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 assess the prevalence and analyze the influence factors of laryngopharyngeal reflux disease(LPRD) in the Fuzhou region, in order to provide a theoretical basis for the development of prevention and control measures for LPRD. METHODS A questionnaire survey in residents in Fuzhou by a random cluster sampling was carried out. Individual information, reflux symptom index(RSI) of Belafsky and risk factors were included. Patients more than 13 scores of RSI were defined as LPRD. Data were statistically analyzed. RESULTS A total of 4100 residents were investigated, 4063 of them were available. The prevalence of LPRD was 5.00%. Often eating too much, often drinking strong tea, menolipsis, rhinitis, tonsillitis were closely related to LPRD. CONCLUSION The prevalence of LPRD in Fuzhou region were closely related to many factors.

Objective To compare the curative effect of transcatheter arterial chemoembolization (TACE) combined with microwave ablation (MWA) with that of simple TACE in treating large liver cancers.Methods A computer-based search assisted by manual searching for TACE+MWA vs simple TACE clinical control trials for large liver cancers was conducted.The patient survival,tumor response and complications were enrolled in the scope of analysis.Results A total of 16 papers met the inclusion criteria,which included 1199 patients in total.Meta-analysis indicated that one-,2-and 3-year survival rates of TACE+MWA group were better than those of simple TACE group,and the differences between the two groups were statistically significant (P＜0.01).The complete response (CR) rate and partial response (PR) rate of TACE+MWA group were higher than those of simple TACE group,and the differences between the two groups were statistically significant (P＜0.01).The stable disease (SD) rate and progressive disease (PD) rate of TACE+MWA group were lower than those of simple TACE group,and the differences between the two groups were statistically significant (P＜0.01).Conclusion For the treatment of large liver cancers,TACE +MWA is superior to simple TACE.(J Intervent Radiol,2017,26:225-231)

Objective:Preformed anti-human leukocyte antigen(HLA)specific antibodies are a major risk for antibody-mediated rejection.The aim of this study is to detect and analyze anti-HLA specific antibodies in sera of renal transplant candidates for evaluating the status of presensitization.Methods:A total of 3 500 patients awaiting renal transplantation in our hospital from 1998 to 2007 were included in the study.Panel reactive antibody(PRA)in sera of 694 candidates was detected by complement-dependent cytotoxicity(CDC)before March 2000,then the sera of other 2 806 recipients were screened by enzyme-linked immune absorbent assay(ELISA)alternatively.The polymorphism,specificity and relevant factors of anti-HLA antibodies were analyzed.Results:Only IgG type of antibodies specific to HLA classⅠcould be detected by CDC,whereas both anti-HLA classⅠand classⅡ of IgG class could be found out by ELISA.Lower PRA positive rate by CDC(8%)was shown when compared to that by ELISA(17%).Furthermore,multiple types of specific antibodies against HLA-A(20),B(37),CW(8),DR(14)and DQ(7)were determined by ELISA.Some types of the antibodies presented higher frequencies,such as anti-HLA-A2,24,68,23 and 32;B27,56,57 and 7;DR7,4,9,13,17 and 12;CW1,2,6,4 and 8.These high frequenies of anti-HLA antibodies were somewhat different from the distribution of HLA antigens in South China population.There were significantly different positive rates of anti-HLA antibodies between the male and the female,as the male were sensitized mainly through blood infusion and the female were sensitized by either blood infusion or pregnancy.Conclusion:Specific antibodies against HLA can be detected out by ELISA accurately,whereby to find high freguencies of the antibodies and to avoid donor-recipient mismatching at HLA-loci.Detection of preformed anti-HLA and reducion of HLA-mismatched blood infusion to reduce production of anti-HLA antibodies may be the valuable pathway to improve graft survival.

αB-crystallin is the structural protein of vertebrate lens, w hich is w idely expressed in non-lens tissue. As one of the heat shock protein fam ily m em bers,αB-crystallin possesses biological proper-ties of m olecular chaperones and anti-apoptotic effects. Multi-factor injuries, such as retinopathy, inflam-m ation and nervous system diseases, have a closely relationship w ith αB-crystallin. T his paper review s the research progress of the expression and m echanism ofαB-crystallin in retina and extraocular tissues and organs.

Objective To investigate concentration and distribution in blood and tissues of form icacid after m ethanol intoxication in rats. Methods The Sprague-Dawley rats were divided into groups for con-trol group and 3-day and 7-day intoxication treatm ent groups. The experim ental groups were adm inis-tered m ethanol by gavage with the initial dose of 8 m L/kg and followed with 4 m L/kg supplem ental dose 24 h later. After 3 days and 7 days later, rats were killed by decapitation. Then sam ples of cardiac blood, liver, kidney, brain, heart and stom ach of each group were collected. Form icacid concentrations were detected by high perform ance liquid chrom atography. Results Form icacid concentrations in tissues were higher than in blood. Com pared with 3-day intoxication group, there was an increase form icacid of concentration in brain and stom ach in 7-day intoxication group, while a decrease in liver and kidney (P<0.05). Conclusion H igh perform ance liquid chrom atography could be used to accurately detect form icacid. As the m etabolite of m ethanol, form icacid accum ulates in rat blood and tissues after intoxication and the concentrations in organs and tissues are obviously higher than in blood.