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.

Objective : To understand the current situation and influencing factors of milk and dairy intake among primary and middle school students in Tongzhou District, Beijing, so as to provide the reference for the intervention of milk and dairy intake among primary and middle school students. Methods: The stratified cluster sampling method was used to randomly select the students from the third to sixth grades of primary school, three grades of junior middle school and three grades of senior high school from downtown and township of Tongzhou District as the survey objects. The demographic information, family data, and milk and dairy intake of a week before were collected. Taking the average daily intake of 300 g milk and dairy as the standard (the Chinese Dietary Guidelines 2016), the multivariate logistic regression model was used to analyze the influencing factors for reaching the standard of average daily milk and dairy intake among the students. Results: A total of 804 questionnaires were sent out, and 771 valid questionnaires were received, with a recovery rate of 95.90%. There were 321 primary school students, accounting for 41.63%; 228 junior high school students, accounting for 29.57%; and 222 high school students, accounting for 28.80%. The intake rate of milk and dairy products was 90.92%, and the adverse reaction rate was 10.12%. The daily intake rate was 36.71%. The median daily intake was 214.29 g, and the rate of average daily intake reaching the standard was 28.02%. The multivariate logistic regression results showed that primary school students (OR=1.672, 95%CI: 1.102-2.535), middle school students (OR=2.086, 95%CI: 1.349-3.225), overweight (OR=1.747, 95%CI: 1.131-2.700), obesity (OR=2.469, 95%CI: 1.698-3.591), and parents with bachelor's degree or above (OR=1.760, 95%CI: 1.022-3.029) were the influencing factors for reaching the standard of average daily milk and dairy intake among the students. Conclusions The average daily intake of milk and dairy products of primary and middle school students in Tongzhou District does not reach the recommended standard, and grade, body mass index and parents'education level were the influencing factors.

OBJECTIVE: To introduce the skills clinical pharmacists applied in guiding the use of insulin and its analogs in patients with type 2 diabetes mellitus.METHODS: The related knowledge needed to be mastered by clinical pharmacists were reviewed,and based on our clinical practice,the skills in offering guidance for the use of insulin and its analogs in patients with type 2 diabetes mellitus were proposed.RESULTS & CONCLUSION: Clinical pharmacists can take advantage of their expertise and skills accumulated in clinical practice to provide better pharmaceutical care for patients with type 2 diabetes mellitus.

Objective To identify the effects of parenteral nutrition (PN) on the gene expressions of rat intestinal inflammatory cytokincs and receptors and to explore the role of these changes in PN-related intestinal impairment. Methods Totally 12 male Sprague-Dawley rats were equally divided into the control group and the PN group. A silastic catheter was inserted into the right jugular vein of each rat. No food or water was administered to the PN group except for a continuous 24-hour PN infusion through the silastic catheter in the jugular vein. The control group, while being regularly fed, was administered with an infusion of normal saline through the silastic catheter in thc jugular vein. After 7 days, intestinal tissues were taken for electron microscopy and real-time PCR array to analyze thc microstructure change in rat intestine and thc gene expressions of inflammatory cytokines and their receptors. Results Electron microscopy revealed atrophy of microvillus, engorgement of mitochondria, cell-cell junction breakage, and several apoptotic bodies in the PN group and normal intestinal microstructure in the control group. Compared with the control group, the PN group showed an up-regulation in the gene expressions of interferon γ, interleukin-1 receptor type I , interlcukin-8 receptor type b and a down-regulation in the gene expressions of CC chemokine ligand 17 (CCL17) , CCL19, CCL21, CCL22, CCL9, CXC chemokine receptor 3, CC chemokine receptor 3 ( CCP3 ), CCR7, CCR5, C-reactive protein, and interleukin-10. Conclusions PN influences the gene expressions of rat intestinal inflammatory cytokincs and receptors. The expression of cytokine interferon γ increases and that of interleukin-10 declines, and the expressions of CCL19, CCL21, CXC chemokine receptor 3, CCR3,CCR7, and CCR5 decline. The alterations of these genes may be associated with the impairment of intestinal immune and mechanical functions.

BACKGROUND: An important initial step in developing a tissue engineering artificial salivary gland organoid is to find an ideal scaffold. To find other new biomaterials should to be further studied.OBJECTIVE: To obtain an acellular matrix from tracheae of rabbits and SD rats, and to investigate its biocompatibility as a primary step toward developing a tissue engineering artificial salivary gland organoid.DESIGN, TIME AND SETTING: A randomized controlled animal study, which was performed at the Key Laboratory of Transplantation Engineering and Immunology of Ministry of Health, West China Hospital of Sichuan University from February 2003 to May 2005.MATERIALS: A modified detergent and enzyme link extraction procedure was performed to remove cells from SD rats and rabbits tracheae. The histology, topography of inner-surface and biocompatibility were studied on both acellular tracheae.METHODS: Eighteen SD rats were randomly divided into 2 groups. One group was planted acellular trachea of SD rats. Other group consisted of acellular trachea of rabbits. On the third generations, submandibular gland cells were inoculated on two acellular tracheae and cultured on PGA membrane; while, cells in the control group were inoculated on 12-well culture plate, and cell/scaffold complex was cultured at the same time.MAIN OUTCOME MEASURES: The structure and topography of inner-surface of the acellular tracheae matrixes were observed both by light and scanning electron microscopy. The inflammatory response of the tissue around acellular tracheae implanted under the skin of cheek was evaluated at 1, 4, 12 weeks. The numbers of cells grown on the acellular tracheae and PGA film were counted at 1, 2, 3, 4, 5, 6, 7 days. At 1, 3, 5, 7 days, the mean values of metabolic activity test and the amylase activities of supernatants of the cells/scaffold complexes were examined.RESULTS: The cells were completely removed from both tracheae. No evident inflammatory response was found in tissues around two kinds of acellular tracheae implanted under the skin of cheek. The number of submandibular gland cells (SSG) grown on the two kinds of naturally derived biomaterials was much more than grown on PGA (P<0.05). The mean values of metabolic activity test and the amylase activities of supernatants containing cell/acellular matrixes were much higher than that of cell/PGA (P<0.05).CONCLUSION: The acelhilar tracheae matrixes made by our laboratory can be used as scaffold in the study of tissue engineering artificial salivary gland organoid.

Objective To investigate the prevalence of drug-resistant mutations in reverse transcriptase and protease coding regions of HIV-1 in treatment-na(i)ve patients. MethodsPlasma specimens were collected from 88 patients from Zhejiang, Shanghai, Henan and Anhui. The entire protease gene and the first 1-251 amino acids of the reverse transcriptase gene were amplified by RT-PCR from viral RNA and sequenced. The sequences were analyzed with HIV drug resistance algorithm, and phyligenetic analyses were performed by PHYLIP software. SPSS 13.0 was used for statistical analysis, and Fisher' s exact test was performed to compare the proportions of each subtype between the groups. Results79 gene sequences were obtained, subtyping analyses indicated that 68.4％ (54/79) were subtype B, followed by CRF01 _AE 24.8％ (22/79), CRF07_BC2.5％ (2/79),andCRF08_BC1.3％ (1/79). 7 (7/79,8.9％)presented with primary mutations associated with resistance to antiretroviral drugs, mutations conferring primary resistance to nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors ( NNRTIs ) were detected in 3 ( 3. 8％ ) and 4 ( 5. 1％ ) cases, respectively. Protease inhibitors (Pls)associated primary resistance mutations were not found.Conclusion Antiretroviral drug resistant mutations have been found in treatment-na(i)ve patients with HIV-1 infections, while the prevalence level is low, which indicates that drug resistance test is not necessary for most HIV-1infected treatment-na(i)ve patients.

Objective To evaluate the diagnostic value of spiral CT [CT arterial portography (CTAP) and CT hepatic arteriography(CTHA)] for hepatic carcinoma. Methods The CTAP and CTHA manifestations in 21 patients with hepatocelluar carcinoma were analyzed and compared with those in three-phase enhanced CT . Results The detection rate of three-phase enhanced CT was 72.4% , CTAP and CTHA was 96.1% and 88.2% respectively. The detection rate of combination CTAP and CTHA was 98.7% . They could reveal tumors of 0.5 cm in diameter . Both CTAP and CTHA gave false-positive findings , such as perfusion defects in 22.3% of CTAP and non-pathologic enhancement in 30.2% of CTHA .Conclusion With the use of spiral CT technique , the quantity of contrast material administrated in CTAP and CTHA can be considerably reduced . And the quality of CT images significantly improved . The detection rate of CTAP and CTHA is higher than that of three-phase enhanced CT . Simultaneous use of both procedures may decrease the false-positive rate.

Objective:To describe the surgical technique of direct anterior approach to total hip arthroplasty and to report the early clinical outcomes.Methods: A series of 100 consecutive,unselected patients who had 116 primary total hip arthroplasty surgeries (16 bilateral) done through direct anterior approach from March 11 2015 to June 21 2016 was reviewed.There were 50 male patients and 50 female patients.The average patient age was 51 years,and the average body mass index was 24.69 kg/m2.The preoperative diagnosis included avascular necrosis of femoral head,hip osteoarthritis,osteoarthritis se-condary to acetabular dysplasia,sequelae of hip old infection,ankylosing spondylitis,rheumatoid arthritis and avascular necrosis of femoral head after cannulated screws fixation of femoral neck fracture.There were 7 hips which had surgical history prior to the index hip arthroplasty,including 3 cases with bone graft treatment for avascular necrosis of femoral head through Smith-Peterson approach,2 cases with acetabular shelf procedures for acetabular dysplasia through Smith-Peterson approach,and 2 cases with cannulated screws fixation for femoral neck fracture (internal fixation residual).All were uncemented hips.The stems used in this study included 67 Triloc stems (DePuy company,USA),45 Corail stems (DePuy company,USA),2 Accolade stems (Stryker company,USA),1 Synergy stem (Smith-Nephew company,USA) and 1 Polarstem (Smith-Nephew company,USA).Results: The average follow up period was 8.5 months,the average incision scar length was 10 cm,and the average postoperative Harris score was 93.62.There was 95％ postoperative leg length discrepancy within 3 mm.The average cup inclination angle was 38.7°with 94.8％ in the range of 30° to 50°.The average cup anteversion angle was 14.3° with 94.2％ within the target range of 5° to 25°.The were 15 (12.9％) operative complications,including two femoral perforations (changing stem from Triloc to Corail),three calcar fractures (treated with cerclage wires),four greater trochanter fractures (2 were treated wire tension band,and 2 nondisplaced fractures untreated),one deep infection (debridement and retaining of the prothesis),one superficial infection (debridement),one hematoma and three wound healing complications (debridement).All the complications were successfully treated without any sequelae at the end of the latest follow-up.There was no postoperative dislocation.There was no major nerve and vascular injuries.There were 35 cases (30.2％) reporting symptoms of lateral femoral cutaneous nerve palsy.Conclusion: Direct anterior approach to total hip arthroplasty allows accurate and reproducible cup orientation positioning and leg length restoration and decreases the risk of postoperative dislocation,which is helpful for early rapid postoperative recovery.

BACKGROUND: Seed cells with good proliferation and enough amounts are need in reconstructing artificial salivary gland in vitro. However, adult stem cells are difficult to be isolated from normal submandibular gland.OBJECTIVE: To in vitro isolate submandibular gland stem/progenitor cells for cloning culture using animal models of damaged gland tissue.DESIGN, TIME AND SETTING: Cytological in vitro experiment was performed at the Gu.izhou Provincial Key Laboratory of Cell Tissue Engineering, Zunyi Medical College from March 2006 to January 2007.MATERIALS: A total of 10 male Sprague Dawley rats aged 8 weeks were supplied by the Animal Center, Third Military Medical University of Chinese PLA.METHODS: The model of tissue damaged submandibular gland in 10 rats was made by deligation. One week later, the gland tissue was obtained to harvest submandibular gland stem/progenitor cells by enzyme digestion in vitro. Following 10-14 days of primary culture, small round cells were collected, purified and subcultured for monoclonal culture.MAIN OUTCOME MEASURES: Immunocytochemical staining and immunofluorescence staining results were measured in submandibular gland stem/progenitor cells. Growth curve was drawn to analyze the proliferation of submandibular gland stem/progenitor cells in vitro.RESULTS: Cells expressing laminin showed stem cell characteristics. Positive expression of CD29 suggested high-adherent and high-proliferative stem cell properties. Positive expression of keratin-19 indicated epithelium-derived submandibular gland stem/progenitor cells. Growth curve was near to "S" shape, and in vitro culture and proliferation was active.CONCLUSION: Submandibular gland stem/progenitor cells had the characteristics of tissue stem cells. They might be as a kind of seed cells for tissue engineered artificial salivary gland in further research.

OBJECTIVE:To study the effects of Buyang huanwu decoction on the contents of CD40 and CD40L in the serum of rats with cerebral ischemia. METHODS:Rats were randomized into a sham-operation(normal saline)group,a model(normal saline)group,a positive control [6.75 mg/(kg·d)clopidogrel hydrogen sulfate] group and Buyang huanwu decoction high-dose and low-dose [26 and 6.5 g/(kg·d)] groups,with 20 rats in each group. Suture occlusion of middle cerebral artery was used to establish the rat models of focal cerebral ischemia,which were given drugs ig on the 2nd day after the operation and for 14 consecutive days. Then pathological changes in the cerebral tissues of all groups of rats were observed and the contents of CD40 and CD40L in the serum thereof were detected by euzyme-linked immunosorbent assay. RESULTS:The rats in the model group demonstrated isch-emia-like pathological change in the cerebral tissue on the side of lesion. The ischemia-like cerebral tissue on the side of lesion in the positive control group and Buyang huanwu decoction high-dose group were improved compared to the model group. The patho-logical change in the cerebral tissue on the side of lesion in Buyang huanwu decoction low-dose group was similar to that in the model group. The contents of CD40 and CD40L in the serum of rats in the model group were higher than in the sham-operation group. The content of CD40L in the serum of rats in positive control group and Buyang huanwu decoction high-dose group were lower than the model group. There were statistical differences(P<0.01 or P<0.05). Except as described above,no other statistical-ly significant differences (P>0.05) were noted. CONCLUSIONS:Buyang huanwu decoction can improve brain cell morphology and reduce cerebral ischemic tissue injury in model rat with cerebral ischemia by a mechanism which may be related to decreasing the content of CD40L.