Exact staging is the important basic tool for choosing reasonable therapy,and accurate staging is also critical for prognosis evaluation,comparison of different therapies and information communication.As the imaging methods for staging of esophageal carcinoma before therapy,CT,MRI,EUS,PET and PET/CT are different in sensitivity,specificity and accuracy for different regions and different organs,depending on the different imaging mechanism.Combination of different methods is the practical way to improve the accuracy of staging.Combining EUS with CT seems to be a practical and precise way.

Objective To investigate the association of complement C1q polymorphism with the susceptibility to lupus nephritis (LN) in the people of Wuhan district,Hubei province, China. Methods The polymorphie frequency at C1q region of accommodation Aexon2, Bexonl,Bexon2,Cexon2 in 30 LN patients,20 non-LN nephropathy controls and 10 healthy controls were examined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP)and then the sequence of mutational site was detected directly.Association of C1q polymorphism with LN was analyzed by chi-square criterion. Results Already repoaed mutable points oversea,such as C1qAexon2:C→T,C1qBexon1:G→A,C1qBexon2:G→A,C1q Cexon2:C deletion,in C1q region of accommodation were not detected in 30 LN patients,20 nonLN nephropathy controls and 10 healthy controls. Conclusion Polymorphism in the regulatory region of C1q region of accommodation is not associated with the susceptibility to LN in the people of Wuhan district,Hubei province,China,which may be influenced by a small number of subjects.

Sepsis is defined as that a variety of pathogenic microorganisms(including bacteria,fungi,viruses and protozoa) invade the blood circulation,produce toxins and cause systemic infection.The early symptoms of neonatal sepsis are atypical.Neonatal sepsis is urgent and progresses quickly,especially in preterm infants,and it is easy to prone to septic shock which is life-threatening.Therefore,early identification,accurate diagnosis,and active intervention for neonatal sepsis and septic shock is essential to reduce mortality and improve prognosis.

0.05). However, the MDA level in the experimental group was higher than that of the control on day 3 [(55.92?5.53)nmol/mg prot vs (22.52?4.36)nmol/mg prot, P

Surgery is the main treatment of esophageal cancer. Esophagectomy by right transthoracic approach is recently recom-mended in China. Minimally invasive esophagectomy is feasible and safe with low perioperative morbidity and offers results that are as good as open thoractomy. Multimodal treatment, especially neoadjuvant chemoradiotherapy or chemotherapy, may improve surviv-al and has become one of the standard treatments for locally advanced esophageal cancer. Fast-track esophagectomy may reduce length of hospital stay, perioperative morbidity, and hospital charges. The surgery of esophageal cancer tends to be minimally invasive, individual, comprehensive, and standardized.

Bronchopulmonary dysplasia(BPD)is a serious complication of respiratory system in preterm infants.The etiology and pathogenesis are complex and have not been clarified yet.In recent years, studies have shown that there is a certain relationship between respiratory microecology and BPD.Before premature infants develop BPD, their respiratory tract microecology has changed, including abnormal microbial diversity and evolution pattern.Therefore, research on the colonization and evolution of neonatal respiratory tract microecology and its relationship with BPD is expected to provide new ideas for its prevention and treatment.

Metabolic bone disease(MBD) in preterm infant is a disorder of calcium and phosphorus metabolism that leads to a decrease in bone mineral content, resulting in clinical, biochemical, and imaging changes.It occurs mostly in very low birth weight and extremely low birth weight newborns.The clinical symptoms usually occur from 6 to 12 weeks after birth, mainly manifested as dyspnea accompanied by mechanical ventilation for a long time, rickety-like changes, and even fracture in severe cases.At present, diagnosis of MBD is characterized by biochemical markers, radiology and ultrasound.As the clinical manifestations of MBD in prematurity occur late, early screening and prevention for high-risk groups play an important role to reduce the risk of MBD.

Intravenous immunoglobulin(IVIG) contains multiple-antigen-specific IgGs and may protect the host from a wide spectrum of pathogens including but not limited to virus and bacteria.With a low IgG level, neonates, especially preterm infants are prone to infection.IVIG can rapidly increase the concentration of serum IgG level, and enhance the anti-infectious and immune-regulatory functions.It has been widely used as a common treatment against neonatal infections.However, there has been inadequate evidence to support the routine usage of IVIG.While prolonged IVIG usage may be beneficial to the extremely or very low birth weight with sepsis, the prophylactic usage of IVIG to decrease the risk of late-onset sepsis in preterm infants depends on the situation of nosocomial infections in different NICUs and the cost-effect efficiency.

Objective To explore the incidence rate and high-risk factors for bronchopulmonary dysplasia(BPD) in premature infants of mechanical ventilation.Methods From Jan 2008 to Dec 2009,196 very low birth weight infants with gestational age less than 32 weeks in our NICU were enrolled in the study.61 cases had the histories of mechanical ventilation.The clinical materials of 21 cases with BPD were compared to 41 cases without BPD in retrospective analysis.Results The total incidence of BPD in the very low birth weight infants with gestational age less than 32 weeks was 10.7%,and 34.4% in those infants with mechanical ventilation.The gestational age and birth weight of BPD group were lower than those without BPD,and the rates of premature rupture of fetal membrane and complicated neonatal respiratory distress syndrome (NRDS),postnatal infection,with long time intravenous nutrition in BPD group were higher than those without BPO control (P<0.05).Gender,asphyxia history,the use of pulmonary surfactant (PS),positive end-expiratory pressure,and mean airway pressure were not different significantly between two groups (P>0.05).Peak inspiratory pressure (PIP),the time of mechanical ventilation and oxygen administration were different significantly between two groups (P<0.05).NRDS,postnatal infection,the duration of ventilation,and hyperoxia were the risk factors for BPD,and the regression coefficient were 3.683,1.541,1.188 and 1.647.Conclusion Preventing premature,low birth weight,NRDS,shortening the duration of high peak inspiratory pressure and hyperoxia with mechanical ventilation and the use of the parenteral nutrition,managing the infection of the prenatal and postnatal are the key points of preventing BPD.

Objective To investigate the expression and significance of Smad4 and Smad7 in newborn rats with hyperoxia-induced chronic lung disease(CLD).Methods Sixty-four newborn Wistar rats 12 h after birth were divided into high-oxygen group (n =32) and air group (n =32,control group) by random number table method.The high-oxygen group was placed in the oxygen glass tank with continuous infusion of oxygen.And 1,3,7,14 d after experiment,tracheal separated,the chest opened to expose heart and lung,slices were Masson staining,undergo dynamic observation of the pulmonary pathological changes under light microscope.Lung fibrosis score was carried out to determine the degree of pulmonary fibrosis,and immunohistochemical technique was used to detect Smad4 and Smad7 protein expression in lung tissue.The expression levels of Smad4 and Smad7 protein in lung tissue were detected with Western blot.Results Compared with the air group,there was statistically significant difference in pulmonary fibrosis score on day 7 (2.67 ± 0.21 vs 0.58 ± 0.17) and day 14 (4.48 ± 0.24 vs 0.63 ± 0.13) in high-oxygen group (P ＜ 0.05) ; Smad4 and Smad7 was main in visible lung epithelial cells and interstitial fibroblasts.Smad4 expression in the high-oxygen group gradually enhanced,compared with the air group (P ＜ 0.05) on day 7 (122.35 ± 10.3 vs 140.08 ±7.77) and day 14(129.7 ± 7.33 vs 144.99 ± 6.49).Smad7 expression in the high-oxygen group first increased and then decreased,expression in the high-oxygen group increased on day 7 (122.35 ± 10.29 vs 130.56 ±9.8),and compared decreased with the air group(P ＜0.05) on day 14(132.16 ±4.38 vs 126.22 ±6.49).Conclusion The newborn rat exposed hyperoxia,the up-regulation of Smad4 protein expression and the down-regulation of Smad7 protein expression are imposible closely related to the happen and development of CLD pulmonary fibrosis.