The incidence of adenocarcinoma of the esophagogastric junction ( AEG) is rising rapidly in recent years. AEG as an independent disease different from squamous cell carcinoma of the esophagus and gastric adenocarcinoma is getting acknowledged for most of scholars, with the distinctive anatomy location and involute recurrence and metastasis style. A higher rate of relapse and poor prognosis after resection become conscious since most of patients have been diagnosed with advanced disease, and adjuvant chemoradiotherapy needs to be valued further. But so far, there is no clinical data and subgroup analysis aimed at the value of postoperative treatment for AEG specially, leading to controversy is remaining in patients could get benefit from postoperative treatment, and delineation of the radiation target, etc. The design of the irradiation target should in terms of the clinical?pathological characteristics of the AEG, Siewert'''' s subtypes, the lymph node metastasis mapping and recurrence characteristics after surgery.

BACKGROUND:Heart valve surgery combined with coronary artery bypass grafting has been gradual y used for treatment of coronary heart disease combined with cardiac valve disease.
OBJECTIVE:To retrospectively summarize the experience of combined coronary artery bypass grafting and valvular procedure.
METHODS:Total y 51 patients who underwent combined heart valve surgery and coronary artery bypass grafting were retrospectively analyzed, including 10 cases with aortic valve replacement, 14 cases with mitral valve replacement, eight cases with mitral valve replacement combined with tricuspid annuloplasty, four cases with aortic valve and mitral valve replacement, three cases with aortic valve and mitral valve replacement combined with tricuspid annuloplasty, seven cases with mitral valvuloplasty, and five cases with mitral valvuloplasty combined with tricuspid annuloplasty.
RESULTS AND CONCLUSION:Biovalve replacement was performed in nine patients, mechanical valves replacement in 31 cases, mitral valvuloplasty in 11 cases and tricuspid annuloplasty in 16 cases. There were total y 109 bypass graft vessels, and the average number of coronary artery bypass grafts was (1.92±0.73) branches. Four cases died within 30 days postoperatively, and 47 patients were successful y discharged from the hospital. Forty-five of 47 discharging patients were fol owed for 3-48 months. One case died of cerebral infarction within 6 months postoperatively, and another case died of cardiac dysfunction over 1 year after operation. The heart function of 45 survival patients was significantly improved. The comprehensive analysis showed that improving the heart function preoperatively, strengthening myocardial protection, shortening operation and myocardial ischemia time, and complete revascularization are the key factors for successful operation.

Effective chemotherapy is the mainstay of malaria control. However it is undergoing the serious threat by resis?tance of falciparum malaria to antimalarial drugs. In recent years with the development of molecular biology technology molec?ular markers have been widely used to monitor antimalarial drug resistance. This paper reviews the researches on the common molecular markers related to Plasmodium falciparum drug resistance.

Objective Promote the use of medical record information, the depth of excavation,provide strong support for clinical research and hospital management.Methods Medical Record Information lower utilization reasons put forward need to build the whole structure of the paperless electronic medical records, electronic medical records for research concluded that the key to building elements to provide support.Results Pointed out that the construction of paperless electronic medical records from the storage structure of the building medical record systems, and data warehouse technology combined start, outpatient and inpatient medical records while achieving interoperability, building regional health care, improve follow-up system, and finally pointed out the key technical implementation.Conclusions It is to promote the utilization of medical records, medical records for research to improve support efforts to promote development and progress of medicine and enhance the hospital's soft power has great significance.

Objective Improve the level of education of medical information to promote faster and better development of medical information.Methods According to the disciplinary development lag,weak teachers' drawbacks of medical education and medical information technology status quo,research talent development solutions.Results Departure from the practice of medical information is proposed to establish and improve the incentive mechanism,curriculum system and teaching content changes,the establishment of hospital information system simulation laboratory recommendations.Conclusion For the development and maturation of the education of medical information,to promote the cultivation of medical information,certain referential significance.

Objective To investigate the efficacy and safety of fluid resuscitation with 75 g/L NaCl solution in traumatic hypovolemic shock using Meta-analysis. Methods Based on the inclusion criteria,the randomized controlled trials (RCTs) were identified by retrieving the databases including PUBMED,EMBASE,OVID,Cochrane library and EBSCO.The quality of studies was also evaluated.Indices including systolic blood pressure,hemoglobin,serum Na level and mortality were extracted from the enrolled RTCs and were comparatively analyzed between the 75 g/L NaCl group and the isotonic saline group for evaluating the safety and efficacy of 75 g/L NaCI solution.The extracted data were analyzed by using the Review Manager 5.0.25. Results Six RCTs were eligible for Meta-analysis.The 75 g/L NaCl group displayed remarkable increase in systolic blood pressure and decrease in hemoglobin level,compared with the isotonic saline group ( MD =6.23,95％ CI 2.78-9.69,P ＜ 0.01 ; MD =-6.11,95％CI -8.25-3.96,P ＜ 0.01,respectively).Short-term hyperosmolar state in 75 g/L NaCl group was increased significantly but was considered acceptable ( MD =7.97,95％ CI 7.55-8.38,P ＜ 0.01 ).No significant difference in mortality was found between 75 g/L NaCl group and isotonic saline group ( RR =0.96,95％ CI 0.84-1.10,P ＞ 0.05). Conclusion Fluid resuscitation with 75 g/L NaCl solution is safe and effective for traumatic hypovolemic shock.

Objective To investigate the role of autophagy and synaptophysin (SYP) in cognitive impairment in de?pressed rats receiving electroconvulsive shock (ECS). Methods Clean and healthy adult male Sprague-Dawley rats were acclimatized to a standard laboratory environment for 7 days. The chronic unpredictable mild stress (CUMS) was used to establish the rat model of depression. Behavior tests were conducted before and after CUMS to evaluate the depression and cognition level of rats. After establishment of the model, 24 rats were randomly divided into ESC group (group E) and depression group (group D) with 12 rats in each group. The rats in group E were administered 80 mg/kg of propofol (10 mg/mL) by intraperitoneal injection, followed by ECS treatment. The rats in group D were administered propofol by intra?peritoneal injection, followed by sham-ECS treatments. The above interventions were conducted daily for 7 consecutive days. After the interventions, rats underwent behavior tests as before. Subsequently, rats were killed and specimens were collected for measurements. Immunohistochemistry was performed to examine autophagy markers such as Beclin 1 and LC3Ⅱand ELISA was used to detect SYP in the hippocampus. Results Group E after ECS significantly increased the percentage of sucrose preference (68.2%±8.7%), rearing times (7.0±1.9), total horizontal distance [(569.5±70.0) cm], es? cape latency [(21.9±5.3)s] and space exploration time [(20.5±3.9)s] compared with group D or group E before ECS. There was no significant difference in these index between groups before ECS or in group E between before and after ECS(P>0.05). Compared with group D, group E had upregulated protein expression levels of Beclin 1 and LC3Ⅱin CA1, CA3, DG as well as the area near the hippocampus and increased SYP contents (P<0.05). Conclusions Cognitive impairment in depression rats following ECS correlates with activated autophagy and increased SYP by ECS.

Objective To understand the malaria epidemic situation and characteristics in Jiangsu Province in 2015,so as to provide the evidence for malaria elimination. Methods The data of malaria cases in Jiangsu Province in 2015 were collected from China's routine diseases surveillance information system. Results Totally 405 imported cases were reported in Jiangsu Province in 2015,and the cases increased by 14.08％compared with those in 2014. All the malaria cases were imported,and 5 cases(1.23％)were from Southeast Asia and 400(98.77％)were from 25 African countries or regions. The imported malaria cases were reported in 13 cities across Jiangsu Province,where Taizhou,Lianyungang,Nantong,Huaian and Yangzhou cities accounted for 68.64％of all the cases in the province. Jiangsu Institute of Parasitic Diseases(JIPD)reference lab checked all the cases and classified 299 falciparum malaria cases,13 vivax malaria cases,18 quartan malaria cases,71 ovale malaria cas-es,and 4 mixed Plasmodium infection cases. Conclusions In Jiangsu Province,there are no local malaria cases for 4 consecu-tive years,but the imported cases are on the rise. Compared to 2014,the imported vivax cases increased significantly in 2015. It should be the key points to strengthen the surveillance of imported malaria cases,improve malaria diagnosis and treatment abili-ties for all levels of medical institutions,and promote the abilities of Plasmodium check,and focus survey and disposal of all Center for Disease Control(CDC)staffs across Jiangsu Province.

To enhance the production of ε-poly-L-lysine (ε-PL) by improving dissolved oxygen level of the fermentation system, different oxygen-vectors were added to broth and n-dodecane was screened as the best oxygen-vector. The best amount of n-dodecane was 0.5% (V/V) and the best time was at start of the fermentation. In a fed-batch fermentation in a 5 L bioreactor, ε-PL concentration reached a maximum of (30.8 ± 0.46) g/L and the dry cell weight obtained was (33.8 ± 0.29) g/L, increasing by 31.6% and 20.7% compared with the control group, respectively. This improvement can be related to 0.5% n-dodecane could maintain dissolved oxygen concentration > 32% of air concentration compared with 23.8% in ε-PL production phase, and the production of a main by-product, poly-L-diaminopropionic acid, fell by 31%. These results indicated that the dissolved oxygen level in the broth was improved by adding n-dodecane, which can inhibit the by-product production and improve the biosynthesis of ε-PL.
Alkanes ; chemistry ; Batch Cell Culture Techniques ; Bioreactors ; Fermentation ; Oxygen ; chemistry ; Polylysine ; biosynthesis

Objective To compare clinical efficacy between microendoscopic discectomy (MED) and open discectomy (OD) in the treatment of patients with lumber intervertebral disc herniation (LIDH).Methods 116 cases of LIDH who were given surgical treatment were selected as research subjects to retrospectively analyze their clinical data.Then,these cases were divided into MED group (n=54) and OD group (n=62) according to operation type.The curative efficacy,operation situation and incidence of complications were compared.Results All patients' operations were successful.After the one-year follow-up,the MED group had an excellent and good rate of 96.3％,which was statistically same with that of 93.5％ in the OD group (P ＞0.05) In comparison with the OD group,MED group had a statistically shorter operation time,less bleeding volume in the operation,shorter length of incision and shorter rest time on bed after operation (all P＜0.05).After operation,there's no case of severe complication,and the incidence of complications between the two groups was statistically same (P＞0.05) Conclusions MED and OD are both effective operations for LIDH,which have high excellent and good rate.But in comparison with OD,MED has advantages of less damage and faster recovery.