Exact staging is the important basic tool for choosing reasonable therapy,and accurate staging is also critical for prognosis evaluation,comparison of different therapies and information communication.As the imaging methods for staging of esophageal carcinoma before therapy,CT,MRI,EUS,PET and PET/CT are different in sensitivity,specificity and accuracy for different regions and different organs,depending on the different imaging mechanism.Combination of different methods is the practical way to improve the accuracy of staging.Combining EUS with CT seems to be a practical and precise way.

Objective To investigate the association of complement C1q polymorphism with the susceptibility to lupus nephritis (LN) in the people of Wuhan district,Hubei province, China. Methods The polymorphie frequency at C1q region of accommodation Aexon2, Bexonl,Bexon2,Cexon2 in 30 LN patients,20 non-LN nephropathy controls and 10 healthy controls were examined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP)and then the sequence of mutational site was detected directly.Association of C1q polymorphism with LN was analyzed by chi-square criterion. Results Already repoaed mutable points oversea,such as C1qAexon2:C→T,C1qBexon1:G→A,C1qBexon2:G→A,C1q Cexon2:C deletion,in C1q region of accommodation were not detected in 30 LN patients,20 nonLN nephropathy controls and 10 healthy controls. Conclusion Polymorphism in the regulatory region of C1q region of accommodation is not associated with the susceptibility to LN in the people of Wuhan district,Hubei province,China,which may be influenced by a small number of subjects.

Surgery is the main treatment of esophageal cancer. Esophagectomy by right transthoracic approach is recently recom-mended in China. Minimally invasive esophagectomy is feasible and safe with low perioperative morbidity and offers results that are as good as open thoractomy. Multimodal treatment, especially neoadjuvant chemoradiotherapy or chemotherapy, may improve surviv-al and has become one of the standard treatments for locally advanced esophageal cancer. Fast-track esophagectomy may reduce length of hospital stay, perioperative morbidity, and hospital charges. The surgery of esophageal cancer tends to be minimally invasive, individual, comprehensive, and standardized.

Sepsis is defined as that a variety of pathogenic microorganisms(including bacteria,fungi,viruses and protozoa) invade the blood circulation,produce toxins and cause systemic infection.The early symptoms of neonatal sepsis are atypical.Neonatal sepsis is urgent and progresses quickly,especially in preterm infants,and it is easy to prone to septic shock which is life-threatening.Therefore,early identification,accurate diagnosis,and active intervention for neonatal sepsis and septic shock is essential to reduce mortality and improve prognosis.

0.05). However, the MDA level in the experimental group was higher than that of the control on day 3 [(55.92?5.53)nmol/mg prot vs (22.52?4.36)nmol/mg prot, P

Bronchopulmonary dysplasia(BPD)is a serious complication of respiratory system in preterm infants.The etiology and pathogenesis are complex and have not been clarified yet.In recent years, studies have shown that there is a certain relationship between respiratory microecology and BPD.Before premature infants develop BPD, their respiratory tract microecology has changed, including abnormal microbial diversity and evolution pattern.Therefore, research on the colonization and evolution of neonatal respiratory tract microecology and its relationship with BPD is expected to provide new ideas for its prevention and treatment.

Metabolic bone disease(MBD) in preterm infant is a disorder of calcium and phosphorus metabolism that leads to a decrease in bone mineral content, resulting in clinical, biochemical, and imaging changes.It occurs mostly in very low birth weight and extremely low birth weight newborns.The clinical symptoms usually occur from 6 to 12 weeks after birth, mainly manifested as dyspnea accompanied by mechanical ventilation for a long time, rickety-like changes, and even fracture in severe cases.At present, diagnosis of MBD is characterized by biochemical markers, radiology and ultrasound.As the clinical manifestations of MBD in prematurity occur late, early screening and prevention for high-risk groups play an important role to reduce the risk of MBD.

Intravenous immunoglobulin(IVIG) contains multiple-antigen-specific IgGs and may protect the host from a wide spectrum of pathogens including but not limited to virus and bacteria.With a low IgG level, neonates, especially preterm infants are prone to infection.IVIG can rapidly increase the concentration of serum IgG level, and enhance the anti-infectious and immune-regulatory functions.It has been widely used as a common treatment against neonatal infections.However, there has been inadequate evidence to support the routine usage of IVIG.While prolonged IVIG usage may be beneficial to the extremely or very low birth weight with sepsis, the prophylactic usage of IVIG to decrease the risk of late-onset sepsis in preterm infants depends on the situation of nosocomial infections in different NICUs and the cost-effect efficiency.

Objective To investigate the ultrastructural alteration in brain tissues as well as the expression of bone morphogenetic protein(BMP) 4 and its effects on regulating myelination in the process of white matter injury development.Methods A total of 152 Sprague-Dawley newborn rats(3 days old) were randomly divided into white matter injury group(n=76) or control group(n=76).The white matter injury model was established by ligation of the right common carotid artery and hypoxic exposure(8% O2 and 92%N2),and samples were collected at 3d,7d,14d and 21d after operation.Morphological changes of the brain tissues were observed under a light microscope,while myelination was analyzed using a transmission electron microscope.The expression and location of BMP4 and myelin basic protein(MBP),a marker for myelination,was detected by immunohistochemistry staining,expression levels of BMP4 and MBP proteins were analyzed by Western blotting,and BMP4 mRNA expression was measured by real-time PCR.Results Observed under the light microscope,the cellular structure was clear,fibers arranged closely and orderly in the white matter of the control group.Whereas in the white matter injury group,sparse cells,loose mesh shaped white matter,and disorderly oriented fibers were observed.In the control group,myelin sheath had regular morphology,uniform density,and same thickness,observed using the transmission electron microscope.While in the white matter injury group,the myelin sheath was loosened,thinned,lamellar separated,and boundary obscured.Using immunohistochemistry staining,Western blot,and real-time PCR analyses,it was found that the protein and mRNA expression of BMP4 had no significant change with the increase of age in the control group,while it was rapidly increased with the extending of ischemic time in the white matter injury group.Comparing with the control group,the expression of BMP4 was significantly increased since 3d after operation in the white matter injury group(P<0.05),and the difference between two groups became more significant with the extending of ischemic time.The expression of MBP protein was analyzed by immunohistochemistry staining and Western blot,and a gradual increase was found in both groups with the increase of age.However,the expression of MBP protein was significantly decreased on 14d and 21d after operation in the white matter injury group compared with the control group(P<0.05).Conclusion Myelination disorders exists in white matter injury induced by ischemia-anoxemia.Meanwhile,the expression of BMP4 is significantly increased in the white matter injury group,indicating a possibility that BMP4 involves in the regulation of myelination disorders in white matter injury.

Objective To evaluate the effects of supine and prone position on ventilation function in neonates in the initial six-hour period after weaning. Methods Sixty-four neonates weaned from mechanical ventilation and with normal body temperature hospitalized from Sep. 2004 to Apr. 2006 in our NICU were randomly divided into prone group and supine group. All of them were oxygen administrated through head net, oxygen flow rate was adjusted continously to keep SpO2 at normal level by monitoring SpO2 and RR. FiO2、RR were recorded at 15 minutes,1 h,2 h,3 h,4 h,5 h,6 h after weaning. Arterial blood gas was meas-ured at 1 h ,6 h after weaning and A-aDO2, RI, OI were calculated. Results (1) At 1～6 h after weaning the values of FiO2 in prone group were significantly lower than those in the supine group(P<0.01). (2) After weaning there was a decreasing tendency of RR in the prone group and the significant decrease was found at 4 h ,5 h ,6 h compared with supine group (P<0.01). (3) At 1h and 6h after weaning, the value of PaO2 and OI were significantly higher and the value of A-aDO2, RI were lower in the prone group than in the supine group(P<0.05,P<0.01). (4) At 6 h the PaCO2 in prone group were obviously higher than that in supine group (P<0.05). Conclusion At first 6h after weaning prone position can improve ventilation functions.