Esophageal cancer is a unique malignant disease in China. A fundamental difference exists between the Chinese population and the western population on esophageal cancer in terms of epidemiology, histogenesis, and carcinogenic risk factors. Therefore, ap-plying the western academic achievements to Chinese is difficult. Thus, Chinese scientists have the responsibility to conquer esopha-geal cancer in China. This article reviews the progress of esophageal cancer focused on the molecular mechanism for interactions of ge-netic and environmental risk factors and human esophageal multistage carcinogenesis.

This study was based on the project prophase of expert consultation and literature consult, and aimed to analyze the medicine establishment from the perspective of traditional Chinese medicine (TCM) doctors, in order to further study the influence of medical insurance on the development of TCM. Detailed suggestions were made in or-der to promote the benign development trend of TCM and medical insurance. Questionnaire survey was used in the investigation on perceptions of TCM related with medical insurance among 253 TCM doctors in appointed medical institution of medical insurance. Data was processed with frequency statistics. The results showed that after becoming the appointed medical institution of medical insurance, the medical insurance patients have become the main service group (73.5%) of hospitals (68.4%) and incomes of TCM doctors (41.9%) have increased, which contribute to TCM hospitals of becoming bigger and stronger (63.6%). The medical insurance patients have chosen TCM treatment main-ly for its curative effect (37.9%) and safety (24.1%). The influence of reimbursement ratio in medical insurance was relatively low (1.2%). The reimbursement range of TCM medical insurance needs to be further expanded, such as Chinese medicine nosocomial preparation (90.5%), decoction preparation fee (78.3%), and etc. It was concluded that under the background of universal health coverage, medical insurance plays a more and more important role in the development of TCM. And TCM should ensure its safety and improve its curative effect through the standardization of TCM and other measures. Meanwhile, the formulation of medical security policy and medical insurance management service standards should also consider the characteristics of TCM, and encourage the service of TCM.

Aim To investigate the protective effects of Diterpene Ginkgolides Meglumine Injection(DGMI)on SY5 Y cells damaged by oxygen-glucose deprivation and its functional mechanisms.Methods After 4 h of OGD,the cells were treated with 25 mg·L-1 drugs for 1 h.Subsequently,cell viabilities were measured by cell counting kit-8(CCK-8 kit)and cell apoptosis was measured by flow cytometric analysis.Furthermore, the mitochondrial membrane potential was detected by rhodamine123 staining.The levels of phospho-p38, phospho-p53,Bcl-2,Bax and cleaved caspase-9/3 were evaluated by western blot.Results DGMI signif-icantly increased the cell viabilities of SY5 Y cells dam-aged by OGD,and reduced OGD-elicited dissipation of mitochondrial membrane potential and cell apoptosis. Furthermore,DGMI also reduced p-p38,p-p53,Bax/Bcl-2 ratio,cleaved caspase-9 and cleaved caspase-3. Conclusion DGMI shows good neuroprotective effects on SY5 Y cells after oxygen-glucose deprivation.The underlying mechanisms may be associated with the sup-pression of p38/p53/Bcl-2 /caspase-9/caspase-3 sig-naling pathway.

Objective To investigate the common risk factors of primary hepatocellular cancer (PHC) in Guizhou province . Methods The group case-control study was adopted .The main related-factors of primary PHC in Guizhou provincial population and the relation between drinking combined hepatitis B viral infection with the PHC occurrence were analyzed by the unconditional Logistic regression analysis and the stratification analysis .Results Drinking(OR=2 .948 ,95% CI 2 .096-4 .146 ,P=0 .000) ,eco-nomic status 5 years ago(OR=0 .386 ,95% CI 0 .279 -0 .534 ,P= 0 .000) ,family history of PHC(OR= 2 .402 ,95% CI 1 .372 -4 .206 ,P=0 .002) ,cigarette smoking (OR=3 .468 ,95% CI 2 .265 -5 .311 ,P=0 .000) ,chronic liver disease(OR= 1 .502 ,95% CI 1 .054-2 .141 ,P=0 .024) ,HBV infection(OR=31 .999 ,95% CI 19 .318 -53 .002 ,P=0 .000) and diabetes mellitus(OR=4 .750 , 95% CI 2 .761-8 .171 ,P=0 .000) ,the differences between the patients group and the control group had statistical significance ;the OR value of drinking combined with HBV infection was 96 .903(95% CI 35 .265-266 .275 ,P=0 .000) .Conclusion HBV infection is still the common risk factor of PHC in Guizhou provincial population .Drinking can increase the risk in the individuals infected with HBV .

Objective:To investigate the expression level of synaptophysin (Syn), tissue neuronal cell adhesion molecule 56 (CD56) and chromogranin A (CgA) in 92 primary esophageal small cell carcinoma (PESC) and to explore its repationship with clinicopathological features and clinical outcome. Methods:Immunohistochemical studies of CD56, CgA, and Syn were performed in 92 paraffin-embed-ded tissues with clinical-related information obtained from 500,000 esophageal and gastric cardia carcinoma databases established by Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital of Zhengzhou University in Henan, China. Binary logistic regression was used to analyze the correlations of CgA, Syn, and CD56 expression with clinicopathological features. Kaplan-Mei-er survival analysis and Cox proportional hazards regression models were performed for univariate and multivariate survival analyses. Log-rank test was used to compare the difference in survival rates. Results:The CgA-positive expression rate in PESC at lower segment of esophagus (72.2%) was higher than those at the middle and lower segments (41.1%, 10.0%) (P=0.001). The expression level of CD56, CgA, and Syn was not correlated with gender (P=0.262, 0.998, 0.931), age (P=0.250, 0.998, 0.703), tumor invasion (P=0.253, 0.997, 0.061), and lymph node metastasis (P=0.767, 0.998, 0.613). Univariate analysis showed no survival influence in patients with and without lymph node metastasis (P=0.563). Multivariate survival analysis showed that patients with PESC mixed squamous cell car-cinoma (HR=2.58;95%Cl, 1.11-5.98) and higher CgA protein expression (HR=1.87;95%Cl, 1.02-3.43) exhibited a longer survival time than those with pure PESC and without CgA expression. Conclusion:Tissue CgA level was associated with tumor location in PESC. His-tological type and tissue CgA expression were independent important prognostic factors, and lymph node metastasis exerted no influ-ence on survival in PESC.

Objective: To assess the trends in clinical characteristics, treatment, and outcomes for hospitalized patients undergoing percutaneous coronary intervention (PCI) in central-western urban hospitals of China in 2001, 2006 and 2011. Methods: We used a 2-stage, random sampling strategy to create a Chinese central-western urban hospital representative sample of 2152 patients undergoing PCI at 26 hospitals in China PEACE- retrospective CathPCI study and calculated the weighted data of clinical information in each year. Results: Between 2001 and 2011, the admission rate for PCI increased by 46 folds. Compared with 2001, the patients undergoing PCI were more likely to be female, older than 80 years, and to have history of diabetes, dyslipidemia and PCI in 2011. The proportion of trans-radial PCIs increased from 3.5% in 2001 to 87.6% in 2011 (Ptrend < 0.0001); the proportion of drug eluting stents (DES) among all the implanted stents increased from 16.4% in 2001 to 95.7% in 2011 (Ptrend < 0.0001), largely due to increased use of domestic DES. Less than 5% of medical record of admission for PCI documented door time and balloon time. The median length of stay decreased from 13 days in 2001 to 10 days in 2011 (Ptrend < 0.0001). In-hospital mortality did not change signiifcantly, but both any bleeding and access bleeding events were decreased signiifcantly over time (Ptrend < 0.05). Conclusion: There has been a rapid increase in the volume and significant change in treatment patterns of PCI over the 10-year period from 2001 to 2011 in Chinese central-western urban hospitals. We identiifed quality gaps that represent opportunities to improve medical care.

Cytomegalovirus infection is one of the most common diseases of newborn viral infection,can cause neurological,digestive,respiratory and blood system damage.In addition to the diagnosis of jaundice,impairment and other clinical manifestations,this disease's diagnosis mainly depend on laboratory examination.Therefore,the application of a sensitive and specific method for early diagnosis of congenital cytomegalovirus(CCMV) infection is particularly important advances in clinical detection method and the research of CCMV infection is reviewed.

Objective:To investigate the clinicopathological characteristics, treatments, and survival of patients with esophageal adeno-squamous carcinoma (EASC). Methods:A total of 494 patients with EASC were selected from the clinical information databases of 500, 000 cases with esophageal and gastric cardiac carcinomas in the Henan Key Laboratory for Esophageal Cancer Research. Among the 494 EASC cases, 361 were males with an average age of 61.47 ± 8.32 years, and 133 were females with an average age of 65.56 ± 8.06 years. SPSS 21.0 software was applied to determine the statistical differences among the different groups. A life-table method was also used to calculate the five-year survival rate. A linear regression model was used to analyze the correlation of changes at different peri-ods. Results:The incidence of EASC in our database was 0.196%(494/251707). EASC occurred predominantly in male patients (male:female=2.71:1.00). The peak age was within 60-69 years in both males and females (39.6%vs. 40.6%). Notably, the incidence of male patients showed a downward trend (R2=0.063), whereas that of female patients showed an upward trend (R2=0.004). The prevalence of EASC was obviously higher in low-incidence areas for esophageal cancer than in high-incidence areas (53.1%vs. 46.9%, P<0.001). Ac-cording to the TNM staging criteria for esophageal cancer, phases II and III patients comprised the majority of cases, which accounted for 40.8%(173/424). The positive lymph node metastasis rate was 47.0%(206/438), and the number of positive lymph node metasta-ses ranged within 1-2 (48.5%, 100/206). In addition, preoperative biopsy was performed in 467 cases, and more than half of the pa-tients (53.96%, 252/467) were diagnosed before the operation. Surgical resection was the predominant treatment method for EASC (88.8%, 419/472). Only 1.9%patients (9/472) underwent radiotherapy and chemotherapy. The five-year survival rate of male patients who were neither smoking nor drinking of alcohol was higher than that of male smokers (26.5%vs. 12.1%). In patients with stagesⅠ,Ⅱ, andⅢ+Ⅳcarcinomas with surgery as lone treatment, the three-year survival rates were 64.7%, 50.9%, and 48.5%, respectively. Correspondingly, these rates were 51.7%, 47.8%, and 33.1%after adjuvant radiotherapy and chemotherapy. Conclusion:EASC is a rare type of esophageal malignant tumor. The preoperative biopsy pathological diagnosis has high misdiagnosis rate. Smoking and drinking of alcohol can influence the prognosis of patients. In EASC patients, lymph node metastasis easily occurs, and a simple surgery is bet-ter than other cancer treatments.

Objective:To elucidate the factors influencing the differences in the survival rates of esophageal squamous cell carcinoma (ESCC) patients between the rural and urban regions in China. Methods:A total of 36,723 ESCC patients derived from the clinical data-bases containing 500,000 esophageal and gastric cardia carcinoma cases (1973-2015) of the Henan Key Laboratory for Esophageal Can-cer Research of the First Affiliated Hospital, Zhengzhou University, were analyzed. Of these patients, 33,625 were from the rural re-gions (91.6%), comprising 20,906 male patients with an average age of 58.98 ± 8.71 years and 12,719 females with an average age of 59.59 ± 8.53 years. The remaining 3,098 were from the urban regions and composed of 2,089 male patients with an average age of 60.84±9.10 years and 1,009 females with an average age of 62.46 ± 9.14 years. All the patients underwent radical esophagectomy, de-tailed histopathological diagnosis, and TNM staging. Chi square test, Kaplan-Meier, Log-rank, and Cox proportional hazards regression model were used to analyze the differences between ESCC patients from rural regions and those from urban regions and among the risk factors in prognosis. Results:Kaplan-Meier and Log-rank analysis results showed that the ESCC patients from the rural regions had significantly higher overall survival than the urban patients (χ2=12.971, P=0.000). Further analysis showed that rural patients≥50 years old and diagnosed with stage IIa and IIb (middle stage) ESCC had higher survival rates than urban patients in males and females (male:χ2=16.188, P<0.001;female:χ2=5.019, P=0.025). However, the survival rates of rural and urban patients with stage 0,Ⅰa,Ⅰb (early stage) and Ⅲa, Ⅲc, and Ⅳ (late stage) were similar (P>0.05). The results of Cox proportional hazards regression model analysis showed that age, gender, and TNM stages were independent risk factors for rural and urban ESCC patients. When the rural and urban ESCC patients were both considered, the Cox proportional hazards regression model analysis results showed that male ESCC patients≥50 years old, urban residence, and TNM stages were independent risk factors. Conclusion:Rural ESCC patients have significantly high-er overall survival than urban patients. Male, age of≥50 years old, urban residence, and TNM stages were independent risk factors for ESCC patient survival.