The definition of esophagogastric junction (EGJ) adenocarcinoma and progress in multidisciplinary treatment for the tumor were revised in this review. Siewert classification is especially useful for the surgical approach of EGJ adenocarcinoma. Siewert I should be treated as esophageal cancer, and Ivor-Lewis esophagogastrectomy (right thoracotomy and laparotomy) is recommended as an extended two-field lymphadenectomy. For Siewert II or III tumors, left thoracophreno-laparotomy is preferred, especially in case of positive thoracic lymph nodes or positive resection margin. If there is any contraindication against thoracotomy, or a high operating risk, a transhiatal esophagectomy with lower mediastinal lymphadenectomy is an alternative. Preoperative chemoradiotherapy or perioperative chemotherapy improves overall survival and the rate of complete resection for patients with large tumor or lymph node metastasis. Neoadjuvant chemoradiotherapy is associated with high but acceptable postoperative complications. Adjuvant chemoradiotherapy remains a rational standard therapy for curatively resected EGJ cancer with T3 or greater lesion or positive nodes.
Adenocarcinoma ; surgery ; therapy ; Combined Modality Therapy ; Esophageal Neoplasms ; surgery ; therapy ; Esophagogastric Junction ; Humans ; Stomach Neoplasms ; surgery ; therapy

Apoptosis ; physiology ; Cell Cycle ; physiology ; Humans ; Neoplasms ; etiology ; metabolism ; Tankyrases ; genetics ; physiology ; Telomerase ; metabolism ; physiology ; Telomere ; genetics ; metabolism ; Telomere-Binding Proteins ; genetics ; physiology ; Telomeric Repeat Binding Protein 1 ; genetics ; physiology ; Telomeric Repeat Binding Protein 2 ; genetics ; physiology

AIM: To establish the quality standard for Huangqi Fufang Granules(Radix Astragali, Fructus Schisandrae Chinensis, Radix Cyathulae, etc.). METHODS: Fructus Schisandrae Chinensis, Radix Cyathulae were identified by TLC, and the content of astragaloside Ⅳ was determined by TLC scanning. RESULTS: Fructus Schisandrae Chinensis, Radix Cyathulae could be identified by TLC. Astragaloside Ⅳ showed a good linear relationship at a range of 1.0?g～6.0?g, r =0.9992. The average recovery was 99.19%, and RSD was 0.63%. CONCLUSION: The methods are simple, accurate and specific, and can be used for the quality control of Huangqi Fufang Granules.

Antineoplastic Agents ; administration & dosage ; Drug Delivery Systems ; Genetic Therapy ; methods ; Hematologic Neoplasms ; drug therapy ; therapy ; Humans

Aim To investigate the molecular mechanisms of differentiation in human leukemia HL-60 cells induced by diallyl disulfide(DADS)using suppression subtractive hybridization(SSH).Methods In our privious study,the subtractive cDNA library was constructed successfully and efficiently. 30 clones were randomly analyed with restriction enzyme.The inserts of cDNAs were analyzed by restrictive enzyme EcoR I.Positive clones were sequenced and the homology of resulting cDNA sequences were analyzed through bioinformatics software Blastn.Results 18 clones contained 100～600 bp cDNA inserts.10 differantiation genes were obtained and involved in cell cycle,signal transduction,metabolism and RNA binding.And 3 of 10 genes,p21,STAT1 and CAMTA1 were up-regulated and detected by RT-PCR,the results matched with SSH.Conclusion sThere are tight correlation between the differentiation induced by DADS and three-upregulated gene:p21,STAT1 and CAMTA1.

BACKGROUND:Proximal humeral fracture fixation can provide a more stable fixation, has a stronger biomechanical stability, but open reduction and fixation wil cause extensive soft tissue dissection and heavy damage to the rotator cuff. Closed wear nail has a high failure rate of fixation, fracture re-displacement and other defects. OBJECTIVE:To investigate the technical methods of applying closed reduction, percutaneous pinning anatomical external fixation in repair of proximal humeral fracture, and to analyze the application characteristics and safety in different types of proximal humerus fractures. METHODS:Based on the special anatomical structure of proximal humerus, a shoulder external fixator has been independently researched and developed by author. The clinical data of 23 patients treated with closed reduction and percutaneous pinning anatomical external fixation (homemade) because of proximal humerus fracture at the Department of Traumatology, Tianjin Hospital during March 2010 to March 2014 were retrospectively analyzed. In accordance with Neer classification type, there were 19 cases of 2-part fractures of the humerus, 4 cases of 3-parts fractures of the humerus, with greater tuberosity avulsion fractures, which were al fresh fractures and were treated with closed reduction pinning and external fixation. Regular fol ow-up was conducted after treatment. Radiographic assessment, pain and function evaluation were conducted during fol ow-up, so as to work out the functional recovery, determine the final repair result. RESULTS AND CONCLUSION:Al patients were fol owed up for 6-24 months. Total y 23 patients initial y healed in fracture within 8 weeks. After treatment, visual analogue pain score of patients was 0.8 points. In the final fol ow-up, the American Shoulder and Elbow Surgery Association of shoulder function scoring system (ASES) score was an average of (91.7±2.6) points, Constant shoulder function score was an average of (88.3±4.7) points, the University of California (UCLA) shoulder joint scoring system score was (31.9±3.1) points, simple shoulder test (SST) system score was an average of (9.6±2.4) points. The shoulder function assessment (UCLA score) of these 12 patients was excel ent, of 9 cases was good, and of 2 cases was poor. The excel ent rate reached 91%after treatment. These results suggest that the application of closed reduction, percutaneous nailing anatomical external fixation in repair of proximal humerus fractures has the features of stable fixation, and smal damage of soft tissue. Standardizing the angle of closed nailing and entrance point, fixing from the intersection of three planes in arcuate-shape and connecting with external fixation can achieve a more stable fixed effects.

Objective To analyze the clinical experience of double lumen endobronchial tube intubation in 41 cases of whole lung lavage .Methods Forty‐one patients with whole lung lavage in our hospital from February 2010 to February 2015 were retro‐spectively analyzed .The effect of bronchoscopy and auscultation location method were explored after double‐lumen endobronchial intubation in whole‐lung lavage .Results Among 41 cases ,39 cases were successfully located by using the auscultation location ,and other 2 cases were successfully positioned by using the bronchoscopy position after repeatedly auscultation location method resulting in lung isolation failure .The catheter depth in 19 cases was adjusted after using bronchoscopy ,and then double lung was isolated well and lavage was successfully conducted .Conclusion The prerequisite for success of whole lung lavage is accurate position of double‐lumen endobronchial tube .Bronchoscopy look positioning has become the gold standard of double‐lumen endobronchial tube position .

Objective To investigate theeffect of ischemic postconditioning (IPO) on ischemia/reperfusion injury via mitochondrial pathway.Methods Male Sprague-Dawley rats were divided into three groups by means of random number table.Rats in IRI group and IPO group received liver transplantation.The portal vein in IRI group was opened immediately after liver implantation to restore the blood supply.The graft rats in IPO group received IPO before the portal vein was completely opened: 60-s ischemia and 60-s reperfusion of the portal vein,repeated 6 times).The rats in the sham-operation group were only subject to dissociation of the liver ligament.Six h after portal vein reperfusion,liver function was tested.The expression of Bcl-2 mRNA and Bax mRNA was detected by using real time-PCR.The protein expression of Cyt-c was detected by using Western blotting.The apoptosis and necrosis of liver tissue and the mitochondrial transmembrane potential were detected by using flow cytomertry.The changes of mitochondrial structure were observed under an electron microscope.Results The liver functions in IRI group and IPO group were significantly worse (P＜0.05),the levels of Bax mRNA were significantly higher (P＜0.05),the levels of Bcl-2 mRNA were significantly lower (P＜0.05),the levels of Cyt-c protein were significantly higher (P＜0.05),the levels of apoptosis and necrosis were significantly higher (P＜0.05),and mitochondrial transmembrane potential (MTP) of liver cells was significantly lower (P＜0.05) than in sham operation group.The changes of all the parameters in IRI group were more significant than in IPO group (P ＜ 0.05).The morphological changes of the liver mitochondria were also significantly aggravated in IRI group as compared with IPO group.Conclusion IPO reduced IRI by inhibiting the mitochondrial signaling pathway in rats undergoing liver transplantation.

Aim To investigate JAKs/STATs signal transduction change in HL-60 cells differentiation induced by diallyl disulfide(DADS)and molecular mechanism regulating the differentiation.Methods After incubation of HL-60 cells with DADS or AG490(50 ?mol?L -1),the cell differentiation indexes were observed by cytomorphology, NBT reduction ability assay,cell myeloid differentiation antigen CD11b by flow cytometry. Kinase activity of JAKs/STATs was tested by western-blotting and expressions of nucleus transcription genes stats,c-myc,c-fos,c-jun were detected by immumocyte chemistry method.Results Cell differentiation index changes indicated that HL-60 cells were induced differentiation toward granulocytic lineage by DADS, Western blot test demonstrated that constitive phosphorylation of Jak1,stat3 kinase was suppressed. Stat3,c-myc gene expression decreased and c-fos, c-jun gene expression increased in HL-60 cells treated with DADS through immunocyte chemistry.Conclusion Inhibition of phosphative Jak1, Stat3 was involved in HL-60 cells differentiation induced by DADS, its molecular mechanism might be related to modulation of gene expression associated proliferation and differentiation,and inhibition of DNA systhesis, induction differentiation.