One hundred and ninety one patients with esophageal carcinoma underwent surgical resection from January 2004 to January 2009. The gastroesophageal anastomosis was performed with auto suture instrument at superior aperture of the thorax in 107 cases (group A) and the instrument anastomosis was performed above or below the aorta arch in 84 cases ( group B ). The electron gastroscopy was performed and biopsy of mucosa at 3cm above the anastomosis was taken during the postoperative follow-up in all patients. Results showed that the incidence rate of reflux esophagitis in group A ( 5% ) was much lower than that in group B (51% ).

Objective To explore the effect of 3-month-exposure to high altitude(4400 m) on military cognitive func-tion.Methods Using pre-post paired t-testdesign, thirty-seven male recruits were enrolled , eight cognitive function variables, including reaction time, speed-perception, time-perception, operating-dexterity, memory span, depth-percep-tion, short-term memory and attention span , were analyzed by paired comparison .Results After 3-month-exposure to 4400 m high altitude, movement time (P<0.05) was shortened, speed-perception became more accurate (P<0.05),memory span and short-term memory both declined slightly(P<0.05), and the errors in depth perception deteriorated (P<0.05). Moreover , the depth-perception was more prone to′see close′.Conclusion During the 3-month-exposure to higher altitude environments , many of the cognitive functions of soldiers may be damaged to different extents , and the negative effect on re-action and movement time , depth-perception and memory is more remarkable .

Objective To determine ff cognitive dysfunction induced by neonatal ketamine anesthesia can persist into adulthood.Methods Thirty 7-day-old SD rats of both sexes were randomly divided into 3 groups.Control group received normal saline 0.2 ml intraperitoneally (IP) (group C),while ketamine groups 1 and 2 received ketamine 25 and 50 mg/kg IP respectively (groups K1,K2 ).Morris water maze test was performed and hippocampal long-term potentiation (LTP) recorded when the rats were 2.5 months old.Results LTP was significantly lower in groups K1 and K2 than in group C.There was no significant difference in LTP between groups K1 and K2.The escape latency and swimming time were comparable among the 3 groups.Conclusion Neonatal ketamine anesthesia can decrease the cognitive function in adult rats.There is no significant difference between light and deep ketamine anesthesia.

ObjectiveTo investigate the role of δ-opioid receptor in remifentanil-induced N-methyl-D-aspartate (NMDA) receptor miniature excitatory postsynaptic currents (mEPSCs) in rat spinal dorsal horn neurons.MethodsMale 14-18 d old Wistar rats weighing 50-60 g were used in this study.The animals were anesthetized with intraperitoneal choral hydrate 400 mg/kg and sacrificed.Their lumbar segments of spinal cord (L1-S1 ) were immediately removed and sliced.Twenty-four slices were randomly divided into 4 groups ( n =6 each): control group (group C) ; glycine group (group G) ; remifentanil group (group R) and remifentanil + naltrindole(a δ receptor antagon) (group RN).Slices were cultured in artificial cerebrospinal fluid (ACSF) (group C) or incubated in ACSF containing glycine 0.24 μmol/L (group G) or remifentanil 4 nmol/L (group R) or remifentanil 4 nmol/L+ naltrindole 1 nmol/L (group RN) for 60 min.Whole cell patch clamp technique was used to measure NMDA receptor mEPSCs.ResultsThe amplitude and frequency of mEPSCs were significantly higher in group R than in groups C and RN ( P ＜ 0.01).There were no significant differences in amplitude and frequency of mEPSCs among gorups C,G and RN ( P ＞ 0.05).ConclusionActivation of δ-receptor can enhance NMDA receptor function in spinal dorsal horn neurons in rats which may be the mechanism of remifentanil-induced hyperalgesia.

Objective To observe the effect of proximal femoral nail anti-rotation(PFNA)combined with salmon calcitonin for the treatment of unstable intertrochanteric fractures in the elderly.Methods A total of 90 elderly patients with unstable intertrochanteric frac-tures were randomly divided into group A,group B and group C(30 cases in each group).Patients in group A received open reduction with DHS,patients in group B got closed reduction with PFNA,and patients in group C received operation as group B but combined with salmon calcitonin after the operation.The intraoperative and postoperative stuation of three groups were compared.Results The intraoperative and postoperative stuation of group B was better than those of group A,the time of weight-bearing exercise and fracture healing in group C was shorter than those of group B(t =4.42;t =5.0,P <0.05).The group B had a less complication than group A(χ2 =7.03,P <0.05).Con-clusion The PFNA has a good restoration effect with shorter operative time,less bleeding and lower complication rate.And combined with the salmon calcitonin,which can shorten the time of recovery.

[Abstract] Objective: To study the effect and possible mechanism of TGF-β2 on the invasion of glioma stem cells (GSCs). Methods: Tumor tissues of 8 patients with glioblastoma multiforme, who underwent resection at Department of Neurosurgery of the FirstAffiliated Hospital of China Medical University duringApril 2016 toApril 2017, were collected. The primary culture of glioma cells were conducted with trypsin digestion. Partial primary glioma cells were seeded into serum-free DMEM/F12 culture medium containing EGF, bFGF and B27 to obtain suspension of tumor spheres. Immunoflurenscent staining and differentiation assay were used to detect whether the tumor spheres were GSCs. TGF-β2 secretion ability of GSCs was determined by ELISAassay.After transfection of TGF-β2 siRNA, the invasion ability of glioma stem cells was determined by Transwell assay. Western blotting was used to examine the effect of TGF-β2 on expression of matrix metalloproteinases (MMP) in glioma stem cells. Results: The suspended tumor spheres were proved to be GSCs by immunofluorescent staining and differentiation assay; the tumor spheres expressed the marker of GSCs（CD133）and had the ability to multi-differentiate (glia and neuronal cells). Compared with the primary glioma cells, Glioma stem cells exerted significantly improved TGF-β2 secretion ability ([74.13±3.63] vs [46.13±2.61] pg/ml, P<0.05); and TGF-β2 silencing significantly reduced the invasion ability of glioma stem cells ([105.71±8.69] vs [63.67±5.93], P<0.05) and inhibited MMP-2 and MMP-9 expressions. Conclusion: TGF-β2 can promote the invasiveness of glioma stem cells through MMP-2 and MMP-9 pathway.

[Abstract] Objective: To detect the expression of zinc transporter 1 (ZnT1) gene in glioma tissue, and to explore its effect on the proliferation, migration and invasion of U87 cells. Methods: From October 2015 to January 2017, 20 patients with glioma, who received no chemoradiotherapy before operation, were collected from Department of Neurosurgery, the First Affiliated Hospital of China Medical University. The protein and mRNA content of ZnT1 in glioma tissues and adjacent tissues were detected by Western blotting and Realtime PCR, respectively. ZnT1 and si-ZnT1 plasmids were transfected into glioma U87 cell line respectively to construct ZnT1 over-expression U87 cell line and ZnT1 knockdown U87 cell line. The effects of ZnT1 on proliferation, migration and invasion of U87 cells were detected by MTT and transwell assay. Results: Both mRNA and protein expressions of ZnT1 in glioma tissues was significantly higher than those in adjacent tissues (all P<0.05). U87 cell lines with ZnT1 over-expression and knockdown were successfully constructed. Compared with the control group and empty plasmid control group, the proliferation (0.54±0.01 vs 0.45±0.04, 0.43±0.03, P<0.01), invasion and migration (all P<0.05) of U87 cells with ZnT1 over-expression were significantly increased at 12 h after transfection; however, the proliferation (0.37±0.03 vs 0.45±0.01, 0.44±0.03, P<0.01), invasion and migration (all P<0.05) of U87 cells with ZnT1 knockdown were decreased significantly. Conclusion: ZnT1 was highly expressed in glioma tissues, and promoted the proliferation, migration and invasion of glioma U87 cells.