Objective To evaluate the efficacy of circinal stapled suture and manual suture in cervical esophagogastric anastomosis in esophageal resection.Methods The clinical data of 187 patients with esophageal cancer who were admitted to the Cancer Hospital of Sichuan Province from January 2010 to January 2012 were retrospectively analyzed.All the patients were divided into the stapled suture group (98 patients) and manual suture group (89 patients).The time of anastomosis,operation time,time for dieting,duration of hospital stay,the incidence of postoperative complications and positive rate of esophageal remnant cancer cells of the 2 groups were compared.All data were analyzed using the t test or chi-square test.Results The time of anastomosis,operation time,time for dieting and duration of hospital stay were (7.8 ± 1.4) minutes,(227 ± 60) minutes,(6.3 ± 0.9) days and (14 ±4)days in the stapled suture group,which were significantly shorter than (28.5 ±2.3)minutes,(301 ±81)minutes,(8.4 ± 1.0)days and (22 ±9) days in the manual suture group (t =75.44,7.14,7.71,7.41,P ＜0.05).The incidence of anastomotic fistula was 1％ (1/98) in the stapled suture group,which was significantly lower than 8％ (7/89) of the manual suture group (P ＜ 0.05).The incidence of anastomotic stricture was 5％(5/98) in the stapled suture group,which was lower than 7％ (6/89) in the manual suture group,but no significant difference was detected (P ＞0.05).The positive rate of esophageal remnant cancer cells was 0(0/98),which was signifiantly lower than 4％ (4/89) in the manual suture group (P ＜0.05).Conclusion Circinal stapled suture in esophagogastric cervical anastomosis not only reduce the time of anastomosis,operation time and duration of hospital stay,but also decrease the incidence of anastomotic fistula and the positive rate of esophageal remnant cancer cells.

ObjectiveTo investigate the clinical significance and characteristics of recurrent laryngeal nerve lymph node metastasis of thoracic esophageal cancer.MethodsOne hundred and twenty-four patients who had undergone thoracic esophageal resection with recurrent laryngeal nerve lymph node dissection in our hospital from March 2007 to February 2010.All clinical data were retrospectively analysed.ResultsRecurrent laryngeal nerve lymph node metastasis was found in 34 of 124 cases,with the metastatic rate of 27.41% (34/124).The left recurrent laryngeal nerve lymph node metastasis was 16.13% and the right was 8.06% .The recurrent laryngeal nerve lymph node metastasis was found in 9 patients with the upper segment esophageal cancer,20 with middle third esophageal cancer and 5 with lower segment esophageal cancer,6 patients with T2 disease had recurrent laryngeal nerve lymph node metastasis,while 27 with,T3 disease.Also there were 4,13,17 cases with metastasis in well-differentiated,moderately differentiated,poorly differentiated respectively.Poorly differentiated esophageal carcinoma was more susceptible to recurrent laryngeal lymph node metastasis than well-differentiated and moderately differentiated esophageal carcinoma.Recurrent laryngeal nerve injury was found in 11 cases,7 cases of them recovered.ConclusionNearly 1/3 of patients with esophageal carcinoma have recurrent laryngeal nerve lymph node metastasis,especially for tumor located in the upper third esophagus,poor differentiation or deep invasion (T2 or more) of esophageal carcinoma were more susceptible to recurrent laryngeal nerve lymph node metastasis.

Post-marketing evaluation is a process which evaluate the risks and benefits of drug clinical application comprehensively and systematically, scientific and systematic results of post-marketing evaluation not only can provide data support for clinical application of traditional Chinese medicine, but also can be a reliable basis for the supervision department to develop risk control measures. With the increasing demands for treatment and prevention of disease, traditional Chinese medicine has been widely used, and security issues are also exposed. How to find risk signal of traditional Chinese medicine in the early stages, carry out targeted evaluation work and control risk timely have become challenges in the development of traditional Chinese medicine industry.
Drug Evaluation ; methods ; Drugs, Chinese Herbal ; Humans ; Medicine, Chinese Traditional

Traditional Chinese medicine Polygoni Multiflori Radix is dried roots of Polygonaceae Polygortum multiflorum Thunb. Its clinical application records were first discovered in literatures of the Tang dynasty. The origins, efficacy, toxicity, processing and taboos of Polygoni Multiflori Radix have been discussed in many ancient herb literatures. In recent years, with the increase in the public awareness in health, Polygoni Multiflori Radix admits preparations have been more widely applied in the treatment and prevention of diseases. However, there have been more and more reports about Polygoni Multiflori Radix induced liver injury, the safety of Polygoni Multiflori Radix has increasingly attracted attention of the society. In this paper, the authors summarized and analyzed the toxicity and medication risk factors of Polygoni Multiflori Radix recorded in ancient herb literatures, and proposed that more attention shall be given to the effect of the planting and processing methods on the components and toxicity of Polygoni Multiflori Radix in safety studies, which provides clues for the further studies.
China ; Drugs, Chinese Herbal ; adverse effects ; history ; History, Ancient ; Humans ; Medicine in Literature ; Medicine, Chinese Traditional ; history ; Polygonum ; adverse effects ; Risk Assessment

The renal toxicity and mutagenicity of aristolochic acid (AA) as well as its carcinogenicity on upper urinary tract transitional epithelial cells have been widely known. Since 2003, drug regulatory departments have successively cancelled the quality standards for AA-containing medicines such as Aristolochiae Radix, Aristolochiae Manshuriensis Caulis and Aristolchiae Fangchi Radix, and adopted measures for strengthening regulation and revising package insert or quality standards for other AA-containing medicines, including Aristolochia Cinnabarina Radix, Aristolochiae Fructus, Aristolochiae Mollissimae Herba, in order to control its safety risk. In recent years, domestic and foreign studies on AA have mainly involved action mechanism and clinical performance of AA toxicity, early-stage diagnosis and treatment method. In this paper, authors gave a brief summary and evaluation on risk factors for using AA-containing medicines, and offered measures and suggestions for preventing and controlling AA toxicity.
Animals ; Aristolochia ; adverse effects ; chemistry ; Aristolochic Acids ; analysis ; therapeutic use ; toxicity ; Drug Therapy ; Drug-Related Side Effects and Adverse Reactions ; epidemiology ; etiology ; Drugs, Chinese Herbal ; analysis ; therapeutic use ; toxicity ; Humans

The adverse reaction monitoring is important in warning the risks of traditional Chinese medicines at an early stage, finding potential quality problems and ensuring the safe clinical medication. In the study, efforts were made to investigate the risk signal mining techniques in line with the characteristics of traditional Chinese medicines, particularly the complexity in component, processing, compatibility, preparation and clinical medication, find early risk signals of traditional Chinese medicines and establish a traditional Chinese medicine safety evaluation system based on adverse reaction risk signals, in order to improve the target studies on traditional Chinese medicine safety, effective and timely control risks and solve the existing frequent safety issue in traditional Chinese medicines.
China ; epidemiology ; Drug Evaluation ; Drug-Related Side Effects and Adverse Reactions ; epidemiology ; etiology ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Humans ; Product Surveillance, Postmarketing

Objective To investigate the expression of endostatin and angiopoietin (Ang)-2 in human ghoma and its significance. Methods The expression of endostatin and Ang-2 were measured by immunohistochemistry and endostatin mBNA by hybridization in situ in 108 cases of brain glioma and 5 cases of normal brain tissues. Results The expression of endostatin (0.0657±0.0038)and Ang-2 (0.0286± 0.0042) were significantly higher in grade Ⅲ-Ⅳ glioma patients than those in grade Ⅰ-Ⅱ ghoma patients (0.0349±0.0048,0.0084±0.0018, respectively) and normal brain tissues (0,0)(P<0.01). The expression of endostatin mRNA were significantly higher in grade Ⅲ-Ⅳ glioma patients (0.0310±0.0041) than that in grade Ⅰ-Ⅱ glioma patients (0.0152±0.0031) and normal brain tissues (0)(P< 0.01 ). Theratio of endo-stalin to Ang-2 was negatively rehted to the grade of glioma (r=-0.810,P <0.01). Conclusion The interaction of endostatin and Ang-2 plays an important role in the invasive growth and malignant development of human glioma, and may be related to the prognosis and the malignant degree of glioma.

Objective To explore the relationship between the anastomotic plane and gastric esophageal reflux by analysizing three different anastomotic plan pressure and esophageal 24 h dynamic pH.Methods From June 2011 to March 2012, 45 patients with esophageal cancer had undergone radical surgery.According to the different locations of esophageal carcinoma, we divided patients into three groups(cervical esophagogastrostomy group, above aortic arches for esophagogastrostomy group, low aortic arches for esophagogastrostomy group).we monitored the LESP, esophageal wet swallowing peristalsis amplitude and 24 h dynamic pH value two days before surgery, and monitored the anastomotic plane pressure, residual esophageal wet swallowing peristalsis amplitude and 24 h dynamic pH value 1 month and 2 months after surgery in the same way.Results Three groups' difference of LESP, esophageal wet swallowing peristalsis amplitude and percentage of total time of 24 h dynamic pH ＜4in preoperative was not statistically significant.The difference of esophagogastrostomy plane pressure in postoperative was not statistically significant, but the wet swallowing peristalsis amplitude and percentage of total time of 24 h dynamic pH ＜ 4 in postoperative was statistically significant.Three groups' difference of LESP(compared with esophagogastrostomy plane pressure), wet swallowing peristalsis amplitude and percentage of total time of 24 h dynamic pH ＜ 4 between preoperative and postoperative was also statistically significant.Conclusion For patients with esophageal neoplasms, we should completely resection the tumor, and remain esophagus as much as possible.

Objective To investigate the perioperative characteristics and changing trends of gastric electrical activity of thoracic (tube) stomach in patients with esophageal cancer.Methods The clinical data of 30 patients with esophageal cancer who were admitted to the Sichuan Cancer Hospital between March 2013 and November 2013 were prospectively analyzed.All the eligible patients underwent esophageal cancer resection by Ivor-Lewis according to the inclusion criteria.The electrogastrograms of patients were recorded at preoperative day 1 and at postoperative day 3,7, 11 and 30.The electrogastrograms of patients at preoperative day 1 were used as the control.The parameters of electrogastrogram were analyzed including main frequency, coefficient of dominant frequency instablility, main power, postprandial/preprandial power ratio, percentage of normal gastric slow wave,percentage of slow gastric slow wave and percentage of tachycardia gastric slow wave.Measurement data with normal distritution were presented as x ± s, and measurement data with skew distritution were presented as M (Qn).The postoperative time and pre-and post-prandial electrogastrograms were compared by the repeated measures two-way ANOVA.The comparison between groups were evaluated with the LSD test and analysis of variance.Results Thirty patients were screened for eligibility with a mean age of 62 years (range, 49-75 years), including 26 males and 4 females.The pre-and post-prandial main frequencies were changed from 2.83 ± 0.13 and 3.01 ± 0.17 before operation to 2.66 ± 0.10 and 2.82 ± 0.10 at postoperative day 30 with coherent changing trend.The main frequencies at postoperative each time points were significantly lower than those before operation while postprandial above indicators were higher than preprandial those, showing a significant increasing trend with the passage of postoperative time (F =285.62, P ＜ 0.05).There was no interaction between the time and meal (F =0.22, P ＞ 0.05).The pre-and post-prandial coefficients of dominant frequency instablility were changed from 0.133 ±0.031 and 0.045 ±0.019 before operation to 0.150 ±0.043 and 0.115 ±0.010 at postoperative day 30 with coherent changing trend, and coefficients of dominant frequency instablility at postoperative each time points were significantly higher than those before operation while postprandial above indicators were lower than preprandial those, showing a significant reducing trend with the passage of postoperative time (F =16.51, P ＜ 0.05).The pre-and post-prandial main powers were changed from (85 ± 15) μV and (149 ± 23) μV before operation to (74 ± 9) μμV and (98 ± 10) μV at postoperative day 30, and main powers at postoperative each time points were significantly lower than those before operation, showing a significant increasing trend with the passage of postoperative time (F =48.45, P ＜ 0.05).There was interaction between the time and meal (F =7.39, P ＜ 0.05).The postprandial/preprandial power ratio was changed from 3.00 ± 0.35 before operation to 2.52 ± 0.25 at postoperative day 30, and postprandial/preprandial power ratios at postoperative each time points were significantly lower than those before operation, showing a significant increasing trend with the passage of postoperative time (F =26.66, P ＜ 0.05).The pre-and post-prandial percentages of normal gastric slow wave were changed from 81％ ± 6％ and 94％ ± 5％ before operation to 57％ ± 5％ and 70％ ± 5％ at postoperative day 30 with coherent changing trend, and percentages of normal gastric slow wave at postoperative each time points were significantly lower than those before operation while postprandial above indicators was lower than preprandial those, showing a significant increasing trend with the passage of postoperative time (F =49.36,P ＜0.05).There was no interaction between the time and meal (F =0.24, P ＞ 0.05).The pre-and postprandial percentages of slow gastric slow wave were changed from 17％ ± 7％ and 4％ ± 4％ before operation to 32％±4％ and 21％±4％ at postoperative day 30 with coherent changing trend, and percentages of slow gastric slow wave at postoperative each time points were significantly higher than those before operation while preprandial above indicators were higher than postprandial those, showing a significant reducing trend with the passage of postoperative time (F =46.54, P ＜ 0.05).There was interaction between the time and meal (F =18.12, P ＜ 0.05).The pre-and post-prandial tachycardia gastric slow wave percentages were changed from 1.55％ (1.04％,2.21％) and 1.95％ (1.74％, 4.22％) before operation to 8.97％ (5.76％, 12.02％) and 12.41％ (8.04％,16.85％) at postoperative day 30 without completely coherent changing trend, and percentages of tachycardia gastric slow wave at postoperative each time points were significantly higher than those before operation while postprandial above indicators were higher than preprandial those, showing a significant difference between before operation and postoperative day 3 (Z =11.47, 13.28, P ＜ 0.05) and no significant difference among the postoperative day 7, 11, 30 (Z =1.88, 0.31, 0.03, P ＞ 0.05).There was no interaction between the time and meal (F=0.85, P＜0.05).Conclusions After the esophagectomy, gastric electrical activity of thoracic (tube) stomach is also retained before and after the meal.There are significant differences among the main frequency, main power, coefficients of dominant frequency instablility, postprandial/preprandial power ratio,percentage of normal gastric slow wave, percentage of slow gastric slow wave, percentage of tachycardia gastric slow wave of thoracis (tube) stomach, they have changed dynamically in the perioperative period.

Objective To systematically evaluate the relationship between atherosclerotic renal artery stenosis (ARAS) and cor‐onary artery disease (CAD) and peripheral arterial disease (PAD) .Methods We gathered all case‐control studies about the correla‐tion of ARAS with CAD and PAD in the following databases:Cochrane library ,PubMed ,EMBASE ,Web of science until April , 2014 .Two reviewers extracted all relevant datas from the screened documents independently according to exclusion and inclusion criteria ,RevMan 5 .2 software were used to conduct Meta‐analysis .Results Fourteen trials were included .Meta‐analysis showed that :the OR (95% CI)of CAD with 1 vascular lesions ,2 vascular lesions ,3 vascular lesions and left main stenosis ,PAD and ARAS were 0 .70(0 .59-0 .82) ,1 .28(1 .10 -1 .48) ,2 .09(1 .69 -2 .59) ,1 .82(1 .40 -2 .36) ,3 .68(2 .21 -6 .10) with statistical signifi‐cance (P<0 .05) .Conclusion CAD with 2 vascular lesions ,3 vascular lesions and left main stenosis ,PAD were connected with ARAS ,CAD with 1 vascular lesions has little relationship with ARAS .