Objective To investigate the correlations of the expressions of CXCR4 and vascular endothelial growth factor (VEGF) in esophageal cancer and their associations with patients' clinicopathological features.Methods The paraffin-embedded samples of 127 patients with esophageal cancer treated by thoracic surgery in Zhongshan Hospital in 2005 were collected. The CXCR4 and VEGF expressions in esophageal cancer tissues were detected with immunohistochemical technique. The immunostaining was evaluated according to the staining area and intensity. Results The overall expression rate was 88.2% and 79.5%, respectively. CXCR4 expression was significantly associated with tumor grade, size, tumor depth, regional lymph node metastasis and TNM stage (P<0.05);VEGF expression was significantly associated with tumor depth, TNM stage and tumor grade.In addition, there were significant correlations between CXCR4 and VEGF (P<0.01). Conclusions There was significant association between CXCR4, VEGF expressions and clinicopathological features of esophageal cancer. There might be some potential correlation between CXCR4 and VEGF expression in esophageal cancer.

Objective To compare the characteristics of MRI, CT, single photon emission computed tomography(SPECT) and transcranial Doppler sonography(TCD) in patients with spongiform leukoencephalopathy after inhaling heroin vapor. Methods Seventeen patients were investigated. MRI or CT was scanned in 17 patients, SPECT in 9 patients′ and TCD in 11 patients. Results MRI or CT: Brain MRI and CT revealed extensive symmetric white matter involvement of bilateral cerebral and cerebellar hemispheres and the brainstem.The lesions, which showed no contrast enhancement, were hypodense on CT and hypointense on T 1 weighted and hyperintense on T 2 weighted MRI. SPECT: The regional cerebral blood flows(rCBF) of white matter involvement on bilateral cerebral and cerebellar hemispheres was reduced obviously. The rCBF of temporal lobes, parietal lobes, occipital lobes, cerebellar hemispheres, and basal ganglion was reduced in varying degrees. TCD: The systolic peak became sharpened, and end diastolic flow velocity and mean flow velocity were reduced obviously and pulsatility index was increased markedly in patients with spongiform leukoencephalopathy after inhaling heroin vapor. Conclusion The characteristic manifestations of MRI and CT imaging may be regarded as the main foundation of diagnosing spongiform leukoencephalopathy after inhaling heroin vapor; SPECT and TCD can help comprehend the changes of hemodynamics of cerebral vessels and the degree of cerebral ischemia in patients with spongiform leukoencephalopathy after inhaling heroin vapor.

Objective To evaluate obstetrics and gynecology training quality by analysis of clinical knowledge and clinical skills scores for long-term graduates.Methods A retrospective analysis of clinical knowledge and clinical skills scores was performed in obstetrics and gynecology training for 134 long-term graduates.Results The clinical knowledge and clinical skills scores of obstetrics and gynecology training were 82.27?7.68,87.69?7.24.There was no,P﹥0.05.Only the scores of clinical skills judged by one teacher in interview was correlated with clinical knowledge scores,while there were no correlation between clinical knowledge judged by other five teachers and scores of clinical skills.Conclusion There was no correlation between clinical knowledge and the scores of clinical skills scores.Culturing students’practical ability and communication ability is worth strengthening,while the consistency of teachers’evaluation standard should be improved.

The research data at home and abroad show that the overall burnout rate of clinical professional graduate students was high. They are vulnerable to burnout because of long duty hours, learn-ing pressure, intense and overloading work and especially the significantly reduced personal accomplish-ment in the situation of the contradiction between doctors and patients in our country. Burnout not only re-sults in psychological distress and physical symptoms, but also has negative effect on the quality of graduate medical education during residency training. Therefore, educators need to develop an active awareness of burnout and ought to perform interventions such as formulating the appropriate learning goals, improving the work efficiency, reducing work hours, positive psychological counseling and stress management training to prevent such occurrences.

Objective To investigate the manifestation and the prevention means of video display terminal (VDT) visual fatigue in old people. Methods Conventional eye inspection were performed for 45 patients, including optical muscle movement, position of eye, confluence function and presbyopia. Results We found that the average difference between middle distance correcting lens and 33 cm reading distance from presbyopia correcting lens was about 0.52 DS( P

Objective We performed experiments using Neuregulin-1β (NRG-1β) treatment to determine a mechanism for the protective role derived from its beneficial effects by remodeling gap junctions (GJs) during heart failure (HF). Methods Rat models of HF were established by aortocaval fistula. Forty-eight rats were divided randomly into the HF (HF, n = 16), NRG-1β treatment (NRG, n = 16), and sham operation (S, n = 16) group. The rats in the NRG group were administered NRG-1β (10 μg/kg per day) for 7 days via the tail vein, whereas the other groups were injected with the same doses of saline. Twelve weeks after operation, Connexin 43 (Cx43) expression in single myocytes obtained from the left ventricle was determined by immunocytochemistry. Total protein was extracted from frozen left ventricular tissues for immunoblotting assay, and the ultrastructure of myocytes was observed by transmission electron microscopy. Results Compared with the HF group, the cardiac function of rats in the NRG group was markedly improved, irregular distribution and deceased Cx43 expression were relieved. The ultrastructure of myocytes was seriously damaged in HF rats, and NRG-1β reduced these pathological damages. Conclusions Short-term NRG-1β treatment can rescue pump failure in experimental models of volume overload-induced HF, which is related to the recovery of GJs structure and the improvement of Cx43 expression.

Objective To analyze safety,efficacy and resection methods of video-assisted thoracic surgery(VATS) for the treatment of intralobar pulmonary sequestration(IPS).Methods Data of 17 patients who were diagnosed as IPS and received VATS from December 2006 to September 2011 were retrospectively analyzed.The patients were 7 males and 10 females with the mean age of 40.3 (14-61) years.Diagnosis was confirmed in 9 patients by enhanced CT and unconfirmed in 8 patients.Three ports were used for surgery.After the aberrant artery was confirmed,liner stapler was used in 16 patients to cut it and Hem-o-lok was used in 1 patient because the aberrant artery was about 3 mm in diameter and long enough.If the diameter of the aberrant artery was longer than 10 mm,a stapling device without knife was used to occlude it centrally and a second stapling device was used to cut it peripherally.Wedge resection or lobectomy was performed due to the different conditions.When the lesion was small with linited range in CT image and the lesion was easily distinguished from normal lung tissue during operation,wedge resection was preferred.Results Seventeen patients underwent VATS successfully without any conversion to thoracotomy or any serious complications.Five patients were planned to receive wedge resection and one was converted to lobectomy.Another 12 patients were planned to receive lobectomy and all succeeded.The mean operating time was 128 (80-170)min.The mean blood loss was 80 (5-200) ml.The mean days of chest tube maintained were 4.0 (2-6) days.The mean postoperative hospitalization days were 7.6 (4-11) days.All patients were diagnosed as IPS according to operating in-sight and postoperative pathology.There was no patient suffering from chronic cough,bloody sputum or recurrent pneumonia during the follow-up.Conclusion VATS for the treatment of IPS is safe and feasible.If conditions permit,wedge resection or segmentectomy may be preferred.

AIM: To prepare anti-Sperm protein 17 (Sp17) immunomagnetic nanoparticles (IMNPs), and make foundation for target diagnosis of ovarian cancer by magnetic resonance imaging. METHODS: The anti-human Sp17 IMNPs were prepared by grafting anti-Sp17 antibodies on the surface of chitosan-coated magnetic nanoparticles （MNPs） using the linker of EDC/NHS (1-ethyl-3-［3-dimethylaminopropyl］carbodiimide/N-hydroxysuccinimide). The morphology and properties of the nanoparticles were characterized by transmission electronic microscopy (TEM), the conjugation of the antibodies was evaluated by native-polyacrylamide gel electrophoresis, the immunologic activity of IMNPs was evaluated by enzyme linked immunosorbent assay (ELISA). A set of in vitro magnetic resonance imaging (MRI) experiments were performed after incubated the IMNPs with human Sp17 gene transfected ovarian cancer HO-8910 cells. RESULTS: We had successfully grafted the MNPs with anti-Sp17 antibody and the IMNPs kept good bioactivity. The MRI showed that the IMNPs were targeted successfully to the positive cells, and no obviously non-specific adsorption was observed. CONCLUSION: The anti-Sp17 IMNPs with good specificity can used for further study of ovarian cancer target therapy.

The receptor of the heart transplantation was a patient with terminal dilated cardiomyopathy, the donor was a patient with congenital ventricular septal defect, in situ double-chamber heart transplantation was performed, and the result of the four-year follow-up was satisfactory. At present, donor is deficient,and those donors with congenital defect can also obtain satisfactory clinical application effects after appropriate handling.