Objective:To establish a feasible method for extracting polysaccharide from the discarded fibrous roots of Radix Panacis Quingueforlii afterpanaquilon had been extracted, and determine the polysaccharide content. Methods:Enzymolysis technique and alcohol was applied for decolorization, and phenol-sulfuric-acid method was used to determine the active polysaccharide content.The content of trace element and heavy mental was measured by element-analyzer and atomic fluorescence photometer respectively. Results: The yield of polysaccharide from the fibrous roots was close (about 11.7%) to the main root.And the content of heavy metal can match the national standard.Conclusion:It is valuable to extract the polysaccharide from the discarded fibrous root of Radix Panacis Quingueforlii.

Objective:To establish a feasible method for extracti ng polysaccharide from the discarded fibrous roots of Radix Panacis Quingueforli i afterpanaquilon had been extracted, and determine the polysaccharide content. Methods:Enzymolysis technique and alcohol was applied for decolorization, and ph enol-sulfuric-acid method was used to determine the active polysaccharide conte nt.The content of trace element and heavy mental was measured by element-analyze r and atomic fluorescence photometer respectively. Results: The yield of polysac charide from the fibrous roots was close (about 11.7%) to the main root.And the content of heavy metal can match the national standard.Conclusion:I t is valuable to extract the polysaccharide from the discarded fibrous root of R adix Panacis Quingueforlii.

Objective To investigate the clinicopathological features of glomus tumor and its differential diagnosis. Methods Clinical, morphologie and immunohistoehemical representations were described in 11 cases of glomus tumor. Results The tumors were located at the hyponychial in 7 cases, forearm subcutaneous in 2 cases, knee subcutaneous in 1 case, gastric antrum forewall in 1 cases. Localized pain was the primary symptom. 9 giomus tumors were histopathologically classified as solid type, and 2 glomangiomatous type. The prominent morphologic features of glomus tumor were as follows: the tumor cells were small, round, uniform, the tumor cells arranged around capillary vessel or expansion of the small vein showing nest pattern,some tumor cells in fasciation pattern; focally myxoid change in the stroma were seen. Immunohistochemistry: 11 cases were positive for SMA and Vimentin; while other markers including CK, CD117, CD34, CgA, Syn, Desmin, S-100 and HMB45, were all negative. All 11 cases were without any evidence of recurrence or metastasis in followed-up for 12-30 months. Conclusion Glomus tumor is extremely rare. The diagnosis depends on the histology and immunohistochemistry. Glomus tumor is rare in visceral sites. It may be misdiagnosed and needs to he differentiated from other tumors.

Background and purpose: Human epidermal growth factor receptor 2 (HER-2) is the member of tyrosine kinase receptor family. Its differential expression plays the key role in choosing targeted drug for breast cancer. This study focused on screening the breast cancer cell clones of different HER-2 expression levels, and studying the bi-ological characteristics of these cells. Methods: Breast cancer SK-BR-3 cells were clonally purified, and the expression level of soluble HER-2 (sHER-2) from the culture supernatant was detected by the ECLIA on ADVIA Centaur CP System. Cell clones with high expression (>50.0 ng/mL), medium expression (15.8-50.0 ng/mL) and low expression (<15.8 ng/mL) of sHER-2 were identified, respectively. This study observed the morphological changes of cell strains with differential expression levels of sHER-2 by cell culture. Besides, biological characteristics were compared by a series of experiments in vitro, such as clone formation, scratch assay, and transwell detection. Results: Compared with normal breast cells, sHER-2 was overexpressed significantly in SK-BR-3 breast cancer cells. Furthermore, the abilities of clone formation, mobility and invasion of sHER-2 high expression cell strain [(51.3±3.4)%, (50.0±0.6)% and (53.5±4.2)%] were signifi-cantly higher than those of sHER-2 medium expression [(42.0±3.7)%, (19.5±3.4)% and (33.2±3.9)%] or sHER-2 low expression [(26.7±2.9)%, (13.6±1.0)% and (28.9±5.4)%], and the differences were all statistically significant (P<0.05). Conclusion: Breast cancer cell strain with high expression level of sHER-2 can enhance cell proliferation, promote cell motility and other biological effects, which may lay the foundation for clinical screening of targeted drug therapies for breast cancer.

ObjectiveTo discuss the surgical treatment for patients with anastomotic stoma cancer,gastric cardial cancer or esophagus cancer after subtotal gastrectomy.MethodsThe clinical data of 21 patients with anastomofic stoma cancer,gastric cardial cancer or esophagus cancer after subtotal gastrectomy were analyzed retrospectively.There were 4 cases with anastomotic stoma cancer after operation of gastric cardial cancer,2 cases with gastric cardial cancer after subtotal gastrectomy due to gastriculcer,3 cases with upper esophagus cancer after subtotal gastrectomy due to gastric ulcer,6 cases with mid-esophagus cancer and 6 cases with distal esophagus cancer after subtotal gastrectomy due to gastric ulcer.There were 6 cases treated with partial esophagus resection,resection of remaining stomach and jejuna-esophagus anastomosis,3 cases treated with partial esophagus and stomach resection and esophagus-gastric anastomosis,12 cases with subtotal esophagectomy and colon interposition.ResultsOne case with incision infection,1 case with anastomosis leaks,1 case dead of pulmonary infection.In the 20 follow-upcases,4 cases were dead of cardiac and cerebral accidents at the third year after operation,and other 16 cases survived and had normal diet.ConclusionsReoperation is still one of the best choices for patients with anastomotic stoma cancer,gastric cardial cancer and esophagus cancer after subtotal gastrectomy when their body condition are acceptable and without distant metastasis.The organ for digestive tract reconstruction should be decided according to the situation of the first gastrectomy and the proficiency of the operator.

Objective To investigate the feasibility of combined laparoscopic and thoracoscopic esophagectomy for esophageal carcinoma and gastro-esophageal anastomosis in right thoracic cavity.Methods We retrospectively analyzed the clinical data of 38 patients who underwent esophagectomy for esophageal carcinoma and gastro-esophageal anastomosis in right thoracic cavity from October 2011 to August 2012.To remove the stomach in laparoscopic and the esophagus in thoracoscopy.The main portion of a gastric conduit is created using three to four firings of a linear stapler(Ethicon Endo-surgery,Cincinati,OH) and jejunum stoma.Gastric conduit was pulled into the chest cavity and anastomosed to the esophagus.Results The average operative time was 280 minutes,the mean operative blood loss was 120 ml.No patient required laparotomy.No pulmonary complications or anastomotic leaks occurred.One had gastric retention,another one had chylous hydrothorax.All patients were cured,no one dead in hospital.Conclusion Combined laparoscopic and thoracoscopic esophagectomy for esophageal carcinoma and gastro-esophageal anastomosis in right thoracic cavity is technically feasible and safe,minimized trauma,less operative blood loss and quick recovery.

Objective To investigate the lymph node metastasis on the middle and lower segment of esopha-geal squamous cell carcinoma ,understand the factors influencing lymph node metastasis ,to further provide the theory evidence for the lymph node dissection on the middle and lower segment of esophageal squamous cell carcinoma patients of Mongolian nationality .Methods A retrospective study was made in 108 Mongolian patients suffered from the middle and lower segment of esophageal squamous cell carcinoma who accepted radical resection of esophageal carcinoma by three incisions of right chest or combined with right thoracic laparoscopic in three incisions .Results A total of 4914 lymph nodes were dissected,with an averaged clean of (45.5 ±6.0)lymph nodes for each case.80.6％of patients(87/108) were found lymph node metastasis .A total of 624 lymph nodes (624/4914,12.7％) existed metastasis.The rates of superior, middle and inferior mediastimum metastasis for middle segment of esophageal squamous cell carcinoma patients of Mongolian nationality were 20.6％,57.4％ and 39.7％,respectively,while the rates of superior ,middle and inferior mediastimum metastasis for lower segment of esophageal squamous cell carcinoma patients of Mongolian nationality were 17.5％,47.5％and 47.5％,respectively.There was no statistically significant difference between the two groups (P >0.05).The rate of lymph node peritoneal metastasis of lower segment of esophageal squamous cell carcinoma patients of Mongolian nationality was higher than that of middle segment of esophageal squamous cell carcinoma patients of Mongolian nationality (62.5％vs.16.2％,χ2 =24.320,P<0.05). The top three lymph node metastasis sites of middle segment of esophageal squamous cell carcinoma were para esophagus ,carina and recurrent laryngeal nerve .The top three lymph node metastasis sites of lower segment of esophageal squamous cell carcinoma were para esophagus ,cardia side and carina .The influence of the depth of tumor invasion,differentiation degree , intravascular cancer embolus and perineural invasion to the rate of lymph node metastasis was statistically significant(χ2 =21.630,7.568,21.066,4.692,all P<0.05).There were no statistically significant differences of the location ,the tumor length or whether had heavy drinking or not to the rate of lymph node metastasis( all P >0.05).Conclusion The rate of lymph node metastasis on both the middle and lower segment of esophageal squamous cell carcinoma is high .The mediastinum lymph nodes needs to be emphatically cleaned . Abdominal lymph nodes cleaning of lower segment of esophageal squamous cell carcinoma can 't be overlooked .Among the Mongolian patients ,the cleaning key of lymph node on the middle segment of esophageal squamous cell carcinoma are para esophagus ,carina and recurrent laryngeal nerve ,while the cleaning key of lymph node on the middle segment of esophageal squamous cell carcinoma are para esophagus ,cardia side and carina.The deeper the tumor infiltration is,the lower the differentiation degree is , with cancer embolus in vessels , nerve invasion , the higher rate of the lymphatic metastasis.

Objective To prospectively study the clinical diversity of the middle and lower segment of stage of esophageal cancer patients who accepted the thoracoscopic combined with laparoscopic esophagectomy ( TLE) between Mongolian and Han nationalities in Inner Mongolia , to further clarity the feasibility of TLE.Methods 92 consecutive cases of middle and lower segment of stage of esophageal cancer patients of Mongolian and Han were selected,and the patients accepted the TLE ,including 41 cases of Mongolian and 51 cases of Han.The postoperative pain was evaluated with the visual analog scale (VAS) at 1-14d after operation,and the postoperative complication , the hospitalization of postoperation and the postoperative pathological situation were compared .Results Compared with the Han patients,the postoperative pain of Mongolian significantly reduced ,duration of postoperative of pain significantly shorter in the 1-5 d after surgery(P <0.05).Mongolian patients turned to mild pain in the second day of the postoperative period,and Han turned to mild pain in the fourth day after surgery .The postoperative pain in the 6-14 d after surgery of the Mongolian was not significantly different from Han (P >0.05).The Mongolian had lower incidence rate of postoperative complication compared with Han (9.8% vs.27.5%,χ2 =4.522,P <0.05).For example,the incidence rates of respiratory complications in Mongolian patients ,such as pulmonary infection,atelectasis and the occurrence of pleural effusion that need to be treated were significantly lower than those in Han (7.3% vs. 23.5%,2.4% vs.15.7%,4.9% vs.19.6%,P <0.05).There was no statistically significant difference in the incidence of other complications(P >0.05).The postoperative hospitalization of Mongolian was significantly shorter than that of Han[(11.9 ±1.2) d vs.(15.5 ±1.0) d,t =-15.811,P <0.05].No significant difference in the total number of cases of lymph node dissection ,the abdominal lymph node dissection and the chest lymph node dissection . The number of the regional lymph nodes metastasis of Mongolian was higher than that of Han [(3.9 ±0.7) vs. (1.8 ±0.7),t =13.460,P <0.05],most of which were poorly differentiated (6 /25/10 vs 20 /20 /11,χ2 =7.139, P <0.05).Meanwhile,the incidence rates of cancer embolus in the vasculature and nerve invasion of Mongolian were higher than those of Han(75.6% vs.47.1%,70.7% vs.17.6%,χ2 =7.706,26.418,all P <0.05).Conclusion The Mongolian were more easily tolerant to the TLE,which has the advantages of reducing pain ,trauma,rapid recovery, satisfactory curative effect and the lesser postoperative complications .The degree of the malignancy of esophageal cancer of Mongolian was higher than Han .Mongolian who suffered from esophageal cancer needed earlier discovery , earlier treatment and further research of the causes of difference .

OBJECTIVETo investigate the safety and feasibility of forgoing postoperative nasogastric tube decompression in minimally invasive esophagectomy for patients with esophagus carcinoma.

METHODSClinical data of 90 eligible patients who underwent elective minimally invasive esophagectomy in our department from January 2012 to May 2013 by the same surgical team were retrospectively analyzed. Among them, 45 patients did not receive the use of postoperative nasogastric tube decompression and 45 patients received nasogastric tube decompression after operation. The observation parameters included the time to first flatus, the time to intake of fluid diet, the duration of postoperative hospitalization, pharyngalgia, vomiting, and postoperative complications, as well as the need for placing or replacing the nasogastric tube.

RESULTSThe incidence of pharyngalgia was significantly higher in nasogastric tube group (100% vs 44.4%, P<0.001). The time to intake of fluid diet [median 2 d(2-4 d) vs. median 9 d(7-20 d), P<0.001] and the time to first flatus [median 3 d(3-8 d) vs. median 6 d(3-9 d), P<0.001] were all significantly shorter in non-nasogastric tube group as compared to nasogastric tube group. Compared with the nasogastric tube group, the non-nasogastric tube group had shorter postoperative hospital stay (P<0.001). There were no significant differences in the incidence of postoperative complications and vomiting between two groups.

CONCLUSIONMinimally invasive esophagectomy without the use of postoperative nasogastric tube decompression is safe and feasible, which can improve recovery and shorten postoperative hospital stay.

Decompression ; Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Humans ; Incidence ; Intubation, Gastrointestinal ; Minimally Invasive Surgical Procedures ; methods ; Postoperative Complications ; Postoperative Period ; Retrospective Studies