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 analyze the correlation of acute pancreatitis with hyperlipemia and C reactive pro-tein. Methods 42 patients with acute pancreatitis with hyperlipemia were divided into two groups of SAP group and MAP group under the diagnostic code. The blood fat and CRP were compared between the two groups, also the scores of APACHE Ⅱ , Ranson and CT were measured. Results The CRP and TG in group SAP compared with those in group MAP had significant difference(P<0.01),but the CHOL has no-difference;the scores of APACHEⅡ , Ranson and CT after control lipid in 42 patients were significantly' different( P < 0.05). Conclusion Hyperlipe-mia is one risk factors of the AP;combined with the CRP, it can be one evaluating index of the severity.

Adult ; Arrhythmogenic Right Ventricular Dysplasia ; physiopathology ; Electrocardiography ; Humans ; Male ; Middle Aged

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.

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 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.

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.

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 determine the dynamic changes of plasma endothelin (ET), calcitonin gene related peptide (CGRP) and atial natriuretic peptide (ANP) in elderly patients with acute cerebral infarction and explore the pathological role of ET, CGRP and ANP in the development of acute cerebral infarction.Methods The concentrations of ET, CGRP and ANP in plasma were determined with radioimmunoassay in 78 elderly patients with acute cerebral infarction and 60 normal controls.Results (1)The levels of ET and ANP in patient group were significantly higher than those in control group ( P3 cm) and small area infarct group (1.5～3.0 cm) were significantly higher (all P