Objective To compare the long-term survival of elderly patients with esophageal squamous cell carcinoma (ESCC) treated with surgical versus non-surgical treatment. Methods A retrospective analysis was conducted on the clinical data of elderly patients aged ≥70 years with ESCC who underwent esophagectomy or radiotherapy/chemotherapy at Sichuan Cancer Hospital from January 2009 to September 2017. Patients were divided into a surgical group (S group) and a non-surgical group (NS group) according to the treatment method. The propensity score matching method was used to match the two groups of patients at a ratio of 1∶1, and the survival of the two groups before and after matching was analyzed. Results A total of 726 elderly patients with ESCC were included, including 552 males and 174 females, with 651 patients aged ≥70-80 years and 75 patients aged ≥80-90 years. There were 515 patients in the S group and 211 patients in the NS group. The median follow-up time was 60.8 months, and the median overall survival of the S group was 41.9 months [95%CI (35.2, 48.5)], while that of the NS group was only 24.0 months [95%CI (19.8, 28.3)]. The 1-, 3-, and 5-year overall survival rates of the S group were 84%, 54%, and 40%, respectively, while those of the NS group were 72%, 40%, and 30%, respectively [HR=0.689, 95%CI (0.559, 0.849), P<0.001]. After matching, 138 patients were included in each group, and there was no statistical difference in the overall survival between the two groups [HR=0.871, 95%CI (0.649, 1.167), P=0.352]. Conclusion Compared with conservative treatment, there is no significant difference in the long-term survival of elderly patients aged ≥70 years who undergo esophagectomy for ESCC. Neoadjuvant therapy combined with surgery is still an important choice to potentially improve the survival of elderly patients with ESCC.

Objective To develop a novel transcatheter tricuspid valve replacement device and test its performance. Methods The transcatheter tricuspid valve stent consisted of double-layer self-expanding nitinol stent, biotissue-derived bovine pericardial leaflets, and PTFE woven. The delivery system, mainly consisting of a handle control unit and a delivery sheath, was sent to the correct position via right atrium or jugular vein. The sheath had a visualization feature, and the handle control unit could realize the functions of stable release and partial recovery of the interventional valve. In addition, this study performed animal survival experiments on the basis of in vitro experiments. A large-white pig was used as the experimental animal. Cardiopulmonary bypass was established through median thoracotomy, then the right atrium was opened, and the interventional valve was released under direct vision without cardiac arrest. Approximately 1 month after interventional valve implantation, the maneuverability and stability of the interventional tricuspid device were evaluated by autopsy. Results Through the animal experiment, the interventional valve was successfully released, and the anchoring was satisfactory. Postoperative transthoracic echocardiography showed that the interventional valve opened and closed well, the flow rate of tricuspid valve was 0.6 m/s, and there was no obvious tricuspid regurgitation. One month after the operation, we dissected the large-white pig and found the interventional valve was not deformed or displaced, the leaflets were well aligned, and there was thrombus attachment in the groove between the inner and outer layers of the interventional valve. Conclusion Animal experiment shows that the novel device can stably and firmly attach to the tricuspid annulus, with good anchoring effect, and effectively reduce paravalvular leakage.

Objective    To compare the clinical effects of segmentectomy and lobectomy for ≤2 cm lung adenocarcinoma with micropapillary and solid subtype negative by intraoperative frozen sections. Methods    The patients with adenocarcinoma who received segmentectomy or lobectomy in multicenter from June 2020 to March 2021 were included. They were divided into two groups according to a random number table, including a segmentectomy group (n=119, 44 males and 75 females with an average age of 56.6±8.9 years) and a lobectomy group (n=115, 43 males and 72 females with an average of 56.2±9.5 years). The clinical data of the patients were analyzed. Results    There was no significant difference in the baseline data between the two groups (P>0.05). No perioperative death was found. There was no statistical difference in the operation time (111.2±30.0 min vs. 107.3±34.3 min), blood loss (54.2±83.5 mL vs. 40.0±16.4 mL), drainage duration (2.8±0.6 d vs. 2.6±0.6 d), hospital stay time (3.9±2.3 d vs. 3.7±1.1 d) or pathology staging (P>0.05) between the two groups. The postoperative pulmonary function analysis revealed that the mean decreased values of forced vital capacity and forced expiratory volume in one second percent predicted in the segmentectomy group were significantly better than those in the lobectomy group (0.2±0.3 L vs. 0.4±0.3 L, P=0.005; 0.3%±8.1% vs. 2.9%±7.4%, P=0.041). Conclusion    Segmentectomy is effective in protecting lungs function, which is expected to improve life quality of patients.

Objective: To analyze the clinical characteristics of cases of novel coronavirus pneumonia and a preliminary study to explore the relationship between different clinical classification and liver damage. Methods: Consecutively confirmed novel coronavirus infection cases admitted to seven designated hospitals during January 23, 2020 to February 8, 2020 were included. Clinical classification (mild, moderate, severe, and critical) was carried out according to the diagnosis and treatment program of novel coronavirus pneumonia (Trial Fifth Edition) issued by the National Health Commission. The research data were analyzed using SPSS19.0 statistical software. Quantitative data were expressed as median (interquartile range), and qualitative data were expressed as frequency and rate. Results: 32 confirmed cases that met the inclusion criteria were included. 28 cases were of mild or moderate type (87.50%), and four cases (12.50%) of severe or critical type. Four cases (12.5%) were combined with one underlying disease (bronchial asthma, coronary heart disease, malignant tumor, chronic kidney disease), and one case (3.13%) was simultaneously combined with high blood pressure and malignant tumor. The results of laboratory examination showed that the alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (ALB), and total bilirubin (TBil) for entire cohort were 26.98 (16.88 ~ 46.09) U/L and 24.75 (18.71 ~ 31.79) U/L, 39.00 (36.20 ~ 44.20) g/L and 16.40 (11.34- ~ 21.15) mmol/L, respectively. ALT, AST, ALB and TBil of the mild or moderate subgroups were 22.75 (16.31- ~ 37.25) U/L, 23.63 (18.71 ~ 26.50) U/L, 39.70 (36.50 ~ 46.10) g/L, and 15.95 (11.34 ~ 20.83) mmol/L, respectively. ALT, AST, ALB and TBil of the severe or critical subgroups were 60.25 (40.88 ~ 68.90) U/L, 37.00 (20.88 ~ 64.45) U/L, 35.75 (28.68 ~ 42.00) g/L, and 20.50 (11.28 ~ 25.00) mmol/L, respectively. Conclusion The results of this multicenter retrospective study suggests that novel coronavirus pneumonia combined with liver damage is more likely to be caused by adverse drug reactions and systemic inflammation in severe patients receiving medical treatment. Therefore, liver function monitoring and evaluation should be strengthened during the treatment of such patients.

Objective To evaluate the safety and efficiency of robot assisted surgery guided by damage control orthopaedics(DCO) in polytraumatised patients with pelvic ring injuries.Methods A retrospective review of the pelvic fracture database was performed.Twenty-six patients who had sustained a pelvic fracture from September 2012 to December 2015 were suitable for robot-assisted minimally invasive internal fixation.They were 17 men and 9 women,aged from 23 to 58 years (average,42.6 years).Their Injury Severity Score(ISS) ranged from 20 to 31 points (average,21.3 years).According to Tile classification,6 cases were type B2,3 type B3,9 type C2 and 8 type C3.Guided by DCO,the vital signs were stabilized by all means and the fractures treated by simple and temporary external fixation before the pelvic and other fractures were managed by the robot-assisted minimally invasive internal fixation.Demographics,times to operating room (TOR),time from acute stabilization to late definitive internal fixation (TAL),time for bone union,type of robot-assisted surgery for major fractures,length of stay (LOS),postoperative complications and mortality were recorded.The outcomes of the pelvis were evaluated at the final follow-up according to the Matta criteria.Results Of the 26 patients,robot-navigated percutaneous screwing was conducted with 23 sacroiliac screws in 19,with 9 ramus pubicus screws in 9,with 6 supraacetabular screws in 4,and with 4 both-column screws in 2 cases.TOR averaged 2.7 times,TAL 5.9 days,LOS at ICU 2.1 days,ICU admission rate 46.2％ (12 of 26),hospital LOS 7.3 days,and time for pelvic bone union 79.0 days.None patients had postoperative complications related to the pelvic fracture and no one died.According to the Matta criteria at the final follow-ups,8 cases were excellent,11 good,5 fair and 2 poor,yielding an excellent and good rate of 73.1％.Conclusion Robot-navigated minimally invasive surgery plus DCO is effective,time saving and safe treatment for polytraumatised patients with pelvic ring injuries.

Objective To observe the effect of a repeated-sprint training on the speed-endurance of basketball players in a hypoxia environment.Methods Sixteen basketball players were divided into a hypoxiagroup and a normoxia group which had 8 persons each group.The 2 groups separatelyhad a repeated-sprint training with anaerobic power bicycles in a simulatedhypoxic environment at the altitude of 3000 meters and a normoxia environment for 4 weeks(twice a week).Before and after the training,the two groups of subjects had a shuttle run testing and a Wingateanaerobic powertestingin a normoxia environment.Then their blood were collected and measured the blood lactate level at the point-intime of after the shuttle run,3 min later,5 min later,7 min later,and 9 min later.Recorded the result of the shuttle run,the relative average power of the Wingateanaerobic powertesting,and carried on a statistic analysis of the data.Results Comparing with the performance of the shuttle run before the training,the performance of the 2 groups was improved obviously after the four-week-long training (P＜0.05).But there was no significant difference between the 2 groups(P＞0.05).The rate of blood lacticacid clearance in the hypoxia group was higher than that in the normoxia group,and there was a significant difference at 7 min (P＜0.01).The relative average power of the hypoxia group had a significant improvement(P＜0.05),while the normoxia group had no significant change(P＞0.05).There was no significant difference of the relative average power between the two groups.Conclusion Repeatedsprint training can improve basketball players' speed-endurance.Repeated-sprint training in a hypoxic environment can effectively improve basketball players' ability of reducing blood lactate in their body,and the improvement of this aerobic ability can help athletes to have a better performance in competitions.

Objective To investigate the effects and mechanisms of hypoxia on the contraction of mesen-teric arteries induced by phenylephrine (PE) in guinea pig. Methods Pressure myograph system was used to study the effects of 20, 40 and 60 min hypoxia (mixed with 95% CO2 and 5% O2) on the constriction induced by PE in acutely separated mesenteric artery (300 ~ 400 μm) of guinea pig. Results PE (0.1 ~ 100 μmol/L) caused the contractions of the mesenteric arteries in guinea pig in a concentration-dependent way . Hypoxia de creased the pH value of perfusion fluid from 7.4 to 6.3. Hypoxia significantly inhibited PE-induced vasocon-striction, and the inhibition was hard to recover after reoxygenation. Hypoxia inhibited PE-induced vasoconstric-tion in a time-dependent way , with the inhibition rate reduced in the sequence of inhibition duration of 60 , 40 and 20 min. When its value was decreased to 6.3 , the perfusion fluid even inhibited PE-induced vasoconstric tion. Conclusion Hypoxia can inhibit PE-induced vasoconstriction in the mesenteric arteries of guinea pig in a time-dependent way. The mechanism may have something to do with the change of pH.

1 1 patients with moderate or severe crowding in the anterior arch were treated with 4 premolar extraction.After canine distaliza-tion first approach,the teeth were aligned and leveled.The results of the study suggest that,with strict implementation of indication,this method may be a viable treatment for the moderate or severe crowding anterior.

23 cases were treated with immediate full denture.The second base-remodeling or re-prosthodontic treatment was given 3 months later based on the oral condition.Masticatory efficiency (ME)was measured at each stage.About 30% patients participated in the second base-remodeling procedure with ME of 52.63%.

Objective The present study was to investigate the effects of acute hypoxia on the electrophysiological properties and outward current of spiral ganglion cell (SGC).Methods SGC of newborn's Sprague Dawley (SD) rats were isolated and digested, primary cultured neurons for 8 h.By perfusion with physical saline solution containing no glucose and low oxygen, SGNs model of acute hypoxia was established.The whole-cell patch clamp recording was used to clarify the effect of hypoxia on the outward currents of SGC.Results The outward current of SGC showed characteristics of outward rectification, which contained two major components, one sensitive to the big conductance Ca2+-activated K + channels (BKca) which blocked by TEA, and the other could be suppressed by the Kv channel blocker 4-AP.When holding at-60 mV, acute hypoxia increased the outward current of SGC in a voltagedependent manner, which mainly increased the amplitude of the current activated by the votage ranged from 0 mV to +60 mV,and increased the amplitude of outward current from(1 160.0 ± 129.1)pA to (2 428 ±239.3) pA (n =9, P ＜ 0.01) at holding potential of-60mV.By perfusion with the Potassium channel blocker TEA or 4-AP, the former could significantly reduced the increasing of outward currents induced by hypoxia on the SGC, the latter had no significant effect on the outward current increased by the hypoxia.Conclusions These results suggest that acute hypoxia causes neuron hyperpolarization possibly by activating big conductance BKca of the SGC.When the BKca channels are activated, K + effluxes increase, which induces cell membrane hyperpolarization , and decreases cell excitability, which may affect the conducting function of SGC.