Objective To evaluate the clinical value of endoscopic ultrasonography (EUS) in diagnosis and treatment of rectal carcinoid tumom, and the safety and efficacy of endoscopic submucosal dissection (ESD) for rectal carcinoid tumors. Methods All the submucous tumor considered rectal carcinoid tumor received EUS examination and according to the result to select appropriate therapeutic regimen. Results All the 45 lesions were verified rectal carcinoid tumors by pathological examination. 42 patients received endoscopic submucosal dissection. Two tumors invaded into the muscularis propria and one tumor invaded beyond serosa and with lymph node metastasis received surgical strategy. Conclusion EUS can be used to determine surgical strategy for rectal carcinoid tumor for it provides precise information of the size, depth, border, muscularis propria or vessel infiltration of the tumor. For rectal carcinoid tumors smaller than 20 mm in diameter, ESD is safe and effective.

Objective To determine the value of EUS- guided fine needle aspiration biopsy (FNAB)for the diagnosis of submucosal lesions.MethodsWe found 28 patients with upper gastrointestinal tract solid submucosal lesions by endoseopies. EUS was performed to assess the lesions arised from the specific layer of the wall and the lymph node metastasis. After excluding extrinsic normal tissues compressing the gastrointestinaltract, EUS guided FNAB were carried out. Results Among these patients, two were extrinsic normal tissues compressing the gastrointestinal tract and all other 26 patients were examined by EUS guided FNAB. EUS- guided FNAB failed in only 3 patients. Among the other 23 patients, cytology demonstrated malignant tumors in 4 patients(lymphoma, n=2; leiomyosarcoma, n=2) and benign lesions in 19 patients(leiomyoma, n=1;lipoma, n=1 ). The results of EUS-guided FNAB were validated by surgery (n=20), endoscopic treatment (n=1) or clinical follow-up (n=7). Conclusion EUS guided FNAB is a safe and accurate method for di-agnosis of submucosal lesions.

Objective To determine the value of endoscopic ultrasonography (EUS)-guided fine needle aspiration biopsy (FNAB) for differential diagnosis of pancreatic lesions. Methods EUS was performed in 23 patients with pancreatic lesions detected by CT, MRI, or US to assess the shape, size, and position of the lesions and the status of lymph nodes metastasis. After excluding blood vessel between the lesions and the fine needle by EUS, EUS guided FNAB was carried out. Results All patients were performed EUS-guided FNAB and only 2 patients failed. Among the other 21 patients, cytology and pathology demonstrated tumors in 10 patients (pancreatic carcinoma, n=8; pancreatic cystadenoma, n=1; non functional neuroendocrine tumor, n=1). The results of EUS-guided FNAB were evaluated by surgery (n=16), or clinical follow-up (n=7). The sensitivity was 83%, and speciality was 100%, and no complication occurred. Conclusions EUS-guided FNAB is a safe and accurate method for differential diagnosis of pancreatic lesions.

ObjectiveTo assess the surgical results and implications of clinicopathologic features on the prognosis of patients with hepatic matastases from gastric adenocarcinoma. MethodsNinety one of 834 patients with primary gastric cancer were diagnosed with synchronous ( n =79) or metachronous ( n =12)hepatic metastases. Twenty-one cases underwent hepatectomy for the metastasis. Results The actuarial 1-year, 3-year survival rates after hepatic resection were respectively 69% and 30%. Solitary and metachronous metastases were significant determinants for a favorable prognosis after hepatic resection. Pathologically, tumor pseudomembrane was found in 13 out of 21 patients which was associated with a favorable prognosis. ConclusionsSolitary and metachronous hepatic metastases from gastric cancer should be treated by a surgical approach which confers a good prognosis. The formation of pseudomembrane of the metastatic tumor predicts a favourable postoperative survival.

Z-Ligustilide, a major phthalide isolated from a widely used traditional Chinese medicine Ligusticum chuanxiong, possesses various pharmacological activities including neuroprotective, anti-inflammatory, antiproliferative and vasorelaxing effects. However, it is unstable and inclined to degrade in natural conditions, which limits its study and application greatly. In this study, degradation behavior of Z-ligustilide and its degradation products stored at room temperature under direct sunlight were investigated and structure elucidated by HPLC-UV, UPLC-QTOF-MS and NMR. Z-ligustilide degradation and total five degradation products were generated and detected. Two degradation products were unequivocally identified as senkyunolide I and senkyunolide H by comparison with reference compounds. Another two degradation products were further isolated by semi-preparative HPLC and structure elucidated as (E)-6, 7-trans-dihydroxyligustilide and (Z)-6, 7-epoxyligustilide by 1H and 13C NMR, respectively. The degradation pathways of Z-ligustilide were finally proposed. Oxidation, hydrolysis and isomerization are the major degradation reactions.

Objective To evaluate the complication rate of secondary surgery in patients with benign thyroid disease. Methods From June 1992 to June 2003, 65 patients underwent reoperation. Operative procedures. pathology and complications were reviewed. Results The first surgery was unilateral in 27 cases (41.5%), bilateral in 38 (58.5%). Reoperation identified carcinoma in 8 cases with complications developed in 8 cases and left over permanent in 1 case (1.5%). Conclusion The complication rate of second operation is higher than that of first thyroid surgery, but still acceptable.

Objective To establish HPLC fingerprint for evaluating and controlling the quality of Gastrodia elata. Methods HPLC Analysis and similarity calculation were used for establishing fingerprint chromatogram and classifying 18 different original samples; LC-MS and pure compound comparisons were employed for the fingerprint peaks identification. Results HPLC Fingerprint chromatogram was cons- tructed with 27 fingerprint peaks, 17 of which were common fingerpring peaks and 12 main compounds were identified. According to the similarity to standardize herbal medicine, 18 samples could be classified three groups, Anhui-Henan, Shanxi-Sichuan, and Yunnan habitats. The two critical points were 0.80 and 0.58 for correlation coefficient and 0.88 and 0.73 for cosine values. Conclusion The selected fingerprint peaks are diagnostic for G. elata and the constituted HPLC fingerprint chromatogram could be used for identifying different habitats and served as a powerful tool for further quality control of G. elata.

Objective To explore the prevalence and risk factors of hyperuricemia(HUA) in patients with chronic kidney disease(CKD) on stages 3-5 and to investigate the effect of uric acid on renal function during the past 15 years.Methods Patients with CKD on stages 3-5 who admitted to the Nephrology Department of Affiliated Hospital of Qingdao University from January 2000 to December 2014 were recruited.The prevalence of HUA in patients with CKD on stages 3-5 were analyzed statistically,the risk factors of HUA and the effect of uric acid on the estimated glomerular filtration rate(eGFR) were analyzed by regression analysis.Results (1)The prevalence of HUA was 55.6%,and there was no significant difference between male and female in the 3 547 patients who met the inclusion criteria(χ2=0.184,P=0.683).The prevalence of HUA for CKD on stage 3,4,5 was 42.6%,59.1%,61.2%,respectively.(2)The independent risk factors of HUA in patients with CKD on stages 3-5 were hypertension(OR:1.209(95%CI:1.002-1.458)),increased BMI(OR:1.039(95%CI:1.015-1.062)),increased total cholesterol(OR:1.411(95%CI:1.274-1.564)),increased CKD stage(OR:1.891(95%CI:1.515-2.359),OR:1.898(95%CI:1.481-2.431)) and decreased HDL-C(OR:0.178(95%CI:0.134-0.238))(P<0.05).(3)In patients with CKD on stages 3-5,multiple regression analysis showed that after adjusting for confounding factors,each 100 mol/L-higher uric acid at baseline led to a change in the rate of the baseline eGFR decline of 1.49 ml.min-1.(1.73 m2)-1[95% CI:-2.20--1.05).(4)In 348 hyperuricemic patients with CKD on stage 3,Logistic regression analysis showed that persistent HUA was associated with a higher risk for eGFR decreasing more than 10 ml/min/(1.73 m2) 1 year later(hazard ratio(HR)=2.645,95%CI:1.388-5.039,P=0.003).Conclusion The prevalence of HUA in patients with CKD stages 3-5 is high.Hypertension,hyperlipidemia and overweight are risk factors of HUA.HUA is an independent risk factor for renal function deterioration.

Objective To study the effect of zoledronate (ZOL) on Ca2+/calmodulin-dependent kinase Ⅱ δ (CaMK Ⅱ δ) and down-stream gene expressions during osteoclast differentiation.Methods Mouse osteoclast precursors RAW264.7 cells were divided into the control group and ZOL group.The cells in both groups were induced with 50μg/L receptor activator of nuclear factor kappa B ligand (RANKL) and were harvested on 5 d,while the cells in ZOL group were also simultaneously treated with 1 × 10-6 mol/L ZOL for 2 d.Five days later,the cells were harvested and examined osteoclastogenesis,as well as gene expressions of CaMK Ⅱ δ,nuclear factor of activated T-cells cytoplasmic 1 (NFATc1),tartrate-resistant acid phosphatase (TRAP) and cell-sarcoma receptor coactivator (c-Src).Results The number of TRAP positive multinuclear osteoclasts,number and size of dentin absorption lacunae and area in the ZOL group were (20.0±3.2),(18.0±4.2) and (6 335.3± 1 043.2)μm2 respectively,which were significantly lower than (36.0 ± 8.4),(37.2 ± 5.0) and (11 636.2 ± 3 661.1) μm2 in the control group and decreased by 44.4 ％,51.6 ％ and 45.6 ％ respectively (P＜0.01).ZOL also significantly inhibited the gene expressions of CaMK Ⅱ δ,NFATc1,TRAP and c-Src,and the mRNA levels of these genes were decreased by 44.1％,49.0％,53.8％ and 49.6％ respectively,the protein level were decreased by 43.5 ％,32.2 ％,45.5 ％ and 48.0 ％ respectively.The immunofluorescent cytochemistry detection results showed the fluorescence intensity of CaMK Ⅱ δ,NFATc1,TRAP and c-Srcin in the ZOL group was significantly weakened when compared with the control group.Conclusion ZOL could significantly inhibit the osteoclast formation and bone absorption function,and down-regulates gene expressions of CaMK Ⅱ δ,NFATc1,TRAP and c-Src in osteoclast differentiation.

This is to report the screening, extracting and validating antitumor components and compounds from Stellera chamaejasme L. under the case of discrete distribution of active data. In this work, different components from Stellera chamaejasme L. were collected by HPD macroporous resin and polyamide resin column, and their antitumor activity on A549 were tested by MTT assay. Activity results indicate that activity of components at 30-39 min is more potent than that of Stellera chamaejasme L. extract, and the activity of components at 33.97 min is equivalent to positive drug, cis-platinum at 100 microg x mL(-1), but with totally different mode of action. Under the case of discrete activity, the weight analysis is capable of screening active components and compounds from natural products.