Background:Recently,the American Society for Gastrointestinal Endoscopy published the PIVI( Preservation and Incorporation of Valuable Endoscopic Innovations)initiative regarding to the“predict,resect,and discard”strategy on diminutive(≤5 mm)colorectal polyps. The low prevalence of adenoma with advanced histology( containing ≥25%villous component,or high-grade intraepithelial neoplasia,or submucosal invasive carcinoma)in diminutive polyps would provide high confidence for endoscopists to adopt the strategy. Aims:To investigate the prevalence of adenoma with advanced histology in diminutive colorectal polyps. Methods:Data of diameter,location and morphology of colorectal polyps were collected prospectively from patients undergoing colonoscopy at Digestive Endoscopy Centre,Shanghai Ren Ji Hospital from Jan. 2013 to Jun. 2013. The polyps were resected,placed in a unique specimen vial,and sent for histological evaluation. Results:A total of 1 986 colorectal polyps were enrolled in the study,including 900(45. 3%) diminutive polyps(≤5 mm),521(26. 2%)small polyps(6-9 mm)and 565(28. 4%)large polyps(≥10 mm). Prevalence of adenoma with advanced histology in diminutive polyps was significantly lower than those in small and large polyps(1. 1% vs. 8. 4% and 43. 7%,P<0. 05),and was not correlated with the location and morphology of diminutive polyps. Submucosal invasive carcinoma was found in 4. 6% of large polyps,0. 4% of small polyps,and 0% of diminutive polyps. Conclusions:The very low prevalence of adenoma with advanced histology and absence of submucosal invasive carcinoma in diminutive colorectal polyps favours the potential practice of“predict,resect,and discard”strategy in the patient population studied.

OBJECTIVETo observe the acupoint distribution and clinical efficacy of lumbar disc herniationi (LDH) with different sensitive types.

METHODSEighty patients with LDH were randomly divided into a heat-sensitive moxibustion group (group A), a heat-sensitive acupuncture group (group B), a force-sensitive acupuncture group (group C) and a force-sensitive moxibustion group (group D), 20 cases in each one. In the group A and the group B, moxibustion and acupuncture were applied at two or three heat-sensitive acupoints separately. In the group C and the group D,acupuncture and moxibustion were used at two or three force-sensitive acupoints respectively. The treatment was given once a day, totally 10 times. The distribution law of the heat-sensitive acupoints and the force-sensitive acupoints and the change of M-JOA before and after treatment were recorded in the four groups.

RESULTSThe frequent heat-sensitive acupoints areas of LDH were at Yaoyangguan (GV 3), Dachangshu (BL 25), Zhiyang(GV 9), Guanyuanshu(BL 26) and Weizhong(BL 40). The major force-sensitive acupoints areas were at Shenshu (BL 23), Dachangshu (BL 25), Tianshu (ST 25), Guilai (ST 29) and Weizhong (BL 40). After treatment, the heat-sensitive acupoints in the group A and the group B were all reduced than those before treatment and the force-sensitive acupoints in the group C and the group D were declined as well (P < 0.01, P < 0.05). The M-JOA scores were obviously lower than those before treatment in the four groups (all P < 0.01). The score in the group A was reduced more apparently than that in the group B (P < 0.05). The score in the group C was declined more markedly than that in the group D (P < 0.05).

CONCLUSIONThere are diverse acupoints for LDH patients due to different sensitive types. All forms of stimulation can change the functional state of acupoints. Moxibustion is more suitable for heat-sensitive acupoints and acupuncture is optimal for force-sensitive acupoints.

Acupuncture Points ; Acupuncture Therapy ; methods ; Adult ; Aged ; Female ; Humans ; Intervertebral Disc Displacement ; therapy ; Male ; Middle Aged ; Moxibustion ; methods ; Treatment Outcome

Blue laser imaging (BLI) is a new endoscopic system equipped with the laser beam emitting two different wavelengths.It produces bright and high resolution images for observation of microvascular and microsurface patterns of esophageal and gastric mucosa, helping the diagnosis of early upper gastrointestinal cancer.Compared with the existed endoscopic techniques, BLI shows its unique advantages.In this article, advances in application of BLI in diagnosis of early upper gastrointestinal cancer were reviewed.

Interventional therapy is an important treatment for biliary stenosis.The treatment methods are different ac cording to the different causes.Conventional interventional therapy include biliary drainage,balloon dilatation and stent implantation.There are some new treatment methods such as radiofrequency catheter ablation and biliary stent loaded with 125I seeds.The applications of interventional therapy in biliary stenosis were reviewed in this article.

Objective To evaluate the diagnostic value of CT by analyzing CT features of right-sided colon cancer.Methods CT findings of 35 cases with surgically proved right-sided colon cancer were analyzed retrospectively with regard to their pathologic features.Results 34 of 35(97.1%) were diagnosed accurately by CT . Of them , 29 cases (82.9%)were polypoid colon cancer , 6 cases were infiltrative colon cancer, 2 cases with typical “target sign”. 9 cases(25.7%) were found with pericolic infiltration during operation, 7 of 9 (77.8%) were detected by CT scan . Distal ileal involvement of 3 cases ( 8.6% ) were all detected by CT . Lymphadenopathy was showed in 11 (31.4%), 7 of 11(63.6%)were found by CT.Conclusion CT scan plays important role in diagnosis of right-sided colon cancer as well as in finding pericolic infiltration, distal ileal involvement and lymphadenopathy.

To investigate the animals infection situation of novel bunyavirus in Xinyang City ,Henan Province ,China , animal serum samples such as cattle ,dog ,swine ,mice were collected in Shangcheng County and Guangshan County in Xinyang City .All the serum samples were detected by novel bunyavirus ELISA and real time RT-PCR method .A total of 292 animal serum samples were collected including 5 kinds of animals .The result of all the animal serum samples were negative by using real time RT-PCR ,and the positive rate was 45 .19% (141/312) by ELISA method .Of the 5 animal serum samples including mice ,cattle ,goats ,swine and dogs ,the positive rate were detected to be 1 .06% ,100 .00% ,76 .27% ,3 .57% ,and 75 .00%respectively .There was significant difference in results among 5 kind of animal serum antibodies .Animals such as cattle and dog may be the host of novel bunyavirus which were detected novel bunyavirus antibodies in cattle and dog in Xinyang City , Henan Province ,China .

To explore the relationship between meteorological factors and incidences of fever, thrombocytopenia and leukopenia syndrome (FTLS), incidence data of FTLS in Xinyang City were collected and described. The relationship between FTLS and monthly meteorological factors such as average atmospheric pressure, average temperature, average relative humidity, average wind speed and precipitation was analyzed with simple correlation and multi-stepwise linear regression. The results showed that there was a significant negative correlation between incidence of FTLS and monthly average atmospheric pressure (P<0.01), and there were significant positive correlations between monthly average temperature, monthly average relative humidity, monthly precipitation and incidence of FTLS (P<0.05). The multi-stepwise regression showed that the regression equation was Y (monthly cases) =-12.70 + 0.28X2 (monthly average temperature), and the coefficient of determination was 0.76. The incidences of FTLS are correlated with temperature.

The national standards of biofuels specify the technique specification and analytical methods. A water content certified reference material based on the water saturated octanol was developed in order to satisfy the needs of the instrument calibration and the methods validation, assure the accuracy and consistency of results in water content measurements of biofuels. Three analytical methods based on different theories were employed to certify the water content of the reference material, including Karl Fischer coulometric titration, Karl Fischer volumetric titration and quantitative nuclear magnetic resonance. The consistency of coulometric and volumetric titration was achieved through the improvement of methods. The accuracy of the certified result was improved by the introduction of the new method of quantitative nuclear magnetic resonance. Finally, the certified value of reference material is 4.76% with an expanded uncertainty of 0.09%.
Biofuels ; standards ; Magnetic Resonance Spectroscopy ; methods ; Octanols ; chemistry ; Reference Values ; Water ; analysis

OBJECTIVETo determine the feasibility and efficiency of terminating atrial flutter (AFL) and atrial fibrillation (AF) using synchronous low-energy shocks delivered through a novel transesophageal electric balloon electrode system.

METHODSBy using a novel electric balloon electrode system, we attempted 91 transesophageal cardioversions in 52 patients, to treat 53 episodes of AFL and 38 episodes of AF.

RESULTSOf the 40 patients of AFL that failed to respond to drug therapy, 37 (92.5%) were successfully countershocked to sinus rhythm by transesophageal cardioversion, with a mean energy of (22.70 +/- 4.50) J (20 - 30 J). Of the 19 patients in AF, transesophageal cardioversion was successful in 16 (84.2%) cases, requiring a mean delivered energy of (17.38 +/- 8.58) J (3 - 30 J). There were no complications such as heart block or ventricular fibrillation, and no evidence of esophageal injury.

CONCLUSIONSTransesophageal cardioversion using an electric balloon electrode system is an effective and feasible method for the treatment of AFL and AF. It requires low energy and no anesthesia, leads to less trauma, and shows a high cardioversion success rate that may prove valuable in the management of tachyarrhythmias.

Atrial Fibrillation ; therapy ; Atrial Flutter ; therapy ; Electric Countershock ; instrumentation ; methods ; Electrodes ; Esophagus ; Humans ; Treatment Outcome

OBJECTIVETo investigate the effects of different anesthesia depth on stress response in elderly patients undergoing elective laparoscopic surgery for colorectal cancer.

METHODSA total of 105 ASA I-III patients aged 60-91 years undergoing elective laparoscopic surgery for colorectal cancer with general anesthesia were randomized into 3 groups, namely group A with a target Narcotrend index (NI) maintained at D0 level, group B with a NI at D2 level, and group C with a NI at E1 level. The anesthetics (profopol and remifentanil) were adjusted according to Narcotrend monitoring results to maintain the specified anesthesia depth. The patients' heart rate (HR) and mean artery pressure (MAP) were recorded before anesthesia (T0), before intubation (T1), immediately after intubation (T2), at 2 min before pneumoperitoneum (T3), 2 min after pneumoperitoneum (T4), at the end of the surgery (T5) and extubation (T6). Serum levels of cortisol, adrenocorticotropic hormone (ACTH), endothelin-1 (ET-1), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) were measured by standard ELISA and radioimmunoassay before anesthesia (Ta), at the end of the surgery (Tb) and 1 day after the surgery (Tc).

RESULTSHR and MAP in group A increased significantly at T2, T4, and T6 compared to those at T0 (P<0.05), and were higher than those in group B and group C (P<0.05). The MAP in all the 3 groups all decreased at T1 and T3 (P<0.05 or P<0.01), and was markedly lower in group C than in groups A and B (P<0.05). The incidence of hypertension was significantly higher in group A than in groups B and C (P<0.05), while the incidence of hypotension was much higher in group C (P<0.01). There were no obvious differences in serum levels of cortisol, ACTH, CRP, IL-6, TNF-a, or ET-1 among the groups at Ta (P>0.05). The serum levels of ACTH in the 3 groups all significantly increased at Tb and Tc (P<0.01). CRP, IL-6 and TNF-a levels in group A were increased at Tb and Tc (P<0.05 or P<0.01) and significantly higher than those in groups B and C (P<0.05 or P<0.01). Cortisol in groups A and B increased at Tb and Tc (P<0.05) to a significantly higher level than that in group C (P<0.01). ET-1 level in group C at Tb and Tc was lower than those in groups A and B (P<0.05 or P<0.01).

CONCLUSIONSMaintaining the anesthesia depth for a NI at the D2 and E1 level can both attenuate the stress response in elderly patients undergoing laparoscopic surgery for colorectal cancer, but the hemodynamic stability can be better at a D2 level.

Adrenocorticotropic Hormone ; blood ; Aged ; Aged, 80 and over ; Anesthesia, General ; methods ; Blood Pressure ; C-Reactive Protein ; metabolism ; Colorectal Neoplasms ; surgery ; Elective Surgical Procedures ; Endothelin-1 ; blood ; Heart Rate ; Humans ; Hydrocortisone ; blood ; Interleukin-6 ; blood ; Laparoscopy ; Middle Aged ; Piperidines ; administration & dosage ; Propofol ; administration & dosage ; Tumor Necrosis Factor-alpha ; blood