Objective To explore the value of carbox dioxide(CO2 )for the upper gastrointestinal endoscopic mucosal dissection(ESD).Methods A total of 158 patients who underwent ESD from January 2012 to May 2014 at Endoscopy Center of Dongguan Hospital were enrolled in the study.The patients were randomly divided into air group and CO2 group.The arterial partial pressure of CO2 (PaCO2 ),the monitering results of SpO2 before,during,afte operation,abdominal pain after operation and postoperative complications were assessed.The safety and advantage of CO2 of the upper gastrointestinal ESD were comparative ana-lyzed.Results PaCO2 of air group and CO2 group during the ESD procedures [(47.8 ±5.4)mmHg, (45.1 ±5.5)mmHg]was significantly higher than that before[(37.2 ±4.6)mmHg,(36.3 ±3.9)mmHg] (P <0.05)and after the operation[(39.9 ±4.0)mmHg,(39.4 ±4.2)mmHg](P <0.05).Preoperative, intraoperative and postoperative PaCO2 were not significantly different between the two groups(P >0.05);all the SpO2 were greater than 90%,and it was not significantly different between the two groups(P >0.05). The abdominal pain score of CO2 group was significantly lower than that of air group less than 2 h after wake-up (P <0.05),but there was no difference between the two groups at 12 h and 24 h after operation(P >0.05).The bleeding rate of air group and CO2 group during and after operation was not significantly different (P >0.05),and there were no other serious complications.Conclusion CO2 is safe in the upper gastroin-testinal ESD,and it can reduce postoperative abdominal pain,so it is suitable for clinical application.

Objective:To study the effects of acitretin or IFNα-2a or both on the apoptosis and caspases expressions in human-cutaneous squamous cell carcinoma cell line SCL-12.Methods: SCL-12 cells were cultured in vitro in the presence of or acitretin or IFNα-2a or both.Apoptosis was detected by enzyme-linked immunosorbent assay(ELISA) in these cells.Apoptotic cells were observed by acridine orange staining .The protein expressions of caspase-3,caspase-8 and caspase-9 in SCL-12 cells were analyzed by Western blot.Results:The inhibition ratio of the cell growth significantly higher in groups of Acitretin or IFNα-2a or both than control group , and the effects of Acitretin combined with IFNα-2a stronger than the Acitretin or IFNα-2a.Caspase-3,caspase-8 and caspase-9 were significantly activated in combined group .The effects of Acitretin combined with IFNα-2a stronger than the Acitretin or IFNα-2a.Conclusion:Acitretin or IFNα-2a or both plays a central role in the apoptosis of cutaneous squamous cell carcinoma cells ,which may be related to the Fas-way and mitochondria-way.

AIM To establish a quantitative analysis of multi-components by single marker(QAMS) method for the content determination of six catechins in Xinnaojian Capsules (Tablets) (tea extract).METHODS The analysis of 50％ methanol extract of this drug was performed on a 35 ℃ thermostatic Shimadzu Wonda Cract ODS-2 column (4.6 mm ×250 mm,5 μm),with the mobile phase comprising of 0.5％ acetic acid (A)-acetonitrile (B) flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 280 nm.With epigallocatechin gallate as an internal standard,the relative correction factors of epigallocatechin,catechin,epicatechin,gallocatechin gallate and epicatechin gallate were calculated,from which the content determination was made.RESULTS Six constituents showed good linear relationships within their own ranges (r ≥ 0.999 8),whose average recoveries were 96.00％-98.47％ with the RSDs of 2.09％-2.91％.The results obtained by QAMS method approximated those obtained by external standard method.CONCLUSION This simple and reliable method can be used for the quality control of Xinnaojian Capsules (Tablets).

Purpose:To assess the value of 99m Tc tetrofosmin SPECT in discrimination of malignant from benign breast mass.Methods:The trial was prospective, blind and diagnostic. From 2000.6 to 2001.12, one hundred one consecutive patients with breast mass detected by clinical examination were included. After injection of 740 MBq 99m Tc tetrofosmin intravenously in the arm contralateral to the breast lesion, 99m Tc tetrofosmin SPECT was performed additional to the regular diagnostic procedure. All patients underwent operation within one week. Using histological assessment as a golden standard, we calculated sensitivity, specificity, positive and negative predictive value for 99m Tc tetrofosmin SPECT of the breast mass. Results:The sensitivity for palpable breast lesions was 86 3%, specificity 84.0%, positive and negative predictive value were 84.6% and 85.7% respectively. Conclusions:The results suggested that 99m Tc tetrofosmin SPECT is a valuable tool for the evaluation of palpable breast lesions.

Purpose:To study the relationship between the expression of the BRCA 1 protein and clinico pathological characteristics of breast cancer,and to clarify the correlation of the expression of the BRCA 1 protein with expression of p53 and c erbB 2 . Methods:The expressions of BRCA 1 , p53 and c erbB 2 of breast cancer tissues taken from 60 breast cancer patients as well as 10 benign breast disease patients were examined using immunohistochemical LDP method. All tissues were taken from formalin fixed and paraffin embedded breast tumor specimens. We analyzed the correlation of the results with other parameters which included age of onset, family history, histological grade, status of estrogen receptor and progesterone receptor, axillary nodal status and so on. Results:The expression of BRCA 1 was 61.66% (37/60) in breast cancer patients and 0 (0/10) in benign diseases patients. The protein expressed was mainly located in the cytoplasm. The correlation between age of onset and the expression of BRCA 1 was significant (r=-0.295, P

Objective To explore the application of CO2 as an insufflation agent in patients under-going colonoscopy by comparing carbon dioxide(CO2 )and air.Methods Consecutive 681 patients who un-derwent conventional colonoscopy from January to May in 2014 at endoscopy center of our hospital were in-cluded.The patients were randomly divided into the air group and CO2 group.The gas flow,capacity,oper-ation time,PaCO2 and abdominal pain during and 20 min,40 min,1 h,2 h,12 h,24 h after colonoscopy were recorded.The safety and advantages of CO2 in the colonoscopy were analyzed.Results The intubation time of CO2 group was significantly shorter than that of air group (P <0.05),but there was no significant difference in endoscopy withdrawal time between the two groups (P >0.05).There was also no difference in air flow and the total volume between the two groups (P >0.05).PaCO2 of two groups were within the nor-mal range.PaCO2 during examination was significantly higher than that before and 20 minutes after examina-tion (P <0.05),but the PaCO2 between the two groups showed no significant difference (P >0.05).The abdominal pain scores during and 20 min,40 min,1 h,2 h after the examination of air group were signifi-cantly higher than those of CO2 group (P <0.05),but they were not 12h and 24h after the examination (P>0.05).Conclusion CO2 is safe and could reduce abdominal discomfort after colonoscopy,which is suit-able for clinical application.

Objective To evaluate right ventricular (RV) global and regional systolic function using real-time three-dimensional echocardiography (RT-3DE) in patients with pulmonary hypertension (PH).Methods Thirty patients with PH and 27 controls were studied.RT-3DE images were acquired on a Philipa iE33 system with an X3-1 probe,then analyzed with a new software(TomTec) to determine RV global and regional (inflow, body, outflow) end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and ejection fraction (EF).The difference of RT-3DE parameters between the two groups,as well as the correlation between RT-3DE and routine echoeardiography parameters was analyzed.Results In patients with PH ,RV global and regional EDV and ESV were significantly higher than those in normal controls (all P ＜0.05); RV global and regional EF were significantly lower than those in normal controls (all P ＜0.05).In the PH group, RV inflow EDV,SV and EF were higher than that of RV body and outflow part (P ＜ 0.05) ;RV global EF was lower than that of RV inflow part and higher than that of RV body and outflow part.In the PH group, RV global and inflow EF correlated with pulmonary artery systolic pressure negatively (r = - 0.611, P ＜0.001 and r = - 0.576, P = 0.001 ,respectively) ,and with the ratio of peak velocity of tricuspid regurgitation over outflow time-velocity integral negatively (r = -0.772, P = 0.002and r = -0.721, P ＜0.001, respectively)Conclusions RV global and regional volume was enlarged and systolic function was impaired in patients with pulmonary hypertension.RV global and regional systolic function was changed in liner relationship with RV after-load.

OBJECTIVETo investigate the prospective association of fibroblast growth factor 21 (FGF-21) with NAFLD development in a 5-year prospective study involving a population-based cohort comprising 352 Chinese subjects.

METHODSThe clinical data of subjects were recorded, serum FGF-21 levels at baseline and follow-up were measured using an enzyme-linked immunosorbent assay,whether FGF-21 was independent predictor of NAFLD development were identified using logistic regressions. Chi-square test, non-parametric test and logistic regression analysis were used in statistical analyses.

RESULTS(1) Serum FGF-21 levels of NAFLD group was significantly higher than that of non-NAFLD group (318.34(169.64,520.77)pg/ml vs 197.22 (121.57, 318.76) pg/ml, Probability value less than 0.05). (2)At follow-up,significant increase of FGF-21 level was observed in those subjects who developed NAFLD (399.4 (253.9,754.2) pg/ml vs 318.34(169.64, 520.77)pg/ml, Probability value less than 0.05), but in non-NAFLD group, there was no significant difference of FGF-21 level between baseline and follow-up. (3) BMI, TC, HOMA-IR and FGF-21 were independent predictors of NAFLD through logistic regressions.

CONCLUSIONHigh FGF-21 levels was independent predictor of NAFLD, it may be useful for early diagnosis and intervention of NAFLD.

Objective To investigate the ability of targeting in vitro breast carcinoma and photoacoustic-mediate apoptosis of breast carcinoma of the nanoparticle probe loaded with Fe3O4 and observe its consequence of photoacoustic imaging in vitro.Methods The polymeric multifunctional nanoparticles probe that was loaded with Fe3O4 and connected with Herceptin targeting breast carcinoma was prepared in the use of double emulsion method and carbodiimide method.General physical property,the condition of Herceptin connected with nanoparticles and the ability of targeting of the probe were tested.The different concentration of nanoparticles was imaged by photoacoustic.The inhibiting effect of targeting nanoparticles on breast carcinoma cells was evaluated in vitro.Results The targeting polymeric multifunctional nanoparticles probes loaded with Fe3O,were prepared successfully with average particle diameter of (235.4± 53.75)nm and Zeta potential (-13.4 ± 4.7)mV.Fe3O4 particles dispersed on the shell of the probes.Antibody Hereeptin was successfully connected with the surface of the nanoprobes.There were massive targeting nanoprobes surround the breast carcinoma cell strains SKBR3 in the targeting group in vitro.The photoascoustic signal of the nanoprobes enhanced with the increase of Fe3O4 concentration in photoacoustic experiment in vitro.The apoptotic rate of breast carcinoma increased after the laser irradiation in the cell inhibition experiment in vitro.That proved the obvious inhibition of breast carcinoma cells was caused by photothermal effect of the prepared nanoprobes.Conclusions The prepared polymeric multifunctional nanoparticles probe that was loaded with Fe3O4 and connected with Herceptin targeting breast carcinoma can be used as a photoacoustic contrast agent,which can inhibit the proliferation of breast carcinoma by targeting photoacoustic therapy.

Objective To prepare a novel ultrasound contrast agent , targeted phase-shift lipid nanoparticles mediated by tumor homing and penetrating peptide tLyP-1 ,and to evaluate its characteristics . Methods The nanoparticles were prepared by filming-rehydration and acoustic-vibration methods .The morphology ,distribution ,particle size and zeta potential were detected . After heating and irradiating of low intensity focused ultrasound ( LIFU) ,the phase-shift characteristic and the enhancement effect in vitro were observed . The tumor homing and cell-penetrating properties of the nanoparticles were examined by confocal laser scanning microscopy and flow cytometry . The cytotoxicity of the nanoparticles was evaluated by CCK 8 assay . Results The size and distribution of nanoparticles were uniformed . The size and zeta potential of nanoparticles were ( 399 .50 ± 29 .98) nm and ( 3 .28 ± 1 .72) mV ,respectively . When the nanoparticles were heated to a temperature of 45 ℃ or after irradiated by LIFU ,nanoparticles generated phase-shift and enhanced ultrasound imaging in vitro ( P < 0 .05 ) . The confocal laser scanning microscopy showed that nanoparticles mediated by tLyP-1 can targetedly aggregate to cell membrane of MDA-MB-231 and penetrate into the cell ,but not to HUVEC . The flow cytometry showed that intracellular fluorescence intensity of nanoparticles mediated by tLyP-1 in MDA-MB-231 group was higher than that in control groups ( P <0 .05) . The CCK8 assay indicated that different concentrations of nanoparticles had no significant effects on cell activity ( P > 0 .05 ) . Conclusions A novel ultrasound contrast agent , targeted phase-shift lipid nanoparticles mediated by tumor homing and penetrating peptide tLyP-1 ,is prepared successfully . It can target to MDA-MB-231 cell and penetrate into the cell in vitro ,and enhance ultrasound imaging in vitro after LIFU irradiation ,which expected to become a novel tumor targeted ultrasound contrast agent and achieve ultrasound molecular imaging at the level of tumor cell .