Objective To explore endoscopic diagnosis,treatment,pathological features and prognosis of gastrointestinal carcinoid tumors.Methods Retrospective analysis of 72 cases of gastrointestinal carcinoid tumors which were endoscopically diagnosed,treated,pathologically confirmed and followed up from July 2004 to July 2010 in Shanxi Provincial People' s Hospital.Common endoscopic diagnosis,endoscopic ultrasound(EUS)diagnosis,pathological features,treatment and prognosis were summarized.Results Twenty six cases of upper gastrointestinal carcinoid tumors and 46 cases of lower gastrointestinal carcinoid tumors were diagnosed and followed up.A total of 65 cases were single carcinoid and 7 were multiple carciniods.Tumors were mostly yellowish hard nodules with limited range of movement.EUS showed uneven hypoechoic nodules in the submucosal layer.Fifty-one cases of single carcinoid tumor were successfully treated with endoscopic mucosal resection(EMR)or endoscopic submucosal dissection(ESD)and the cure rate was 96.2％(51/53).Three cases of multiple carciniods were cured with EMR and the cure rate was 3/7.There was no tumor recurrence after treatment during follow-up.Conclusions Endoscopy examination is an important way to detect early carcinoid tumors.Endoscopic ultrasound probe can further clarify source and level of the lesion,and provide the basis for the endoscopic therapy.EMR and ESD are the preferred radical treatment for early carcinoid tumors.

OBJECTIVE:To prepare the norcantharidin (NCTD) nano-micelle and study its antitumor effect. METHODS:NCTD nano-micelle was self-formed in water using Triblock copolymers distearyl phosphatidylethanolamine-polyethylene glycol-ma-leimide;its shape was observed,the drug-loading rate,entrapment efficiency,particle size,Zeta potential were investigated. MTT was used to investigate the cell survival rate of human lung cancer A549 cells in negative control group (Phosphate buffer solu-tion),carrier group (blank nano-micelle),positive control group (NCTD APIs,5-320 μg/mL) and NCTD nano-micelle group (NCTD,5-320 μg/mL) after acting different time (24,48,72 h). Tumor nude mice were randomly divided into blank control group,NCTD injection group(1 mg/kg),NCTD low-dose,high-dose groups(0.5,1 mg/kg),6 in each group. All mice were in-travenously injected relevant medicines in tail,once a day,for 8 weeks. Tumor size was measured every week,and tumor quality was detected after the second day of finishing administration. RESULTS:NCTD nano-micelle was round,drug-loading rate was (2.82±0.05)%,entrapment efficiency was(83.67±1.78)%,particle size was(138.6±45.8)nm,Zeta potential was -(12.75± 0.34)mV(n=6). Cell survival rate of A549 cells in carrier group had no obvious changes,and was obviously decreased in posi-tive control group and NCTD nano-micelle group,which was positively correlated with concentration and time. And the decrease degree of cell survival rate in NCTD nano-micelle group was stronger than positive control group(P<0.01). Compared with blank control group,the tumor quality of mice in 3 administration groups was reduced (P<0.05),the reduction degree in NCTD na-no-micelle high-dose group was stronger than NCTD nano-micelle injection group (P<0.05). CONCLUSIONS:NCTD nano-mi-celle is successfully prepared,which has good in vitro and in vitro anti-tumor effect on A549 cells.

The effects of Traditional Chinese medicine (TCM) nursing operation in cervical spondylitis have been generally recognized. This paper reviewed the applications and improvements of the major three TCM nursing operations, cupping, Gua-Sha and acupressure. The future developments in moxibustion, auricular point sticking, fumigation and washing therapy and moisten compress therapy were also prospected.

Objective To discuss Si tactic of breathing exercises on the rehabilitation of lung function, dyspnea, distance of 6-minute walk distance (6MWD), respiratory muscle endurance and quality of life in stable patients with chronic obstructive pulmonary disease (COPD). Methods 63 patients with COPD were divided into experimental group with 31 cases and control group with 32 cases according to random digital table method. The experimental group were given routine treatment and nursing care, take Si tactic of breathing exercises. The control group were given routine treatment and nursing care only. Both groups were given treatment for 4 months. The indexes of lung function (FEV1, FEV1%, FEV1/FVC), scores of the Modified Medical Research Council Scale (MMRC), 6MWD, scores of Saint-George′s Respiratory Questionnaire (SGRQ), maximal voluntary ventilation (MVV) changes before and after the therapy were measured. Results After intervention, the lung function as measured by FEV1, MVV, 6MWD showed a significant improvement in the experimental group, and was higher than that in the control group[(1.42±0.43) L vs.(1.22±0.32) L and(1.21±0.45) L,(52.39±14.21) L vs.(47.20±14.59) L and (43.65±11.89) L, (288.36±71.70) m vs.(244.42±71.50) m and (250.56 ±79.25) m, P<0.05]; MMRC scores, SGRQ scores, activities and daily life part score were lower after intervention and was lower than that in the control group [(2.63 ±1.00) points vs. (3.21 ±0.92) points and (3.14±1.12) points, (44.38±5.23) points vs. (54.74±5.73) points and (52.87±5.49) points, (41.25± 6.03) pints vs.(66.48±6.38) points and (64.13±5.34) points, (28.00±7.34) points vs. (44.87±4.86) points and (42.31 ±9.12) points, P<0.05]. Conclusions For COPD patients in stable stage, Si tactic of breathing exercises can improve the pulmonary function and alleviate dyspnea, enhance exercise endurance and respiratory endurance, thereby improve the quality of life of patients, so this is one of the method for comprehensive pulmonary rehabilitation in the future.

Objective To study the homocysteine induced gene(HCY-2) expression in human fetus arterial smooth muscle cells(hASMCs) in culture and explore the effects of homocysteine(HCY) and folic acid on HCY-2 expression and cell proliferation of hASMCs. Methods Immunohistochemistry ABC staining method was used to observe and analyze HCY-2 expression in hASMCs in culture.The image analysis system was used to research of hASMCs quantificationally.The effect of different HCY concentration on the proliferation of hASMCs was investigated by the cell counting. Results Immunoreactive substance of HCY-2 was chiefly found in cytoplasm of hASMCs.The expression of HCY-2 could be affected by HCY concentrations.There was a positive dose-dependent correlation with HCY concentrations in the culture medium.Folic acid increased the expression of HCY-2.The different concentration of HCY enhanced the proliferation of hASMCs,and this enhancement was maximal at the concentration of 1.25 mmol/L of HCY,while the proliferation was decreased when the concentration of HCY was over 1.25 mmol/L.Conclusion HCY increases the expression of HCY-2,and affects the proliferation of hASMCs.HCY is inhibited by folic acid.

Objective To observe the effects of bone marrow?derived mesenchymal stem cells (BMSC) on glomerular podocyte injured by lipopolysaccharide (LPS) and the expression of related protein. Methods Podocytes are divided into control group, BMSC group, LPS group and LPS plus BMSC group. After 24 hours of intervention, observing each experimental group podocyte form under inverted phase contrast microscope;detecting the expressions of mRNA and protein of nephrin, CD2AP, synaptopodin, and TRPC6 by RT?PCR and Western?blot. Results Compared with control group, expressions of nephrin, CD2AP, and synaptopodin in LPS group decreased (P<0.05) while that of TRPC6 increased (P<0.05); compared with LPS group, expressions of nephrin, CD2AP, and synaptopodin in LPS+MSC group increased (P<0.05) while that of TRPC6 decreased (P<0.05). Conclusion BMSC may relieve LPS?induced podocyte injury.

Objective To develop an LC-MS/MS method for simultaneous determination of metolazone and valsartan in beagle dog plasma.Methods The chromatographic separation was achieved on an Agilent Poroshell 120(2.1 mm ×30 mm × 2.7 μm)analytical column.The multiple reaction monitoring mode operating in positive ion was adopted in MS detection, and precursors to the product ion transitions of m/z 366.2/259, 436.2/291 and 423.4/207 were used to measure metola-zone, valsartan and internal standard ( losartan potassium) .Results The method was linear over the concentration range of 0.5 ng/ml-100 ng/ml for metolazone and 5-5000 ng/ml for valsartan, with the correlation coefficients ( r2 ) of 0.9937 and 0.9939, respectively.The average intra-day precision values ( RSD) were 2.09% -8.85% for metolazone and 2.36%-13.12%for valsartan.The matrix effect values were 87.73%-98.62%for metolazone and 99.03%-137.35%for valsartan.The average recovery was 75.74%-81.82%for metolazone and 83.89%-95.64%for valsartan.Conclu-sion This analytical method for metolazone and valsartan is simple, accurate and sensitive, so it can be used for pharma-cokinetic research of metolazone and valsartan immediate release tablets in beagle dogs.

Objective To study the clinical value of electronic bronchoscope in diagnosis and treatment of recurrent dyspnea in neonates.Method From October 2014 to October 2017,the clinical data of recurrent dyspnea receiving electronic bronchoscopy examination and treatment in the neonatal intensive care unit of our hospital were retrospectively selected.Their clinical characteristics and treatment effects were summarized and analyzed.Result A total of 171 infants of neonatal recurrent respiratory infections were examined using electronic bronchoscope.The top four causes included endo－tracheo－bronchitis in 78 cases (45.6%), laryngomalacia, and tracheobronchomalacia in 22 cases (12.9%), airway stenosis in 14 cases (8.2%) and esophagotracheal fistula in 12 cases ( 7.0%).The complications of intraoperative and postoperative included decline of percutaneous oxygen saturation and /or heart rate (20.5%, 35/171), mucosal bleeding (12.3%, 21/171 ), and fever after bronchoalveolar lavage.Electronic bronchoscopy examination confirmed all the 171 neonates′diagnosis and some of them recovered after corresponding treatment.78 cases of infants with endo－tracheobronchitis were all cured.22 cases of laryngomalacia and tracheobronchomalacia and nine patients with airway stenosis improved and were discharged after treatment . One patient with subglottic stenosis received bronchoscopic holmium laser ablation therapy and the airway significantly expanded.No re－stenosis was found during follow－up.Conclusion Electronic bronchoscopy is an important method to determine the cause of recurrent dyspnea in newborns , and it′safe,reliable and can play a therapeutic role in some neonates.

BACKGROUND: In recent years, the development of tissue engineering has provided a new approach for the treatment of periodontal bone defect. Tissue engineering therapy includes seed cells, scaffolds and growth factors. Platelet gel contains a large number of platelet growth factors, and collagen is often used for the preparation of scaffold materials. Therefore, the platelet gel and collagen biologically active composite membrane can provide scaffolds and growth factors for the defect bone. OBJECTIVE: To investigate the effect of autologous platelet gel-collagen biologically active composite membrane on the repair of periodontal bone defect in rats. METHODS: Forty-two Wistar rats (Shanghai Xipuer-Bikai Experimental Animal Co., Ltd., China) were selected. (1) Collagen was cut into 5 mm×2 mm size, and 10 mL of whole blood was extracted from 6 rats to obtain platelet-rich plasma. Autologous platelet gel-collagen composite membrane was prepared by adding bovine thrombin, calcium chloride and collagen in a certain proportion. Platelets in whole blood and in platelet-rich plasma were detected. The levels of platelet derived growth factor AB, transforming growth factor-β, basic fibroblast growth factor and vascular endothelial growth factor in whole blood and platelet-rich plasma were detected by ELISA. (2) The models of mandibular periosteal defect were established in 36 rats (the size of the bone defect was 5 mm×2 mm, and the root surface cementum was removed) , and randomly divided into two groups. Autologous platelet gel-collagen group placed the autologous platelet gel-collagen composite membrane in the bone defect, and the control group did not place any materials. The hematoxylin-eosin staining of periodontal tissues of rats in each group was analyzed at 2, 4 and 8 weeks after surgery. Rate of new born, new centumum formation, new alveolar bone formation, and new periodontal ligament tissue formation height were measured. The expression of bone morphogenetic protein-2 was detected by immunohistochemical staining. RESULTS AND CONCLUSION: (1) The mean platelet count in platelet-rich plasma was 4.78 times as high as the whole blood, indicating that the number of platelets increased significantly after prepared into platelet-rich plasma (P < 0.05) . The levels of platelet derived growth factor AB, transforming growth factor-β, basic fibroblast growth factor and vascular endothelial growth factor in platelet-rich plasma were 3.10, 3.45, 7.17 and 5.45 times of the whole blood, respectively (P < 0.05) . (2) The results of hematoxylin-eosin staining observed that the rate of new born, new centumum formation, new alveolar bone formation, and new periodontal ligament tissue formation height at 2 weeks in the autologous platelet gel-collagen group showed no significant difference from the control group (P> 0.05) . At 4 and 8 weeks, all above indexes in the autologous platelet gel-collagen group were significantly higher than those in the control group (P < 0.05) . (3) Results of immunohistochemical staining revealed that at 2 weeks, bone morphogenetic protein-2 in the autologous platelet gel-collagen group began to express, and the expression of bone morphogenetic protein-2 was highest at 4 weeks (P < 0.05) , and the positive expression was weakened at 8 weeks (P> 0.05) . (4) Our results clarify that autologous platelet gel-collagen bioactive composite membrane can significantly promote the regeneration of new tooth, which is associated with the expression of bone morphogenetic protein-2, and reduce the repair time after periodontal tissue defect.

Objective:To investigate the association of time in range with metabolic associated fatty liver disease(MAFLD) and advanced liver fibrosis in patients with type 2 diabetes.Methods:This study was a retrospective study. A total of 494 type 2 diabetic patients were recruited in the Department of Endocrinololgy of Henan Provincial People′s Hospital from November 2019 to April 2022. Time in range(TIR) was calculated with continuous glucose monitoring data. Abdominal ultrasound scan was used to diagnose fatty liver. Liver stiffness measurement(LSM) by transient elastography was used to evaluate liver fibrosis. Pearson and multivariate linear regression analysis was used to evaluate the association between TIR and LSM. Multivariate logistic regression analysis was used to analyze the association of TIR with risk of MAFLD and advanced liver fibrosis.Results:Pearson correlation analysis showed that LSM was negatively correlated with TIR( r=-0.86, P<0.001) and was positively correlated with homeostasis model assessment for insulin resistance(HOMA-IR; r=0.48, P<0.001). After adjusting for confounding factors, multivariate linear regression analysis showed that TIR significantly negatively predicted LSM( β=-0.75, P<0.001), and HOMA-IR significantly positively predicted LSM( β=0.21, P=0.025). After adjusting for confounding factors, logistic regression analysis showed that compared with TIR Q4 patients, TIR Q1 patients had an increased risk of MAFLD( OR=1.96, 95% CI 1.07-3.62, P=0.027), advanced liver fibrosis( OR=3.82, 95% CI 1.17-12.50, P=0.027), and HOMA-IR was an independent risk factor for MAFLD( OR=1.22, 95% CI 1.04-1.43, P=0.005) and advanced liver fibrosis( OR=1.26, 95% CI 1.03-1.54, P=0.025). Conclusions:TIR and insulin resistance are independent risk factors for MAFLD and advanced liver fibrosis in patients with type 2 diabetes. TIR has a significant predictive value for MAFLD and advanced liver fibrosis.