Esophageal cancer is the leading cause of cancer-related deaths worldwide.A single intraoperative intervention is unlikely to benefit the outcome.A multimodal management plan that includes the use of TEA seems to demonstrate improved results in high-volume centers.Anesthetic management may contribute to the containment of pulmonary morbidity and anastomotic leakage by the use of TEA,protective ventilation strategies during OLV,prevention of tracheal aspiration,and judicious fluid management.

ObjectiveTo explore the effects of Yiqi Yangyin Huoxue principle on the expression of neurotrophin-3 of the frontal lobe cortex neurons in diabetic rat brain. Methods The diabetic rat model was produced by intraperitoneal injection of streptozotocin(STZ).The Yiqi Yangyin Huoxue drugs was poured into the stomach of the treated group. The brains were taken and the expression of neurotrophin-3 was estimated with immunochemistry 8 weeks later. Results Immunochemistry showed that there were many positive cells in the frontal lobe cortex of the normal group and they were deeply dyed.Positive cells of the model group decreased and their color was shallow .The number and the color of positive cells in the treated group were close to that of the normal group. Conclusion The Yiqi Yangyin Huoxue principle can effectively improve the degenerating of the frontal lobe cortex neurons in diabetic rat brain.

Objective:To compare the cardiovascular effects of sufentanyl and fentanyl as combined with propofol in anesthesia during laparoscopic cholecystectomy(LC).Methods:Patients undergoing LC were randomly divided into two groups: 60 patients in the Sufentanyl group(group S,0.3 ?g/kg) and 53 patients in the Fentanyl group(group F,3 ?g/kg).The mean arterial pressure(MAP),heart rate(HR),cardiac output(CO),and cardiac index(CI) were recorded before induction,before pneumoperitoneum,after pneumoperitoneum and at the end of operation.Results:There was no difference in MAP,HR,CO or CI between the two groups before induction.The values of HR and CO increased significantly in group F after preumoperitoneum comparing with the values before preumoperitoneum(P

The incidence of thyroid dysfunction has increased year by year; the degree of public concern about thyroid disease also has been growing; the accuracy and comparability of results given by thyroid hormone assays from clinical laboratories face new challenges .This paper reviewed the clinical significance and measurements of thyroid hormones , also summarized the outcome of IFCC Working Group on Standardization of Thyroid Function Tests .It is expected to bring manufacturers′and clinical laboratories′attention to the importance of standardization/harmonization; and they could collaborate with each other .

Objective To investigate the effect of Buyanghuanwu decoction(BYHWD) on angiogenesis and Ang-1/Tie-2 expression after focal cerebral ischemia in mice. Methods Focal cerebral ischemia was induced by 30 min of middle cerebral artery occlusion followed by reperfusion. BYHWD (20 g/kg) was administered orally 24 h after ischemia and once a day. The neurological score and the corner test were used to evaluate sensorimotor function during 28 days after ischemia. The microvessels density and the expression of Ang-1/Tie-2 in the ischemic boundary zone were determined by immunohistochemistry on 28 days after ischemia. Results Compared with the model group, BYHWD significantly ameliorated neurological dysfunction and reduced the number of right turn during 3 to 28 days after ischemia(P＜0.05 ). In addition,the numbers of CD31 ,Ang-1 and Tie-2 immunopositive cells were (437 ±59) ,(389 ±61 ) and (251 ±42) at the boundary zone in model group 28 days after ischemia,respectively. However, BYHWD treatment significantly increased the numbers of CD31(609 ± 68 ), Ang-1 (551 ±66) and Tie-2 (342 ±46) immunopositive cells(P＜0. 01 ). Conclusion BYHWD promotes angiogenesis,which may contribute to recovery of neurological function after focal cerebral ischemia,and Ang-1/Tie-2 pathway appears to mediate BYHWD-induced angiogenesis.

Objective To investigate the relationship between acute biliary pancreatitis (ABP) and anomalous pancreaticobiliary duetal union (APBDU). Methods 131 patients with ABP were enrolled to test the serum total bilirubin (TB), alanine amintransferase (ALT), aspartate amintransferase (AST), alkaline phosphates (ALP), γ-glutamyl transferase (γ-GT). All the patients received medical treatment, and then these tests were performed again. Thereafter, all the patients underwent selective surgery and intra-operative cholangiography was performed to observe the pancreaticobiliary duetal union. Results 27 patients (20.6%) with APBDU were found in 131 patients. Among them, 8 cases (29.6%) was B-P subtype (TypeⅠ), 16 cases (59.3%) was P-B subtype (TypeⅡ) , and the remaining 3 cases was mixed subtype (TypeⅢ). A significant decrease of ALT, AST, ALP, γ-GT after non-surgical treatment in both group of APBDU and NAPBDU was noted (P＜0.05). The serum levels of ALT, AST,γ-GT in APBDU patients were (71.81± 23.19) U/L, (47.85±27.87) U/L, (52.86±31.49) U/L, respectively; and in NAPBDU patients were (51.96±15.40) U/L, (40.77±16.58) U/L, (34.86±26.47) U/L. The difference was statistically significant (P＜0.05). Condusions APBDU is an important etiology of ABP.

Objective To investigate the relationship between the activity of Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling pathway in cerulein-induced pancreatic acinar cell line AR42J. Methods The in vivo model of AP was induced by cerulean treated pancreatic acinar cell line AR42J, then RPM and AG490 were given for intervention. Western blot was used to determine theexpressions of JAK1 and phosphorylation JAK1 ( P JAK1 ) , STAT1, PSTAT1 and TNFα, IL-1β, IL-6. The expressions of IL-6, IL-1 β, and TNFα mRNA were measured by RT-PCR. Survival rate of cells was evaluated by trypan blue stain. Results The relative expressions of JAK1, P JAK1, STAT1, P STAT1 and TNF-o, IL-1β, IL 6 without cerulean treatment were 0.09 ±0.04,0.14 ±0.08,0.21 ±0.09,0.12 ±0.12,0.10 ±0.02,0.08 ± 0.03,0.02 ± 0.02. After cerulean treatment, the expressions of abovementioned protein increased in a time-dependant manner, the expressions at 24h were 0.53 ± 0.09,0.53 ± 0.13,0.56 ± 0.09,0.55 ± 0.10,0.25 ± 0.04,0.25 ±0.09,0.27 ±0.07, which were significantly higher than those in the control group (P ＜0.05). 2 4 h after RPM and AG 4 9 0 inhibition, the expressions of TNF-α, IL-1 β, IL-6 proteins significantly decreased to 0.17 ± 0.03and 0.17 ± 0.01,0.15 ± 0.05 and 0.14 ± 0.07,0.19 ± 0.04 and 0.19 ± 0.05; their expressions of mRNA significantly decreased ( P ＜ 0.05 ). The cell survival rates in RPM and AG490 treatment group were (72.4 ± 11.2) %, (69.7 ± 9.8 ) %, and in cerulein-stimulated cells (42.2 ± 12.3 ) % ( P ＜ 0.05 ).Conclusions The JAK1/STAT1 signaling pathway was involved in pancreatic inflammatory response with cerulein stimulation. Early treatment with inhibitors to the JAK1/STAT1 signaling pathway might control the inflammatory response in acute pancreatitis.

Objective To explore the value of cardiac troponin-I (cTnI), B-type natriuretic peptide (BNP) and blood lactic acid (Lac) on evaluation of severity and prognosis in patients with septic myocardial dysfunction (SMD). Methods According to retrospective analysis of clinical data,161 cases with sepsis were divided in to SMD group and non-SMD group. And the SMD group was further divided in to death group and survival group. Blood cTnI, BNP and Lac value in each group were detected respectively. The ROC curve was used to evaluate the forecast value of cTnI, BNP and Lac on prognosis for patients. Results The value of cTnI, BNP and Lac in SMD group were significantly higher than those in non-SMD group(P<0.05);The value of cTnI, BNP and Lac in death group among the SMD patients were significantly higher than those in survival group(P<0.05);cTnI, BNP and Lac contribute to predict the 28 day mortality rate of SMD. Conclusions Blood cTnI, BNP and Lac contributes to the assessment of the severity and the prognosis of septic patients with myocardial dysfunction.

Objective Controversies remain as to the recovery time, recovery quality, and incidence of peri-recovery adverse reactions of the patient receiving general anesthesia with remifentanil and sufentanil.This study aimed to systematically assess the qual-ity of recovery from general anesthesia with remifentanil and sufentanil. Methods Randomized controlled trials ( RCTs) were re-trieved from The Cochrane Library, PubMed, MEDLINE, EMbase, Ovid, Springer, Web of Science, CNKI, CBM, VIP, and Wan-Fang Data.According to the modified Jadad quality scale, the literature retrieved was screened and subjected to quality evaluation and meta-analysis was performed on the included studies using the RevMan 5.1 software. Results Thirty-three RCTs involving 2175 pa-tients were finally included.The results of meta-analysis showed no significant differences between the remifentanil and sufentanil groups undergoing thyroid surgery either in the recovery time to spontaneous breathing ( T1) and eye-opening ( T2) and endortracheal extubation time ( T3 ) ( P >0.05 ) or in the incidence rate of postoperative nausea and vomiting (PONV) (P>0.05).T1, T2 and T3 were significantly shorter in the sufentanil than in the remifentanil group in other types of surgery (P<0.05).The patients with level-1 Ramsay score were remarkably more in the remifentanil than in the sufentanil group ( MD =13.67, 95% CI 2.67 -69.91 ) ( P <0.05), and the VAS scores were markedly higher in the former than in the latter group at 30 minutes (MD=3.37, 95% CI 3.28-3.46) and 1 hour after extubation (MD=2.53, 95% CI 2.43 -2.63) (P<0.05). Conclusion Compared with sufentanil, remifentanil provides a quicker recovery but a weaker analgesia effect and a higher rate of post-operative agitation.However, sufentanil produces a better pain relief and a higher quality of recovery after operation.

Objective To look for and confirm the downstream regulated gene of microRNA (miRNA)-148a in pancreatic cancer cell line.Methods The target gene regulated by miRNA-148a was predicted through bio-informatics analysis.The plasmid containing desired gene and with luciferase 3'-untranslated region (3'-UTR) reporter was constructed.Pancreatic cancer cells BXPC-3 were transfected with analogs and inhibitors of miRNA-148a by liposomes.The activity of luciferase was measured to determine whether miRNA-148a directly connected with desired gene.The expression level of miRNA-148a was changed in BXPC-3 cells,and the changes of target gene v-verb-b2 erythroblastic leukemia viral oncogene homolog 3 (awian) (ErbB3) expression were detected by Western blot at protein level.The data were analyzed by one way ANOVA.Results There was a conservative binding site of ErbB3 with miRNA-148a detected by bio-informatics analysis,miRNA-148a directly combined with ErbB3 and the activity of luciferase decreased to (25.00+47.00) ％ of the negative control (F=4.66,P＜ 0.01).After miRNA-148a overexpression,the gray value of ErbB3 expression in BXPC-3 cells decreased to (26.16±4.69)％ of control group (F=6.563,P＜0.05).Conclusion miRNA-148a directly targeted and regulated the expression of ErbB3 in pancreatic cancer cell line BXPC-3.