OBJECTIVETo explore the pattern of lymph node metastasis (LNM) in advanced Siewert type II adenocarcinoma of the gastroesophageal junction (AGEJ) in order to properly guide lymphadenectomy.

METHODSFrom January 2009 to Jun 2011, a total of 86 patients with advanced Siewert type II AGEJ underwent radical esophagogastrectomy by thoracic-abdominal incision and two-field lymphadenectomy. The clinical characteristics, pathologic features, LNM, and influence factor of thoracic metastasis were retrospectively analyzed.

RESULTSLNM was observed in 65 of the 86 cases (75.6%). Simple abdominal lymph node metastasis was observed in 49 of the 86 cases (57.0%), simple thoracic lymph node metastasis was 2.3%, and thoracic-abdominal metastasis was 16.3%, with a significant difference between the abdominal and thoracic metastatic patterns. LNM frequency was found in the lymph node groups No. 3, No. 1, No. 7, No. 110, No. 2 and No. 9 (from the highest to the lowest). The incidences of those lymph node metastases were 46.5%, 41.9%, 17.4%, 14.0%, 10.5%, and 5.8%, respectively. Vascular tumor embolus was the only independent factor for thoracic lymph node metastasis.

CONCLUSIONSAbdominal lymph node metastases of advanced Siewert type II AGEJ mainly occur around the proximal stomach and the coeliac trunk. The metastatic rate of distal stomach and splenic perihilar lymph nodes is low, but metastatic rate of the group No.110 lymph nodes is high. The thoracic lymph node metastasis is only correlated with vascular tumor embolus.

Abdominal Cavity ; Adenocarcinoma ; pathology ; surgery ; Adult ; Aged ; Aged, 80 and over ; Esophageal Neoplasms ; pathology ; surgery ; Esophagogastric Junction ; Female ; Gastrectomy ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Neoplastic Cells, Circulating ; Stomach Neoplasms ; pathology ; surgery ; Thorax

Background and purpose:Myelosuppression is the most common dose-limiting toxicity of tumor chemotherapy in which leukocytopenia and neutropenia are the most common conditions. Not only are up-titrations of the doses of chemotherapeutic drugs limited, but also normal process of the chemotherapy is affected. Filgrastim-Recombinant Human Granulocyte Colony-Stimulating Factor (rhG-CSF) has the activity of stimulating the formation of granulocyte colony and promoting the growth, proliferation and differentiation of granulocytes which can be signiifcantly effective on leukocytopenia and neutropenia induced by chemotherapy. In this study, we observed the leukogenic effects, toxic and side effects of low, medium, and high doses of rhG-CSF used prophylactically after chemotherapy in patients with advanced non-small cell lung cancer (NSCLC), to explore a rational application strategy for rhG-CSF..Methods:One hundred and twenty six patients with pathologically proved advanced non-small cell lung cancer (NSCLC) under chemotherapy were digitally randomized to A, B and C groups. Filgrastim was given to patients of the three groups 24h after the end of chemotherapy. The dosages are: Group A (low dose): 300 μg of Filgrastim, s.c., qd × 1 day; Group B (medium dose): 300 μg of Filgrastim, s.c., qd × 2 days; Group C (high dose): 300 μg of Filgrastim, s.c., qd × 3 days. Then the signs and symptoms as well as toxic and side effects of Filgrastim after medication were observed.Results:Prophylactic usage of medium and high dosages of rhG-CSF could maintain WBC count at no less than 4.0×109/L in nearly 60% of patients. In patients with Grade III leukopenia, more days were needed for recovery of white blood cell (WBC) count with the low dose, while signiifcantly (P<0.05) less days were needed with the high dose. In view of the dynamic changes of neutrophil(ANC), additioning of the high dose of rhG-CSF after chemotherapy could increase the average level ofANC, notably shortening the duration of lowANC caused by chemotherapy. The incidence of infections was 4.76% for the 126 patients as a whole, 9.52% for the low dose group, and 4.76% for the middle dose group. The patients could tolerate the slight side effects incurred during treatment with Filgrastim.Conclusion:All of the three doses (low, medium, and high) of prophylactic administration of Filgrastim after chemotherapy can promote recoveries of WBCs and neutrophil granulocytes and reduce opportunities of infections. High doses of rhG-CSF can be faster and safer in increasing WBCs and neutrophil granulocytes.

OBJECTIVETo explore Poloxamer 188, a non-ionic surfactant as a potential tool for early intervention into the chondrocyte damaged by blunt mechanical trauma in vitro.

METHODSThree groups were control group (n = 6), no treatment group (n = 12) and Poloxamer 188 treatment group (n = 12). Two groups are then loaded to 20 MPa in unconfined compression. At 1 and 24 h the percentages of live and dead cells of superficial zone in compressed and control groups were determined with a cell viability stain.

RESULTSAt 1 h post-trauma, specimens of Poloxamer 188 treatment group (76%) had a significantly increased percentage of live cells in the superficial zone versus the no treatment group (55%). In 24 h the percentages of live cells in the superficial zone of the Poloxamer 188 treatment group (57%) were significantly greater than in the no treatment group (38%).

CONCLUSIONSPoloxamer 188 surfactant could help restore the integrity of cell membranes in cartilage damaged by blunt mechanical trauma. Models of mechanical cartilage injury in vitro may explain aspect of the interactions between mechanical forces and degradative pathways which lead to osteoarthritis progression.

Apoptosis ; drug effects ; Cartilage, Articular ; pathology ; Cell Survival ; drug effects ; Chondrocytes ; drug effects ; pathology ; Humans ; In Vitro Techniques ; Poloxamer ; pharmacology ; Random Allocation ; Weight-Bearing

Objective To know the contract nurses'professional pressure features in one 3A hospital, nd analyze the factors of influencing the contract nurses'professional pressure.Methods 235 contract nurses ere randomly investigated by a nurse working stress scale and a self-designed general information questionnaire. Nother 125 registered nurses were regarded as the controls.Results The score of contract nurses'working ressure was(85.32±20.49),with low wage and other welfare for ranking first in priority.There was a tatistical meaning compared to the registered nurses(P<0.05).The difference had statistical meanings in the cores of different departments,reasons for selecting the nursing work,attitude to present department,work atisfactory,attitude for switching to another trade,satisfaction degree of wage,numbers of night shift among the ontract nurses(P<0.05).Conclusions The contract nurses'working pressure belongs to the middle level. He stressors for ranking first in priority are low wage and other welfare.Attitude to work.attitude to present epartment,satisfaction degree of wage and objective support have obvious inflences to contract nurese'working ressure.

OBJECTIVETo observe the effects of low-intensity pulsed ultrasound (LIPUS) on repairing extracellular matrix in rabbit knee osteoarthritis and analyze its mechanism.

METHODSSixty adult female rabbits with an average weight of (2.0 ± 0.2) kg, were divided randomly into two groups (experimental group and control group, 30 rabbits in each group). All rabbits were replicated in right knees by Hulth method for knee osteoarthritis model. Two weeks after operation, the rabbits in experimental group were treated with LIPUS, and the ultrasonic frequency was (800 ± 5%)KHz and the maximum intensities of spatially averaged and time averaged (SATA) was (50 ± 10%) mw/cm2, for 1 time a day and every time 20 min, while the rabbits in control group were treated with sham LIPUS,the same operation with experimental group but without energy output. At the 2, 4, 8 weeks after treatment, 10 rabbits in each group were randomly killed for each time. The general changes of cartilage and its histopathological changes by HE staining were observed; the expression of collagen type II, proteoglycan, MMP-3, 7, 13 in cartilage were analyzed by immunohistochemical and RT-PCR technique; and the expression of NO in cartilage was analyzed by nitrate reduction method.

RESULTSOn the same observed time point, the damage degree of cartilage in experimental group was slighter than that of control group (P < 0.01), the expression of MMP-3, 7, 13 and NO in cartilage in experimental group was lower than that of control group (P < 0.01) while collagen type II and proteoglycan was higher than that of control group (P < 0.01).

CONCLUSIONLow-intensity pulsed ultrasound can repair the damaged cartilage by reducing the expression of MMP-3, 7, 13, inhibiting the secretion of NO and promoting the synthesis of collagen type II and proteoglycan in cartilage.

Animals ; Cartilage, Articular ; pathology ; Collagen Type II ; biosynthesis ; Extracellular Matrix ; metabolism ; Female ; Matrix Metalloproteinases ; analysis ; Nitric Oxide ; biosynthesis ; Osteoarthritis, Knee ; metabolism ; therapy ; Rabbits ; Ultrasonic Therapy ; methods

A randomized crossover study was performed to compare the effects of low glycemic index diets (LGI)and high glycemic index diets(HGI)on blood glucose,lipid profile and control of body weight in patients with type 2 diabetes.Compared with HGI group,the fasting serum insulin,Homa-IR,LDL-C and body weight significantly decreased in LGI group(P

Aim To investigate the effect of nifedipine on the formation of autophagosomes in hepatoma cell line Huh-7 and its mechanism.Methods Different concentrations of nifedipine were used to interfere with the proliferation of Huh-7 cells in vitro.The effect of nifedipine on the proliferation of Huh-7 cells was detected by cell proliferation experiment and colony formation experiment.The expressions of Beclin1 and LC3B-Ⅱ were detected by Western blot.The effect of nifedipine on the formation of autophagosomes in Huh-7 cells was observed by laser scanning confocal microscopy.Results Nifedipine significantly inhibited the proliferation of Huh-7 cells in a time-and concentration-dependent manner.The IC50 of nifedipine on day 2 was 22.7 mg·L-1.Nifedipine at the concentration of 25 mg·L-1 significantly reduced the colony formation rate of Huh-7 cells compared with the control group, and the inhibition rate of colony formation was(95.46±0.45)%.Western blot analysis showed that nifedipine significantly up-regulated the protein expression levels of Beclin1 and LC3B-Ⅱ.The amount of autophagosomes in nifedipine group cells were more than that of control group, which was observed by laser scanning confocal microscopy.Conclusions Nifedipine significantly inhibits the proliferation of Huh-7 cells and promotes the formation of autophagosomes, which may be related to the up-regulation of Beclin1 protein expression by nifedipine.

Objective:To observe the effects of low intensity pulsed ultrasound (LIPUS) on repairing extracellular matrix in rabbit knee osteoarthritis and analyze its mechanism. Methods:Sixty adult female rabbits with an average weight of (2.0± 0.2) kg,were divided randomly into two groups (experimental group and control group,30 rabbits in each group). All rabbits were replicated in right knees by Hulth method for knee osteoarthritis model. Two weeks after operation ,the rabbits in experi-mental group were treated with LIPUS,and the ultrasonic frequency was (800±5%)KHz and the maximum intensities of spa-tially averaged and time averaged(SATA) was (50±10%) mw/cm2,for 1 time a day and every time 20 min,while the rabbits in control group were treated with sham LIPUS ,the same operation with experimental group but without energy output. At the 2,4,8 weeks after treatment,10 rabbits in each group were randomly killed for each time. The general changes of cartilage and its histopathological changes by HE staining were observed;the expression of collagen typeⅡ,proteoglycan,MMP-3,7,13 in cartilage were analyzed by immunohistochemical and RT-PCR technique;and the expression of NO in cartilage was analyzed by nitrate reduction method. Results:On the same observed time point,the damage degree of cartilage in experimental group was slighter than that of control group(P<0.01),the expression of MMP-3,7,13 and NO in cartilage in experimental group was lower than that of control group (P<0.01) while collagen typeⅡand proteoglycan was higher than that of control group (P<0.01). Conclusion:Low intensity pulsed ultrasound can repair the damaged cartilage by reducing the expression of MMP-3,7,13,inhibiting the secretion of NO and promoting the synthesis of collagen typeⅡand proteoglycan in cartilage.

Objective To observe the ability of dengue virus recombinant envelope protein domain expressed in E. coil to inhibit virus infection and induce the neutralizing antibody. Methods E Ⅲ protein of Dengue virus serotypes 1-4 were expressed in E. coli BL21 (DE3) then purified. Recombinant proteins were tested to inhibit DV2 from infecting BHK-21 cell. Rabbits were immunized with recombinant proteins to produce anti-E Ⅲserum. Antibody titers were determined by neutralizing assay. Results The recombinant E Ⅲ proteins of Dengue virus serotypes 1-4 were expressed in E. coli. They effectively protected BHK cells in culture against DV2infection. All four type anti-E Ⅲ sera can neutralize DV2 but their efficacies are different. Conclusion E Ⅲproteins of dengue virus expressed in E. coli can directly inhibit DV2 infection. Neutralizing antibodies were induced by E Ⅲ proteins. Both E Ⅲ protein of dengue virus and the neutralizing antibodies they induced are more efficient in inhibiting homologous dengue serotypes infection than heterologous serotypes.

OBJECTIVETo analyse the related epidemic factors of rabies and to provide basic evidence for developing rabies control and prevention programs in China.

METHODSPossible factors that causing rabies epidemics in the southern part of China were obtained through collecting both epidemic and surveillance data of rabies in 2005, and to analyse every factor by software of Excel 2002.

RESULTSThe number of rabies cases was 2548 in 2005. Among 885 cases being investigated, 60.56%, 49.04%, 96.16% had not had any chance to receive treatment, vaccine or immunoglobulin. Among the exposed persons, 89.95% received treatment on wounds and 94.93% were immunized, and 8.56% received immunoglobulin. 94.86% of them accomplished the full rabies post-exposure prophylaxis course, but 8.56% of them did not accomplish it. 88.50% of the cases and 92% of the persons under exposure were bitten by dogs. The density of dogs was 3.20-13.37 per 100 persons. The vaccination coverage rates among dogs were 5.31% -75.11% with a positive rate of 2.93 % -6.40%.

CONCLUSIONFactors as: low rate of post-exposure prophylaxis and failed to have finished the necessary post-exposure treatment (PET) of the cases, nonstandard PET in hospital or local clinic, low rabies vaccination coverage and high infectivity of rabies virus in animal host (mainly for dog) might be responsible for rabies epidemics in China, in 2005.

Animals ; Bites and Stings ; China ; epidemiology ; Disease Outbreaks ; Dogs ; Humans ; Population Surveillance ; Post-Exposure Prophylaxis ; Rabies ; epidemiology ; Rabies Vaccines ; administration & dosage