Programmed cell death(PCD)of human leukemic HL-60 cell and human poorly differentiated gastric adenocarcinoma cell BGS-180 induced by efoposid(VP-16) was preliminarily observed comparatively in the same experimental condition through rate of cell death, DNA agarose gels electrophoresis and terminal deoxynucleotidyl transferase(TdT) mediated biotin-11-dUTP nickend labeling(TUNEL).It was found that apoptosis is the main pattern of HL-60 cell death induced by low does VP-16 in a short time, and it can be suppressed when protein kinase C(PKC) is activated. The main pattern of BGS-180 cell death induced by VP-16 is necrosis, and PCK activation does not affect its necrosis rate. Extracellular Ca2+ reduction do not affect BGS-180 and HL-60 cell death rate. The mechanism of VP-16 action on BGS-180 and HL-60 cell is different, apoptosis is not the main pattern of cell BGS-180 death induced by VP-16.

Programmed cell death(PCD)of human leukemic HL 60 cell and human poorly differentiated gastric adenocarcinoma cell BGS 180 induced by efoposid(VP 16) was preliminarily observed comparatively in the same experimental condition through rate of cell death, DNA agarose gels electrophoresis and terminal deoxynucleotidyl transferase(TdT) mediated biotin 11 dUTP nickend labeling(TUNEL).It was found that apoptosis is the main pattern of HL 60 cell death induced by low does VP 16 in a short time, and it can be suppressed when protein kinase C(PKC) is activated. The main pattern of BGS 180 cell death induced by VP 16 is necrosis, and PCK activation does not affect its necrosis rate. Extracellular Ca 2+ reduction do not affect BGS 180 and HL 60 cell death rate. The mechanism of VP 16 action on BGS 180 and HL 60 cell is different, apoptosis is not the main pattern of cell BGS 180 death induced by VP 16.

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

Objective:To investigate ulinastatin (UTI) combined with Xingnaojing injection in the treatment of acute cerebral hemorrhage (ACH) and its effect on the serum high sensitivity C reactive protein (hs-CRP),D-dimer (D-D) and neuron specific enolase(NSE) levels.Methods:110 cases of ACH patients admitted in our hospital from January 2015 to December 2016 were selected and divided into two groups according to the random number table method.The control group was given UTI treatment,while the observation group was given UTI combined with Xingnaojing treatment.Then the brain edema absorption effect,NIHSS score,serum hs-CRP,D-D and NSE levels before and after the treatment of the two groups were recorded and compared;the safety ofmedicidstion of the two groups was evaluated.Results:At the 14th day after treatment,the total effective rate of cerebral hematoma absorption in the observation group was 89.1％,which was significantly higher than 67.3％ of the control group (P＜0.01).At the 14th day after treatment,the NIHSS scores of both groups were significantly lower than those before the treatment (P＜0.01);compared with that of the control group of the same time period,at the 14th day after treatment,the improvement effect of NIHSS score in the observation group was more significant (P＜0.01).Compared with those before the treatment,the serum hs-CRP,D-D and NSE levels of both groups at the 14th day after treatment were significantly decreased (P＜0.01);at the 14th day after treatment,the serum indicators of the observation group improved more significantly than those of the control group (P＜0.01).The incidence rate of adverse reaction in the observation group was 3.6％ compared with 5.5％ of the control group (P＞0.05).Conclusion:Ulinastatin combined with Xingnaojing Injection could rapidly relieve or eliminate hematoma in the treatment of acute cerebral hemorrhage,control the inflammatory response,improve the blood coagulation system and fibrinolytic system,protect the nerve cells and reduce the neurological damagee.

Objective To construct the recombinant RIP3 over-expressed plasmids and transfect them in breast cancer MCF7 cells, and identify the expression and localization of fusion protein, as well as its effect on the death way of MCF7 cells. Methods The expression levels of RIP3 mRNA in four breast cancer cell lines and normal mammary epithelial cells were detected by reverse transcription polymerase chain reaction (RT-PCR). The RIP 3 coding sequence was amplified by polymerase chain reaction and subcloned into mCherry vector to construct recombinant plasmids. The plasmids were transfected into MCF7 cells by lentivirus after DNA sequencing, then screened by basticidin (4 mg/L) for 1 week. The efficiencies of RIP3 expression were validated by Western blotting assay. The death way of mCherry-RIP3-MCF7 cells was observed under the treatment of TNF-αand Z-VAD-FMK. Results The lowest expression of RIP3 mRNA was found in MCF7 cells. The sequencing results validated the well recombinant plasmids. The expression of mCherry-RIP3 fusion pro-tein with a molecular weight of 85 ku was detected by Western blot assay. The mCherry-RIP3 expression enhanced the sensi-tivity of MCF7 cells to TNF-αand Z-VAD-FMK induced cell death. Conclusion The recombinant RIP3 over-expressed plasmids were successfully constructed, and the stable MCF7 cells with ectopic RIP3 transfection were obtained. The mCher-ry-RIP3 fusion protein was expressed in the cytoplasm and was conformed to mediate TNF-αinduced necroptosis.

Objective To analyze endoscopic histological characters and establish diagnostic standards of colorectal polyps with confocal laser endomicroscopy (CLE) examination and to explore the diagnostic value of the CLE in adenomatous polyps and non-adenomatous polyps. Methods From June to December in 2009, 90 patients were recruited in this study, which included 40 pathologically confirmed colorectal polyps patients (total 48 colon and rectal polyps) and 50 patients for prospective study (total 106 colon rectal polyps). At same time 10 spots of normal mucosa was taken for comparison. Firstly the CLE images of 48 pathologically confirmed colorectal polyps (22 adenomatous polyps and 26 non-adenomatous polyps) were analyzed, and the diagnosis criteria for distinguishing adenomatous polyps and non-adenomatous polyps was established with CLE. Then according to the criteria, 106 colorectal polyps underwent prospective diagnosis with CLE. Finally, the CLE diagnosis result was compared with pathologically result to evaluate the diagnosis efficiency of CLE. Results In the 48 colorectal polyps of 40 pathologically confirmed colorectal polyps patients, there were 22 adenomatous polyps and 26 non-adenomatous polyps. The sensitivity, specificity and accuracy of CLE in adenomatous polyps diagnosis were 94. 0%, 92. 9%, and 93. 4%, respectively. The positive predictive value was 92.2% and the negative predictive value was 94.5%. The sensitivity, specificity and accuracy of CLE in non-adenomatous polyps diagnosis were 92. 9%, 94.0%, and 93. 4%respectively, the positive predictive value was 94.5% and the negative predictive value was 92.2%.The coherence of CLE and histopathology in adenomatous polyps diagnosis was pretty good (Kappa=0. 893). Conclusion The accuracy of CLE in adenomatous polyps and non-adenomatous polyps differential diagnosis was high, and the coherence with histopathology diagnosis was good, which provided experience for further detection of early rectal precancerous.

Objective To investigate the diagnostic potential of magnifying narrow-band imaging endoscopy (NBI-ME) for different intrapapillary capillary loop (IPCL) for the diagnosis of esophageal lesion.Methods Patients with abnormal esophageal mucosa found by white light gastroscopy in digestive endoscopy center,Chinese PLA General Hospital during the period of November 2009 to November 2010 were enrolled in this study.IPCL was observed and divided into different types by NBI-ME.Histopathology of biopsy or endoscopic submucosal dissection (ESD) specimens was evaluated and used as the gold standard to evaluate the diagnostic value of NBI-ME for IPCL.Results A total of 146 lesions from 145 subjects with esophageal mucosa abnormal were collected. Among them, 88 were pathology-proven inflammation,5 were pathology-proven esophageal cancers,20 were pathology-proven low intraepithelial neoplasia (LIN) and 33 were pathology-proven high intraepithelial neoplasia (HIN) detected with NBI-ME.By a per-lesion analysis,the accuracy of inflammation and cancer were 100％ (88/88) and 7/7.For the sensitivity,specificity,accuracy,positive predictive value,negative predictive value,positive likelihood ratio,negative likelihood ratio of LIN and HIN were 7/10,69.8％ ( 30/43 ),69.8％ ( 37/53 ),35.0％ (7/20),90.9％ (30/33),12.5％ (70/559),2.3％ (30/1290) and 87.1％ (27/31),72.7％ ( 16/22),81.1％ ( 43/53 ),81.8％ ( 27/33 ),80.0％ ( 16/20 ),634.1％ ( 837/132 ) and 35.2％ ( 124/352 ),respectively.Conclusions NBI-ME can classify the different esophageal IPCL.Higher diagnostic accuracy of IPCL indicates the feasibility of NBI-ME for the efficacious diagnosis of esophageal inflammation and cancer.There is the higher diagnostic accuracy of HIN than LIN.

Objective To determine the incidence and clinical factors associated with bleeding after endoscopic submucosal dissection (ESD) of gastric mucosal lesions.Methods Clinical,endoscopic and pathological data of 223 lesions in 215 ESD patients between January 2009 and October 2011 were collected.The following factors associated with bleeding were analyzed:( 1 ) patient-related factors:sex,age,concomitant diseases including hypertension and diabetes mellitus,history of administration of anticoagulants or antiplatelet agents; (2) lesion-related factors:size,location,ulcer or scar findings,macroscopic types and pathological types; (3) procedure-related factors:en-bloc resection,spray of porcine fibrin sealant and operation time. Results Thirteen patients (13 lesions ) developed bleeding after ESD,among whom 7(53.8％) occurred within 24 hours after the procedure,5 (38.5％) within 1 week and 1 (7.7％) on the sixteenth day after ESD.Univariate and multivariate analysis revealed that lesion size ( ≥5 cm; odds ratio 8.663 ; 95％ CI:2.081 - 36.075) was an independent risk factor for bleeding.Conclusion Lesion size is the independent risk factor for bleeding after ESD,so careful preparation and close monitoring are required during and after ESD.In the meantime efforts should be made to identify and exactly demarcate lesions to minimize the size of resected specimens and reduce the risk of bleeding after ESD.

ObjectiveTo evaluate preoperative biopsy in the treatment of gastric mucosal lesions by endoscopic submucosal dissection (ESD).MethodsClinical data of 195 patients diagnosed as having gastric intraepithelial neoplasia (GIEN) or early cancer by preoperative biopsy were retrospectively analyzed.The discrepancy between endoscopic biopsies and pathological diagnosis after ESD were studied.ResultsThe overall consistency rate between preoperative biopsies and postoperative pathological diagnosis was 93.8％ (183/195) and complete consistency rate was 50.8％ (99/195).For low-grade and highgrade gastric intraepithelial neoplasia ( LGIEN),the complete consistency rates were 49.4％ (42/85)and 38.0％ (30/79),respectively,which were not different ( P ＞ 0.05 ).For early cancer it was 87.1％(27/31 ),which was significantly higher than those in the LGIEN group and HGIEN group ( P ＜ 0.05 ).Post-ESD diagnosis was more severe than biopsy in 66 patients (33.8％,66/195 ),including 36 LGIEN (42.4％,36/85) and 30 HGIEN (38.0％,30/79).Final pathological diagnosis was milder than biopsy in 18 patients (9.2％,18/195),i.e.14 HGIEN (17.7％,14/79) and 4 early cancer (12.9％,4/31).Gastritis was diagnosed in 12 patients (6.2％,12/195),i.e.7 LGIEN (8.2％,7/85) and 5 HGIEN (6.3％,5/79).ConclusionPreoperative biopsy is insufficient for accurate diagnosis of gastric mucosal lesions,but facilitates resection of gastric mucosal lesions by ESD.

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.