Objective To summarize our experience in prevention and treatment of stricture after esopageal burns in the past thirty years.Methods There were 168 cases in this series.Of them,158 cases underwent surgical management in this study.Modified intraluminal stenting was used in 34 cases, colon interposition without resection of strictured esophagus in 77 cases,gastric transposion with resection of the stricture in 27,repair of cervical stricture with platysma myocutaneous flap in 22,and miscellane- ous operation in 12.Eleven cases experienced operation twice or more at our department.Results Twenty-nine cases recovered after treatment with intraluminal stenting,and 5 re-experienced stricture after stent removal.One of the 5 cases with failed stent responded to bougienage,and the remaining 4 cases re- quired esophageal reconstruction later.Of the 77 colon interpositions,5 cases died postoperatively,and complications of cervical anastomotic fistula occurred in 14 cases,anastomotic stenosis in 4,and abdomi- nal incision dehiscence in 2 cases.In the 27 cases with gastric transpositions,postoperative complications of anastomotic stricture occurred in 2 cases and empyema in 1 patient.There was a cervical leak in 3 ca- ses of the 22 cases treated with the repair of cervical esopageal or anastomotic stricture with a platysma myocutaneous flap.In the 12 cases treated with miscellaneous operation,one died of intestinal obstruc- tion.All the survivors had regular diet after discharge.Conclusions Intraluminal stenting can prevent the formation of caustic esophageal stricture.The location of the cicatricial esophagus dictates whether to perform concomitant esophagectomy during esophageal reconstruction.Platysma myocutaneous flap repair is an excellent method for the treatment of severe cervical esophageal or anastomotic stricture.

The infection status of anisakid larvae was examined in 290 marine fish of 25 species and in 108 cephalopods of 3 species purchased in Bayuquan region, Yingko city nearby the coast of the Bohai Sea from may to August 1992. A total of 7,327 larvae were collected from 156 fish of 19 species and 8 squids of one species. The 3rd-stage larvae of Anisakis simplex were collected from 121 fish (63.4%) of 15 species (N = 191) and from 8 squids (14.8%) of one species (N = 54), and they were total, 5,992 (81.8%). Out of remaining 1,335 larvae, 154 (2.1%) were classified as Thynnascaris type B from 23 fish of 4 species, 1,013 (13.8%) as Thynnascaris type C from 79 fish of 13 species. 164 (2.2%) as Hysterothylacium China type V from 20 fish of 4 species, 3 (0.04%) as Raphidascaris from 3 fish of 2 species and one was Pseudoterranova decipiens larva.
Animal ; Anisakiasis/veterinary* ; Anisakiasis/parasitology ; Anisakiasis/epidemiology ; Anisakis/isolation & purification ; Anisakis/classification* ; China ; Fish Diseases/parasitology* ; Fish Diseases/epidemiology ; Fishes ; Larva ; Seawater ; Squid/parasitology*

OBJECTIVETo observe the experience and the outcome of pharyngo-colonic anastomosis for esophageal reconstruction in diffuse corrosive esophageal stricture involving hypopharynx.

METHODSThis retrospective report reviews the experience and results of 14 patients who underwent esophageal reconstruction by pharyngo-colonic anastomosis without resection of intra thoracic stricture esophagus. The left half colonic segment was pulled up to the neck through the substernal space in all patients.

RESULTSThere was no operative or hospital death. Postoperative complications include cervical anastomotic fistula in four patients, rupture of the abdominal incision in 1. The length of follow-up ranged from half year to 10 years with an average of 4 years. Anastomotic stenosis occurred in 2 patients. One case improved after dilatation and the other one healed by plastic operation. One patient began to vomit after diet in seven months later with barium swallowing the abdominal colon graft was redundant and this patient was cured with side by side between the colon and the stomach.

CONCLUSIONThe successful reconstruction for hypo-pharyngo-esophageal stricture requires a correct and larger hypopharyngeal opening and a good anastomotic technique. From our experience this procedure is shown to be safe and effective.

Adolescent ; Adult ; Anastomosis, Surgical ; Burns ; complications ; Child ; Child, Preschool ; Colon ; surgery ; Esophageal Stenosis ; etiology ; surgery ; Esophagoplasty ; methods ; Female ; Humans ; Male ; Pharynx ; surgery ; Retrospective Studies

OBJECTIVETo study the effects of exogenous ER beta on the growth of breast cancer MCF-7 cells under different treatment.

METHODSAn eukaryotic expression vector containing 1.6 kb of human entire coding sequence of ER beta (pCDNA3-ER beta) was transfected into human breast cancer MCF-7 cells using lipofectamine 2000. The biological activity of ER beta was detected with the luciferase reporter containing estrogen responsive element (ERE) and the expression of ER beta protein by Western blot. The growth properties of MCF-7, pCDNA 3-transfected MCF-7 and pCDNA 3-ER beta-transfected MCF-7 cells under different treatment, including E2 (17beta-estradiol) and 4-OHT (4-hydroxytamoxifen), were observed.

RESULTSA stronger activation of the reporter by ER beta in the presence of E2 was observed in the pCDNA 3-ER beta-transfected MCF-7 cells than in the pCDNA 3-transfected MCF-7 and in MCF-7 cells. Western blot analysis showed that the protein level of ER beta in the pCDNA 3-ER beta-transfected MCF-7 cells was markedly increased. Exogenous ER beta expression did not change the growth properties and the morphology of MCF-7 cells under normal condition. The pCDNA 3-ER beta-transfected MCF-7 cells proliferated at the same rate as naive cells in the presence of 4-OHT, whereas a strong inhibition of the proliferation of the pCDNA 3-ER beta-transfected MCF-7 cells in the presence of E2 was observed.

CONCLUSIONExogenous ER beta expression does not increase the resistance to 4-OHT, and a strong inhibition of the proliferation may occur in the presence of E2.

Breast Neoplasms ; metabolism ; pathology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Estradiol ; pharmacology ; Estrogen Antagonists ; pharmacology ; Estrogen Receptor beta ; genetics ; metabolism ; Female ; Humans ; Tamoxifen ; analogs & derivatives ; pharmacology ; Transfection

OBJECTIVETo investigate the influential factors for job burnout among the managerial staff in a Sino-Japanese joint venture automobile manufacturer in Guangzhou, China.

METHODSA total of 288 managers in a Sino-Japanese joint venture automobile manufacturer were surveyed using the Occupational Stress Indicator, Maslach Burnout Inventory (MBI), Eysenck Personality Questionnaire, Simplified Coping Style Questionnaire, and Social Support Rating Scale.

RESULTSOn the depersonalization dimension, the male managers had significantly higher scores than the female managers. The scores of emotion exhaustion and depersonalization of MBI showed significant differences among the managers with different levels of occupational stress. The path analysis showed that occupational stress, neuroticism, and psychoticism had negative effects on emotion exhaustion, while job satisfaction and utilization of social support had direct positive effects on emotion exhaustion. Occupational stress, psychoticism, and passive coping style had direct negative effects on depersonalization, while job satisfaction, objective support, and utilization of social support had positive effects on depersonalization. Job satisfaction and active coping style had positive effects on sense of personal accomplishment, while passive coping style had a negative effect on sense of personal accomplishment. Personality exerted its effect on social support through coping style and thus on job satisfaction and job burnout.

CONCLUSIONMale managers have a greater propensity to depersonalization than their female counterparts. High occupational stress is a risk factor for job burnout. Personality, social support, and coping style are influential factors for job burnout.

Administrative Personnel ; psychology ; Adult ; Burnout, Professional ; etiology ; psychology ; Fatigue ; etiology ; Female ; Humans ; Job Satisfaction ; Male ; Middle Aged ; Stress, Psychological ; Surveys and Questionnaires ; Young Adult

Objective: The current study was designed to investigate the relationship between bcl-2 expression and apoptosis of lung cancer cells in vitro. Methods:Lung cancer cell lines with different expression of bcl-2 were cocultured with tumor infiltrating lymphocyte(TIL) isolated from fresh tumor samples,and JAM test was performed to evaluate apoptosis of cancer cells. Immunohistochemistry and TUNEL assay were used to determine bcl-2 expression and apoptosis of tissue sections of lung cancers respectively. Results: As shown in JAM test, apoptosis increased with the elevation of TIL in coculturing assay in bcl-2 negative cancer cell lines, but in one of bcl-2 positive cell lines it remained stable. Conclusions: Lung cancer cells with bcl-2 expression may antagonize apoptosis, which may account for their immune evasion mechanism.

OBJECTIVETo evaluate the efficacy and adverse reactions of Herceptin as a single agent in patients with HER2 overexpressing metastatic breast cancer.

METHODSThere were two kinds of therapy protocol. One was loading-dose of 4 mg/kg intravenously, followed by a 2 mg/kg maintenance dose of weekly intervals. The other was loading-dose of 8 mg/kg, followed by 6 mg/kg of every three weeks intervals.

RESULTSAmong 20 patients with evaluated efficacy, there was no complete response, 5 patients (25.0%) showed partial response (PR), 5 (25.0%) stable disease (SD) and 10 (50.0%) progressive disease (PD). Of 22 patients, the overall response rate was 22.7%. The median time of disease progression and treatment failure was 6 weeks and 6.5 weeks, respectively. The most common adverse reactions were fever and chill. Cardiac symptoms could be seen in some patients.

CONCLUSIONHerceptin is an active agent for the patients with HER2 overexpressing metastatic breast cancer and the adverse events are well tolerated.

Adult ; Aged ; Antibodies, Monoclonal ; administration & dosage ; adverse effects ; Antibodies, Monoclonal, Humanized ; Antineoplastic Agents ; administration & dosage ; adverse effects ; Bone Neoplasms ; drug therapy ; secondary ; Breast Neoplasms ; drug therapy ; metabolism ; pathology ; Disease Progression ; Disease-Free Survival ; Drug Administration Schedule ; Female ; Fever ; chemically induced ; Heart Diseases ; chemically induced ; Humans ; Middle Aged ; Neoplasm Recurrence, Local ; drug therapy ; metabolism ; Receptor, ErbB-2 ; metabolism ; Soft Tissue Neoplasms ; drug therapy ; secondary ; Trastuzumab

BACKGROUNDA few recent studies have reported that inflammation is associated with the prognosis of acute aortic dissection (AD). There is, however, no systemic investigation regarding the role of plasma C-reactive protein (CRP) and white blood cell (WBC) levels in predicting in-hospital clinical events of acute type A AD.

METHODSThe levels of high-sensitivity CRP and WBC counts were systemically determined after admission in 36 patients with acute type A AD. The variations of plasma CRP and WBC levels in different time windows (admission, 1, 2, 3, 4, 6, 8 days) in patients with acute type A AD were analyzed between patients with events and without events.

RESULTSDuring hospitalization, five patients died, and increased levels of CRP and WBC were found in patients died with acute type A AD compared with patients survived (P < 0.01, respectively). Medical treatment may significantly decrease inflammatory response in survived patients with acute type A AD. Additionally, patients with complication of pleural effusion showed higher CRP and WBC levels (P = 0.046, P = 0.018, respectively). Lower WBC levels were found in survived patients treated medically (P = 0.001). Moreover, mean CRP and WBC levels had positive correlations with aortic diameter (r = 0.364, P = 0.000; r = 0.333, P = 0.000, respectively) and age (r = 0.270, P = 0.000, respectively), while negative correlations with the time from onset of symptoms to hospital admission (r = -0.229, P = 0.000, r = -0.200, P = 0.002, respectively). Univariate analysis showed that age ≥ 65 years, CRP ≥ 12.05 mg/L, WBC ≥ 12.16 × 10(9)/L, aortic diameter ≥ 48 mm, pleural effusion and diastolic blood pressure ≥ 105 mmHg were associated with hospital mortality. While CRP ≥ 12.05 mg/L, WBC ≥ 12.16 × 10(9)/L, aortic diameter ≥ 48 mm were strongly associated with hospital mortality in multiple Logistic regression analysis.

CONCLUSIONSThe results suggested that CRP and WBC were preferred markers for predicting the clinical events in patients with acute type A AD, especially death during hospitalization. Therefore, further study enrolling larger cohort, prospective study would be warranted.

Adult ; Aneurysm, Dissecting ; blood ; diagnosis ; Aortic Aneurysm, Thoracic ; blood ; diagnosis ; C-Reactive Protein ; metabolism ; Female ; Humans ; Leukocyte Count ; methods ; Logistic Models ; Male ; Middle Aged

OBJECTIVETo evaluate the efficacy and adverse reactions of Xeloda in the treatment of recurrent and metastatic breast cancer.

METHODSThis clinical study was designed to treat 69 patients with recurrent and metastatic breast cancer with Xeloda, 2500 mg/m(2)/d, twice daily for 2 weeks followed by a 1-week rest period, repeated every 3 weeks.

RESULTSSixty-nine patients received Xeloda for more than 1 cycle. The overall response rate (CR + PR) was 16.0%, clinical benefit rate (CR + PR + SD > or = 24 months) was 27.5%, disease control rate (CR + PR + SD) was 75.4%. The median time to failure (TTF) was 3 months (range: 0.7 - 11 months). The median time to progression (TTP) was 2 months (range: 0.7 - 11 months). The median duration of response (CR + PR) was 6 months (range: 4 - 11 months). The most common treatment-related adverse events were hand-foot syndrome (HFS) that occurred in 60.8% (42/69) patients mostly as grade I-II. Fifty-five percent (22/40) of patients who had received high dose preventive Vit B6 developed HFS without grade III; while 69% (20/29) of patients who had not received such treatment did develop HFS including 2 patients with grade III. However, there was not significant difference between the two groups.

CONCLUSIONXeloda is an effective and well tolerated treatment in patients with recurrent and metastatic breast cancer. The symptoms of HFS may be relieved by high dose Vit B6 as prevention.

Adult ; Aged ; Antimetabolites, Antineoplastic ; therapeutic use ; Bone Neoplasms ; drug therapy ; secondary ; Breast Neoplasms ; drug therapy ; pathology ; Capecitabine ; Deoxycytidine ; analogs & derivatives ; therapeutic use ; Drug Administration Schedule ; Female ; Fluorouracil ; analogs & derivatives ; Humans ; Liver Neoplasms ; drug therapy ; secondary ; Lung Neoplasms ; drug therapy ; secondary ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Recurrence, Local ; drug therapy

BACKGROUNDSevere bilateral carotid stenosis caused by atherosclerosis has not been unusual in the elderly. Such patients have high stroke risk. Many studies show that carotid artery stenting (CAS) is an alternative to treat unilateral carotid stenosis. However, the optimal procedural strategy of bilateral carotid stenosis remains unclear. The purpose of our study was to evaluate the safety of simultaneous bilateral carotid artery stenting (SBCAS) compared with unilateral carotid artery stenting (UCAS).

METHODSIn this single-center retrospective study, we analyzed 234 consecutive patients who underwent carotid stenting from January 2005 to December 2009. Thirty-nine patients (16.7%) of them underwent SBCAS, and the others (n = 195) underwent UCAS. Indication for CAS was defined as carotid artery diameter reduction > 60% (symptomatic) or > 80% (asymptomatic). Six-month and 30-day hemodynamic depression (HD), hyperperfusion syndrome (HPS), stroke, death and myocardial infarction (MI) after carotid stenting were assessed.

RESULTSSBCAS group had no more HD and HPS compared with UCAS group at 30 days (HD: 28.2% vs. 20.0%, P = 0.396; HPS: 2.6% vs. 2.1%, P = 0.262). Moreover, there was no statistically significant difference between SBCAS group and UCAS group in major stroke, death, MI and their combinations within 30 days (major stroke: 0 vs. 3.6%, P = 0.604; death: 2.6% vs. 1.5%, P = 0.520; MI: 2.6% vs. 0.5%, P = 0.306; and their combinations: 5.1% vs. 4.6%, P = 1.000) and 6 months (major stroke: 0 vs. 3.6%, P = 0.604; death: 5.1% vs. 2.1%, P = 0.262; MI: 5.1% vs.1.0%, P = 0.130 and their combinations: 7.7% vs. 5.1%, P = 0.459).

CONCLUSIONSThe patients undergoing SBCAS had no more events than those undergoing UCAS in 30-day and 6-month follow-up. Our finding suggests that SBCAS appears to be as safe as UCAS.

Aged ; Angioplasty, Balloon ; adverse effects ; Carotid Stenosis ; physiopathology ; therapy ; Female ; Hemodynamics ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Retrospective Studies ; Stents ; adverse effects ; Time Factors