Purpose:To explore the rational operative approach in patients with carcinoma of the middle third of the esophagus by T and N status as determined by preoperative CT scan. Methods:87 cases with carcinoma of the middle third of the esophagus chosen for the operative approach by CT findings entered the observational group, 118 cases with carcinoma of the middle third of the esophagus who were not scanned by CT were put into the control group. The observational group adopted different operative approaches by the relationship between the primary tumour and the aorta,and the relationship between the primary tumour and the azygos vein,and by the metastasis of regional lymph nodes. The operative approaches were chosen as follows:if the aorta was not involved, the operative approaches were chosen by the metastastatic status of the regional lymph nodes; left thoracoabdominal approaches were chosen,if the aorta was involved,and Ivor-Lewis operation was involved if the azygos vein was involved.The control group adopted the Ivor-Lewis operation. The rate of resection between two groups and the difference in positivity rates of the resected regional lymph node were analysed by chi-square test and T test. Results:Sensitivity of N staging by CT scan was 74.7%(65/87), and specificity of N staging was 60%(39/65). Sensitivity of diagnosis of the aorta involved by tumour by CT scan was 21.8%(19/87), and specificity was (26.3%)(5/19). The rate of resection in the observational group was 92%, and the rate of resection in the control group was'81.4%. Both were markedly different,P

Objective To examine the expression of lipoxygenases (LOXs)on human pancreatic carcinoma and their effects on proliferation and apoptosis of human pancreatic carcinoma in vitro.Methods Expression of 5- LOX and 12-LOX in the tissue of human pancreatic carcinoma and pancreatic cancer cell line (SW1990) was detected by immunohistochemical staining and RT-PCR.To examine the effects of polyunsaturated fatty acids on pancreatic cancer cell line,the proliferation rate of SW1990 cells treated with arachidouic acid (AA),docosahexaenoic acid (DHA) and eicosapentenoic acid (EPA) was analyzed by MTT and the incorporation of bromodeoxyuridine (BrdU) methods.An annexinV/propidium iodide (PI) assay with flow cytometry and in situ terminal deoxynucleotidyl transferase-mediated dUTP-digoxigenin end labeling (TUNEL) assay were used to identify potential induction of apoptosis by the unsaturated fatty acids.The effects of 5-LOX inhibitor (MK-886) and 12-LOX inhibitor (baicalein) on the proliferation of SW1990 cells were determined by above methods.Results Both 5-LOX and 12-LOX were over expressed in the tissue of human pancreatic carcinoma and the pancreatic cancer cell line.AA had a stimulatory effect on the growth of SW1990 cells while EPA and DHA had an inhibitory effect in a dose-dependent manner.The apeptosis of SW1990 cells co-cultured with DHA or EPA lasting for 24 hours was increased markedly.Furthermore, both MK-886 and baicalein in a dose-dependent-manner inhibited the growth of SW1990 cells ard induced a significant increase of apoptotic cells rate.Conclusions Expression of lipoxygenase is up-regulated in human pancreatic cancer. Polyunsaturated fatty acids have regulatory effects on the growth of pancreatic carcinoma in vitro.AA stimulates proliferation of pancreatic cancer cell line,while DHA and EPA suppress proliferation,simultaneously inducing apoptosis of pancreatic cancer cell line.Blocking the functions of lipoxygenase with its inhibitor exerts a negative regulatory effect on the growth of pancreatic carcinoma in vitro.Lipoxygenase might be a novel therapeutic target for the pancreatic cancer.

Objective To identify the efficacy small interfering RNA against Pseudomonas aeruginosa expressing MexA-MexB-OprM efflux pumps.Methods Four siRNA ( siRNA1,siRNA2,siRNA3 and siRNA4) against mexB gene were designed and prepared by electricity transference in vitro.MICs of antibiotic combined with efflux pump inhibitors against multiple resistant strain PAO1 and PAO3 were determined by E-test method.The mRNA expression levels of efflux pump gene (mexB) were quantified by real time fluorescent quantitative PCR.Results siRNA expression vectors were constructed success by enzyme cut method.48 after PAO1 and multiple drug resistant PAO3 transfected with siRNA4,the sensibilities to antibiotic were enhanced.48 after PAO1 and multiple drug resistant PAO3 transfected with siRNAl,siRNA2 and siRNA3,the sensibilities to antibiotic didn't change obviously.48 after PAO1 and multiple drug resistant PAO3 ttransfected with siRNA4,the expression level of mexB was decreased obviously (P ＜ 0.05 ).48 after PAO1 and multiple drug resistant PAO3 transfected with siRNA1,siRNA2 and siRNA3,the expression level of mexB didn't change obviously.Conclusion siRNA against Pseudomonas aeruginosa expressing MexA-MexB-OprM efflux pumps enhanced the sensibility to antibiotic and inhibited the expression of mexB gene.Our results demonstrate the using RNAi may be potential targets for novel therapies directed against treatment of antibiotic-resistant infections.

Arthritis, Gouty ; therapy ; Humans ; Integrative Medicine ; Medicine, Chinese Traditional

Objective To discuss the influence hand hygiene intervention on general ICU acquired methicillin-resistant staphylococcus aureus (MRSA) infection and its improvement. Methods Hand Hygiene Cognition Questionnaire that passed the reliability and validity test was used to compare the change of cognition on hand hygiene of medical staff. According to the results of the questionnaire, the intervention was carried out by continuous intensive training. The compliance with hand hygiene of medical staff was observed by monitoring equipment in the ward. Implementation status and effect of hand hygiene of medical staff on duty were examined randomly each month. At the same time MRSA infection rate of patients in comprehensive ICU was monitored in the same period. The relationship between hand hygiene compliance and MRSA infection rate was analyzed. Results The score of medical staff of cognition of hand hygiene was (41.70±3.67) points before the intervention, while the score was (44.10±3.55) points after the intervention. The difference had statistical significance (t=24.37, P<0.01). The correct rate of hand washing, positive rate of bacterial culture in hand, hand hygiene compliance and infection rate of MRSA of patients in comprehensive ICU were 68.75%, 14.58%, 66.90%, 12.90% respectively before the intervention. The correct rate of hand washing, positive rate of bacterial culture in hand, hand hygiene compliance and infection rate of MRSA of patients in comprehensive ICU were 88.54%, 3.12%, 74.14%, 3.10% respectively after the intervention. The difference had statistical significance (χ2=7.809-24.520, P<0.01). Conclusions Questionnaires with high credibility reviews could better identify issues in hand hygiene compliance, and sustained, reinforcing intervention measures could improve the compliance of hand hygiene; Good hand hygiene practice of medical and nursing staff contributes to controlling MRSA infection rates in general ICU.

Paget's disease of the breast is an uncommon disorder that accounts for 1% to 3% of all mammary tumors. The incidence of underlying carcinoma associated with Paget's disease has been reported in 82% to 100% of cases. The finding of underlying carcinoma reaches almost 100% when a palpable lump is also present. In this rare case, we described a patient presenting with Paget's disease but no palpable lump. However, we found 11 independent regions which were all invasive ductal carcinoma after the operation. Considering this patient, we should pay more attention to a multifocal and multicentric breast carcinoma associated with Paget's disease. Furthermore, we believe the mammography examination and a modified radical mastectomy are the most appropriate treatments for this population in clinical practice.

Purpose To explore the diagnostic value of quantitative measurements of magnetic resonance images (MRI) in transverse and coronary sections in patients with ischiofemoral impingement (IFI) syndrome.Materials and Methods The data of 70 patients (127 hips) in the Affiliated Hospital of Chengde Medical College from 2013 June to 2016 April who were performed hip MRI examination was analyzed retrospectively.39 patients (67 hips) with clinical diagnosis of IFI syndrome were selected as case group,while the other 31 patients (58 hips) with clinical exclusion of IFI syndrome were selected as control group.Ischiofemoral space (IFS),quadratusfemoris space (QFS),ischial angle,femoral neck angle (FNA) and lesser trochanter angle (LTA) were measured on axial MR image with PDWI FS sequence.The cervicodiaphyseal angle (CCD) was measured on coronary section MR image with T2WI TIRM sequence.The above measurements of two groups were analyzed.Results IFS,QFS and LTA in patients of case group were 12.2 (10.2-13.9) mm,8.5 (6.9-10.4) mm and (13.8±0.7) °,while these measurements were 26.3 (22.9-30.4) mm,21.6 (19.5-25.4) mm and (19.9± 1.0) ° in patients of control group.Compared with control group,these measurements were significantly lower in case group (P＜0.01).Ischial angel,FNA were significantly higher in case group compared with control group [(131.2±0.4) ° vs.(127.1±0.6) °,29.2 (22.8-34.1) ° vs.22.7 (19-28.3) °,P＜0.01].CCD showed no significant difference between the two groups (P＞0.05).QFS,LTA have positive correlation with IFS in case group (r=0.870 and 0.653,P＜0.05),while FNA,ischial angel have significant negative correlation with IFS in case group (r=-0.623 and-0.655,P＜0.05).The cut-offvalues ofQFS,FNA,ischial angel and LTA were ≤ 12.7 mm,≥ 21.75 °,≥ 131.65 °,≤ 9.3°,respectively.Conclusion The reduction ofIFS and QFS is the main imaging signs of IFI syndrome.

ObjectiveTo observe the clinical efficacy of hair needle therapy in treating dry eye syndrome (DES).Method Eighty patients diagnosed with DES were randomized into a treatment group and a control group, 40 cases in each group. The treatment group was intervened by 0.1% Sodium Hyaluronate eye drops plus Hair needle therapy; the control group was by 0.1%Sodium Hyaluronate eye drops alone. The subjects were re-examined after 1-month treatment. The therapeutic efficacy was evaluated by observing the subjective symptoms, SchirmerⅠtest (SIT), tear break-up time (BUT), and fluorescein test (FL).Result The subjective symptoms, SIT, BUT, and FL scores were significantly improved after intervention in the treatment group (P<0.05);the control group only had the subjective symptoms improved after intervention (P<0.05), while other indexes didn’t show significant differences (P>0.05); after treatment, there were significant differences in comparing the subjective symptoms, SIT, BUT, and FL scores between the two groups (P<0.01).ConclusionHair needle therapy plus Sodium Hyaluronate eye drops can produce a more significant efficacy than Sodium Hyaluronate eye drops alone in treating DES.

Objective To study the age, the degree of hearing loss and the characteristics of inner ear imaging in children with GJB2 and SLC26A4 gene mutation-related deafness.Methods A total of 218 children with GJB2 and SLC26A4 gene mutations were enrolled in this study.Among them, with the combined test of deafness gene chip and DNA sequencing, 123 patients were diagnosed with GJB2 homozygous or complex mutations, and 95 patients were diagnosed with SLC26A4 homozygous or complex mutations.The age of the onset, the degrees of hearing loss and CT features of the temporal bone in children with GJB2 and SLC26A4 mutations were studied.Results The incidence of GJB2 and SLC26A4 gene mutations was 43.09%, 37.40%, 14.63%, 4.88% and 24.2%, 44.21%, 18.95% and 12.63% in the periods of infancy,early childhood,preschool and shoolage,respectively.The age composition of onset in the two groups showed statistical significance(P=0.014).The constituent ratio of children with moderate, severe and extremely severe degrees of hearing loss in the two groups with GJB2 and SLC26A4 gene mutations were 8.94%, 17.89%, 73.17% and 9.47%, 34.74% and 55.79%, respectively.Most of the group with GJB2 gene mutation had profound hearing loss, and the composition ratio of hearing loss degree in SLC26A4 group was statistically significant(P=0.014).99.19% of the children with GJB2 gene mutation group had normal structures of the inner ears.Only one case of CT showed bilateral internal auditory canal stenosis.For 95.79% of the children with SLC26A4 gene mutation, the CT results of the temporal bone were associated with the vestibular aqueduct expansion.Conclusion The onset age of GJB2 gene mutation children is concentrated in the infancy.Most of them are with very severe sensorineural deafness, not associated with the inner ear malformation.The onset age of SLC26A4 gene deafness children is concentrated in the early childhood.Most of them are with severe and extremely sever sensorineural deafness, closely related to vestibular aqueduct expansion and inner ear malformations.

Objective To study the effect of selective COX-2 inhibitor NS-398 on IL-1α and TNF a expression in HaCaT cells induced by UVA/UVB,and further to explore the mechanism on anti human skin photo damage. Methods The subcuhured HaCaT cells were divided into three groups:simple illuminated group was exposed to UVA/UVB directly,NS-398 interfered group was exposed to UVA/UVB after being treated with NS-398 in different concentrations,and the control group was cultured in normal without any treatment.The expression of IL -1α and TNF-α in supernarant was detected by ELISA kit.Results The level of IL-1α and TNF-α expression in supernatant from simple illuminated group was remarkably higher than that in the control group,NS-398 interfered group showed much lower level than the simple illuminated one,and the expression of IL-1α and TNF-α was dependent on the concentration of NS-398.Conclusions NS-398 can reduce IL-1α and TNF-α expression in HaCaT cells induced by ultraviolet rays,suggesting the possibility of anti human skin photo- damage effect.