Extended lymph node dissection helps increase the radical resection rate,the accuracy of surgical-pathological staging,and the distant prognosis of thoracic esophageal carcinoma.However,it is also associated with significantly increased surgical morbidity and has noticeable negative effects on the quality of life after surgery.Selective lymph node dissection based on clinical evidences is helpful in reducing surgical risks while assuring the completeness of resection.

Objective To increase the radical resection rate and decrease local-regional relapse rate in thoracic esophageal carcinoma. Methods One-hundred and four patients were prospectively randomized to receive esophagectomy with thoraco-abdominal 2-field lymphadenectomy (48 cases) or with lymph node sampling (56 cases). In 101 patients who survived after surgery, 29 received adjuvant chemotherapy with cisplatin and fluorouracil (FP). Results Comparing with lymph node sampling, the operation time for lymphadenectomy was prolonged. However, there was no increase in blood loss, surgical morbidity, or mortality. Mean stations of lymph node dissected (10.5 stations vs. 3.2 stations,P

Objective To simulate local hemodynamic factors at particular arterial positions.Method A combination of high-lipid diet and immuoreactive injury was used to establish a hyperlipemia and atherosclerosis model in rabbit.Serrial sections were analysed by OLYSIA software.Data of caliber at different positions of carotid bifurcation,areas and circumference and thickness of the atherosclerotic plaque at carotid bifurcation were obtained and to establish a geometric model of rabbit carotid artery bifurcation with Gambit software.Wall shear stress distribution of the carotid sinus were analysed by numerical simulation.Result 1) A geometric model of rabbit carotid artery bifurcation was obtained.2) The wall shear stress of the carotid sinus of the atherosclerosis(AS) model group was found to be lower than that of the control group at shear rate 128.5 S~(-1).The lowest wall shear stress of the control was 4.028 times that of the AS model.Conclusion Low wall shear stress is a risk hemodynamic factor in the development of atherosclerotic plaque.

Objective To study the respiratory and circulatory changes in elderly patients, and their relationship with pulmonary complications after thoracotomy. Methods 58 elderly patients either aged over 75 years, with major organ dysfunction or underwent highly invasive procedures (group 1). Respiratory and circulatory status, including arterial blood gas under room air, water balance, urine gravity, and hemodynamics monitoring through pulmonary artery catheter were documented. The results were compared with those from 56 young patient controls receiving thoracotomy in the same period (group 2). Results All 12 patients having pulmonary complications were from group 1 (group 1A). Ten of them presented on the 2nd or 3rd postoperative day with hypoxemia. The other 2 died of type II respiratory failure after severe infection. Preoperative pulmonary co-morbidity (P=0.026, Exp(B)=5.4) and obesity (P=0.043, Exp(B)=4.9) were identified as independent risk factors for pulmonary complications after thoracotomy in elderly patients. During the first 3 postoperative days, PaO_2 of group 1A was significantly lower than group 2 as well as the other elderly patients who did not develop pulmonary complications after surgery (Group 1B). PaCO_2 of group 1A and 1B were significantly lower than group 2. There were also significant differences between the three groups in water balance on the first postoperative day (group 1A +832ml, P=0.006 vs. group 1B +109ml, P=0.004 vs. group 2 -243ml ). Urine gravity in group 1A was also significantly higher than in group 2 in the first 3 postoperative days. Pulmonary artery catheter monitoring revealed increased cardiac output and decreased systemic vascular resistance, showing a hyperdynamic status, in elderly patients after surgery. Pulmonary vascular resistance was elevated in the same time. Conclusion Pulmonary co-morbidities commonly seen in elderly patients are responsible for pulmonary complications, the major cause of surgical mortality after thoracotomy. Hypoxemia in the early postoperative period is mainlycaused by relative volume overloading from trauma induced interstitial edema. Close monitoring of arterial blood gas under room air, water balance, and urine gravity after thoracotomy may identify elderly patients at risk of developing pulmonary complication and prompt timely intervention.

Objective To investigate risk factors for feeding intolerance of preterm infants under the reactive scope model guidance, and provided empirical evidence for effective prevention and treatment of feeding intolerance in preterm infants. Methods Checked the cases of 242 preterm infants been treated in the neonatal department from August 2014 to January 2015 according to the order of admission. Through literature reviewing and expert consultation, the clinical observation table was designed based on the reactive scope model, and risk factors for feeding intolerance of preterm infants were investigated by single factor analysis and logistic regression analysis from the feeding intolerance (FI) group and non-FI group. Results The incidence of feeding intolerance in preterm infants was 33.8%(70/207), feeding intolerance in preterm infants often occurred during the period of being fed within 72 hours, and the clinical manifestations were gastric retention, abdominal distension and emesis. Single factor analysis showed that gestational age, birth weight, fetal distress, aminophylline application, intrauterine infection, breast milk feeding and twice stool interval were the related factors to the feeding intolerance. Logistic regression analysis showed that gestational age and birth weight were the protective factors of FI. Fetal distress, aminophylline application, twice stool interval >3 d were the risk factors of FI. Conclusions Gestational age and birth weight were the protective factors of FI. Fetal distress, aminophylline application, twice stool interval>3 d were the risk factors of FI.

Objective To develop prototype foamy virus (PFV) detection method by loop-mediated isothermal amplification. Methods Three pairs of primers targeting core region of PFV integrase were designed in this study and Bst DNA polymerase was used to amplify target sequence at 63℃. The system was established with all the conditions optimized. Results The method was established with the plasmid containing target sequence as the template. This method could specifically detect PFV infectious clone, no crossreaction was observed with human immunodeficieney virus infectious clone, bovine immunodefieiency virus infectious clone and bovine foamy virus infectious clone as templates. The detection capability of this system was 50 copy, one order more sensitive than PCR. The amplification could be finished in 15 min and human genomic DNA did not adversely affect the amplification efficiency. Conclusion The PFV detection method by loop-mediated isothermal amplification was established and it had potential usefulness in PFV detection.

Objective To investigated the clinicopathological findings and prognosis of 60 patients with pleomorphic carcinoma.Methods 60 cases of pleomorphic pulmonary carcinoma were collected and studied clinicopathologically between 1999 and 2011.All patients underwent pulmonary resections.Results There was no in-hospital death.1 had haemothorax that required reoperation,1 patient had a late cicatricial bronchial stenosis after sleeve lobectomy of the upper right lobe,and treated successfully by the resection of the right two lobes.The 3,5-year survival rates of all patients were 47.2％ and 25.6％ respectively.For N0 and N1-N2 patients,3-,5-year survival rates were 57.3％,32.5 ％ and 25.4％,17.1％,respectively.Overall survivals were of significant difference between radical resection and uncomplete resection.Multivariate Cox regression analyses of overall survival of all 60 patients indicated that radical resection (P =0.041) and nodal status (P =0.029) were significant independent prognostic factors.Conclusion Pleomorphic carcinoma is a rare type of lung cancer.Pleomorphic carcinoma of the lung was often found as a large mass peripherally located and was associated with poor prognosis.Radical resection and nodal status were significant independent prognostic factors.

Objective To study the probability of transferring the regulatory T cells induced by TGF-β1 to prolong the allograft survival and the mechanisms involved.Methods According to the different culture conditions.three experimental groups were established:control group(T cells from C57 BL/6 mice cultured with II-2),MLR group(T cells from C57BL/6 mice activated by alloantigen)and TGF-βgroup(T cells from C57BL/6 mice activated by alloantigen and cultured with 5.0 ng/ml TGF-β1).After the culture,the ratio of CI4+CD25+T and the Foxq3 expression were measured by FACS and RT-PCR,respectively.On 9th day,the pathologic analysis was performed and the ratios of TH1,TH2 and Treg and the proliferation of lymphocytes were measured.Results The ratio of CD4+CD25+T in TGF-β group was higher than that in control group and MLR group(P<0.05),and Foxp3 was expressed in CD4+CD25+T cell from TGF-βgroup.After transferring ofthe cells,the allografi survival time in TGF-β group was prolonged and its mean survival time(MST)was(22.8±1.9)d,which was longer than that in MLR group and control group (P0.05),lower than that of control group(P<0.05). And the ratio of CD4+CD25+T in TGF-β group was higher than that in control and MLR group obviously(P

[Objective] To investigate the value of HBV-M and HBV DNA of newborns born to HBsAg-positive mother, which were tested before combined immunization of hepatitis B. [Method] A total of 420 infants born to HBsAg-positive mothers delivered in Obstetric Department of the Third Affiliated Hospital of Sun Yat-Sen University from June 2006 to February 2008 were followed up at least 6 months and rechecked HBV-M to confirm the diagnosis of HBV intrauterine infection, which included 33 HBsAg or HBV DNA positive newborn babies and 6 newborns with both HBsAg seropositive and HBV DNA seropositive. [Result] HBV intrauterine infection rate was 0.95%. Using newborn both HBsAg positive and HBV DNA positive as diagnostic criterion to diagnose HBV intrauterine infection, the positive likelihood ratio was 208.3, while using newborn HBsAg positive or HBV DNA positive as diagnostic criterion, it was 14.3. [Conclusion] Newborn both HBsAg positive and HBV DNA positive obtained before combined immunization of hepatitis B may predict HBV intrauterine infection, and it may play as a clinical index of preliminary diagnosis of HBV intrauterine infection.

Objective:To prepare the production of TIGIT-Fc fusion protein using H22 cells stably integrated the gene by lentivirus vector , and to explore the immunoregulatory effect on macrophages by TIGIT-Fc.Methods: TIGIT-Fc fusion gene were constructed by molecular cloning.The fusion gene was then subcloned to plasmids contained the secretion signaling peptide .The secrected TIGIT-Fc fusion gene was inserted into the lentivirus backbone vector.The purified lentivirus vector was the used to infect the murine H22 cell line.TIGIT-Fc protein was purified by protein A column from the ascites of H 22-injected C57BL/6 mice.Macrophages stimulated by lipopolysaccharide ( LPS ) was challenged to TIGIT-Fc treatment or control.Cytokine levels was then detected by ELISA.Results: TIGIT-Fc protein was purified from the ascites of H 22-injected mice.PVR was upregulated in LPS-treated macrophages.IL-10 level was upregulated in TIGIT-Fc treated macrophages.Conclusion: TIGIT-Fc promotes the mature macrophages to secrete anti-inflammatory cytokine IL-10.