Objective To explore the surgical treatment of cervical and upper thoracic esophageal carcinoma in patients aged 70 or ol-der. Methods A retrospective analysis were made among 68 patients who were over 70 years old, and all the patients have undergone stom-ach esophagus cervical anastomosis through esophageal carcinoma excision and regional lymph node cleaning. Results All the 68 patients have completed the surgery successfully, and they have recoveried well except 3 cases of death. And the main postoperative complication was cardiopulmonary complication and anastomotic fistula. Conclusion Operative treatment of ercervical and upper thoracic esophageal carcino-ma for elderly patients is characterized with highly difficulty and more complications. Stomach esophagus cervical anastomosis through 2-inci-sion with left chest and left neck could simplify the operative procedure, decrease the postoperative complication and improve the curative effect.

The paper introduces the common methods for automatic de-identification of clinical texts,including the method based on rules,machine learning method,comprehensive method,etc.,states the challenges for clinical texts practicability,system universality and scalability of clinical texts de-identification research,analyzes the further research direction,and provides reference for researchers of this field.

Objective To study the effects of amniotic epithelial cells conditioned medium on the differentiation of bone marrow stromal cells into neural cells. Methods Bone marrow stromal cells and amniotic epithelial cells were isolated and cultured in vitro,then the cell surface antigen was detected by flow cytometry and the expressions of nestin and ki67 were detected by immunofluorescence staining method.When the cells were co-cultured with amniotic epithelial cells conditioned medium,the morphological character of cells was observed by inverse phase-contrast microscope,and the expressions of NSE(neurone specific enolase),TH(tyrosine hydroxylase) and DAT(dopamine transporter) were detected by immunofluorescence staining method. Results Amniotic epithelial cells conditioned medium had obvious inductive effect on bone marrow stromal cell's neural differentiation.Conclusion The amniotic epithelial cells conditioned medium may have inductive effect neuron-like cell's differentiation and dopaminergic neuron-like cell's differentiation of bone marrow stromal cells in vitro.

Objective To explore the potential correlation between fluoride levels of urine and influencing factors in water-high-fluoride areas.Methods In 2010,based on plain area,mountainous area and mixed area (altitudes were 898,2 200,1 460 m,respectively),3 villages of water-high-fluoride areas were selected by purpose sampling;pupils' family members were selected as survey population by cluster sampling.Questionnaire was conducted to collect general information;fluoride contents in urine and drinking water were measured using ionselective electrode.A linear multiple regression was used to examine which factors affected urinary fluoride.Results Totally there were 968 people distributed in plain area (444),mixed area (368) and mountainous area (156),medians of urinary fluoride level were 0.71,1.59 and 1.67 mg/L,respectively,the difference was significant (F =203.90,P ＜0.01);medians of water fluoride level in the three different habitats were 0.50,1.00 and 3.50 mg/L,respectively,the difference was significant (F =331.98,P ＜ 0.01).Age,gender,fluoride contents in drinking waters and habitat explained 33.1％ of urinary fluoride variation.Male had higher urine fluoride than female,older age and higher level fluoride in drinking water contributed to higher fluoride level in urine,higher altitude contributed to higher urinary fluoride.Conclusion Once fluoride content in urine is used to estimate fluoride exposure level among people in high fluoride area,gender and age must be taken in consideration.

OBJECTIVE To investigate the efficacy and safety of local lauromacrogol injection in the treatment of laryngopharyngeal hemangioma. METHODS A total of 10 patients suffering from hemangioma of pharynx and larynx from Aug 2015 to Mar 2018 were collected. Endoscope assisted local lauromacrogol injection under topical was used. The therapeutic effects were observed and analyzed.RESULTS All patients were followed up for 3 months to 1 year. Among them, 9 cases were cured and 1 was obviously effective for totally 1 to 4 (mean 1.9) injections. All patients complained of postoperative pain or foreign body sensation, 3 patients were significantly affected by local swelling of the injection site. 2 patients underwent tracheostomy and 1 patient returned to ward with endotracheal intubation postoperatively. No complications such as mucosal ulceration, fever, allergies occurred. CONCLUSION Lauromacrogol injection is a safe and effective method to treat hemangioma of pharynx and larynx.

Objective Pulmonary oxygen poisoning resulting from hyperbaric oxygen, frequently occurs in specialized operations, without any current effective prevention or treatment measures. To elucidate the impact and mechanism of neostigmine （NEO） in combination with anisodamine （ANI） （neoscopolamine） on pulmonary oxygen toxicity. Methods The animal model of pulmonary oxygen poisoning was established. C57BL/6 mice were exposed to 2.5 ATA 99.9% oxygen for 6 h. The control group mice were injected with normal saline ip, while the treatment group mice received injections of ANI （25 mg/kg, ip）and NEO （50 μg/kg, ip）. Lung tissues were collected and stained with HE to observe any pathological injuries after exposure. Evans blue stain was utilized to identify lung permeability, wet/dry lung ratio, and protein concentration in the bronchoalveolar lavage fluid （BALF） to assess the lung injury’s severity. The modifications in inflammatory factors, oxidative stress indicators, and iron content in lung tissue were assessed. Results The results showed that the 2.5 ATA 99.9% oxygen-exposed group experienced a significant worsening of lung injury, as well as increased lung permeability, lung wet/dry ratio, and protein content in alveolar lavage fluid when compared to the control group. Moreover, mRNA levels of pro-inflammatory cytokines IL-1β, IL-6, TNF-α, and IFN-γ in the lung tissue of the model group were significantly elevated, while the levels of anti-inflammatory cytokines IL-4 and TGF-β were significantly reduced. The oxidative index MDA also significantly increased, while the antioxidant index GSH significantly decreased. Additionally, the expression of GPX4, a marker of ferroptosis, increased with an increase in iron content. Neoscopolamine treatment successfully reversed those effects. Conclusion The combined use of ANI and NEO had a protective effect on pulmonary oxygen poisoning. Neoscopolamine may inhibit inflammation and oxidative stress by activating the cholinergic anti-inflammatory pathway, thereby reducing the content of free iron in lung tissue and finally inhibiting cell ferroptosis.

We reported a case of a patient dignosed as tuberculosis and severe malnutrition with coronavirus disease 2019 （critical type） treated with a combination of Chinese medicine and Western medicine. Through the retrospective analysis of the diagnosis and treatment process of this patient， on the basis of Chinese medicine's understanding of the etiology and pathogenesis of “old state” and “deficient state”， the critical coronavirus pneumonia combined with pulmonary tuberculosis and severe malnutrition was mostly due to the physical condition and the invasion of epidemic toxin， resulting in dysfunctions of the internal organs such as the lungs， spleens， kidneys and other organs. Based on the understanding of the cause and mechanism of the coronavirus disease， the treatment combined Chinese and Western medical therapies was given. The western medicine was used with the main treatments of oxygen therapy， anti-viral， intestinal nutritional support， and anti-coagulation， while the Chinese medicine was used by tonifying qi， blood， yin， and yang， warming yang and dissipating cold， and clearing heat and dampness， then tonifying qi， nourishing yin and eliminating heat， in which tonifying middle and replenishing qi ran through the whole process. The integrated treatment eventually improved the patient's symptoms and accelerated the negative conversion of nucleic acid of the coronavirus.

Objective: To investigate whether plague phages were present in the indicator animals of plague foci in Yunnan Province, and to explore their epidemiological significance. Methods: Anus swabs were collected from indicator animals (dogs or cats) of the 41 plague affected villages in 26 towns of 10 cities (counties, districts) of Yunnan plague foci from November of 2015 to March of 2018. The Yersinia pestis phages were isolated by plague vaccine strain EV76. The isolation of plague phages from different plague foci, the isolation of plague phages from different canine species (cats), the polymorphism of plaque and the host spectrum of phages were analyzed. Results: A total of 1 014 indicator animals (1 003 dogs and 11 cats) were studied, and 102 of plague phages were isolated. In the 10 cities (counties, districts), plague phages were only not isolated from Lancang County, and the plague phages were isolated from the other 9 cities (counties, districts). The separation rates from high to low were as follows: Yiliang County (21.00%, 21/100), Menghai County (19.23%, 25/130), Yuanjiang County (11.63%, 10/86), Midu County (11.50%, 13/113), Wenshan County (10.10%, 10/99), Mile Country (7.07%, 7/99), Lianghe County (6.67%, 7/105), Baoshan Longyang District (4.90%, 5/102) and Gengma County (3.81%, 4/105). Of the 102 plague phages, 75 were isolated from the native dogs (Chinese pastoral dogs, 9.32%, 75/805), 20 from the pug dogs (13.70%, 20/146), 5 from the wolf dogs (17.24%, 5/29), 1 from Samoye (1/4) and 1 from Alaska dog (1/2). The plaque of the phage was divided by five appearance of complete lysis (the plate was clear), large (2.5-4.0 mm), big (1.5-< 2.5 mm), middle (0.5-< 1.5 mm) and small (< 0.5 mm). The representative phages were all of the Myoviridae family. Most of the phages could lysis the strains of Yersinia pestis, and some phages could lysis Shigella and type 5 Yersinia pseudotuberculosis (PST5). Conclusion The plague phages are present in the plague foci of Yunnan, and the phages are polymorphic.