Objective To evaluate the advantage of video-assisted mini thoracotomy for patients with esophageal cancer compared with routine open thomcotomy.Methods Perioperative clinical results were compared between 24 csses received VAMT(test group)and 26 cases underwent routine open thoracotomy(control group)during the same period.All the cancer stages were T2-3N0-1M0.Results This study showed that VAMT Was a minimally invasive swgew with shorter operation time(40.0±3.3)min vs.(70.3±3.2)min,P＜0.05)and had less bleeding volume both during and after operation compared to the control group(108.1±15.2)ml V8.(200.1±11.3)ml,(380.8±45.4)ml vs.(780.1±52.2)ml,P＜0.05).No significant differences were observed in the two groups with respect to complication occurrence rate(4.2%vs.19.2%,P＞0.05).Conclusion It is suggested that VAMT is safe,reliable and less invasive in the treatmem of esophagus carcinoma.

Objective To explore the feasibility,necessity and the skill of total mesoesophageal excision (TME ) during thoracoscopy combined with laparoscopy in radical resection of esophageal carcinoma.Methods 69 patients with esophageal carcinoma were divided into the TME group(40 cases)and the thoracotomy with triple incisions group(29 cases)according to the admission sequence.The operation time,intraoperative blood loss,total lymph nodes removed,postoperative complication rate and disease -free survival were compared between the two groups.Results The operation time of TME group was (182.85 ±26.73)min,which was significantly shorter than (295.71 ±19.50)min of the thoracotomy group (t=-19.301,P<0.001).The intraoperative blood loss in TME group was (86.43 ±59.34)mL,which was significantly less than (163.47 ±58.82)mL in the thoracotomy group (t=-5.342,P<0.001 ).No significant differences were detected between the two groups in total lymph nodes removed and incidence rate of postoperative complication (all P>0.05 ).The disease-free survival period in TME group was (14.78 ±2.14)months,which in the thoracotomy group was (13.10 ±4.09)months,the difference was significant (t=2.200,P<0.05).Conclusion TME is safe and feasible during thoracoscopy combined with laparos-copy in radical resection of esophageal carcinoma.TME is better in improving the regional control in esophageal carci-noma.

Objective To explore the feasibility of endothelial function of dorsal artery of foot in patients with type 2 diabetes(T2DM) by high frequency ultrasound combined with warm bath test.MethodsThirty-five patients with T2DM and thirty normal people were collected,all subjects were examined by high frequency ultrasound.Diameter of brachial artery in baseline and after reactive hyperaemia were detected;Diameter of dorsal artery of foot in baseline and after the foot immersed in 40℃ warm water for 5 minutes were acquired.Flow mediated dilatation of dorsalis pedis artery(FMDDPA) and flow mediated dilatation of brachial artery(FMDBA) were calculated and compared.Multiple stepwise regression analysis was used to examine the correlation between FMDDPA and hemoglobin A1c(HbAlc). Results The FMDDPA and FMDBA were decreased in patients with T2DM (P<0.01).The FMDDPA and FMDBA were correlated significantly(r=0.864,P<0.01).In stepwise regression analysis,HbA1c is the most affecting factor for FMDDPA (R2=0.321,P<0.01).Conclusions Ultrasound combined with warm bath test can be used to detect the change of endothelial function of dorsal artery of foot in patients with T2DM,which have a certain clinical application value in endothelial function of terminal limb artery.

Objective The purpose of this study was to develop a database program based on Microsoft Access 2003 for patients with breast cancer to save and manage clinical data.This makes it easier to analyze data of the database.Methods A total of 1177 cases with breast cancer who were performed surgical treatment from December 1998 to June 2007,the clinical data collection which included regular fouow-up data of these patients after therapy,the database was designed by using Microsoft Access 2003 included the creation of tables,forms and queries according to the therapy guidelines for breast cancer.Results The clinical data for patients with breast cancer can be stored in an Access database that is both user-friendly with reliable data administration and that can be shared in network,and it is capable of recording regular updated data.Conclusion This program will not only convenient for researchers to statistic and analyze their outcome data,but also for minimizing data entry errors and reducing the time spent on data query.

Objective To observe the role of abatacept in the treatment of diabetic nephropathy in rats. Methods Type 2 diabetic nephropathy rat model was established, and was randomly divided into abatacept group and non-intervention group, 15 each. 15 normal rats were served as control group ( NC) . The abatacept group was given abatacept for 8 weeks. The control group was set at the same time period. Then the blood biochemical indexes, blood flow parameters of renal main artery, elasticity of renal parenchymal, HE staining of renal parenchymal and ultrastructure of podocytes were all evaluated. The expression of CD31, CD34, podocin, nephrin, and B7-1 in renal parenchyma were detected. Results Compared to the NC group, the fasting blood glucose, creatinine clearance rate, urine albumin excretion rate, and kidney hypertrophy index in the non-intervention and abatacept groups were significantly increased (P<0. 05);creatinine clearance rate, urine albumin excretion rate, and kidney hypertrophy index in the abatacept group were significantly lower compared to the non-intervention group (P<0. 05). There were significant differences in peak systolic velocity, end diastolic velocity, and mean velocity among these 3 groups, and these differences were ranked as non-intervention groupabatacept>control groups (P<0. 05). There were significant differences in the stiffness of kidneys among these three groups, with the differences ranked as non-intervention>abatacept>control groups (P<0. 05). HE staining and transmission electron microscope observation showed that there were obvious changes in the renal parenchyma of rats in the non-intervention group and the abatacept group, and the changes of kidney in the non-intervention group were worse than those in the abatacept group. CD31 and CD34 expression in kidney parenchyma of rats in the abatacept group and non-intervention group were higher than those in the control group, the abatacept group and non-intervention group>the control group (P<0. 05), while no significant differences between the abatacept group and non-intervention group in CD31 and CD34 expression (P>0. 05). There were significant differences in podocin and nephrin expression in kidney parenchyma of rats among these three groups, and these differences were ranked as the control>abatacept>non-intervention groups (P<0. 05). There were significant differences in B7-1 expression in kidney parenchyma of rats among these three groups, and these differences were ranked as the control

Phytochemical studies of the the herb Sarcopyramis bodinieri var. delicate (Melastomataceae) have been carried out. The compounds were separated by repeated D101 macroporous adsorption resin column combined with Sephadex LH-20, ODS, and silica gel chromatgrophy. The structures were identified on the basis of extensive spectroscopic data analysis, and by comparison of their spectral data with those reported. Eight flavonoid compounds isolated from the ethyl acetate extract was identified as isorhamnetin (1), quercetin (2), isorhamnetin-3-O-beta-D-glucopyranoside (3), quercetin-3-O-beta-D-glucopyranoside (4), isorhamnetin-3-O-(6"-acetyl)-beta-D-glucopyranoside (5), isorhamnetin-3-O-(2"-acetyl)-beta-D-glucopyranoside (6), quercetin-3-O-(6"-acetyl)-beta-D-glucopyranoside (7), and quercetin- 3-O-(6"-O-E-p-coumaroyl)-beta-D-glucopyranoside (8). All of the compounds were separated from the genus of Sarcopyramis for the first time.
Flavonoids ; analysis ; isolation & purification ; Magnetic Resonance Spectroscopy ; Melastomataceae ; chemistry ; Spectrometry, Mass, Electrospray Ionization

OBJECTIVETo observe the effect of resting heart rate (RHR) on the progression to hypertension in patients with prehypertension.

METHODSPeople who participated the physical examination between 2006 and 2007 at Kailuan medical group and diagnosed as prehypentension were selected as the observation cohort. The second and the third physical examination were conducted between 2008 and 2009 and between 2010 and 2011. The observation population was divided into five groups according to the different levels of RHR at baseline: the first group ( ≤69 beats/min), the second group (70-74 beats/min), the third group (75-79 beats/min), the fourth group (80-84 beats/min) and the fifth group ( ≥85 beats/min). The rate of the progression to hypertension was compared among five groups, and the relationship between RHR and the progression to hypertension was estimated using Cox proportional hazard analysis.

RESULTSA total of 34 512 patients with prehypentension were recruited and 25 392 patients were involved in the final statistics after excluding patients who died or were lost to follow-up. A total of 13 228 (52.1%) patients with prehypentension developed hypertension during follow-up. The rate of the progression to hypertension increased with the RHR (first group: 51.2%, second group: 50.1%, third group: 52.9%, fourth group: 53.5%, fifth group: 57.5%). Multiple Cox regression models showed that the risk of the progression to hypertension increased with the RHR levels. Patients in the fifth group carried 1.25 times higher risk for developing hypertension than patients in the second group after adjustment for age, gender, systolic blood pressure, diastolic blood pressure, waist circumference, body mass index, triglyceride, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, fasting blood glucose, serum uric acid, C-reactive protein, smoking, drinking, physical exercise and family history of hypertension at baseline.

CONCLUSIONElevated RHR is an independent risk factor for the progression to hypertension in patients with prehypertension.

Adult ; Blood Pressure ; Body Mass Index ; C-Reactive Protein ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Cohort Studies ; Disease Progression ; Female ; Heart Rate ; Humans ; Hypertension ; Male ; Middle Aged ; Prehypertension ; Proportional Hazards Models ; Risk Factors ; Triglycerides

Objective To investigate the multivariate analysis of renal parenchymal elastic changes in diabetic and the value of virtual touch quantization ( VTQ ) techniques in the diagnosis of diabetic nephropathy . Methods According to urinary albumin excretion rate( UAER) ,72 cases of diabetics were divided into 3 groups:the normal albuminuria group ( UAER<30 mg/24 h) 16 cases ,the trace albuminuria group(30 mg/24 h< UAER< 300 mg/24 h) 30 cases and the mass albuminuria group ( UAER > 300 mg/24 h) 26 cases . And 50 healthy volunteers were selected as the control group . The basic clinical data of subjects were collected ,routine laboratory tests were detected ,and VTQ was used to measure the left renal parenchymal shear wave velocity ( SWV ) ,then the statistical software was applied to analyze these data . Results The left renal parenchymal SWV in the control group ,the normal albuminuria group ,the trace albuminuria group and the mass albuminuria group increased in turn ,respectively ( 2 .01 ± 0 .22 ) m/s , (2 .20 ± 0 .22) m/s ,(2 .51 ± 0 .42) m/s ,(2 .88 ± 0 .32) m/s ,the difference among 4 groups was statistically significant( P <0 .05) . Multiple linear regression analysis showed that SWV ( Y) had linear relationship with duration of diabetes(X1 ) ,left renal parenchymal thickness(X2 ) and serum creatinine(X3 ) ,and the regression equation was Y = 2 .719 + 0 .043 X1 -0 .051 X2 + 0 .002 X3 . In addition ,SWV was positively correlated with the duration of diabetes and serum creatinine ,and negatively correlated with the left renalparenchymal thickness . Conclusions There is correlation between the left renal parenchymal SWV andduration of diabetes ,left renal parenchymal thickness and serum creatinine ,and the left renal parenchymal SWV increases as the renal injury aggravating . VTQ has a certain reference value to judge the degree of early renal damage in diabetics .

Objective To explore the feasibility of the promoting effect of ultrasound targeted microbubble destruction(UTMD) on establishment of type Ⅰ diabetic nephropathy in rats.Methods Forty male SD rats were randomly and equally divided into four groups(n =10):control group(group A),streptozocin group(group B),streptozocin and ultrasound microbubble group(group C) and streptozocin and UTMD group(group D).The fasting blood-glucose (FBG) were tested,the 24 h's urine were collected and the 24 h's urine mieroalbumin(mAlb) were measured and then urinary albumin excretion rate(UAER) were calculated twice a week at fixed time in all groups.When greater than 3-fold increase in UAER compared with controls at the same age and gender,the diabetic nephropathy model in rats was considered to be established successfully,then the change of time and weighed were recorded and rats were killed and collected the blood of left atrial appendage to measure,blood urea nitrogen (BUN),serum creatinine (SCr) and Alanine aminotransferase (ALT).The left kidneys were weighted and then observed glomerular pathological changes under light microscope and detected the expression of CD34 in kidney of rats in each group by immunohistochemical method.Results ①The time of establishing diabetic nephropathy model in group D was obviously shorter than that in group B and C (all P ＜ 0.05).The FBG,the kidney index,UAER,BUN and Scr values in group B,C and D were significantly higher than those in group A(all P ＜0.05),but ALT had no significant change among each groups(all P ＞0.05).②The pathological changes of diabetic nephropathy appeared in rats of group B,C and D;the expression of CD34 in B,C and D groups were raised.Conclusions UTMD can obviously shorten the molding time of type Ⅰ diabetic nephropathy rats,which has feasibility.

Objective To investigate the impact of different levels of systolic blood pressure on brachial-ankle pulse wave velocity(baPWV). Methods A total of 5 852 participants was selected with stratified random sampling from the 101 510 workers of Tangshan Kaiuan Company who had undergone a physical check-up program. 5 222 of them with integral data were recruited into this survey. According to SBP collected during the 2010-2011 health examination program,the population under observation was divided into four groups:optimal SBP(SBP<120 mmHg),high-normal blood pressure Ⅰ period(120 mmHg≤SBP<130 mmHg),high-normal blood pressure Ⅱ period (130 mmHg≤SBP<140 mmHg)and hypertension(SBP≥140 mmHg or SBP<140 mmHg but antihypertensive drug user). Multivariate logistic regression analysis was used to analyze the influence of different levels of systolic blood pressure on baPWV. Results 1)There were 3 132 males and 2 090 females in all the 5 222 participants with an average age of 55.1 years old. Their mean of baPWV was(1 587.57±400.71)cm/s,with the detection rates as 62%(baPWV≥1 400 cm/s). 2)The means of baPWV for the above groups of SBP were 1 322.19,1 456.27,1 544.78 and 1 827.77 cm/s, respectively,with detection rates of baPWV≥1 400 cm/s as 26.4%,49.3%,64.2% and 88.3%, respectively. 3)Results from the Multiple linear regression analysis revealed that β of SBP was 0.40,only ranking second,on age(0.48). 4)Data from the Multiple logistic regression analysis showed that after adjusting for age,gender and other risk factors,when compared to optimal SBP,factors as high-normal blood pressure Ⅰ period、high-normal blood pressure Ⅱ period and hypertension were risk factors for increasing baPWV,with OR values as 2.70(95%CI:2.20-3.32),4.56(95%CI:3.67-5.67)and 13.51(95%CI:10.87-16.78),respectively. Conclusion Higher SBP seemed an independent risk factor for the increase of baPWV.