Background: Surgical treatment of esophageal carcinoma is a main operation in term of both technique and anesthesiology. The Orringer technique is one of the treatments. Objectives: 1. To describe clinical and subclinical characteristics of the middle and lower-third esophageal carcinoma. 2. To assess preliminary results of Orringer technique in treating of the middle and lower-third esophageal carcinoma. Subjects and method: A prospective, descriptive, following by time study was conducted in the patients who were diagnosed the middle and lower third esophageal carcinoma and operated by Orringer technique at the Department of Digestive Surgery in Viet Duc Hospital from January/2000 to June/2006. Results: The subclinical symptoms included difficult swallow (98.5%), anorexia and loss weight (98.5%), pain in chest (23.5%), loss of voice (2.9%) and bloody vomiting (5.9%). For clinical symptoms, 54/68 patients (79.4%) had lesions in lower-third esophageal, 14/68 (20.6%) had lesions in the middle-third esophageal. The average length of the lesions was 6.23\xb12.22cm (95% CI=5.69-6.77). The average operation time was 273.38 \xb154.56 minutes (range: 140-420), which is much faster than those in esophagectomy via thoracotomy: Lewis-Santy technique (324 minutes) and Akiyama technique (480 minutes). Both intraoperative and post-operative complications of Orringer technique were less than those of esophagectomy via thoracotomy. Conclusion: In this study, the clinical and subclinical strongest characteristics of the patients with the middle-third esophageal carcinoma appear in the advanced period (III period and IV period (over 70%)). Orringer technique had faster operation time, less complications and lower mortality than those of esophagectomy via thoracotomy.
Esophageal Neoplasms/ surgery ; therapy

Objective To investigate the specimen source and gene phenotype of ESBLs in ESBLs-producing Klebsiella pneumonia of people′s hospital of Sanya city,so as to provide basis for clinical use of drugs and nosocomial infection.Methods Klebsiella pneumoniae was isolated from specimens during January 2013 to December 2014,bacteria identification and susceptibility tests were detected by Phoenix-100 system biochemical,supplementary susceptibility test was confined by K-B method according to 2014 CLSI standards.WHONET 5.6was used in the statistical analysis of all data.Results Totally 213 strains Klebsiella pneumoniae were isolated.The detection rates were 78.4％ of the respiratory secretions,8.92％ and 5.2％ respectively of the secretion and the midstream urine.The strains had a certain resistance to commonly used antimicrobial.The highest resistance rate was 98.1％ to cefotaxime,and the lowest resistance rate was 2.86％ to imipenem.There were 195 in 213 ESBLs producing Klebsiella pneumoniae strain were detect one or more drug resistance gene.The detecting rates of 6 p-lactamase gene of CMY,CTX,TEM,SHV,DHA1 and KPC were 6.10％,76.53％,59.62％,76.06％,12.21％ and 2.82％.Conclusion Klebsiella pneumoniae is mainly isolated from respiratory secretions in the hospital,has a certain resistance to commonly used antimicrobial.We should learn more about the distribution of resistance genes of ESBLs strains,improve the efficiency of the treatment of the infection and to control nosocomial infection and the incidence of multi-drug resistance.

Objective To explore the expressions of growth factor receptor binding protein 2 -associated bin-ding protein -1 (Gab -1 )and glioma -associated oncogene homologue -1 (Gli -1 )in pediatric medulloblastoma,and to analyze their correlation between clinical and pathological characteristics and prognosis in pediatric medulloblastoma. Methods Elivision immunohistochemistry was used to detect the expressions of Gab -1 and Gli -1 protein in tissue microarray of 40 paraffin embedded pediatric medulloblastoma specimens.Chi -square test or Fisher exact test was used to analyze the correlation between Gab -1 and Gli -1 protein expressions with gender,age,tumor location and pathological subtypes.Follow -up data were handled by using Kaplan -Meier survival analysis and Cox regression anal-ysis.Results Positive expression ratios of Gab -1 and Gli -1 protein in 40 pediatric medulloblastoma were 35.0%and 55.0%,respectively.The positive expression rate of Gab -1 in medulloblastoma tissues had no statistical signifi-cance between different genders[male:30.4%(7 /23 cases)vs.female:41 .2%(7 /17 cases)],age[<3 years old:40.0%(6 /15 cases)vs.≥3 years old:32.0%(8 /25 cases)],tumor location[cerebellum:25.0%(5 /20 cases)vs. the fourth ventricle:45.0%(9 /20 cases)]and pathological subtype[classical type:40.7%(11 /27 cases)vs.desmo-plastic /nodular type:50.0%(5 /10 cases)vs.anaplastic /large cell type:66.7%(2 /3 cases)](χ2 =0.496,0.264, 1 .758,3.289,all P >0.05).There were statistical differences of positive expression rate of Gli -1 protein in different age groups[<3 years old:80.0%(12 /15 cases)vs.≥3 years old 40.0%(10 /25 cases)],different pathological sub-types[classical type:40.7%(11 /27 cases)vs.desmoplastic /nodular type:90.0%(9 /10 cases)vs.anaplastic /large cell type:66.7%(2 /3 cases)](χ2 =6.061 ,7.333,all P <0.05 ).There was no statistical difference in positive expression rate of Gli -1 protein between different gender[male:60.9%(14 /23 cases)vs.female:47.1 %(8 /17 cases)]and different tumor location [cerebellum:55.0% (11 /20 cases)vs.the fourth ventricle:55.0% (11 /20 cases)](χ2 =0.753,0.000,all P >0.05).Kaplan -Meier survival analysis showed that the age,the expressions of Gab -1 and Gli -1 protein were correlated with prognosis of pediatric medulloblastoma(all P <0.05).Cox regression indicated that the age,pathological subtypes and the expression of Gli -1 protein were independent prognostic indicators in pediatric medulloblastoma(all P <0.05).Conclusion Expression of Gab -1 and Gli -1 protein is significantly correlated with the prognosis of medulloblastoma,and the positive expression is a marker of unfavorable prognosis.

OBJECTIVETo study the effect of microfilament cytoskeleton changes induced by simulated microgravity on the NO/NOS system of osteoblasts, and explore the mechanism of weightlessness leading to osteoporosis.

METHODSMouse osteoblast-like cell line MC3T3-E1 were divided into simulated microgravity (by rotating clinostat) group, 0.5 microg/ml cytochalasins B group, simulated microgravity+cytochalasins B group, and normal gravity group. After cell culture for 48 h with corresponding treatments, immunofluorescence staining of the cells by FITC-phallacidin was performed to observe the changes of microfilament under laser confocal microscope. NOS activity of the cells was tested with NOS detection kit, and the NO concentration in the cell supernatant was measured with nitrate reductase method.

RESULTSDepolymerization of the microfilament cytoskeleton with irregular arrangement and reduced tension fibers occurred in the cells except for those in the normal gravity group, which was especially obvious in the microgravity+cytochalasins B group. Compared with the normal gravity group, the cells in the other groups showed increased iNOS activity and NO concentration but decreased eNOS activity, especially obvious in simulated microgravity+ cytochalasins B group.

CONCLUSIONDisruption of the microfilament cytoskeleton induced by simulated microgravity can regulate the NO/NOS system to influence the signal transduction of the osteoblasts.

Animals ; Cell Line ; Cytoskeleton ; physiology ; Mice ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase Type II ; metabolism ; Nitric Oxide Synthase Type III ; metabolism ; Osteoblasts ; cytology ; metabolism ; Signal Transduction ; Weightlessness ; Weightlessness Simulation

OBJECTIVETo compare the characteristics of suicides in the four main demographic groups: urban males, urban females, rural males and rural females in order to help clarify the demographic pattern of suicides in China.

METHODSA detailed psychological autopsy survey instrument was independently administered to 895 suicide victims in family members and close associates from 23 geographically representative locations from around the country.

RESULTSPesticide ingestion accounted for 58% (519) of all suicides and 61% (318/519) of deaths were due to unsuccessful medical resuscitation. A substantial proportion (37%) of suicide victims did not have a mental illness. Among the 563 victims with mental illness, only 13% (76/563) received psychiatric treatment. Compared to other demographic groups, young rural females who died from suicide had the highest rate of pesticide ingestion (79%), the lowest prevalence of mental illness (39%), and the highest acute stress from precipitating life events just prior to the suicide.

CONCLUSIONMany suicides in China are impulsive acts of deliberate self-harm following acute interpersonal crises. Prevention of suicides in China must focus on improving awareness of psychological problems, improving mental health services, providing alternative social support networks for managing acute interpersonal conflicts, limiting access to pesticides, and improving the resuscitation skills of primary care providers.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Autopsy ; Child ; China ; epidemiology ; Female ; Humans ; Male ; Mental Disorders ; epidemiology ; psychology ; Middle Aged ; Rural Population ; Suicide ; psychology ; statistics & numerical data ; trends ; Urban Population

OBJECTIVEThe mortality and trend of injury in 1991 - 2000, the distribution of causes of injuries by areas as well as disease burden in Chinese population were discussed.

METHODSData on mortality level and causes of injuries provided by National Disease Surveillance Program in 1991 - 2000, adjusted by under-reporting rate together with years of potential life lost (YPLL) and WPYLL of injuries and proportion of YPLL and WPYLL of total death, were calculated.

RESULTSThe mortality of injury was kept at a stable level from 1991 to 2000. The adjusted average death rates were 66.56/100,000 with 81.41/100,000 in males, 51.17/100,000 in females, and 38.68/100,000, 74.63/100,000 in urban and rural populations respectively. Death rates of injury in the east, central and west rural areas were 1:1.14:1.21 respectively. Injury was the main cause of death among children and youths. Traffic accident, suicide, drowning, poisoning and fall were main causes of injury accounting for 70 percent of all the injury mortality. Since 1990's, the death rate of traffic accident had been obviously increasing, YPLL and WPYLL in injury 2132 years/10,000 and 1587 years/10,000, respectively. The YPLL and WPYLL were 24.56% and 26.51% of total deaths.

CONCLUSIONThe disease burden of injury was heavy and the death of injury caused more social and economic losses owing to premature death. The increasing death rate of traffic accident called for more attention. Different effective control strategies should be formulated based on different death causes of injury and different target populations.

Age Factors ; China ; epidemiology ; Female ; Humans ; Male ; Retrospective Studies ; Sex Factors ; Suburban Population ; statistics & numerical data ; Survival Rate ; Urban Population ; statistics & numerical data ; Wounds and Injuries ; epidemiology ; mortality

OBJECTIVETo identify the factors that may influence the prognosis of patients with hepatorenal syndrome and try to establish a prognostic model.

METHODSData of 126 patients with hepatorenal syndrome were analyzed and 56 indexes that might affect the prognosis were focused on, involving history, symptoms, signs and lab findings. Cox model and Kaplan-Meier survival analysis were used.

RESULTSMany factors were found to affect the prognosis independently, including hepatic encephalopathy (HE) and its degree, gastrointestinal bleeding (GIB), blood neutrophil count (N1) and serum creatinine (Cr). The prognosis model was established as the following equation where PI represents prognosis index: PI = 0.711HE + 0.836GIB + 0.052N1 + 0.002Cr (GIB: no = 0, yes = 1; HE: no = 0, phase I = 1, phase II = 2, phase II = 3, phase IV = 4). When PI < 1, the average survival time was 42 days; when 1 < or = PI < or = 3, the average survival time was 15 days; when PI > 3, the average survival time was 2 days.

CONCLUSIONThe results obtained from this study may help in estimation of diagnosis, analysis of illness state and evaluation of therapy in clinical work.

Adolescent ; Adult ; Aged ; Female ; Hepatorenal Syndrome ; complications ; mortality ; Humans ; Kaplan-Meier Estimate ; Liver Failure ; complications ; mortality ; Male ; Middle Aged ; Prognosis ; Proportional Hazards Models

methods had some limitations. There was big difference between the results when using SEG and GGB, suggesting that we should try to combine GGB and SEG methods to get the better results.

Objective To study the nucleotide and amino acid sequences of norovirus G Ⅱ.4/Sydney 2012 variants,in China.Methods Twenty-two stool specimens,confirmed as G Ⅱ.4/Sydney 2012-positive were collected from Beijing in the winter of 2012-2013.RT-PCR was performed to target the complete capsid gene.G Ⅱ.4/Sydney 2012 strains from other regions in China were searched and obtained from the GenBank.Nucleotide and amino acid sequences of G Ⅱ.4/Sydney 2012 strains were analyzed,using the CLUSTAL X (Version 1.83)and followed by phylogenetic analysis using Mega version 5.1.Results The complete major capsid nucleotide sequences of thirty-eight G Ⅱ.4/Sydney 2012 strains from seven regions in China were obtained.The VP1 nucleotide and amino acid sequences diversity were 0.1％-3.3％ and 0-3.1％,respectively.Result from phylogenetic analysis demonstrated that the G Ⅱ.4/Sydney 2012 variant shared a common ancestor with both the dominant norovirus G Ⅱ.4 variants Apeldoom 2008 and the New Orleans 2009.G Ⅱ.4/Sydney 2012 variants appeared to have had two A/D/E site combinations at the amino acid level,TSRN-GTT-SNT and TSRN-STT-SNT.Conclusion G Ⅱ.4/Sydney 2012 variant had been circulating in many regions in China.There seemed a high nucleotide and amino acid identity among G Ⅱ.4/Sydney 2012 strains collected from China.G Ⅱ.4/Sydney 2012 variants showed different A/D/E site combination from other pandemic G Ⅱ.4 variants.

AIMTo ascertain the bioactivity and to analyse quantificationally the denervating action of botulinum toxin A (BTXA) in gel.

METHODS36 Sprague-Dawley rats were randomized into four groups. In group A - D, the gastrocnemius muscle of one leg was randomly selected to receive injection of BTXA solution 5U in 0.1 ml, BTXA gel 12.5U in 0.1 ml, BTXA gel 5U in 0.1 ml and BTXA gel 2U in 0.1 ml respectively, while the gastrocnemius muscle of other leg was injected with 0.1 ml of saline solution in group A and 0.1 ml of gel in group B to group D as control. Compound muscle action potential (CMAP) of both gastrocnemius muscles were measured and the amplitudes were recorded before injections, and 5 days, 2 weeks, 3 weeks, 1 month, 2 months and 3 months after the injections respectively.

RESULTSThe reduction of CMAP amplitude was significantly different at various time (P < 0.01), and CMAP amplitude decreased significantly after the treatment of BTXA (P < 0.01). The reduction of CMAP amplitude was significantly dif ferent in group A to I) (P < 0.01), and more reduction was found in group A and B (P < 0.01), and the reduction was higher in group C than in group D (P < 0.05). However, there were no significant differences in the reduction of CMAP amplitude between group A and group B.

CONCLUSIONBioactivity of BTXA in gel was showed and the denervating action of BTXA in gel was demonstrated in a dosage and time dependent manner.

Animals ; Botulinum Toxins, Type A ; administration & dosage ; Dosage Forms ; Female ; Gels ; Injections, Intramuscular ; Mice ; Muscle Denervation ; methods ; Muscle, Skeletal ; innervation ; Rats ; Rats, Sprague-Dawley ; Solutions