Objective To investigate the effect oflevecamitine on nutrition,microinflammation status in ma-intenance hemodialysis (MHD) patients. Methods Forty two MHD patients were selected, who had undergone he-modialysis for at least two months before the study. One gram of levoeamitine was injecfed to the patients at the end of each dialysis treatment for six months. The parameters of inflammation stress were studied. Results After treatment with levocarnitine for six months, the average levels of dry body weight decreased markedly. ( P<0.05 ), The aver-age serum levels of C2reaetive protein (CRP),interleuldn26 (IL26) ,tumor necrosis factor2α(TNF2α), (P<0.01 ). Difference was not significant between serum lipid parameters before and after the treatment. Conclusion Intravenous supplement with levocamitine in MHD patients, appears to be associated with an improvement of nutrition and mieroinflammation status.

Objective To analyze the prognosis of 225 patients according with clinical staging of esophageal carcinoma treated with non-surgical methods, and investigate the practicality and predictive value of the clinical staging. Methods From March 2001 to July 2007, 225 patients with esophageal carcinoma received 3DCRT treatment. The prescribed doses were ranged from 5000 -7000 cGy with the median dose of 6400 cGy, 25 patients received accelerative radiation of 300 cGy per fraction after conventional radiotherapy of 3000 -4000 cGy, 57 patients received concurrent chemotherapy with or without consolidation chemotherapy. All the patients were divided into subgroups of different T stages, different N stages and different TNM stages. Local control rates, survival rates were observed and Cox regression analysis were performed to search valuable prognostic factors. Results The following-up rate was 99. 6%. The 3-and 5-years following-up number were 116 and 33 patients, respectively. The 1 -,3-,and 5-year local control rates were 77. 2% ,48.2% and 34. 5%, respectively. The 1-,3-,and 5-year overall survival rates were 68.4% ,33.7% and 20. 8%, respectively. The median survival time was 20 months. There were significant difference between survival curves for T1-4 stages, N0-2 stages and Ⅰ - Ⅲ stages with x2 value of 13.07,20. 49 and 17.16, with P value of 0. 004,0. 000 and 0. 000, respectively. For the group of stage Ⅰ, Ⅱ and Ⅲ, the 1-,3-,and 5-year survival rates were 89.4% ,56. 1% ,and 37.8% ;69.6% ,32. 4% ,and 18.0%and 47. 2%, 19. 5%, and 13. 0%, respectively. According to the result of Cox regression analysis, the tumor length of CT scan, clinical N stage, short term restlt were most valuable predictive factors.Conclusions The clinical staging of esophageal carcinoma treated with non-surgical methods could predict the prognosis accurately, clinical N stage may have more closely association with prognosis, however, some details of the staging program need more consummate.

Objective: To explore the pattem of lymphatic metastasis and influencing factors of thoracic esophageal carcinoma. Methods: We reviewed the pathological specimens from 229 esophageal carcinoma patients who underwent radical esophagectomy with two-field lymphadenectomy. A total of 2,458 lymph nodes were dissected. We analyzed the lymph node metastasis pattern of the primary tumor in different loca-tions and the corresponding influencing factors such as pathological T stage, tumor length, pathological mor-phology and tumor differentiation. Results: Lymph node metastasis rates were 44.5% (102/229) and 10.5% (258/2458), respectively. For patients with upper thoracic esophageal carcinomas, lymphatic metastasis rates in the superior mediastinum, the middle mediastinum, the inferior mediastinum and the abdominal cavity were 19.0%, 6.7%, 9.8% and 12.2%, respectively. For patients with middle thoracic esophageal carcinomas, the rates were 26.1%, 7.4%, 11.8% and 11.9%, respectively. For patietns with lower thoracic esophageal carcino-mas, the rates were 0, 1.6%, 5.3%, and 10.0%, respectively. Lymphatic metastasis rate in T_1, T_2, T_3, T_4, stage cancer were 28.6%, 43.8%, 47.6%, and 31.3%, respectively; the rate of positive lymph nodes were 7.9%, 10.8%, 10.7%, and 10.8%, respectively, with no significant differences among the four stages (x~2=2.733, P=0.435 and x~2=0.686, P=0.876). Lymphatic metastasis rate and rate of positive lymph nodes in patients with tu-mor ≤3cm, 3 to 5cm, and >5cm were 45.2% and 43.4%, 46.2% and 9.1%, and 11.6% and 11.7%, respective-ly, with no significant differences (x~2=0.094, P=0.954 and x~2=3.933, P=0.140). Lymphatic metastasis ratios of the pathological morphology in medullary, ulcerative, mushroom and stenotic types were 14.0%, 9.6%, 4.3% and 18.3%, respectively (x~2=19.292, P=0.000). Lymphatic metastasis rate and rate of positive lymph nodes of squamous cell carcinoma of moderately and poorly differentiation were 42.5%, 75.0% and 9.5%, 18.6%, re-spectively (x~2=4.852, P=0.028 and x~2=11.323, P=0.001). Patients with squamous cell carcinoma of poorly dif-ferentiation had a higher rate of lymph node metastasis. Conclusion: Lymphatic metastasis of esophageal car-cinoma metastasize widely even if in early T stage. Pathological morphology and tumor differentiation are re-lating facors of lymph node metastasis of thoracic esophageal carcinoma.

0.05). Significant difference in diffused carbon monoxide percentage and change of heart rates before and after stair climbing test was found in LPF group (P0.05).Conclusions Patients of lung cancer intolerable for lobectomy by static pulmonary function test can be screened by stair climbing test before surgical operation,which can make some of them regain opportunity of surgical operation.

Purpose To evaluate the effectiveness of exfoliative cytology in chronic oral ulcers diagnosis.Methods To examined 107 cases of chronic oral ulcers which were difficult to determine the nature of the ulcer in exfoliaticve cytology,and compared postoperative histopathological results or clinical results,and made the final diagnosis with cytology.Results The qualitative diagnostic accuracy of cytology was 95.3％.The sensitivity and specificity for benign and malignant lesions was 94.6％ and 100％,respectively.False positive rate was 0,and false negative rate was 5.4％,and the coincidence rate of cytological examination with the final pathology was 67.0％.Conclusion Exfoliative cytology has important reference value in chronic oral ulcer diagnosis.It is characterized by simple,rapid procedure and less trauma.Doctors can develop next treatment plan based on the results of exfoliative cytology.

Microarray has become a popular biotechnology in biological and medical research.However, systematic and stochastic variabilities in microarray data are expected and unavoidable, resulting in the problem that the raw measurements have inherent "noise" within microarray experiments. Currently, logarithmic ratios are usually analyzed by various clustering methods directly, which may introduce bias interpretation in identifying groups of genes or samples. In this paper, a statistical method based on mixed model approaches was proposed for microarray data cluster analysis. The underlying rationale of this method is to partition the observed total gene expression level into various variations caused by different factors using an ANOVA model, and to predict the differential effects of G V (gene by variety)interaction using the adjusted unbiased prediction (AUP) method. The predicted G V interaction effects can then be used as the inputs of cluster analysis. We illustrated the application of our method with a gene expression dataset and elucidated the utility of our approach using an external validation.

Objective To compare the prevalence of patent foramen ovale (PFO) in young and middle-aged patients with cryptogenic ischemic stroke (CS) and in normal population.Methods The casecontrol study included consecutive 318 young and middle-aged patients with CS and 336 normal control subjects with matched age and sex for group comparisons.Stroke risk factors including hypertension,diabetes mellitus,hyperlipidemia,ischemic heart disease,atrial fibrillation,carotid atherosclerosis plagues and smoking,etc.were studied.Transesophageal echocardiography (TEE) were performed to detect the presence of PFO.The prevalence of PFO and difference of risk factor levels between the groups was compared.Then the odds ratios (OR) of a PFO was estimated in CS patients versus control subjects.Results The prevalence of PFO was significant higher in patients with CS than in control subjects (145/318,45.6 ％ versus 46/336,13.7％,P ＜0.001).The odds ratio(OR) for PFO in CS for patients versus control subjects was 5.3 (confidence interval,3.6 to 7.8).The mean size of PFO was larger in stroke group than that in control group (P ＜ 0.001).There were no significant differences in levels of other stroke risk factors between two groups.Conclusions PFO may play an important role in etiology of CS in young and middleaged adults.Larger and longer PFOs may be more concomitant with ischemic attacks.More efforts should be employed in patients with CS to detect PFO for further treatment.

Objective To probe into the color Doppler echocardiographic characteristics of bilocular heart (BH) and associated malformations. Methods Twenty patients of BH were examined with color Doppler echocardiography (CDE) and the characteristics were observed. All the CDE results were compared with angiocardiography and 14 were confirmed by operation. Results Nineteen cases were properly diagnosed based on the CDE characteristics,1 case were misdiagnosed as mitral atresia. CDE characteristics of BH were obvious:① Apical four-chamber view of two-dimensional echocardiography (2DE) showed total echo dropout in both the interatrial septum and the interventricular septum and disappearance of the intracardiac "cross". The common atrioventricular valve closed during systole and appeared as figure "8", named 2DE "8" sign. During diastole, the common atrioventricular valve opened to a common ventricle. ② Color Doppler flow imaging (CDFI) showed common intra-atrial flow signal entereda common ventricle through common atrioventricular valve during diastole in all patients and colorful reflux through common atrioventricular valve during systole in 15 cases. ③ Among the 20 eases, 16 of the common atria were situs solitus,4 were situs inversus; 10 of the common ventricles were type A,2 were type B and 8 were type C. According to the spatial relationship of the great arteries,there were 4 type Ⅰ ,7 type Ⅱ and 9 type Ⅲ.There were 18 pulmonary stenosis and 2 pulmonary hypertension. ④ In the presence of pulmonary stenosis, CDFI showed colorful shunt signals through pulmonary artery during systole. Conclusions BH and associated malformations have obvious echocardiographic characteristics. CDE has a specific value in diagnosing BH and associated malformations.

Objective To investigate the effect of cocaine-amphetamine-regulated transcript peptide (CART) on the content of 4-hydroxy-2-noneral (HNE) and infarct volume after cerebral ischemia/reperfusion in mice.Methods A total of 96 healthy male mice were randomly divided into four groups:ischemia/reperfusion (n =27),CART (n =27),normal saline control (n =27) and sham operation (n =15) groups.A middle cerebral artery occlusion (MCAO) model was induced.Two hours after MCAO,CART 55-102 and equivalent normal saline were injected respectively via the tail veins of mice in the CART group and the normal saline control group,and then they were injected every other 24 hour.The neurological scores,infarct volume and the HNE content of lipid metabolism of oxidative stress were performed and detected respectively at 12,24,48 and 72hours after reperfusion.Results CART could significantly improve the neurological deficit scores (all P ＜0.05) and reduce infarct volume (all P＜0.05) at different time points after ischemia/reperfusion.The content of HNE was upregulated (all P＜0.05) at different points after referfusion.CART could significantly down-regulate the increased HNE levd in brain after ischemia (all P＜0.05).Conclusions CART may protect ischemic brain injury in mice by inhibiting lipid peroxidation.

ObjectiveTo evaluate the feasibility and efficacy of ex-vivo liver resection combined liver autotransplantation for patients with massive primary liver cancer who underwent complex liver resection.Methods The clinical data of 4 patients suffering from massive primary liver cancer who were admitted to the Beijing Chaoyang Hospital from January 2008 to May 2010 were retrospectively analyzed.Regular liver resection could not be carried out because the first,second and third hepatic hilum of the 4 patients were invaded by the tumors,so ex-vivo liver resection combined liver autotransplantation were performed.ResultsThe operation was successfully carried out for the 4 patients.The operation time,the duration of anhepatic phase and the volume of operative blood loss were 690-840 minutes,250-300 minutes and 400-1400 ml,respectively.Portacaval bypass operation was not performed.After ex-vivo liver resection,the inferior vena eava or hepatic vein and portal vein of the 4patients were repaired,and the allogenous blood vessels were kept to extend the superior vena cava of the remnant liver so as to facilitate the anastomosis of blood vessels and reconstruction of the first hepatic hilum. After operation,the hepatic function of 1 patient was back to normal; 1 patient who stfffered from abdominal hemorrhage received reoperation for hemostasia; 1 patient was found with hepatic dysfunction; 1 patient died of hepatorenal dysfunction at postoperative day 5.Compensatory hypertrophy was observed in the 3 patients who survived at postoperative months 1-2.Of the 3 patients,2 were found with multiple pulmonary metastases at postoperative months 8 and 9,and they died at postoperative mouths 13 and 15.Until April 2012,1 patient survived for 37 months with no tumor recurrence or metastasis. ConclusionsEx-vivo liver resection combined liver autotransplantation provides the technical feasibility for performing complex liver resection for patients. The incomplete compensation of liver function and the short-term recurrence of tumors after operation are still the main issues which hinder the development of this technique.