Objective·To investigate factors affecting the prognosis of aged esophageal cancer patients after esophagectomy.Methods·Clinical data of 103 aged patients (≥ 80 years old) undergoing esophageetomy were collected.Effects of age,sex,clinical manifestations,pre-operative diseases,post-operative complications,T stage,lymph node metastasis,maximum diameter and location of the tumor,and surgical methods on the post-operative survival were analyzed.Results·1,3,and 5 years survival rates of 103 patients were 63.2％,15.9％,and 2.7％,respectively.Kaplan-Meier survival curve analysis indicated that the post-operative survival was significantly higher in patients with T1 and T2 stages than in patients with T3 stage.The 3 and 5 y survival rates of patients with T 1 stage were 50％ and 25％,respectively.Results of Cox regression multivariate analysis showed that T stage,maximum diameter of tumor,postoperative complications,and lymph node metastasis were independent factors affecting the post-operative survival.Conclusion·Esophageal cancer patients aged over 80 years with smaller tumor diameters,less postoperative complications,and negative lymph node metastasis have a longer post-operative survival period.Esophagectomy for patients with earlier stages (T1 and T2) can achieve an ideal post-operative survival period.

Objective To explore the improving safety measures of colon interposition after esophagectomy .Methods From January 2003 to December 2014, 65 cases of colon interposition after esophagectomy were performed, and some improve-ments were made in the methods and procedures .Mainly including: Preoperative evaluation to first operation; Selection of co-lon segment; Simplify vascular anatomy;Cervical anastomosis was replaced by intrathoracic anastomosis;Modified anastomosis sequence; Strengthen preoperative preparation.Results There were no perioperative deaths.Only 2 patients with cervical fis-tula, due to malnutrition automatically discharged.The rate of anastomotic leakage on neck were 27.77%(10/36) and 6.89%(2/29) in the chest.2 cases were completed intestinal obstruction after jejunostomy , 1 cases of volvulus and 1 cases of intus-susception confirmed by reoperation.Conclusion Colon interposition after esophagectomy is a very important way of surgery. The operation process is complex, but as long as mastering the point of surgery, improving the surgical procedures, the good effect can be obtained and greatly improve the safety of the operation .

Objective To investigate the feasibility of treatment mode of end-to-end anastomosis of esophagus(EAS) af ter partial resection for early-stage cervical esophageal carcinoma(ECEA).Methods 7 patients were substantially confirmed as squsmous cell carcinoma of cervical esophagus by endoscopy,the nearest distance of the lesion from the incisors was 17cm,and the furthest was 20 cm,the maximum extent was 2.5 cm,and the minimum was 1 cm.None of them with longitudinal muscularis invasion.Confirmed by PET/CT or chest enhancement CT examination preoperatively,intrathoracic and cervical lymphatic metastasis was excluded,cT1 -2 N0 M0.Incisal margin length was not less than 1 cm,the maximum was 5 cm and the minimum was 3 cm.Meanwhile,the cervical lymph node should be dissected,and the average number was 6.43 per case.After surgery,all the patients were fixed by plaster slab to release the tension of anastomosis.Postoperative adjuvant radiotherapy or chemotherapy was received.Results None of the patients had severe postoperative complications,and the average hospital stay was 14.5 days.All the patients are alive,the longest follow-up lasts for 3 years and 4 months,all of them can take normal food,without anastomotic stenosis.Conclusion Treatment mode of EAS after partial resection for ECEA significantly decrease the operative damage,apparently improve the patient's quality of life(QOL),so that the patients can better receive adjuvant treatment subsequently; it is a feasible and effective method for cervical esophageal carcinoma at the early stage.

OBJECTIVETo explore the methods and means of surgical treatment for cervical esophageal cancer in order to get the best efficacy.

METHODSRetrospective investigation and analysis were carried out in 137 patients with cervical esophageal cancer undergoing operation in our hospital from January 2005 to December 2013. According to lesion locations, these cases were divided into two groups: larynx preservation group(Group A) and laryngectomy group(Group B). Surgery options of Group A included inversion esophagectomy without thoracotomy, three-incision esophagectomy, end to end anastomosis of cervical esophagus after local resection. Group B included gastric-pharyngeal anastomosis, pharyn-esophagus plasty, colon replacement of the esophagus or jejunal interposition. All the patients received postoperative adjuvant therapy.

RESULTSThere were no perioperative deaths. The main postoperative complications included anastomotic fistula in 20 cases(14.6%), postoperative massive bleeding after inversion esophagectomy in 3 cases, chylothorax in 1 case, anastomotic stenosis in 9 cases, severe gastroesophageal reflux in 6 cases and serious aspiration pneumonia in 2 cases. All these patients had complete resolution of disease with good postoperative quality of life. The 1-year, 3-year and 5-year survival were 73.7%, 48.4% and 26.8% respectively. The most important causes of postoperative death included local recurrence, cervical or mediastinal lymph node metastases, cachexia and multiple organic metastasis.

CONCLUSIONIt is critical to select reasonable methods of operations to reduce postoperative complications and to receive proper adjuvant therapy.

Anastomosis, Surgical ; Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Humans ; Lymphatic Metastasis ; Neck ; pathology ; Postoperative Complications ; Quality of Life ; Retrospective Studies

OBJECTIVETo search for the best acupuncture treatment for sudden sensorineural deafness.

METHODSOne hundred and eighty-seven patients were randomly divided into an acupuncture group (group A), an electroacupuncture group (group B), an acupuncture pius acupoint injection group (group C), an electroacupuncture plus acupoint injection group (group D). Ermen (TE 21), Tinggong (SI 19), Tinghui (GB 2), Yifeng (TE 17), Fengchi (GB 20) on the affected side, and Shangxing (GV 23), Baihui (GV 20), Sishencong (EX-HN 1), Hegu (LI 4), Waiguan (TE 5), etc. were selected. The treatment was given once each day. Hearing was tested after treatment for 40 sessions and the therapeutic effects were compared.

RESULTSThe total effective rate was 47.6% in the group A, 79.2% in the group B, 76.0% in the group C and 94.0% in the group D, the group D being the best and the group A being the worst, and with significant differences between the group D and the other groups (all P < 0.05). In the group D, the therapeutic effect for patients who received the treatment within 2 weeks after attack were superior to those who received the treatment over 2 weeks after attack (P < 0.05); the acupuncture therapeutic effect for the mild and moderate patients was superior to that of severe patients (P < 0.05); the acupuncture therapeutic effect for the patients less than 50 years old was superior to those more than 50 years old (P < 0.05).

CONCLUSIONElectroacupuncture plus acupoint injection is the heat therapy for sudden sensorineural deafness, and the timely intervention of acupuncture, the severity degree of the illness and the patient's age are all related to the prognosis of this disease.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Drugs, Chinese Herbal ; therapeutic use ; Electroacupuncture ; Female ; Hearing Loss, Sudden ; drug therapy ; therapy ; Humans ; Male ; Middle Aged

Objective: To learn about the construction and staffing of the school health system in Chinese institutions for disease prevention and control, and to provide basic information for the school health system, team capacity building and work development. Methods: Electronic questionnaire was used to collect the setting and staffing of school health departments (including school health centers and departments/rooms) at the provincial, prefecture and county (district) levels in the centers for disease control and prevention. Statistical analysis was made on the proportion of school health, the number of staff and the characteristics such as age, education, major and working years in the provincial, prefecture and county (district) levels. Results: Among the 3 313 institutions, the proportion of independent school health departments was 10.8%, and those of the provincial, prefecture and county (district) levels were 74.2%, 15.0%, and 9.6%, respectively. Among the institutions with separated department, the average number of staff members was 4.4, while the number of staff was 2.5. The average age of school health workers was 40.4 years old, and the proportion of male and female employees was 45.2% and 54.8%. The proportion of personnel who have been engaged in school health work for less than 5 years on average was as high as 65.1%. The majors of the staff were mainly public health ( 40.4 %), 54.0% of the provincial staff had a master s degree or above, and 47.8% and 58.7% of the staff at the prefecture and county (district) levels were junior college or below respectively.The proportion of provincial level personnel with intermediate and senior titles was 69.6%, and the proportion of municipal and countylevel personnel at the junior level and below was 52.2% and 56.2% respectively. Conclusion The proportion of independent school health departments within centers of disease control and prevention across China was low. There is a serious shortage of school health personnel, and there are problems such as low levels of education and professional titles, especially in county (district) level institutions. It is urgent to strengthen the construction of the school health system of the centers for disease control and prevention in China.

Objective:To analyze the internal conditions and external environment of high-quality development of high-level public hospitals and establish a high-quality development strategy model, for reference of public hospitals to formulate and implement high-quality development strategies.Methods:The case hospital was a pilot in high-quality development of high-level public hospitals. SWOT method was used to analyze the influencing factors, AHP analytic hierarchy process was used to compare the importance of each influencing factor, and then the four-quadrant coordinate system method was used to establish a high-quality development strategy model.Results:The total strength(S), the total weaknesses(W), the total opportunity(O), and the total threat(T)were 0.095, 0.063, 0.065 and 0.024 respectively, reflecting that the strength of internal conditions was greater than the weaknesses, and the opportunities of external environment were greater than the threats. In the four-quadrants, the growth strategy model had the largest triangle area(0.003), and the strategic quadrilateral center of gravity was located in the opportunity area of the growth strategy.Conclusions:High-level public hospitals as represented by the case hospital had entered a period of important strategic opportunities, which the external opportunities were greater than its own strength. These hospitals were recommended to fully leverage the external opportunities, adopt a positive growth oriented(SO)strategy, formulate a development strategy with their own characteristics, promote the interaction of internal conditions and external environment to form new momentum, hence achieving high-quality development.

Objective To explore the methods and means of surgical treatment for cervical esophageal cancer in order to get the best efficacy. Methods Retrospective investigation and analysis were carried out in 137 patients with cervical esophageal cancer undergoing operation in our hospital from January 2005 to December 2013. According to lesion locations , these cases were divided into two groups: larynx preservation group (Group A) and laryngectomy group (Group B). Surgery options of Group A included inversion esophagectomy without thoracotomy, three-incision esophagectomy, end to end anastomosis of cervical esophagus after local resection. Group B included gastric-pharyngeal anastomosis, pharyn-esophagus plasty, colon replacement of the esophagus or jejunal interposition. All the patients received postoperative adjuvant therapy. Results There were no perioperative deaths. The main postoperative complications included anastomotic fistula in 20 cases (14.6%), postoperative massive bleeding after inversion esophagectomy in 3 cases, chylothorax in 1 case, anastomotic stenosis in 9 cases, severe gastroesophageal reflux in 6 cases and serious aspiration pneumonia in 2 cases. All these patients had complete resolution of disease with good postoperative quality of life. The 1-year , 3-year and 5-year survival were 73.7%, 48.4% and 26.8% respectively. The most important causes of postoperative death included local recurrence , cervical or mediastinal lymph node metastases , cachexia and multiple organic metastasis. Conclusion It is critical to select reasonable methods of operations to reduce postoperative complications and to receive proper adjuvant therapy.

Objective To explore the methods and means of surgical treatment for cervical esophageal cancer in order to get the best efficacy. Methods Retrospective investigation and analysis were carried out in 137 patients with cervical esophageal cancer undergoing operation in our hospital from January 2005 to December 2013. According to lesion locations , these cases were divided into two groups: larynx preservation group (Group A) and laryngectomy group (Group B). Surgery options of Group A included inversion esophagectomy without thoracotomy, three-incision esophagectomy, end to end anastomosis of cervical esophagus after local resection. Group B included gastric-pharyngeal anastomosis, pharyn-esophagus plasty, colon replacement of the esophagus or jejunal interposition. All the patients received postoperative adjuvant therapy. Results There were no perioperative deaths. The main postoperative complications included anastomotic fistula in 20 cases (14.6%), postoperative massive bleeding after inversion esophagectomy in 3 cases, chylothorax in 1 case, anastomotic stenosis in 9 cases, severe gastroesophageal reflux in 6 cases and serious aspiration pneumonia in 2 cases. All these patients had complete resolution of disease with good postoperative quality of life. The 1-year , 3-year and 5-year survival were 73.7%, 48.4% and 26.8% respectively. The most important causes of postoperative death included local recurrence , cervical or mediastinal lymph node metastases , cachexia and multiple organic metastasis. Conclusion It is critical to select reasonable methods of operations to reduce postoperative complications and to receive proper adjuvant therapy.