Objective To investigate the efficacy of small-axillary-incision esophagectomy combined with mechanical esophagogastric anastomosis for esophageal carcinoma.Methods From April 2005 to April 2007,56 patients with esophageal cancer underwent small-axillary-incision esophagectomy combined with mechanical esophagogastric anastomosis in our hospital.After thoracotomy was performed via a small axillary incision,the stomach and esophagus were separated.Circular stapler was used for esophagogastric anastomosis after esophagectomy.The anastomotic segment was then enveloped and placed at the esophageal bed.Results The average length of the axillary incision was(13.2?1.6)cm(10-15 cm).No anastomotic leak and hemorrhage,injury to the laryngeal nerve,or chylothorax occurred in this series.53 of the patients were followed up for 4-16 months(mean,7.8 months),during which 1(1.9%)patient developed slight anastomotic stenosis,and 4(7.5%)had gastroesophageal reflux.Conclusions Small axillary incision causes less trauma to the patients leading to a quick recovery.By using mechanical cervical anastomosis,man-mad injuries to the anastomotic segment are avoided,resulting in a low rate of postoperative complications.

Objective To investigate the effect of magnesium sulfate on NF-κB p65,inflammatory cyto-kines in brain and serum of preeclampsia model rats by magnesium sulfate. Methods The healthy SD rats were randomly divided into 4 groups,normal pregnancy group(n = 10),magnesium sulfate control group(n = 10), preeclampsia(PE)model group(n = 10)and magnesium sulfate intervention group(n = 10). Blood pressure, urinary protein,blood urea nitrogen and alanine aminotransferase levels were detected in rats in each group. RT-qP-CR and ELISA were used to detect the expression of IL-1β,TNF-αand IL-6 in the brain and serum. Western blot assay was used to detect the expression of the NF-κB p65 in brain. Results The level of proteinuria,blood urea nitrogen and blood pressure in PE model rats were significantly higher than those in the normal pregnancy group and those in the magnesium sulfate intervention group at 20 days of gestation(P<0.05). Results of RT-qPCR and ELISA assay showed that IL-1β,TNF-α and IL-6 level in magnesium sulfate intervention group were sig-nificantly lower than those in PE model group(P<0.05),but still higher than those in the normal pregnancy group (P < 0.05). Western blot result showed that NF-κB p65 in the magnesium sulfate intervention group was lower than that in the PE group(P<0.05),but still higher than that in the normal pregnancy group(P<0.05). Con-clusion The prevention and treatment preeclampsia mechanism of magnesium sulfate may inhibit inflammatory cyto-kines through NF-κB p65 pathway in the preeclampsia model rats.

Objective To investigate the correlation of the middle cerebral artery stenosis (MCAS) and the mild cognitive function impairment (MCI),and the clinical efficacy of statins in patients with MCI. Methods Six hundred and thirty-six patientse,who received transcranial color doppler ultrasound (TCD)assay, were enrolled in our hospital hospitalization or outpatients. The simple mental state examination (MMSE) and clinical dementia rating scale (CDR) were used as cognitive function assessment indexes. Forty-four cases of MCI with MCAS and 58 cases of MCI with NMCAS were used as the treatment group , who received the atorvastatin 20 mg every day , 56 cases of MCI with NMCAS were used as the control group , who only received the routine and basic diseases treatment. One yearlater,we determined the changes of MMSE and CDRagain. Results We detected 124 patients with MCAS, 512 patients with NMCAS, and 44 cases of MCAS patients with MCI, the prevalence was 35.5%,114 cases of NMCAS in patients with MCI, with the prevalence of 22.3%, the prevalence between the two groups was statistically different. One year later, the patients in the treatment group, MMSE score was improved, the score of MCI of the MCAS group improved more significantly. Conclusion The middle cerebral artery stenosis correlated with the occurrence of MCI. Atorvastatin could improve cognitive function in patients with MCI, especially for MCI which was caused by middle cerebral artery stenosis.

Professor YU Ren-cun believes that the responsibility of cough and asthma of lung cancer patients not only lies in the lungs, but also relates with spleen, kidney, heart and liver. Treatment should focus on the whole body and overall conditioning. Syndrome can be divided into 4 types: qi deficiency with phlegm resistance, yin deficiency with toxic heat, qi stagnation with blood stasis, and lung and kidney deficiency. Clinical treatment should pay attention to the combination of disease and syndrome, which can achieve satisfactory efficacy.

Objective To define the indications and evaluate the results of various surgical treatment options in patients with nonparasitic hepatic cysts. Methods The clinical data of 284 patients with nonparasitic hepatic cysts treated in our hospital from January 1995 to December 2005 were retrospectively analyzed. Results Percutaneous aspiration and sclerotherapy were performed in 161 cases and complications occurred in 9 (5.59%), recurrence in 53 (32.92%) and the mortality was 0%.Open surgery was conducted in 71 cases and the complications occurred in 16 (22.54%), recurrence in 8 cases (11.27%) and the mortality was 2.82%. Laparoscopic surgery was employed in 52 cases and complications occurred in 7 ( 13.46%), recurrence in 6 (11.54%) and the mortality was 1.92%.Conclusion There is currently no general agreement in the literature concerning when nonparasitic hepatic cysts should be treated. Laparoscopic surgery was more favorable than other therapeutic options.However, we should choose individually suitable methods according to different clinical symptom of patients.

Objective To explore the significance of day surgery mode on cataract patients for achieving win-win among patient, hospital and medical insurance.Methods 120 cataract patients (selected from December 2015 to June 2016, in the Ophthalmic Center of Leshan People′s hospital) were included in this retrospective study and day surgery group (n=60) was observation group and hospitalization surgery group was control one (n=60).All cases underwent cataract phacoemulsification and intraocular lens implantation.Treatment process, average day on the waiting list, average preoperative stay, average length of stay, medical cost and patient satisfaction were compared between the two groups.Results Days on the waiting list in day surgery group (1.2 d) reduced 8 days than in hospitalization surgery group (9.2 d).Preoperative stay in day surgery group reduced 1.5 days than in hospitalization surgery group.Length of stay ware reduced by 3 days as compared to the control group.The average medical cost in day surgery group was much less than the control group and the patient satisfaction was much higher.Conclusion The high efficiency of day surgery mode can shorten the length of hospital stay, lessen the cost of medical expense, realize the security management of medical service, so as to provide more convenience, more safety, better quality and cheaper medical service for patients.It achieves social and economic benefits and finally achieves win-win among patient, hospital and medical insurance.

Objective　To evaluate therapeutic effect and opportunity of laser in situ keratomileusis(LASIK) for treatment of hypermetropia.Methods　Three hundred and ninety hypermetropia eyes were treated with LASIK using solid excimer laser instrument(made in Novatec Corporation, USA),and were reexamined at 1,3,6 and 12 months after LASIK.Results　Therapeutic effect of LASIK was more remarkable, stable and reliable, that of other methods in treating +2.00～+10.00D hypermetropia and astigmatism, and the rate and degree of refraction regression were small. The diopter has been stable in 6～12　months after LASIK. Diopter of 87 percentage of all eyes≤+2.00D, and 61 percentage≤+1.00D. LASIK had shorter recovery time, more gently operation reaction, more remarkable droping of diopter than other methods. Elevation of vision was remarkable after LASIK. Elevation of vision of amblyopia children who were treated with LASIK was quicker and more remarkable after treatment of amblyopia than that of other amblyopia children who were not treated with LASIK.Conclusion　At present, LASIK is the best therapeutic method to treat hypermetropia.

OBJECTIVETo observe the efficacy of Modified Xiaoyao Decoction (MXD) combining clomipramine in treatment of depression.

METHODSOne hundred and five depression patients were randomly assigned to two groups. The treated group (53 patients), all were differentiated as Gan-qi stagnation syndrome type and treated with MXD combining clomipramine 25-50 mg/d. The control group (52 patients) treated with clomipramine 75-225 mg/d alone. The treatment lasted for 8 weeks in both groups. Scores of depression was assessed with Hamilton Depression Scale (HAMD) before treatment and at the 2nd, 4th, 8th week of the treatment, efficacy and adverse reactions were evaluated with Global Impression of Change (CGI) and Treatment Emergent Symptom Scale (TESS) respectively.

RESULTSAfter treatment the scores in both groups were significantly different from those before treatment (P < 0.01), but no significant difference was found between the two groups (P > 0.05). Main adverse reactions were dry mouth, constipation in the treated group, much less than those in the control group, which were mainly dry mouth, constipation, dizziness, insomnia, blurred vision and prolonged Q-T interval (P < 0.01).

CONCLUSIONMXD combining clomipramine has the efficacy on depression similar to clomipramine, but has less adverse reactions.

Adolescent ; Adult ; Antidepressive Agents, Tricyclic ; therapeutic use ; Clomipramine ; therapeutic use ; Depression ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Treatment Outcome ; Young Adult

Objective To observe the effects of interleukin-1β (IL-1β) and pentylenetetrazol (PTZ) induced acute epilepsy and the dynamic expression of aquaporin-4 (AQP4) in hippocampus. To explore the role of IL-1β in the pathogenesis of epilepsy by regulating AQP4. Methods All rats were randomly divided into control group, IL-1β group, PTZ group, IL-1ra + PTZ group and dexamethasone + PTZ group. Observe the behavior of the rats within 60 minutes after injection and record seizure score in each group. Then immunohistochemistry and RT-qPCR were used to detect the expression of AQP4 at at 6 , 12, 24 and 36 h. Results Almost of rats in IL-1β group and PTZ group showed severe degree seizure. The rats in control group and dexamethasone + PTZ group showed no obvious seizure. The seizure of rats were more remarkable serious in PTZ group than that in the IL-1ra + pentylenetetrazole group (P < 0.05). Immunohistochemistry and RT-qPCR Show: the expression of AQP4 in hippocampus in PTZ group increased gradually after 12 h (P < 0.05), then reached in the peak after 24 h (P < 0.001). The expression of AQP4 in IL-1ra + PTZ group was lower compare with PTZ group in each time (P < 0.05). Although the expression of AQP4 in dexamethasone + PTZ group higher than the control group, it was not significantly different (P < 0.05). Conclusion The proinflammatory cytokine IL-1β break the balance of water in brain and increasing the concentration of extracellular excitatory amino acids or ions by upregulate the expression of AQP4 in order to promote the excitatory of neurons.