Background:Mediastinoscopy is an effective method for the treatment of early esophageal cancer with minimal invasiveness and lower risk. Preoperative accurate staging of esophageal cancer is the key for the choice of mediastinoscopic operation as the treatment modality. Aims:To evaluate the value of combination of endoscopic ultrasonography(EUS)with CT for the treatment of esophageal cancer under mediastinoscopy. Methods:Sixty patients with esophageal cancer were enrolled. The TN staging results of esophageal cancer by EUS and CT examination were compared with the results of postoperative TN staging. Patients were divided into mediastinoscopic operation group and conventional operation group, and the operation time,intraoperative bleeding volume,postoperative pleural drainage flow and postoperative hospitalization time of the two groups were compared. Results:The accuracy rates of preoperative EUS examination in assessing T and N stage were 81. 7% and 83. 3% ,respectively;accuracy rates of preoperative CT examination were 60. 0% and 53. 3% , respectively;and accuracy rates of EUS combined with CT were 85. 0% and 86. 7% ,respectively. Compared with conventional operation group,intraoperative bleeding volume[(178. 2 ± 30. 1)mL vs.(232. 0 ± 48. 2)mL,P ﹤ 0. 05], postoperative pleural drainage flow[( 142. 8 ± 22. 5 ) mL vs. ( 256. 0 ± 42. 3 ) mL,P ﹤ 0. 01 ],postoperative hospitalization time[(12. 1 ± 2. 5)days vs. (14. 3 ± 3. 6)days,P ﹤ 0. 05]in mediastinoscopic operation group were significantly decreased,and no significant difference in operation time was found between the two groups[(152. 4 ± 13. 2) minutes vs.(163. 3 ± 25. 5)minutes,P ﹥ 0. 05]. Conclusions:Combination of EUS with CT examination can improve the accuracy of preoperative staging,thus provides an important reference for the choice of treating esophageal cancer by mediastinoscopic operation.

It has been suggested that progression of bladder transitional cell cancer (BTCC) may be regulated at the molecular level by a typical pattern of expression of genes involved in apoptosis. Recently Livin, belonging to the inhibitors of apoptosis (IAP) family, has been found to be expressed in most solid tumors, where its expression is suggested to have clinical significance. In order to explore the significance of Livin expression in the development of BTCC, immunohistochemistry and RT-QPCR were used to detect the expression of Livin mRNA in tumor tissues and adjacent normal tissues of 30 cases of BTCC. The results showed that the positive rate of Livin expression in adjacent normal tissues and tumor tissues was 0 and 60% (18/30) respectively. The-DeltaDeltaCT value of Livin in BTCC tissues was 8.0454 (7.4264-8.6644) times of that in adjacent normal tissues. The expression of Livin mRNA had no correlation with tumor pathological grades and clinical stages. It was suggested that there was weak expression of Livin mRNA in adjacent normal tissues, but strong in tumor tissues.

Objective To investigate the expression of the hypoxia-inducible factor (HIF)-1α in rat brain neurons and the intervention of β-sodium aescinate after restoration of spontaneous circulation (ROSC).Methods Sixty SD adult rats were randomly (random number) divided into 3 groups (n =20),namely experiment group,control group and sham operation group.(1) The rats of experiment group were injected intraperitoneally with β-sodium aescinate (5 mg/kg) immediately after ROSC.(2) The rats of control group received normal saline injected intraperitoneally instead of β-sodium aescinate solution.(3)The rats of sham operation group did not have cardiac arrest and β-sodium aescinate intervention.Cardiac arrest rat model was established by using asphyxiation and intra-venous potassium chloride solution.Blood samples were taken 1 h,6 h,12 h and 24 h after ROSC,and subsequently rats were sacrificed and their brain tissues were harvested.The expressions of HIF-1 α mRNA,vascular endothelial growth factor (VEGF)mRNA and erythropoitin (EPO) mRNA and their protein levels in rat brain neurons were detected by using RT-PCR and immunohistochemistry,and the levels of serum neuron-specific enolase (NSE) and S100β proteins were determined by using enzyme-linked immunosorbent assay.The t test or one-way ANOVA was used to assess overall differences among groups for each of the variables,followed by Bonferroni test for multiple comparisons.Pearson method was used for correlation analysis.Results Compared with the sham operation group at intervals of 1 h,6 h,12 h and 24 h after ROSC,levels of serum S100β and NSE proteins were significantly increased in rats of the control group (P ＜ 0.05).Meanwhile,the expressions of HIF-1 α mRNA,VEGF mRNA and EPO mRNA and their protein levels in rat brain neurons were significantly increased in the control rats (P ＜0.05).Compared with the control group at intervals of 1 h,6 h,12 h and 24 h after ROSC,levels of serum NSE and S100β proteins were significantly decreased in rats of the experiment group (P ＜ 0.05).Whereas,the expressions of HIF-1 α mRNA,VEGF mRNA and EPO mRNA and their protein levels in rat brain neurons were significantly increased in rats of the experiment group (P ＜0.05).HIF-1 α mRNA was positively correlated with EPO mRNA and VEGF mRNAs (r =O.866,P ＜0.05 ; r =0.952,P ＜ O.01).Conclusions The expression of hypoxia-inducible factor-1 α is increased in rat brain cells after ROSC,and β-sodium aescinate up-regulates the expression of hypoxia-inducible factor1 α mRNA and protein levels.The up-regulated expression of hypoxia-inducible factor-1α improves the resistance of brain cells to ischemia and hypoxia contributing neuronal protection,which might be due to upregulated EPO and VEGF expressions induced by hypoxia-inducible factor-1α.

Objective To explore the relationship between lipids profile and body composition in the young and middle?aged adults. Method The relationship between body composition and lipids profile was examined in 642 adults (21-60 years, 178 male, 464 female). According to the result of body composition assessment, they were assigned to three groups: Normal (N, n=272), Obesity (O, n=245), Sarcopenic Obesity (SO, n=125). The lipids profile among three groups and its related factors were analyzed. Results In groups N, O and SO, the levels of total cholesterol (TC), triglycerides (TG), low density lipoprotein?cholesterol (LDL?C) increased gradually (P<0.01), and the high density lipoprotein?cholesterol (HDL?C) level decreased gradually (P<0.01). In a multiple logistic regression analysis, the odds ratio for high levels of TC, TG, LDL?C and low level of HDL?C risk increased gradually in groups N, O and SO [compared to group N, the odds ratio of the four kinds of dyslipidemia in group O were 2.617 (1.117-6.132), 3.549 (1.481-8.503), 4.618 (1.288-16.564), 1.222 (0.529-2.822), respectively, and in group SO were 5.915 (2.512-13.926), 10.430 (4.400-24.722), 9.522 (2.637-34.388) , 4.253 (1.957-9.242) , respectively]. After adjusting for age, sex, waist?to?hip ratio and visceral fat area, the odds ratio for high level of TG risk still increased gradually in group N, O and SO [compared to group N, the odds ratio of group O was 3.565 (1.319-9.632), and of group SO was 8.173 (2.685-24.881)]. Moreover, the odds ratio for high TC and low HDL?C levels of group SO were higher than those of group N [compared to group N, the odds ratio in group SO were 5.658 (1.871-17.111), 6.823 (2.119-21.969) respectively]. With stepwise multivariate logistic regression analysis, for male, the related factors for high levels of TC, TG and low level of HDL?C were high percentage of body fat;sarcopenia, sarcopenia obesity;sarcopenia, respectively. For female, the related factors for high levels of TC, TG and LDL?C were sarcopenia, aging;high percrntage of body fat, aging;sarcopenia, aging, respectively. Conclusion SO was the main risk factor for dyslipidemia in young and middle?aged adults, even more severe than obesity alone and sarcopenia was the risk factor of high TG, low HDL?C levels for male;and the risk factor of high TC, high LDL?C levels for female.

Objective To study the effect of Chinese wild rice diet on lipid metabolism in rats. Method Forty four male SD rats were divided into 4 groups:control group, high lipid group, white rice-flour group and Chinese wild rice group. All groups were given different experimental diets for 8 w and body weights, serum TC, TG, HDL-C, high sensitive C-reactive protein (hs-CRP), TNF-? and IL-6 were measured. Results The hyperlipidemic rat model was successfully induced. When compared with high lipid group and white rice-flour diet group, serum TG and TC contents were significantly decreased, and HDL-C significantly increased in the Chinese wild rice group. Moreover, Chinese wild rice group had lower contents of serum hs-CRP and TNF-? than those in high lipid group and white rice-flour group, but no effect on serum IL-6. Conclusion Chinese wild rice could improve lipid metabolism and low-grade inflammation of hyperlipidemic rats induced by high lipid diet.

Fatigue, which is one of the most commonly reported symptoms in cancer, can negatively impact the functional status and the health-related quality of life of individuals. Although awareness and
study of CRF have grown in recent years,the biological mechanisms and risk factors that induce CRF remain unclear.This paper systematically reviews the available evidence on the biological mechanisms and the risk factors to guide the development of targeted, individualized interventions for cancer-related fatigue.

Fatigue is commonly experienced in patients with advanced kidney disease and associated with poor outcomes. The purpose of this review was to discuss the prevalence, assessment methods and contributing factors of fatigue in patients with end-stage renal disease (ESRD), and also examined possible interventions to improve fatigue and concludes by defining some future research directions.

Sodium prasterone sulfate (DHEAS) and dehydroepiandrosterone (DHEA) are endogenous steroid compounds, which are synthesized and secreted by adrenal gland.They are the precursors of steroid hormones,including sex hormone.Based on intracrine theory,the majority of postmenopausal women will have vaginal atrophy,which is caused by the absence of endogenous hormones,DHEAS or DHEA.Moderate supplementation of DHEAS can relieve the associated symptoms of vaginal atrophy.Many clinical researches have demonstrated that DHEAS can efficiently alleviate the related symptoms of vaginal atrophy.The concentration of androgen and estrogen in patients with long term use of DHEAS are still in the normal intracrine physiological range.Therefore,DHEAS may become the first drug for the treatment of vaginal atrophy in the future.

It has been suggested that progression of bladder transitional cell cancer (BTCC) may be regulated at the molecular level by a typical pattern of expression of genes involved in apoptosis. Re- cently Livin, belonging to the inhibitors of apoptosis (IAP) family, has been found to be expressed in most solid tumors, where its expression is suggested to have clinical significance. In order to explore the significance of Livin expression in the development of BTCC, immunohistochemistry and RT-QPCR were used to detect the expression of Livin mRNA in tumor tissues and adjacent normal tissues of 30 cases of BTCC. The results showed that the positive rate of Livin expression in adjacent normal tissues and tumor tissues was 0 and 60% (18/30) respectively. The -△△CT value of Livin in BTCC tissues was 8.0454 (7.4264-8.6644) times of that in adjacent normal tissues. The expression of Livin mRNA had no correlation with tumor pathological grades and clinical stages. It was sug- gested that there was weak expression ? Livin mRNA in adjacent normal tissues, but strong in tumor tissues.

Objective:To build a comprehensive clinical management of outpatient with orthotopic neobladder based on doctor-nurse cooperation to provide overall service to patients.Methods:The comprehensive clinical management was established in October 2018, 32 patients were collected retrospectively from January 2009 to before the establishment of the clinic, and 14 patients were collected from the establishment of the clinic to January 2020. After the establishment of the clinic, the comprehensive management mode was adopted, including the medical team implementing management from the aspects of implementing doctor-patient joint decision-making, guiding patients to carry out pelvic floor muscle rehabilitation training, teaching family members to carry out new bladder irrigation, and establishing patients′ records. Before the establishment of the clinic, there was no specialized personnel for unified management, and the doctor for new bladder irrigation and so on.Results:The rate of complete urinary control in the 46 patients with orthotopic neobladder was 82.6%(38/46) in the day and 71.7%(33/46) in the night. The rates of complete urine control of patients in the day and night were 12/14 and 9/14 after the establishment of the clinic. The length of stay which was (13.36 ± 9.44) d, and feeding time which was (5.00 ± 2.11) d of the patients after the establishment of the clinic were both less than those of the patients before the establishment of the clinic, which were (17.28 ± 9.98) d and (5.78 ± 2.90) d, but the differences were not statistically significant ( t values were -1.247 and -0.905 respectively, both P>0.05). However, for diurnal and night-time urine control, the proportion of people with more than one diaper was better after the establishment of outpatient clinic than before. Conclusions:The establishment of the comprehensive clinical management meets the needs of patients with orthotopic neobladder, enables patients to get the function of continence and urination sooner, and contributes to improve the clinical outcome of patients.