Surgery is still the basic treatment of esophageal carcinoma. Quality of life, a new evaluation criterion for the health and disease, reflects the surgical outcome of esophageal cancer comprehensively. The findings of clinical research demonstrate that in the surgical treatment of esophageal carcinoma, quality of life could provide us with new selections such as surgical method, lymph node dissection and digestive tract reconstruction. Further application of quality of life scale in esophageal carcinoma surgical treatment, will greatly enhance the surgical outcome and improve patients'quality of life.

Objective To investigate the expression of nuclear factor kappa B (NF-?B ) in focal cerebral ischemia and reperfusion and effects of N-acetylcysteine (NAC) pretreatment.Methods The focal cerebral ischemia and reperfusion model was made by suture occlusion of right middle cerebral artery. The rats were randomly assigned to nine groups: sham operated group, 6 hours and 24 hours ischemia groups, 6 hours and 24 hours reperfusion groups, corresponding NAC treatment groups. NAC groups’ rats were treated with NAC (150 mg/kg) prior to occlusion. NF-?B p65 were detected by immunohistochemistry. Brain was stained with 1% triphenyltetrazolium chloride for assessment of the volume of infarction. Apoptosis was detected by terminal-deoxynucleotidyl transferase mediated nick end labeling (TUNEL).Results The translocation of NF-?B from cytoplasm to nucleus increased significantly after ischemia and reperfusion. The expression of NF-?B p65 decreased in NAC pretreatment groups, which were respectively (0.462% ? 0.022%) in 6 hours ischemia-reperfusion groups, (0.452% ? 0.015%) in 24 hours ischemia-reperfusion groups, as compared with saline control groups which were (0.563% ? 0.028%) and (0.554% ? 0.013%) (P

BACKGROUND: Nuclear factor-kappa B (NF-κB) is an important transcription factor, which can promote the transcription of many target genes after activated.OBJECTIVE: To investigate the expressions of NF-κB in local cerebral ischemia-reperfusion and the influence of the pretreatment of the N-acetylcysteine.DESIGN: Randomized grouping experiment with animals as subjects.SETTING: Department of Neurology, the Second Clinical Medical College, Harbin Medical University.MATERIALS: The experiment was finished in the Animal Experimental Center and Laboratory of Pathology of Harbin Medical University. Ninetynine male healthy Wister rats were randomly divided into 3 groups: Sham-operated group(n=l 1), saline control group(n=44), N-acetylcysteine group(n=44).METHODS: Rat models of cerebral ischemia were made with the method of thread blocking improved by Longa et al in rats of the three groups. A nylon line with a smooth spherical captular end of 0.26 mm in diameter made by heating was inserted through the cut of crotch of the common carotid artery. The prepared line for common carotid artery was tied tightly and the arteriole clamp of internal carotid artery was unclamped. The nylon line entered the common carotid artery and the inserted length of the saline control group and the N-acetylcysteine group from the crotch of the internal and external carotid artery was calculated about (18.5±0.5)mm in order to obstruct the blood supply of the middle cerebral artery. The inserted depth in sham-operated group was less than 15 mm and the blood supply of the middle cerebral artery was kept normal. Intraperitoneal injection of N-acetylcysteine was given with 150 mg/kg at 30 minutes before ischemia in N-acetylcysteine group and injection of normal saline was given with equal volume at 30 minutes before ischemia in saline control group.Eleven rats each time in saline control group and N-acetylcysteine group were killed by cutting off heads at the time points of ischemia 6, 24 hours,and reperfusion 1 hour after ischemia 6, 24 hours. The express of NF-κB of brain tissue was observed with immunchistochemical method. Percentage of cerebral infarction of rats in each group was determined by dyeing of tetrachloro red tetrazoline. Apoptosis of brain tissue cells was detected with terminal deoxynucleotide transferase-mediated dUTP nick-end labeling (TUNEL).MAIN OUTCOME MESURES: Percentage of cerebral infart volume of rats in each group, the activity of combination of the NF-κB and apoptosis of cells.RESULTS: Ninety-nine animals attended the experiment, all of them entered the final analysis. ① Percentages of infarct volume at 1 hour of ischemia and 6, 24 hours of reperfusion in N-acetylcysteine group were (8.39±2.54)%, (24.54±6.02)% respectively, and that of corresponding saline control group were (15.50±4.18)%,(32.22±3.99)%. The focus of infartion with ischemia for 24 hours in each group was increased as compared with that for 6 hours and the infarct volume in group with N-acetylcysteine was obviously decreased as compared with that in saline control group (P ＜ 0.01). ② NF-κB p56 transfered from the kytoplasm to the nucelus after the ischemia and reperfusion. The rates of p56 masculine cells in N-acetylcysteine group of ischemia for 6 and 24 hours were (0.462±0.022)%, (0.452±0.015)% respectively, the express of which was decreased as compared with that in saline control group [(0.563±0.028 )%,(0.554±0.013)%] (P ＜ 0.01 ). ③ Cells of apoptosis pretreated with N-acetylcysteine were obviously decreased as compared with that pretreated with normal saline.CONCLUSION: Focal cerebral ischemia and reperfusion can activate NF-κB p65, which participate in the damage of cerebral ischemia and reperfusion. NF-κB can inhibit the express of p65, and relieve the nerve injury and so have the effct of protection for brain.

Objective To compare the therapeutic effects of closed reduction and transverse fixation with Kirschner wires and open reduction and fixation with mini-plates or Kirschner wires for the fifth metacarpal base fracture.Methods Data of 50 patients,who had been treated in our hospital for the fifth metacarpal base fracture from August 2005 to May 2012,were enrolled in this study.Twenty-six patients underwent closed closed reduction and transverse fixation with Kirschner wires,including 22 males and 4 females,aged from 17 to 41 years; according to the OTA classification,there were 8 of type A1,11 of type B1,and 7 of type C1.Twenty-four patients underwent open reduction and fixation with mini-plates or Kirschner wires,including 21 males and 3 females,aged from 19 to 46 years (average,26 years); according to the OTA classification,there were 11 of type A1,8 of type B1 and 5 of type C1.The total active motion (TAM) score of Chinese Medical Associaition was used to evaluate the range of motion of the joint.Results In closed reduction group,the operation time ranged from 14 to 33 min; the treatment costs ranged from 2018 to 2995 yuan; 23 patients were followed up for 6 to 26 months; X-rays showed the anatomic reduction was achieved in all patients,and the fracture healing time ranged from 4 to 7 weeks; according to the TAM score,the result was excellent in 15,good in 6 and fair in 2,and the excellent and good rate was 91.3％.In open reduction group,the operation time ranged from 45 to 105 min; the treatment costs ranged from 3874 to 4793 yuan; 22 patients were followed up for 6 to 21 months; X-rays showed the anatomic reduction was achieved in all patients,and the fracture healing time ranged from 4 to 8 weeks; according to the TAM score,the result was excellent in 13,good in 7 and fair in 2,and the excellent and good rate was 90.9％.Conclusion Closed reduction and transverse fixation with Kirschner wires is an effective method for the fifth metacarpal base fracture,which has several advantages,such as simple operation,stable fixation,satisfactory results,short operation time and low treatment costs.

Objective To investigate the effects of β-adrenoceptor (β-AR) activation on the apoptosis in human mesangial cells and it's mechanism.Methods Cultured HMC were used in experiments and were divied into four groups:the control group; β-AR activation (β-AR agonist NE/Pra) group; β-AR inhibitor (Prop) group; antioxidants group.The experiments technology including PCR,confocal scanning microscope,immunofluorescence and Tunel.Results The results of RTPCR and confocal scanning microscope showed that β1-AR and β2-AR were expressed in human HMC.β-AR activation induced reactive oxygen species (ROS) increase in human MCs,the relative levels of ROS were elevated as early as 0.5 h after β-AR activation,and gradually increased and peaked at 4 h on a concentration and time dependent manner.Tunel results demonstrated that β-AR activation induced apoptosis with ROS on a concentration and time dependent manner,β-AR blocking agent-propranolol significantly inhibited β-AR activation induced apoptosis.Antioxidants including vitamin C and NAC could inhibited β-AR activation induced apoptosis (all P ＜ 0.01).Conclusions β-AR is functionally expressed in human mesangial cell,furthermore β-AR activation-induced ROS increase mediate apoptosis.Antioxidants can inhibit β-AR activation induced apoptosis.

Objective: To evaluate the feasibility,the safety and the effect of early postoperative enteral nutrition in patients with esophageal cancer.Methods: On the first postoperative day,40 patients were randomly divided into two groups.One group was given isocaloric total parenteral nutrition through central vein(TPN group) and the other group was fed with enteral nutrition through nasoenteric tubes or jejunostomy tubes which were inserted during the operation(EEN group).All variables were measured before operation and on postoperative day 1 and 8.Blood was drawn at different time points to assess albumin,prealbumin and transferrin.Immune response was determined by immunoglobins,total lymphocytes,T-lymphocyte subsets and NK cells. Inflammatory response were determined by C-reactive protein,IL-6 and TNF-?.Morbidity,mortality and length of hospital stay were also evaluated. Results: Tolerance of enteral nutrition was excellent.Neither mortality nor serious morbidity occurred in all patients during the period of study.After the study,the levels of serum prealbumin,total lymphocytes,CD3,CD4 and CD4/CD8 ratio in the EEN group were significantly higher than the levels in the TPN group.The concentrations of IL-6 and the length of hospital stay in the EEN group were significantly lower than in the TPN group.Conclusion: Early postoperative enteral nutrition in patients with esophageal cancer is safe,and also has the benefit effects of enhancing the body status of nutrition and immune function,and reducing the inflammatory response and the length of hospital stay.

Objective To elucidate the association of the susceptibility for rheumatoid arthritis ( RA )and peptidylarginine deiminase 4(PADI4) genetic single nucleotide polymorphism (SNP) in Han population in Hebei province.Methods This hospital-based ease-control study included 105 untreated RA patients and 96 healthy controls.The genotypes and allele frequencies of padi4_92 gene polymorphisms were analyzed by PCR-RFLP method,and the analysis of linkage disequilibrium and haplotype construction were performed for padi4_92,padi4_94 and padi4_104 SNPs.The Peason Chi-square test and Woolf statistic method were used to analyze the odds ration (OR) and 95％ confidence interval (95％CI).Results Significant differences in the frequency of PADI4 alleles and genotypes between the cases and controls were observed.The combined effect of padi4_92,padi4_94 and padi4_104 SNPs was analyzed by SHEsis snd Genehunter software,and got three haplotypes,CCC,GTT and GCC.There was significant difference in haplotypes distribution of 3 SNPs of padi4 between the two groups.This analysis of haplotypes revealed that haplotype of PADI4 was a risk factor for RA The ORs for these three haplotypes for RA susceptibility were 0.634 (95％CI=0.425-0.946),1.306 (95％CI=0.864-1.975),4.286 (95％CI=1.274-14.424),respectively.Conclnsion The SNPs of PADI4 may contribute to genetic susceptibility to RA in Han population in Hebei Province.

We changed the form of literature reading from simple reading and translation to comprehensive lecture,analysis,discussion and exchange under the guidance of teachers in order to promote postgraduates' capability of learning professional English and to enhance their overall quality.The new form not only improves students' English proficiency but also enhances their overall quality,such as literature quality,teaching ability,competitive consciousness,psychological quality,etc.At the same time,it is also beneficial for teachers.

Objective To assess the effectiveness and safety of non-insufflation intra-abdominal compression as a prehospital hemostatic technique in treatment of liver injury.Methods Twenty-nine male Wistar rats were enrolled and randomly assigned into four experimental groups:IAP0 group ( n =8 ),IAP5 group (n =8),IAP10 group (n =8) and IAP15 group (n =5).Then,the anticoagulated rat models of severe liver injury were established with different intra-abdominal pressures ( 0,5,10 and 15 mm Hg) by using a non-expansible insufflated gas bag.Once the mean artery pressure (MAP) was less than 95 mm Hg,Lactated Ringer' s solution was infused through the right jugular vein at speed of 3.3 ml · min-1 · kg-1 until MAP reached 100 mm Hg.Thirty minutes later,the animals were killed by intravenous injection of 0.2 ml saturated potassium chloride solution to measure the intraperitoneal total blood loss,liver weight,volume of infused solution and MAP.Results No death was observed in IAP0,lAP5 and IAP10 groups and four rats (4/5) died at 10-15 minutes following exposure to the 15 mm Hg intra-abdominal pressure in IAP15 group.Total blood loss was reduced to ( 54.20 ±11.30)ml/kg in IAP0 group,(43.98 ±9.2) ml/kg in IAP5 group,(32.49 ±7.40) ml/kg in IAP10group and (25.77 ± 14.16) ml/kg in IAP15group ( P ＜0.01 ).The infused volume of resuscitation solution was (31.06 ± 3.14) ml in IAP10 group,which was higher than (24.94 ±6.67) ml in IAP0 group,(23.06 ± 7.98) ml in IAP5 group and (16.50 ±7.27) ml in IAP15 group (P ＜0.05).Liver weight was ( 11.18 ± 1.45) g in IAP5 group,( 12.13 ± 0.96) g in IAP10 group and ( 11.41 ± 1.20) g in IAP15 group,which was significantly higher than (10.03 ±0.58) g in IAP0 group (P＜0.05).The MAP was (64.81 ± 19.65) mm Hg in IAP5 group and (65.80 ± 15.36) mm Hg in IAP10 group ( insignificant difference between groups,P ＞ 0.05 ),which was higher than (41.22 ± 10.00) mm Hg in IAP0 group and (44.50 ±28.60) mm Hg in IAP15 group (P ＜0.05).Conclusions Non-pneumatic intra-abdominal compression can effectively control bleeding in rat models of severe liver injury,while the adverse effect of intra-abdominal hypertension should be avoided.

Objective:To evaluate the diagnostic and therapeutic value of bedside severe ultrasound in children with shock.Methods:Children who were diagnosed shock in the PICU of Shengjing Hospital of China Medical University from May 1, 2019 to April 31, 2020 were included in this study.Rapid ultrasound in shock (RUSH) exam was used to evaluate the morphology and function of heart, lung and abdomen of children with shock, so as to assist the diagnosis and treatment of shock.Results:Twenty-six children with shock were evaluated immediately according to the RUSH exam when they were admitted to hospital.Eight cases were diagnosed as septic shock, six cases as cardiogenic shock, six cases as hypovolemic shock and six cases as mixed shock.The left ventricular ejection fraction (LVEF) of children with cardiogenic shock was (26.5±8.24)%, and the width of inferior vena cava was greater than 10 mm.After the shock was corrected, LVEF increased to (32.17±26.11)%.However, the LVEF of children with septic shock was (73.25±1.28)% at admission and (50.12±31.41)% at shock correction.Nine cases (34.6%) found more B-lines in the lungs after fluid resuscitation for one hour in 26 children with shock.Among them, about 50% of the children with cardiogenic shock found more B-lines in their lungs one hour after fluid resuscitation, and 11 cases(57.9%) of the surviving children showed more B-lines after shock correction, but only six children could hear blisters after physical examination.Conclusion:According to RUSH exam, we can evaluate the volume status, cardiac function, volume responsiveness and focus on infection in children with shock, distinguish the type of shock earlier and more accurately, assist in guiding fluid resuscitation, and facilitate accurate and individualized fluid management and treatment of patients.