Objective:To study the scalp electroacupuncture combined with language training on the language function of post-stroke aphasia patients.Method:Ninety patients were divided into experimental group and control group by random number table method.The patients in the experimental group were treated by language rehabilitation training combined with electroacupuncture,while the control group was treated only by verbal training.Schuell stimulation was performed by one to one training and different types of aphasia patients focued on the different types of training.A course of treatment consisted of 2 weeks training with 30mins for each time,5 times a week.For acupuncture treatment,scalp acupuncture points were employed with motor area for motor aphasia,sensory area for sensory aphasia and three language areas for complete language aphasia,also combined with Baihui,wind House,dumb gate and other points.All patients received a course of treatment.The language function was evaluated by using Chinese Aphasia Test and the scores of spontaneous speech,language comprehension,repetition and nomenclature were compared before and after treatment.The degree of aphasia was assessed by the Boston Diagnostic Aphasia Examination (BDAE).The total efficacy was compared by Boston Diagnostic Aphasia.Result:There were significant differences in spontaneous speech,verbal comprehension,repetition,nomenclature and aphasia scores in the experimental group before and after treatment(P=0.01,0.03,0.02,0.02,0.02,P＜0.05)There were significant differences(P=0.02,0.03,0.01,0.02,0.03,P＜0.05) in the spontaneous speech,verbal comprehension,repetition and nomenclature and aphasia scores in the control group before and after treatment.There were significant differences in spontaneous speech,verbal comprehension,repetition,nomenclature and aphasia scores between the two groups(P=0.03,0.03,0.03,0.02,0.03,P＜0.05).There was significant difference in the total curative effect between the two groups(P=0.03,P＜0.05).Conclusion:The scalp electroacupuncture combined with language training can significantly improve spontaneous speech,verbal comprehension,repetition and naming degree score and aphasia for post-stroke patients,and has better curative effect than pure language training.

Objective To observe the difference of morphology and phagocytosis between alveolar macrophages (AMs) and pulmonary interstitial macrophages (IMs). Methods AMs were collected by lung lavage and IMs by treatment of the lung tissue with DNAse and collagenase. The two cell populations were analyzed with respect to morphology by transmission electron microscopy, and the variation of these macrophages of phagocytosis were tested by malachite green colorimetry. Results There were great differences in morphology between AMs and IMs. The phagocytosis of AMs was much stronger than that of IMs. Conclusion There is functional and morphological heterogeneity between AMs and IMs. IMs should not be regarded as the precursors to AMs.

Objective To evaluate the modularized operative process during video-assisted thoracoscopic esophagectomy for esophageal cancer.Methods The clinical data of 45 patients with esophageal cancer who were admitted to the Daping Hospital from December 2011 to December 2012 were retrospectively analyzed.The influence of modularized operative process on the intra-and post-operative condition and short-term complications after videoassisted thoracoscopic esophagectomy + esophagogastric anastomosis were analyzed to investigate the efficacy and value of modularized operative process.Patients received video-assisted thoracoscopic and laparoscopic resection of esophageal carcinoma or thoracoscopic resection of esophageal carcinoma + gastric mobilization.Thoracoscopic esophageal mobilization and mediastinal lymph nodes dissection were done according to the modularized operative process:(1) Pulmonary ligament mobilization and groups 8L and 9 lymph nodes dissection.(2) Mobilization of the esophagus under the arcus venae azygos.(3) Mobilization of esophagus above the arcus venae azygos.(4) Transection of the arcus venae azygos.(5) Complete removal of thorax esophgus.(6) Ligation of thoracic duct.(7) Dissection of groups 4,5,7,10 and 2L lymph nodes.All the patients were followed up via phone call or mail till February 2013.Patients received thoracoabdominal computed tomography and gastrofiberscopy to detect tumor recurrence or metastasis every 3 months within the first year after the operation,and they were re-examinated every half year at 1 year later.Results Of the 45 patients,29 received video-assisted thoracoscopic and laparoscopic resection of esophageal carcinoma and 16 received video-assisted thoracoscopic resection of esophageal carcinoma + gastric mobilization.The length of the tumor was (4.2 ± 2.5) cm.The numbers of patients in AJCC T1,T2,T3 and T4 stages were 7,14,15 and 9,and the number of patients with AJCC N0,N1,N2,N3 stages were 23,13,7,2,respectively.The intrathoracic operation time,total operation time,volume of intraoperative blood loss,number of lymph node resected and postoperative duration of hospital stay were (72 ± 13)minutes,(249 ± 39) minutes,(183 ± 62) ml,27 ± 7,(18 ± 7) days,respectively.Two patients were transferred to open surgery.No patient died postoperatively,and 11 complications were detected after the operation.Six patients were complicated with cervical anastomotic fistula,4 with anastomotic stricture and 3 with hoarseness.Forty-five patients were followed for 1.5-14.0 months with the median follow-up time of 8 months.One patient died of upper gastrointestinal hemorrhage at postoperative month 12,and 1 died of multi-organ dysfunction syndrome at postoperative month 8.The remaining 43 patients survived.Conclusions The modularized operative process for thoraeoscopic esophagectomy is safe and effective,its short-term efficacy is satisfactory.

BACKGROUND: The role of p53 gene in human lung cancer has been confirmed. Since the discovery of p63 gene as the homologue of p53, its role and possible mechanism-have aroused the attention of investigators all over the world. But the principle concerning transcription and expression of p63 in small-cell lung carcinoma (SCLC) remains unclear.OBJECTIVE: To investigate the level of the expression of p63 gene in SCLC and lung adenocarcinoma tumor tissues, peri-carcinoma tissues and normal tissues, and observe the expression of p63 protein in these tissues so as to understand the principle and clinical significance concerning p63gene expression in SCLC and lung adenocarcinoma.DESIGN: Controlled experiment.SETTING: Department of Thoracic and Cardiovascular Surgery, Research Institute of Field Surgery of Daping Hospital of Third Military Medical University of Chinese PLA.PARTICIPANTS: Six SCLC specimens dissected during the surgical operation in Daping Hospital, Third Military Medical Univers ity of Chinese PLA, between October 2000 and September 2002 , were recruited. There were 4 male and 2 female patients aged 42 to 67 years (mean age of 50.7years); 15 specimens of lung adenocarcinoma were also collected at the same time. Tumor tissues, peri-carcinoma tissues and normal tissues were chosen in each specimen.METHODS: Reverse transcriptase polymerase chain reaction (RT-PCR)was used to detect and compare the transcription expression of two subtypes of p63 gene (TAP63 and △NP63)in the tumor tissues of 6 cases of SCLC and 15 cases of lung adenocarcinoma. At the same time, immunohistochemical staining technique was used to detect the expression of p63protein in the above tissues.MAIN OUTCOME MEASURES: ① Expression of p63 protein detected by RT-PCR in tissue specimens. ② Expression of p63 protein detected in tissue specimens detected by immunohistochemical staining technique.RESULTS: ① Expression of p63 protein detected by RT-PCR in tissue specimens: The positive expression of △Np63 gene could be found in 5cases (83%, 5/6) of SCLC cancer tissues and 1 case of SCLC peri-carcinoma tissues (17%, 1/6), and the expression of TAp63 was not observed in all of the tumor, peri-carcinoma and normal tissues of SCLC. There was no expression of △Np63 or TAp63 in tumor, peri-carcinoma and normal tissues of lung adenocarcinoma. ② Expression of p63 protein detected by immunohistochemical staining in tissue specimens: The positive expression rate of p63 protein in SCLC tumor tissues was significantly higher than that in lung adenocarcinoma tissues [83% (5/6), 17% (1/6), P ＜ 0.01].CONCLUSION: p63 gene shows positive expression in SCLC, among which the expression level of △NP63 is increased while the expression level of p63 protein is obviously higher in SCLC than in adenocarcinoma tissues, which may be related to its regulatory role in the occurrence and development of SCLC. It is presumed that△NP63 gene has high transcription expression level in SCLC, which might inhibit cellular apoptosis, promote the proliferation of tumors, play the role as an oncogene. It suggests that p63 may be one of the factors influencing the prognosis of SCLC.

Objective To evaluate the short-term outcome of side-to-side staple cervical esophagogastrostomy after esophagectomy. Methods The clinical data of 105 patients with esophageal cancer who were admitted to the Daping Hospital from January 2006 to March 2009 were retrospectively analyzed. Of the 105 patients, 97 received side-to-side stapled cervical esophagogastrostomy and eight received traditional hand-sewn end-to-end cervical esophagogastrostomy. Nine patients were selected from the 97 patients who received side-to-side stapled cervical esophagogastrostomy to conduct matched pair analysis. The efficacy of the two methods was analyzed using the t test. Results No postoperative death was observed. The mean operation time of side-to-side staple cervical esophagogastrostomy was (21 ± 3 )minutes (range, 15-30 minutes). Postoperative complications were observed in 16 patients, including pulmonary complications in seven patients, vocal cord paralysis in four patients, anastomotic leakage in three patients and anastomotic stricture in two patients. The mean anastomotic diameter of patients who received side-to-side staple cervical esophagogastrostomy was ( 3. 01 ± 0. 17 ) cm, which was significantly longer than ( 1.69 ± 0. 26) cm of patients who received traditional hand-sewn end-to-end cervical esophagogastrostomy (t =2. 093, P ＜0.05 ). Dysphagia occurred in two patients who received side-to-side stapled cervical esophagogastrostomy and in four patients who received traditional hand-sewn end-to-end cervical esophagogastrostomy.Conclusions Side-to-side stapled cervical esophagogastrostomy is simple, safe and effective for patients with esophageal cancer after esophagectomy. This technique could decrease the incidence of postoperative dysphagia and improve the pharyngo-esophageal motor function.

OBJECTIVE:To survey the dosage range,clinical effect and safety of hypertonic sodium chloride hydroxylethyl starch 40 injection(HSS40) on anti-hemorrhagic shock METHODS:The changes of blood pressure and laboratory examination indices were detected after HSS40 was infused into the patients who suffered from hemorrhagic shock RESULTS:HSS40 could rapidly raise the blood pressure in a dose below 500ml and the effective rate could reach 100% In part of patients,the levels of serum Cl- and Na+ increased temporarily and restored after 24 hours CONCLUSION:HSS40 was safe and effective in doses of 80ml～500ml The clinical doses of 300ml～500ml are recommended

BACKGROUNDTo investigate the expression of p63 gene and its significance in non-small cell lung cancer (NSCLC) and pulmonary benign disease tissues.

METHODSp63 gene mRNA expression (TAp63 and ΔNp63) was detected in 40 NSCLC and 10 pulmonary benign disease tissues by RT-PCR (reverse transcriptase-PCR) technique, and immunohistochemical method was used to observe p63 protein expression in the above tissues.

RESULTSΔNp63 mRNA overexpression was observed in 18 squamous cell carcinoma (18/23), 1 bronchioloalveolar carcinoma (1/6) and 2 paracancerous tissues of squamous cell carcinoma (2/23). There was no expression of TAp63 both in NSCLC and benign disease tissues of the lung. Immunochemistry showed that the positive rate and intensity of p63 protein expression were significantly higher in squamous cell carcinoma than those in adenocarcinoma and benign disease tissues of the lung ( P < 0.01).

CONCLUSIONSp63 gene is mainly amplified in squamous cell carcinoma of the lung. It may act as an oncogene in the carcinogenesis and development of squamous cell carcinoma.