Objective: To evaluate the feasibility of performing muscle-sparing thoracotomy and intercostal sutures in the treatment of upper and/or middle thoracic esophageal cancer for the purpose of tumor control and postoperative quality of life improvement.Methods: Seven patients with esophageal cancer were treated with vertical muscle-sparing thoracotomy and Mckeown esophagectomy.Detailed clinic data were summarized and analyzed with patient follow-up information.Results: Of the 7 patients,five were still alive with a 71.4% five-year survival rate.There were no deaths resulting from the operation in this group.The mean length of thoracic incision was 11 cm.The range of hospital stays was 14 to 25 days,with a mean length of 18 days.No patients complained of impaired shoulder action,and the incision pain was hardly perceived without external stimulation 1 month after operation.Conclusion: Performing the muscle-sparing thoracotomy in the treatment of early-stage esophageal cancer located in the upper and /or middle thoracic segment yields a satisfactory long-term survival rate with an improved life quality in terms of incision pain relief and shoulder function.

MicroRNA-451 (miR-451) is significantly lowly expressed in glioma,gastric cancer,colorectal cancer,liver cancer and other tumor tissues.Upregulation of miR-451 can significantly inhibit tumor cell proliferation,invasion and metastasis as well as increasing tumor cell apoptosis and improving radiotherapy and chemotherapy sensitivity and other biological effects.

Objective To evaluate the effects of prostaglandin E1 (PGE1 ) infused in the pulmonary artery of the ventilated lung on hemodynamics and pulmonary gas exchange during one-lung ventilation (OLV).Methods Experiments were performed on 12 healthy pigs of both sexes (6 males , 6 females) aged 3 months, weighing 14-17 kg. The animals were anesthetized with intramuscular ketamine 15-20 mg?kg-1 , diazepam 1.5-2.0 mg?kg-1 and atropine. The animals were mechanically ventilated after tracheal intubation (FiO2 = 0.7, VT = 12-15 ml?kg-1, RR=15bpm, I:E=l:2). PaCO2 was maintained at 35-45 mm Hg. Swan-Ganz catheter was positioned in the right pulmonary artery via the left femoral vein. The right femoral artery was cannulated for BP monitoring and blood sampling. Anesthesia was maintained with a mixture of ketamine 100 mg and succinylcholine 100 mg in 2% procaine 100 ml infused i.v. at a rate of 2-3 ml?kg-1?h-1. The animals were placed in right lateral position. The left chest was opened and OLV was established by clamping the left main bronchus. During OLV RR was increased from 15 to 20 bpm but the minute ventilation remained unchanged. The animals were randomly divided into 2 groups of six : group A and B. Group A received PGE1 infusion in the right pulmonary artery with an initial dose of 0.01 ?g?kg-1?min-1 which was gradually increased to 0.02, 0.04, 0.06, 0.08 and 0.1 ?g?kg-1?min-1 . Theinfusion of each dose was maintained for 20 min. In group B normal saline was infused instead of PGE1. MAP, HR, CVP, PCWP, CO, PaO2 PvO2 were recorded at each dose and at 20, 40, 60 min after PGE1 infusion was terminated. Qs/Qt, PVR and SVR were calculated.Results MPAP, PVR, SVR, peak inspiratory pressure (PIP) and Qs / Qt significantly increased while CO, Cdyn and PaO2 significantly decreased (P 0.05) and a significant decrease of MPAP and PVR ( P

Training of war trauma rescue personnel under modern war time is the key point for strengthening the war preparation and satisfying the logistic supply. In the present paper,the training model of war field surgeon in Russian was firstly introduced,and then by combining the status of war rescue of our army,the strategies suitable for the training of field war surgeon in our army were put forward.

Objective To explore the effect of swallowing training on dysphagia in patients with head and neck neoplasm receiving ra-diotherapy. Methods 60 patients with head and neck neoplasm receiving radiotherapy from March, 2014 to August, 2015 were divided into intervention group (n=30) and control group (n=30) randomly. The control group received routine nursing and relevant health education, while the intervention group received swallowing training from 2 weeks before to 3 months after radiotherapy. They were assessed with Functional Oral Intake Scale and M. D. Anderson Dysphagia Inventory 1 week, 3 months after radiotherapy. Results The scores of Function-al Oral Intake Scale (Z=-3.195, P<0.01), the total score of M. D. Anderson Dysphagia Inventory and the subscores (t>4.385, P<0.01) were better in the intervention group than in the control group 1 week after radiotherapy, as well as 3 months after radiotherapy (Z=-4.436, P<0.01;t>5.361, P<0.01). Conclusion Swallowing training could improve the condition of dysphagia of head and neck neoplasm patients after radiotherapy.

Objective To synthesize 628F-Py-AMD3465,to investigate its biodistribution in mice and to perform the microPET/CT imaging on mice bearing human lung cancer cell (A549).Methods AMD3465 quaternary ammonium salt precursor was directly labeled with 18F,then 628F-Py-AMD3465 was synthesized through nucleophilic reaction,hydrolysis,neutralization and the product was purified using HPLC.The labeling yield and radiochemical purity were analyzed by HPLC.Fifteen Kunming mice were injected with 5.55 MBq of 628F-Py-AMD3465 and sacrificed at 5,20,40,60 and 120 min postinjection.The selected tissues were harvested and weighed,and the radioactivity in the tissues was measured by an automated γ-spectrometer.The ％ID/g was calculated.MicroPET/CT studies were performed on A549-bearing mice after injecting 6-18F-Py-AMD3465 through vena caudal.Paired t test was used.Results 6-18F-Py-AMD3465 was successfully synthesized with the labeling yield of (9.0±2.0)％,the total synthesis time was about 60 min,and the radiochemical purity was more than 98％.Biodistribution studies showed that the radiouptake was higher in the kidneys and bladder of normal mice,which demonstrated that 6-18 F-Py-AMD3465 was mainly excreted through the kidneys.Biodistribution in A549-bearing mice was similar to that in normal mice.The tumor/muscle ratio at 40 min was 5.0,but the radiouptake of the tumor was still lower than that of the normal lung:(8.05±0.35) ％ID/g vs (9.33±0.66) ％ID/g;t=5.26,P＜0.05.MicroPET/CT imaging showed that the high-uptake location of 6-18F-Py-AMD3465 in tumor-bearing mice was similar to the normal mice,and the tumor uptake reached the maximum level at 45 min post-injection (SUV 0.67).Conclusions 6-18F-Py-AMD3465 can be synthesized by a simple method.A lower uptake could be shown in the tumor compared to that in the lung and the tracer has limited diagnostic value for lung cancer.

Objective To study and estimate the effective dose of interventional employees in the common cerebralvascular, cardiovascular and liver interventional diagnosis and treatment.Methods The absorbed doses of tissue or organ of anthropomorphic phantom in these three procedures were estimated by the anthropomorphic phantom experiment.The effective doses were calculated by the tissue weight factor which was given by International Commission on Radiological Protection publication 103.Results The effective doses to high, medium and low group were 24.0, 9.7,6.8 μSv for cerebralvascular interventional diagnosis and treatment, and 36.3, 29.3, 17.8 μSv for cardiovascular interventional diagnosis and treatment, and 23.9, 11.3, 5.5 μ Sv for liver interventional diagnosis and treatment, respectively.Conclusions The effective doses of high, medium and low group of interventional employees in cardiovascular interventional procedure are higher than those of cerebralvascular and liver interventional procedures.

Objective To study the relationship between soluble CD147 (sCD147) level in peripheral blood and serum lipid level and explore the effect of sCD147 on atherosclerosis in rheumatoid arthritis (RA). Methods The level of sCD147 in 36 patients with RA,36 patients with coronary artery disease (CAHD) and 30 healthy volunteers was detected by enzyme linked immunosorbent assay (ELISA) .The disease activity score (DAS28) in RA patients was evaluated and the correlation between sCD147 level and DAS28 score was analyzed.The serum lipid level of RA patients was detected by an automatic biochemical analyzer and the cor relation between sCD147 level and serum lipid level was analyzed.Results The level of sCD147 in serum of RA patients was significantly higher than that in patients with CAHD and healthy volunteers,sCDI47 level in the RA group with high DAS28 score was significantly higher than that with low or medium DAS28 score.In RA patients,elevated total cholesterol (TC) and triglyceride (TG) level was positively correlated with serum sCDI47 level (r=0.84,P＜0.05;r=0.87,P＜0.05;while slightly elevated,normal TC and normal TG had no correlation with serum sCDI47 level (r=0.41,P=0.21;r=0.14,P=0.57;r=0.49,P=0.87).Elevated or slight ly elevated LDL-C was positively correlated with serum sCD147 level (r=0.86,P＜0.05;r=0.81,P＜0.05), while no correlation could be found in the group with normal LDL-C level (r=0.78,P=0.22).The high density lipoprotein-cholesterol (HDL-C) level decrease in RA patients had no correlation with serum sCD147 level (r--0.04,P=0.96;r=0.13,P--0.87).Conclusion sCD147 may be involved in the pathogenesis of RA and associate with disease activity.Elevated sCD147 level may be associated with abnormal serum lipid in RA.

OBJECTIVETo compare the cleaning effect of automatic cleaning machine and manual cleaning on coupling type surgical instruments.

METHODSA total of 32 cleaned medical instruments were randomly sampled from medical institutions in Putuo District medical institutions disinfection supply center. Hygiena System SUREII ATP was used to monitor the ATP value, and the cleaning effect was evaluated.

RESULTSThe surface ATP values of the medical instrument of manual cleaning were higher than that of the automatic cleaning machine.

CONCLUSIONCoupling type surgical instruments has better cleaning effect of automatic cleaning machine before disinfection, the application is recommended.

Objective To compare the effect of transthoracic contrast echocardiography (cTTE) with transesophageal contrast echocardiography (cTEE) for detecting right to left shunt (RLS) in patients with patent foramen ovale (PFO). Methods The prospective study was conducted in 29 consecutive patients with PFO who suffered from cryptogenic stroke and/or migraine. Contrast echocardiography was performed in all 29 patients. The cTTE was performed using transducer with second harmonic imaging modality (transmitting frequency 1.7 MHz, receiving frequency 3.4 MHz). The cTEE was performed using transducer with frequency 7 MHz. Ten milliliter saline solution of contrast were rapidly administrated through an antecubital vein. According to whether microbubble (MB) appearing in left atrium after complete opaciifcation of right atrium within the ifrst 3 circles, the results were classiifed by a four-level semi-quantitative categorization:Level 1 (no PFO-RSL), no MB in left atrium; Level 2 (small PFO-RSL) 1-10 MBs; Level 3 (medium PFO-RSL) 10-30 MBs;Level 4 (large PFO-RSL)>30 MBs. Results The total detection rate of PFO-RSL was signiifcant different between cTTE and cTEE (86.2%vs 55.2%,χ2=5.711, P=0.017). In cTTE there were 4 cases at level 1, 1 case at level 2, 5 cases at level 3 and 19 cases at level 4. In cTEE there were 13 cases at leverl 1, 2 cases at level 2, 6 cases at level 3 and 7 cases at level 4. The comparison of semi-quantitative grading derived from cTTE and cTEE was also signiifcant different (Wilcoxon signed ranks test showed Z=-3.789, P=0.000). Conclusions The efifciency in detection of PFO-RLS with cTTE was better than with cTEE. Compared with cTEE, cTTE was easier in practice and brought less discomfort and complications to patients.