Objective To explore the value of carbox dioxide(CO2 )for the upper gastrointestinal endoscopic mucosal dissection(ESD).Methods A total of 158 patients who underwent ESD from January 2012 to May 2014 at Endoscopy Center of Dongguan Hospital were enrolled in the study.The patients were randomly divided into air group and CO2 group.The arterial partial pressure of CO2 (PaCO2 ),the monitering results of SpO2 before,during,afte operation,abdominal pain after operation and postoperative complications were assessed.The safety and advantage of CO2 of the upper gastrointestinal ESD were comparative ana-lyzed.Results PaCO2 of air group and CO2 group during the ESD procedures [(47.8 ±5.4)mmHg, (45.1 ±5.5)mmHg]was significantly higher than that before[(37.2 ±4.6)mmHg,(36.3 ±3.9)mmHg] (P <0.05)and after the operation[(39.9 ±4.0)mmHg,(39.4 ±4.2)mmHg](P <0.05).Preoperative, intraoperative and postoperative PaCO2 were not significantly different between the two groups(P >0.05);all the SpO2 were greater than 90%,and it was not significantly different between the two groups(P >0.05). The abdominal pain score of CO2 group was significantly lower than that of air group less than 2 h after wake-up (P <0.05),but there was no difference between the two groups at 12 h and 24 h after operation(P >0.05).The bleeding rate of air group and CO2 group during and after operation was not significantly different (P >0.05),and there were no other serious complications.Conclusion CO2 is safe in the upper gastroin-testinal ESD,and it can reduce postoperative abdominal pain,so it is suitable for clinical application.

Euphorbia lathyris (Caper spurge) is a toxic and potent Chinese materia medica (T/PCMM).This study sought a method for identifying five diterpenoids (Euphorbia factors L1-L3,L7a and L8) with the spectra of UV and mass,quantifying three diterpenoids L1,L2,and L8 in crude extracts of unprocessed and processed E.lathyris seeds by liquid chromatography/electrospray ionization mass spectrometry (LC-ESI-MS).The analysis was achieved on an Agilent Eclipse XDB-C18 column (4.6 mm × 150 mm i.d.,5 μm) with an isocratic elution with a mobile phase consisting of water and acetonitrile at a flow rate of 0.25 mL/min at column temperature of 30 ℃ and UV detection was set at 272 nm.An ESI source was used with a positive ionization mode.The calibration curve was linear in the ranges of 9.9-79 μg/mL for Euphorbia factor L1,3.8-30.5 μg/mL for Euphorbia factor L2,and 1.0-20.6 μg/mL for Euphorbia factor L8.The average recoveries (n=6) of three diterpenoids were 98.39％,91.10％ and 96.94％,respectively,with RSD of 2.5％,2.4％ and 2.1％,respectively.The contents of the three diterpenoids in processed E.lathyris seeds were 3.435,1.367 and 0.286 mg/g,respectively,which decreased more sharply than those in unprocessed E.lathyris seeds which were 4.915,1.944 and 0.425 mg/g,respectively.The method is simple,accurate,reliable and reproducible,and it can be applied to control the quality of unprocessed and processed E.lathyris seeds.

Objective To explore the application of CO2 as an insufflation agent in patients under-going colonoscopy by comparing carbon dioxide(CO2 )and air.Methods Consecutive 681 patients who un-derwent conventional colonoscopy from January to May in 2014 at endoscopy center of our hospital were in-cluded.The patients were randomly divided into the air group and CO2 group.The gas flow,capacity,oper-ation time,PaCO2 and abdominal pain during and 20 min,40 min,1 h,2 h,12 h,24 h after colonoscopy were recorded.The safety and advantages of CO2 in the colonoscopy were analyzed.Results The intubation time of CO2 group was significantly shorter than that of air group (P <0.05),but there was no significant difference in endoscopy withdrawal time between the two groups (P >0.05).There was also no difference in air flow and the total volume between the two groups (P >0.05).PaCO2 of two groups were within the nor-mal range.PaCO2 during examination was significantly higher than that before and 20 minutes after examina-tion (P <0.05),but the PaCO2 between the two groups showed no significant difference (P >0.05).The abdominal pain scores during and 20 min,40 min,1 h,2 h after the examination of air group were signifi-cantly higher than those of CO2 group (P <0.05),but they were not 12h and 24h after the examination (P>0.05).Conclusion CO2 is safe and could reduce abdominal discomfort after colonoscopy,which is suit-able for clinical application.

Euphorbia lathyris （Caper spurge） is a toxic and potent Chinese materia medica （T/PCMM）. This study sought a method for identifying five diterpenoids （Euphorbia factors LI-L3, L7a, and Ls） with the spectra of UV and mass, quantifying three diterpenoids L1, L2, and L8 in crude extracts of unprocessed and processed E. lathyris seeds by liquid chromatography/ electrospray ionization mass spectrometry （LC-ESI-MS）. The analysis was achieved on an Agilent Eclipse XDB-C18 column （4.6 mm× 150mm i.d., 5 μm） with an isocratic elution with a mobile phase consisting of water and acetonitrile at a flow rate of 0.25 mL/min at column temperature of 30 ℃ and UV detection was set at 272 nm. An ESI source was used with a positive ionization mode. The calibration curve was linear in the ranges of 9.9-79 μg/mL for Euphorbia factor Lb 3.8-30.5μg/mL for Euphorbia factor L2, and 1.0-20.6 μg/mL for Euphorbia factor LB. The average recoveries （n=6） of three diterpenoids were 98.39%, 91.10% and 96.94%, respectively, with RSD of 2.5%, 2.4% and 2.1%, respectively. The contents of the three diterpenoids in processed E. lathyris seeds were 3.435, 1.367 and 0.286 mg/g, respectively, which decreased more sharply than those in unprocessed E. lathyris seeds which were 4.915, 1.944 and 0.425 mg/g, respectively. The method is simple, accurate, reliable and reproducible, and it can be applied to control the quality of unprocessed and processed E. lathyris seeds.

OBJECTIVETo investigate the prospective association of fibroblast growth factor 21 (FGF-21) with NAFLD development in a 5-year prospective study involving a population-based cohort comprising 352 Chinese subjects.

METHODSThe clinical data of subjects were recorded, serum FGF-21 levels at baseline and follow-up were measured using an enzyme-linked immunosorbent assay,whether FGF-21 was independent predictor of NAFLD development were identified using logistic regressions. Chi-square test, non-parametric test and logistic regression analysis were used in statistical analyses.

RESULTS(1) Serum FGF-21 levels of NAFLD group was significantly higher than that of non-NAFLD group (318.34(169.64,520.77)pg/ml vs 197.22 (121.57, 318.76) pg/ml, Probability value less than 0.05). (2)At follow-up,significant increase of FGF-21 level was observed in those subjects who developed NAFLD (399.4 (253.9,754.2) pg/ml vs 318.34(169.64, 520.77)pg/ml, Probability value less than 0.05), but in non-NAFLD group, there was no significant difference of FGF-21 level between baseline and follow-up. (3) BMI, TC, HOMA-IR and FGF-21 were independent predictors of NAFLD through logistic regressions.

CONCLUSIONHigh FGF-21 levels was independent predictor of NAFLD, it may be useful for early diagnosis and intervention of NAFLD.

Esophageal squamous cell carcinoma (ESCC) is one of the most aggressive cancers in China, but the underlying molecular mechanism of ESCC is still unclear. Involvement of micro-RNAs has been demonstrated in cancer initiation and progression. Despite the reported function of miR-503 in several human cancers, its detailed anti-oncogenic role and clinical significance in ESCC remain undefined. In this study, we examined miR-503 expression by qPCR and found the downregulation of miR-503 expression in ESCC tissue relative to adjacent normal tissues. Fur-ther investigation in the effect of miR-503 on ESCC cell proliferation, migration, and invasion showed that enhanced expression of miR-503 inhibited ESCC aggressive phenotype and overexpres-sion of CCND1 reversed the effect of miR-503-mediated ESCC cell aggressive phenotype. Our study further identified CCND1 as the target gene of miR-503. Thus, miR-503 functions as a tumor suppressor and has an important role in ESCC by targeting CCND1.

Objective To observe the epidemiology characterization of Borna disease virus (BDV) in animal brain in Ili, Xinjiang, and to find out the potential infection of the Borna disease virus to prevent its outbreak. Methods The BDV p24 gene of animal brain tissues in Ili including 200 horses, 75 donkeys and 100 shepherd dogs was detected by fluorescence quantitative nest reverse transcriptase polymer-ase chain reaction(FQ-nRT-PCR). GFP-p24,pMD-19 plasmid contamination was excluded from positive products. Clone sequencing was used to analyze the homology of gene and amino acid sequence. Results BDV p24 gent was found in 3 Ili horses, 4 Ili donkeys and 9 shepherd dogs, and the positive ratio is 1.5%, 5.3% and 9.0%, respectively. The GFP-p24,pMD-19 were not found in BDV p40 gene and plasmid stand-ard. The sequence of BDV p24 amplification production was totally the same as He/80 virus strain. Conclu-sion Natural infection of BDV may exist in the animals(horses, donkeys and dogs)in Ili, and the epidem-ic strain of BDV in this area was homological as He/80 virus strain.

Objective:To evaluate the ophthalmic service ability of county hospitals in China based on the improved DS evidence theory.Methods:Convenient sampling method was used to select the data of ophthalmology department of 9 county hospitals in eastern, central and Western China in 2019. The improved DS evidence theory method based on Mahalanobis distance weight coefficient was applied to evaluate the medical service ability, and the evaluation results were compared with the classical evidence theory method.Results:The regional development of ophthalmic service capacity in counties of China was uneven, and there were regional differences in the evaluation results of some indicators. Hospitals in the eastern region were generally leading in the evaluation of a number of indicators related to the amount of medical services. The numbers of inpatient operations, outpatient operations, bed turnover times, bed utilization rate, number of inpatients, number of outpatients, number of patients in the eastern region were 3.25, 1.60, 1.81, 1.61, 2.64, 2.63 and 4.47 times of the numbers of hospitals in western region. Compared with the classical evidence theory method, the analysis results of the improved DS evidence theory method were consistent with the actual business development of each hospital, and the evaluation results were credible, which could more effectively reduce the uncertainty in the evaluation results.Conclusions:Ophthalmic service ability of county hospitals in China needs to be continuously improved. Improved DS evidence theory can be adopted to make continuous evaluation.

Objective To evaluate the bioequivalence of domestic and imported terazosin hydrochloride tablets after single oral dose .Methods It was a single center ,randomized ,open ,cross-over trail design ,21 subjects were fasting oral adminis-tered of 2 mg domestic and imported terazosin hydrochloride tablets in different periods ,venous blood 4 ml were collected in different time points before and 60 h after administration ,plasma concentration of terazosin was determined by LC-MS/MS . Results The main pharmacokinetic parameters of domestic and imported terazosin hydrochloride tablets were as follows :t1/2 :(13.2± 2.39)hvs(12.5±1.93)h,tmax :(1.01±0.83)hvs(1.08±0.69)h,Cmax :(40.1±10.6)ng/mlvs(37.3± 9 .57) ng/ml;AUC0- ∞ :(428 ± 82 .1) ng · h/ml vs (426 ± 85 .2) ng · h/ml .The relative bioavailability of domestic terazosin hydrochloride tablets was (101 .2 ± 14 .7)% .90% CI of domestic and imported terazosin hydrochloride tablets AUC0-t and Cmax geometric mean ratio fell between 80% -125% .Conclusion The domestic tablets are bioequivalent to the imported tablets .