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 risk factors of Gallstone Disease ( GD) by a meta-analy-sis, which hopefully will help to develop a strategy for its prevention .Methods Thirty case-control studies on risk factors of GD in Chinese patients reported from 1987 to 2014 were included .A quantitative compre-hensive analysis and a heterogeneity test were conducted and the OR value and its 95% confidence interval (CI) were calculated by using Stata 12.0.Results A family history of GD [OR(95%CI):2.73(2.22~3.35)], alcohol drinking [OR(95%CI):1.53(1.20~1.97)], a history of biliary tract roundworm [OR (95%CI):5.28(3.10 ~9.00)], a history of biliary tract infection [OR(95%CI): 28.50(19.22 ~42.26 ) ] , a BMI≥25 kg/m2 [ OR ( 95%CI ):1.70 ( 1.51~1.92 ) ] , greasy food intake [ OR ( 95%CI ):3.27(1.76~6.07)], a non-vegetarian diet [OR(95%CI):2.03(1.48~2.77)], hyperlipidemia [OR (95%CI):2.26(1.88~2.71)], menopause [OR(95%CI):3.25(2.49~4.24)] and multiple preg-nancies [OR(95%CI):1.56(1.29~1.88)] were risk factors of GD in China.Besides, milk drinking [OR(95%CI):0.43(0.34~0.55)] and regular breakfast [OR(95%CI):0.19(0.06~0.64)] were protective factors of GD.Tea drinking [OR(95%CI): 0.43(0.34 ~0.55)], smoking [OR(95%CI):0.86(0.51~1.45)], and a vegetarian diet [OR(95%CI):0.24(0.05~1.13)] were possible GD’s protective factors as they were not statistically significant .Conclusion Having breakfast , drinking milk , keeping fit , less alcohol and avoiding Ascaris infection prevent the occurrence of GD in China .

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.

Objective To explore the changes of the levels of CA-125 antigen(CA125) and vascular endothelial growth factor (VEGF) in serum and peritoneal fluid in patients with endometriosis (EMT), and the relationship with EMT. Methods One hundred and twenty patients with EMT (EMT group)and 98 patients with uterine fibroids (control group) were enrolled in this study. The levels of CA125 and VEGF in serum and peritoneal fluid were detected by enzyme linked immunosorbent assay (ELISA), and the results were compared. Results The levels of serum CA125,VEGF in EMT group were significantly higher than those in control group:(40.31±11.14) kU/L vs.(24.71±9.19) kU/L,(59.75±6.87) ng/L vs. (36.38±8.12) ng/L, there were significant differences(P<0.05). The levels of serum CA125,VEGF inⅠ-Ⅱphase andⅢ-Ⅳphase in EMT group had no significant differences ( P>0.05). The levels of peritoneal fluid CA125,VEGF in EMT group were significantly higher than those in control group:(311.46± 107.29) kU/L vs.(158.17± 55.42) kU/L,(73.28 ±10.40) ng/L vs. (40.21 ±9.84) ng/L, there were significant differences (P<0.05). The levels of peritoneal fluid CA125,VEGF in Ⅲ-Ⅳ phase were significantly higher than those in Ⅰ-Ⅱ phase in EMT group:(387.41±70.91) kU/L vs. (308.42±81.21) kU/L, (69.22±7.13) ng/L vs. (55.44±8.23) ng/L, there were significant differences (P<0.05). In EMT group, the levels of CA125 and VEGF in serum were significantly lower those in peritoneal fluid:(40.31±11.14) kU/L vs. (311.46±107.29) kU/L, (59.75±6.87) ng/L vs. (73.28 ±10.40) ng/L, there were significant differences (P<0.05). Conclusions The levels of CA125 and VEGF in serum and peritoneal fluid are closely related to EMT. Peritoneal fluid in monitoring of EMT may be more sensitive and reliable than serum.

Objective To investigate the role of zenapax in the prevention of acute rejection in renal transplant recipients.Methods The medical records of 50 renal transplant recipients treated with one dose of zenapax(study group) and simultaneously 30 renal transplant recipients without treatment of zenapax(control group) were retrospectively analyzed.The follow-up was six months.The incidence of acute rejection,renal allograft function,infection,and adverse effects of zenapax were comparatively analyzed between the 2 groups.Results Acute rejection rate was lower in study group(13/50,26%) compared with that in control group(17/30,57%;P)(0.05)).Conclusions One dose regimen of zenapax as part of immunosuppressive therapy is effective in the prevention of acute rejection in renal transplant recipients.It has less side effects and contributes to the improvement of renal allograft function.

Objective To uncover the possible factors of rapid increasing incidence of syphilis. Methods The clinical data of 100 patients firstly diagnosed as syphilis and their spouses were analyzed. Results There were 65 couples (130 cases) both were infected with syphilis, accounting for 65%. Among these cases, 25 males firstly diagnosed, 15 of them were primary syphilis; and 40 females firstly diagnosed as syphilis, 32 of them were secondary syphilis. Among 65 syphilis couples, 48 spouses were quickly diagnosed as syphilis through contact tracing, but the other 17 spouses were not diagnosed as syphilis until 1~3 months later, and most of them were latent syphilis, accounting for 83.2%(54/65). Chancre, which may be noticed by the patients themselves, was not so common in this group of patients, accounted for only 28.5%(37/130), and mainly in males. Conclusions The infections rate of syphilis between spoused is high, especially latent syphilis, and chancre is low, which might be one of the factors for the rapid spreading of the disease.

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.