Objective To investigate the technique and feasibility of video-assisted thoracoscopic surgery (VATS) in the treatment of esophageal carcinoma. Methods Sixteen patients with esophageal carcinoma underwent esophagectomy by VATS between October 2002 and October 2003. The tumors were found in mid-segment in 13 patients and lower segment in 3 patients. Their TNM staging was: stage T 1 2 patients, stage T 2 5 patients and stage T 3 9 patients; stage Ⅰ 2 patients, stage Ⅱ 8 patients and stage Ⅲ 6 patients. Results No conversion to open surgery was required. The operation time of VATS was 90～150 min (mean, 110 min). The number of removed mediastinal lymph nodes was 6～14 (mean, 7.3). Drainage tube was taken out 2～3 days after operation and the drainage volume was 300～600 ml. No complications were seen. Conclusions VATS for esophageal carcinoma is feasible. Indications for VATS should be stage Ⅰ～Ⅱ and in addition no outward infiltration (≤stage T 3).

Diabetic retinopathy (DR) is a common disease of ophthalmology,often causes irreversible decline of patients' vision,which has two features including macular oedema,diabetic retinal neovascularization.Diabetic retinal neovascularization is one of the most important reasons leading to blindness.Endostatin (ES) is one of the most effective agents inhibiting angiogenesis,whose biological function has a close relationship with its chemical construction.However,its mechanisms of treating diabetic retinal neovascularization are very complicated and remain unclear.Therefore,in this review we summarized several possible mechanisms,including regulating the expression of extracellular matrix,inhibiting the expression of pro-angiogenic factors,and regulating the signaling pathways,by which ES may inhibiting diabetic retinal neovascularization.

The effects of low-level radiation on cAMP in peasma, adrenal and testis and cGMP in adrenal of rats were studied. Adult male rats were given whole-body irradiation with x-rays at a dose rate of 15 mGy/min. They were irradiated with 50 and 100 mGy daffy for 30 days within 5 weeks with cumulative doses of 1.5 and 3.0 Gy respectively. One, two and four weeks after termination of irradiation, the levels of cAMP in plasma, the adrenal gland and testis, the level of cGMP in the adrenal gland and the weights of the body, testes and pitutary were examined. The weights of testes decreased within 4 weeks after irradiation as compared with the control and the level of cAMP in the testis was significantly increased at weeks 1 and 2 in the 3.0 Gy group. At week 4, it returned to near normal. In another experiment, animals were irradiated with ~(60)Co ?-ray at a dose rate of 45.3?Gy/min, 16.3 mGy/6h/day and 6 days per week. At 6, 10, 14, 18 and 22 weeks, with cumalative doses of 0.59, 0.98, 1.37, 1.76 and 2.15 Gy respectively, the levels of cAMP in the pitutary and testis and testicular weight were quantified. No significant changes were found. These results suggest that dose rate is an important factor In the determination of the degree of damage of the testis following low-level irradiation.

The paper discusses the basic contents, characteristics, and development trend of training programs abroad for high level hospital administrators as represented by MHA (Master of Hospital Administration) programs. Those programs establish curricula and training modes in light of the primary tasks and responsibilities of high level hospital administrators. They attach importance to the cultivation of concepts of macro health and ideas of modern management, provide training in methodologies of public health as represented by bio statistics and epidemiology, emphasize practical matters of operation and management such as hospital planning, quality control and financial accounting, and make wide use of case studies so as to enhance the abilities to solve practical problems. Hospital reform and development make it imperative to improve the training of high level hospital administrators, which must be properly oriented, and to develop domestic MHA programs with Chinese characteristics by utilizing existing resources of health administration education and integrate relevant courses.

Commercialization of the doctors sector and lawyers sector, and that of medical services, sharp rise of medical disputes and its impact on healthcare services have grown into major challenges for the healthcare system in the United States where litigation is the legal way out of medical disputes at large.Anglo-American law system depends heavily on precedence as the criteria and the majority of such disputes trials are held in state courts, there is also a complete system of laws and decrees on medical disputes on the federation level.In an effort to handle medical disputes that are rising sharply in a piling-up amount, American lawyers, social organizations of arbitration and medicine, and many state courts are seeking alternative dispute resolution as a better way out for medical dispute mediation and resolution.Given the gaps between China and USA in social systems, legal systems, ,economic development, cultural background, healthcare systems and heahhcare security systems, these experiences will prove their value of reference for medical disputes resolution in China.

Arteriovenous Shunt, Surgical ; Blood Vessel Prosthesis ; Blood Vessels ; pathology ; Humans ; Neoplasms ; blood supply ; pathology ; surgery ; Vascular Surgical Procedures ; instrumentation ; methods ; Vena Cava Filters

Carotid Arteries ; diagnostic imaging ; surgery ; Feasibility Studies ; Head and Neck Neoplasms ; blood supply ; diagnostic imaging ; surgery ; Humans ; Radionuclide Imaging

The early diagnosis of serious infection is very important since the fatality rate is quite high.Traditional diagnostic methods of infection includes procalcitonin,leukocyte count,CRP and so on,of which the sensitivity and specificity is not able to achieve the early diagnosis.Recently,neutrophil CD64 has been widely concerned for the high sensitivity and specificity in early diagnosis of bacterial infection.Flow cytometry is applied to detect neutrophil CD64 in early diagnosis of infectious diseases including respiratory infection,septicemia,neonatal intensive infection,burn and postoperative infection.What's more,the sensitivity and specificity can be further improved if neutrophil CD64 was combined with other inflammatory markers.Thus,neutrophil CD64 detected by flowy cytometry plays an important role in the diagnosis,monitoring,prognosis,therapeutic effect evaluation of infectious diseases.

Objective To investigate the relationship between Clq/tumor necrosis factor (TNF)-related protein 9 (CTRP9)and coronary heart disease.Methods A total of 232 patients diagnosed with coronary heart disease(CHD)by coronary angiography at our hospital were selected as the CHD group,and 90 cases with normal coronary angiography served as the control group.The double antibody sandwich enzyme-linked immunosorbent assay(ELISA)was used to determine serum CTRP9 levels.Results Serum CTRP9 levels were lower in the CHD patients than in the controls [(116.9±19.5)ng/ml vs.(142.3±17.9)ng/ml,t＝-5.404,P＝0.000].SerumCTRP91evelswere negatively correlated with body mass index,fasting plasma insulin,fasting blood glucose,insulin resistanceindex(IRI),triglyceride and TNF-α(r＝-0.230,-0.225,-0.267,-0.235,-0.230and-0.222,P＝0.017,0.011,0.002,0.010,0.011 and 0.022).Multiple logistic regression analysis revealed that uric acid,IRI,CTRP9,and TNF-α were independent influencing factors for CHD,of which CTRP9 was a protective factor for CHD occurrence(OR ＝ 0.907,95％C1:0.854～0.963,P＝ 0.001).Conclusions Decreased serum levels of CTRP9 are associated with coronary heart disease,indicating that CTRP9 may play a protective role in coronary heart disease occurrence.