Background:Concurrent chemoradiotherapy (CCRT) significantly increases the survival rate of esophageal squamous cell carcinoma (ESCC) patients with malignant fistulae.Recent clinical evidence has shown the benefits of enteral nutrition for malnourished cancer patients.In this study,we aimed to validate that,with the support of enteral nutrition,ESCC patients who develop malignant fistulae might be able to complete CCRT and achieve long-term survival.Methods:We reviewed the medical records of 652 patients with ESCC who received definitive CCRT at Sun Yat-sen University Cancer Center between January 2010 and December 2012.Treatment outcome and toxicity were retrospectively evaluated in 40 ESCC patients with malignant fistulae.All the 40 patients were treated with CCRT and evaluated by clinical nutritionists using nutrition risk screening (NRS) before,during,and after treatment.Twenty-two patients received a nasogastric tube,and 18 underwent percutaneous endoscopic gastrostomy feeding.The median energy intake was 2166 kcal/day.Treatment response was evaluated at 3 months after the completion of CCRT.Results:With a median follow-up of 18 months (range,3-39 months),patients' 1-year overall survival (OS) rate was 62.5％,and the estimated OS time was 25.5 months.Univariate analysis showed that the NRS score (P =0.003),increase in NRS score (P =0.024),fistula closure (P =0.011),and response to treatment (P ＜ 0.001) were significantly associated with OS.Multivariate analysis showed that tumor response (P =0.044) and increase in NRS score (P =0.044) were independent predictors of OS.Grade 3 vomiting was observed in 8 patients (20.0％),grade 3 neutropenia was observed in 11 patients (27.5％),and grade 3 cough was observed in 13 patients (32.5％);2 patients (5.0％) died of massive bleeding during treatment.Conclusions:CCRT combined with enteral nutrition support is effective for ESCC patients with malignant fistulae.Patients have an increased potential to be cured,especially those who experience complete response and have an increase in NRS score.Careful observation and nutrition support are required for patients with advanced T-category ESCC who undergo CCRT.

AlM: To evaluate the effect of rigid gas permeable contact lens ( RGP ) in correcting high myopia and astigmatism.METHODS: Forty-one patients ( 65 eyes ) with myopia (-9. 03 ± 6. 19DS, maximum -23. 00DS) and astigmatism (-1. 41 ± 1. 32DC, maximum -5. 50DC) were fitted with RGP after strict routine ophthalmological examination, objective refraction and subjective refraction. All these patients were followed after 1wk, 1, 3mo and half one year.RESULTS:Sixty-five eyes were fitted with RGP (-9. 92± 5. 96DS). RGP base curve ( BC) was majorly located within the range 7. 20 ~8. 25mm. 46. 2% eyes with RGP achieved 1. 0 ( BCVA ) and 80. 1% achieved above 0. 6 ( BCVA) . However, with spectacles, the percent was 28%(1. 0) and 60% (>0. 6), respectively. BCVA of RGP was 0. 81 ± 0. 22, but BCVA with spectacles was 0. 66 ± 0. 28, there was statistical significance (P<0. 01). There were 40 eyes (62%) fitted with RGP whose vision were enhanced more than 1 line, 24 eyes ( 37%) whose vision were not changed and 1 eye (2%) whose vision were dropped 1 line.CONCLUSlON:RGP effectively improves visual acuity of high myopia and astigmatism compared with spectacles.

0.05).The height and weight of the children with good balancing function were weightier and higher than those of poor function children(Pa

Objective To realize the status in the implementation of three industry standards of central sterile sup-ply department (CSSD),and provide a scientific basis for carrying out of the standards. Methods According to three standards,investigation forms were designed by specialists,written survey on 365 hospitals in 9 provinces and field investigation on 1 5 hospitals in 3 provinces were performed,the implementation of three standards were investi-gated.Results Of 365 hospitals,the number of provincial and ministerial level,municipal level,and county level hospitals were 90,87 and 188 respectively. More than 94% of hospitals established CSSD management system and regulations,>90% of hospitals met the requirements of CSSD layout;All hospitals were equipped with pressure steam sterilizer,all levels of hospitals basically equipped with the necessary equipments and facilities;CSSD respon-sible officers of 94.52% (345/365)of hospitals participated in training on standards;69.61% (252/362)of hospi-tals were using or developing CSSD information systems;>92% of the CSSD responsible officers considered that three standards played an important role in facilitating centralized management,and improving the quality of clean-ing,disinfection and sterilization.Conclusion Hospitals need to strengthen the management and training on stand-ards of CSSD,management of loaner instruments and development of information system need to be standardized.

Objective:To describe the expression profiling of microRNAs of patients with non-small cell lung cancer. Methods:We reduced the scope of downregulated microRNAs in patients with non-small lung cancer by high throughput microarray based on quantitative real-time PCR (qRT-PCR). In this process, the downregulated microRNAs of non-small cell lung cancer tissues can be de-tected and compared with adjacent healthy lung tissues with relatively small samples. Different microRNA expression levels in non-small cell lung cancer and adjacent healthy lung tissues were verified in a large sample by RT-PCR. Results:A total of 20 types of microRNAs were significantly downregulated in non-small cell lung cancer tissues compared with adjacent healthy lung tissues. These microRNAs were listed as follows: hsa-miR-1; hsa-miR-22; hsa-miR-27a; hsa-miR-27b; hsa-miR-125a-5p; hsa-miR-125b;hsa-miR-142-5p;hsa-miR-143;hsa-miR-148a;hsa-miR-148b;hsa-miR-370;hsa-miR-373;hsa-miR-381;hsa-miR-489;hsa-miR-519a;hsa-miR-376c;hsa-miR-206;hsa-miR-380-5p;hsa-miR-223-5p;and hsa-miR-520c-3p. Among these microRNAs, 13 types were down-regulated in non-small cell lung cancer tissues as verified by RTPCR. These 13 types of microRNAs were listed as follows:hsa-miR-125a-5p; hsa-miR-143; hsa-miR-519a; hsa-miR-223-5p; hsa-miR-1; hsa-miR-520c-3p; hsa-miR-489; hsa-miR-27a;hsa-miR-373; hsa-miR-125b; hsa-miR-27b; hsa-miR-142-5p; and hsa-miR-206. Conclusion: In non-small lung cancer tissue, several kinds of microRNAs were significantly downregulated. Changes in microRNA expressions were significantly associated with tumori-genesis, progression, or other cancer cell functions in non-small cell lung cancer.

Objective To explore the effect of iron chelators on labile iron pool and expression of apoptosis associated genes in cells of K562, an erythroleukemia cell line.Methods K562 cells were incubated at 37 ℃ in RPMI 1640 containing 10% heat-inactived fetal bovine serum in an saturated humidity and 5% CO_2 incubator. K562 cells were incubated with different concentrations of desferro-(xamine(DFO)). The study groups were divided as following: DFO group, iron+DFO group and the control group. Following indices were detected which included apoptosis by flow cytometry (FCM) assay, expression of Rb, c-myc, bax mRNA by RT-PCR. The intracellular LIP was measured with a fluorimetric assay using the metalsensitive probe calcein-AM.Results 1. The viability of K562 cells incubated with different concentrations of DFO was lower than that of control group at 12 h,24 h and 48 h (P

Animals ; Brain Ischemia ; drug therapy ; metabolism ; physiopathology ; Hippocampus ; metabolism ; physiopathology ; Insulin-Like Growth Factor II ; pharmacology ; therapeutic use ; Male ; Neuroprotective Agents ; pharmacology ; therapeutic use ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; metabolism ; prevention & control ; Tumor Necrosis Factor-alpha ; metabolism

The applicator therapy is a unique method to treat infant diarrhea in traditional Chinese medicines and widely applied in clinical practice. Currently, many researchers have proved the rationality of the therapy based on the traditional Chinese medicine mechanism and on the data from clinical practice, but its action mechanism is uncertain at present. In this study, with the assistance of pediatric practitioners, the automated ribosomal intergenic-spacer analysis (ARISA) was adopted to study the effect of the adjuvant therapy with Dingguier umbilical paste on intestinal flora of diarrhea infants, in which Dingguier umbilical paste served as the adjuvant therapy in oral traditional Chinese medicines and fecal samples of infants with different diarrhea symptoms were collected and used as the study materials. The results showed that the adjuvant therapy had a significant effect on the shift of intestinal flora, which was associated with the decrease in the similarity difference to the normal control group and the increase in the number of operational taxonomic units (OTUs) shared with the normal control group. Additionally, adjuvant therapy with Dingguier umbilical paste also showed long action duration and increased OTUs number. These results indicated that Dingguier umbilical paste has the effect in restoring the micro-ecosystem of unbalanced intestinal bacteria. Intestinal flora may be one of major targets for the applicator therapy for the infant diarrhea, but not for the single oral traditional Chinese medicine for infant diarrhea.
Adjuvants, Pharmaceutic ; therapeutic use ; Diarrhea ; drug therapy ; microbiology ; Feces ; microbiology ; Female ; Humans ; Infant ; Intestines ; drug effects ; microbiology ; Male ; Medicine, Chinese Traditional ; methods ; Ointments ; Treatment Outcome ; Umbilicus

BACKGROUND: Spondyloarthropathies(SpA) are a group of interrelated disorders that involve the spine, peripheral joints, and tissues around or outside the joints. SpA are most common in young males, and both the incidence and the mutilation rate are very high. It is important to evaluate the disease activity of patients with SpA since the evaluation can help in therapeutic selection and prognostic prediction of SpA. But up to now there still has not been a widely clinically acceptable criterion to evaluate the disease activity of SpA.OBJECTIVE: To study the worth of color Doppler(CD) in assessing the disease activity of patients with SpA.DESIGN: Non-random and self-control clinical study based on the patients.SETTING: All patients recruited in this study were from department of rheumatology of the Third Affiliated Hospital of Sun Yat-sen University. And all the ultrasonic examinations were conducted in the department of ultrasound of the same hospital.PARTICIPANTS: Thirty(24 males and 6 females) patients with SpA who met the European SpA Study Group criteria for the classification of SpA issued in 1991 and consented to be examined by CD were included.METHODS: CD was used to determine the blood perfusion at 18 major entheses of lower limbs of each patient with a semi-quantitative method. Blood sample was also taken from the patients for the examination of erythrocyte sedimentation rate(ESR) and C reactive protein(CRP) . The disease activity of the patients was also evaluated with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI).MAIN OUTCOME MEASURES: To observe the inter-correlations between entheseal blood perfusion, ESR, CRP and BASDAI.RESULTS: 80% of the 30 patients were detected to have positive perfusion in at least one enthesis of the 18 examined entheses, and all together 84 entheses were found to have positive perfusion among the 540 entheses being detected(positive rate 15.6% ) . The sum of entheseal perfusion detected in all the 18 sites was statistically correlated with the sum of patients' ESR,CRP, BASDAI respectively with the correlation coefficients of 0. 658, 0. 428and 0. 821 (all P ＜ 0.05) . ESR and CRP were also statistically correlated with BASDAI and their correlation coefficients were 0. 675 and 0. 368(Both P ＜ 0.05) . The sum of perfusion detected in the 18 entheses sites was correlated with BASDAI better than ESR or CRP was.Detecting the.entheseal perfusion by CD can help to determine the disease activity of patients with SpA, and then to guide selecting therapeutic strategy. It is also important for following up and prognosis.

BACKGROUND: Seronegative spondyloarthropathies(SpA) are a group of diseases involving the spine, peripheral joints and structures around the joints that mostly occur in adult males with high morbidity and disability rate. Presently, it is widely believed that enthesis is the initiated site of SpA so that enthesitis is an important pathologic base and one of the characteristic clinical manifestations of SpA, however, there is no specific clinical manifestation enthesitis.OBJECTIVE: To compare the difference on entheseal blood flow between health volunteers and patients with SpA and explore the value of color Doppler(CD) in assessing the pathological change of enthesis.DESIGN: Non-randomized case controlled study to patients SETTING: Department of Rheumatology, Department of Ultrasound of a university, Department of Rheumatology of General Hospital of Chinese PLA.PARTICIPANTS: Totally 30 patients with SpA admitted into Third Affilated Hospital of Sun Yat-sen University during August 2001 to April 2002 and willing to take CD examination were selected as case group. All of them met the classification criteria of SpA set up by the European SpA Study Group in 1991 with 24 males and 6 females. Thirty healthy workers and students working or studying in the same Hospital were enrolled as volunteers for the control group, none of them had any histories of arthropathy or chronic lower back pain, and there were 22 males and 8 females among them.INTERVENTIONS: Color Doppler was used to examine the blood flow of 18entheses in lower limbs of every healthy volunteers and SpA patients and semi-quantitative method was used to classify the blood flow.MAIN OUTCOME MEASURES: Blood flow of enthesesRESULTS: Among 30 healthy volunteers, 5 cases(16.7% ) had been detected blood flow from at least one enthesis. From the 540 entheses being examined, 9entheses were detected blood flow signals of grade Ⅰ, the positive rate was 1.7%. While among 30 SpA patients, 24(80.0%) had at least one enthesis being detected for positive blood flow. Eighty-four of totally 540 exanined entheses were found for positive blood flow signals with a positive rate of 15.6%, and the number of entheses with grade Ⅰ, Ⅱ and Ⅲ of blood flow were 19, 33 and 32 respectively among the 84 positive entheses. There was significantly different in the positive rate of blood flow and classification of entheses between SpA patients and healthy volunteers by x2 test (P＜ 0.05).CONCLUSION: Colour Doppler examination is an effective way to detect the blood flow of enthesis. There were blood flow abnormity in the entheses of lower limbs in patients with SpA.