Objective To evaluate the therapeutic effectiveness and safety of endoscopic submucosal dissection(ESD)for early colorectal carcinoma and its precancerous lesions. Methods The clinical pathologi-cal characteristics,en bloc resection rate,curative resection rate,complications and follow-up results of 21 pa-tients with early colorectal carcinoma or precancerous lesions,who were treated by ESD,were retrospectively analyzed. Results Most lesions were located in left colon,which accounted for 80. 9%(17/ 21).The most com-mon macroscopic morphology(TypeⅠ)was protrusion type(61. 9%,13/ 21),while flat type was the least (14. 3%,3/ 21). The mean procedure time was 79(35-120)min. The en blot resection rate was 100. 0%(21/ 21),and curative resection rate was 85. 7%(18/ 21). Postoperative hemorrhage occurred in 1 patient (4. 7%,1/ 21)and postoperative infection occurred in 1(4. 7%,1/ 21)and no perforation was recorded. Tubu-lar adenoma with high-grade intraepithelial neoplasia(LGIEN)was the most occurence(33. 3%,7/ 21),villous adenoma with LGIEN was the least(4. 7%,1/ 21). No local recurrence or metastasis was observed during follow-up of 3-20 months. Conclusion ESD is safe,effective,minimal invasive for early colorectal carcinoma and its precancerous lesions,with optimistic prospect of clinical application.

Relaxation and contraction factors influencing penile erection are produced and released by the central and peripheral nerves as well as intracavernosal sinus gap and vascular endothelial cells. Aging, diabetes, cardiovascular disease and spinal cord injury can influence these factors. Further researches of hyperbaric oxygenation (HBO) on the erectile dysfunction (ED) can provide some theoretical evidences for the clinical treatment of ED.
Erectile Dysfunction ; therapy ; Humans ; Hyperbaric Oxygenation ; Male ; Penis ; physiopathology

Objective To investigate the correlation between phosphatidylinositol-3kinase(PI3′K)/serine/threonine kinase(Akt)/Forkhead like 1(FKHRL1)signaling pathway and chemoresistance in human gastric cancer cell line SGC7901.Methods From Jan.2004 to sep.2005,cells were exposed to doxorubicin with or without Wortmannin(a special inhibitor of PI3′K/Akt pathway)in Department of Gastroenterology the people's Hospital of when University.Cytotoxicity was assessed by determining cell survival with MTT.By Western blot analysis,the phosphorylation levels of FKHRL1 was evaluated in SGC-7901 cell.Results It was found that doxorubicin caused reduction of cell viability of SGC-7901 and induced phosphorylation of FKHRL1 in a time-dependent manner.Wortmannin enhanced the cell inhibitory efficiency of doxorubicin.Phosphorylation levels of FKHRL1 was significantly induced by Doxorubin in a time-dependent manner and was blocked by wortmannin.Conclusion Doxorubin may activate PI3′K/Akt signaling pathway and then induce phosphorylation of FKHRL1 in a time-dependent manner,which affects the chemoresistance of gastric cancer cell .However,Wortmannin enhances the chemotherapy sensitivity by suppressing this pathway.

Objective To investigate multi-slice spiral computer tomography(MSCT)images of gastrointestinal lymphoma.Methods MSCT data of 23 cases with primary gastrointestinal lymphoma verified by pathology were retrospectively analyzed. Results Non-Hodgkin'S lymphoma was confirmed in all of the 23 cases.For all of the cases a B-cell origin was in 22 cases and a T-cell origin in 1 case localized in transverse colon.CT images of gastric lymphoma included three kinds:diffuse thickening(n=13,81.2%),segmental thickening(n=2,12.5%),and mass(n=1,6.3%).Median thickness of gastric wall was 3.3cm (0.6～6.8 cm).CT scan of intestinal lymphoma showed irregular thickening of intestinal wall,and mass was visualized in I case of ileum lymphoma and I case of ileocecal lymphoma.Median thickness of intestinal wall was 2.8cm(0～7.0 cm).Of all the cases lesions appeared a common density by conventional CT scan,and low or moderate intensification by contrast-enhanced CT. Conclusions With its character-istic information MSCT remains the method of choice for the diagnosis of gastrointestinal lymphoma.

Background and purpose:Irinotecan plus fuorouracil/Leucovorin has become the standard regimen as the first-line in treating advanced colorectal cancer.We investigated the clinical response and side-effects of the first-line treatment with Irinotecan plus fuorouracil/ leucovorin(FOLFIRI) for advanced colorectal cancer.Methods:From may 2001 to march 2005,37 patients with advanced colorectal cancer were treat with irinotecan 180mg/m~(2) i.v.on day 2,and fuorouracil 400 mg/m~(2),bolus on day 1,2 and 1200 mg/m~(2),civ.44hour;leucovorin 200 mg/m~(2) i.v.on day 1,2,two weeks per cycle.Results:The response rate was 41.7%.Incidence of III/IV Grade myelosuppression was 35.1%/8.1%,and 4 patients suffered from febrile neutropenia.Incidence of III Grade delayed diarrhea was 8.1%.Conclusions:The first-line chemotherapy with a combination of irinotecan and fuorouracil/ leucovorin is effictive and well tolerated by patients with advanced colorectal cancer.

Objective To investigate the clinical efficacy of atorvastafin intensive treatment before percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) and its affects on serum interleukin (IL)-6 and IL-8.Methods Sixty ACS patients were divided into observation group and control group according to different treatment with 30 cases each.Control group received conventional therapy,while observation group was added with atorvastafin intensive treatment before PCI on the basis of conventional therapy.The serum IL-6 and IL-8 levels were detected before PCI at 24 h,3 d and 6 months after surgery,and the occurrence of cardiac adverse events were observed within 30 days after surgery.Results The serum IL-6 and IL-8 levels between observation group and control group had no statistical differences before surgery (P＞ 0.05).The serum IL-6 and IL-8 levels of observation group were significantly lower than those of control group at 24 h,3 d and 6 months after surgery,respeclively [ IL-6:( 11.56 ± 4.95 )ng/L vs.(20.24 ± 8.67) ng/L,(8.51 ± 3.65) ng/L vs.( 18.83 ± 8.07 ) ng/L,(5.60 ± 2.40) ng/L vs.( 10.02 ±4.29) ng/L;IL-8:(50.34 ± 21.57) ng/L vs.(74.50 ± 31.93) ng/L,(30.80 ± 13.20) ng/L vs.(53.30 ± 22.84)ng/L,( 26.00 ± 11.14 ) ng/L vs.( 40.61 ± 17.40 ) ng/L ] ( P ＜ 0.05 ).There was no cardiac adverse event in observation group within 30 days after surgery.There was 1 case who occurred angina pectoris at 16 days after PCI in control group,and the syrnptoms disappeared after emergency treatment.Conclusions The atorvastatin intensive treatment before PCI can effectively decrease the levels of IL-6 and IL-8 in ACS patients and has the effects of anti-inflammatory and protecting myocardium from damage.

BACKGROUND: The morbility of rheumatoid arthritis is closely associated with cell apoptosis process. Hyperplasia of synoviocyte lies in the relatively insufficiency of synoviocyte apoptosis. Therefore, induction of synoviocyte apoptosis has clinical significance in the treatment of rheumatoid arthritis. Arteannuin and its derivatives can induce the apoptosis of various cells. OBJECTIVE: To observe the effect of artesunate on the expression of Fas/FasL and Bcl-2/Bax, which are correlated with apoptosis in synoviocyte of adjuvant arthritis. DESIGN: Randomized and controlled observation. SETTING: First College of Clinical Medical Science, Three Gorges UniversityMATERIALS: The experiment was conducted in the laboratories of Immunology and Morphology, Three Gorges University from September 2005 to November 2005. Fifty 8-week-old male Wistar rats of clean grade and (150±21) g were provided by the Animal Experimental Center of Tongji Medical College, Huazhong University of Science and Technology; Complete Freud adjuvant by SIGMA, U.S., and artesunate solution by Guilin Pharmaceutical Corporation.rabbit anti-mouse Fas (SC-716), rabbit anti-mouse FasL and Technology (No. SCXK 2004-2007).Complete Freud adjuvant (SIGMA, U.S. No. 093K8932); artesunate solution (Guilin Pharmaceutical Cor); rabbit anti-mouse Fas (SC-716), rabbit anti-mouse FasL multi-antibody (SC-834), goat anti-mouse IgG-HRP multimer, rabbit anti-mouse P53 (M3566) multi-antibody, Bcl-2 (sc-7382) multi-antibody, rabbit anti-mouse Bax (sc-7480) multi-antibody, ABC compound reagent kit and DAB coloring reagent all acquired from Santa Cruz biotechnology (Santa Cruz, USA); methotrexate (MTX) purchased from Shanghai Hualian Pharmaceutical Co., Ltd.; microscope and image analysis system obtained from Leica (Leica,Germany); microtome (Leica, Germany).METHODS: Fifty rats were randomly divided into six groups: normal group (n =8), model group (n =8), high dose artesunate group (n =8), low dose artesunate group (n =8), artesunate plus methotrexate (MTX) group (n =8), and MTX group (n =8). ①Model construction was referred to literature: Except the normal group with 0.1 mL normal saline, all rats were injected with 0.1 mL complete Freund's adjuvant into the right voix pedis to establish the models of adjuvant arthritis. Since the 13th day after modeling, high and low dose artesunate groups were intraperitoneally injected with 40 and 20 mg/kg artesunate, respectively everyday; artesunate plus MTX group was intraperitoneally injected with 20 mg/kg artesunate everyday and 0.4 mg/kg MTX every three days; MTX group with 0.4 mg/kg MTX solution every three days;model group with 1 mL normal group everyday. ②The arthrosis index (Al) of each group was evaluated before and 13 days after administration; the expressions of Fas/FasL, Bcl-2, and Bax in synovial membrane tissue were examined by immunohistochemistry.MAIN OUTCOME MEASURES : Al and the expression of Fas/FasL, Bcl-2, and Bax in synovial membrane tissue of each group.RESULTS: Fifty rats were involved in the result analysis. ①Thirteen days after administration, the Al of each experiment group (including model control) was remarkably lower than that before treating (P ＜ 0.01). The Al of eachexperiment group was significantly lower than that in model control group (P ＜ 0.01). ②The expression of Fas/FasL in high and low dose artesunate groups and artesunate plus MTX group was up-regulated significantly compared with that in model group (P ＜ 0.01). There was no statistically significant difference in the expression between MTX group and model group (P ＞ 0.05); the expression of Bcl-2 was significantly down-regulated but Bax up-regulated in two artesunate groups,artesunate plus MTX group and MTX group compared with that in model group (P ＜ 0.05).CONCLUSION: The findings suggest that artesunate could alleviate adjuvant arthritis, up-regulate the expression of Fas/FasL and Bax, but down-regulate that of Bcl-2, in which the induction of synoviocyte apoptosis may be one of the mechanisms.

Objective To discuss the technical factors of extrapleural locating in CT-guided percutaneous pulmonary biopsy. Methods 137 cases undervent CT-guided percutaneous pulmonary biopsy were retrospectively analyzed. The technical methods of operation,points and points for attention were analyzed. Results In this group the success rate of data manipulation was 98.5%. No serious complications of the operation were occured. Scan completed within 40-story biopsy rate was 71.5%. The needle into the target rate for the first time was 93.4%. Conclusion CT-guided biopsy could increase the detection rate of difficult lesions and patient satisfaction rate paying attention on thinking and practice in the preoperative preparation and intraoperative specific operations.

Objective:Total 621 cases of medical disputes occurred during 2000 to 2013 were analyzed retro-spectively, to investigate the dispute factors and analysis of improvement, to promote doctor-patient relationship. Methods:621cases of medical disputes from 2000 to 2013, on a case by case attributes are classified, analyzed two year interval comparison, find the dispute factors in evolution.Results:Through the analysis of 621 cases of disputes over property, complications of the disease cause dispute case first, economic reasons, the second medical defect.Conclusions:Analysis of the two year interval comparison shows:how to strengthen the hospital scientific management, innovative service mode, the medical system implemented is the important link of reducing medical disputes.

Objective To explore the effect of coronary artery bypass grafting(CABG) on left atrial (LA) function by strain rate imaging(SRI). Methods Twenty-three patients with coronary heart disease who underwent coronary artery bypass grafting were involved. SRI was performed on those patients to evaluate LA function quantitatively at baseline (before CABG),and at 1 week, 1 month and 3 months after CABG. Peak strain rate(SR) was measured at each segment (septal, lateral, posterior, anterior, and inferior walls) and mean peak systolic SR (SRs),peak early diastolic SR (SRe) and peak atrial systolic SR (SRa) were calculated by averaging data in each segment. Results Compared with the baseline,LV pre-systolic volume(LAVp), maximal volume (LAVmax), minimal volume (LAVmin), LV active emptying fraction (LAAEF) and passive empting fraction(LAPEF) had on significant differences at 1 week (P >0.05). LAVp,LAVmin,LAVmax and LAAEF decreased gradually after CABG, LAPEF increased gradually after CABG (P <0.05). Compared with the baseline, the peaks of SR curve showed no significant differences at 1 week (P >0.05). Nevertheless,the peaks of SR were increased at systole and early diastole,decreased at atrial contraction at 1 month (P <0.05). Those changes were turned more significantly at 3 months (P 0.01). Left ventricular ejection fraction (LVEF) both increased at 1 month and 3 months,and its changing rate correlated inversely with the changing rate of SRa respectively (r = -0.751, -0.783,all P<0.01).Conclusions LA function is affected by CABG, presented as reservoir and pump functions decreased and conduit function increased. SRI can evaluate the atrial function quantitatively and monitor the changing of LA function dynamically after CABG.