Objective To discuss the indication,technique,effect,and safety of colonoscopic resection of colorectal submucosal tumor(SMT).Methods A total of 33 patients with SMT,which was diagnosed colonoscopically and pathologically,were treated by endoscopy.The sizes of the tumors were 0.2-2.2 cm in diameter,and 0.2-1.2 cm in the diameter of the roots.After injecting adequate adrenalin saline deeply into the root of SMT,the mass of those,who had negative nonlifting sign,was attracted,snared,and then cut using high frequency electrotome.In 7 cases of smaller SMT,the tumor was gripped.Results No perforation,large amount of hemorrhage,or burns of the colorectal wall was found.Complete resection was achieved(no tumor tissue was detected on the edge or bottom of the SMTs after endoscopic resection,or pathological examination found no tumor tissue after open surgery) in 29 cases,including 18 carcinoids,6 leiomyomas,2 hamartomas,2 lipomas,and 1 neurofibroma.Except 3 patients with leiomyoma were lost,26 of the patients were followed up for a median of 44.5 months(3 months to 12 years and 7 months).No recurrence was found during the follow-up.The 4 carcinoids were resected partially(there were tumor tissues remained on the edge or bottom of the SMTs after endoscopic resection,or the pathological examination after open surgery showed tumors).Two of the 4 were transferred to open surgery(one was followed up for 2 years and 3 months,the other was lost).The other two patients refused operation and received a followed-up of 5 months and 2 years and 4 month respectively.None of the 4 patients had recurrence during follow-up.Conclusions Colonoscopic treatment can be applied to the patients with SMT sized ≤1.2 cm at the root and negative nonlifting sign.The method is safe,effective,and minimal invasion.Pathological examination is recommended after the colonoscopic resection,open surgery is necessary for the partially resected SMTs.

ObjectiveTo explore the current status of physical exercise of older adults and its effect on depression.Methods270 subjects from three living strata(public,community and hospital) were randomly investigated by the Geriatric Depression Scale-short form(GDS-s) and the self-designing Geriatric Exercise Scale.ResultsOlder adults had a higher risk of suffering from depression.There were significant differences between attitudes and prevalence rates among the subjects in three environments.Exercises had significant influence on older adults' depression,with the more negative attitude,less frequency,shorter exercising time,less companions,worse feeling after doing exercises,the more serious of one's depression.The demographic variables had also significant influence on both exercise and depression of older adults.ConclusionDoing exercise is one of the important measures to prevent,reduce and overcome depression of older adults.

Objective To investigate the role of miR-203 in radiation-induced thymic lymphoma (RITL).Methods A 60Co irradiator was used for total-body irradiation.MicroRNAs(miRNAs) level was assayed by qRT-PCR.Cell proliferation was assayed by MTT assay.Cell apoptosis was examined by fluorescence activated cell sorter (FACS).Dual luciferase reporter assay system was used to detect the 3'UTR reporter.Results MiR-203 was down-regulated in RITL tissues.Overexpression of miR-203 strongly inhibited the proliferation of both NIH3T3 cells and EL4 cells and vice versa.MiR-203 inhibited cells proliferation and induced apoptosis via TANK-binding kinase (TBK1),SLUG (SNAI2) and Cyclin D1 (CCND1).Conclusions Radiation down-regulated the level of miR-203 in thymic,which promoted radiation-induced thymic lymphoma by targeting TBK1,SNAI2 and CCND1.

Aim To investigate the effects of ursolic acid from loquat leaves on proliferation inhibition and expression of PPAR-γ 、TGF-β1 in rat hepatic stellate cells, so as to explore the mechanism of anti-hepatic fibrosis of UA.Methods HSC-T6 cells were randomly divided into blank group, rosiglitazone control group, the low, medium and high concentration of UA group to detect the cell proliferation inhibition by CCK-8 after 24,48,72 h.The content of type collagen Ⅰ in cell culture supernatant of each group was examined by ELISA.The expression of PPAR-γ mRNA, TGF-β1 mRNA in HSC-T6 cells exposured were examined by real-time quantitative PCR.Effects on HSC-T6 PPAR-γ and TGF-β1 protein from each group were detected by immunocytochemical method.Results CCK-8 results showed that the inhibitory rate of UA on cell proliferation increased with the prolongation of drug action time(P<0.01).ELISA results showed that with the increase of the concentration of UA, the content of type Ⅰ collagen content decreased(P<0.01).Real-time PCR results showed that with the increase of the concentration of UA, and the expression of PPAR-γ mRNA increased, the expression of TGF-β1 mRNA decreased(P<0.01).The results of immunocytochemistry showed that the expression of PPAR-γ protein was increased, and the expression of TGF-β1 protein was decreased with the increase of the concentration of UA(P<0.01).All effects mentioned above were dose-dependent.Moreover, the effects in the high concentration groups were stronger than those in control group.Conclusion UA can inhibit the proliferation of HSC-T6 cells, Which may be associated with the up-regulation of PPAR-γ expression and the down-regulation of TGF-β1 expression.

Objective To compare the clinical effect between retropubic extraperitoneal laparoscopic prostatectomy with prostatic urethra preservation and transurethral resection of the prostate (TURP) for giant benign prostatic hyperplasia (BPH).MethodsThe clinical data and follow-up of 128 cases of giant BPH were analyzed retrospectively.Seventy-two cases underwent TURP (TURP group) and 56 cases underwent retropubic extraperitoneal laparoscopic prostatectomy with prostatic urethra preservation ( laparoscopic group ).The operation time,blood loss,gland mass excision,bladder washing time,catheterization time,hospital stay,hospital cost,international prostate symptoms score (IPSS) and quality of life questionnaires (QOL),maximum flow rate (MFR),residual urine volume (RUV) were compared between two groups.ResultsThe bladder washing time,catheterization time,hospital stay in laparoscopic group were less than those in TURP group[0 d vs.(2.8 ± 1.2) d,(2.3 ± 0.6) d vs.(5.2 ± 1.5) d,(4.2 ± 0.5) d vs.(7.5 ±0.5) d],gland mass excision in laparoscopic group was more than that in TURP group [(100.2 ±25.4) g vs.(85.6 ± 15.5) g],there were significant differences between two groups(P＜ 0.05).There was no significant difference in the operation time,blood loss,hospital cost between two groups (P ＞ 0.05).There were significant differences in IPSS,QOL,RUV and MRF before and after 3,6 months treatment for two groups [ laparoscopic group:(9.1 ± 3.4),(7.5 ± 2.5 ) scores vs.(27.5 ± 5.8) scores,( 1.8 ± 1.1 ),( 1.6 ± 0.8)scores vs. (5.5 t0.5) scores,(26.5 ± 11.5),(22.4 ± 12.6) ml vs. (145.0 ±48.0) ml,(17.6 ±8.4),(20.2 ± 5.4) ml/s vs.(8.3 ± 3.5) ml/s;TURP group:(9.2 ± 3.8),(7.8 ± 2.2) scores vs.(28.5 ± 5.4) scores,( 1.9 ± 1.2),( 1.7 ± 0.6) scores vs.(5.0 ± 0.5 ) scores,(28.5 ± 12.9),(23.0 ± 11.7) ml vs. ( 155.0 ± 47.0) ml,( 17.8 ± 9.2),( 19.8 ± 4.5 ) ml/s vs.(7.2 ± 3.2 ) ml/s ] (P ＜ 0.01 ),but there was no significant difference between two groups (P ＞ 0.05).ConclusionsThe clinical effect of two microtrauma surgery are good.Laparoscopic technique is a feasible treatment option for patients suffered from giant BPH for which has the benefit of a quicker recovery,shorter hospital stay,less complications,no bladder washing.

Objective To study the value of reverse CT scan in eliminating the respiratory motion artifacts in the thoracic CT of the patients with chronic obstructive pulmonary diseases(COPD).Methods Fourty patients with COPD were randomly selected and underwent chest CT examinations with the technique of GR-Helical including directive and reverse CT scans.The images were blindly evaluated by three experienced doctors.Results In 40 cases,the respiratory motion artifacts were present in 17 cases,among them,70.59%(12/17) artifacts was in lower lung field,and 64.7%(11/17) artifacts occurred in the people over 60 years of age.The rate of artifact was 35% at directive scan,while it was reduced to 7.5% at reverse scan,the image quality was improved at 27.5%.There was statistical significance in eliminating respiratory motion artifacts between two scanning method (P＜0.05).Conclusion Reverse CT scanning can effectively eliminating or reducing the respiratory motion artifacts in lower lung field,it is the best choice of scanning mode in elderly patients with COPD.

Objective·To investigate effect and the possible molecular mechanism of JQ1,a specific inhibitor of bromodomain containing protein 4,on human hypertropic scar.Methods·Primary fibroblasts were isolated from human hypertrophic scars and treated with JQ-1 of different concentrations (0.1,0.5,1.0,2.0,2.5,and 12.5μmol/L) for 48 h.Then CCK-8 kit and wound healing assay were used to measure proliferation and migration of the fibroblasts.ELISA was adopted to detect the levels of collagen type Ⅰ (COL Ⅰ) and TGF-β1 after JQ-1 treatment for 24 h.Thirty-six nude mice were used for hypertrophic scar models.Human hypertrophic scars (1.0 cm× 1.0 cm×0.5 cm) were grafted subcutaneously at the backs of nude mice to establish scar animal models.After 4 weeks,the nude mice were averagely divided into two groups,i.e.JQ-1 group and DMSO group,which were respectively injected with 0.5 μmol/L JQ-1 and 0.1％ DMSO each mouse every day.COL Ⅰ / Ⅲ and α-smooth muscle actin (α-SMA) were examined by immunohistochemical method and sirius red staining.Results·Cell experiments showed that JQ-1 with the concentration of 0.5 μmol/L and above significantly inhibited proliferation of fibroblasts (P＜0.01).JQ-1 inhibited migration of fibroblast (P＜0.01).JQ-1 inhibited secretion of COL Ⅰ and TGF-β1 of fibroblasts (P＜0.01).Animal experiments showed that concentration and proportion of COL Ⅰ / Ⅲ in JQ-1 group decreased compared to DMSO group (P＜0.05).α-SMA protein expression in JQ-1 group also decreased (P＜0.05).Conclusion·JQ-1 can inhibit proliferation,migration,secretion of COL Ⅰ,and production of TGF-β1 of human sear fibroblasts in vitro;it can also inhibit secretion of COL Ⅰ /Ⅲ and fibroblast-myofibroblast differentiation in the human hypertrophic scars in nude mice.

Objective: To investigate the effect of progressive early rehabilitation training in patients with severe acute pancreatitis. Methods: A total of 67 patients with severe acute pancreatitis requiring mechanical ventilation who were treated in the intensive care department of Shanghai first people's hospital from May 2015 to May 2018 were selected. According to the order of admission, they were divided into the control group (n=32) and the intervention group (n=35). On the basis of this nursing, the intervention group was jointly evaluated by the ICU rehabilitation team and adopted the progressive early rehabilitation nursing mode according to the different degrees of patients' conditions. The intervention effects of the two groups were compared. Results: The success rate of one-time weaning, mechanical ventilation time and ICU hospitalization time in the intervention group were 97.14% (34/35), (4.62±1.98) d, (8.76±1.02) d, and 78.12% (25/30), (9.01±2.15) d, and (14.01±2.87) d, respectively, in the control group. The difference between the two groups was statistically significant (χ² = 3.986, t=-5.012, -8.260, P < 0.05 or 0.01). The incidence of delirium, Barthel index (BI) scale score and grip strength score were 2.86% (1/35), 47.54±4.32, (34.05±10.68) kg, in the intervention group, 12.50% (4/32), 41.68±3.18, and (26.79±8.97) kg, in the control group, respectively. The difference between the two groups was statistically significant (χ²=4.024, t=7.651, 3.194, P < 0.05 or 0.01). Conclusions Progressive early rehabilitation training and nursing has a great influence on the prognosis of patients with severe acute pancreatitis, which can effectively improve the prognosis of patients, accelerate the recovery of patients, shorten the length of hospital stay and the duration of use of ventilator, reduce the incidence of delirium, help patients to restore muscle strength, and improve the Barthel index score of patients, which is worthy of promotion and application.

Abstract Oral health problems is one of major public health problems that threatens children s overall health. Children s oral health is closely related to family parenting styles. Currently, grandparenting is becoming increasingly common in China, and its impact on children s oral health should not be underestimated. This article reviews the impacts of the oral health knowledge level, behavior habits, gender, socioeconomic status, and other factors related to grandparenting on children s oral health, in order to reduce the negative impact of grandparenting involvement on children s oral health, and to provide theoretical basis and guidance.

Objective To observe the efficacy and complications of iodine-125 radioactive seeds implantation after surgery of recurrent malignant gliomas.Methods Fifty-eight patients with recurrent gliomas,admitted to our hospital from September 2006 to January 2010,were randomly divided into observation group (n=26) and control group (n=32).All patients accepted tumor subtotal resection.Patients in the observation group were implanted with iodine-125 seeds which were planned by therapy planning system (TPS) depending on the tumor size and position.Patients in the control group were irradiated at 50-60 Gy after the operations.Patients from both groups were followed up for 3 years,and the 1-year and 3-year survival rates,median survival time,complications and quality of life were observed.Results The survival rate of 1-year of observation group and control group was 46.2％ and 34.4％,without significant difference (P＞0.05),while that of 3-years time was 19.2％ and 12.5％,with significant difference (P＜0.05).The average survival time of the two groups was (15.6±2.5) months to (9.4±1.3) months,with statistically significant difference (P＜0.05).No severe complications (grade four or higher than grade four) were noted; lower rates of dizziness and headache were found in observation group as compared with those in control group (P=0.030,P=0.035).Conclusions The iodine-125 radioactive seeds implantation after surgery of recurrent malignant gliomas not only can improve the survival rate and prolong survival time,but also reduce radiation brain damage to improve the life quality.So it is a safe and effective treatment,and worth of applicattion in clinic.