Objective To explore the clinical effect of neoadjuvant chemo-radiation combined with thoracoscopic and laparoscopic three-incision esophagectomy for esophageal cancer.Methods The retrospective cohort study was conducted.The clinicopathological data of 111 esophageal cancer patients who underwent neoadjuvant chemo-radiation combined with thoracoscopic and laparoscopic three-incision esophagectomy in the Cancer Hospital of Chinese Academy of Medical Sciences between January 2010 and December 2016 were collected.Among 111 patients,68 with interval time between neoadjuvant chemo-radiation and thoracoscopic and laparoscopic three-incision esophagectomy ＜ 8 weeks were allocated into the ＜ 8 weeks group and 43 with interval time between neoadjuvant chemo-radiation and thoracoscopic and laparoscopic three-incision esophagectomy ≥8 weeks were allocated into the ≥8 weeks group.Patients underwent preoperative radiotherapy and chemotherapy with TP regimen,and then underwent selective thoracoscopic and laparoscopic three-incision esophagectomy.Observation indicators:(1) neoadjuvant chemo-radiation situations;(2) surgical and postoperative situations;(3) follow-up.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival of patients and tumor recurrence or metastasis up to March 2017.Measurement data with normal distribution were represented as (x)±s and comparison between groups was analyzed using the t test.Count data were analyzed using the chi-square test or Fisher exact probability.Comparison of ranked data was done by the nonparametric test.Results (1) Neoadjuvant chemo-radiation situations:all the patients underwent neoadjuvant chemo-radiation,without severe adverse reaction.Number of patients with complete remission based on oncopathology were 34 in the ＜8 weeks group and 15 in the ≥ 8 weeks group,with no statistically significant difference between the 2 groups (x2=2.441,P＞0.05).(2) Surgical and postoperative situations:all the patients underwent successful thoracoscopic and laparoscopic three-incision esophagectomy,with negative surgical margins.Operation time,volume of intraoperative blood loss,number of lymph node dissected,time of postoperative intrathoracic drainagetube removal,time of postoperative neck drainage-tube removal,hoarseness,upper gastrointestinal hemorrhage,anastomotic fistula,respiratory complication,pleural effusion and empyema,cardiovascular complication,incision abnormal healing,death within postoperative 30 days and duration of hospital stay were (354±103)minutes,(400± 76)mL,19±4,(11±4)days,(4.9±1.6)days,5,1,12,3,6,5,8,0,(19± 17) days in the ＜ 8 weeks group and (343±92) minutes,(392±51)mL,19±3,(12±6)days,(4.5±1.0)days,2,0,7,5,3,4,3,2,(18± 11) days in the ≥ 8 weeks group,respectively,with no statistically significant difference between the 2 groups (t =1.080,0.569,0.326,1.223,1.286,x2=0.029,0.035,1.114,0.000,0.000,0.246,t=0.315,P＞ 0.05).(3) Follow-up:90 of 111 patients were followed up for 3-82 months,with a median time of 25 months,including 55 in the ＜8 weeks group and 35 in the ≥8 weeks group.During follow-up,death and tumor recurrence were detected in 9,11 patients in the ＜8 weeks group and 6,11 patients in the ≥ 8 weeks group,respectively.Conclusion Neoadjuvant chemo-radiation combined with thoracoscopic and laparoscopic three-incision esophagectomy is safe and effective,and it doesn't increase the perioperative risks based on preoperative 8-week interval time.

Background Retinal hemorrhage in newborns is a common clinical finding,and serious retinal henorrhage resulting in poor prognosis.The factors affecting retinal henorrhage in newborns are unelucidated now.Identifying these factors is helpful for the early prevention and treatment.Objective This study was to explore the underlying maternal,obstetric,and neonatal clinical factors for degree of retinal hemorrhages in healthy full-term newborns.Methods A cross-sectional study was performed in the approval of Ethic Committee of Zhongshan City People's Hospital.A total of 1 311 full-term infants,with gestational age more than 37 weeks and Apgar ≥9 scores were included in this study.Infants with severe systemic diseases or any other eye diseases were excluded.Ocular fundus of the infants were examined with Ret Cam Ⅲ within 4 days of birth and were independently identified by 2 eye doctors.The newborns of retinal hemorrhage were divided into grade Ⅰ,Ⅱ and Ⅲ groups based on Egge criteria,and the infants without retinal hemarrhage served as the normal control group.Maternal,obstetric,neonatal parameters and general factors were analyzed and compared among different groups,and the risk factors that affected the newborns retinal hemorrhage were analyzed by logistic regression analysis.Results Retinal hemorrhage was seen in 28.30％ infants (371/1 311),and 152,116 and 103 infants were identified as grade Ⅰ,Ⅱ and Ⅲ,with the percentage of 11.59％,8.85％ and 7.86％,respectively.Among the factors that examined in the study,cord around fetal neck was the risk factor of aggravation of degree of retinal hemorrhage in newborns (OR =1.308,95％ CI:1.011-1.693,P =0.041).In the mode of delivery,spontaneous vaginal delivery appeared to be the positive factor of the incidence of retinal hemorrhage (OR=0.134,95％ CI:0.132-0.137,P＜0.001),but cesarean section was not a main risk factor.Conclusions Spontaneous vaginal delivery and cord around fetal neck are the potential risk factors for the aggravation of degree of retinal hemorrhage in full-term infants.Accordingly,infants with these risk factors should be paid more attention to prevent the progression of retinal hemorrhage.

Objective:To develop a two-step method for purification of monoclonal antibody rhTF243 protein from mouse ascites by using hydrophobic charge induction chromatography(HCIC) and affinity chromatography with protein A sepharose CL-4B.Methods:The ascites was first purified by HCIC after centrifugation and filtration.Then the fraction containing the protein of interest was directly purified by affinity chromatography with protein A sepharose CL-4B.Results:The purity of the obtained monoclonal antibody was up to 97% with recovery of 73% and of high activity.Conclusion:The method for purification of monoclonal antibody is developed using HCIC and Protein A affinity chromatography and the obtained antibodies are of high purity and activity.

Continuously cropping obstacle restricts ginseng production and rational use of land resource severely, and autotoxicity is one of the most important factors. In our previous work, ginseng autotoxin degrading bacteria were isolated, in the present re- search, plate culturing method and traditional physiological and biochemical method were used to analyze biological indices and protective enzyme activities, in order to elucidate the mitigative effect of autotoxin degrading bacteria on autotoxicity of P. ginseng. Results indicated that, except for palmitic acid, autotoxicity of benzonic acid, diisobutyl phthalate, diisobutyl succinate, and 2,2-bis (4- hydroxyphenyl) propane on the growth of ginseng seeds was significantly alleviated after autotoxins degrading bacteria was inoculated, and which have no evident difference with control. Except for benzoic acid, enzyme activity of SOD, POD and CAT in other autotoxin degrading treatments decreased significantly. The present research showed that, microbial degradation could alleviate the autotoxicity of autotoxins on ginseng seeds effectively, and which will be helpful for the resolution of ginseng continuously cropping obstacle problem.
Bacteria ; metabolism ; Panax ; enzymology ; growth & development ; metabolism ; microbiology ; Toxins, Biological ; metabolism

OBJECTIVETo explore an optimal anesthesia method with less impact on hemodynamics and electrocardiogram (ECG) of old patients with coronary artery disease (CHD) during abdominal operation.

METHODSThe 133 CHD patients waiting for abdominal operation were randomly divided into continuous epidural anesthesia (EA) group, general anesthesia group (GA) and combined spinal-epidural anesthesia (CSEA) group. Continuous monitoring was carried out during operation and mean arterial pressure (MAP), heart rate (HR), oxygen saturation (SaO2), abnormal ECG were measured respectively at different time for comparison and the differences of the above hemodynamic parameters and abnormal ECG features were compared among the 3 groups.

RESULTSAt the 15 min and 30 min point after anesthesia, SaO2 in GA group was significantly increased compared to that in the EA group (P < 0.05). At 15 min, 30 min and 60 min point after anesthesia, MAP in CSEA group was significantly increased compared to that in the EA group (P < 0.05). At 30 min point after anesthesia, HR in CSEA group was increased significantly compared to the EA group (P < 0.05). At 15 min and 30 min point after anesthesia, SaO2 in the CSEA group was increased significantly compare to the EA group (P < 0.05). Compared with preanesthesia (T0) in EA group, MAP, HR and SaO2 decreased significantly at 15, 30 and 60 min after anesthesia (P < 0.05). The fluctuation of the three parameters in GA and CSEA groups were relatively small (P > 0.05). As well as the comparison of abnormal ECG among the 3 groups was concerned, the incidence of ST-T changes in GA and CSEA groups were significantly lower than that in EA group at the time of 15 min, 30 min and 60 min after anesthesia and at the time of surgery termination (P < 0.05, P < 0.01). The incidence of arrhythmia in GA and CSEA groups were significantly lower than that in EA group at the time of 15 min, 30 min and 60 min after anesthesia (P < 0.05, P < 0.01). Compared with T0 in the same group, the incidences of ST-T changes and arrhythmia in GA or CSEA group at the time of 15, 30 and 60 min after anesthesia and at the time of surgery termination were significantly lower than that before anesthesia (P < 0.05, P < 0.01).

CONCLUSIONGA and CSEA have less impact on hemodynamics and have smaller incidence of abnormal ECG of old CHD patients with abdominal operation.

Aged ; Anesthesia ; methods ; Coronary Disease ; physiopathology ; Electrocardiography ; Female ; Hemodynamics ; drug effects ; Humans ; Male ; Middle Aged ; Perioperative Period

Thirteen compounds were isolated from the ethyl acetate fraction of Crepis crocea by column chromatographies on silica gel, Sephadex LH-20 and semi-preparative HPLC. The structures were elucidated on the basis of spectral analysis as tectorone I (1), 8β- (2-methyl- 2-hydroxy-3-oxobutanoyloxy) -glucozaluzanin C (2), tectoroside (3), luteolin-7-O-glucoside (4), cosmosiin (5), esculetin (6), 3,4-dihydroxybenzaldehyde (7), trans-4-hydroxycinnamic acid (8), Caffeic acid (9), methyl p-hydroxyphenyllactate (10), ethylp- hydroxyphenyllactate (11), cis-3,4-dihydroxy-β-ionion (12). All the compounds, except for compounds 4 and 9, were isolated from this plant for the first time, and tectorone I (1) is a new natural product.
Crepis ; chemistry ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Mass Spectrometry ; Molecular Structure

Aged ; Coronary Disease ; epidemiology ; Humans ; Myocardial Infarction ; epidemiology ; Perioperative Period

Objective To investigate the renoprective effect and its possible mechanism of Niaoduqing on the adriamycin(ADR)-induced nephropathy rats. Methods Forty eight male Sprague-Dawley rats were randomly divided into normal control(n=12), ADR-induced nephropathy(model, n = 12), Benazepril-treated ADR nephropathy(Benazepril, n=12)and Niaoduqing-treated ADR nephropathy(Niaoduqing, n =12)groups. The rat nephropathy model was established by adriamycin injection and unilateral nephrectomy. The rats were sacrifficed per batch at the 4th and 8th weekend.The pathological change of nephridial tissue, the 24-hour urinary protein excretion and renal function were examined. Immunohistochemistry was used to meassure the expression of fibronection(FN), collagenⅣ(COLⅣ), osteopontin(OPN). Results The 24-hour urinary protein excretion, BUN, Scr, triglyeride(TG), cholesterol(Cho)in model group were significantly higher than those in normal group(P<0.01), as well as more server glomerulosclerosis in kidney were observed in model group than those in control group(P<0.01), while the albumin(Alb)was lower (P<0.01). Compared with model group, the 24-hour urinary protein excretion, BUN, Scr, TG, Cho were significantly reduced and renal glomerulosclerosis was improved in Niaoduqing group(P< 0.01), while the Alb was higher(P<0.01). Conclusion Niaoduqing palys an important role in the prevention and treatment for nephropathy.

Objective To evaluate the clinical effect of the lung protective ventilation combining with Re-duning injection on the acute lung injury (ALI). Methods 59 patients with ALI were randomly divided into the lung protective ventilation group (control group, n =30) and the lung protective ventilation wmbined with Reduning injection group(experimental group,n = 29) ,and the changes of vital signs,RR,blood gas analysis,and so on were observed. The comparison between PaO2 and PaO2/FiO2 was carried out. The efficacy and the mortality rate were evaluated. Results Lung injury in 21 cases of experimental group were improved after applied Reduning treatment(72. 41%),there was a significant difference ( P < 0.05) with that of 14 cases in control group (46. 67% ) ; PaO2 increased, PaO2/FiO2 significantly increased in experiment group,there were significant difference compared with those of control group(P <0. 01). The mortality rate in the experimental group was 24.14% ,there was a significant differ-ence(P<0.05) compared with the mortality of 50. 00% in control group. Conclusion Reduning treatment could, improve the pulmonary function in lung protective ventilation to cure ALI,reducing the mortality rate as well.

Objective To identify potential serum biomarkers specific for hepatocellular carcinoma (HCC).Methods Eighty-one patients wilh hepatitis B-related HCC and 80 healthy controls were randomly divided into a training set (48 HCC,47 controls) and a testing set (33 HCC,33 controls).Serum proteomic profiles were measured using surface-enhanced laser desorption/ionization time-offlight mass spectroscopy (SELDI-TOF-MS).A classification tree was established by the Biomarker Pattern Software.Candidate biomarkcrs were separated by HPLC and identified by MA1DI-MS/MS and database searching.Forty-eight patients with HCC,54 cirrhotic patients and 42 healthy subjects were clinically validated using candidate biomarkers by SELDI-Immunoassay.Real-time reverse transcriptase-polymerase chain reaction was performed to observe GRO-1 and Thrombin in 55 HCC tissues and 13 normal hepatolage tissues.Results Two up-regulated protein peaks were automatically chosen as a classification tree in the training set.These biomarkers were identified as thrombin light chain and CXC chemokines ligand 1 (GRO-1).The sensitivity and specificity of this classification tree were 89.6％.The multivariate model using the two biomarkers and alpha-fetoprotein (AFP) resulted in a sensitivity of 91.7％ and specificity of 92.7％,which was significantly better than AFP alone.The mRNA expression of GRO-1 and Thrombin were found in all HCC tissues.There were significant associations between GRO-1 gene expression and some clinical and pathological findings such as metastasis and recurrence (P＜0.05).Significant differences of 5-year survival rates wee observed among subgroups according to the expression of GRO-1 (P＜0.05).There were significant associations between Thrombin gene expression and some clinical and pathological findings such as recurrence and AFP (P＜0.05).Significant differences of 5-year survival rates were observed among the subgroups according to the expression of THROMBIN (P＜0.05).A positive correlation was found between GRO-1 and Thrombin (r=0.73,P＜0.01).Conclusion Thrombin light chain and GRO-1 are potential biomarkers of HCC.The expression of GRO-1 in HCC tissues was a valuable indicator in estimating metastasis and recurrence in HCC patients.