ObjectiveTo explore a feasible animal model of dysphagia after stroke. MethodsTwenty-two clean Sprague-Dawley rats were randomly divided into normal group (n = 11) and model group (n = 11). The model of dysphagia after stroke was established by the thread embolism, and the normal group received no intervention. The latency of the first swallowing attack and the number of swallowing were recorded three and seven days after modeling. The cerebral infarction was detected by TTC staining, and the neuronal apoptosis in ischemic brain was detected by TUNEL fluorescence staining. ResultsCompared with the normal group, the swallowing latency prolonged and the number of swallowing reduced three days in the model group, however, there was no significant difference (P > 0.05); seven days after modeling, the swallowing latency prolonged (P < 0.05), and the number of swallowing slightly reduced with little significant difference (P > 0.05). Compared with the normal group, the brain tissue showed obvious infarction area and a large number of apoptotic cells, while the body mass reduced in the model group (P < 0.05). ConclusionThe model rats express some features of dysphagia, which may become a transformation model of dysphagia after stroke.

【Objective】 To analyze the clinical characteristics of patients with primary carcinoma of the gallbladder (PGC) who underwent radical intent resection in our center in the last decade and the therapeutic effects of the operation. 【Methods】 A single-institution database of The First Affiliated Hospital of Xi'an Jiaotong University from January 2008 to December 2017 was queried for patients with PGC who had received surgical treatment. The data were studied retrospectively to assess the trend of total admission, radical resection rate, prognosis and clinicopathological characteristics of PGC in the last decade. 【Results】 A total of 2 159 patients with PGC were treated in our institution from 2008 to 2017. Of them, 1072 were surgically treated and 503 underwent radical intent resection. In the past 5 years (2013-2017), the radical resection rate was 26.5% (319 cases of the operation), which was significantly higher than that in 2008-2012 (19.2%) (P<0.001). The overall survival time of the patients who underwent radical resection was 32 months, and the 1-, 3-, and 5-year survival rate was 68.9%, 48.4% and 41.6%, respectively. Compared with the data of 2008-2012, the proportion of the patients with preoperative jaundice decreased in the past 5 years (7.8% vs. 14.7%, P<0.05), that of the patients who underwent D2 lymphadenectomy (74.0% vs. 26.1%, P<0.001) increased significantly (P<0.001), the total number of lymph nodes obtained from the dissection (8.07±5.18 vs. 5.89±3.14, P<0.001) increased significantly (95.6% vs. 89.7%, P<0.05), and the proportion of R0 resection (95.6%) increased significantly (P<0.05). 【Conclusion】 The diagnosis and treatment of radical intent resection of PGC in our hospital have changed significantly in the last decade, mainly reflected in the extension of lymphadenectomy, increase in R0 resection rate and decrease in patients with preoperative jaundice.

Objective: To forecast the risk distribution of inter-animal plague in Meriones unguiculatus effectively and provide scientific evidence for prevention and control of inter-animal plague, through studying the correlation between meteorological and environmental factors and inter-animal plague in Meriones unguiculatus. Methods: Positive data of plague bacterial culture in 30 epidemic source areas of Meriones unguiculatus in the Inner Mongolia plateau from 2005 to 2018, including detecting time, number of bacteria, latitude and longitude or detailed location, host type, were from the Chinese Disease Prevention and Control System Plague Prevention Management Information System and related professional institutions for plague prevention and treatment. Logistic regression was used to explore the relationship between the inter-animal plague and climate-related risk factors. The Maximum Entropy (Maxent) model was used to predict the habitat distributions of inter-animal plague, and the receiver operating characteristic (ROC) curve was used to validate the model. Results: There were 11 climatic factors including annual mean temperature, isothermality, temperature seasonality, mean temperature of driest quarter, mean temperature of warmest quarter, mean temperature of coldest quarter, annual precipitation, precipitation seasonality, globcover, normalized difference vegetation index and slope, were related to the outbreak of plague among Meriones unguiculatus and included in the model (OR = 1.302, 0.455, 0.957, 0.930, 4.864, 0.179, 0.986, 1.126, 0.992, 0.981, 0.721, P < 0.01). The increase of annual mean temperature, mean temperature of warmest quarter and precipitation seasonality will increase the risk of animal plague in the plague foci of Meriones unguiculatus; the increase of isothermality, temperature seasonality, mean temperature of driest quarter, mean temperature of coldest quarter, annual precipitation, globcover, normalized difference vegetation index, and slope will reduce the risk of animal plague in the plague foci of Meriones unguiculatus. The areas under the curve (AUCs) of the Maxent model training data and test data were 0.988 and 0.985, the prediction effect of the model was better. The habitat distribution of Meriones unguiculatus plague mainly concentrated in the central and northern Ulanqab plateau, Ordos plateau, and eastern Hetao plain. Conclusions The use of Maxent model and climate data can predict the potential risks and spatial distribution of animal plague in Meriones unguiculatus; the results are accurate and reliable.

The paper analyzes the status of trauma rescue and treatment informatization in Xinjiang,states the thoughts of construction of intelligent trauma medical center in southern Xinjiang (including the telemedicine system based on regional medical network,orthopedics trauma and disease diagnosis and treatment platform,etc.).It also provides the application examples and discusses the social economic benefits.

Objective To evaluate the effect of conversion from mycophenolic acid (MPA) to mizoribine (MZR) in renal transplant recipients with gastrointestinal tract (GI) symptoms.Methods A total of 355 renal transplant recipients with GI symptoms caused by MPA administration were enrolled from April 2015 to March 2017 in 25 different renal transplant centers in China.The symptomatic improvement of GI before (baseline) and after conversion to MZR (1,2,4 weeks) was assessed by each item of GI symptoms indication.In addition,the efficacy and safety of the conversion therapy during 12 months were determined.Results Patients showed improvement in GI symptoms including diarrhea,abdominal pain,abdominal distention and stomachache after conversion to MZR 1,2,4 weeks (P＜0.05).In patients with different severity of diarrhea,conversion to MZR therapy significantly improved diarrhea (P＜0.05).During 12 months,no patient experienced clinical immune rejection.We did not observe any infections,leucopenia and other serious side effects.Conclusion MZR could markedly improve GI symptoms caused by MPA administration in renal transplant recipients.

Objective To evaluate the role of hippocampal adenosine monophosphate-activated protein kinase (AMPK) signaling pathway in reduction of postoperative cognitive dysfunction by electroacupuncture (EA) preconditioning in aged rats.Methods A total of 150 healthy male Sprague-Dawley rats,aged 18-20 months,weighing 400-500 g,were randomly divided into 5 groups (n=30 each) using a random number table:control group (group C);splenectomy group (group O);preconditioning with EA at non-acupoint group (group NEA);preconditioning with EA at Baihui acupoint group (group EA);preconditioning with EA at Baihui acupoint + AMPK inhibitor group (group EAC).EA and EAC groups received EA at Baihui acupoints with a sparse-dense wave at an intensity of 1 mA and a frequency of 2 Hz/15 Hz for 30 nin,once a day,for 5 consecutive days,and splenectomy was performed at 24 h after the end of the last stimulation.Group NEA received EA at the points 2 mm lateral to the acupoints of Baihui,and the other treatments were similar to those previously described in group EA.Compound C 20 mg/kg was injected intraperitoneally at 5 min before operation in group EAC.Morris water maze test was performed at 1,3 and 5 days after operation,and the escape latency and swimming distance were recorded.The rats were then sacrificed,and brains were removed for examination of the pathological changes in the hippocampal CA3 region and for determination of the expression of AMPK,phosphorylated AMPK (p-AMPK),nuclear factor kappa B (NF-κB),interleukin-1beta (IL-1β),and tumor necrosis factor-alpha (TNF-α) by Western blot.Results Compared with group C,the escape latency and swimming distance were significantly prolonged,and the expression of AMPK,p-AMPK,NF-κB,IL-13,and TNF-α was significantly up-regulated in O,NEA,EA and EAC groups (P＜0.05).Compared with group O,the escape latency and swimming distance were significantly shortened,and the expression of AMPK,p-AMPK,NF-κB,IL-1β and TNF-α was significantly down-regulated in EA and EAC groups (P＜0.05),and no significant change was found in the parameters mentioned above in group NEA (P＞0.05).Compared with group EA,the escape latency and swimming distance were significantly prolonged,the expression of AMPK and p-AMPK was significantly down-regulated,and the expression of NF-κB,IL-1β and TNF-α was significantly up-regulated in group EAC (P＜0.05).Conclusion Activation of hippocampal AMPK signaling pathway is involved in EA preconditioning-induced improvement in postoperative cognitive dysfunction in aged rats.

Objective To investigate the human epidermal growth factor receptor?2 ( HER?2 ) expression in esophagogastirc junction adenocarcinoma ( Siewert type Ⅱ) and its clinical significance. Methods A total of 180 patients with esophagogastric junction adenocarcinoma ( Siewert type Ⅱ) were included in this study. The HER?2 expression was detected by immunohistochemistry ( IHC ) , and fluorescence in situ hybridization ( FISH) analysis was performed to assess the HER?2 gene amplification in the IHC?positive and IHC?weak positive cases. Results HER?2 overexpression ( 3+) , weak positive ( 2+) and negative (1+/0) was 11.7%(21/180), 8.9%(16/180), and 79.4%(143/180), respectively. The FISH analysis showed HER?2 gene amplification in 95.2%(20/21) of HER?2(3+) cases and 18.8% (3/16) of HER?2( 2+) cases. The concordance rate between IHC and FISH was 95. 2%. Overexpression of HER?2 (3+) was associated with the tumor differentiation (P<0.05), and irrelevant to age, sex, pT stage, pN stage, pM stage and pTNM stage ( P>0.05) . The median overall survival time ( OS) was 13 months in HER?2( 3+) patients, significantly shorter than the 21 months in HER?2 ( 2+) and HER?2 (+/-) cases ( P<0.01) . Conclusions Approximately 11. 7% of the patients with esophagogastric junction adenocarcinoma ( Siewert type Ⅱ) are HER?2?positive on IHC. HER?2 overexpression is associated with the tumor differentiation. IHC can be used as a screening test for the positive expression of HER?2 in the esophagogastirc junction adenocarcinoma ( Siewert typeⅡ) . However, FISH detection can be used as a more reliable detection method.

Objective To investigate the human epidermal growth factor receptor?2 ( HER?2 ) expression in esophagogastirc junction adenocarcinoma ( Siewert type Ⅱ) and its clinical significance. Methods A total of 180 patients with esophagogastric junction adenocarcinoma ( Siewert type Ⅱ) were included in this study. The HER?2 expression was detected by immunohistochemistry ( IHC ) , and fluorescence in situ hybridization ( FISH) analysis was performed to assess the HER?2 gene amplification in the IHC?positive and IHC?weak positive cases. Results HER?2 overexpression ( 3+) , weak positive ( 2+) and negative (1+/0) was 11.7%(21/180), 8.9%(16/180), and 79.4%(143/180), respectively. The FISH analysis showed HER?2 gene amplification in 95.2%(20/21) of HER?2(3+) cases and 18.8% (3/16) of HER?2( 2+) cases. The concordance rate between IHC and FISH was 95. 2%. Overexpression of HER?2 (3+) was associated with the tumor differentiation (P<0.05), and irrelevant to age, sex, pT stage, pN stage, pM stage and pTNM stage ( P>0.05) . The median overall survival time ( OS) was 13 months in HER?2( 3+) patients, significantly shorter than the 21 months in HER?2 ( 2+) and HER?2 (+/-) cases ( P<0.01) . Conclusions Approximately 11. 7% of the patients with esophagogastric junction adenocarcinoma ( Siewert type Ⅱ) are HER?2?positive on IHC. HER?2 overexpression is associated with the tumor differentiation. IHC can be used as a screening test for the positive expression of HER?2 in the esophagogastirc junction adenocarcinoma ( Siewert typeⅡ) . However, FISH detection can be used as a more reliable detection method.

OBJECTIVETo compare the value of applicability of the 7th edition of UICC-AJCC esophageal and gastric cancer TNM staging system in the prognostic prediction of adenocarcinoma of esophagogastric junction (EGJ).

METHODSDuring June 1, 2007 through Dec. 31, 2010, a total of 199 patients with adenocarcinoma of esophagogastric junction (Siewert type II) underwent R0-intent resection from June 1, 2007 to Dec 31, 2010 in our hospital. Their clinicopathological and survival data were retrospectively analyzed with Kaplan-Meier and Cox regression models. They were restaged according to the 7th edition of UICC/AJCC TNM stage systems for esophageal adenocarcinoma and gastric cancer, respectively. Then the likelihood ratio chi-square test related to the Cox regression model and Akaike information criterion (AIC) were used for measuring goodness of fit for both staging systems.

RESULTS199 patients with Siewert type II esophagogastric junction adenocarcinoma were identified in this study. Out of them, there were 162 males and 37 females. Their age range was from 38 to 79 years, with a median age of 62 years. 176 cases underwent transthoracic surgery, and other 23 cases underwent transabdominal surgery. TNM-EC and TNM-GC classified 4 patients to stage T1, 39 to T2, 139 to T3, and 17 to T4a, respectively, and classified 76 patients to stage N0, 58 to N1, 49 to N2, 16 to N3, respectively. The median follow-up period was 30 months. The 1-, 3-, and 5-year survival rates were 95.0%, 52.7% and 39.2%, respectively. Univariate analysis indicated that age at surgery (P = 0.009), surgical approach (P = 0.002), cell differentiation (P = 0.030), preoperative co-morbidity implications (P = 0.026), depth of tumor invasion (P < 0.001) and number of metastatic lymph nodes (P < 0.001) were significantly influencing factors of postoperative overall survival. Multivariate analysis showed that the independent prognostic factors for adenocarcinoma of esophagogastric junction were only T stage, N stage and preoperative co-morbidity and morbidities according to the 7th edition of esophageal cancer or gastric cancer TNM staging systems. The AIC value was 961.4 for the 7th edition of esophageal adenocarcinoma caner staging system, and 965.7 for the 7th edition of gastric cancer staging system.

CONCLUSIONSThe UICC/AJCC 7th edition of esophageal adenocarcinoma cancer TNM classification staging system is superior to the 7th edition of gastric cancer TNM staging system for adenocarcinoma of esophagogastric junction.

Adenocarcinoma ; diagnosis ; Adult ; Aged ; Aged, 80 and over ; Esophageal Neoplasms ; diagnosis ; Esophagogastric Junction ; Female ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Stomach Neoplasms ; Survival Rate

Objective To compare the applicability of the 7th and 6th editions of the UICC-AJCC esophageal cancer TNM staging systems for adenocarcinoma of esophagogastric junction (EGJ).Methods During June 2007 through December 2010,199 patients with EGJ adenocarcinoma(Siewert type Ⅱ) underwent R0-intent resection in our hospital.Their clinicopatholigical and survival data were retrospectively analyzed with Kaplan-Meier and Cox regression models.They were restaged according to the 7th and 6th UICC/AJCC TNM staging systems for esophageal cancer,respectively.Then the Akaike information criterion(AIC) was used for measuring goodness of fit of both staging systems.Results Among 199 patients,there were 162 males and 37 females.Univariate analysis indicated that age(P =0.009),surgical approach(P =0.002),cell differentiation (P =0.030),preoperative co-morbidity (P =0.026),depth of tumor invasion (P ＜ 0.000) and number of metastatic lymph nodes(P ＜ 0.000) were significant influencing factors on overall survival.Multivariate analysis demonstrated that the independent prognostic factors for EGJ adenocarcinoma were age,T stage,N stage and preoperative co-morbidity according to the 6th edition of esophageal cancer TNM staging system,and only T stage,N stage and preoperative co-morbidity according to the 7th edition of esophageal cancer TNM staging system.The AIC value was 961.4 for the 7th edition of esophageal cancer staging system and 972.4 for the 6th edition.Conclusion The 7th edition of UICC/AJCC esophageal cancer TNM classification is su perior to its 6th edition of esophageal cancer staging system for EGJ adenocarcinoma.