Objective To evaluate the feasibility of CT staging for esophageal cancer. Methods A retrospective analysis of 304 patients treated,from Jan. 1996 to Dec. 1998 chiefly with radiotherapy(126 conventional radiotherapy,55-65 Gy/27-35 fx/5.5-7.0 w;178 late-course accelerated hyperfractionated radiotherapy ,55-60 Gy/33-36 fx/ 4.5 -5.5 w)complete with CT data before treatment was done. The long survival was compared with pre-therapy CT findings and CT staging. ResultsThe survival rate of stage T1+T2 was very significantly different from those lesion with stage T3,T4(? 2=12.90,P0.05).The survival rates of patients positive for lymph nodes or distant metastasis were lower. Conclusion CT staging is quite optimal for non-operable esophageal cancer in clinical staging,as it is conducive to predict the prognosis.

The chemical constituents from Euphorbia lunulata was investigated in this paper. Fourteen compounds were isolated and purified by column chromatographies on silica gel and preparative HPLC. Their structures were identified by physiochemical properties and NMR data analysis as lupeol (1), euphol (2), cassipourol(3) , 24-methylenecycloartan-3beta-ol (4), 24-hydroperoxycycloart-25-en-3beta-ol (5), 25-hydroperoxycycloart-23-en-3beta-ol (6), betulin (7), uvaol (8), (23E) -25-methoxycycloart-23-en-3beta-ol (9), (23E) -cycloart-23,25-dien-3beta-ol (10), 24-methylenecycloartan-3beta, 28-diol (11), salicinolide (12), 2alpha, 3beta, 5alpha, 9alpha, 15beta-pentaacetoxy-11,12-epoxy-7beta, 8alpha-diisobutyryloxyjatropha-6 (17) -en-14-one (13) and 3beta, 5alpha, 15beta-triacetoxy-7beta-isobutyryloxy-9alpha-nicotinoyloxyjatropha-6 (17), 11(E)-dien-14-one (14). Among them, compounds 1-11 were isolated from E. lunulata for the first time.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Euphorbia ; chemistry ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Spectrometry, Mass, Electrospray Ionization ; Stereoisomerism

OBJECTIVETo explore the effect of Bushen Huoxue Compound (BHC) on lactate dehydrogenase (LDH) leakage, expressions of vascular endothelial growth factor (VEGF) and VEGF mRNA in retinal Muller cells under high glucose condition or advanced glycosylation end products (AGEs) condition by using serum pharmacological method.

METHODSThe retinal Müller cells of 5-7 days post-natal Sprague Dawley (SD) rats were cultured with modified enzyme-digestion method. Purified retinal Muller cells were cultured in normal conditions, high glucose condition (50 mmol/L) or AGEs (50 mg/L and 100 mg/L) conditions, and BHC-containing serum was added to culture medium. The LDH leakage and VEGF expressions were measured by enzyme-linked immunosorbent assay (ELISA). In addition, the relative expression of VEGF mRNA was tested by reverse transcription polymerase chain reaction (RT-PCR).

RESULTSCompared with the normal control group, expressions of VEGF and VEGF mRNA were significantly increased in the high glucose group, the low dose AGEs group and the high dose AGEs group (all P < 0.01). The LDH leakage was obviously increased in the high dose AGEs group, when compared with the normal control group and the high glucose group (P < 0.01). The LDH leakage, expressions of VEGF and VEGF mRNA were obviously decreased by BHC-containing serum both in high glucose and AGEs conditions (P < 0.05, P < 0.01). BHC-containing serum had no significant effect on the LDH leakage and expressions of VEGF and VEGF mRNA in normal conditions (P > 0.05).

CONCLUSIONSAGEs intervention could obviously lower the stability of Müller cell membrane. Up-regulated expressions of VEGF and VEGF mRNA in cultured Müller cells could be induced by AGEs or high glucose. BHC-containing serum could stabilize the stability of Müller cell membrane, inhibit the transcription of VEGF mRNA and decrease the protein expression of VEGF, which might be one of important mechanisms for preventing and treating diabetic retinopathy.

Animals ; Cells, Cultured ; Diabetic Retinopathy ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Ependymoglial Cells ; Glucose ; L-Lactate Dehydrogenase ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; Vascular Endothelial Growth Factor A

Objective To investigate the effects of different doses of alcohol on the synthesis of testosterone and the expression of androgen binding protein(ABP)mRNA in rat testis.Methods Forty male Wistar rats were randomly divided into 4 groups(10 rats each group)and received either distilled water(control group)or alcohol(alcohol-fed groups)for 5 months.Alcohol was administered by garage with a single daily dose : 5 g/kg(large dose group),2.5 g/kg(middle dose group)and 0.5 g/kg(small dose group).Testosterone content was measured by ELISA.mRNA levels of peripheral-type benzodiazepine receptors(PBR),PPARct and ABP were assayed by RT-PCR.Results Compared with control group:(1)ethanol feeding with daily doses of 5 g/kg,2.5 g/kg and 0.5 g/kg significantly decreased testosterone levels by 31.13%(P0.05)respectively,indicating that ethanol might impair testosterone synthesis;(2) mRNA levels of PBR were decreased in all three ethanol-treated groups(all P

ObjectiveAnalyze preoperative clinical relevanted factors of acute type A aortic dissection with hypoxemia according to a group clinical data.MethodsFrom January 2011 to June 2011,we have collected 54 preoperative cases of acute type A aortic dissection,including 42 males,12 females,aged 28-73 years old,onset to treatment time is 0.4-14.0 days.General information:age,gender,time of onset,body mass index,hypertension,diabetes mellitus,smoking,drinking,heart ejection fraction,prothrombin time,quantitative fibrinogen,fibrinogen degradation products,D-dimer,C-reactive protein,procalcitonin,ICU time,length of hospital stay.According to the blood gas analysis of quiet state case without oxygen,with PaO2 ＜ ( 100-age ×0.33 ±5) mm Hg is for the hypoxemia group,equal or higher than this is no-hypoxemia group.ResultsNo-hypoxemia group has 14 cases,11 males,3 females,average aged (51.14 ± 14.24) years old,including 12 operation patients ( no death) and 2 no-operation patients(2 cases death).Hypoxemia group has 40 cases,31 males,9 females,average aged (50.53 ± 9.73 ) years old,including 33 operation patients(2 cases death) and 7 no-operation patients(7 cases death).There is no significant difference in age,gender,time of onset,hypertension,diabetes mellitus,smoking,drinking,cardiac ejection fraction,prothrombin time and fibrinogen.There is statistically significant on body mass index,fibrinogen degradation products,D-dimer,C-reactive protein,procalcitonin,ICU time and length of hospital stay time ( P ＜ 0.05 ).ConclusionPreoperative hypoxemia with acute type A aortic dissection is associated with obesity,excessive inflammation and activation of coagulation and fibrinclytic system,and hypoxemia may prolong the time of operative patients with acute type A aortic dissection in ICU and hospital.

Objective To summarize clinical characteristics of infradiaphragmatic craniopharyngioma and explore its prognosis factors. Methods The clinical date, imaging and follow-up findings were analyzed retrospectively in 58 pa?tients with infradiaphragmatic craniopharyngioma who underwent surgical operation in our hospital. Factors related to the postoperative quality of life of patients were analyzed using multi-factors Logistic regression analysis. Results There were 45 minor cases with infradiaphragmatic craniopharyngioma, of which forty cases (88.9%) had preoperative visual im?pairment. Preoperative endocrine examination revealed that 21 cases (46.7%) had pan-hypopituitarism and 24 cases (53.3%) had pari-hypopituitarism. In addition, preoperative MRI showed that 38 cases (84.4%) had tumor involvement in/on the saddle and the average tumor size was(4.53 ± 1.71)cm. There were 13 adult cases, of which 8 cases (61.5%) had preoperative visual impairment. Only 1 case (15.4%) had pan-hypopituitarism, 7 cases had pari-hypopituitarism and 5 cases had normal pituitary function. Ten cases (76.9%) had tumor involvement in/on the saddle and average tumor size was(2.92 ±1.18)cm. Multi-factors Logistic regression analysis revealed the patient's age (OR=0.090, P=0.090) and tu?mor size (OR=8.350, P=8.350), preoperative vision loss (OR=0.086, P=0.086), preoperative hypopituitarism (OR=0.198, P=0.198) were the relative factors affecting the quality of life. Conclusion Infradiaphragmatic craniopharyngioma is
more common in minor patients. The clinical features and prognosis are significantly different between minor patients and adult patients. Age, size of tumors, preoperative vision loss and hypopituitarism of patients are associated with poor prog?nosis.

Objective To evaluate the expression and clinical significance of Periostin (POSTN) in craniopharyngi?oma. Methods Forty-two patients with pathologically diagnosed adamantinomatous craniopharyngioma involving the floor of 3rd ventricle were retrospectively analyzed. The correlation between expression of POSTN and outcome was studied. Results POSTN was expressed in stroma of craniopharyngioma tissues. The expression of POSTN was not associated with the postoperative recurrence (Z=-0.236,P=0.813) while was associated with the degree of the adhesion between tumor and floor of 3rd ventricle (r=0.685, P<0.001), postoperative Hypothalamic Status Scale (r=0.569, P<0.001) and Body Mass Index (r=0.594, P<0.001). Conclusions POSTN may predict the degree of the adhesion between craniopharyngioma and 3rd ventricle floor. The high expression of POSTN may indicate the worse hypothalamus function.

Objective To compare the diagnostic value of myocardial perfusion imaging (MPI) and 64 multi-slice spiral CT (64-MSCT) for coronary artery disease (CAD). Methods Fifty-two patients with suspected or known CAD were included in the study. Each patient underwent both stress and rest MPI,MSCT as well as conventional coronary angiography (CAG) within 1 month. The stress and rest MPI were scored by a 5-grade criteria (0 ～ 4) based on 17 coronary artery segments. The difference between summed stress and rest scores ＞ 1 was defined as myocardial ischemia. Stenosis in one main vessel or one main branch of the main vessel ≥50% was defined as myocardial ischemia by MSCT. CAG was used as the reference for comparison. Statistical analysis was performed using SPSS 13. 0 software. Kappa value was used to test the accordance of MPI and MSCT results. X2 test was used to evaluate the difference between MPI and MSCT results. Results The patient-based sensitivity, specificity, positive and negative predictive values and accuracy of MPI and MSCT for the diagnosis of CAD were 86.7% (26/30), 77.3% ( 17/22),83.9% (26/31), 81.0% ( 17/21), 82.7% (43/52) and 83.3% ( 25/30), 86.4% ( 19/22), 89.3%( 25/28), 79.2% ( 19/24), 84.6% (44/52), respectively. The vessel-based sensitivity, specificity, positive and negative predictive values and accuracy of MPI and MSCT were 74.5% (38/51), 81.0% (85/105 ), 65.5% (38/58), 86.7% ( 85/98), 78.8% ( 123/156 ) and 90.2% (46/51 ), 88.6% ( 93/105 ),79.3 % (46/58), 94.9% (93/98), 89.1% ( 139/156), respectively. There was no statistically significant difference between MPI and MSCT for either patient or lesion-based diagnosis (X2 =0.44, 0.21, both P ＞0.05 ). 96.0% (24/25) patients with both abnormal MPI and MSCT positive were valified by CAG while 83.3% (15/18) patients with both MPI and MSCT negative were excluded by CAG. Conclusions Both MPI and MSCT are reliable diagnostic modalities for CAD. They also provide complementary diagnostic value to each other.

Objective To explore the safety and feasibility of performing total thoracoabdominal aortic aneurysm repair (tTAAAR) under normal thermia and non-cardiopulmonary bypass fashion by comparing surgical indications and details of different surgical strategies in tTAAAR.Methods From February 2009 to May 2011,46 consecutive patients with extensive Crawford Ⅱ thoracoabdominal aortic aneurysm (TAAA)underwent total thoracoabdominal aortic aneurysm repair( tTAAAR ) in An Zhen Hospital.The patients were divided into 2 groups ( A and B) according to their different surgical strategies.Patients in group A underwent total thoracoabdominal aortic aneurysm repair with deep hypothermia and circulatory arrest.Patients in group B underwent total thoracoabdominal aortic aneurysm repair in a normal thermia and non-circulatory bypass was performed via a combined left thoracoabdominal incision.After established the bypass from descending aorta to bilateral iliac arteries under normal thermia,the reestablishment of intercostal arteries and visceral arteries was followed with subsection circulatory arrest.The clinical results of these 2 groups were analyzed by SPSS 18.0.Results Patients in group A underwent total thoracoabdominal aortic aneurysm repair with deep hypothermia and circulatory arrest have higher mortality rate and transient nervous dysfunction rate (26.67％ vs 3.20％,P =0.033 ; 33.30％ vs 3.30％,P =0.018,respectively) than patients in group B underwent total thoracoabdominal aortic aneurysm repair in a normal thermia and non-circulatory bypass.Statistical significance was also observed between group A and circulatory arrest and group B in operation time,descending aortic clamping time,and transfusiori volume of red blood cells ( P ＜ 0.05 ).Average age,sex,pathological type,the maximal diameters of aneurysm,preoperative complications,visceral ischemia time,spinal cord ischemia time,ICU treatment time,intubation time,respiratory complications,plasma dosage,platelets dosage,RBC dosage,thoracotomy hemostatic,spinal cord injury,renal insufficiency were found no statistical significance(P ＞ 0.05 ) between two groups.In addition to death and paraplegia,the others were cured.Conclusion The normal thermia and non-cardiopulmonary bypass tTAAAR is a safe and feasible therapeutic strategy for TAAA patients.A bypass from descending aorta to iliac arteries can be built under normal thermia in TAAA patients,which is the indication of this new technique.Reestablishment of intercostal arteries is an important protective adjunct to avoid spinal cord injury.

OBJECTIVETo measure the iodine nutritional status on adult islanders and to evaluate the advantages and disadvantages of iodized salt prophylactic programs.

METHODSA comparative study was carried out in 8 rural townships selected from Dinghai (iodized salt district) and Daishan (non-iodized salt district) of Zhoushan islands by random sampling method. Mann-Whitney test was used to compare the urinary iodine concentration and dietary iodine intake of the two groups. Spearman correlation test was used to look for the correlation of urinary iodine concentration and dietary iodine intake in the two groups respectively.

RESULTSThe amounts of daily iodine intake excluding the iodine intake from iodized salt in the two groups were 128 micro g and 147 micro g respectively but the difference was not statistically significant (u = 1.847, P = 0.065). The urinary iodine concentration of non-iodized salt group was 90 micro g/L, lower than 194 micro g/L in iodized salt group (u = 14.673, P = 0.000). There was no significant correlation between daily iodine intake and urinary iodine concentration (r(s) = 0.052, P = 0.095).

CONCLUSIONSIn Zhoushan islands, the daily iodine intake did not meet the daily need (150 micro g/day) suggesting that iodized salt supplement was necessary. However, side effect due to overdose should be brought into attention.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Goiter ; epidemiology ; Humans ; Infant ; Iodine ; administration & dosage ; adverse effects ; deficiency ; urine ; Male ; Middle Aged ; Sodium Chloride, Dietary ; administration & dosage ; adverse effects