Objective To identify the possible risk factors for esophageal delayed bleeding after endoscopic submucosal dissection ( ESD ) of early esophageal carcinoma and precancerous lesions. Methods Data of 281 patients with early esophageal carcinoma and precancerous lesions treated by ESD were reviewed. Risk factors for esophageal delayed bleeding were investigated by univariate analysis and logistic multivariable regression analysis. Results Esophageal delayed bleeding occurred in 22 patients ( 7. 83%) . Univariate analysis showed there was significant difference between delayed bleeding group and non?delayed bleeding group in regard of age ( P=0. 046 ) , lesion size ( P=0. 013 ) , and lesion infiltration depth( P<0. 001 ) . Together with three factors above, the intraoperative bleeding ( P=0. 068 ) was also analyzed by Logistic multivariable regression analysis which showed only infiltration depth was the independent risk factor of early esophageal carcinoma and precancerous lesions treated by ESD( P=0. 002, OR=6. 88,95%CI:1. 07?39. 28) . Conclusion Patients older than 60 years and diameters more than 3 cm might be prone to delayed bleeding, but the direct factor is infiltration depth. The deeper lesions infiltrate, the delayed bleeding is more likely to occur.

Objective:To seek the best part and optimal culture medium for the tissue culture of Bletilla striata. Methods: The effects of hormone concentration and proportion on the induced differentiation, propagation and rootage of Bletilla striata were investiga-ted. Results:The radicle of Bletilla striata was the best part to induce the clustered shoots with the optimal culture medium of 1/2MS+1. 0 mg·L-1 6-BA+2. 0 mg·L-1 NAA. The best hormone concentration for inducing the clustered shoots was MS+1. 0 mg·-1 L 6-BA+0. 05 mg·L-1 NAA, and the optimal rooting medium was 1/2MS+0. 5 mg·L-1 NAA. Conclusion: The tissue culture system for Bletilla striata is established.

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.

Objective: To study the biotransformation of Poria cocos by Ganoderma lucidum and the changes of total polysaccharide and total triterpenes contents of the biotransformation products. Method: The experiment uses the microwave method to extract and sulfuric acid-phenol method to measure total polysaccharide content. And the ultrasonic wave method was used to extract total triterpenes and the content was measured by vanillin-perchloric method. Result: After treatment by G. lucidum, the total polysaccharide and triterpenes content of the biotransformation products were significantly higher than the non-conversed P. cocos (P<0.01), showing that the original performance of P. cocos was changed by way of biotransformation of G. lucidum; P. cocos had a promotion effect on the growth of G. lucidum. Conclusion: Biotransformation of P. cocos for Increasing the total polysaccharide and triterpenes contents by using G. lucidum has advantages of simple, low cost and so on. This method has a certain application value in modernization of Chinese traditional medicine.

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 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 effects of Chaishao Chengqi Decotion on intestinal microbiota and intestinal mucosal lesion in severe acute pancreatitis(SAP).Methods 46 Patients with SAP were randomized into two groups.Routine medical management was initiated in two groups.The treatment group received Chaishao Chengqi Decotion for 1 week.The plasma concentrations ofDiamine Oxidase (DAO),D-lactate were detected and changes of microflora were evaluated by bacterial culture.Results The levels of DAO in the treatment group (4.65 ±0.82)U/ml were significantly lower than those in the control group (5.66 ±2.17) U/ml (P ＜ 0.05) 7 days after treatment.The levels of D-lactate in the treatment group (10.65 ± 5.24)mg/L were significantly higher than those in the control group (5.42±2.13)mg/L (P＜0.05).Bacterial culture revealed that the amount of bifidobaterium (6.02± 1.42)In/g and lactobacilli (7.21 ± 2.02) In/g were significantly increased when compared to those before treatment (3.74± 1.71)In/g and (4.03 ± 1.79)In/g respectively,while there was imbalance of intestinal microflora to some extent in the control group.Conelusien Chaishao Chengqi Decotion exerted the protective effects on gut barrier function by alleviating the damage of intestinal mucosa and balancing the intestinal microbiota following severe acute pancreatitis.

ObjectiveTo evaluate the Fuji intelligent chromo endoscopy (FICE) in the diagnosis of Barrett esophagus (BE).MethodsFrom September 2010 to March 2011,a total of 180 patients with suspected reflux esophagitis were examined successively by FICE,magnifying FICE,acetic dyeing endoscopy and magnifying acetic dyeing endoscopy.The diagnosis was made out under the observation of lesion extensions,superficial mucosa contrast ratio,pit patterns and capillary forms of BE.The endoscopic diagnosis was made and compared with the pathologic diagnosis,and the consistency of the diagnosis was evaluated by Kappa value.ResultsBE was confirmed in 35 patients ( 19.4％ ) pathologically.The consistency rates of diagnosis under FICE and acetic dyeing endoscopy were 81.7％ and 72.8％ ( P ＜ 0.05 ).The consistency rates of diagnosis under magnifying FICE and magnifying acetic dyeing endoscopy were 97.8％ and 85.6％,respectively (P ＜ 0.05).FICE magnifying endoscopy revealed better mucosal structures of capillaries than magnifying acetic dyeing endoscopy did ( P ＜ 0.05 ),but there was no significant difference in revealing of duct openings (P ＞ 0.05).The specificity,sensitivity,positive predictive value,negative predictive value and Kappa value of FICE in diagnosis of BE were 82.1％,80.0％,51.9％,94.4％ and 0.52,respectively,which were 73.2％,71.4％,39.1％,91.4％ and 0.34 of acetic dyeing endoscopy,98.6％,94.3％,94.3％,98.6％ and 0.93 of magnifying FICE,and 88.3％,74.3％,60.5％,93.4％ and 0.58 for magnifying acetic dyeing endoscopy.ConclusionAs a neotypical endoscopic system,magnifying FICE could exhibit clearly the pit patterns and microvascular structures of esophagus mucosa,and it can capture the optimal images of Barrett's epithelium.FICE could improve the diagnosis of BE in vivo.

Objective To investigate the role of adhesion molecules P-selectin (CD62P) as a pathogenic factor in Henoch-Schonlein purpura nephritis (HSPN) patients.Methods The expression of adhesion molecules CD62P marked by fluorescent monoclonal antibody in renal biopsy tissue and peripheral blood was studied by flow cytometry in patients with HSPN.The renal tissue was collected and analyzed by light microscopy (HE,PAS,Masson,PASM).Results ① CD62P expressed in renal tissue of 27 cases among all 32 patients with HSPN (84.4%).It expressed mainly in glomerular mesangial area and capillary vessels,then,interstitial small blood vessels,renal tubule.CD62P most significantly expressed in type Ⅲ and Ⅳ,then the type Ⅱ and the last type Ⅰ.② Thirty-two patients of HSPN were highly expressed on CD62P in peripheral blood than those of control group (P

OBJECTIVE:To establish the quality standard for Qindan granules. METHODS: The constituents including Radix Scutellariae, Radix Astragali, Cortex Moutan and Fructus Gardeniae in Qindan granules were identified respectively by TLC. RESULTS: The test samples and their respective reference substances were alike in that the same color chromatographic spots were noted at the corresponding places. The color spectra of the samples were clear yet without interference of surrounding impurity. CONCLUSION: The established method has high specificity and can be used for the quality control of Qindan granule.