Objective To investigate the influence of injection color regents concentration on completed resection rate, operation time and injection volume of patients with intestinal tumor by ESD.Methods 90 elderly patients with intestinal tumor by ESD were chosen from June 2013 to June 2016. They were randomly divided into 3 groups including A group (30 patients) with glycerin fructose used alone, B group (30 patients) with glycerin fructose combined with 2% mythylene blue on the basis of glycerin fructose and C group (30 patients) with glycerin fructose combined with 4% mythylene blue on the basis of glycerin fructose; and the completed resection rate of tumor, operation time, injection volume and complication incidence in the peri-operative period of 3 groups were compared.Results There was no signiifcant difference in the completed resection rate of tumor among the 3 groups (P < 0.05). The operation time and injection volume of C group were signiifcant better than A group and B group (P< 0.05). There was no signiifcant difference in operation time and injection volume between A group and B group (P < 0.05). There was no signiifcant difference in the complication incidence in the peri-operative period among the 3 groups (P < 0.05).Conclusion Compared with glycerin fructose used alone and glycerin fructose combined with 1% mythylene blue for 2 mg, glycerin fructose combined with 1% mythylene blue for 4 mg by intestinal submucosal injection on patients with intestinal tumor by ESD can efifciently shorten the operation time and reduce the injection volume.

Objective To investgate risk factors of delayed bleeding after endoscopic submucosal dissec-tion(ESD)for early colorectal tumor and precancerrous lesions. Methods We retrospectively reviewed clinical date of 138 patients with early colorectal tumor and precancerrous lesions who received ESD in Hubei Cancer Hos-pital from October 2012 to October 2016. Risk factors of delayed bleeding were analysed by univariate and multi-variable logistic regression analysis. Results Ten(7.2%)of 138 patients occurred delayed bleeding after ESD. Univariate analysis showed that there was significent difference between the bleeding group and the non-bleeding group in location of the lesion(P = 0.022),severe fibrosis of submucosa(P = 0.016),Obvious intraoperative bleeding(P = 0.032)and inadequate endosopic experience of endoscopist(P = 0.045). Multivariate Logistic re-gression analysis showed that location of lesion(P = 0.003,OR = 4.64,95%CI:1.71~12.58),severe fibrosis of submucosa(P = 0.009,OR = 4.83,95% CI:1.49~15.60)were independent risk factors of delayed bleeding after ESD for early colorectal tumor and precancerrous lesions. Conclusion Patients with early colorectal tumor and precancerrous lesions in the rectum and severe fibrosis of submucosa are prone to delayed bleeding after ESD.

Objective To develop a stable method for fingerprint analysis of extractum platycodi liquidum to ensure its u‐niformity and stability .Methods UPLC‐ELSD was applied to obtain a chromatogram with 11 well separated peaks ,and the chromatographic condition was as follows:mobile phase was gradient elution by acetonitrile‐water ,column was ACQUITY UPLC BEH C18 (2 .1 × 100 mm ,1 .7 μm) with the column temperature of 30 ℃ and the flow rate of 0 .2 ml/min .Results The chromatographic fingerprints were analyzed with similarity evaluation system for chromatographic fingerprint of TCM .Similar‐ities were all greater than 0 .90 ,which could meet the requirement for chromatographic fingerprint of TCM .Conclusion The stability ,repeatability and precision of the developed method were all validated ,and the chromatographic fingerprint analysis was a rapid and accurate method for the quality evaluation of traditional Chinese medicine .

Perioperative blood volume monitoring and treatment is an important part of clinical anesthesia,which is essential for restoring effective blood volume,ensuring oxygen supply to organs and tissues,and stabilizing the internal environment.It is also an important part of rapid recovery after surgery.Selecting appropriate blood volume monitoring methods and reasonable fluid therapy during the perioperative period can optimize the hemodynamics of patients.But there is still some controversy about the intraoperative blood volume monitoring scheme.This article intended to analyze and review the characteristics and clinical value of various perioperative blood volume monitoring methods,and explore the strategies of perioperative blood volume monitoring and treatment,so as to provide a theoretical basis for preventing or reducing postoperative complications and improving the prognosis of patients.

Objective:To study the role of interleukin 6 (IL-6) in the occurrence and development of acute liver injury.Methods:Twelve C57BL/6 male mice without specific pathogens were randomly divided into a control group and an acute liver injury model group, with six mice in each group. Control and model group were injected with an equal volume (dosage of 10 mg/kg) of phosphate-buffered saline (PBS) and concanavalin A (ConA) into the tail vein, respectively. Samples were collected at 6 h for liver HE staining. Transaminase assay was used to determine the success of the induction model. The expression of IL-6, IL-17, IL-1β, interferon (IFN) γ and tumor necrosis factor α were screened by quantitative fluorescence PCR (qPCR). The expressional condition of IL-6 and IFNγ were measured by enzyme-linked immunosorbent assay (ELISA). Subsequently, three control groups and three IL-6 neutralizing antibody groups were established for acute liver injury, respectively. Equal volumes of PBS or IL-6 neutralizing antibody (100 μg/body) were injected prior 30 minutes, followed by injection of ConA (10 mg/kg) into the tail vein. Blood sampled from eye and liver tissue were fetched at 6 h. Liver tissues were stained with HE and serum alanine aminotransferase (ALT) was determined. An independent sample T-test was used for data comparison.Results:Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) of the model group was significantly higher than control group [ALT: (2 618.99 ± 188.08) U/L and (43.34 ± 5.02) U/L, t = -13.69, P = 0.001; AST: (942.48 ± 150.44) U/L and (57.80 ± 4.84) U/L, t = -5.878, P = 0.01]. Liver HE staining showed that the structure of hepatocyte cord was disordered, the cytoplasm of hepatocyte was lightly stained, and large necrotic foci were gradually formed, accompanied by lymphocyte infiltration, and then a mouse model of acute liver injury was successfully established. Protein levels of IL-6 and IFN, and mRNA of the model group were significantly up-regulated, as compared to control group. IL-6 mRNA expression of the model group was increased 73.7 times that of the control group ( t =-6.218, P < 0.001), and the serum IL-6 expression level was also higher than that of the control group (18 537.02 ± 92.57) pg/ml ( t = -199.782, P < 0.001). IFNγ mRNA was 108.4 times higher than that of the control the group ( t = -4.413, P = 0.003), and serum IFNγ concentration of the model group was also higher than the control group (12 068.30 ± 288.43) pg/ml ( t = -41.748, P < 0.001). Among them, IL-6 level was obviously increased, suggesting that it could participate in the occurrence and development of liver injury. IL-6 neutralizing antibody was injected into the tail vein. ALT level of IL-6 neutralizing antibody was significantly lower than acute liver injury control group [(167.41 ± 47.80) U/L and (1 520.34 ± 190.21) U/L, t = 6.899, P = 0.015]. Liver tissue HE staining showed that hepatocyte necrosis and the number of necrotic foci was significantly alleviated after blocking serum IL-6.Immunohistochemical results showed that the expression of activated caspase3 and hepatocyte apoptosis in the IL-6 neutralizing antibody group was decreased. Conclusion:Neutralizing IL-6 can significantly reduce acute liver injury caused by concanavalin A.

Adenocarcinoma, Clear Cell/pathology* ; Carcinoma in Situ ; Cell Transformation, Neoplastic ; China ; Endometriosis/pathology* ; Female ; Humans