Objective To discuss the application of minimally invasive surgery in the treatment of esophageal leiomyoma. Methods Clinical data of 26 patients with esophageal leiomyoma from September 1996 to October 2002 treated by minimally invasive surgery were reviewed retrospectively. Results Video-assisted thoracoscopic leiomyoma enucleations were performed in 23 patients, and a conversion to mini-thoracotomy was required in 3 of them because of dense pleural adhesion (2 patients) or location failure of tumor (1 patient). The remaining 3 patients underwent transjugular leiomyoma enucleation (2 patients) or esophagoscopic resection of leiomyoma (1 patient), respectively. All the procedures were completed smoothly and the postoperative recovery was uneventful, without mortality or severe complications. All the patients were pathologically diagnosed as leiomyoma after surgery. Follow-up for 2 ～ 73 months (mean,32.3months) found no recurrence. Conclusions Video-assisted thoracoscopic enucleation can be the first choice for the esophageal leiomyomas that derived from lamina propria, while esophagoscopic removal may be considered for those from muscularis mucosa.

Carcinoma, Squamous Cell ; surgery ; Head and Neck Neoplasms ; surgery ; Humans ; Neoplasm Recurrence, Local ; prevention & control ; surgery ; Prognosis

ObjectiveTo detect the effect of electroacupuncture combined with acupoint injection of deer melon polypeptide on the bone morpho-genetic protein synovial, BMPs and serum rheumatoid factor IgA-RF, IgM-RF.MethodsA total of 246 patients with Rheumatoid arthritis were divided randomly into control group and combined treatment group, 123 patients in each group. The control group received the treatment of electro-acupuncture, drug and Ultrashort wave therapy, and the combined treatment group continue to receive acupoint injection of deer melon polypeptide after 30 minutes when the treatment of control group was completed. Both groups were treated for 2 weeks. The expression of BMPs, MMP-1 and the ESR, serum rheumatoid factor IgA-RF, IgM-RF were detected. The morning stiffness time, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analogue scale (VAS) were recorded for outcome assessment.ResultsCompared with control group after treatment, the positive expression rates of ESR (8.79 ±1.61 mm/hvs.12.41 ± 2.57 mm/h,t=3.654), IgM-RF (22.38% ± 5.45%vs.39.57% ± 6.18%,t=2.365), IgA RF (32.84% ± 6.57%vs.49.84% ± 4.20%,t=2.574) in the combined treatment group significantly decreased. Compared with the control group, the expression of BMPs (15.43 ± 2.94vs.7.22 ± 1.52,t=3.914) in the combined treatment group significantly increased, while MMP-1 (8.01% ± 1.54%vs. 15.34% ± 2.47%,t=2.015) in the combined treatment group significantly decreased (P<0.05). Compared with control group, the outcomes VAS (3.37 ± 0.35 vs.5.75 ± 0.39, t=3.251), WOMAC (22.36 ± 3.49vs.30.50 ± 4.11,t=4.021), and morning stiffness (34.32 ± 5.57 minvs. 49.84 ± 4.20 min,t=3.914) in the combined treatment group significantly decreased (P<0.05). The total effect rate (82.11%vs. 71.55%,χ2=12.764) of combined treatment group was significantly higher than control group (P<0.05).Conclusion Electroacupuncture combined with acupoint injection of deer and melon peptide can improve effect rate.

Head and Neck Neoplasms ; pathology ; Humans ; Lymphangiogenesis ; Neoplasm Metastasis

Objective:To investigate the inhibitory effect of cytokine-induced killer cells (CIK) against implanted gastric cancer cells. Methods:Gastric cancer SGC-7901 cells were subcutaneously injected into the inguina of nude mice to establish gastric cancer model. The tumor bearing mice were randomly divided into CIK group and fibroblasts group,in which mice were subcutaneously injected with fluorescence dye SP-DiI labeled CIK and fibroblasts HFL-I cells,respectively. Distribution of CIK and HFL-I cells in different tissues of gastric cancer bearing mice were observed. Meanwhile,tumor volume was measured after different treatments and tumor inhibitory rate was calculated. Tumor necrosis areas in different groups were observed. Results:SP-DiI labeled CIK was mainly located in the gastric cancer tissues 10 d after injection,and was hardly detected at the injection sites,liver,spleen and lung tissues (P

OBJECTIVETo explore the effect of qidong huoxue decoction (QHD) on inflammatory factors and Toll-like receptor (TLR4) mRNA expressions in acute lung injury (ALI) rats.

METHODSTotally 50 healthy male SD rats were randomly divided into the blank control group, the lipopolysaccharide (LPS) model group, low, middle, high dose QHD groups according to body weight, 10 rats in each group. Rats in low, middle, high dose QHD groups were intragastrically administered with QHD at 4, 8, and 16 mL/kg 24, 12 h before modeling and 12 h after modeling, respectively. Normal saline was intragastrically administered to rats in the blank control group and the LPS model group. An ALI rat model was established using intratracheal instillation of LPS. Rats were killed after 24-h modeling. Then the bronchoalveolar lavage fluid was prepared. Contents of TNF-α, IL-1β, and L-10 were detected using ELISA. TLR4 mRNA expressions were determined byreal time PCR.

RESULTSCompared with the blank control group, contents of TNF-α, IL-1β , and IL-10 increased (P <0. 01), TLR4 mRNA expressions also increased in the LPS model group (all P <0. 01). Compared with the LPS model group, contents of TNF-α and IL-1β decreased (P <0. 05, P <0. 01), IL-10 levels increased (P <0. 01) , TLR4 mRNA expressions were also reduced (P <0. 01), in high and middle dose QHD groups. Compared with the high dose QHD group, con- tents of TNF-α and IL-1β increased in middle and low dose QHD groups (P <0. 05); IL-10 levels decreased (P <0. 05) in the low dose QHD group(P <0. 05), TLR4 mRNA expressions also increased in the low dose QHD group (P <0. 05). Compared with the middle dose QHD group, IL-10 levels was reduced, but TLR4 mRNA expressions increased in the low dose QHD group (P <0. 05).

CONCLUSIONSQHD had the protective effect on LPS induced ALI rats. Its mechanism might be associated with inhibiting TLR4 mRNA expressions, leading to decreased pro-inflammatory cytokines such as TNF-α and IL-β, elevated anti-inflammatory cytokine IL-10, and thereby, correcting unbalanced inflammation.

Acute Lung Injury ; genetics ; metabolism ; Animals ; Anti-Inflammatory Agents ; Bronchoalveolar Lavage Fluid ; Drugs, Chinese Herbal ; pharmacology ; Inflammation ; Interleukin-10 ; metabolism ; Interleukin-1beta ; metabolism ; Lipopolysaccharides ; Male ; RNA, Messenger ; metabolism ; Rats ; Rats, Sprague-Dawley ; Toll-Like Receptor 4 ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

Objective To compare the clinical efficacy of different treatments based on radical surgery in stage Ⅰ b2 and Ⅱ a2 cervical cancer through prospective randomized controlled study. Methods A total of 133 patients with stage Ⅰb2 and Ⅱa2 cervical cancer treated at Beijing Obstetrics and Gynecology Hospital of Capital Medical University during January 2009 to December 2012 were enrolled and randomly assigned to receive one of the following three treatments: preoperative intracavitary irradiation (PII) group, radical hysterectomy (RH) group, and neoadjuvant chemotherapy (NACT) group. Operation method included uterine extensive resection, pelvic lymph node excision, with or without para-aortic lymph node resection. The recent curative effect and side effect of preoperative treatment were observed. The operation time, intraoperative blood loss, surgical complications, postoperative pathological risk factors and postoperative adjuvant therapy and side effect, the survival situation were evaluated among the 3 groups. Results (1)The response rates were 88%(37/42) and 82%(37/45) respectively of the PII group and NACT group. The difference was insignificant (P=0.528). Side effects were less in the PII group. Only 5 patients (12%,5/42) had slight gastrointestinal reaction. Myelosuppression and gastrointestinal reaction in NACT group were 76%(34/45) and 67%(30/45) respectively, which were more serious than that in group PII group (P<0.05). (2) Intraoperative blood loss and operation time in PII group [(678 ± 239)ml and(181 ± 39)minutes] and NACT group [(625 ± 137)ml and(168 ± 25)minutes] had a decreasing trend compared with that in RH group [(711 ± 319) ml and (202 ± 64) minutes], but the differences were no significant (P>0.05). NACT group could shorten operation time compared with the RH group (P<0.05). The lymph node metastases rate were 30%(14/46), 29%(12/42)and 29%(13/45)and the deep stromal invasion rate were 22%(10/46), 31%(13/42)and 31%(14/45)in RH group, PII group and NACT group respectively (all P>0.05). The lymph-vascular space involvement (LVSI) in NACT group was significantly lower than that in RH group [31%(14/45) vs 57%(26/46), P=0.015]. The number of patients with histological risk factors in NACT group was higher thanthat in RH group [27%(12/45)vs 9%(4/46),P=0.024]. All surgery were successfully completed and no treatment-related deaths occurred in three groups. The incidence of 3-4 grade adverse reactions evaluated by the common terminology criteria for adverse event (CTCAE) was 13% (6/46), 14% (6/42), 18% (8/45) in RH group, PII group and NACT group respectively (P=0.855). Three-year disease free survival (PFS) were 74.0%, 78.5%and 80.0%, and 3-year overall survival (OS) were 80.4%, 83.3%and 84.4%in RH group, PII group and NACT group respectively (all P>0.05). Conclusions The recent curative effect of PII and NACT were similar. They couldn′t improve 3-year of PFS and OS of the patients withⅠb2 andⅡa2 stage cervical cancer. But NACT can reduce the operation difficulty and can reduce the incidence of postoperative pathological risk factors, which could reduce postoperative adjuvant therapy.

10.3969/j.issn.2095-4344.2013.25.023

The operating room is the main place of surgery,but there exist many ethical problems when developing quality nursing service in operating rooms.These problems mainly related to the imperfect preoperative and postoperative visit systems,the lack of effective communication and protection of patients privacy during the operations,and the lack of self-discipline spirit.To solve these problems,we should improve the preoperative and postoperative visit system,strengthen the psychological counseling for patients,cultivate the nurses' self-discipline spirit,respect and protect the privacy of patients,so as to improve the quality of nursing service in the operation rooms,and better service for patients.

Objective To evaluate the rehabilitation effects of walk exercise training on the heart function rehabilitation in the patients with heart failure with preserved left ventricular ejection fraction (HFPEF) .Methods A total of 142 cases of HFPEF were randomly assigned to 2 groups on the basis of medication therapy ;the control group (70 cases) was given only routine medica‐tion therapy without the exercise prescription;On the bases of control group ,the exercise group (72 cases) conducted the rehabilita‐tion training according to the exercise prescription .After 24 weeks follow up ,6 min walking distance ,plasma NT‐proBNP level and left ventricular diastolic function were compared between the two groups .Results The 6 min walking distance after walk exercise training in the exercise group was significantly increased compared with before walk exercise training and the control group ,while the level of NT‐proBNP was significant decreased(P<0 .01) .Conclusion The walking exercise training mode according to the ex‐ercise prescription can significantly improve the exercise tolerance in the HFPEF .