Objective To study the clinical application effect of Ivor-Lewis combined with thoracic-lapa-roscopy for esophageal carcinoma resection in patients with esophageal lowest cancer.Methods A total of 68 patients with esophageal lowest cancer were individed into the observation group and control group by the random number method,each of 34 cases.The patients in the observation group received Ivor-Lewis combined with thoracic-lapa-roscopy,and the patients in the control group received intrathoracic esophagogastrostomy by left chest posterolateral incision,then to compare the differences of clinical effect and complications.Results The operation time,blood loss in-operation,in-hospital time,thoracic drainage after operation in the observation group were all significantly less than those of the control group[operation time:(165.3 ±53.7)vs (214.3 ±71.5)min,t=3.814,P=0.037;blood loss in-operation:(153.6 ±23.1)vs (312.3 ±48.6)min,t=3.413,P=0.042;in-hospital time:(7.4 ±1.2)vs (10.5 ±2.3)d,t=3.256,P=0.043;thoracic drainage after operation:(635.6 ±34.2)vs (831.3 ±45.6)mL,t=2.594,P=0.039].The total rate of complications including pulmonary infection,gastric emptying,anastomotic fistula and diaphragmatic hernia and the recurrence rate after 6 months including recurrence in situ,lymph node and hema-togenous metastasis were all significantly lower in the observation group(complication:17.65%vs 38.24%,χ2 =4.012, P<0.001;recurrence:20.59% vs 47.06%,χ2 =4.825,P<0.001).Conclusion Ivor-Lewis combined with tho-racic-laparoscopy for esophageal carcinoma resection in patients with esophageal lowest cancer is safe and effective.

Objective To investigate the effect of siRNA-down-regulating astrocyte elevated gene-1(AEG-1)on the proliferation and apoptosis of cervical carcinoma cells.Methods The designed and synthesized AEG-1 siRNA was transfected to the cervical car-cinoma SiHa cells.The influence of AEG-1 siRNA on the expression of AEG-1 gene was detected by real-time fluorescent quantita-tive-polymerase chain reaction (RT-PCR);the inhibiting effect of AEG-1 siRNA on the proliferation of cervical cancer SiHa cells was detected by the MTT method;the influence of AEG-1 siRNA on apoptosis and cell cycle of the cervical cancer SiHa cellswas determined by the flow cytometry.Results Compared with the control group,AEG-1 siRNA transfecting human cervical cancer Si-Ha cells could evidently down-regulate the expression of AEG-1 gene with statistical difference (P<0.01);at the same time,the dwn-regulation of AEG-1 gene expression could significantly inhibit the proliferation of the cervical cancer SiHa cells (P<0.01), promote the apoptosis of SiHa cells (P<0.01)and arrest the cell cycle in G0/G1 phase.Conclusion AEG-1 siRNA can down-regulate the expression of AEG-1 gene in the cervical carcinoma SiHa cells,inhibit the proliferation of the cervical carcinoma SiHa cells and promote their apoptosis.

The decision-making problems of buying medical equipment in hospitals are given. With Dempster fusion of evidence decision-making theory, according to the expert judgment complexion for buying large-scale medical equipment on technical performance, price, maintenance cost, matching degree, economical efficiency and qualify, basic probability partition function and computational belief function are established, and then achieves advantage connection on candidate equipment and gives support for buying medical equipment in hospital.

Objective To investigate the effect of different postures in three dimensional conformal therapy for head and neck tumors.Methods 40 patients with head and neck cancer were selected as the research subjects.All patients were randomly divided into observation group and control group,20 cases in each group.The observation group for neck shoulder film fixed position,the control group was the first film fixed position each patient,radiotherapy 10 times.The display error condition of different position fixing of the two groups was compared.Results There was no significant difference in the error of the two groups in the X direction (P>0.05).The Y direction error,Z direction error of observation group were (0.12±0.12)mm,(0.10±0.11)mm,which were significantly lower than those of the control group[(0.23±0.19)mm,(0.19±0.15)mm] (t=2.189,2.163,all P<0.05).Set-up repeatability errors in the Y axis,error more than 2mm in the observation group was 14 times,the error rate was 7%,which in the control group was 40 times,the error rate was 20%,the observation group was significantly smaller than the control group,the differences were statistically significant(x2=29.286,7.236,all P<0.05).Set-up repeatability error in the Z axis,error more than 2mm in the observation group was 12 times,the error rate was 6%,which in the control group was 34 times,the error rate was 17%,the observation group was significantly smaller than the control group,the differences were statistically significant(x2=29.286,5.944,all P<0.05).Conclusion For the patients with head and neck cancer who received three-dimensional conformal radiotherapy,the positioning accuracy and repeatability of the head and neck shoulder film position is better,has higher clinical value,it is worth to be popularized.

Objective To investigate the effect of S-phase kinase-associated protein 2 antisense oligodeoxynucleotide (Skp2 ASODN) on the growth and proliferation of colorectal cancer cells SW480 and its mechanism .Methods The liposome-mediated dif-ferent concentrations of Skp2 ASODN was adopted to transfect SW480 cells ,the final concentrations of 0 .050 ,0 .125 ,0 .250 ,0 .500 , 1 .000 ,2 .000 ,4 .000 μmol/L were respectively set up with Skp2 nonsense oligodeoxynucleotides(NSODN) and blank group as con-trol .Then the inhibited effect of growth and proliferation of colorectal cancer cells were measured by the inverted microscope obser-vationandmethylthiazolyltetrazolium(MTT),thecellcyclewassurveyedbytheflowcytometry(FCM).TheexpressionofmRNA and protein of Skp2 and P27kip1 were inspected by reverse transcription-polymerase chain reaction(RT-PCR) and immunocytochem-istry methods .Results The inverted microscope observed that the SW480 cells had no change in form and grew at a slower speed . When the Skp2 ASODN concentration reached 0 .125 μmol/L ,the inhibition rate was 14 .48% (P<0 .05) .As the Skp2 ASODN concentration increase ,its inhibition action on the growth and proliferation of SW480 cells was enhanced in a dose-dependent man-ner(P<0 .01) .The SW480 cells were increased in G0/G1 phase(P<0 .01) and decreased in S phase(P<0 .05) ,the progression of cell cycle was blocked .RT-PCR and the immunocytochemistry showed that both Skp2 mRNA and protein levels were down-regula-ted(P<0 .05) .Although the P27kip1 mRNA level had no change(P>0 .05) ,but its protein expression was elevates obviously (P<0 .01) .Conclusion Skp2 ASODN can inhibit the growth and proliferation of SW480 cells .Its possible mechanism is that the ubiq-uitin degradation of the Skp2 to P27kip1 is decreased by the gene occlusion effect of Skp2 ASODN ,thus the cell cycle progression is arrested .

Objective To investigate the effect of head-up tilt on cerebral blood flow velocity during general anesthesia in patients with diabetic neuropathy.Methods Sixty ASA Ⅰ - Ⅱ patients of both sexes aged 40-60 yr weighing 52-70 kg undergoing general anesthesia were divided into 3 groups according to diseases complicated with diabetes situation ( n =20 each):group Ⅰ normal control the patients did not have diabetes mellitus; group Ⅱ type Ⅱ diabetics without neuropathy and group Ⅲ Ⅱ diabetics with neuropathy.Anesthesia was induced with propofol 2 mg/kg,fentanyl 3 μg/kg and vecuronium 0.1 mg/kg and maintained with 1％ sevoflurane.The patients were intubated and mechanically ventilated.PErCO2 was maintained at 35-45 mm Hg.Transcranial doppler (TCD)was used to measure middle cerebral artery blood flow velocity (MBFV).MAP and MBFV were measured and recorded in supine position (baseline) and at 1.5,3.5 and 5.5 min of 45° head-up tilt.Results The 3 groups were comparable with respect to age,body weight,height and M/F sex ratio.MAP and MBFV significantly decreased at 45° head-up tilt as compared with the baseline in all the 3 groups.There was no significant difference in MAP and MBFV among the 3 groups.Conclusion Cerebral blood flow velocity decreases when the patients are tilted 45° head-up during general anesthesia in both diabetics with and without neuropathy,but there is no significant difference between the 2 groups.

Objective To discuss the work modes of PACS in radiology department.Methods New work flow was established to integrate all equipments of radiology department into a system by PACS,so as to implement the transmission and storage of image data.Results The application of PACS resulted in promoted integration and informatized management & quality inspection in radiology department.Conclusion With PACS,the work flow of radiology department is optimized,and the medical quality and work efficiency are enhanced greatly.

Objective To investigate the role of zenapax in the prevention of acute rejection in renal transplant recipients.Methods The medical records of 50 renal transplant recipients treated with one dose of zenapax(study group) and simultaneously 30 renal transplant recipients without treatment of zenapax(control group) were retrospectively analyzed.The follow-up was six months.The incidence of acute rejection,renal allograft function,infection,and adverse effects of zenapax were comparatively analyzed between the 2 groups.Results Acute rejection rate was lower in study group(13/50,26%) compared with that in control group(17/30,57%;P)(0.05)).Conclusions One dose regimen of zenapax as part of immunosuppressive therapy is effective in the prevention of acute rejection in renal transplant recipients.It has less side effects and contributes to the improvement of renal allograft function.

The islet secretion function in 42 clinically diagnosed diabetic ketosis and ketoacidosis pa- tients,aged 25～39 year-old,were studied.The results showed that the acute insulin responses to L-ARG (AIRarg) was significantly reduced in patients compared to control.As disease prolonged,AIRarg de- creased gradually.In the patients less than three months,the acute insulin responses to glucose(AIRglu) were markedly reduced,although the AIRarg were still sustained to some extent.The fasting blood insulin levels,in the patients more than three months were not different from controls,but C-peptide levels were significantly lower than those of controls.However,the C-peptide responses to L-ARG stimulation were not as evident as the insulin responses.The results suggested that impairment of the insulin secretion exist of in the early stage of DM,and exaggerated as the disease prolonged.Terapy of this type of diabetes mellitus de- pended mainly on insulin.

Small conductance Ca 2+ activated potassium channels ( SK channels) are potassium selective , voltage independent, and Ca 2+ high sensitivity. SK channels are widely distributed in neurons. SK underlie the slow afterhyperpolarization , which regulate the fire of neurons by spike frequency adaptation. Three mammalian SK channels (SK 1, SK 2, SK 3) have been cloned . Ca 2+ , CaM and neurotransimitters involve in the gating of these channels. The changes of these channels may result in memory, neuromuscular disorder and schizophrenia.