Objective To investigate the effect of obesity on the early complications after esophageal cancer operation.Methods Clinical data of 327 patients who had esophageal cancer operation in our hospital from August 2012 to September 2015 were retrospectively analyzed.The patients were divided into 4 groups:lean group(n =75), normal group(n =120),overweight group(n =103)and obesity group(n =29)by body mass index(BMI).The impact of obesity on early complications of esophageal carcinoma after surgery was analyzed.Results The operation time of the lean group,normal group,overweight group and obesity group were (257.8 ±52.6 )min,(289.3 ± 48.7)min,(321.5 ±55.9)min,(367.9 ±50.2)min respectively.The operation time was increased with the increase of BMI (F =13.397,P =0.000).The incidence rates of incision infection,empyema,hoarseness,diaphragmatic hernia,postoperative bleeding,chylous fistula,pulmonary complication were 5.3%,1.3%,1.3%,1.3%,2.7%, 2.7%,16.0% in the lean group,5.0%,1.6%,1.6%,1.3%,1.6%,1.6%,17.5% in the normal group,5.8%, 1.9%,0.9%,1.9%,1.9%,1.9%,1.9% in the overweight group,10.3%,3.4%,0.0%,3.4%,3.4%,0.0%, 13.8% in the obesity group.No significant differences were found about the hospital days,wound infection,empyema, hoarseness,diaphragmatic hernia,operation hemorrhage,chylous fistula,pulmonary complications among the 4 groups (all P >0.05 ).The incidence rates of cardiovascular complications and anastomotic leakage after operation were 0.0%,4.0% in the lean group,1.9%,5.0% in the normal group,6.8%,9.7% in the overweight group,13.8%, 17.2% in the obesity group.The incidence of cardiovascular complications,postoperative anastomotic leakage increased with the increase of BMI.The differences of the four groups were statistically significant(F =1.675,1.054, all P <0.05).Conclusion Obesity can increase the incidence of early postoperative complications in patients with esophageal cancer.But obesity is not a contraindication of surgery for esophageal cancer,but obese patients should be more carefully treated in the perioperative period.

Objective: This study aimed to observe the long-term effect of Pseudomonas aeruginosa preparation used in peritoneal injection of advanced colorectal cancer patients during surgery. Methods: A total of 83 colorectal cancer patients who received surgery between September 2006 and March 2008 were enrolled in this study. The patients were divided into two groups. Palliative resection and a 10 ml P. aeruginosa peritoneal injection were performed in 30 of 83 patients in the treatment group. Simple palliative resection was conducted in the other 53 patients, which comprised the control group. Both groups were then treated by regular chemotherapy and radiotherapy. Results:The follow-up visit was completed in 79 of 83 patients, with a high follow-up rate of 95.2%. No significant difference was found in the five-year overall survival time between the two groups (P=0.403). However, the five-year median survival time in the control group was only 13.9 ± 2.14 months, whereas that in the treatment group was 17.2 ± 2.12 months. Conclusion: Within a short period, peritoneal injection of P. aeruginosa during surgery could confer certain survival advantages for advanced colorectal cancer patients. However, the long-term effect of this therapy remains unknown.

Purpose:To study the effectiveness of inserting central venous catheter was inserted into pericardial cavity for the drainage and treatment of lung cancer hydropericardium. Methods:A central venous catheter into pericardial cavity by pericardial puncture and continuous drainage, then chemotherapeutic agents were administered. Results:Among twelve patients, complete response was seen in 4 cases and partial response in 7, no cardiostenosis and sinus appeared. Conclusions:This method is convenient, effective, safe for the treatment of lung cancer hydropericardium and without apparent complications.

Objective To introduce the donor heart preservation techniques and study the clini- cal results in 26 patients undergoing orthotopic heart transplantations with long donor ischemia time (DIT) in our center.Methods From Sept.2004 to Aug.2006,26 patients underwent orthotopic heart transplantation at our center with DIT longer than 360 min.Crystalloid cardioplegia was infused through aortic root after aorta was cross clamped.UW solution was used when donor heart was removed.All patients underwent bicaval anastomotic cardiac transplantation.NO was inhaled through ventilator during and after operation in patients with pulmonary hypertension.Results DIT was 360- 560 (mean 401?43) min.There was no operative death in this group.Echocardiography and X-ray examinations in one month were normal.One case of abnormal coronary orifice was subjected to re- anastomosis of aorta.One case of renal failure post-operation was subjected to blood dialysis.Conclu- sion With proper donor heart procurement and preservation,recipient selection,anastomotic technique,efficient postoperative surveillance and pulmonary hypertension treatment,transplanted patients with long DIT can obtain the satisfactory short-term outcome.

Through setting up the elective course Protein Abnormity and Diseases for the undergraduates,we combine basic courses and clinic courses to enhance the students' enthusiasm in biochemistry.And at the same time modern molecule biology knowledge is organically combined with clinic lessons.

Objective To observe the clinical outcome of closed reduction and percutaneous screw fixation for talar neck fractures,and explore the minimally invasive treatment for talar neck fractures.Methods From June 2009 to December 2012,12 cases with talar neck fracture were treated by closed reduction and percutaneous screw fixation,including 10 males and 2 females with an average age of 34 years (range,21-52).All cases are unilateral side,including five cases of left foot and seven cases of right foot.All cases are evaluated the displacement,shape and number of fracture fragments by CT before fixing the fracture.According to Hawkins classification:type Ⅰ 7 cases,type Ⅱ 5 cases.Seven patients with type Ⅰ were used direct percutaneous screw fixation,five patients with type Ⅱ were treated with closed reduction and subsequent percutaneous screw fixation.The Computed Tomography was used to evaluate the quality of close reduction.The AOFAS (ankle-hindfoot scale) scores was used to evaluation clinical outcome in follow-up,and Computed Tomography was used to evaluate the result of reduction and fixation after operation.Recording Hawkins sign according to X-ray film,recording infection,talar body necrosis,traumatic arthritis and other complications.Results Twelve patients were followed up for an average of 34 months (range,22-40).At the end of followup,the AOFAS scores was average 90 points (range,84-95).Nine patients showed Hawkins sign 6 to 10 weeks after operation,2 patients did not find Hawkins sign,but in the follow-up period didn't appear talar body necrosis.One case did not appear Hawkins sign,and who's talar body necrosis was diagnosed by MRI,but no collapse,no pain and did not need further treatment.There patients with postoperative subtalar traumatic arthritis,patients are asymptomatic,at end no further treatment.All patients with no wound complications and no neurovascular injury.Conclusion Closed reduction and percutaneous screw fixation for talar neck fractures can obtain excellent clinical results,but should be selecting the appropriate patients,and Computed Tomography must be used to ensure satisfactory reduction.

BACKGROUND:It is hopeful that skeletal muscle satellite cells(SMSCs)can be served as seed cells for hematopoietic reconstitution.Angelica polysaccharides(APS)can not only promote hematopoietic stem cells and hematopoietic progenitor cells proliferation and differentiation,but also change the growth characteristics of SMSCs.OBJECTIVE:To investigate the effects of APS on the proliferation of mouse SMSCs in different culture environments.METHODS:SMSCs were procured by a modified method from new born mouse.The α-actin protein of the SMSCs was examined by immunohistochemistry at 5 days after culture.SMSCs were cultured and synchronized for 24 hours in the 96-well plate.After that,SMSCs were assigned into the blank control group,marrow stroma cell supernatant group,APS DMEM/F12 groups(contained 50,100,200,300,400 mg/L APS)and the marrow stroma cell conditioned medium(disposed by 50,100,200,300,400 mg/L APS in DMEM/F12).The proliferation of SMSCs was determined by MTT.RESULTS AND CONCLUSION:The α-actin was positive in the cultured SMSCs.MTT results demonstrated that,SMSCs showed a proliferative property in the marrow stroma cell conditioned medium groups.Additionally,the marrow stroma cell conditioned medium can effectively alter growth characteristics of SMSCs in a dose-dependent manner.

Objective To investigate the relationship between the serum adiponectin levels and prognosis of septic patients, by detecting the serum levels of adiponectin in septic patients. Methods 110 septic patients and 100 healthy controls subjects were enrolled. The serum levels of adiponectin were measured and compared. Clinical data and outcomes of septic patients were analyzed multi-factor Logistic regression analysis were used. Results The serum levels of adiponectin in septic patients were lower than that in healthy controls (P < 0.05). Serum levels of adiponectin in death group was lower than that in sepsis survival group (P < 0.05). There were close correlations between age, MODS, adiponectin and sepsis death(P < 0.05), which were the independent risk factors of death in septic patients. Conclusion The lower the adiponectin level is, the higher mortality rate occurs.Adiponectin can be used as the indicators of patients′ prognosis.

Objective To investigate the characteristic changes of the metabolism products in the auditory cortex (transverse temporal gyrus) in diabetes combined with nerve deafness using 1 H magnetic resonance spectros‐copy (1 H -MRS) ,and to discover the early warning indicator of nerve deafness in type 2 diabetes .Methods PTA was performed in 98 patients with type 2 diabetes (diagnosed by Endocrinology Department) ,and in 15 healthy sub‐jects in the control group .The patients were classified into four groups :the group of type 2 diabetes;type 2 diabe‐tes with unilateral and bilateral deafness ,and the normal control group .Cerebral metabolism was studied by assess‐ing the ratios of nitro -acetyl aspartate contrast to choline (NAA/Cho) as well as to creatine (NAA/Cr) ,myo-in‐ositol to creatine (mI/Cr) and choline to creatine (Cho/Cr) ratios in the auditory cortical separately in these groups . The Pearson correlation analysis was applied to determine blood glucose value with the nerve metabolites while the ROC curves were made for those metabolism markers to find the best diagnostic threshold .Results NAA/Cr and NAA/Cho were negatively correlated with AHI index and Cho/Cr ,mI/Cr was positively correlated with blood glu‐cose value .Significantly lower values of NAA/Cho ratio were found in patients'(diabetes without deafness) auditory cortex compared with 15 age-matched control subjects (P<0 .05) .NAA/Cr and NAA/Cho ratio in diabetes with deafness were significantly lower than those in control group (P< 0 .05) ,Cho/Cr higher than those of in other groups (P<0 .05) .NAA/Cr and NAA/Cho ratio in injured and uninjured auditory cortex of diabetes with unilateral deafness were significantly lower than those of in control group (P<0 .05) ,then we made a self -comparison be‐tween the injured and uninjured auditory cortex ,finding that NAA/Cho ratio had a significant difference .All of the metabolisms were tested by the curve of ROC .The area of NAA/Cho under the ROC curve was 81% ,which had a higher accuracy .NAA/Cho equal to 1 .65 can be used as boundary indicators between diabetes without deafness and diabetes with deafness groups ,the areas of the remaining indicators under the ROC curve was<50% .Conclusion NAA/Cho may be the early warning marker of nerve deafness in type 2 diabetes .

Background and purpose:It has confirmed that docetaxel, in combination with cisplatin or oxaliplatin have good effect in the treatment of advanced gastric cancer. This study in order to observe the clinical efficacy and adverse reaction of weekly docetaxel combined with cisplatin (DP) versus weekly docetaxel combined with oxaliplatin (DO) as the firrst-line treatment of advanced gastric cancer.Methods:A total number of 76 cases of advanced gastric cancer were randomly assigned 2 arms, 38 per arm. DP regimen group (docetaxel 35 mg/m2,ivgtt,dl,d8 combined with cisplatin 60 mg/m2, ivgtt,dl,repeated every 3 weeks) and DO regimen group(docetaxel 35 mg/m2,ivgtt,dl,d8 combined with oxaliplatin 120 mg/m2 ivgtt,dl,repeated every 3 weeks). Results:No significant difference was found between DP regimen group and DO regimen group on the objective RR(37%vs 41%),PFS (4.9vs 4.4 months) and OS (9.7vs 12.3 months). The main grade 3 or 4 toxicity in the DP and DO groups was neutropenia, DO was less associated with nausea and vomiting, but more associated with peripheral neuropathy than DP group. No signiifcant difference was found between DP regimen group and DO regimen group on the anemia, thrombocytopenia, diarrhea, alopecia (P>0.05).Conclusion:Weekly docetaxel combined with cisplatin (DP) shows similar efifcacy and toxicity compared with weekly docetaxel combined with oxaliplatin (DO) as the ifrst-line treatment of advanced gastric cancer and worthy of further study.