Esophageal cancer is one of the most common malignant tumors in clinic, and its morbidity and mortality are always high. Staging is the main basis for comprehensive treatment and prognosis evaluation. Accurate staging is essential for proper diagnosis, individualized treatment and good prognosis. Related technologies of endoscopic ultrasonography can determine the depth of tumor invasion and local lymph node metastasis, which makes the diagnosis of esophageal cancer more accurate, and plays an increasingly important role in the diagnosis and treatment of early esophageal cancer.

OBJECTIVE: To investigate the regularity and characteristics of moxifloxacin-induced torsade de pointes (TDP), and to provide reference for rational use of drugs. METHODS: A total of 5 reported cases of moxiflixacin-induced TDP in recent 10 years were analyzed retrospectively. RESULTS: Of 5 cases, 2 cases were male and 3 female with mean age of (81?7) years. 5 patients suffered from organic heart disease. The onset time of TDP by oral administration was later than that by intravenous administration. Mean QTc intervals was (567?35) ms at attach period and the time recovered to base level (18?15) h. Potassium, magnesium, and sodium were kept at normal level at attach period. CONCLUSION: Clinical physicians and pharmacists should pay attention to moxifloxacin-induced TDP.

Objective: To investigate the association of polymorphisms of related genes in folic acid metabolic pathway and the tumor candidate genes with the survival of gastric cancer patients treated with capecitabine combined with paclitaxel. Methods: Ninety-three patients with pathological diagnosis of gastric cancer were treated with capecitabine plus paclitaxel-based chemotherapy. The gene polymorphisms of tumor necrosis factor ( TNF) A308G (rs1800629), methylenetetrahydrofolate reductase ( MTHFR) C677T (rs1801131) and A1298C (rs1801133), methionine synthase ( MTR) A2756G (rs1805087) and methionine synthase reductase ( MTRR) A66G (rs1801394) were detected by TaqMan-MGB probe typing method. The median survival time (MST) of patients with different genotypes was compared, and the effects of various factors on the prognosis were evaluated. Results: The median follow-up period was 29.6 months. The MST of 93 patients was 34.93 months. The MST of patients with MTHFR 1298CA and 1298CC were 47.50 and 22.91 months, respectively. The log-rank test revealed that the polymorphism of MTHFR 1298C/A had marginally significant correlation with the survival of patients (χ2=3.447, P=0.062), and other gene polymorphisms were not associated with the survivals. The gender, drinking and operation were the major prognostic factors for gastric cancer patients receiving chemotherapy. Conclusion: Detection of MTHFR 1298CA polymorphism may predict the survival of gastric cancer patients receiving chemotherapy of capecitabine combined with paclitaxel.

OBJECTIVE: To evaluate the relative factors influencing olfactory dysfunction in patients with chronic rhinosinusitis (CRS). METHOD: Visual analogue scale (VAS) was applied to measure the severity of olfactory dysfunction of 270 patients with CRS. Patients were divided into two groups, one was that the quality of life (QOL) of patients was affected by olfactory dysfunction (VAS > 5), the other was that without QOL affected by olfactory dysfunction (VAS ≤ 5). The association between age, gender, nasal polyps, allergic rhinitis, smoking history, early nasal surgery history and other clinical factors, and serum total IgE level, peripheral blood eosinophil count, peripheral blood mononuclear cell count and olfactory dysfunction was analyzed. RESULT: The number of patients with nasal polyps, allergic rhinitis, previous nasal surgeries, the level of serum total IgE, and the severity of edema were significantly increased in patients with impaired QOL associated with olfactory dysfunction (P < 0.05). Sex distribution, age, smoking history, deviation of nasal septum, eosinophil and mononuclear cell count did no statistically differ between the groups with and without impaired QOL associated with olfactory dysfunctions (P > 0.05). Serum total IgE increased (OR = 1.003, P < 0.01) and severe edema (OR = 2.483, P < 0.01) were the risk factors for the impairment of olfactory function, more notably for edema; whereas previous nasal surgeries was a protective factor (OR = 0.408, P < 0.01). CONCLUSION Sever edema and increased serum total IgE are risk factors, whereas previous nasal surgeries history is a protective factor for the olfactory dysfunction.
Chronic Disease ; Female ; Humans ; Leukocytes, Mononuclear ; Male ; Nasal Polyps ; Olfaction Disorders ; etiology ; Quality of Life ; Rhinitis ; complications ; immunology ; Rhinitis, Allergic ; complications ; immunology ; Risk Factors ; Sinusitis ; complications ; immunology ; Smell ; Smoking ; adverse effects

Objective: To observe the effect of electroacupuncture (EA) combined with Stretta radiofrequency treatment on contents of motilin (MTL) and gastrin (GAS) in gastroesophageal reflux disease (GERD) patients.
Methods: A total of 90 eligible GERD cases were randomly allocated into three groups, 30 in each group. Patients in the EA group were treated with EA, patients in the radiofrequency group were treated with Stretta radiofrequency, and patients in the observation group were treated with EA combined with Stretta radiofrequency. Assessment was made after a course of treatment.
Results: The recovery, improvement and failure cases and total effective rate in the EAgroup were 2, 18, 10 and 67.7% respectively, versus 13, 13, 4 and 86.7% in the radiofrequency group and 20, 9, 1 and 96.7% in the observation group. The therapeutic efficacy in the observation group was significantly better than that in the other two groups (P<0.01). After treatment, symptom scores of regurgitation, heartburn and substernal burning pain in all three groups were significantly reduced (P<0.05); the reduction in the observation group was more significant than that inthe other two groups (P<0.05),and the reduction in the radiofrequency group was more significant than that in the EA group (P<0.05). After treatment, the contents of MTL and GAS in all three groups were increased; and the increase in the observation group was more significant than that in the other two groups (P<0.05).
Conclusion: EA combined with Stretta radiofrequency treatment can significantly improve the clinical effect of GERD patients, improve regurgitation, heartburn and substernal burning pain and increase the contents of MTL and GAS.

Objective] Discussing the relationship between COPD phenotypes and patterns of TCM. [Methods] Discussing the relationship by searching of documents about research of COPD phenotypes. [Result]The phenotype of chronicbronchitis and exacerbation, emphysema,inflammation,FEV1 declining or overlap syndrome may match with different patterns of TCM.[Conclusion] COPD phenotypes have similarities with patterns of TCM at component, influence and typing target.

Objective To investigate the effect of baicalin on inflammatory factors and oxygen free radical metabolism in patients with traumatic shock.Methods 38 patients with traumatic shock were treated with baicalin 200mg intravenous injection when admitted to hospital.Before and 1 h after treatment,TNF-α,IL-6,IL-8,MDA and SOD were measured in blood.Results Compared with before treatment,TNF-,IL-6,IL-8,and MDA levels were decreased after treatment (t =7.32,6.12,20.21,16.10,all P ＜ 0.05),while SOD activity was significantly increased (t =1.69,P ＜ 0.01).Conclusion Baicalin could inhibit the production and release of inflammatory factors TNF-α,IL-6,IL-8 in patients with traumatic shock,reduce the damage of oxygen free radicals to the cells.Early treatment with baicalin had protective effect on patients with traumatic shock.

[Objective]On May 12,2008,an over 8.0-magnitude earthquake occurred in Wenchuan county,Sichuan province,China.The anthor's field hospital was deployed to An county,which arrived on the 3rd day after the disaster.During the first week of the deployment,284 victims with musculoskeletal injuries received orthopedic management.The objective of this article is to highlight the experience gained by this author's medical assistance team,focusing on the orthopedic care in the early part of the post-disaster relief activities.[Method]Records of 284 patients who underwent orthopedic management were reviewed retrospectively.[Result]There were a large number of musculoskeletal injuries amongst the survivors in the acute phase of the disaster,including spinal trauma,fractures and dislocations,peripheral nerve injuries and soft tissue injuries.The average age was 49.3 years(range,11 to 92 years) with 133 men and 151 women.The patients with upper extremity fracture were 85,with lower extremity fracture 73,with spinal fracture 23,with shoulder or hip dislocation 7.The patients with hand or foot injuries,peripheral nerve injuries and soft tissue injuries were 96.Open injuries were 67,the remaining were closed injuries.Totally 131 patients recovered,and the rest were transferred to the rear hospital for further management.The X-ray postoperatively showed that 21 open fractures were reduced functionally by means of external fixator,and the shoulder or hip dislocations were reduced anatomically.The wounds with primary suture had no infection.There were no other complications.[Conclusion]Correct diagnsis of the injuries,providing scientific and resonable therapeutic measures,and correct operative indication should be emphasized for early orllopedic care.Definitive surgeries such as open reduction and internal fixation are not recommended strongly.External fixation for post-earthquake open fractures is simple and effective,allowing simple approach to wound care and transferring to rear hospital during the whole period of fixation.

Objective To evaluate the effects of various resection and reconstruction method on pain relief and function restoration for periacetabular metastatic destruction in different grade. Methods This study involved 20 patients, 11 males and 9 females, with the average age of 52 years(range, 43-82 years). The original tumor consisted of 5 renal cell carcinoma, 4 breast carcinoma, 3 lung carcinoma, 2 thyroid carcinoma, 1 prostate carcinoma, 1 rectum carcinoma and 4 unknown primary cancers. A solitary periacetabular metastatic lesion was demonstrated in 14 patients and multi-metastases were seen in 6 patients, and accompanying periacetabular pathologic fractures in 4 patients. As to the Harrington grading system for the periacetabular metastatic destruction, there were 8 grade Ⅰ, 5 grade Ⅱ, and 7 grade Ⅲ. And according to grade Ⅰ, curettage and cement packing (5 cases) as well as stability reconstruction in iliac and acetabulum (3 cases) were performed; grade Ⅱ, curettage, cement packing and total hip arthroplasty with reinforcement ring was performed; grade Ⅲ, en bolc resection of acetabular lesion and modular prosthesis reconstruction was performed. The average score was 5.4(ranged from 3 to 9) according to Tomita scoring system. The pain relief and functional recovery were investigated from the regular follow up postoperatively. Results All patients showed the improvement in pain relief and mobility postoperatively. No prosthetic dislocation, deep infection and leg length discrepancy occurred. The prosthesis or internal fixation loosening happened in 5 of 15 patients at different stage. The median survival time of all patients was 16.5 months (range from 4.2 to 63 months). 2 patients survived over 5 years, 3 over 2 years, 6 over 1 year, 6 over 6 months, and 3 less than 6 months. According to the Enneking functional scoring system, the patients were rated as excellent in 10 cases, good in 8, fair 1 and poor 1 at the 3rd month postoperatively, and for the 7 cases with grade Ⅲ, excellent 2, good 2, and poor 2. The functions of 11 patients survived one year after surgery were excellent in 3, good 4, fair 2 and poor 2. Conclusion The favorable resections and reconstructions for periacetabular metastatic destruction could lead to remarked improvement in pain relief, functional recovery and quality of life.

[Objective]A new limited contact femoral supracondylar interlocking intramedullary nail(LCFSIIN) was made,which was part of a new custom-made hemi-knee joint,to improve the results of childrens' limb salvage.[Method]A new LCFSIIN was performed and the stress of bolts,intramedullary nails and bone were analyzed by finite dement analysis(FEA) while the bolts were implanted in different angulafions-0?,15?,30?,45?and 60?.[Result]The results of FEA show that the stress of bolts,bone and nails with 15? insertion angles of bolt was the tiniest and well distributed.Stress of bone with 0? insertion angles was more obvious than that with 15?,30?and 45?.The more the angles,the stress of proximal bolt became more obvious and the stress of distal bolt decreasing.[Conclusion]This new LCFSIIN can reduce destruction of biological environment of bone and is easy in use in limb salvage surgery of allograft.