Objective To investigate the pattern of lymph node metastasis in patients with 17 and middle thoracic esophageal squamous cell carcinoma( ESCC). Methods Retrospective review the clinical data of 246 cases with T2 and middle thoracic esophageal squamous cell carcinoma who were treated by three-field lymphadenectomy. Analyze the relationship between clinical pathological factors and lymph node metastasis. Results Lymph node metastases were found in 129 of the 246 patients (52.4% ).The average number of resected lymph nodes was 25 per patient (rangel5 -59). The rates of lymph node metastasis were 28.9% in the neck, 28.5% in thoracic mediastinum and 22.0% in abdominal cavity for patients with T2 and middle thoracic ESCC. No significant difference in lymph node metastasis' rate was observed among the neck, thoracic mediastinum and abdominal cavity. Logistic-regression showed the length of tumor, tumor cell differentiation and angiolymphatic invasion were factors influencing lymph node metastasis. Conclusion Lymph node metastasis in T2 and middle thoracic ESCC has the characteristics of upward, downward and skip spreading. Patients with T2 and middle thoracic ESCC should be treated with radical surgery with three-field lymphadenectomy.

Objective To study the quantitative changes of gap junction (GJ) in the detrusors of unstable bladder(USB) in rats,and to deduce the functional changes of GJ,which mediates intercellular communication,so as to demonstrate one of the mechanisms of USB. Methods Thirteen Wistar rats, which were identified to have USB by manometry of filling bladder after establishment of bladder outlet obstruction (BOO) model, served as study,ie,USB group.Another 10 healthy female Wistar rats served as control group.The content and distribution of connexin (Cx) 43 of the detrusors, which were taken from these rats,were quantitatively analyzed by Western blot and laser confocal microscopy with a double-label immunohistochemical technique. Results Cx43 protein was expressed in both control and USB group, the relative molecular weight was 43000.The mean gray levels of the detrusor protein bands in USB group and control group were 31.066 and 11.701,respectively;the difference of the values between the 2 groups was significant (P

Objective To explore the effect of psychological counseling skills on medical treatment and satisfaction degree of patients in hospital.Methods Toally 60 discharged patients during December 2015 were assigned as the control group and another discharged one during January 2016 as the intervention group.Training on psychological counseling skills was done for the nurses by the psychological counselor in the intervention group while the control group was not.The two groups were compared on the basis of investigation with the patient's consultation experience scale as well as the medical satisfaction questionnaire.Result The satisfaction levels of consultation experience and medical consultation satisfaction in the intervention group were both higher than those of the control group (all P＜0.01).Conclusion Psychological counseling skills used in the nurse patient communication can enhance the patient's medical experience and their satisfaction with medical treatment.

Objective To compare the clinical efficacy of gemcitabine arterial infusion chemotherapy with intravenous chemotherapy in the management of patients with advanced pancreatic cancer and to evaluate the efficacy and safety of gemcitabine arterial infusion chemotherapy. Methods 43 patients with advanced pancreatic cancer were included in this study, of whom 21 patients received arterial infusion chemotherapy (Group A) and the other 22 were treated by intravenous chemotherapy (Group B), gemcitabine combined with 5-FU chemotherapy was administrated in both groups. The main outcomes were clinical benefit response (CBR), tumor response rate and toxicity. Results Compared with Group B, there was a significant improvement of CBR in group A (81% vs 50%, P =0.033) ; there was also significant improvement of pain control in group A (76.2% vs 45.5%, P =0.039). There was no significant difference in the tumor response rate between two groups (33.3% vs 22.7%, P =0.498). No significant increase of side effects was observed in both groups. Conclusions In the management of advanced pancreatic cancer, the arterial infusion method may be more favorable than intravenous approach in improving clinical benefits with mild toxicity and well tolerability.

Objective To establish mathematical model for the differential diagnosis of endoscopic gastric ulcerative lesions with the help of image processing software and statistical analysis method. Methods The microscopic images of 25 gastric ulcers and 25 gastric peptic cancers were collected from January 2013 to December 2013.Then the Photoshop CS4 software was used for image processing and representative measurements gathering(area,perimeter,roundness,height,width,gray scale,involving the density,color,lightness,pixels).Then the principal component analysis,the scatter plot and cluster analysis were performed by SPSS 16.0.Results According to the results of principal component analysis, Z1 showed a strong positive correlation with area,perimeter,height,width,cumulative density,pixel,which represented the shape statistics of ulcer.And Z2 showed a strong positive correlation with gray scale,color, lightness,which represented the color statistics of ulcer.On the Scatter plot,gastric peptic cancer images showed a stronger positive correlation with the principal component Z1 and Z2 .Clustering analysis results showed that for the majority of patients,there was a pattern in its incidence.In the gastric ulcer diagnostic models,the effective information should include area≤10 000;perimeter≤250;height≤90;width≤60;gray scale≥90;cumulative density≤190 000;color≥110;and lightness≥110(unit:pixel).In the gastric ulcera-tive cancers,the effective information should include area≥38 000,perimeter≥690,height≥300,width ≥ 426,gray scale ≤ 100,cumulative density ≥ 14 000 000,color ≤ 125,and lightness ≤ 130 (unit:pixel). Conclusion Among the endoscopic image data,area,perimeter,roundness,height,width,gray scale, cumulative density,color,brightness,pixels are important indices,which can contribute to the differential diagnosis of gastric ulcerative lesions.The established mathematical model based on the ten indices can be applied to predict and diagnose gastric ulcerative lesions.

Objective To investigate the prevalence and the clinical features of pancreatic cancer pain in a Chinese patient population.Methods The study was carried out in 415 cages of pancreatic cancer which were admitted to the First Municipal people's Hospital of Guangzhou Medical college and the Second Affiliated Hospital of Sun Yat-sen University from 1999 to 2007.The prevalence,clinical features of pancreatic cancer pain and its correlations with the cancer site and the clinical staging were analyzed.Results Of the 415 patients.the prevalence of pain wag 65.1%and 60.5%of all the patients presented pain as the initial symptom;the incidence of pain in pancreatic body/tail cancer patients was 80.7%.while it was 71.4%in total pancreatic cancer patients.and the incidence was 58.2%in pancreatic head cancer patients;the incidence between pancreatic body/tail cancer and pancreatic head cancer patients was statistically different (P＜0.05).The incidence of pain in patients with stage Ⅰ,Ⅱ,Ⅲ,and Ⅳ was 28.6%,58.1%,66.2%and 78.6%.and the difference was statistically significant(P＜0.01).The incidence of moderate to severe degree of pain in patients with stage Ⅰ,Ⅱ,Ⅲ,and Ⅳ was 18.8%,44.4%,53.1%and 68.2%,and the differenee was statistically significant(P＜0.01).Conclusions Pain was very common in patients with advanced pancreatic cancer.The incidence and severity of pain increased with the progression of pancreatic cancer.

Objective: To analyze the association between hepatitis B virus (HBV) infection and pancreatic cancer. Methods: Retrospective analysis was performed to explore the positive rate of serum hepatitis B virus surface antigen (HBsAg) in patients with pancreatic cancer, lung cancer, diabetes mellitus and general population. Z test was used to compare the rate of HBV infection between the samples and general population. The rates among the samples were compared by Chi-square test. Results: A total of 3,701 registered patients seen in our hospital between January 1st 2003 and March 31st 2009 were collected. There were 230 pancreatic cancer patients with a positive rate of serum HBsAg of 16.1%, 1,188 lung cancer patients with a positive rate of serum HBsAg of 10.7%, and 2,283 patients with diabetes mellitus with a positive rate of serum HBsAg of 11.6%. There was no statistical significance in Z-test results between lung cancer patients and general population (Z=1.104, P=0.163), but the Z-test results between patients with diabetes mellitus and general population showed a statistical significance (Z=2.98, P=0.002). The positive rate of HBsAg was higher in pancreatic cancer patients than that in lung cancer patients (OR=1.60, 95% Cl: 1.077-2.382, r=5.487, P=0.019). Similar results were found between pancreatic cancer patients and diabetic patients (OR=1.46, 95% CI: 1.004-2.123, r=3.965, P=0.046). Conclusion: The positive rate of HBsAg is high in pancreatic cancer patients. There might be an association between HBV infection and pancreatic cancer.

Objective To explore the method for detecting the connexin 43(Cx43) in detrusor of bladder in rats with detrusor instability.Methods The model of rats with detrusor instability was established.Ten rats in unstable bladder group were determined by filling cystonetry method controlled by 10 normal rats.The fluorescein isothiocyanate(FITC) was used to label the Cx43 and the tritin conjugated rhodamine was used to label the cell membrane of detrusor muscle.The Cx43 and the cell membrane of detrusor muscle were detected by laser scanning confocal microscopy(LSCM),and the images were analyzed by the image analysis program.Results The distinct images of Cx43 and cell membrane of detrusor muscle could be obtained by the LSCM.The expression of Cx43 and pixel density were increased significantly in rats of unstable bladder group than those of the control group(all P

Objective To understand the distribution of the river beach wetlands and Oncomelania snails in the lower reach-es of the Yangtze River,and explore the countermeasures of snail control. Methods The river beach wetlands outside the Yang-tze River levee were investigated and classified according to the hierarchical and classification system of wetlands of China. The snail survey was carried out in the beach wetlands of Runzhou section of lower reaches of the Yangtze River from 2004 to 2013. The change trend of snail areas and the densities was analyzed in the wetlands. Results The river beach of Runzhou section of lower reaches of the Yangtze River belongs to the riverine wetland. There was Oncomelania snail breeding except the permanent wa-ter area. At present,there were natural wetlands of 1 303.0 hm2,human-made wetlands of 1 479.0 hm2 and wetland function chang-es of 1 059.0 hm2 in the river beach of Runzhou section. There was the snail area of 181.4 hm2 in the natural wetland in 2013. The area of snail control by the molluscicide and environmental modification was 4 624.55 hm2 from 2004 to 2013. The decline rates of snail areas and densities were 66.53%and 77.66%respectively. The existing Oncomelania snails were distributed in the natural wetlands. Conclusion The human-made wetland is helpful to snail control. The snail control in the river beach wetlands should attach a great importance to the protection of wetland ecology.

Objective To evaluate the mid-term effectiveness of the medium-and-long-term programme of the prevention and control of schistosomiasis in Jiangsu Province. Methods The programme was carried out in Jiangsu Province and the comprehensive measures relied mainly on snail control, detection and chemotherapy of schistosomiasis for residents and livestock. The mid-term effectiveness of the programme was observed and evaluated longitudinally. Results The coverage rate of snail control areas and the ratio of chemotherapy of schistosomiasis for residents and livestock rose year after year. The snail areas, the infected snail areas and the infection rate of schistosome for residents and livestock reduced year after year. There were negative correlations between the coverage rates of snail control and the infected snail areas, the number of settings with infected snails, the infection rate of schistosome for residents, the infection rate of schistosome for livestock and the morbidity of acute schistosomiasis, respectively (rInfected snail areas=-0.897,P=0.039;rNo. of settings with infected snail=-0.937,P=0.019;rInfection rate for residents=-0.913,P=0.031;rInfection rate for livestock=-0.991,P=0.001;rMorbidity of acute schistosomiasis=-0.894,P=0.041). There were negative correlations between the ratio of chemotherapy of schistosomiasis for residents and the infected snail areas, and between the ratio of chemotherapy of schistosomiasis for livestock and the infected snail areas (rRatio of chemotherapy for residents =-0.965,P=0.008;rRatio of chemotherapy for livestock=-0.921,P=0.027). There were negative correlations between the funds of schistosomiasis control and the infection rate of schistosome for residents livestock, respectively (rInfection rate for residents=-0.897,P=0.039;rInfection rate for livestock=-0.971,P=0.006). The multiple linear regression analysis showed that there were the linearity relationships between the infection rate of schistosome for residents and the coverage rates of snail control, and between the infection rate of schistosome for livestock and the coverage rates of snail control, and between the morbidity of acute schistosomiasis and the coverage rates of snail control. Conclusions The effect of the comprehensive strategy of schistosomiasis control which relies mainly on snail control, detection and chemotherapy of schistosomiasis for residents and livestock are remarkable. The snail control and chemotherapy are effective and immediate. The increased funds would be essential guarantee for control and elimination of schistosomiasis.