Objective To evaluate the outcome and safety of endoscopic submucosal dissection (ESD) versus endoscopic mucosal resection (EMR) in the management of esophageal mucosal lesion.Methods The clinical data of 70 patients with esophageal mucosal lesion were analyzed.Twenty-five patients were treated by ESD (ESD group) and 45 patients were treated by EMR (EMR group).The enbloc resection rate,tissue healing resection rate,operation time,complication and recurrence rate were compared between two groups.Results The enbloc resection rate,tissue healing resection rate in ESD group were significantly higher than those in EMR group [60.0％(15/25) vs.48.9％(22/45),48.0％(12/25) vs.40.0％ (18/45)] (P ＜0.05).The local recurrence rate in ESD group was lower than that in EMR group [4.0％ (1/25) vs.20.0％ (9/45)] (P ＜ 0.05).The severe complication such as delayed hemorrhage,perforation,stenosis between two groups had no significant difference (P ＞ 0.05).The operation time in ESD group was (64.3 ±27.1) min,and significantly longer than that in EMR group [(27.6 ± 14.1) min] (P ＜0.05).Conclusions Compare with EMR,ESD has better enbloc resection rate,tissue healing resection rate,and lower recurrence rate.It is more safe and effective in the therapy of esophageal mucosal disease.

Objective To realize the automatic delivery of the data in the laboratory and the synchronous transmission of the information on patient,diagnosis and laboratory.Method The system was designed and developed under the Client/server structure,with the application of MSSQLSERVER2000 database management and PowerBuilder8.0 language program.It has many functions,such as data transmission,quality control,comprehensive inquiry and data security management.Result The seamless connection between pre bar code hospital-laboratory information system and HIS makes the work efficiency and work quality enhanced,and makes the information shared and transmitted synchronously.The formal lab requisition results in scientific,normalized and standardized management.

Objective To evaluate measurement of the submucosal thickness with endoscopic ultrasonography (EUS) for activity of Crohn disease (CD).Methods Ten patients with active stage of CD and 10 healthy controls (HC) underwent EUS.Simple endoscopic score for Crohn disease(SES-CD)and submucosal thickness at the most severe lesions were measured and recorded.Submucosal thickness of the same region in CD patients were measured at remissive stage.In order to analyze the relationship between submucosal thickness and the stage of CD, submucosal thickness were compared among patients at active stage of CD, remissive stage of CD and HC.And the cut-off value of submucosal thickness was calculated to diagnose the stage of CD.Results The mean submucosal thicknesses of active stage and remissive stage of CD were 6.48±1.95 mm and 2.47±1.08 mm,respectively (P<0.01).The correlation analysis showed that submucosal thickness had a positive correlation with Crohn disease activity index(CDAI)(r=0.708,P<0.01) and SES-CD(r=0.807,P<0.01).Receiver operating characteristic curve analysis was used for 10 cases of CD patients and the area under the curve was 0.985(P<0.01).The cut-off value of submucosal thickness to diagnose active stage of CD was 3.85 mm, and the sensitivity and specificity reached 100% and 90% respectively.The Youden index was 0.9.Conclusion Measurement of gastrointestinal submucosal thickness by EUS could contribute to evaluate the stage of CD and to guide clinical treatment.

Objective To determine the feasibility and safety of transprostatic utricle seminal vesiculoscopy in the treatment of hemospermia. Methods Totally 11 patients with hemospermia, mean age of (46.6 ± 3.5) years, ranging from 38 to 68 years, for 3 months admitted from September 2012 to August 2015 were enrolled, Their main manifestations were hemospermia. Painful ejaculation was observed in 7 patients, and perineal and testicular pain occured in 4 patients. They all underwent transprostatic utricle seminal vesiculoscopy, and then were followed up for 3 to 6 months. Results Ten patients were operated successfully, but 1 patient failed. The operation revealed that the causes of hemospermia were seminal vesiculitis in 8 cases, seminal vesiculitis accompanied with seminal calculi in 2 cases, and ejaculatory duct cyst in 1 case. Operation time was (29.2 ± 3.2) min ( ranging from 25 to 37 min) , and hospital stay was 2 d ( from 2 to 4 d). Hemospermia disappeared in 10 patients within 1 month of surgery, and hemospermia recurrence was observed in 1 patient within 6 months. The patient was treated with transprostatic utricle Holmium laser incision, then hemospermia was dispeared,Two cases of postoperative epididymitis were cured after one week of antibiotic treatment. Conclusions Seminal vesiculoscopy is a safe and effective to treat hemaospermia.

Objective To evaluate the effect of MRI in reflecting the pathological changes of VX2 carcinoma in rabbits after radiofrequency ablation (RFA) . Methods RFA was performed in the livers of 24 rabbits with planted VX2 carcinoma. The rabbits were divided into 4 groups. After RFA, the rabbits were killed after MR imaging on 0, 1, 2, and 4 weeks, respectively. The correlation between MRI and pathological findings was analyzed. Results In the acute phase, coagulative necrosis of the ablated tumors and inflammatory reaction with hyperemia around were detected at microscopic examination. The ablated tumor showed as hypointensity on T1WI and hyperintensity on T2WI, while rim of high signal intensity on T1WI and low signal intensity on T2WI was found. Gadolinium-enhanced MRI showed a thin high signal rim surrounding the central coagulative necrosis. In the subacute phase, extensive coagulative necrosis and marked infiltration by neutrophils, lymphocytes, macrophages and a peripheral fibrous generation rim were observed microscopically on the ablated tumor. The ablated tumor showed iso-or hyperintensity on T1WI and hypointensity on T2WI, while the periphery of ablated lesions was hypointensity on T1WI and hyperintensity on T2WI. There was prominent rim enhancement along the ablated margin. In the chronic phase, peripheral fibrous rim became obvious, more regular and thicker than at subacute phase as hypointensity on T1WI and T2WI, and unenhancement was observed. Residual or recurrence of tumor was found in 17 rabbits as hypointensity on T1WI and hyperintensity on T2WI, and irregular, thicker rim or nodular enhancing abnormalities. Conclusion MRI can effectively show the histopathological tissue changes of rabbit VX2 carcinoma after ablation and demonstrate the residual or recurrence of tumor.

Purpose/Significance To optimize the patient's treatment process,to shorten the treatment time and moving path in the hospital,to help patients predict the time of each treatment process.Method/Process Based on graph theory and machine learning algo-rithm model,the intelligent treatment path recommendation model is constructed by integrating data information such as hospital spatial layout,diagnosis and treatment department distribution and patient treatment items.Based on the big data of hospital patients,the pre-diction model of patient treatment time is constructed to predict the time spent in registration,waiting for treatment or examination,etc.A real-time recommendation system for intelligent treatment paths is designed and implemented to provide patients with clear guidance and more accurate time-consuming estimation services.Result/Conclusion The intelligent real-time treatment path recommendation system integrates the capability of treatment time prediction and path recommendation,which significantly improves the treatment experi-ence of patients and the service efficiency of hospitals.

Objective To evaluate the safety and efficacy of endoscopic ultrasonography(EUS) guided ethanol ablation in patients with insulinoma. Methods The data of 10 patients with insulinoma trea-ted at the First Affiliated Hospital of Guangxi Medical University from December 2013 to January 2015 were prospectively analyzed. Results The patients were given EUS-guided ethanol ablation with dose of 0. 10 to 2. 00 ml(average 0. 70 ± 0. 62 ml)in pancreatic lesions for 15 times. No complications were observed dur-ing and after the procedure. The blood glucose improved after the procedure[4. 8(3. 9-5. 5)mmol/ L VS 2. 4 (1. 9-2. 5)mmol/ L,P < 0. 05]and the serum insulin level significantly decreased[83. 7(40. 1-143. 5) pmol/ L VS 177. 3(66. 5-200. 6)pmol/ L,P<0. 05]. The average hospital stay was(4. 3±1. 5)days. The patients were followed up for 6-12 months. EUS indicated that the echo of pancreatic lesions changed from high to low. CE-EUS revealed low enhancement and lack of blood supply. Conclusion EUS-guided ethanol ablation may become a promising minimally invasive treatment for insulinoma because of its safety,efficacy and low price. Trail registration Clinical Trial.gov,NCT02121366.

Objective:To analyze the situation of therapeutic drug monitoring ( TDM) for 3 new antiepileptic drugs including leve-tiracetam, lamotrigine and oxcarbazepine in our hospital to provide reference for the individualized drug treatment for the children with epilepsy. Methods:The basic information, dose and TDM data of levetiracetam, lamotrigine and oxcarbazepine of the children with ep-ilepsy during 2015 and 2016 were collected and statistically analyzed in our hospital. Results: Without obvious difference in mean dose, the average plasma concentrations of oxcarbazepine in 3-6-year-old,6-10-year-old and 10-18-year-old children were significantly higher than those in less than 3-year-old children(P<0. 05). The mean dose and the average plasma concentrations of lamotrigine in children at different ages had no statistical significance(P>0. 05). The average plasma concentration of levetiracetam in less than 3-year-old children was significantly higher than that in the other children (P<0. 05). The effective rate of clinical treatment within dif-ferent plasma concentration ranges had statistical significance(P<0. 05). Conclusion: There are inter-individual differences in the plasma concentrations of antiepileptic drugs among the children with epilepsy at different ages. So the plasma concentration of antiepi-leptic drugs should be monitored regularly in order to ensure the safety and effectiveness of medication for children.

Objective:To analyze the situation of therapeutic drug monitoring ( TDM) for 3 new antiepileptic drugs including leve-tiracetam, lamotrigine and oxcarbazepine in our hospital to provide reference for the individualized drug treatment for the children with epilepsy. Methods:The basic information, dose and TDM data of levetiracetam, lamotrigine and oxcarbazepine of the children with ep-ilepsy during 2015 and 2016 were collected and statistically analyzed in our hospital. Results: Without obvious difference in mean dose, the average plasma concentrations of oxcarbazepine in 3-6-year-old,6-10-year-old and 10-18-year-old children were significantly higher than those in less than 3-year-old children(P<0. 05). The mean dose and the average plasma concentrations of lamotrigine in children at different ages had no statistical significance(P>0. 05). The average plasma concentration of levetiracetam in less than 3-year-old children was significantly higher than that in the other children (P<0. 05). The effective rate of clinical treatment within dif-ferent plasma concentration ranges had statistical significance(P<0. 05). Conclusion: There are inter-individual differences in the plasma concentrations of antiepileptic drugs among the children with epilepsy at different ages. So the plasma concentration of antiepi-leptic drugs should be monitored regularly in order to ensure the safety and effectiveness of medication for children.

Objective:To study the biological behavior of nasopharyngeal carcinoma stem cells and to explore the activation of Ras signaling pathway regulated by CD44.Methods:CNE2-SC and 5-8F-SC were nasopharyngeal carcinoma stem cells and obtained by serum-free suspension culture. Cell counting kit-8 (CCK-8) assay, colony formation assay, Transwell migration assay, cell adhesion array were used to investigate the growth, proliferation, migration and adhesion of nasopharyngeal carcinoma stem cells. Western blot test was used to detect the expressions of Ras signaling pathway related proteins and siRNA-mediated interference was used to determine the activation of Ras signaling pathway regulated by CD44.Results:The growth rates of CNE2-SC and 5-8F-SC cells were significantly lower than those of nasopharyngeal carcinoma cells at 24, 48 and 72 hours after inoculation ( P<0.05). After 14 days of implantation, the colony formation rates of CNE2-SC (44.5±1.9)% and 5-8F-SC (47.4±1.8)% were higher than those of CNE2 (34.9±1.5)% and 5-8F (37.2±1.7)%, respectively( P<0.01). The migration cell number of CNE2-SC was (87.6±7.8), 3.97 times higher than that of CNE2 ( P<0.01). The migration cell number of 5-8F-SC was (67.2±5.7), 3.07 times higher than 5-8F ( P<0.01). The adhesion rates of CNE2-SC and CNE2 cells were (42.1±7.6)% and (8.9±2.0)%, respectively at 3 hours after inoculation and were (82.4±5.0)% and (12.1±2.2)% at 6 hours after inoculation, respectively. The adhesion rate of CNE2-SC cells was higher than that of CNE2 cells (all P<0.01). The adhesion rates of 5-8F-SC and 5-8F cells were (53.6±6.1)% and (7.3±1.5)% at 3 hours after inoculation, and (90.7±3.6)% and (11.0±1.2)% at 6 hours after inoculation, respectively. The adhesion rate of 5-8F-SC cells was higher than that of 5-8F cells ( P<0.01). The expression levels of CD44, Ras and N-cadherin were significantly higher, while phosphatase and tensin homolog deleted on chromosome 10 (PTEN), E-cadherin in nasopharyngeal carcinoma stem cells were lower than those of the nasopharyngeal carcinoma cells. Furthermore, the levels of phosphorylated mitogen extracellular kinase1/2 (p-MEK1/2) and phosphorylated extracellular signal-regulated protein kinase1/2 (p-ERK1/2)were significantly increased in nasopharyngeal carcinoma stem cells ( P<0.01). Correlation analysis showed that the protein expression levels of CD44 was highly positively correlated with RAS in nasopharyngeal carcinoma stem cells( r=0.985, P=0.002; r=0.962, P=0.038). Deletion of CD44 in CNE2-SC decreased the expression levels of HER-2, Ras and p-ERK1/2, p-Akt and phosphorylated protein kinase C-δ(p-PKCδ) ( P<0.01). Conclusions:Despite compare to the nasopharyngeal carcinoma cell, nasopharyngeal carcinoma stem cells grows at a relatively slow rate, the capacities of clone formation, migration, adhesion are promoted. This may be related to the CD44-regulated abnormal activation of Ras signaling pathway.