Objective To investigate the indications and clinical efficacy of an exclusive right-thoracic approach in esophageal surgery.Methods The clinical data of 35 patients with esophageal disease who underwent an exclusive right-thoracic approach operation from June 2008 to June 2010 at the Affiliated Hospital of Qingdao University were retrospectively analyzed.Of the 35 patients,21 were with esophageal cancer,and their ages were above 70 years,the partial pressure of oxygen of arterial blood (PaO2),maximal voluntary ventilation and forced vital capacity of the first second were (70 ± 9) mm Hg (1 mm Hg =0.133 kPa),51％ ± 9％ and 57％ ± 11％,respectively.Fourteen patients were with benign esophageal disease or low grade malignancy,and their PaO2 maximal voluntary ventilation and forced vital capacity of the first second were (96 ± 13) mm Hg,83％ ± 11％ and 91％± 14％,respectively.Exclusive right-thoracic approach was selected for all the patients,and surgical procedure was selected according to the location of the lesions.Patients were followed up by out-patient examination or phone call till April 2012.Results All the operations were carried out successfully,21 patients with esophageal cancer underwent partial esophagus resection and stomach-esophagus intrathoracic anastomosis through a right-thoracic approach.Of the 14 patients with benign esophageal disease or low grade malignancy,2 patients were with esophageal leiomyoma,3 with esophageal stromal tumor and 1 with esophageal leiomyomatosis underwent partial esophagus resection + intrathoracic anastomosis ; 7 patients with esophageal leiomyoma and 1 with esophageal stromal tumor underwent tumor extirpation.The operation time and operative blood loss were (3.4 ± 1.8)hours and (160 ± 44)ml,respectively.The number of lymph node dissected of the 21 patients with esophageal tumor was 14 ± 5,including 1.1 ± 0.7 lymph nodes dissected near the left gastric artery.No anastomosis fistula and perioperative death were detected,and the duration of hospital stay was (10 ± 4)days.The postoperative PaO2,maximal voluntary ventilation and forced vital capacity of the first second were (66 ± 10)mm Hg,50％± 11％ and 51％ ± 13％ for patients with esophageal cancer,and (94 ± 13) mm Hg,80％ ± 13％ and 87％ ± 16％ for patients with benign esophageal disease or low grade malignancy.All the patients were followed up for 1-2 years,no eating obstruction was detected,and the postoperative 1-and 2-year survival rate were 82.9％(29/35) and 77.1％ (27/35),respectively.Of the 8 patients with esophageal cancer who died postoperatively,1 died of cardiovascular diseases and 7 died of tumor recurrence and metastasis.Conclusion Exclusive rightthoracic appraoch could be used for patients with benign esophageal disease,low-grade malignancy and old esophageal cancer patients with poor pulmonary function.

Traditional Chinese medicine (TCM) Xiaoaiping shows a pharmacological activity in treatment of breast cancer. Although neoadjuvant chemotherapy has been more and more widely used in treatment of breast cancer in recent years, no report has been made about the clinical efficacy and mechanism of the combined application of neoadjuvant chemotherapy and Xiaoaiping in treatment of breast cancer. In this study, 66 patients with breast cancer were selected and divided into the control group and the treatment group evenly with the random number table method. All patients received TEC neoadjuvant chemotherapy. On that basis, the treatment group also received the adjuvant therapy of Xiaoaiping injection (60 mL, i. v. , qd). The short-term response rate and the follow-up survival rate of the two groups were observed and compared. Surgical specimens of the patient were collected to observe and compare their expressions of estrogen receptor ER-α36 in breast cancer tissues with the immunohistochemical method. According to the findings, the overall response rate of the treatment group was 78.79%, which was significantly higher than that of the control group (57.58% , χ2 = 5.48, P < 0.05). Compared with the control group, the treatment group showed significant increases in the disease-free survival (DFS) rate and the total survival rate at the 3rd year and 5th year (all P < 0.05) , and a notable reduction in ER-α36 expression in breast cancer tissues (P < 0.05). Based on the our results, Xiaoaiping can significantly enhance short-term ad long-term efficacies of neoadjuvant chemotherapy for breast cancer. Its mechanism may be correlated with the inhibition of ER-α 36 expression in breast cancer tissues.
Adult ; Aged ; Antineoplastic Agents ; administration & dosage ; Breast Neoplasms ; drug therapy ; genetics ; metabolism ; mortality ; Combined Modality Therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; Estrogen Receptor alpha ; genetics ; metabolism ; Female ; Humans ; Middle Aged ; Neoadjuvant Therapy ; Treatment Outcome

Objective:To study the efficacy comparison between the antibacterial catheter and common central venous catheter in ICU patients.Methods: The 110 ICU patients with central venous catheter were randomized into the control group (common central venous catheter)and the observation group (antibacterial catheter), 55 patients per group. The success rate of catheter, the averange catheter days, complications, and the incidence of catheter-related infection (CRI)and pathogen distribution in the two groups were observed and compared.Results: Compared with the control group, the success rate of catheter was significantly increased(100.0% vs 81.8%,x2=11.00,P<0.05), the averange catheter days were obviously reduced(12.5±3.0 vs 13.5±3.0,t=3.49,P<0.05)days, the incidences of complications (red and swelling in puncture site(3.6% vs 27.3%,x2=11.76,P<0.05), fluid in puncutre site (3.6% vs 21.8%,x2=8.18,P<0.05), catheter herniation(1.8% vs 20.0%,x2=9.35,P<0.05)were significantly decreased in the observation group with statistical difference (P<0.05). Conclusion: The antibacterial catheter can significantly reduce the incidence of CRI for ICU patients and improve the security of central venous catheter.

OBJECTIVETo investigate the clinical effects of enblock distal radius T-plate fixation in treating trailing edge fracture of tibial plateau medial condyle and posterior cruciate ligament (PCL) avulsion fracture.

METHODSFrom September 2008 to November 2011, 5 patients with trailing edge fracture of tibial plateau medial condyle and PCL avulsion fracture caused by knee joint hyperextension,were treated with surgery. There were 3 males and 2 females with an average age of 35 years old (25 to 42). Left knee injury was in 3 cases and right knee had in 2 cases; 2 cases caused by sports injury and 3 cases caused by road accident. All patients were undergone emergency treatment. Fractures were anatomically reduced and fixed with T-plate through poples approach. Complications were observed after operation. Bone healing and clinical effects were respectively evaluated by X-rays and HSS system.

RESULTSFive patients were followed up for 1 to 4 years with a mean of 2 years. All incisions obtained healing of I stage. All knee joints recovered well and were stable with inflexion more than 120 degrees, no complications such as knee joint pain, injuries of nerve and blood vessel, infection, internal fixation failure were found. The mean score of HSS system was 94.40 +/- 6.09 and all patients got excellent result.

CONCLUSIONFor the treatment of trailing edge fracture of tibial plateau medial condyle and PCL avulsion fracture caused by knee joint hyperextension, enblock distal radius T-plate fixation had advantages of good stability,higher success rate, and knee joint function can recover well.

Adult ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; Humans ; Male ; Posterior Cruciate Ligament ; diagnostic imaging ; injuries ; surgery ; Tibial Fractures ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome

Objective To study the relativity between serum vascular endothelial growth factor(sVEGF),its receptors(sVEGFR1 and sVEGFR2) and uterine myoma. Methods Thirty hospitalized patients with uterine myoma were chosen as the study group and the other healthy women of the same age as control group.The levels of sVEGF,sVEGFR1 and sVEGFR2 of the two groups were determined by using ELISA technology. Results The levels of sVEGF and sVEGFR2 in the study group were much higher than in the control group(P0.05).The levels of sVEGF and sVEGFR2 in women with myoma had no differences during the menstrual cycle.The level of sVEGFR2 was correlated with the number of myoma(P

Objective To explore the effects of Helicobacter pylori (H.pylori) on the expression of catalytic subunit of the DNA-dependent protein kinase (DNA-PKcs) and Ku70/Ku80 heterodimer in gastric mucosa epithelial cells in vivo and in vitro.Methods After treated with H.pylori for one,three,six,12 and 24 hours,the expressions of DNA-PKcs and Ku70/Ku80 heterodimer in gastric epithelial cells (GES) 1 and gastric adenocarinoma cells (AGS) were detected by Western blot.Mongolian gerbils were gavaged with H.pylori,and were sacrificed after infected for six and 12 months.The gastric mucosa tissues were taken for immunohistochemistry to detect the expressions of DNA-PKcs and Ku70/Ku80 heterodimer at protein level.The data were analyzed by t test and chi-square test.Results After H.pylori infection for one hour,the relative quantity of the expression of DNA-PKcs in GES-1 was 1.16±0.09,which was higher than that of non infected group (1.04±0.31) and the difference was statistically significant (t=4.67,P＜0.05).After infected by H.pylori for one,three,six,12 and 24 hours,the relative quantities of the expressions of Ku70/Ku80 heterodimer in GES-1 were 1.58±0.32,1.84±0.40,1.97±0.35,3.72±1.42 and 3.74±1.56,respectively,all were higher than that of non infected group (1.24±0.31) and the differences were statistically significant (t=3.57,4.20,5.03,8.11 and 8.14,all P＜0.05).The relative quantities of the expressions of Ku70/Ku80 heterodimer in AGS were 4.69 ± 0.87,3.67 ± 0.67,2.41±0.24,1.35±0.35 and 1.32±0.10 after H.pylori infected for one,three,six,12 and 24 hours,respectively,all were lower than that of no H.pylori infected group (4.84 ± 0.76) and the differences were statistically significant (t=34.13,27.68,19.81,4.47 and 5.69,all P＜0.05).In Mongolian gerbil models,DNA-PKcs did not express in H.pylori negative group (0/25),the total positive rate of H.pylori infected group was 98.1％ (53/54),the difference between the two groups was statistically significant (x2 =74.55,P＜0.01).The total positive rate of Ku70/Ku80 heterodimer in H.pylori negative group was 92.0％ (23/25) and in H.pylori infected group was 68.5％ (37/54),the difference between the two groups was statistically significant (x2=5.16,P＜0.05).Conclusion H.pylori infection affected cellular DNA damage repair through changing the expression of DNA-PKcs and Ku70/Ku80 heterodimer in gastric mucosa in vivo and in vitro,which may cause gastric mucosal lesions.

Objective To study the effects and mechanisms of infrasound with low sound pressure level on focal cerebral ischemia-refusion injury. Methods Focal cerebral ischemia was produced by 2 hours of occlusion of the middle cerebral artery in rats. lnfrasound generated by infrasound 8TM device was used as treatment factor. Thirty-two Sprague-Dawley rats were divided into three groups: sham group (n=8), model group (n=8) and in-frasound group (n=16) , and the infrasound group was subdivided into 20- and 120-min infrasound groups, with 8 rats in each group. Neurological symptoms was assessed at 2 h, 1 d, 3 d and 7 d, respectively. These rats were sacrificed after 7 days of infrasound treatment and their brains were harvested. The number of IGF-1 posive cells of ischemia cortex was counted by using immunohistochemical technique. Results Compared with model group, neurological symptoms of rats in 120-min infrasound group was significantly improved (P<0.05); the number of IGF-1 positive cells of ischemia cortex in 120-min infrasound group increased significantly as compared with that in model group (P<0.01). Conclusion Infrasound with low sound pressure level (120 min/d, 7 d) could exert neuroprotective effect in focal cerebral ischemia injury by increasing expression of IGF-1 in brain.

Objective To examine the neuroprotective effect of pulsed magnetic field in a animal focal cere-bral ischemica-reperfusion injury model. Methods Forty-eight Sprague-Dawley (SD) rats were randomized into 3 groups, a sham-operation group, a model group and a pulsed magnetic field group, with rats 16 in each group. Mid-dle cerebral artery occlusion (MCAO) method was employed to establish the focal cerebral ischemia-reperfusion inju-ry model in rats of model group and pulsed magnetic field group. Rats in sham-operation group was subject to the same operation procedure but not underwent ischemia-reperfusion. The infarction volume, histopathological damage and expressions of IGF-1 in ischemic brain tissue were investigated to evaluate the effect of pulsed magnetic field. Results The infarction volume was reduced, histopathological damage alleviated and expressions of IGF-1 in ische-mic brain tissue elevated in the pulsed magnetic field group as compared against the model group (P<0.05). Con-clusions Pulsed magnetic field might provide neuro-protection against cerebral ischemia-reperfusion injury.

Objective To observe dynamically the expression of insulin-like growth factor(IGF-1)in the brain and liver,and to explore changes in IGF-1 levels.Methods The thread method waa used to establish middle cerebral artery occlusion in rats.The expression of IGF-1 on the ischemic side of the cerebral cortex and in the liver wag observed dynamically using immunohistochemical techniques. Results The number of IGF-1-positive cells increased significantly,peaking on the 3rd day in the cortex and the 7th day in the liver.Conclusion The expression of IGF-1 Wag upregulated in the brain after the experimental cerebral ischemia;peripheral humoral regulation of IGF-1 responded more slowly and recovered to some extent at the 7th day after cerebral ischemia.

Objective To compare the efficacy of balloon dilation and YAG laser endouretertomy in treatment of secondary ureteric stricture . Methods 32 patients with secondary ureteral stricture were randomly divided into balloon dilatation group and holmium laser cut group, 16 cases in each, respectively. The two kinds of treatment efficacy was compared after two years postoperative follow-up. Results The clinical results of the two groups showed no statistical differences at the third, sixth and twelfth month follow-up (P > 0.05), and there were no statistical differences in the overall effective rates (P > 0.05). The clinical results of the two groups showed no statistical difference at the twenty-fourth month follow-up (P < 0.05), and the overall effective rates had statistical difference (P < 0.05). Conclusions Balloon dilation and YAG laser endouretertomy in treatment of secondary ureteral stricture have the same short-term clinical effects. But the middle-term efficacy of YAG laser endouretertomy is superior to that of balloon dilation.