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 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 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.

Electrochemiluminescence was used to determine thyroid function and thyroid autoantibodies in 140 pregnant women,who were then divided into normal group (n =117) and subclinical hypothyroidism group (n =23) based on the thyroid function.The urine iodine level in the pregnant women was detected by arsenic cerium catalytic spectrophotometric method.The awareness of past history of thyroid disease among the subjects with thyroid dysfunctions were investigated.The results showed that the prevalences of iodine deficiency were 50％ and 57％ in the normal group and the subclinical hypothyroidism group,respectively.The state of iodine level was not related to thyroid function.The levels of serum thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody were markedly related to serum TSH(P＜0.01),so was the level of serum TPOAb related to serum FT4 (P＜0.05).Among the subclinical hypothyroidism women,70％ did not undergo thyroid function and thyroid autoantibodies screening before pregnancy,8.7％ denied past history of thyroid disease,and 21.7％ suffered from hypothyroidism before pregnancy.Therefore,we advocate the screening of urine iodine and thyroid autoantibodies before or during the first trimester of pregnancy,aiming to correct iodine deficiency,avoid supplementing too much iodine,improve the outcome of perinatal stage,and reduce all the negative effects on the offsprings.

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 investigate the expression of extracellular matrix metalloproteinase induced (EMMPRIN) in the synovial membrane of patients with rheumatoid arthritis (RA).Methods Immunohistochemistry were performed to characterize the EMMPRIN-expressing cells at sites of joint destruction derived from RA and osteoarthritis (OA) patients.Reverse trancription polymerase chain reaction (RT-PCR) was performed to study the existence of EMMPRIN in synovial membrane samples.And it was followed by computer assisted image analysis in order to detect the A values of their experession.Results EMMPRIN immunoreactivity was more intense in RA than in OA synovial membrane (P

The clinical data were retrospectively analyzed for 21 cases of liver neoplasms undergoing laparoscopic hepatectomy from December 2007 to October 2012.Among 11 cases of borderline hepatocellular carcinoma (HCC) (1.0-9.0 cm),6 of them were of micro hepatocellular carcinoma (MHCC) with a diameter ≤2 cm.There were 10 cases of borderline hepatic benign tumor,including liver hemangioma (n =7),hepatic adenoma (n =1),liver lymphoma (n =1) and liver focal necrosis (n =1).According to Couinaud's liver segmentation method,neoplasm was located on segment Ⅲ (n =13),segment Ⅳ (n =6),segment Ⅴ (n =1) and segment Ⅵ (n =1).Laparoscopic hepatectomy was successful in all patients.There was neither conversion into open approach nor postoperative complications of bile leakage,air embolism or perioperative mortality,etc.The mean operative duration was (120 ± 30) minutes,average hemorrhagic volume (165-±79) ml and normal diet & ambulation at Day 1-2 post-operation.The average postoperative hospitalization stay was (16 ± 10)days and l-year survival rate 100％.The parameters of leucocyte,liver enzymes,albumin and bilirubin returned to normal at Week 1 post-operation.Once a reasonable surgical indication is selected,laparoscopic resection is both safe and effective for peripheral micro hepatocellular carcinoma.