un-reattached retina and vitrectomy was performed in 2 eyes. One eye underwent vitrectomy due to the development of PVR. After the first operation, the curative ratio of retinal detachment was 67.4%, and effective ratio (cure and alleviation) was 93.5%. The visual acuity improved in 28 eyes (60.9%), kept no change in 11 eyes (23.9%), and decreased in 7 eyes (15.2%). Conclusion Reattachment of retina and improvement of visual acuity can be achieved in some degree in some patients with old retinal detachment who undergo simple scleral buckling procedure without vitrectomy.

AIM:To study the correlation of serum uric acid ( UA) level with carotid plaques and arterial stiff-ness in the patients with essential hypertension ( EH) , and to explore the predictive value of serum UA for evaluating EH preclinically .METHODS:A total of 92 patients with EH and 30 healthy individuals were enrolled .The value of UA and other indicators were detected .B-mode ultrasound examination was performed to measure the common carotid artery intima -media thickness ( IMT) and the sites of plaque in the internal carotid-artery, external carotid artery and carotid bifurca-tions.Carotid-femoral arterial pulse wave velocity ( CFPWV) was assessed by Complior?atherosclerosis measurement in-strument.RESULTS:The serum level of UA in the patients with EH was higher than that in control group [(361.51 ± 83.81) μmol/L vs (317.03 ±62.22) μmol/L, P<0.05].The mean value and abnormal rate of IMT between hyperten-sion group and control group were significant difference [(0.69 ±0.14) mm vs (0.60 ±0.12) mm, 42.39%vs 10.00%, P<0.05].In 92 EH patients, 45 cases had carotid plaques .These 45 cases were divided into 3 groups according to the plaque severity, among which the serum UA level had statistically significant differences [(285.25 ±78.41) μmol/L, (341.19 ±63.99) μmol/L and (401.33 ±88.49) μmol/L, P<0.05].Compared with rigid plaque group ( n=34), the serum UA level in soft plaque group (n=11) was significantly higher [(389.00 ±69.45) μmol/L vs (323.03 ± 72.71) μmol/L, P<0.05].A stepwise multiple linear regression analysis demonstrated that age ( r=0.414), systolic blood pressure (r=0.224), pulse pressure (r=0.270) and uric acid (r=0.219) were predisposed factors for higher CFP-WV (P<0.05).CONCLUSION:UA is one of the risk factors causing hypertension .Serum UA level may reflect the sever-ity and stability of carotid plaques .The increased arterial stiffness is closely related to the increased serum UA level in EH .

In this paper,we made an analysis of the organization and content settings of medical laboratory students' summer clinical practices,and summarizes the students' achievements and experience of clinical practices in many years.Standardized organization and reasonable content settings are the guarantees for the students to have a comprehensive understanding of the basic major contents.Through the summer clinical practices,students can have a good understanding of their major in short period of time.

Objective To explore the relationship between genetic polymorphisms of ADIPOR2 with serum APN level ,inti‐ma‐media thickness(IMT)and atherothrombosis cerebral infarction risk .Methods The case control study was adopted ,300 patients with atherothrombosis cerebral infarction in our hospital from September 2009 to September 2014 were selected as the observation group ,meanwhile contemporaneous 300 individuals undergoing the physical examination were selected as the control group .The clinical data in all the subjects were collected and performed the carotid arterial examination ,the serum APN level was detected ,the rs12342 polymorphism of ADIPOR2 gene was detected .The genetic polymorphisms of ADIPOR2 were compared between the two groups and its relationship with serum APN and IMT was analyzed .Results The probability for suffering from atherothrombosis cerebral infarction in the AA genotype was increased compared with the GG genotype ,the difference was statistically significant (OR=1 .903 ,95% CI:1 .092-2 .703 ,P=0 .011) .Compared with the control group ,the IM T values in various subgenotype groups of the observation group were elevated ,while the APN levels were decreased ,the differences were statistically significant ( P<0 .01) .Compared with the genotype GG ,the IM T values in the genotype AA and AG were increased and APN levels were de‐creased ,the differences were statistically significant (P<0 .01) .Conclusion Genetic polymorphisms of ADIPOR2 maybe a genetic locus for the pathogenesis of Chinese Han people of atherothrombosis cerebral infarction .

Objective To explore the adaptive modulation of brain in structure and function when moving to high altitude areas based on voxel-based morphometry (VBM),amplitude of low frequency fluctuation (ALFF)and regional homogeneity (ReHo) method.Methods Resting-state functional magnetic resonance imaging (fMRI)of brain was respectively performed in 1 9 normal adults who moved to high altitude areas within a week,and they have matched age and education level.The subj ects were performed the same scanning after one year.The VBM,ALFF and ReHo methods were adopted to analyze the functional MRI data.Results There were no significant differences in brain structure between the two groups.There were significant differences in brain function in resting state.Subj ects staying in high altitude areas for one year had increased ALFF in left middle frontal gyrus,decreased ALFF in right lingual gyrus(P<0.01),increased ReHo in the left orbital frontal gyrus,and decreased ReHo in right cuneus and right superior parietal gyrus(P<0.05).Conclusion There are significant changes in brain function of normal adult after stayed in high altitude for one year,which might be associated with long-term chronic hypoxia.

Objective To observe the clinical effects of pars plana vitrectomy (PPV) combined with internal limiting membrane peeling (ILMP) for macular hole (MH) and macular retinoschisis in high myopic eyes,and to analyze factors affecting the MH closure rate.Methods This is a retrospective case study.21 high myopic patients (22 eyes) with MH and macular retinoschisis were enrolled in this study.All eyes were examined for best corrected visual acuity (BCVA),intraocular pressure,slit lamp microscope,indirect ophthalmoscope,A and/or B-scan ultrasound,optical coherence tomography and visual electrophysiological examination.The BCVA was ranged from finger counting to 0.2.The axial length (AL) was ranged from 26.00 to 31.00 mm,with an average of 27.47 mm.Among 22 eyes,AL was between 26.00 mm to 27.00 mm in 9 eyes,27.10 mm to 28.00 mm in 5 eyes,28.10 mm to 29.00 mm in 3 eyes,29.10 mm to 30.00 mm in 3 eyes,and longer than 30.00 mm in 2 eyes.The diameter of MH was ranged from 227 μm to 597 μm and with an average of 432 μm.Among them,the minimum diameter was between 200 μm to 400 μm in 4 eyes,401 μm to 450 μm in 13 eyes,451 μm to 500 μm in 3 eyes,501 μm to 600 μm in 2 eyes.All the eyes were treated with PPV combined with ILMP surgery.The average follow-up time was 17 months after surgery.The efficacy was determined at the final follow up,including the MH closure,the state of macular retinoschisis and the BCVA.MH closure rate with different MH diameters and different AL were compared and analyzed.Results During the final followup,MH were fully closed in 17 eyes (77.3％),bridge-closed in 4 eyes (18.2％) and not closed in 1 eye (4.5％).Retinoschisis was resolved in 19 eyes (86.4％),partially resolved in 2 eyes (9.1％) and not changed in 1 eye (4.4％).MH with smaller diameter had higher MH closure rate (x2=12.036,P=0.032).MH with longer AL had lower MH closure rate (x2=16.095,P=0.003).The final BCVA was ranged from finger counting to 0.25.Among 22 eyes,BCVA or metamorphopsia were improved in 9 eyes (40.9％),stable in 8 eyes (36.4％).BCVA was reduced and metamorphopsia was more severe in 5 eyes (22.7％).Conclusions PPV combined with ILMP is a safe and effective surgical treatment for MH (with minimum diameter ≤600 μm) and macular retinoschisis in high myopic eyes.After surgery,MH was closed and retinoschisis was resolved in most patients.The major factors affect the MH closure were the minimum diameter of MH and AL.

Objective investigate the correlation between plasma soluble receptor for advanced glycation endproducts (sRAGE) and arterial stiffness in patients with different types of metabolic syndrome (MS).Methods A total of 180 subjects were drawn from a epidemiologic follow-up study,including 60 cases non-metabolic syndrome (NMS),60 cases metabolic syndrome without diabetes mellitus (NDMMS),60 cases metabolic syndrome with diabetes mellitus (DMMS).Carotid femoral arterial pulse wave velocity (CFPWV) was assessed by the French KangPuLe atherosclerosis measurement instrument,and plasma sRAGE levels were measured by ELISA.Comparison of mean in multiple groups was conducted by analysis of variance.Multivariate analysis was done with multiple linear stepwise regression analysis.P ＜ 0.05 was considered as statistically significant difference.Results Compared with NMS group,plasma sRAGE levels were significantly lower in DMMS and NDMMS groups [(635.07 ± 229.20) pg/mL vs.(671.17 ± 358.16) pg/mL vs.(992.99 ± 427.83) pg/mL,P =0.001].CFPWV of DMMS group was significantly higher than that of NMDMS and NMS groups (14.22 ±3.14) m/s vs.(12.15 ±2.79) m/s vs.(11.66 ± 2.52) m/s,P =0.002).Plasma sRAGE level was negatively correlated with CFPWV (r =-0.278,P =0.005).(3) Multiple linear regression analysis demonstrated that age (β =-0.091,95％ CI-0.096 ～-0.095,P =0.031),HDL-C (β =1.295,95％ CI 1.231 ～ 1.360,P =0.022) and sRAGE (β =0.119,95％ CI 0.118 ～ 0.130,P =0.032) had a significant effect on CFPWV.Conclusions The increased arterial stiffness is closely related to the discreased plasma sRAGE levels in MS.Plasma sRAGE maybe a novel target for vascular disease prevention and treatment in patients with metabolic syndrome.

To reduce morbidity and mortality and improve quality of life for patients with diabetes,the China Da Qing Diabetes Prevention Study was initiated as health education and behavior intervention in the 1980s in Daqing City.576 subjects with impaired glucose tolerance (IGT) were recruited and randonized into a clinical trial,either to a control group or to one of three active treatment groups:diet only,exercise only,or diet plus exercise.Follow-up evaluation examinations were conducted 2-year intervals over a 6-year period and after 20-year period to identify subjects who developed diabetes mellitus.Diet and/or exercise interventions led to a significant decrease in the incidence of diabetes over a 6-year and 20-year period among those with IGT.The implementation of this study indicates that diabetes can be prevented through health education and behavioral intervention,and the prevention of diabetes and other chronic diseases should also focused on strengthening the muhi-sectoral cooperation,developing professional skills of health care providers,re-orientating health care services toward prevention of illness and promotion of health.

Objective To observe the effect of electroacupuncture in preventing delayed cerebral vasospasm (DCVS).Method Sixteen healthy Japanese big ear rabbits were randomized into a treatment group and a control group, 8 in each group. The treatment group was developed into models by intramuscular anesthesia on the 6th day after 5 days’ 20-min daily intervention of transcutaneous acupoint electrical stimulation during a specific time period; the control group was developed into models by the same way on the 6th day but without electrical stimulation. The diameter of basilar artery was measured by using CTA prior to the electrical stimulation and after modeling in both groups, the plasma levels of ET-1, CGRP, and IL-6 were detected, and behavioral changes 1 d, 3 d, and 5 d after modeling were observed.Result After modeling, there was a significant difference in comparing the basilar artery diameter between the two groups (P<0.05). The plasma levels of ET-1, CGRP, and IL-6 in the treatment group were significantly different from that in the control group (P<0.05). In the treatment group, the neural function scores 3 d and 5 d after modeling were markedly different from that 1 d after modeling (P<0.05). There were significant differences in comparing the neural function scores 3 d and 5 d after modeling between the two groups (P<0.05).Conclusion Pre-intervention with electroacupuncture prevents and improves DCVS possibly via modulating the levels of ET-1, CGRP, and IL-6, and subsequently involving in anti-inflammation, immune inhibition, and vasodilation.