China is one of the countries with the highest incidence of esophageal cancer, which is still increasing year by year in recent years. Surgical treatment is the first choice for early and middle esophageal cancer. Surgeons have been exploring how to remove the tumor as completely as possible and reduce the trauma as far as possible. In recent years, with the rapid development of minimally invasive surgery and endoscopic technology, minimally invasive esophagectomy(MIE)has led the trend of radical surgery for esophageal cancer. At present, the mainstream minimally invasive surgery is thoracoscopic thoracoscopic(VATS)resection of esophageal cancer, which requires thoracotomy and anesthesia, resulting in large surgical trauma and more complications of postoperative circulatory respiratory system. Mediastinose-assisted esophagectomy(MAE), which eliminates a thoracotomy, is also an important part of MIE. Overseas MAE application started early, but the domestic development is relatively slow. This article summarizes the experience of different MAE surgical methods in China, and provides the basis for its promotion in China.

Objective To analyze the screening results of yon Willebrand factor among patients before blood transfusion in Ruijin Hospital and discuss von Willebrand factor in ABO blood group and the relationship between age and gender,refine the classification of vWF antigen and activity by reference factors.Methods The von Willebrand factor among 247 cases of patients before blood transfusion in Ruijin Hospital with no clinical manifestations of abnormal blood clots and routine coagulation as laboratory tests for normal surgical patients.The vWF:Ag and vWF:Act were measured by immune turbidimetric method and ABO blood group was identified by blood type serology.Furthermore,the differences between A,B,O,AB different blood groups,sex and high (≥40 years) and low age group (＜40 years) were compared by statistical methods.Results The levels of vWF:Ag in different blood groups were as follows:A blood type:98.5-142.00,B blood type:97.90-160.30,O blood type:82.13-125.45,A B blood type:103.00-135.80.The levels of vWF:Act in different blood groups were as follows:A blood type:76-130.14,B blood type:78.06-144.3,O blood type:60.89-116.11,AB blood type:88.99-124.09.O blood type vWF:Ag and vWF:Act were lower significantly (P＜0.05) than non-O blood type,the difference was.Besides,young vWF:Ag and vWF:Act were lower significantly than in the elderly.There was no significant difference in vWF:Ag and vWF:Act levels between male and female groups.At last,the reference range of four groups of vWF activity (antigen) was obtained.Conclusion Plasma vWF antigen and activity levels were significantly affected by ABO blood type and age,and the refined reference range established for these influencing factors was beneficial for more detailed diagnosis of VWD and predicting vWF levels associated with bleeding and thrombosis risk.

Objective To introduce an effective nursing practice for patients with Grave's ophthalmopathy(GO) undergoing endoscopic trans-ethmoid orbital decompression(ETOD). Methods The treatment and nursing experience of 31 cases (57 eyes) undergoing orbital decompression through endoscopic trans-ethmoid approach were reviewed and analyzed. Results Three months after operation, exophthalmos was corrected in all 31 cases (57 eyes) with satisfying result, and the visual acuity was improved in all 9 cases (16 eyes),who complained of visual loss preoperatively. At the 3-months' review, 2 patients presented diplopia on the primary eye position due to newly on-set global displacement. Conclusions Advanced treatment and careful nursing are very important to improve the surgical safety and decrease the complications.

OBJECTIVETo study the chemical changes of salvianolic acid B and lithospermic acid of Salvia miltiorrhiza under the conditions of high temperature and high pressure and explore the reaction mechanism.

METHODS. miltiorrhiza extracts, salvianolic acid B and lithospermic acid were put in the reactor under the conditions of high temperature and high pressure (120 degrees C, 0.2 MPa), and the chemical changes and stability was studied.

RESULTSalvianolic acid A was the primary product in salvianolic acid B and lithospermic acid's conversion process, and lithospermic acid was an intermediate in the conversion process of salvianolic acid B. Compared with salvianolic acid B, lithospermic acid could convert into more salvianolic acid A and fewer other products in the same conditions. Salvianolic acid A was not stable under the conditions of high temperature and high pressure, and could sequentially convert into other small molecules.

CONCLUSIONReferring to the chemical conversion of salvianolic acid B and lithospermic acid, a method of large-scale preparation of salvianolic acid A can be developed.

Benzofurans ; analysis ; Caffeic Acids ; analysis ; Depsides ; analysis ; Hot Temperature ; Lactates ; analysis ; Pressure ; Salvia miltiorrhiza ; chemistry

Objective To inquiry the changes of serum miRNAs expression in pneumoconiosis complicated with pulmonary tuberculosis patients.Methods The study subjects (all subjects are male) were divided into three groups:I stage pneumoconiosis (38 cases)、Pneumoconiosis complicated with pulmonary tuberculosis (12 cases) and healthy control (40cases).The first two groups come from Tianjin worker's sanatorium and healthy control group came from a Hospital Health Screening Center.RT-qPCR was used to detect the expression levels of miR-21,miR-200c,miR-16,miR-204,miR-206,miR-155,let-7g,miR-30b,miR-192,miR-29a in serum.Results Compared with the healthy control group,the expression levels of miR-204,miR-206,miR-21,miR-16,miR-29a,miR-155,miR-200c in other two groups are different (P＜0.05);Compared with the I stage pneumoconiosis,the expression levels of miR-155 is significantly higher (P＜0.05) and miR-29a is significantly lower (P＜0.05).Conclusion Compared with the I stage pneumoconiosis,the expression levels of miR-155 and miR-29a are significantly different,suggesting that these two miRNAs may play a important role in the process of pneumoconiosis complicated with pulmonary tuberculosis

Objective To inquiry the changes of serum miRNAs expression in pneumoconiosis complicated with pulmonary tuberculosis patients.Methods The study subjects (all subjects are male) were divided into three groups:I stage pneumoconiosis (38 cases)、Pneumoconiosis complicated with pulmonary tuberculosis (12 cases) and healthy control (40cases).The first two groups come from Tianjin worker's sanatorium and healthy control group came from a Hospital Health Screening Center.RT-qPCR was used to detect the expression levels of miR-21,miR-200c,miR-16,miR-204,miR-206,miR-155,let-7g,miR-30b,miR-192,miR-29a in serum.Results Compared with the healthy control group,the expression levels of miR-204,miR-206,miR-21,miR-16,miR-29a,miR-155,miR-200c in other two groups are different (P＜0.05);Compared with the I stage pneumoconiosis,the expression levels of miR-155 is significantly higher (P＜0.05) and miR-29a is significantly lower (P＜0.05).Conclusion Compared with the I stage pneumoconiosis,the expression levels of miR-155 and miR-29a are significantly different,suggesting that these two miRNAs may play a important role in the process of pneumoconiosis complicated with pulmonary tuberculosis

Objective: To understand the prevalence and disease burden of major chronic diseases in the elderly in China and provide scientific basis for the prevention and control of chronic diseases and for the rational allocation of health resources. Methods: We analyzed the prevalence of chronic diseases in residents aged ≥60 years in China by using national and provincial surveillance data of chronic diseases and related risk factors in China. We conducted the analysis on the burden of chronic diseases in the elderly in China by using the data of global burden of disease. Results: The prevalence rates of hypertension, diabetes and hypercholesterolemia were 58.3%, 19.4% and 10.5% respectively in residents aged ≥60 years in China. Up to 75.8% of the residents aged ≥60 years had at least one chronic disease. The prevalence rate was higher in women than in men, higher in urban area than in rural area. With the increase of age, the prevalence rate of chronic diseases also increased. The top three chronic diseases with heavy disease burden in residents aged ≥70 years were stroke, myocardial infarction, cancer and chronic obstructive pulmonary disease. Conclusion The prevalence of major chronic diseases in the elderly is high with three quarters of the elderly suffering from at least one chronic disease, and the burden of chronic diseases is increasing.

Objective To explore the effects of combining traditional Chinese and western medicine nursing for leukemia patients′ hope levels and treatment adherence. Methods To select 90 leukemia paitents from January 2012 to July 2014 in our hospital for treatment, the patients were randomly divided into experimental group and control group by random number table. The patients of experimental group received combining traditional Chinese and western medicine nursing, while the patients of control groups underwent routine nursing methods. We compared the hope level, treatment adherence between two groups and quality of life before and after treatment in two groups. Results After treatment in the experimental group, patients′hope levels presented better than the patients of control group in positive attitudes towards reality and future, positive behavior and keeping close relationship with others (Z =4. 563, 2. 951, 2. 366;P <0. 05). The patients′compliance of experimental group was better than that of the control group (Z =3. 035,P <0. 05). Before treatment, the difference of quality of life had no statistical significance between two groups (P>0. 05), but after treatment, each dimensions of quality of life in the experimental group was higher than that of the control group (P<0. 05). Conclusions Combining traditional Chinese and western medicine nursing not only can improve patients′hope level and treatment adherence, but also can contribute patients′quality of life.

Objective: To provide scientific evidence for the prevention and control measures of silicosis by analyzing the epidemiological characteristics of silicosis cases reported in Tianjin city during 2001-2015. Methods: The database of silicosis cases reported in Tianjin from 2001 to 2015 was established and analyzed by SPSS 24.0 software. Results: 2 213 cases of silicosis were reported during 2001~2015 in Tianjin, 2015 of them were new cases, and fewer reports of promoting stage cases and death cases, which were129 and 69 cases. The new cases were increasing by years, mainly stage I silicosis accounting for 99.2%, the years of dust exposure were concentrated from 1970 to 1989, accounting for 69.58%. From 2001 to 2015, the median length of service at the onset of silicosis was 19.30 years, the age of the onset of silicosis is decreasing. The median of onset age in new cases of silicosis was 53.28 years, and increased year by year. There were significant differences in indirect dust working age and diagnostic age in different reporting years. Most cases were distributed in non-mental mineral product industry, and ferrous metal smelting and rolling processing industry. The work types of these cases are various. Conclusion The increasing incidence of silicosis and the shortening of dust-exposed working years suggest that the form of silicosis hazards is still severe in Tianjin. According to the epidemic characteristics of silicosis, we should strengthen the supervision and management of key industries and special investigation, carry out silicosis census and silicosis screening of dust-removal workers, and take pertinent measures to prevent and control the occurrence of silicosis.