Objective To explore the feasibility,necessity and the skill of total mesoesophageal excision (TME ) during thoracoscopy combined with laparoscopy in radical resection of esophageal carcinoma.Methods 69 patients with esophageal carcinoma were divided into the TME group(40 cases)and the thoracotomy with triple incisions group(29 cases)according to the admission sequence.The operation time,intraoperative blood loss,total lymph nodes removed,postoperative complication rate and disease -free survival were compared between the two groups.Results The operation time of TME group was (182.85 ±26.73)min,which was significantly shorter than (295.71 ±19.50)min of the thoracotomy group (t=-19.301,P<0.001).The intraoperative blood loss in TME group was (86.43 ±59.34)mL,which was significantly less than (163.47 ±58.82)mL in the thoracotomy group (t=-5.342,P<0.001 ).No significant differences were detected between the two groups in total lymph nodes removed and incidence rate of postoperative complication (all P>0.05 ).The disease-free survival period in TME group was (14.78 ±2.14)months,which in the thoracotomy group was (13.10 ±4.09)months,the difference was significant (t=2.200,P<0.05).Conclusion TME is safe and feasible during thoracoscopy combined with laparos-copy in radical resection of esophageal carcinoma.TME is better in improving the regional control in esophageal carci-noma.

Objective To investigate the effect of different promoters on the expression level of transgene containing MAR expression vector in recombinant CHO cells.Methods The CMV promoter and 3-globin MAR were amplified by PCR,then CMV promoter was replaced the SV40 promoter in pCAT1 for constructing the expression vector droved by CMV promoter.The control vectors of pCAT1 and pCAT2 without containing MAR were simultaneously transfected into the CHO cells.Then the stably transfected cell line was screened by G418.The CAT gene expression level was analyzed by ELISA.Results The expression level of CAT enzyme in the cells transfected with MAR-containing vectors was increased compared with the cells transfected by pCATG and pCAT3 vectors without containing MAR,which were increased by 1.75 and 1.25 times respectively(P＜0.05);but CAT enzyme expression level in the pCAT1 transfected cells droved by SV40 promotor with the MAR-containing expression vectors was 1.4 times higher than that in the pCAT2 vector droved by the CMV promoter(P＜0.05).Conclusion MAR can enhance the transgene expression level in stably recombinant CHO cells,and the promoting efficiency of SV40 promoter and MAR combination is superior to that of CMV promoter and MAR combination.

The literatures were searched and summarized about the autophagic operating mechanism on the TCM benefiting Qi and promoting blood circulation for the diabetes and diabetic complications. The study found that Chinese herbs with the function of benefiting Qi and promoting blood circulation could motivate the tissues's autophagy, which had good the rapeutic effect on diabetes and diabetic complications.

Objective To evaluate the incidence and imaging features of tibial plateau fracture combined with dislocation.Methods A total of 298 patients with intact imaging data treated for tibial plateau fracture from December 2012 to June 2014 were analyzed retrospcctively.Tilt angle of medial fragment fracture line,ratio of width of medial fragment to total plateau,surface area percentage,fragment height,and major displacement were measured on CT images using picture archiving and communication system (PACS).Results Eighteen patients (6.0％) had tibial plateau fractures combined with dislocation,with tilt angle of medial or posteromedial fragment fracture line of (62.1 ± 14.1)°.Eleven patients (61％) had split of the medial tibial plateau with surface area percentage of (46.3 ± 2.5) ％,fragment height of (43.9 ± 6.2) mm,and major displacement of (5.3 ± 2.1) mm.Seven patients (39％) had posteromedial fragment fracture with surface area percentage of (25.1 ± 5.7) ％,fragment height of (40.0 ± 10.1) mm,and major displacement of (4.8 ± 6.45) mm.Conclusions Fracture line of fracture-dislocation tibial plateau fracture is much often through the eminence or located at the lateral eminence with large medial or posteromedial fragments.Surgical approaches and directions of nailing should be considered properly according to the morphological characteristics.

Objective To explore the influence of cognitive-behavioral intervention on the anxiety and oral health-related quality of life in adult orthodontic patients.Methods 152 adult orthodontic patients whose MDAS scores were greater than 11 were divided into the intervention group and the control group according Multistage Grouping Process.The former were treated with MBT appliance combined with cognitive-behavioral intervention,and the latter were treated with MBT appliance only.The State-Trait Anxiety Inventory(STAI) was adopted to evaluate anxiety in all patients during orthodontic treatment,and the UK oral health-related quality of life questionnaire(OHRQoL-UK) was adopted to evaluate the oral health-related quality of life in all patients before and after orthodontic treatment,respectively.Results 1.After 3 and 6 months cognitive-behavioral intervention,the scores of SAI in the intervention group(50.37±9.18,35.65±8.92) were significantly reduced compared to the control group(56.62± 10.52,54.13± 10.03) (P＜0.01).After 6 months cognitive-behavioral intervention,the scores of TAI in the intervention group(47.92±6.82) were significantly reduced compared to the control group(51.52±7.41) (P ＜0.05).2.After the orthodontic treatment,the scores of OHRQoL-UK in the intervention group(58.27±13.43) were significantly improved compared to the control group (51.99± 11.69) (P＜ 0.01).3.The oral health-related quality of life after the orthodontic treatment were significantly related to post-treatment anxiety of adult orthodontic patients(r=-0.192 ～-0.459,P＜ 0.05).Conclusion Cognitive-behavioral intervention can effectively reduce anxiety and improve the oral health-related life quality in the adult orthodontic patients.

Objective To explore the effect of argatroban injection on serum copeptin, NT-proBNP levels and clinical efficacy in patients with acute cerebral infarction.Methods 120 patients with acute cerebral infarction were selected neural department of internal medicine in our hospital .They were randomly divided into two groups, 60 patients in control group, treated with bed rest, oxygen, nutrition support treatment, giving control of blood pressure, blood glucose, lipid symptomatic disposal according to the disease, anti platelet aggregation, nourishing brain cells and other conventional treatment, 7 days for a course of treatment two course of treatment;the experimental group in the control group based on routine treatment, the first days with argatroban 60 mg,500 mL diluted with normal saline, 60 mg/d, 24 hcontinuous intravenous infusion for second days was given argatroban 20 mg, 200 mL diluted with normal saline,continuous intravenous pumping, total treatment 14 d.After the end of treatment, compared before and after treatment in patients with NIHSS (America National Institutes of Health Stroke), Barthel score (ADL) index score, serum copeptin, NT-proBNP levels and clinical efficacy.Results The two groups after treatment in patients with neurological functions were improved, compared with the control group, patients in the experimental group the NIHSS score was significantly lower , the difference was statistically significant (P<0.05).7 days after treatment, two groups of patients with self-care ability were improved, compared with the control group, patients in the experimental group significantly increased Barthel index score, the difference was statistically significant ( P <0.05 ); 14 days after treatment, compared with control group, patients in the experimental group significantly increased Barthel index score, the difference was statistically significant (P<0.05);14 days after treatment, compared with the same group 7days after treatment, patients in the experimental group significantly increased Barthel index score, the difference was statistically significant (P<0.05).After the treatment two groups of patients with serum copeptin, NT-proBNP levels were decreased, the experimental group patients serum copeptin, NT-proBNP levels were significantly lower than the control group, the difference was statistically significant (P <0.05). Efficiency of total the experiment group (96.7%) was significantly higher than the control group (80%), the difference was statistically significant (P<0.05).Conclusion Argatroban can significantly reduce the levels of serum copeptin, NT-proBNP levels in patients with, improve self-care ability recovery of nerve function and life, has a good clinical effect.

Arg-Gly-Asp (RGD) is a unique minimal integrin-binding sequence found within several glycoprotein ligands and also in snake-venom disintegrins. Adinbitor, a protein with 73 amino acid residues including 12 cysteins and an RGD motif, was cloned from Gloydius blomhoffi brevicaudus in my laboratory. As a new member of disintegrin family, adinbitor can inhibit both human platelet aggregation induced by ADP and angiogenensis in vivo and in vitro, the typical characters of disintegrin family. To separate the effect of inhibiting platelet aggregation from that of inhibiting angiogenensis, the motif KGD was introduced into adinbitor cDNA to replace RGD by site-directed and PCR-based mutagenesis. The recombinant protein (recombinant adinbitor (KGD)) was expressed in E. coli BL21 and purified through the His· Bind affinity chromatography. Recombinant adinbitor (KGD) could inhibit ADP-induced platelet aggregation with IC50 value of 85 nmol/L. Considerably, it was a more effective inhibitor on platelet aggregation than recombinant adinbitor (RGD), which has an IC50 of 150 nmol/L. Interestingly, recombinant adinbitor (KGD) has no potency in inhibiting angiogenesis in vivo compared with recombinant adinbitor (RGD). These findings showed that KGD containing adinbitor was more suitable for inhibiting ADP-induced human platelet aggregation as a potential and specific inhibitor of human platelet aggregation, which might have promising therapeutic potential as an antithrombotic agent.

ObjectiveTo characterize the gene expression in acute phase of irradiated oligodendrocytes (OL) in vitro.Methods The total RNA was extracted from irradiated OLs with 10 Gy by 6 MV X-rays at 1 and 4 h.The Affymetrix RAT 230 2.0 microarray were used to evaluate and screen the gene expression profile.The quantitative real-time RT-PCR was performed to validate the microarray results of selected myelin basic protein (MBP) and neural cell adhesion molecule 1 ( NCAM-1 ) genes.Results Compared with un-irradiated OLs,there were 1079 different expressed genes in irradiated cells.Those genes were classified in 79 categories based on the functional classification.Some familiar genes associated with OL cellular physiological process,apoptosis,cell cycle control,metabolism,cell communication and receptor binding were included.Compared with the microarray results,the coincidence rate of real-time RT-PCR was 91.7%.The down-regulation of MBP and up-regulation of NCAM 1 gene expression were confirmed.Conclusions Radiation-induced changes in gene expression in OLs took place in acute phase and influenced by time-course.The changes of MBP and NCAM1 gene expression may play a key role in the pathogenesis of radiation-induced demyelination.

Objective The purpose of this study was to develop a database program based on Microsoft Access 2003 for patients with breast cancer to save and manage clinical data.This makes it easier to analyze data of the database.Methods A total of 1177 cases with breast cancer who were performed surgical treatment from December 1998 to June 2007,the clinical data collection which included regular fouow-up data of these patients after therapy,the database was designed by using Microsoft Access 2003 included the creation of tables,forms and queries according to the therapy guidelines for breast cancer.Results The clinical data for patients with breast cancer can be stored in an Access database that is both user-friendly with reliable data administration and that can be shared in network,and it is capable of recording regular updated data.Conclusion This program will not only convenient for researchers to statistic and analyze their outcome data,but also for minimizing data entry errors and reducing the time spent on data query.

Objective To assess the value of approximal side angle of carotid atherosclerotic plaques in patients with cerebral infarction by ultrasonography.Methods One hundred and seventy six patients with carotid atherosclerotic plaques were examined with uItrasonography and divided into two groups:cerebral infarction group (n=67)and none cerebral infarction group(n=109).Vessel area and residual lumen area of carotid artery were measured in axial view using linear probe.Area stenosis rate was calculated.The approximal side angle and thickness of plaque were measured respectively.The results of two groups were compared.Results The approximal side angle of plaque of cerebral group was significantly higher than that of none cerebral infarction groups(P<0.05).The sensitivity and specificity for approximal side angle of plaque(cutoff value:13.0°)were 79.1%,71.6%,respectively.There were no significant difference of area stenosis rate and plaque thickness between two groups(P>0.05).Conclusions The approximal side angle of plaque can be regarded as a novel index to assess the stability of plaque.