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.

Objective　To explore the effect of video-assi sted thoracic surgery (VATS) on common diseases of chest. Methods　Video-assisted thoracoscopic surgery was performed on 131 patients with ches t diseases from April 1994 to December 2000 in which 109 cases were spontane ous pneumothorax and hemothorax, 10 pulmonary tuberculoma, 5 pulmonary carcinoma , 3 esophageal carcinoma, 2 localized benign mesothelioma, 1 pulmonary hamartoma and 1 myasthenia gravis. Results　There was no operative death in all cases. Four patients with spontaneous pneumothorax complicated persist ent air leak(more than 7 d) and 1 patient with hemopneumothorax formed hemoth orax after the operation, which was stopped by the second VATS. The others recov ered well without any postoperative complications. Conclusion　 VATS is characterized by safety and mild tissue injury in the operation, and les s pain, fewer complications, rapid recovery and short duration of hospitalizatio n after the operation.

The experiments were carried out on guinea pig isolated ventricular myocytes by using whole-cell patch clamp. The effects of angiotensin II (Ang II) on potassium ion channels of acute ischemic myocytes were observed. Whole-cell patch clamp recordings showed that physiological potassium current, including delayed rectifier potassium current and inward rectifier potassium current were inhibited under the condition of simulated ischemia, and then further inhibited by treatment with Ang II. ATP-sensitive potassium currents were increased under simulated ischemia and were further enhanced by Ang II treatment.
Angiotensin II ; pharmacology ; Animals ; Cells, Cultured ; Female ; Guinea Pigs ; Heart Ventricles ; cytology ; drug effects ; Male ; Myocardial Ischemia ; pathology ; physiopathology ; Myocytes, Cardiac ; drug effects ; Potassium Channels ; drug effects ; physiology

Using whole cell patch clamp, the effects of angiotensin II (Ang II) on the current L-type calcium channel (I(Ca.L)) were observed in guinea pig isolated ventricular myocytes under simulated ischemia condition, which was realized through hypoxia, glucose deficiency, high lactic acid and acidosis. The results showed that, under the condition of simulated ischemia, the peak of I(Ca.L) was reduced with maximal activation potential at 0 mV. Administration of Ang II (100 nmol/L) enhanced the peak of I(Ca.L) during ischemia and shifted the maximal activation potential to -10 mV. The possible mechanism of these effects is discussed.
Angiotensin II ; pharmacology ; Animals ; Calcium Channels, L-Type ; drug effects ; Cells, Cultured ; Guinea Pigs ; Heart Ventricles ; cytology ; Myocytes, Cardiac ; cytology ; drug effects ; Patch-Clamp Techniques

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 explore the clinicopathologic characteristics, treatment and prognosis of differentiated thyroid carcinoma (DTC) in adolescents.

METHODSThe data of 46 patients with DTC under the age of 18 years were retrospectively reviewed.

RESULTSTwenty patients were misdiagnosed in this group (43.5%). All patients received operation, including 39 unilateral neck dissection and 6 bilateral neck dissection, followed by postoperative thyrotropin suppressive therapy. There were 42 cases of papillary carcinoma (91.3%) and 4 cases of follicular carcinoma (8.7%). Cervical lymph node metastasis was found in 39 cases (84.8%). In the follow-up period of 1 to 25 years (mean 10 years), no death of thyroid carcinoma occurred.

CONCLUSIONSThe most common DTC in adolescents is papillary carcinoma with better prognosis regardless of the higher incidence of cervical lymph node metastasis. The optimal extent of primary thyroidectomy and neck dissection followed by postoperative thyrotropin suppressive therapy in adolescents with DTC may improve the quality of life and decrease the incidence of complications.

Adenocarcinoma, Follicular ; diagnosis ; therapy ; Adolescent ; Carcinoma, Papillary ; diagnosis ; therapy ; Child ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Male ; Prognosis ; Retrospective Studies ; Thyroid Gland ; pathology ; Thyroid Neoplasms ; diagnosis ; therapy

BACKGROUND: Osteoporosis, known as "a quiet epidemic disease", is an "invisible killer" that impairs the health of the elderly. Fracture as the most dangerous complication of osteoporosis is not only a medical problem, but also a serious social problem. OBJECTIVE: To summarize the selection, establishment methods, characters and evaluation of the animal model of osteoporosis. METHODS: A computed-based search of CBM, WanFang, VIP, CNKI and PubMed databases was conducted for the relevant articles published from January 1986 to December 2016 using the keywords of "osteoporosis, animal models" in English and Chinese, respectively. Finally 39 articles were included for result analysis after reading the title and abstract. RESULTS AND CONCLUSION: Animal experiments play an important role in the studies of osteoporosis, so a desirable animal model should hold similarity, reliability, repeatability, applicability, controllability, efficacy and economy. Osteoporosis is a progressive and long-lasting disease that has different characteristics at different stages. But an animal model only simulates one etiology, one stage, major symptoms and pathophysiological changes, and cannot exhibit the whole pathological changes. The current study suggests that animal species and modeling methods can affect the characters of models, and there is a lack of standards for animal age, feeding methods, modeling time and assessment.

Objective　To study the effect of epidermal growt h factor receptor(EGFR) on the development and progress of thymoma. Me thods Expression of EGFR was detected by immunohistochemical stain in t he tissues of 11 cases of normal thymus and 29 cases of thymoma. Result s　 The positive expression of EGFR was 75.9%(22/29) in thymomas and 18.2%(2/11) in normal thymus. The difference was significant(P<0.01). The positive rate of EGFR was higher in invasive thymomas than in non-invasive ones (P<0.01). T he positive rate of EGFR increased with Masaoka stage with a significant increm ent in Ⅲ-Ⅳ stage compared with I stage (P<0.01). EGFR was strongly expre ssed in 5 cases of invasive thymomas, in which recurrence or metastasis occurred in 3 during the follow-up period after operation. But there was no statistical correlation with whether complicated with myasthenia gravis (MG) and histolog ical type. Conclusion　EGFR might be related to the tumori genesis and development of thymoma. There is high risk of recurrence and metast asis in case of EGFR over-expression and radiotherapy, chemotherapy and follow up should be enhanced.

OBJECTIVETo evaluate the feasibility and curative effect of thymectomy for myasthenia gravis (MG) by video-assisted thoracoscopic surgery (VATS) through right anterior-lateral approach.

METHODSFifty-six patients of MG were treated with thoracoscopic thymectomy and mediastinal fat dissection through right anterior-lateral approach from August 2001 to October 2007. The feasibility, safety, complication and remission for MG were retrospectively analyzed.

RESULTSFifty-five operations were completed by VATS. The mean operative time and blood loss were (96.2 +/- 52.1) min and (68.7 +/- 21.4) ml, respectively. The brachiocephalic vein injury by the electric coagulator occurred in two cases and one of them performed thoracotomy for homeostasis, the other performed ligation. The postoperative pathology showed hyperplasia in 38 cases, atrophy in 5 cases, thymoma in 12 cases and cyst of thymus in 1 case. And the operative complication included one myasthenia crisis (1.8%) at the third day and one death (1.8%) at the eighth day because of postoperative hemorrhage. The average length of stay was (7.9 +/- 2.9) d. All cases were followed up from one to seventy months. Eight (14.3%) of complete remission, 39 cases (69.6%) of partial remission and 7 cases (12.5%) of no change were found. The total effective rate was 83.9%.

CONCLUSIONSThoracoscopic thymectomy through right anterior lateral approach is technically feasible, safe and minimally invasive. It has a high remission rate for MG.

Adolescent ; Adult ; Aged ; Child ; Feasibility Studies ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myasthenia Gravis ; surgery ; Retrospective Studies ; Thoracic Surgery, Video-Assisted ; Thymectomy ; methods ; Treatment Outcome

Objective To optimize the conditions for the synthetic process of iron sucrose complex (ISC), via the investigation of the effects of reaction temperature (X1), reaction time (X2), amount of alkali (X3), and amount of sucrose (X4) on the relative molecular mass of the ISC product. Methods According to the experimental results for the single factor, the conditions dealing with the X1, X2, X3, and X4 parameters for the preparation of ISC were optimized by the Box-Behnker design combined with the response surface methodology using the weight average relative molecular mass of ISC as an indicator, and analyzed with gel permeation chromatography. Results The reaction temperature and the amount of alkali had a significant effect on the weight average relative molecular mass of ISC. The influence of the four factors in the descending order was as follows:X3＞X1＞X2＞X4. In the designed experimental conditions, theresponsevaluedecreasedwiththeincreaseofbothreactiontemperaturesandalkaliamounts. Conclusion Theresponse surface methodology could provide the relationship between the response values and variables via the minimum number experiments to obtain the optimized conditions for the preparation of ISCs.