Objective To explore the pattern of lymph node metastasis in patitsen with squamous cell carcinoma of the thoracic esophagus and its significance in lymphadenectomy.Methods The clinical data of 230 patients who received radical esophagectomy with three-field lymphadenectomy was analyzed.The metastatic sites of lymph nodes were correlated with tumor location by chi-square test.Logistic regression was used to analyze the relationship between clinic pathoingical factors and lymph node metastasis.Results Lymph node metastases were found in 133 of the 230 patients(57.8%).The average number of resected lymph nodes was 25.3? 11.4 per patient(range 11～71).The rates of lymph node metastasis were 41.6%,19.44%and 8.3%in the neck,thoracic medi- astinum and abdominal cavity for patients with upper thoracic esophageal carcinoma,33.3%,34.7%and 14%for patients with mid- die thoracic esophageal carcinoma and 36.4 %,34.1%and 43.2 %for patients with lower thoracic esophageal carcinoma.No signifi- cant difference in cervical or thoracic metastatic rate was observed among upper,middle and lower thoracic carcinoma.The difference in lymph node metastatic rate for nodes in the abdominal cavity was significant among upper,middle and lower thoracic carcinoma. The lower thoracic esophageal cancers were more likely to metastasize to the abdominal cavity.Logistic-regression showed depth of tu- mor invasion and angiolymphatic invasion were factors influencing lymph node metastasis.Conclusion Cervical and mediastinal node dissection should be performed independently from tumor location.Abdominal node dissection should be conducted more vigorously for lower thoracic esophageal cancer than of other locations.Patients with greater tumor grade,depth of tumor invasion and angiolymphatic invasion were more prone to develop lymph node metastasis.

Objective To study the changes of iodine source and the nutritional status of iodine after termination of iodized salt supply in the areas with different water iodine concentrations in Shanxi province,in order to provide scientific bases for developing strategies on control and prevention of iodine deficiency disorders,and to study the cut-off value of water iodine level where iodized salt supply should be stopped.Methods In 2010 in Shanxi province,6 villages with 100％ of non-iodized salt consumption rate were selected as the survey spots based on the iodine concentration in drinking water of 0-,50-,100-,150-,300-,≥500 μg/L.Villages'iodized salt supply was terminated thoroughly.In each village,20 children aged 8 to 10 were selected.At the same time,women of childbearing age 18 to 50 years old and adult men aged 18 to 60 were selected from the same families as the children.Diet surveys were conducted by the method of 3 days recall on all subjects.Drinking water samples,staple foods,supplementary foods and urinary samples of all subjects were collected and the iodine concentration was determined by arsenic-cerium catalytic spectrophotometry.Results ①In the villages of water iodine 25.9,70.6 μg/L,the medians urinary iodine of children,women and men were all ranged from 100 to 199 μg/L,which meant their iodine nutrition levels were appropriate.In the village of water iodine 109.0 μg/L,the medians urinary iodine of children,women and men were all ranged from 200 to 299 μg/L,which meant their iodine nutrition levels were more than appropriate.In the villages of water iodine 225.8,430.0,581.2 μg/L,the medians urinary iodine of children,women and men were all ≥ 300 μg/L,which meant their iodine nutrition levels were too high.②)In all the 6 villages,the intaking amount of iodine met and exceeded the standard recommended intake of dietary iodine by ICCIDD/UNICEF/WHO (8 to 10-year-old children ≥ 120 μg/d,women of childbearing age and adult men ≥ 150 μg/d).But in the village of water iodine 581.2 μg/L,the iodine intake was exceeded the daily maximum safe intake (children aged 8 to 10 ≤800 μg/d,women of childbearing age and adult man ≤ 1000 μg/d).③The amount of iodine ingestion from drinking water was increased with the water content of iodine.When water iodine exceeded 100 μg/L,the amount of iodine ingestion from drinking water was higher than from food intaking,and became a main resource of iodine in the human body.Conclusions In the counties of iodine concentration in drinking water above 100 μg/L in high iodine areas of Shanxi province,the water iodine becomes the most important source of iodine,and iodine nutritional level is more than appropriate or possible excess.It is recommended that in areas of high water iodine of Shanxi province,the standard cut-point of water iodine value is set to 100 μg/L.

Objective To learn the present status of defluoridation water improvement project in Shanxi province in order to provide scientific basis for speeding up the prevention and control of endemic fluorosis.Methods According to "The National Technical Scheme for Endemic Disease Control" from 2005 to 2009, the investigation points were selected in the counties that implemented the measures of water improvement and defluoridation,the status of drinking water defluoridation Project was investigated, and the water fluoride levels were determined by fluoride selective ion electrode. Results The primary status was surveyed in 1658 water improvement and defluoridation projects in 51 counties. The resource of drinking water for water improvement and defluoridation projects was mostly ground water[accounting for 93.12% (1544/1658)]. Among 1658 water improvement and defluoridation projects 1405 projects worked well(accounting for 84.74%) and 190 projects intermittently worked (accounting for 11.46%). Sixty three projects abandoned (accounting for 3.80%), in Datong basin the abandoned projects accounted for 36.36% (12/33). Water fluoride content of 1595 water improvement and defluoridation projects had been determined, among them water fluoride content of 874 projects were above 1.0 mg/L (accounting for 54.80%). The situations of exceeded national standard in the five basins was different(H = 33.22,P ＜ 0.01). The rate of over national standard of fluoride levels in drinking water was 88.37%(38/43) in Datong basin. Therefore, in Datong basin water improvement should be strengthened. Conclusions In Shanxi province the water improvement and defluoridation projects are basically running normally. However, the qualified rate is lower for the water improvement and defluoridation projects. The water improvement status varies dramatically among areas.The situation is still grim in Shanxi province. Water improvement and defluoridation needs to be strengthened to improve the effect of prevention and control of the disease.

Objective To evaluate the clinical significance of glycated albumin (GA), a parameter in reflecting recent glycemic control, in patients with impaired glucose regulation (IGR) and newly diagnosed diabetes mellitus. Methods From January to June 2007, 516 subjects who accepted oral glucose tolerance test (OGTT) in out-patient department were randomly enrolled, including 130 with normal glucose regulation (NGR), 154 with IGR and 232 with diabetes mellitus. The fasting plasma glucose (FPG), 0.5 h plasma glucose (PG), 1hPG, 2hPG, 3hPG after glucose loading, HbA1c and GA were measured in each subject. The correlation between GA and the other parameters were analyzed. Results There were significant differences in the values of GA among NGR, IGR and diabetes mellitus groups (all P < 0.01), but no difference in the values of HbA1c between NGR group and IGR group (P > 0.05). GA was positively correlated with HbA1c (r = 0.75, P < 0.01). Stepwise regression analysis showed that FPG, 2hPG and body mass index were the major independent contributing factors. Conclusion The combination of plasma glucose with GA measurement may be helpful in evaluating the status of glucose metabolism.

Objective To investigate the prevalence and relative factors of cognitive disfunction among the community- dwelling old adults. Methods 766 participants over 60 years old dwelling in Luzhou, Sichuan, China were enrolled with Multi-stage stratified sampling. Information about sociodemographic characteristics, lifestyle, health condition, nutrition were interviewed, and their cognitive function was evaluated with Mini-Mental State Examination (MMSE). Results The prevalence of cognitive disfunction was 19.7% among them. Gender (male vs. female, OR=0.577), age (over 90 years vs. 60- 64 years, OR=29.857), administrator (administrator vs. not administrator, OR= 0.360), farmer (farmer vs. not farmer, OR=2.121), nutrition (malnutrition vs. eutrophia, OR=2.460), body weight (underweight vs. normal weight, OR=3.222), living status (UN-Habitat vs. living alone, OR=0.658), marital status (widowed vs. not widowed, OR=2.208), education attainment (junior college vs. illiteracy, OR=0.328), income (over 1000 yuan vs. no income, OR=0.596) significantly related with cognitive disfunction (P<0.05). Multiple Logistic regression analysis showed that old age, occupation (farmer) and malnutrition were independent risk factors for cognitive disfunction. Conclusion The cognitive disfunction related with multi-factors, and need more effective and available intervention in the old adults.

In this paper 3 different media (A,for yeast cultivation ; B, for laccase producing; D, for white rot fungi cultivation) were compared in enriching and screening decolorizing fungi culture using Reactive Black 5 (RB5) and Reactive Red (M-3BE) from the following three points: decolorization effects, abilities of producing enzymes and diversity of microbial community. 11 groups of fungi with obvious decolorization effects were obtained after enrichment for near one month. Among them, 6 groups came from medium D, the other two 3 groups from medium A and B, respectively. However, the 3 groups from medium A exhibited the highest microbial diversity and best decolorization results with 99.53% and 97.42% color removal rate of Reactive Red M-3BE and Acid Red. From them, 16 strains of fungi were isolated and primarily identified as Saprolegniaceae, Eurotiaceae (Monascus went), Erysiphaceae and Physodermataceae. Fungi groups from medium B and D exhibited a bit lower color removal rate of various dyes and only 3 and 2 isolates primarily classified as Saccharomycetaceae and Eurotiaceae (Penicillium) were obtained from them. Fungi cultures in medium A and B could produce lignin peroxidase, and those in medium D could be detected higher activity of laccase. All the fungal cultures exhibited very weak activity of manganese dependant peroxidase.

AIM:To investigate the safety and effect of femtosecond laser-assisted cataract surgery with Cionni modified capsular tension ring (MCTR) implantation in the management of traumatic lens subluxation.METHODS: Totally 11 patients (11 eyes) with traumatic lens subluxation were divided into three groups according to the severity of lens dislocation, ranging from 90° to 120° (4 eyes), 120° to 180° (5 eyes) and 180° to 270° (2 eyes).The contact LenSx femtosecond laser cataract surgery platform was applied to create the capsulotomy, prepare nuclear fragmentation and make corneal wound creation.Anterior vitrectomy was performed in some patients during the surgery.After capsular retractors insertion and phacoemulsification, the MCTR was inserted to the capsular bag and fixed to the sclera.Finally, the IOL was implanted into the capsular bag.Postoperative visual acuity, intra-and post-operative complications, anterior capsular opening, IOL and MCTR position and intraocular pressure (IOP) were assessed.RESULTS:The duration of follow-up was 2mo.All the operations were completed successfully.Five eyes underwent cataract surgery combined with anterior vitrectomy.Four eyes had been inserted with 2-eyelet MCTR and seven eyes with 1-eyelet MCTR.The best corrected visual acuity (BCVA) after operation was better than 0.5 in 4 eyes, between 0.3 and 0.5 in 3 eyes, between 0.1 and 0.3 in 3 eyes, and less than 0.1 in 1 eye.Compared with preoperative BCVA, the difference was statistically significant (P<0.05).All the IOLs were stably centered and the eyelet of MCTR was fixated steadily between the iris and the anterior capsule.The common intra-and post-operative complications were subconjunctival hemorrhage, incomplete capsulotomy, residual cortex, secondary glaucoma and posterior capsular opacification.CONCLUSION:Femtosecond laser-assisted cataract surgery can improve the success rate of capsulorhexis, and reduce the difficulty of nuclear fragmentation.Femtosecond laser-assisted cataract surgery combined with MCTR implantation is an ideal surgical method for traumatic lens subluxation.

Activation of microglia plays a vital role in the initiation and maintenance of specific neuropathic pain states. By activating microglia in central nervous system, Toll-like receptor 4 (TLR4) can promote the release of proinflammatory cytokines and neuroactive compounds, participate in the initiation and maintenance of neuropathic pain, and trigger the opiate side effects. Therefore, TLR4 may be a potential therapeutic target for neuropathic pain. Inhibition of TLR4 has shown some biological effects in neuropathic pain models and ibudilast (the TLR4 pathway-inhibiting agent) has been approved for for phase 2 clinical trials. This article briefly reviews the structure, function, and mechanism of TLR4 as well as the development of TLR4-targeted drugs.
Humans ; Neuralgia ; drug therapy ; physiopathology ; Toll-Like Receptor 4 ; antagonists & inhibitors ; physiology

Thirty-eight individuals with normal glucose regulation and thirty-nine newly diagnosed type 2 diabetic patients were observed by continuous glucose monitoring system(CGMS)for three days.The mean blood glucose,mean amplitude of glycemic excursions(MAGE),and absolute means of daily differences(MODD)were calculated in each subject.The results suggested that the amplitude of glyeemic excursions revealed by CGMS could be used to evaluate the quality of glycemic control in type 2 diabetic patients.

Objective To investigate the relationship between urinary iodine level and thyroid disease.Methods The study used a case-control design.One hundred and nine patients with thyroid disease from the Affiliated Hospital of Shanxi Institute for Endemic Disease Control were selected as case group from 2011 to 2012,and these patients were divided into three groups:Graves's disease (GD) group (n =48),chronic lymphocytic thyroiditis (HT) group(n =34) and thyroid nodules group(n =27).Sixty-two healthy people from the same region were selected as a control group.Urinary iodine was determined using arsenic cerium catalytic spectrophotometry,thyroid autoantibody (TRAb) and thyroid peroxidase antibody (TPOAb) was detected using electrochemiluminescence,while iodine absorption rate was measured using thyroid function analyzer,and thyroid volume was measured using type-B ultrasonic method.The relationship between urinary iodine level and patients with thyroid disease was compared with that of control group.Results Urinary iodine levels of patients with GD,HT,thyroid nodules and control groups were 313.95,375.20,220.20 and 196.50 μg/L,respectively.Urinary iodine levels of patients with GD and HT groups were higher than that of control group(Z =3.238,4.275,all P ＜ 0.0125).Urinary iodine level of patients with HT was higher than that of thyroid nodules(Z =3.762,P ＜ 0.0125).Iodine uptakes of GD,HT,thyroid nodules and control groups were (84.20 ± 16.90)％,(23.51 ± 6.72)％,(28.34 ± 8.02)％ and (29.31 ± 8.41)％; TRAbs of patients with GD,HT,thyroid nodules and control groups were (58.57 ± 20.31)％,(2.54± 1.00)％,(2.98 ± 0.83)％ and (3.01 ± 1.21)％; TPOAbs of patients with GD,HT,thyroid nodules and control groups were (117.03 ± 57.21)％,(251.00 ± 98.20)％,(16.81 ± 9.87)％ and (15.00 ± 7.23)％.Iodine uptake,TRAb and TPOAb of GD group were higher than those of control group(P ＜ 0.05).TPOAb of HT group was higher than that of control group(P ＜ 0.05).Urinary iodine levels of GD group and HT group were positively correlated with TPOAb(correlation coefficient were 0.462,0.478 all P ＜ 0.05).Conclusions Excessive iodine intake is found in patients with GD and HT.Determination of urinary iodine is helpful for individualized iodine supplementation.