Objective To investigate the clinical efficacy of minimally invasive esophagectomy and open triple-incision esophagectomy for esophageal cancer (EC).Methods The retrospective cohort study was conducted.The clinicopathological data of 454 EC patients who were admitted to the Tianjin Medical University Cancer Institute and Hospital from January 2012 to September 2016 were collected.Of 454 patients,229 undergoing thoracoscopic esophagectomy (194) or combined thoracoscopic + laparoscopic esophagectomy (35) were allocated into the minimally invasive group,and 225 undergoing open triple-incision esophagectomy in the left cervical,right chest and epigastric regions were allocated into the open group.Observation indicators:(1) intraoperative situations;(2) postoperative recovery situations;(3) stratified analysis;(4) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative survival up to October 2017.Measurement data with normal distribution were represented as-x±s,and t test was used for comparison between groups.Measurement data with skewed distribution were described as M (range),non-parametric test was used for comparison between groups.Count data were expressed as percentage,and the chi-square test or fisher exact probability method were used to test comparison between groups.KaplanMeier method was used to calculate survival rate and draw survival curve.Log-rank test was used for survival analysis.Results (1) Intraoperative situations:operation time,numbers of upper mediastina lymph node dissected and right laryngeal nerve lymph node dissected in stage 0-Ⅱ of TNM staging and numbers of neck lymph nodes dissected in stage Ⅲ of TNM staging were respectively (307±70)minutes,4 (range,0-18),2 (range,0-10),0 (range,0-24) in the minimally invasive group and (267±49)minutes,3 (range,0-15),1 (range,0-7),0 (range,0-46) in the open group,with statistically significant differences between groups (t =7.071,Z=-2.207,-2.717,-1.969,P＜0.05).(2) Postoperative recovery situations:thoracic drainage-tube removal time and volume of drainage fluid were respectively 5 days (range,2-88 days),280 mL (range,0-7 792 mL)in the minimally invasive group and 8 days (range,1-72 days),1 650 mL (range,225-7 970 mL),with statistically significant differences between groups (Z =-9.618,-15.443,P ＜ 0.05).The cases with total postoperative complications,arrhythmia and recurrent laryngeal nerve paralysis were 72,20,35 in the minimally invasive group and 100,36,56 in the open group,with statistically significant differences between groups (x2=8.155,5.542,6.533,P＜0.05).Patients may be combined with multiple complications.Two patients died within 30 days postoperatively,including 1 with respiratory failure and 1 with pulmonary embolism.Patients with other complications were improved after symptomatic and supportive treatments.(3) Stratified analysis:of 229 patients in the minimally invasive group,93 underwent surgery within the physician's learning curve and 136 underwent surgery after physician's learning curve.Operation time,volume of intraoperative blood loss,dissected numbers of upper mediastina lymph node,right laryngeal nerve lymph node,left laryngeal nerve lymph node,middle mediastinal lymph node and lower mediastinal lymph node,cases with pneumonia,recurrent laryngeal nerve paralysis,chylothorax,anastomotic stenosis,anastomotic fistula,respiratory failure and pulmonary embolism in 93 patients were respectively (306±68)minutes,(217± 178)mL,3 (range,0-20),2 (range,0-8),0 (range,0-10),6(range,0-17),1 (range,0-6),5,16,1,5,3,2,2 in the minimally invasive group and (308±72)minutes,(200±112)mL,4 (range,0-37),2 (range,0-10),0 (range,0-8),7 (range,0-20),1 (range,0-10),4,19,3,3,4,4,0 in the open group,with a statistically significant difference in number of upper mediastina lymph node dissected between groups (Z=-2.472,P＜0.05) and no statistically significant difference in other indicators between groups (t =-0.160,0.917,Z =-0.113,-1.698,-0.950,-0.510,x2 =0.342,0.446,P＞0.05).(4) Follow-up and survival situations:of 454 patients,415 were followed up for 1-62 months,with a median time of 28 months.Among the 415 patients,operation time ≥ 3 years was detected in 162 patients,(77 in the minimally invasive group and 85 in the open group),and 3-year cumulative survival rates of the minimally invasive and open groups were 68.1％ and 53.8％,showing no statistically significant difference between groups (x2=3.293,P＞0.05).Further subgroup analysis showed that postoperative 3-year cumulative survival rates of patients with the stage Ⅰ-Ⅱ and Ⅲ of TNM staging were respectively 82.1％,53.7％ in the minimally invasive group and 62.6％,48.6％ in the open group,showing no statistically significant difference between groups (x2=2.664,0.382,P＞ 0.05).Conclusion Minimally invasive esophagectomy has some characteristics of less surgical trauma postoperative complications,and its resection effect is comparable to open esophagectomy.

The voltage-gated Na channel subtype Nav1.7 is important for pain and itch in rodents and humans. We previously showed that a Nav1.7-targeting monoclonal antibody (SVmab) reduces Na currents and pain and itch responses in mice. Here, we investigated whether recombinant SVmab (rSVmab) binds to and blocks Nav1.7 similar to SVmab. ELISA tests revealed that SVmab was capable of binding to Nav1.7-expressing HEK293 cells, mouse DRG neurons, human nerve tissue, and the voltage-sensor domain II of Nav1.7. In contrast, rSVmab showed no or weak binding to Nav1.7 in these tests. Patch-clamp recordings showed that SVmab, but not rSVmab, markedly inhibited Na currents in Nav1.7-expressing HEK293 cells. Notably, electrical field stimulation increased the blocking activity of SVmab and rSVmab in Nav1.7-expressing HEK293 cells. SVmab was more effective than rSVmab in inhibiting paclitaxel-induced mechanical allodynia. SVmab also bound to human DRG neurons and inhibited their Na currents. Finally, potential reasons for the differential efficacy of SVmab and rSVmab and future directions are discussed.
Animals ; Antibodies, Monoclonal ; therapeutic use ; Biotin ; metabolism ; Cells, Cultured ; Disease Models, Animal ; Female ; Ganglia, Spinal ; cytology ; HEK293 Cells ; Humans ; Hybridomas ; chemistry ; Hyperalgesia ; drug therapy ; Male ; Mice ; Mice, Inbred C57BL ; NAV1.5 Voltage-Gated Sodium Channel ; metabolism ; NAV1.7 Voltage-Gated Sodium Channel ; chemistry ; immunology ; metabolism ; Neuralgia ; drug therapy ; metabolism ; Protein Binding ; drug effects ; Recombinant Proteins ; biosynthesis ; therapeutic use ; Sensory Receptor Cells ; drug effects ; physiology

Objective Obstructive sleep apnea (OSA) is closely related to obesity, insulin resistance and inflammation. Secreted frizzled-related protein 5 (SFRP5) is a recently discovered adipokine. It is involved in insulin resistance and inflammation in obesity. This study aimed at evaluating the association between SFRP5 and sleeping characteristics as well as biochemical parameters of OSA patients. Methods This was a prospective case control study. Nondiabetic OSA patients and controls were consecutively recruited and divided into three groups: OSA group, apnea-hypopnea Index (AHI)≥5/h; healthy controls with normal body mass index (BMI); obese controls without OSA, and BMI > 24.0 kg/m. All participants underwent polysomnography (PSG). Plasma SFRP5 was examined using enzyme-linked immunosorbent assay (ELISA). Blood biochemical examinations, including fasting blood glucose (FBG), lipid profile, hypersensitive C-reactive protein (hsCRP), were performed early in the morning after PSG. Patients with severe OSA were treated with nasal continuous positive airway pressure (nCPAP), and plasma SFRP5 was repeatedly measured for comparison. Results Sixty-eight subjects were enrolled in the study, including 38 patients of OSA, whose medium AHI was 58.70 /h (36.63, 71.15), 20 obese controls, and 10 healthy controls. The plasma SFRP5 level of OSA patients was not significantly different from that of healthy controls or obese controls. In OSA patients, SFRP5 level correlated positively with triglyceride level (r=0.447, P=0.005) and negatively with LDL-cholesterol level and HDL- cholesterol level (r=-0.472 and P=0.003; r=-0.478 and P=0.002; respectively). SFRP5 level was not found correlating with FBG, AHI, or any of nocturnal hypoxia parameters. After overnight nCPAP treatment, plasma SFRP5 levels of OSA patients did not change significantly (t=1.557, P = 0.148) compared to that of pretreatment. Conclusions In nondiabetic OSA patients, plasma SFRP5 is associated with the lipid profile. However, no correlation was observed between SFRP5 and FBG or sleep parameters. The SFRP5 level of OSA patients did not differ from that of non-OSA individuals in our study.

Objective To analyze the health life expectancy (HALE) of the residents aged 15 years and above in Zhejiang Province and to evaluate the health level among adults. Methods The study was based the mortality data collected from Zhejiang Chronic Disease Surveillance Information and Management System, and the mortality rates were from the Under-Reporting Survey and the sample data in Zhejiang from the 5th National Health Service Survey in 2013. A Sullivan' s method was used to calculate the HALE. Results The life expectancy and self-evaluated HALE were 63.62 years, 55.80 years, respectively, and the difference was 7.82 years (61.49 years VS 55.13 years in males and 66.10 years VS 56.57 years in females) . The self-evaluated HALE 55.89 years in urban and 55.54 years in rural residents aged 15 years and above. The proportion of self-evaluated HALE in the total life expectancy was 87.70%, and it decreased with age, and the proportion has dropped to 67.31% in ≥65 age group. Life expectancy without chronic morbidity was 46.68 years (46.35 years in males and 47.01 years in females; 44.03 years in urban and 47.15 years in rural areas) among residents aged 15 years and above, and the proportion of self-evaluated HALE without chronic morbidity in the total life expectancy without chronic morbidity was 73.37%. Conclusion In general the proportion of self-evaluated HALE in the total life expectancy was small , and males had a greater proportion than female, and adults in rural areas had a greater proportion than that in urban areas. We should consider NCDS management for the elderly residents and to improve the life quality among the elderly residents.

Adult ; Antiviral Agents ; therapeutic use ; China ; Humans ; Male ; Zika Virus Infection ; diagnosis ; drug therapy ; physiopathology

To discuss the inheritance and innovation study of Chinese medicine processing technology from three aspects： inheritance, standardization and industrial innovation development, propose "three lacks" in inheritance, "six lacks of standardization, and one lack of unity" in standardization, and "three emphasizing and three despising aspects" in industrial innovation, and propose feasible solutions for the above mentioned problems, providing a good foundation for inheritance and innovation of Chinese medicine processing.

Objective To investigate the association between breast tissue specified variants in p53 binding sites and the risk of BC in Chinese women.Methods ChIP-seq database on p53 binding sites in MCF-7 cell lines was extracted to identify the possible variants in p53 target genes.A hospital-based case-control study was then performed to investigate the association between variants in p53 binding sites and the risk of BC in a Chinese women population.Results Three variants were identified from the bioinformatics analysis.A total of 1 274 BC cases and 1 255 frequency-matched cancer-free controls were included in this case-control study.The average age was comparable between the case and the control groups,with the P value as 0.318.Meanwhile,distributions on menopausal status,smoking and alcohol intake between cases and controls were similar with the P values as 0.539,0.258 and 0.131,respectively.The genotype distribution of rs1295925 was significantly different between the case and the control groups.Individuals that carrying rs1295925-CT and rs1295925-TT genotypes were significantly associated with an increased BC risk when compared with rs1295925-CC genotype after adjustment of age,menopausal status,smoking and alcohol intake (0R=1.32,95％ CI:1.07-1.62 and OR=1.41,95％CI:1.13-1.78,respectively).Positive associations were also observed under the allelic,dominant and additive models.Conclusion rs1295925 which located in VMP1 gene was associated with increased BC risk in the Chinese women population.

BACKGROUNDThe N400 component of event-related potentials (ERP) has recently drawn widespread attention at home and abroad. This study was to explore the relationship between N400 changes and risperidone treatment and rehabilitation infirst-episode schizophrenia (FES).

METHODSERP component N400 was recorded by Guangzhou Runjie WJ-1 ERP instruments, in 58 FES before and 6 months, 15 months after risperidone treatment, and in 62 normal controls. The patients' syndromes were assessed by Positive and Negative Syndrome Scale (PANSS). And the stimuli are Chinese sentences with matching (congruent) or mismatching (incongruent) ending words.

RESULTSN400 latencies were prolonged, and amplitudes were decreased in Cz, Pz, Fz, C3, C4, in FES compared with in NC, before treatment. The prolonged N400 latencies and decreased amplitudes were negatively correlated with the patients' positive scale and total scale of PANSS. There are significant differences of N400 amplitudes and latencies in 6 months and 15 months follow-up after treatment. Before treatment, 6 months and 15 months after treatment, N400 latencies are 446 ± 35 ms, 440 ± 37 ms, 414 ± 31 ms (F = 9.72, P < 0.01) in incongruent situation; N400 amplitudes are 5.2 ± 4.6 μV, 5.7 ± 4.8 μV, 7.3 ± 5.0 μV (F = 2.06, P > 0.05) in congruent situation, and 8.5 ± 5.9 μV, 10.1 ± 5.0 μV, 11.9 ± 7.0 μV (F = 3.697, P < 0.05) in incongruent situation.

CONCLUSIONSN400 could be used to predict the effects of treatment of schizophrenia to some degree. The linguistic and cognitive impairment in schizophrenia can be improved by antipsychotic drugs.

Adult ; Evoked Potentials ; Follow-Up Studies ; Humans ; Middle Aged ; Risperidone ; therapeutic use ; Schizophrenia ; drug therapy ; rehabilitation

INTRODUCTIONMultimodality therapy, including preoperative chemoradiotherapy (CRT) and total mesorectal excision (TME), has effectively reduced local recurrence rates of rectal cancer over the past decade. However, the benefits and risks of the addition of neoadjuvant CRT to surgery need to be evaluated. This study was to compare the efficacy of TME with versus without preoperative concurrent chemoradiotherapy (CCRT) involving XELOX regimen (oxaliplatin plus capecitabine) in Chinese patients with stages II and III mid/low rectal adenocarcinoma.

METHODSWe randomly assigned patients to the TME group (TME without preoperative CCRT) or CCRT + TME group (TME with preoperative CCRT). The primary endpoint was disease-free survival (DFS); the secondary endpoints were overall survival (OS), local and distant recurrence, tumor response to CRT, toxicity, sphincter preservation, and surgical complications. An interim analysis of the potential inferiority of DFS in the CCRT + TME group was planned when the first 180 patients had been followed up for at least 6 months.

RESULTSA total of 94 patients in the TME group and 90 patients in the CCRT + TME group were able to be evaluated. The 3-year DFS and OS rates were 86.3 % and 91.5 % in the whole cohort, respectively. The 3-year DFS rates of the TME and CCRT + TME groups were 85.7% and 87.9 % (P = 0.766), respectively, and the 3-year OS rates were 90.7 % and 92.3 % (P = 0.855), respectively. The functional sphincter preservation rates of the TME and CCRT + TME groups were 71.3 % and 70.0 % (P = 0.849), respectively. In the TME group, 16 (17.0 %) patients were proven to have pTNM stage I disease after surgery. In the CCRT + TME group, 32 (35.6 %) patients achieved a pathologic complete response (pCR).

CONCLUSIONSPreliminary results indicated no significant differences in the DFS, OS, or functional sphincter preservation rates between the TME and CCRT + TME groups. However, preoperative CCRT with XELOX yielded a high pCR rate. Newer techniques are needed to improve the staging accuracy, and further investigation is warranted.

CLINICAL TRIAL REGISTRATION NUMBERChi CTR-TRC-08000122.

Adenocarcinoma ; Antineoplastic Combined Chemotherapy Protocols ; Chemoradiotherapy ; Combined Modality Therapy ; Deoxycytidine ; analogs & derivatives ; Disease-Free Survival ; Fluorouracil ; analogs & derivatives ; Humans ; Neoadjuvant Therapy ; Neoplasm Staging ; Organoplatinum Compounds ; Prognosis ; Prospective Studies ; Rectal Neoplasms ; Survival Rate

OBJECTIVETo observe the effect of Chuanhuang No.1 Recipe (CHR) on renal function and micro-inflammation in phase 3 chronic kidney disease (CKD) patients.

METHODSTotally 60 phase 3 CKD patients were randomly assigned to the treatment group (treated by CHR) and the control group (treated by Losartan Potassium), 30 in each group. All patients received basic treatment. Patients in the treatment group took CHR decoction, 400 mL each time, one dose per day, while those in the control group took Losartan Potassium, 50-100 mg per day. All medication lasted for 24 weeks. Changes of serum creatinine (SCr), blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), serum uric acid (UA), 24 h urinary protein excretion (24 h U-pro), urinary microalbumin (U-Alb), high-sensitivity C-reactive protein (hs-CRP), serum tumor necrosis factor (TNF)-alpha, and serum IL-6 were detected and compared before and after treatment. Efficacy was also compared.

RESULTSCompared with before treatment, SCr and BUN significantly decreased in the treatment group (P<0.05, P<0.01); eGFR in- creased (P<0.05). Only UA obviously decreased in the control group (P<0.05), but with no obvious change in SCr, BUN, or eGFR. Compared with before treatment, 24 h U-pro decreased after treatment in the treatment group (P<0.05), but with less decreased level when compared with the control group. U- Alb was also significantly decreased in the control group (P<0.01). There was statistical difference in 24 h U-pro and U-Alb between the two groups after treatment (P<0.05). Compared with before treatment, hs-CRP obviously decreased after treatment in the two groups, but serum levels of TNF-alpha and IL-6 obviously decreased only in the treatment group (P<0.05). The total effective rate was obviously higher in the treatment group than in the control group (70.00% vs. 43.33%, P<0.01).

CONCLUSIONCHR could efficiently improve the renal function of phase 3 CKD patients and alleviate the micro-inflammation.

Adult ; Blood Urea Nitrogen ; C-Reactive Protein ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Inflammation ; Interleukin-6 ; metabolism ; Losartan ; therapeutic use ; Male ; Middle Aged ; Phytotherapy ; Renal Insufficiency, Chronic ; drug therapy ; Tumor Necrosis Factor-alpha ; metabolism ; Urea