Objective To evaluate the feasibility of CT staging for esophageal cancer. Methods A retrospective analysis of 304 patients treated,from Jan. 1996 to Dec. 1998 chiefly with radiotherapy(126 conventional radiotherapy,55-65 Gy/27-35 fx/5.5-7.0 w;178 late-course accelerated hyperfractionated radiotherapy ,55-60 Gy/33-36 fx/ 4.5 -5.5 w)complete with CT data before treatment was done. The long survival was compared with pre-therapy CT findings and CT staging. ResultsThe survival rate of stage T1+T2 was very significantly different from those lesion with stage T3,T4(? 2=12.90,P0.05).The survival rates of patients positive for lymph nodes or distant metastasis were lower. Conclusion CT staging is quite optimal for non-operable esophageal cancer in clinical staging,as it is conducive to predict the prognosis.

Objective To discuss external fixation method for the complex diaphyses fracture involving condyles of femur and evaluate its clinical efficacy.Methods A retrospective study was done on 42 patietns with comminuted femur diaphyses fracture combined with distal intra-articular fractures treated surgically from January 2001 to Janurary 2007.There were 24 males and 18 females at mean age of 33 years (20-66 years).According to AO/ASIF classification,there were 18 patients with type C2 fractures and 24 with type C3 ones.Simple internal fixation plus external fixation was performed on patitents with C3 fractures but only external fixation on those with C2 fractures.Four patients were treated with intramedular fixation.Results All patients were followed up for 1-12 months.According to Kotmert's assessment standard on function of proximal femur,the knee function was satisfactory in 35 patients (83% ) ,good in six (14% ) and unsatisfactory in one (2% ).Conclusions Minimally invasive external fixation can utmostly restore relative length of the femur and regulate between articular face of the femur and longitudinal axis of femur shaft to reach a symmetrical relation with middle and inferior part of opposite femur.Postoperative exercise is important for maximal recovery of the knee function.Attention should be paid to reconstruction of tubiform structure of the femur.

Objective To study the influence of arachidonic acid (AA) on L-type calcium channel in rabbits sin-gle cardiomyocyte and its mechanism of antiarrhythmia. Method The single ventricular cardiomyocyte was isolat-ed by using enzyme dispersion method and whole-cell clamp-patch technique was used to record L-type calcium current.All data were analyzed using ANOVA. Results AA inhibited Ica-L in a concentration-dependent manner. The application of 3 μmol/L, 10 μmol/L and 20 μmol/L arachidonic acid reduced the density of peak Ica-L from (10.79±0.93)pA/pF to (8.99±0.43)pA/pF to (7.60±0.35)pA/pF and to (5.60±0.30)pA/pF, respctive-ly (n=7, P<0. O1 ). The Ica-Lpartially resumed after washout. The AA up-shifted the I-V curves of Ica-L without changes of their shape,peak and reverse potentials. The AA also markedly shifted the inactivation curve to left, and prolonged the recorvery time from inactivation,but did not change the curve of calcium channel activation. Con-clustions By acceleration of L-type calcium channel inactivation and prolongation of recorvery time from inactiva-fion,arachidonic acid can reduce the calcium ion influe and prolong effective refractory period, playing the role of antiarrhythmia.

Objective To search for the reasons of high positive rate of amotile bacteria and the diagnosis of septicemia in new-born Methods The blood was drawn from the different site of the new-born with septicemia and carricd out blood culture. The drug sensitivity test had been done by the method of paper stripdiffusion. The plasmids of bacteria were extracted rapidly by medified Birnboim method and the plasmid analyss was carried out. The plasmids's DNA of 35 epidemic strain was cut off by both restriction enzyme of Hind Ⅲ and EcoR Ⅰ. The outer membrane protein (OMP) was determined by SDS-polyacrylamide gel electrophoresis.Results There are 51 patients with positive blood culture amotile bacterium,of them, pollution; 35 cases (68．6%), septicemia: only 16 cases (31．4%),54．8% (57/104) strains bacteria have drug resistance to more of 12 drugs. 87．3% (165/189) strains bacteria have plasmids. They are cut off as 6 DNA fragments (1．9,2,4,5, 8．5 and 18Kb) by Hind Ⅲ restrietion enzyme. and as 5 DNA fragments (2,2．6,3．2, 6．3 and 22 Kb) by EcoR Ⅰrestrietion enzyme, it is showed that they come from a same clone. The epidemic strain include 10 slips OMP, but non-epidemic strain have 11 slip OMP, increase a 25Kd belt. The amotile bacteria with above-mentioned plasmid spectrum, restriction enzyme spectrum and OMP spectrum are only seen in the air, therapeutic dish and syringe needle.Conclusion The pollution is an important reason of amotile bactorium high positiye rate in new-born.Diagnosing septicemia should depend on bacteria culture, plasmid analysis restriction enzyme analysis of plasmid DNA, oMP determination and combining medical history and clinical manifestation.

Objective To investigate factors affecting the metastasis of lymph nodes around the root of inferior mesenteric artery(IMA) in rectal cancer,and the significance of root lymph nodes dissection of IMA in radical surgery for rectal cancer.Methods Clinicopathological data of 105 rectal cancer patients undergoing root lymph node dissection of IMA during radical resection in Peking University First Hospital from January 2005 to December 2008 were analyzed retrospectively.Rectal cancer patients without root lymph node dissection of IMA during the same period served as control.Results were compared between these two groups for survival and local recurrence rates.Results The rate of lymph node metastasis around the origin of IMA was 9.5％ (10/105).The five-year survival rate in patients with IMA root nodal dissection was 71.3％,and that without was 70.6％ (P =0.995),while the local recurrence was respectively 1.9％ and 7.4％ (P ＜ 0.05).In multivariate analyses,IMA root nodal metastasis occurred more frequently in patients with pT3 and pT4 tumor(Wald =5.764,P ＜ 0.05) and poorly differentiated tumor(Wald =7.818,P ＜ 0.05).Conclusions Root lymph nodes dissection of IMA could not increase five-year survival rate,but it could reduce local recurrence rate in patients with rectal cancer.In radical surgery of rectal cancer,lymphadenectomy of IMA root should be performed in patients with T3 and T4 tumor with poorly differentiated tumor,so as to reduce local recurrence rate.

ObjectiveTo establish the reference intervals of serum triiodothyronine (TT3),the thyroxine ( TT4 ),free triiodothyronine ( FT3 ),free thyroxine ( FT4 ) and thyroid-stimulating hormone (TSH)in the apparently healthy individuals of Beijing and Shanghai.Methods According to the requirement for laboratory support for the diagnosis and monitoring of thyroid diseases in the National Academy ofClinicalBiochemistry(NACB)laboratorymedicinepracticeguidelines, therewere 390 apparently healthy individuals tested (221 male,169 female,18 -65 years old) from Beijing and Shanghai for serum TT3,TT4,FT3,FT4 and TSH on American Beckman UniCel DXI 800 Automatic Chemiluminescent Analyzer.All markers were analyzed between gender,region,age group using t test and ANOVA.The reference intervals of all markers were determined by P2.5 - P97.5.ResultsTT3,TT4,FT3,FT4,TSH levels in the male group were ( 1.90 ± 0.32) nmol/L,( 116.77 ± 18.02) nmol/L,( 5.28 ±0.67) pmol/L,( 11.54 ± 1.97) pmol/L,( 1.92 ± 1.12 ) mIU/L,respectively,while the above indicators in the female group were ( 1.82 ± 0.32) nmol/L,( 115.73 ± 14.39 ) nmol/L,(5.04 ± 0.59 ) pmol/L,( 10.94 ± 1.45) pmol/L,( 2.37 ± 1.86 ) mIU/L,respectively.When comparing the results in genders,statistical significance was shown in TF3,FT3,FT4 and TSH of two gender groups( t =2.377,3.642,3.471,2.520,all P ＜ 0.05 ).When comparing different regions,statistical significance was only shown in FT3 ( t =6.410,P ＜ 0.05 ),in which Beijing group was (5.01 ± 0.63) pmol/L,and Shanghai group was (5.41 ±0.61 ) pmol/L,and no significant difference were shown in other four markers.Correlation analysis showed that TT4 was positively correlated with age (r =0.22,P ＜ 0.001 ) while TSH was negatively correlated with age ( r =- 0.12,P ＜ 0.05 ).TT3,TT4,FT3,FT4,TSH reference intervals were ( 1.22 - 2.50 ) nmol/L,(83.37 - 149.37 ) nmol/L,( 3.88 - 6.48 ) pmol/L,( 7.70 - 14.86) pmol/L,( 0.38 - 5.58 ) mIU/L,respectively.ConclusionDifferences of serum thyroid hormones were observed in different areas of China,It is important to establish reference intervals of the serum thyroid hormones in Chinese population.

Objective To study the changes of NOS positive neurons in cortex motor area and spinal cord in rats of cirrhosis with portacaval shunts. Methods NADPH-diaphorase, fluorescence immunohistochemistry with confocal laser scanning microscope (CLSM) were used. Results The number of NOS and nNOS positive neurons in cirrhosis rats with portacaval shunts decreased obviously.Conclusion Cirrhosis with portacaval shunts can influence motor neurons of cortex; NO may participate in the central nervous system changes of cirrhosis rats with portacaval shunts.;

Objective To study the role of using PSA in prostate cancer screening in the male physical examination population over 50yrs in Beijing.Methods From January 2010 to December 2010,in Physical Examination Center of Beijing Hospital and Beijing MeiZhao Health Screening Center,men over 50years with PSA records in the past three years (from 2007 to 2009) were selected.The exclusion criteria included history of prostate cancer,severe diseases of the heart,brain,lung,liver and kidney,and mental or neurological disorders.People who couldn't cooperate with the investigation due to any reasons were excluded as well.The number of recruited cases was 2862.Among the cases,males with PSA over 4 μμg/L received prostate biopsy after singing the informed consent form.The average age was 67.2 ± 9.3 years.Results In the 2862 males,2621 cases (91.5％) had normal PSA levels and 241 cases (8.5％) had abnormal PSA levels.With the age increasing from 50 to 89 years,the proportion of abnormal PSA levels increased significantly from 2.7％ to 10.9％,P ＜ O.001.86 patients (33.2％) received prostate biopsy in the group of abnormal PSA levels; The positive prostate biopsy rate was 41.4％ (39/86).In PSA ＜4 μg/Lgroup,the positive rate was 25.0％ ; in 4 μg/L≤PSA ＜ 10 μg/L group,the positive rate was 29.8％ ; in PSA ≥ 10 μg/L group,the positive rate was 68.9％,P ＜ 0.001.With the PSA level increasing,the proportion of the localized cancer decreased from 100％ to 70％,and the ratio of locally advanced and distant metastatic tumor increased from 0 to 30％ ; the proportion of Gleason≤6 fell from 100％ to 30％,the proportion of Gleason ≥ 8 increased from 0 to 50％.The differences above did not show statistical significance.Conclusions Use of PSA in prostate cancer screening for men over 50 years could increase the detection rate of prostate cancer.

Objective To evaluate the efficacy and safety of doxazosin gastrointestinal therapeutic system (DOX GITS) in the treatment of lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH).Methods A total of 4063 BPH patients aged ≥60 years from 16 regions and 86 hospitals were enrolled in this study.Patients were divided into 4 groups according to the previous medication:group 1 (treated with α1 receptor blocker but non-doxazosin),group 2 (treated with drugs without α1 receptor blocker),group 3 (without treatment),group 4 (treated with α1 receptor blocker but non-doxazosin and other drugs for BPH).Patients received DOX GITS with a flexible-dosage for 4 weeks.International prostate symptom score (IPSS),quality of life (QOL),maximum urine flow rate (Qmax) and adverse effects were assessed.Results After 4 weeks of the treatment,lower urinary tract symptoms were significantly improved in the 4 group.IPSS in the 4 groups were decreased to (12.3±4.6) scores,(12.2±4.6) scores,(10.9±4.5) scores and (9.9±4.4) scores successively.QOL in the 4 groups were improved to (2.8±0.9) scores,(2.8 ±1.0) scores,(2.5±0.9) scores and (2.4±0.9) scores successively.Qma x in the 4 groups were increased to (16.4±4.5) ml/s,(15.0±4.7) ml/s,(15.3±4.8) ml/s and (16.7±5.7) ml/s qsuccessively.There were significant differences in IPSS,QOL and Qmax of the 4 groups between before and after the treatment (P＜0.001).Adverse events were reported in 64％ of patients.The most common adverse events were dizziness of 43 cases (1.06％),postural hypotension of 10 cases (0.25％) and hypotension of 8 cases (0.20％).Conclusions DOX GITS can significantly improveLUTS and quality of life in BPH patients with a good tolerance and compliance.

Objective To reveal the role of inhibitor of nuclear factor kappa B kinase alpha (IKKα) in renal inflammation after renal ischemia-reperfusion (IR) injury and its potential associated mechanism.Methods Ischemia-reperfusion injury models were induced in a total of 24 healthy C57BL/6 male mice.Renal function and histological changes were estimated.The expression and site of IKKα,p52,RelB,IL-10 and IL-18 were determined by immunohistochemistry and Western blotting.After the short hairpin RNA(shRNA)targeting IKKα was injected into renal parenchyma,renal function and protein expressions of IKKα,p52,RelB,IL-10,IL-18 were detected.Results Compared with sham-operated group[Scr(7.30±0.13) μmol/L,BUN (8.39± 0.30) mmol/L],levels of Scr [(29.80± 2.10)μmol/L,(27.00±3.40) μmol/L,(23.00±3.70) μmol/L] and BUN [(9.47±3.50) mmol/L,(11.68 ±4.30)mmol/L,(13.12±2.10) mmol/L] were higher on day 1,3,7 and the injury of kidney was serious in IR injury group.Immunohistochemical expression of both IL-18 and IL-10 were increased.Markedly increased IKKα,p52 and RelB protein expression were noted in experiments from day 1 to day 7 during kidney recovery period,with a peak on day 3 and then decreasing toward baseline after day 7.Compared with IR injury group,low-expression of IKKα by injection of shRNA up-regulated the expression of IL-18 and down-regulated the expression of IKKα,p52,RelB and IL-10.Conclusions The NF-κB pathway is activated and IKKα expression is up-regulated during the kidney ischemiareperfusion injury,low-expression of IKKα may block inflammation resolution via down-regulation of alternative NF-κB pathway family members of both p52 and RelB.