The definition of esophagogastric junction (EGJ) adenocarcinoma and progress in multidisciplinary treatment for the tumor were revised in this review. Siewert classification is especially useful for the surgical approach of EGJ adenocarcinoma. Siewert I should be treated as esophageal cancer, and Ivor-Lewis esophagogastrectomy (right thoracotomy and laparotomy) is recommended as an extended two-field lymphadenectomy. For Siewert II or III tumors, left thoracophreno-laparotomy is preferred, especially in case of positive thoracic lymph nodes or positive resection margin. If there is any contraindication against thoracotomy, or a high operating risk, a transhiatal esophagectomy with lower mediastinal lymphadenectomy is an alternative. Preoperative chemoradiotherapy or perioperative chemotherapy improves overall survival and the rate of complete resection for patients with large tumor or lymph node metastasis. Neoadjuvant chemoradiotherapy is associated with high but acceptable postoperative complications. Adjuvant chemoradiotherapy remains a rational standard therapy for curatively resected EGJ cancer with T3 or greater lesion or positive nodes.
Adenocarcinoma ; surgery ; therapy ; Combined Modality Therapy ; Esophageal Neoplasms ; surgery ; therapy ; Esophagogastric Junction ; Humans ; Stomach Neoplasms ; surgery ; therapy

Female ; Humans ; Polycystic Ovary Syndrome ; genetics

Magnetic manipulation of particles/cells in microfluidic chips is a promising research field.This paper stated the operation mechanism and the main means of manipulation, including separation, concentration, capture, arrangement and assembly.Especially, the concept of particles/cells separation was emphasized with different criteria, like sizes, shapes, and magnetic properties.In addition, the effects of the channel geometry, the intensity and distribution of the magnetic field, and the types of magnetic liquid (paramagnetic salt solutions and ferrofluids) on the performance of the magnetic manipulation were also compared.The prospective to the prospect of magnetic manipulation about particles/cells in microfluidic chip was also depicted.

Objective To study soil environment characteristics of high_mortality areas of esophageal cancer in Three Gorge dam region. Methods To contrast the disparity of soil type,soil use,and basic characteristics,in particular microelement contents in high_mortality area and low_mortality area of esophageal cancer. Results Calcareous purple soils distributed dominantly in high_mortality area,and soil pH and CaCO3 content was high,and soil fertility low. While paddy soils occupyed mainly in low_mortality area,and pH and CaCO3 content was low however soil fertility high.Moreover,the microelement contents in soils in high_mortality area were lower than those in low_mortality area apparently. Conclusion Mortality of esophageal cancer was closely relative to the contents of some microelements in the soil environment.

Objective:To investigate the expressions of peripheral lymph node addressin(PNAd)andGlcNAc-6-sulfotransferase(GlcNAc6ST)in endometrium and their impacts on implantation.Methods:PNAd expression in endometrium was examined by immunohistochemistry and Western Blot from 75women(12 from healthy women,in proliferative phase;63 from sterile women,of whom,27 were inearly-secretory and 36 in mid-secretory phase).GlcNAc6ST mRNA was examined by real-time PCR in41 sterile women.The 63 sterile women had underwent ⅣF-ET and were consequently divided into clini-cal pregnant(29 cases)and nonpregnant(34 cases)groups.Results:(1)PNAd localized to the mem-brane and cytoplasm of luminal and glandular epithelia.Staining was patchy and much less intense duringthe proliferative phase than during the secretory phase.In Western Blot of PNAd,four bands appeared,which were Sgp200,CD34,MAdCAM-1,GlyCAM-1 respectively,and each was positively correlatedwith the others significantly.The former three molecular levels were significantly higher during the secre-tory phase as compared with the proliferative phase.Message RNA of GlcNAe6ST was positive in all ca-ses and showed no correlation with any component of PNAd.(2)The expressions of CD34 and GlyCAM-1,but not Sgp200 and MAdCAM-1,were significantly higher in pregnant women than in nonpregnantones.However,the GlcNAc6ST mRNA level did not differ between groups.(3)No significant differ-ence was found in female age,methods of fertilization,thickness of endometrium on day hCG,cumulativeembryo score(CES)and mean score of transferred embryo(MSTE)between the groups.Conclusion:PNAd expression in the human endometrium fluctuates with the menstrual cycle.Elevated CD34 and Gly-CAM-1 during the secretory phase might be stimulative factors for embryo implantation.Defect in PNAdexpression may account for a portion of unexplained infertility.

Melamine is a kind of triazine compound and the fluorescence of it can get enhanced in the presence of cationic surfactant in weak alkaline medium. A new fluorescent spectrophotometry based on this principle) has been developed to determine melamine under the optimum conditions such as Tris-HCl buffer solution), pH 8.0 and with CTMAB as sensitizing agent. The linear range, detection limit and relative standard deviation were 25-1000 μg/L, 19 μg/L and 1.6%,respectively. The samples were pretreated according to the solid phase extraction monolithic column to carry out the detection of real milk. This method is simple, rapid and accurate. It can be used to screen and detect the milk samples primarily.

Objective To explore the nursing effects of self-care body posture in patients after modified radical mastectomy. Methods The clinical data of 102 patients with modified radical mastectomy were randomly divided into the study group and the control group, all patients met the following standard:clear consciousness, effective communication, no paralysis of limbs, no fracture. In the study group, according to Orem"self-care theory" concept, patients carried out self-care body posture with mainly focus on self-emancipated and the body center of gravity position, in the control group patients were given traditional posture care with mainly emancipated assistance. The first time getting out-of-bed, the occurrence of various complications, the comfort level of emancipation and posture, as well as nursing satisfaction on the first day after surgery were observed and compared between the two groups. Results The two groups showed significant difference in the first time out-of-bed, anxiety, the comfort level of emancipation and posture, as well as nursing satisfaction. There was no significant difference between the two groups in dizziness, limb swelling, flap effusion, flap necrosis. No pressure ulcer occurred. Conclusions Making use of self-care body posture in patients after modified radical mastectomy can improve the satisfaction and comfort of the patients, and improve the patients' recovery, without increasing the complication, which is worth promoting.

Objective To observe the clinical efficacy of bamboo-circled salt-partitioned moxibustion in treating arthritis of temporomandibular joint.Method Eighty patients were randomized into two groups. Forty cases in the bamboo-circled salt-partitioned moxibustion group received bamboo-circled salt-partitioned moxibustion at temporomandibular joint; forty cases in the warm needling group were intervened by selecting Xiaguan (ST7), Ashi point, etc. at the affected side. For the two groups, 3-day treatment was taken as a treatment course, and the therapeutic efficacy was analyzed after 2 treatment courses. The improvements in pain and mouth opening were observed before and after the treatment, and the treatment efficacy was evaluated by a 1-month follow-up study.Result The bamboo-circled salt-partitioned moxibustion group was superior to the warm needling group in comparing the real-time analgesic effect (P<0.05) and in the improvement of mouth opening (P<0.05); the comprehensive markedly effective rate was respectively 67.5% and 45.0% in the bamboo-circled salt-partitioned moxibustion group and warm needling group, and the between-group difference was statistically significant (P<0.05), indicating that bamboo-circled salt-partitioned moxibustion is better than warm needling in treating arthritis of temporomandibular joint; the follow-up study revealed satisfactory therapeutic efficacies in both groups: the effective rate was 92.5% in the bamboo-circled salt-partitioned moxibustion group versus 87.5% in the warm needling group, and the difference was statistically insignificant (P>0.05).Conclusion Bamboo-circled salt-partitioned moxibustion can produce a real-time analgesic effect and improve mouth opening; it's especially suitable to treat the patients who are afraid of needling, as it's significantly effective, safe, non-invasive,and easy-to-operate.

Objective To demonstrate the effect of tumor necrosis factor-α induced protein 8 like-2 (TIPE2) expression in patients with acute respiratory distress syndrome (ARDS) and its mechanism. Methods A prospective observation was conducted. Thirty-nine patients with ARDS admitted to department of emergency of PLA General Hospital from July 2013 to July 2015 were enrolled, and 35 healthy persons served as control group. The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score within 24 hours after admission, blood gas analysis, procalcitonin (PCT), and C-reactive protein (CRP) were recorded. The mRNA expressions of TIPE2 in peripheral blood mononuclear cell (PBMC) and myxoma resistance protein 1 (MX1) in plasma were determined by real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR). The correlations were analyzed by Spearman rank correlation analysis. Results The mean of APACHE Ⅱ score in 39 patients with ARDS was 25±3, the mean of PCT was (1.85±0.41) μg/L, and the mean of CRP was (18.0±3.0) mg/L. The TIPE2 mRNA expression in PBMC of ARDS patients was significantly down-regulated as compared with that of healthy control group (2-ΔΔCt: 3.28±0.15 vs. 8.87±0.20, P < 0.001), and the MX-1 mRNA expression in plasma was significantly higher than that of healthy control group (2-ΔΔCt: 39.44±0.46 vs. 20.10±0.32, P < 0.001). It was shown by correlation analysis results that the TIPE2 mRNA expression was negatively correlated with MX1 mRNA expression (r = -0.630, P < 0.001), so as APACHE Ⅱ score (r = -0.781, P < 0.001), but no correlation was found between TIPE2 mRNA and PCT as well as CRP (r value was 0.143 and 0.330, respectively, both P > 0.05). The MX1 mRNA expression was positively correlated with APACHE Ⅱ score (r = 0.893, P < 0.001), but no correlation was found between MX1 mRNA and PCT as well as CRP (r value was 0.230 and 0.210, respectively, both P > 0.05). Conclusion TIPE2 expression was decreased in ARDS patients, which negatively correlate with disease severity, and indicate TIPE2 might be involved in the pathogenic process of ARDS.

Objective To investigate the effect of metformin on the proliferation and apoptosis in human pancreatic cancer cell line CFPAC-1,and to explore the potential mechanism.Methods Human pancreatic cancer CFPAC-1 cells were cultured in vitro,and were treated with metformin at different concentrations (1,2.5,5,10,20,40,60 mmol/L) for different durations (24 h,48 h and 72 h),and cells without treatment were considered as control group.Cell proliferation was evaluated by CCK-8,cell cycle was determined by flow cytometry,apoptosis was determined by Annexin V/PI double staining method,and Western blot was used to detect the protein expression of p-AMPK,FAS,cyclin D1,Bcl-xl,Bax,caspase-3 and survivin.Results Metformin could inhibit the proliferation of CFPAC-1 cells in a time and dose dependent manner.Forty-eight hours after 40 mmol/L metformin treatment,the proportion of CFPAC-1 cells in phase G0/G1 was significantly increased [(65.93 ± 0.27)％ vs (42.89± 1.02)％],and the proportion of CFPAC-1 cells in phase G2/M,S was significantly decreased [(22.01 ± 2.95) ％ vs (38.28 ± 4.93) ％,(13.58±0.43)％ vs (20.12 ± 3.38)％],and the difference between the two groups was statistically significant (P ＜0.05).The apoptosis rate was increased from (3.01 ± 0.49) ％ to (32.97 ± 3.19) ％,(P ＜ 0.05) ; and the expression of p-AMPK,Bax,and caspase-3 was increased,while the expression of FAS,cyclin D1,Bcl-xl,survivin were decreased.Conclusions Metformin can inhibit proliferation and promote apoptosis of CFPAC-1 cells mainly by activation of AMPK pathway,and down-regulation of FAS,cyclin D1,survivin and Bcl xl/Bax ratio,as well as up-regulation of caspase-3.