Objective To explore endoscopic diagnosis,treatment,pathological features and prognosis of gastrointestinal carcinoid tumors.Methods Retrospective analysis of 72 cases of gastrointestinal carcinoid tumors which were endoscopically diagnosed,treated,pathologically confirmed and followed up from July 2004 to July 2010 in Shanxi Provincial People' s Hospital.Common endoscopic diagnosis,endoscopic ultrasound(EUS)diagnosis,pathological features,treatment and prognosis were summarized.Results Twenty six cases of upper gastrointestinal carcinoid tumors and 46 cases of lower gastrointestinal carcinoid tumors were diagnosed and followed up.A total of 65 cases were single carcinoid and 7 were multiple carciniods.Tumors were mostly yellowish hard nodules with limited range of movement.EUS showed uneven hypoechoic nodules in the submucosal layer.Fifty-one cases of single carcinoid tumor were successfully treated with endoscopic mucosal resection(EMR)or endoscopic submucosal dissection(ESD)and the cure rate was 96.2％(51/53).Three cases of multiple carciniods were cured with EMR and the cure rate was 3/7.There was no tumor recurrence after treatment during follow-up.Conclusions Endoscopy examination is an important way to detect early carcinoid tumors.Endoscopic ultrasound probe can further clarify source and level of the lesion,and provide the basis for the endoscopic therapy.EMR and ESD are the preferred radical treatment for early carcinoid tumors.

Objective To investigate the role of thrombelastography(TEG) in assessing the risk of bleeding and diagnostic value in patients with acute leukemia(AL) .Methods The TEG and PLT data were counted in 127 patients(272 sets of data) who were diagnosed with AL .Those patients were divided into two groups :group 1 (including patients with bleeding) and group 2 (in‐cluding patients with no bleeding) .The indicators(R values ,K values ,α‐angle ,MA values)and PLT count were compared between two groups .Those data with PLT<30 × 109/L of these two groups also were divided and the 4 indicators of TEG were compared between the two groups .We used the ROC curve to evaluate the sensitivity and specificity in assessing the risk of bleeding .Results According to the data in total ,the K value ,R value of the group 1 were higher than those of the group 2(P<0 .05);theα‐angle and MA value ,PLT counts of group 1 were lower than those of the group 2(P<0 .05) .In those AL patients whose PLT<30 × 109/L ,the K value of the group 1 was higher than that of the group 2(P<0 .05);theα‐Angle and MA value of the group 1 were lower than those of the group 2(P<0 .05);R values and PLT count were not different between the two groups(P>0 .05);the are‐as under the ROC curve about the PLT counts ,MA value andα‐angle were more than 0 .5 (0 .750 ,0 .740 and 0 .653) .Conclusion T EG could predict the risk of bleeding in acute leukemia patients and it could be used in clinical application .

The application of resonance charging circuit to electro-hydraulic impulse apparatus for treating wastewater is introduced in this paper.The circuit permits the graduating increase of current without influence from time.The unique change of voltage on capacitor is favorable for the recovery of electric strength of electro-hydraulic impulse apparatus.The theory and design method of resonance charging circuit are provided.

Objective:To compare the nutritional status of inpatients after enteral nutrition (EN) and parenteral nutrition (PN). Method: A multi-center survey of 1 142 inpatients from the Department of gastrointestinal surgery, thoracic surgery, gastroenterology, respiratory disease, neurology, neurosurgery and the intensive care unit of 6 general hospitals in Beijing and Shanghai was adopted in this study. Body weight (BW), haemoglobin (Hb) and serum albumin (sALB) were compared before and after EN or PN respectively. Results: BW, Hb and sALB all decreased after the nutritional support both in EN and PN groups, but only significantly in BW and sALB (BW: -1.58?2.36 kg/m2 vs -2.09?2.66 kg/m2, P

Objective To evaluate the efficacy of ultrasound-guided continuous brachial plexus block for analgesia after fixation of upper extremity fractures in the pediatric patients.Methods Sixty American Society of Anesthesiologists physical status Ⅰ pediatric patients of both sexes,aged 3-10 yr,weighing 13-46 kg,with body height of 97-152 cm,scheduled for open reduction and internal fixation of distal humeral fractures,were selected and divided into 2 groups (n =30 each) using a random number table:intravenous analgesia group (group Ⅴ) and continuous brachial plexus block group (group B).Surgery was completed under brachial plexus block combined with general anesthesia in the two groups.At the end of surgery,patient-controlled intravenous analgesia was used in group Ⅴ,and continuous brachial plexus block was performed with 0.1％ ropivacaine 250 ml (background infusion 0.1 ml · kg-1 · h-1,bolus dose 0.2 ml/kg,lockout interval 30 min) in group B.Tramadol was given as rescue analgesic when necessary.Ramsay sedation scores were assessed and recorded at 2,4,8,12,24,36 and 48 h after surgery,and the development of over-sedation was recorded.The require,nent for rescue analgesics and development of respiratory depression,dizziness,nausea and vomiting,pruritus and urinary retention during analgesia were recorded.The development of adverse reactions such as vascular and nerve injury,local hematoma and pneumothorax was recorded in group B.Family's satisfaction with analgesia was assessed and scored.Results Compared with group Ⅴ,Ramsay sedation scores at 2-12 h after surgery,the incidence of oversedation,nausea and dizziness and requirement for tramadol were significantly decreased (P＜0.05),and no significant change was found in the degree of family's satisfaction with analgesia in group B (P＞ 0.05).The adverse reactions such as vascular and nerve injury,local hematoma or pneumothorax were not found in group B.Conclusion Ultrasound-guided continuous brachial plexus block can be safely and effectively used for analgesia after fixation of upper extremity fractures in the pediatric patients.

Objective:The poor prognosis of patients with malignant gliomas (MG) has led to the search for new therapeutic strat-egies. Recently, nimotuzumab has been studied as a new anti-EGFR-receptor humanized monoclonal antibody in patients with MG, who showed improvement of outcome and good tolerability. We conducted phase I of our study to determine the toxicity, tolerated dose, and clinical feasibility of nimotuzumab in combination with concurrent chemoradiotherapy for Chinese MG patients after surgical resection. Methods:Patients with pathologically proven grades 3 and 4 glioma were enrolled in the study. The protocol included infu-sions of nimotuzumab plus standard Stupp schedule (postoperative radiotherapy in a total dose of 60 Gy in combination with daily te-mozolomide). Patients received 6 weekly infusions of nimotuzumab at three levels (100, 200, and 400 mg/week). If none of the first three patients enrolled at a dose level experienced dose-limiting toxicity (DLT), the dose was increased, as appropriate. If DLT was ob-served, another three patients were added to the dose level. Results:Nine patients with MG were enrolled, including 7 with grade 3 MG and 2 with glioblastoma. The treatment was well tolerated, and no evidence of grade 3 or 4 adverse events was detected, even at the highest level (400 mg/week). Grade 1 or 2 myelosuppression was the most common toxicity. Three months after treatment, stable dis-ease occurred in 5 patients, whereas progression disease was observed in 4 patients. Conclusion:Nimotuzumab combined with concur-rent chemoradiotherapy was associated with mild toxicity in Chinese MG patients.

Osteonecrosis of the femoral head (ONFH) is caused by the blockage of the blood supply of the femoral head due to by a variety of reasons, resulting in the death of the bone in the femoral head, which is characterized by osteonecrosis occurdead bone resorption-new bone formation. And total hip arthroplasty (THA) is the final choice for the vast majority of these patients. Though treating hard, it is necessary to choose an appropriate head-preserving treatment in the early stage to delay the time of THA.Methods to treat femoral head necrosis varies, however, it is still hard to have a uniform standard until now. Thus, this paper discusses the epidemiological characteristics, related risk factors, pathology, stage, current head-preserving methods and prognostic factors of femoral head necrosis, so as to further enhance clinicians' understanding of osteonecrosis of the femoral head and provide reference to choose more appropriate head-preserving methods for those patients. As demonstrated in literatures, in China, the incidence of non-traumatic ONFH in males is significantly higher than that in females, and it is more common in northern residents and urban residents. In addition, glucocorticoid intake, hyperlipidemia, heavy smoking and alcohol abuse tend to increase the risk of ONFH; Histologically, osteonecrosis and repair of the femoral head occurred after blood supply was blocked; In terms of pathological staging, Ficat staging is the most commonly used and most directly classification method; core decompression, non-vascularized bone grafting, vascularized bone grafting and osteotomy are still the mainstream surgical methods at present. Patient's age, etiology, stage, etc are important factors affecting the prognosis of ONFH. Therefore, surgeons can choose the most appropriate treatment for the patients according to their specific conditions and prognostic factors.

Objective: To observe the effect of the intravenous infusion of vasostatin-2 (VS-2) on hemodynamics in experimental rats with spontaneous hypertension (SH).
Methods: A total of 36 (14-16) weeks male SH rats with the mean body weight at (160-250) g were randomly divided into 6 groups:①Control group, the rats received normal saline (100μl/kg),②Catestatin (20μg/kg) group,③VS-2 (5μg/kg) group,④VS-2 (10μg/kg) group,⑤VS-2 (20μg/kg) group and⑥VS-2 (40μg/kg) group. n=6 in each group. The average blood pressure (BP), heart rate (HR) and barorelfex sensitivity (BRS) were monitored and compared upon VS-2 treatment and between VS-2 and catestatin treatments in conscious and freelance rats.
Results: Compared with prior treatment, VS-2 (20μg/kg) and VS-2 (40μg/kg) could obviously decrease the HR, BP and BRS in SH rats. In VS-2 (20μg/kg) group, HR by bpm was (341.3 ± 19.3) vs (365.5 ± 25.5), BP by mmHg was (133.0 ± 8.9) vs (147.5 ± 11.2) and BRS by ms/mmHg was (0.52 ± 0.18) vs (0.37 ± 0.12);in VS-2 (40μg/kg) group, HR was (348.8 ± 30.8) vs (374.5 ± 34.8), BP was (131.5 ± 9.3) vs (151.7 ± 10.8) and BRS was (0.53 ± 0.05) vs (0.38 ± 0.03), all P<0.01. Catestatin treatment could also decrease the HR as (318.7 ± 13.4) vs (365.5 ± 25.5), BP as (119.7 ± 7.3) vs (147.5 ± 11.2) and BRS as (0.58 ± 0.15) vs (0.35 ± 0.11), all P<0.01. Compared with catestatin (20μg/kg), the rats received VS-2 (20μg/kg) had the weaker reduction of HR as (318.7 ± 13.4) vs (341.3 ± 19.3), BP as (119.7 ± 7.3) vs (133.0 ± 8.9), all P<0.01, while BRS was similar as (0.58 ± 0.15) vs (0.52 ± 0.18), P>0.05.
Conclusion: Intravenous infusion of VS-2 may obviously affect HR, BP and BRS in experimental SH rats;compared with the same dosage of catestatin, VS-2 had the weaker reduction of HR, BP and BRS.

Objective To discuss the diagnostic value of serum sialic acid for glioma.Methods A retrospective study was conducted.The levels of sialic acid in serum samples of 95 glioma patients, 175 patients with brain benign tumor and 400 normal persons from October 2014 to March 2015 were detected by automatic biochemistry analyzer using enzymic method.The SNK-q test and analysis of variance were used to compare the difference of the groups.By making receiver operating characteristic ( ROC) curve, the cut-off value, sensitivity, specificity, positive predictive value and negative predictive value were calculated to assess the diagnostic value of serum salivary acid.Then the cut-off value was validated by using the serums of 30 glioma patients and 30 normal persons who were out-patients and healthy controls.Results The levels of serum sialic acid in patients with gliomas, patients with brain benign tumor and healthy individuals were (0.66 ±0.14 ) g/L, (0.61 ±0.09 )g/L, (0.54 ±0.07 )g/L.The serum salivary acid of glioma patients were higher than brain benign tumor patients (q=6.74,P<0.05) and normal persons (q=16.42,P<0.05), and there was no significant difference (F=1.67,P>0.05) among the glioma patients of different grades (8 of gradeⅠ,32 of gradeⅡ,24 of grade Ⅲ,31 of grade Ⅳ).There was no significant difference between the low grade patients (gradeⅠandⅡ) and the high grade patients (gradeⅢandⅣ) (t=0.55, P>0.05), but the level of serum sialic acid of high grade group had an increasing trend than the low grade group.The area under the ROC curves was 0.79.The cut-off value of serum salivary acid for diagnosing glioma was 0.61 g/L.The sensitivity was 67.74%, and the specificity was 80.60%.The positive predictive value was 44.68%, and the negative predictive value was 90.76%.Then the cut-off value was used as a diagnostic criteria, and the detected results of 30 glioma patients and 30 normal persons showed that the sensitivity was 63.30% and the specificity was 83.30%.Conclusions The serum sialic acid has good specificity and negative predictive value for diagnosing glioma.It may be a valuable diagnostic marker.

Objective To construct the genetic recombinant adenovirus vector carrying the human growth and differentiation fac-tor-5(GDF-5) gene by using AdEasy-1 adenovirus vector system and to amplify and prepare the recombinant adenovirus in HEK 293 cells .Methods Human GDF-5 gene obtained by PCR was inserted into plasmid pMD19-T and the 1 .7 kb GDF-5 cDNA sequence was cloned into the adenoviral shuttle plasmid pShuttle-cytomegalovirus(CMV) of the AdEasy-1 system .It was identified by DNA sequencing and a digestion with Hind Ⅲ restriction enzyme .The resultant pShuttle-CMV-GDF-5 was used to generate the adenovi-ral GDF-5 vector through homologous recombination with the adenoviral backbone plasmid ,pAdEasy-1 in BJ5183 bacterial cells .It was selected by kanamycin and identified by a digestion with Hind Ⅲ restriction enzyme and amplified in XL10-Gold competent bac-teria .The DNA of recombinant adenovirus vector was finally linearized by Pac Ⅰ and the adenoviral recombinants were used to pro-duce adenoviruses in HEK293 packaging cells ,resulting in an Ad-GDF-5 identified by Western blot .The virus titer was assayed by TCID50 .Results GDF-5 cDNA sequence obtained by PCR was 1 .7 kb .Gene sequencing results indicated that the sequence was i-dentical with the one in GENBANK .Cloned sequence 1 .7 kb(GDF-5) was obtained by a digestion with Hind Ⅲ restriction enzyme after GDF-5 cDNA segment was cloned into pShuttle-CMV and AdEasy-1 .Western blot showed that two bands migrating at ap-proximately 15 and 55 kDa were clearly observed in PVDF membrane .These data confirmed that HEK293 cells expressed a large number of mature GDF-5 protein after infected with Ad-GDF-5 .Our research results demonstrated that recombinant adenovirus vector GDF-5 was successfully constructed .The virus titer was 5 .6 × 109 PFU/mL .Conclusion Recombinant adenovirus vector carrying the human GDF-5 gene is successfully constructed by using the AdEasy-1 adenovirus vector system .Moreover ,the Ad-GDF-5 with high titer is prepared .These provide the basis for further study of the biological function of GDF-5 and the gene thera-py of its related diseases .