Objective To investigate the pattern of lymph node metastasis in patients with 17 and middle thoracic esophageal squamous cell carcinoma( ESCC). Methods Retrospective review the clinical data of 246 cases with T2 and middle thoracic esophageal squamous cell carcinoma who were treated by three-field lymphadenectomy. Analyze the relationship between clinical pathological factors and lymph node metastasis. Results Lymph node metastases were found in 129 of the 246 patients (52.4% ).The average number of resected lymph nodes was 25 per patient (rangel5 -59). The rates of lymph node metastasis were 28.9% in the neck, 28.5% in thoracic mediastinum and 22.0% in abdominal cavity for patients with T2 and middle thoracic ESCC. No significant difference in lymph node metastasis' rate was observed among the neck, thoracic mediastinum and abdominal cavity. Logistic-regression showed the length of tumor, tumor cell differentiation and angiolymphatic invasion were factors influencing lymph node metastasis. Conclusion Lymph node metastasis in T2 and middle thoracic ESCC has the characteristics of upward, downward and skip spreading. Patients with T2 and middle thoracic ESCC should be treated with radical surgery with three-field lymphadenectomy.

Objectives To study the influential factors of the von Clauss method and to promote the method for fibrinogen assay in clinical laboratories in China. MethodsKits of foreign and domestic products were used. Calibration curves for fibrinogen determination were established, and calibration plasma was used for comparison. Effects of pH value, thrombin activity, and temperature on the measurement were studied.Results The reproducibility of the von Clauss method using domestic thrombin and related reagents was excellent, the within day CV being 0.039 1, and the between day CV 0.049 7. The percentage variations of calibration plasma determination, with the foreign fibrinogen assay kits using domestic reagents, were +3.17% , +4.76%, and -6.03%, respectively. Determination of a lyophilized plasma using the two sources reagents showed similar results.Conclusions Thrombin and relevant reagents produced in China could be used as a substitute for kits purchased abroad, which would promote the use of von Clauss method in clinical laboratories of China.

A hammerhead RZ DNA was designed and synthesized, which can specifically cleave the bcl-2 mRNA. After demonstration of right sequences by sequencing and cleavage activity of RZ by in vitro cleaving experiment, The RZ DNA was recombinated into the pDOR - neo vector to form the recombinant pDOR - RZ. Using lipofectin - mediated DNA transfectionpDOR-RZ was successfully introduced into HL - 60 cells. The RZ expression was observed by Southern, RNA dot blot hybridization and flow cytometry (FCM) . The results demonstrated that (a) the RZ was expressed in 72 hours after transfection; (b) the synthesis of Bel - 2 protein was inhibited by the expression of RZ; (c) apoptotic peak appeared in FCM.

Objective To review the results of limb lengthening over an intramedullary nail in management of femoral defect and length discrepancy.Methods Femoral lengthening over an antegrade intramedullary nail was applied to treat length discrepancy of 4 to 7 cm for three cases,and femoral defects of 8 and 11 cm respectively for two cases from January 2001 to December 2003.The nail and an external fixator(Ilizarov external fixator for bone defect and Orthofix limb-reconstruction system for discrepancy)were applied concomitantly at the time of femoral osteotomy.After a mean fixation time of 16.2 days(13 to 24 days),gradual distraction began at a rate of 0.25 millimeter four times a day.When the managed femur reached the expected length,the nail was locked and the fixator was removed in patients with length discrepancy.The procedure was not finished in patients with bone defects until bony consolidation was partially seen.Results All the patients were followed up for a mean time of 36.4 months(range,22 to 47 months).The mean gain in length was 7.2 cm(range,4 to 10 cm)with good consoli- dation,the mean duration of external fixation was 5 months(range,3 to 8 months),and the mean external fixation index was 0.75 month per centimeter(range,0.57 to 1.00 month per centimeter).Neither axial deviation nor re-fracture occurred.At the last follow-up,the mean range of movement of knee was 107?(80?to 135?).Con- clusions In management of defect and length discrepancy of limbs,lengthening over an intramedullary nail has the advantages of short duration of external fixation,good protection against refracture,and earlier rehabilitation of knee joint,as well as disadvantages of long operation time,massive intraoperative bleeding,high cost and much post- operative scarring.

OBJECTIVE:To provide reference for rational drug use in the clinic. METHODS:The calculation was carried out in type,amount and consumption sum of Chinese patent medicines containing Salvia miltiorrhiza in our hospital during 2011-2014. These data were analyzed,classified and sorted by DDDs sequence and the method of pharma-coeconomics with Excel statistically. RESULTS:The consumption sum of Chinese patent medicines containing S. miltiorrhiza took on little changes in our hospital dur-ing 2011-2014,decreasing by 10.52% in 2012 compared to 2011 but increasing by 8.49% in 2013 compared to 2012. The order of DDDs kept stable,indicating that Chinese patent medicines containing S. miltiorrhiza were used frequently in 4 year. The order of consumption sum also kept stable relatively. CONCLUSIONS:The utilization of Chinese patent medicines containing S. miltiorrhi-za in our hospital is rational. Those with suitable prices and proved efficacy take a great share in the clinical application.

[Objective] To evaluate the surgical techniques and its clinical results of CDH Legacy in the treatment of scoliosis.[Method]Nine patients(7 female and 2 male)with scoliosis instrumented with posterior CDH Legacy system were recruited for this retrospective study.The etiological classification of scoliosis were idiopathic for 7,congenital for 1,neurofibromatosis(NFl)for 1.The average age was 13.5 years(ranged 11～18 years).The average preoperative Cobb's angle was 54?(ranged 48?～68?).Seven AIS and one CS patients received one stage posterior CDH Legacy instrumentation;the NFl patients received one stage anterior epiphysiodesis and second stage posterior CDH Legacy instrumentation.[Result]There was no death,no infection and no neurological complication.No intra-operative fracture,no dura matter or pleuml laceration occurred.Superior Mesenteric Artery Syndrome occurred in one patients and recovered with conservative treatment.Posterior Cobb's angle averaged 20? with correction rate of 63%.The duration of follow-up averaged 23 months(ranged 20～30 months).Surgical time averaged 260 min(ranged 210～300 min)and mean EBL was 700 ml(300～1 000 ml).Bony fusions were achieved in all patients and no coronal or sagittal plane decompensation occurred.The loss of correction at last follow-up was 4? with 7.4% loss of correction rate.[Conclusion]The clinical results of CDH Legacy are as good as the other three generation implants,its advantage lies in lower profile,solid inter-locking,versatile implants and handy manipulation.

Objective To compare the clinical outcomes of selective thoracic spinal fusion in adolescent idiopathic scoliosis using either iliac bone or autologous rib combined with allografts. Methods A retrospective study was made in 84 cases of idiopathic thoracic scoliosis, who were operated on with posterior instrumentation of CD, CDH or TSRH from 1999 to 2000. These patients were divided into two groups. In Group A, 34 patients, who were 12 to 20 years with a mean age of 14.5 years with a mean Cobb angle 56?(range, 40? to 82?), received autologous iliac bone grafting, and no thoracoplasty were performed. In group B 50 patients, who were 13 to 19 years with a mean age of 15.4 years with a mean Cobb angle of 54? (range, 38? to 80?), had allograft bone grafting combined with the ribs from thoracoplasty. The patients were followed up for at least 2 years with an average of 3.4 years regarding the clinical and radiographic outcomes. Results For group A, an average of 73.2% correction rate was achieved, and average 10% loss of correction and 3% of pseudoarthrosis was recorded at 2 year follow-up. The incidence of donor site morbidity was 26%, which included deep infection, hematoma, delayed healing of incision and continuous pain. For group B, an average of correction rate was 70.4% with 9% average loss of correction and 2% of pseudoarthrosis at 2 year follow-up. The complications related to thoracoplasty consisted of intraoperative tear of parietal pleural, pneumothorax, effusive pleuritis, and chest pain. Conclusion The clinical outcomes are comparable between the group of iliac bone grafing and the group of rib grafing associated with allografts in terms of fusion rate and loss of correction. If chose appropriately, allografts plus autologous rib harvested from thoracoplasty will be a good alternative to iliac crest regarding its safety, efficacy and reliability.

Objective:To investigate the effects of strain force on t he expression of osteoclast differentiation factor(ODF) and osteoclasto-genesis i nhibitory factor(OCIF) in human periodontal ligament cells (HPDLCs). Met hods: HPDLCs were subjected to cyclic strain force for 0, 6, 12 and 24 h ours, mRNA expression of ODF and OCIF were determined by RT-PCR. Result s:After treatment of the cells for 0,6,12 and 24 hours the ODF/?-actio n values were 0.7280?0.0261,0.6831?0.0411,0.5801?0.2230 and 0.4572?0.0373( P0.05) respectively.Conclusion:Strain force may decrease the expression of ODF and increase the expression of OCIF.

Purpose: To confirm the therapeutic effects of thyrotropin-releasing hormone(TRH) on the experimental spinal cord injury. Method: Wistar rats were subjected to incomplete spinal cord injury using the modified Allen method. The effects were observed by means of neurologic scoring, quantitative enzyme histocytoehemistry、quantitative immunohistocytochemistry and electron microscopy. Results: 1) The treated group exhibited significantly higher scores than the control group. 2) Acetylcholinesterase (AchE) activity of anterior horn cells in the treated group was higher than that of the control group invarious time, and its activity restored to normal level two weeks after injury; Acid phosphatase(AePase) activity was lower than that of the control group in various time. and its activity restored to normal level four weeks after injury. The content of Nissl's bodies in anterior horn cells in the treated group was higher than that of the control goup one week after injury. 3)The number of axon in a certain area of spinal white matter in the treated group was more than that of the control group. 4)Ultrastructural observation showed that both the nerve tissue injury and the extent of hemorrhage were milder in the treated group than that of the control group. Conclusion: The therapeutic effects of TRH on the spinal cord injury" are shown not only in the improving recovery of motor function, but also in the morphology.

Objective To analyze the effect of circulatory failure on ventilation therapy of respiratory failure after resuscitation in neonates with severe asphyxia. Methods Three hundred and eighty-two neonates with mechanical ventilation following severe asphyxia were retrospectively analyzed. Two groups were divided according to the efficacy of mechanical ventilation: effective and noneffective. Results The non-effective rate was 24.1% at 1 hour after ventilation (19.4% in full term babies,34.5% in preterm babies). The degree of asphyxia in noneffective group was significantly more severe than the effective group. The incidence of persistent pulmonary hypertension of the newborns(PPHN),exsanguine shock,cardiogenic shock,DIC and cardiac failure was 84.3%、51.0%、80 4%、49.0% and 54.9% respectively in term babies,while the incidence of exsanguine shock,cardiogenic shock,DIC and cardiac failure was 65.9%、68.3%、75.0% and 58.5% respectively in preterms babies. All of them were significantly higher than the effective group. After treatment of the circulation problems,the blood gas turned to normal in 94.1% term babies and 92.7% of preterms. No difference was shown in the recovery rate in both groups. Conclusion The circulatory failure is a main cause of non-effective mechanical ventilation in asphyxia neonates. To correct the pathophysiologic changes of the circulation in time can effectively improve the prognosis.