ObjectiveTo determine the clinical effect and the prospect of cervical side-to-side stapled esophagogastric anastomosis. MethodsEighteen cases of upper and middle thoracic esophageal carcinoma were treated with esophagectomy and cervical side-to-side stapled esophagogastric anastomosis. The clinical data were collected and retrospectively analyzed. The average age of patients was 60.7 years and the ratio of male to female was 17∶1. The tumor included 4 upper part and 14 middle thoracic parts. The length of tumors was from 1 cm to 7 cm, with an average of 3.2 cm.ResultsThe post-operative TNM staging(AJCC) included 4 Stage Ⅱa,9 Stage Ⅱb,and 5 Stage Ⅲ. The operative incisions included 8 nontransthoracic cervical and abdominal double incisions, 9 right cervico-thoraco-abdominal triple incisions, and 1 left cervico-thoracic incision. One (5.56%) patient complicated with anastomotic leakage and was cured in 2 weeks by cervical drainage and absolute diet. All the 18 patients were followed up for 1 to 5 years,and no anastomotic stricture was found. Reflux esophagitis was found in 2 and the incidence rate was 11.11%.ConclusionCervical side-to-side esophagogastric anastomosis is a safe procedure with larger resection of margins and fewer complications. It is worth replicating.

80 years)in China is increasing.As a special type of hypertension,the hypertension in the very elderly has some specificities in pathogenesis,clinical manifestation,treatment and prognosis.The topic to effectively cure and prevent hypertension in the very elderly is increasingly emphasiced.This article presents an overview of recent progress in clinical characteristics,and treatment strategy related to hypertension in the very elderly.

Objective To discuss and analyze the reliability and validity of the application Chinese version of Caregiver Grief Scale (CGS) on caregivers of patients with advanced hepatocarcinoma. Methods To translate the original English scale into Chinese and adapt it to the culture of China, forming a Chinese CGS. Totally 330 patients were selected with advanced hepatocarcinoma who were hospitalized in a gradeⅢ, class A hospital by the convenient sampling method. They were carried out exploratory factor analysis and confirmatory factor analysis respectively. Results For Chinese CGS, the critical value of every purpose has statistical significance (P < 0.05) by comparison. Exploratory factor analysis showed:KMO value was 0.923;Bartlett's sphericity test value was 794.31;cumulative variance contribution rate was 67.532%;four common factors can be extracted. Confirmatory factor analysis showed that the structural model of the scale was good: χ2/d?=1.11<3.0,goodness of fit index=0.995,root mean square error of approximation=0.021,adjusted goodness-of-fit index=0.968,normed fit index=0.973, comparative fit index=0.957,Tucker-Lewis index=0.993,incremental fit index=0.943. Each correlation coefficient of the scale has statistical significance and expert validity is between 0.832 and 0.973. Reliability analysis shows that the total Cronbach'sαof the scale was 0.908;Cronbach'sαcoefficient of every dimension was between 0.896 and 0.913; Guttman's split-half reliability was 0.917; test-retest reliability was 0.831. ROC curve showed that when the total score of the scale ≥24.5, specificity and sensitivity were good. Conclusions Chinese version of CGS has good reliability and validity, which is suitable for preliminary screening grief emotion of caregivers of patients with advanced hepatocarcinoma.

Attention Deficit Disorder with Hyperactivity ; therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Phytotherapy ; methods

Objective To investigate the value of the acupuncture with Medicinal herbs in the treatment of the intractable hiccup after severe craniocerebral injury. Methods Sixty patients diagnosed of intractable hiccup after severe craniocerebral injury were randomly recruited into a therapeutic group and a control group. The therapeutic group was treated with acupuncture and medicinal herbs, while the control group was treated with western medicine. The therapeutic course for both groups was one week. The efficacy was evaluated by observing the cure rate, improvement rate and non effective rate respectively. Results In the therapeutic group :23 patients were cured and the total effective rate was 96.67%;While in the control group: 12 patients were cured and the total effective rate was 70.00%. The effective rate of therapeutic group was obviously better than the control group. Conclusion Acupuncture with medicinal herbs in the treatment of the intractable hiccup after severe craniocerebral injury has good efficacy.

Objective To evaluate the efficiency and safety of amiodarone in patients with acute myocardial infarction (AMI) complicated ventricular tachyarrhythmia (CVT). Methods 106 CVT patients of AMI with stable haemodynamics was randomized into trial group (53 cases) and control group (3 cases). Based on routine therapy, the trial group was intravenously given amiodarone. Electrical cardioversion is necessary if the haemodynamics turns to unstable. Intravenous amiodarone will be used for at least 24 hours to maintain sinus rhythm. The control group was administrated intravenous lidocainein. If the patients made no response to lidocainein, given amiodarone as substitute. Electrical cardioversion is necessary when the haemodynamics turns to unstable and lidocainein was followed for at least 24 hours after successful cardioversion to maintain sinus rhythm. The therapeutic effects, cardiac function and the changes of arrhythmia were compared between the two groups. Results The incidence of angina pectoris, consumption of nitrates were decreased in trial group when compared with that in control group, whereas the ejection fraction, left ventricle fast filling interval and the mitral valve peak velocity of blood flow during left atrium contraction(E/A) all were higher than that in control group (all P<0.01). The total effective rate in trial group was higher than that in control group (75.5% vs 62.3%, P<0.01), especially the ventricular tachycardia control rate is significantly higher than control group (86.7% vs 50.0%,P<0.01). Conclusion Intravenous injection of amiodarone efficaciously control the complicated ventricular tachy-arrhythmia in patients with acute myocardial infarction as well as to improve the cardiac function.

Objective To investigate the effect of sevoflurane on adriamycin-induced damage to primary neonatal rat cardiomyocytes.Methods Primary neonatal rat cardiomyocytes were isolated from Sprague-Dawley rats (within 24 h after birth) and cultured in DMEM liquid culture medium.The cells were seeded in 96-well plates (200μl/hole) or 6-well plates (2 ml/hole) with a density of 5 × 104/ml and randomly divided into 4 groups (n =24 each):control group (group C),adriamycin group (group A),sevoflurane group (group S) and adriamycin + sevoflurane group (group AS).In groups A and AS,adriamycin 1 μmol/L was added to the cultured medium,the equal volume of PBS was added instead in groups C and S,and the cells were then incubated for 24 h.The cells were exposed to 2.4％ sevoflurane for 2 h starting from 24 h of incubation in groups A and AS.The cell viability,concentrations of cTnI and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in the culture medium,and expression of Bax and Bcl-2 were detected 2 h after the end of exposure to sevoflurane.The Bax/Bcl-2 ratio was calculated.Results Compared with group C,the cell viability and expression of Bcl-2 were significantly decreased,while the concentrations of cTnI and NT-proBNP in the culture medium,expression of Bax and Bax/Bcl-2 ratio were significantly increased in group A,and the cell viability was decreased in group AS (P ＜ 0.05).The expression of Bcl-2 was significantly higher and the concentrations of cTnI and NT-proBNP in the culture medium,expression of Bax and Bax/Bcl-2 ratio were significantly lower in group AS than in group A (P ＜ 0.05).Conclusion Sevoflurane can reduce adriamycin-induced damage to primary neonatal rat cardiomyocytes and inhibition of cell apoptosis is involved in the mechanism.

The amount of the funds supported by National Natural Science Foundation of China (NSFC) played as an important role in judging the capabilities and tendency of scientific research.It is believed that the supporting rate of NSFC is promoted via scientific management policies.To explore the tendency and potential of scientific management plan in the first affiliated hospital of Xi'an Jiaotong University,we analyze the projects supported by NSFC of our hospital from 2002 to 2011.Accordingly,our outcomes show the supporting rates of variable programs from NSFC were similar to the average for whole nation.The inspiring policies encourage our staff to put their passion on the scientific research and funding application.The quality of bidding documents for NSFC is partially improved by the suggestions and lecture of invited experts who took the charge of evaluation of funds from NSFC for actively guide,so as to increase goal average.Of note,a cohort of the researchers at the age below 45 did the main contribution to scientific research developing and programs application from NS-FC.Furthermore,we will pay more attention to reach 3 point following:1.the policy of matching fund to strengthen the competition of the researchers all over the nation.2.the policy of Integrated research resources for the major programs.3.further improvement of projects supervision.

To compare the merit and shortcoming of treatment and securities with absorbable implants and metallic fixation for fractures of the ankle,45 patients with ankle fractures were enrolled from the the Fifth Hospital of Dalian between February 2000 and May 2004 and treated with absorbable implants(n =21)and metallic fixation(n =24),respectively.All patients were available for an average duration of follow-up of 10-18 months.The results were evaluated by radiographic representations and joint function and showed that all the patients were healed in ankle fractures.The total rate of good and excellent results was 92%(19/21)in absorbable implants group and 92%(22/24)in metallic group.There were no statistic differences between these two methods.Absorbable implants is believed to be a good method for the treatment of ankle fracture instead of metallic implants.

Objective To study the therapeutic efficacy of combined interventional chemotherapy and intravesical instillation of mitomycin on preventing bladder cancers from recurring after local ablation. Methods 28 patients with superficial bladder cancers were randomized into combined interventional chemotherapy and intravesical instillation of mitomycin or intravesical instillation of mitomycin alone for preventing recurrence after local ablation.The result was assessed by ? 2 test. Results The patients have been followed up for 12～26 months (mean 21 months).1 case has had tumor recurrence in the combined modality therapy group and 4 in the intravesical instillation alone group,the tumor recurrence rate being 7% (1/14) and 29% (4/14) respectively(P