Currently,resectable esophageal cancer is commonly initially treated with surgery in China,but the optimal postoperative treatment remains unclear.Postoperative concurrent chemoradiotherapy can improve local control and reduce distant metastasis and may become the preferred treatment for patients after surgery for esophageal cancer.By summarizing the studies on concurrent chemoradiotherapy after surgery for esophageal cancer,this review points out that postoperative concurrent chemoradiotherapy can improve the overall survival of patients with positive lymph nodes and has tolerable adverse effects,but the populations who can benefit from this treatment,the optimal radiotherapy dosage,target volume,and chemotherapy regimen of postoperative concurrent chemoradiotherapy await further investigation.

OBJECTIVE:To establish the method for simultaneous determination of alantolactone,isoalantolactone,gallic acid,emodin,aloe-emodine,rhein,physcion and chrysophanol in Liuwei nengxiao pills.METHODS:HPLC method was adopted.The determination was performed on Diamonsil C18 with mobile phase consisted of methanol-acetonitrile-0.1％ glacial acetic acid (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelengths were set at 254 nm (alantolactone,isoalantolactone,emodin,aloe-emodine,rhein,physcion and chrysophanol),270 nm (gallic acid).The column temperature was 25 ℃,and sample size was 10 μ L.RESULTS:The linear ranges of alantolactone,isoalantolactone,gallic acid,emodin,aloe-emodine,rhein,physcion,chrysosphanol were 0.121-3.63 μg(r=0.999 9),0.122-3.66 μg(r=0.999 9),0.219-6.57 μg(r=0.999 9),0.016 4-0.492 μg(r=0.999 7),0.017 3-0.519 μg(r=0.999 9),0.015 3-0.459 μg(r=0.999 9),0.007 2-0.216 μg(r=0.999 9),0.016 2-0.486(r=0.999 9).The limits of quantification were 0.41,0.26,0.35,0.13,0.17,0.14,0.15,0.13 ng;limits of detection were 0.12,0.08,0.11,0.04,0.05,0.04,0.05,0.04 ng.RSDs of precision,stability and reproducibility tests were all lower than 2.0％.The recoveries were 98.05％-102.46％ (RSD=1.75 ％,n=6),98.55％-102.89％ (RSD=1.91％,n=6),98.53 ％-102.34％ (RSD=1.66％,n=6),101.71％-103.41％ (RSD =0.57 ％,n=6),101.04％-103.01％ (RSD=0.69％,n=6),101.63％-102.75％ (RSD=0.39 ％,n=6),96.94％-101.11％ (RSD=1.61％,n=6),98.06％-99.10％ (RSD=0.40％,n=6).CONCLUSIONS:The method is accurate,simple and suitable for simultaneous determination of 8 components in Liuwei nengxiao pills.

Over-expression of P-glycoprotein (Pgp) is associated with the development of multi-drug resistance ( MDR). Pgp has been focused on as the main target in designing chemotherapy strategy. In this article we review some of the latest advancement in designing and evaluation methods of P- glycoprotein inhibitors.

Obstructive sleep apnea (OSA) has been definitively shown to be a risk factor for the development of cardiovascular disease and mortality. Recent reports have indicated that obstructive sleep apnea is associated with insulin resistance and impaired glucose metabolism, also have type 2 diabetes. The potential mechanisms leading to the development of type 2 diabetes in OSA patients are likely to be various. Reduced physical activity resulting from daytime somnolence, sympathetic nervous system activation, intermittent hypoxia, sleep fragmentation and sleep loss, dysregulation of the hypothalamic-pituitary axis, alteration in adipokine profiles, and activation of inflammatory pathways have been proposed. Based on the current evidence, clinicians should assess the risk of OSA in patients with type 2 diabetes and, conversely, consider that possibility of glucose intolerance in patients with OSA. Further large-scale and long-term follow-up studies in patient populations with selected by reliable but inexpensive diagnostic measures, controlled for potential confounder factor, are needed.
Adipokines ; Anoxia ; Axis, Cervical Vertebra ; Cardiovascular Diseases ; Glucose ; Glucose Intolerance ; Humans ; Insulin Resistance ; Motor Activity ; Risk Factors ; Sleep Apnea, Obstructive ; Sleep Deprivation ; Sympathetic Nervous System

BACKGROUND: Alendronate has been recently used for treating osteoporosis by inhibiting the activity of osteoclasts, but further clinical observation is necessary to compare its therapeutic effect with exclusive use of calcium supplement.OBJECTIVE: To observe the therapeutic effect of oral alendronate (tianke tablet) on the clinical symptoms and bone mineral density (BMD) of middle-aged and elderly patients for comparison with calcium gluconate.DESIGN: A self-controlled study and controlled trial with concurrent patients.SETTING: Department of Orthopedics, Shenzhen Hospital, Peking UniversityPARTICIPANTS: Sixty-eight middle-aged and elderly patients with osteoporosis were admitted in the Department of Orthopedics, Shenzhen Hospital of Peking University between July 1999 and July 2000. From these patients 62 at the age over 45 years without secondary osteoporosis were selected for this study, who were randomly divided into oral alendronate group (n=32) and oral calcium gluconate group (n=30).INTERVENTIONS: On the basis of comprehensive therapies, the patients in the alendronate group were given 10 mg alendronate daily and those in calcium gluconate group had 20 mL oral calcium gluconate solution (containing 100 mg calcium gluconate, equivalent to 9 mg calcium in every 10 mL) three times daily for three months. According to bodily pain relief, occurrence of new fracture and improvement in BMD, the therapeutic effect was assessed in three grades.RESULTS: Thirty patients in the alendronate group and 26 in the calcium gluconate group completed the study. Alendronate treatment for 3months significantly increased BMD of the patients [(0.716±0.082) g/cm2in comparison with that before treatment [(0.667±0.083) g/cm2, t= 2.473,P ＜ 0.01], whereas the BMD underwent no obvious changes after treatment with calcium gluconate [(0.671±0.081) g/cm2 before vs (0.680±0.073) g/cm2after treatment, t=1.812, P ＞ 0.05]. Significant difference in BMD after treatment was noted between the two groups (t=2.384, P ＜ 0.01). The effective rate was significantly higher in alendronate group than in calcium gluconate group (X2=14.9, P=0.005), but 7 patients complained of abdominal discomfort in the former group and the patients in calcium gluconate group reported no adverse effects.CONCLUSION: Alendronate can inhibit bone absorption, promote the recovery of bone matrix, and increase the bone mass, producing better effect than exclusive use of calcium gluconate oral solution in treatment of the osteoporosis in the middle-aged and the elderly.

Objective To explore the accuracy of bedside arterial blood gas analyzer in detecting electrolytes and anionic gap (AG) in ICU patients, and compare it with auto-analyzer. Methods Results of blood sodium, potassium, chlorine, bicarbonate ions and AG measured by arterial blood gas analyzer and auto- analyzer of 376 ICU adult patients admitted to ICU were retrospectively analyzed. With the outcomes of auto-analyzer as standard, the correlation and difference of electrolytes and AG measured by 2 methods were analyzed. Results The sodium, potassium, chlorine and AG measured by auto-analyzer were 121 - 183 mmol/L, 2.13 - 6.77 mmol/L, 86 - 146 mmol/L and 1 - 62 mmol/L. The blood sodium, potassium, chlorine and AG measured by arterial blood gas analyzer were 114 - 180 mmol/L, 1.78 - 6.36 mmol/L, 94 - 150 mmol/L, -7 - 40 mmol/L. The blood sodium, potassium and AG measured by arterial blood gas analyzer were lower than those measured by auto-analyzer, but the blood chlorine was higher than that measured by auto- analyzer. There were statistical differences in the difference of low, normal and high electrolytes and AG between 2 methods (P<0.01). Conclusions The electrolytes and AG measured by arterial blood gas analyzer and auto-analyzer are significantly different, and the electrolytes measured by arterial blood gas analyzer are unreliable to calculate AG.

DSS group,although without statistical significance.JOA score of two groups before and after surgery without statistical significance.[Conclusion]Developmental spinal stenosis is pathology found,which influences course of ossification of cervical posterior longitudinal ligament.The principal factor is trauma,which induces ossification of cervical posterior longitudinal ligament.Decompressed from a posterior approach is a reasonable treatment way.

Tsutsugamushi disease is an acute infectious rickettsial disease caused by the intracellular parasite Orientia tsutsugamushi. Due to its variety of clinical signs, this disease is often misdiagnosed. This article examines a total of 4 patients who visited our clinics with fever and sore throat. 3 of them had body temperature of 39.5 Celsius degrees when admitted. The characteristic black eschar occurred on 4 of them. Lymphadenopathy occurred on 2 of them. Cough occurred on 1 of them. Lab tests showed that 3 of them had Leukocytosis, 1 of them had increased bronchovascular markings, and 3 of them had Weil-Felix test positive. After admission, all patients, who were confirmed of diagnosis of tsutsugamushi disease instead of tonsillitis, received the comprehensive treatment and cured afterwards.
Diagnostic Errors ; Humans ; Orientia tsutsugamushi ; Pharyngitis ; etiology ; Scrub Typhus ; complications ; diagnosis ; Tonsillitis ; diagnosis

Objective: To observe the effect of Wuzhuyu Decoction on the serum metabolic profile of the model rats with deficiency cold, and explore its possible mechanism for treating deficiency cold and vomiting syndrome. Methods: A rat model of deficiency cold and vomiting was prepared by a composite method (Rhei Radix et Rhizoma + cisplatin). The high-throughput metabolome data of the serum of rats with deficiency-cold and vomiting was obtained by ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS), and multivariate analysis combinated with database retrieval was used to analyzed the endogenous metabolites in rat serum from different groups and discover differential metabolites. Besides, metabolites were analyzed by Metabo Analyst software for possible metabolic pathways. Results: The serum metabolic spectrum of control group and model group were completely separated. The Wuzhuyu Decoction group was close to the control group, indicating that the horizontal model of endogenous material changes was successfully replicated, and Wuzhuyu Decoction could interfere with the symptoms of deficiency cold and vomiting in rats, suggesting that the rat body had a tendency to return to normal state. In total, modular analysis of 35 serum differential metabolites, and deficiency cold and vomiting syndrome was related to abnormal lipid metabolism and amino acid metabolism pathways and Wuzhuyu Decoction may have a regulatory effect on its pathways; Metabolites revealed close relationship among seven modules; Pyroglutamic acid, arachidonic acid, serotonin, isocitric acid, triglyceride and other biological targets can thus be used as biomarkers of deficiency cold and vomiting. Conclusion: Wuzhuyu Decoction can improve the physiological characteristics of the model of deficiency-cold and vomiting. The mechanism may be related to the regulation of abnormal amino acid metabolism, energy metabolism, and lipid metabolism in rats with deficiency-cold vomiting.

Objective To introduce the Bernese periacetabular osteotomy through ilioinguinal approach for the treatment of adult acetabular dysplasia. Methods From October 1997 to April 2001, 51 patients(53 hips) with acetabular dysplasia were operated upon with Bernese periacetabular osteotomies through ilioinguinal approach. The mean age of the patients at the time of surgery was 30.6 years(range, 13-48 years). Male∶female= 1∶10. Preoperatively, the average duration of the symptoms was 3.4 years(3 months to 15 years), the range of motion(ROM) of the hip was normal in most patients. Average CE angle was 1.1?(?15?-15?); the Tonnis osteoarthritis grade was Ⅰto Ⅱ. Fifty three percent of the hips had Shentons line broken. Results Twenty four hips had 12 to 38 months followed up. Most patients were pain free; the hip ROM remained normal. Harris hip score increased from 79.8(64-83) pre operatively to 93.8(75-100) post operatively. CE angle increased to 40?(20?to 60?). Shentons line broken rate decreased to 33%. The complications include: 1 femoral nerve damage, 1 bladder malfunction and 2 skin incision hernia. Conclusion The Bernese periacetabular osteotomy through ilioinguinal approach is a safe and efficient procedure for the treatment of adult acetabular dysplasia. The deformities could be easily corrected, the anatomic relations could be restored nicely, the pelvic ring and the abductor muscles are reserved. The post operative recovery is fast, and it is efficient to prevent the development of osteoarthritis of the hip joint.