Objective To evaluate the treatment outcome of endoscopic esophageal mucosal resection (EMR) and alleviate or prevent the complication of EMR. Methods We explore a strategy of endoscopic esophageal mucosal resection to treat early esophageal cancer and severe dysplasia . Endoscopic esophageal mucosal resection was performed with transparent-cap technique, resdiual lesions were treated by Argon Plasma Cocagulation( APC). All patients have been followed up by endoscopic examinations at one month, 4 months, and 12 months after therapy. Results Seventy one cases (88 lesions) were treated by endoscopic esophageal mucosal resection with transparent-cap method. Average doses of saline-epinephrine 18 ml is injected submucosally to each lesion. The resected specimens were on average(21.8 ?1.0)mm ? (18.2?1. 0)mm in size. Five cases have bleeding after mucosectomy, bleeding were managed and controlled by compression , local injection of saline-epinephrin, and APC. Perforation never occurred. Four cases have stenosis after mucosal resection, in three of them the resected area was more than 3/4 esophageal circumference, then it was dilated with water ballon dilater at one month, two months and three months after mucosal resection, all cases were cured. Conclusions Endoscopic esophageal mucosal resection is a safe, simple, minimally invasive and effective procedure with few complication in treating early esophageal cancer and precan-cerous lesion.

Objective To study if tumor retraction assessed by endiscopic uhrasonography (EUS) during radiotherapy has prognostic value in esophageal carcinoma, which may further predict the radiosensi-tivity. Methods The maximal tumor thickness was measured by EUS before radiotherapy and at 40 Gy in patients with esophaged carcinoma. Response was defined as at least 50% reduction in tumor thickness. Re-suits A total of 51 patients were included. The median follow-up time was 28.5 months. The median sur-vival time was 24.3 months. The treatment was radiotherapy alone, concurrent chemoradiotherapy and pre-operative treatment in 35, 10 and 6 patients, respectively. Tumor response was assessed by EUS in 18 pa-tients (34%). The 2-year overall survival (OS) and progression-free survival (PFS) were 69% and 59% for responders, comparing with 37% and 29% for non-responders (χ~2= 5.78, P = 0.016 and χ~2= 3.97, P =0.046, respectively). In radiotherapy alone group, the 2-year OS and PFS were significantly higher in responders (n = 11) comparing with non-responders (n =24)(60% vs 44% ,χ~2 =5.84,P =0.016 and 20% vs 10% ,χ~2 =4.20, P =0. 040). In preoperative radio (chemo) therapy group (n =6), pathological-ly complete response, partial response and minimal response were observed in 4, 1 and 1 patients, respec-tively. EUS detected tumor response in 4 of 5 (80%) patients with tumor regression, and non-response in 1 of 1 patient without tumor regression. Conclusions The prognosis is better in patients with esophageal car-cinoma responding to neoadjuvant treatment identified by EUS than that of non-responders.

Objective To identify endoscopic and the endoscopic ultrasonography (EUS) features of esophageal tuberculosis.Methods We retrospectively analyzed the data of 39 cases (mean age 50.7) of esophageal tuberculosis diagnosed by endoscopy and EUS in past 6 years.Results A total of 29 lesions were found in the middle part of esophagus,and 5 in upper and lower part,respectively.The lesions under endoscope demonstrated as protrusion in 30 and ulceration in 9.EUS found esophageal wall thickness in 9 cases,intra-wall occupying lesion in 17,mediastinum occupying lesions involving esophagus in 13,and calcified lymph nodes in mediastinum which was integrated with esophageal outer wall in 28 cases.Conclusion The esophageal tuberculosis occurs mainly in the middle part of the esophagus,and appears as protrusion and ulceration under endoscopy.EUS can find occupying lesions intra-or out of the esophageal wall,and full layer thickness,which can accompany calcified lymph nodes in meidastinum,and can be the basis of diagnosis.

Objective To investigate the expression levels of interferon -inducible genes (MNDA)in the peripheral blood mononuclear cells (PBMCs)of patients with systemic lupus erythematosus (SLE),and the relations between the gene expression levels and disease activity were explored.Methods Reverse transcription polymerase chain reaction(RT -PCR)method was used to detect the expression levels of MNDA in 30 patients with SLE and 25 controls.The associations between the expression levels of MNDA and urine protein,complement C3,C4,anti -double stranded DNA antibody and SLEDAI scores in patients with SLE were analyzed.Results (1)The expression level of MNDA mRNA in the SLE patients was significantly higher than that of the normal controls(t =6.99,P <0.01).(2)The expression level of MNDA in the urinary protein positive patients was significantly higher than that of the urinary protein negative patients (t =3.08,P <0.01),they were all significantly higher than the normal controls (t =9.32,4.87,all P <0.01).(3)The expression levels of MNDA mRNA were positively correlated with anti -double stranded DNA antibody and SLEDAI scores(r =0.534,0.508,all P <0.05),and not correlated with comple-ment C3 and C4(r =-0.472,-0.349,all P >0.05 ).Conclusion The expression levels of MNDA mRNA in patients with SLE are significantly higher than those of the normal controls.It is linked to kidney damage and disease activity,and helpful in evaluating SLE disease activity and severity.

Objective To observe clinical effects of Guilong decoction combined conventional western medi-cine in the treatment of rheumatoid arthritis with cold-dampness syndrome.Methods 106 cases of rheumatoid arthri-tis with cold-dampness syndrome were randomly divided into the treatment group and the control group,with 53 cases in each group.The control group was orally given methotrexate and hydroxychloroquine,while the treatment group was given Guilong decoction based on the treatment of the control group.The clinical effects of the two groups were observed after a treatment course of 3 months.Results In the treatment group,35 cases were markedly effective, which was significantly higher than the control group(P <0.05);12 cases were effective,and there was no statistically significant difference with the control group (P >0.05).The total effective rate of the treatment group was 88.68%, which was significantly higher than the control group (χ2 =4.810,P =0.028).There were no significant differences of the adverse reaction ratio between the two groups(P >0.05).Conclusion Guilong decoction combined with con-ventional western medicine can obviously improve the rheumatoid arthritis disease severities,the curative effect is re-markable.It is worth popularizing in clinical application.

Objective To prospectively evaluate the value of US,MSCT,EUS and MRI in the quantitative evaluation of the extent of pancreaticobiliary duct obstruction in pancreatic cancer.Methods Consecutive 68 patients with pancreatic carcinoma underwent US,MSCT,EUS and MRI before surgery.The diameter of extrahepatic bile duct and pancreatic duet were measured,and correlation analysis was performed with surgical specimens.Results Diameters of extrahepatic bile duct scaled by US.MSCT,EUS and MRI were(16.60±6.33)mm,(18.90±6.74)mm,(18.80±5.88)nun and(17.26±4.83)mm,and diameter measured from surgical specimens was(18.39±6.05)mm;the correlation among the four imaging examinations and the surgical evaluation were r=0.3839,P=0.1055;r=0.7113,P=0.0011; r=0.3759,P=0.0465;r=0.3376,P=0.2872,respectively. Kappa Values were 0.6285,0.7115,0.6661 and 0.7490,respectively.The diameter of pancreatic duct was(15.90±3.41)mm,(6.83 4-3.70)mm,(6.77±3.22)mm and(5.58±2.65)mm,and diameter measured from surgical specimens was(5.97±2.60)mm,the correlation among the four imaging examinations and the surgical evaluation were r=0.3584,P=0.2895;r=0.6148,P＜0.0001; r=0.7373,P＜0.0001;r=1.0746,P＜0.0001.Kappa values were 4.159,9.094,9.001 and 4.050.All of these parameters were in coherence with surgical findings.Condusions US could be used as the initial method in the assessment of extrahepatic and pancreatic duct obstruction.MRI and MSCT,combined with EUS if necessary,could be used to quantitatively evaluate the extent of pancreaticobiliary obstruction.

Objective To investigate the differences of histopathological diagnosis between the endoscopic mucosal resection (EMR) specimens and the biopsy specimens,and to evaluate the value and the limitation of EMR in diagnosis of early esophageal cancers and its precursor lesions.Methods A retrospective analysis on 217 lesions with early esophageal cancers or the precursor lesions treated by EMR was performed.The differences between pathological diagnoses of biopsy and EMR were compared.Results Compared with pathologic diagnosis after EMR,the yield of biopsy consisted of 41.9％ (91/217) as under-diagnosed,15.7％ (34/217) as over-diagnosed,and 42.4％ (92/217) as consistent.EMR diagnosis also explicated the differentiation,the grade,the invasive depth and the lympho-vascular infiltration of the lesions.Conclusion The endoscopic biopsy diagnosis is limited for the pathological diagnosis of early esophageal cancer and precancerous lesions,while the EMR sample can provide objective diagnosis and provide the guideline for the further treatment.

Objective To investigate the expressions of the annexin A1 ( ANXA1 ) in pancreatic cancer and the correlations with proliferating cell nuclear antigen (PCNA). Methods Tissue microarray instrument was used to construct the chip. There were 39 samples of normal pancreas tissue, 42 samples of pancreatic cancer, 7 samples of islet cell tumor and 8 samples of ampullary carcinoma. The expressions of ANXA1 and PCNA protein were examined by immunohistochemistry and their correlation was analyzed. Results The off-chip rate of tissue chips after immunohistochemistry was 11.7% ～ 13.3%, which could satisfy the needs for experiment. Immunohistochemical results of pancreatic cancer tissue microarray showed that the positive rate of ANXA1 expression in pancreatic cancer was 71.4% (30/42), which was significantly higher when compared with that of normal pancreas tissue ( 18.4%, 7/38; P < 0. 01 ). The positive rate of PCNA expression in pancreatic cancer was 73.8% (31/42), which was significantly higher than that of normal pancreas tissue (22.2%, 8/36; P < 0.01 ). The expression of ANXA1 had a significant correlation with PCNA in pancreatic cancer ( P < 0.01 ). Conclusions The expression of ANXA1 protein was significantly increased in pancreatic cancer. The expression of ANXA1 was significantly correlated with the expression of PCNA.

Objective　To evaluate the expression of MAGE-1 gene in esophageal carcinoma and determine whether esophageal carcinoma patients should be eligible for MAGE-1 antigen-based vaccine therapies． Methods　 MAGE-1 mRNA expression in esophageal carcinoma was assessed by reverse transcription and polymerase chain reaction amplification． The PCR products were then digested by restriction endonucleases and inserted into the pET-30a(+) vector． The sequence of the inserted gene fragment was confirmed by DNA sequence analysis． Results　Out of the 30 esophageal carcinomas studied, 43% of the esophageal carcinomas tissues expressed MAGE-1 gene and no expression was found in matched adjacent normal esophageal mucosae． The entire cDNA of the gene was cloned． Conclusion　Owing to the high frequency of MAGE-1 gene expression in esophageal carcinoma and MAGE-1 antigen can be recognized by cytolytic T lymphocytes when presented by class-I HLA molecular, a large proportion of these patients might be suitable candidates for immune therapy involving tumor specific antigens encoded by MAGE-1 gene．

Objective To explore the role of ubiquitin-proteasome pathway for the gelsolin protein degradation in pancreatic cancer.Methods Pancreatic cancer cell lines BxPC-3 and PANC-1 were first treated with specific 26s proteasome inhibitor lactacystin.Immunoblots of cell lysates were probed for gelsolin expression.To determine whether gelsolin was conjugated to ubiquitin,proteins extracted from the cells with or without lactacystin were immunoprecipitated with anti-gelsolin antibody,followed by Western blot analysis.Results The expression of gelsolin protein increased obviously after treatment with lactacystin in BxPC-3 cells for 12 h.Using anti-gelsolin antibody to immunoprecipitate gelsolin protein and followed by Western blot using anti-ubiquitin monoclonal antibody,it was found that inhibition of proteasome pathway by lactacystin resulted in accumulation of ubiquitylated forms of gelsolin protein.In PANC-1 cell line,there was no significant changes of gelsolin after treatment with lactacystin.Conclusion Ubiquitin-proteasome dependent degradation may be an important regulatory mechanism for gelsolin down-regulation in pancreatic cancer cells.