Overexpression of epidermal growth factor receptor (EGFR) in esophageal cancer has been related to tumor grade, vascular invasion and metastasis. The level of EGFR expression may be a predictive marker of esophageal caneer's sensitivity to chemoradiotherapy. EGFR inhibitors have been indicated as an effective targeted therapy, and promising results have been observed in phase Ⅱ and Ⅲ clinical trials.

Objective To investigate the risk factors of vagus nerve invasion of advanced adenocarcinoma of esophagogastric junction (AEG).Methods The specimens from 98 patients with advanced AEG who underwent radical total gastrectomy and esophagogastric Roux-en-Y anastomosis from January 2011 to August 2012 at the First Affiliated Hospital of Anhui Medical University were collected.Serial section cutting was done and the upper and bottom incisional edges of every section were marked.The specimens were stained by hematoxylin-eosin solution,S-100 and CK immunohistochemistry.Vagus nerve invasion could be affirmed if cancer cells were observed in the peripheral space of vagus nerve and vagus nerve parenchyma or cancer cells infiltrated along the peripheral space of vagus nerve.Relationship between nerve invasion and clinicopathological factors was analyzed using chi-square test or Fisher exact probability.Factors related to vagus nerve invasion were analyzed using one-way analysis of variance and multi-factor logistic regression analysis.Results The incidence of vagus nerve invasion was 28.6％ (28/98),and the tumor only invaded the vagus nerve which had the same altitude as the upper incisional edge.The results of one-way analysis of variance showed that Siewert classification,intravascular cancer emboli,lymph node metastasis,the degree of lymph node metastasis,clinical staging,the degree of tumor differentiation were correlated with the vagus nerve invasion (x2 =14.156,14.552,5.454,10.706,6.919,14.767,P ＜ 0.05).The results of multi-factor logistic regression analysis showed that Siewert classification,intravascular cancer emboli and degree of tumor differentiation were the independent influencing factors of vague nerve invasion (OR =3.667,10.368,0.249,P ＜ 0.05).Conclusion Vagus nerve invasion is correlated with Siewert classification,intravascular cancer emboli and degree of tumor differentiation.The range of vagus nerve invasion is restricted under the upper incisional edge of tumor section.

As the third generation platinum antitumor drug with independent intellectual property rights,a number of basic and clinical research shows lobaplatin can effectively inhibit the proliferation of human breast cancer cell lines including triple-negative breast cancer in vivo.Compared with the cisplatinbased regimens,lobaplatin-based regimens have similar efficacy,and better safety profile.It becomes the new treatment option of metastatic breast cancer,and remains to be further study to optimize clinical rational drug use.

Thirty-four patients with chronic lingual tonsillar hypertrophy were treated in our department from 1994 to 2000. There were 18 males and 16 females ranging in age from 21 to 60 years old. The clinical feature of lingual tonsillar hypertrophy usually appeared a series of pharyngeal symptoms, such as foreign-body sensation, sore throat, speech change, difficulty in swallowing, dysapnea and obstructive sleep apnea. The CO2 laser surgical lingual tonsillectomy was used for these patients. Result showed that the cure rate was 100% without any serious complications by following up 2 months to 3 years. The variety of presentations of lingual tonsillar hypertrophy and methods of surgical treament were discussed.

Objective To discuss the promoting effect of clinical pathway in the standard and reasonable medication by the application of clinical pathway in the anticoagulation treatment of warfarin and health education for patients with atrial fibrilation.Methods Sixty eight patients with atrial fibrilation and receiving anticoagulation treatment of warfarin were divided randomly into the intervention group(36 cases)and the control group(32 cases).The control group received routine nursing while the intervention group underwent nursing intervention with clinical pathway based upon routine nursing intervention.The time cost to achieve the aims,compliance,incidence rate of complications and satisfaction degree were compared between the two groups.Results All the items in the intervention group were superior to those of the control group except for the items of satisfaction degree and health knowledge score(P<0.05).Conclusion Application of clinical pathway in the anticoagulation treatment of warfarin for patients with atrial fibrilation could ensure standard and reasonable medication in order to decrease medical cost,lower the incidence rate of complications,improve patients compliance and increase nursing quality.

Objective To observe the effects of mirtazapine to improve the life quality of malignant tumor patients with moderate or severe depres-sion. Methods Patients with mood disorders screened by the physician were then graded by the Hamilton Depression Scale(HAMD)under the tu-telage of ward psychological consultant. Fifty patients with moderate or severe depression were selected by psychological doctors and recruited for the study. After obtaining consent,the patients received 15-60 mg/d mirtazapine every night for 9 weeks. According to the Quality of Life Rating Scale (QOL),the scores of these patients were evaluated at the pretreatment,the 3rd week and the 9th week of the post-treatment. Then,the life quality conditions before and after treatment were revaluated. Results The scores of HAMD were 33.16±7.25,28.74±6.24,and 22.58±6.71 at the pretreat-ment,the 3rd week and the 9th week of the post-treatment,respectively. There were significantly different among the HAMD scores at the pretreat-ment,the 3rd week and the 9th week of the post-treatment.(F=30.99,P<0.01). The scores of HAMD were improved significantly between the pre-treatment and the 3rd week of the post-treatment(P<0.05). The scores of HAMD were also improved significantly between the 3rd week and the 9th week of the post-treatment(P<0.05). After treatment by mirtazapine,the appetite,spirit,sleep,fatigue,pain,the reorganization of cancer,the attitude towards treatment,the side effect of treatment and the facial expression were significantly improved(P<0.01). Conclusion Mirtazapine could improve the life quality of malignant tumor patients with moderate or severe depression.

Myopic foveoschisis is a disease caused by abnormal vitreoretinal interface status and progressive posterior scleral staphyloma.Its occurrence and development are associated with centripetal traction (posterior vitreous cortex,internal limiting membrane and stiff retinal vessel)and centrifugal traction (increasing axial lengths and posterior scleral staphyloma).Currently vitrectomy is the major option to treat this condition as it can alleviate or eliminate centripetal and centrifugal traction.However as myopic foveoschisis is a life-long progressive degenerative disease,often with abnormalities in retinal pigment epithelium,choroid and sclera;the therapeutic effect of current surgical strategy (vitrectomy or scleral surgery,or combined surgery)is limited and unsatisfactory.A full assessment macular structure,function and related factors before surgery is helpful to predict the anatomical and functional prognosis.

The training mode of the medical doctoral students in Albert Einstein College of Medicine is relatively perfect. Its advances are mainly embodied in the following three aspects:detailed and comprehensive training in scientific research capabilities, great emphasis on the process control and the strict assurance system in quality control. The above training mode helps Albert Einstein Col-lege of medicine to set up the good medical doctoral cultivation characteristics with the tolerance, competition, flexibility and freedom. To learn from those good traits, great efforts should be made in our medical doctoral cultivation mode to strengthen the role of tutor team, ensure the students' inter-ests, deepen the academic exchanges and meet the various needs of society.

Objective To study the leaf morphology and structure of Cyclocarya paliurus.Methods Foliar maceration,preparation of venation order,sectioning paraffin blocks,and scanning electron microscope were used to study the leaf morphology and structure.Results Cuticular papillates,glandular hairs,peltate scales,and non-glandular hairs presented on the leaf epidermis of C.paliurus.Anomocytic stomata were confined to the lower epidermis.Large cluster crystals existed in the uppermost layer of palisade cells.Midrib included one closed vascular system and one additional vascular strand.Secondary veins are semicraspedodromous and form marginal loops,tertiary veins are percurrent,quaternary veins form orthogonal or polygonal areoles filled up by branched and freely ended veinlets.Conclusion These structure characteristics are first reported and are useful for leaf identification of C.paliurus from other Juglandaceae plants.

A novel exonuclease protection mediated PCR assay (EPM-PCR) to detect the interaction of protein and DNA at a dioxin-responsive enhancer (DRE) upstream of the CYP1A1 gene in rat hepatic cytosol was established. A double-stranded DNA fragment containing two binding sites was designed and incubated with the aryl hydrocarbon receptor (AhR) transformed by 2,3,7,8-tetrachlorodibenzo-p dioxin (TCDD) to generate TCDD: AhR: DNA complex which could protect receptor-binding DNA against exonuclease II (Exo III) digestion. With Exo III treatment, free DNAs were digested and receptor-bound DNAs remained that could be amplified by PCR. By agarose gel electrophoreses a clear band (285bp) was detected using TCDD-treated sample, while nothing with control samples. To detect transformed AhR-DRE complex, 2 fmol DNAs and 3 ug cytosol proteins were found to be sufficient in the experiment. Compared with gel retardation assay, this new method is more sensitive for monitoring the Ah receptor-enhancer interaction without radioactive pollution.
Binding Sites ; Cytochrome P-450 CYP1A1/*genetics ; Cytosol/metabolism ; DNA-Binding Proteins/chemistry ; Exodeoxyribonucleases/chemistry ; Liver/*metabolism ; Polymerase Chain Reaction ; Rats, Sprague-Dawley ; Receptors, Aryl Hydrocarbon/*chemistry ; Tetrachlorodibenzodioxin/*analogs & derivatives ; Tetrachlorodibenzodioxin/chemistry