Objective To investigate the technique and feasibility of video-assisted thoracoscopic surgery (VATS) in the treatment of esophageal carcinoma. Methods Sixteen patients with esophageal carcinoma underwent esophagectomy by VATS between October 2002 and October 2003. The tumors were found in mid-segment in 13 patients and lower segment in 3 patients. Their TNM staging was: stage T 1 2 patients, stage T 2 5 patients and stage T 3 9 patients; stage Ⅰ 2 patients, stage Ⅱ 8 patients and stage Ⅲ 6 patients. Results No conversion to open surgery was required. The operation time of VATS was 90～150 min (mean, 110 min). The number of removed mediastinal lymph nodes was 6～14 (mean, 7.3). Drainage tube was taken out 2～3 days after operation and the drainage volume was 300～600 ml. No complications were seen. Conclusions VATS for esophageal carcinoma is feasible. Indications for VATS should be stage Ⅰ～Ⅱ and in addition no outward infiltration (≤stage T 3).

The effects of low-level radiation on cAMP in peasma, adrenal and testis and cGMP in adrenal of rats were studied. Adult male rats were given whole-body irradiation with x-rays at a dose rate of 15 mGy/min. They were irradiated with 50 and 100 mGy daffy for 30 days within 5 weeks with cumulative doses of 1.5 and 3.0 Gy respectively. One, two and four weeks after termination of irradiation, the levels of cAMP in plasma, the adrenal gland and testis, the level of cGMP in the adrenal gland and the weights of the body, testes and pitutary were examined. The weights of testes decreased within 4 weeks after irradiation as compared with the control and the level of cAMP in the testis was significantly increased at weeks 1 and 2 in the 3.0 Gy group. At week 4, it returned to near normal. In another experiment, animals were irradiated with ~(60)Co ?-ray at a dose rate of 45.3?Gy/min, 16.3 mGy/6h/day and 6 days per week. At 6, 10, 14, 18 and 22 weeks, with cumalative doses of 0.59, 0.98, 1.37, 1.76 and 2.15 Gy respectively, the levels of cAMP in the pitutary and testis and testicular weight were quantified. No significant changes were found. These results suggest that dose rate is an important factor In the determination of the degree of damage of the testis following low-level irradiation.

Diabetic retinopathy (DR) is a common disease of ophthalmology,often causes irreversible decline of patients' vision,which has two features including macular oedema,diabetic retinal neovascularization.Diabetic retinal neovascularization is one of the most important reasons leading to blindness.Endostatin (ES) is one of the most effective agents inhibiting angiogenesis,whose biological function has a close relationship with its chemical construction.However,its mechanisms of treating diabetic retinal neovascularization are very complicated and remain unclear.Therefore,in this review we summarized several possible mechanisms,including regulating the expression of extracellular matrix,inhibiting the expression of pro-angiogenic factors,and regulating the signaling pathways,by which ES may inhibiting diabetic retinal neovascularization.

The paper discusses the basic contents, characteristics, and development trend of training programs abroad for high level hospital administrators as represented by MHA (Master of Hospital Administration) programs. Those programs establish curricula and training modes in light of the primary tasks and responsibilities of high level hospital administrators. They attach importance to the cultivation of concepts of macro health and ideas of modern management, provide training in methodologies of public health as represented by bio statistics and epidemiology, emphasize practical matters of operation and management such as hospital planning, quality control and financial accounting, and make wide use of case studies so as to enhance the abilities to solve practical problems. Hospital reform and development make it imperative to improve the training of high level hospital administrators, which must be properly oriented, and to develop domestic MHA programs with Chinese characteristics by utilizing existing resources of health administration education and integrate relevant courses.

Arteriovenous Shunt, Surgical ; Blood Vessel Prosthesis ; Blood Vessels ; pathology ; Humans ; Neoplasms ; blood supply ; pathology ; surgery ; Vascular Surgical Procedures ; instrumentation ; methods ; Vena Cava Filters

To observe the preventive effects of flumeprednisolone and spongia gelatinosa on peridural adhesion after nucleus pulposus resection of lumbar intervertebral disc, 153 cases with lumbar intervertebral disc protrusion were selected from the Department of Orthopaedics, Fourth Affiliated Hospital of Guangxi Medical University between June 2002 and August 2006. Among them, the flumeprednisolone and spongia gelatinosa were put surrounding nerve root and dura mater of spinal cord in 83 cases. According to the Macnab criterion, the Lasegue symptom was effectively relieved after operation, and 96.4% of excellent and good result was achieved by periodic follow-up with good functional recovery and satisfactory surgical effect. It indicates that flumeprednisolone and spongia gelatinosa composite is effective in preventing peridural adhesion after intervertebral disc operation.

Carotid Arteries ; diagnostic imaging ; surgery ; Feasibility Studies ; Head and Neck Neoplasms ; blood supply ; diagnostic imaging ; surgery ; Humans ; Radionuclide Imaging

Commercialization of the doctors sector and lawyers sector, and that of medical services, sharp rise of medical disputes and its impact on healthcare services have grown into major challenges for the healthcare system in the United States where litigation is the legal way out of medical disputes at large.Anglo-American law system depends heavily on precedence as the criteria and the majority of such disputes trials are held in state courts, there is also a complete system of laws and decrees on medical disputes on the federation level.In an effort to handle medical disputes that are rising sharply in a piling-up amount, American lawyers, social organizations of arbitration and medicine, and many state courts are seeking alternative dispute resolution as a better way out for medical dispute mediation and resolution.Given the gaps between China and USA in social systems, legal systems, ,economic development, cultural background, healthcare systems and heahhcare security systems, these experiences will prove their value of reference for medical disputes resolution in China.

Objective: To investigate the clinical efficacy of prednisone combined with aminomethylbenzoic acid in the treatment of patients with irritability purpura and its effects on inflammatory factors and coagulation function.Methods: Totally 98 cases of patients with irritability purpura were randomly divided into the observation group (n=49) and the control group (n=49).The control group was treated with prednisone, while the observation group was given aminomethylbenzoic acid injection on the basis of the control group.Both groups were treated for 4 weeks.The efficacy of the two groups was compared, and the changes of serum inflammatory factors and coagulation function before and after the treatment, the disappearance time of stomachache, purpura and arthralgia and adverse drug reactions were also observed and compared.Results: The total effective rate of the observation group (93.88%) was significantly higher than that of the control group (73.47%, P<0.05).After the treatment, the serum level of IL-12 increased, the IL-15 and IL-23 levels decrease, and the D-D dimer and Fib levels decreased in both groups;the serum level of IL-12 in the observation group was higher than that in the control group, and the IL-15 and IL-23 levels were lower than those in the control group (P<0.05);the D-D dimer and Fib levels in the observation group after the treatment were lower than those in the control group (P<0.05).The disappearance time of abdominal pain, purpura and joint pain in the observation group was significantly shorter than that in the control group (P<0.05).ECG, blood and urine routine, liver and kidney function were normal in both groups without serious adverse reactions.Conclusion: Prednisone combined with aminomethylbenzoic acid in the treatment of irritability purpura shows striking effects without obvious adverse reactions, and the actions may be related to reducing the inflammatory reaction and improving coagulation function, which is better than prednisone used alone.