Objective To study the role of esophageal dynamic double contrast radiography(DDCR) in diagnosing early esophageal carcinoma(EEC).Methods The patients with clinical suspected EEC underwent conventional double contrast radiography(CDCR) and DDCR using digital fluoroscopic imaging unit.The radiographic materials including CDCR and DDCR in 40 cases of EEC proved by endoscopy or pathologic histology were analyzed by a blind study,and the reliability of CDCR and DDCR was evaluated.Results The major findings of EEC included the mucosal irregularity and tortuous,small niches and filling defect,the soft and expansive extent of esophageal wall reduced or disappeared.In showing the esophageal function,DDCR was significantly superior to CDCR(?~2=4.50,?

ObjectiveTo observe the effects of electroacupuncture on IL-1β in brain tissue of rats after total cerebral ischemia-reperfusion.MethodsThirty male Wistar rats were randomly divided into the sham operation group, model group and acupuncture group, in each group. In acupuncture group and model group, 4-vessel-occlusion method was used to make a rat model of cerebral ischemia reperfusion. Acupuncture group used electroacupuncture on points Quchi and Zusanli, 6 hours after reperfusion. The rats of each group were killed and ELISA was used for the measurement of IL-1β in brain tissues.ResultsIL-1β in brain tissue in model group increased significantly compared with sham operation group and acupuncture group(P<0-001). No significant differences were found between sham operation group and acupuncture group (P>0-05).ConclusionAcupuncture can lower IL-1β content of brain tissue of rats with brain ischemia/reperfusion injury.

Objective To evaluate the efficiency and clinical value of modular flexible ureteroscope combined with Holmium laser lithotripsy for treatment of renal calculi. MethodsA total of 46 patients with renal calculi were treated with modular flexible ureteroscope combined with Ho:YAG lithotripsy in our hospital from December 2009 to May 2011.There were 19 cases in middle and upper calyx,8 cases in lower calyx,15 case in renal pelvic,and 4 cases in multiple calyxes.The calculi diameter ranged from 6mm to 31 mm (average in 15 ± 7.9 mm).Flexible ureteroscope was used to find renal calculus under epidural anesthesia,and Holmium laser lithotripsy was used at a maximum energy of 12 to 20W (0.8 - 1.0 J/15 -20Hz).F5 or F6 double-J tubes and catheters were indwelled routinely postoperatively.-examine with KUB and removethe catheter 2 days after operation.Re-examine with B-ultrasonography or KUB 4 weeks after op-eration to evaluate the stone free rate.Residual stones ≥4 mm were regarded as clinical significance of residual stone fragments. Results 45 operations were successful except one case changed to percutaneous nephrolithotomy (PCNL) because of ureteral stricture.The operation time was 45 -150 min (average in 110.4 ±25.3 min).The patients were discharged from hospital in 2 -5 days(average in 3 days) after operation.The stone detection rate was 95.6％ (44/46),and the stone free rate was 86.9％ (40/46) after one operation. No severe complications such as ureteral perforation or hemorrhea occurred. Conclusions Modular flexible ureteroscope combined with Holmium laser lithotripsy is effective and safe for treatment ofrenal calculi,meanwhile it can decrease the high maintenance costs of integrated flexible ureteroscope.

Objective To observe the effects of acupuncture on blood lipids of hyperlipidemia mice, and explore the mechanism of acupuncture against endothelial dysfunction. Methods 40 ApoE (-/- ) mice were randomly divided into control group (C), acupuncture at non-acupoint group (D), acupuncture at acupoint group (E), and simvastatin group (F) with 10 cases in each group. After 8 weeks, total cholesterol (TC), the plasma angiotensin II (Ang II), endothelin-1 (ET-1) and nitric oxide (NO) were measured with enzyme-linked immuno sorbent assay (ELISA). The mice myocardial angiotensin II type 1 receptor (AT1R), and endothelin-1 type A receptor (ETAR) protein were detected with Western blotting. Results The blood lipid, the content of plasma Ang II and ET-1, and the level of AT1R and ETAR in the heart tissue were significantly lower, and the content of NO was significantly higher in groups E and F than in group C (P<0.05). Conclusion Acupuncture can inhibit the level of blood lipids in ApoE(-/-) mice, reduce the levels of Ang II and ET-1, increase the level of NO in peripheral blood, and inhibit the expression of AT1R, ETAR in heart tissue.

Objective To explore the role of National Natural Science Foundation (NSFC) funding on improving medical research of China,based on the SCIE paper output of a teaching hospital in East China,in order to provide evidence-based decision-making basis for hospital management of scientific research and discipline construction.Methods SCIE output of a teaching hospital in East China during 2009-2015 was retrieved based on the web of science (WOS) platform.The papers funded by the NSFC were further analyzed.Results From 2009 to 2015,the output of SCIE of the hospital showed a steady upward trend,with an annual growth rate of 26.10％.Among them,the NSFC funded project output 835 papers SCIE,accounting for 46.62％oo of the total paper;and the absolute value of the output of the paper showed an upward trend year by year,an increase of 49.52％.The main subjects of the NSFC funded by the hospital focus on oncology,liver disease and digestive system diseases and cardiovascular and cardiovascular diseases,and the hospital's clinical status basically.The quality of the journals published by the NSFC SCIE project funded by the hospital was significantly improved.Conclusions NSFC funding plays an important role in improving the output and quality of SCIE papers in clinical medicine,which should be paid attention to in scientific research management and decision-making.

Objective To evaluate the efficiency and clinical value of modular flexible ureteroscope combined with Holmium laser litho-tripsy on the treatment for upper ureteral calculi of solitary kiden. Methods There were 26 cases of upper ureteral calculi of solitary kidney, including 12 cases of left ureter calculi and 14 cases of right ureter calculi. The diameter of the calculi ranged from 0. 6~2. 2 cm, averagely (1. 38 ± 0. 22) cm. F6 double-J tubes were indwelled postoperatively for 4 weeks, and catheters were indwelled postoperatively for one week. Examine with KUB one day after operation to evaluate the effective rate. Results The Ureteral guiding sheath were successfully implanted in 23 cases, 2 cases underwent second lithotripsy after indwelling D-J tubes 2 weeks later, D-J tubes failed to be implanted only in one case, which has changed to percutaneous nephrolithotomy (PCNL) for ureter stricture. The stone free rates was 88. 5%(23/26)after the first ses-sion,and it was 100%(26/26)at the end of the session. The operation time was 15~45 min, meanly (27 ± 3. 2) min. One patient had ureter perforation during the operation, and one patient had severe infection after operation. Conclusion The modular flexible ureteroscopy com-bined with Holmium laser lithotripsy is an effective and safe treatment, especially for upper ureteral calculi of solitary kideny, and it should be considered as the first choice for solitary kidney calculi.

Objective:To investigate the clinical characteristics, differential diagnosis and treatment of IgG4-related kidney disease (IgG4-RKD) presenting as a cystic renal mass.Methods:A 42-year-old male patient was found having a tumor in the left kidney in an annual physical examination. Subsequent CTU scan revealed a round shadow in the lower pole of the left kidney, with slightly lower, uneven density and obscure boundaries, which was slightly enhanced on contrast-enhanced CT imaging, suggesting a cystic mass (Bosniak category Ⅲ). Contrast-enhanced MRI showed a long T1, long T2 signal lesion in the lower pole of the left kidney, which was not obviously enhanced in the cortical phase but exhibited continuous and separated enhancement in parenchymal and delayed phases, suggesting a cystic renal cell carcinoma. A preoperative diagnosis of a left renal mass was made, for which the patient underwent a laparoscopic partial nephrectomy.Results:The resected cystic mass was grey white with obscured boundaries. Microscopically, the mass showed lymphoplasmacytic hyperplasia with lymphoid follicles, cystic formation, fibrosis hyperplasia and vascular obstruction. Immunohistochemistry revealed that the number of IgG4 (+ ) plasma cells was more than 50/HPF, and over 40% IgG (+ ) plasma cells were IgG4 (+ ). By virtue of the radiologic and pathologic findings, the patient was diagnosed with IgG4-RKD. At 2 weeks after operation, serum IgG level was 0.71g/L (reference: 0.03-2.01 g/L). Chest and abdominal CT scans performed 3 months after operation showed no evidence of other organ involvement and serum IgG4 level was within the normal range. Therefore no adjuvant therapy was prescribed.Conclusions:It is usually difficult to differentiate IgG4-RKD presenting as a cystic renal mass by radiography alone. The presence of other organ involvement, serum IgG4 test and renal biopsy can help the diagnosis and so as to avoid unnecessary surgery.

Objective:To analyze the molecular characteristics of Echovirus 11 (Echo11) strains isolated in Xiangyang, Hubei Province from 2016 to 2017 based on the sequences of VP1 gene.Methods:Rectal and throat swab specimens were collected from children with hand, foot and mouth disease (HFMD) in Xiangyang from 2016 to 2017. Echo11 strains were detected by real-time reverse transcriptase PCR (RT-PCR) and isolated after cultured in human rhabdosarcoma (RD) cells. The VP1 regions of Echo11 strains isolated from RD cells and the whole genomes of three representative Echo11 strains were amplified by conventional RT-PCR and the sequences were analyzed. DNAStar7.0 (MegAlign) and MEGA6.0 (Data) were used to analyze the homology and mutation sites in nucleotide and amino acid sequences. Neighbor-joining method was used to construct phylogenetic trees. Recombination analysis was performed with SimPlot software (BootScanning).Results:A total of 11 Echo11 strains were isolated from 3 494 HFMD cases, accounting for 0.31%. They were highly homologous in the VP1 gene. These strains shared 98.4%-100.0% homology in nucleotide sequences and 98.3%-100.0% homology in amino acid sequences. The homology between the 11 Echo11 strains and the prototype strain (Echo11/Gregory, X80059) was 73.9%-74.8% in nucleotide sequences and 87.7%-88.7% in amino acid sequences. All of the Echo11 strains circulating in Xiangyang were classified into lineage D, having a similarity to the strains circulating in some regions of mainland China since 2013. In multiple regions of the genome, the Echo11 strains isolated in Xiangyang were highly similar to the Henan Echo1 strains in 2010 and the Hubei Echo6 strains in 2015, suggesting there was recombination within the genome of Echo11 strains in Xiangyang.Conclusions:The Echo11 strains circulating in Xiangyang from 2016 to 2017 belonged to lineage D and were recombinant strains.

OBJECTIVETo assess the reproducibility of 3.0 T high-resolution magnetic resonance imaging (HR MRI) for evaluation of atherosclerotic stenosis in the middle cerebral artery (MCA).

METHODSFrom February, 2011 to December, 2013, 66 consecutive patients with MCA-M1 atherosclerotic stenosis (50%-99%) confirmed by digital subtractive angiography (DSA) received examinations with 3.0 T HR MRI for measurement of the vessel area (VA) and lumen area (LA) at the maximum narrow site (VA(narrow) and LA(narrow)) and the reference site (VA(reference) and LA(reference)) as well as the plaque distribution (ventral, dorsal, superior, and inferior). Two independent readers reviewed all the images and one reader reevaluated these images 4 weeks later. The inter- and intra-observer reproducibility was evaluated using the intraclass correlation coefficient (ICC).

RESULTSThe measurements of VA(narrow), VA(reference), and LA(reference) using HR MRI showed excellent inter- (ICC=0.801, 0.843, and 0.808, respectively) and intra-observer reproducibility (ICC=0.811, 0.916, and 0.958, respectively), but the measurement of LA(narrow) had only moderate inter- and intra-observer reproducibility (ICC=0.584 and 0.625, respectively). For plaque distribution analysis (ventral, dorsal, superior, and inferior plaques), HR MRI also showed excellent inter- (ICC=0.856, 0.836, 0.791, and 0.905, respectively) and intra-observer reproducibility (ICC=0.876, 0.827, 0.825, and 0.950, respectively).

CONCLUSIONHR MRI shows good inter- and intra-observer reproducibility in identifying MCA-M1 atherosclerotic plaque distribution and vessel and lumen measurements, but its reliability for lumen area measurement at the maximum narrowing site needs to be improved.

Objective To discuss primary experience the clinical use of "All-seeing needle set" combined with Holmium laser to treat the single renal stone lesser than 2 cm in diameter through a super minimal tract (F12).Methods From January 2015 to December 2016,43 patients were enrolled into this retrospective study.There were 23 males and 20 females who were diagnosed as single renal stone less than 2 cm in diameter(age range from 23-65 years).There were 8 upper pole renal stones,13 lower pole renal stones and 22 renal pelvis stones.The mean stone size was (1.63 ± 0.32) cm in diameter (range from 1.2 cm to 2.0 cm)."All-seeing needle system" was applied during percutaneous puncture.After building a F12 minimal tract by fascia dilator,all patients received lithotripsy with Holmium laser.Indwelling catheters for 3 days and an F6 double-J tube was left for 2 weeks without a tube in the percutaneous tract after operation.Finally,KUB and/or urinary CT were used to check the results on day 1.Result All operations were completed successfully.The operation time was 23-65min [averaged (31.0 ±9.2) min].41 cases' renal stones were store free,and the 2 stone residues was clear with later extracorporeal shock wave lithotripsy.No severe complications occurred.Conclusion As an alternative to standard procedures for treatment of renal stones less than 2 cm in diameter,adopting "All-seeing needle set" with Holmium laser through a super minimal tract (F12) is safe,minimally invasive,fast and effective with a low complication rate.