Objective To retrospectively analyze the value of postoperative adjuvant therapy in the treatment of stageⅢthoracic esophageal squamous cell carcinoma ( ESCC) . Methods From 2008 to 2011, a total of 395 patients with stageⅢthoracic ESCC undergoing radical resection were enrolled as subjects. In those patients.97 received surgery alone (S).212 postoperative adjuvant chemotherapy (POCT),and 86 postoperative radiotherapy (PORT).Comparison of categorical data was made by chi?square test. The survival rates were calculated by the Kaplan?Meier method. The log?rank test was used for between?group comparison and univariate analysis. Results All patients were followed up for at least 3 years.125 cases were followed up for at least 5 years. The 5?year overall survival ( OS) rates in patients treated with S,POCT and PORT were 17. 1%,29. 2% and 36. 4%,respectively (P=0. 000).POCT and PORT could mainly increased OS in patients of males.upper?and middle?segment,severe ahhesion at surgery.well?or middle?differentiation,stageⅢa andⅢb(P=0. 000?0. 049);whenever ages.tumor lesion,two?/three field esophagectomy.and the number of removal lymph nodes. PORT could improved OS also (P=0. 001?0. 047).POCT could also improve OS in patients of ages≤60, tumor lesion<6 cm and removal lymph nodes<10 ( P=0. 002?0. 049 ) . The 5?year progression?free survival (PFS) were 19. 0% with S,28. 8% with POCT,36. 4% with PORT,respectively (P=0. 012).PORT could improve PFS (P=0. 012);especially for patients of males,ages ≤60,upper?and middle segment ESCC,tumor lesion ≥6 cm,severe ahhesion at surgery,removal lymph node<10 and ≥10,well or middle differentiation,stageⅢa andⅢb(P=0. 001?0. 042).But POCT could not increased PFS (P=0. 119) . Conclusions In the treatment of patients with stage Ⅲ thoracic ESCC undergoing radical resection,both POCT and PORT can improve the OS rate, particularly in patients with stage Ⅲa or Ⅲb middle and upper thoracic ESCC, severe adhesion formation during surgery. and moderately or well differentiated squamous cell carcinoma. The DFS rate is improved in patients treated with PORT,but not in those treated with POCT.

Total 967 patients with diabetes mellitus treated in Morindawa People's Hospital from June 2012 to June 2014 were included in the study,among them 425 (44.0％) were of Daur nationality and 542 (56.0％) were of Han nationality.The clinical data and laboratory tests were analyzed and compared between two groups.Compared with Han nationality,Daur patients presented a younger average age[(55 ± 1 1) y vs.(58 ± 1 0) y,P=0.000],an earlier age of onset[(50±10)y vs.(53 ± 1 1) y,P=0.000],a higher percentage of males (54.8％ vs.46.9％,P =0.008),a higher percentage of rural residents (42.1％ vs.36.2％,P =0.034),a lower level of fasting blood-glucose (FBG) [(9.25 ± 3.37) mmol/L vs.(10.28 ±4.33) mmol/L,P =0.000],higher levels of HbA1c [(7.61 ± 1.71)％ vs.(7.29 ± 1.63)％,P=0.008],triglyceride (TG) [(2.91 ±2.06) mmol/L vs.(2.36 ±2.13) mmol/L,P =0.008],low density lipoprotein cholesterol (LDL-C) [(3.22 ± 1.06) mmol/L vs.(3.01 ±0.92)mmol/L,P=0.020],systolic blood pressure (SBP) [(139.48 ± 21.58) mmHg (1 mmHg =0.133 kPa) vs.(136.37 ± 23.44) mmHg,P =0.002],diastolic blood pressure (DBP) [(87.23 ± 12.59) mmHg vs.(85.32 ± 12.52) mmHg,P =0.019],blood uric acid [(324.97 ± 106.45) μmol/L vs.(285.32 ± 98.69) μmol/L,P =0.000] and the ratio of urine microalbumin to urine creatinine [(2.29 ±5.57) mg/g vs.(0.12 ±0.98) mg/g,P =0.000].The results show that Daur diabetic patients are.younger in age,with more severe disorders in HbA1 c,blood pressure,blood uric acid and lipids levels,which increase the probability of renal damage or cardiovascular diseases in these patients.

Objective To explore the efficacy of tumor necrosis factor inhibitor in hip joint lesion of ankylosing spondylids (AS). Methods Eight-six patients with hip joint lesion of ankylosing spondylitis were Enrolled in this study. The treatment protocol was: ①Etanercept 25 mg was suncutaneously injected twice a week in the first two months and once a week in the following two months. Then it was injected once every oth-er two weeks in the last two months of the study period.②Methotrexate 15 mg was administered orally or in-travenously once a week.③NSAIDs and prednisone were stopped when symptoms sunsides. Results Twenty-eight cases (33%) stopped NSAIDs because of the disappearance of symptoms in 2 weeks after starting of the study. Forty-three (50%) stopped NSAIDs with in 8 weeks and 36 cases (42%) in them stopped NSAIDs and prednisone. During the 9th and 16th week, etanercept was used once a week and 49 cases (60%) stopped NSAIDs and prednisone. During the 17th and 24th week, etanercept was used once every two weeks, and 38 cases (44%) stopped NSAIDs and prednisone and their disease was stable. Hip Functional Scores of patients were elevated significantly at 2, 4 and 6 months after the treatment (p<0.05) BASDAI and BASFI decreased, and the difference was significant when compared to those before the treatment (P<0.05). For the 19 cases with hip joint synovitis and hydrarthrosis in MRI image but without obvious change in pelvic plain films, syn-ovitis of 11 cases disappeared and 4 cases improved significantly. In 84 hip joints with grade Ⅱ or Ⅲ changes, 13 joints improved for one grade, 16 joints had improvement but less than one grade, and 49 joints had no radiological changes. Conclusion Etanercept, when combined with methotrexate, is effective in treat-ing hip joint lesion of ankylosing spondylitis. The dosage of etanercept can be tapered after the disease is un-der control.

Objective To explore the relationship between Adult-onset Still's disease (AOSD) and macrophage activation syndrome (MAS). Methods A total of 78 patients with AOSD who had completed medical information were included in this study. Eleven patients who were diagnosed as rheumatic disease associated hemophagocytic syndrome among 26 patients who had hemophagocytic syndrome with histological evidence consisted of the MAS group. Clinical and laboratory data were analyzed in 78 patients with AOSD and 11 patients with MAS. Results Among 78 cases of AOSD, 9 patients (12%) could be diagnosed as MAS but didn't have hemophagocytic histological evidence. In the 11 MAS cases with hemophagocytic phenomenon, 6 patients fulfilled the diagnostic criteria of AOSD, 2 cases with panniculitis, 1 case with SLE, 1 case of dermatomyositis and 1 case of systemic vasculitis. Logistic analysis showed that splenomegaly (OR =2.13, 95%CI=1.11-3.42), leukopenia (OR=3.57, 95%CI=2.30～4.86), anaemia (OR=0.85, 95%CI=1.03～2.76), thrombocytopenia (OR=2.98, 95%CI=1.17-4.30) and hypertriglyceridemia (OR=1.66, 95%CI=1.02～2.74) were associated with development of MAS in AOSD. Conclusion The development of MAS in AOSD patient is frequent and hemophagocytic histological evidence could be found in severe cases. When splenomegaly and hypocytomsis present in AOSD patients, bone marrow examination should be done and the level of triglyceride and fibrinogen and activity of NK cells should be measured for early diagnosis.

Objective To establish an animal model by placing one end of PICC in the hepatic portal vein of a beagle dog and leaving the other end out of its body.Methods Six Beagle dogs were given respiration anesthesia through orotracheal intubation.An incision was made through the right rectus abdominalis to locate the superior mesenteric vein (SMA) and the main hepatic portal vein.The left branch of SMA was separated and cut to put PICC into the main hepatic portal vein before being ligated and fixed.The other end of PICC was elicited through the right abdominal wall and passed beneath the skin to the back neck and fastened in case of movement.Results The anesthetic effect was good and all the operations were successful.The mean operation time was about an hour and the mean blood loss was about 15 ml.The incision healed 5-7 d after operation.Conclusion The establishment of the model can improve the effects of liver-targeting drugs,which can cut down the dosage,lower the cost of treatment and experiment and reduce the adverse effect of medicines.Through PICC,we can directly draw blood from the hepatic portal vein to measure the blood concentration before the first pass elimination.Then according to the concentration,we can calculate the absorption rate in the gastrointestinal tract,which can facilitate related experimental studies.

Objective Five yeast-expressed recombination nucleotide proteins of European hantaviruses were prepared as coated antigens to detect hantavirus-specific antibodies in sera from hemorrhagic fever with renal syndromes (HFRS) in Hubei province, through ELISA assay. The relativity among hantaviruses prevailing in different areas was investigated. Methods 34 pairs of acute/convalescent serum samples were collected from HFRS patients in Hubei during 1985 - 1989 and 1996-2000. ELISA assay was performed to detect the reactivity of these sera to different hantavirus-recombinant nucleocapsid proteins(HV-rNP) which were derived from puumala virus (PUUV), dobrava virus (DOBV) while using hantaan virus (HTNV) to serve as control. Qualitative results were used to analyze the detection rate and the quantitative results of optical density values were used to investigate the antibodies' level and the changes. Results The detective efficiency of rNP against IgG antibody in samples was as follows:HTNV-rNP＞DOBV-rNP＞PUUV-rNP. As to the detection of IgA, it was: DOBV-rNP＞HTNV-rNP＞PUUV-rNP. However, there was no difference between DOBV-rNP and HTNV-rNP when the hantavirus-specific IgM was detected. PUUV-rNP showed a very weak reactivity to all the antibodies in samples, but 3-pair samples reacted strongly to all the three subtype-rNP of PUUV. Results from quantitative analysis revealed that there was a relative higher level of IgM and IgA in acute phase sera. No significant difference between IgM and IgA levels was found and the level of IgG was low. A high level of IgA was detected in convalescent sera. Moreover, the level of IgA and IgG significantly increased with the progress of the disease. Conclusion DOBV-rNP had a high detective efficiency to serum samples from HFRS patients in Hubei. HV-specific IgA was kept on a high level in acute and convalescent phases and had important implications for the surveillance of HFRS. Also,it is assumed that PUUV and DOBV might have existed in Hubei province.

Adult ; Anemia, Aplastic ; chemically induced ; genetics ; immunology ; Benzene ; poisoning ; Gene Expression ; Genes, T-Cell Receptor beta ; genetics ; Humans ; Male

AIMTo observe the effect of melatonin (MT) on morphine withdrawal syndromes and determine the content of NO in plasma and brain tissue in morphine dependent mice.

METHODSA physical dependent model in mice was established by subcutaneous injection of morphine. MT (15 mg.kg-1, qd x 3) was given by intragastric infusion (ig) for three days. Withdrawal syndromes were induced by intraperitoneal injection of naloxon (5 mg.kg-1). The intensity of withdrawal syndromes was evaluated according to the jumping latency, the jumping times and the body weight loss. The content of NO was detected with Griess method.

RESULTSThe jumping latency of morphine withdrawal reaction was prolonged and the jumping times were reduced obviously by ig MT. The increased NO content in plasma and brain tissue in morphine dependent mice was reduced by ig MT.

CONCLUSIONThe physical withdrawal syndromes and the content of NO in plasma and brain tissue in morphine dependent mice are inhibited by MT.

Animals ; Brain ; drug effects ; metabolism ; Disease Models, Animal ; Male ; Melatonin ; therapeutic use ; Mice ; Morphine Dependence ; blood ; Nitric Oxide ; blood ; Substance Withdrawal Syndrome ; blood ; prevention & control

BACKGROUNDNon-heart-beating donor lung has been a promising source of lung transplantation. Many studies on non-heart-beating donor lungs are based on animal lung transplantation. In this study, we assessed by organ bath the effect of one-hour warm ischemia on the non-heart-beating donor lung in terms of the integrity of contractile and relaxant functions and tissue structures of pulmonic arteries and bronchi.

METHODSSixteen Swedish pigs were randomly classified into two groups: heart-beating donor group and 1-hour warm ischemia non-heart-beating donor group. Pulmonic and bronchial rings were taken from the isolated left lungs of the pigs. The pulmonic rings were stimulated by U-46619 (5.7 mol/L) and acetylcholine (10(-4) mmol/L) to assess the contractile abilities of smooth muscle and the endothelium-dependent relaxation response, respectively. As such, acetylcholine (10(-5) mmol/L) and natrium arachidonic acid (0.01%) were used to detect the contraction of bronchial smooth muscle and epithelium-dependent relaxation response. Meanwhile, the variances of precontraction tension of control groups were recorded to measure whether there was spontaneous relaxation during endothelium/epithelium-dependent relaxation course. Finally, papaverine solution (10(-4) mmol/L) was used to detect the non-endothelium/epithelium-dependent relaxant abilities of pulmonic and bronchial smooth muscles.

RESULTSThere was no significant difference in the tension values of precontraction of pulmonic rings (P > 0.05), endothelium-dependent relaxation (P > 0.05), precontraction of bronchial rings (P > 0.05) and epithelium-dependent relaxation (P > 0.05) between the heart-beating donor group and the 1-hour warm ischemia non-heart-beating donor group. And the pulmonic and bronchial rings of each subgroup B had no spontaneous relaxation. Finally, papaverine solution relaxed the smooth muscle of all the rings completely.

CONCLUSIONSThe results of this experiment suggest that the contractile and relaxant functions and tissue structures of pulmonic arteries and bronchi are not damaged after warm ischemia for 1 hour, and support the further study of non-heart-beating donor lung.

Animals ; Bronchi ; physiology ; Endothelium, Vascular ; physiology ; Lung Transplantation ; Pulmonary Artery ; physiology ; Swine ; Tissue Donors ; Vasodilation ; Warm Ischemia ; methods

OBJECTIVETo investigate whether Hantavirus (HV) and Orientia tsutsugamushi ( OT) can naturally infect and coexist in their host and role.

METHODSBy field epidemiological study, Leptotrombidium scutellare (3829) was collected and separated from mice(166) in epidemic areas. The cells of mites separated from their host and role were cultured. PCR was used to detect HV-RNA and OT-DNA in the cell culture.

RESULTSIn 105 Apodemus agrarius, 3 HV-RNA positive, 2 OT-DNA positive and 2 coinfection with HV and OT were detected;in 41 Brown rattus, 2 HV-RNA positive, 1 OT-DNA positive and 1 co-infection with HV and OT were detected. From 15 mites co-infected with HV and OT, 2 strains of HV pathogen, 2 strains of OT pathogen were separated and 1 HV and OT pathogen in the same mite were separate.

CONCLUSIONThe study demonstrates that co-infection of HV and OT did simultaneously exist in wild Leptotrombidium scutellare. This theory has some significance to the epidemic and precaution of HV and OT.

Animals ; Disease Vectors ; Hantavirus ; genetics ; pathogenicity ; Hemorrhagic Fever with Renal Syndrome ; epidemiology ; Host-Parasite Interactions ; Orientia tsutsugamushi ; genetics ; pathogenicity ; Rats ; Scrub Typhus ; epidemiology ; Trombiculidae ; microbiology