Objective To evaluate the feasibility and safety of interventional microinvasive techniques in the management of high level cervical esophageal strictures.Methods Among 20 cases of high level cervical esophageal strictures,13 cases of strictures at the level of C_7~T_3 were given an oral placement of nitinol metal stents woven by single thread under fluoroscopic guidance,while 7 cases of strictures at the level of C_7 and above were given a percutaneous gastrostomy(PG) under endoscopic or fluoroscopic guidance.Results All the operations were successfully accomplished without complications.Out of 13 cases of intraesophageal stent implatation,the improvement of dysphagia was classified as grade 0 in 10 cases and as grade Ⅰ in 3 cases.Esophago-tracheal fistula was completed occluded in 5 cases.Slight downward stent shift was found in 2 cases and no further management was carried out.Follow-up in 11 cases for 1~30 months(mean,18 months) revealed 3 cases of recurrence of esophageal stricture and 8 fatal cases.No stentinduced esophago-tracheal fistula occurred.Of 7 cases of percutaneous gastrostomy,liquid diet was given 2 days after operation.Infection with redness and swelling in the area of fistula wound was noted in 1 case at 1 week postoperatively and the fistula tube was found loosened in 1 case at 5 months postoperatively.No intraabdominal infection,peritonitis,or internal fistula occurred.Follow-up in 7 cases for 1~18 months showed 5 fatal cases.Conclusions Stent implantation should not be contraindicated in patients with high level cervical stricture of esophagus.Radiologically guided percutaneous gastrostomy is safe and feasible,which is preferred as the first choice of treatment.

Objective To investigate the relationship between the activity of nicotinamide adenosine dinucleotide phosphate(NADPH ) oxidase in peripheral blood mononuclear cell and left ventricular remodeling in patients with acute myocardial infarction (AMI).Methods Fifty-two patients with AMI hospitalized from December 2010 to June 2011 were selected as AMI group,and 25 patients with paroxysmal supraventricular tachycardia hospitalized in the same period were selected as control group.All patients were examined by Doppler echocardiography and left ventricular mass index (LVMI) was calculated.Fasting blood was drawn on the second day after hospitalization to measure the level of biochemical indexes,malondialdehyde(MDA ) and the activity of NADPH oxidase.The correlation of the level of MDA,the activity of NADPH oxidase and LVMI was analyzed.Results The level of MDA in AMI group was significantly higher than that in control group [(6.14 ±t 2.80) μ mol/L vs(2.95 ± 1.82) μmol/L,P ＜ 0.01 ].The levd of O2- in AMI group was also obviously higher than that in control group [(21.61 ± 10.66) RLU/mg protein vs.( 7.12 ± 4.48 ) RLU/mg protein,P ＜ 0.01 ],as well as the activity of NADPH oxidase [ ( 2.84 ± 1.05 ) RLU/mgprotein vs.( 1.97 ± 0.80) RLU/mg protein,P ＜ 0.01].Positive correlation was found between LVMI and the level of MDA(r =0.57,P ＜ 0.01 ),as well as between LVMI and the activity of NADPH oxidase(r =0.71,P＜0.01 ).Conclusions The activity of NADPH oxidase in peripheral blood mononuclear cell inereases in AMI patients and plays an important role in left ventricular remodeling after AMI.

Objective:This work aims to use the characteristics of dendritic cells (DCs) pulsed with recombinant human HSP70, which can present and process tumor antigens, to enhance the killing activity of cytotoxic t lymphocytes (CTLs) against breast neoplasms. Methods:Autologous DCs were isolated from peripheral blood mononuclear cells and then stimulated in vitro with granulocyte macrophage-colony stimulating factor and interleukin-4. The DCs were loaded with A549 tumor cell freeze-thaw lysate, and rhHSP70 was added as an immune adjuvant. The specific groups were subjected to tumor-specific cytotoxic assay, enzyme-linked immunosorbent assay, and fluores-cence-activated cell sorting. Results:DCs pulsed with A549 tumor cell lysate enhanced the growth expansion of CTLs, upregulated CD40 and CD80 populations in CTLs, and augmented Th1 cytokines. In addition, the cytotoxicity of specific CTLs against A549 was highly enhanced. The above indications became more obvious after the addition of rhHSP70. Conclusion:DCs pulsed with freeze-thaw cell lysates derived from breast cancer can enhance growth expansion of lymphocytes. They may serve as an effective tumor antigen to stimulate the proliferation of specific CTLs, which are very effective in activating specific T-cell responses against breast cancer cells in vitro. The improved anti-tumor immunity response by DC-based vaccines may be related to the maturation of the DCs promoted by rhHSP70.

Objective To make use of the characteristics of presenting and processing tumor antigen of Dendritic cells pulsed with recombinant human Hsp70 and Mage-3 peptide to enhance killing capability of breast neoplasms. Methods Autologous dendritic cells were isolated from PBMC and then stimuiated in vitro with GM-CSF and IL-4.Dendritic cells were loaded with Mage-3 peptide;at the same time Hsp70L1 was added. The specific groupings each induce generation of tumor specific cytotoxic assay with ELISA. Results DCs pulsed with Mage-3 peptide enhanced the growth expansion of CTL, and promoted the secretion of cytokines such as TNF-αand IL-6. DCs pulsed with recombinant human Hsp70 and Mage-3 peptide had cytotoxicity against human breast cancer cells MCF-7.Conclusions DCs pulsed with recombinant human Hsp70 and Mage -3 peptide have higher biological activities. Modified DCs can stimulate the proliferation of lymphoeytes,present effectively tumor antigen to stimulate generation of speeific CTLs. Dendritic cells pulsed with recombinant human Hsp70 and Mage-3 peptide have high ability to kill breast cancer cells.

ObjectiveTo investigate the impact of blood glucose,blood pressure and blood uric acid level on hematuria in patients with acute coronary syndrome (ACS).MethodsOne hundred and sixty-two ACS patients were selected and received standardized treatment after admission to hospital.Urine test was taken and patients were divided into no hematuria group(37 cases),microscopic hematuria group (56 cases) and gross hematuria group(69 cases) according to the results.Blood pressure,fasting and postprandial 2 hours blood glucose,glycated hemoglobin and blood uric acid level were measured and compared among three groups.ResultsMicroscopic hematuria group compared with no hematuria group,fasting and postprandial 2 hours blood glucose,glycated hemoglobin,systolic blood pressure and blood uric acid level raised 58.0％[(7.9 ±0.7) mmol/L vs. (5.0 ± 1.1) mmol/L],33.3％[(12.4 ±0.8) mmol/L vs.(9.3 ± 0.6 ) mmol/L ],48.2％ [ ( 8.3 ± 0.8 )％ vs.( 5.6 ± 0.5 )％ ],23.8％ [ ( 151.6 ± 7.0) mm Hg ( 1 mm Hg =0.133 kPa) vs.(122.5 ±9.9) mm Hg],29.2％ [(635.4 ±47.4) μmol/L vs.(491.8 ±83.4)μmol/L]respectively,there were significant differences (P ＜ 0.05 or ＜ 0.01 ).Gross hematuria group compared with microscopic hematuria group,the above mentioned indexes raised 16.5％[ (9.2 ± 1.1 ) mmol/L vs.(7.9 ± 0.7)mmol/L],30.6％[ ( 16.2 ± 1.8) mmol/L vs.( 12.4 ± 0.8) mmol/L],14.5％[ (9.5 ± 0.8)％ vs.(8.3 ± 0.8)％ ],18.8％[(180.1 ± 12.3) mm Hg vs.(151.6 ±7.0) mm Hg],34.6％[(855.5 ±74.5) μ mol/L vs.(635.4 ±47.4 ) μ mol/L ] respectively,there were significant differences ( P ＜ 0.05 or ＜ 0.01 ).Gross hematuria group compared with no hematuria group,the above mentioned indexes increased significantly(P＜ 0.01 ).The level of diastolic blood pressureamong three groups had no significant difference(P ＞ 0.05).The Logistic regression analysis showed that fasting and postprandial 2 hours blood glucose (r =3.175,P =0.001 ;r =0.906,P =0.001 ),glycated hemoglobin ( r =16.109,P =0.001 ),systolic blood pressure (r =0.429,P =0.003 ),blood uric acid level(r =1.317,P =0.004) were risk factors on hematuria after antiplatelet and anticoagulant therapy in ACS patients,the impact of glycated hemoglobin and fasting blood glucose on hematuria was stronger than that of blood uric acid level and systolic blood pressure.ConclusionWith the increase of blood glucose,systolic blood pressure,blood uric acid,the risk of hematuria increases in ACS patients.

Objective To evaluate the efficacy of PAD regimen (bortezomib, doxorubicin, dexamethasone) and VAD-like T regimen (vincristine, doxorubicin/doxorubicin derivatives, dexamethasone combined with thalidomide) in the treatment of patients with newly diagnosed multiple myeloma (MM). Methods The efficacy of 54 patients with MM who received VAD like-T regimen and 72 patients with MM who were treated with PAD regimen, including complete remission (CR) rate, very good partial remission (VGPR) rate, overall response rate (ORR), overall survival (OS), progression-free survival (PFS) and adverse events, were retrospectively analyzed. Results The CR rate of PAD group was higher than that of VAD-like T group [31.5 % (23/72) vs. 9.3 % (5/54), χ2=0.30, P=0.002]. The VGPR rate and ORR of PAD group were not statistically higher than those of VAD-like T group [16.7 % (12/72) vs. 16.6 % (9/54), P=0.180; 82.2 %(65/72) vs. 81.5 % (44/54), P=0.190, respectively]. Median PFS of PAD group was significant longer than that of VAD-like T group [(38.2±2.2) months vs. (28.0±7.6) months, P=0.017]. The 3- and 5-year OS rates of PAD group were higher than those of VAD-like T group, but there were no significant differences between two groups (P>0.05). In terms of the adverse events, the incidence of peripheral neuropathy in PAD group was significantly higher than that of VAD-like T group [31.5 % (23/72) vs. 14.5 % (8/54), P=0.03]. Conclusions Compared with PAD protocol, the CR and median PFS of VAD-like T regimen are poor, however, VGPR,ORR, PFS and 5-year OS are similar between the two groups, and VAD-like T regimen is safer with low incidence of peripheral neuropathy. VAD-like T regimen as the first-line treatment is effective and well-tolerated, especially for newly diagnosed MM patients not suitable for transplantation and bortezomib.

This article discusses the meaning,problem and suggestion which come from the university quality of teaching collection of information,the reorganization and the feedback.

Objective To establish an high performance liquid chromatography method for determination of 2-indole ketone derivative and its related substances. Methods Agilent Eclipse XDB-C18(250 mm×4.6 mm,5 μm) column was adopted.The mobile phase was acetonitrile-water with gradient elution mode at a flow rate of 1. 0 mL?min-1; the column temperature was 35 ℃;the injection volume was 20 μL and the detection wavelength was set at 257 nm. Results 2-indole ketone derivative ID and related substances could be well separated. The 2-indole ketone derivative had good linear correlation ( r=0.999 4) within the range of 40-300 μg?mL-1 . It had a good precision ( RSD<1%) . The limit of detection was 8 ng. Conclusion The method is accurate,simple,sensitive and selective,which can be used for the quality control of 2-indole ketone derivative and related substances.

Objective To investigate the clinical effect of large piece of mid -thick head skin applicated in repairing of wound in childrens′functional location.Methods 24 children with functional parts burn and scar con-tracture were selected.Using electric machine,the large piece of mid -thick head skin(thickness ≥0.25mm)was taken,then transplanted it to functional location directly or punching,and dressed or suture package fixed it,1 week after the skin transplanting,anti -scarring therapy and functional exercise were carried out.Control group:selected the thighs,back,abdomen as donor sites;The scar of operation area of the two groups were evaluated and analyed after 3 months by the Vancouver Scar Scale Rating.Results In the study group,the functional parts burn and scar con-tracture deformity was primary wound repairing,by the early anti -scarring therapy,the function and appearance was satisfied with repairing,during follow -up,there were varying degrees of repair site scar,but functional activity was not significantly affected;There were no scar hyperplasia of the head blood supply area,no bald hair deformity,compared with the control group after 3 months:surgical color (t =0.48,P >0.05),surgical vascular distribution (t =0.47, P >0.05),scar thickness (t =0.07,P >0.05)and softness (t =0.42,P >0.05),four indicators had no significant statistical difference.Conclusion The large piece of mid -thick head skin transplanting applied in children functional parts and scar contracture deformity restorative treatment,combined with early anti -scarring therapy and functional exercise,function and appearance can achieve satisfactory clinical results,but also for further post -repair function and appearance of the skin to provide more options source and surgical methods.

Objective To compare the effects of different opportunity internal fixation in treatment of trau-matic flail chest.Methods Clinical data of 53 cases of patients with traumatic flail chest were selected,in which 28 patients were given internal fixation treatment in 72h after injury (early surgery group),25 patients were given sur-gery after 72h(late surgery group),recovery situation(postoperative ventilation time,chest improve time,ICU stay time,extubation time,hospitalization time)of the two groups were observed,respiratory function changes and compli-cations were compared before and after treatment.Results Postoperative ventilation time,chest X -ray improvement time,ICU stay time,extubation time and hospitalization time of the early operation group were (27.4 ±4.8)h, (88.6 ±7.5)h,(3.8 ±0.7)d,(3.2 ±0.8)d,(13.2 ±5.0)d,which were significantly shorter in the late operation group of (40.7 ±5.2)h,(195.3 ±8.0)h,(5.6 ±1.4)d,(5.2 ±1.3)d,(19.8 ±6.4)d,with significant difference (t =7.389,11.204,3.837,3.916,5.261,all P <0.05 ).After treatment,PaO2 ,PaCO2 ,PaO2 /FiO2 ,RR and HR were all significantly improved (early surgery group t =12.497,6.205,4.136,7.381,14.327,all P <0.05;late sur-gery group t =11.976,5.813,4.649,6.892,14.627,all P <0.05),but the indexes between the two groups were not significantly different(t =0.126,0.013,0.002,0.010,0.215,all P >0.05 ).There was no dead case in the two groups,and the incidence of atelectasis,ARDS and thoracic deformity had no significantly different between two groups (P >0.05 ).Conclusion In treatment of traumatic flail chest,early surgical treatment can rapidly improve the respiratory and circulatory function,it can shorten the postoperative recovery time,and does not increase complica-tions.So,when conditions permit,patients should be given early surgical fixation.