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 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.

[Objective]To evaluate the clinical and radiological findings in 56 patients with multilevel lumbar spinal stenosis in pre-and post-surgical treatment. [Method]From 1998 and 2002,56 patients suffering from multilevel lumbar spinal stenosis were included in a retrospective clinical study.Plain radiographs,MRI and/or CT myelograms were obtained preoperatively.The patients were assessed clinically with Oswestry disability index(ODI),visual analog scale(VAS) and the Beaujon functional score.Surgical procedure included wide posterior decompression and fusion using a transpedicular instrumentation system and bone grafts. [Result]After a mean follow-up of 2.2(2~2.6) years,the patients' clinical improvement by ODI,VAS was statistically significant and the Beaujon score was significantly improved(P

Objective To evaluate the role of phosphatidylinositol 3-kinase/protein-serine-threonine kinases (PI3K/Akt) signaling pathway and autophagy in reduction of adriamycin-induced myocardial injury by sevoflurane in the rats.Methods Thirty-six healthy male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 6 groups (n =6 each) using a random number table:control group (group C),adriamycin-induced myocardial injury group (group Dox),sevoflurane group (group Sev),LY294002 inhibitor group (group LY),solvent control group (group dimethyl sulfoxide [DMSO]),and 3-MA inhibitor group (group 3-MA).Adriamycin 4 mg/kg was injected intraperitoneally once a week for 3 weeks in all the groups except group C.The rats were mechanically ventilated for 2 h in C and Dox groups.The rats inhaled 2.4％ sevoflurane for 2 h in group Sev.In group LY,0.3 mg/kg LY294002 was injected via the tail vein at 10 min before anesthesia,and the rats inhaled 2.4％ sevoflurane for 2 h.In group DMSO,the equal volume of DMSO was injected,and the rats inhaled 2.4％ sevoflurane for 2 h.After the blood samples were collected from the heart,the rats were sacrificed,and myocardial specimens were obtained for determination of cardiac troponin Ⅰ (cTnI) concentrations in serum (by enzyme-linked immunosorbent assay),expression of total Akt (t-Akt),phosphorylated Akt (p-Akt),mammalian target of rapamycin (mTOR),phosphorylated mTOR (p-mTOR) and autophagy marker microtubule-associated protein light chain 3 Ⅱ (LC3 Ⅱ) (by Western blot),and cell apoptosis (by TUNEL).Apoptosis index (AI) was calculated.Results Compared with group C,the expression of p-Akt and p-mTOR was significantly down-regulated,and the expression of LC3 Ⅱ,AI,and serum cTnI concentration were significantly increased in the other five groups (P＜ 0.05).Compared with group Dox,the expression of p-Akt and p-mTOR was significantly up-regulated,and the expression of LC3 Ⅱ,AI,and serum cTnI concentration were significantly decreased in group Sev (P＜0.05).Compared with group Sev,the expression of p-Akt and p-mTOR was significantly down-regulated,and the expression of LC3 Ⅱ,AI,and serum cTnI concentration were significantly increased in group LY,and the expression of LC3 Ⅱ was significantly down-regulated,and serum cTnI concentrations were significantly decreased in group 3-MA (P＜0.05).Conclusion Sevoflurane can activate PI3K/Akt signaling pathway and inhibit autophagy,thus reducing adriamycin-induced myocardial injury in rats.

AIM: To evaluate the effect of endothelial myosin light chain kinase on extravasation migration of sarcoma cell. METHODS: An in vitro model of sarcoma cell transmigration across a monolayer of HUVEC cultured on collagen gel was used to observe extravasation migration of sarcoma cell and calculated the electrical resistance of HUVEC monolayer in extravasation migration of sarcoma cell. RESULTS: Sarcoma cell migrated through a gap between adjacent endothelial cells into collagen gel. The electrical resistance of a HUVEC monolayer reduced in extravasation migration of sarcoma cell.Endothelial myosin light chain kinase inhibitor(ML-7) inhibited extravasation migration of sarcoma cell and inhibited reduction of electrical resistance of a HUVEC monolayer in extravasation migration of sarcoma cell in a dose-dependent manner. CONCLUSION: Endothelial myosin light chain kinase regulates sarcoma cell transendothelial migration by phosphorylation of myosin light chain.