Objective To assess the curative effect and safety of endoscopic therapy at duodenum elevated lesions. Methods We retrospectively studied the clinical data including general data, the procedure of performance, the lesions pathological characters, complications and recurrence after the treatment of patients who underwent endoscopic treatment. Results 111 patients of 112 patients were treated by endoscopic treatment successfully, 1 case was treated by surgery. 49 lesions were treated by electrocoagulation, 36 lesions were treated by polypectomy or endoscopic mucosal resection (EMR), 27 by endoscopic submucosal dissection (ESD). Complication rate was 16.96%(19/112), 1 case of active bleeding was treated by surgery in hemostasis difficulty. 6 cases of perforation, 2 cases of delayed bleeding, 2 cases of transient increase in amylase level and 1 case of delayed perforation. All the patients were successfully performed. Post-operation follow-up period was 1~12 months. Conclusion Endoscopic treatment holds advantages of minimally invasive, quick recovery, low cost, and less risk which may be play an important role in duodenal elevated lesions.

Background and purpose:Esophageal carcinoma is one of main malignancies with rapid course and a poor prognosis in China. The reasons of poor overall survival are the invasion and metastasis of the tumor. Matrix metalloproteinase (MMPs) play essential roles in promoting tumor invasion and metastasis. In this study, we aimed to investigate the expression and functional signiifcance of matrix metalloproteinase 16(MMP-16) in esophageal squamous cell carcinoma (ESCC). We expect to ifnd a lead molecule for the beneift of early detecting tumor and the development of novel treatment of ESCC. Methods:The expression levels of MMP-16 protein and mRNA in human ESCC and the matched normal tissues were determined by immunohistochemistry, Western blot and Real-Time PCR (RT-PCR). The stable Ec109 cell line with MMP-16 knockdown and negative controls were established by RNA interference technology. The cell migration, invasion, proliferation and cell apoptosis of MMP-16 in stable interfered Ec109 cell line was examined by cell counting, scratch test, Transwell test and lfow cytometry assays. The data were analyzed by t test. Results:MMP-16 protein was downregulated in cancerous group compared with the matched normal tissue and correlated with the clinical features of histological differentiation (P<0.05) and tumor stage (P<0.05). The levels of MMP-16 mRNA and protein in Ec109 were signiifcantly decreased by RNA intetrence (P<0.05). We demonstrated that MMP-16 silencing signiifcantly promoted cell invasion and migration (P<0.05), and inhibited cell apoptosis (P<0.05), while no significant effect was observed on cell proliferation (P>0.05). Conclusion: MMP-16 is downregulated in human ESCC tissues. The cell migration and invasion is promoted by interference of MMP-16 in Ec109, while the cell apoptosis is inhibited. MMP-16 may be considered as a target gene for therapy of ESCC.

Objective·To investigate and compare the curative effect of rubber ring and dental floss combined with hemoclipping assisted endoscopic submucosal dissection(ESD) on gastrointestinal tumors.Methods·A total of 54 patients with gastrointestinal tumors were collected.Twenty-seven patients in rubber ring group accepted ESD assisted by rubber ring with hemoclipping,and the other 27 patients in dental floss group accepted ESD assisted by dental floss.with hemoclipping.Duration of the operation,installation time of the traction device,detachment frequency of hemoclipping,injury of mucosa,one-time complete resection rate,and complication rate were analyzed as key indicators.Results·The detachment frequency of hemoclipping in rubber ring group was significantly less than that in dental floss group (t=4.418,P＜0.05).There was no injury of mucosa in rubber ring group,while,three patients had mucosa injury in dental floss group.There was no statistically significant difference on duration of operation,installation time of traction device,one-time complete resection rate,and complication rate between two groups.After 2 ～ 12 months of follow-up,the wound healed well in all patients in rubber ring group.No evidence of tumor recurrence was noted.Conclusion·Compared with dental floss,rubber ring combined with hemoclipping is superior in assisted ESD,especially in the right half colon.It is an effective assist device with little trauma and adjustable direction.

Objective To observe the effect of dexmedetomidine in cerebral aneurysm embolization in pa-tients with hypertension. Methods Sixty patients with hypertension undergoing emergency cerebral aneurysm em-bolization were randomly divided into two groups:research group(dexmedetomidine given group) and control group. SBP,DBP,HR,plasma norepinephrine(NE):baseline value(T0),before intubation(T1),after intubation (T2),after extubation(T3). Extubation time and anesthetic-related complications were also recorded. Results The hemodynamic parameters and plasma norepinephrine concentration in the research group were more stable than those in the control group at different time point during perioperative period. There was no difference between two groups about extubation time. The incidence of anesthetic-related complications in research group was lower than control group(P < 0.05). Conclusions Dexmedetomidine can reduce the stress response of intubation ,extuba-tion and perioperative hemodynamic fluctuations in cerebral aneurysm embolization in patients with hypertension. It can also reduce the consumption of prorofol and the incidences of adverse effects.

Third-grade class A hospitals undertake three tasks-medical service,scientific research and teaching.scientific research is the motivation for third-grade class A hospitals' continuous development and also an important symbol of their medical and academic level.On the purpose of evaluating overall scientific level of such hospitals this thesis analyze the scientific projects and the outcomes of 34 hospitals by using the method of literature research and questionnaire,extracting advantages for scientific research,seeking their problems and coming up with corresponding strategy.have analyzed the achievements we acquired as well as the problems still existing.According to the reality of Fujian Province,some suggestions are coming up with so as to improve the scientific research.

Objective: To discuss the clinical features of basaloid squamous carcinoma(BSC)and the factors relating to its prognosis and to compare patient survival between poorly differentiated squamous cell carcinoma(PDSC)and BSC. Methods: Clinical and pathological data of BSC and PDSC cases seen in our hospital between January 2004 and December 2008 were reviewed. Results: There were no statistical differences in demographic and clinical features between PDSC and BSC patients,with the exception that a larger proportion of BSC patients were female(P=-0.001).Additionally,higher tobacco consumption was observed among BSC male patients (P=0.003).There were no significant differences in survival rate between BSC and PDSC groups(X2=0.03,P=0.5470).The median survival time of BSC and PDSC patients was 19 months and 30 months，respectively.The 4-year survival rate was 22.4%and 36.1%，respectively(u=0.740,P=0.230).No significant difference was found in survival rate between stage Ⅰ and stage Ⅱ patients(X~2=0.109，P=0.2974).The median survival time of stage Ⅰ and stage Ⅱ patients was 19 months and 46 months，respectively；and the 4-year survival rate of stage Ⅰ and stage Ⅱ patients was 47.3% and 45.2%，respectively(u=0.122，P=0.450).Using Cox proportional hazard model，we found that surgical types and clinical stages of BSC were correlated with its prognosis.Compared with that of patients who received lobectomy,the postoperative mortality hazard of patients who received pneumonectomy and segmentectomy was increased by 1.379 times(P=0.031)and 1.634 times(P=0.061)，respectively.A more advanced clinical stage was associated with an increase in the postoperative morta,ty hazard ratio(X~2=14.12,P=0.000).The postoperative mortality hazard of patients of stage Ⅲ and stage Ⅳ was 2.437 times higher than that of stage Ⅰ patients(P=0.018).There were no statistical differences in postoperative mortality risk between stage Ⅰ patients and stage Ⅱ patients(P=0.057). Conclusion: Compared with that of PDSC,the incidence of BSC is higher among females.However,there is no difference in the prognosis between BSC and PDSC.BSC can be treated with the same therapies as those for other types of non-small cell lung cancer(NSCLC).

Objective To investigate the feasibility and efficacy of iliofemoral endovascular therapy for the treatment of chronic ischemia of lower extremities due to arterial atherosclerosis. Methods During the period of September 2005-January 2009 percutaneous endovascular angioplasty and stent implantation were performed in 15 consecutive patients with CTA-proved chronic occlusive iliofemoral artery disease. The patients included 11 males and 4 females with a mean age of (72.1 ± 5.9) years (ranged from 61 to 82 years). Before the procedure, all patients underwent clinical and imaging assessments, including Fontaine classification, ankle-brachial pressure index (ABI), and lower limb computed tomography angiography (CTA). According to the length, morphology and location of the occlusive segment, different types of stents were employed together with pereutaneous transluminal angioplasty (PTA) to treat the occluded lilac or superficial femoral artery. At the end of the procedure, distal angiogram was performed to assess the success of the procedure and to exclude thromboembolism or dissection complications. After PTA, the residual stenosis < 30% and/or pressure gradient < 10 mmHg were defined as technical success. Clinical success was identified when patient's clinical symptoms were improved by one or more grade according to Fontaine classification. Results Technical success was totally achieved in all patients with no occurrence of complication. Recanalization of the occluded artery was performed preferably by retrograde ipsilateral femoral artery approach in 5 patients and by contralateral access using the crossover aorta technique in 10 patients. PTA was performed in all patients after stent release to open the occluded vessel to its normal diameter. The mean length of the lilac arterial segment covered with 8 stents was (7.6 ± 1.4) cm (ranged from 6 cm to 10 cm). The mean diameter ± SD of the iliac stents was 9.5 mm ± 1.4 mm (ranged from 8 mm to 12 mm). The mean length of 5 superficial artery implanted stents was (4.5 ± 1.1) cm (ranged from 4 cm to 6 cm). The mean ABI before treatment and six months after treatment was 0.64 (range 0.41 to 0.89) and 0.76 (range 0.50 to 0.95), respectively. The difference in ABI between pre-interventional and post-interventional procedure was statistically significant (t = -4.64, P < 0.01). Clinical improvements according to Fontaine classification were obtained in all patients, in whom technical success was achieved (100%). Conclusion Endovascular interventional procedure is a safe and effective treatment for iliofemoral arterial occlusive disease due to arterial atherosclerosis. PTA combined with subsequent stent implantation can well improve the patient's quality of life as well as the hemodynamics of lower extremities, which is very important for preserving the diseased limb for a long period of time.

Objective To evaluate the image quality and radiation dose of prospective electrocardiography-triggered coronary 320-slice volume CT angiography with different kV, and the feasibility of coronary scan with ＜ 1 mSv radiation dose.Methods Eighty consecutive patients were randomly divided into two groups equally.The tube voltage according to paradigm was 100 kV in group A and 120 kV in group B.All raw data in group A was reconstructed by the software AIDR in CT system to create a new group named as A1. Such parameters as the mean intraluminal attenuation (SI),noise (SD),signal-to-noise ratio (SNR),contrast-to-noise ratio (CNR),effective radiation dose(E) and image quality score measured in group A were compared with those in group B.The values such as SI,SD,SNR,CNR,image quality scores were compared between group A and group A1.The significance of group B and group A1 was compared in SI,SD,SNR,CNR,image quality scores as well.Results E in group A was significantly lower than that in group B[ E =(0.67 ± 0.18) mSv in group A vs.E =(3.08 ± 1.04) mSv in group B].The value of E in group A was decreased by 78％ compared to group B(t =- 14.30,P＜0.05 ).There was no significant difference in mean image quality scores between two groups(4.57 ± 0.57in groupA vs.4.59 ± 0.59 in group B,t=-1.17,P＞0.05).The values of SI,SD,SNR,CNR in group A were (570.8 ±131.5)HU,25.1 ±6.9,24.5 ±9.1,19.8 ±6.1.And the values of SI,SD,SNR,CNR in group B were (460.6 ± 14.3) HU,15.1 ±3.6,31.7 ±7.7,29.3 ±6.8.The values of SI and SD in group A were significantly higher than those in group B(t =4.49,8.18,P ＜0.05). The values of SNR and CNR in group A were lower than those in group B (t =-4.24,-6.19,P＜0.05).The valuesofS1,SD,SNR,CNR,image quality scores in group Al were (557.9 ±24.5) HU,21.1 ±6.0,27.7±10.0,23.4±7.8,4.60 ± 0.56.There was no difference in the SI and the image quality scores between group A and group A1 ( t =1.09,- 1.90,P ＞ 0.05).Conclusions 320-slice volume CT with 100 kV tube voltage and prospective ECG-triggered technique can reduce the radiation dose to less than 1 mSv and obtain optimal images in diagnosis of coronary arterial diseases.

Aim To screen out the antigenic sequences from HCV core protein random peptide libraries displayed on phage and to explore a new way to screen the viral antigens. Methods The anti-HCV core antibody-positive serum was used to screen antigenic peptides from the HCV core protein random peptide libraries displayed on phage for 4 rounds. Detection of numbers of positive clones, positive rate of insertion of HCV random DNA and positive rate of hybridization with HCV core probes were used to evaluate the screening effects. The DNA sequences of 7 selected clones with positive hybridization were determined and analysed. Results Six out of 7 sequences are HCV core protein sequences, in which 5 were perfectly displayed,and one was possibly displayed. These sequences included several major HCV core antigenic epitopes. The remaining one was E.coli nrfa gene. Conclusion The phage display technique can be applied to study the viral antigenic peptides with the advantages of simple, accuracy and rapidity.

Objective:To evaluate the clinical efficacy of C-type endoscopic submucosal dissection (C-ESD) for rectal neuroendocrine tumors (NEN).Methods:The retrospective analysis was performed on data of 55 patients who underwent ESD for rectal NEN at the Department of Endoscopy in Quanzhou First Hospital from January 2018 to July 2021. Patients were divided into the C-ESD group ( n=28) and the conventional ESD group ( n=27). The dissection time, the dissection speed, the number of submucosal injections, the enbloc resection rate, the curative resection rate and the rate of postoperative complications of the two groups were compared. Results:There were no statistically significant differences in basic information between the two groups ( P>0.05). The dissection time was 13.8±4.2 min in the C-ESD group and 19.9±3.9 min in the conventional ESD group with statistically significant difference ( t=5.649, P<0.001). The dissection speed in the C-ESD group was 0.08±0.04 cm 2/min, which was faster than 0.06±0.04 cm 2/min in the conventional ESD group ( t=2.218, P=0.031). The number of submucosal injections in the C-ESD group was less than that in the conventional ESD group [2 (1, 2) VS 3 (2, 3), Z=-8.701, P<0.001]. The lesions were enbloc resected in both groups. The curative resection rate in the C-ESD group was 100.0% (28/28) and 88.9% (24/27) in the conventional ESD group with statistically significant difference ( P=0.011). There were 7 cases of postoperative complications in the conventional ESD group, including 1 delayed bleeding, 5 delayed perforation and 1 muscularis propria injury, while no postoperative complications occurred in the C-ESD group ( P=0.004). Conclusion:C-ESD is a safe and effective treatment strategy for colorectal NEN, which can shorten the dissection time, improve the dissection speed, reduce the number of submucosal injections, improve the curative resection rate, and reduce complications.