ObjectiveTo explore the safety and therapeutic effect of 8 patients with esophageal Hiatal Hernia treated by laparoscopic hernia repair.MethodsA retrospective analysis was performed on the clinical data of 8 patients with esophageal Hiatal Hernia form Jun.2009 to Jun. 2010.Among the participants,3 conducted 360-degree fundoplication,5 conducted partial(270-degree) fundoplication.Silk sutures were used for the repair of esophageal perforation in 4 patients,and patch repair was used for the other 4 cases.ResultsEight patients were treated by laparoscopic hernia repair,and all of them were cured without postoperative complications.The mean duration of surgery was ( 120 ± 30) min,with average blood loss ( 50 ± 12 ) ml.Patients had a mean postoperative hospital stay of(4.5 ± 2.5 )days.All the patients were followed up for 1 to 2 years,and no case was found to be relapsed.ConclusionTotal laparoscopic hernia repair is minimally invasive,with short recovery course,less pain after surgery,little complication and short hospitalized time.Laparoscopic Hernia repair should be the preferred effective operation method for patients with esophageal Hiatal Hernia.

Objective:To study the correlation between serum homocysteine (Hcy) and the staging of gastric cancer,by comparing the concentrations of patients with gastric cancer at different pathological staging.Methods:90 patients with benign gastric diseases and 138 patients with gastric cancer were selected and admitted by Shandong University Qilu Hospital during the date from Mar 2014 to Jun 2015.The patients with gastric cancer were divided into 4 groups,according to the 7th AJCC Cancer Staging.To compare the difference of the concentration levels of Hcy and Tumor marks in different groups and analyze the relationship between benign disease and gastric cancer,and analyze it correlation with different pathological stagings of gastric cancer.Enzymatic cycling assay was used for detecting serum Hcy.Results:The serum Hcy concentration level in benign disease was (1 2.31 ± 3.22) μ mol/L,and significantly lower than cancer group(1 6.19 ± 4.84) μ mol/L,the difference was statistically significant (P＜0.05):The serum Hcy concentration levels increased gradually from staging I to staging Ⅳ,and the concentration level in staging Ⅰ was (13.94 ± 4.07) μ mol/L,in staging Ⅱ was (15.49 ± 4.09) μ mol/L,in staging Ⅲ was (17.10 ± 4.79) μ mol/L,in stagingⅣ was (19.81 ± 5.77) μ mol/L,the differences among the four groups were statistically significant(P＜0.05).Spearman Rank Correlation analysis confirmed that,the Hcy concentration level was positively related with pathological staging(r=0.503,P＜ 0.001).Logistic regression analysis showed that,the serum Hcy concentration level is significantly correlated with gastric cancer,after the adjustment of other risk factors (OR=1.208,P=0.003).Conclusions:The serum Hcy concentration level is closely correlated with gastric cancer staging,and increase significantly with the cancer staging (from staging Ⅰ to staging Ⅳ),so itcan be used to evaluate the severity of gastric cancer.

Objective To investigate the effect of early early enteral nutrition combined with parenteral nutrition support on postoperative gastrointestinal function,nutritional status and liver function of patients with obstructive jaundice.Methods Sixty-two patients with obstructive jaundice of hepatobiliary who were treated in the General Surgery Department of the Affiliated Hospital of North China University of Science and Technology from July 2013 to July 2014 were randomly divided into the control group and the observation group,31 cases in each group.The control group were treated with simple parenteral nutrition,and were injected by central venous catheter at the first day after operation,with the injection tiem of 12-15 h and continuous infusion of 7 d or more.The observation group were received enteral nutrition combined with parenteral nutrition,parenteral nutrition was given first,and the preparation method of the nutrient solution was identical with that of the control group;and then slowly dropped 250 ml physiological saline into the jejunum nutrition tube at the second day,dropped into the enteral nutrition liquid at the third day with the initial dose of 300 to 500 ml per day,slowly dropped in the speed of 20-30 ml/h.Results The first exhaust time,first defecation time and hospitalization time in the observation group were (41.37±6.85) h,(46.85±7.13) h and (12.79±3.76) d,significantly shorter than those in the control group ((57.21 ± 9.23) h,(61.43 ± 10.62) h and (16.94 ± 4.33) d;t =7.67,6.35,4.03;P＜O.05),daily hospitalization expenses was (1637.65± 138.24)yuan,significantly less than that in the control group((2121.42±112.38)yuan;t=15.12;P＜0.05).The serum albumin berofe and after the operation in the control group and observation group were (28.73±3.24) g/L and (29.21±3.31) g/L,(36.85±4.05) g/L and (47.21±4.13) g/L,respectively.The serum pre albumin berofe and after the operation in the control group and observation group were (162.81±31.27) g/L and (163.14±30.56) g/L,(248.95±58.62) g/L and(324.24±61.34) g/L,respectively.There was no difference before operation between the two groups (P＞0.05),while the serum protein levels were significantly increased in observation group than the control group (P＜0.01).There were no difference in ALT,total bilirubin and direct bilirubin levels between the two groups before operation (P ＞ 0.05),after treatment,the levels of ALT,total bilirubin and direct bilirubin in the observation group were significantly higher than those in the control group(P＜0.01).The patients in the two groups recovered well,and no serious adverse reactions occurred.Conclusion Early enteral and parenteral nutrition support in patients with obstructive jaundice has better effect and safety in the clinical treatment.

Objective To explore the influence of icotinib in the apoptosis of the human salivary adenoid cystic carcinoma cells ACC-M, and to clarify the mechanism of icotinib for the treatment of salivary adenoid cystic carcinoma.Methods The ACC-M cells were randomly divided into control group,2,4,8μmo1·L-1 icotinib groups,p38-MAPK inhibitor SB203580 (20μmol· L-1 )group,SB203580 (20 μmol· L-1 )+4μmo1 · L-1 icotinib group;the cells were collected 4 h after treatment.The viability of ACC-M cells was measured by MTT assay.The apoptosis of ACC-M cells was assessed by caspase-3 activity kit. The expression of p-p38-MAPK protein was determined by Western blotting analysis.Results Compared with control group,the inhibitory rates of growth of the ACC-M cells in icotinib groups were significantly decreased (P<0.05 ), and the activities of caspase-3 were increased (P<0.05),and the expression levels of p-p38-MAPK were significantly increased (P<0.05).Compared with 4μmo1·L-1 icotinib group,the expression level of p-p38-MAPK in SB203580+icotinib group were decreased (P < 0.05 ), and the activity of caspase-3 was decreased dramatically (P < 0.05 ). Conclusion Icotinib may induce the apoptosis of ACC-M cells through the activation of p38-MAPK signaling pathway.

Objective To investigate the measurement , feasibility and clinic effect of hyperthermic intraperitoneal chemotherapy (HIPEC) guided by B ultrasound in the treatment of malignant ascites from peritoneal carcinomatosis. Methods From July 2011 to June 2013, B ultrasound-guided approach was used to perform HIPEC on 36 patients affected by malignant ascites secondary to peritoneal carcinomatosis. Every patient underwent HIPEC for three times , by way of continuous circulatory perfusion into peritoneal cavity with saline at 400 ~ 600 mL/min and intraperitoneal perfusion with 5-FU mitomycin-C and cisplatin for 90 minutes with an inflow temperature of (43 ± 0.2)℃. These patients were followed up for a long term. Results Intraoperative course was uneventful in all cases. Complete clinical regression of ascites and related symptoms was achieved in all the 26 patients, partial regression achieved in 8 patients, and no curative effect achieved in 2 cases. The acquired total clinic effectiveness was 94.44%. No postoperative deaths and complication related to the procedure occurred in this study. The KPS grades of patients rose (P < 0.001), the level of tumor markers decreased, including CA199 (P < 0.001), CEA (P < 0.001), CA125 (P = 0.003). Conclusion HIPEC guided by B ultrasound appears to be a safe, feasible and effective procedure for the treatment of debilitating malignant ascites from unresectable peritoneal carcinomatosis , which would have a clinic good perspective in future.

Objective Through detecting the expression of triggering receptor expressed on myeloid cells-1 (TREM-1) in pancreas and lung of rats with severe acute panereatitis,to approach the role of TREM-1 in severe actute pancreatitis pathogenesis,and provid a new molecular target for SAP.Methods Thirty healthy male Wistar rat were randomly divided into two groups:control group(group A),n =15 ; severe acute pancreatitis group (group B),n =15.The model of severe acute pancreatitis of rats was induced by retrograde injection of 5％ sodium taurocholate into the pancreatic duct.Results TREM-1 in pancreatic tissues and lung tissues was significantly higher in group B than group A in three time points(6 h,12 h,24 h) and had significant changes(P ＜ 0.05),and had a positive correlation with pancreatic pathology.Conclusion TREM-1 was significantly expressed in severe acute pancreatitis,and aggravated pancreas damage and systemic inflammatory response syndrome.

Induced-current electrical impedance tomography (ICEIT) is a newly hot research field in electrical impedance tomography (EIT) because of its advantages of contactless exciting. A preliminary ICEIT system with 3 excitation coils has been accomplished. It includes the constant current source (CCS), power amplifiers, excitation coils,physical phantom, measurement-mode setting circuit, signal measuring block, DAC and digital I/O card. The CCS is accomplished with Direct Digital Synthesis (DDS) technique. Its frequency is 46.875 KHz. Its output current is divided into 16 steps from 0.16 mA to 2.56 mA which can be set by computer. The three driving coils have the same diameter of 50 cm, each coil's inductance is 193.5 microH. The power amplifier can provide 800 mA driving current (f = 46.875 KHz) to the coil under +/- 25 V power supplying. The signal from measurement electrodes is switched to measurement channel which includes IA, BP filter and synchronized demodulator, then the analog signal is converted to digital signal by a 12b A/D Card and the data is acquired by DMA mode. Our experiments show that a distinguish change of signal from the surface electrodes can be acquired by the experimental system when different objects are placed in the physical phantom. And 3 x 31 signals for preliminary imaging have been acquired.
Algorithms ; Amplifiers, Electronic ; Electric Impedance ; Electrodes ; Electromagnetic Fields ; Electromagnetic Phenomena ; instrumentation ; Humans ; Image Processing, Computer-Assisted ; Phantoms, Imaging ; Tomography ; instrumentation ; methods

Non-coding RNAs (ncRNAs) is a kind of RNA without protein coding function. A large number of studies in recent years have shown that the occurrence and development of colorectal cancer (CRC) are closely related to the aberrant expression of ncRNAs. ncRNAs can be used as non-invasive biomarkers for early diagnosis of CRC. We review the research progress of ncRNAs in early diagnosis of CRC, and summarize the potential clinical value of ncRNAs detection, which can provide a theoretical basis for improving the early diagnosis rate of CRC.

Objective:To analyze circRNAs specifically differentially expressed in esophageal squamous cell carcinoma (ESCC) based on high-throughput sequencing data.Methods:Six patients with pathologically confirmed ESCC in Tangdu Hospital of Air Force Medical University from March 2018 to March 2019 were selected as the research subjects, among which 3 were stage Ⅰ ESCC and 3 were stage Ⅲ ESCC. High-throughput sequencing technology was used to analyze the difference in the expression of circRNA in cancer tissues and adjacent tissues of patients. GO enrichment analysis, KEGG enrichment analysis and Venn analysis were performed on differentially expressed genes. The circRNA-miRNA-mRNA network was constructed using Cytoscape software. The most significantly differentially expressed genes in cancer tissues were verified in cells and tissues, and the relationships between circRNAs and clinical pathological indicators of patients were analyzed.Results:A total of 553 differentially expressed circRNAs were screened in paracancerous tissues and cancer tissues of 3 stage Ⅰ ESCC patients, of which 413 were up-regulated and 140 were down-regulated in cancer tissues; A total of 425 differentially expressed circRNAs were screened in paracancerous tissues and cancer tissues of 3 stage Ⅲ ESCC patients, of which 276 were up-regulated and 149 were down-regulated in cancer tissues. GO enrichment analysis showed that the host genes of differential circRNAs in patients with stage Ⅰ ESCC were mainly enriched in cell cycle-related biological processes such as mitotic G 2/M transition. The host genes of differential circRNAs in patients with stage Ⅲ ESCC were mainly enriched in biological processes related to cell division and tumor development, such as mitotic spindle checkpoint and cell matrix adhesion. KEGG enrichment analysis showed that the differential circRNAs in cancer tissues of stage Ⅰ and stage Ⅲ ESCC patients were mainly enriched in cancer-related biological pathways such as cell adhesion. The results of Venn analysis showed that in stage Ⅰ ESCC patients and stage Ⅲ ESCC patients, 2 and 8 circRNAs that were only specifically expressed in paracancerous tissues and had significant differences were screened out respectively, and were only specifically expressed in cancer tissues with significant differences were 11 and 14 respectively. The circRNA-miRNA-mRNA network showed that the cancer tissue-related circRNA-miRNA-mRNA network in stage Ⅰ ESCC patients consisted of 7 circRNA nodes, 10 miRNA nodes and 28 mRNA nodes, and the cancer tissue-related circRNA-miRNA-mRNA network in stage Ⅲ ESCC patients consisted of 7 circRNA nodes, 9 miRNA nodes and 49 mRNA nodes. The most significantly differentially expressed hsa-circ-0060927 and hsa-circ-0109301 in cancer tissues of patients with stage Ⅰ ESCC and stage Ⅲ ESCC were selected for cytological and histological verification. The results showed that the relative expression levels of hsa-circ-0060927 in ESCC cell lines TE1, TE13, KYSE30, KYSE170, and human normal esophageal epithelial cell line HEEC were 7.82±1.96, 12.69±2.68, 12.78±2.74, 7.53±1.75, and 2.43±0.17, respectively, with a statistically significant difference ( F=4.68, P=0.004). The relative expression levels of hsa-circ-0060927 in ESCC cell lines TE1, TE13, KYSE30, and KYSE170 were higher than that in human normal esophageal epithelial cell line HEEC, with statistically significant differences ( P=0.009; P=0.003; P=0.003; P=0.007). The relative expression levels of hsa-circ-0109301 in ESCC cell lines TE1, TE13, KYSE30, KYSE170, and human normal esophageal epithelial cell line HEEC were 5.16±1.32, 6.28±1.57, 4.89±1.13, 8.92±2.12, and 22.56±4.13, respectively, with a statistically significant difference ( F=4.31, P=0.022). The relative expression levels of hsa-circ-0109301 in ESCC cell lines TE1, TE13, KYSE30, and KYSE170 were lower than that in human normal esophageal epithelial cell line HEEC, with statistically significant differences ( P=0.027; P=0.015; P=0.024; P=0.008). The expression level of hsa-circ-0060927 in cancer tissues of 13 early ESCC patients was 12.89±2.67, significantly higher than 5.73±1.18 in paracancerous tissue, and there was a statistically significant difference ( t=15.02, P<0.001) ; the expression level of hsa-circ-0109301 in cancer tissues of 19 patients with advanced ESCC was 7.78±2.17, significantly lower than 16.32±3.15 in paracancerous tissue, and there was a statistically significant difference ( t=9.73, P<0.001). The expression of hsa-circ-0109301 was related to the degree of tumor differentiation in advanced ESCC patients ( P=0.023) . Conclusion:One circRNA (hsa-circ-0060927 and hsa-circ-0109301) with the most significanty differential expression is selected in early and advanced ESCC patients respectively, in which hsa-circ-0060927 is highly expressed in ESCC cancer tissues and hsa-circ-0109301 is lowly expressed in ESCC cancer tissues, and the expression of hsa-circ-0109301 is correlated with the degree of tumor differentiation.

Objective:To explore the effect of mind mapping teaching of gastroenterology in the standardized training for general practitioners, and provide new ideas for general practice education.Methods:A total of 65 physicians who were enrolled in the standardized training of general practice from January to December 2017 were collected as the control group, and the traditional teaching method was adopted; another 58 physicians from January to December 2018 were selected as the experimental group, and the mind mapping was adopted based on the traditional teaching method. The learning effect (theoretical and operational results) and the satisfaction questionnaire of trainees and teachers were used as evaluation indicators. SPSS 21.0 was used for t test and chi-square test. Results:The theory exam and clinical skills examination results of experimental group (80.80±5.30, 82.66±5.90) were significantly higher than those of the control group (71.60±5.20, 75.72±4.57), and the difference was statistically significant ( P<0.05). Compared with the control group, the experimental group had better understanding of knowledge points of this discipline, clinical thinking ability, higher learning interest, teamwork ability, innovation ability and teacher satisfaction, with statistical significance ( P<0.05). Conclusion:The mind mapping has more advantages than traditional teaching methods in the standardized training for general practitioners, which can be further extended.