Objective To analyze the influence of thoracoscopy combined with laparoscopy for radical operation of esophageal carcinoma and open ones on the perioperative effects and postoperative quality of life.Methods The data in 74 esophagus cancer patients in the thoracic surgery department of our hospital from October 2012 to June 2015 were collected and divided into the endo-scopic group and open group according to different operative ways.The perioperative effects and complications in the two operation ways were analyzed.The EORTC QLQ-C30 and QLQ-OES18 were used to conduct the questionnaire investigation and comparative analysis.Results The mean intraoperative blood loss,postoperative catheter drainage,hospitalization time,occurrence rates of post-operative complications such as pneumonia,hydrothorax and gastric emptying disorder in the endoscopic group were lower than those in the open group,while the operative time was longer than that in the open group,the differences were statistically significant (P <0.05).The total healthy status and function scores at postoperative 1,12 weeks in the two groups were decreased and symp-tom scores were increased,which at postoperative 24 weeks were back to close to preoperative level.The scores in the aspects of to-tal healthy status,physical functioning,role functioning,social functioning,fatigue,pain,dyspnea and difficultly coughing at postop-erative 1,12 weeks in the endoscopic group were superior to those in the open group,in which the scores of total healthy status, physical functioning and fatigue symptom at postoperative 24 week were still superior to those in the open group,the differences were statistically significant(P <0.05).Conclusion Thoracoscopy combined with laparoscopy for radical operation of esophageal carcinoma has the advantages in the aspects of intraoperative blood loss,catheter drainage,hospitalization time,some postoperative complications and QOL scores,but the operative time is longer.

Objective To analyze the use of narcotic drugs and the first class of psychotropic drugs in inpatient pharmacy of Wuhan Red Cross Hospital from 2011 to 2015.Methods Using the defined daily dose (DDD) which recommended by WHO as an index, and the dispensatory and clinical routine dose recommended by Chinese Pharmacopoeia and New Materia Medica as references.Adopting DUI as the statistic index, the drug's variety, quantity, sums and use frequency of the narcotic drugs and the first psychotropic drugs in inpatient pharmacy of our hospital from 2011 to 2015 were analyzed.Results According to the results, there was an increasing trend in sales amount from 2011 to 2015,among them,4 kinds of injections, 2 kinds of oral tablets,1 kind of transdermal patch and 1 kind of the sustained-release tablets.The sales amount of narcotic drugs showed an upward trend year by year.Conclusion In the past 5 years,the use of narcotic drugs and the first class of psychotropic drugs in inpatient pharmacy of the hospital are basically rreasonable, but it still needs to continuously strengthen the knowledge management of narcotic drugs and the related training, so as to ensure safe and effective use of medication in patients.

The level of HLA-antibody and sensitization can be predicated by the determination of panel reactive antibody(PRA)which is of great significance in preventing hyperaeute and accelcrated rejection.The sensitivity of PRA is markedly higher than CDC.The level of PRA(positive rate above 50%)is closely relevant,to the degree of rejection and the decrease of graft survival.Although plasma exchange(PE)can be used to decrease the level of PRA before transplantation to prevent hyperacute and accelerated rejection,good HLA-matching is more important in securing a successful graft patient.Control study between random panel lymphocytotoxicity test(RPLT)and PRA showed that RPLT is a simpler and more dependent and more easily practised method to predict the sensitivity of recipients of renal transplantation.

Objective To study the risk factors of complications of 364 cases in treatment of rad-ical esophagectomy.Methods 364 patients underwent two or three-incision radical esophagectomy and the clinic data were retrospectively analyzed.After review of the reference,ten factors were regarded as the potential risk factors of postoperative complications,then univariate and multivariate analyses were per-formed.Results In 364 patients,66 patients had complications of this research field within postoperative 6 months.By univariate analysis,preoperative nutritional risk score、T-staging、preoperative complications、operation time、operation experience、anastomotic position、anastomotic extra manual suturing were deter-mined as influence factors.By multivariate analysis,preoperative nutritional risk score≥3、T-staging score≥3、preoperative complications、operation time≥240 min、cervical anastomosis were determined as risk factors,anastomotic extra manual suturing was determined as a protective factor.Conclusion The risk factors of the complications after radical esophagectomy are preoperative nutritional risk score≥3、T-stag-ing score≥3、preoperative complications、operation time≥240 min、cervical anastomosis;and the protective factor is anastomotic extra manual suturing.Paying attention and controling these risk factors may reduce the occurrence of postoperative complications.

Objective To investigate the effects of nitric oxide (NO) and cholecystokinin (CCK) on the regulation of the motility of sphincter of Oddi (SO).Methods The basal pressure,action rate and contraction range of the SO were examined before and after the injection of CCK,sodium nitroprusside (SNP) and NG-nitroL-argininemethyl ester hydrochloride (L-NAME).The expression of neurons with positive expression of NO synthase was detected by immunohistochemical staining.The measurement data were analyzed by using the t test.Results The basal pressure,contraction rate and contraction range of the SO were (27 + 10)mm Hg (1 mm Hg =0.133 kPa),( 10 ± 3 ) times/minute and (32 + 8 ) mm Hg before injection of CCK,and (61 + 14) mm Hg,(64 +21 ) times/minute,(44 ± 15 ) mm Hg after injection of CCK of 20 ng/kg.After injection of CCK of 100 ng/kg,the basal pressure,contraction range and contraction rate of the SO were (77 ± 31 )mm Hg,(69 ± 18 ) times/minutes,(79 + 14) mm Hg when the inhibition effect of CCK reached peak,and were ( 140 ± 21 ) mm Hg,( 129 ± 25 )times/minutes,( 173 ± 63 ) mm Hg when the excitatory effect of CCK reached peak.After injection of SNP into the common bile duct,the basal pressure,contraction range and contraction rate of the SO decreased significantly ( t =3.706,5.183,P ＜ 0.05),while the 3 indexes increased significantly after injection of SNP (t =5.859,3.588,P ＜O.05).Conclusion Different from physiological dose (20 ng/kg) of CCK,large dose of CCK enhances motility of SO intensively.NO relaxes SO,which may play an important role in the inhibitor pathway of CCK.

Objective To explore the effects of restraint water-immersion stress (RWIS) on the firing activities of pyramidal neurons in the medial prefrontal cortex (MPFC) of rats.Methods Multi-channel in vivo recording techniques were used to record firing activities of pyramidal neurons before and during 4-h RWIS in rats.Firing rates,inter-spike intervals and burst firing rates were taken as indices to study the influence of RWIS on neuronal firing activities.Results Twenty-five pyramidal neurons of 12 rats were recorded.The opposite patterns of firing activities were observed in two different classes of neurons,type A and type B neurons which account for 72％ and 28％,respectively.In type A neurons,inhibited firing activities were in direct proportion to the stress-exposure.Mean firing rates and mean burst firing rates were significantly reduced to (0.81 ± 0.11) Hz and (1.012 ± 0.50) counts/min after 4h constant RWIS compared with those before RWIS,(3.57 ± 0.63) Hz and (10.29 ± 3.04) counts/min.However,in type B neurons,firing activities were enhanced.After 2h constant RWIS,mean firing rates and mean burst firing rates were increased from (1.77±0.45) Hz and (2.01±0.73) counts/min to (2.67±0.74)Hz and (9.04±2.42) counts/min,respectively.Moreover,the percentage of spikes in bursts was significantly increased and mean inter-spike intervals were remarkably shortened.Interestingly,the effect of RWIS on type B neurons lasted for shorter time compared with its effect on type A neurons.Conclusion RWIS differentially affects the firing activity of pyramidal neuron in the MPFC,i.e.,inhibiting the firing activity of type A neurons,but enhancing the firing activity of type B neurons.

AIM: AIM: To explore the relationship between apoptosis in the lung tissues and lung ischemia/reperfusion injury, and observe effects of panax notoginseng saponins (PNS) on apoptosis in lung ischemia/reperfusion injury. METHODS: Single lung in situ ischemia/reperfusion animal model was used. Eighty four Japanese white rabbits were randomly divided into control group (control), ischemia/reperfusion 1 h group (IR1h), IR3h, IR5h, Panax Notoginseng Saponins 1 h group (PNS1h), PNS3h and PNS5h. TUNEL, immunocytochemistry and in situ hybridization techniques were used to observe apoptosis and Fas/FasL expression in various phases of lung ischemia/reperfusion. RESULTS: Cell apoptosis in lung tissues were significantly high, Fas/FasL mRNA and its protein were up-regulated in lung tissues of lung ischemia/reperfusion injury compared with control (all of P

Purpose:The image information and technique of positron emitter nuclei generated by high energy X-ray photonuclear reactions with body tissues from MM50 is studied.It is explored to verify for dose delivery and location monitoring in tumor target after high energy photon radiation therapy with the image information.Materials and Methods:The technique is based on the photonuclear reactio-as in body tissues elemental composition ~(12)C,~(16)O and ~(14)N with high energy X-Ray,energies well above 20 MeV,resulting primarily in ~(11)C and ~(15)O but also ~(13)N.The induced positron activity distributions were scanned off-line in a PET/CT after irradiation.The activity distributions and position may be used to verify for dose delivery and location in tumor target.These radiations are similar to RT in three fields with some different dose delivery from TPS.The phantom began to be scanned off-line in a PET/CT a couple of minutes after irradiation.The scanning time is respectively 20 minutes and(2～5)mniutes for ~(12)C and ~(16)O.The levels of the beam energy are 10MV,25MV,50 MV.The extent of dose is 1.0 Gy～10.0 Gy.Since measured PET images change with time post irradiation,as a result of the different decay tim-es of the radionuclides,the signals from activated ~(12)C,~(16)O within the irradiated volume could be separated from each other.Most informationis obrained from the carbon and oxygen radionuclide's which the most abundant elements are in soft tissue.A brain phantom Rlade oneself was irradiated with high energy X-ray beams from IBA MM50.The 3D radiation treatment planning system,Nucletron-TPP 3.2,was used to calculate the delivered dose distributions.The phantom was directly simulated in the Nucletron-TPP after CT scan.PET/CT is fro-m GE Discovery LS Ⅱ.Resuits:It was confirmed that no activity was detected at 10 Mv X-ray energy,which was far below the energy threshold for photonuclear reactions.Totally 25 MV X-ray beams can produce photonuclear reactions and get to activity distributions images in PET/CT.It need to greater dose in order to good images information.For 50 MV X-ray beams,2 Gy-3 Gy dose,a normal RT dose,can get to activity distributions images.Conclusions:It was concluded that the PET-CT image acquired from the activity of the ~(15)O and ~(11)C positron emitter nuclei might provide the area and dose distribution information of 50 MV X-ray irradiation in a phantom.It can verify the in vivo dose delivery and location in tumor target after high energy X-ray RT.

AIM: To investigate the effect of puerarin (Pur) on expression of Fas/FasL mRNA in lung tissue during pulmonary ischemia and reperfusion injury(PIRI) in rabbits.METHODS: Single lung ischemia and reperfusion animal model was used.The rabbits were randomly divided into three groups,sham operated group(sham,n=10),PIR group(I-R,n=30) and PIR+ Pur group(Pur,n=30).Changes of several parameters included apoptotic index(AI),wet to dry ratio of lung tissue weight(W/D) and index of quantitative assessment of histologic lung injury(IQA) were measured at 60,180 and 300 minutes after reperfusion in lung tissue.Meanwhile,the location and expression of Fas/FasL mRNA were observed.Lung tissue was prepared for light microscopic and electron microscopic observation at 60,180,300 minutes after reperfusion.RESULTS: As compared with group I-R,Fas/FasL mRNA slightly expressed in intima and extima of small pulmonary artery,alveoli,and bronchiole epithelia in group Pur.The values of AI,W/D and IQA showed significantly lower than that in group I-R at 60,180,300 minutes after reperfusion in lung tissue(P

BACKGROUND: As it results in minimal trauma and physical influence or interference, and a better curative effect, the minimally invasive surgery is preferred in clinic. However, the perioperative stress reaction of minimally invasive surgery needs further study.OBJECTIVE: To evaluate the levels of neurohormone, C-reactive protein (CRP) and the changes of resting energy expenditure (REE) resulted from the operative stress reaction due to minimally invasive surgery in arthroscopy on knee joint.DESIGN: Controlled observation and analysis.SETTING: Department of Orthopaedics, Affiliated Hospital of Xiangnan University and Department of Orthopaedics,Xiangya Hospital of Central South University.PARTICIPANTS: Sixteen patients with meniscal lesions in knee and 26 with cruciate ligament injury, which were closed injury, were selected from the Department of Orthopaedics of Affiliated Hospital of Xiangnan University and Xiangya Hospital of Central South University between January 2003 and April 2004. Meniscal lesions were diagnosed according to the physical examination, drawer test combined CT and MRI examination, and the patients were in accordance with the indication of arthrotomy; cruciate ligament injury according to the physical examination, grinding test combined CT and MRI examination. Those with open injury, body multiple injury, combined injury and emergency operation were excluded. Ten patients with meniscal lesions and 12 with cruciate ligament injuries underwent minimally invasive surgery on knee joint as minimally invasive surgery group (MIS). The others were given traditionally invasive surgery on knee joint as the traditional group. The informed consent was obtained from the patients.METHODS: Fasting venous blood was taken on the morning of 1 day before, and 1 and 3 days after operation, which was analyzed within 2 hours after sampling. ①All hormones were quantitatively assayed. Serum insulin was determined by competitive radioimmunoassay (RIA); growth hormones levels by double-antibody RIA; serum cortisol by competitive RIA; CRP by nephelometry, respectively. ②Energy metabolism detection: The energy consumption was assessed by indirect calorimeter on the morning of 1 day before, 1 day and 3 day after operation, respectively. All the detection was performed by medical graphics critical care monitor desktop analysis system. Based on the indirect calorimeter theory,REE and respiratory quotient (RQ) were figured out.MAIN OUTCOME MEASURES: ①Concentrations of insulin, growth hormones and cortisol of patients at 1 day before, 1 day and 3 day after operation; ②Resting energy consumption, RQ and CRP of patients at 1 day before, 1 day and 3 day after operation.RESULTS: Totally 42 patients were involved in the result analysis. ①On the third postoperative day, the insulin levels of the traditional group were lower than those before operation [(12.4±1.1), (17.5±2.2) mlU/L, P ＜ 0.05]; On the first postoperative day, the levels of growth hormone of the traditional group were significantly higher than the MIS group [(2.8±0.9), (5.3±2.4) μg/L, P ＜ 0.05], and on the third day after operation, the levels of the MIS group were remarkably increased compared with those before operation [(1.4±0.5), (1.0±0.3) μg/L, P ＜ 0.05]; the cortisol levels of the traditional group on the first postoperative day were higher than the MIS group [(1.12±0.25), (0.59±0.11) μmol/L, P ＜ 0.05]. ②REE levels of the traditional group and MIS group on the first day after operation were(1437.8±415.9) and (1223.8±179.9) K,higher than those before operation [(1 186.4±297.4), (1 160.7±158.6) K, P ＜ 0.05]; on the first and third days after operation, REE levels of the MIS group were higher than the traditional group [(1 223.8±179.9), (1 151.7±150.8) K;(1 437.8±415.9), (1 329.4±350.5) K, P ＜ 0.05]. ③RQ of the traditional group and MIS group on day 1 after operation were all (0.8±0.05), lower than that before operation (0.9±0.11, 0.9±0.15, P ＜ 0.05). ④On the first and third days after operation, CRP of the MIS group were lower than the traditional group [(14.8±2.5), (34.37±7.5) mg/L; (64.1±14.4),(93.87±12.7) mg/L, P ＜ 0.05], but higher than that before operation [(8.0±0.11) mg/L, P ＜ 0.05].CONCLUSION: Minimally invasive surgery on knee joint results in less trauma, low stress reaction and slight influence on metabolism of patients, moreover, it benefits the restoration of stress hormones, nitrogen balance and energy metabolism.