Objective To retrospectively analyse the factors related to the risk of malignant change in relation with various colorectal polyps. Methods Data on a total of 820 patients (900 polyps), who had undergone polypectomy between 1997 and 2001 were collected. The relation between colorectal cancer and polyps characteristics was assessed by Logistic Regression and Chi square. Results The risk of malignant change was significantly related with the size of polyps, histology of polyps, grade of dysplasia, pathological changes of mucosa, sessile or pedunculated polyps. Conclusion High grade dysplasia, large size, adenoma, absence of a stalk, and ulcerous mucosa were confirmed as the major predictors. The likelihood of malignant degeneration of colorectal polyps seemed to be correlated with the number of the above mentioned risk factors present

Atopic dermatitis (AD) is an allergic skin disease with a genetic predisposition.The pathogenesis is complex,including environment stimulation,epidermal barrier deficiency,and autoimmune disorders.The destruction of epidermal barrier stimulates the inflammatory response.In acute period,Th2 cells are activated to produce IL-4 and induce B lymphocytes to secrete IgE.Thus leads to degranulation of mast cells and basophils.After acute period,epidermis is thickened,accompanied with increasing expression levels of several chemokines and cytokines.In chronic phase,the cellular infiltration includes mainly Th1 and Th2 cells,and less Th17 and Th22 cells.The latter two cells together with their specific cytokines and chemokines are derived from keratinocytes and fibroblasts,which can produce tissue remodeling and fibrosis.So far,the treatment of AD contains allergens exposure avoid,anti-inflammatory,anti-infection,phototherapy,and immune therapy,etc.

Objective:To explore the mechanisms by which DNA methylation regulates miR-126 and its host gene EGFL7 in CD4+T cells from patients with systemic lupus erythematosus (SLE).
Methods:We analyzed the expression and the DNA methylation status within promoter region of EGFL7 and miR-126 by real-time qPCR and bisulifte genomic sequencing analysis.
Results:miR-126 and EGFL7 mRNA expression was upregulated in CD4+T cells from SLE compared with that from healthy controls (P<0.01). EGFL7 mRNA level was positively correlated with miR-126 expression in CD4+T cells from SLE (r=0.538, P=0.015). The average methylation level of EGFL7 promoter in CD4+T cells from SLE was lower than that from healthy controls (P<0.05).
Conclusion:hTe upregulation of miR-126 and its host gene EGFL7 expression in CD4+T cells from SLE is associated with the hypomethylation of the EGFL7 promoter.

Objective To explore the risk factors affected the timing of endoscopic examination in nonvariceal upper gastrointestinal bleeding (NVUGIB).Methods From January 2001 to December 2011 , 441 patients diagnosed as NVUGIB under endoscope were enrolled,and they were divided into the group receiving endoscopy within 24 hours (233 cases)and the group receiving endoscopy beyond 24 hours (208 cases).The demographic and clinical characteristics of the two groups were analyzed.Student′s t test was used for measurement data comparison and chi-square test for numerical data.Logistic regression analysis was used to analyze the multivariate factors which influenced the timing of endoscopy examination.Results The rates of complication in the group receiving endoscopy within 24 hours and the group receiving endoscopy beyond 24 hours were 9.0% (21/233)and 19.7% (41/208),and the difference was statistically significant (χ2 =10.411 ,P =0.001 ).The mean systolic blood pressure were (118 ±19 )and (122±19)mmHg (1 mmHg=0.133 kPa),respectively,and the difference was statistically significant (t=2.099,P = 0.036 ).On admission the mean hemoglobin were (98 ± 27 )and (93 ± 28 )g/L, respectively,and the difference was not statistically significant (t=1 .640,P =0.102).The mortality rate were 1 .3% (3/233 )and 5 .3% (11/208 ),respectively,and the difference was statistically significant (χ2 =5 .723,P =0.017).With multivariate Logistic regression,multivariate factors analysis indicated that complication was the main factor influenced the timing of endoscopy examination (OR =2.710,95 %CI :1 .502 to 4.899,P < 0.01).However,age,gender,systolic blood pressure,hemoglobin levels on admission,location of lesion and clinical symptoms were not related with timing of endoscopy examination (all P >0.05).Conclusion Complication is a risk factor in the timing delayed endoscopy.

ObjectiveTo investigate the popularity of the sedated gastrointestinal endoscopy in mainland China.MethodsThe survey on the popularity of the sedated gastrointestinal endoscopy was conducted with questionnaires sent by e-mails or telephones to the GI endoscopy units of three levels of hospitals.ResultsFrom May,2010 to November,2010,169 units from 28 provinces (90.3％ ) were enrolled,including 46 hospitals of grade Ⅲ,91 of grade Ⅱ and 32 of grade Ⅰ.Sedated gastrointestinal endoscopy were performed in 110 (65.1％,110/169) hospitals,i.e.93.5％ (43/46) grade Ⅲ hospitals,68.1％(62/91) grade Ⅱ hospitals and 15.6％ (5/32) grade Ⅰ hospitals.Significant difference was observed between the grade Ⅲ and the grade Ⅱ hospitals (P ＜ 0.05 ),so was between the grade Ⅱ and the grade Ⅰ hospitals ( P ＜ 0.05 ).Propofol was frequently used in sedation in 98 hospitals ( 89.1％ ).The only 9.1％( 10/110)hospitals,which had full-time anesthetists or anesthetic nurses,were all grade Ⅲ hospitals.ConclusionThere has been great progress in the popularity of sedated gastrointestinal endoscopy in mainland China during the past decade.However,it is less frequently pefformed in grade Ⅰ and Ⅱ hospitals.Shortage of full-time anesthetists is still a problem.

OBJECTIVE:To study the protective effect of Weidean tablets on rats with stress-induced gastric ulceration. METH-ODS:Water immersion restraint stress method and empty stomach were employed to establish rat models with gastric ulceration. 60 SD rats were equally randomized into normal control group(isometric sodium chloride injection),model group(isometric sodium chloride injection),ranitidine group(0.015 g/kg),and groups of high,medium and low doses(1.70,0.87 and 0.43 g/kg)of Wei-dean tablets. General situation of stomach was observed .The gastric mucosal injury index,the NO content in serum,and the activi-ties of SOD and iNOS and the contents of MDA and PGE2 in the gastric tissue were detected for rats. Pathomorphological observa-tion of rats’gastric tissues was conducted under the microscope. RESULTS:Compared with normal control group,the rats in the model group had higher gastric mucosal injury index,lower content of NO in serum,and weaker activity of SOD,stronger activity of iNOS,higher content of MDA and PGE2,in the gastric tissue. There was statistical significance (P<0.01 or P<0.05). Dark matter,severe deformation and necrosis of gastric mucosal cells in rats were noted,as well as multiple large-area superficial ulcers. Compared with the model group,the rats in groups of high,medium and low doses of Weidean tablets had lower gastric mucosal injury index,higher content of NO in serum,and stronger activity of SOD,weaker activity of iNOS,lower content of MDA and higher content of PGE2,in the gastric tissue. There was statistical significance(P<0.01 or P<0.05). General situation of stomach and the pathomorphological condition of rats’gastric tissues were improved. CONCLUSIONS:Weidean tablets has protective ef-fect to some extent on rats with stress-induced gastric ulceration,the mechanism is related to the improvement of serum levels of anti-oxidation index in rats.

Objective To study the X-ray signs of pulmonary lymphangitis carcinomatosa (PLC).Methods X-ray and HRCT signs of PLC proved by bronchoscopic or pleural or open-lung biopsy in 37 cases were retrospectively analyzed in order to find out some X-ray signs that suggested the PLC.Results The major X-ray features of PLC included:(1)Multiple thickened bronchovascular bundles in the bilateral lung in 37 cases;(2)Irregular thickened kerley A distributed over the bilateral lung in 28 cases;(3)The reticular and inosculating shadows(kerley C) extensively distributed over the bilateral lung in 19 cases;(4)The multiple irregular thickened kerley B distributed over the bilateral lung in 15 cases ;(5)Pulmonary hilar lymph adenopathy in 18 cases ;(6)Pleurae irregularly thickened in 16 cases;(7)Hydrothoraxes in 9 cases.Conclusion HRCT is the most satisfactory method in diagnosing PLC,but the super-quality thoracic plane film can supply some useful signs of PLC.

Objective To evaluate the application and efficacy of direct anterior fixation of odontoid fractures with hollow screw.Methods From March 2001 to January 2006,13 patients with odontoid fractures were treated by direct anterior fixation with hollow screw.Results Of the 13 patients,except 2 patients with postoperative temporary dysphagia, 11 had excellent results.The follow-up was ranged from 9 to 18 months,with an average of 12.5 months.The odontoid fractures acquired fusion,and no unstability or pseudoarthritis was found. Conclusion The technique of direct anterior fixation with hollow screw is an efficacious means in the treatment of odontoid fractures.The meticulous surgical technique along with appropriate patients selection will be the key to successful surgery.

Objective To compare the cost-effectiveness between endoscopic submucosal dissection (ESD) procedure and traditional surgery for the treatment of early gastrointestinal cancer or precancerous lesions.Methods A total of 866 early GI cancer/precancerous patients who had been admitted to Chinese PLA General hospital and Qilu hospital were included in this study.The medical records of all 866 patients were reviewed.Patients were divided into ESD group and traditional surgery group.Parameters of each patient,such as time of hospitalization,total treatment cost and incidence of complications,were documented and later compared in detail.Results A total of 607 patients were included in the ESD group and 259 in the traditional surgery group.There was no statistical difference in complete resection rate between the two groups (93.1％ vs 93.0％,P ＞ 0.05).The ESD group showed a shorter mean hospitalization time (d)(13.01 vs 18.88,P ＜ 0.05) and lower treatment cost (RMB) than the traditional surgery group (22932.17 vs 57993.88,P ＜ 0.05).The incidence of hemorrhage and perforation for each group were 3.63％ and 3.10％ respectively,which were not significantly different (1.98％ vs 3.01％,P ＞ 0.05; 2.80％ vs 1.16％,P ＞ 0.05).Conclusion ESD and surgery are both effective for early gastrointestinal cancer/precancerous lesions therapy,but ESD procedure is superior to surgery in terms of hospitalization time and expediture.

BACKGROUND: Nitric oxide plays an important role in bone metabolism. However, the effects of different doses of L-arginine, nitric oxide substrate, on the healing of osteoporotic fractures remain unclear. OBJECTIVE: To investigate the influence of different doses of L-arginine on the healing of osteoporotic fractures and blood biochemistry in rats. METHODS: A total of 50 female Wistar rats, aged 6-month-old, were randomly divided into sham-surgery (n=10) and osteoporosis (bilateral ovariectomy, n=40). After osteoporosis model was established, left middle femoral fractures were made in al 50 rats, and the osteoporosis group was further divided into four groups, low, middle and high dose of L-arginine, and control groups. The L-arginine groups were intraperitoneal y injected with 1, 3, and 5 mg/kg L-arginine at the second day fol owing surgery, while the control and sham-surgery groups were injected with the same volume of normal saline. At 8 weeks, the lumbar and cal us bone mineral density, serum nitric oxide, and nitric oxide synthase were detected. Meanwhile, the bone cal us histological examination was conducted. RESULTS AND CONCLUSION: During fracture healing, osteoporosis rats showed a low level of serum nitric oxide and nitric oxide synthase compared with normal fractured rats (P < 0.05). L-arginine can improve the concentration of serum nitric oxide and nitric oxide synthase in osteoporosis rats. Moreover, middle dose of L-arginine can increase the cal us and lumbar spine bone mineral density of osteoporosis rats, so the number and continuity of bone trabecula were enhanced. These findings suggest that middle dose of L-arginine (3 mg/kg) can promote healing process of osteoporotic fractures and improve osteoporosis.