Objective To investigate the regularity of thoraco-abdominal two-field lymphatic metastasis and methods of the nodal dissection in middle-third thoracic esophageal carcinoma,and to guide the scope of the lymph-node clearance.Methods Thoraco-abdominal two-field lymph-node dissection based on surgical incisions of the right chest and middle upper abdomen were conducted in 62 cases with middle-third thoracic esophageal cancer and the regularity of nodal metastasis was analyzed.Results Five hundred and five pieces of lymph node were cleaned in all 62 patients and among them 102 pieces were detected as metastasis lymph node,the nodal metastasis ratio was 20.2％ (102/505).The middle-third thoracic esophageal cancer not only includes the nodal metastases up to the trachea of the right neck,around the bilateral recurrent laryngeal nerve chains,near the esophagus and the tumor,and the lymph-node metastasis at the inferior tracheal protuberance,but also the nodal metastases down to the cardiac,around the left gastric artery and at the retina of the lesser curvature of the stomach etc,presenting a tendency of 2-way metastasis.The infiltration depth and differentiation of the tumor is of statistical significance on the nodal metastasis ratio.There was significant difference on the metastasis rate of lymph node from T1 to T4 (T1:10.0％ (1/10),T2:20.0％ (3/15),T3:43.3 ％ (13/30),T4:57.1％ (4/7),x2 =18.56,P ＜ 0.05).It indicated that metastasis rate was increased with the development of the infiltration depth.There was significant difference on the metastasis rate of high differentiation carcinoma,moderate differentiation carcinoma and low differentiation carcinoma (14.3％ (2/14) vs 39.5％ (15/38) vs 57.1％(4/7),x2 =17.75,P ＜ 0.05).Conclusion The lymph node metastasis of patients with middle-third thoracic esophageal carcinoma is significantly correlated with the depth of tumor invasion and the degree of differentiation,with the tendency of thoraco-abdominal 2-field nodal metastasis.The peritracheal lymph node at right neck and bilateral recurrent laryngeal nerve chains are important regions of the metastasis.The surgical incision of the right thorax and upper abdomen greatly facilitates the excision of the middle-third thoracic esophageal cancer and the 2-field lymph node dissection Thus on this basis,the lymph node clearance around the right trachea and at bilateral recurrent laryngeal nerve chains through the right thoracic apex is safe and feasible.

Age Factors ; China ; epidemiology ; Dental Caries ; epidemiology ; Dental Health Surveys ; Epidemiologic Studies ; Humans ; Oral Health ; Periodontal Diseases ; epidemiology ; Prevalence

OBJECTIVETo compare the efficacy differences between needle-knife therapy and acupuncture-cupping for treatment of cervical spondylosis (CS) of cervical type.

METHODSSixty cases of CS were randomly divided into a needle-knife group (30 cases) and an acupuncture-cupping group (30 cases). The needle-knife therapy was applied at points among superior nuchal line of occipital bone, bilateral neck muscle, neck centerline, trapezius and medial border scapula for only once. In the acupuncture-cupping group, acupuncture was applied at Fengchi (GB 20), Fengfu (GV 16), Tianzhu (BL 10), Dazhui (GV 14), Jianjing (GB 21), Jiaji (Ex-B2, from C4 to C6), Houxi (SI 3) and Ashi point, followed by cupping on local skin, once every other day for totally six times. The score of neck stiffness and visual analogue scale (VAS) were observed before and after treatment, in follow-up of 1, 3 and 6 months after treatment in the two groups, and the efficacy was compared.

RESULTSIn the needle-knife group, 9 cases were cured, 12 cases were markedly effective, 8 cases were effective and 1 case was failed; the total effective rate was 96.7% (29/30) and the cured and markedly effective rate was 70.0% (21/30). In the acupuncture-cupping group, 8 cases were cured, 9 cases were markedly effective, 11 cases were effective and 2 cases were failed; the total effective rate was 93.3% (28/30) and the cured and markedly effective rate was 56.7% (17/30). The difference of total effective rate in the two groups was not statistically significant (P > 0.05), but the cured and markedly effective rate of needle-knife group was significantly superior to that of acupuncture-cupping group (P < 0.05). The needle-knife therapy was significantly superior to acupuncture-cupping on improvement of neck stiffness in the follow-up of 1, 3, 6 months after treatment (P < 0.05, P < 0.001); both treatments were effective on relief of neck pain, but the needle-knife group had better effects in the follow-up of 3 and 6 months after treatment compared with acupuncture-cupping group (both P < 0.01).

CONCLUSIONThe needle-knife therapy has better effects on neck stiffness and pain relief than acupuncture-cupping, and it is more treatment time saving.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; Adult ; Aged ; Cervical Vertebrae ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Spondylosis ; physiopathology ; therapy

OBJECTIVE:To provide basic industrial research and development recommendations for the supply-side structural reform in drug distribution in China. METHODS:Structure-conduct-performance(SCP)analysis paradigm from Harvard was used for in-depth study of market structure,business conduct and business performance in China since 2010. RESULTS:Since 2010, drug distribution industry in China had shown the scale of decline in the growth rate,low market concentration,increased barriers to entry,the leading of state-owned capital,etc. Though corporate mergers and acquisitions and public financing expanded the scale,management information,third-party logistics,Internet+and pharmacy alliance business model flourished,the industry op-erating performance was poor,state-owned enterprises showed poor performance. CONCLUSIONS:The transformation and upgrad-ing of the industry business model should be promoted by targetedly accelerating the supply-side structural reforms in the drug distri-bution industry,encouraging corporate finance mergers,breaking local protectionism,developing cooperative pharmacies and phar-maceutical third-party logistics alliances and leveraging the Internet.

Animals ; CD4 Antigens ; blood ; CD4-Positive T-Lymphocytes ; metabolism ; radiation effects ; CD8 Antigens ; blood ; CD8-Positive T-Lymphocytes ; metabolism ; radiation effects ; Male ; Mice ; Ultraviolet Rays

Mast cells (MCs) are bone marrow-derived and tissue-homing immune cells which have important functions.Recruitment and activation in tumors are demonstrated to be mainly mediated by tumorderived stem cell factor (SCF) and its receptor c-kit on MCs.The numbers and distributions of MCs in tumors are closely related to the growth of tumors and angiogenesis.MCs can mediate angiogenesis by releasing a series of angiogenesis factors,so as to promote the progress of tumors.

Humans ; Non-alcoholic Fatty Liver Disease ; diagnosis ; therapy

Description of the security grading protection used in the security protection system for information systems in medical organizations. Elaboration of the research ideas, process and some outcomes for the Fundamental Requirements for Security Grade Protection of Information Systems in Medical Organizations, from the five aspects of system modeling, grading guidance for industries, threat and risk analysis, security objective output, and security adjustment.

Hepatolenticular Degeneration ; diagnosis ; therapy ; Humans

Objective: To investigate the effects of DFMO on the growth characteristics, apoptosis and activity of telomerase of K562 cells. Methods: The growth rate, phase distribution of cell cycle and apoptosis of treated cells with DFMO were detected by cell count, morphological assay, FCM analysis and DNA electrophoresis, respectively. The telomerase activity was examined by telomeric repeat amplification protocol(TRAP). Results: In K562 cells treated with DFMO, the growth rate was markedly retarded. The increase in G1 -phase cells and decrease in s-phase population and induction of apoptosis were observed. The activity of telomerase of treated cells was inhibited. Conclusion: The growth inhibition and apoptosis induction of K562 cells treated by DFMO were associated with suppressed telomerase activity. It is suggested that inactivation of telomerase in cancer cells conld be one of important events in antitumor molecular mechanism of inhibition of polyamine biosynthesis.