Currently,resectable esophageal cancer is commonly initially treated with surgery in China,but the optimal postoperative treatment remains unclear.Postoperative concurrent chemoradiotherapy can improve local control and reduce distant metastasis and may become the preferred treatment for patients after surgery for esophageal cancer.By summarizing the studies on concurrent chemoradiotherapy after surgery for esophageal cancer,this review points out that postoperative concurrent chemoradiotherapy can improve the overall survival of patients with positive lymph nodes and has tolerable adverse effects,but the populations who can benefit from this treatment,the optimal radiotherapy dosage,target volume,and chemotherapy regimen of postoperative concurrent chemoradiotherapy await further investigation.

OBJECTIVE:To establish the method for simultaneous determination of alantolactone,isoalantolactone,gallic acid,emodin,aloe-emodine,rhein,physcion and chrysophanol in Liuwei nengxiao pills.METHODS:HPLC method was adopted.The determination was performed on Diamonsil C18 with mobile phase consisted of methanol-acetonitrile-0.1％ glacial acetic acid (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelengths were set at 254 nm (alantolactone,isoalantolactone,emodin,aloe-emodine,rhein,physcion and chrysophanol),270 nm (gallic acid).The column temperature was 25 ℃,and sample size was 10 μ L.RESULTS:The linear ranges of alantolactone,isoalantolactone,gallic acid,emodin,aloe-emodine,rhein,physcion,chrysosphanol were 0.121-3.63 μg(r=0.999 9),0.122-3.66 μg(r=0.999 9),0.219-6.57 μg(r=0.999 9),0.016 4-0.492 μg(r=0.999 7),0.017 3-0.519 μg(r=0.999 9),0.015 3-0.459 μg(r=0.999 9),0.007 2-0.216 μg(r=0.999 9),0.016 2-0.486(r=0.999 9).The limits of quantification were 0.41,0.26,0.35,0.13,0.17,0.14,0.15,0.13 ng;limits of detection were 0.12,0.08,0.11,0.04,0.05,0.04,0.05,0.04 ng.RSDs of precision,stability and reproducibility tests were all lower than 2.0％.The recoveries were 98.05％-102.46％ (RSD=1.75 ％,n=6),98.55％-102.89％ (RSD=1.91％,n=6),98.53 ％-102.34％ (RSD=1.66％,n=6),101.71％-103.41％ (RSD =0.57 ％,n=6),101.04％-103.01％ (RSD=0.69％,n=6),101.63％-102.75％ (RSD=0.39 ％,n=6),96.94％-101.11％ (RSD=1.61％,n=6),98.06％-99.10％ (RSD=0.40％,n=6).CONCLUSIONS:The method is accurate,simple and suitable for simultaneous determination of 8 components in Liuwei nengxiao pills.

Over-expression of P-glycoprotein (Pgp) is associated with the development of multi-drug resistance ( MDR). Pgp has been focused on as the main target in designing chemotherapy strategy. In this article we review some of the latest advancement in designing and evaluation methods of P- glycoprotein inhibitors.

Obstructive sleep apnea (OSA) has been definitively shown to be a risk factor for the development of cardiovascular disease and mortality. Recent reports have indicated that obstructive sleep apnea is associated with insulin resistance and impaired glucose metabolism, also have type 2 diabetes. The potential mechanisms leading to the development of type 2 diabetes in OSA patients are likely to be various. Reduced physical activity resulting from daytime somnolence, sympathetic nervous system activation, intermittent hypoxia, sleep fragmentation and sleep loss, dysregulation of the hypothalamic-pituitary axis, alteration in adipokine profiles, and activation of inflammatory pathways have been proposed. Based on the current evidence, clinicians should assess the risk of OSA in patients with type 2 diabetes and, conversely, consider that possibility of glucose intolerance in patients with OSA. Further large-scale and long-term follow-up studies in patient populations with selected by reliable but inexpensive diagnostic measures, controlled for potential confounder factor, are needed.
Adipokines ; Anoxia ; Axis, Cervical Vertebra ; Cardiovascular Diseases ; Glucose ; Glucose Intolerance ; Humans ; Insulin Resistance ; Motor Activity ; Risk Factors ; Sleep Apnea, Obstructive ; Sleep Deprivation ; Sympathetic Nervous System

BACKGROUND: Alendronate has been recently used for treating osteoporosis by inhibiting the activity of osteoclasts, but further clinical observation is necessary to compare its therapeutic effect with exclusive use of calcium supplement.OBJECTIVE: To observe the therapeutic effect of oral alendronate (tianke tablet) on the clinical symptoms and bone mineral density (BMD) of middle-aged and elderly patients for comparison with calcium gluconate.DESIGN: A self-controlled study and controlled trial with concurrent patients.SETTING: Department of Orthopedics, Shenzhen Hospital, Peking UniversityPARTICIPANTS: Sixty-eight middle-aged and elderly patients with osteoporosis were admitted in the Department of Orthopedics, Shenzhen Hospital of Peking University between July 1999 and July 2000. From these patients 62 at the age over 45 years without secondary osteoporosis were selected for this study, who were randomly divided into oral alendronate group (n=32) and oral calcium gluconate group (n=30).INTERVENTIONS: On the basis of comprehensive therapies, the patients in the alendronate group were given 10 mg alendronate daily and those in calcium gluconate group had 20 mL oral calcium gluconate solution (containing 100 mg calcium gluconate, equivalent to 9 mg calcium in every 10 mL) three times daily for three months. According to bodily pain relief, occurrence of new fracture and improvement in BMD, the therapeutic effect was assessed in three grades.RESULTS: Thirty patients in the alendronate group and 26 in the calcium gluconate group completed the study. Alendronate treatment for 3months significantly increased BMD of the patients [(0.716±0.082) g/cm2in comparison with that before treatment [(0.667±0.083) g/cm2, t= 2.473,P ＜ 0.01], whereas the BMD underwent no obvious changes after treatment with calcium gluconate [(0.671±0.081) g/cm2 before vs (0.680±0.073) g/cm2after treatment, t=1.812, P ＞ 0.05]. Significant difference in BMD after treatment was noted between the two groups (t=2.384, P ＜ 0.01). The effective rate was significantly higher in alendronate group than in calcium gluconate group (X2=14.9, P=0.005), but 7 patients complained of abdominal discomfort in the former group and the patients in calcium gluconate group reported no adverse effects.CONCLUSION: Alendronate can inhibit bone absorption, promote the recovery of bone matrix, and increase the bone mass, producing better effect than exclusive use of calcium gluconate oral solution in treatment of the osteoporosis in the middle-aged and the elderly.

Relevant literatures on the relationship betw een fluorosis and oxidative stress were reviewed.Based on most of the original papers published in recent years,we can see the increased free radicals and oxidative stress may occur in certain stage of fluoride intoxication,but confirmation of the causality between oxidative stress and fluoride-induced damages still remains much work to do.

Background Silicon oil tamponade eyes following vitrectomy accelerate and induce lens opacification,so the accurate measurement and calculation of intraocular lens (IOL) diopter before cataract extraction+ IOL implantation is very important for the recovery of visual function.Objective This study was to compare the differences of IOL powers measured and calculated by different apparatus and different IOL power formulas before cataract extraction + IOL implantation silicon oil tamponade combined with cataractous eyes.Methods A prospective,consecutive,nonrandomized study was performed.Thirty-six silicon oil tamponade with cataract eyes of 36 patients were included in the Second Affiliated Hospital of Soochow University from August 2011 to October 2013.Patients with silicone oil emulsification for 4 months to 2 years prepared to treat by cataract extraction + IOL implantation+silicon oil removal.Axial length (AL),corneal curvature (CC) and anterior chamber depth (ACD) were measured with IOLMaster and A-scan with manual kerameter (MK) in the eyes for the prediction of IOL power by SRK-Ⅱ,SRK/T,Hoffer Q,Holladay 1 and Haigis formulas under the oral informed consent.The mean predictive error (MPE) and mean absolute refractive error (MAE) between predictive IOL diopters before operation and actual IOL diopters after operation were evaluated.Results The AL and ACD values measured by IOLMaster was (25.43± 0.90)mm and (3.22±0.38)mm,which were significantly higher than (25.21±1.02)mm and (3.07±0.62) mm by A-scan+ MK respectively,the difference between the two measure methods was statistical significance (both at P =0.000).No significant difference was found in measured CC values between IOLMaster and A-scan+MK ([44.58±1.57] D vs.[44.56±1.62] D) (P=0.568).When the parameters measured by IOLMaster were used,the MAE from SRK/T formula was smaller than that from SRK-Ⅱ,Hoffer Q,Holladay 1 and Haigis formulas (P =0.017,0.009,0.012,0.001),and the MAE from Haigis formula was significantly larger than that from SRK-Ⅱ,Hoffer Q and Holladay 1 formulas (P =0.026,0.035,0.021).When measured by A-scan + MK,the MAE from Haigis formula was significantly larger than that from SRK-Ⅱ,SRK/T,Hoffer Q and Holladay 1 formulas (P=0.007,0.004,0.018,0.006).There was no significant difference in the number of eyes with MAE ≤ 1.0 D between IOLMaster and A-scan+MK measurements under the calculation of SRK-Ⅰ,SRK/T,Hoffer Q and Holladay 1 formulas (x2 =0.107,2.250,0.845,0.084,all at P＞0.05).However,the number of eyes with MAE ≤ 1.0 D was significantly increased in IOLMaster measurement compared with A-scan+MK under the calculation of Haigis formula (x2 =4.431,P =0.035).Conclusions In silicon oil-filled cataract eyes,SRK/T formula appears to have a more accurate predictive value of IOL power than that of other formulas when employ IOLMaster;when use A-scan+MK measurement,the predictive value of IOL power seems to be better by using SRK-Ⅱ,SRK/T,Holladay 1 or Hoffer Q formulas.

Tsutsugamushi disease is an acute infectious rickettsial disease caused by the intracellular parasite Orientia tsutsugamushi. Due to its variety of clinical signs, this disease is often misdiagnosed. This article examines a total of 4 patients who visited our clinics with fever and sore throat. 3 of them had body temperature of 39.5 Celsius degrees when admitted. The characteristic black eschar occurred on 4 of them. Lymphadenopathy occurred on 2 of them. Cough occurred on 1 of them. Lab tests showed that 3 of them had Leukocytosis, 1 of them had increased bronchovascular markings, and 3 of them had Weil-Felix test positive. After admission, all patients, who were confirmed of diagnosis of tsutsugamushi disease instead of tonsillitis, received the comprehensive treatment and cured afterwards.
Diagnostic Errors ; Humans ; Orientia tsutsugamushi ; Pharyngitis ; etiology ; Scrub Typhus ; complications ; diagnosis ; Tonsillitis ; diagnosis

Objective To explore the accuracy of bedside arterial blood gas analyzer in detecting electrolytes and anionic gap (AG) in ICU patients, and compare it with auto-analyzer. Methods Results of blood sodium, potassium, chlorine, bicarbonate ions and AG measured by arterial blood gas analyzer and auto- analyzer of 376 ICU adult patients admitted to ICU were retrospectively analyzed. With the outcomes of auto-analyzer as standard, the correlation and difference of electrolytes and AG measured by 2 methods were analyzed. Results The sodium, potassium, chlorine and AG measured by auto-analyzer were 121 - 183 mmol/L, 2.13 - 6.77 mmol/L, 86 - 146 mmol/L and 1 - 62 mmol/L. The blood sodium, potassium, chlorine and AG measured by arterial blood gas analyzer were 114 - 180 mmol/L, 1.78 - 6.36 mmol/L, 94 - 150 mmol/L, -7 - 40 mmol/L. The blood sodium, potassium and AG measured by arterial blood gas analyzer were lower than those measured by auto-analyzer, but the blood chlorine was higher than that measured by auto- analyzer. There were statistical differences in the difference of low, normal and high electrolytes and AG between 2 methods (P<0.01). Conclusions The electrolytes and AG measured by arterial blood gas analyzer and auto-analyzer are significantly different, and the electrolytes measured by arterial blood gas analyzer are unreliable to calculate AG.

DSS group,although without statistical significance.JOA score of two groups before and after surgery without statistical significance.[Conclusion]Developmental spinal stenosis is pathology found,which influences course of ossification of cervical posterior longitudinal ligament.The principal factor is trauma,which induces ossification of cervical posterior longitudinal ligament.Decompressed from a posterior approach is a reasonable treatment way.