Objective:To explore the application value of endoscopic ultrasonography (EUS) on preoperative diagnosis and clinical staging of esophageal cancer.Methods: In accordance with the international federation of tumor cancer alliance (UICC) and the United States (AJCC) (2003) TNM staging criteria, 45 cases of esophageal cancer patients confirmed by biopsy and gastroscope examination did preoperative diagnosis and clinical staging with EUS, and the results were compared with postoperative pathological staging results.Results: Fourty-five patients had esophageal EUS imaging characteristics, EUS on 45 cases of esophageal cancer patients with preoperative diagnostic accuracy rate was 100.0%; Clinical staging based on the result of postoperative histopathologic examination, preoperative EUS for esophageal T staging overall diagnostic accuracy was 82.2%, T1, T2, T3, T4 diagnostic accuracy respectively was 85.7%, 83.3%, 82.4% and 85.7%; The overall diagnostic accuracy was 77.8% for N staging, N0 and N1 stage diagnostic accuracy respectively was 80.0%, 76.0%.Conclusion: Accuracy rate of EUS on preoperative diagnosis of esophageal cancer is higher, accuracy rate of EUS on preoperative T and N staging of esophageal cancer is also high, it can be important basis of esophageal preoperative treatment selection and prognostic evaluation, and has higher clinical value.

Objective To investigate the clinical characteristics of isolated renal mucormycosis in children. Methods The clinical manifestations,CT,IVU and surgical findings of 3 children with isolated renal mucormycosis were analyzed. Results A three-month newborn presented asymptomatically except for renal mass.The other two children had fever,lumbar pain,hematuria,renal enlargement and tenderness.CT scan showed multiple low density foci in the kidneys.All of the three children underwent nephrectomy and systemic amphotericin B treatment,and the diagnoses were confirmed by pathological examination. Conclusions Isolated renal mucormycosis is a rare fungal infection without predisposing factors,and its clinical characteristics are different from the usual systemic mucormycosis.Early diagnosis,nephrectomy and systemic amphotericin B treatment are necessary for improving the prognosis.

Objective To seek an effective and feasible treatment for esophageal carcinoma with unequal fractionation radiotherapy.Methods 160 patients with esophageal squamous carcinoma were randomized into an unequal frationation radiotherpy (UEFRT) group and a conventional fractionation radiotherapy (CFRT) group with 80 cases on each side. All the patients were simulated and irradiated by three port technique. Patients in the UEFRT group received D T70 Gy, at 4 Gy once daily, 5 days in the first week, then at 2 Gy daily, 5 days per week during the following five weeks. In the CFRT group,70 Gy was delivered with the routine regimen. Results The 5 year local control rates in UEFRT and CFRT groups were 46.3% and 27.5%(P

Objective To investigate the mechanical properties of carbon-fiber-reinforced polyether-ether-ketone (CF/PEEK)composite materials and to evaluate the biocompatibility and bioactivity of CF/PEEK after implanted into mandibula.Methods 27 adult Japanese white rabbits were randomly divided into experimental group (n=9) and control group (n=18),CF/PEEK was implanted into bilateral mandibula of the rabbits in experimental group, autologous bone was implanted into left mandibula of the rabbits in positive control group (n=9 )while the right sides were taken as blank control group (n=9 )without implants. The materials-bone interface of samples were collected to make the observation of gross,imaging and histology and to analyze the histological score after 8,12, and 16 weeks.Results All the animals and no infection had secondary fractures.Obviously callus formation was observed on the edge of the defect in both experimental group and positive control group in the imaging observation, while the rabbits in blank control group had no obvious change.Compared with 8 weeks after operation, the score evaluation of local cellular immune response showed significant decreasing in 12 weeks after operation(P<0.01), the data was the minimum in 16 weeks(P<0.05).At the same time,the score evaluation of local cellular immune response in three groups showed no significant difference (P> 0.05).Trabecular bone and osteoblasts could be observed in the bone defect of both experimental group and positive control group after 16 weeks,and blank control group was filled with fibrous connective tissue.The osteogenesis rates in experimental group and positive control group were increased with the prolongation of time, and they were better than that in blank control group (P<0.01).Conclusion CF/PEEK material has good mechanical property,biocompatibility and bioactivity;and it has light immune response after implantation.

Objective To evaluate the therapeutic effect of extra-fine choledochoscope in treating polypoid lesions of gallbladder by percutaneous trans-hepatic and trans-gallbladder puncture(PTGB). Methods Extra-fine choledochoscope(2. 7 mm diameter)was inserted into tract soon after it was made per-cutaneously trans-hepatic and dilated in one session,gallbladder polyps was removed with biopsy forceps or snare or basket,and PTCD drainage tube(10. 2 F diameter)was imbedded for external drainage until 10 days after. If the gallbladder puncture point fell on the bed and gallbladder polyps were not clearly visual-ized,or puncture points were on non-gallbladder bed of the body,drainage tube(10. 2 F diameter)was placed for external drainage. Results Forty-two patients were successfully punctured,and 40 patients were punctured accurately on the bed in,and the fresh endoscope tract of these patients was established in 45 mi-nutes on average. Of the 29 cases of simple bottom and body ventral polyps,complete clearance of gallbladder polyps was achieved in 27. Gallbladder polyps clearance rate was 93. 10%. Complications of minor hemobi-lia occurred in 9 cases,and infection of biliary tract occurred in 3 cases after operation. There was no recur-rence after a follow-up of 15 months on average. Conclusion Extra-fine choledochoscope by PTGB is a less invasive,more reliable and effective method to cure benign polypoid lesions of the gallbladder. The gallblad-der is preserved and for malignant polyps,it can help to achieve early diagnosis and provide reliable evidence for further treatment.

Objective To study the clinical characteristics,diagnosis,and treatment of paratyphoid fever A (fever A) complicated with severe kidney damage. Methods The data were retrospectively reviewed.Results The symptoms of poisoning and gastrointestinal symptoms as well as the slightly abnormal urinalysis (proteinuria, hematuria) appeared early, which got worse along with the progression of the disease. The symptoms of urinary system and azotemia appeared in the worst period. After treatment with antibiotic, 4 patients recovered early.Conclusion Paratyphoid fever A can cause severe kidney damage, with non-specific symptoms at the early stage. The seriousness of the abnormal of urine test can't be ignored as those provides the basis for the early diagnosis. The early use of antibiotic is the key to avoid and lessen the serverity of kidney damage.

ObjectiveTo observe the treatment effects in 48 cases of advanced lung cancer patients,with the immune therapy of the dendritic cells loading of tumor autologous antigen (DCTAA) combining with the cells induced factor of the killer cells(CIK)from the matched umbilical cord blood cells.MethodsThe peripheral blood mononuclear cell(PBMC)from the matched umbilical cord blood cells was seperated,and induced to CIK and DC with some cytokines in vitro, such as CD3McAb, IL-2, IFN-γ IL-1α, etc. After 12 to 15 days, the amplified CIK cells obtained were obtained, with the strict quality control, infused the CIK cells to the patients body back in six times,about(5-8)×109 CIK cells in each time.In the fifth day of the cultivation,DETAA cells were loaded and DCTAA cells were collected in the eighth day,and then hypodermic injection was done. The patient' s general situation after the immune treatment was observed, such as the size of the tumors, clinical symptom score, the quality of life and immune indexes. Karnofsky score, weight, toxic side effects and the patient's survival were also studied.ResultsIn the 48 cases with the DCTAA-CIK treatment, complete remission (CR), partial remission (PR)was 37 cases, the overall remission rate was 77.1％. The improvement rate of clinical symptom scores was from 78.9 ％ to 84.7 ％, the increasing rate of Karnofsky score was 89.6 ％ (43/48). 1-year survival reached to 80.6 ％. There were significant difference in little toxic side effects(P ＜ 0.01). The proportion of CD3, CD4 and NK cells in peripheral blood cells increased significantly (P ＜ 0.01) after DCTAA-CIK cells treatment[(42.21±6.12)％, (24.42±3.01)％, 0.99±0.34, (24.98±3.02) ％; (71.58±7.64) ％, (37.25±2.13) ％, 1.62±0.45, (35.23±4.11) ％](t = 6.34, 5.67, 0.25, 4.43, P ＜0.01).ConclusionThe DCTAA-CIK immune therapy is benefit for advanced lung cancer,not only improve the immune function but also ameliorate the clinical symptoms.

Objective To investigate the effect of long non-coding RNA HOX transcript antisense RNA ( lncRNA HOTAIR ) on the cell proliferation, radiosensitivity and apoptosis of the rectal adenocarcinoma cell lines SW480 and HCT116 in vitro. Methods The expression levels of lncRNA HOTAIR in the rectal adenocarcinoma cell lines ( SW480 and HCT116 ) were assessed by real-time quantitative PCR (RT-qPCR).Silencing of HOTAIR by RNA interference was performed to explore its roles in cell proliferation,radiosensitivity and apoptosis. After treatment with irradiation at a gradient dose,the cell viability was measured and the rate of cell apoptosis was tested. Results Compared with the human rectal epithelial cell lines,the expression of lncRNA HOTAIR was significantly higher in the rectal adenocarcinoma cell lines. The colonic assay demonstrated that the sensitizing enhancement ratios ( SERs) were 1. 58 and 1. 33 for the cells transfected with HOTAIR siRNA in SW480 and HCT116 cell line compared with the control isRNA transfection group. In vitro silencing of lncRNA HOTAIR could enhance the apotosis rate and radiosensitivity of the rectal adenocarcinoma cell line SW480. Conclusion The expression level of lncRNA HOTAIR is correlated with the cellular radiosensitivity, which is probably a parameter for predicting the radiosensitivity of rectal adenocarcinoma cells. Radiotherapy combined with HOTAIR-siRNA can significantly inhibit the cell proliferation,induce cell apoptosis and enhance the radiosensitivity.

Objective:To investigate the diagnosis and prognosis of one patient with carcinoma ex pleomorphic adenoma (CXPA)composed of three malignant components in parotid gland,and to raise the clinicians'awareness of the disease.Methods:A patient was presented to hospital because of the mass in left parotid gland region for more than 30 years and the accompanied pain lasted for one month.After color ultrasonography,the left parotid gland tumor resection was performed. Results: The operation was successful. The postoperative pathological diagnosis results comfirmed as CXPA,it was composed of three malignant components,including non-specific adenocarcinoma,ductal carcinoma,and myoepithelial carcinoma.Conclusion:CXPA composed of three malignant components at the same time are extremely rare.CXPA is difficult to diagnose and its prognosis is poor.The clinicians are supposed to improve the understanding of CXPA.

Objective:To explore the improvement effect of rhein lysinate (RHL)on the insulin resistance in the KK/HlJ diabetes mellitus (DM ) mice induced by streptozotocin (STZ ), and to elucidate its mechanism. Methods:The KK/HlJ diabetic mouse models were made by intraperitoneal injection of STZ (50 mg· kg-1 )and fed with DM diet.A total of 48 mice were divided into normal control group,model group,low dose of RHL group (25 mg·kg-1 )and high dose of RHL group (50 mg·kg-1 ) (n= 12).All the mice were treated for 16 weeks. The levels of fasting glucose (FBG),total cholesterol (TC)and triglyceride (TG)of the mice were measured by glucose oxidase method.HE staining was used to observe the morphology of pancreas tissue of the mice.The insulin level in pancreas islet tissue was detected by immunohistochemistry method.The levels of insulin and of C reactive protein (CRP)in serum and tumor necrosis factorα(TNF-α)and interleukin 6 (IL-6)in liver tissue of the mice were detected by enzyme linked immunosorbent assay (ELISA)method.The expression levels of glycogen synthesis related genes (PI3K,AKT and GSK-3β)phosphorylation were detected by Western blotting method. Results:Compared with model group,the levels of FBG,TG and TC of the mice in low and high doses of RHL groups were significantly decreased (P < 0.05),but there was no significant difference in the insulin level (P >0.05).Compared with model group,the levels of CRP in serum and the levels of TNF-αand IL-6 in liver tissue of the mice in low and high doses of RHL groups were significantly decreased (P <0.01).The HE staining results showed that compared with model group,the islet morphology of the mice in low and high doses of RHL groups was partially restored,and the occasional inflammatory infiltration was observed.The immunohistochemical staining results showed that compared with model group,the brown granular substance in the islets of the mice in low dose of RHL group was significantly reduced,which was disappeared in high dose of RHL group.Compared with model group,the expression levels of glycogen synthesis related genes (PI3K,AKT and GST-3β)phosphorylation of the mice in low and high doses of RHL groups were increased (P <0.01).Conclusion:RHL has improvement effect on the insulin resistance in the KK/HlJ DM mice induced by STZ,and the mechanism may be related to promoting the glycogen synthesis.