Objective: To evaluate the impact of esophagectomy and palliative treatment on short term and long term quality of life (QL) in patients with esophageal cancer. Methods: 88 consective patients treated with radical esophagectomy or palliative treatment were scored by European organization of cancer research and treatment (EORTC), QLQ C30 measurement of QL before treatment and at regular intervals until death or 3 years after operation. The cases were divided into 3 groups and mean scores were obtained from each group. Patients surviving more than 2 years were classified as group 1, with group 2 surviving less than 2 years, and group 3 undergoing palliative treatment. Results: Baseline functional and symptomatic QL scores were similar before treatment in the first and second group, which were higher than scores from the third group. Six weeks after esophagectomy, patients reported worse functional, symptom and global QL scores than before treatment. In the first group, QL scores returned to preoperative level within 9 months. However, improved symptom of dysphagia the second group never regained their former QL scores apart from dysphagia improved after surgery. QL scores of the third group were similar to those of the second group after treatment. Conclusion: Esophagectomy might have a negative impact on patients QL. This effect was found to be transient in the first group but inreversible in the second group. It might seem reasonable for patients in late stage to be treated palliatively.

Objective [WT5”BZ]To evaluate the interventional therapy for Budd Chiari syndrome in which inferior vena cava was segmentally stenotic or occlusive combined with obstruction of hepatic vein and thrombosis.[WT5”HZ] Methods [WT5”BZ] 13 cases with regional stricture or occlusion in inferior vena cava (8 cases with hepatic vein occlusion and 5 cases with thrombosis of inferior vena cava) were reviewed and the length of lesions ranged from 2?cm to 5?cm. For patients with IVC occlusion, atrial septum puncture was used, followed by 1 0～2 0?cm balloon dilation and implantation of metal stent. For patients with hepatic vein occlusion, RUPS 100 liver puncture apparatus was applied and followed by 0 5～1 0?cm balloon dilation. Postoperative anticoagulant therapy was used for 3 months.[WT5”HZ] Results [WT5”BZ]Procedures were successful in all cases. Shrinkage of the spleen and absorption of ascites were observed after operation. There were no relapse of symptoms, nor digestive tract bleeding during 3～26 months of follow up. [WT5”HZ]Conclusions [WT5”BZ] Thrombolytic therapy was very important before the repatency of the IVC for patients with thrombosis formation. The embedded in stent must be away from the orifice of accessory liver vein. Angioplasty of hepatic vein is essential for the interventional treatment of Budd Chiari syndrome. [WT5”HZ]

Objective To establish an equation between canine and other permanent teeth,and probe a new method to predict the sum of the mesiodistal diameters of unerupted permanent canines.Methods Samples consisted of 118 dental casts were obtained from Chinese patients(50 males,68 females,respectively).Mesiodistal tooth diameters were measured by a vernier caliper.GAS was used to establish the equation between canine and other permanent teeth,and compared with stepwise regression analysis.Those were modelling samples that optimized equations coefficient(112 samples).Others were inspection samples(6 samples).Results The equation between canine and other permanent teeth was established.MU=0.0511U1+0.2164U2+0.2780U4+0.0407U5+0.2853U6+0.8321①;ML=0.2998U1+0.1294U2+0.3912U4+0.0088U5+0.0791U6+0.9839②;FU=0.1419U1+0.1741U2+0.3258U4+0.0412U5+0.093U6+1.7355③;FL=0.2796U1+0.3750U2+0.2968U4+0.0268U5+0.0043U6+0.6030④.Compared with stepwise regression analysis,the mean error of precision by GAS was less(P

Objective To construct a eukaryotic expression vector in Pichia pastoris containing human fibrinogen gene, in order to achieve high level secretory expression in extracellular.Methods Expression plasmid,pGAPZαA-FGB-FGG-FGA-AOX1,was constructed by inserting the synthesized sequence encoding human fibrinogen(FGA, FGB,FGG) and then introduced into Pichia pastoris SMD1168H by electroporation.Transformants were availably screened by Zeocin resistance,the expression of recombinant protein was identified by SDS-PAGE and Western blot analysis, the protein yield was tested by ELISA assay.After ultrafiltration and purification, the biological activity of protein was detected.Results The crude yield of human fibrinogen in Pichia pastoris supernatant reached 15 mg/L in flask and the biological aggregation activity was determined.Conclusion The human fibrinogen gene was obtained and successfully expressed in Pichia pastoris and the active products were secreted into the medium.

Objective To investigate the feasibility of establishing a digital model of juxtahepatic vena cava.Methods The clinical data of 120 participants (without liver diseases) who were admitted to the Cangzhou Central Hospital from January 2013 to May 2013 were collected.The results of computed tomography were analyzed.The diameters of juxtahepatic vena cava on different levels (P1 plane:inferior vena cava at the entrance to the right atrium,P2 plane:the upper margin of the roots of hepatic veins,P4 plane:lower boundary of liver,P5 plane:confluence of renal veins and inferior vena cava),and the circumference of the inferior vena cava and the lengths between these levels were recorded.A digital model of juxtahepatic vena cava was established by these data on the premise that the juxtahepatic vena cava was engorged.All data were analyzed using the analysis of variance,paired sample t test and independent samples t test,and correlation and regression were used in analysis of relations between there data.Results Data of the P1 plane and P2 plane were both missed in 3 cases,and the data of the P4 plane was missed in 8 cases.The theoretical diameter of hepatic vena cava at the P1,P2 and P4 planes were (28.1 ± 4.0) mm,(28.7 ± 3.5) mm and (23.5 ± 2.7) mm,respectively.The median diameter of hepatic vena cava at the P5 plane was 24.3 mm.The juxtahepatic vena cava was a 3 dimensional structure of cylinder with a slightly protruding middle part.There were significant differences in P1D-P2D,P2D-P4D,P1D-P4D (F =77.5,P ＜ 0.05).There were significant differences between P2D-P4D and P1D-P4D (t =14.893,11.210,P ＜ 0.05).The median length of hepatic vena cava between P1 and P2 planes was 7.5 mm.The lengths of hepatic vena cava between P1 and P4 planes,P2 and P4 planes were (85.2 ± 11.0)mm and (78.2 ±9.8)mm,respectively.The median length of hepatic vena cava between the P4 and P5 planes was 10.0 mm.P1D-P2D,P2D-P4D,P2D-P5D and P4D-P5D were positively correlated (r =0.862,0.308,0.186,0.788,P ＜ 0.05),while P1D-P4D and P2D-P5D did not correlated (r =0.180,0.118,P ＞0.05).P2D was correlated with the body weight,and P5 D was correlated with the age (r =0.200,0.130,P ＜ 0.05).The P1 D,P2D,P4D and P5 D of the inferior vena cava were (28.5 ± 3.7) mm,(29.0 ± 3.4) mm,(23.9 ± 2.8) mm and (24.3 ± 2.6) mm in males,and (27.8 ±4.2) mm,(28.5 ± 3.6) mm,(23.1 ± 2.5) mm and 24.0 mm in females.There were no significant difference in P1D,P2D,P4D and P5D between males and females (t =0.911,0.809,1.588,1.902,P ＞ 0.05).The length between P1 and P2 planes was negatively correlated with P1D and P2D (r =-0.245,-0.160,P ＜ 0.05),while the length between P4 and P5 planes was positively correlated with P1D (r =0.149,P ＜ 0.05).The length between P2 and P4 planes was positively correlated with P2D (r =0.195,P ＜ 0.05).The length between P1 and P2 planes did not correlated with the age,height and body weight (r =-0.092,-0.047,-0.033,P ＞ 0.05).The lengths between P2 and P4 planes,P1 and P4 planes were negatively correlated with the age (r =-0.343,-0.371,P ＜ 0.05),but positively correlated with the body weight (r =0.271,0.208,P ＜ 0.05).The length between P4 and P5 planes was positively correlated with the height and body weight (r =0.154,0.255,P ＜ 0.05).There were no significant difference in the lengths between P1 and P2 planes,P1 and P4 planes,P2 and P4 planes,P4 and P5 planes between males and females (t =-1.046,-1.274,-0.908,1.375,P ＞ O.05).The length between P2 and P4 planes was similar to the length of retrohepatic vena cava.The length between P2 and P4 planes(mm) =71.23-0.293 × age (years) +0.32 × body weight (kilogram).Conclusion The establishment of digital model of juxtahepatic vena cava based on the computed tomography imaging data is feasible,which provides basis for clinical investigation.

Objective To summarize the clinical experience of harvesting and using the kidneys from donation after cardiac death (DCD) donors.Methods Fourteen kidney transplantations were successfully performed on 14 patients with end-stage renal diseases.The kidneys were harvested from 7 volunteer donors (age 30～53 years) diagnosed with cardiac death,who were scored 19～23according to the University of Wisconsin donation after cardiac death evaluation.Primary diseases of the donors were cerebral hemorrhage,brain injury,ischemic cerebral vascular disease and brain tumor.Warm ischemia time ranged from 5 to 45 min,and cold ischemia time was 4.5 ～ 12.5 h.Results After transplantation,three patients had delayed graft function (DGF),one had primary non-function (PNF),and two patients developed acute rejection.In the patient with PNF,the transplanted kidney was removed one day after operation and the patient went back to hemodialysis.One patient with DGF was still in recovery with serum creatine 149 μmnol/L (within 3 months after operation).The above two cases both utilized the kidneys with 45 min of warm ischemia time.The rest 12 patients were discharged with normal renal function.Conclusion Under the condition of our country,kidneys strictly harvested from DCD donors can be used as one of the main sources of kidney grafts for kidney transplantation.

Objective　To investigate the clinical efficacy of anterior cervical surgery by comparative analyzing hand dysfunction using brief Michigan hand questionnaire(Brief MHQ)in Hirayama disease patients.Methods　From Aug 2011 to Dec 2016,27 patients of hirayama disease who underwent surgery were enrolled in this study.The study group consisted of 27 men.The mean follow-up period was 41.1 months.The levels of surgery included 18 cases of C4-C7,6 cases of C3-C6,2 cases of C4-C6 and 1 case of C5-T1.Brief MHQ were evaluated for the 27 patients.According to the Wilcoxon analysis,the unchanged domains were analyzed with the multifactor Logistic regression analysis by preoperative duration of symptoms,age of onset,and number of affected extremities.Dynamic flexion-extension lateral X-rays were performed at baseline and at final follow-up.Results　No failure of internal fixation was detected on dynamic flexion-extension lateral X-rays.Five domains of preoperative Brief MHQ had lower scores,including Function,Satisfaction,Aesthetics,Activities of daily living,Work domain.With the exception of Aesthetics and Pain domain,all the other four domains showed significant improvement after surgery.The total score was 38.44±5.83 at base-line and 43.19±4.47 at follow-up.The score of Function was 5.19±1.36 at baseline 6.37±1.15 at follow-up;The score of Satisfaction was 5.56±1.22 at baseline 6.60±1.05 at follow-up;The score of Activities of daily living was 6.33±1.84 at baseline 7.60±1.47 at follow-up;The score of Work was 6.85±1.75 at baseline 7.67±1.33 at follow-up.The risk factors of postoperative outcomes reported in the literature included duration of disease at the time of surgery,age of onset,and extremity involvement.According to the Logistic regression,pre-operation duration was the risk factor for Aesthetics domain and the cut-off time was 1.75 years.Conclusion　Four domains of Brief MHQ score were improved significantly after anterior surgery for patients with hirayama disease.Brief MHQ was useful to evaluate the hand dysfunction and clinical efficacy in patients with hirayama disease.

Objective:To explore the ability of training on a three-dimensional motion platform to improve the walking ability and skill in the activities of daily living of hemiplegic stroke survivors.Methods:A total of 70 stroke survivors with hemiplegia were randomly divided into a control group ( n=35) and an intervention group ( n=35). In addition to routine rehabilitation, the control group received 40 minutes of ground balance training, while the intervention group received 40 minutes of training on a three-dimensional motion platform 6 times a week for 4 weeks. Before and after the intervention, step length, speed and frequency were evaluated in both groups using the Gait Watch 3D gait analysis system. Walking ability and ability in the activities of daily living were assessed using the de Morton mobility index (DEMMI) and the modified Barthel index (MBI). Results:Before the treatment, there was no significant difference in average step length, speed or frequency between the two groups. The average standing phase percentage on the affected side, percentage of double support period, DEMMI score, and MBI score also were not significantly different. After the treatment those indicators had improved significantly in both groups. The intervention group′s averages were then all significantly better than those of the control group.Conclusions:Three-dimensional motion platform training can improve the walking ability and skill in the activities of daily living of hemiplegic stroke survivors.

Objective To study and prepare the monoclonal antibody library against human FXYD6 functional region,to screen the hybridoma cell lines secreting the monoclonal antibodies against intracellular or extracellular region of human FXYD6,and to identify the biological function of monoclonal antibody against extracellular domain.Methods FXYD6 functional region recombinant protein which did not contain the transmembrane region was prokaryotically expressed,purified,and FXYD6 recombinant protein was used to immunize BALB/c mice.Then splenocytes after immunization were fused with myeloma cells SP2/0.After several rounds of screening and cloning,the hybridomas which secreted the antibodies against the extracellular domain or the intracellular domain of human FXYD6 were established.The antibody specificity and subtype were identified with indirect ELISA,western blot and immunohistochemistry.The monoclonal antibodies against the extracellular domain which recognized the native conformation were screened with flow cytometry.The antibody against extracellular region was prepared with the ascites revulsion method and purified.The affinity constants were measured with indirect ELISA.The function of extracellular monoclonal antibody was detected by HepG2 cell line with high expression of FXYD6.Results The hybridoma cell library which secreted the monoclonal antibody against extracellular domain or the intracellular domain of human FXYD6 was successfully obtained,and extracellular region monoclonal antibodies with the functional blocking were prepared.Conclusion The prepared anti-human FXYD6 extracellular monoclonal antibodies could inhibit HepG2 cell proliferation.

Objective:To compare the therapeutic effects of cannulated screws and Kirschner wires in the treatment of medial malleolar fractures of Salter-Harris types Ⅲ and Ⅳ in children.Methods:A retrospective study was conducted to analyze the data of 48 and 16 children who had been treated respectively at Department of Pediatric Orthopaedics, Fuzhou Second General Hospital, and Department of Pediatric Orthopaedics, Foshan Hospital of Traditional Chinese Medicine for medial malleolar fractures of Salter-Harris types Ⅲ and Ⅳ from June 2016 to June 2022. There were 32 males and 32 females with an age of 12 (10, 14) years; 31 left and 33 right sides were affected. By the Salter-Harris classification: type Ⅲ in 45 cases, and type Ⅳ in 19 cases. The patients were divided into 2 groups according to their internal fixation methods. Group A (44 cases) was subjected to internal fixation with cannulated screws and group B (20 cases) to internal fixation with Kirschner wires. At the last follow-up, anteroposterior and lateral X-ray films of their ankle joints were taken for imaging evaluation. Functional recovery of the affected limbs was evaluated based on the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scoring, and related complications were recorded.Results:The 2 groups were comparable because there were no significant differences in their preoperative general data except laterality ( P>0.05). All the patients were followed up for (37.3±21.5) months and achieved bony union. At the last follow-up, for groups A and B respectively, the distal lateral angle of the tibia was 89.0° (89.0°, 90.0°) and 89.0° (89.0°, 90.0°), the range of ankle motion was 73.5° (67.8°, 76.0°) and 70.0° (70.0°, 75.0°), and the good and excellent rate by the AOFAS ankle-hindfoot scoring was 97.7% (43/44) and 95.0% (19/20), showing no significant difference between the 2 groups ( P>0.05). There was a significant difference between the 2 groups in the incidence of premature physeal closure [36.4% (16/44) versus 65.0% (13/20)] ( P=0.033). Conclusions:In the treatment of medial malleolar fractures of Salter-Harris types Ⅲ and Ⅳ in children, internal fixation with both cannulated screws and Kirschner wires can lead to comparable efficacy in good functional recovery and imaging evaluation. However, fixation with cannulated screws may be more advantageous in reducing the risk of early closure of the epiphysis.