Objective To investigate the efficacy of small-axillary-incision esophagectomy combined with mechanical esophagogastric anastomosis for esophageal carcinoma.Methods From April 2005 to April 2007,56 patients with esophageal cancer underwent small-axillary-incision esophagectomy combined with mechanical esophagogastric anastomosis in our hospital.After thoracotomy was performed via a small axillary incision,the stomach and esophagus were separated.Circular stapler was used for esophagogastric anastomosis after esophagectomy.The anastomotic segment was then enveloped and placed at the esophageal bed.Results The average length of the axillary incision was(13.2?1.6)cm(10-15 cm).No anastomotic leak and hemorrhage,injury to the laryngeal nerve,or chylothorax occurred in this series.53 of the patients were followed up for 4-16 months(mean,7.8 months),during which 1(1.9%)patient developed slight anastomotic stenosis,and 4(7.5%)had gastroesophageal reflux.Conclusions Small axillary incision causes less trauma to the patients leading to a quick recovery.By using mechanical cervical anastomosis,man-mad injuries to the anastomotic segment are avoided,resulting in a low rate of postoperative complications.

Aim To observe the effects of recombinant human endostatin(rhEndostatin) on cell cycle and the expression of proliferating cell nuclear antigen(PCNA) in fibroblast-like synoviocytes in rats with adjuvant arthritis(AA),and to explore the molecular mechanisms of the inhibitory effect of rhEndostatin on proliferation of fibroblast-like synoviocytes(FLS) in AA rats.Methods Adjuvant arthritis was induced by Freund′s complete adjuvant in rats.Flow cytometry was applied to measure the effects of rhEndostatin on the cell cycle in AA FLS.The effect of rhEndostatin on the expression of PCNA mRNA and protein in synovial tissue in AA rats was examined quantitatively by real-time fluorescent quantitative PCR and Western blot assays,respectively.Results The percentage of cells in G1 phase in AA FLS decreased significantly(P

0.900.Comparison of the HPLC profiles of the total flavonoids material and the effective parts of the total flavonoids was established and the similarity with the corresponding Citrus Aurantium L.var daidai Tanaka fruits indicated that they were closely related to each other.Conclusion:The HPLC fingerprints of the medicine material and the effective parts of the total flavonoids with high specificity and can be used to control its quality.

Neovascularization is one of the early pathologic changes of rheumatoid arthritis(RA)synovium and is the major players in the promotion and perpetuation of pannus.Endostatin has antiangiogenic effect via inhibition of endothelial cell proliferation,migration and induction of apoptosis.The inhibition of angiogenesis in synovium by endostatin appears to be a promising means for the future treatment of RA.Also,endostatin has a therapeutic effect on RA by the inhibition of proliferation and induction of apoptosis in fibroblast-like synoviocytes.

Human tumor suppressor gene beclin 1 regulates cell growth through autophagy. The mRNA expression of beclin 1 was reported to be down-regulated in breast cancer with high frequency of loss of heterozygosity (LOH). However, there was no report about the expression levels or the regulatory mechanisms of beclin 1 in gastric and colorectal cancer. Both the mRNA and protein expression levels of beclin 1 was detected in the tissues of gastric and coiorectai cancers, as well as the aberrant DNA methylation and LOH related to the expression of beclin 1. By comparing with normal tissues adjacent to the tissue of these tumors, it was found that beclin 1 mRNA expression levels were significantly decreased in gastric tumor tissue. Furtherly by explorating the 5' region of beclin 1 gene sequence, a large and dense CpG island was discovered and meanwhile methylations in the promoter and the intron 2 regions of beclin 1 were found in both gastric and colorectal tumors. And LOH was found in gastric tumors. These findings suggested that aberrant DNA methylation, as well as LOH, were involved in the regulation of beclin 1 expression in gastric and colorectal cancer.

ObjectiveTo explore the prevalence and clinical features of hyperuricemia and its influencing factors in elderly male people aged 90 years and above. MethodsOne hundred elderly male people aged 90 years and above who underwent routine health examination in our hospital in 2007 were selected in the study. Serum uric acid level was examined by uricase-peroxidase method, and all patients were divided into hyperuricemia group and control group according to the serum uric acid level. Clinical and biochemical indications were compared between the two groups, and logistic regression was used to analyze the influencing factors of hyperuricemia in elderly people. ResultsThe serum uric acid level was increased in 20% of the elderly people, and the prevalence of gouty arthritis was 1%. The levels of blood urea nitrogen and serum creatinine were higher in hyperuricemia group than in control group[(10. 98±4.29) mmol/L vs. (6. 87± 1.86) mmol/L, (125.2±25.9)μmol/L vs. (93. 4±19. 8)μmol/L;both P<0.05)3. The patients in hyperuricemia group had a higher prevalence of hypertension and hypertriglyceridemia, and a higher proportion of diuretic application than patients in control group(P<0. 05). Logistic regression analysis showed that serum uric acid level had the most remarkable correlation with serum creatinine(OR= 1. 969), followed by fasting blood glucose (OR= 1. 310)and blood urea nitrogen(OR = 1.161). There was negative correlation between serum uric acid level and plasma cholesterol level(OR = 0. 802). ConclusionsThe prevalence of hyperuricemia is high in elderly people aged 90 years and above, while the incidence of gouty arthritis is low. Renal function impairment, metabolic syndrome and thiazide diuretic are the major factors for hyperuricemia.

Objective To investigate the correlation of disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS)-5 gene single nucleotide polymorphism (SNP) and osteoarthritis (OA) in Beijing.Methods In this case-control study 166 OA patients and 204 normal controls were collected from Beijing.Sorted gene type by SNaPshot technique,and analyzed the difference of allele and genotype frequencies between OA and the controls.The correlation of linkage disequilibrium and haplotype of SNPs with OA was analyzed through Haploview softeware.Results Rs2132824 was the positive site with Bonferroni method after multiple testing correction (x2=0.1 1,P＜0.05),of which allele frequencies had no significant difference between OA and the control (P＞0.05).But in codominant genetic model,rs2132824 CT genotype with OA was inversely proportional to the risk of OA [OR (95％CI) was 0.52 (0.32,0.86),P＜0.05],and TT genotype was directly proportional to the risk of OA [OR(95％CI) was 3.16 (1.55,6.47),P＜0.05],while in recessive genetic model,TT genotype was in direct proportion to the risk of OA [OR (95％CI) was 3.99 (1.99,8.01),P＜0.05].Linkage disequilibrium in SNPs of rs151065,rs229077,rs56153501,rs2830580 and rs58215296 did exist,which made haplotype of rs 151065-rs229077-rs56153501-rs2830580-rs58215296 (G-T-A-C-A) directly proportional to the risk of OA [OR(95％CI) was 1.874(1.019,3.446),P＜0.05].Conclusion ADAMTS-5 gene SNP is associated with OA susceptibility risk in Beijing.Genotype CT of rs2132824 is a low risk factor for OA while TT is a hygh risk factor.Haplotype of G-T-A-C-A is connected with high risk of OA.

Objective To study effects of polo-like kinase-1(PLK1)small interfering RNA(siRNA)on proliferation and apoptosis of undifferentiated human thyroid cancer cells.Methods 5 PLK1 siRNA(S1,S2,S3,S4 and S5)were constructed and used to transfect human thyroid cancer cell line ARO.RT-PCR was employed to pick out the most effective siRNA,which was then used to transfect ARO cell.RT-PCR and western blot were used to detect PLK1 expression in thyroid cancer cells,which were divided into different groups.MTT assay was performed to examine the effects of PLK1 siRNA on thyroid cancer cells in all groups.Apoptosis of thyroid cancer cells was observed by caspase-3 activity and TUNEL.Results All the 5 siRNA down-regulated PLK1 mRNA expression.among which S4 showed the best effect.S4 transfection could obviously inhibit proliferation of thyroid cancer cells in dose and time dependent manner.Compared with control groups,caspase-3 activity of cancer cells in s4 transfeeted group increased significantly.The effect of S4 transfection was dose and time dependent.TUNEL results showed apoptosis of cancer cells transfected by S4 siRNA was obvious and apoptosis of cells was dose-dependent.Conclusions PLK1 may play an important role in proliferation of undifferentiated thyroid carcinoma.PLK1 siRNA transfection can inhibit proliferation of throid cancer cell through apoptosis induction.

Objective To evaluate the efficacy of accelerated partial breast irradiation ( APBI ) and whole breast irradiation ( WBI ) with simultaneous integrated boost ( SIB ) from the perspective of economics, and provide a reference for postoperative adjuvant therapy mode selection for early-stage breast cancer after breast-conserving surgery. Methods A total of 355 early-stage breast cancer patients who underwent APBI or WBI-SIB after breast-conserving surgery were evaluated on efficacy and cost-effectiveness, of which 177 patients received APBI, and 178 patients received WBI-SIB. Survival analysis was done according to treatment received. NCI-CTC 3.0 was used to score the toxicities. Breast aesthetic outcome were evaluated with Harris standards. Results Median follow-up was 42 months ( 5.8 -92.7 months) . The 3-year locoregional recurrence free survival( LRFS) rates in APBI group and WBI-SIB group were 98.2％ and 97.6％, distant metastasis free survival( DMFS) were 94.3％ and 93.7％, disease-free survival ( DFS) were 93.1％ and 91.6％, and overall survival 95.5％ and 94.3％, respectively, without statistically significant differences(P>0.05). Compared with WBI-SIB group, the acute reaction rates in APBI group decreased from 5. 6％ to 3.4％(χ2 =6.044, P <0. 05), and late reactions from 5.6％ to 2.3％ (χ2 =6.149, P<0. 05), while the cosmetic outcome improved from 88.8％ to 93.8％(χ2 =5.22, P<0. 05). Moreover, the processing average time was shortened by 26.5 d (χ2 =40.76, P<0. 05). Conclusions After breast-conserving surgery, the efficacy of APBI showed no difference from WBI-SIB with respect to 3-year local control, disease-free survival, and overall survival, but displayed a significantly better toxicity profile and cost-effectiveness ratio for early breast cancer patients. It can be used as a good radiotherapy model after breast-conserving surgery in early-stage breast cancer.

Objective To observe the effect of two different chemotherapy regimens, including irinotecan, folinic acid and FU chemotherapy regimen (FOLFIRI) versus folinic acid, FU and oxaliplatin chemotherapy regimen (mFOLFOX6) on nutritional status in patients with advanced colon cancer. Methods A total of 110 patients with advanced colon cancer in Shanxi Cancer Hospital were divided into FOLFIRI (group A) and mFOLFOX6 (group B). To investigate the effect of two different regimens on the patients with advanced colon cancer by toxicity, the traditional methods of nutritional assessment, scored patient-generated subjective global assessment (PG-SGA), nutrition risk screening-2002 (NRS-2002). Shapiro-Wilk was used to detect the normality of small samples, t test was used to analyze measurement data conformed to the normal distribution, Wilcoxon non-parametric test was used to analyze the abnormal distribution data, and enumeration data was detected by using chi-square test. Results The incidence of vomiting, diarrhea and alopecia in group A and group B was respectively 53.8 % (28/52) vs. 29.3 % (17/58), 65.4 % (34/52) vs. 43.1 %(25/58),46.2 %(24/52)vs.20.7 %(12/58)respectively,and there was a significant difference(all P <0.05). The albumin, body mass index, NRS-2002 score, PG-SGA score after chemotherapy were significantly lower than those before chemotherapy in both groups (all P < 0.05). PG-SGA scores after chemotherapy in group A and group B were respectively 7.0 and 5.5 (Z= -2.026, P< 0.05). There were no statistically significant differences between the two groups in the albumin, body mass index, triceps skin fold (TSF), arm muscle weeks diameter(MAMC)and NRS-2002 score(all P >0.05).Conclusions FOLFIRI and mFOLFOX6 scheme can reduce the patient's nutritional status. The probability of gastrointestinal adverse reaction of FOLFIRI regimen is high, which may have an obvious impact on nutritional status of patients compared with mFOLFOX6 scheme.