Currently,resectable esophageal cancer is commonly initially treated with surgery in China,but the optimal postoperative treatment remains unclear.Postoperative concurrent chemoradiotherapy can improve local control and reduce distant metastasis and may become the preferred treatment for patients after surgery for esophageal cancer.By summarizing the studies on concurrent chemoradiotherapy after surgery for esophageal cancer,this review points out that postoperative concurrent chemoradiotherapy can improve the overall survival of patients with positive lymph nodes and has tolerable adverse effects,but the populations who can benefit from this treatment,the optimal radiotherapy dosage,target volume,and chemotherapy regimen of postoperative concurrent chemoradiotherapy await further investigation.

Objective To observe the effect of Bufalin on controlling ECA109 cells , and to explore its potential anti-tumor mechanism. Method The effect of Bufalin on the proliferation of human esophageal cancer ECA109 cells was evaluated by CCK-8 assay and it effects on apoptosis of esophageal cancer ECA109 cells were determined by flow cytometry (FCM). Protein expressions of NF-κBp65, ERK, PERK1/2 and Caspase-3, Cleaved Caspase-3, PARP, Cleaved PARP in esophageal cancer ECA109 cell were observed through Western blot. Results The proliferation of human esophageal cancer ECA109 cells was significantly inhibited in bufalin group in a time- and concentration-dependent manner. Bufalin can induce the apoptosis in human esophageal ECA109 cells. Results of Western blot showed the protein expressions of apoptosis-related protein Cleaved Caspas-3 and Cleaved PARP in esophageal cancer ECA109 cells could be markedly up-regulated by Bufalin , but p-ERK1/2, NF-κBp65 in esophageal cancer ECA109 cells could be markedly down-regulated by Bufalin. Conclusion Bufalin can potently inhibit the growth of esophageal cancer ECA109 cells and the potential anti-tumor mechanism might be involved in inhibiting ERK/ NF-κB signal pathway.

BACKGROUND:Posterior lumbar interbody fusion can thoroughly decompress the central canal, which is the common surgical technique for the central type of lumbar disc herniation with intervertebral instability at low lumbar segment. However, due to the regular traction on dural sac and nerve root in the operation, lower limb radicular pain in the early stage is inevitable. OBJECTIVE:To evaluate the effect of local use of gelatin sponge containing prednisolone acetate around the nerve roots after posterior lumbar interbody fusion on lower limb radicular pain. METHED:Sixty-three cases of lumbar disc herniation with degenerative instability were devided into treatment group (n=21) and control group (n=42) based on the type of implants. Gelatin sponge containing prednisolone acetate was implanted into patients in the treatment group after posterior lumbar interbody fusion, while pure gelatin sponge was implanted into patients in the control group. RESULTS AND CONCLUSION:Compared with the control group, radicular pain in the treatment group was significantly relieved within 1 week after surgery. The visual analog scale score and Oswestry disability index score were similar between the two groups. There were three cases of radicular pain recurrence in the control group, but no incision infection and epidural hematoma after surgery in both two groups. In conclusion, local use of gelatin sponge containing prednisolone acetate around the nerve roots can significantly relieve lower limb radicular pain in the early stage after posterior lumbar interbody fusion in lumbar disc herniation, contributing to early rehabilitation exercise and patient satisfaction outcomes.

Background:Recently,the American Society for Gastrointestinal Endoscopy published the PIVI( Preservation and Incorporation of Valuable Endoscopic Innovations)initiative regarding to the“predict,resect,and discard”strategy on diminutive(≤5 mm)colorectal polyps. The low prevalence of adenoma with advanced histology( containing ≥25%villous component,or high-grade intraepithelial neoplasia,or submucosal invasive carcinoma)in diminutive polyps would provide high confidence for endoscopists to adopt the strategy. Aims:To investigate the prevalence of adenoma with advanced histology in diminutive colorectal polyps. Methods:Data of diameter,location and morphology of colorectal polyps were collected prospectively from patients undergoing colonoscopy at Digestive Endoscopy Centre,Shanghai Ren Ji Hospital from Jan. 2013 to Jun. 2013. The polyps were resected,placed in a unique specimen vial,and sent for histological evaluation. Results:A total of 1 986 colorectal polyps were enrolled in the study,including 900(45. 3%) diminutive polyps(≤5 mm),521(26. 2%)small polyps(6-9 mm)and 565(28. 4%)large polyps(≥10 mm). Prevalence of adenoma with advanced histology in diminutive polyps was significantly lower than those in small and large polyps(1. 1% vs. 8. 4% and 43. 7%,P<0. 05),and was not correlated with the location and morphology of diminutive polyps. Submucosal invasive carcinoma was found in 4. 6% of large polyps,0. 4% of small polyps,and 0% of diminutive polyps. Conclusions:The very low prevalence of adenoma with advanced histology and absence of submucosal invasive carcinoma in diminutive colorectal polyps favours the potential practice of“predict,resect,and discard”strategy in the patient population studied.

The basement membrane (BM) is crucial in regulating the physical and biological activities of esophageal epithelial cells which attach to the underlying BM. In order to simulate the natural construction of BM, we prepared the fibrous scaffolds using biodegradable polylactide (PLA) and silk fibroin (SF) as the materials via electrospinning technology. BM's proteins containing collagen (IV), laminin, entactin and proteoglycan were extracted from porcine esophagus and coated on the eletrospun fibers. Morphology, mechanical strength, biodegradability and cytocompatibility of the coated and uncoated scaffolds were tested and evaluated using scanning electron micrography, mechanical test system, immunofluorescence assay and western blotting with CK14 as the primary antibody. The fibrous scaffold PLA or PLA/SF, generated from the present protocol had good formation and mechanical and biodegradable properties. After coating with BM's proteins, the scaffold could enhance the growth and differentiation of esophageal epithelial cells, which would contribute to remodel and regenerate the tissue engineered epithelium and further contribute to engineer the whole esophagus in future.
Absorbable Implants ; Basement Membrane ; Biocompatible Materials ; chemistry ; Epithelium ; Esophagus ; physiology ; Fibroins ; chemistry ; Humans ; Nanostructures ; chemistry ; Polyesters ; chemistry ; Regeneration ; physiology ; Tissue Engineering ; methods ; Tissue Scaffolds ; chemistry

BACKGROUND:Polyurethane has good mechanical and physical characteristics and is extensively used in
clinical and experimental studies, but its hydrophobicity and histocompatibility are not ideal, which limits its use in tissue engineering as a biomaterial scaffold to some extents.
OBJECTIVE:To observe the hydrophilicity of polyurethane membrane grafted with silk fibroin and glutin and its compatibility with human hypopharyngeal cel s.
METHODS:The changes in hydrophilicity of polyurethane membrane grafted with silk fibroin and glutin were detected by contact angle measurements. Human hypopharyngeal fibroblasts were cultured in vitro on
polyurethane membrane, silk fibroin-polyurethane membrane, glutin-polyurethane membrane and tissue culture plate. Cel compatibility was compared using cytometry and cel morphology obsevation.
RESULTS AND CONCLUSION:Hydrophilicity of silk fibroin-or glutin-polyurethane membranes significantly increased (P<0.01). The hydrophilicity of silk fibroin-polyurethane membrane was higher than that of
glutin-polyurethane membrane (P<0.01). The number of cel s on the tissue culture plate was the most. The number of human hypopharyngeal fibroblasts on the silk fibroin-or glutin-polyurethane membrane was higher
than that on the polyurethane membrane, especial y on the silk fibroin-polyurethane membrane. These suggested that hydrophilicity and cel compatibility of silk fibroin-or glutin-polyurethane membrane were elevated.

Objective To explore the CT and MRI manifestations and clinical features of juxtaglomerular cell tumor (JGCT). Methods A retrospective analysis the data of eight JGCT patients who resected by surgery and comfirmed by histopathology. Seven cases were examined by CT before operation, five of whom underwent CT scan and dynamic enhanced scan, two of whom underwent CT scan, and all of the eight underwent MRI scan and dynamic enhanced scan. The clinical manifestations of patients were also observed, whether they have hypertension and reduced blood potassium, recorded the results of lying and standing test, and collected the segmental renal vein blood to detect the renin levels. Meanwhile, the CT and MRI manifestations were also recorded. Results (1) We found that all of the eight patients appeared hypertension, and hypokalemia were found among five cases. Seven patients proceeded the lying and standing test, six of whom the plasma renin activity (PRA) were elevate in erect position, and the levels of angiotensin Ⅱand aldosterone (ALD) were rised among all of the seven cases in erect position. Four patients were collected the segmental renal vein blood, and one of whom has positive result of the renin activity. (2) The tumors of all the eight cases were single, the border was clear, and the average size was 2.7 cm (range 1.9 to 3.8 cm). The CT scan results showed there's no calcification or pseudocapsule were detected, four cases showed homogeneous iso-density, one case with slightly high density, another one showed low density with dotty high density and one case with low density. The dynamic enhanced CT scan showed that four cases performed continuous enhancement from cortical to medullary phase, and no obvious enhancement was found in one case. The T2WI results of MRI scan showed six cases had pseudocapsule, 6 cases had heterogeneous signal (4 cases with patchy low signal and 2 cases with patchy high signal), and 2 cases had homogeneous signal (one case with iso-high signal and another with high signal). The T1WI results showed two cases performed low signal, anther two cases showed iso-signal, and four cases with heterogeneous signal. The DWI results showed all of the 8 lesions with homo-or peripheral high signal. The dynamic enhanced MRI scan results showed seven cases performed gradual enhancement, and the border of another case became clear on delay phase. Conclusions JGCT has specific clinical and imaging features, and the combination will help make a correct diagnosis.

OBJECTIVE:To provide reference for the rational use of Potassium chloride injection and the management of high-risk drugs. METHODS:A total of 1 065 prescriptions containing Potassium chloride injection during the first half year of 2014 were analyzed retrospectively according to“Rules for Comment on Prescriptions”. RESULTS:The qualification rate of pre-scription was 95%. The irrational prescriptions accounted for 5%. The main problems included unreasonable route of administra-tion,unreasonable selection of solvent,incompatibility with TCM injection and other types of injections as well as the risk of Potas-sium chloride injection combined with a few oral drugs. CONCLUSIONS:The defect still exist in the management of high-risk drug aspotassiam chloride injection in our hospital,so that the hospital should set up high-risk drug prescription special review sys-tem and emergency plan which is the effective way for avoiding the drug risk of high-risk drugs.

Objective To investigate the effect of concurrent exercise intervention in metabolic endotoxemia induced by high-fat diet in rats,and further understand the damage of liver mitochondrial ultramicrostructure.Methods Eighteen SD rats with the weight of 100g were randomly divided into 3 groups:group A (standard diet group),group B(high-fat diet group) and group C (treadmill-trained group with high-fat diet).Training (1 hour/d) initiated at the same time as the HF diet was fed.After being raised for 6 weeks,the rats was euthanized and weighed up.Blood samples were taken and the levels of serum lipid were detected.The levels of serum endotoxin were detected by enzyme-linked immunoadsorbent assay.The membrane potentials of isolated mitochondrion were detected by flow cytometry instrument and the morphologic changes in mitochondria in liver were observed by electronic microscopy.Results In group B,the levels of endotoxin increased significantly(2.916 ± 0.761 rs 5.454 ± 1.254,t =-4.236,P ＜ 0.05),and the liver mitochondrial density and membrane potential also increased significantly compared with group A after 6 weeks (4.330 ±0.501 vs 3.507 ±0.532,t =2.759,P ＜0.05;l.660 ±0.202 vs 0.473 ±0.064,t =13.712,P ＜0.05).But there was no markedly different in serum endotoxin between group B and group C (4.972 ± 1.757 vs 5.454 ± 1.254,t =-0.547,P ＞ 0.05).Compared with group B,the liver mitochondrial density of group C decreased significantly (4.330±0.501 vs 3.581 ±0.188,t =3.426,P ＜ 0.05).The mitochondrial ultrastructurctural changes in each group were not obvious.Conclusions The rats fed with high-fat diet for 6 weeks can reach the state of metabolic endotoxemia.The increasing levels of the liver mitochondrial membrane potential caused by metabolic endotoxin may affect the happening and development of other diseases in the future.Concurrent exercise can not decrease the level of endotoxin.It also shows that metabolic disease caused by high-fat diet should be prevented by moderation in eating and drinking.

Objective To investigate the effect of the overexpression of NeuroD1 on mediating transdifferentiation of spinal reactive astrocytes into neurons. Methods Spinal cord astrocytes were cultured from the SD rat, and reactive astrocytes were prepared by scratches treatment. Cells were divided into blank groups (NV group), control virus group (GFP group) and NeuroD1 virus group (NeuroD1 group). At 7 d after scratches treatment, GFP and NeuroD1 groups were infected with retroviruses carrying the GFP gene and and GFP gene plus NeuroD1 gene, respectively,whereas NV group was not infected with the virus. Twenty-four hours late, the culture medium were replaced by neuron conditioned medi?um. Cell morphology was examined at 1, 2, 3, 5, 7 and 14 d. DCX positive and NeuN positive cells were detected at 7 d and 14 d after infection by using immunofluorescence staining method, respectively. Results After replacement with the neuron conditioned medium, the nucleus was obviously plump, the cytoplasm was thin and neurites was reduced and ex?tended. Compared with the NeuroD1 group, neurites of NV group and GFP group were shorter with many branches and the nucleus was smaller. At 7 d after infection, cell morphology of NV group and GFP group gradually recovered, but cell morphology of NeuroD1 group did not. Compared with NV group and GFP group, NeuroD1 group had more DCX(9.84 ± 2.06%)and NeuN(8.25±2.78%)positive cells [F values 40.107 for DCX and 21.73 for NeuN (P<0.05)]. Conclusion The overexpression of NeuroD1 can mediate the transdifferentiation of spinal reactive astrocytes into neurons.