BACKGROUNDThe latest version of the American Joint Committee on Cancer (AJCC) TNM staging system has not comprehensively evaluated the impact of tumour length on survival in patients with esophageal squamous cell carcinoma. Our study explored the relationship between tumour length and clinicopathological characteristics as well as long-term survival.

METHODSAll 202 cases of esophageal resections done from January 1, 2004 to December 31, 2008 in Huashan Hospital, Fudan University were reviewed and followed up.

RESULTSPatients with tumour length = 3 cm were related to more advanced tumour stage (χ(2) = 55.9, P < 0.001), more metastatic lymph nodes (χ(2) = 14.6, P < 0.001), increased metastatic lymph node ratio χ(2) = 16.1, P < 0.001) and worse overall TNM stage (χ(2) = 48.1, P < 0.001). Univariate and multivariate analyses indicated that tumour length was a significant prognostic risk factor (95% CI 0.235 - 0.947, P = 0.035). Subgroup analyses disclosed that tumour length was a valuable prognostic predictor in patients with lower T stage, absence of metastatic lymph nodes and lower TNM stage.

CONCLUSIONSEsophageal tumour length is a predictive factor for long-term survival especially for lower tumour stage, absence of metastatic lymph nodes and lower TNM stage patients. Tumour length should be incorporated in the staging system as an important grouping factor for better prognostic evaluation.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; mortality ; pathology ; Esophageal Neoplasms ; mortality ; pathology ; Female ; Humans ; Lymphatic Metastasis ; pathology ; Male ; Middle Aged ; Multivariate Analysis

Objective To investigate the clinical efficacy of intraluminal enucleation in transurethrat vapor- ization and electro-reesection of the prostate.Methods A retrospective analysis was reviewed in 62 case of prostatic hypertrophy,which were treated with intraluminal enucleation in vaporization of prostate.All pacients had a sucessful operation.There were 12 case in unipolar vaporization and 50 in plasmakenitic bipolar vaporization.Results Opera- tion time ranged from 50 to 162 minutes,with an average of 76min.Bleeding ranged from 40 to 200 ml,with an av- erage of 110ml.There was no blood transfusion.The weight of prostate was 62～138g,the catheter was maintained for 3～5 days postoperatively.The hospital stay was 7～10 days,average 8 days.All patients were cured.There was a fllow-up for 1～20 months,with an average of 8 months.The IPSS decreased by 22 points on average,and peak urine flow(Qmax)increasd to(16.8?3.3)ml/s.There wre no urethralstricture,permanent urinary incontinence, TURS,postoperative hemorrhage,retrograde ejaculation and recurrence.Conclusions Intraluminal enucleation in treatment of prostalic hypertroply is a new,safe,and effective method,which should be popularized in clinical prac- tice.

Objective To explore parental confidence on immunization and its influential factors and provide scientific basis for immunization management and confidence enhancement strategy in Jinhua. Methods A questionnaire survey was conducted among 1 865 parents in the district, and the cumulative Logit regression model was used to analyze the influential factors of parental confidence on immunization. Results It was found that 96.41% of the children′s parents believed immunization was necessary, 70.03% believed immunization was safe, 93.51% was willing to be vaccinated, and parental confidence on immunization was 90.89%.The sequence of influential factors of confidence was satisfaction of immunization services, cognitive level of immunization knowledge, immunization about route and age obtained through medical staff. Conclusion By strengthening health education and health promotion, improving the cognitive level of parents′ immunization knowledge and elevating the quality of daily immunization service, the parental confidence can be improved effectively in immunization.

The change in plasma ghrelin level after 4-and 12-week adjunctive therapy of rosiglitazones in type 2 diabetic patients inadequately controlled by sulphonylurea alone was observed and the relation between ghrelin and insulin resistance was analysed.The results showed that rosiglitazones significantly increased circulating ghrelin level and obviously decreased insulin resistance index after therapy for 4 and 12 weeks in type 2 diabetic patients.

A novel mucoadhesive microcapsule with drug-resin complex core loaded with berberine hydrochloride (BH) was developed and optimized. Drug-ion exchange resin (IER) complex was prepared by static method which stirring IER in drug solution at certain conditions. The influences of different IERs, different temperature, pH values and concentrations of drug solution on the drug loading were investigated. IER complex was coated by emulsion-solvent evaporation method. The coating fluid formulation was optimized using central composite design-response surface methodology, where the ratio between Carbopol 934 and IER (X1), the ratio between Eudragit and IER (X2) and the ratio between Eudragit RL and RS (X3) were taken as independent variables. Time of cumulative release 85% (Y1) and percentage of gastric retention (Y2) were taken as response variables. Drug loading achieved a high level and more drug available in the condition of IER (IRP 88), 37 degrees C, pH 5 and 1.0 mg x mL(-1) drug solution. When X1 = 0.75, X2 = 0.9, X3 = 0.6, the time of cumulative release reached 85% at 300 min, the highest percentage of gastric retention in the range of this experiment were procured.
Acrylates ; chemistry ; Animals ; Berberine ; administration & dosage ; pharmacokinetics ; Capsules ; Delayed-Action Preparations ; Drug Compounding ; methods ; Drug Delivery Systems ; Emulsions ; Gastric Mucosa ; metabolism ; Hydrogen-Ion Concentration ; Ion Exchange Resins ; chemistry ; Male ; Polymers ; chemistry ; Rats ; Rats, Sprague-Dawley ; Temperature

The dosage-efficacy/toxicity relationship of the 50% alcohol extracts of Polygonum multiflorum was comparatively investigated on either normal or CCl4-induced chronic liver injury rats, by determining the general condition, serum biochemical indices and liver histopathology, coupled with the factor analysis. The dosages were 10 and 20 g raw materials per kg body weight. Compared with the normal control group, the normal high dose group showed significant increases of the serum alanine transaminase (ALT), total bilirubin (TBIL), high mobility group box 1 (HMGB-1) and interleukin-1β (IL-1β) (P < 0.05 or P < 0.01), as well the frequent incidences of inflammatory cell infiltration, hepatic sinus enlargement and fiber stripes formation in histopathological sections. Compared with the model control group, the model low dose group showed significant declines of serum ALT, aspartate transaminase (AST) and total bile acid (TBA) (P < 0.05), as well the alleviation of vacuoles of hepatocytes, but no amelioration of the inflammatory cell infiltration and fibrous tissue hyperplasia; moreover, the model high dose group showed significant degeneration declines of serum HMGB-1, tumor necrosis factor-α (TNF-α) and IL-1β (P < 0.05, P < 0.01), as well the evident alleviation of vacuoles degeneration of hepatocytes, inflammatory cells infiltration and fibrosis degree. The factor analysis showed that the low dosage treatment had almost neither injuring effect on the normal rats nor protective effect on the model rats; while the high dosage treatment showed observable injuring effect on the normal rats, expressed by the significant increases of the factor-1 (HMGB-1, TNF-α and IL-1β as the main contributors) and factor-2 (TBIL, ALT and TBA as the main contributors) relative to the normal control group. The liver protective effect of the high dosage treatment could be observed with the significant reduction of the factor-1, indicating the effective alleviation of the expression of inflammatory cytokines. In conclusion, it could illustrated the phenomenon of symptom-based prescription theory of Polygonum multiflorum on rat livers: the high dosage of the herb had either an injuring effect on normal rats, or a therapeutic effect on the rats with chronic liver injury.
Alanine Transaminase ; blood ; Animals ; Aspartate Aminotransferases ; blood ; Bile Acids and Salts ; metabolism ; Bilirubin ; blood ; Chemical and Drug Induced Liver Injury ; drug therapy ; Drugs, Chinese Herbal ; pharmacology ; Fallopia multiflora ; chemistry ; HMGB1 Protein ; metabolism ; Hepatocytes ; drug effects ; Interleukin-1beta ; metabolism ; Liver ; drug effects ; pathology ; Plant Extracts ; pharmacology ; Rats ; Tumor Necrosis Factor-alpha ; metabolism

OBJECTIVETo study the therapeutic effect of combined multifunctional external fixator for treatment of tibiofibular fracture.

METHODSFrom Oct 1999 to Apr 2006, 37 patients of tibiofibular fractures were treated with combined multifunctional external fixator. There were 28 males and 9 females with an average of 47.8 years (range,from 22 to 76 years). There were 7 cases with transverse fracture, 18 comminuted fracture, 8 spiral fracture and 4 oblique fracture;closed fracture was in 29 cases and open fracture was in 8.

RESULTSAll the patients were followed up 6 to 13 months (mean,9 months)and achieved union of the fractures.

CONCLUSIONCombined multifunctional external fixator for tibiofibular fracture has many advantages such as minimal invasion, convenient operation, reliable fixation and high union ratio of fracture. Moreover,the treatment has no influence on motion of knee and ankle joint, even patient can walk with external fixator without long-term bed rest.

Adult ; Aged ; External Fixators ; Female ; Fibula ; injuries ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery

OBJECTIVETo evaluate the roles of cell adhesion, multidrug resistance and cell proliferation in short-term recurrent cases with superficial bladder cancer, and the prognostic value of the three indexes.

METHODSImmunohistochemical staining for E-cad, P-gp and Ki-67 was performed on the tumors of 100 patients with stage T0-T1 transitional cell carcinoma of the bladder who had been included in a retrospective research by follow-up.

RESULTSE-cad and P-gp expression was positive in 51 (43.2%)and 17 (14.4%) of the tumors, respectively and mean proliferation index (PI) was 22.1%. The decrease in E-cad expression was accompanied with the increasing recurrent episodes (P < 0.05), while increase of P-gp expression and PI were accompanied with the increasing recurrence episodes (P < 0.05). There was significant difference according to E-cad, P-gp positivity and between T(1)G(3) patients and no-T(1)G(3) patients (P < 0.05). There was negative correlation of E-cad expression with P-gp expression and PI.

CONCLUSIONSMinimum adhesion, strong drug resistance and maximum proliferation are the main factors that promote short-term recurrence of superficial bladder cancer and also the inherent reasons for easy recurrence and high malignancy of T(1)G(3) tumors. During this course, the three aspects may interact.

ATP-Binding Cassette, Sub-Family B, Member 1 ; analysis ; Adult ; Cadherins ; analysis ; Cell Adhesion ; Cell Division ; Drug Resistance, Multiple ; Drug Resistance, Neoplasm ; Female ; Humans ; Ki-67 Antigen ; analysis ; Male ; Neoplasm Recurrence, Local ; etiology ; Urinary Bladder Neoplasms ; drug therapy ; etiology ; pathology

OBJECTIVETo study the molecular types of Staphylococcus aureus isolated from a severe food-poisoning and to trace the possible strains.

METHODSReal-time PCR was applied to detect nuc gene as a specific marker for S. aureus, mecA gene encoding methicillin resistance and 5 other genes encoding staphylococcal enterotoxins (sea, seb, see, sed, see). Isolates were also performed with 16S rRNA oligonucleotide sequence analyzing by DNAStar MegAlign 5.0 software and pulse-field gel electrophoresis (PFGE) by BioNumerics Version 4.0 software.

RESULTSThe nuc gene was detected from the 10 isolated strains, sea and seb genes were detected from 7 strains. There were 4 16 S rRNA types and 5 PFGE types found from all the strains.

CONCLUSIONSThree relative S. aureus strains were involved in the severe food-poisoning at least. Molecular subtyping might give a molecular epidemiological evidence and support the source tracing of an outbreak.

Bacterial Typing Techniques ; China ; Electrophoresis, Gel, Pulsed-Field ; Enterotoxins ; Humans ; Staphylococcal Food Poisoning ; epidemiology ; microbiology ; Staphylococcus aureus ; classification ; genetics ; isolation & purification

Objective Toevaluatetheeffectof3differentkindsofpropagandamodesofchargevaccinesonchanging knowledge,attitude and behavior of community residents,and to explore the effective propaganda mode of vaccination. Methods Sanjiang,JiangnanandSumengwereselectedaspilotstreets,respectively.And"motherclass"(A)mode, vaccination clinics "inform-booking"(B)mode and the community responsible doctor recommended mode (C)mode were used to carry out intervention.Intervention time was from March to September,2014.Awareness rate,necessity awareness rate,compliance rate and vaccination rate of the children of school age were used to evaluate effect of 3 propagandamodes.Results Therewerenosignificantdifferencesindemographiccharacteristicsamongthreemodes(P>0.05).Through intervention of A,B mode,the awareness knowledge,necessity awareness and willingness to vaccination were improved (P<0.05),while the other indicators were not improved through C mode intervention except for 4 vaccine related knowledge (P<0.05).After controlling for the time factor,the improving effect of related knowledge,attitude and behaviorofchargevaccinethroughAandBmodeswerebetterthanthosethroughCmode(P<0.05).Conclusion The effect of"mother class"mode,the vaccination clinics"inform-booking"mode to carry out the charge vaccine propaganda is significant,but the community responsible doctor recommended mode needs to be improved.