Objective To investigate the feasibility and safety of transabdominal perposterior mediastinum radical operation in the treatment of cardiac carcinoma. Methods Twenty-six cases of cardiac carcinoma invading low esophagus underwent transabdominal posterior mediastinum radical resection. Among them 9 patients received radical proximal gastroesophagectomy, and 17 cases did radical total gastroesophagectomy. Results The procedures were all successful. The mean operation time for total gastrectomy was (189±39) min, proximal subtotal gastrectomy was (153±35) min. The averge blood loss of total gastrectomy was (200±80) ml, proximal subtotal gastrectomy was (168±76) ml. The harvest of celiac lymph nodes were (23.3±7.3), esophageal lymph nodes were (4.1±2.0). Pneumonia was complicated in 4 cases and there was no anastomotic hemorrhage, leakage nor stenosis. All patients were followed up from 5 to 51 months, liver metastasis was found in 4 cases, lung metastasis in 2 patients and death in 1. There was no anastomotic stoma tumor recurrence. Conclusion It was feasible and safe to perform transabdominal perposterior mediastinum radical operation for cardiac carcinoma patients, provided that diaphragms was not involved and tumor invaded esophageal length was less than 5 cm.

BACKGROUND: It is discovered by administrating different emetics to vomiting animals, like cats, that there are a large amount of Fos positive neuronal expressions in the arc region from nucleus of solitary tract, lateral tegmentum to ventrolateral area. And it has been viewed that the arc region from area postrema, nucleus of solitary tract to ventrolateral reticular structure is the main emetic region. Whether do the non-vomiting animals reflect in response or not after emetic injection?OBJECTIVE: To observe the distribution of Fos positive neurons in relevant emetic regions of brain and spinal cord in rats after abdominal injection of emetic, cisplatin.DESIGN: Randomized controlled experiment based on animals.SETTING: Neural Physiological Research Room of Life Science College in Hebei Normal University and Physiological Room of Basic Medicine Institute in Hebei Medical University.MATERIALS: The experiment was performed in Neural Physiological Research Room of Life Science College in Hebei Normal University and Physiological Room of Basic Medicine Institute in Hebei Medical University from March to August 2003. Twelve SD male rats were employed, body weighted varied from 220 to 250 g, of clean-grade. They were randomized into experimental group of 6 rats and the control of 6 rats.INTERVENTIONS: In experimental group, the emetic, cisplatin, was injected abdominally 10 mg/kg. In the control, the physiological saline of same dose was injected. Afterwards, the activity changes in rats were observed at room temperature, quiet and light-avoided environment. Six hours later, the brain tissue was collected for frozen continuous sectioning. Immunohistochemical staining method was used to observe the distribution of Fos positive neurons in brainstem and forebrain nuclei and to count positive cell.MAIN OUTCOME MEASURES: ① Behavior observation in rats after emetic injection. ② Counts of Fos positive cell in relevant regions of brain in rats.RESULTS: Twelve rats all entered result analysis. ① In 20 minutes after injection, the rats in both groups were in tranquilizing state, lying prone with body curled, almost without any movement. In 60 minutes after injection, the rats in the control were recovered to normal, free of eating or drinking. The rats in experimental group were in prone-lying state with body curled. They rose up or shook the heads occasionally, and they breathed fast and uneven.In 2 hours after injection, in experimental group, the rats were still in abdominal prone tightly in the cage, with heads lowed and irregular shaking of noses. In 5 hours, the rats in experimental group began standing up and moving, with normal breathing, but they still did not eat or drink. ② Fos positive neurons in solitary tract, area postrema and lateral parabrachial nucleus and paraventricular nucleus, supraoptic nucleus and arc nucleus in hypothalamus (64.3 ±9.6, 83.4 ±15.0, 148.8 ±19.9, 80. 2 ± 11.8, 20.7 ±3.8, 86. 6 ± 10.8) were remarkably higher than those in the control(56. 2 ±6.3,73.5±9.9,136.9±17.8,66. 1±10.3,17.3±3.4,78.8±10.5).CONCLUSION: Emetics induce discomforts in internal organs of rats, due to which, there probably exist emetic regions similar to vomiting animals in central neural system. But it is probably lack of vomiting-related adjusting mechanism. Emetics irritate the increase of Fos positive neurons in relevant regions in the brain of rat, which suggests that there exist relevant neural chemical pathways similar to nausea in the brain of non-vomiting rats.

Dihydrofolate reductase (DHFR) is a well-known key target in the treatment of tumors, bacterial infections, and parasitic infections; and it plays a critical role in the biosynthesis of cellular DNA. DHFR inhibitors interfere with one-carbon metabolism by inhibiting substrate binding to DHFR, thereby inhibiting cell proliferation. Research on DHFR inhibitors has continued since the 1940s. To date, a variety of DHFR inhibitors have come into the market, primarily used for anti-tumor, antibacterial, antiparasitic, and anti-inflammatory therapy. This review summarizes the research progress of DHFR inhibitors with antitumor or antibacterial effects in recent years based on the classification of single-target and dual-target and looks forward to the opportunities and challenges faced by the work in this field.

Objective To study the relationship ofiliac vein, portal vein(PV) and superior mesenteric vein (SMV), explore the feasibility on application of iliac vein in extended pancreatoduodenoctomy, and observe the clinical results. Methods Portal system and iliac venous system were dissected in 20 adult corpses. The caliber, thickness and branches of iliac vein, PV and SMV were observed and compared. The application of iliac vein in extended pancreateduodenoctomy were studied in 2 patients. Results There were no branch in 30 mm near lilac vein, 1 branch in 30--50 nun and 2-3 branches in 51-70 ram. The thickness and caliber of iliac vein matched with PV's and SMV's, there was no significant difference. Only proper pro-longed operative incisions were needed and the operation time was 5-7 hours. Postoperative vascular throm-bosis, necrosis of intestine, liver failure and so on were not occurred. No evidence of vascular embolism and recurrence happened within 6-16 months' follow-up. Conclusion Uiac vein, as a choice, can be used for vasotransplantation in the pancreatoduodenectomy.

Objective To investigate the effect of small interfering RNA (siRNA) mediated silencing of △Np73 on 5-FU chemotherapy sensitivity in SW620 colocancer cells and provide new treatment approach for the colon cancer.Methods siRNAs were transfected into SW620 colon cancer cells.The expression of △Np73 was observed.Cell viability of colon cancer cells were measured by MTr assay and cell apoptosis was assessed with flow cytometry after treatment of control siRNA or △Np73 siRNA or combined with 5-FU,respectively.The tumorigenesis was assessed by injecting △Np73 siRNA or control siRNA transfeeted SW620 colon cancer cells into nude mice,followed by treatment with 5-FU in the tumors.Results △Np73 siRNA was able to strongly inhibit △Np73 expression,however,it did not inhibit the growth of cells.Combination treatment with △Np73 siRNA and 5-FU produced significant higher apoptotic cell(42.9%) as compared with those with 5-FU treatment(18.9%) alone or those with △Np73 siRNA(8.8%) alone.The treatment with 5-FU in the xenngrafts derived from △Np73 siRNA transfected SW620 cells in nude mice can inhibitor tumor growth significantly (t=15.32,P<0.05).Conclusion △Np73siRNAs can specifically repress the expression of △Np73.Thus it sensitizess the cells to 5-FU chemotherapy in colon cancer.

Objective To explore the hospitalization status of patients with chronic obstructive pulmonary disease ( COPD ) . Method In total, 12,838 COPD patients hospitalized from January 2008 to December 2014 were involved in the study and their hospitalization status were analyzed. Results Among the 12,838 patients, 2,499 were hospitalized for critical conditions (19.47%), 5,455 for acute attack (42.49%), 4,884 for acute exacerbation (38.04%). The ratio of male/female was 5.32:1. Those in 71 to 80 years old were at the highest risk. They were hospitalized at least for 1 time, at most for over 38 times, averaged (3.52 ± 4.05) times. Conclusions The COPD patients were hospitalized due to acute attack and acute exacerbation. The patients'age ranged from 71 to 80 years. The male patients had a predominant incidence than the female ones. The times of hospitalization were related with possible complications of other chronic diseases. Therefore, nursing staff should draw up individual continuing nursing strategies based on the patients′ hospitalization reasons to reduce the hospitalization rate of acute attack and acute exacerbation. Meanwhile, we should formulate the pre-hospital rescue plan for the hospitalized patients at the peak age and implement prospective nursing.

Objective To investigate the expression of livin of kidney tissues in rats with acute kidney injury (AKI) induced by endotoxin ,and the role of livin in the cell apoptosis of AKI .Methods The rat models with AKI were induced by endotoxin .The de-gree of kidney injury was observed by hematoxylin and eosin stain ,measuring the levels of the serum creatinine and urea nitrogen . The expression of livin and caspase-3 in kidney tissue at different time points was analyzed by immunohistochemistry assay ,and the relationship between the expression of livin and caspase-3 and kidney injury was analyzed .Results Compared to the control group , the rats injected endotoxin had the performance of AKI ,with obviously pathomorphological damage in the kidney tissues ,signifi-cantly increasing in the serum creatinine and urea nitrogen (P<0 .01) .The livin and caspase-3 of kidney tissues in rats with AKI caused by endotoxin were positive expression (P<0 .01) .With the lapse of time ,the trend of increasing of caspase-3 showed gradu-ally slow after the highest expression of livin .Conclusion The livin involved in the pathogenesis of endotoxin-induced AKI ,it might relieve the kidney injury and protect renal function by inhibiting casepase-3 important apoptotic effector protein .

Objective:To study age distribution of attention deficit hyperactivity disorder(ADHD) comorbidities in a relatively large sample,and exam the hypothesis of bad prognosis for ADHD.Methods:Using semi-structured clinical diagnosis interview scale,we investigated comorbidities of 1 002 ADHD children and adolescents from psychiatric out-patient clinic,and compared comorbidity frequency in 4 age groups.Results:The comorbidity frequencies of disruptive behavior disorder(DBD),mood disorder,tics disorder and learning disorder(LD) in different age groups of ADHD patients differed significantly(P

Objective To explore the effects of preoperative neoadjuvant endocrine therapy on expression and significance of ER, PR, C-erbB-2 in pestmenopause breast cancer patients over 60 years old. Methods 36 patients were treated with endrocrine therapy by oral tamoxifen for 60 ～ 90 days, and the expression of ER, PR and C-erbB-2 was examined before and after the endrocrine therapy. Results In 36 patients the negative expres-sion rate of ER, PR was 16.78% and 11.11% respectively before the endrocrine therapy, compared to 50% and 33.33% after the endrocrine therapy. There was significant difference(P<0.05). The expression of C-erbB-2 was 13.8% and 16.67% before and after the endrocrine therapy, and there was no significant difference between the two figures. Conclusions The neoadjuvant endocrine therapy by tamoxifen alone can down-regulate the ex-pression of ER, PR, and can inhibit tumor growth. Some patients may get partially relieved.

Objective To explore the effect of endocrine therapy in breast cancer patients whose estrogen receptor (ER) and progesterone receptor(PR) was preoperatively negative and turned positive after neoadjuvant chemotherapy. Methods The clinical experimental study was carried out in 97 cases of breast cancer which were divided into endocrine treatment group and control group. The follow-up time ranged from 15 to 60 months. Results In endocrine treatment group, 3 and 5-year disease-free survival were respectively 74.5% (38/51), 60.7% (31/51), and 3 and 5-year overall survival were respectively 80%(41/51), 74. 5% (38/51). In control group, 3 and 5-year disease-free survival were respectively 54.2% (26/46), 41.7%(20/46), and 3 and 5-year overall survival were 60.9%(28/46),50%(23/46),respectively. The corresponding values were significantly higher in endocrine treatment group than in control group(P＜0.05).Conclusions Remedy endocrine therapy improves the disease-free and overall survival rate in breast cancer patients with the expression of ER and PR turning positive after initial neoadjuvant chemotherapy.