This paper discusses the definition , classification, selection, monitoring and evaluation of animal biosafety isolation device .Evaluation order of animal biosafety isolation device follows animal survival needs -biosafety needs-animal welfare requirements .

Objective To investigate the efficacy of the Ivor-Lewis cervical stapled esophagogastrostomy via thorax in the treatment of middle esophageal carcinoma.Methods The clinical data of 303 patients with middle esophageal carcinoma who were admitted to the Rugao Boai Hospital (107 patients) and the Rugao People's Hospital (196 patients) from March 2005 to March 2013 were prospectively analyzed.All the patients received Ivor-Lewis stapled cervical esophagogastrectomy (Ivor-Lewis group,151 patients) or Sweet stapled cervical esophagogastrostomy (Sweet group,152 patients) according to the admission order.The intraoperative condition,perioperative complications,lymph node dissection and postoperative follow-up of the 2 groups were analyzed.All the patients were followed up via out-patient examination till December 2012.The measurement data,enumeration data and the ranked data were analyzed using the independent samples t-test,chi-square test or Fisher exact probability and Wilcoxon rank sum test,respectively.The survival curve was drawn by the Kaplan-Meier method,and the postoperative mortality rate was analyzed using the Cox proportional hazard model.Results The operation time of the Ivor-Lewis group was (239 ± 21)minutes,which was significantly longer than (188 ± 30)minutes of the Sweet group (t =11.32,P ＜ 0.05).The surgical resection rate of the Ivor-Lewis group was 98.68％ (149/151),which was significantly higher than 92.76％ (141/152) of the Sweet group (x2 =6.45,P ＜ 0.05).The positive rate of the upper resection margin of the esophagus,postoperative morbidity rate and operative were 0.67％(1/149),10.07％ (15/149) and 0 in the Ivor-Lewis group,and 0.71％ (1/141),11.35％ (16/141) and 0.71％(1/141) in the Sweet group,with no significant difference between the 2 groups (P ＞ 0.05).The number of lymph nodes dissected from the cervical-thoracic junction and the upper abdomen were 3.6 ± 1.1 and 3.5 ± 1.1 in the Ivor-Lewis group,which were significantly greater than 2.3 ± 0.8 and 2.4 ± 0.8 in the Sweet group (Z =9.96,9.02,P ＜ 0.05).The number of positive lymph nodes dissected from the cervical-thoracic junction was 0.7 ± 1.1 in the Ivor-Lewis group,which was greater than 0.3 ± 0.6 of the Sweet group,with significant difference between the 2 groups (Z =3.26,P ＜ 0.05).Of the 290 patients who received surgical treatment,273 were followed up with the follow-up rate of 94.14％ (273/290),and the median time for follow-up was 28.0 months.The 1-,2-,3-year tumor recurrence rates were 8.21％ (11/134),19.64％ (22/112) and 29.35％ (27/92) of the Ivor-Lewis group,which was significantly lower than 19.05％ (24/126),35.24％ (37/105) and 44.19％(38/86) of the Sweet group (x2=6.55,7.33,5.03,P ＜ 0.05).There were significant differences in the 1-,2-,3-year locoregional recurrence rate of the lymph nodes between the 2 groups (x2 =7.03,9.68,6.87,P ＜0.05).The 1-,2-,3-year accumulative survival rates of the Ivor-Lewis group were 90.30％ (121/134),80.36％(90/112) and 71.74％ (66/92),which were significantly higher than 80.95％ (102/126),59.05％ (62/105)and 51.16％ (44/86) of the Sweet group (x2=4.65,1 1.73,7.97,P ＜ 0.05).Conclusion Ivor-Lewis stapled cervical esophagogastrostomy via thorax has advantages of high resection rate,better safety and better quality of life of patients,and it could be an optimized design of the treatment for patients with middle esophageal cancer without intumescent lymph node of neck.

Objective To investigate the reasons for delayed diagnosis of ankylosing spondylitis(AS) in a Chinese population.Methods Three hundred and eight patients fulfilled the 1984 Modified New York criteria of AS were enrolled.They were interviewed in person or by telephone by rheumatologists for 13 ques-tions.Results Of the 308 AS patients.238(75%)completed 13 questions.Among these 238 patients,male to female ratio was 6 to 1.The average age at AS onset was 22.1 years.Those aged under 15 years at disease onset Was 18.1%.and between 15 and 39 years was 79.0%while over 39 years was 2.9%.Of these 238 pa-tients.27(23.9%)had family history of AS.84.9% of the patients were HLA-B27 positive.The average dura-tion of delayed diagnosis in HLA-B27(+)and HLA-B27(-)were 70.1 and 88.1 months respectively,which was not significant statistically.Among those delayed over 10 vears,24 AS patients were HLA-B27(+)and 10 were HLA-B27(-),which was statistically significant(P=0.012).66.4% of 238 patients were misdiagnosed, of which 23.4%were diagnosed as arthritis associated with rheumatic fever,22.9% as fatigue and 20.3%as inter-vertebrate disc.45.0%were misdiagnosed by one physician while 2 1.4%were misdiagnosed for several times,and the average length of delay diagnosis was 72±68 months.Seven cases,although the diagnosisi was being delaved for more than 10 years the initial diagnosis was correct. Conclusion Delayed diagnosis of AS is common in China.The major reasons for delayed diagnosis are HLA-B27 negative and lack of X-ray changes of sacroiliac joint at the initial visit.

Objective To investigate the distribution of HLA-B27 subtypes in ankylosing spondylitis(AS) patients of Chinese Han population by using the updated HLA-B27 typing data. Methods One hundred AS subjects were randomly selected from spondyloarthritis patients data bank of the third affiliated hospital of Sun Yat-sen university. All subjects were independent individuals, and the duplicated samples in the same family were excluded. Salt fraction method was used to prepare genome DNA. Luminex liquid array combining PCR-SSOP was used to perform the low resolution HLA-B genotyping. PCR-SSP was applied to perform the high resolution HLA-B27 typing for HLA-B27 positive subjects. Results Ninety-eight independent AS patients were recruited randomily, of which, 93 were HLA-B27 positive, with positive rate 94.9%, and covered 96% patients with family history of AS. Three subtypes were detected in this population including B * 2704 (n=76, 81.7%), B * 2705 (n=12, 12.9%) and B * 2715 (n=5, 5.4%). Compared with the two reports about HLA-B27 subtype distribution in healthy HLA-B27 positive Han population there was no significant difference between AS patients and healthy controls. But no B * 2715 case was found in those two reports of healthy population. Three reports (including 1 report in Chinese) could found about B * 2715 subtype, but all positive cases were oriental people. Furthermore, all B * 2715 positive patients were AS patients. Conclusion B * 2704 is the predominant subtype ,in AS patients of Chinese Han population, and followed by B * 2705. We found five cases with positive B * 2715, a considerable rare allele. This may suggest association between B * 2715 and AS.

Objective To study T lymphocyte subsets and expression of costimulatory molecule CD154 on T-cells in peripheral blood from patients with ankylosing spondylitis and their changes after treated with Enbrel. Methods Sixty-six patients with AS(39 active and 27 inactive, 35 axial and peripheral joint involvement and 31 axial involvement only), 30 patients with rheumatoid arthritis(RA), 30 healthy volunteers were analyzed. The expression of CD154 on CD3+ T cell as well as T-cells subsets were evaluated using flow cytometry respectively. The changes of the expression of costimulatory molecule CD154 in 39 active AS patients(Enbrel treatment or placebo treatment) were observed in a randomized, double-blind, placebothan that of healthy volunteers, and CD154 expression on CD3+ T cells in peripheral blood in AS patients was on CD3+ T cells in the peripheral blood of active AS or AS patients with peripheral joint involvement were significantly higher than those in inactive or axial involvement only AS patients(P＜0.05), and CD154 on CD3+ placebo, in AS patients group, there was significant reduction in CD154 expression on CD3+ T cells in Enbrel group at week 6(P＜0.05), there was no significant difference between Enbrel group and healthy volunteers at week 6(P＞0.05). Conclusion T lymphocyte subsets are significantly abnormal and CD154 is overexpressed on T-cells in peripheral blood of patients with AS. A six-week course of treatment with Enbrel in active AS can induce a down-regulation of the expression of CD154 on T cells.

Objective To study the single nucleotide polymorphisms (SNPs) in IL-23R gene in Chinese Han population with ankylosing spondylitis (AS). Methods SNPs rs11209026, rs1343151, rs11209032 and another three SNPs near them based on their physical distances were genotyped by PCR-directed sequencing. Hardy-Weinberg equilibrium, genotypes and allele frequency analysis were analyzed by SPSS 13.0. Linkage disequilibrium and haplotype analysis were carried out by SHEsis software. Results The difference of genotypes of rs11209032 and the difference of genotypes and allele frequencies of rs6677188 between patients and controls were statistically significant (P＜O.01) ; The two SNPs rs11209032 and rs6677188 had strong linkage disequlibfium (D'=0.925, r2=0.561 ). Haplotype analysis had shown a higher proportion of GAC haplotype in patients and a higher proportion of GTC haplotype in controls. Conclusion These results suggest that IL-23R polymorphisms is associated with susceptibility to AS in Chinese Han population and IL-23R gene may be a susceptible gene of AS.

Objective To investigate the effect of triggering receptor expression in myeloid cells-1 (TREM-1) on intestinal macrophage apoptosis in rat.Methods In vitro,the achieved rat intestinal macrophages were divided into 3 groups:control group,LPS (Lipopolysaccharides) group and LPS + LP17 group (n =6 holes of culture plate in each).The concentrations of LPS and LP17 were 1 mg/L and 0.1 mg/L,respectively.The intestinal macrophage apoptosis was measured by using TUNEL kit and flow cytometry after culture for 6 h.All data were statistically analyzed using SPSS 18.0 software.Results The shape and growth of rat intestinal macrophages were quite favorable after culture.The membrane marker of intestinal macrophages,CD14 was clearly observed under immunofluorescence.After macrophage was treated with specific procedure,the cell apoptosis found in LPS group (44.33 ± 7.74)％ was significantly higher than that in control group (19.17 ± 6.01) ％ (P=0.000) measured by TUNEL;the cell apoptosis in LPS +LP17 group (28.33 ± 6.53)％ apparently reduced compared with LPS group (44.33 ±7.74) ％ (P =0.004);there was no significant difference in cell apoptosis between control group (19.17 ± 6.01) ％ and LPS + LP17 group (28.33 ± 6.53) ％ (P =0.050).By flow cytometry,the apoptotic cells in LPS group (16.47 ± 1.66) ％ was significantly increased compared with control group (7.70 ± 1.52) ％ (P =0.000);apoptotic cells in LPS + LP17 group (11.47 ± 3.12) ％ was significantly reduced in comparison with LPS group (16.47 ± 1.66) ％ (P =0.018).There was no significant difference in apoptotic cells between control group (7.70±1.52)％ and LPS + LP17 group (11.47±3.12) ％ (P =0.061).Conclusion LP17 can inhibit TREM-1 expression in intestinal macrophages and reduce intestinal macrophage apoptosis.

Objective To study the postoperative survival rate of elderly patients with hip fracture at different time and its related factors.Methods We conducted the follow-up studies of 255 elderly hip fracture patients from June 2008 to June 2011 in our hospital.The survival rates of patients at 6 months,1,2 and 3 years after operation and their related factors were studied.Results The survival rate was 96.5％,89.8％,78.0％ and 69.4％ at 6 months,1,2 and 3 years after operation respectively in 255 elderly hip fracture patients.Survival analysis showed that many kinds of preoperative comorbidities,low albumin level,old age and severe anemia were the risk factors for survival.Good activity of daily living before injury was a protective factor for survival.Gender,fracture type,the American Society of Anesthesiologists (ASA) classification,time from injury to surgery,anesthesia type,surgical approach,operative time,blood loss and hospital stay periods had no effect on survival after operation.Conclusions The survival rate in elderly patients with hip fracture after surgery is affected by many factors.Preoperative comorbidities,anemia and hypoalbuminemia should be actively treated,the activity of daily living should be improved by the directed therapy and rehabilitation,in order to improve the survival rate in elderly patients with hip fracture.

Objective To find out the difference of responses to HDT between females and males of different occupations.Methods Healthy female employees(group A,n=11)and female pilots(group B,n=10)and male special pilots(group C,n=14)and male employees(group D,n=7)were tested with-30? head-down tilt for 45 min.Results Heart rate(HR)of females and males all decreased with time during HDT,especially male employees group and female pilots group(P

Objective To evaluate the color Doppler ultrasonographic findings of active ankylosing sacroiliitis.Methods Thirty three patients (66 sacroiliac joints in total) with active ankylosing sacroiliitis identified by MRI and twenty eight healthy volunteers (56 sacroiliac joints) underwent color Doppler ultrasound examinations of sacroiliac joints.Degree of blood flow within and around the sacroiliac joints was evaluated by semi-quantitative scale (0 - 4 grade).For arteries, resistive index was also measured.Statistical analyses were performed to compare blood flow demonstration rate, blood flow signal scale distribution,degree of blow flow and RI value between the two groups.Results Higher blood flow demonstration rate was found in patients with active ankylosing sacroiliitis(60/66,90.1%) than control group (25/56,44.6%)( P = 0.000).The scale distribution and degree of blow flow between these two groups were statistically different (all P = 0.000) ,with mainly 2～3 grade for the patients and 0～1 grade for the control.Mean value of RI in the patients was 0.57 ± 0.07, which was lower than the control (0.66 ± 0.04, P = 0.000).Conclusions Patients with active ankylosing sacroiliitis tend to have higher degree of blood flow in sacroiliac joints and lower RI values of artery.Color Doppler ultrasound may help to evaluate the activity of ankylosing sacroiliitis.