Objective:To retrospectively analyze the survival outcomes of the surgical management of primary small cell carcino-ma of the esophagus. Methods:The medical records were reviewed for patients diagnosed with esophageal carcinoma and underwent esophagectomy from January 2000 to December 2009 at the Department of Thoracic Surgery of the Henan Cancer Hospital. We fo-cused on the clinical data of patients with small cell carcinoma of the esophagus. The Kaplan-Meier approach with log-rank test was used for survival analysis. Results:A total of 5,062 patients underwent esophagectomy with curative intent at the Department of Thorac-ic Surgery of the Henan Cancer Hospital;among which, 57 (1.1%) were diagnosed with small cell carcinoma of esophagus. The most common surgical approach was trans-left thoracic incision esophagectomy. Cervical esophagogastrostomy was performed for all pa-tients. The most common chemotherapy regimen was EP. The overall 5-year survival rate was 12.5%, and the median survival time was 45 months. Among the various stages, the 5-year survival rate and survival time were 25% and 50 months for Stage I, 5.9% and 43 months for Stage II, and 4.3%and 43 months for StageⅢ. Subgroup analysis showed that cases treated with surgery alone had poorer overall median survival time compared with those cases that underwent surgery plus chemotherapy (23.2 months vs. 60.7 months, re-spectively;P<0.01). Even for Stage I patients, thesurgery plus chemotherapysubgroup was associated with a significantly longer me-dian survival time than the surgery alone subgroup (81.9 months vs. 22.3 months, P<0.01). Conclusion:For patients with primary small cell carcinoma of the esophagus, surgery alone cannot provide the optimal prognosis. Surgery combined with systemic chemother-apy can improve the survival time.

Objective To evaluate the association between R353Q polymorphism of the coagulation factor Ⅶ gene and cerebral infarction in Chinese Han people. Methods Restriction fragment length polymorphism(PCR-RFLP) methods was adopted to detect FⅦR353Q genotype and R、Q allelomorphie gone frequency of 100 cerebral infarction(CI) patients and 106 healthy people. Results There was FⅦR353Q polymorphism in the CI patients and healthy subjects. RR and RQ genotype could be found in the control group and CI group. RR and RQ genotype dis-position consistented with Hardy-weinberg equilibrium. In CI group,RR genotype was in 91 cases,RQ was in 9 cases and QQ in 0 case(the distribution frequencies were 91.00% ,9.00% and 0), and in the healthy subjects, those are 94 cases, 12 cases and 0 case(88.70% ,11.30% and 0). In the control group and CI group,R allele genotype fre-quencies were 94.33% and 95.50%, and Q were 5.67% and 4.50%. There was not significantly different in the R353Q polymorphism (χ20.3027, P=0.5822);Q allele genotype was not significantly different between the cases of control group and CI patients(χ20.2865, P=0.5925). Conclusion There are the FⅦR353Q polymorphism in Han population,however,the idea that the Q allele is a protective factor in CI is not supported.

OBJECTIVE:To observe the clinical efficacy and safety of piperazine ferulate combined with glutathione in the treatment of diabetic nephropathy. METHODS:80 patients with diabetic nephropathy in our hospital were divided into observation group and control group according to random number table,with 40 cases in each group. Both groups was given general treatment as blood glucose,blood lipid and blood pressure control. Control group was additionally given Reduced glutathione tablets 400 mg, tid,on the basis of general treatment. Observation group was additionally given Piperazine ferulate tablets 100 mg,tid,on the ba-sis of control group. Both groups were treated for 12 weeks. The fasting plasma glucose(FPG),2 h postprandial plasma glucose(2 hPG),blood pressure,blood lipid,serum creatinine (Scr),blood urea nitrogen (BUN),24 h urinary total protein and albumin, urine β2 microglobulin(β2-MG)and N-acetyl-β-glucosaminidase(NAG)of 2 groups were detected before and after treatment. The occurrence of ADR was observed. RESULTS:Before treatment,there was no statistical significance in FPG,2 hPG,blood pres-sure,blood lipid,Scr,BUN,24 h urinary total protein and albumin,urine β2-MG and NAG between 2 groups(P>0.05). After treatment,above indexes of 2 groups were improved significantly,and the observation group was better than the control group, with statistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:In the treatment of diabetic ne-phropathy,piperazine ferulate combined with glutathione can improve blood glucose,blood pressure,blood lipid levels and renal function with good safety.

Background and purpose:18?-glycyrrhetinic acid(GA) is one of the important components of glycyrrhiza.Recent years,studies showed that GA has the effect of proliferation inhibition in human acute lymphoblastic leukemia cells,human liver carcinoma and lung cancer cells.We investigated the effects of GA on induction of apoptosis in human breast carcinoma(MCF7) cells.The previous studies have demonstrated that the dynamic change of intracellular free Ca~(2+) concentration([Ca~(2+)]i)plays important roles in many links of apoptosis-induced process.Therefore we also researched the relationship between GA-induced apoptosis and [Ca~(2+)]i in MCF-7 cells.Methods:After MCF-7 cells were treated with 50-250 ?mol/L GA for 24 h,cell viability for proliferation was assessed by MTT assay.MCF-7 cells treated with 100 ?mol/L and 150 ?mol/L GA for 24 h,the apoptotic rates in MCF7 cells were examined by terminal deoxynucleotide transferase mediated dUTP nick-end-labeling method,flow cytometry with Annexin V/ propidium iodide fluorescent stain and single cell gel electrophoresis assay(SCGE).For cells treated with 150 ?mol/L GA for 24 h,i was measured by Fure-2 fluorescein load method.For cells treated with 150 ?mol/L GA combined with 100 ?mol/L BAPTA-AM or 0.5 mmol/L EGTA for 24 h,cell apoptosis were examined by SCGE.Results:For cells treated with GA from 100 ?mol/L to 250 ?mol/L,the rate of proliferative inhibition was increased significantly(P

Objective:To investigate the status of professional identity among student nurses and explore its influential factors.Methods:A total of 1,302 student nurses from 3 universities of different levels in Shaanxi Province were selected using stratified and cluster random sampling method and investigated by adopting Professional Identity Questionnaire for Nurse Students (PIQNS).Results:Student nurses in Shaanxi Province scored (57.56 ± 12.55) in professional identity,of which the lowest was independence of career choice in the 5 dimensions.It showed that educational status,gender,and the reasons to choose nursing specialty correlated to student nurses' professional identity (P ＜0.05).Conclusions:The professional identity of student nurses especially for the undergraduate nurses is not high,which should cause the attention of the nursing educators and nursing managers to stabilize nursing team.

Objective To investigate the effects of therapeutic hypercapnia on type Ⅱ alveolar cells (ATⅡ ) in the transplanted lung in rats.Methods Twenty-eight pathogen free adult male Wistar rats weighing 180-220 g were randomly divided into 2 groups (n= 14 each) : control group (group C) and therapeutic hypercapnia group (group T). The animals were anesthetized with intraperitoneal 3% pentobarbital 30 mg/kg, tracheostomized and mechanically ventilated with 50% O2-50% N2 (VT 10 ml/kg, RR 60 bpm, I∶ E1∶1). Left lung transplantation was performed. In group T starting from the beginning of reperiusion of the transplanted lung, the animals were ventilated with a mixture of 50% O2-N2 and C02(in appropriate concentrations) to keep PaCO2 between 80-100 mm Hg. After 90 min of reperfusion of the transplanted lung, blood samples were collected from pulmonary vein of the transplanted lung and blood gas analysis was performed. Oxygenation index was calculated.AT II cells were isolated from the transplanted lung and purified and examined with electronic microscope. The apoptosis rate of AT Ⅱ cells was detected by flow cytometry. Results Oxygenation index was significantly higher, the apoptotic rate of ATⅡ cells lower, the damage to ATⅡ cells was less in group T than in group C.Conclusion Therapeutic hypercapnia can protect the AT Ⅱ cells in the transplanted lung and improve the function of the trans planted lung.

Objective To evaluate the clinical performance of AQT90 FLEX,a novel time-resolved fluorescence based point-of-care test (POCT) for quantification of D-dimer in elderly patients.Methods The method from Quantitative D-dimer assay (WS/T 477-2015) for testing equipment performance was used as a reference to evaluate the clinical performance of AQT90 FLEX.The correlation was compared between testing results of D-dimer using the AQT90 immune-assay analyzer and those using the ACL TOP coagulation analyzer.Results At high concentration of D-dimer,the within-run precision coefficient of variation (CV)was 2.619％,and at low concentration of D-dimer,the within-run precision CV was 2.767％.The pollution-carrying rate was 0.12％.The measured data from AQT90 and ACL TOP had a correlation coefficient of r =0.9491 (P ＜ 0.01).The equation of the line of best fit for D-dimer with which all AQT90 results can be adapted to the ACL TOP was:AQT90 =2.52 ACL TOP + 0.15.The number from the equation was slightly greater in female than that in male,and it was also increased in elderly.Conclusions The AQT90 FLEX had rational precision and linearity in determination of concentration.There was a high agreement between the testing results from AQT90 and those from ACL TOP.It was recommended to use a slope of 2.52 and an intercept of 0.15 to adjust the D-dimer values of the ACL TOP to the AQT90 FLEX assay systems.POCT for D-dimer by AQT90 FLEX raises feasibility for use in elderly patients.

OBJECTIVE:To explore the role of clinical pharmacist in the therapy for patient with community-acquired Pseudo-monas aeruginosa lung abscess. METHODS:Clinical pharmacist participated in the therapy for a patient with community-acquired P. aeruginosa lung abscess,analyzed anti-infective therapy plan,and adjusted drug use timely to correct agranulocytosis induced by anti-infective drugs. RESULTS:The physicians adopted the suggestions of clinical pharmacists,controlled the infection successful-ly and corrected agranulocytosis. CONCLUSIONS:Community-acquired P. aeruginosa lung abscess is rare but has high mortality. Clinical pharmacists participate in drug therapy,assist physician to improve and optimize therapy plan and formulate individual medication plan so as to promote promote care rate of patients.

Objective To explore the effect of Activating Blood to Resolve Stagnation on the expression of CD34 and vascular endothelial growth factor (VEGF) in rats with acute myocardial infarction. Methods 32 Sprague-Dawley rats were randomly divided into sham operation group (A, n=8), model group (B, n=8), Xuesaitong Injection + granulocyte colony- stimulating factor (G- CSF) group (C, n=8) and G-CSF group (D, n=8). Corresponding medicine was given to each group 3 hours after modeling, for 6 days. Pathomorphological changes were observed through HE staining, and the expression of CD34, VEGF and Ki-67 were observed through immunohistochemical staining. Results The expressions of CD34, VEGF and Ki-67 were higher in groups B, C and D than in group A (P<0.05), and were higher in group groups C and D than in group B (P<0.05). The expressions of CD34 and VEGF were higher in group C than in group D (P<0.05). However, there was no significant difference in the expression of Ki-67 between 2 groups (P>0.05). Conclusion The expression of CD34 and VEGF increases with Activating Blood to Resolve Stagnation method, which is superior to using G-CSF only. Activating Blood to Resolve Stagnation may play an important role in the treatment of acute myocardial infarction.

Objective:To investigate the protective effect of Naoxin'an capsule （NC） against glial cell activation and inflammatory damage in brain of rats with chronic cerebral hypoperfusion-induced vascular cognitive impairment （VCI）. Method:One hundred and fifty rats were randomly divided into a sham operation group （n=20） and a modeling group （n=130）. Following the modeling with the two vessels occlusion （2-VO） technique， 87 successfully modeled rats were randomly divided into the model group， positive drug group （aricept， 0.5 mg·kg^-1）， and low-， medium-， and high-dose （0.18， 0.36， 0.72 g·kg^-1） NC groups， with 17-18 rats in each group. After intragastric administration of NC for eight weeks， the Morris water maze test and passive avoidance test were conducted to detect the effects of NC on learning and memory ability of VCI rats. Changes in neuronal structure of rat hippocampal CA1 area were observed by hematoxylin-eosin （HE） staining， and the neuronal apoptosis in hippocampus by terminal deoxynucleotidyl transferase （TdT）-mediated dUTP nick end labeling （TUNEL） staining. Western blot assay was used to detect the expression levels of glial fibrillary acidic protein （GFAP）， ionized calcium-binding adapter molecule 1 （Iba-1）， phosphorylated p38 mitogen-activated protein kinase （p38 MAPK）， and phosphorylated nuclear factor κB （NF-κB）， followed by the measurement of interleukin-1β （IL-1β） and tumor necrosis factor-α （TNF-α） in the brain by enzyme-linked immunosorbent assay （ELISA）. Result:Compared with the sham operation group， the model group displayed obviously decreased spatial learning and memory ability and memory retention ability （P<0.05， P<0.01）， neuronal damage in hippocampal CA1 area， enhanced neuronal apoptosis （P<0.01）， up-regulated GFAP and Iba-1 （P<0.01）， elevated phosphorylation of p38 MAPK and NF-κB （P<0.01）， and increased IL-1β and TNF-α （P<0.01）. Compared with the model group， NC at each dose significantly improved the spatial learning and memory ability and memory retention ability of VCI rats （P<0.05， P<0.01）， ameliorated the neuronal damage in hippocampus CA1 area， reduced the apoptosis rate of nerve cells （P<0.05， P<0.01）， down-regulated the expression of GFAP and Iba-1 （P<0.01）， decreased the phosphorylation levels of p38 MAPK and NF-κB （P<0.05， P<0.01）， and lowered TNF-α and IL-1β levels （P<0.01）. Conclusion:NC alleviates the inflammatory damage of the central nervous system caused by activated p38 MAPK and NF-κB and improves chronic cerebral hypoperfusion-induced VCI in rats by inhibiting the activation of microglia and astrocytes.