Objective: To evaluate the feasibility of performing muscle-sparing thoracotomy and intercostal sutures in the treatment of upper and/or middle thoracic esophageal cancer for the purpose of tumor control and postoperative quality of life improvement.Methods: Seven patients with esophageal cancer were treated with vertical muscle-sparing thoracotomy and Mckeown esophagectomy.Detailed clinic data were summarized and analyzed with patient follow-up information.Results: Of the 7 patients,five were still alive with a 71.4% five-year survival rate.There were no deaths resulting from the operation in this group.The mean length of thoracic incision was 11 cm.The range of hospital stays was 14 to 25 days,with a mean length of 18 days.No patients complained of impaired shoulder action,and the incision pain was hardly perceived without external stimulation 1 month after operation.Conclusion: Performing the muscle-sparing thoracotomy in the treatment of early-stage esophageal cancer located in the upper and /or middle thoracic segment yields a satisfactory long-term survival rate with an improved life quality in terms of incision pain relief and shoulder function.

MicroRNA-451 (miR-451) is significantly lowly expressed in glioma,gastric cancer,colorectal cancer,liver cancer and other tumor tissues.Upregulation of miR-451 can significantly inhibit tumor cell proliferation,invasion and metastasis as well as increasing tumor cell apoptosis and improving radiotherapy and chemotherapy sensitivity and other biological effects.

Training of war trauma rescue personnel under modern war time is the key point for strengthening the war preparation and satisfying the logistic supply. In the present paper,the training model of war field surgeon in Russian was firstly introduced,and then by combining the status of war rescue of our army,the strategies suitable for the training of field war surgeon in our army were put forward.

Objective To evaluate the effects of prostaglandin E1 (PGE1 ) infused in the pulmonary artery of the ventilated lung on hemodynamics and pulmonary gas exchange during one-lung ventilation (OLV).Methods Experiments were performed on 12 healthy pigs of both sexes (6 males , 6 females) aged 3 months, weighing 14-17 kg. The animals were anesthetized with intramuscular ketamine 15-20 mg?kg-1 , diazepam 1.5-2.0 mg?kg-1 and atropine. The animals were mechanically ventilated after tracheal intubation (FiO2 = 0.7, VT = 12-15 ml?kg-1, RR=15bpm, I:E=l:2). PaCO2 was maintained at 35-45 mm Hg. Swan-Ganz catheter was positioned in the right pulmonary artery via the left femoral vein. The right femoral artery was cannulated for BP monitoring and blood sampling. Anesthesia was maintained with a mixture of ketamine 100 mg and succinylcholine 100 mg in 2% procaine 100 ml infused i.v. at a rate of 2-3 ml?kg-1?h-1. The animals were placed in right lateral position. The left chest was opened and OLV was established by clamping the left main bronchus. During OLV RR was increased from 15 to 20 bpm but the minute ventilation remained unchanged. The animals were randomly divided into 2 groups of six : group A and B. Group A received PGE1 infusion in the right pulmonary artery with an initial dose of 0.01 ?g?kg-1?min-1 which was gradually increased to 0.02, 0.04, 0.06, 0.08 and 0.1 ?g?kg-1?min-1 . Theinfusion of each dose was maintained for 20 min. In group B normal saline was infused instead of PGE1. MAP, HR, CVP, PCWP, CO, PaO2 PvO2 were recorded at each dose and at 20, 40, 60 min after PGE1 infusion was terminated. Qs/Qt, PVR and SVR were calculated.Results MPAP, PVR, SVR, peak inspiratory pressure (PIP) and Qs / Qt significantly increased while CO, Cdyn and PaO2 significantly decreased (P 0.05) and a significant decrease of MPAP and PVR ( P

Objective To explore the effect of swallowing training on dysphagia in patients with head and neck neoplasm receiving ra-diotherapy. Methods 60 patients with head and neck neoplasm receiving radiotherapy from March, 2014 to August, 2015 were divided into intervention group (n=30) and control group (n=30) randomly. The control group received routine nursing and relevant health education, while the intervention group received swallowing training from 2 weeks before to 3 months after radiotherapy. They were assessed with Functional Oral Intake Scale and M. D. Anderson Dysphagia Inventory 1 week, 3 months after radiotherapy. Results The scores of Function-al Oral Intake Scale (Z=-3.195, P<0.01), the total score of M. D. Anderson Dysphagia Inventory and the subscores (t>4.385, P<0.01) were better in the intervention group than in the control group 1 week after radiotherapy, as well as 3 months after radiotherapy (Z=-4.436, P<0.01;t>5.361, P<0.01). Conclusion Swallowing training could improve the condition of dysphagia of head and neck neoplasm patients after radiotherapy.

Objective To synthesize 628F-Py-AMD3465,to investigate its biodistribution in mice and to perform the microPET/CT imaging on mice bearing human lung cancer cell (A549).Methods AMD3465 quaternary ammonium salt precursor was directly labeled with 18F,then 628F-Py-AMD3465 was synthesized through nucleophilic reaction,hydrolysis,neutralization and the product was purified using HPLC.The labeling yield and radiochemical purity were analyzed by HPLC.Fifteen Kunming mice were injected with 5.55 MBq of 628F-Py-AMD3465 and sacrificed at 5,20,40,60 and 120 min postinjection.The selected tissues were harvested and weighed,and the radioactivity in the tissues was measured by an automated γ-spectrometer.The ％ID/g was calculated.MicroPET/CT studies were performed on A549-bearing mice after injecting 6-18F-Py-AMD3465 through vena caudal.Paired t test was used.Results 6-18F-Py-AMD3465 was successfully synthesized with the labeling yield of (9.0±2.0)％,the total synthesis time was about 60 min,and the radiochemical purity was more than 98％.Biodistribution studies showed that the radiouptake was higher in the kidneys and bladder of normal mice,which demonstrated that 6-18 F-Py-AMD3465 was mainly excreted through the kidneys.Biodistribution in A549-bearing mice was similar to that in normal mice.The tumor/muscle ratio at 40 min was 5.0,but the radiouptake of the tumor was still lower than that of the normal lung:(8.05±0.35) ％ID/g vs (9.33±0.66) ％ID/g;t=5.26,P＜0.05.MicroPET/CT imaging showed that the high-uptake location of 6-18F-Py-AMD3465 in tumor-bearing mice was similar to the normal mice,and the tumor uptake reached the maximum level at 45 min post-injection (SUV 0.67).Conclusions 6-18F-Py-AMD3465 can be synthesized by a simple method.A lower uptake could be shown in the tumor compared to that in the lung and the tracer has limited diagnostic value for lung cancer.

OBJECTIVETo compare the cleaning effect of automatic cleaning machine and manual cleaning on coupling type surgical instruments.

METHODSA total of 32 cleaned medical instruments were randomly sampled from medical institutions in Putuo District medical institutions disinfection supply center. Hygiena System SUREII ATP was used to monitor the ATP value, and the cleaning effect was evaluated.

RESULTSThe surface ATP values of the medical instrument of manual cleaning were higher than that of the automatic cleaning machine.

CONCLUSIONCoupling type surgical instruments has better cleaning effect of automatic cleaning machine before disinfection, the application is recommended.

Alcoholic liver disease ( ALD ) , a chronic progres-sive disease, threatens human health seriously. An increasing number of studies have shown that gut flora dysbiosis plays an important role in the development of ALD. Intestinal microbiota maintains a steady state under normal conditions, regulating gut flora normal physiological function. However, chronic alcohol consumption produces intestinal bacteria overgrowth and dysbio-sis, including the alteration of the composition of intestinal mi-croflora, the increment of gut permeability and bacterial translo-cation. Subsequently, the host immune is activated, promoting the production of inflammatory cytokines in liver, which plays a central role in the development of ALD. Notably, the supple-ment of prebiotics or probiotics reverses the intestinal flora disor-der,ameliorating the clinical symptoms effectively in ALD pa-tients. The evidence impies that the modulation of dysbiosis may be effective in the prevention and treatment of ALD. This review summarizes the research progress on the mechanism of the devel-opment of dysbiosis-mediated ALD, to provide a theoretical basis for the research on intestinal flora and ALD.

Objective To evaluate the therapeutic effect of Xiao'er Zhixie Paste (XZP) by using the young rat model of chronic diarrhea,and to explore its mechanism.Methods Chronic diarrhea model in young rats was induced by ig senna.Rats were ig with Montmorillonite powder of 1.62 g/kg,XZP of low,medium,and high dose (2.03,4.05,and 8.10 g/kg) for treatment.Loose stools rate,loose stool grade and diarrhea index were determined 1 and 3 d after treatment respectively.The water content of small intestine was measured and blood was collected for testing serum succinate dehydrogenase (SDH),amylase,D-xylose by colorimetric determination,testing serum D-lactic acid,IL-1 β,and TNF-α by Elisa after administration.Results The rate of loose stools in XZP 4.05 and 8.10 g/kg dose group,and diarrhea index in 8.10 g/kg dose group significantly reduced after the first treatment.The loose stools rate of XZP 2.03,4.05,and 8.10 g/kg dose group,diarrhea index,serum D-lactic acid level in 4.05,8.10 g/kg group significantly reduced,and serum D-xylose level in 8.10 g/kg dose group significantly increased 3 d after treatment.However,XZP had no significant effect on SDH,amylase activity and IL-1β,TNF-α levels.Conclusion XZP has obvious therapeutic effect on chronic diarrhea in young rats,the mechanism is to increase improve the absorptive function and permeability of intestinal tract.

Objective Surgical treatment of lung cancer needs to follow strict quality control standard for the aims of accuracy of pathological staging and potentially improved prognosis.However,there are short of studies related to surgical quality analysis.Methods One hundred and twelve patients were enlisted with the diagnosis of lung cancer and received surgical intervention in 2007.Surgical quality of these cases were retrospectively analyzed in compliance with three international standards,National Comprehensive Cancer Network (NCCN),American College of Surgeons’ Oncology Group (ACOSOG),and International Association for the Study of Lung Cancer (IASLC).Results No surgical death was reported in this group.According to NCCN,ACOSOG and IASLC standards,qualified operations were 82 cases (80.4％),73 cases (71.6％),45 cases (44.1％) in 102 cases with R0 resection,respectively.The median total lymph nodes,median mediastinal nodes,and N1 nodes were 27 (range 0-63),16.5 (range 0-43),and 10.5 (range 0-26),respectively.The median mediastinal node stations resected were 4 (range 0-6).In the mediastinum,stations of 4R,5,6 and 7 presented the highest frequency of receiving lymph node dissection.For N1 stations,10 and 12 were among the top list.For the whole group,1-year survival,3-year survival and 4-year survival were 92％ (95％ CI,89-95),67％ (95％ CI,62-72),57％ (95％ CI,52-62),respectively.Conclusion Quality control is the essential part of surgical treatment of lung cancer,which will facilitate the baseline standardization of clinical research.Since IASLC provides the strictest standard for lung cancer surgery,we suggest that all thoracic surgeons need to follow this standard to secure the accuracy of pathological diagnosis and for a potential better prognosis.