ObjectiveTo determine the clinical effect and the prospect of cervical side-to-side stapled esophagogastric anastomosis. MethodsEighteen cases of upper and middle thoracic esophageal carcinoma were treated with esophagectomy and cervical side-to-side stapled esophagogastric anastomosis. The clinical data were collected and retrospectively analyzed. The average age of patients was 60.7 years and the ratio of male to female was 17∶1. The tumor included 4 upper part and 14 middle thoracic parts. The length of tumors was from 1 cm to 7 cm, with an average of 3.2 cm.ResultsThe post-operative TNM staging(AJCC) included 4 Stage Ⅱa,9 Stage Ⅱb,and 5 Stage Ⅲ. The operative incisions included 8 nontransthoracic cervical and abdominal double incisions, 9 right cervico-thoraco-abdominal triple incisions, and 1 left cervico-thoracic incision. One (5.56%) patient complicated with anastomotic leakage and was cured in 2 weeks by cervical drainage and absolute diet. All the 18 patients were followed up for 1 to 5 years,and no anastomotic stricture was found. Reflux esophagitis was found in 2 and the incidence rate was 11.11%.ConclusionCervical side-to-side esophagogastric anastomosis is a safe procedure with larger resection of margins and fewer complications. It is worth replicating.

80 years)in China is increasing.As a special type of hypertension,the hypertension in the very elderly has some specificities in pathogenesis,clinical manifestation,treatment and prognosis.The topic to effectively cure and prevent hypertension in the very elderly is increasingly emphasiced.This article presents an overview of recent progress in clinical characteristics,and treatment strategy related to hypertension in the very elderly.

Objective To discuss and analyze the reliability and validity of the application Chinese version of Caregiver Grief Scale (CGS) on caregivers of patients with advanced hepatocarcinoma. Methods To translate the original English scale into Chinese and adapt it to the culture of China, forming a Chinese CGS. Totally 330 patients were selected with advanced hepatocarcinoma who were hospitalized in a gradeⅢ, class A hospital by the convenient sampling method. They were carried out exploratory factor analysis and confirmatory factor analysis respectively. Results For Chinese CGS, the critical value of every purpose has statistical significance (P < 0.05) by comparison. Exploratory factor analysis showed:KMO value was 0.923;Bartlett's sphericity test value was 794.31;cumulative variance contribution rate was 67.532%;four common factors can be extracted. Confirmatory factor analysis showed that the structural model of the scale was good: χ2/d?=1.11<3.0,goodness of fit index=0.995,root mean square error of approximation=0.021,adjusted goodness-of-fit index=0.968,normed fit index=0.973, comparative fit index=0.957,Tucker-Lewis index=0.993,incremental fit index=0.943. Each correlation coefficient of the scale has statistical significance and expert validity is between 0.832 and 0.973. Reliability analysis shows that the total Cronbach'sαof the scale was 0.908;Cronbach'sαcoefficient of every dimension was between 0.896 and 0.913; Guttman's split-half reliability was 0.917; test-retest reliability was 0.831. ROC curve showed that when the total score of the scale ≥24.5, specificity and sensitivity were good. Conclusions Chinese version of CGS has good reliability and validity, which is suitable for preliminary screening grief emotion of caregivers of patients with advanced hepatocarcinoma.

Attention Deficit Disorder with Hyperactivity ; therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Phytotherapy ; methods

Objective To investigate the value of the acupuncture with Medicinal herbs in the treatment of the intractable hiccup after severe craniocerebral injury. Methods Sixty patients diagnosed of intractable hiccup after severe craniocerebral injury were randomly recruited into a therapeutic group and a control group. The therapeutic group was treated with acupuncture and medicinal herbs, while the control group was treated with western medicine. The therapeutic course for both groups was one week. The efficacy was evaluated by observing the cure rate, improvement rate and non effective rate respectively. Results In the therapeutic group :23 patients were cured and the total effective rate was 96.67%;While in the control group: 12 patients were cured and the total effective rate was 70.00%. The effective rate of therapeutic group was obviously better than the control group. Conclusion Acupuncture with medicinal herbs in the treatment of the intractable hiccup after severe craniocerebral injury has good efficacy.

Objective To evaluate the efficiency and safety of amiodarone in patients with acute myocardial infarction (AMI) complicated ventricular tachyarrhythmia (CVT). Methods 106 CVT patients of AMI with stable haemodynamics was randomized into trial group (53 cases) and control group (3 cases). Based on routine therapy, the trial group was intravenously given amiodarone. Electrical cardioversion is necessary if the haemodynamics turns to unstable. Intravenous amiodarone will be used for at least 24 hours to maintain sinus rhythm. The control group was administrated intravenous lidocainein. If the patients made no response to lidocainein, given amiodarone as substitute. Electrical cardioversion is necessary when the haemodynamics turns to unstable and lidocainein was followed for at least 24 hours after successful cardioversion to maintain sinus rhythm. The therapeutic effects, cardiac function and the changes of arrhythmia were compared between the two groups. Results The incidence of angina pectoris, consumption of nitrates were decreased in trial group when compared with that in control group, whereas the ejection fraction, left ventricle fast filling interval and the mitral valve peak velocity of blood flow during left atrium contraction(E/A) all were higher than that in control group (all P<0.01). The total effective rate in trial group was higher than that in control group (75.5% vs 62.3%, P<0.01), especially the ventricular tachycardia control rate is significantly higher than control group (86.7% vs 50.0%,P<0.01). Conclusion Intravenous injection of amiodarone efficaciously control the complicated ventricular tachy-arrhythmia in patients with acute myocardial infarction as well as to improve the cardiac function.

Objective To observe the efficacy of treating cerebral hemorrhage with operation combined with Chinese medicines with the functions of stopping endogenous wind, eliminating phlegm and removing blood stusis. Methods A total of 142 patients after surgery for cerebral hemorrhage were randomly recurited into two groups: a treatment group (n= 41 ) was administrated with Chinese medicines of stopping endogenous wind, eliminating phlegm and removing blood stasis, and a control group (n=41) accepted conventional treatment after the surgery. Results The therapeutic effects in the treatment group was superior to that in control group (X2=13.12, P<0.05) . Conclusion It is effective to treat cerebral hemorrhage with operation combined with Chinese medicines with the functions of stopping endogenous wind, eliminating phlegm and removing blood stasis.

Vasovagal reflex is one of complications from cardiac intervention.The major causes of vasovagal reflex postprocedure are commonly believed to be associated with mental stress,pain,low blood volume,visceral dilation,local hematoma and cardiac function.The incidence of vasovagal reflex may be effectively reduced with standard intervention training,strictly selected indications for PCI,adequate fluid replacement after procedure,anesthetic lidocaine to reduce pain,improved manual compression for vascular hemostasis and elimination of risk factors.

Objective To detect the expression and activation level of nuclear factor ?B (NF-?B) in synovium of rheumatoid arthritis (RA).Method Forty-six specimens including 17 RA, 24 osteoarthritis (OA) and 5 normal synovial tissues were subjected to RT-PCR to determine the mRNA level of NF-?B p65,p50,inhibitor of NF-?B (I?B),interleukin-1? (IL-1?) and matrix metalloproteinase 9 (MMP-9).Thirty-nine sections including 14 RA,21 OA and 4 normal synovium were subjected to immunohistochemistry to determine the expression level of NF-?B p65.Synoviocytes from 14 synovial specimens including 8 RA and 6 OA were cultured and the nuclear protein was extracted and reserved for western blot.Results The mRNA level of p65,IL-1(,MMP-9 were higher in RA group than that of control (P

Objective To study the feasibility of composite of human fibrinous gel and transgeneic MSCs aiming at replicating adenoviruses-bone morphogenetic proteins-2 (Ad-BMP-2) in repair of segmental bone defects. Methods Bone defects for 10 mm were created on the bilateral radius of 14 Japanese big ear rabbits and treated with four kinds of implantations (seven radii per group), ie, composite of transgeneic MSCs and fibrinous gel (Group A), composite of MSCs and fibrinous gel (Group B),fibrinous gel alone (Group C) and nothing as control group. The defects were observed radiologically and histologically and examined by biomechanical test at the 12th week after operation. Results The defects treated in the Group A were repaired and regenerated much more new bone, bridged earlier and stronger than those in the Group B 12 weeks after operation. The defects treated in the Groups C and D could not attain osseous tissue healing. Conclusions The composite of transgeneic MSCs and fibrinous gel can be used to effectively repair segmental bone defects.