Purpose:To study the effectiveness of surgical treatment of 15 tracheoesophageal fistulas secondary to carcinoma of esophagus a fter radiotherapy. Methods:clinical records of 15 tracheoesophageal fistulas secon dary to carcinoma of esophagus after radiotherapy were analysed.several surgical techniques were analyged for different cases. Results:In all 15 cases, only two of them died,the postoperativ e death rate is 15.38%, and the total complication rate is 30.76%.1-year survi val is 50%, and the median-life span is 12 months. Conclusions:Approriate surgical treatment together with active preoperative preparation, elaborative postoperative nursing care, can improve t he quality of life, reduce postoperative complication rate, and prolong survival .

Objective To study the surgical repair mode of skin cancer in facies in aged patients. Methods The modes of surgical repair in 216 cases of aged patients with skin cancer in facies were analyzed. Results The special characteristics of physiology and pathology and the facies anatomy in the elderly determined the complexity of surgical repair. The surgical mode of excision and suture was the safest and the most efficacious. Skin flap transfer could mostly satisfy the function requirements of facies for the wound that was not able to be sutured after excision. Free skingrafting was applicable to the case that the deep tissue was not invaded by the tumor and the general condition of the patients was not much good. Conclusion The order of surgical repair modes for skin cancer in the facies in the elderly is excision and suture, skin flap transfer, and free skingrafting. Local skin flap must be the primary source as the selection of the skin flap is concerned. The suitable axial pattern skin flap or musculo-cutaneous flap can be selected according to the different section of the facies while there is no suitable local tissue.

Objective To analyze proliferating cell nuclear antigen(PCNA) index in invasive, proliferative,aged parts of keloid to explore the mechanism of keloid invasive growth characteristics. Methods PCNA in 10 cases of keloid and 10 cases of normal skin was detected by immunohistochemical staining, and the PCNA index of different parts in keloid and normal skin was compared. Results The PCNA index of invasive part in keloid was obviously higher than that of proliferative,aged parts of keloid and normal skin (P

Objective To explore the clinical efficacy of Naikan cognitive therapy(NCT) for alcohol dependent patients.Methods 64 cases of alcohol-dependent patients were randomly assigned to the study group (32 cases) and the control group (32 cases).The study group was treated with NCT for successive 7 days on the basis of taking original drugs; and the control group was only given the original drug therapy.The obsessive compulsive drinking scale (OCDS),self-report symptom inventory(SCL-90),nurses observation scale for inpatient evaluation(NOSIE) were administered to all subjects at pre-and post-treatment.Results ①After the treatments,the scores of OCDS in study group (49.51 ± 1.63) were lower than that in control group(53.92 ± 1.82),and the statistical difference had the significance (P ＜ 0.01).②After the treatments,the total scores and some factor scores of SCL-90 in study group were lower than in control group (t =-2.413,P =0.019 ; t =-2.033,P =0.047 ; t =-2.065,P =0.044 ; t =-2.038,0.046),and the difference was statistically significant.③After the treatments,in the study group,the scores of the total estimated factor and total positive factor(187.10 ± 18.80;78.51 ±12.22) were higher than in control group (175.51 ± 11.71 ; 68.22 ± 11.87),total negative factor score (15.55 ±9.46) were lower than in control group (20.51 ± 9.33),and the difference was statistically significant.Conclusion NCT can effectively inhibit alcohol craving,and reduce the drinking wine relevant questions.It can help to improve psychological symptoms in patients with alcohol dependence,especially depression and anxious symptoms.

Objective Nonsyndromic cleft lip with or without cleft palate(NSCL/P)is a common craniofacial birth defect which results in lifelong medical and social consequences.Although Asians have the highest birth prevalence of oral-facial clefts,the majority of gene mapping studies of cleft lip with or without cleft palate(CL/P)have been in European or Ameriean Caucasians.Therefore,the obiective of this study was to evaluate association between transforming growth factor alpha(TGF-α)gene BamH Ⅰ polymorphism and NSCL/P in Chinese.Methods 107 patients with NSCL/P and 136 healthy controls were examined for TGF-α/BamH Ⅰ genotypes.TGF-α/BamH Ⅰ typing was carried out by digesting the locus specific polymerase chain reaction amplified products with alleles specific BamH Ⅰ restriction enzyme(PCR-RELP).Resuits A1 allele frequency was 0.06 and A2 allele frequency was 0.94 in the controls.A1 allele frequency was 0.14 and A2 allele frequency was 0.86 in patients with NSCL/P(x2=8.27,df=1,P＜0.05).A1 allele frequency was 0.17 and A2 allele frequency was 0.83 in the bilateral cleft lip with or without cleft palate.A1 allele frequency was 0.13 and A2 allele frequency was 0.87 in the unilateral cleft lip with or without cleft palate(x2=0.36,df=1,P＞0.05).There was no statistically significant between the case with family history and the case without family history(x2=0.34,df=1,P＞0.05).Conclusions The above data demonstrate that there is evidence for the association of TGF-α polymorphism with development of NSCL/P in Chinese.

Objective:To investigate the pathogenic bacteria distribution and risk factors of pulmonary infection after tracheotomy in patients with stroke coma,and to put forward preventive measures.Methods:96 patients with stroke coma from January 2016 to February 2017 in our hospital were retrospectively analyzed.The incidence of pulmonary infection and distribution of pathogenic bacteria of patients with stroke coma were analyzed.At the same time,the risk factors of pulmonary infection were analyzed by single factor and multiple factors logistic regression analysis,and corresponding preventive measures were put forward.Results:The incidence of pulmonary infection after tracheotomy in 96 patients with stroke coma was 48.96％ (47/96).A total of 104 pathogens were isolated and cultured,including gram negative bacteria 69 strains (66.35％),gram positive bacteria 20 strains (19.23％) and fungus 15 strains (14.42％).Single factor regression analysis results showed that pulmonary infection after tracheotomy in patients with stroke coma was closely related with age,basic diseases,time of tracheotomy,and bed time,use of broad-spectrum antibiotics,smoking history,artificial airway,times of sputum suction and inhalation(P＜0.05),and it was not related to the patient's gender,weight,stroke type (P＞0.05).Multivariate logistic regression analysis showed that age 45 years old,complicated with basic disease,time oftracheotomy 5 d,use of broad-spectrum antibiotics,smoking history and the establishment of artificial airway were risk factors of pulmonary infection after tmcheotomy in patients with stroke coma (P＜0.05).ROC analysis results showed that the critical point (threshold C) oftmcheotomy time was 4.3 days,and the sensitivity and specificity were 0.851 and 0.918 respectively.Conclusion:The main pathogenic bacteria of pulmonary infection after tracheotomy in patients with stroke coma is gram-negative bacteria,age 45 years old,complicated with basic disease,time of tmcheotomy 5d,use of broad-spectrum antibiotics,smoking history and the establishment of artificial airway can lead to pulmonary infection after tracheotomy in patients with stroke coma,and the risk of pulmonary infection in patients with stroke coma will increase considerably after the time of tracheotomy for more than 4.3 days.Targeted measures should be taken to reduce the risk of pulmonary infection according to pathogenic features and risk factors.

Background and purpose:Resistance to anticarcinogen is one of the key factors that affect the treatment efficiency in lung cancer. The purpose of this study was to investigate the clinical significance of the multidurg resistance-related proteins P-gp, multidrug resistance-related proteins(MRP),lung resistance associated protien(LRP) and GST-?by detecting their expression in lung cancer and to investigate the mechanism of resistance to anticarcinogen. Methods:S-P immunohistochemistry was used to examine the expression level of proteins P-gp, MRP, LRP and GST- ?in 226 samples of lung cancer and 23 samples of normal lung tissues. Results:The positive rates of P-gp, MRP, LRP and GST-? in lung cancers were 46.0%, 42.0%, 54.4%, 62.4% respectively. Significant difference existed between tumorous tissue and normal lung tissue (17.4%, 13.0%, 17.4%, 21.7%). The positive rates of P-gp, MRP, LRP and GST-? in poorly differentiated-type of NSCLC were 33.3%, 22.8%, 33.3%, 47.4%, compared with differentiated-type of NSCLC (59.7%, 58.1%, 73.6%, 79.1%) (P

Objective To observe the effect of different concentrations of realgar on the apoptosis of gastric adenocarcinoma cell Line SGC-7901. Methods MTT assay was conducted to detect the growth inhibition ratio of SGC-7901 cells treated by different concentrations of realgar (0,10,20,50 and 80 μg·mL-1 ). AnnexinⅤ/ Propidium iodide double staining method together with flow cytometry were used to detect the effect of realgar at 0,20,50 and 80 μg·mL-1 on the apoptosis of SGC-7901 cells. Results The growth inhibition ratio of SGC-7901 cells by various concentrations of high-purity realgar (10,20,50 and 80 μg·mL-1 ) was 6. 15% ,7. 54% ,42. 31% and 63. 54% ,respectively,24 h after realgar treatment. At 48 h after the treatment,the growth inhibition ratio rose to 32. 56% ,46. 14% ,64. 51% and 87. 52% ,respectively (P<0. 05). Half inhibitory concentration was 45. 23 μg·mL-1 after 24 h and 15. 34 μg·mL-1 after 48 h. After treated by various concentrations of pure realgar (0,20,50 and 80 μg·mL-1 ) for 24 h,early cell apoptosis rate was (11. 10±2. 10)% ,(15. 31±1. 30)% ,(25. 81 ±2. 68)% and (43. 62 ±8. 51)% ,respectively,significantly different among the four groups (P<0. 05). The late cell apoptosis rate in each group was (1. 84±0. 25)% ,(4. 41±0. 09)% ,(4. 37±0. 14)% and (5. 00±0. 10)% ,respectively (P>0. 05). Conclusion High purity realgar can inhibit the proliferation and induce early apoptosis of gastric adenocarcinoma SGC-7901 cells.

Objective The antiviral effects of polysaccharides from Eucheuma gelatinae and Eucheuma striatum on herpes simplex virus type 1(HSV-1) and coxsackie virus(CVB3) in vitro were assayed and their antiviral mechanism was elucidated.Methods The antiviral effects of samples were evaluated with cell cytotoxicity by MTT and cytopathic effect(CPE) methods.Antiviral mechanism of two extracts was investigated by four different ways.Results and Conclusion Polysaccharides from Eucheuma gelatinae and Eucheuma striatum had an obviously HSV-1 and CVB3 inhibitory effect.Antiviral activities of two extracts(ESPA and ESPA2) were better than acyclovir(ACV).Antiviral activities of all extracts were better than ribavirin injection.Polysaccharides from Eucheuma striatum had remarkable anti-CVB3 effects.The experiment also showed that Eucheuma polysaccharides not only kill the above viruses directly but also restrain them via getting into cells or absorbing on cells.

Objective To investigate knowledge of cervical cancer,human papillomavirus (HPV) and HPV vaccine and attitude to HPV vaccine among employed urban women in China,and to assess willingness to vaccinate their children.Methods This study was conducted in women from 16 factories or companies in Beijing,Hangzhou,Changsha,Chcngdu and Guangzhou.A questionnaire on cervical cancer,HPV knowledge and HPV vaccine acceptability was administered to participants before and after educational intervention.Results A total of 1 146 women were surveyed from August to November,2011.The awareness rates of cervical cancer,HPV and HPV vaccine were 95.06 ％,27.98 ％ and 12.82 ％,respectively.Only 20.68 ％ knew that HPV was related to cervical cancer.After educatioual instruction,89.26 ％ understood the relationship between HPV and cervical cancer (x2 =93.414,P ＜ 0.001).Only 19.25 ％ women were unwilling to allow their children to be vaccinated.The main reasons were as follows:worried about vaccine safety (23.52 ％),belief that their child was not at risk (21.92 ％),lack of scientific evidence for the vaccine (13.01％),and worricd about vaccine efficacy (12.79 ％).Conclusions In general,there is a high acceptability of HPV vaccine to prevent cervical cancer among employed urban Chinese women after educational intervention.However,some women remain reluctant to vaccinate their children due to concern about vaccine safety and efficacy.