Adenocarcinoma ; classification ; pathology ; surgery ; therapy ; Cardia ; Chemotherapy, Adjuvant ; Esophageal Neoplasms ; classification ; pathology ; surgery ; therapy ; Esophagectomy ; methods ; Esophagogastric Junction ; surgery ; Gastrectomy ; methods ; Humans ; Neoplasm Staging ; Radiotherapy, Adjuvant ; Stomach Neoplasms ; classification ; pathology ; surgery ; therapy

Objective To investigate the value of plasma H-FABP level and Acute Physiology and Chronic Health Evaluation(APACHE Ⅱ) in severity and prognosis estimation for patients with acute pumonary embolism(APE).Methods Totally 160 APE patients were hospitalized from January 2010 to January 2015 and enrolled in this study.According to the severity of the disease,these patients with APE were divided into low-risk group,moderate-risk group and high-risk group.According to clinical prognosis,these patients with APE were divided into survival groups and death groups.Plasma levels of H-FABP were measured by enzyme linked immunosorbent assay(ELISA),and APACHE Ⅱ score were analyzed.The differences of Plasma H-FABP levels and APACHE Ⅱ score were compared and which the relationship with severity and the prognosis of APE were also assessed.Results With the increased severity in patients,the H-FABP and APACHE Ⅱ score were significantly increased (P ＜ 0.05);the H-FABP and APACHE Ⅱ score were significantly higher in death group as compared with survival group(P ＜0.05).The H-FABP levels and APACHE Ⅱ score were positive correlated(r =0.71,P =0.000).ROC curves analysis results showed that the area under curve of H-FABP was 0.854 (95 ％ CI:0.784-0.927),and optimal operating point (OOP)was 13.3 μg/L,which had 81.0％ sensiticity and 79.4％ specificity;ACU of APACHE Ⅱ was 0.861 (95％ CI:0.812-0.932),and OOP was 19.2,which had 77.8％ sensiticity and 80.4％ specificity.The AUC was 0.914 (95％ CI:0.825-0.948),and the sensitivity was 88.9％,specificity was 87.6％ when the two cutoff values were both achieved,which were higher than the single H-FABP and APACHE Ⅱ score.Conclusion The H-FABP and APACHE Ⅱ score can effectively assess severity and prognosis of APE patients,meanwhile,it provide an objective basis for the clinical individual treatment and reducing the mortality rate of APE patients.

Objective: We present our preliminary experience on the treatment of intracranial arterial lesions with covered stent in a series of patients. Methods: 20 patients have been treated by using Jostent coronary covered stent deployed in the parent artery across the lesions, which included aneurysms, iatrogenic or traumatic arterial injury, and traumatic carotid-cavernous fistula (TCCF). The profile of stent was determinded with the diameter of parent artery and the length of lesion. 5 cases of intradural vertebral aneurysms, 7 internal carotid artery (ICA) aneurysms (1 petrous, 2 cavernous, 2 ophthalmic, 2 supracliniodal segment), 1 iatrogenic ICA injury, 3 traumatic ICA aneurysms, 3 traumatic carotid cavernous fistula and 1 ICA cavernous segment stenosis with spontanous CCF were treated. 21 Jostent covered stent had been used. Combination of bare stent and covered stent were used in 3 cases. Results: Technical success were achieved in 17 cases. Each case had one lesion. Lesions were excluded from circulation in 14 cases. There were 3 cases with lesion reminants or endoleakage just after treatment, but disappeared soon in the follow-up angiography. No complication was found in successful cases. Covered stent deployment were failed in 3 cases. One had transient slight paraplegia. There was no severe complication or death. Conclusion: Excluding the lesion from circulation with covered stent has been proved to be an effective reconstructive treatment of intracranial arterial lesions. Further research and development are needed to make the indication even broader.

Objective To investigate the emergency treatment and correlation factors of aqueous misdirection during glaucoma and cataract surgery in glaucoma patients.Design Retrospective case series.Participants 126 cases(132 eyes)of angle-closure glaucoma patients with aqueous misdirection during surgery,100 cases(100 eyes)of angle-closure glaucoma patients without aqueous misdirection during surgery and 100 cases(100 eyes)of senile cataract patients.Methods We performed pars plana vitreous water-bag aspiration or anterior vitrectomy on glaucoma patients with aqueous misdirection during surgery.All the factors in observation group and control groups were compared and analyzed by logistic regression.Main Outcome Measures Preoperative highest intraocular pressure(HIOP),intraocular pressure after maximum dose(IOP),anterior chamber depth(ACD),lens thickness(LENS),axial length (AXL),mean keratometry(K),intraocular lens diopter within-0.5D corrected by SRK-T formula(IOLD).Results Among all the 132 angle-closure glaucoma eyes whose posterior chamber pressures were increased during surgery,we performed pars plana vitreous water-bag aspiration in 123 eyes(93.18%),and anterior vitrectomy in 9 eyes(6.8%).Postoperative complications included shallow anterior chamber in 20 eyes(7 eyes with malignant glaucoma,9 eyes with choroidal detachment,4 eyes with delayed local suprachorodal hemorrhage),and vitreous local hemorrhage in 1 eye.Means of all the observation indexes on three groups showed significant difference(all P

Objective To investigate the expression of aquaporin-3 (AQP3) in tongue tissues of rats with experimental severe acute pancreatitis (SAP) and regulating effects of emodin. Methods Rat models with SAP were established by injecting 5% sodium taurocholate retrogradely into gallbladder and pancreas. SD male rats were randomly divided into sham-operation group, model group, and emodin group. After model establishment, rats in the emodin group received gavage with emodin 20 mg/kg each day, while rats in the model group and sham-operation group received gavage with normal saline. The mental state, thick greasy tongue fur and mortality of rats were observed every day after model establishment, and 5 days later, protein and genetic expression of AQP3 were detected by Western blot and RT-PCR. Results Compared with the model group, the mortality and the thick greasy tongue fur significantly decreased, the protein and genetic expression of AQP3 significantly decreased in the emodin group (P<0.05). On the 5th day, 11 rats in the model group survived, and 5 rats had thick greasy tongue fur. Compared with the sham-operation group, the protein and genetic expression of AQP3 in the model group were higher (P<0.05). Conclusion Emodin can improve the severity of SAP and decrease the incidence of thick greasy tongue fur significantly by reducing the protein and genetic expression of AQP3.

Objective To explore the clinical value of the duplex ultrasonography (duplex US) for evaluating the re-stenosis after peripheral arterial bypass grafting. Methods Eighty prosthetic grafts of sixty-three patients with femoral-pop-liteal arterial bypass grafting were follow-up regularly by duplex US. They were divided into non significant stenosis group (n=56), the significant stenosis group (n=15) and occlusion group (n=9) according to the tube diameter and arterial blood flow-ing parameters, which changed postoperatively. The diagnostic results were compared and analyzed between duplex US and digital subtraction angiography (DSA). The peak flow velocity of middle grafts (MG) to 40 cm/s was defined to evaluate risk of graft occlusion. Results The diagnostic coincidence rate of duplex US and DSA for grafts stenosis classification was 90%. The diagnostic sensitivity of duplex US to grafts stenosis was 91.7%, and the specificity was 92.9%. The positive pre-dictive value was 84.6%for grafts stenosis, and the negative predictive value was 96.3%, the false positive rate was 16.7%, and the false negative rate was 8.3%. The grafts occlusion rate was higher in MG<40 cm/s group than that of MG≥40 cm/s group. Conclusion There was a good consistency with Duplex US and DSA for the diagnosis of peripheral artery bypass graft restenosis. Duplex US showed characteristics of non-invasive, simple and easily accepted by patients.

Objective To compare the effects of fresh amniotic membrane (FAM), glycerol-preserved amniotic membrane (GPAM), alcohol-preserved amniotic membrane (APAM) and amniotic membrane preserved under vacuum drying condition (VXAM) on rabbit corneal alkali burn and to observe the outcomes of the grafted amniotic membrane. Methods Thirty-six New Zealand rabbits were used to establish corneal alkali burn models and then divided into 4 groups according different preserved amniotic membrane they received (FAM, GPAM, VXAM and APAM), with 9 rabbits in each group. After transplantation, we observed the changes of amniotic membrane graft, corneal opacity, corneal neovascularization (CNV) with slit lamp microscopy. The amniotic membrane graft was examined by HE staining 10 d, 14 d and 1 month after transplantation. Results One month later, FAM graft, GPAM graft and VXAM graft showed better curative effect than APAM graft. Ten days after transplantation, the amniotic membrane graft began to dissolve and desquamate, and disappeared completely till 14 d after transplantation. Amniotic membrane tissues were not found under light microscope in any rabbit. FAM graft dissolved most quickly, and APAM graft was the most slowly. The dissolution of GPAM graft and VXAM graft had no significant difference. Conclusion After amniotic membrane transplantation, it dissolves and sheds instead of fusing with recipient tissues. Corneal epithelium grows under amniotic membrane graft. Amniotic membrane graft transplantation should be called as amniotic membrane patching.

ADP-ribosyl Cyclase 1 ; immunology ; Biopsy ; Bone Marrow ; immunology ; pathology ; Epoxy Resins ; Humans ; Immunohistochemistry ; Ki-67 Antigen ; immunology ; Plastic Embedding ; Staining and Labeling ; methods

Objective To evaluate the clinical value of transesophageal echocardiography (TEE) on minimally invasive surgical closure of heart septal defects. Methods Thirty-four patients with atrial septal defect (ASD) and 38 patients with ventricular septal defect(VSD) were selected by transthoracic echocardiography (TTE) prepared for minimally invasive surgical closure. TEE was performed to choose appropriate occluder and guide occluder release during the procedure. The immediate closure effect also evaluated by using TEE. A week follow-up was done by using TTE. Results Successful occlusion was in 32 patients with ASD and 29 patients with VSD. On 1 week follow-up,neither displacement for the occluders nor residual shunt except minimal residual shunt in 3 patients. The ventrieular remodeling was improved, the valvular regurgitation and pulmonary arterial pressure decreased. Conclusions TEE is important in minimally invasive surgical closure of atrial, ventricular septal defects, especially in choosing the candidate for the procedure and occluder, guiding occluder released and evaluating the procedure.