Flow injection on-line sorption preconcentration and separation in a knotted reactor (KR) was coupled to cold vapor atomic fluorescence spectrometry for the determination of trace mercury in mineral water. Mercury was preconcentrated by on-line formation of mercury diethyldithiocarbamate complex (Hg-DDTC) and absorption of the resulting neutral complex on the inner walls of a knotted reactor. A 20%(V/V) HNO3 solution heated by electromagnetic induction heating technique was used as eluent to remove the absorbed Hg-DDTC from the KR, and then the vapor mercury generated by mixing the resulting solution and KBH4 was determined on-line by cold vapor atomic fluorescence spectrometry. The 20% HNO3 was employed as both the efficient eluent and the required acidic medium for subsequent mercury vapor generation in our work. Using 20% HNO3 instead of conventional organic solvent as eluent, the proposed method is simple, easy operational and environmentally friendly. Under the optimal experimental conditions, the sample throughput was approximatively 30/h with an enhancement factor of 35. The detection limit of mercury was 2.0 ng/L. The precision(RSD, n=11) was 2.2% at the 0.1 μg/L Hg2+ level.

OBJECTIVE:To evaluate the curative effect and safety of dexamethasone for severe asthma and severe sepsis systematically. METHODS:Randomized controlled trials about dexamethasone for severe asthma and severe sepsis were retrieved from database,such as Cochrane library(1996～2007),PubMed(1966～2007),EMCC(1995～2007),CHKD(1994～2007)and pertinent literatures. The qualities of included studies were evaluated and extracted data were analyzed by Meta-analysis respectively. RESULTS:11 trials containing 1 435 cases were up to included standard. Therapy results of severe asthma:(1)in remission rate of the total symptom,difference between dexamethasone and prednisone was not statistically significant [OR 1.44,95%CI(0.75, 2.75);P=0.27];(2)In the incidence rate of ADR,dexamethasone was lower than prednisone [OR 0.13,95%CI(0.04,0.44);P= 0.001];(3)In the recurrence rate,no statistical significance was noted in difference between dexamethasone and prednisone [OR 0.58,95%CI(0.25,1.31);P=0.19]. Therapy results of severe sepsis:(1)In the mortality,difference between dexamethasone and placebo was not statistically significant [OR 0.85,95%CI(0.41,1.78);P=0.67];(2)In the incidence rate of ADR,no statistical significance was noted in difference between hydrocortisone and placebo [OR 1.05,95%CI(0.51,2.19);P=0.89]. CONCLUSION: Dexamethasone is similar to prednisone in the treatment of severe asthma but better than prednisone in drug safety. The safety of dexamethasone is similar to placebo in the treatment of severe sepsis.

This article introduced the method and procedure of measuring the electrical skin resistance(ESR) by the digital electrical skin-resistance meter.And the factors affecting the ESR were discussed in the article.

Objective To analyze the differences in paraoperative morbidity and lymph node dissection between thoracoscopic esophagectomy and open procedure.Methods From October 2012 to April 2014,207 patients with esophageal cancer underwent surgery.125 patients underwent video-assisted esophagectomy,and 82 underwent open procedure.In the minimally invasive group,there were 109 thoracoscopic cases and 16 thoracolaparoscopic cases.Results There were significant differences between the thoracoscope group and the open group in atelectasis(0.8％ vs.7.3％,P ＜ 0.05),pleural effusion (0 vs.4.9％,P ＜ 0.05),acute respiratory distress (0 vs.6.1％,P ＜ 0.05),ligation of thoracic duct (3.2％ vs.15.9 ％,P ＜ 0.05),recurrent laryngeal nerve paralysis (19.2％ vs.32.9％,P ＜ 0.05),c hylothorax (0 vs.4.9％,P ＜ 0.05),number of lymphonode along the right recurrent laryngeal nerve lymphatic chains[1.91 ± 0.73 vs.1.12 ± 0.81,P ＜ 0.05)] and achievement ratio(97.6％ vs.89.0％,P ＜0.05) and number of lymphonode along the left recurrent laryngeal nerve lymphatic chains (0.93 ± 0.71 vs.1.76 ± 0.84,P ＜ 0.05) and achievement ratio(52％ vs.76.8％,P ＜ 0.05).No significant differences were observed in pneumonia,anastomotic leak,thoracic abscess,esophago-tracheal fistula,re-laparotomy,re-thoracotomy,wound infection,arrhythmia,cardia failure,renal failure,hepatic inadequacy,cerbral infarction,and mortality(P ＞ 0.05).There were also no significant differences in number of lymphonode and achievement ratio of periesophagel lymph nodes,subcarinal lymph nodes and hilar lymph nodes (all P ＞ 0.05).Conclusion The thoracoscopic esophagectomy has some obvious advantage associated with less pulmonary complications,lower injury of thoracic duct and recurrent laryngeal nerve,more lymphonode and higher achievement ratio along the right recurrent laryngeal nerve lymphatic chains.But it has still a larger space for improvement of lymphadenectomy along the left recurrent laryngeal nerve lymphatic chains.

Objective To investigate the effect of gastrodin on rat vascular smooth muscle cell (VSMC) migration induced by platelet-derived growth factor-BB (PDGF-BB) and its possible mechanisms.Methods Enzyme digestion method wasused to obtain rataorticVSMCs and be purified bypassage.Immunofluorescence staining was used to identify VSMC marker proteins.A PDGF-BB induced cell migration model was established.Transwell chamber assay was used to evaluate the effect of gastrodin on PDGF-BB induced VSMC migration.Western blots were performed to detect the phosphohorylation levels of c-jun N-terminal kinase (JNK).Results The purity of primary cultured VSMC was more than 99％.The VSMC migrated number in the PDGF-BB group was 85.2 ± 3.486 per field.It was significantly more than 42.5 ± 1.927 per field in the control group (t =9.981,P＜0.001),and gastrodin was enable to make PDGF-BB induced the number of VSMC migration significantly reduce to 71.3 ± 1.783 per filed (t=3.550,P =0.002).Western blots analysis showed that gastrodin inhibited PDGF-BB induced JNK phosphorylation (0.190 ± 0.015 vs.0.190 ± 0.015; t =14.548,P =0.000).Conclusions Gastrodin inhibits PDGF-BB induced VSMC migration,its mechanisms may be associated with the inhibition of the JNK signaling pathway activation.

Esophagectomy and lymph node dissection are the cornerstones for the treatment of esophageal cancer. Upper mediastinal lymph node dissection is of great value for accurate staging and improving the prognosis of patients. Lymph node dissection along the left recurrent laryngeal nerve is the most challenging procedures in esophageal surgery, and there has been no relevant consensus on the scope and boundary of lymph node dissection. In recent years, with the application of endoscopic technology, especially robotic surgery system in esophagectomy, and the introduction of the concept of superior mediastinal microdissection, the authors have proposed the border of lymph node dissection along the left recurrent laryngeal nerve, so as to achieve precise, radical and standardized dissection. Combined with their own experiences, the authors elaborate on the anatomic boundary, extent and technique of lymph node dissection along the left recurrent laryngeal nerve.

Objective To explore the clinical distribution states of human papillomavirus genotypes in tissues of 691 women with vulva condyloma acuminates in Nanjing city and Zhenjiang city in Jiangsu Province and genotyping clinical significance.Methods Polymerase chain reaction(PCR)and gene-chips technology were utilized for the detection of 23 kinds of HPV genotypes in tissue specimens from 619 women of vulva condyloma acuminates in Nanjing city and Zhenjiang city in Jiangsu Province.And related materials of all subjects were analyzed.Results In 691 women of vulva condyloma acuminates,597 women of HPV infecton,total infection rate of HPV was 86.40％(597/691),including single genotype infection rate of HPV was 51.38％(355/691),11、6 and 16 genotypes are the most common in single genotypes,they are successively 51.55％(183/355)、41.97％(149/355)and 3.38％(12/355).multiple genotypes infection rate of HPV was 35.02％(242/691),6+11、11+18、6+16 and 11+16 genotypes are the most common in multiple genotypes,they are successively 9.92％(24/242)、9.09％(22/242)、4.96％(12/242)and 4.13％(10/242).Conclusion The low-risk HPV types are the main factors to cause the female vulva CA,a few high-risk HPV types may cause warts as well in tissues of women with vulva condyloma acuminates in Nanjing city and Zhenjiang city in Jiangsu Province.The vulva examine of HPV types should be held to the vulva CA patients.This precaution will has extremely important meaning to the prevention and treatment of the female vulva CA and cervical lesion in our nation.

BACKGROUNDTo investigate the clinical characteristics of thoracic lymph node metastasis in lung cancer.

METHODSThree hundred and eighteen patients with lung cancer underwent pneumonectomy or lobectomy and lymphadenectomy from Jan 2000 to Jan 2002.

RESULTSA total of 1534 groups of lymph nodes were removed. Metastatic frequency of thoracic lymph nodes was 58.5% (186/318), in which N1 was 27.0% (86/318), N2 was 31.4% (100/318). There were higher frequencies of lymph node metastasis in 4, 7, 10, 11 regions around the root of lung. Among the skipping N2 metastasis (14.5%, 46/318), upper lobe cancer led to only upper mediastinal lymph node metastasis, however, lower or right middle lobe cancer caused both upper and lower mediastinal lymph node metastasis. Of the patients with swelling hilar and mediastinal lymph nodes reported by preoperative CT scan, only 48.2% were confirmed with lymph node metastasis by postoperative histopathology; while 22.4% of the patients with normal size lymph nodes had lymph node metastasis.

CONCLUSIONSIf there is no hilar and inferior carinal metastatic lymph node in patients with upper lobe cancer, the lower mediastinal lymph node dissection might not be necessary. But systematic mediastinal lymph node dissection should be performed in patients with lower lobe or right middle lobe cancer whether there is hilar or inferior carinal metastatic lymph node or not. The extent of lymph node dissection should not depend on the results of preoperative chest CT scan.

OBJECTIVETo study the impact of preoperative fasting plasma glucose(FPG) on postoperative morbidity and outcome following surgical resection of esophageal squamous cell carcinoma (ESCC), and to analyze the risk factor of postoperative complication in ESCC.

METHODSClinicopathological data of 314 ESCC patients undergoing esophagectomy in our center between January 2011 and December 2012 were retrospectively collected. Patients were divided into two groups according to their preoperative FBG: normal FPG group (FPG<6.1 mmol/L, 252 cases) and high FBG group (FPG≥6.1 mmol/L, 62 cases, including 14 diabetes cases). Clinicopathological data and postoperative morbidity were analyzed and compared between two groups. Multivariate logistic regression analysis was used to evaluate risk factors for postoperative complications.

RESULTSThere were 278 male and 36 female patients with a median age of 59 years (range 42-83 years). As compared to normal FPG group, high FBG group had higher ratio of female [22.6%(14/62) vs. 8.7%(22/252), P=0.000], older median age (66 years vs. 59 years, P=0.010), lower ratio of smoking and alcohol drinking [48.4%(30/62) vs. 73.8%(186/252), 38.7%(24/62) vs. 69.0%(174/252), both P=0.000], higher ratio of comorbid diabetes and hypertension [51.6%(32/62) vs. 15.1%(38/252), 16.1%(10/62) vs. 1.6%(4/252), both P=0.000]. Pathology results showed 206 patients in normal FPG group (81.7%, 206/252) were moderate-poor differentiation, which was obviously lower than 93.5%(58/62) in high FPG group(P=0.023). Patients of two groups completed their operations successfully. Perioperative overall complication morbidity was 24.2%(76/314), and the most common was lung lesions (24 cases of pneumonia, 10 cases of respiratory failure), then was anastomotic leakage (28 cases) and incision infection (18 cases). Differences in overall and other complication morbidity were not significant between two groups (all P>0.05). Multivariate logistic regression analysis revealed that operation time was an independent risk factor of postoperative complications (P=0.047), anastomosis site was an independent risk factor of anastomotic leakage (P=0.036), and FPG was not a risk factor of postoperative complications(respectively, P=0.683, P=0.836, P=0.784, P=0.637).

CONCLUSIONSPreoperative control of FBG does not increase the postoperative complication morbidity. Shortening operation time and choosing appropriate surgical procedure are important to decrease postoperative complications.

Adult ; Aged ; Aged, 80 and over ; Alcohol Drinking ; adverse effects ; Anastomotic Leak ; etiology ; Blood Glucose ; physiology ; Carcinoma, Squamous Cell ; complications ; surgery ; Comorbidity ; Diabetes Complications ; epidemiology ; Diabetes Mellitus ; Esophageal Neoplasms ; complications ; surgery ; Esophagectomy ; adverse effects ; Female ; Humans ; Hypertension ; complications ; Male ; Middle Aged ; Operative Time ; Pneumonia ; epidemiology ; etiology ; Postoperative Complications ; epidemiology ; Respiratory Insufficiency ; epidemiology ; etiology ; Retrospective Studies ; Risk Factors ; Smoking ; adverse effects ; Surgical Wound Infection ; epidemiology ; Treatment Outcome

OBJECTIVETo compare the perioperative complications and the stress response between thoracoscopic esophagectomy and open esophagectomy in patients with esophageal cancer.

METHODSClinicopathologic data of 154 patients with esophageal cancer undergoing thoracoscopic esophagectomy (thoracoscope group) and 113 undergoing open procedure(open group) in the Tianjin Medical University Cancer Institute and Hospital from October 2012 to September 2014 were analyzed retrospectively. The incidence of perioperative complications and the change of stress response index in patients without complications were compared between two groups.

RESULTSThe total complication rate in thoracoscope and open group was 33.8% and 38.1%(P = 0.470) respectively. Compared with open group, incidence of ligation of thoracic duct(2.6% vs. 14.2%), recurrent laryngeal nerve paralysis (16.9% vs. 28.3%), chylothorax (0 vs. 4.4%), atelectasis (1.3% vs. 7.1%), pleural effusion (0.6% vs. 6.2%) and acute respiratory distress(0.6% vs. 6.2%) were obviously decreased in thoracoscope group(all P<0.05). No significant differences were observed in other complications (all P>0.05). Thirty-two cases and 24 cases without complication and with complete test data in thoracoscope and open group were selected for the detection of stress response index. There were no significant differences in white blood cell count, and the levels of cortisol, thyroxine (FT3 and FT4) and C-reactive protein between two groups at the same time points (before operation, 1, 3 and 6 days after operation) (all P>0.05).

CONCLUSIONThoracoscopic esophagectomy has some obvious advantages associated with less pulmonary complications, lower morbidity of injury in thoracic duct and recurrent laryngeal nerve, while no significant difference of stress response is found in patients without complication between thoracoscope group and open group.

Esophageal Neoplasms ; surgery ; Esophagectomy ; Humans ; Ligation ; Postoperative Complications ; Retrospective Studies ; Thoracoscopy