Objective To evaluate the diagnostic value of electronic staining endoscopy combined with endo -scopic ultrasound(EUS) in the preoperative early gastric cancer .Methods A total of 17 patients diagnosed with intramucosal carcinoma by ordinary gastric endoscopy combined with pathological findings were selected ,who under-went the T staging by EUS and electronic staining endoscopic examination before ESD .The findings were compared with pathological findings.Results 17 cases were diagnosed with gastric cancer in T1 stage by EUS(12 cases limited mucous layer or mucosal muscular layer ,5 cases involving the submucossa ) .14 cases were diagnosed with gastric cancer in T1 stage by pathological examination (11 cases limited mucous layer or mucosal muscular layer ,3 cases involving the submucossa ) ,3 cases in T2 stage had received surgery .The accuracy of EUS in determining the depth of intramucosal carcinoma invasion was 88.2%;The total accuracy of T staging was 82.4%.The lesions border was more clear in electronic staining mode ,and easier marked.Conclusion The diagnostic value of electronic staining endoscopy combined with endoscopic ultrasound in the preoperative early gastric cancer is high .

An investigation was made on the rehabilitation treatment for the injuries wounded in Wenchuan Earthquake offered in 30 hospitals of 8 provinces, including Beijing, Shanghai, Jiangsu, Shandong, Hubei, Guangdong, Cbongqing, and Sichuan. On the basis of data from this investigation, the paper made analysis and summary of the challenges and problems encountered in the said rehabilitation treatment, and raises such recommendations as relessing rehabilitation assessment principles and policies for the injuries to return to their home towns in Siehuan, clarifying the responsibilities of individual government authorities in the later-stage rehabilitation treatment of the injuries, and enhanced synergy among respective disciplines and authorities of both clinical practice and rehabilitation treatment. The goal of these recommendations is further development of the rehabilitation medicine discipline in China.

Objective To learn the size and income of off-staff medical workers in a survey of public county-level general hospitals in China.Methods Human resources investigation of public county-level general hospitals,with SPSS data analysis of the outcomes.Results From 2011 to 2013,the proportion of off-staff medical workers increased from 31.44% to 36.69%,of whom the highest proportion was found in China′s western region,accounting for 40.69%;the ratio of off-staff practicing physicians increased from 14.24% to 16.64%,of whom China′s central region accounted for 19.92%;the ratio of off-staff nurses increased from 43.03% to 49.77%,of whom China′s western region accounted for 55.88%.In 13.7% of the hospitals,income of off-staff medical workers was less than a half of that for permanent staff;41.32% and 26.31% of the hospitals surveyed were fully covered with social insurance and housing fund account respectively.Conclusions Off-staff labor is a distinct feature at such hospitals,making imperative a HR system reform of public hospitals.The discriminative income and welfare between permanent and off-staff medical workers calls for a fundamental change to the income and welfare system.

Rapid tumor cell growth depends on intracellular polyamine levels higher than those of normal cells. Intracellular polyamine depletion inhibits tumor cell proliferation and induces tumor cell apoptosis. Therefore, polyamine metabolism has recently been identified as an important target for anti-tumor therapy. This article briefly summarizes recent polyamine metabolism targeting, polyamine depletion within the tumor cells through a variety of methods, and the antitumor effects of the treatment.

Endoscopic ultrasound was initially introduced in 1980s as a diagnostic modality combining echoendoscopes with radial scanning, which permitted reconstruction of cross-sectional images similar to computed tomography. Many studies showed that endogastric ultrasonography is more accurate than endoscopy or CT in evaluating the depth of invasion ( T category) and the involvement of lymph nodes (N category) in patients with gastric carcinoma. In addition to being very useful in tissue acquisition for diagnostic purposes, the principles behind endoscopic ultrasound-guided fine needle aspiration ( FNA) paved the way for the development of therapeutic endoscopic ultrasound, which improve the prognosis of patients with gastric cancer.

To improve the quality of clinical teaching of plastic surgery for foreign students at different levels,we think that good teaching result will be got by applying English teaching for whole range,attaching importance to the selection and cultivation of the teaching staff,establishing individualized teaching program and compiling suitable material,and sticking to trial teaching before class,collective discussion and flexible teaching methods.

Objective To study on the relationship between insulin resistance and thyroid nodule in the patients of normal glucose metabolism. Methods The clinical data of 105 patients of normal glucose metabolism were analyzed. The patients were divided into nodules group (54 patients) and non- nodules group (51 patients). The age, sex, body mass index (BMI), fasting plasma glucose (FPG), postprandial 2 h blood glucose (2 h PG), fasting insulin (FINS), postprandial 2 h (2 h INS), fasting C peptide (FC-P), postprandial 2 h C peptide (2 h C-P), glycosylated hemoglobin (HbA1c), blood uric acid (BUA), homeostatic model assessment insulin resistance index (HOMA-IR) were compared between two groups. According the level of HOMA-IR, 105 patients were divided into different subgroups, the detection rate of thyroid nodules was compared. The influencing factors of thyroid nodules were analyzed by multi-factor Logistic regression analysis. Results The age and sex between two groups had no significant differences (P>0.05). The levels of BMI, BUA, HOMA-IR, FPG, FINS, 2 h INS, FC-P, 2 h C-P and HbA1c in nodules group were significantly higher than those in non-nodules group (P<0.05). The detection rate of thyroid nodules in HOMA-IR 3. 01- 4.00 group (12/14) and HOMA-IR > 4.00 group (20/20) was higher than that in HOMA-IR 0- 1.00 group (0), HOMA-IR 1.01- 2.00 group (39.5%, 17/43) and HOMA-IR 2.01-3.00 group (5/17), there were significant differences (P<0.01). Multi-factor Logistic regression analysis showed that the detection rate of thyroid nodules had positive correlation with levels of HOMA-IR, BUA and BMI (OR=0.278, 0.004 and 0.115, 95%CI 1.695-5.043, 1.001-1.015 and 1.046-1.644). The detection rate of thyroid nodules had no correlation with level of FPG (P>0.05). Conclusions The detection rate of thyroid nodules in HOMA-IR>3.00 patients is significantly higher. The insulin resistance, higher BMI and hyperuricemia are the independent risk factors of thyroid nodules.

Objective To investigate the value of differential diagnosis of 5-hydroxytryptamine,dopamine and their metabolic productions in cerebral spinal fluid(CSF) in patients with viral encephalitis and schizophrenia.Methods The CSF concentrations of DA,5-HT,5-hydroxyindole acetic acid(5-HIAA) and homovanillic acid(HVA) were assayed by high-performance liquid chromatography(HPLC) in the patients with viral encephalitis and meningoencephalitis(67 cases),schizophrenia(37 cases) and other diseases(21 cases).Results(1) Compared with case control group,the concentrations of 5-HT,5-HIAA and the ratios of 5-HIAA/5-HT,5-HT/DA were significantly lower in viral encephalitis and meningoencephalitis group(P

Objective To assess the exposure to polycyclic aromatic hydrocarbons(PAHs) in traffic police and suburban inhabitants in Beijing and to explore the factors that can influence urinary 1-hydroxypyrene(1-OHP) which will be taken as PAHs exposure biomarker.Methods From Jun.to Aug.2007,Sixty-two traffic policemen and 35 male suburban inhabitants were selected.The ambient PM2.5 samples were collected within two consecutive days in the work place of traffic policeman and in the residential area of suburban inhabitants respectively.The levels of urinary 1-OHP and 10 PAHs species in the collected PM2.5 were determined by high performance liquid chromatography(HPLC),while the information on smoking,drinking alcohol,exercising habit and so on was investigated by questionnaire.Results The average levels of benzo[a]pyrene,pyrene and total PAHs in the traffic policeman group were 3.20,6.48 and 38.32 ng/m3 respectively,while the corresponding values in the suburban inhabitant group were 1.54,4.05 and 25.43 ng/m3 respectively.The concentration of urinary 1-OHP in the policeman group was higher than that of the suburban inhabitant group.In addition,the effect of smoking on the 1-OHP concentrations were also detected in the smoking suburban inhabitants and serious smoking traffic policemen(≥20 cigarettes per day).There was no effect of other factors(such as drinking alcohol,exercising and cooking habit) on 1-OHP.Conclusion Both traffic policemen and suburban inhabitants in Beijing were exposed to high level of PAHs.The ambient air exposure and smoking are the most important factors influencing the concentration of urinary 1-OHP.

Objective To explore polycyclic aromatic hydrocarbons(PAHs) exposure of traffic policemen in Beijing and its impact on DNA oxidative damage. Methods From Jun. to Aug. 2007,41 male traffic policemen and 34 male suburban inhabitants in Beijing were selected. The ambient fine particulate matter(PM2.5) was sampled within two consecutive days in the work places of traffic policeman and in the residential area of suburban inhabitants respectively . The levels of urinary 1-hydroxypyrene(1-OHP) and 10 PAHs species were both analyzed by high performance liquid chromatography(HPLC) . The levels of urinary 8-hydroxy-2’-deoxyguanosine(8-OHdG) were detected by ELISA kit,while the questionnaires for health information on smoking,drinking alcohol,exercise habit and so on were also inquired. Results The average levels of PM2.5,benzo[a]pyrene [B(a) P] and total PAHs in the traffic policeman group were 0.096 mg/m3,3.20 ng/m3,and 38.32 ng/m3 respectively,while the corresponding values in the suburban inhabitant group were 0.045 mg/m3,1.54 ng/m3 and 25.43 ng/m3 respectively. The concentration of urinary 1-OHP in the policeman group [(0.50 ?0.38 ) ?mol/mol Cr] was higher than that of the suburban inhabitant group([0.34?0.28) ?mol/mol Cr],P0.05. Multiple factors analysis indicated that urinary 1-OHP and smoking habit had influence on urinary 8-OHdG level,while there was no relationship with other factors(such as drinking alcohol,exercise and cooking habit) . Conclusion Traffic pollution may increase the level of DNA oxidative damage in policemen in Beijing.Traffic and smoking habit-related PAHs exposure is the important influencing factor.