Objective To analyze endoscopic histological characters and establish diagnostic standards of colorectal polyps with confocal laser endomicroscopy (CLE) examination and to explore the diagnostic value of the CLE in adenomatous polyps and non-adenomatous polyps. Methods From June to December in 2009, 90 patients were recruited in this study, which included 40 pathologically confirmed colorectal polyps patients (total 48 colon and rectal polyps) and 50 patients for prospective study (total 106 colon rectal polyps). At same time 10 spots of normal mucosa was taken for comparison. Firstly the CLE images of 48 pathologically confirmed colorectal polyps (22 adenomatous polyps and 26 non-adenomatous polyps) were analyzed, and the diagnosis criteria for distinguishing adenomatous polyps and non-adenomatous polyps was established with CLE. Then according to the criteria, 106 colorectal polyps underwent prospective diagnosis with CLE. Finally, the CLE diagnosis result was compared with pathologically result to evaluate the diagnosis efficiency of CLE. Results In the 48 colorectal polyps of 40 pathologically confirmed colorectal polyps patients, there were 22 adenomatous polyps and 26 non-adenomatous polyps. The sensitivity, specificity and accuracy of CLE in adenomatous polyps diagnosis were 94. 0%, 92. 9%, and 93. 4%, respectively. The positive predictive value was 92.2% and the negative predictive value was 94.5%. The sensitivity, specificity and accuracy of CLE in non-adenomatous polyps diagnosis were 92. 9%, 94.0%, and 93. 4%respectively, the positive predictive value was 94.5% and the negative predictive value was 92.2%.The coherence of CLE and histopathology in adenomatous polyps diagnosis was pretty good (Kappa=0. 893). Conclusion The accuracy of CLE in adenomatous polyps and non-adenomatous polyps differential diagnosis was high, and the coherence with histopathology diagnosis was good, which provided experience for further detection of early rectal precancerous.

To establish seven kinds of minerals containing sulfate kind of near infrared spectral identification method
of traditional Chinese medicine (TCM). 7 species of mineral medicine containing sulfate after crushing sieving, measure all the samples in 12 000-4 000 cm-1 section within the scope of the near infrared spectrum, spectrum signal by different pretreatment methods, after the screening of the different characteristics of the spectrum to extract the effective information, using cluster analysis method for qualitative identification. In 8 600-8 100 cm-1, 5 843-4 245 cm-1, 7 096-6 337 cm -1 section within the scope of the atlas signal after the vector normalization and multiple scattering correction, K-average clustering analysis to 20 batches sulfate kind of mineral medicine is divided into seven categories, the results of the analysis method and the traditional traits identification results are basically identical. This method is simple, fast, and can be used for these minerals containing sulfate class the qualitative identification and quality control of Chinese traditional medicine.

This study was aimed to establish a qualitative model of near-infrared spectroscopy in order to accurately and rapidly identify several mineral Chinese medicinals from fossil including Os Draconis, Dens Draconis, Fossil Shell of Spirifer, and Fossil Crabs. The near-infrared diffuse reflectance spectroscopy combined with OPUS software was used to analyze the spectral characteristics of these samples. The pattern recognition method was explored through cluster analysis. And the accuracy of the model was verified. The results showed that these mineral Chinese medicinals from fossil had their characteristics absorption so that they can be quickly and accurately differentiated from each other through pattern recognition method. It was concluded that based on near-infrared spectroscopic mod-eling, these mineral Chinese medicinals from fossil including Os Draconis, Dens Draconis, Fossil Shell of Spirifer, and Fossil Crabs can be quickly and accurately identified.

Objective:To develop a qualitative analysis model for the fast identification of Dens Draconis and its adulterants by NIR correlation coefficient method. Methods:On the basis of the traditional morphological identification, the spectra were collected u-sing the fiber accessory of a near-infrared spectroradiometer. The reference spectra were set up using the NIR spectra of certified Dens Draconis. The characteristic spectral section was chosen and the appropriate threshold was set to establish a qualitative analysis model for the rapid identification of Dens Draconis and its adulterant. Results:The spectral section of 5 000-4 200 cm-1 was selected as the characteristic spectral section, the correlation coefficient of Dens Draconis and its adulterant was calculated in training set samples, and 92. 67% was used as the threshold. Totally 10 batches of validation set samples were validated the qualitative analysis model, and the prediction accuracy was 90%. Conclusion:The method has good prediction ability, and can be used in the rapid identification of Dens Draconis and its adulterant.

Objective:To understand the development reality of pastes in Hubei province through the investigation of paste busi-ness in 2013. Methods:Issued by Hubei provincial administration of traditional Chinese medicine, a questionnaire investigation was a-dopted in the study. The implementation, usage amount, scope, composition of the users, price, technical personnel and propaganda of pastes were investigated and statistically analyzed in 91 TCM, integrated Chinese and western and national hospitals in our province. Results:The business conduction rate of pastes in Hubei province was nearly 61. 54% in 2013 with the production of approximately 45,000 batches and the technical personnel of 1 538. The paste business created great economic value of 0. 48 million yuan in 2013 with strengthened propaganda. However, the brand building was slightly weak. Conclusion:The business of pastes in Hubei province has developed rapidly and still shows great development potential.

s:Objective Discuss the application of CTA for renal vascular control in laparoscopic renal transplantation of relative renal donors. Methods 83 cases of relative renal transplantation donors which are completed in our department during March 2007 to Junuary 2012 were divided into 3 Groups. There were 35 cases in group A ( laparoscopic nephrectomy with preoperative CTA examination) , 15 cases in group B ( laparoscopic nephrectomy without preoperative CTA examination) , and 33 cases group C ( conventional nephrectomy) . In group A, the location and quantity of renal arteries and veins were observed with preoperative CTA to make plan for vascular control. And the oper-ation time, amount of bleeding, vascular injury cases, the renal warm ischemia time in the graft, mean time of postoperative hospitalization were compared with those of group B and group C. Results 5 cases of renal vascular anomalies were observed in Group A, including 2 cases of single accessory renal artery, 2 cases of early branch of renal artery and 1 case of double renal veins. And all of them were intraoperatively comfirmed. 3 cases of renal vascular anomalies were observed in group B, including 1 case of renal arteriovenous ectopic, 1 case of injury in the accessory renal artery with diameter of 0. 6 cm, and it were given artery elongation with inferior epigastric artery postoperatively, and 1 case of renal vein injure during blocking lumbar vein with Hemolock which were repaired postoperatively. 5 cases of renal vascular anomalies were observed in group C, including 1 case of single accessory renal artery, 3 cases of early branch of renal artery, and 1 case of accessory renal artery with the diameter of 0. 1cm in the right renal was injured during surgery. The operation time, amount of bleeding, cases with vascular injury , renal warm ischemia time of donor , and the mean time of postoperative hospitalization in group A were superior to those in group B and group C. Conclusion CTA is a simple noninvasive imaging method, which can provide the details of the renal vascular preop-eratively to ensure the safety of patients during surgery and improve survival quality of donor renal, and it is of great advance in laparoscopic renal transplantation of living-related renal donors.

Objective To evaluate the impact of postoperative adjuvant chemotherapy on prognosis of patients with advanced rectal carcinoma using a meta-analysis.Methods We searched PubMed to identify literature comparing observation with adjuvant chemotherapy after neoadjuvant chemoradiotherapy and surgery for patients with advanced rectal carcinoma.Data were analysed using Revman 5.0 statistical software.Results Nine trials were included consisting of 6 212 patients:3 421 patients received adjuvant chemotherapy and 2 791 patients did not.The age ranged from 55.6 to 68 years.Adjuvant chemotherapysignificantly affects overall and disease-free survival (P =0.002 and P =0.000 5 respectively) of patientswho had received neoadjuvant chemoradiotherapy.The subgroup analysis which originate from insufficient data reveales ypT0-2 patients and ypT3-4 patients can't benefit from adjuvant chemotherapy.Conclusion Postoperative adjuvant chemotherapy can improve the survival of advanced rectal carcinoma patients after neoadjuvant chemoradiotherapy,but can't increase the survival of pathology complete respone and yPN + patients.

Objective:To explore the cooperation and clinical significance of HIF-1α,ALDH1 and Hedgehog signaling pathway in the activation of cancer stem cell(CSC) in triple negative breast cancer(TNBC).Methods: ALDH1+(Aldehyde dehydrogenase1)breast cancer stem cells and ALDH1-breast cancer cells were selected from MDA-MB-231 cells by magnetic activated cell sorting system(MACS),qRT-PCR method was employed to analyze the expression differences of HIF-1α and Hedgehog signaling molecules Sonic hedgehog(SHH),patched1(PTCH1),Smoothened(SMO) and Glioma-associated oncogene homoglog1(GLI1) in ALDH1+ breast cancer stem cells and ALDH1-breast cancer cells.Immunohistochemical method was applied to study the expressions of HIF-1α and ALDH1 and the relationships among HIF-1α,ALDH1 and Hedgehog signaling molecules in TNBC.Results: The expressions of HIF-1α mRNA,SMO mRNA and GLI1 mRNA in ALDH1+ breast cancer stem cell were higher than those in ALDH1-breast cancer cell(P all<0.05).The positive expression rates of HIF-1α were 90.0% and 70.0%,and the positive rates of ALDH1 were 93.3 % and 66.7 % in TNBC and non-TNBC,respectively(P all<0.05).Spearman rank correlation analysis showed that the expression of HIF-1α was positively related with that of ALDH1 in TNBC(r=0.53,P<0.01).HIF-1α expression was correlated with lymph node metastasis and TNM stage(P all<0.05),ALDH1 expression was correlated with histological grade and TNM stage(P all<0.05).In addition,the expression of HIF-1α was positively related with that of Hedgehog signaling molecules SHH(r=0.584,P<0.01),SMO(r=0.467,P<0.01) and GLI1(r=0.439,P<0.05),the expression of ALDH1 was positively related with that of SHH(r=0.426,P<0.05) and GLI1(r=0.394,P<0.05).Conclusion: HIF-1α and Hedgehog signaling pathway were activated in ALDH1+ breast cancer stem cell.HIF-1α,ALDH1 and Hedgehog molecules may cooperate with each other to activate breast CSC to promote the malignant progression of TNBC.

Compared with that for botanical drugs and animal-derived drugs, the identification study for mineral traditional Chi-nese medicines is relatively weak. The traditional identification methods can’ t meet the quality control requirements of mineral tradi-tional Chinese medicines, and the application of modern analysis techniques are needed urgently in the systematic research of mineral traditional Chinese medicines. In the paper, the identification of traditional methods combined with some modern analysis techniques such as X-ray diffraction, near infrared spectroscopy and Raman spectroscopy for mineral traditional Chinese medicines was summarized and analyzed to provide basic idea and methods for the systematic identification construction of mineral traditional Chinese medicines.

Objective To analyze the causes of failed transcatheter closure for ventricular septal defects (VSD)in children. Methods One thousand two hundred and eighty children aged 13 to 141 months who underwent transcatheter closure from June 2009 to September 2013 in Guangdong General Hospital were selected. There were 43 failures(3. 36% ). The clinical data including transthoracic echocardiograph( TTE),radiography,interventional ap-proach and surgical findings were analyzed. Results Forty - three patients included 25 male and 18 female. The pa-tients' ages ranged from 13 to 141(43. 0 ± 31. 9)months and their weight ranged from 10 to 35(16. 3 ± 5. 59)kg. The causes of failure including doubly committed subarterial VSD misdiagnosed as perimembranous VSD(PMVSD)or intracristal VSD were in 6 patients. The size of occluder was too small in 13 cases,and there were statistical differences between three measurements of size of VSD(F = 19. 134,P = 0. 001). The size of VSD measured by left ventricular an-giography was significantly smaller than that measured by TTE,and there was statistical difference[(4. 78 ± 1. 11) mm vs(6. 48 ± 1. 43)mm,t = 4. 50,P = 0. 001]. The dimension of VSD measured by left ventricular angiography was significantly smaller than that measured by surgical findings,and there was statistical difference[(4. 78 ± 1. 11) mm vs(7. 02 ± 1. 08)mm,t = 5. 92,P = 0. 001]. But,the size of VSD measured by TTE had no significant difference compared with that measured by surgical findings(t = 1. 42,P = 0. 168). Aortic regurgitation occurred in 14 cases;atrioventricular block or left bundle branch block in 3 patients;tricuspid stenosis in 2 cases and residual shunt in 5 pa-tients. Conclusions Doubly committed subarterial VSD may be misdiagnosed as PMVSD or intracristal VSD. In the ca-ses of VSD concomitant with aortic valve prolapse,size of the occluders should be referred to VSD dimensions measured by TTE. In the cases of VSD adjacent to aortic valve,suitable occluders should be selected and operation technique should be improved to avoid aortic regurgitation.