Objective To investigate the regularity of thoraco-abdominal two-field lymphatic metastasis and methods of the nodal dissection in middle-third thoracic esophageal carcinoma,and to guide the scope of the lymph-node clearance.Methods Thoraco-abdominal two-field lymph-node dissection based on surgical incisions of the right chest and middle upper abdomen were conducted in 62 cases with middle-third thoracic esophageal cancer and the regularity of nodal metastasis was analyzed.Results Five hundred and five pieces of lymph node were cleaned in all 62 patients and among them 102 pieces were detected as metastasis lymph node,the nodal metastasis ratio was 20.2％ (102/505).The middle-third thoracic esophageal cancer not only includes the nodal metastases up to the trachea of the right neck,around the bilateral recurrent laryngeal nerve chains,near the esophagus and the tumor,and the lymph-node metastasis at the inferior tracheal protuberance,but also the nodal metastases down to the cardiac,around the left gastric artery and at the retina of the lesser curvature of the stomach etc,presenting a tendency of 2-way metastasis.The infiltration depth and differentiation of the tumor is of statistical significance on the nodal metastasis ratio.There was significant difference on the metastasis rate of lymph node from T1 to T4 (T1:10.0％ (1/10),T2:20.0％ (3/15),T3:43.3 ％ (13/30),T4:57.1％ (4/7),x2 =18.56,P ＜ 0.05).It indicated that metastasis rate was increased with the development of the infiltration depth.There was significant difference on the metastasis rate of high differentiation carcinoma,moderate differentiation carcinoma and low differentiation carcinoma (14.3％ (2/14) vs 39.5％ (15/38) vs 57.1％(4/7),x2 =17.75,P ＜ 0.05).Conclusion The lymph node metastasis of patients with middle-third thoracic esophageal carcinoma is significantly correlated with the depth of tumor invasion and the degree of differentiation,with the tendency of thoraco-abdominal 2-field nodal metastasis.The peritracheal lymph node at right neck and bilateral recurrent laryngeal nerve chains are important regions of the metastasis.The surgical incision of the right thorax and upper abdomen greatly facilitates the excision of the middle-third thoracic esophageal cancer and the 2-field lymph node dissection Thus on this basis,the lymph node clearance around the right trachea and at bilateral recurrent laryngeal nerve chains through the right thoracic apex is safe and feasible.

Age Factors ; China ; epidemiology ; Dental Caries ; epidemiology ; Dental Health Surveys ; Epidemiologic Studies ; Humans ; Oral Health ; Periodontal Diseases ; epidemiology ; Prevalence

OBJECTIVETo compare the efficacy differences between needle-knife therapy and acupuncture-cupping for treatment of cervical spondylosis (CS) of cervical type.

METHODSSixty cases of CS were randomly divided into a needle-knife group (30 cases) and an acupuncture-cupping group (30 cases). The needle-knife therapy was applied at points among superior nuchal line of occipital bone, bilateral neck muscle, neck centerline, trapezius and medial border scapula for only once. In the acupuncture-cupping group, acupuncture was applied at Fengchi (GB 20), Fengfu (GV 16), Tianzhu (BL 10), Dazhui (GV 14), Jianjing (GB 21), Jiaji (Ex-B2, from C4 to C6), Houxi (SI 3) and Ashi point, followed by cupping on local skin, once every other day for totally six times. The score of neck stiffness and visual analogue scale (VAS) were observed before and after treatment, in follow-up of 1, 3 and 6 months after treatment in the two groups, and the efficacy was compared.

RESULTSIn the needle-knife group, 9 cases were cured, 12 cases were markedly effective, 8 cases were effective and 1 case was failed; the total effective rate was 96.7% (29/30) and the cured and markedly effective rate was 70.0% (21/30). In the acupuncture-cupping group, 8 cases were cured, 9 cases were markedly effective, 11 cases were effective and 2 cases were failed; the total effective rate was 93.3% (28/30) and the cured and markedly effective rate was 56.7% (17/30). The difference of total effective rate in the two groups was not statistically significant (P > 0.05), but the cured and markedly effective rate of needle-knife group was significantly superior to that of acupuncture-cupping group (P < 0.05). The needle-knife therapy was significantly superior to acupuncture-cupping on improvement of neck stiffness in the follow-up of 1, 3, 6 months after treatment (P < 0.05, P < 0.001); both treatments were effective on relief of neck pain, but the needle-knife group had better effects in the follow-up of 3 and 6 months after treatment compared with acupuncture-cupping group (both P < 0.01).

CONCLUSIONThe needle-knife therapy has better effects on neck stiffness and pain relief than acupuncture-cupping, and it is more treatment time saving.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; Adult ; Aged ; Cervical Vertebrae ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Spondylosis ; physiopathology ; therapy

OBJECTIVE:To provide basic industrial research and development recommendations for the supply-side structural reform in drug distribution in China. METHODS:Structure-conduct-performance(SCP)analysis paradigm from Harvard was used for in-depth study of market structure,business conduct and business performance in China since 2010. RESULTS:Since 2010, drug distribution industry in China had shown the scale of decline in the growth rate,low market concentration,increased barriers to entry,the leading of state-owned capital,etc. Though corporate mergers and acquisitions and public financing expanded the scale,management information,third-party logistics,Internet+and pharmacy alliance business model flourished,the industry op-erating performance was poor,state-owned enterprises showed poor performance. CONCLUSIONS:The transformation and upgrad-ing of the industry business model should be promoted by targetedly accelerating the supply-side structural reforms in the drug distri-bution industry,encouraging corporate finance mergers,breaking local protectionism,developing cooperative pharmacies and phar-maceutical third-party logistics alliances and leveraging the Internet.

ObjectiveTo evaluate the applicable value of attitude control system combined with attitude controllable intelligent capsule endoscope for stomach examination.MethodsA total of 15 patients were recruited to the study.Manipulability of movement and posture change of capsule endoscope,diagnostic efficacy for such locations as gastric cavity,bulb and descending duodenum,image quality and patients'compliance were assessed.ResultsThe procedure was completed in 14 patients.One failed due to downfall of the endoscope to duodenum within 5 min. Mean operation time was ( 23.7 ± 6.5 ) min ( from 5 to 30 min).Ten cases of superficial gastritis,one case of superficial gastritis with bile regurgitation and 1 case of ulceration of the duodenal bulb were diagnosed.No abnormalities were found in 3 others.Endoscopic images were of high quality and only a few were influenced by gastrointestinal peristalsis.All patients showed compliance with no discomfort.Capsule endoscopes were discharged within 2 or 3 days.ConclusionAttitude control system combined with attitude controllable intelligent capsule endoscope in stomach examination is feasible and valuable in clinic.

Description of the security grading protection used in the security protection system for information systems in medical organizations. Elaboration of the research ideas, process and some outcomes for the Fundamental Requirements for Security Grade Protection of Information Systems in Medical Organizations, from the five aspects of system modeling, grading guidance for industries, threat and risk analysis, security objective output, and security adjustment.

Objective To explore the methods for treating no-functioning renal graft.Methods The management of 240 cases of non-functioning renal graft between 1978 and December 2003 was retrospectively analyzed.Results Twenty-nine recipients with renal failure one month after renal transplantation were subjected to removal of the renal graft. One year after renal transplantation, the recipients with renal failure received resection of the renal graft, 4 were treated with renal artery embolism, and 114 did not receive special treatment.Conclusion The non-functioning renal graft required removal at early stage of renal transplantation. At later stage, no symptomatic cases of post-transplanted renal failure required no management after stopping immunosuppressant. The appropriate management is reserved for the symptomatic cases.

The present investigation was carriied out in scald-shocked cats to observe the cardiovascular effects of diphenhydramine ( 2 mg/kg iv ) and cimetidine ( 20mg/kg iv ) . Changes in B-glucuronidase ( B-G ) activity and blood lactate level were also observed.lt was found that inanimals treated with cimetidine the cardiovascular parameter ( BP, LVSP , dP/dtmax, IP, VPm, HR ) were decreased significantly in 2 - 4 h after scalding. These results were the same as those of the saline-treated control. In animals treated with diphenhydramine, the cardiovascular parameters were increased in 1 h after administration of the drug and still persisted at normal level in 4h after scalding.There were no significant differences between groups in changes of B-G activity and the blood lactate level. These data suggest that the benefit of cimetidine in burn-shock is dubious and diphenhydramine may be of value as an adjuvant used in combination with other vasoactive drugs for the treatment of burn shock.

Five patients with Peutz-Jeghers Syndrome(PJS) have been reported in this paper. One ofthem developed polypous malignancy in the rec-tum, one associated with bladder canaer. The au-thers have once performed multiple operations, in-cluded small bower Roux-Y anastomosis keepedpylorus for a patiet with duodenal obstruction in-duced by polyps. The questions related with surgi-cal management is PJS are discussed principally inthis paper.

Objective:In order to achieve a dynamic supervision system throughout the logistics process of high-value consumables of oral and maxillofacial surgery and solve the problem of inaccurate traceability. Methods: It is based on the theory of supply chain management and summarizes the logistics process on high-value consumables of oral and maxillofacial surgery. It is a combination of bar code and information management system. Results: The dynamic supervision system throughout the logistics process of high-value consumables of oral and maxillofacial surgery will replace the original static and extensive mode management. It will achieve the refine management of high-value consumables of oral and maxillofacial surgery. Conclusion:It promotes the integration of material flow, information flow, capital flow. It achieves the dynamic supervision system in every procedure including purchasing, warehousing, consuming, destroying, Checking inventory and ensures the accurate traceability.