Surgical approaches for esophageal carcinoma are many and varied. Minimally invasive techniques are increasingly used widely in esophagectomy as they not only ensure patients' therapeutic effects, but also reduce trauma and accelerate recovery. The lymph nodes excisional area of esophageal carcinoma is still in controversy. It is necessary to carry out further researches on selective lymph nodes excision, which can decrease complication rate and improve patients' survival in the meantime.
Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Humans ; Lymph Node Excision ; methods ; Minimally Invasive Surgical Procedures

Animals ; Apoptosis ; drug effects ; Capillaries ; pathology ; Fibrosis ; Fingolimod Hydrochloride ; Kidney Diseases ; metabolism ; pathology ; Kidney Tubules ; blood supply ; Male ; Propylene Glycols ; pharmacology ; therapeutic use ; Rats ; Rats, Sprague-Dawley ; Sphingosine ; analogs & derivatives ; pharmacology ; therapeutic use ; Vascular Diseases ; prevention & control

Objective To explore the clinical features of pulmonary tuberculosis complicated with DM and related factors. Method The manifestations of 87 newly diagnosed PTB patients with type 2 DM(DM-PTB group) at two hospitals in Tianjin during October 2003 to October 2004 were compared to 88 PTB patients without DM who were randomly choosen from the same hosipital.The factors related to sputum-positive TB or cavity were explored through unconditional logistic regression model. Results DM-PTB patients showed significanly lower frequencies of cough(66.7% vs 83.0%),toxicity symptoms(37.9% vs 62.5%) and haemoptysis(16.1% vs 33.0%) than those of PTB group.Positive-sputum(63.2% vs 34.1%),cavity(56.3% vs 13.6%),wide lesions and bilateral lesions on chest radiographs was more common in DM-PTB group than in PTB one.Introversion(OR=1.582, 95%CI:1.063 ～2.355),type 2 DM(OR =2.186,95% CI:1.082 ~4.420)and cavity(OR =2.793,95% CI:1.308 ～5.964)were factors independently associated with positive-sputum TB.The factors related to cavity included diabetes(OR=14.199,95%CI:5.376~ 37.501),cough,postive sputum and lore-up lobe lesion.Conclusion This study confirmed that clinical manifestations and chest radiographs of PTB patients complicated with type 2 DM significantly departed from the typical presentation.Type 2 DM seems to have a negative effect on postive-sputum and cavity.So it should be alarmed that DM-PTB patients who tend to have untypical clinical symptom and higher rate of positive sputum become the reservoirs of infection to cause the transmission of TB.

Adult ; Antigens, CD20 ; metabolism ; Empyema, Pleural ; complications ; diagnostic imaging ; pathology ; virology ; Epstein-Barr Virus Infections ; Humans ; Ki-67 Antigen ; metabolism ; Lymphoma, Large B-Cell, Diffuse ; metabolism ; pathology ; surgery ; virology ; Male ; Pleural Neoplasms ; complications ; metabolism ; pathology ; surgery ; virology ; Radiography

Air Pollution ; analysis ; Barium ; analysis ; chemistry ; Solubility ; Spectrophotometry, Atomic ; methods ; Workplace

Adult ; Bone Marrow Transplantation ; Fractures, Ununited ; therapy ; Humans ; Male ; Transplantation, Autologous

Objective To evaluate the value of fMRI guided brain surgery for the lesions in or around Broca's area.Methods Forty-three patients with lesions in or adjacent to the Broca's area were studied.fMRI imaging was obtained by BOLD technique with the tasks of reciting.Fiber tract imaging of white matter was obtained by DTI technique.All functional imaging and anatomic imaging were transferred to neuronavigation system.The technique of direct cortical stimulation was used to validate the language cortex in fMRI.The lesions were resected in microscope.Results Broca's area activation was detected in 38 cases..The distance between the fMRI peak and direct cortical stimulation was rated as overlapping (<1 cm diatance) in 25 cases and neighbouring (<2 cm diatance) in 11 cases.Total lesion resection was achieved in 17 cases, subtotal resection in 14 cases, and partial resection in 12 cases.Postoperative neurological functions were improved in 8 cases, unchanged in 31 cases, and temporary worsen in 4 cases.Conclusions The identification of the Broca's area by reciting task in fMRI is sensitive and precise.The fMRI is helpful to decrease the side effect injury in the brain surgery for the lesions in or around the Broca's area.

Objective To investigate the significance of serum neuron specific enolase (NSE) in the severity and prognosis assessments of diffuse axonal injury (DAI).Methods The levels of serum NSE were measured by radioimmunoassay (RIA) at 12 hours and 1st,2nd,3rd,7th and 14th days after injury in 79patients with DAI.The relationship of serum NSE level with the severity and the prognosis of DAI were analyzed in the patients with DAI.Another 15 patients with only limb fracture and without hemorrhagic shock treated in the hospital during the same period served as the control group.Results The serum NSE levels of the mild injury group were (10.47 ± 2.75) ng/L,(13.41 ± 3.45) ng/L,(16.41 ±4.14) ng/L,(15.57 ±4.28) ng/L,(7.95 ±2.79) ng/L,and (6.39 ± 1.55)ng/L at 12 hours and 1st,2nd,3rd,7th and 14th days after injury.The serum NSE levels of the moderate injury group were (14.98 ± 3.78) ng/L,(19.88 ± 4.78)ng/L,(22.41 ±5.50) ng/L,(20.11 ±6.60) ng/L,(14.59 ±6.64) ng/L,and (8.31 ±3.83) ng/L respectively at 12 hours and 1st,2nd,3rd,7th and 14th days after injury.While the serum NSE levels of the severe injury group were (27.22 ± 4.54) ng/L,(36.43 ± 10.38) ng/L,(41.32 ± 12.44) ng/L,(43.98 ±9.51) ng/L,(42.22 ± 13.05) ng/L,and (37.59 ± 12.96) ng/L at 12 hours and 1st,2nd,3rd,7th and 14th days after injury respectively.The NSE levels in each time point were significantly higher in the severe injury group than in the mild and moderate injury groups (F within =28.11,P ＜ 0.001 ; F between =57.34,P ＜0.001 ;F interaction =8.21,P ＜ 0.001 ;P ＜ 0.01).Compared with the control group ((6.26 ± 1.35) ng/L),the serum NSE levels of the DAI group were significantly different at 12 hours after injury ((18.16 ± 3.76)ng/L,t =2.938,P ＜ 0.01).At three months after injury,patients were divided into the decreased group (n =9),poor prognoses group (in vegetative state or severely disabled,n =29) and good prognoses group (moderately disabled or completely recovered,n =41) according to the GOS score.The serum NSE levels of the decreased group were (32.07 ± 5.73) ng/L,(43.12 ± 15.04) ng/L,(48.26 ± 14.89) ng/L,(50.47 ±11.05) ng/L,(52.90 ±3.82) ng/L,and (56.17 ± 14.62) ng/L respectively at 12 hours and 1st,2nd,3rd,7th and 14th days after injury.The serum NSE levels of the poor prognoses group were (21.90 ± 4.95) ng/L,(24.13 ± 9.94) ng/L,(26.43 ± 6.99) ng/L,(21.62 ± 9.77) ng/L,(15.80 ± 7.15) ng/L,and (10.16 ± 2.33) ng/L respectively at 12 hours and 1st,2nd,3rd,7th and 14th days after injury.The serum NSE levels of the good prognoses group were (13.61 ±4.56) ng/L,(13.75 ±5.10) ng/L,(14.77 ±5.41) ng/L,(13.47 ±4.49) ng/L,(8.92 ± 5.61) ng/L,and (6.60 ± 2.30) ng/L at 12 hours and 1 st,2nd,3rd,7th and 14th days after injury respectively.At each time point,the serum NSE levels were significantly different in the decreased group than in the good prognoses and the poor prognoses groups (F within =18.70,P ＜ 0.001 ; F between =62.97,P ＜0.001 ;F interaction =11.83,P ＜0.001).Conclusion The serum NSE levels can be regard as an index for judging the injury severity and prognosis of DAI,and can be used to guide the option and adjustment of therapeutic approaches for patients with DAI.

Objective To compare genomic expression differences between androgenic complete hydatidiform mole (AnCHM) and normal first trimester villi with similar gestation weeks,and search for potential adjuvant diagnostic molecular markers.Methods Short tandem repeat (STR) detection was used to identify AnCHM,human oligonucleotide array U133 Plus 2.0 was used to measure genomic expression differences between AnCHM and normal villi,and quantitative fluorescent RT-PCR was used to verify array of several genes.Results Nine of 11 histologically diagnosed complete hydatidiform moles were found to be AnCHM by means of STR,and the other 2 were biparental complete hydatidifonn mole (BiCHM). Compared with villi,oligonueleotide array showed 279 genes (0.72%,279/38 500) were over expressed and 1710 genes (4.44%,1710/38 500) under expressed in AnCHM.Bioinformatics analysis found that differentially expressed genes were involved in multiple biological processes and pathways.Changes of imprinting genes,growth hormone genes and chorionie somatomammotropin hormone genes were especially remarkable.Conclusions Pathogenesis of AnCHM is a complex process involving multiple genes and pathways.Altered expression of imprint genes may play important roles in the process.