At present, the level of diagnosis and treatment of early gastrointestinal cancer has a larger gap between China and developed countries. In recent years, the advent of new endoscopic imaging techniques has improved the detection rate of early gastrointestinal cancer. Along with this, endoscopic submucosal dissection(ESD) enables radical resection for early cancer. In this article, we discuss how to improve the level of endoscopic diagnosis and treatment of early gastrointestinal cancer.
China ; Endoscopy, Digestive System ; Gastrointestinal Neoplasms ; diagnosis ; surgery ; Humans

Objective The purpose of this study was to investigate the effects of ropivacaine and bupivacaine on energy supply and mitochondrial oxidation phosphorylation of isolated rabbit heart muscle in order to compare the cardiotoxicity of the two local anestheties and explain the mechanism Methods Twenty four New Zealand rabbits weighing (2135?345)g were randomly divided into three groups of 8 animals each: control group(C); ropivacaine group(R) and bupivacaine group (B) The animals were anesthetized with intraperitoneal urethane 2g?kg -1 and heparinized (heparin 4mg?kg -1 ) Heart was quickly removed and connected to Langendoff preparation and perfused with oxygenated Krebs Henseleit buffer solution at normothermia(37℃) via aorta After 15 min perfusion, ropivacaine (group R) or bupivacaine(group B) was added to perfusate(500ng?ml -1 ) The heart was then perfused for another 10 min Myocardial tissue was taken from ventricle for determination of ATP, ADP and AMP content with high performance liquid chromatography Myocardial mitochondria was prepared and its oxidation of pyruvate and palmitoylcarnitine was measured using Clark electrode Results Myocardial ATP and ADP decreased significantly in group R and B as compared with those in group C The decrease in ATP and ADP in group B was more than that in group R (P

Objective To study the effects of heart ischemia reperfusion on conductive function of atrioventricular node (AVN) in rabbits. Methods Animal models of ischemia reperfusion of AVN were established by ligating and reopening the right coronary artery of rabbits. A total of 60 adult rabbits were divided into control groups ( n =10), right coronary artery occlusion group ( n =10), and ischemia reperfusion groups with ligation of the right artery occlusion for 10, 30, 60 and 120 min respectively ( n =10 for every subgroup). The hemodynamics, His bundle electrography and epicardial electography were carried out and recorded. Results After occlusion of right coronary artery, 94.8% animals in experimental groups were found to have prolonged atrial His interval (AH) ( P

ObjectiveTo study the effect of hyperbaric oxygen therapy on the cholinergic neurons of hippocampus and praxiology of vascular dementia rats.MethodsThe vascular dementia models were made and divided into control and therapy group. After 30 days of HBO therapy, abilities of learning and memory of rats were tested by using the Morris water maze. Immunochemistry staining was used to observe the number of cholinergic neurons of CA1 subfield of hippocampus. ResultsAbilities of learning and memory of rats and the number of the neurons positive to ChAT like immunoreaction in the CA1 subfield of the hippocampus significantly increased in therapy group.ConclusionHyperbaric oxygen therapy is effective on the vascular dementia model rats.

Objective To evaluate the significance of standardized ultrasound examination of fetal structures in the ifrst trimester (11-13+6 weeks). Methods The ultrasound data of 29 858 fetuses who underwent the ifrst trimester screening were analyzed retrospectively in Beijing Obstetrics and Gynecology Hospital of Capital Medical University from January 2010 to December 2012 and followed up the cases with structural abnormalities and increased nuchal translucency (NT). Results Among 29 858 fetuses, 328 structural defects were detected in 284 fetuses (0.95%) by ultrasound in the first trimester, including fetal hydrops (124 cases), choroid plexus cysts (36 cases), exencephaly (32 cases), gastroschisis (24 cases), exomphalos (22 cases), cardiac defects (19 cases), megacystis (14 cases), spine abnormalities (10 cases), meningoceles/encephaloceles (9 cases), alobar holoprosencephaly (8 cases), hydrocephaly (7 cases), abnormalities of extremities (7 cases), acrania (6 cases), amniotic band syndrome (4 cases), abdominal cyst (3 cases) and conjoined twins (3 cases). Pregnancy was terminated in all cases (115) with exencephaly, gastroschisis, exomphalos, meningoceles/encephaloceles, alobar holoprosencephaly, hydrocephaly,abnormalities of extremities, acrania, amniotic band syndrome and conjoined twins, and the defects were verified by the gross appearance of fetuses. Two cases of megacystis were turned out to be normal during follow-up while 1 case was proved to be aneuploid and 1 other case progressed to multiple abnormalities during the second trimester. Most choroid plexus cysts, except 1 case of aneuploid, were normal during the second and the third trimester follow-ups by ultrasound. Thirteen cases of fetal hydrops were found to be aneuploids and 4 hydrops cases were proved to be complicated with other structural defects during the second and the third trimester. NT was increased in 422 cases (1.41%), among which 122 cases (28.91%) were complicated with structural defects and/or fetal hydrops. Ninty-nine cases with increased NT underwent chromosomal examination and 38 cases were found to be aneuploides. During the follow-up of 298 cases with increased NT who continued pregnancy, 21 structural abnormalities were found, including cardiac defects (14 cases), neural abnormalities (4 cases) and diaphragmatic hernia (3 cases). Conclusion The standardized fetal ultrasound in the first trimester is a effective tool for the screening of aneupolides and major structural abnormalities.

ObjectiveTo explore the genetic impact of TPH1 A218C,MAOA-uVNTR on abnormal frontal lobe of depressed patients and the interactions between the two polymorphisms using the method of genetic imaging.Methods28 patients with major depression and 34 healthy controls which were equal in sex,age,years of education and had negative family history of mental illness were recruited in our study.All paticipants underwent functional Magnetic Resonance Imaging (FMRI) in negative emotion recognition and were divided into different genotypes.Then frontal lobe was extracted as region of interest by WFU software into six subregions-bilateral superior frontal lobe,middle frontal lobe and inferior frontal lobe.ResultsPatients (0.19 ± 0.01 ) and controls (0.15± 0.05 ) with TPH1 AA genotype showed increased activation in left inferior frontal lobe than patients and controls with AC or CC genot.Patients with AA genotype showed increased activation in right inferior frontal gyrus(0.28 ±0.07) than other five groups as well.Patients with MAOA-H genotype showed increased activation in right middle frontal gyrus(0.15 ±0.06),left inferior frontal gyrus(0.18±0.02) than patients and controls with L genotype.Superimposition of TPH1 A218C and MAOA-uVNTR exsited in abnormal function of left inferior frontal gyrus(F=4.98,P =0.047 ).Patients with AA and H genotype showed increased activation in this area significantly than other patient group.ConclusionDifferent genes in serotonin system can affect brain function through a common 5-HT feature.

Objective To examine the white matter micro structural changes of hippocampus in the mid-die-aged major depression, and hypothesis that the hippocampal neurogenesis during the effective antidepressants can be found by diffusion tensor imaging(DTI) technology. Methods Middle-aged patients with major depression were enrolled, twenty patients received open but controlled with SSRIs for 10 weeks,twenty age, gender, education-matched healthy controls were involved as control group. All the subjects were scanned by DTI,using both whole-brain,voxel-based analysis(VBA) and Regions of interests (ROIs) methods to analyze the data. Results The VBA analysis found the post treatment patients made significant improvement in the fight inferior frontal lobe, left cingulate gyms of iimbic lobe and the right sub-gyral of occipital,but no significant difference in the hippocampus were found between any groups (all P<0.01, cluster>20). For the hippocampal relative FA of ROIs analysis,there were no significant difference between the patients before and after treatment, even no difference between the prior-treatment patients and healthy control,the remitted patients and the healthy controls(P<0.05). Conclusions Micro structural white matter changes in the frontal gyms, temporal and cingulated gyms are associated with mid-die-aged depression,no changes were found in the hippocampus. These findings do not support the hypothesis that the hippocampal neurogenesis can be found by DTI technology.

Objective To discuss the application of implantation temporary cardiac pacing by balloon-tipped floating catheter for peroperative period patients. Method Thirty-three patients with severe bradyarrhythmia were received the balloon-tipped floating catheter to RV by Seldinger puncture technique.Meantime, the pacing signals of ECG were observed. The threshold and QRS waves to ensure the electrode position were determined. Result All of 33 cases were successfully punctured and 32 cases get paced, except 1 case had the electro - mechanical dissociation (EMD). Pacing threshold was less than 0. 9V, and mean remaining time was 12.47 ～ 161 (67. 05 ±34. 48) hours. Apical pacing was operated in 23 patients,and right ventricular outflow tract pacing in 10 patients. No severe complications were occurred. Conclusion The implantation method of temporary cardiac pacing by balloon-tipped floating catheter was convenient and safe. It could help the patients get safety in anesthesia and peroperative period.

Objective To study the clinical and pathologic features of chromphobe renal cell carcinoma (ChRCC) and to evaluate the conventional pathologic prognostic parameters in prognosis.Methods Seventy-five cases (42 males and 33 females) with pathological confirmed ChRCC (36 on the left and 39 on the right kidney) after nephrectomy during 1998 to 2009 were retrospectively analyzed. Patient's age ranged from 25 to 74 years, with a mean age of 56 years. Evaluation of conventional prognostic parameters was carried out. Kaplan-Meier survival curve was used to study the survival relationship. Results The mean tumor diameter was 7.3 cm. The majority of tumor macroscopic surface color was gray and yellow or gray and red. The majority of tumor cells were big polygon chromphobe cell or small round eosinophils. The TNM stages of these ChRCC were as follows: 30 cases in T1N0M0, 1 in T1N0M1, 26 in T2N0M0, 1 in T2N0M1, 11 in T3N0M0, 3 in T3N0M1, 1 in T3 N1 M0, 1 in T4 N0 M1 and 1 in T4 N1 M1. The pathologic grade of ChRCC was G1 in 3 cases, G2 in 24cases, G3 in 46 cases and G4 in 2 cases. All the 75 cases were followed up for 9 to 93 months (mean 44months), 7 patients died and others were alive without recurrence and metastasis. 3-year and 5-year survival rates were 93.3% and 90. 7%, respectively. The univariable analysis showed that tumor size (P=0. 028), TNM stage (P＜0. 001) were associated with tumor progression. The multivariable Cox regression model revealed that TNM stage was an independent predictor of aggressive ChRCC. Conclusions The ChRCC tumors are generally larger than other types of RCC and with a favorable prognosis. Fuhrman nuclear grade is not suitable for ChRCC. TNM stage is an independent predictor of aggressive ChRCC.

Objective To investigate the white matter microstructural changes of cingulation and congni-tive function impairment in patient with major depression. Methods 25 middle-aged first episode patients and 24 nondepressed comparison participants were enrolled,and all the subjects scanned by diffusion tensor imaging and tested by Wisconsin Card Sorting Test. Correlation analysis was done respectively for both two groups with FA and WCST items. Results Male patients with depression decreased FA in the middle frontal lobe ( - 29 24 32,16 voxels),the left superior temporal lobe (-36 -34 16,11 voxels),the sub-gyral of temporal lobe ( -45 1 - 15/ - 47 - 6 - 9; 16/10 voxels) and the right lobe of cingulate (18 - 2 29,22 voxels). And the female patients with depression shows reduced FA in the inferior frontal lobe ( -42 23 4/45 24 6; 15/21 voxels) ,the left precentral gy-rus (39 -44 -15,17 voxels) ,the right medial frontal gyrus (6 16 -18; 10 voxels) ,the left superior temporal lobe ( -55 -31 15; 89 voxels) ,the sub-gyral of temporal lobe ( -38 - 12 - 19;12 voxels) and the right anterior cingulate gyrus (71 26 -9; 15 voxels) (P<0.001 ,cluster > 10 voxels). The Regions of interests analyze with cingulate only found reduced FA in the right lobe of female group(0.26 ±0.05,0.33 ±0.08; P=0.03). Correlation were found between the right anterior cingulate and Rpe (r= -0.49, P = 0. 03) ,the right middle cingulate and Rpe (r= -0.56, P = 0. 01) in depressed patients. No significant association were found in healthy control group(P> 0.05). Conclusion Cingulate white matter fiber is abnormal in first episode depression and these abnormalities may be one of the pathophysiology of major depression.