Objective To compare the outcome between McKeown minimally invasive approach and left chest-neck incision approach esophagectomy in mid-to-distal esophageal cancer.Methods The clinical data of 148 patients with mid-to-distal esophageal cancer from January 2009 to October 2013 were analyzed retrospectively.Seventy-eight patients (observation group) were performed with McKeown minimally invasive approach esophagectomy and 70 patients (control group) were performed with left chest-neck incision approach esophagectomy.The peroperative period status,postoperative complications and lymph nodes transfer between two groups were compared.Results All the operations were performed successfully.One patient in control group was dead because of acute myocardial infarction.The blood loss in observation group was significantly lower than that in control group[(89.2 ± 40.7) ml vs.(361.6 ± 81.5) ml] (P ＜ 0.05),the number of lymph nodes harvested and lymph node of thorax were significantly higher than those in control group[(22.8 ± 5.6) lymph nodes vs.(15.7 ± 3.4) lymph nodes,(14.7 ± 4.6) lymph nodes vs.(9.1 ± 3.6)lymph nodes] (P ＜ 0.05),the hospital stay was significantly shorter than that in control group [(11.6 ± 3.5)d vs.(14.0 ±6.6) d] (P ＜0.05).There were significant differences between two groups with regard to pneumonia,atelectasis,pleural effusion and delayed gastric emptying [5.1％ (4/78) vs.12.9％ (9/70),3.8％ (3/78) vs.11.4％(8/70),2.6％(2/78) vs.10.0％(7/70),9.0％(7/78) vs.1.4％(1/70)] (P ＜0.05).The transfer rate at the side of right recurrent laryngeal,left recurrent laryngeal and upper mediastinal lymph node in observation group were significantly higher than those in control group(P ＜ 0.05).Conclusion McKeown minimally invasive approach esophagectomy is feasible and safe which has lower blood loss,lower respiratory complication,shorter hospital stay and more number of lymph nodes harvested.

Objective To analyze effects comparison of thoracoscopy combined with laparoscopy surgery and the conventional thoracotomy in treatment of esophageal cancer.Methods 88 patients with esophageal carcinoma in the past two years in our department were randomly divided into the two groups according to the digital form,each group had 44 cases.The control group was given radical operation as the treatment for esophageal carcinoma,while the observation group used thoracoscope combined with laparoscope radical operation for treatment.The clinical efficacy of the two groups was compared.Results The operation time of the observation group was slightly higher than that of the control group (t =1.372,P ＞ 0.05),the number of lymph node dissection in the observation group was more than that of the control group (t =1.573,P ＞ 0.05).The intraoperative blood loss [(85.6 ± 30.7) mL],postoperative extubation time [(4.1 ± 1.3) d],chest drainage volume [(550.0 ± 30.5) mL] and postoperative hospital stay [(10.8 ± 2.2)d] in the observation group were significantly lower than those in the control group [(220.4 ± 58.7)mL,(7.5 ±1.8)d,(1 130.0 ±50.8)mL,(17.1 ±3.8)d,(t =18.847,6.486,40.649,8.938,all P ＜0.05)].The incidence of postoperative complications in observation group(6.82％)was significantly lower than that of control group (27.27％) (x2 =5.143,P ＜ 0.05).Conclusion Thoracoscope and laparoscope combined surgery in treatment of esophageal carcinoma can shorten time of being in hospital,decrease blood loss,reduce the incidence of complications,receive high safety and remove lymph node more thoroughly.

Objective To study the rationality of biochemistry teaching of liberal arts students and science students in one class and further to improve the quality of teaching.Methods A total of 138 students of seven-year traditional Chinese medicine of Grade 2013 as the objects of study,among whom there were 58 liberal arts students and 80 science students.Questionnaire were surveyed at the end of the teaching of biochemistry,including evaluation of the teaching effect and teaching reform.138 valid questionnaires were dispatched and recovered.And at the same time unified examination was carried out to both liberal arts students and science students.The t test,chi square test or the exact probability method were used to compare the data of two types of students with SPSS 19.0.Results Questionnaire survey:31.03％ (18/58) arts students and 27.50％ (22/80) science students felt that the class hours were not enough.48.28％ (28/58) arts students thought the weak chemical base to be the main factor affecting learning,and 50.00％ (40/80) science students thought that lack of interest was the most important factor.53.45％ (31/58) arts and 47.50％ (38/80) science students would agree that a metabolic reaction of the material was the most difficult problem.51.72％ (30/58) arts students and 42.50％ (34/80) science students preferred blackboard-writing.Test scores:arts and science students got average grades (70.81 ± 9.71) and (77.05 ± 8.46) respectively,and the difference was statistically significant (t=-4.02,P=0.000).Conclusions Survey results and analysis of test scores shows that teaching of liberal arts students and science students in one class is feasible.However,it is necessary to strengthen the students' chemical basis,improve their learning interest and optimize their learning methods,so as to realize the harmonious development of the students of arts and science,and to improve the overall teaching level.

Objective To evaluate the effectiveness and safety of DTaP-IPV/Hib combined vaccine in comparison with commercially available DTaP (diphtheria, tetanus and pertussis), Haemophilus influenzae type b (Hib), tetanus conjugate and IPV monovalent vaccine. Methods Randomized controlled trials (RCTs) on DTaP-IPV/Hib were retrieved by searching interna-tional and national databases. The pooled mean difference and relative risk and 95% CI were assessed by meta analysis with RevMan 5.0 software. Results Totally 6 studies were included for the final analysis. The seroprotection/seroconversion level of the Anti-PT (RR=0.26, 95%CI: 0.14, 0.48) in combination vaccine was higher. The antibody titer levels of Anti-PT (WMD=21.11, 95%CI:9.36, 32.86), Anti-polio type1 (WMD=59.15, 95%CI:2.81, 115.48), Anti-polio type 3 (WMD=169.82, 95%CI:75.33, 264.30) were higher respectively. But the antibody titer level of Anti-PRP (WMD=-3.58, 95%CI:-5.52,-1.64) in the com-bination vaccine group was lower. Redness (RR=0.82, 95%CI:0.72, 0.93) and Tenderness (RR=0.45, 95%CI:0.30, 0.65) were lower in the combination vaccine. Swelling (RR=2.03, 95%CI:1.02, 4.01) was more common in the patients given the combina-tion vaccine. Conclusions This study supports the conclusion that the DTaP-IPV/Hib combination vaccine is equivalent to the separate injections based on similar antibody responses to the vaccine antigens, effectiveness and safety after primary doses.

Chronic rhinosinusitis is a common disease and frequently encountered disease in otolaryngology, but the therapeutic effect is not ideal. While its pathogenesis is exploring in the continuously. Found in the recent years, Th17 cells are a new subset of T cells and closely related with inflammatory disorders, autoimmune diseases and cancer. Its differentiation, regulation and biological effects are widely noted as a hot area of research. This review explores the discovery of differentiation and regulation of Th17 cells, the relationship between related cytokines and chronic rhinosinusitis, in order to have a beteer knowledge of chronic rhinosinusitis. This review regards Th17 cells as the main clue, nevertheless, lacking consideration of the impacts of other factors on chronic rhinosinusitis.
Chronic Disease ; Humans ; Rhinitis ; immunology ; Sinusitis ; immunology ; Th17 Cells ; immunology

Calcium calculi account for about 80% of urolithiasis with high incidence and recurrence rate. Recurrent urolithiasis increases the risk of hypertension and chronic kidney disease. Comprehensive metabolic evaluation is of paramount importance for the prevention of calcium calculi. With deepening of the study on the pathogenesis of calculi, we find crystallization inhibitors, inflammation and oxidative stress molecules play an important role in the formation of calculi, and susceptibility gene sites of urinary calculi are identified in succession. These may be used as novel markers for the prevention and evaluation of urinary calculi. Models that predict the risk of kidney stone recurrence can help warn people at high risk.

Background Refractive surgery has propelled itself forward to become widely performed surgical procedure nowadays.After the surgery,corneal biomechanics decreases lead to keratoconus and corneal ectasia.Doctors pay more attention to biomechanics changes after refractive surgeries.Objective This clinical study was to investigate the influence of different laser refractive surgeries on corneal biomechanics.Methods A prospective nonrandomized and controlled clinical study was designed.One hundred and sixty-four eyes of 82 patients with moderate myopia were enrolled.The patients were divided into sub-Bowman keratomileusis (SBK) group (60 eyes of 30 patients),laser in situ keratomileusis (LASIK) group (54 eyes of 27 patients) and laser subepithelial keratomileusis (LASEK) group (50 eyes of 25 patients),with the matched demography among the three groups.Corneal hysteresis (CH) and corneal resistance factor (CRF) were detected by ocular response analyzer (ORA) before and 1 week,5 months after refractive surgery.The correlations between stromal ablation depth and postoperative changing values of CH or CRF were analyzed.Results Significant differences were found in CH and CRF at different time points in the three groups (Ftime =41.90,P =0.00;Ftime =49.65,P =0.00),and the CH and CRF values were significantly lower 1 week and 5 months after surgery than those before surgery (all at P =0.00).However,no significant difference of CH or CRF was seen at all time points among the three groups (Fgroup =2.17,P =0.08;Fsroup =2.67,P =0.07).No correlation was found between corneal ablation depth and CH in 1 week and 5 months after surgery (both at R2 =0.000),however,weaker correlations were seen between corneal ablation depth and CRF 1 week and5 months after surgery (Y=3.253+ 0.010X,R2=0.007;Y=1.073+0.021 X,R2=0.004).Conclusions SBK,LASIK and LASEK lead to the change of corneal biomechanics by altering CH and CRF,they play the same influence on cornea.CRF appears to be an useful indicator in evaluating corneal biomechanical changes after laser refractive surgery.

OBJECTIVE:To observe the clinical efficacy and safety of piperazine ferulate combined with glutathione in the treatment of diabetic nephropathy. METHODS:80 patients with diabetic nephropathy in our hospital were divided into observation group and control group according to random number table,with 40 cases in each group. Both groups was given general treatment as blood glucose,blood lipid and blood pressure control. Control group was additionally given Reduced glutathione tablets 400 mg, tid,on the basis of general treatment. Observation group was additionally given Piperazine ferulate tablets 100 mg,tid,on the ba-sis of control group. Both groups were treated for 12 weeks. The fasting plasma glucose(FPG),2 h postprandial plasma glucose(2 hPG),blood pressure,blood lipid,serum creatinine (Scr),blood urea nitrogen (BUN),24 h urinary total protein and albumin, urine β2 microglobulin(β2-MG)and N-acetyl-β-glucosaminidase(NAG)of 2 groups were detected before and after treatment. The occurrence of ADR was observed. RESULTS:Before treatment,there was no statistical significance in FPG,2 hPG,blood pres-sure,blood lipid,Scr,BUN,24 h urinary total protein and albumin,urine β2-MG and NAG between 2 groups(P>0.05). After treatment,above indexes of 2 groups were improved significantly,and the observation group was better than the control group, with statistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:In the treatment of diabetic ne-phropathy,piperazine ferulate combined with glutathione can improve blood glucose,blood pressure,blood lipid levels and renal function with good safety.

Objective To investigate the effect of continued nursing on postoperative outcomes of discharged patients with chronic suppurative otitis media.Methods Toally 198 discharged patients were randomized into the control group (n=98) and the observation group (n=100).The patients in both groups received normal health education and additionally the continued nursing was used in the observation group for health education by way of phone call follow-up,on-the-spot consultation and QQ consultation.The mastery of related knowledge and skills,incidence of secondary tympanic membrane and readmission rate were compared.Results Six months after discharge,the observation group was significantly better than those the control group in the mastery of related knowledge and skills (P＜0.05).The incidence of secondary tympanic membrane perforation was not statistically significant between the groups(P＞ 0.05).The readmission rate at the second week and the third week between the two groups had no statistically significant difference (P＞ 0.05).However,the readmission rate at the first,second,third and sixth month were statistically different (P＜0.05).Conclusion Continued nursing to the postoperative discharged patients with chronic suppurative otitis media can improve the follow-up rate after discharge and self-nursing capacity,and as a result promote their recovery.

Objectives:To explore the relationship between sleep quality and coping styles in cervical cancer patients undergoing radiotherapy.Methods:68 cervical cancer patients were assessed by convenient sampling,who had been investigated with Pittsburgh Sleep Quality Index (PSQI) and Jalowiec coping scale (JCS-60).Results:Global PSQI score was (8.60 ± 4.47).Optimistic coping scored highest with score of (2.11 ± 0.45),which was the style most often applied by cervical cancer patients.Emotive coping scored lowest with score of (0.97 ± 0.62).Among 60 coping items,Hoped that things would get better was the most often used coping strategy,Took a drink to make yourself feel better was the least used coping strategy.Global PSQI score was positively correlated with fatalistic coping(r =0.325,P =0.008).Confrontive coping was positively correlated with subjective sleep quality score(r =0.318,P =0.009),while supportive coping was negatively related to subjective sleep quality score(r =-0.306,P =0.013),and palliative was negatively related to daytime dysfunction(r =-0.245,P =0.047).Gonclusions:Sleep problems are a common complaint in cervical cancer patients undergoing radiotherapy.Health care workers should guide the patients to adopt active coping styles to improve sleep quality.