Objective To explor the value of Tei index for evaluation the cardiac function of patients with chronic heart failure(CHF).Methods Tei index in 60 patients with CHF(CHF group) and 30 normal controls(control group) were evaluated and compared with the levels of NT-ProBNP and the NYHA class,and the sensitivity and specificity of Tei index for CHF diagnosis were appraised.Results (1) Tei index in CHF group was significantly higher than that in control group.When Tei index was more than and equal to 0.45,the sensitivity,specificity,positive predictive value,and negative predictive value of Tei index for diagnosing CHF were 85.6％,90.4％,89.8％ and 78.0％.(2)There was a remarkable positive correlation between Tei and Log NT-ProBNP(r =0.84,P ＜ 0.01).(3)There were significant differences in Tei index among NYHA Ⅱ,Ⅲ,Ⅳ class [(0.47 ± 0.06),(0.56 ± 0.08),(0.64 ±0.13)].Conclusion Tei index can be used to diagnose CHF and evaluate the degree of it.

Objective To investigate the changes of T cell subsets including Th1,Th2,Th17 and Treg in the hand,foot and mouth disease(HFMD) patients.Methods 35 EV71 induced HMFD patients and 12 non-infectious children were included in this study.Patients were divided into mild symptoms group and severe symptoms group.The ratios of Th1,Th2,Th17 and Treg were analyzed by flow cytometry.Results Sixteen mild cases and 19 severe cases were included in the 35 patients.No statistical difference of children′s age and sex were found among the groups(P>0.05).The proportion[M(P25,P75)] of Th1 cells of mild and severe groups were 10.65%(8.73%,14.08%) and 15.51% (13.47%,18.31%),respectively,which were significantly higher than normal control group 5.51% (3.61%,8.61%)(P<0.05).The proportion of Th2 cells of mild and severe groups were 4.32%(2.60%,5.32%) and 3.87% (2.34%,5.32%),no significant difference from control group 2.11% (1.02%,5.11%)(P<0.05).The proportion of Th17 cells of mild and severe groups were 8.32%(5.25%,12.33%),7.36% (5.05%,11.9%),significantly higher than that of normal control group 4.23% (2.44%,6.22%)(P<0.05).The proportion of Treg cells of mild and severe groups were 1.46% (0.31%,2.73%),1.59%(0.35%,2.62%),no significant difference from the control group 1.78% (0.31%,2.77%)(P<0.05).Conclusion The Th1/Th2 and Th17/Treg ratios of HFMD patients with EV71 virus infection were changed,and the Th1 and Th17 cells may play an important role in the in the disease and body′s resistance.

OBJECTIVETo investigate the feasibility of no nasogastric intubation and early oral feeding at will after thoracolaparoscopic esophagectomy for patients with esophageal cancer.

METHODSBetween January 2013 and January 2014, the feasibility of no nasogastric intubation and early oral feeding at postoperative day(POD) 1 after thoracolaparoscopic esophagectomy was prospectively investigated in 156 patients (trial group) with esophageal cancer in the Henan Cancer Hospital. One hundred and sixty patients previously managed in the same unit who were treated routinely after thoracolaparoscopic esophagectomy were served as control group.

RESULTSOf 156 patients of trial group, 6(3.8%) patients could not take food early as planned because of postoperative complications. The overall complication rate in trial group was 19.2%(30/156), which was 25.0%(30/160) in control group (P=0.217). The anastomotic leakage in trial group and control group was 2.6%(4/156) and 4.3%(7/160) respectively (P=0.380). Compared with control group, time to first flatus [(2.1±0.9) d vs. (3.3±1.1) d, P<0.001], bowel movement [(4.4±1.3) d vs. (6.6±1.0) d, P<0.001] and postoperative hospital stay [(8.3±3.2) d vs. (10.4±3.6) d, P<0.001] were significantly shorter in trial group.

CONCLUSIONSNo nasogastric intubation and early oral feeding postoperatively in patients with thoracolaparoscopic esophagectomy is feasible and safe. This management can shorten postoperative hospital stay and fasten postoperative bowel function recovery.

Eating ; Esophageal Neoplasms ; surgery ; Esophagectomy ; Fasting ; Feasibility Studies ; Humans ; Intubation, Gastrointestinal ; Postoperative Complications ; Postoperative Period

Objective To investigate the feasibility of no nasogastric intubation and early oral feeding at will after thoracolaparoscopic esophagectomy for patients with esophageal cancer. Methods Between January 2013 and January 2014, the feasibility of no nasogastric intubation and early oral feeding at postoperative day (POD) 1 after thoracolaparoscopic esophagectomy was prospectively investigated in 156 patients (trial group) with esophageal cancer in the Henan Cancer Hospital. One hundred and sixty patients previously managed in the same unit who were treated routinely after thoracolaparoscopic esophagectomy were served as control group. Results Of 156 patients of trial group, 6 (3.8%) patients could not take food early as planned because of postoperative complications. The overall complication rate in trial group was 19.2%(30/156), which was 25.0%(30/160) in control group (P=0.217). The anastomotic leakage in trial group and control group was 2.6%(4/156) and 4.3%(7/160) respectively (P=0.380). Compared with control group, time to first flatus [(2.1±0.9) d vs. (3.3±1.1) d, P<0.001], bowel movement[(4.4±1.3) d vs. (6.6±1.0) d, P<0.001] and postoperative hospital stay [(8.3 ±3.2) d vs. (10.4 ±3.6) d, P<0.001] were significantly shorter in trial group. Conclusions No nasogastric intubation and early oral feeding postoperatively in patients with thoracolaparoscopic esophagectomy is feasible and safe. This management can shorten postoperative hospital stay and fasten postoperative bowel function recovery.

Objective To investigate the feasibility of no nasogastric intubation and early oral feeding at will after thoracolaparoscopic esophagectomy for patients with esophageal cancer. Methods Between January 2013 and January 2014, the feasibility of no nasogastric intubation and early oral feeding at postoperative day (POD) 1 after thoracolaparoscopic esophagectomy was prospectively investigated in 156 patients (trial group) with esophageal cancer in the Henan Cancer Hospital. One hundred and sixty patients previously managed in the same unit who were treated routinely after thoracolaparoscopic esophagectomy were served as control group. Results Of 156 patients of trial group, 6 (3.8%) patients could not take food early as planned because of postoperative complications. The overall complication rate in trial group was 19.2%(30/156), which was 25.0%(30/160) in control group (P=0.217). The anastomotic leakage in trial group and control group was 2.6%(4/156) and 4.3%(7/160) respectively (P=0.380). Compared with control group, time to first flatus [(2.1±0.9) d vs. (3.3±1.1) d, P<0.001], bowel movement[(4.4±1.3) d vs. (6.6±1.0) d, P<0.001] and postoperative hospital stay [(8.3 ±3.2) d vs. (10.4 ±3.6) d, P<0.001] were significantly shorter in trial group. Conclusions No nasogastric intubation and early oral feeding postoperatively in patients with thoracolaparoscopic esophagectomy is feasible and safe. This management can shorten postoperative hospital stay and fasten postoperative bowel function recovery.

OBJECTIVEWe analyzed the lymph node (MLNs) metastasis of thoracic esophageal squamous cell carcinoma (ESCC) to explore the patterns of lymphatic spread and the rational surgical procedure and extent of lymph node dissection for ESCC.

METHODSWe retrospectively evaluated 313 consecutive patients treated in our hospital between January 2010 and May 2014 who underwent minimally invasive esophagectomy (MIE) for ESCC. The information of lymph node status was obtained and the features of lymph node metastasis were analyzed.

RESULTSOf the 313 cases, 122 (39.0%) were found to have lymph node metastasis. In the 4461 dissected lymph nodes, metastasis was identified in 294 (6.6%) lymph nodes. The recurrent laryngeal nerve lymph nodes were the most frequent metastatic nodes with a metastasis rate of 25.2%, followed by the paracardiac and left gastric artery lymph nodes (18.2%). Chi-square test showed that the lymph node metastasis is associated with tumor invasion and tumor differentiation (P<0.001 for both). Metastases were more frequently found in the recurrent laryngeal nerve lymph nodes in patients with tumors in the upper third esophagus and with histologically poor differentiation (P<0.05 for both). The metastasis rate of para-cardiac and left gastric artery lymph nodes was associated with tumor in the lower third of esophagus, T stage and differentiation (all P<0.05). Logistic regression analysis showed that tumor differentiation and location are independent factors affecting the metastasis of recurrent laryngeal nerve lymph nodes (P<0.05 for all). T stage, tumor differentiation and location were independent factors associated with metastasis of para-cardiac and left gastric artery lymph nodes (P<0.05 for all).

CONCLUSIONS(1) Metastases of thoracic esophageal carcinoma are often found in the recurrent laryngeal nerve lymph nodes, para-cardiac and left gastric artery lymph nodes. (2) Extensive lymph node dissection should be performed for ESCC with poor differentiation and deep tumor invasion.

Carcinoma, Squamous Cell ; secondary ; surgery ; Esophageal Neoplasms ; pathology ; surgery ; Esophagectomy ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Lymphatic Vessels ; Recurrent Laryngeal Nerve ; Retrospective Studies