Objective To evaluate the therapeutic effectiveness and toxicity of low-dose cisplatin chemotherapy combined with three-dimensional conformal radiotherapy for mid-advanced esophageal cancer.Methods 89 patients with advanced esophageal cancer either who were inoperable or refused operation were randomized into two groups: 45 cases in the study group and 44 cases in the compared group. The study group

Objective Toinvestigate the changes of liver and kidney function and morphology of the renal artery of the metabolic syndrome (MS) rats.Methods The rats were respectively fed with ordinary or high-fructose diet for 10 weeks,and then took the blood and anatomical observation,to explore the changes of liver and kidney function and morphology of the renal artery of the rats.Results The serum levels of ALT,AST,UA,BUN,CR in the control group and MS group were gradually increased with the feeding time.But those in MS rats were significantly increased than the control rats.MS rats showed dysfunction of liver and kidney,which similar to the clinical MS cases.Compared with the control group,the renal artery of MS rats had the same pathological changes as MS cases,presented with intima uneven thickening and structural disorder,medial smooth muscle cells hyperplasia to intimal,the internal elastic membrane with different degrees of damage and fracture,the film elastic fibers thickening and structural disorder,smooth muscle cell proliferation apparently,medial obvious thickening.Conclusion MS rats have mild dysfunction of liver and kidney and abnormal changes in intima and tunica media of renal artery.

Aim To set up a highly effective and automatic mouse sleep-wake bioassay system,and evaluate the system through analysis of the somnogenic effects of L-stepholidine(SPD),targeting at dopamine D1/D2 receptors in mice.Methods The animals were housed in an insulated and soundproof recording chamber maintained at a constant temperature and humidity on an automatically controlled 12 h light/12 h dark cycle.The electroencephalogram and electromyogram were recorded continuously for 48 hours and analyzed by SleepSign software.Saline was administered ip to the mice at 21:00 on the first day,and SPD was given on the next day at the same hour.The vigilance state was analyzed based on the polygraphic recordings by the same software.Results The system has been demonstrated to be highly efficient and stable in recording and reliable in analyzing sleep-wake behavior in mice.With the aid of the sleep bioassay system,we found that SPD significantly increased the total time spent in sleep during dark period,and prolonged durations of non-rapid eye movement sleep episodes,with a concomitant reduction in amount and EEG power density of wakefulness.SPD rendered no effect on rapid eye movement sleep.Conclusion Through the reliable mouse sleep bioassay system,we found that SPD promotes non-rapid eye movement sleep but not rapid eye movement sleep in mice.

AIM: To investigate the effects of nitric oxide (NO) inhalation on nitric oxide synthase (NOS) and endothelin-1 (ET-l) of patients with hypoxic pulmonary hypertension. METHODS: Examined 13 pulmonic blood samples to determine the concentration of NOS in leukocyte and ET - 1 in plasma before NO inhalation, 30 minutes after inhalation, 2 and 12 hours after stopping of inhalation respectiviy. RESULTS: The values taken before inhalation was NOS (0.70 ? 0.21 )mol/min?mg-l, ET-1 (78.89 ? 46.59) Pmol/L; 30 minutes after inhalation (0.74?0.14)mol/min.mg-l, ET - 1 (88 .27 ? 45 .41 )pmol/L; 2 hours after stopping of inhalation NOS (0.64 ? 0.22)mol/min.mg-1, ET - 1 (80.76?42.66)pmol/L; and 12 hours after stopping of inhalation NOS (0. 63? 0. 17)mol/min.mg-1, ET-1(61.07?29.44)pmol/L. NO significant difference was found in the values of NOS and ET- 1 before and after inhalation, P＞ 0. 05. CONCLUSION: The effects of NO inhalation on NOS and ET-l in patients with hypoxic pulmonary hypertension are not significant according to the above investigation.

Objective To investigate the effect of the combined use of ultrasound (US) elastography and color Dop-pler on the differential diagnosis and TNM staging of benign or malignant breast neoplasm. Methods A cohort of 58 biop-sy-proved cases, who underwent US elastographic and Doppler US imaging, were included in the current study. The pathological results after operation were considered the‘gold standard’of diagnosis. ROC curves were used to compare the changing rates of the diameter and area, elastographic indices and Doppler blood flow score in diagnosis of breast cancer. Re-sults Compared with other indices, the area changing rate showed the highest diagnostic ability with the AUC=0.914. More-over, the combined use of the elastography and color Doppler US increased the AUC to 0.981. The elastographic indices for neoplasm in the advanced-stage (stageⅡ~Ⅳ) were high than those of early-stage (stage 0~Ⅰ). The elastographic and Dop-pler scores increased with the progress of the TNM stages. Conclusion The changing rate of elastographic area can be used to accurately diagnose the breast neoplasm. Moreover, the combined use of US elastography and color Doppler US can in-crease the accuracy of the diagnosis, and may also provide useful information for the TNM staging.

Objective To investigate the risk factors of pancreatic fistula after pancreaticoduodenectomy (PD).Methods The clinical data of 186 patients who received PD at the Second Affiliated Hospital of Kunming Medical College from May 2000 to May 2010 were retrospectively analyzed.All patients were divided into pancreatic fistula group (39 patients) and non-pancreatic fistula group ( 147 patients).Risk factors of pancreatic fistula after PD were screened out from 20 factors by univariate and multivariate analysis.The univariate analysis was carried out by chi-square test or Fisher exact test,and the muhivariate analysis was done by Logistic regression.Results Thirty-nine patients were complicated with pancreatic fistula,including 26 in grade A,10 in grade B and 3 in grade C.The results of univariate analysis showed that duration of preoperative jaundicc,loss of body weight at 6 months before operation,preoperative total bilirubin level,preoperative albumin level,postoperative albumin level,length of pancreas dissected,pancreatic tube diameter,pancreatic texture and time of abdominal drainage tube pull out were high risk factors of pancreatic fistula ( x2 =34.990,20.480,8.212,10.890,13.561,11.505,13.820,4.539,36.590,P ＜ 0.05).The results of multivariate analysis showed that duration of preoperative jaundice ＞ 8 weeks,loss of body weight at 6 months before operation ≥ 10％,pancreatic tube diameter ＜ 3 mm,soft pancreatic texture and time of abdominal drainage tube pull out ＞ 5 days were the independent risk factors of pancreatic fistula ( OR =2.229,3.383,1.437,1.273,11.939,P ＜ 0.05).Conclusion Duration of preoperative jaundice ＞ 8 weeks,unconscious loss of body weight ≥ 10％ within 6 months before operation,pancreatic tube diameter ＜ 3 mm,soft pancreatic texture,time of abdominal drainage tube pull out ＞ 5 days would increase the risk of pancreatic fistula after PD.

Objective To develop a reverse genetics system for Hantaan virus (HTNV) 84FLi strain by using RNA polymerase [ (pol Ⅰ)-mediated transcription. Methods Complementary DNA (cDNA) containing the coding sequence for chloramphenicol acetyhransferase (CAT) was inserted into the 5'-and 3'-terminal untranslated regions of HTNV 84FLi L segment. These chimeric cDNAs (pol Ⅰ expression cassette) were cloned into plasmids and between the human pol Ⅰ promoter and terminator to generate sense and anti-sense RNA pol Ⅰ transcription reporter plasmids. The reporter plasmids were transfeeted into 293T cells or the 1:1 combination of 293T and HTNV infected Vero cells. These cells were cotransfected with expression plasmids encoding Ⅰ. (RNA dependent RNA polymerase) and N (nucleoprotein) viral proteins, Cells were harvested 48 h post-transfection and the CAT activity was detected. The 293T cells were infected with the supernatant to explore the passage ability of CAT activity. ResultsThe reporter plasmids pLvRNA-CAT and pLcRNA-CAT were constructed successfully. CAT activity was detected in transfected cells and could also be serially passaged in the rescued virus minigenomes. Conclusion The RNA polymerase ]-driven reverse genetics system successfully rescues HTNV 84FLi minigenomes.

Objective To analyze the current status of exercise and exercise self-efficacy (ESE) and its influencing factors in middle-aged and elderly patients with high blood pressure, and to provide a basis for the intervention of patients with hypertension in the community. Methods The stratified random sampling method was used to select 546 patients with hypertension who had received hypertension management for one year in the community. The general condition, exercise condition, and ESE scores were collected using survey questionnaires. Chi-square test was applied to analyze the difference of exercise efficacy score among different characteristic objects, and analysis of regression method was applied to analyze the influencing factors of exercise self-efficacy. Results A total of 546 people were surveyed in this study, of which 67.03% of hypertension patients participated in exercise. The main exercise program was walking healthily (87.43%). A total of 262 people (47.99%) had strong performance on ESE score, while 284 people (52.01%) had weak self-efficacy. The univariate unconditional logistic regression analysis found that there were significant differences in the distribution of educational level, family monthly income, years of hypertension, whether they received the guidance from family doctors, whether they exercised and whether they warmed up before exercise (P<0.05). The multivariate unconditional logistic regression analysis showed that educational level of junior high school and low average monthly household income were the risk factors affecting exercise efficacy, and the guidance of family doctors, exercise, and hypertension less than 5 years were the protective factors affecting exercise efficacy. Conclusion The exercise self-efficacy of middle-aged and elderly patients with hypertension in this community is at a medium level, and family doctors should carry out targeted interventions based on influencing factors to improve exercise self-management ability.

Objective To investigate the availability and strategy of breast reconstruction for patients with caesarotomy scar using pedicled TRAM flap.Methods From January 2007 to May 2011,12 cases of breast reconstruction with caesarotomy scar were carried out with pedicled TRAM flaps.All the patients that were classified as the class Ⅱ that was 0.5 or less by score were operated on by using the inverted trapezoid incision,of which the upper edge was 2 or 3 cm down to the umbilicus.Double pedicles were adopted for the patient with the longest vertical scar; single pedicle of the breast contralateral side and the muscle sheath of the breast ipsilateral side were harvested for the rest of the patients.A synthetic mesh was used for the enforcement of the muscle and sheath defect.Results No flap necrosis or abdominal complications were observed.With the follow-up from 3 months to 4 years and 4 months,the overall satisfactory rate was 100 ％.Conclusions The strict patient selection and the operating strategy are the keys to the successful breast reconstruction for patients with caesarotomy scar using pedicled TRAM flap.

The increasing prevalence of obesity in children worldwide has been a global healthy issue.It is important to identify the effect of fat mass on the bone, which contributes to promote the peak bone mass and prevent osteo-porosis-induced fracture.Body mass index (BMI), as an index to evaluate the state of obesity, is simple and easy to measure, and is suitable for self-test of a large range of people.This review aims to discuss the role of BMI in evaluating the interaction between obesity and bone density, and the predictive potential in fracture risk of children.