Objective To analyze and investigate endoscopic and pathological characteristics in the diagnosis of early esophageal carcinoma. Methods The clinical data of 62 patients with early esophageal carcinoma who had been admitted to Southwest Hospital from January 2003 to December 2007 were retrospectively analyzed. Results Of all patients, 8 had upper esophageal carcinoma, 42 had middle esophageal carcinoma and 12 had lower esophageal carcinoma. The tumor growth patterns included surface diffusion growth (n = 30), bidirectional growth (n = 11), intracavitary growth (n = 9), intra-esophageal wall growth (n = 7) and mixed growth (n = 5). The diameter of lesions ranged from 1.0 cm to 2.9 cm in majority. Surgical resection was done in 38 patients, endoscopic mucosal resection in 23 patients and endoscopic submucosal dissection in 1 patient. Postoperative pathological examination showed that 13 patients had in situ carcinoma, 22 had intramucosal carcinoma and 27 had submucosal carcinoma. The lymph node metastatic rate of intramucosal carcinoma and submucosal carcinoma were 5% (1/22) and 15% (4/27), respectively. The numbers of squamous cell carcinoma, adenocarcinoma, small cell carcinoma, sarcoma carcinoma and spindle carcinoma were 57, 2, 1, 1, 1, respectively. ConelusionsEarly esophageal carcinoma tends to appear in the middle part of esophagus, and with surface diffusion growth type. Most of the early esophageal carcinoma are squamous cell carcinoma. Endoscopy combined with lugol's iodine and methyleneblue staining is effective in detecting early esophageal carcinoma.

Objective To discuss the donor site complications and the treatments of the anterolateral thiIgh flap transfer. Methods From July 1988 to July 2007,427 patients treated by anterolateral thish flap surgery were followed up.The donor sites were treated by several methods,including direct closure(49 cases),skin graft transfer(258 cases),anterolateral fascial flap transfer(27 cases),musculocutaneous flap and skin sraft transfer(65 cases), superficial epigastric artery flap transfer(28cases).The area of these flaps ranged from 30 cm×10 cm to 18 cm×7 cm.and the average follow-up was 21 months(ranged from 8 months to 54 months). All the data was analyzed by SPSS for Windows,Version 11.0.1. Results Short-term complications(within 4 weeks)and long-term complications (over 6months)were observed.The former included skin necrosis(5.4%),wound infection(4.0%),and necrosis of rectus femoris(0.5%); and the latter included chronic ulcer(4.9%), aerious scar(6.6%), serious discomfortable(5.9%),and quadriceps femoris disfunction(3.7%).The statistical results showed that there was a close correlation between the donor site morbidity and the surgical methods. Conclusion The complications of the donor site cannot be ignored.Protect the soft-tissue of the donor site carefully,design all appropriate operation plan.Careful preoperative examination and local flap transplantation can effectively decrease the rate of complications.

Objective To investigate the effect of fish oil parenteral supplementation on monocyte function in gastrointestinal cancer patients.Methods Sixty-four gastrointestinal cancer volunteers were equally randomized into study group and control group.Both groups received conventional lipid emulsion,and the study group was added with fish oil parenteral supplementation for 5 days.Blood samples were collected on the 1st,3rd,and 6th post-operative days to detect the interleukin (IL)-1β,IL-10,IL-6,tumor necrosis factor-α,and human leukocyte antigen-DR.Results After 5 days of continuous management,the IL-1β,IL-6,and tumor necrosis factor-o levels in the study group became significantly lower than those in the control group [(1 818 ± 213)pg/Lvs (2292 ±289)pg/L,P=0.027; (415 ±71)pg/Lvs (791±163)pg/L,P=0.001; (2 194± 350) pg/L vs (2 509 ± 507)pg/L,P =0.036,respectively),whereas the level of IL-10 by mononuclear leukocytes in two groups showed no significant difference.The expression of human leukocyte antigen-DR was significantly increased in both groups,but was significantly higher in the study group than in the control group [(76.6±15.2)％ vs (62.3±16.8)％,P=0.029].Conclusion Fish oil helps improve postoperative monocyte function in patients with gastrointestinal tumor.

Objective To investigate the quality of autoantibody testing around the whole country.Methods Laboratories that perform autoantibody testing were recruited by letters or telephone communications.The auto-antibodies examined by the quality-control survey included anti-nuclear antibody (ANA),anti-double-stranded DNA (anti-dsDNA) antibody,anti-extractable nuclear antigens (anti-ENA),antimitochondria antibody (AMA),anti-smooth muscle antibody (ASMA),and anti-citrulline antibody (CCP).Each autoantibody was tested for 3 samples,so 15 samples were tested in total.Sample distribution and data analysis were double-blinded.Qualitative interpretation,staining patterns were evaluated by IIF.The agreement with qualitative interpretation for each specimen was evaluated by ELISA,and Immuno-Blot/Dot-Blot.Results One hundred and eight laboratories participated in this study.The testing methods included indirect immumofluorescence (IIF),immuno-Blot (IB),Dot-Blot (DB),double diffusion method (DID),enzymelinked immunosorbent assay (ELISA),chemo-illuminescent assay,Dot-immunogold filtration assay.The accuracy rates were 82％,83％,95％,96％,86％,respectively for ANA,anti-dsDNA,AMA,ASMA,and anti-CCP antibody.Anti-ENA were further divided into anti-SNP,anti-Sm,anti-SSA,anti-SSB,anti-Scl-70 subgroups,and the accuracy rates were 84％,95％,98％,98％,88％,respectively.The distribution of quantitative values by different laboratories for ANA (by IIF),anti-dsDNA,anti-CCP antibody (by ELISA) varied remarkably.Conclusion Hospitals that enrolled in the survey and the items involved for quality control were increasing year by year.The accurate rates of ANA,anti-dsDNA in this survey were similar to the past national quality control surveys,the quality of AMA/ASMA,anti-CCP antibodies test was better than that of the past surveys,but the quality of anti-ENA antibodies test needs to be improved.

Objective To investigate the misdiagnosed vascular vagovagla reflexes (VVR) and the treat-ments during interventional therapy for peripheral anerial disease (PAD). Methods The clinical data of 5 patients with VVRs from 128 PAD patients undergoing interventional therapy so as to analyse the causes for the misdiag-noses and then render pertinent treatment. Results The VVR in the 5 patients belonged to mixed type and all cas-es occurred after intervention and initially misdiagnosed. All patients were recovered well without adverse reaction. Conclusion Intervention therapy for PAD may be susceptible to VVR. Prompt management may bring in a good prognosis when VVR happens.

Objective To discuss the application of run?through wire stretch technique in the procedure of endovascular therapy for complex subclavian artery occlusive diseases. Methods The clinical data of 22 patients who were diagnosed complex subclavian artery occlusive diseases were retrospectively analyzed from June 2013 to January 2016 in vascular surgery department of Wangjing Hospital .The patients were treated endovascular therapy using run?through wire stretch technique in all procedures successfully. Results The complex subclavian artery occlusive diseases were including long segment occlusion of the left subclavian artery and ostial stenosis or occlusion of the right subclavian artery. The left subclavian artery occlusion patients was 16 and right subclavian artery ostial stenosis or occlusion was 6. The technical success rate was 100%. All patients were using combination of femoral artery and brachial artery approach. Run?through wire stretch technique was used in the procedure of endovascular therapy, which had improved the technical success rate. After the treatment the symptom improvement rate was 88%. The symptoms of upper limb and posterior circulation ischemia were improved. Conlusion Upper limb artery combined femoral artery approachand run?through wire stretch technique can improve the recanalization in the procedure of endovascular therapy for complex subclavian artery occlusive diseases.

Objective:To probe the different influence of pericardial devascularization by preserving vagus trunk(VTPPD) and pericardial devascularization (PD) on portal hypertensive gastropathy (PHG).Methods:77 patients with portal hypertension were divided into VTPPD and PD group,the VTPPD group included 36 cases,and PD group included 41 cases.Varices of esophagus and fundus of stomach and PHG were observed by gastroscopy before and 3 weeks after operation in all cases,and compared postoperative incidence of PHG in the 2 groups.Results:In all cases,Varices of esophagus and fundus of stomach disappeared or relieved obviously.The incidence of PHG in VTPPD group before operation was 55.6%(20/36),and that after operation was 69.4%(25/36),the former was not higher statistically(P=0.224);the incidence of PHG in PD group before operation was 61.0%(25/41),and that after operation was 87.8%(36/41),the former was not higher than the latter statistically(P=0.005);and the postoperative incidence of PHG in PD group was higher significantly than that in VTPPD group (P=0.048).There were 8(22.2%,8/36)patients whose degree of PHG aggravated in VTPPD group,and there were 19(46.3%,19/41)patients whose degree of PHG aggravated in PD group,the rate of the former was significantly lower than that of the latter(P=0.027).Conclusion:Comparing with the classic portoazygous devascularization,VTPPD can reduce the incidence and the degree of PHG.

Objective To investigate the effect of atorvastatin on atherosclerosis formation of common carotid artery and its possible mechanism. Methods A total of 36 male apolipoprotein E gene knockout (ApoE-/-) mice were randomly divided into 3 groups: a control group, a model group, and an atorvastatin group. The mice of the control group were fed with normal diet and received a sham operation, while the mice in the model group and the atorvastatin group were given high fat diet and received a right common carotid artery cannulation. At 5 weeks after procedure, the mice in the model group and the atorvastatin group were intragastric administration of normal saline and atorvastatin (10 mg/kg daily), respectively. At 8 weeks after procedure, the blood from femoral arteries was obtained for biochemical detection, then right common carotid arteries were taken out for histopathological study. Real-time quantitative polymerase chain reaction (PCR) was used to detect the expression levels of NF-κB mRNA in the plaques. Western blotting was used to detect phosphorylated NF-κB p65. Results The lipid levels in the model group and the atorvastatin group were significant higher than those in the control group (al P<0. 05). The lipid level in the atorvastatin group was lower than that in the model group, but there was no significant difference (P> 0. 05 ). The histopathological study showed that the obvious plaque formation and the necrotic core and neovessels in plaques were observed in the model group; obviously thickened intima and more intact endothelial cel s in the vessel wal were observed in the atorvastatin group. The plaque burden in the model group and the atorvastatin group was significantly higher than that in the control group (al P<0. 001), while the plaque burden in the atorvastatin group was significantly less than that in the model group (P<0. 001). Real-time fluorescence quantitative PCR detection showed that the expression levels of NF-κB mRNA in the model group and the atorvastatin group were significantly higher than that in the control group (al P<0. 001), and the expression level of NF-κB mRNA in the atorvastatin group was significant lower than that in the model group (P= 0. 022). Western blotting showed that the expression level of the phosphorylated NF-κB p65 was significantly higher than that of the control group (P<0. 001), and the expression level of the phosphorylated NF-κB p65 was significantly lower than that in the model group (P<0. 001). Conclusions Atorvastatin may reduce atherosclerosis in the common carotid artery in ApoE-/-) mice by down-regulating NF-κB.

This study was conducted to evaluate the relationship between serum insulin levels and the production of insulin antibody (IA) in type 2 diabetes (T2DM).A total of 647 T2DM were included.Among them,20.9％ patients were IA positive,who were elder and had a longer duration,lower BMI,a higher positive rate of glutamic acid decarboxylase antibody(GADAb) and higher serum insulin levels during an insulin secretion test.More patients were treated with insulin in IA positive group than in IA negative group (65.9％ vs 41.0％,P =0.000).Fasting serum insulin level was associated with occurrence of IA in all patients (OR =1.02,P =0.001) and insulin treated patients (OR =1.033,P =0.002).The cut-off point of fasting serum insulin level for predicting IA positive was 17.87 mIU/L (sensitivity 55.1％,specificity 89.0％).Exogenous insulin use is associated with the presence of IA.Fasting serum insulin level can be used as a predictor for the production of IA in insulin-treated patients.

Object To isolate the active compounds on reversing multidrug resistance (MDR) of tumor cell from the ethanol extract in the seeds of Cnidium monnieri (L ) Cuss Methods The fractionation directed by bioactivity was carried out with silica gel chromatography and RP HPLC Results Three active coumarins were obtained: imperatorin (Ⅰ), edultin (Ⅱ) and 3′ isobutyryloxy O acetyl columbionetin (Ⅲ) Their sturctures were identified by spectroscopic analysis Conclusion These three compounds have a medium reversing MDR of KBV200 in vitro