Objective To explore the feasibility and reliability of thoracoscopic surgery in the treatment of esophageal leiomyoma.Methods According to the tumor site selection of incision,7 patients with esophageal leiomyoma were taken myomectomy by thoracoscopic surgery.Results All cases were cured,and there was no death and serious complication.The patients were followed up for 3 to 24 months.There was no recurrence.Conclusion The myomectomy by thoracoscopic surgery would be an alternative to open surgery for patients with esophageal leiomyomas,which is safe and effective.

Objective To detect the changes of CD4 + CD25 + CD127low/-regulatory T (Treg) cells in peripheral blood in patients with portal hypertension and hepatitis B virus infection before and after splenectomy,and to study the effects of splenectomy on the immune function of patients with portal hypertension.Methods The clinical data of 20 patients with portal hypertension,hepatitis B virus infection and hypersplenism who were admitted to the Third Hospital of Hebei Medical University from May 2012 to May 2013 were retrospectively analyzed.The dynamic levels of CD4 + CD25 + CD127low/ Treg cells in the peripheral blood of the 20 patients (portal hypertension group) at 1 day before splenectomy and at postoperative week 1,month 1 and month 3 were detected by flow cytometry,and the dynamic levels of CD4 + CD25 + CD127low/ Treg cells in the peripheral blood of 10healthy individuals (control group) from the same hospital were also detected by flow cytometry.The effects of changes of Treg cells on the immune function were analyzed.All data were analyzed using the t test or repeated measures analysis of variance.Results The proportions of CD4 + CD25 + CD127low/-Treg cells before operation were 5.1％ ± 3.5％ in the portal hypertension group and 1.4％ ± 0.2％ in the control group,with significant difference between the 2 groups (t =2.573,P ＜ 0.05).The proportions of CD4 + CD25 + CD127low/ Treg cells in the portal hypertension group at postoperative week 1,month 1 and month 3 were 9.2％ ±2.7％,5.6％ ± 1.7％and 2.5％± 2.1％,respectively.There was significant difference in the proportion of CD4+ CD25 + CD127low/-Treg cells between postoperative week 1 and that before operation (F =9.814,P ＜ 0.05),while there was no significant difference in the proportion of CD4 + CD25 + CD127low/-Treg cells between postoperative month 3 and that before operation (F =2.364,P ＞ 0.05).Conclusion The proportion of Treg cells increases in a short period after splenectomy,and then it decreases as time passed by,which indicates that splenectomy has slight influence on the immune system from the perspective of Treg cells.

Objective The purpose of this study was to provide efficient evidence to the treatment and nursing for patients with colorectal cancer after colostomy surgery by conducting a quality of life survey on the patients. Methods The WHOQOL-BREF scale was distributed to 103 patients after colostomy surgery in the Tumor Hospital of Yunnan Province. Results The average score of these patients was 23.45±9.92,with the highest score of 29, the lowest score of 13. In terms of quality of life in the physiological field and psychological field, there was a significant difference between the high self-efficacy ability and low self-efficacy ability ( <0.05) .In terms of quality of life in the social field and environment field, there was no significant difference between the high self-efficacy ability and low self-efficacy ability (>0.05). Conclusion The patients’familiarity with stomas was closely related to the quality of life, which indicated that the quality of life could be improved by improving the patient's familiarity with stoma care.It is necessary to know the condition of colostomy care in different postoperative stages and provide efficient support and help for the patients.

Objective To evaluate the value of carotid artery bruit in predicting carotid stenosis in patients with cerebral arterial thrombosis. Methods Two hundred cerebral arterial thrombosis patients were divided into bruit group and no bruit group according to carotid artery auscultation,with 100 cases in each group. The patients with cardiac murmur, vein sound and thyroid noise were excluded from bruit group. The examination of carotid artery auscultation (transcranial Doppler sonography ) was managed in all the patients,and digital subtraction angiography (DSA) about aortic arch and the whole brain were perfomed. The carotid stenosis rate, site, degree were compared and the relationship between carotid bruit grade and carotid stenosis degree were evaluated. Results The carotid stenosis rate in bruit group [67% (67/100)] was higher than that in no bruit group [29%(29/100)](P＜ 0.01 ). There was significant difference in the carotid stenosis site and degree between two groups (P ＜0.05). Carotid bruit were significantly associated with stenosis near carotid bifurcation or serious stenosis (P ＜ 0.05). The carotid bruit grade was positively related with the carotid stenosis degree (P ＜ 0.05 ). Conclusions Carotid bruit is associated with site and degree of carotid stenosis. Carotid bruit is valuable in screening for carotid stenosis in patients with cerebral arterial thrombosis.

Objective To investigate the serum C-reactive protein (CRP) level in patients with acute cerebral infarction and acute massive cerebral infarction with multiple organ dysfunction syndrome (MODS),and analyze the clinical value of CRP. Methods The serum CRP level of 50 patients of control group and 50 patients of cerebral infarction admitted to hospital within 7 days (30 patients were admitted into acute cerebral infarction group and 20 patients into acute massive cerebral infarction with MODS group) were determined by immune scatter turbidimetry. Results (1)In cerebral infarction patients,serum CRP level in 48 cases(96%) was equal and over 5 mg/L.In control group,serum CRP level in 3 cases(6%) was equal and over 5 mg/L(P＜0.0 5).(2)The level of serum CRP acute in cerebral infarction group and in acute massive cerebral infarction with MODS group increased significantly than that in control group (P＜0.01).The level of serum CRP in acute massive cerebral infarction with MODS group increased significantly than that in acute cerebral infarction group.(3)When the level of CRP＜25 mg/L,the incidence of MODS in patients with acute cerebral infarction was zero.When the level of CRP≥25 mg/L,the incidence of MODS increased gradually with the rise of CRP. Conclusions There is positive correlation between the serum level of CRP and the severity of acute cerebral infarction and the incidence of MODS.CRP is a useful marker in predicting the prognosis of acute massive cerebral infarction with MODS.

OBJECTIVETo observe the therapeutic effects of continuous plasma filtration absorption (CPFA) treatment on burn sepsis.

METHODSThirty burn patients with sepsis hospitalized in Beijing Fengtai You'anmen Hospital from July 2009 to October 2012 were treated by CPFA for twice besides routine treatment. The blood samples were collected at five sites (A, B, C, D, and E, respectively) of blood purification equipment before and after CPFA, before and after hemoabsorption, and before hemofiltration. The plasma levels of TNF-α, IL-1β, IL-6, IL-10, interleukin-1 receptor antagonist (IL-1RA), soluble tumor necrosis factor receptor (sTNFR) I , and sTNFR-II from sites A, C, and E were determined with ELISA before CPFA was performed for the first time, and those from sites B and D were determined with ELISA after CPFA was performed for the first time. Plasma levels of the above-mentioned cytokines from sites A and B were determined with ELISA before CPFA and after CPFA was performed for the second time. The data of plasma levels of IL-1βP3, IL-1RA, sTNFR-I, sTNFR-II, and TNF-α before CPFA and after CPFA was performed for the second time were collected for calculation of the ratios of IL-1RA to IL-1β and sTNFR-I plus sTNFR-II to TNF-α. The expression rate of human leukocyte antigen DR (HLA-DR) on the CD14 positive monocytes, acute physiology and chronic health evaluation (APACHE) II score, body temperature, pulse, respiratory rate, and leukocyte count of patients were evaluated or recorded before CPFA and after CPFA was performed for the second time. Patients'condition was observed. Data were processed with paired t test.

RESULTSThe plasma levels of TNF-α, IL-1β, IL-6 and IL-10 from site B after CPFA was performed for the second time were significantly lower than those from site A before CPFA was performed for the first time (with t values respectively 7.05, 5.23, 4.73, 2.37, P values below 0.01). After CPFA was performed for the first time, the plasma levels of TNF-α, IL-1β, and IL-6 from site D were significantly lower than those from site C before CPFA was performed for the first time (with t values respectively 5.48, 2. 17, 1.78, P < 0.05 or P <0.01). The plasma levels of all cytokines were close between site B after CPFA was performed for the first time and site E before CPFA was performed for the first time (with t values from 0.04 to 1.05, P values above 0.05). The plasma levels of TNF-α, IL-1β, and IL-6 from site B after CPFA was performed for the second time were significantly lower than those from site A before CPFA was performed for the second time (with t values from 1.87 to 5.93, P <0.05 or P <0.01). The ratios of IL-1RA to IL-1β and sTNFR-I plus sTNFR-II to TNF-α, and expression rate of HLA-DR were increased significantly after CPFA was performed for the second time as compared with those before CPFA (with t values from 3.99 to 7. 80, P values below 0.01). APACHE II score after CPFA was performed for the second time was 11 ± 6, which was lower than that before CPFA (22 ± 7, t =4.63, P <0.01). After CPFA was performed for the second time, body temperature, pulse, and respiratory rate of patients were improved (with t values from 1.95 to 3.55, P values below 0.05) , and the leukocyte count was significantly decreased (t =4.36, P <0.01) as compared with those before CPFA. All patients survived and were discharged with length of stay of (27 ± 31) d, and no adverse effects occurred during CPFA treatment.

CONCLUSIONSCPFA, which combines hemoabsorption and hemofiltration, can facilitate the treatment of burn sepsis by decreasing the level of pro-inflammatory cytokines efficiently, alleviating systemic inflammatory response, and improving the immune status.

Adsorption ; Aged ; Biomarkers ; blood ; Burns ; blood ; complications ; immunology ; Cytokines ; blood ; Fluid Therapy ; Hemofiltration ; methods ; Hospitalization ; Humans ; Inflammation Mediators ; blood ; Interleukin 1 Receptor Antagonist Protein ; blood ; Interleukin-10 ; blood ; Interleukin-6 ; blood ; Sepsis ; blood ; immunology ; therapy ; Treatment Outcome ; Tumor Necrosis Factor-alpha

Objective To investigate the perioperative characteristics and changing trends of gastric electrical activity of thoracic (tube) stomach in patients with esophageal cancer.Methods The clinical data of 30 patients with esophageal cancer who were admitted to the Sichuan Cancer Hospital between March 2013 and November 2013 were prospectively analyzed.All the eligible patients underwent esophageal cancer resection by Ivor-Lewis according to the inclusion criteria.The electrogastrograms of patients were recorded at preoperative day 1 and at postoperative day 3,7, 11 and 30.The electrogastrograms of patients at preoperative day 1 were used as the control.The parameters of electrogastrogram were analyzed including main frequency, coefficient of dominant frequency instablility, main power, postprandial/preprandial power ratio, percentage of normal gastric slow wave,percentage of slow gastric slow wave and percentage of tachycardia gastric slow wave.Measurement data with normal distritution were presented as x ± s, and measurement data with skew distritution were presented as M (Qn).The postoperative time and pre-and post-prandial electrogastrograms were compared by the repeated measures two-way ANOVA.The comparison between groups were evaluated with the LSD test and analysis of variance.Results Thirty patients were screened for eligibility with a mean age of 62 years (range, 49-75 years), including 26 males and 4 females.The pre-and post-prandial main frequencies were changed from 2.83 ± 0.13 and 3.01 ± 0.17 before operation to 2.66 ± 0.10 and 2.82 ± 0.10 at postoperative day 30 with coherent changing trend.The main frequencies at postoperative each time points were significantly lower than those before operation while postprandial above indicators were higher than preprandial those, showing a significant increasing trend with the passage of postoperative time (F =285.62, P ＜ 0.05).There was no interaction between the time and meal (F =0.22, P ＞ 0.05).The pre-and post-prandial coefficients of dominant frequency instablility were changed from 0.133 ±0.031 and 0.045 ±0.019 before operation to 0.150 ±0.043 and 0.115 ±0.010 at postoperative day 30 with coherent changing trend, and coefficients of dominant frequency instablility at postoperative each time points were significantly higher than those before operation while postprandial above indicators were lower than preprandial those, showing a significant reducing trend with the passage of postoperative time (F =16.51, P ＜ 0.05).The pre-and post-prandial main powers were changed from (85 ± 15) μV and (149 ± 23) μV before operation to (74 ± 9) μμV and (98 ± 10) μV at postoperative day 30, and main powers at postoperative each time points were significantly lower than those before operation, showing a significant increasing trend with the passage of postoperative time (F =48.45, P ＜ 0.05).There was interaction between the time and meal (F =7.39, P ＜ 0.05).The postprandial/preprandial power ratio was changed from 3.00 ± 0.35 before operation to 2.52 ± 0.25 at postoperative day 30, and postprandial/preprandial power ratios at postoperative each time points were significantly lower than those before operation, showing a significant increasing trend with the passage of postoperative time (F =26.66, P ＜ 0.05).The pre-and post-prandial percentages of normal gastric slow wave were changed from 81％ ± 6％ and 94％ ± 5％ before operation to 57％ ± 5％ and 70％ ± 5％ at postoperative day 30 with coherent changing trend, and percentages of normal gastric slow wave at postoperative each time points were significantly lower than those before operation while postprandial above indicators was lower than preprandial those, showing a significant increasing trend with the passage of postoperative time (F =49.36,P ＜0.05).There was no interaction between the time and meal (F =0.24, P ＞ 0.05).The pre-and postprandial percentages of slow gastric slow wave were changed from 17％ ± 7％ and 4％ ± 4％ before operation to 32％±4％ and 21％±4％ at postoperative day 30 with coherent changing trend, and percentages of slow gastric slow wave at postoperative each time points were significantly higher than those before operation while preprandial above indicators were higher than postprandial those, showing a significant reducing trend with the passage of postoperative time (F =46.54, P ＜ 0.05).There was interaction between the time and meal (F =18.12, P ＜ 0.05).The pre-and post-prandial tachycardia gastric slow wave percentages were changed from 1.55％ (1.04％,2.21％) and 1.95％ (1.74％, 4.22％) before operation to 8.97％ (5.76％, 12.02％) and 12.41％ (8.04％,16.85％) at postoperative day 30 without completely coherent changing trend, and percentages of tachycardia gastric slow wave at postoperative each time points were significantly higher than those before operation while postprandial above indicators were higher than preprandial those, showing a significant difference between before operation and postoperative day 3 (Z =11.47, 13.28, P ＜ 0.05) and no significant difference among the postoperative day 7, 11, 30 (Z =1.88, 0.31, 0.03, P ＞ 0.05).There was no interaction between the time and meal (F=0.85, P＜0.05).Conclusions After the esophagectomy, gastric electrical activity of thoracic (tube) stomach is also retained before and after the meal.There are significant differences among the main frequency, main power, coefficients of dominant frequency instablility, postprandial/preprandial power ratio,percentage of normal gastric slow wave, percentage of slow gastric slow wave, percentage of tachycardia gastric slow wave of thoracis (tube) stomach, they have changed dynamically in the perioperative period.

Objective To explore the effect of iron chelators on labile iron pool and expression of apoptosis associated genes in cells of K562, an erythroleukemia cell line.Methods K562 cells were incubated at 37 ℃ in RPMI 1640 containing 10% heat-inactived fetal bovine serum in an saturated humidity and 5% CO_2 incubator. K562 cells were incubated with different concentrations of desferro-(xamine(DFO)). The study groups were divided as following: DFO group, iron+DFO group and the control group. Following indices were detected which included apoptosis by flow cytometry (FCM) assay, expression of Rb, c-myc, bax mRNA by RT-PCR. The intracellular LIP was measured with a fluorimetric assay using the metalsensitive probe calcein-AM.Results 1. The viability of K562 cells incubated with different concentrations of DFO was lower than that of control group at 12 h,24 h and 48 h (P

Background and purpose: Postoperative chemotherapy targets the metastatic cancer in the remaining lymph nodes, but the heterogeneity in multidrug resistance (MDR) of metastatic cancer cells is a main factor affecting chemotherapeutic efficacy. Recent studies only examined the primary lesion of esophageal squamous cell carcinoma(ESCC). There is no report about heterogeneity between the primary tumor and metastases lymph node. The purpose of this study was to explore the heterogenous expression and clinical signiifcance of multidrug resistance (MDR) associated proteins in primary tumors and metastatic lymph nodes in patients with thoracic ESCC. Methods:The expressions of lung cancer associated resistance protein (LRP), P-glycoprotein (P-gp), topoisomeraseⅡ(TOPO-Ⅱ), thymidylate synthase (TS), glutathione S-transferase-π (GST-π) were examined by immunohistochemistry in primary lesions and corresponding metastatic lymph nodes in 54 patients with thoracic ESCC. The differences between expression of primary lesions and matched metastatic lymph nodes were compared and analyzed in relationship with tissue differentiation degree. Results: The discordant rates of the expression and drug resistance between primary lesions and corresponding metastatic lymph nodes in LRP, P-gp, TS, TOPO-Ⅱ and GST-π were 63.0% and 26.9%, 42.6%and 22.2%, 48.1%and 25.9%, 50.0%and 29.6%, 18.5%and 1.9%respectively. The expression of LRP showed signiifcant difference between the primary tumors and lymph nodes (P=0.026). No signiifcant differences were found for the other four proteins, and GST-πwas expressed in all patients in both the primary tumors and lymph nodes. Protein expression was not associated with degree of differentiation. Conclusion:There is evident of heterogenous expression of MDR associated proteins in metastatic lymph nodes compared to the primary tumors of ESCC. The examination of expression levels of MDR associated proteins in metastatic lymph nodes is helpful to select the postoperative rational chemotherapy plan.

OBJECTIVETo observe the influence of copper-bearing stainless steel on adhesion, proliferation and apoptosis of vascular endothelial cell (VEC). METHODS; The samples of two kinds of materials were inoculated with VEC and incubated for 1, 2 and 3 d. After stained by acridine orange, the cells adhered on the surface of samples were observed under a fluorescent microscope. The proliferation of VEC was detected by methyl thiazolyl tetrazolium (MTT) test. Next, leaching liquor of these two kinds of materials was prepared and used to culture VEC. The apoptosis of VEC was measured by flow cytometry.

RESULTSFluorescent microscope showed VEC spread into fusiform shape, copper-bearing stainless steel surfaces had a significantly higher number of adherent VEC than 316L stainless steel at 1 and 2 d (P < 0.05). No significant difference of adherent VEC was observed between two kinds of materials at 3 d (P > 0.05). MTT results indicated that the optical density (OD) value of copper-bearing stainless steel were higher than that of 316L stainless steel at 1 and 2 d (P < 0.05). No significant difference of OD value was observed between two kinds of materials at 3 d (P > 0.05). The early apoptosis ratio of 316L stainless steel was higher than copper-bearing stainless steel (P < 0.05).

CONCLUSIONCopper-bearing stainless steel could promote the adhesion, proliferation of VEC, and inhibit the early apoptosis ratio of VEC.

Apoptosis ; Copper ; Endothelial Cells ; Humans ; Stainless Steel