ObjectiveTo investigate the correlation factors of cervical lymphatic metastasis in thoracic esophageal squamous cell carcinoma.Methods Data of 62 patients with thoracic esophageal squamous cell carcinoma were retrospectively analyzed.Factors associated with cervical lymphatic metastasis were analyzed by using x2 test and multivariate Logistic regression analysis.ResultsLymphatic metastasis was found in 36 cases (58.1％ ),of which metastasis in cervical lymph node was found in 15 cases(24.2％ ).A total of 1954 lymph nodes were excised,with an average of 31.5 per patient.Of all the lymph nodes,metastasis was found in 187 (9.6％) nodes.Logistic regression showed that tumor location,tumor length,thoracic lymphatic metastasis,the metastasis number of thoracic lymph nodes and thoracic lymphatic metastasis along recurrent laryngeal nerve were independent risk factors of cervical lymphatic metastasis [ OR:1.976 ( 1.436-2.538 ),P =0.035 ; 1.346(1.032-1.683),P =0.041;3.012( 1.572-6.825),P =0.012;2.023( 1.463-4.745),P =0.025 and2.254 ( 1.483-4.952 ),P =0.020,respectively ].Conclusion The independent risk factors of cervical lymphatic metastasis are foundation of selective 3-field lymph node dissection and their validities should be validated in further clinical trials.

Objective To observe the clinical curative effect of cinobufacini injection in the treatment of primary bronchopulmonary carcinoma.Methods 120 patients with primary bronchopulmonary carcinoma were randomly divided into the control group and treatment group,60 cases in each group.Patients of the control group were treated with the general,symptomatic and dialectical therapy.Patients of the treatment group were given general,symptomatic,dialectical treatment and cinobufacini injection.The curative effect was determined by the standard efficacy of tumor,the survival quality of the patients was judged by the Karnofsky score.The adverse reactions,median survival time and the survival rate were compared between the two groups.Results The effective rate of the control group was 40.0％,that of the treatment group was 56.7％,the difference was statistically significant (x2 =4.034,P ＜ 0.05).By the Karnofsky score,27 patients of the control group were stable,39 patients of the treatment group were stable,the difference was statistically significant(x2 =12.265,P ＜0.05).Median survival time of the control group was (168 ± 16) d,that of the treatment group was (178 ± 20)d,the difference was statistically significant(x2 =12.265,P ＜ 0.05).One year survival rates of the control group and the treatment group were 5.0％,10.0％,the difference was statistically significant.There was no statistically significant difference between two groups in adverse reactions (P ＞ 0.05).Conclusion Cinobufacini injection can improve the quality of life and prolong survival of patients with primary bronchopulmonary carcinoma.It is effective and safe in clinical application.

Objective: To investigate the effect of urinastatin on the expression levels of NF-?B and TNF-? liver transplantation in patients. Methods: Thirty-six patients of late stage hepatic cirrhosis were randomly divided into two eaquel groups: the experiment group was administrated by urinastatin 300 000 U and saline 10 mL via venous injection during liver transplantation, the control group was administrated 10 mL saline by venous injection at the same time. The blood samples were harvestd at 1, 2, 4 and 6 h after the blood recovery of donated liver. The nuclear factor-?B (NF-?B) P65 relative level of blood was detected by Western blot analysis and the TNF-? level of blood was detected by double antibody Sandwich enzyme linked immunosorbent assay. Serum ALT and AST were also measured. Results: The expression level of serum NF-?B p65, TNF-? in the experiment group were lower than those in the control group, and the difference was significant(P

Objective To investigate the relationship between programmed death 1 ( PD?1), programmed death receptor?1 ligand ( PD?L1 ) and clinical pathological parameters, early postoperative recurrence and metastasis in patients with esophageal squamous cell carcinoma.MethodsThe retrospectively analyze of Paraffin tissue specimens and clinical pathology data in 58 Patients undergoing radical esophageal squamous cell carcinoma surgery from January 2015 to January 2017 in the 910 hospital of PLA Joint Service Support force were performed.Expression of PD?1 and PD?L1 in esophageal squamous cell carcinoma and normal esophageal mucosa were detected by SP immunohistochemical staining.The positive expression rates of PD?1 and PD?L1 in normal esophageal mucosa and esophageal squamous cell carcinoma were compared.the relationship between PD?1 and PD?L1 and gender, age, family history, depth of tumor invasion, degree of differentiation, lymph node metastasis, and TNM staging were analyzed.Follow?up was performed by outpatient consultation and telephone consultation.The recurrence and metastasis of early postoperative (≤1 year) was analyzed.The PD?1 and PD?L1 in esophageal squamous cell carcinoma were analyzed in patients with recurrent metastasis and non?relapsing and metastasis.Results The positive expression rate of PD?1 in esophageal squamous cell carcinoma was 37.93%( 22／58 ), which was significantly higher than that in normal esophageal mucosa 15.52%( 9／58).The difference was statistically significant (χ2＝7.440,P＝0.006).The positive expression rate of PD?L1 in esophageal squamous cell carcinoma was 43.10%( 25／58), which was significantly higher than that of normal esophageal mucosa 18.97%(11／58).The difference was statistically significant (χ2＝7.894,P＝0.005).There was a difference in the positive expression rate of PD?L1 between different infiltration depth and TNM stage, P＜0.05.58 patients who underwent radical esophageal squamous cell carcinoma had been followed up for 6?12 months.A total of 14 patients had recurrence and metastasis,the incidence rate was 24.14%.The positive expression rate of PD?1 in the recurrence group was 42.86%(6／14),and that in the non?recurrent group was 36.36%(16／44).The difference was not statistically significant,(χ2＝0.190,P＞0.05).The positive expression rate of PD?L1 in the recurrence group was 71.43%(10／14),and that in the non?recurrent group was 34.09%(15／44).The difference was statistically significant,(χ2＝6.037,P＜0.05).Conclusion The expression of PD?1 and PD?L1 in cancer tissues of patients with esophageal squamous cell carcinoma is highly expressed.PD?L1 is closely related to the occurrence and progression of esophageal squamous cell carcinoma,and it is also an important index affecting early recurrence and metastasis.Which can be selected as a new target for early diagnosis and treatment.

Liver failure is a common severe liver disease syndrome in clinical practice and is one of the critical medical conditions in internal medicine. Massive hepatocyte death is the main pathological feature of liver failure, and its core mechanisms include endotoxin, immune response, and inflammatory cascade reaction. Effective regeneration of hepatocytes to compensate liver function is the physiological basis for promoting the good prognosis of liver failure, which directly affects the prognosis and quality of life of patients with liver failure. It has been found in clinical practice that liver failure patients with a low serum level of cholesterol tend to have an extremely high mortality rate, but as an index of hepatocyte anabolism, the association between cholesterol and hepatocyte regeneration has not been taken seriously. Based on the association between cholesterol and liver regeneration, this article reviews its significance and potential value in the clinical treatment of liver failure, in order to understand the pathogenesis of liver failure from another perspective and provide new ideas for the diagnosis and treatment of liver failure and the development of drugs.