Objective To evaluate the feasibility and indications of endoscopic submucosal dissection (ESD) by analyzing the early gastric cancer cases.Methods All the pathological materials of radical gastric resections in Huashan hospital from 2007 to 2011 were retrieved and the EGC cases were selected.All the cases in EGC group which met the extended ESD criteria were reviewed.Extended ESD criteria were cited from Treatment guidelines for gastric cancer in Japan edited by JGCA in 2001.The risk factors relevant with regional metastasis,such as invasive depth and differentiation degrees,were also analysed.Results In the recent five years,there were 1159 cases of gastric cancer undergoing radical gastrectomy in Huashan hospital including 210 EGC.According to the extended criteria of JGCA,151 cases could be candidates for ESD while 126 cases could be candidates for ESD according to the typical criteria for ESD.The local metastases of lymphatic or vascular involvement for mucosa cancer,muscularis mucosae cancer,sm1 and sm2 cancer were 6.75％,15.00％,23.25％,and 39.62％ respectively (P ＜0.05).Twenty-five cases had local metastases that met the extended criteria for ESD.Within the 210 EGC cases,the local metastases of differentiated type and undifferentiated type were 13.95％ and 47.37％ respectively (P ＜ 0.05).Conclusion Most EGC cases undergoing radical gastrectomy can be cured by ESD.Its metastases are highly correlated with invasion depth and differentiation,so indications of ESD should be assessed.

Objective To investigate the expressions and clinical significanees of suppressors of cytokine signaling-1 (SOCS-1) and SOCS-3 in myocardium of patients with sudden cardiac death (SCD). Method This study included myocardial autopsy specimens of 24 patients admitted between 2005 and 2006. Of them, 9 cases had the findings of autopsy examination consistent with coronary atberosclerosis (non-myocardial infarction) leading to SCD (non-MI group), 7 patients died of acute myocardial infarction (MI group) and 8 patients died of traffic accidents and trauma The expressions of SOCS-1 mRNA and SOCS-3 mRNA in the myocardium of non-MI and con-trol group were detected by using RT-PCR. The levels of SOCS-1 protein and SOCS-3 protein were detected by us-ing immunohistochemistry. Statistical analysis were performed by using SPSS version 13.0 software and the data were processed with ANOVA test. Results The expressions of SOCS-1 mRNA and SOCS-3 mRNA in non-MI and MI groups were were significantly higher than those in control group (0. 788±0. 101) and (0. 741±0.111) vs.(0.436±0.044) (P <0.01); (0.841±0.092) and (0.776±0.070) vs.(0.454±0.076), P <0.01, re-spectively). The antibody-positive cells of SOCS-1 protein in myocardium of non-MI group and MI group were significantly higher than those in myoeardium of control group (320.00±48.48) and (347.14±70.88) vs.(42.50±10.35) (P < 0.01), respectively. The antibody-positive cells of SOCS-3 protein in myoeardium of non-MI group and MI group were significantly higher than those in myocardium of control group (381.11±59.25) vs.(40.00±10.69), (P < 0.01)and (332.86±111.91) vs. (40.00±10.69), (P =0.001). Conclusions The expressions of SOCS rnRNA and SOCS-3 mRNA in myoeardium of patients with SCD from coronary diseases are significantly increased contributing to the pathogenesis of SCD.

ObjectiveTo study the efficacy of different doses of tamsulosin hydrochloride sustained release tablets for treatment of premature ejaculation (PE). MethodsEighty PE patients from September 2010 to January 2011 were divided into two groups randomly,the 0.2 mg dose group and the 0.4 mg dose group.The therapeutic effect was assessed by the changes of the patients' CIPE-5 scores.ResultsThe intra-vaginal ejaculation latency time (IELT) of the two groups were (0.98 ± 0.47 ) and ( 0.89 ± 0.47 ) min respectively before treatment,and (4.40 ± 1.86 ) and (6.40 ± 5.10) min respectively after treatment.There were significant differences ( P ＜ 0.01 ).As for satisfaction degree of sexual life,lessening the patients' sexual anxiety and nervousness,and decreasing the difficulty in retarding ejaculation,the group of 0.4 mg had better effect than the other group.ConclusionLarge dose of tamsulosin hydrochloride sustained release tablets could prolong IELT and increase the sexual satisfaction.

Adenocarcinoma, Mucinous ; Humans ; Thyroid Neoplasms

Objective To investigate the changing characteristics of the fractional anisotropy (FA) in cerebral peduncles and its relation with motor evoked potential (MEP) after acute cerebral infarction and to clear the clinical sigiificance of the low limit value of the FA in cerebral peduncles. Methods The low limit value of the FA in normal cerebral peduncles was determined based on mean - 1. 64 standard deviation. The patients with acute cerebral infarction (n = 58) were divided into MEP positive group and MEP negative group according to the absence and presence of MEP, in which the patients in the MEP positive group were redivided into the FA in cerebral peduncles ＜ the low limit value and≥ the low limit value groups according to the FA in cerebral peduncles on the affected sides. Results The low limit value of the FA in normal cerebral peduncles was 0. 36. There was significant difference in the FA in cerebral peduncles on the affected sides between the MEP negtive and MEP positive groups. The MEP negative group was the lowest (P=0. 000). The FA in cerebral peduncles on the affected sides in the positive group was significantly lower than that on the unaffected sides (P=0. 000), and the latency on the affected sides was longer than that on the normal sides (P=0. 000). The FA in cerebral peduncles on the affected sides was negatively correlated with the MEP latency (r=-0.332,P=0. 042). The MEP latency in the FA＜the low limit value group was significantly longer than that in the FA ≥ low limit value group (P=0. 002). There were no significant differences in the FA in cerebral peduncles on the normal sides and the MEP latency among an groups. The detection rate of the FA in cerebral peduncle＜0. 36 on the affected sides was the highest (50%). Conclusions In the evaluation of the prognosis of the patients, the changes of the FA in cerebral peduncles on the affected sides in patients with acute cerebral infarction had correlation,consistency, and complementarity with MEP.The detection rate of the low limit value of the FA in normal cerebral peduncles was the highest in the MEP negative patients. When the FA in cerebral peduncles was＜0.36 on the affected sides, particularly when MET was negative, it might predict that the prognosis was poor.

Objective To evaluate the effect of penehyclidine hydrochloride on Toll-like receptor 4 (TLR4)/nuclear factor kappa B (NF-κB) signaling pathway in the myocardium of pediatric patients undergoing radical correction of tetralogy of Fallot with cardiopulmonary bypass (CPB).Methods One hundred pediatric patients of both sexes,aged 5 months-3 yr,with body mass index of 13.9-16.0 kg/m2,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ (New York Heart Association classification Ⅱ or Ⅲ),with the left ventricular ejection fraction＞50％,scheduled for elective radical correction of tetralogy of Fallot with CPB,were divided into 2 groups (n =50 each) using a random number table:penehyclidine hydrochloride group (group P) and control group (group C).Penehyclidine hydrochloride was intravenously injected at a dose of O.04 mg/kg immediately after successful internal jugular vein puncture in group P,and the equal volume of normal saline was given instead at the same time in group C.Before anesthesia induction,at 10 min after induction,after re warming to 36 ℃,at 1 h after termination of CPB,at the end of surgery and at 24 h after surgery,venous blood samples were collected to detect the concentrations of tumor necrosis factor-alpha,interleukin-6 (IL-6),IL-8 and cardiac troponin T in plasma (by enzyme-linked immunosorbent assay).Myocardial specimens were obtained from the right auricular appendage after opening of pericardium and at 1 h after aortic unclamping for microscopic examination and for determination of activated NF-κB and TLR4 protein and mRNA expression (by Western blot and real-time polymerase chain reaction,respectively).Results Compared to group C,the concentrations of plasma tumor necrosis factor-alpha,IL-6,IL-8 and cardiac tropnin T were significantly decreased after re-warming to 36 ℃C,at 1 h after termination of CPB,at the end of surgery and at 24 h after surgery,the expression of activated NF-κB and TLR4 protein and mRNA was down-regulated at 1 h after aortic unclamping (P＜0.05),and the pathological changes of myocardium were significantly attenuated in group P.Conclusion The mechanism by which penehyclidine hydrochloride reduces inflammatory responses is related to inhibition of the activation of NF-κB/TLR4 signaling pathway in the myocardium of pediatric patients undergoing radical correction of tetralogy of Fallot with CPB.

Objective To observe the mRNA and protein expression of SOCS-1 and SOCS-3 in the peripheral blood mononuclear cells(PBMCs) in patients with systemic inflammatory response syndrome(SIRS) and explore its clinical significance.Methods Peripheral blood of 20 patients with SIRS and 16 healthy people wag collected and the PBMCs were isolated by centrifugafion and Ficoll-Hypaque sedimentation.The mRNA of SOCS-1 and SOCS-3 was determined by reverse transcription-polymerase chain reaction(RT-PCR).And the protein content of SOCS-1 and SOCS-3 was determined by Western Blotting.Results The SOCS-1 mRNA expression in the PBMCs of SIRS group (0.642±0.112) was significant higher than that of control group(0.458±0.044)(P<0.05).There was no significant difference between the PBMCs,SOCS-1 content of control group(0.488±0.019) and SIRS group (0.471±0.041).The SOCS-3 mRNA expression in the PBMCs of SIRS group(0.989±0.324) was higher than that control group(0.459±0.046)(P<0.05).There was no significant difference between the PBMCs'SOCS-3 content of control group(0.400±0.025) and SIRS group(0.426±0.015).Conclusions The mRNA expression of SOCS-1 and SOCS-3 in the PBMCs were higher in SIRS patients.The SOCS-1 and SOCS-3 may participate in the development of SIRS.

The practical experiences with subject service in Medical Library of Chinese PLA were summarized in terms of the establishment of user information records, accumulation and summation of information, and construc-tion of information platform. Suggestions were put forward for the improvement of subject service in Medical Library of Chinese PLA, such as holding the big information concept in the big data era, using the biomedical data as the target of study, providing various kinds of service, integrating seamless, dynamic and interactive library service into user service. The fact that focus on artificial intelligence, computer, information and coomunication technologies is one of the future directions was pointed out.

Objective To study the auditory perception and speech ability outcomes after cochlear implantation in prelingually deaf children with extremely severe neurosensory hearing loss and comorbid leukoencephalopathy.Methods Our study included 14 prelingually deaf children with leukoencephalopathy (confirmed by preoperative MRI scanning) who were treated with cochlear implantation in the Department of Otorhinolaryngology Head and Neck Surgery of Hainan Provincial People''s Hospital, including 8 males and 6 females of 1~6 yr with a mean age of 3.8 yr.Sixteen synchronous prelingually deaf children without central nervous system (CNS) diseases were also included as the control group, including 11 males and 5 females of 1~6 yr with a mean age of 4.4 yr.All the patients underwent pre-surgical assessments of audiology, radiology, speech ability and intelligence before cochlear implantation via transmastoid facial nerve recess approach was done, after which rehabilitation was provided at the Hainan Rehabilitation Center for Deaf Children.Categories of auditory performance (CAP) and speech intelligibility rate (SIR) were employed as the assessment criteria for the outcome of surgery, the scores of which at different timepoints after surgery were statistically compared through paired t-test between the two groups.Results All the patients gained post-surgical hearing and speech abilities to different degrees, whereas CAP and SIR scores both chronologically improved in the both groups.No statistical difference was revealed either in CAP or in SIR scores between the two groups at 6, 12 and 24 months after surgery (P>0.05).Conclusion Children with extremely severe neurosensory hearing loss can be reated with cochlear implantation even if they have comorbid leukoencephalopathy.The effects of auditory and speech rehabilitation for the same age patients with leukoencephalopathy are similar to those without leukoencephalopathy in 2 years after surgery.

Objective To compare the biomechanical difference of two internal fixation approaches for the posterior pelvic ring fracture dislocation.Methods Six fresh adult cadaver pelvic specimens were tested biomechanically.Then,the specimens were subjected to Denis-I sacral pelvic fracture.The specimen was first fixed with improved Galveston fixation and then with improved Galveston fixation plus sacral rod.Biomechanical tests were performed from vertical and reversed directions on the fixed pelvis.Results Under vertical compression,the biomeehanical value of the improved Galveston fixation plus sacral rod was lower than that of the improved Galveston fixation,with no statistical difference between two methods(P ＞ 0.05).Under the reversed compression,the biomeehanieal value of the improved Galveston fixation plus sacral rod was lower than that of the improved Galveston fixation,with statistical difference between two groups(P ＜ 0.05).Conclusion The improved Galveston fixation combined with sacral rod can increase the anti-reverse stability of the posterior pelvic ring.