Objective To explore the efficacy and safety of improved covered metallic stents for proximal malignant esophageal strictures.Methods A total of 56 patients with proximal malignant esophageal strictures were treated with improved covered metallic stents whose diameter was 14 mm or 16 mm at Shanxi Province Tumor Hospital from Feburary 2013 to August 2014.Swallowing condition, physical and life quality were compared before and after surgery and analyzed.At the same time, side effects and complications were recorded during and after surgery.Results All 56 patients were treated successfully with improved covered metallic stents, no complications related with stents occurred after surgery.Swallowing conditions were improved after surgery, there were 45 patients with obvious improvement, 10 patients with better improvement and 1 patient's stent taken out due to stent intolerance.Remission rate of swallowing conditions was 98.2％ (55/56).Two weeks after surgery, Stooler of swallowing conditions obviously improved (t =7.05, P ＜ 0.05), physical conditions (ZPS) also improved (t =22.49, P ＜ 0.05), but there was no significant difference in life quality (Kamofsky scores) (t =1.07, P ＞ 0.05).During 90 days of follow-up there was no hemorrhage or perforation.Conclusion The application of improved covered metallic stents for proximal malignant esophageal strictures is safe and effective.

0.05). Conclusions With intravenous injection of low-dose combination, droperidol and fentanyl can produce effective, painless and safe sedation for TEE examination.

BACKGROUND: There are different reports on the comorbidity rates of anxiety and depression. In the pathopsychology of depression, it is unclear for the relationship between coping styles and personality in depressive patient accompanied with anxiety disorders.OBJECTIVE: To analyze the relationship between coping styles and personality in depressive patient with anxious disorders.DESIGN: A case-control study.SETTTNG: Second Xiangya Hospital of Central South University; Hunan Brain Hospital.PARTICIPANTS: Eighty-eight patients with depression were selected from the Second Xiangya Hospital of Central South University and Hunan Brain Hospital from June 2002 to January 2003. Ninety subjects were selected as normal control group from the employees or their family members, health volunteers in the Second Xiangya Hospital of Central South University and Sun Yat-sen University.METHODS: All the subjects were surveyed with self-rating depression scale (SDS), self-rating anxiety scale (SAS), coping style questionnaire and Eysenck personality questionnaire (EPQ).MATN OUTCOME MEASURES: ① Comparison of the scores of SDS, SAS, coping styles questionnaire and EPQ between the depressive group and normal control group; ② Comparison of the scores of SDS, SAS, coping styles questionnaire and EPQ between the depressive patients with and without anxious symptoms. ③ Pearson correlation analysis and stepwise regression analysis of all the indexes in the depressive group.RESULTS: ① All the 178 subjects were involved in the final analysis of results. ① The total scores of SDS and SAS, the scores of psychoticism and neuroticism of EPQ in the depressive group were significantly higher than those in the normal control group, but the score of introversion-extraversion of EPQ and passive coping style were lower than those in the control group. ② The total scores of SDS and SAS, the scores of psychoticism and neuroticism of EPQ were obviously higher but the score of active coping style was lower in the depressive patients with anxious symptoms than in those without anxious symptoms. ③ The correlation analysis and stepwise regression analysis suggested that the severity of depressive symptom was significantly related with SAS, introversion-extraversion dimension of EPQ and passive coping style.CONCLUSION: ① Depressive patients suffer from obvious depressive and anxious symptoms and psychoticism, and they inclined to introversion and emotional instability, and adopt less active coping style. ② Depressive patients with anxious symptoms suffer from more serious depressive symptoms, psychoticism and neuroticism, and they adopt active passive coping style. ③ Less adoption of active coping style can be brought into the dimension of introversion-extraversion in personality trait.

BACKGROUND: Nitric oxide synthase(NOS) is extensively distributed in the central nervous system and modulates neuronal activities. However,there are few reports about NOS' s involvement in nociceptive information transmission at the supraspinal level.OBJECTIVE: To investigate the relation between the primary afferent visceral terminials and the NOS-containing neurons which project from the interstitial nucleus of spinal trigeminal tract(INV) to the parabrachial nucleus(PBN).DESIGN: A controlled experimental observation based on the experimental animals.SETTING: Department of anatomy in a military medical university of Chinese PLA.MATERIALS: The experiment was conducted in the Department of Anatomy,Fourth Military Medical University of Chinese PLA,from January to December 2002. Ten adult male SD rats were selected in this experiment.INTERVENTIONS: Tetramethyl rhodamine-dextran(TMR) and biotinylated dextran-amine(BDA) were injected into the PBN and vago-glossopharyngeal nerves respectively combining with the immunohistochemical method for NOS and the observation with laser confocal scanning microscope.MAIN OUTCOME MEASUREES: Overlapping of TMR retrogradely labeled neurons,NOS positive labeled neurons and transganglionic tracing labeled terminals,and their relationship in INV.RESULTS: After injection of TMR into the PBN,the retrogradely labeled neurons,mostly small and medium-sized(below20 μm),were found in the INV ipsilateral to the injection side. The distribution of the NOS positive neurons overlapped with retrogradely labeled neurons in INV. The proportion of the number of double-labeled neurons with NOS/TMR was 55% (17/31)and 34% (17/49) in the whole population of the NOS positive neurons and retrogradely neurons,respectively. Some transganglionic tracing labeled terminals after BDA injection had close contact with the double-labeled neurons.CONCLUSION: The visceral nociceptive pathway exists from INV to PBN and NO may act as the transmitter or neural signal molecule in the transmission and regulation of visceral nociceptive process.

Objective To observe the therapeutic effects of endovascular stenting on the patients with drop attacks caused by carotid artery or vertebra-basilar artery stenosis.Methods Two drop attacks patients,who were diagnosed with symptomatic carotid artery or vertebra-basilar artery stenosis by DSA,were performed endovascular stenting.Case one had four serious artery stenoses at basilar artery,left vertebra artery and subclavian artery.Case two had double internal carotid artery.Six stents were placed,and filter protection devices were used in case two.After operating,the flowing up was performed for nine months or two years.Results The clinical symptoms of two patients were disappeared after operation.Case one performed flowing up for 9 months after operation,but he died by infarction of brain stem for his irregular taking medicine for 3 months since 6 months after operation.During flowing up for 2 years,case two was no relapse and no restenosis by DSA peoformed at 1 year after operating.Conclusions Endovascular stenting is a safe and efficient method for treating the patients with drop attacks caused by carotid artery or vertebra-basilar artery stenosis.

Objective To develop a portable and automatic quick screener for noise-induced hearing loss(NIHL),which is suitable for airman and ground crew.Methods Through using audio decoder chip VS1003 to achieve quick screener for noise-induced hearing loss and pre-exposing for special background noise.LPC2148 of ARM7-TDMI configuration was adopted as main controlling chip,and its software design was completed by multitask scheduler based on UCOS-Ⅱ,while the FAT system controlled the read-write to the files in SD card.The signal emergence,change in hearing class,frequency selection as well as records of subject reaction were automatically achieved.Results The system can produce stable signal of exact frequency according to GBZ49-2002 Diagnostic Criteria of Occupational Noise-induced Hearing Loss to output stability of the frequency and intensity of the audio signal,and the specific context of the noise pre-exposure function with screening of hearing impairment was achieved automatically.Conclusion Based on the great power of embedded system and VS1003,the portable and automatic quick screener for noise-induced hearing loss(NIHL) can be developed to carry out many functions,which has several features,such as simple structure,high integration,good stability and use of flexible etc.

Objective:To investigate the characteristic of life events and social support in patients with major depression.Methods:A cohort of 96 major depressed in-patients was assessed on admission. The assessments included Self-Rating Depression Scale (SDS), the Life Events Scale and the Social Support Scale. Ninety-nine healthy subjects were assessed too.Results:Compared with the controls, the patients experienced more stressful life events and got more subjective social support, but the utilization of social support was lower in the patient group. There was no gender difference in the life events and social support. The patients experiencing more life events got less subjective social support and social support as a whole.Conclusions:The depressed patients experience more life events.Social support acts as one of the cushion factors between life events and the onset of major depression.

Objective: To explore the effects of life events, automatic thoughts, social support and coping styles on the severity of depression in major depression at discharge. Methods: A cohort of 97 major depressed in-patients was assessed at discharge. The assessment included Self-Rating Depression Scale (SDS), Life Events Scale, Social Support Scale, Automatic Thoughts Questionnaire and Coping Styles Questionnaire. 100 normal controls were assessed, too.Results: Compared with the controls, the patients experienced more stressful life events in the last one year(t=2.6,P

Objective To discuss curative results of breast-conserving therapy for early primary breast cancer. Methods Fifty-two patients with stage Ⅰ~Ⅱ breast cancer(solitary tumor ≤ 3 cm in size) underwent local lumpectomy and axillary lymph node dissection from March 2000 to September 2005 in this hospital.After operation,the radiation therapy,chemotherapy,and endocrine therapy were given.Results The breast specimens were pathologically examined and no infiltrating margin was found.The rate of good cosmetic effects was 86.5%(45/52).Follow-up examinations in 50 cases for 10~36 months(median,16 months) found no local recurrence and distant metastasis.Conclusions The cosmetic and clinical results of breast-conserving surgery for stage Ⅰ~Ⅱ primary breast cancer are satisfactory.

Objective To investigate micrometastasis in axillary lymph nodes and its relationship with nm23 expression of the tumor tissue in breast cancer patients. Methods Paraffin blocks of 832 surgically removed lymph nodes and carcinoma tissues from 52 lymph node negative cases comfirmed by routine pathology were re examined by immunohistochemical staining using monoclonal anti EMA and anti nm23 H1 respectively. Results Micrometastasis were observed in 12 of the 52 patients (23.0%) and in 34 of the 832 lymph nodes ( 4.1% ). The positive rate of micrometastasis that in the tumor larger than 2.0cm or poorly differentiated was significantly higher than in the tumor