Objective To evaluate the diagnostic value of electronic staining endoscopy combined with endo -scopic ultrasound(EUS) in the preoperative early gastric cancer .Methods A total of 17 patients diagnosed with intramucosal carcinoma by ordinary gastric endoscopy combined with pathological findings were selected ,who under-went the T staging by EUS and electronic staining endoscopic examination before ESD .The findings were compared with pathological findings.Results 17 cases were diagnosed with gastric cancer in T1 stage by EUS(12 cases limited mucous layer or mucosal muscular layer ,5 cases involving the submucossa ) .14 cases were diagnosed with gastric cancer in T1 stage by pathological examination (11 cases limited mucous layer or mucosal muscular layer ,3 cases involving the submucossa ) ,3 cases in T2 stage had received surgery .The accuracy of EUS in determining the depth of intramucosal carcinoma invasion was 88.2%;The total accuracy of T staging was 82.4%.The lesions border was more clear in electronic staining mode ,and easier marked.Conclusion The diagnostic value of electronic staining endoscopy combined with endoscopic ultrasound in the preoperative early gastric cancer is high .

Objective To evaluate the effects of epidural anesthesia by target controlled introduction (TCI) of 0.375% ropivacaine (Ropi) combined with propofol on the blood pressure (BP) and heart rate (HR) of the patients in different age during thoracotomy. Methods Seventy five ASA Ⅱ-Ⅲ patients undergoing elective resection of esophageal carcinoma were divided into 3 groups according to their age (25 each): groupⅠ (aged 40～59), group Ⅱ (aged 60～74) and group Ⅲ (aged ≥75). An epidural catheter was inserted at the T6～T8 interspace in all patients before induction, and then 5ml of 1% lidocaine was given to all the patients. For each patient, 6 ml of 0.375% Ropi was given epidurally. Anesthesia was induced with propofol TCI 3?g/ml, fentanyl 3?g/kg and atracurium 0.6mg/kg. Tracheal incubation was performed when bispectrum index (BIS) value was less than 50. The patients were mechanically ventilated. Anesthesia was maintained with propofol TCI and epidural anesthesia of 0.375% Ropi at 6ml/h. Propofol was subsequently adjusted to maintain BIS at 50～55 during operation. The concentrations of propofol TCI, mean arterial pressure (MAP), HR, and the amount of ephedrine were continuously monitored during anesthesia. Results MAP in group Ⅱ and Ⅲ was lower than that in groupⅠ (P0.05). The amount of ephedrine used in group Ⅱ and Ⅲ was higher than that in group Ⅰ (P

Objective To compare the clinical effects of different reconstructive modes of alimentary canal for total gastrectomy. Methods 67 cases of the patients with gastric malignant tumor received total gastrectomy and alimentary canal restruction of SS loop /Roux_Y, P loop/Roux_Y or Roux_Y. The diety complaint, digestive tract symptom and the nutritional status of the patients were investigated 6 months after operation. Results Compared with Roux_Y or Lahey+Broun mode,the complication frequency of SS loop /Roux_Y and P loop/Roux_Y modes was significantly lower(P

Objective To explore the early diagnosis and operative treatment of duodenal injury. Methods The clinic data of 36 patients with duodenal trauma were retrospectively analyzed. Results Among 36 cases of duodenal injury, 4 cases (4/36,10.3%) were located in the first section of duodenum, 26 cases (26/36,72.2%) were between the second and third sections of duodenum, 6 cases (6/36,16.7%) were located in the fourth section of duodenum, and 14 cases were accompanied by other organ injury. The frequency of the postoperative complications was 13.9%, the curative rate was 94.4%, and the mortality was 2.8%. Conclusion Familiarizing with charateristics of duodenum injury, early diagnosing, mastering surgical exploration indication, selecting suitable operative approach, effective duodenal decompression, sufficient drainage and anti-infection treatment can improve the curative rate of duodenal injury.

Objective:To analyze the ultrasonographic images and clinical characteristics of congenital mesoblastic nephroma (CMN), and to investigate the differential performances with Wilm′s tumor (WT).Methods:Twenty-one cases of CMN patients confirmed by pathology from December 2008 to December 2019 in Beijing Children′s Hospital, Capital Medical University were collected as the CMN group, and in the same criterion, 51 cases of WT patients were taken as WT group. Ultrasonographic images and clinical characteristics were collected retrospectively, and then the tumor size, site, echo and age were compared and analyzed between the two groups. ROC curve was used to evaluate the differential performance.Results:The difference analysis showed that except for echo ( P=0.694), there were statistically significant differences in tumor size, site and age between the two groups (all P<0.05). In prenatal, the incidence of CMN was significantly higher than WT (61.9% vs 3.9%, P<0.001), and the specificity was 96.1%. The median age (interquartile range) of CMN after birth was significantly earlier than WT( Z=-4.044, P<0.001). The area under the ROC was 0.949, the best cutoff was 112.5 days, with a sensitivity of 87.5% and a specificity of 93.9%. Conclusions:It is difficult to distinguish CMN and WT by echo, but the diagnosis performance can be improved through combining tumor size with site, especially age.

AIM: To identify the effect and safety of Zhuifeng Tougu Pills(Radix aconiti praeparata;Radix aconiti kusnezoffii praeparata,Ramulus cinnamomi,Radix et Rhizoma asari,Radix angelieae dahuricae,Radix gentianae macrophyllae,Radix saposhnikoviae,Rhizoma et Radix notopterygii,Radix angelicae sinensis,Rhizoma chuanxiong, Rhizoma cyperi,Radix paeoniae rubra) for the osteoarthritis with chronic kidney disease. METHODS: Patients were divided into the treatment group and the control group randomly and paired with 1∶1 ratio by the involved joints.The treatment group was given Zhuifeng Tougu Pills,and the control group was treated with intermitted NSAIDs. RESULTS: The ratio of pain and stiffness of joint in treatment group was higher than that in control group.And those in treatment group had a less and later development of chronic kidney disease. CONCLUSION: Compared with intermitted NSAIDs,Zhuifeng Tougu Pills were more effective and safer to treat osteoarthritis with chronic kidney disease.

BACKGROUND:Undergoing femoral head replacement in senile osteoporosis patients with intertrochanteric fracture is a chal enging problem.
OBJECTIVE:To explore the clinical effect of the use of joint instal ation and fracture reduction on the treatment of unstable intertrochanteric fractures in elderly patients.
METHODS:A total of 21 elderly patients with unstable intertrochanteric fractures underwent femoral head replacement. Simultaneously, we col ected clinical data of 20 elderly patients with unstable intertrochanteric fractures undergoing internal fixation of dynamic hip screw. Operation time, blood loss amount, time of walking practice after replacement, complications, and Harris score were compared between the two groups. Clinical effects in patients with femoral head replacement were observed.
RESULTS AND CONCLUSION:Al patients were fol owed up for averagely 20 months (ranged from 6 months to 36 months). After replacement, the incision was first healing. The operation time of femoral head replacement was short;blood loss amount was less;the time of walking practice was early. However, no significant difference in Harris score was detected between the two groups (P>0.05). After femoral head replacement, no infection, inversion and shift, or hip joint loose occurred. Results suggested that correct anteversion angle, eccentricity and femoral calcar size should be identified before the implementation of artificial joint replacement for the elderly femoral intertrochanteric fracture. After implantation of the prosthesis, reduction and fixation of trochanter and femoral calcar bony landmarks are simple easily operated surgery. It can reduce blood loss amount, shorten operation time and elevate clinical effects.

Objective To detect the expression of survivin in suprarenal epithelioma(SRE) and elucidate its function in suprarenal epithelioma.Methods A total of 53 SRE specimens and 8 nomal nephridial tissues were obtained.Immunohistochemistry method was used to test protein expression of survivin.Semi-quantitative RT-PCR was used to measure survivin mRNA levels.Results Survivin protein were detected in 33 of 53(62.3%) SRE tissues.In contrast,no expression of survivin in nomal nephridial tissues was detected.The expression rate of survivin mRNA in tumor tissues(56.25%,18/32) was significantly higher than that in normal tissues(0,0/8).Conclusion Over expression of survivin is common in suprarenal epithelioma.Survivin may play an important role in SRE and is associated with prognosis.

BACKGROUND: Undergraduates from military medical universities face many psychological stresses. Poor coping style might affect the status of mental health. Mental health might also be associated with social support and personality.OBJECTIVE: To investigate the correlation of social support and coping style with mental health among undergraduates from military medical universities.DESIGN: Cluster sampling and questionnaire investigation.SETTING: The Center of Basic Medicine Eexperiment, School of Basic Medicine and School of Preventive Medicine of Fourth Military Medical University of Chinese PLA, and Xi'an Hospital of Sports Trauma.PARTICIPANTS: Totally 352 freshmen of a military medical university were chosen by cluster sampling in October 2004 as the subjects.METHODS: Investigationwas performed on subjects with Symptom checklist-90 (SCL-90), social support rating scale (SSRS), coping style questionnaire (CSQ) and revised Eysenck's personality questionnaires short scale for Chinese (EPQ-RSC).SCL-90 consists of 90 items, including 10 factors. SSRS consists of subjective support, objective support and the utilization of support 3 factors as well as total score of social support. CSQ consists of problem solving, self-reproach, asking for help, keeping out of the way, fancy, rationalization 6 factors. EPQ-RSC mainly consisted of extraversion-introversion (E), neuroticism (N), psychoticism/tough mindedness (P) and lie/social diserability (L) 4 dimensions. Data were performed statistical management with t test and correlation analysis.MAIN OUTCOME MEASURES: ①Comparison of the scores of various factors of social support, coping style and personality among undergraduates with different mental health levels from military medical universities. ② Correlation of different social supports, copying styles and personalities with SCL-90. ③ Comparison of scores of mental health,coping style and personality of military medical undergraduates under different social supports.RESULTS: Totally 352 questionnaires were handed out and all of them were retrieved and eligible, with responding rate of 100%. ① The total scores of SRSS were taken as the grouping index, and 25% of the undergraduates who had the highest scores and the lowest scores were respectively chosen as severe symptom group and mild symptom group.Total scores of social support, subjective support and the utilization of support were higher in the mild symptom group than in the severe symptom group, but no difference in the objective support existed between two groups; Compared with mild symptom group, self-reproach, fancy, keeping out of the way and other immature coping styles were more significantly used, but asking for help was less, the scores of E were lower, but those of N were higher in the severe symptom group. ② Various factors of mental health were significantly negatively correlated with the total scores of support, the utilization of support, asking for help, E and L (r=-0.131 to -0.306 ,P ＜ 0.05 or P ＜ 0.01 ), but positively correlated with self-reproach,fancy, keeping out of the way, rationalization and N (r=0.141-0.450, P＜ 0.05 or P ＜ 0.01). ③ Total scores of support was used as the grouping index, 27% of the subjects who had the highest scores and lowest scores were chosen respectively as high support group and low support group.Mental health level was superior in the high support group to in the low support group; Most of the undergraduates of high support group preferred active coping styles, and those of low support group preferred passive coping styles; Scores of E of high support group were higher than those of low support group, and the scores of N and P were lower than those of low support group (P ＜ 0.05).CONCLUSION: Social support, coping style and EPQ-RSC interact and co-influence mental health.

Objective To investigate the effect of propofol and midazolam on the serum vascular endothe lial growth factor (VEGF) concentration and granulocyte colony-stimulating factor (G-CSF)-induced bone marrow stem cell (BMSC) mobilization after acute myocardial infarction in rats.Methods Thirty-six male Wistar rats,weighing 250-280 g,were anesthetized with intraperitonel 1％ pentobarbital 45 mg/kg.Acute myocardial infarct was induced by ligation of left anterior descending branch of coronary artery.BMSC mobilization was induced by intraperitoneal injection of G-CSF for 5 days.On 7th day after BMSC mobilization,the rats were equally and randomly divided into three groups:G-CSF group (group G),midazolam group (group M) and propofol group (group P).In group G,normal saline was continuously infused via the femoral vein at a rate of 0.5 ml/h for 6 h.In group M,midazolam was infused via the femoral vein at 0.05 mg· kg - 1 · h- 1 for 6 h.In group P,propofol was infused via the femoral vein at 5 mg·kg1 -h-1 for 6 h.Blood samples were obtained from the femoral vein after administration to determine the number of CD34+ monocyte (CD34+ MNC) and endothelial progenitor cells (EPCs) by flow cytometry and the serum concentration of VEGF by ELISA.Six rats from each group were chosen 4 weeks after myocardial infarction for measurement of the left ventricular end-diastolic pressure (LVEDP) and ± dp/dtmax Results Compared with group G,the number of CD34 + MNC and EPCs,the serum concentration of VEGF,and the absolute value of - dp/dtmax were significantly increased,while LVEDP was significantly decreased in group ( P ＜0.05),and LVEDP was significantly decreased,and the absolute value of - dp/dtmax was significantly increased in group P ( P ＜ 0.05).Compared with group P,the number of CD34+ MNC and EPCs,the serum concentration of VEGF,and the absolute value of - dp/dtmax were significantly increased,while LVEDP was significantly decreased in group M (P ＜ 0.05).Conclusion Midazolam can promote the release of VEGF,strengthen G-CSF-induced BMSC mobilization and improve the cardiac function after acute myocardial infarction in rats.Propofol can not promote the release of VEGF and produce G-CSF-induced BMSC mobilization after acute myocardial infarction in rats.