Objective To evaluate endoscopic ultrasonography (EUS) for diagnosis and treatment of ectopic pancreas in upper gastrointestinal tract.Methods Data of 52 patients with ectopic pancreas diagnosed by EUS and confirmed by pathological examination were reviewed.The feature of EUS image and diagnostic accuracy were retrospectively analyzed.Results Out of 52 patients, 41 (78.85% ) were pathologically diagnosed as having ectopic pancreas, 6 were stromal tumors, 4 were leiomyoma and 1 was nerve sheath tumor.All ectopic pancreases presented as protruding lesions, in which 37 were located at gastric antrum, 2 in duodenum, 1 in gastric body and 1 in gastric fundus.Under EUS, 1 case appeared as hyperechoic, 10 as isoechoic, 18 as hypoechoic and 12 as mixed echoic.The lesion involved mucosa in 2 cases, muscularis mu-cosae in 8, submucosa in 30 and muscularis propria in 1, in which 15 cases from submucosa underwent endoscopic resection.Bleeding occurred in 2 cases and no other complications occurred.There was one relapse during the 6 months of followed-up.Conclusion EUS is valuable and safe for the diagnosis of ectopic pancreas in upper gastrointestinal tract.Depth of lesions revealed by EUS can help further treatment.

Objective To evaluate the valuse of endoscopic ultrasonography ( EUS ) for upper gastrointestinal submucosal lesions and the role of Photoshop in differentiating leiomyoma and stromal tumors. Methods Data of 656 patients with upper gastrointestinal submucosal lesions evaluated by EUS and receiving endoscopic submucosal dissection ( ESD ) from April 2010 to March 2015 were collected and retrospectively analyzed. The goldern standard for lesions size and origin was the intraoperative diagnosis of ESD, and that of the type of lesions ( leiomyoma, stromal tumor, ectopic pancreas, lipoma, etc.) was pathological and immunohistochemical finding. The consistency of diagnosis of the EUS was evaluated. In addition, Photoshop was used to differentiate diagnosis of leiomyoma and stromal tumors which were confirmed by pathology and immunohistochemistry. Results The consistency in diagnosing the size and lesion origins was 92?56%(560/605) and 88?43%(535/605)between EUS and ESD intraoperative result. The consistency in pathological types of EUS was 79?34%(480/605). Photoshop was used to analyze the EUS images of 177 stromal tumor and 241 leiomyoma. The gray value of stromal tumor was significantly higher than that of leiomyoma(59?97 VS 39?39, t=43?27, P<0?05).The echo of stromal tumor was higher. The standard deviation of gray value of leiomyoma were significantly lower than that of the stromal tumor ( 4?81 VS 5?42, t = 2?83, P < 0?05 ) , indicating the echo uniformity of leiomyoma was better. Conclusion EUS shows high accuracy rate for upper gastrointestinal submucosal lesions, providing more accurate basis for endoscopic therapy. EUS combined with Photoshop is helpful for differentiating stromal tumor from leiomyoma.

Objects: To investigate the behavior of gastric electrical activity in patients with gastrointestinal stromal tumor(GIST) to identify the influences of GIST on the normal gastric electrical activity. Methods: The electrogastrogram (EGG) parameters of 27 patients with gastric GIST (GIST group) and 30 healthy volunteers (control group) were detected by the multi-channel electrogastrogram and the data were analyzed. Results: The values of postprandial mean frequency (MF), mean amplitude (MA) and the percentage of normal slow wave (N%) were increased, and the percentage of bradygastria (B%) was decreased than those of the fasting in control group(P < 0.05 or P < 0.01). However, those postprandial parameter changes were not found in GIST group(P > 0.05). Compared with control group, the fasting MF and MA increased, the fasting N% of lead 1, 3, 4 and postprandial N% decreased, both percentages of fasting and postprandial tachygastria (T%) increased in GIST group (P < 0.01). The tachygastria incidence was significantly higher in GIST group than that of control (66.7% vs 3.3%, P <0.05). Conclusion: The gastric electrical activity was affected by the existence of GIST. The abnormal gastric electrical rhythm displayed mainly as tachygastria.

Objective To investigate the abnormal brain activity of first-episode depression by rest-ing state functional magnetic resonance imaging ( fMRI) .Methods Twenty-one adolescent participants diag-nosed with depression(AD) and 18 healthy controls ( HC) were recruited.Resting state fMRI brain scans were performed on all participants.Regional homogeneity ( ReHo) approach was applied to preprocess the fMRI datasets.The value of ReHo maps were obtained in the whole brain.Results ReHo values in the AD group were higher than those in the healthy controls in the right inferior temporal gyrus ( MINI:66,-24,-20) ,left upper cingulate cortex (-27,47,-6) ,frontal polar (-24,59,14) ,after upper left cingulate cortex (-1,-16,35),after the bottom left cingulate cortex (-2,-38,32),left praecuneus (-1,-48,65) com-pared with that in the healthy controls (P<0.05) .ReHo in the AD group decreased in the right middle tempo-ral gyrus (45,-34,32) compared with that in the healthy controls (P<0.05).Conclusion Extensive ReHo abnormalities were found in the brains of patients with first-episode,drug-naive depression,and these abnor-malities in spontaneous neural activity may contribute to the neuropathology of adolescent depression.

Surface molecularly imprinted polymers (SMIPs) for selective adsorption of ampicillin sodium were synthesized using surface molecular imprinting technique with silica gel as a support. The physical and morphological characteristics of the polymers were investigated by scanning electron microscope (SEM), Fourier transform infrared spectroscopy (FT-IR), thermogravimetric analysis (TGA), elemental analysis and nitrogen adsorption–desorption test. The obtained results showed that the SMIPs displayed great adsorption capacity (13.5μg/mg), high recognition ability (the imprinted factor is 3.2) and good binding kinetics for ampicillin sodium. Finally, as solid phase extraction adsorbents, the SMIPs coupled with HPLC method were validated and applied for the enrichment, purification and determination of ampicillin sodium in real milk and blood samples. The averages of spiked accuracy ranged from 92.1%to 107.6%. The relative standard deviations of intra-and inter-day precisions were less than 4.6%. This study provides a new and promising method for enriching, extracting and determining ampicillin sodium in complex biological samples.

Objective To compare the effects of different intervention methods on relieving the xerostomia and to explore the best method to relieve xerostomia in patients during anesthesia recovery period.Methods A total of 108 patients in post anesthesia care unit after general anesthesia were recruited from March 2015 to June 2016 in Chinese PLA General Hospital.They were randomly divided into the experimental group 1 (27 cases),experimental group 2 (26 cases),condition conditional group (28 cases),blank control group (27 cases) with different methods of moistening oral cavity after extubation with 2 ml at a time for every 10 minutes including lemon water sprayer,vitamin C sprayer,warm water sprayer and non-intervention.And then,the visual analogue scale (VAS) for the intensity of xerostomia and the prevalence of adverse reactions including nausea,vomiting,abdominal pain,abdominal distension and so on were compared before intervention,20 minutes and 50 minutes after intervention.Results The results showed that the scores of VAS in the experimental group 1 were lower than those in the experimental group 2,the conditional control group and the blank control group 20 minutes and 50 minutes after intervention with significant differences [(Dunnett-t =-1.200,-1.733,-1.733;P＜ 0.01;20 minutes after intervention),(Dunnett-t =-2.150,-2.500,-5.567;P＜0.01;50minutes after intervention)].Conclusions The application of the lemon water sprayer for moistening oral cavity can effectively relieve the xerostomia in patients during anesthesia recovery period.Besides,the effects of the lemon water sprayer are better than those of vitamin C sprayer and warm water sprayer.

Time in range (TIR) refers to the time or percentage of time within 24 h that glucose levels are in the target range; or the time that blood glucose levels are higher and lower the target range. TIR is a core parameter of continuous glucose monitoring (CGM) and an important indicator for the evaluation of blood glucose in treatment of diabetic patients. Recent studies have confirmed that TIR is closely related to cardiovascular complications of diabetes, and it may become a key indicator for predicting the risk of cardiovascular complications in the future. This article reviews the research progress on the relationship between TIR and cardiovascular complications in diabetic patients, and discusses the value of TIR in the integrated management of diabetes and cardiovascular diseases.

OBJECTIVETo explore the epidemiological characteristics of inhalation injury and to summarize the clinical application experience of diagnostic standard of burn of larynx.

METHODSMedical records of 443 patients with inhalation injury admitted to our burn unit from January 1999 to June 2013 were analyzed, including gender, age, severity of inhalation injury, complications and diseases before injury; total area and that of full-thickness burn injury, admission time after burn, and burn condition of larynx of patients with different degrees of inhalation injury; treatment and outcome including rate, time, and complication of tracheotomy, mortality, and cause of death. Data were processed with nonparametric Kruskal-Wallis test and chi-square test. The relationship between severity of inhalation injury and total burn area, degree of burn of larynx, tracheotomy rate, and mortality was assessed by Spearman correlation analysis.

RESULTS(1) Among the patients, there were 353 (79.7% ) male and 90 (20.3% ) female, with the ratio of male to female 4:1. There were 64 (14.4%) patients younger than or equal to 20 years, 203 (45.8%) patients older than 20 years and younger than or equal to 40 years, 144 (32.5%) patients older than 40 years and younger than or equal to 60 years, and 32 (7.2%) patients older than 60 years. The numbers of patients with mild, moderate, and severe inhalation injury were respectively 297, 108, and 38. Seven patients suffered from complications, and 21 patients had diseases before injury. There were statistically significant differences among the patients with different degree of inhalation injury in regard to total burn area and full-thickness burn area (with H values respectively 73.752 and 142.830, P values below 0.01), while no statistically significant difference was observed in admission time after burn ( H = 1.528, P > 0.05). Correlation analysis showed that severity of inhalation injury was positively correlated with total burn area (r = 0.399, P < 0.001). Among the patients with mild inhalation injury, incidences of patients with mild, moderate, and severe burn of larynx were respectively 68.0% (202/297), 32.0% (95/297), and 0, and those among the patients with moderate inhalation injury were respectively 0,53.7% (58/108), and 46.3% (50/108). There were statistically significant differences in degree of burn of larynx of patients with different degree of inhalation injury (χ2 = 336.703, P < 0.001). Correlation analysis showed that severity of burn of larynx was positively correlated with severity of inhalation injury (r = 0.700, P < 0.001). (2) The rate of tracheotomy was 37.02% (164/443). The rates of tracheotomy in patients with mild, moderate, and severe inhalation injury were respectively 10.44% (31/297), 87.96% (95/108), and 100.00% (38/38), χ2 = 271.654, P < 0.001. Correlation analysis showed that the rate of tracheotomy was positively correlated with severity of inhalation injury (r = 0.784, P < 0.001). Tracheotomy was done mainly within 6 h post burn (63.4%, 104/164). The incidence rate of complication of tracheotomy was 5.5% (9/164). (3) Thirty-one patients died, with a mortality rate of 7.00%. The mortality rates of patients with mild, moderate, and severe inhalation injury were respectively 1.01% (3/297), 12.96% (14/108), and 36.84% (14/38), H = 74.273, P < 0.001. It was found that the mortality was positively correlated with severity of inhalation injury (r = 0.371, P < 0.001). The causes of death of the patients were respectively sepsis (14, 45.2%), respiratory failure (7, 22.6%), airway obstruction (2, 6.5%), airway hemorrhage (2, 6.5%), cerebral hemorrhage (2, 6.5%), cardiac accident (2, 6.5%), and diabetes insipidus (1, 3.2%), and 1 (3.2%) patient quit treatment and discharged from hospital for economic reason.

CONCLUSIONSAmong the patients with inhalation injury, male is dominated in number, and the young adults formed the highest constituent ratio. The severity of inhalation injury was correlated with total burn area, severity of burn of larynx, tracheotomy rate, and mortality. With the guidance of diagnostic criteria of burn of larynx and indication of tracheotomy, the risk of laryngeal obstruction can be eliminated. The early preventive tracheotomy can decrease the difficulty and risk of the operation.

Adolescent ; Adult ; Age Distribution ; Aged ; Airway Obstruction ; etiology ; surgery ; Burn Units ; Burns ; Burns, Inhalation ; complications ; mortality ; surgery ; China ; epidemiology ; Female ; Humans ; Incidence ; Injury Severity Score ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Sepsis ; epidemiology ; Severity of Illness Index ; Sex Distribution ; Tracheotomy ; methods ; Young Adult

Objective To observe the bone marrow signals of acetabulum and proximal femur of asymptomatic non?professional marathoners by 3.0 T magnetic resonance imaging (MRI) T1WI, and evaluate the bone marrow transformation, so as to obtain the effect of Marathon exercise on bone marrow composition and function. Methods The study group was randomly selected to participate in and complete the whole marathon at least once a year in the past two years. The training mileage of long?distance running was not less than 1 600 kilometers per year. There were no symptoms such as hip pain. There were no abnormalities in hip joint physical examination. The age of 22?53 years old. A total of 31 and 62 hips were evaluated. The control group was randomly selected 29 healthy persons (58 hip joints), aged 23?53 years, without hip pain and regular exercise. All subjects underwent hip joint MRI scan, and the hip joint MRI showed normal. At least 12 hours before MR scan, he did not engage in long?distance running or other sports. The bone marrow signal intensity of acetabulum and proximal femur in T1WI was compared with that of surrounding muscles and fat. The signal intensity was graded from low to high and evaluated by grade. The research group was divided into two groups according to the training years of marathon (running age). The running age of group A was more than 4 years and group B was less than 4 years. The distribution of bone marrow signal in proximal femur was also evaluated by a more intuitive 3?4 classification method. Mann?Whitney U test was used for statistical analysis. Results Bone marrow signal grading evaluation showed that there were significant differences in bone marrow signal grade distribution between the two groups (Z=-6.828, -4.779, -3.046,-5.266,-3.490,-5.053, P<0.05). In the study group, there were 14, 28 hips and 168 parts in group A, 17, 34 hips and 204 parts in group B, bone marrow signals were graded. There were significant differences in acetabulum, femoral neck and upper femoral shaft bone (Z=-2.202, -2.214, -2.730, P<0.05), but no significant differences in femoral head, trochanter and trochanter bone (Z=-0.886,-1.642,-0.711, P>0.05). To evaluate the classification of bone marrow signals in proximal femur, 62 cases of bone marrow signals in the study group were classified as follows: 10 cases with type 1a, 24 cases with type 1b, 17 cases with type 2 and 11 cases with type 3. In the control group, 58 cases of bone marrow signals in proximal femur were classified as follows: 2 cases with type 1a, 13 cases with type 1b, 26 cases with type 2 and 17 cases with type 3. There were significant differences between the two groups (Z=-4.003, P<0.05). Conclusion The T1WI signal intensity of asymptomatic non?professional marathoners′acetabulum and proximal femur bone marrow is lower than that of non?marathoners; the T1WI signal intensity of acetabulum, femoral neck and upper femoral shaft bone marrow of the elderly runners is lower; that is, marathon exercise has certain influence on the bone marrow signal of acetabulum and proximal femur, that is, the change of bone marrow signal in weight?bearing area has a certain phase with the amount of exercise.

Objective: To observe the bone marrow signals of acetabulum and proximal femur of asymptomatic non-professional marathoners by 3.0 T magnetic resonance imaging (MRI) T₁WI, and evaluate the bone marrow transformation, so as to obtain the effect of Marathon exercise on bone marrow composition and function. Methods: The study group was randomly selected to participate in and complete the whole marathon at least once a year in the past two years. The training mileage of long-distance running was not less than 1 600 kilometers per year. There were no symptoms such as hip pain. There were no abnormalities in hip joint physical examination. The age of 22-53 years old. A total of 31 and 62 hips were evaluated. The control group was randomly selected 29 healthy persons (58 hip joints), aged 23-53 years, without hip pain and regular exercise. All subjects underwent hip joint MRI scan, and the hip joint MRI showed normal. At least 12 hours before MR scan, he did not engage in long-distance running or other sports. The bone marrow signal intensity of acetabulum and proximal femur in T₁WI was compared with that of surrounding muscles and fat. The signal intensity was graded from low to high and evaluated by grade. The research group was divided into two groups according to the training years of marathon (running age). The running age of group A was more than 4 years and group B was less than 4 years. The distribution of bone marrow signal in proximal femur was also evaluated by a more intuitive 3-4 classification method. Mann-Whitney U test was used for statistical analysis. Results: Bone marrow signal grading evaluation showed that there were significant differences in bone marrow signal grade distribution between the two groups (Z=-6.828, -4.779, -3.046, -5.266, -3.490, - 5.053, P<0.05). In the study group, there were 14, 28 hips and 168 parts in group A, 17, 34 hips and 204 parts in group B, bone marrow signals were graded. There were significant differences in acetabulum, femoral neck and upper femoral shaft bone (Z=-2.202, -2.214, -2.730, P<0.05), but no significant differences in femoral head, trochanter and trochanter bone (Z=-0.886, -1.642, -0.711, P>0.05). To evaluate the classification of bone marrow signals in proximal femur, 62 cases of bone marrow signals in the study group were classified as follows: 10 cases with type 1a, 24 cases with type 1b, 17 cases with type 2 and 11 cases with type 3. In the control group, 58 cases of bone marrow signals in proximal femur were classified as follows: 2 cases with type 1a, 13 cases with type 1b, 26 cases with type 2 and 17 cases with type 3. There were significant differences between the two groups (Z=-4.003, P<0.05). Conclusion The T₁WI signal intensity of asymptomatic non-professional marathoners′ acetabulum and proximal femur bone marrow is lower than that of non-marathoners; the T₁WI signal intensity of acetabulum, femoral neck and upper femoral shaft bone marrow of the elderly runners is lower; that is, marathon exercise has certain influence on the bone marrow signal of acetabulum and proximal femur, that is, the change of bone marrow signal in weight-bearing area has a certain phase with the amount of exercise.