High intensity focused ultrasound(HIFU) is a technique that ultrasound energy is focused on tumor target to function the treatment through the biological effects including heating effect, cavitation effect and mechanical effect of body to caused cell coagulation necrosis in vivo. Ultrasound contrast agent is one of the most important applicational agent for the treatment of hepatocellular carcinoma(HCC). We discussed in this paper the application of ultrasound contrast agent in the diagnose and focusing of target before the treatment and the assesement of treatment of HCC. Considering the enhancement of cavitation effect, better acoustic environment that enhance biological efficacy of HIFU during the treatment of HCC, ultrasound contrast agent is drawing more attention as an HIFU enhancement agent.

Objective To analyze the clinical features and causes of benign paroxysmal positional vertigo(BPPV).Methods The clinical data of 521 patients with BPPV were collected.The percentage of patients with BPPV in all the outpatients with dizziness and vertigo,the clinical characteristics of BPPV,and the prevalence of comorbidity with migraine were analyzed.Results BPPV accounted for 35.7% of patients with vertigo and 12.1% of patients with dizziness.Among the 521 patients with BPPV,158(30.3%)were male and 363(69.7%)were female,with an average age of(57.5?12.8)years old(20 to 93 years old).Right semicircular canals were involved in 323 cases(62.0%),and left semicircular canals in 187 cases(35.9%).The latency period of nystagmus of vertical canals was(3.22?2.37)s,and time of persistence was(8.31?7.98)s.The latency period of nystagmus of horizontal canals was(2.33?1.50)s,and the time of persistence was(14.77?11.40)s.There were significant differences in the latency period of nystagmus and time of persistence between the vertical and horizontal canals(P=0.001 and P=0.000).Fifteen patients(2.9%)had a history of head trauma and 39(7.5%)were complicated with migraine.Conclusion BPPV is prevalent in patients with dizziness and vertigo,and misdiagnosis and missed diagnosis should be avoided.

Objective To evaluate the efficacy and safety of endoscopic therapy in the treatment of symptomatic pancreatic divisum (PD).Methods Data of 8 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) with the diagnosis of pancreas divisum at our institution from June 2006 to June 2013 was retrospectively analyzed.Results The patients were identified as pancreatic divisum with 28 ERCP procedures.All patients received stent placement,7 underwent minor papilla sphincterotomy,6 pancreatic duct stricture dilatation,and 1 stone extraction.Post-endoscopic retrograde cholangiopancreatography pancreatitis occurred in 1 patient,and no other complications occurred.After a follow-up of 2-47 months,1 patient died of pancreatic carcinoma,3 patients removed the stents,3 patients were followed up regularly,and 1 was unavailable for the interview.The episode of chronic pancreatitis and the extent of abdominal pain decreased after the operations.Conclusion Endoscopic therapy is effective and safe for the pancreatic divisum patients.It can reduce the episode of chronic pancreatitis and relieve the chronic abdominal pain in PD patients with low incidence of complication.

Objective We aimed to explore the experience of posttraumatic growth in patients with cervical cancer who had a hysterectomy at the childbearing age.Methods The phenomenological methodology was used in the study.An in-depth interview was conducted among 12 patients chosen by purposive sampling method.Results Through careful analysis and collation,three themes were identified:smashing the original assumption,searching the meaning of existence and rebuilding the new cognitive schemata.The experience of patients' was conformed to the model which was put forward by Tedeschi,and the theme changes in personal relationships,personal strength,altruism born from sufferings and new philosophy of life were conformed to theoretical connotation of PTG.Conclusions Clinical medical staff should update psychological nursing concept timely and taking advantages of PTG to help patients pass through their difficult period.

OBJECTIVETo explore a selected-media of Bifidobacterium from oral cavity, to detect the distribution of Bifidobacterium in different sites of children and primarily investigate the relationship between oral Bifidobacterium and early childhood caries.

METHODS70 children aged from 3 to 5-year-old were selected, 30 children were caries-free and 40 were severe early childhood caries (S-ECC). Saliva was collected and plaque samples from the 30 healthy subjects were pooled. For S-ECC group, plaques were collected separately from four different sites as follows: Saliva, surfaces of intact enamel, surfaces of white spot-lesions, and deep dentin-lesions. Samples would be grown in the selected-media, and the whole DNA of bacteria was extracted. Polymerase chain reaction was performed with specific primers and the results were analyzed by the electrophoresis.

RESULTSBifidobacterium were detected 0 in the caries-free children, while 47.5% in the S-ECC group. There was significant difference between two groups (P < 0.05) and there was no difference between different sites of teeth in S-ECC group (P > 0.05). 27.5% Bifidobacterium were detected in saliva, 27.5% on surfaces of intact enamel, 20.0% on surfaces of white spot-lesions and 22.5% in deep dentin-lesions. 10% Bifidobacterium dentium were detected in saliva, 7.5% on surfaces of intact enamel, 7.5% on surfaces of white spot-lesions and 10.0% in deep dentin-lesions.

CONCLUSIONOne type of modified selected media of Bifidobacterium in oral cavity was explored. Bifidobacterium may be related to the occurrence of the S-ECC and has nothing to do with different sites of teeth in children.

Bacteria ; Bifidobacterium ; Child ; Child, Preschool ; Dental Caries ; Dental Enamel ; Dental Plaque ; Dentin ; Humans ; Polymerase Chain Reaction ; Saliva ; Tooth

Cell Transformation, Neoplastic ; drug effects ; genetics ; Dimethyl Sulfoxide ; pharmacology ; Electroporation ; methods ; HL-60 Cells ; Humans ; Membrane Proteins ; genetics ; Neoplasm Proteins ; genetics ; RNA Interference ; RNA, Small Interfering ; genetics ; Stromal Interaction Molecule 1 ; Transfection

ObjectiveTo evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for precancerous lesions and early cancer at gastroesophageal junction (GEJ) by comparing endoscopic mucosal resection (EMR) with ESD.MethodsData of patients with GEJ precancerous lesions or early cancer,who received EMR ( n =51 ) or ESD ( n =28) were reviewed to compared the en bloc resection rate,R0 resection rate,operation time,complication and recurrence rate between 2 methods.ResultsEn blcc resection and R0 resection rates of ESD group (92.9％,78.6％ respectively) were significantly higher than those of EMR group (45.1％,43.1％ respectively).Local recurrence rate in ESD group (3.6％,1/28) was significantly lower than that of EMR group ( 19.6％ ).Complications including perforation,delayed hemorrhage,stricture were not significantly different between EMR and ESD groups.Mean operation time of ESD group (64.3 ±27.1 min) was significantly longer than that of EMR group (27.6 ± 14.1 min)(P ＜0.05).ConclusionESD,with a higher cure rate and en bloc rate and a lower local recurrence rate,is superior to EMR for precancerous lesions and early cancer at GEJ.

Objective To investigate the therapeutic efficacy and safety of endoscopic resection of giant gastric stromal tumors without explicit evidence of metastases.Methods A total of 12 giant gastric stromal tumors with no evidence of metastases diagnosed by endoscopic ultrasound (EUS) and computed tomography (CT) scan were managed by endoscopic resection.Operation time,blood loss and the incidence rate of perforation were recorded respectively.The diagnoses of tissue specimens were made by pathological examination and immunohistochemistry.In order to assess local recurrence and distant metastases,endoscopy and endoscopic ultrasound follow-up examinations were performed routinely at 2,6 and 12 months,and the whole abdominal CT scan was also performed at 12 months after operation.Results Endoscopic resections were successfully performed in 10 of 12 cases (83.3％),among which,6 underwent endoscopic submucosal excavation (ESE) without unexpected perforation and 4 endoscopic full-thickness resection (EFR)with intentional perforation.The rate of intentional perforation was 33.3％ (4/12),and all the perforations could be sealed by endoscopic methods.The blood losses were all more than 100 ml,which could be controlled by argon plasma coagulation,electrocoagulation or hemostatic clips.In the 10 encapsulated tumors,8 could be smoothly removed from esophagus,whose long diameter of the minimum cross section was less than 3.5 cm,however,2 tumors whose diameters were larger than 3.5 cm were taken out after segmentation.In the 10 tissue samples,9 were confirmed as low risk GIST,1 larger than 5 cm was pathologically confirmed as high risk GIST.During 1-year follow-up,no local recurrence or peritoneal metastasis was found.2 tumors,larger than 5.0 cm,could not be removed by endoscopic methods due to uncontrolled bleeding.The rate of uncontrolled bleeding was 16.7％ (2/12).The patients were transferred to surgery,and pathologically confirmed as having high risk GIST.Conclusion For low-risk giant gastric stromal tumors whose diameters were less than 5cm without evidence of metastases,endoscopic resection is considered as a safe and effective procedure.Tumors with long diameter of the minimum cross section less than 3.5 cm are more suitable for endoscopic resection,which can be smoothly taken out through cardia.However,for high-risk GIST larger than 5.0 cm,the rate of uncontrolled bleeding is high,so endoscopic resection should be adopted with discretion.

Objective To explore the effect of cigarette smoke exposure on testis structure and nitric oxide (NO) level in testis of rats.Methods A total of 160 adult male SD rats were divided into control group and low,medium,high dose groups.The smoke-exposed rats were respectively exposed to the smog for the periods of 2,4,6,8 and 12 weeks,10 rats in each group.The smoke-exposed rats were exposed to cigarette smoke for 0.5 h per day.The testicular tissue structure was observed and the body mass and the NO level of testis were measured.Results Compared with the control group and low dose group,the body mass of the rats was significantly lower in the medium and high dose groups exposed for 4,6,8,12 weeks (P<0.05).Compared with the medium dose groups,the body mass of the rats was significantly lower in the high dose group exposed for 8 weeks and 12 weeks (P<0.05).And with the increase of exposure dose,the reducing was even more obvious.Compared with the control group and low and medium dose groups,NO level in testis of rats was significantly increased in the high dose groups exposed for 2,4,6,8 weeks (P<0.05).Compared with the control group,NO level in testis of rats was significantly increased in the medium dose groups exposed for 8 weeks (P<0.05).Compared with the control group,NO level in testis of rats was significantly increased in the low,medium and high dose groups exposed for 12 weeks (P<0.05);and compared with the low dose group,NO level in testis of rats was significantly increased in the medium and high dose groups(P<0.05).Conclusion Cigarette smoke exposure may have impacts on testis tissue and lead to the increase of NO level in testis of male rats.

Objective To evaluate the influence of C-reactive protein (CRP),insulin resistance (IR) and epicardial fat volume (EFV) on the extent of coronary atherosclerosis in patients with different body mass index(BMl).Methods One hundred and three patients with coronary artery disease were involved in current study who underwent 64-slice dual source CT and percutaneous coronary angiography.Measurements of height,weight,waist circumference (WC) were recorded,and BMI was calculated.All patients were divided into obesity group (n =45) and non-obesity group (n =58) based on BMI.EFV were calculated through 64-slice dual source CT.Blood samples were collected for biochemical examination.Gensini score were adopted to quantify the severity of coronary artery stenosis.The relationship between Gensini score and EFV,CRP and homeostasis model assessment-insulin resistance(HOMA-IR) index were statistical analyzed by SPSS16.0 software.Results The level of CRP,WC,EFV and BMI in obesity group were (11.0 ± 5.8) mg/L,(96.1 ± 7.0) cm,(122.7 ± 43.3) cm3,(27.9 ± 2.9) kg/m2 respectively,significantly higher than those in non-obesity group ((6.5 ± 3.4) mg/L,(86.4 ± 7.6) cm,(92.9 ± 39.5) cm3,(22.4 ± 1.9) kg/m2) and the differences were significant (t =2.24,6.74,3.64,11.74,and P ＜ 0.05).CRP were positively correlated with EFV (r =0.404,0.364,P ＜0.05) in both obesity and non-obesity group,While HOMA-IR were only associated with BMI in obese group(r =0.322,P ＜0.05).Gensini score in non-obesity groups were positively related with EFV and CRP (r =0.358,0.315,P ＜ 0.05),while in obesity groups were positively related with EFV,CRP and HOMA-IR(r =0.348,0.297,0.384; P ＜ 0.05).The associations between Gensini score and CRP were not significant in obesity group after adjusting BMI and WC.Multiple linear regression analysis showed that EFV and diabetes mellitus were independent risk factors of patient Gensini score.Conclusion Coronary atherosclerosis is positively related with EFV and CRP in all patients.While,coronary atherosclerosis is influenced by BMI,WC and HOMA-IR in obese group.EFV is an independent risk factor of coronary atherosclerosis.