Objective To investigate the value of narrow band imaging (NBI) and lugol chromo-endoscopy (LCE) in the diagnosis of advanced esophageal carcinoma.Methods The clinical data of 162 patients with advanced esophageal carcinoma who received NBI and LCE at the Cancer Hospital of Peking University from November 2010 to May 2012 were retrospectively analyzed.Esophageal mucosa was first examined using white light imaging (WLI),and then followed by NBI and LCE,and the lengths of the lesions were recorded.Biopsy histology was obtained in all abnormal mucosa which were detected by NBI or LCE.Difference in the length of lesions detected by the NBI/LCE and WLI was calculated.Surgical approach and method of anastomosis were recorded for patients who received surgical treatment,and the final treatment method was recorded for patients who did not receive surgical treatment.Difference in the treatment methods was compared before and after endoscopy.Results The length of the lesions detected by the 3 methods was identical in 121 patients,different in 41 patients.The difference ranged between 1 and 3 cm was observed in 22 patients,＞3 cm and ≤5 cm in 8 patients,＞5 cm and ≤10 cm in 7 patients,＞ 10 cm in 4 patients.Of the patients in the above mentioned 4 categories,there were 1,2,2,4 patients in each category received neo-adjuvant therapy,and the rest patients received operation.Superficial cancer contiguous to the primary lesion was found in 41 patients,including squamous cell carcinoma in 31 patients,carcinoma-in-situ in 3 patients and severe dysplasia in 7 patients.Of the 153 patients who received surgery,the surgical plan for 12 patients was modified.Intrathoracic anastomosis was changed to cervical anastomosis in 2 patients,anastomosis under the aortic arch was changed to anastomosis above the aortic arch in 3 patients,trans-abdominal operation was changed to thoraco-abdominal operation in 7 patients.Conclusions The combination of NBI and LCE is more accurate to evaluate the extent of lesions of advanced esophageal carcinoma,and is useful to decide the treatment protocol.Pathological examination of the adjacent abnormal mucosa should be carried out for patients whose lesion length was inconsistent under different observation methods.

Objective To evaluate the accuracy and influencing factors of mini-probe endoscopic ultrasonography (EUS) in determining the T stage for early gastric cancer (EGC).Methods The clinical data of 103 patients with EGC who were admitted to the Peking University Cancer Hospital from March 2011 to June 2014 were retrospectively analyzed.The diagnosis results of mini-probe EUS were compared with postoperative pathological findings,of which the differences in the accuracy of mini-probe EUS in determining the T stage of EGC were analyzed according to tumor location,diameter,differentiated types,with or without ulceration and Lauren classification.The rate comparison and univariate analysis were done by the chi-square test,and multivariate analysis was done using the Logistic regression model.Results Among 107 lesions,75 lesions were detected in uT1a stage by mini-probe EUS and 32 lesions in uT1b stage.The results of pathological examination showed that 61 lesions were detected in T1 a stage,40 lesions in T1 b stage and 6 lesions in T2 stage.The accuracy of mini-probe EUS in the T1 stage of EGC was 66.4％ (71/107),including 70.7％ (53/75) in the uT1 a stage and 56.3 ％ (18/32) in the uT1b stage of EGC.There were significant differences in the accuracy of mini-probe EUS for determining the T stage of EGC among the patients with different tumor diameters,different differentiated types and with or without ulceration (x2=7.834,7.432,6.461,P ＜0.05).The results of multivariate analysis showed that tumor diameter more than 30 mm and undifferentiated types of tumors were independent risk factors affecting the accuracy of miniprobe EUS in determining the T stage of EGC (OR =0.340,0.332,95％ confidence interval:0.563-0.932,0.582-1.022,P ＜ 0.05).Conclusions The clinical value of mini-probe EUS in the T stage of EGC is relatively high.The accuracy of mini-probe EUS detecting in the T1 a stage of EGC is higher than the T1 b stage of EGC,and the factors affecting the accuracy of mini-probe EUS in determining preoperative stage of EGC include tumor diameter more than 30 mm and undifferentiated type of tumors.

Objective To investigate the clinical efficacy of covered self-expanding metal stent in the treatment of malignant esophageal stricture.Methods The clinical data of 512 patients accepted stent were retrospectively analyzed,which included patients' profiles,relief of dysphagia,incidence of complications and survival period.The data were analyzed by t test.Results A total of 596 stents were placed in 512 patients.There was significant difference in mean dysphagia score between before and after stent placement (grade 3.4±0.6 vs grade 1.1±0.8,t=54.09,P＜0.01).After the placement,the overall incidence of complications was 14.5％ (74/512),of which there were 21 cases of severe retrosternal pain (4.1％),16 cases of bleeding (3.1 ％),29 cases of stent displacement (5.7％),six cases of food impaction (1.2％),two cases of fistula without completely blocked (0.4％).The survival period of 238 patients with complete follow-up ranged from 30 to 1445 days,the mean time was 218.9 days.Conclusion Endoscopic covered self-expanding metal stent placement may effectively relieve dysphagia symptoms in patients with malignant esophageal stricture.

Objective: To observe the eff ect and mechanism of chronic high-fat diet on predation behavior in rats. Methods: Ten female SD rats with 4-week-old were randomly divided into a normal control group (NC group,n=5) and a chronic high-fat diet group (HF group,n=5). The rats in the NC group received the regular diet while rats in the HF group were fed with high-fat diet. Fitf een weeks later, the predation behavior of rats was evaluated by open if eld test and food foraging tests. At the end of experiments, the rats were killed and brain tissues were collected for evaluation of c-Fos protein expression in anterior cingulate cortex by immunohistochemical assay. Results: hT e predation behavior of rats in the HF group was signiif cantly impaired in the competitive or non-competitive food foraging test compared with the control rats (P<0.001). hT e c-fos protein expression in anterior cingulate cortex of rats from the HF group was signiif cantly decreased (P<0.001). Conclusion: Long time high-fat diet can aff ect the predation behavior of rats, which is related todysfunction of neuron in anterior cingulate cortex.

ObjectiveTo study the effect of music exposure in juvenile stage on anxiety-like behavior and fear extinction in adult rats.Methods4 broods of two-week-old healthy Sprague-Dawleyda rats were separated into two groups randomly.The music groups were exposed to music from 20:00 to 22:00 for 21 consecutive days.When the rats were 5 weeks old,they were caged by sex,with 8 male rats and 6 female rats in each group.When the rats were 8 weeks old,the two groups were assessed in the elevated-plus maze test,the open-field test,trained and assessed by the conditional fear training and fear extinction training.ResultsIn the elevated-plus maze test:Prior to the foot shock,the percent of time spent in the open arms in the music group (female(7.07 ± 1.14)％,male (5.12 ± 1.95 ) ％ ) exhibited no significant difference (P＞ 0.05 ) comparing with the rats in the control group (female (4.65 ± 0.86 ) ％,male ( 4.86 ± 1.95 ) ％ ).After the foot shock,the percent of time spent in the open arms in the music group ( female ( 8.63 ± 3.35 ) ％,male ( 7.79 ± 2.49 ) ％ ) increased comparing to the control group (female(1.48 ±0.11)％,male(4.29 ± 1.68)％) (P＜0.01). In the open-field test:prior to the foot shock,the percent of time spent in the center zone of the music group ( female (6.16 ± 2.17 ) ％,male (6.25 ±3.47) ％ ) exhibited no significant difference (P＞ 0.05) comparing with the rats in control group (female(5.27 ±1.95 )％,male (6.22 ± 3.13 )％ ).After the foot shock,the percent of time spent in the center zone in the music group (female(8.52 ± 1.93) ％,male (6.95 ± 2.46 ) ％ ) was larger than the control group ( female ( 3.47 ±0.93 ) ％,male (4.36 ± 2.22 ) ％ ) (P ＜ 0.05 ).The fear extinction training showed that the percent of freezing time exhibited no significant difference between the male and female rats of the music group and control group in the first block of the first extinction training day and the percentage of freezing time of female rats in music group was significantly lower than that of female rats in control group on the third extinction training day.The percentage of freezing time of male rats in the music group was significantly lower than that of male rats in control group on the second and third training day.ConclusionMusic exposure in juvenile stage decreases the anxiety level after foot shock,and promotes the long-term fear extinction,while has no effect on the level of fear memory.

ObjectiveTo explore the possible mechanism of adult offspring rats'anxiety-like behavior induced by parents experienced morphine addiction and withdrawal.MethodsEstablishing the model of Sprague-Dawley rats morphine addiction,Male and female rats were mated after morphine withdrawal 21 days.Meaning-while,saline control group was established in the same method.5 female and 5 male offspring's brains were obtained to observe the neuronal morphology of hippocampal CA1 through Golgi staining when they were 8 weeks old,the same number of female and male's hippocampus were derived after deeply anesthetized to perform the whole genome expression profiles analysis.ResultsThe total length and the number of basal dendrites branches on hippocampal CA1 neurons in offspring of morphine groups were significantly decreased compared to the offspring of saline group.Comparison with the offspring of saline group,663 up-regulated genes (ratios ≥2.0) and 499 down-regulated genes ( ratios ≤0.5 ) were detected in the male offspring of morphine groups,and 350 up-regulated genes (ratios ≥2.0) and 188 down-regulated genes (ratios ≤0.5) were done in the female.Furthermore,they included many genes associated with regulation of emotional behavior,such as 5-HT2c receptor up-regulation 7-fold,Igf-2 up-regulation 7.1-fold and reelin down-regulation 3.3-fold were observed.ConclusionExperienced morphine addiction and withdrawal in parents prior to mating leads to dysplasia of dendritic morphology in hippocampal CA1 neurons of adult offspring rats,and 5-HT2c,Igf-2,reelin expressing abnormally,which may be the possible mechanism of anxiety-like behavior in adult offspring rats.

OBJECTIVETo study the main causes of death in workers from different industries in Guangzhou.

METHODSThe industrial systems in Guangzhou were classified into six categories according to the Chinese Public Health Inspection Statistical Report. Baseline data on 79,547 workers, age > or = 35, were retrieved from individual health records under the Guangzhou Occupational Health Surveillance Record System established in 1989-1992. In this prospective cohort study, the workers' vital status and causes of death were followed up until 31 December 1998. Using SPSS 10.0, crude death rates were calculated and relative risks(RR) (95% CI) were estimated using Cox proportional-hazard models.

RESULTS(1) Among 79,547 workers were 49,355 men and 30,192 women, with mean age of (43.8 +/- 6.5) years, and 64% were aged 35-44. The mean age difference of workers in different industries was +/- 1 year. At baseline, 41% had been exposed to occupational hazards. Exposure was most prevalent in petroleum chemical industry(53.9%), followed by metallurgical industry, and the lowest exposure was in mechanical industry (30.2%). (2) The mean follow-up period was (8.0 +/- 1.3) years with 633,510 person-years. 1,577 workers had died with a total death rate of 248.9 per 100,000 person-years. The death rate in rubber industry was the highest, followed by metallurgical and petroleum chemical industries. Malignant neoplasms, vascular and respiratory diseases were most common, constituting 80.3% of all causes of death. (3) For all causes of death and the three main categories, the top three crude death rates were observed in rubber and petroleum chemical industries, and in the metallurgical industry except for vascular causes. The rubber industry had the highest crude death rate for all and vascular causes, and the metallurgical industry for malignant neoplasms and respiratory causes. (4) With the light industry as a reference (RR = 1.0), the metallurgical industry had the highest adjusted relative risks (RR) (95% CI) of 1.62(1.20-2.18) and 7.42(3.38-16.31) for malignant neoplasms and respiratory causes, respectively. The rubber industry had the highest RR of 1.69(1.40-2.04) for all causes. A significant RR of 2.03(1.43-2.88) for vascular causes was observed only in the rubber industry.

CONCLUSIONSThe main causes of death varied from industry. Malignant neoplasms and respiratory diseases were the leading causes in metallurgical and petroleum chemical industries. In rubber industry, vascular and respiratory causes were most common. Preventive measures for disease control should be tailor-made for each industry.

Adult ; Aged ; Cause of Death ; Cohort Studies ; Female ; Humans ; Industry ; Male ; Middle Aged ; Occupational Diseases ; mortality ; Occupational Exposure ; Proportional Hazards Models ; Prospective Studies