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.

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.

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.

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.

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.

Objective To observe the effects of 6%hydroxyethyl starch(Volven 130/0.4)infusion on hemodynamics and coagulation.Methods 60 cases of open heart surgical children under cardiopulmonary bypass were randomly divided into two groups(30 cases for each):The control group(group C)were infused with 400 ml plasma and volven group(group V)were infused with 400 ml Volven before cardiopulmonary bypass.Then mean aterial pressrue(MAP),heart rate(HR),and central venous pressure(CVP)were measured.The venous blood samples were collected before and after infusion for the measurements of the following parameters:haematocrit(HCT),blood sedimentation(BSR),platelet count(PLC),prothrombin time(PT),and activated whole blood clot time(ACT).Those indexes before operation,15 min after bypass,after returning to ICU,and 24 hours after operation were observed.Results HCT and PLC after infusion were significantly lower than that before infusion.BSR after infusion was significantly faster than that before infusion.There were no significant changes in MAP,HR,CVP,PLC,ACT and PT.Conclusion 6%Hydroxyethyl starch infusion is safe and beneficial during cardiopulmonary bypass.

Fifty-six patients with abdominal wall endometriosis(AWE)were assigned into the proliferous group or the secretory group and the expression of estrogen receptor(ER)in the entopie,ectopic and normal endometrium was investigated.In the proliferous group,the positive ER expression rate on the entopie endometrium(85%)was significantly higher than that on the normal(60%)or ectopie endometrium (58%)(P<0.05).In the secretory group,the positive ER expression rate on the eetopie endometrium (57%)was significantly higher than that on the entopic (26%) or normal endometrium(25%)(P< 0.05).There was significant difference in the entopie and normal endometriilm between the two groups (P<0.01):however,there was no significant diffeFence in the ectopic endometrium.Abnormal ER expression on the entopic or ectopic endometrium may play a role in the pathogenesis of AWE.