The determination of tumor markers is of great value for esophageal squamous cell carcinoma. This article reviews the application status of routine tumor markers and the progression on the role of tumor markers in early diagnosis, predicting chemotherapy or radiotherapy response, monitoring disease recurrence and evaluation of prognosis in esophageal squamous cell carcinoma.

Objective To assess the predictive and prognostic role of the alteration of serum carcinoembryonic antigen (CEA),squamous cell carcinoma antigen (SCC-Ag) and cytokeratin 19 fragment (CYFRA21-1) during chemotherapy in patients with advanced esophageal squamous cell carcinoma (ESCC).Methods The serum levels of CEA,CYFRA21-1 and SCC-Ag were measured in 50 patients with advanced ESCC at baseline and after first line chemotherapy.The data was correlated with objective efficacy and overall survival.To evaluate the role of tumor marker change in predicting response to therapy,receiver operating characteristic (ROC) curves were constructed.Results CEA,SCC-Ag and CYFRA21-1 increased higher than the cutoffs in 22.0 %,34.0 %,and 44.0 % of tested patients,respectively.Statistically significant correlations were observed between CYFRA21-1 and SCC responses and objective efficacy evaluated by RECIST criteria (Z =3.181,2.389; P = 0.001,0.017).Based on the ROG curve analysis,a post treatment 32 % and 38 % increase in serum concentration was used as cut-off level for defining CYFRA21-1 and SCC-Ag change,respectively.When the cut-off levels were used to predict chemotherapy efficacy,the accuracy for CYFRA21-1 and SCC-Ag were 76 % and 70 %.In the univariate survival analysis,a statistically significant prognostic impact on survival from the change of CYFRA21-1 and SCC-Ag was observed.Conclusion CYFRA21-1 and SCC-Ag are useful for diagnosis,predicting chemotherapy objective efficacy and prognosis in advanced ESCC.

Objective To compare the effect of crystalloid and crystalloid plus albumin in the treatment of pediatric septic shock.Methods Data of 63 pediatric patients with septic shock admitted to Department of Critical Care Medicine of Hebei Provincial Children's Hospital were collected and retrospectively analyzed.The patients were divided into two groups according to whether they received albumin for volume resuscitation within 1 day after admission or not.The patients in observation group (crystalloid + albumin group,n =33) received normal saline (20 mL/kg) followed by 1 g/kg albumin 30 minutes after admission,and those in control group (crystalloid group,n =30) received only normal saline (20 mL/kg) 30 minutes after admission,and normal saline resuscitation was continued according to the effect of fluid therapy.Anti-infection and vasoactive drugs strategies were the same in both groups.The first-hour infusion volume,time showing stable hemodynamics,the incidence of pulmonary edema,and blood lactate levels at 0,6,12 hours after achieving the goals were compared,and blood lactate clearance rates were calculated.Results The first-hour infusion volume time in the observation group was lower than that in control group (mL:41.56 ± 10.50 vs.57.24 ± 7.54,t=4.596,P=0.000),and time showing stable hemodynamics was shorter than that in control group but without statistically significant difference (minutes:219.87 ±70.23 vs.287.10 ± 67.00,t=2.047,P=0.360).The incidence of pulmonary edema in observation group was slightly lower than that in control group [6.1％ (2/33) vs.10.0％ (3/30),x2±2.272,P=0.259].The lactic acid levels were decreased gradually along with rehabilitation time,while lactate clearance rate was increased in both groups.At 0 hour and 6 hours after resuscitation,the lactate level (mmol/L) in the observation group was significantly lower than that in control group [0 hour:3.65 ± 2.84 vs.5.72 ± 2.11,t＝ 1.940,P=0.046; 6 hours:2.12 ± 1.21 vs.4.09 ± 1.45,t=2.892,P=0.005],while the lactate clearance rate was significantly increased compared with control group [0 hour:(0.38 ± 0.15)％ vs.(0.18 ± 0.09)％,t=1.447,P=0.018; 6 hours:(0.62 ± 0.14)％ vs.(0.51 ± 0.11)％,t=1.920,P=0.047].However,at 12 hours after resuscitation,there were no statistically significant differences in the lactic acid level (mmol/L:1.46 ± 0.39 vs.1.54 ± 1.90,t=0.450,P=0.072) and the lactate clearance rate [(0.78 ± 0.19) ％ vs.(0.77 ± 0.18) ％,t =0.091,P=0.928] between observation group and control group.Conclusion Albumin resuscitation in children with septic shock can stabilize hemodynamics earlier,reduce the incidence of pulmonary edema,and improve the successful rescue rate of refractory septic shock.

Objective:To assess mechanical hyperalgesia of the bilateral masseter muscles following the induction of experimental unilateral malocclusion in rats. Methods:① An elastic rubber(3M Unitek,1/8#) was inserted between the first and sencond upper molars on the left side of 4 Sprague- Dawley rats to induce malocclusion.② The left maxillary first molar of 4 rats were filled with metal arsenic for 7 days to inactivate tooth pulp, and then a dentin pin(d 0.75 mm, long 1.5-2.0 mm,0.5-1.0 mm above the occlusion surface)was bonded in the pulp chamber to induce acute traumatic occlusion, and 4 control animals were treated as the same procedure but not raised occlusion surface.③ According to Ren's method, von Frey filaments were used to assess the muscle mechanical threshold.Head withdrawal, leg raising and crying were observed as painful actions. Results:① In gradually induced malocclusion group,hyperalgesia was induced in bilateral masseter muscles from 3 to 9 d, and the peak time was the 7th day. ②In the acute traumatic occlusion group, the ipsilateral masseter muscle was demonstrated hyperalgesia for 5-7 days, and the peak time was the 2nd day. Conclusions:Traumatic occlusion may lead to masseter muscles hyperalgesia, and there existe some differences for pain behavior between the acute and the chronic occlusion trauma.

This paper analyzed the characteristics of pathophysiology teaching for Mongolian students.Exploration was made in aspects of designing,implementing and evaluating multilingual pathophysiology teaching mode for Mongolian students.The problems of the mode were summarized and optimization measures were proposed.

Objective To observe the effect of finger-pressing combined with conventional rehabilitation therapy on the recovery of upper limb function after stroke.Methods A total of 60 cerebral stroke patients were randomly divided into an experimental group (n =30) and a control group (n =30).All patients were treated with conventional anti-symptomatic drugs but no anti-spasticity ones.The experimental group was given conventional rehabilitation and finger-pressing therapy,while the control group was given conventional rehabilitation only.Both groups were measured the motor function,using the upper-extremity portion of the Fugl-Meyer Scale,and the mean integrated electromyography (iEMG) output of biceps and flexor carpi radialis after the first finger-pressing treatment and 1 month later,so as to observe the immediate and continuous effects of finger-pressing therapy respectively.Results After the first session of finger-pressing therapy,the average Fugl-Meyer score(FMA) (12.63 ± 4.64) of the experimental group was significantly higher than in a pretest (12.13 ± 4.88) (P ＜ 0.05),while the iEMG of biceps (41.64 ± 9.22) and flexor carpi radialis (37.06 ± 7.02) were lower than before (P ＜ 0.01).One month after the treatment,compared with the control group,the average FMA (25.17 ± 5.93) and iEMG of biceps(34.42 ± 7.55) and flexor carpi radialis sEMG(30.63 ± 5.54) in the experimental group were significantly improved (P ＜ 0.01).Conclusions Finger-pressing therapy has significant and immediate effects in improving the upper extremity spasticity of stroke survivors.Combined with conventional rehabilitation therapy it can effectively reduce the upper extremity spasticity in stroke patients and significantly improve the upper extremity function.The combination is superior to conventional rehabilitation alone.

Objective To investigate the guidance of a new classification on the treatment methods selection for cystic dilation of bile duct (CDBD).Methods The clinical data of 213 patients with CDBD who received treatment according to the Todani 2003 classification at the Peking Union medical College Hospital from September 1968 to July 2013 were retrospectively analyzed.The CDBD was reclassified with a new classification proposed by Dong Jiahong et al,and the guidance of the new classification on the treatment methods selection for CDBD was analyzed.Patients were followed up via out-patient examination and telephone interview till August 2013.Results Of the 213 patients,139 were with Todani type Ⅰ CDBD (type C CDBD of the new classification) ; 3 were with Todani type Ⅱ CDBD (type C1 CDBD of the new classification) ; 1 was with Todani type Ⅲ CDBD (type E CDBD of the new classification); 52 were with Todani type Ⅳa CDBD (35 with type D1 and 17 with type D2 CDBD of the new classification) ; 1 was with Todani type Ⅳb CDBD (type C CDBD of the new classification) ; 8 were with Todani typeⅤ-Ⅰ CDBD (type B CDBD of the new classification) ; 9 were with Todani type Ⅴ-Ⅱ CDBD (type A CDBD of the new classification).Eighteen patients did not receive the surgical treatment.Of the 195 patients who received surgical treatment,patients with type C and D CDBD of the new classification took a large proportion.Patients with type C CDBD of the new classification received cystectomy,biliary cyst resection,Rouxen-Y cholangiojejunostomy or internal drainage.Patients with type D CDBD of the new classification received extrahepatic biliary cyst resection,Roux-en-Y cholangiojejunostomy.Patients with severe intrahepatic disease and with type D1 CDBD of the new classification received concomitant left hemihepatectomy or pancreaticoduodenectomy.Patients with type A1 CDBD of the new classification received right hemihepatectomy.Patients with type A2 CDBD of the new classification were cured by conservative treatment after split liver transplantation.Patients with type B1 CDBD of the new classification received left hemihepatectomy and Roux-en-Y cholangiojejunostomy.Patients with type B2 CDBD of the new classification received bile duct stone extraction.There was 1 patient with type E CDBD,and partial resection of the CDBD ± bile duct reconstruction was carried out.Pancreatic fistula,biliary fistula,reflux cholangitis,cholangitis and anastomotic stricture were detected on 74 patients,and they were cured by conservative treatment or lithotomy.A total of 187 patients were followed up with the median time of 85 months (range,1-432 months).One hundred of seventy-five patients recovered well,and 12 patients with canceration of the bile duct died of tumor metastasis at postoperative 1-282 months.Conclusion This new classification simplifies the typing of extrahepatic bile duct dilation,refines the typing of intrahepatic bile duct dilation,and has better guidance for surgical treatment.

Objective To evaluate the effect of raltitrexed plus oxaliplatin combined with concurrent radiotherapy on life quality of advanced esophageal carcinoma.Methods Oesophageal cancer specific health related quality of life questionnaire(QLQ-OES18) was used to evaluate the life quality of 54 patients with esophageal carcinoma respectively at 1 day pre-treatment(baseline level),1 day post-treatment and 1month post-treatment.Total 54 patients were treated with raltitrexed plus oxaliplatin combined with con-current radiotherapy.Comparing the differences of quality of life scores at different time points,and analyzing the correlation of the differences between the 1month post-treatment and baseline score and short term effect.Results The scores of difficulty swallo-wing,eating difficulties,saliva decreased significantly at 1 day post-treatment than that of pre-treatment(P<0.05),the scores of eating pain increased significantly at 1 day post-treatment than that of pre-treatment(P<0.05)and there was no significantly differ-ences in other items(P>0.05).The scores of 1 day post-treatment were significantly reduced compared to baseline levels except re-flux and speech(P<0.05).It was positive correlation between the difference of 1 month post-treatment and baseline score and short term effect,and the correlation coefficients was 0.85,0.55,0.73,0.32(P<0.05),respectively.Conclusion There is a transient im-pact of raltitrexed plus oxaliplatin combined with concurrent radiotherapy on quality of life for advanced esophageal carcinoma after treatment,but most of the life quality of the patients could be improved after 1 month obviously.

Objective To investigate the expression and tissue distribution of CD31 in the process of the calf cortical with partial cancellous bone xenograft, to explore the healing mechanism and relationship between bone remodeling and revascularization, and to provide a basis for the further study of tissue engi-neered bone.Methods Thirty-six New Zealand rabbits were selected as our experimental animals.All ani-mals were implanted with the calf cortical with partial cancellous bone.Specimens were procured at 4, 8, 12 and 24 weeks after surgery, respectively.The expression and tissue distribution of CD31 were observed in the process healing with general condition, X-ray, histology and immunohistochemistry.The image analy-sis computer system was used for quantitative analysis.The extent of revascularization and remodeling was separately represented by revascularization indexes and new bone areas.The relationship was studied be-tween bone remodeling and revascularization.Results ⑴ The X-ray showed significant healing.⑵ The positive expression of CD31 was seen in the whole process of bone xenograft and was different at various stage and sites.By the 4 weeks and 8 weeks postoperative,the strong positive expression was seen in the pe-ripheral soft tissue of graft bone, the callus of joint and the periphery of cartilage nests.Much positive ex-pression was seen in the cancellous bone.There was seen some single, cord, and cluster vascular endotheli-al cells.The positive expression was seen in the enlarged haversian canals and periphery.By the 24 weeks postoperative,the positive expression was seen in the enlarged haversian canals and periphery with increasing newborn capillaries.⑶ The correlation analysis between new bone areas and revascularization showed a closely positive correlation ( r =0.984).Conclusions The positive expression of CD31 was seen in the whole process of bone xenograft and was different at various stage and sites.The positive expression of CD31 reflected the extent of revascularization and bone remodeling of bone grafts.The extent of revascularization of bone grafts and bone remodeling showed a closely positive correlation.

Objective: To study a new purification method of Polysaccharide Peptide of Coriolus versicolor in affinity chromatography. Methods: Isotherm and kinetics in absorption and the optimal conditions of absorption and elution were studied through static experiments. The static absorption capacity q m and absorption constant K d were calculated according to Chase model. Results: q m =55.57mg/g wet resin, K d =5.312g/L, the dynamic absorption capacity is 43.1mg, polysaccharide/g wet resin and 10.3mg protein/g wet resin.Conclusion: Affinity chromatography can be used to purify PSP preliminarily.