Objective To study the clinical application effect of Ivor-Lewis combined with thoracic-lapa-roscopy for esophageal carcinoma resection in patients with esophageal lowest cancer.Methods A total of 68 patients with esophageal lowest cancer were individed into the observation group and control group by the random number method,each of 34 cases.The patients in the observation group received Ivor-Lewis combined with thoracic-lapa-roscopy,and the patients in the control group received intrathoracic esophagogastrostomy by left chest posterolateral incision,then to compare the differences of clinical effect and complications.Results The operation time,blood loss in-operation,in-hospital time,thoracic drainage after operation in the observation group were all significantly less than those of the control group[operation time:(165.3 ±53.7)vs (214.3 ±71.5)min,t=3.814,P=0.037;blood loss in-operation:(153.6 ±23.1)vs (312.3 ±48.6)min,t=3.413,P=0.042;in-hospital time:(7.4 ±1.2)vs (10.5 ±2.3)d,t=3.256,P=0.043;thoracic drainage after operation:(635.6 ±34.2)vs (831.3 ±45.6)mL,t=2.594,P=0.039].The total rate of complications including pulmonary infection,gastric emptying,anastomotic fistula and diaphragmatic hernia and the recurrence rate after 6 months including recurrence in situ,lymph node and hema-togenous metastasis were all significantly lower in the observation group(complication:17.65%vs 38.24%,χ2 =4.012, P<0.001;recurrence:20.59% vs 47.06%,χ2 =4.825,P<0.001).Conclusion Ivor-Lewis combined with tho-racic-laparoscopy for esophageal carcinoma resection in patients with esophageal lowest cancer is safe and effective.

Objective To investigate the effect of siRNA-down-regulating astrocyte elevated gene-1(AEG-1)on the proliferation and apoptosis of cervical carcinoma cells.Methods The designed and synthesized AEG-1 siRNA was transfected to the cervical car-cinoma SiHa cells.The influence of AEG-1 siRNA on the expression of AEG-1 gene was detected by real-time fluorescent quantita-tive-polymerase chain reaction (RT-PCR);the inhibiting effect of AEG-1 siRNA on the proliferation of cervical cancer SiHa cells was detected by the MTT method;the influence of AEG-1 siRNA on apoptosis and cell cycle of the cervical cancer SiHa cellswas determined by the flow cytometry.Results Compared with the control group,AEG-1 siRNA transfecting human cervical cancer Si-Ha cells could evidently down-regulate the expression of AEG-1 gene with statistical difference (P<0.01);at the same time,the dwn-regulation of AEG-1 gene expression could significantly inhibit the proliferation of the cervical cancer SiHa cells (P<0.01), promote the apoptosis of SiHa cells (P<0.01)and arrest the cell cycle in G0/G1 phase.Conclusion AEG-1 siRNA can down-regulate the expression of AEG-1 gene in the cervical carcinoma SiHa cells,inhibit the proliferation of the cervical carcinoma SiHa cells and promote their apoptosis.

Objective To investigate the effect of different postures in three dimensional conformal therapy for head and neck tumors.Methods 40 patients with head and neck cancer were selected as the research subjects.All patients were randomly divided into observation group and control group,20 cases in each group.The observation group for neck shoulder film fixed position,the control group was the first film fixed position each patient,radiotherapy 10 times.The display error condition of different position fixing of the two groups was compared.Results There was no significant difference in the error of the two groups in the X direction (P>0.05).The Y direction error,Z direction error of observation group were (0.12±0.12)mm,(0.10±0.11)mm,which were significantly lower than those of the control group[(0.23±0.19)mm,(0.19±0.15)mm] (t=2.189,2.163,all P<0.05).Set-up repeatability errors in the Y axis,error more than 2mm in the observation group was 14 times,the error rate was 7%,which in the control group was 40 times,the error rate was 20%,the observation group was significantly smaller than the control group,the differences were statistically significant(x2=29.286,7.236,all P<0.05).Set-up repeatability error in the Z axis,error more than 2mm in the observation group was 12 times,the error rate was 6%,which in the control group was 34 times,the error rate was 17%,the observation group was significantly smaller than the control group,the differences were statistically significant(x2=29.286,5.944,all P<0.05).Conclusion For the patients with head and neck cancer who received three-dimensional conformal radiotherapy,the positioning accuracy and repeatability of the head and neck shoulder film position is better,has higher clinical value,it is worth to be popularized.

The decision-making problems of buying medical equipment in hospitals are given. With Dempster fusion of evidence decision-making theory, according to the expert judgment complexion for buying large-scale medical equipment on technical performance, price, maintenance cost, matching degree, economical efficiency and qualify, basic probability partition function and computational belief function are established, and then achieves advantage connection on candidate equipment and gives support for buying medical equipment in hospital.

Objective To investigate the effect of S-phase kinase-associated protein 2 antisense oligodeoxynucleotide (Skp2 ASODN) on the growth and proliferation of colorectal cancer cells SW480 and its mechanism .Methods The liposome-mediated dif-ferent concentrations of Skp2 ASODN was adopted to transfect SW480 cells ,the final concentrations of 0 .050 ,0 .125 ,0 .250 ,0 .500 , 1 .000 ,2 .000 ,4 .000 μmol/L were respectively set up with Skp2 nonsense oligodeoxynucleotides(NSODN) and blank group as con-trol .Then the inhibited effect of growth and proliferation of colorectal cancer cells were measured by the inverted microscope obser-vationandmethylthiazolyltetrazolium(MTT),thecellcyclewassurveyedbytheflowcytometry(FCM).TheexpressionofmRNA and protein of Skp2 and P27kip1 were inspected by reverse transcription-polymerase chain reaction(RT-PCR) and immunocytochem-istry methods .Results The inverted microscope observed that the SW480 cells had no change in form and grew at a slower speed . When the Skp2 ASODN concentration reached 0 .125 μmol/L ,the inhibition rate was 14 .48% (P<0 .05) .As the Skp2 ASODN concentration increase ,its inhibition action on the growth and proliferation of SW480 cells was enhanced in a dose-dependent man-ner(P<0 .01) .The SW480 cells were increased in G0/G1 phase(P<0 .01) and decreased in S phase(P<0 .05) ,the progression of cell cycle was blocked .RT-PCR and the immunocytochemistry showed that both Skp2 mRNA and protein levels were down-regula-ted(P<0 .05) .Although the P27kip1 mRNA level had no change(P>0 .05) ,but its protein expression was elevates obviously (P<0 .01) .Conclusion Skp2 ASODN can inhibit the growth and proliferation of SW480 cells .Its possible mechanism is that the ubiq-uitin degradation of the Skp2 to P27kip1 is decreased by the gene occlusion effect of Skp2 ASODN ,thus the cell cycle progression is arrested .

In order to meet the needs of the skin venerealdiseases study direct-viewing teaching and the new curriculum reforms,and fully display the multimedia technology in the dermatology departmentteaching function,on the basis of the sixth edition of the teaching material on skin venereal diseases and in combination with the union massive pictures,theanimation as well as the correlation data,the richly colorful direct-viewing teaching coursewares were designed with abundant pictures,and the teaching effect was satisfied.Besides,some deficiencies were proposed.

Objective To observe the clinical efficacy of Qihuang needle therapy in treating knee osteoarthritis.Methods Sixty knee osteoarthritis patients were randomly divided into treatment group and control group,30 cases in each group.The treatment group was given Qihuang needle therapy and the control group was given conventional acupuncture therapy.After treatment for 10 days,we evaluated the curative effect of the two groups by the scores of the simplified McGill pain scale (MPQ) and the Lysholm knee scoring criteria.Results (1) After treatment for 10 days,the symptoms of pain,swelling,stiffness,and inhibited bending and stretching of knee joints of the two groups were relieved.Pain rating index (PRI),visual analogue scale (VAS) scores and present pain intensity (PPI)of MPQ in the two groups were obviously decreased,while Lysholm knee scores were markedly increased(P ＜ 0.01 compared with those before treatment),and the effect of the treatment group was superior to that of the control group (P ＜ 0.05).(2) The total effective rate of the treatment group was 86.67％,and that of the control group was 66.67％,the difference between the two groups being significant (P ＜ 0.05).Conclusion Qihuang needle therapy is effective for the treatment of knee osteoarthritis,with the advantages of shorter treatment course,better therapeutic effect and being more practical.

Objective To investigate the effect of head-up tilt on cerebral blood flow velocity during general anesthesia in patients with diabetic neuropathy.Methods Sixty ASA Ⅰ - Ⅱ patients of both sexes aged 40-60 yr weighing 52-70 kg undergoing general anesthesia were divided into 3 groups according to diseases complicated with diabetes situation ( n =20 each):group Ⅰ normal control the patients did not have diabetes mellitus; group Ⅱ type Ⅱ diabetics without neuropathy and group Ⅲ Ⅱ diabetics with neuropathy.Anesthesia was induced with propofol 2 mg/kg,fentanyl 3 μg/kg and vecuronium 0.1 mg/kg and maintained with 1％ sevoflurane.The patients were intubated and mechanically ventilated.PErCO2 was maintained at 35-45 mm Hg.Transcranial doppler (TCD)was used to measure middle cerebral artery blood flow velocity (MBFV).MAP and MBFV were measured and recorded in supine position (baseline) and at 1.5,3.5 and 5.5 min of 45° head-up tilt.Results The 3 groups were comparable with respect to age,body weight,height and M/F sex ratio.MAP and MBFV significantly decreased at 45° head-up tilt as compared with the baseline in all the 3 groups.There was no significant difference in MAP and MBFV among the 3 groups.Conclusion Cerebral blood flow velocity decreases when the patients are tilted 45° head-up during general anesthesia in both diabetics with and without neuropathy,but there is no significant difference between the 2 groups.

Objective To detect the level of plasma superoxide dismutase(SOD) in patients with lung cancer and effect of chemotherapy(CGM + CBP) on it,and to investigate the role of SOD in the development .of lung cancer. Methods Xanthine oxidation enzyme was availabe to detect the level of plasma SOD in 30 cases of normal control subjects and 29 cases of patients with lung cancer before and after first, second, third cycle of chemotherapy. Resuits The levels of plasma SOD in lung cancer after chemotherapy were lower than those in the control group(P＜0.01). The level of plasma SOD in lung cancer after first and second chemo-cycle was higher than that before, but lower than that of control group(P＜0.01), the differences between after third chemo-cycle and control group were not significant(P＞0.05 ). The differences in squamoun cell carcinoma and adenocarcinoma before chemothrapy and after were not significant (P＞0.05 ). The differences in squamoun cell carcinoma and adenocarcinoma and adenosquamoun carcinoma before chemotherapy and after were highly significant (P＜0.01 ). The differences in each chemo-cycle were highly significant (P＜0.01). Conclusion SOD played an important role in growth, regulation and treatment of lung cancer,and it might be a clinical index in lung cancer.

Objective To evaluate the clinical efficacy of the non-ablative 1550 nm fractional laser on post-acne atrophic scarring and post-acne erythema.By following up,the correlative factors were analyzed to guide the further use of the non-ablative 1550 nm fractional laser.Methods Twentyseven patients who received the non-ablative 1550 nm fractional laser therapy from Dec.2011 to June 2013 were enrolled in this retrospective study.We used a quartile grading scale for evaluation of postacne atrophic scarring and post-acne erythema.Results The effective rate was 13.0％ (3/23) for post-acne atrophic scarring and 44.0％ (11/25) for post-acne erythema.Nonparametric test showed that there was no statistical correlation of the efficacy with gender,age and courses of disease.But there was positive correlation between efficacy and treatment frequencies on post-acne erythema (r=0.619,P＜0.05).No severe adverse effect was observed.Conclusions We suggest that the nonablative 1550 nm fractional laser may provide a new treatment algorithm in some cases of post-acne atrophic scar and post-acne erythema.