Objective:To investigate the risk factors for synchronous multiple early gastric cancer (SMEGC).Methods:A retrospective analysis was conducted on data of 390 patients with early gastric cancer, including 353 cases of solitary early gastric cancer (SEGC group) and 37 cases of SMEGC (SMEGC group), who underwent endoscopic submucosal dissection (ESD) in Chinese PLA General Hospital from January 2017 to June 2019. The differences in clinical characteristics (gender, age, body mass index, smoking status, drinking status, family history of gastrointestinal cancer and other cancers, etc.) and pathological characteristics (size, location, morphology, differentiation degree, invasion depth, with or without Helicobacter pylori infection, intestinal metaplasia, ulcers and atrophic gastritis of lesions, etc.) between the two groups were compared by t test, Mann-Whitney U test, Chi-square test, or Fisher′s exact test. Logistic regression (forward LR) was used to screen the independent risk factors for SMEGC. Results:There were no significant differences in the general clinical characteristics between SMEGC group and SEGC group ( P>0.05). Significant statistical differences were observed in the location of lesions ( χ2=8.375, P=0.015), the proportion of atrophic gastritis [48.6% (18/37) VS 23.8% (84/353), χ2=10.710, P=0.001] and the proportion of intestinal metaplasia [81.1% (30/37) VS 43.1% (152/353), χ2=19.452, P<0.001] between the two groups, but there were no significant differences in other pathological characteristics ( P>0.05). Multivariate logistic regression analysis showed that location of lesions in the middle 1/3 of stomach (VS upper 1/3: P=0.036, OR=3.38, 95% CI: 1.08-10.53), in the lower 1/3 of stomach (VS upper 1/3: P=0.049, OR=2.59, 95% CI: 1.00-6.69), presence of intestinal metaplasia ( P=0.001, OR=4.38, 95% CI: 1.77-10.86) and atrophic gastritis ( P=0.043, OR=2.24, 95% CI: 1.04-5.07) were independent risk factors for SMEGC. Conclusion:Patients with early gastric cancer located in the middle or lower 1/3 of stomach, with intestinal metaplasia and atrophic gastritis are prone to SMEGC and should be carefully evaluated and closely followed up after ESD.

Objective To explore diagnostic value of MR perfusion weighted imaging(PWI)on complications and tumor recurrence in hypopharyngeal and laryngeal cancer after operation and radiotherapy. Methods MR PWI was performed in 31 patients with hypopharyngeal and laryngeal cancer who suffer from tumor recurrence, granulation or infection after operation and radiotherapy. Blood flow (BF), blood volume(BV), mean transit time(MTT) and time to peak (TTP) values were measured in the lesions. Analysis of variance and pair-wise comparison of q test were used for statistical analysis. Results Eleven cases with tumor recurrence,11 case with granulation tissues, 9 cases with infection were confirmed by pathological examinations. Average BF, BV, MTT and TTP values of recurrent tumors were (145.1 ± 29.3)ml · 100 g-1 · min-1,(14.2 ± 3.2)ml · 100 g-1,(5.4 ± 0.6)s,(13.7 ± 1.3)s respectively;Average BF, BV MTT and TTP values of granulation tissues were(109.1±27.4)ml·100 g-1·min-1,(11.1±1.7)ml·100 g-1,(7.7±1.0)s, (19.8 ± 2.1)s respectively;Average BF, BV, MTT and TTP values of infectious tissues were(86.9 ± 7.7)ml · 100 g-1·min-1,(8.8±1.0)ml·100 g-1,(8.0±0.9)s,(19.7±1.3)s respectively. Average BF and BV values of the recurrent tumors group were higher than those of the granulation(q=4.89, 4.64 respectively,P<0.01)and infection group(q=7.52,7.71 respectively,P<0.01)respectively. Average BV values of granulation group was higher than that of the infection group(q=3.31,P<0.05), Average MTT and TTP values of recurrent tumor group were lower than those of the granulation (q=9.38, 12.48 respectively,P<0.01)and infection group(q=9.77, 11.53 respectively,P<0.05). There were no significant difference in average BF, MTT and TTP between the granulation and infection group. Conclusion MR PWI can be helpful in the diagnosis of complications and tumor recurrence in hypopharyngeal and laryngeal cancer after operation and radiotherapy.

Aged ; Anthracosis ; complications ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Pulmonary Emphysema ; complications ; diagnostic imaging ; Tomography, Spiral Computed ; Trachea ; diagnostic imaging ; pathology

Objective To probe ultrastructurally into the mechanism why hip region is the predilected site of fracture in aged people, yet with femoral head exempted.Methods Proximal femoral ends were collected from 14 aged people, who had undergone endoprosthetic replacement for intra-capsular fracture of the femoral neck, and from 7 young men died of brain injury. These specimens were processed and subjected to scanning electron microscopic and transmission electron microscopic observation for bone resorption.Results As compared with the specimens from young men, there were three types of bone resorption in the proximal femoral ends of aged people, i.e. osteoclastic resorption and osteocytic resorption of the trabeculae of cancellous bone, and osteoclastic resorption of Haversian systems of the cortical bone. In the proximal femoral ends of the young men, the arch structures composed of trabeculae in the femoral head showed a round or roundish configuration, while those at the femoral head-neck junction revealed an oval profile and those in the femoral neck exhibited a narrow oval contour. In the proximal femoral ends of the aged people, the morphological characteristics of the trabecular arch remained unchanged despite overt bone resorption.Conclusions Vulnerability of hip region to fracture in aged people is due to a decline in the structural strength of bone tissues of the proximal femoral ends resulting from osteoclastic and osteocytic resorption. The round and roundish trabecular arch of the femoral head can bear external forces from different directions, so that no fracture occurs here, while the oval and narrow oval arches at the head-neck junction and in the neck region fail to stand the horizontal external forces (abduction and adduction injuries), thereby fracture easily happens.

This study retrospectively reviewed the experimental clinical programs at The First Affiliated Hospital of Nanjing Medical University. Experience was summarized, and methods for improving clinical pharmaceutical research were discussed including recruiting talent people, managing resources and trail results, and establishing international cooperations.

Objective To determine the median effective concentration (EC50) of amitriptyline for intravenous regional anesthesia (IVRA) in rats.Methods Ninety healthy male SD rata weighing 190-240 g were randomly divided into 3 groups (n=30 each) : amitripryline group,bupivncaine group and lidocaine group.The rat's tail was divided into 3 epual parts: the proximal,middle and distal part.A 24 gauge needle was inserted into vena caudalis in the distal part.Esmarch bandage was applied around the tail from distal to proximal to expel blood from the taft and was removed after a tourniquet was applied between the proximal and middle part of the tail to occlude artery.0.5 ml of amitriptyline,bupivncaine or lidocaine was injected into the taft vein immediately after the application of the tourniquet.Ten minutes after drug administration the tourniquet was released.The ECho was determined by the up-and-down sequence method.The initial concentration of amitriptyline was 0.05%,the consecutive concentration-ratio was 1.4i4; the initial concentration of bupivacaine was 0.03%,the consecutive concoatration-ratio was 1.667 and the initial concentration of lidncaine was 0.08%,the consecutive concentrationratio was 1.250.EC50 and 95% confidence interval were calculated.Tail-flick latency (TFL) was assessed at 1 h before (baseline) and at 3 min and 2 d after drug administration.Central nervous system toxicity (seizure,convulsion,death) and local tissue damage to the tail were also recorded.Results The EC50 for IVRA was 0.111% (95% CI,0.092%-0.133%) in amitripthline group; 0.058% (95% CI,0.048%-0.078%) in bupivacaine group and 0.129% (95% CI,0.103%-0.160%) in lidocaine group respectively.The EC50 was significantly lower in bupivacaine group than in amitriptyline and lidocaine group.There was no significant difference in EC50 between amitriptyline and lidocaine group.The TFL measured at the proximal part of the tail was not significantly different between different time points in each group.The TFL measured at the middle part at 3 rain after drug adminisuation was significantly increased as compared with the baseline in all 3 groups but was not significantly different between the baseline and that measured at 2 d after drug administration.No CNS toxicity and local tissue damage were found during the experiment in all 3 groups.Conclusion Amitriptyline can produce intravenous regional anesthesia.The potency of amitriptyline is significantly lower than that of bupivncaine but is not significantly different from that of lidocaine.

OBJECTIVE: To investigate ultrastructurally into traumatic avascular necrosis of femoral head. METHODS: Femoral heads were procured during endoprosthetic replacement for 8 cases of intracapsular fracture of femoral neck, which had been subjected to internal fixation and developed Stage II avascular necrosis. The specimens were processed and studied under transmission electron microscope. RESULTS: In the normal bone tissues of the avascular necrotic femoral heads, the collagen fibrils constituting the collagen bundles of the bone matrix were of uniform diameter, and were regularly arrayed with orientation. In the necrotic bone tissues of the avascular femoral heads, the collagen fibrils were of unequal diameter, and were haphazardly arrayed without orientation. From the trabeculae of the avascular femoral heads emerged three different conditions of osteocytes: (1) In the trabeculae of normal bone tissues, the osteocytes belonged to both degenerative phase and formative phase osteocytes with the latter showing signs of degeneration; (2) In the necrotic trabeculae, the osteocytes perished leaving behind empty lacunae; (3) Over the trabeculae of the interface region could be discerned many active osteogenic cells, which were on their way of transformation into osteoblasts. In the trabeculae here, the osteocytes belonged to both formative phase and degenerative phase osteocytes. CONCLUSIONS: These results suggest that in the femoral heads with traumatic avascular necrosis, there is active osteogenetic activity around the necrotic bone tissues, amply implying a local reparative response following partial bone necrosis.

OBJECTIVE: To investigate further into the osteogenic potential of rabbit dermal fibroblasts with scanning electron microscope. METHODS: Split-thickness rabbit skin was processed into small chips that were cultured in vitro and then subjected to scanning electron microscopic study. RESULTS: The fibroblasts swam out from the skin chips and they increased in number rapidly and became confluent. The cells exhibited squamous configuration, possessing arboreal bifurcation and forming multi-layer structure. The fibroblasts then excreted numerous minute granules, heaping up on and around the cells. Thenceforth emerged on the cell surface fine needle-like crystals, that agglomerated with the granules to form nodules. The fibroblasts orientated themselves in a radiating pattern around the large nodules. Neighboring nodules could be linked up into trabecular structures. CONCLUSIONS: Sequence of events of new bone formation by rabbit dermal fibroblasts cultured in vitro is fully depicted and confirmed.

Objective To explore molecular mechanism and the curative effect of Yisuishengxue powder and its function of the hepersensitive site 2 (HS2) in ?-globin gene cluster locus control region binding with nucleoprotein.Methods After 3 months treatment of Yisuishengxue powder, nucleoprotein was extracted from the morrow cell before and after treatment. The HS2 DNA probes was combined with nucleoproteins.Electrophoresis gel mobile lag was utilized for observing the mobile velocity of DNA segment.Observe the mobile velocity of DNA probes.Results The mobile velocity of probes combined with nucleoproteins before treatment was different form that of the controls, while it was very close to the controls after treatment.Conclusions It is suggested that this compounding medicine might affect the DNA segment of HS2 site in ?-LCR binding with nucleoprotein GATA-1, which may be one molecular mechanism of Chinese herb therapy.