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.

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 improve the efficiency of donated organs and to investigate the possi- bility and operation protocol of heart and lung transplantation from the same donor to different reci- pients.Methods The organs of heart and lung were obtained from three donors through the method of orthotopic lavage and whole cutting,and transplanted to end-stage patients with heart diseases or lung diseases.First,the donor was subjected to mechanical ventilation,thoracotomy and lavage of heart and lung.The heart and lung were cut in whole and separated.The recipients were subjected the re- trograde lavage of heart and lung.In the patients receiving unilateral lung transcription,the left and right lungs were isolated.Among 3 recipients of lung transcription,one underwent left unilateral lung transplantation and 2 bilateral lung transplantation.Three cases received orthotopic cardiac transplan- tation by using bicaval orthotopic heart transplantation (BOHT) anastomosis method.Results One recipient of left unilateral lung transplantation recovered well after operation.In one recipient under- going bilateral lung transplantation,right upper lung embolism occurred.After re-operation of cutting the right upper lung on the 9th day of the first one,he recovered from the illness.In another recipient receiving bilateral lung transplantation,anastomotic stenosis of trathea and pulmonary infection occurred after operation.After expectant treatment,he recovered from the illness,but died from serious infection 7 months after operation.One of the heart recipients was found having renal failure of first stage,and recovered from disease after hemodialysis treatment.Quality of life was good in all 3 heart recipients after operation and their heart function achieved the restoration of 0-Ⅰstage.Conclusion The treatment protocol of transplantation from the same donor to different recipients at the same time, which can make full use of the organs from donors,is feasible and has good effect.

Gold nanostructures with unique optical and photo-thermal properties based on their size and shape have wide applica-tion potential in tumor diagnosis, imaging, photo-thermal therapy, and drug delivery because of surface plasmon resonance. The optical properties of gold nanomaterials allow its use for dark field imaging, optical coherence tomography, and two-photon imaging. Gold nanomaterials can also be used as carriers for a variety of fluorescent molecules and drugs, achieving multifunctional imaging, chemo-therapy, photodynamic therapy, and so on. Photon-electron and electron-electron interactions of gold nanomaterials, which are excited by near-infrared laser, will generate heat that can be used for tumor photothermal therapy. This phenomenon promotes drug release, and photoacoustic imaging. The combined application of hyperthermia and chemotherapy based on gold nanoparticles is effective in opti-mizing the efficacy of cancer treatments. Therefore, gold nanoparticles can integrate multiple functions into one single system and real-ize the integration of tumor diagnosis and therapy, which provide new insights for the on-demand therapy and personalized medicine de-velopment. This study reviews the recent progress of several gold nanoparticles in the integrated applications for tumor theranostics, in-cluding gold nanoshells, gold nanorods, hollow gold nanospheres, gold nanocages, and gold nanostars. The major strategies of gold nanomaterials in biomedical applications are also discussed.

Objective:To analyze the rationality of off-label drug use in nephritic syndrome prescriptions to provide scientific basis for clinical rational drug use and further regulate the off-label drug use in our hospital. Methods:Totally 1 908 outpatient prescriptions of nephritic syndrome selected from our hospital during November 2014 to April 2015 were analyzed, and all the off-label drugs were listed . The rationality of the off-label drug use was analyzed and evaluated by searching the related kidney disease guidelines and litera-tures. Results:The off-label drug use of tacrolimus capsules, mycophenolate mofetil capsules, cyclophosphamide for injection, ciclos-porin soft capsules, dipyridamole tablets, hydroxychloroquine sulfate tablets and warfarin sodium tablets were recommended by domes-tic and overseas guidelines with better evidence of evidence-based medicines. Tripterygium glycosides tablets and leflunomide tablets were supported by the literatures on clinical studies at home and abroad. The above 9 kinds of off-label drugs were rational drug use. Lumbrokinase enteric-coated capsules, salvia miltiorrhiza and ligustrazine injection and pidotimod dispersible tablets were reported only by a handful of journals. Bacteria lysate capsules and boric acid powder had no related information support, which belonged to the em-pirical prescriptions of physicians. The above 5 kinds of off-label drugs were not rational drug use. Conclusion:It is a widely existing phenomenon that the medication in nephrotic syndrome is beyond the instruction, the most of off-label drug use are reasonable, and cli-nicians should prescribe medicines carefully. Our hospital needs to further standardize the management of off-label drug use supported by higher evidence in order to improve the level of clinical rational drug use and the reasonable rate of prescriptions.

Objective To investigate the change of Th22 cells in peripheral blood of patients with Primary sjogren’s syndrome (pSS)and evaluate clinical significance.Methods 37 patients with pSS from January 2014 to November 2015 were enrolled the study as the observation group.Then 37 healthy adults receiving check-up during the same period were selected as con-trol groups in accordance with the proportion of 1∶1.Flow cytometry was performed to evaluate the levels of Th22 cells in peripheral blood,and tenzyme-linked immuno sorbent assay (ELISA)was used to measure the serum IL-22 levels.Pearson analysis was performed to investigate the relationship between Th22 level and serum IL-22 level,C3,C4,anti-SSA,anti-SSB, ANA antibody,EULAR Sjogren's syndrome disease activity index (ESSDAI)score in observation group.Then the levels of Th22 cells and serum IL-22 were compared among different labial gland pathologic stage in patients with pSS.Results The levels of Th22 cells and serum IL-22 in the observation group were (2.53±1.56)%,718.6±176.8 pg/ml respectively,and significantly higher than (1.24±0.51)%,258.9±72.4 pg/ml in control group (P<0.05).Th22 cell level was positively related with the level of serum IL-22,anti-SSA,anti-SSB and ESSDAI score,and negatively related with the content of C3 and C4 (P<0.05).There were no significant differences in the levels of Th22 cells and serum IL-22 different labial gland pathologic stage in patients with pSS (P>0.05).Conclusion The levels of Th22 cells and serum IL-22 significantly in-creased in patients with pSS,and related to other inflammatory indexes and disease activity,so they may participate in the genesis and development of pSS.

Tamoxifen(TAM)is an important therapeutic strategy for the treatment of estrogen receptor(ER)-positive breast cancer.However,tamoxifen resistance is a major cause of endocrine therapy failure.The potential mechanism of TAM resistance is multifactorial and most of them are still unknown.This review presents recent advances in the mechanism of TAM resistance in breast cancer,providing valuable information and ideas for elucidating the mechanism of tamoxifen resistance and overcoming drug resistance.

Objective To investigate the neurosurgery nurses turnover intention and the psychological contract status to analyze the relationship between them. Methods The Departure Will Scale and Questionnaire of Psychological Contract were used to survey 128 neurosurgery nurses from seven general hospitals in Lishui city. Results Of neurosurgery nurses turnover intention scale was (2.24±0.71) points, whose leaving intend was stronger;Psychological contract items was (4.17±0.67) points, which organization responsibility score wasbelow employees responsibility; Hierarchical regression analysis showed that the psychological contract in the organization responsibility (organization specification responsibility, organization, personal responsibility and organizational development responsibility) could predict neurosurgery nurses′ willingness to leave, which could be able to explain their willingness to leave 13.5%of the variation. Conclusions Neurosurgery nurses′willingness to leave is strong, and psychological contract is an important factors affecting the will of their departure.

ObjectiveTo explore the effects of extended nursing intervention (ENI) in nursing ability of discharged patients with intubation of T-tubes.Methods Eighty-two patients with biliary diseases discharged with intubation of T-tubes were equally divided into two groups.The patients in the experiment group were treated with ENI and those in the control group were treated with conventional nursing.Each group received routine nursing and health education before discharge.All patients were followed up by a self-designed written questionnaire.Data regarding patients’ compliance behavior,knowledge of the diseases and satisfaction were collected and analyzed.Result Significant differences were observed between the two groups,the patients in the experiment group exhibiting better compliance behavior,their knowledge of their diseases improved and the rate of satisfaction higher (P<0.05). Conclusion ENI may be effective for the discharged patients with intubation of T-tubes to improve their compliance behavior, enhance their knowledge of their diseases and raise the rate of satisfaction.

0.05). Conclusions The distribution of the RMSh was widely ranged among hyperopic children,and some children expressed higher value of RMSh. As the pupil diameter got larger,the RMS value of HOA significantly increased. Vertical coma was more frequent dominating type of HOA among hyperopic children. (Ophthalmol CHN ,2006,15: 187-190)