Objective To evaluate the diagnostic value of serum albumin (Alb),total protein (TP),body mass index (BMI),Mini Nutritional Assessment (MNA) and hand strength in the nutritional status in maintenance hemodialysis (MHD) patients.Methods A total of 126 MHD patients were included in this study who had been on MHD for at least 3 months.Depending on the levels of Alb,patients were divided into two groups:normal nutrition group (group A) and malnutrition group (group B).TP,BMI,MNA and hand strength were also detected at the same time.Independent samples t test,Spearman correlation analysis,ROC curve were used to analyze their difference between the two groups and evaluate their diagnostic value in nutritional status in MHD patients.Results Age,sex,height,weight and dialysis ages had no statistical significant difference (P ＞ 0.05) between group A and group B,while Alb,TP,BMI,MNA and hand strength had statistical significant difference (P ＜ 0.05) between two groups.After adjusting for age,sex and hemodialysis age,Alb,TP,BMI,MNA and hand strength were positively correlated with each other (P ＜ 0.05).Since the area under the ROC curve of BMI was the smallest,BMI had the lowest diagnostic value in evaluation of the nutritional status in those patients.Conclusions Alb,TP,MNA and hand strength are good indexes in evaluation of the nutritional status in MHD patients but BMI is not.

Background and purpose: The incidence rate of elderly esophageal carcinoma patients is increasing year by year. In this study, the clinicopathologic factors, operational factors and postoperative complications were compared between the older and the younger elderly patients with thoracic esophageal squamous cell carcinoma (ESCC), and the influence of different surgical approaches to older elderly patients were analyzed. Methods: A retrospective review of 371 cases of elderly patients with thoracic esophageal squamous cell carcinoma (≥60 years) between Jan. 2006 and Dec. 2008 were performed. The patients were divided into two age groups. The patients over 75 years old named the older elderly group including 53 patients, and the patients between 60-74 years named the younger elderly group including 318 patients, the clinicopathological factors, operational factors, postoperative hospital mortality and average length of stay were compared. Meanwhile, according to different surgical approaches, the comparison of the left chest and right chest approach of operative time, blood loss and postoperative complication rate, and so on and so forth. Results: The older elderly group compared with the younger elderly group had more preoperative complications. Preoperative ASA classiifcation and postoperative complications, length of stay and hospital mortality rates were signiifcantly higher. The older elderly group over the right chest approach had less postoperative complications, especially pulmonary complications, the results were statistically signiifcant.(13.0%vs 40.0%,P<0.05) Conclusion: The patients over 75 years old with thoracic esophageal squamous cell carcinoma have a higher risk during the operation, we can choose relatively simpler operation approach to reduce the incidence of postoperative complications, especially pulmonary complications.

Object To explore the regularity of recipe composition by observing different bacteriostasis among compositions of Gegen Qinlian Decoction (GQD) against Streptococcus pneumoniae. MethodsTo evaluate the minimal inhibitory concentration (MIC) of 15 decoctions through double fold dilution method. Results Not all of the decoctions are of the same MIC. Conclusion Not all of the 15 decoctions have the same bacteriostasis against S. pneumoniae. Among the four herbs of GQD Coptis chinensis Franch. has the strongest bacteriostasis and the next Scutellaria baicalensis Georgi. While Glycyrrhina wralensis Fisch and Pueraria lobata (Willd.) Ohwi have no bacteriostasis, but they can influence the bacteriostasis of C. chinensis and S. baicalensis when combinating with them.

AIM: To investigate combination principle of Gegenqinlian Decoction through experiment of anti-diarrhea. METHODS: Propelling rate of mouse's small intestine was selected as index on the condition of ink as colour reagent, diarrhea frequence served as second index for orthoganal design on the basis of mouse's diarrhea induced by senna. RESULTS:Coptis chinensis franch and Glycyrrhiza uralensis fisch and reduce drive rate. Scutellaria baicalensis Georgi and Pueraria lobata(wild) ohwi had counteracter against Coptis chinensis franch's effect, while Glycyrrhiza uralensis fisch could enforce Coptis chinensis franch's effect.as to DI, Coptis chinensis franch had anti-diarrhea effect. Scutellaria baicalensis Georgi had counteracter against Coptis chinensis franch's effect, Pueraria lobata(wild) Ohwi could enforce Scutellari, baicalensis Georgi effect, but Glycyrrhiza uralensis fisch could enforce Coptis chinensis's effect after compounding with Scutellaria baicalensis Georgi. CONCLUSION: ~Among the combinantion of Gegenginlian Decoction, as to the pharmcological effects on anti-diarrhea, the best compound is Coptis chinensis franch and Glycyrrhiza uralensis fisch.

Objective: To investigate the feasibility, safety, short-term efficacy and long-term efficacy of elective lymph node dissection in patients with early esophageal cancer. Methods: The study retrospectively evaluated 405 patients with cT1N0M0 esophageal carcinoma who received minimally invasive esophagectomy in the First Affiliated Hospital of University of Science and Technology of China between March 2007 and March 2013. Of those patients, 208 patients underwent systematic lymph node dissection (SLND) and 197 patients underwent elective lymph node dissection (ELND). The clinicopathologic factors, operational factors, postoperative complications, lymph node dissection and prognosis of patients were compared by independent sample t test, χ² test, or Mann-Whitney rank test. The 5-year overall survival was calculated by the Kaplan-Meier estimation method using the Log-rank test. Results: There was no significant difference in clinicopathological data between the SLND group and the ELND group. The incidence of pulmonary infection (8.2% vs. 2.9%, P=0.04) and arrhythmia (6.2% vs. 2.0%, P=0.03) of the minor postoperative complications in the SLND group were higher than the ELND group. The incidence of pulmonary infection (6.2% vs. 2.0%, P=0.03), Chylothorax (5.8% vs.1.5%, P=0.02), anastomotic or pleural hemorrhage requiring reoperation (2.9% vs.0.5%, P=0.04) of major postoperative complications in the SLND group were higher than the ELND group, the difference was statistically significant. In the perioperative data of two groups, the incidence of total postoperative complications, total pulmonary complications, operation time, intraoperative blood loss, postoperative hospitalization, postoperative thoracic drainage duration and postoperative thoracic drainage fluid volume of the SLND group were higher than the ELND group, the difference was statistically significant. The mean numbers and stations of dissected lymph node in the SLND were 30.2±4.2 and 12.1±2.7, the mean numbers and stations of dissected lymph node in the ELND were 25.7±3.8 and 8.4±3.6. The survival rates of 1, 3, 5 years of all patients were 100%, 95.9% and 82.5%, respectively. The median survival time was 87.4 months. Further analysis showed that the 1, 3 and 5 years survival rate of patients with stage Ⅰ esophageal cancer was 100%, 97.1% and 88.9%, respectively. The median survival time was 89.3 months. The 1, 3 and 5 years survival rate of patients with stage Ⅱa esophageal cancer was 100%, 93.2% and 76.8%, respectively. The median survival time was 77.2 months. There was no significant difference in survival rate between the SLND group and the ELND group in 1, 3 and 5 years. When taking a further analysis of stage Ⅰ esophageal cancer, the survival rates between 188 patients in the SLND group and 180 patients in the ELND group were no significant difference. When focus on the stage Ⅱa esophageal cancer, the 1, 3 and 5 years survival rate were higher in the SLND group than that in the ELND group (100%, 94.5%, 83.2% vs. 100%, 91.3%, 72.1%, P=0.047), the difference was statistically significant. Conclusion ELND can be safely and effectively performed for early esophageal cancer with favorable short-term efficacy and long-term efficacy.

ObjectiveTo explore the safety and efficacy of robot-assisted minimally invasive esophagectomy （robot-assisted minimally invasive esophagectomy， RAMIE） and thoracic laparoscopy combined with minimally invasive esophageal resection （minimal invasive esophagectomy， MIE）. MethodsThe data of 188 patients treated with Da Vinci robot assisted minimally invasive esophageal resection （RAMIE） from April 2021 to December 2022 were analyzed. In the RAMIE group， 69 patients， 49 males and 20 female， age （67.2 ± 7.2）； 119 in the MIME group， respectively， 89 males and 30 female， age （69.1 ± 7.0）. At 1 ∶ 1， including 58 patients in the RAMIE group and 58 patients in the MIE group. The t-test， Wilcoxon rank-sum test， χ² test， and so on. ResultsAfter PSM treatment， the clinical data between the two groups. There was no significant difference in operation time， postoperative tube days， and total number of lymph node dissection between the RAMIE and MIE groups （P <0.05）； the RAMIE group was better in terms of intraoperative bleeding and the MIE group， statistically significant （P <0.05）； the MIE group was better in drainage flow and lymph node dissection for three days （P <0.05）. In terms of postoperative complications， there was no statistical difference between RAMIE and MIE groups （P>0.05）. ConclusionThe recent efficacy of robot-assisted minimally invasive esophagectomy is comparable to that of thoracic laparoscopy and minimally invasive Mckeown esophagectomy； robotic-assisted minimally invasive esophagectomy can reduce intraoperative bleeding and have more advantages in left recurrent laryngeal nerve lymph node dissection.

Objective To investigate the feasibility, safety, and short-term efficacy of minimally invasive McKeown esophagectomy (MIME) in patients with locally advanced thoracic esophageal squamous cell carcinoma (TESCC) after neoadjuvant immunotherapy. Methods The clinical data of the patients with locally advanced TESCC in the First Affiliated Hospital of University of Science and Technology of China from July 2022 to March 2023 were restrospectively analyzed. They were divided into a neoadjuvant immunotherapy (NI) group and a non-neoadjuvant immunotherapy (NNI) group according to different preoperative neoadjuvant therapy. The perioperative clinical data and 3-month follow-up data were compared between the two groups. Results A total of 47 patients were collected, including 31 males and 16 females with a mean age of (67.57±7.64) years. There were 29 patients in the NI group and 18 patients in the NNI group. There were no statistical differences in baseline data, perioperative complications, short-term complications, surgical time, intraoperative bleeding, postoperative adjuvant therapy, metastasis/recurrence within 3 months, R0 resection rate, postoperative pathological staging decline, or College of American Pathologists (CAP) tumor regression grade between the two groups (P＞0.05). Conclusion Neoadjuvant immunotherapy combined with minimally invasive McKeown esophagectomy can be safely and effectively performed for patients with locally advanced TESCC without increasing operation time, intraoperative blood loss and perioperative complications.