Esophageal cancer is one of the most common alimentary malignancy.Although drugs and radiation treatments for esophageal cancer are constantly improved,surgical resection is still recognized as the most effective treatment method at present.With the continuous development of esophageal surgical techniques,minimally invasive treatment of esophageal cancer surgery technology has bcen performed at home and abroad,for the purpose of reducing the complications or mortality and improving the post-operative quality of life.Minimally invasive surgical indications,surgical procedure selection,complications and prognosis compared with traditional surgery are reviewed in this article to explore the application and clinical significance of minimally invasive treatment in patients with esophageal carcinoma.

Objective To evaluate the efficacy of β-blockers in treatment of postural orthostatic tachycardia syndrome( POTS) in children. Methods Clinical controlled trials were collected from a variety of medical electronic databases including PubMed(1990-2014),Excerpta Medica database(EMBASE 1990-2014),ELSEVIER(1990-2014),China National Knowledge Internet(CNKI 1990—2014) and WANFANG(1990—2014) by 2 researchers simultaneously and respectively based on same inclusion and exclusion criteria. Studies were assessed based on the Juni scale evaluation,and the Meta-analysis was conducted using the Rev-Man 5. 0 software. Results In total 8 clinical trials were included out of over 200 papers. Possible publication bias were assessed by Funnel plot analysis. Meta analy-sis of the 8 studies demonstrated that compared with the placebo group, metoprolol group showed significantly better ef-ficacy in treating children with POTS(RR=0. 37,95%CI:0. 21-0. 64,P=0. 000 5). Furthermore,these included trials were divided into different subgroups based on trial design ( randomized controlled trial/non-randomized con-trolled trial and Scored/N-scored) . Although no statistical heterogeneities were detected within each subgroups by the subgroup analysis,marked heterogeneities were found among subgroups; there was no significant difference of efficacy between metoprolol and placebos in treating POTS in non-randomized controlled trial group(RR=0. 68,95%CI:0. 45-1. 02,P=0. 06). Conclusions Low-dose metoprolol is effective in treating POTS,but the conclusion still needs to be tested by more large-scaled,multi-centered and standardized clinical randomized controlled trials.

Objective To observe the intervention efficacy of Tiao Ren Tong Du (regulating the Conception Vessel and unblocking the Governor Vessel) needling in treating perimenopausal insomnia and its effect in improving the symptoms, for providing theoretical evidence for the treatment of perimenopausal insomnia. Method A total of 72 female perimenopausal insomnia patients were randomized into a treatment group (36 cases) and a control group (36 cases). The treatment group was intervened by Tiao Ren Tong Du needling at Baihui (GV20), Shenting (GV24), Yintang (EX-HN3), Zhongwan (CV12), Qihai (CV6), Guanyuan (CV4), Neiguan (PC6), Shenmen (HT7), Sanyinjiao (SP6), and Zusanli (ST36) after standard sterilization, with lifting and thrusting manipulations until needling sensation was obtained. The treatment was given three times a week, successively for 4 weeks. The control group was intervened by conventional public education, without treatment. The Pittsburgh Sleep Quality Index (PSQI) and Kupperman Menopausal Index (MI) were scored before and after the treatment to evaluate the therapeutic efficacy. Result Thirty-three cases in the treatment group finished the treatment and 3 dropped out; while 32 cases in the control group finished the treatment and 4 cases dropped out, and the drop-out rate was 9.7%. The total effective rate was 87.9% in the treatment group versus 40.6% in the control group, and there was a significant difference in comparing the clinical efficacy between the two groups (P<0.01). After the treatment, PSQI and MI sores were significantly changed in thetreatment group (P<0.01,P<0.05). There were no significant changes in PSQI and MI scores in the control group after the treatment (P>0.05). There were significant differences in PSQI and MI scores between the two groups after the treatment (P<0.01,P<0.05). Conclusion Tiao Ren Tong Du needling is effective in treating perimenopausal insomnia, and it can improve perimenopausal syndrome and significantly enhance the patients' quality of life.

Cerebrovascular Intervention is to study the subject of diagnosing and treating cerebrovascular disease with interventional endovascular techniques monitored and guided by neuroimaging. With the continuous development of computer, imaging and angiography techniques, their study method and category are being innovated and expanded continuously in recent years. This article reviews the novel techniques of imaging diagnosis, intra-arterial thrombolysis, angioplasty and endovascular embolization in cerebrovascular diseases, and also evaluates their clinical applications.

Objective To investigate the expressions and clinical significance of Ki-67,p53,and survivin in esophageal cancer and precancerosis.Methods The expressions of Ki-67,p53,and survivin proteins were detected by immunohistochemical staining in 40 normal esophageal mucosa,136 precancerosis (42 mild atypical hyperplasia,43 moderate atypical hyperplasia,and 51 severe atypical hyperplasia),and 68 esophageal cancer tissues.The correlation of three proteins expressed in esophageal carcinoma tissues was analyzed.Results The positive expression rate of Ki-67 was 0 (0/40)for normal epithelium,35.7％ (15/42) for mild dysplasia,51.2％ (22/43) for moderate dysplasia,74.5％ (38/51) for severe dysplasia,92.6％ (63/68) for squamous carcinoma,respectively.The positive expression rate of p53 protein was 0 (0/40) for normal epithelium,28.6％ (12/42) for mild dysplasia,46.5％ (20/43) for moderate dysplasia,52.9％ (27/51) for severe dysplasia,67.6％ (46/68) for squamous carcinoma,respectively.The positive expression rate of survivin protein was 0 (0/40) for normal epithelium,38.1％ (16/42) for mild dysplasia,55.8％ (24/43) for moderate dysplasia,64.7％ (33/51) for severe dysplasia,89.7％ (61/68) for squamous carcinoma,respectively.Rank correlation analysis showed that abnormal expressions of Ki-67,p53,and survivin were correlated significantly with the pathological grading of the lesions (r =0.637,0.454,0.590,P ＜0.01).The expressions of Ki-67,p53,and survivin were positively correlated in esophageal carcinoma (r =0.407,0.646,P ＜ 0.01).Conclusions The abnormal expressions of Ki67,p53,and survivin were associated with the processes of the esophageal canceration,and the joint detection with three parameters has important clinical value.

Objective To explore the differences in the expression of inhibin(INH)receptors and activin (ACT)receptors in the follicular/luteinic phase in normal human ovaries and their relationship with female endocrine hormone levels.Methods Real time PCR and immunohistochemistry were used to determine the expression of inhibin receptors(INHR)genes,activin receptors(ACTR)genes.Serum estradiol(E2),follicle stimulating hormone(FSH),luteinizing hormone(LH),INHB,ACTA levels were determined by a solid quantitative sandwich enzyme immunoassay technique(Sandwich ELISA)in 21 women during follicular phase and another 21 women during luteinic phase,the correlations between each gene and each hormone were analyzed.Results(1)ACT type Ⅰ and Ⅱ receptors genes(ACTR Ⅰ A,ACTR Ⅰ B,ACTRⅡA,ACTR Ⅱ B)and INH receptor β-glycan genes were expressed higher in the follicular phase than in the luteinic phase:ACTR Ⅰ A(0.50±0.17 vs 0.36±0.18;P＜0.05),ACTR Ⅰ B(0.050±0.019 vs0.036±0.020;P＜0.05),ACTRⅡ A(0.10±0.04 vs 0.07±0.04;P＜0.05),ACTR Ⅱ B(0.28±0.10vs 0.19±0.11;P＜0.05),β-glycan(0.26±0.10 vs 0.17±0.09;P＜0.01).(2)The intensities of ACTR I A,ACTR Ⅱ A,β-glycan immunostaining in human normal ovaries in the follicular phase were significantly stronger compared to those in luteinic phase.In the follicular phase β-glycan expression was positively correlated with serum E2,FSH,LH,INHB levels.The correlation coefficient was 0.53(P＜0.05).0.74(P＜0.01),0.85(P＜0.01)and 0.76(P＜0.01)respectively.Conclusion In normal human ovary in the follicular phase INH and ACT bind their receptors and down-regulate or up-regulate FSH,thus influencing the follicular development.

Objective To analyze the impact of medical insurance reimbursement mechanism on the income of urban community health centers run by various entities. Methods The data of the baseline survey of community health centers in 28 cities made in 2007 were called into play. These data were used to compare the percentage of the annual medical insurance income from outpatient clinics of three types of community health centers in their gross annual income and their annual outpatient clinic income. Results For 929 community health centers with income from medical insurance reimbursement, the average percentage of their annual income from outpatient clinic accounts for 24% of their gross annual income and 26. 09% of their annual outpatient income;In respect of the reimbursement rates of medical insurance at outpatient clinics, the highest come from those run by enterprises, secondly those by the government,and the least those run by social organizations or individuals. Conclusion The mechanism of medical insurance reimbursement has already affected the income of the third type of community health centers. It is recommended to raise the coverage rate of medical insurance of such type of centers and their reimbursement rates of medical insurance. This may further consolidate the policies of medical insurance reimbursement.

The recurrence rate of non -small cell lung cancer ( NSCLC) patients after radiotherapy and chemotherapy have been increasing .The therapy scheme consists of reirradiation、chemotherapy、and chemoradio-therapy,with the purpose of improving the local control and prolonging the survival time .Reirradiation is feasible for locally recurrence of non -small-cell lung cancer patients , treatment is security and could better improve quality of life in patients .The majority of patients are tolerable and have better short -term efficacy , No severe short term radiation induced injury is observed .But the long term radiation induced injury and long term efficacy need further investigation .In the present paper ,we review the roles of reirradiation for locally recurrence of non -small-cell lung cancer patients after radiotherapy and chemotherapy and the progress in clinical research .

Objective To improve and establish an RP-HPLC method for the determination of related substances of piracetam and its injection. Methods Using thermo syncronis C18(4.6 mm ×250 mm,5μm)chromatographic column, mobile phase was acetonitrile-phosphate buffer (adjust pH of 1.0 g/L potassium hydrogen phosphate solution to 6.0 with phosphoric acid), gradient elution with initial mobile phase 5% acetonitrile.The flow rate was 1 mL/min, detected at 205 nm.Five calibration factors of the known impurities were separately measured.the related substances were determined using main component self-compare with calibration factor.Results Piracetam and their related substances were well separated.The calibration curves of five known impurity A~E were linear within the concentration range measured.The average recoveries were 99.46%,98.21%,97.22%,100.23% and 97.58%, respectively(n=9), RSDs of the average recoveries were lower than 2.0%.The calibration factors of five known impurity A ~E were 1.1, 1.4,1.5,0.8, 1.4, respectively.Conclusion The method can be used to determine the related substances in piracetam and its injection.The related substances can be determined accurately using main component self-compare with calibration factor.

Objective To evaluate the clinical efficacy of transcatheter renal sympathetic denervation(RDN)in the treatment of resistant hypertension.Methods Clinical data of 10 patients with resistant hypertension treated by transcatheter renal sympa-thetic denervation were retrospectively analyzed.The blood pressure and complications were analyzed.Results In all of the 10 pa-tients,systolic and diastolic blood pressure decreased significantly after two weeks compared with preoperative,and further de-creased after 3 months (P <0.05 ).There were no statistical difference of systolic and diastolic blood pressure between 3 and 6 months(P >0.05).Before the RDN,the mean number of antihypertensive drugs was 5.3±0.9.After 6 months which was 3.2±0. 6,and which was decreased significantly compared with the preoperative (P <0.05).No adverse reactions were found.Conclusion The RDN can be quickly and sustained decrease the blood pressure in patients with resistant hypertension.