Objective To investigate the surgical approach of Siewert Ⅱ and Ⅲ gastroesophageal junction adenocarcinoma.Methods A total of 148 cases with Siewert Ⅱ,Ⅲ type patients were prospectively studied.The patients were divided into two groups,including transthoracic approach group (58 cases) and transabdominal approach group(90 cases).The results of surgery were compared.Patients were followed up for 2 years and survival rate were compared.Results In transthoracic approach group and transabdominal approach group,operative time ((329.5 ± 84.3) min vs.(202.4± 84.5) min,t =15.431,P ＜ 0.001),the positive rate margin stump (8.62％ vs.1.11％,x2 =5.763,P =0.012),pleural effusion (13.79％ vs.2.22％,x2 =10.462,P ＜0.001) and pulmonary infection rate (15.52％ vs 1.11％,x2 =12.574,P＜ 0.001) were significantly higher than transabdominal approach group,and number of lymph node dissection ((16.7 ± 4.3) vs.(22.6± 5.5),t =6.321,P =0.004) was significantly less than transabdominal approach group.In incidence of blood loss,tumor diameter,anastomotic leakage (or bleeding) and discharge time,there was no significant difference (P ＞0.05).One-year survival rate of transthoracic approach group was 73.24％,and 2-year survival rate was 53.43％.Oneyear survival rate of transabdominal approach group was 78.42％,and 2-year survival rate was 57.51％.Survival rate of two groups showed no significant difference (P =0.453,0.311).Conclusion Transabdominal surgical approach in Siewert Ⅱ,Ⅲ patients is better than transthoracic approach,can better carry out abdominal lymph node dissection,does not destroy the integrity of the chest,and avoid the occurrence of related complications.

Objective To edit Chinese version of the Minnesota living with heart failure questionnaire (MLHFQ) and to estimate its reliability and validity.Metheds Translated and edited the Chinese version of MLHFQ according to the standard procedures,and tested 83 inpatients which were recruited from three polyclinics of Beijing district in China.Results Cronbach's alpha consistency was>0.80 for the three MLHFQ scores.Reproducibility ranged from 0.48 to 0.84 for items of weighted kappa coefficient and from 0.88 to 0.94 for three do-mains of Spearman's correlation coefficient.MLHFQ scores varied significantly with NYHA functional class(P<0.05),and there were intermediate-to-high correlations with the assumed corresponding SF-36 domains(-0.73 to -0.59).Factor analysis revealed three-factor structure explained 49.34% of the total variance.The MLHFQ scores before and after the treatment combined TCM and western medicine were significant (physical domain (26.15±7.15,17.63±8.50),emotional domain (8.96±5.73,6.8l±5.31),overall score(56.38±16.88,39.77±15.69) all P<0.01).Conclusions The Chinese version of MLHFQ is translated and edited according to the standard procedures.Its reliability and validity is good,and could be used as a clinical outcome measurement.