Objective To evaluate the diagnostic superiority of endoscopic ultrasonography (EUS) in primary gastric lymphoma (PGL) and its value in follow-up.Methods From January 2012 to June 2015,38 patients with suspected PGL under regular gastroendoscopy,biopsy and surgery operation received EUS combined with targeted deep biopsy.T test and chi-square test were performed for statistical analysis.Results Among 50 patients suspected for PGL under regular gastroendoscopy,38 patients were confirmed pathologically.The sensitivity of EUS examination with targeted deep biopsy in PGL was 86.8％ (33/38),the specificity was 83.3％ (10/12) and accuracy was 86.0％ (43/50).The accuracy of EUS examination with deep biopsy was higher than that of regular gastroscopy,and the difference was statistically significant (86.0％ (43/50) vs 57.9％ (22/38),x2 =19.4,P＜0.05).The main endosonographic characteristics of PGL were partial or diffuse thickening of stomach wall presented with,even or uneven hypoechoic lesions and extramural enlarged lymph nodes.Compared with pathological stage after surgery,the accuracy of T and N stage of EUS was 8/8 and 7/8.The times to achieve complete remission of Helicobacter pylori (H.pylori) eradication group and H.pylori eradication group were (3.3±0.8) months and (4.6± 0.9) months,respectively,and the difference between the two groups was statistically significant (t =4.3,P＜0.05).Conclusions The detection rate of EUS combined with targeted deep biopsy is high,which could clearly indicate the depth and extent of lesion invasion and guide clinical stage and selection of therapy.EUS could effectively evaluate efficacy of PGL treatment.

Objective To conduct a hiomechanical comparison of the four common internal fixation methods for the anterior eruciate ligament(ACL)avulsion fractures of displaced tibial eminence.Methods Sixteen fresh cadaver knee joints were used and randomized into four equal groups of four fixation methods:antegrade wiring group, retrograde wiring group,suturation group,and intramedullary screw group.The knee joint specimens were fixed at flexion of 30?and subject to continuous stretch stresses of 30 N,60 N and 90 N respectively on a material testing machine(MTS 858 Bionix test system,USA)which conducted a simulated Lachman test.The specimens were scanned at different angles by a three dimensional laser scanner.Data were recorded and processed by image software to es- tablish three-dimensional structure models of femur,tibia and knee joint.The test results were analyzed statistically on a computer.Results There were no obvious differences between each fixation group in the length change of ACL when the stresses were 30 N and 60 N(P＞0.05).Under 90 N stress,however,the mean length change between the femoral and tibial attachments of ACL was the smallest(4.8?1.7)mm(2.5 to 6.2 mm)in the suturation group(P＜0.05). There were no distinct differences between the intramedullary screw group and the retrograde wiring group in the changes of A CL shift(P=0.214).The average front shift in the retrograde wiring group was(6.2?1.2)mm(4.8 to 8.2 mm) and significantly smaller than that in the antegrade wiring group(P＜0.05).The antegrade wiring group made the largest average front shift under different stresses and its average front shift was(7.2?1.3)mm(5.6 to 8.7 mm). Conclusions The knee joint stability provided by the suturation fixation is distinctly better than that by the other three fixation methods.The antegrade wire fixation provides the poorest knee joint stability.There is hardly any difference between intramedullary screw fixation and retrograde wiring fixation.

Sugarcane molasses containing large amounts of sucrose is an economical substrate for succinic acid production. However, Escherichia coli AFP111 cannot metabolize sucrose although it is a promising candidate for succinic acid production. To achieve sucrose utilizing ability, we cloned and expressed cscBKA genes encoding sucrose permease, fructokinase and invertase of non-PTS sucrose-utilization system from E. coli W in E. coli AFP111 to generate a recombinant strain AFP111/pMD19T-cscBKA. After 72 h of anaerobic fermentation of the recombinant in serum bottles, 20 g/L sucrose was consumed and 12 g/L succinic acid was produced. During dual-phase fermentation comprised of initial aerobic growth phase followed by anaerobic fermentation phase, the concentration of succinic acid from sucrose and sugarcane molasses was 34 g/L and 30 g/L, respectively, at 30 h of anaerobic phase in a 3 L fermentor. The results show that the introduction of non-PTS sucrose-utilization system has sucrose-metabolizing capability for cell growth and succinic acid production, and can use cheap sugarcane molasses to produce succinic acid.
Bioreactors ; Escherichia coli ; genetics ; metabolism ; Escherichia coli Proteins ; genetics ; Fermentation ; Membrane Transport Proteins ; genetics ; Metabolic Engineering ; Molasses ; Saccharum ; chemistry ; Succinic Acid ; chemistry ; Sucrose ; chemistry

Adult ; Electrocoagulation ; methods ; Female ; Humans ; Injections ; Intervertebral Disc Displacement ; therapy ; Lumbar Vertebrae ; Male ; Middle Aged ; Ozone ; administration & dosage ; Radio Waves ; therapeutic use

OBJECTIVETo explore the clinical effects of Dynesys system for the treatment of multiple segment lumbar degenerative disease.

METHODSA total of 28 patients with lumbar degenerative disc disease treated with Dynesys system from December 2008 to May 2011 were retrospectively reviewed. There were 16 males and 12 females, aged from 27 to 75 years old with an average of 49.1 years. Thirteen patients with multiple segmental lumbar intervertebral disc protrusion, including L3-L5 in 7 cases, L2-L4 in 1 case and L4-S1 in 5 cases. Fifteen patients with multiple segmental lumbar spinal stenosis, including L3-L5 in 10 cases, L4-L5 in 4 cases and L2-S1 in 1 case. The symptoms of lumbago and (or) intermittent claudication in all patients were treated with conservative treatments for more than 6 months and these methods did not work. Visual analogue scale (VAS) was used to analyze the lumbar and leg pain, imaging data were used to measure the intervertebral space height and intervertebral motion of fixed segment and upper adjacent segment, Oswestry Disability Index (ODI) was used to evaluate the clinical effect.

RESULTSAll operations were successful and the patients were followed up from 38 to 65 months with an average 50.6 months. At final follow-up, ODI and VAS of the low back pain and leg pain were (25.10±6.52)%, (1.25±0.70) points and (1.29±0.89) points, respectively and were decreased compared with preoperative (P<0.05). Postoperative intervertebral space heights were increased and intervertebral motions were decreased in fixed segment compared with preoperative (P<0.05). There were no significant differences in intervertebral space heights and intervertebral motions of upper adjacent segment between preoperative and postoperative (P>0.05).

CONCLUSIONDynesys system may obtain long-term clinical curative effect in treating multiple lumbar degenerative disease. It can partially preserve the intervertebral motions of the fixed segments, have little effect on adjacent segments. The long-term clinical effect of Dynesys still need longer time follow-up observation.

Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Degeneration ; pathology ; surgery ; Joint Instability ; Lumbar Vertebrae ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Visual Analog Scale

OBJECTIVETo develop a new technique for assessing the risk of birth defects, which are a major cause of infant mortality and disability in many parts of the world.

METHODSThe region of interest in this study was Heshun County, the county in China with the highest rate of neural tube defects (NTDs). A hybrid particle swarm optimization/ant colony optimization (PSO/ACO) algorithm was used to quantify the probability of NTDs occurring at villages with no births. The hybrid PSO/ACO algorithm is a form of artificial intelligence adapted for hierarchical classification. It is a powerful technique for modeling complex problems involving impacts of causes.

RESULTSThe algorithm was easy to apply, with the accuracy of the results being 69.5%±7.02% at the 95% confidence level.

CONCLUSIONThe proposed method is simple to apply, has acceptable fault tolerance, and greatly enhances the accuracy of calculations.

Algorithms ; Artificial Intelligence ; China ; epidemiology ; Environmental Exposure ; adverse effects ; Humans ; Infant, Newborn ; Models, Biological ; Neural Tube Defects ; epidemiology ; Risk Factors

Objective To investigate the effectiveness and safety of bilateral lung transplantation with simultaneous lung volume reduction surgery in the treatment on end-stage lung disease and analysis its prognosis.Methods Clinical data of 79 patients with end-stage 1ung diseases receiving BLTx in our hospital were retrospectively analyzed between Sept.2002 to Dec.2012.Bilateral lung transplantations were performed on 48 male and 31 female patients, with a mean age of(57.0 ± 6.3) years (ranging from 15 to 75 years).Amongst them 56 patients received LTx under circulation support,including 1 cases of cardiopulmonary bypass(CPB) support and 55 cases of extracorporeal membrane oxygenation(ECMO) support.34 patients accepted lung volume reduction surgery, other 45 patients receive standard BLTx.The Patients were divided into lung volume reduction group(group Ⅰ)and control group(group Ⅱ).Differences in various clinical parameters such as Pulmonary function, postoperative complications, and prognosis between the two groups were compared.Results The 1、2、3 and 5-year survival rate after LTx was 80.5％ 、71.4％ 、58.2％ and 43.5％.The mean survival time post-transplant in size reduction group and control group were(38.54 ±4.72) months and(42.19 ±6.64) months repectively.The main causes of mortality included primary graft dysfunction(PGD) ,acute rejection(AR) , multiple organ failure(MOF) , bronchiolitis obliterans(BOS) and sepsis.No tendency of increase in mechanical ventilation, chest tube drainage time, volume of chest drainage were observed.Compared clinical parameters between the two groups, none had significant differences(P ＞0.05).Lung function test was performed on 63 cases after transplantation.There was no significant difference in FEV1 improvement after lung transplantation between the two groups[(74.23 ±4.86)％, (72.0 ±3.64)％, P ＞0.05].Conclusion This study demonstrates that BLTx with simultaneous lung volume reduction surgery is safe and effective, which have the same outcome and prognosis compare with standardbilateral lung transplantation.

Objective To discussion the effect of endoscopic single nostril transsphenoidal pituitary tumor resection on improving clini-cal symptoms and related quality of life of patients. Methods Selected 114 cases of patients with pituitary tumors in our hospital from August 2013 to August 2015, and randomly divided them into the nasal endoscopic group and the microscopic group according to the random number table,with 57 patients in each group. Patients of the 2 groups were treated with nasal endoscopic and microscopic single nostril transsphenoi-dal pituitary tumor resection respectively. The operation situation,hormone decline,incidence of complications after surgery and SNOT-20 and VAS score of the two groups were compared. Results Operative time of nasal endoscopic group was significantly higher than that in the mi-croscopic group,whlie the blood loss,length of hospital stay in endoscopic group was significantly lower than the microscopic group,and the difference was statistically significant (P<0. 05). The total resection rate of pituitary tumor of the two groups were of no statistically signifi-cance (P>0. 05). One week after operation,cerebrospinal fluid cell count,cerebrospinal fluid protein,adrenocorticotropic hormone,serum chloride,sodium, growth hormone,and prolactin levels of the nasal endoscopic group were lower than the microscopic group (P<0. 05). The complication rate was 14. 9% in the nasal endoscopic group,which was obviously lower than 59. 6% in the microscopic group (P<0. 05). One week after operation,the SNOT-20 scores and VAS scores were increased in both of the two groups,but the microscopic group increased more significantly (P<0. 05). Conclusion Endoscopic single nostril transsphenoidal pituitary tumor resection surgery cost longer operation time,but it lead to less trauma and less postoperative complications,which may delay the decline of patients’ quality of life and promote the improvement of prognosis.

Objective To explore the clinical features, treatment and prognosis of mucinous tubular and spindle cell carcinoma of the kidney. Methods Patient 1, a 42-year-old woman presented with space-occupying lesion of the lower pole of the left kidney with no symptoms in physical examination for 1 week. CT revealed a low-enhanced tumor located in the lower pole of the left kidney in cT1b N0M0. Radical left nephrectomy was performed. Patient 2, a 76-year-old woman presented with space-occupying lesion of the middle of the left kidney with no symptoms in physical examination for 10 d. CT revealed a low-enhanced tumor located in the middle of the left kidney in cT1b N0 M0. Laparoscopic radical left nephrectomy was performed. The patient received adjuvant treatment with IL-2 and interferon-α 3 months after nephrectomy. Patient 3, a 50-year-old woman presented with lumbago for 3 months. CT revealed a low-enhanced tumor located in the right kidney in cT2 N0 M0. Radical right nephrectomy was performed. The patient received adjuvant treatment with IL-2 and interferon-α 3months after nephrectomy. Patient 4, a 60-year-old woman presented with lumbago and hematuria for 15 d. CT revealed a low-enhanced tumor located in the lower pole of the left kidney in cT1a N0M0.Radical left nephrectomy was performed. Results Histological examination of the tumors showed that they consisted of spindle cells arranged in tubular and trabecular patterns embedded in a myxoid stroma. Pathologic diagnosis of all 4 patients were MTSCCa. There was no evidence of recurrence in all patients for 9- 46 months. Conclusions MTSCCa is a rare low-grade renal cell carcinoma.There is a female predominance. Early surgical excision is the best treatment and the prognosis is relatively good.

Objective To explore the changes of nitric oxide (NO) and superoxide dismutase(SOD) in the serum and intestine mucosal and the treatment of ulcerative colitis(UC) with Tanshinone.Methods Seventy-nine patients with UC were randomly divided into the treatment group(group A,n=40) and the routine treatment group(group B,n=39).Patients in the group A were given Tanshionon and routine treatment.Patients in group B were given routine treatment.The levels of NO and SOD were measured in all patients before and after the treatment.The clinical symptom,enteroscopy,and hospital day were compared in the patients of the two groups.Twenty normal healthy controls(group C) were involved in the study.Results The NO level in the serum and intestine mucosal was significantly increased and the SOD level was significantly decreased in the patients with UC compared with those of the controls(all P