ObjectiveTo investigate the clinical effect of three-dimensional conformal radiotherapy simultaneously combined with XELOX program(oxaliplatin +capecitabine) for local recurrence of esophageal carcinoma after radiotherapy.MethodsSixty patients with local recurrence of esophageal carcinoma after radiotherapy were divided by random digits table method into treatment group and control group with 30 cases each.The patients in treatment group were treated with three-dimensional conformal radiotherapy simultaneously combined with XELOX program chemotherapy.While control group received three-dimensional conformal radiotherapy.The efficacy between two groups were compared.ResultsThe complete remission rate and efficiency rate in treatment group were significantly higher than those in control group [ 53.3％ (16/30) vs.23.3％ ( 7/30 ),86.7％ ( 26/30 ) vs.63.3％ (19/30) ] ( P ＜ 0.05 ).The 1,2,3-year survival rate and median survival time in treatment group were 65.5％,44.8％,34.5％ and 24.8 months,which were significantly higher than those in control group (48.3％,41.4％,6.9％ and 12.1 months)(P ＜0.01 ).The incidences of radioactive esophagitis,radioactive pneumonia and thrombocytopenia in treatment group were higher than those in control group,but there were no statistical differences between two groups (P ＞0.05).The incidences of nausea,vomiting,leukocyte decrease and anemia in treatment group were significantly higher than those in control group [36.7％(11/30) vs.13.3％(4/30),40.0％(12/30) vs.16.7％(5/30),43.3％( 13/30 ) vs.13.3％(4/30),P ＜ 0.05 ].ConclusionsThree-dimensional conformal radiotherapy simultaneously combined with XELOX program can improve short-term efficacy and long-term survival rate of local recurrence of esophageal carcinoma after radiotherapy.

Laparoscopic surgery for upper-third gastric cancer has gradually been accepted by experienced surgeons as the mature of this technique.Different from the standardized and programmed D2 lymph node dissection in Laparoscopy-assisted Billroth Ⅰ gastrectomy,the indications and methods for laparoscopic splenic hilar lymphadectomy in the upper-third gastric cancer remains controversial.Unsolved problems include joint organs resection,appropriate surgical approach selection and variable vascular anatomy of the splenic hilum.Meanwhile,the long-term efficacy and safety of laparoscopic splenic hilar lymphadectomy for the upper-third gastric surgery need to be confirmed by evidence-based medical trials.With the advance of the theory and clinical practice,laparoscopic splenic hilar lymph node dissection will continue to progress.

OBJECTIVE: To study the absorption and transport of pachymic acid (PA) isolated from the sclerotium of Poria cocos (Schw.) Wolf. in human intestinal epithelium. METHODS: By using Caco-2 (the human colonic adenocarcinoma cell lines) cell monolayers as an intestinal epithelial cell model, the permeability of PA was studied from apical side (AP side) to basolateral side (BL side) or from BL side to AP side. The PA was measured by reversed-phase high performance liquid chromatography coupled with UV detector at maximum absorption wavelength of 210 nm. Transport parameters and apparent permeability coefficients (Papp) were then calculated and compared with those of propranolol and atenolol, which were the transcellular transport markers for high and poor permeability respectively. RESULTS: The Papp values of PA were (9.50+/-2.20) 10(-7) cm/s from AP side to BL side, and (11.30+/-5.90) 10(-7) cm/s from BL side to AP side, respectively. Under the condition of this experiment, the Papp values were 1.45x10(-5) cm/s for propranolol and 4.22x10(-7)cm/s for atenolol. CONCLUSION: PA is transported through the Caco-2 cell monolayer in a concentration-dependent manner and the transport was linear with time. The absorption in apical to basolateral direction and secretion in basolateral to apical direction were poor and their Papp values were comparable to atenolol. Besides passive diffusion of PA, ATP is partially involved in its transport.

Objective To investigate the association of the SNP in miRNA146A with genetic prediposion and earlier recurrence after resection for hepatocellular carcinoma (HCC).Methods In the casecontrol study including 173 HCC cases,DNA were exacted from cancer tissue embedded with paraffin and were amplificated by PCR,SNP was explored in gene sequence of miRNA146a (385 base pair including extron).The outcome were analyzed with genetic prediposion and clinical features.Result Only hsa-mir-146a rs2910164 was found.The genetype frequence of C/C 、G/G and C/G at rs2910164 gene locus were separately 61 (35.3％),21 (15％) and 86(49.7％) in cases.Compared to G/G genetype,C/C and C/G genetype were danger factor to onset risk of HCC (OR =3.086,95％ CI:1.289-7.390) ; C/G was danger factor to earlier recurrence after resection(OR =8.179,95％ CI:2.248-29.759).Conclusion rs2910164 may be associated with genetic prediposion and earlier recurrence after resection of HCC in Jiangxi hans

Objective To observe the effects of serum intefleukin-8,-4,-9 levels on the children with bronchus asthma.Methods 186 cases of children with bronchus asthma in our hospital during May 2010 to December 2010 were randomly selected,and given routine clinical therapy for 6 months,observing the serum interleukin-8,-4,-9 levels before and after treatment.Results The serum interleukin-8,-4,-9 levels of the children with bronchus asthma was higher than normal,but after treatment,the levels were totally decreased,there had a significant difference in the indexes.Conclusion The serum interleukin-8,-4,-9 levels was a good kind of reference index of disease progressed and effect determination in the children with bronchus asthma,it can more accurate evaluated the occurrence,development,metastasis and curative effect of asthma.

Objective To evaluate the imaging quality and diagnostic value of different MR sequences for abnormalities of knee cartilage. Methods Three sequences of MR, including double echo steady state (DESS), multi echo data imagine combination (MEDIC) and true fast imaging with steady state precession (TrueFISP) were performed in 18 healthy volunteers. Signal-to-noise ratio (SNR) of knee cartilage and contrast-to-noise ratio (CNR) to surrounding tissues were measured and compared. Results SNR of cartilage was the highest in MEDIC sequence imaging, CNR of cartilage-synovia was the highest in DESS sequence imaging among three sequences (P<0.05). Conclusion Compared with the other sequences, DESS seems to be optimal in diagnosis of abnormalities in knee cartilage.

Objective:To investigate the use of antibacterial drugs during the perioperative period of a cesarean section and observe the differences before and after antibacterial drug remediation. Methods:1 569 cesarean cases from 2010 to 2012 were investigated, and the use of antibacterial drugs, drug categories, drug combinations, medical expenses, and so on was statistically analyzed with the use of the statistical software SPSS13. 0. Results:The rate of antibacterial drug usage within the 1 569 cesarean cases was 100%;for pre-operative antibacterial drug remediation, azithromycin, cefathiamidine, and ornidazole were the top three, while the top three antibacterial drugs for post-oper-ative remediation were arecefathiamidine, cefuroxime, and clindamycin. There was no significant difference between the two groups of incision infections, and the rate for combined use of drugs dropped. The analysis of drug costs is of statistical significance. Conclusion:The analysis of antibacterial drug remediation is useful for the rational use of anti-bacterial drugs and a reduction of costs.

Objective To analyze the clinical effects, as well as its advantages and disadvantages, of laparoscopic surgery for appendicitis in obese patients. Methods Clinical data of 80 obese patients receiving appendectomy, including 38 cases of open appendectomy and 42 cases of laparoscopic appendectomy, were analyzed retrospectively.The operative time, blood loss, analgesic and antibiotic use, postoperative fever, postoperative complications, length of hospital stay, and hospitalization cost were compared between the two operative methods. Results Conversions to open surgery were required in 2 patients in the laparoscopic group. There was no significant difference in operative time between the 2 groups (P >0.05).Compared with the open group, the laparoscopic group had less blood loss [(14.98 ±12.77) ml vs.(31.58 ±19.00) ml, t=-4.550, P=0.000], shorter time of postoperative antibiotic use [(2.7 ±1.0) d vs.(4.1 ±1.2) d, t=-5.470, P=0.000], less postoperative analgesics needed [5.0%(2/40) vs.26.3%(10/38),χ2 =6.802, P=0.009], less drainage [2.5% (1/40) vs.18.4% (7/38), χ2 =5.367, P=0.021], less postoperative fever [5.0%(2/40) vs.23.7%(9/38),χ2 =5.616, P=0.018], less postoperative wound healing [5.0%(2/40) vs.21.1%(8/38),χ2 =4.493, P=0.034], and shorter hospital stay [(5.9 ±3.2) d vs.(8.7 ±4.1) d, t=-3.345, P=0.001], but the higher cost of hospitalization [(7800 ±396) yuan vs.(4914 ±434) yuan, t=30.716, P=0.000]. Conclusion For obese patients with appendicitis, laparoscopic appendectomy has less surgical trauma, faster recovery, less postoperative pain, fewer complications,and shorter hospital stay, being a preferred method of treatment.

Objective To evaluate the preoperative diagnostic procedures and treatment choice of primary tumor of the duodenum (PTD).Method The clinical data of 52 cases with PTD in the last 10 years was analyzed retrospectively.Results The correct diagnostic rate of auxiliary examination was:duodenal endoscopy of 90.5%,air barium double radiography of 80%.Six primary benign tumors of duodenum (PBTD)were resected completely with a 5 year's survival of 100%.Among the 46 cases of primary malignant tumors of duodenum (PMTD),28 cases underwent pancreatoduodenectomy,4 cases received segmental duodenectomy,the remaining 13 cases in which the tumors were unresectable were treated bypass.The resection rate was 69.6% and the 5 years' survival rate was 32.6%.Conclusions Duodenal endoscopy and air barium double radiography are mainstays for the diagnosis of PTD.Segmental duodenectomy and simple tumor resection are curable for PBTD; while for PMTD,the therapy of choice should be pancreatoduodenectomy.

Transforming growth factor β( TGF-β) plays an important role in regulating cell proliferation , differentiation and apoptosis , and also in the carcinogenesis .Unlike its tumor suppressor function in normal tissue , continuous activation of TGF-βsignaling pathway in inflammatory microenvironment and cancer tissue promotes the progression of hepatocellular carcino-ma ( HCC) .Loss of Smad4 and epithelial to mesenchymal tran-sition ( EMT ) may be the potential mechanisms how TGF-βtransforms from a tumor suppressor to a tumor promoter .Further studies on regulatory mechanism of TGF-βsignaling pathway are of great significance , which could provide new evidence for pre-venting and treating HCC .