Objective To investigate the related factors of recurrence of early gastric cancer (EGC) after endoscopic resection. Methods Clinicopathologic data of 169 patients with EGC who underwent endoscopic resection and periodically followed up by the Chinese PLA General hospital were analyzed retrospectively. Results During a follow-up of 13-57 months (median time 24. 5 months), 12patients had gastric cancer again and the recurrence rate was 7. 1% (12/169). The recurrence time varied from 3 to 36 (28 ± 23)months and the median time was 18 months. The recurrence rates of 0.5 year, 1st year, 2nd year and 3rd year were 1.18% (2/169), 3.55% (6/169), 9.91% (11/111) and 12.24%(12/98), respectively. Eleven patients had gastric cancer again within 2 years after resection.Undifferentiated histology (including poorly differentiated carcinoma and signet ring cell carcinoma),submucosal infiltration and lymphovascular invasion of the primary lesion of EGC were related to thepostsurgical recurrence ( all P ＜ 0. 05). Conclusion Most recurrence of EGC occurred within 2 years afterendoscopic resecton and is related with undifferentiated histology, submucosal infiltration andlymphovascular invasion. It is important for these patients to receive endoscopy follow up.

[ ABSTRACT] AIM:To observe the effect of ursodeoxycholic acid ( UDCA) on the treatment of infantile hepatitis syndrome ( HIS) and to investigate its mechanism.METHODS:The children with infantile hepatitis syndrome were divid-ed into conventional treatment group and the UDCA treatment group.Twenty healthy children were selected as normal con-trol.The children in conventional therapy group were given antiviral and hepatoprotective treatments.The children in UD-CA treatment group were given ursodeoxycholic acid (10 mg? kg-1? d-1 ) in addition to the conventional treatment group for 2 to 3 weeks.The levels of total bilirubin (TBIL), direct bilirubin (DBIL), alanine aminotransferase (ALT), glu-tamyltransferase ( GGT) , total bile acids ( TBA) and TNF-α, IL-6 were detected before admission and 2 weeks later.RE-SULTS:The levels of TNF-αand IL-6 were significantly higher in the children with IHS than those in the normal control (P<0.01).The levels of TBIL, DBIL, ALT, GGT, TBA, TNF-αand IL-6 in conventional treatment group were reduced after therapy (P<0.01).All the above index in UDCA treatment group were decreased compared with conventional treat-ment group (P<0.01).CONCLUSION:On the basis of conventional therapy, ursodeoxycholic acid effectively alleviates the systemic inflammatory response in the children with IHS, reduces the liver damages.

Objective To analyze endoscopic histological characters and establish diagnostic standards of colorectal polyps with confocal laser endomicroscopy (CLE) examination and to explore the diagnostic value of the CLE in adenomatous polyps and non-adenomatous polyps. Methods From June to December in 2009, 90 patients were recruited in this study, which included 40 pathologically confirmed colorectal polyps patients (total 48 colon and rectal polyps) and 50 patients for prospective study (total 106 colon rectal polyps). At same time 10 spots of normal mucosa was taken for comparison. Firstly the CLE images of 48 pathologically confirmed colorectal polyps (22 adenomatous polyps and 26 non-adenomatous polyps) were analyzed, and the diagnosis criteria for distinguishing adenomatous polyps and non-adenomatous polyps was established with CLE. Then according to the criteria, 106 colorectal polyps underwent prospective diagnosis with CLE. Finally, the CLE diagnosis result was compared with pathologically result to evaluate the diagnosis efficiency of CLE. Results In the 48 colorectal polyps of 40 pathologically confirmed colorectal polyps patients, there were 22 adenomatous polyps and 26 non-adenomatous polyps. The sensitivity, specificity and accuracy of CLE in adenomatous polyps diagnosis were 94. 0%, 92. 9%, and 93. 4%, respectively. The positive predictive value was 92.2% and the negative predictive value was 94.5%. The sensitivity, specificity and accuracy of CLE in non-adenomatous polyps diagnosis were 92. 9%, 94.0%, and 93. 4%respectively, the positive predictive value was 94.5% and the negative predictive value was 92.2%.The coherence of CLE and histopathology in adenomatous polyps diagnosis was pretty good (Kappa=0. 893). Conclusion The accuracy of CLE in adenomatous polyps and non-adenomatous polyps differential diagnosis was high, and the coherence with histopathology diagnosis was good, which provided experience for further detection of early rectal precancerous.

Objective To establish diagnostic standards of colorectal tubular adenocarcinoma with confocal laser endomicroscopy(CLE), and to evaluate its diagnostic value in vivo.Methods The confocal images of 12 cases, which were pathologically confirmed colorectal tubular adenocarcinoma(4 well differentiated, 4 moderately differentiated and 4 poorly differentiated), were collected and analyzed to establish diagnostic standards of the disease with CLE.Then 49 lesions were prospectively evaluated based on CLE standards,which were compared to histopathology results.Results The sensitivity, specificity, accuracy, positive predictive value(PV +)and negative predictive value(PV -)of CLE in diagnosing tubular adenocarcinoma were 94.7%, 90.9%, 93.9%, 100% and 76.9%, respectively.The corresponding data of well differentiated adenocarcinoma were 100%, 83.3%, 88.9%, 85.7% and 87.0%, those of moderately differentiated adenocarcinoma were 86.7%, 90.5%, 86.1%, 86.7% and 90.5%, and those of poorly differentiated adenocarcinoma were 77.8%, 92.6%, 88.9%, 100% and 86.2%.Conclusion CLE is able to diagnose and grade colorectal tubular adenocarcinoma.

Objective To analyze the association of gastrointestinal symptoms and sleep disturbance after Wen-Chuan earthquake. *Methods Using random sampling method, compared with Beijing publics at the same time, within two weeks, questionnaire was performed in the disaster area population.Gastrointestinal symptoms were diagnosed according to the Rome Ⅲ standard, and were analyzed in relation to sleep investigation. Results Among 956 disaster area individuals, 459 (48.0%) have gastrointestinal symptoms. Among 1021 Beijing publics, the corresponding number was 78(7. 6% ) ,which was significantly lower. The main gastrointestinal symptoms included abdominal pain ( 14. 0% ), distension ( 12. 1% ),constipation ( 10. 3 % ), heartburn (8. 6% )and dysporia (8. 3% ). Compared with Beijing publics (24. 4% ),the disaster area publics ( 83.7% ) with gastrointestinal symptoms had significant differences in sleep disturbance (P ＜0. 05 ). Early awakening with acratia had significant differences in disaster area publics (P ＜ 0. 05). Conclusion There was relatively high incidence of gastrointestinal symptom after Wen-Chuan earthquake. The incidence of gastrointestinal symptom was related to sleep disturbance, and gastrointestinal symptoms were related to early awakening with acratia.

Objective To observe the effect of Danshen in the treatment of severe hand-foot-and-mouth disease and investigate its mechanism.Methods One hundred and forty cases of children with severe hand foot and mouth diseases who hospitalized the intensive care unit were enrolled in the study from February 2012 to July 2014.The children were randomly divided into a control group and an observation group,with 70 cases in each group.The control group was given antiviral to reduce the intracranial pressure and intravenous immunoglobulin and the observation group was given Danshen in addition to the control group.The levels of neuron specific enolase (NSE)、S-100βprotein、TNF-α and IL-6 were detected at admission and checked again seven days after treatment.The changes of the above indicators and the clinical curative effect were compared before and after therapy.Results The total effective rate of the control group and the observation group was 80.0% and 92.9% respectively,showing statistical significance(P<0.05). After treatment, observation group of serum NSE (9.42 ± 2.56μg/Lvs. 11.71 ± 3.21μg/L,t=2.159), S-100β (177.34 ± 87.28 ng/Lvs. 286.14 ± 159.69 ng/L, t=2.315), TNF-α (15.98 ± 4.35 ng/Lvs. 23.17 ± 4.80 ng/L, t=4.297), IL-6 (41.72 ± 6.64 ng/Lvs. 52.05 ± 9.33 ng/L,t=3.492) , the level of were lower than those in the control group(P<0.05 orP<0.01). In the observation group, serum. The fever clearance time、the disappearance time of rash and the hospitalization time in the observation group (3.55 ± 1.02 d vs.4.55 ± 1.09 d, 7.14 ± 1.04 d) were shorter than those in the control group (4.46 ± 0.97 d vs.5.88 ± 1.44 d, 8.68 ± 1.06 d;t=5.409, 6.161, 8.677 respectively, P<0.01).Conclusions On the basis of conventional therapy,Danshen can effectively alleviate the systemic inflammatory response in children with severe hand foot and mouth diseases, reduce brain damage and improve the clinical efficacy.

Hypoxic-ischemic brain damage is a serious complication of perinatal asphyxia. Enriched environment is the living condi-tions for the promotion of feeling, cognition and behavior. Enriched environment may promote the repairing of hypoxic-ischemic brain dam-age in term of praxiology, morphology and molecular biology, that enriched environment may regulate the secretion and release of various factors, and enhance synaptic plasticity, induce neuron regeneration, inhibit its apoptosis, and result in ethological and morphological recov-ery.

Objective To study the effect of cluster needling of scalp acupuncture combined with rehabilitation on neurological function and expression of basic fibroblast growth factor (bFGF) and angiostatin (AS) in rats after focal cerebral ischemia. Methods 90 male Sprague-Dawley rats were randomly divided into sham operation group, model group, acupuncture treatment group, rehabilitation treatment group and acupuncture and rehabilitation treatment group, each group was further divided into 3 days, 7 days and 14 days subgroups (n=6). Permanent cerebral ischemia rat model was established according to Longa's method. The model group and the sham operation group accepted no treatment, the acupuncture treatment group was treated by cluster needling of scalp acupuncture, the rehabilitation treatment group received the treadmill training, the acupuncture and rehabilitation treatment group was treated by acupuncture and rehabilitation therapy. 3 days, 7 days, 14 days after operation, the neural function was evaluated with the modified Neurological Severity Score (mNSS), the expression levels of bFGF and AS proteins were detected by Western blotting. Results Compared with the model group, the acupuncture treatment group and the rehabilitation treatment group, mNSS decreased, the expression of bFGF protein increased, and the expression of AS protein decreased in the acupuncture and rehabilitation treatment group 3 days, 7 days, 14 days after operation (P<0.05). Conclusion Acupuncture and rehabilitation therapy can reduce the neurological function defect in rats with focal cerebral ischemia, which may be related to the upregulation of bFGF protein expression and down-regulation of AS protein expression.

Objective:To explore the effects of NOD2 gene on the proliferation and apoptosis of tongue squamous cell carcinoma Tca8113 cells.Methods:NOD2 expression vector(NOD2-pEZ-M29)and NOD2-shRNA vector were established,then were trans-fected into Tca8113 cells respectively.Expressions of HBD-2 and NOD2 in the cells was detected by RT-PCR and Western blot.Cell proliferation was examined by MTT assay and apoptosis by flow cytometry at 48h post transfection.Results:Compared with the control group,the expression of NOD2 and HBD-2 in NOD2-pEZ-M29 transfection group was significantly higher and markedly lower in NOD2-shRNA group.The proliferation rate of Tca8113 cells was markedly lower in NOD2-pEZ-M29 transfection group and signifi-cantly higher in NOD2-shRNA group while the apoptosis rate was significantly higher in NOD2-pEZ-M29 transfection group and sig-nificantly lower in NOD2-shRNA group.Conclusion:In Tca8113 cells NOD2 expression was positively correlated with HBD-2 ex-pression.NOD2 gene may promote the apoptosis,inhibit the proliferation of Tca8113 cells.

Objective To make a comparison of transthoracic echocardiography (TTE) and cardiac multi-slice spiral computed tomography (MSCT) in the diagnosis of partial anomalous pulmonary venous connection (PAPVC) in children.Methods One hundred and one patients admitted from February 2008 to April 2014 in Guangdong General Hospital primarily diagnosed with PAPVC with or without other congenital heart diseases were analyzed retrospectively,all the cases underwent routine TTE,which 74 cases underwent cardiac MSCT examination,and the TEE and cardiac MSCT diagnosis results were compared with final surgical findings,then the TTE and cardiac MSCT diagnosis accuracy was calculated.SPSS 13.0 software was used to analyze the data.Results All the patients underwent TTE examination,meanwhile,74 cases received cardiac MSCT examination.Ninety-three cases were confirmed by surgical findings,while 8 cases were misdiagnosed with PAPVC.Sixty-eight cases diagnosed by TTE coincided with surgical findings,and the diagnosis accuracy was 73.12％ (68/93 cases);65 cases diagnosed by cardiac MSCT coincided with surgical findings,and the diagnosis accuracy was 94.20％ (65/69 cases).Among the patients who received both TTE and cardiac MSCT examinations,66 cases were confirmed through final surgical operation,2 cases were mis-diagnosis,so the diagnosis accuracy was 97.06％ (66/68 cases).Conclusions In terms of the diagnosis accuracy of PAPVC,cardial MSCT examination is superior to TTE,as almost all of the cases could be diagnosed by TTE combined with cardial MSCT.In consideration of the acoustics window of children,apart from the conventional parasternal approach of detecting pulmonary veins,the importance of suprasternal and subcostal views should also be attached.