Objective To investigate the efficacy and safety of SB( stag beetle) knife in peroral en?doscopic myotomy( POEM) for achalasia( AC) . Methods A total of 58 cases of AC treated with POEM at department of gastroenterology of the People′s Hospital of Wuhan University from January 2013 to December 2014 were randomly divided into two groups,SB knife group and Dual knife group by using random number table, 29 patients in each group. The complications and therapeutic effects were analyzed. Results All 58 patients with achalasia successfully completed POEM. There were no significant complications in SB knife group such as subcutaneous emphysema, perforation or bleeding.But there were 4 cases of subcutaneous em?physema and 4 cases of bleeding occurred in Dual knife group.The overall incidence of complications was sig?nificantly lower in SB group than that in Dual knife group[0 VS 27?6%(8/29), P<0?05]. The operation time of SB group was(36?32±5?87)mins, which was significant less than that in Dual knife group(56?20± 14?41)mins(P<0?05). The symptom scores significantly increased(P<0?05) and the sphincter resting pressure decreased significantly( P<0?05) after POEM treatment compared with before in the two groups, and there was no statistical significance between the two groups(P>0?05). Conclusion SB knife is safe and effective for achalasia with POEM, which can effectively shorten the operation time and reduce the inci?dence of complications.

This paper reports the effects of compound fish oil on the fluidity of the red cell membrane in rats. Experimental results showed that as compared with young control group the degree of fluorescence polarization of the middle aged group was significantly raised (P

Objective:To study the relationship betwen the mechanism of autoimmune disease and CD4+CD25+ T cell population in NIK mutated mice-aly mice.Methods:NIK mutated mice-aly/aly mice were used as model,aly/+mice as NIK normal control;cell populations were determined by FACS and the thymus structure were analyzed by immunohistochemistry.Results:The CD4+CD25+CD8- population were remarkably decreased in aly mice;and the UEA-1 positive cells were absent in aly mice.Conclusion:The autoimmune disease in aly mice might be the result of deceased the CD4+CD25+ population;the UEA-1 positive cells might play an important role in the development of CD4+CD25+ population. [

ObjectiveTo evaluate Fuji intelligent color enhancement (FICE) chromoendoscopy for diagnosis of early gastric cancer. MethodsFrom February 2010 to March 2011 ,a total of 67 patients with suspected gastric mucosal lesions were enrolled in this study. The lesions were observed with magnifying endoscopy, FICE, magnifying chromoendoscopy and indigo-carmine-magnifying-chromoendoscopy.Suspected gastric mucosal pit patterns and microvascular morphology were compared. Targeted biopsy was performed on suspected locations. Sensitivity, specificity and pathological consistency were compared between the 3 procedures. ResultsOut of 67 patients, 17 were diagnosed as having early gastric cancer.There was no difference among magnifying endoscopy, FICE magnifying chromoendoscopy and indigo-carmine-magnifying-chromoendoscopy in pit pattern findings,however, FICE magnifying chromoendoscopy was superior to other 2 procedures in displaying capillary loop. The sensibility, specificity and pathological accordance rate of FICE magnifying chromoendoscopy were 94. 1％ ( 16/17 ), 98. 0％ (49/50) and 97.0％(65/67), which were higher than those of the magnifying endoscopy [58.8％ ( 10/17), 84％ (42/50)and 77.6％ ( 52/67 )] ( P ＜ 0. 05 ), and were not different from those of indigo-carmine-magnifying-chromoendoscopy [88.2％ (15/17), 96％ (48/50) and 94.0％ (63/67)] (P ＞0.05). Conclusion FICE magnifying chromoendoscopy provides rather clear images of gastric mucosa and intrapapillary capillary, thereby improving the accuracy of endoscopic biopsy and then imporving the diagnosis rate of early gastric cancer.

Objective To evaluate the flexible spectral imaging color enhancement (FICE) system for determine the margin of early gastric cancer and precancerous lesions.Methods From February 2008 to October 2011,a total of 51 patients with early gastric cancer or high-grade intraepithelial neoplasm who received ESD were enrolled and randomly divided into experimental group to determine lesion margin by FICE (n =26) and control group to identify lesion margin by indigo carmine (n =25).Histological complete resection rate (the lateral and vertical margins were free of cancer),operation time,complications,post-ESD ulcer-healing rates and local recurrence were assessed.Results The histological complete resection rate,acute minor bleeding rate and post-ESD abdominal pain rate in experimental group were 2.3％ (24/26),88.5％ (23/26),15.4％ (4/26) and 73.1％ (19/26),which were not significantly different from those of control group,i.e.,92.0％ (23/25),84.0％ (21/25),12.0％ (3/25)and 72.0％ (18/25) (P＞0.05).The mean operation time of in experimental group was shorter than that of control group (P ＜ 0.05).No massive bleeding,delayed bleeding or perforation occurred in either group.Follow-up showed no local residue or recurrence.Conclusion FICE is safe and effective to determine the tumor demarcation of early gastric cancer and high-grade intraepithelial neoplasm,and needs less operation time.

Objective To investigate the expression and clinicopathological features of matrix metalloproteinase 17 (MMP17) in gastric cancer.Methods The expressions of MMP17 at protein and mRNA level in 42 gastric carcinoma surgical specimens,42 endoscopic biopsy specimens of normal gastric tissue and 40 endoscopic biopsy specimens of atrophic gastritis were detected by immunohistoehemistry and reverse transcriptase-polymerase chain reaction (RT-PCR) respectively.Their relations with gastric clinicopathological features were analyzed.Chi square test,t-test and one-way ANOVA analysis were performed for comparing the differences between groups.Results There was no statistically significant difference(P＞0.05) in the expression rate of MMP17 between 42 specimens of normal gastric tissue(7.1％,3/42) and 40 specimens of atrophic gastritis (10.0％,4/40),however both were significantly lower than that of gastric carcinoma (73.8％,31/42,x2 =38.74,34.10,both P＜0.05).The expression quantity of MMP17 at mRNA level of 42 specimens of normal gastric tissue and 40 specimens of atrophic gastritis was 0.226 ± 0.032 and 0.254 ± 0.074 respectively,there was no significant difference(P＞0.05),however both were lower than that of gastric carcinoma (0.476±0.043,t=8.079 and 4.493,both P＜0.05).The expressions of MMP17 at protein and mRNA level were related to depths of invasion,lymph node metastasis and serous membrane involvement in gastric carcinoma patients (x2 =5.300,5.054,4.438,t =2.437,2.372,2.203,all P＜0.05),but not correlated with age,gender,lesion length,lesion site and histological grade (all P＞0.05).The positive rate of MMP17 expression in patients with survival time less than 2 years was significantly higher than that in patients with survival time over two years (x2 =12.71,P＜0.05).Conclusions In gastric carcinoma tissues,the expression of MMP17 increased along with the progression of gastric carcinoma.The detection of MMP17 may have some clinical reference value in determining the prognosis of gastric cancer patients.

Objective To evaluate the flexible spectral imaging color enhancement (FICE) system in the diagnosis of early esophageal carcinoma and precancerous lesions.Methods A total of 257 patients with suspicious esophageal lesions were examined successively by FICE,magnifying FICE,iodine dyeing endoscopy and magnifying iodine dyeing endoscopy.Findings were compared with the pathologic diagnosis.Results The positive rates of early esophageal carcinoma by FICE (92.6％,25/27) and iodine dyeing endoscopy (88.9％,24/27) were not significantly different (P =0.642),nor were those of magnifying FICE (96.3％,26/27) and magnifying iodine dyeing endoscopy (92.6％,25/27),(P =0.556).The magnifying FICE could reveal the IPCL of early esophageal carcinoma clearly.Early esophageal carcinoma and advanced neoplasia were mainly type Ⅳ + Ⅴ,low-level neoplasia and esophagitis were type Ⅱ + Ⅲ,and normal esophagus was type Ⅰ.However,the magnifying iodine dyeing endoscopy was not able to reveal IPCL.There was no adverse reaction in FICE,but the adverse reaction rate was 12.8％ (33/257) in iodine dyeing endoscopy.Conclusion Magnifying FICE can accurately determine the pathological types of early esophageal carcinoma,which is an effective complement to iodine dyeing endoscopy.

Aim To investigate the mechanism of protection of reperfused ischemic heart by Gross Saponin Tribulus Terrestris(GSTT).Methods Hearts of 40 SD rats were isolated,linked to Langendorff perfusion apparatus,and randomly divided into 5 equal groups:control group,to be perfused with modified Kreb-Henseleit(K-H) buffer for 170 min;ischemia /reperfusion(I/R) group,to be perfused with K-H buffer for 20 min,exposed to ischemia for 30 min,and then reperfused with K-H buffer for 120 min;Chelerythrine group,to be perfused with K-H buffer with Chelerythrine,a PKC? antagonist for 20 min,exposed to ischemia for 30 min,and then reperfused with K-H buffer with Chelerythrine for 120 min;GSTT group,perfused with K-H buffer with GSTT for 20 min,exposed to ischemia for 30 min,and then reperfused with K-H buffer with GSTT for 120 min;and GSTT+Chelerythrine group,perfused with K-H buffer with GSTT+Chelerythrine for 20 min,exposed to ischemia for 30 min,and then reperfused with K-H buffer with GSTT+Chelerythrine for 120 min.The heart rate,mean aortic pressure and CK-MB were measured 20 min after the stabilization of perfusion,and 60 or 120 min after reperfusion.After the stop of reperfusion,hearts were sliced into 1-mm-thick transverse sections and incubated in triphenyltetrazolium chloride solution(TTC) to determine infarct size.The phosphorylation level and translocation of PKC? from hearts were determined by western blot analysis.Results GSTT significantly reduced infarct size from 63.2%?4.7% in controls to 37.2%?15.7%.And GSTT could reinforce PKC? translocate from cytoplasm to cellular membrane.Chelerythrine abolished these effects.Conclusion GSTT protects the heart from I/R injury partially by activating PKC?.

Plague, infectious disease in modern medicine, refers to a type of disease with strong pathogenicity and infectiousness, it refers to the infectious diseases of western medicine. Due to its wide variety, the knowledge and understanding of plagues of Traditional Chinese Medicine (TCM) doctors in different stages have evolved and developed with the times. This article, via collating ancient documents, differentiatesthe classification in TCM and analyzes itsrelated theories to perfect the type of plagues in TCM, providing the theoretical basis for the research of plague in modern times.