Objective To investigate the technical feasibility and oncological safety of EPMR for early esophageal cancer and precancerous lesions. Methods Clinicopathological data, procedure quality and complications of 70 patients with early esophageal cancer or precancerous lesions were retrospectively ana?lysed. The technical safety and feasibility were assessed, and the complications were investigated through postoperative surveillance. The results were compared with published data from two high?quality meta?analysis studies on ESD. Results In a total of 70 patients who underwent EPMR, 35?7%( 25/70) were diagnosed as having early esophageal cancer and 64?3%( 45/70) atypical hyperplasia. And tumor size greater than 2 cm was 78?6%(55/70). The mean EPMR time was(28?31±9?49) minutes. The R0 resection rate of EPMR was 88?6%(62/70) and no perforation occurred. The bleeding rate was 21?4%(15/70). The esoph?ageal stricture rate was 1?4%( 1/70) . The recurrence rate was 2?9%( 2/70) . Compared with published ESD data from the two studies, EPMR showed shorter procedure time, lower curative rate and lower rates of stric?ture and perforation, but slightly higher rates of bleeding and recurrence. Conclusion Both EPMR and ESD are feasible and effective for early esophageal cancer and precancerous lesions. The curative results of EPMR are similar to ESD, with shorter procedure time, but higher bleeding and recurrence rates.

Bone marrow mesenchymal stem cells (MSC) are the non-hematopoietic cellular component in the bone marrow that have multiple differentiation potency. MSC play a key role in the regulation of bone marrow hematopoietic niche and modulation of immune function through various mechanisms. They are currently recognized as a promising cell source in tissue engineering, a vehicle in gene therapy and a powerful tool in the management of graft-versus-host disease after allogeneic stem cell transplantation. In this review some momentous aspects regarding the current status and potential clinical applications of MSC in hematopoietic stem cell transplantation, aplastic anemia and multiple myeloma were summarized.

Objective To investigate the relationship between fatty liver progress and metabolic changes.Methods A total of 414 patients who had B-mode ultrasonography confirmed fatty liver development during 2 health check-ups within 2 years were enrolled in this study.Paired t and χ2 tests were used to compare body mass index (BMI),alanine aminotransferase (ALT),aspartate aminotransferase (AST),fasting plasma glucose (FPG),serum uric acid (UA),triglycerides (TG),and high-density lipoprotein cholesterol (HDL-C) among the participants.Results BMI,TG,HDL-C,ALT,AST,and UA were significantly increased after fatty liver progressed,although HDL-C was largely decreased.ConclusionsPrevention and treatment of MS as well as early intervention for fatty liver should be important for successful control of fatty liver.

Objective To investigate the effect of vasoactive intestinal peptide (VIP) and methylprednisolone (MP) on Toll-like receptor (TLR)2/4 mRNA expression in endotoxin (lipopolysaccharide,LPS) induced shock.Methods Ninety Sprague-Dawley rats were randomly divided into LPS group (n =20),LPS + VIP group (n =20),LPS + MP group (n =20),LPS + VIP + MP group (n =20) and control group (n =10).LPS group injected intravenously LPS (E Coli O55B5) 10 mg/kg.LPS + VIP group,LPS + MP group and LPS + VIP + MP group were injected intravenously VIP 5 nmol/kg,MP 3 mg/kg and VIP 5 nmoL/kg + MP 3 mg/kg after LPS 10 mg/kg injection.The control group injected normal saline intravenously instead of LPS.The rats were sacrificed at 6 h and 24 h after injection and the intestine samples were collected.Pathological changes of the intestine were observed by microscopy.RT-PCR was used to detect the intestinal TLR2 mRNA and TLR4 mRNA expressions.Results Intestinal mucosa showed edema or necrotic change with structure of the microvilli disappeared after LPS injection.The inestinal lesions in VIP,MP and VIP + MP groups were milder than LPS group.At 6 h after LPS injection,TLR2 mRNA and TLR4 mRNA expressions were significantly up-regulated in LPS group,LPS + VIP group,LPS + MP group and LPS + VIP + MP group (TLR2 mRNA:1.14 ±0.38,1.17 ±0.42,1.16 ±0.41,0.92 ± 0.29;TLR4 mRNA 1.21 ±0.18,1.04 ± 0.38,1.11 ± 0.34,1.01 ± 0.20) compared with the control group (0.32 ± 0.20,0.24 ± 0.17) (P ＜ 0.01).But there was no significant difference between LPS group,LPS + VIP group,LPS + MP group and LPS + VIP + MP group (P ＞ 0.05).At 24 h after LPS injection,TLR2 mRNA and TLR4 mRNA expressions in LPS + VIP group,LPS + MP group and LPS + VIP + MP group (TLR2 mRNA:0.63 ± 0.12,0.59 ± 0.13,0.52 ±0.19;TLR4 mRNA 0.67 ±0.09,0.64 ±0.09,0.51 ±0.13) were significantly lower than LPS group (1.04 ± 0.38,0.82 ±0.18) (P ＜0.01) (P ＜0.05).Conclusion VIP and/or MP can mitigate intestinal injury induced by LPS shock.The gastrointestinal protection of VIP and glucocorticoids were related to downregulation signaling TLR2 mRNA and TLR4 mRNA expression.But VIP/MP and VIP + MP have no significant effect on expression of intestinal TLR2/4 mRNA until 24 h after LPS shock.

Serum bone alkaline phosphatase (BAP) , osteocalcin (OC) , C-telopeptides of type-1 collagen (CTx) , osteoprotegerin (OPG) levels, and bone mineral density (BMD) were evaluated in 62 hyperthyroid patients and 60 healthy subjects matched for sex and age. In hyperthyroid patients, the biochemical evaluations and bone density were performed before and after 6 months of methimazole ( MMI) treatment. Results showed that the BMD in lumbar spine L2 - L4, neck of femur, Ward's triangle and greater trochanter of patients before treatment were all significantly lower than those in healthy controls, and improved markedly after MMI treatment. The serum bone turnover parameters BAP, OC and CTx in patients before treatment were all significantly higher than those in control group, and were decreased markedly after treatment. The serum OPG level in patients with hyperthyroidism was significantly higher than that in healthy controls, and decreased markedly after treatment. The serum OPG levels were significantly correlated with bone turnover parameters ( BAP, OC, CTx) and BMD, which indicates that serum OPG level can reflect the abnormality of bone metabolism in patients with hyperthyroidism.

The effects of magnolol (Mag) on hyperglycemia and hyperlipemia, hepatic oxidative stress and cytochrome P4502E1 (CYP2E1) activity of diabetic rats induced by high-fat diet (HFD) and streptozotocin (STZ) were studied. After oral administration of Mag (25, 50 and 100 mg x kg(-1) x d(-1)) for continuous 10 weeks, the blood glucose and lipids (TC, TG and LDL-C) levels, as well as the hepatic CYP2E1 activity and MDA content of diabetic rats, decreased significantly (P < 0.05 or P < 0.01), whereas the oral glucose tolerance and hepatic antioxidant enzymatic activities (CAT and GSH-Px) of diabetic rats, increased significantly (P < 0.05 or P < 0.01). The results indicated that Mag was effective against the hepatic oxidative damage, hyperglycemia and hyperlipemia of diabetic rats induced by HFD and STZ, and the inhibition of Mag on hepatic CYP2E1 activity could be an important mechanism of Mag against hepatic insulin resistance and oxidative damage.

Objective To investigate the correlation of diastolic blood pressure (DBP) ＜70mm Hg and isolated systolic hypertension (ISH) with coronary atherosclerosis (CAS) and coronary heart disease (CHD) in elderly patients and to analyze the independent risk factors for low DBP.Methods A total of 246 elderly patients with untreated ISH who underwent coronary angiography were divided into the low DBP group (n=102) and the non-low DBP group (n=144) according to DBP level.All clinical and angiographic data were collected and the retrospective analysis was performed to assess the risk of CAS and CHD in patients with low DBP and to analyze the risk factors for low DBP.Results There were no significant differences in systolic pressure level between the low DBP group and the non low DBP group [(156.2±15.6) mmHgvs.(154.4±14.2) mmHg,t=0.93,P＞0.05],while pulse pressure level was significantly higher in the low DBP group than in the non-lowDBPgroup [(91.3±±17.7) mmHgvs.(72.9±15.1) mm Hg,t=8.54,P＜0.01].Stepwise logistic analysis showed that age,diabetes and smoking were independent risk factors for low DBP.After adjustment for age,gender and other common risk factors,low DBP was independently associated with CAS and CHD (OR =1.72 and 1.44,95％ CI:1.082.72 and 1.04-1.99,respectively,both P＜ 0.05).Conclusions Low DBP is independently associated with CAS and CHD in elderly patients with untreated ISH.Age,diabetes and smoking are the independent risk factors for low DBP.

For all the time the book Symptomatic Figures of Lip and Tongue(Chunshe Zhenghou Tu)was described as written by Li Jun of Qing dynasty. We made studies on historical records on Li Jun and the features and contents of this book, and proved that Symptomatic Figures of Lip and Tongue was not written by him, but a Chinese medical book written by Japanese.

Objective To investigate the relationship between isolated systolic high-normal blood pressure and cor-onary heart disease (CHD) in the middle-aged and elderly population. Methods A total of 236 patients over 50 years old and undergone coronary angiography were enrolled and divided into isolated systolic high-normal blood pressure (ISHNBP) group (n=135) and non-ISHNBP (NISHNBP) group (n=101) according to their systolic and diastolic blood pressure levels. All clinical data and angiographic data were collected. Results There was no significant difference in systolic blood pres-sure between NISHNBP group and ISHNBP group (P>0.05). There were significantly lower levels of diastolic blood pres-sure and higher pulse pressure in ISHNBP group (P＜0.01). Results of multivariate logistic analysis showed that isolated sys-tolic high-normal blood pressure was the independent risk factor for CHD (OR=2.67,95%CI:1.50-4.75, P＜0.01). And the distribution of diseased coronary vessel numbers was more extensive in the ISHNBP group (P＜0.01). Conclusion The iso-lated systolic blood pressure in the middle-aged and elderly population with high risk of coronary heart disease should be paid attention to, and make appropriate interventions, which may help reduce the incidence of cardiovascular disease.

Object To investigate the effect of PPARαactivation on PPARγ-induced fatty liver in the mouse. Methods Wild type mice ( C57BL/6) aged 4 to 5 weeks were used as animal models.All mice were divided into four groups.The mice in the first group were fed with chow diet.The mice in the second group were fed with a diet containing 0.125%Wy-14,643, an agonist of PPARa, for 8 days.The mice in the third group were injected with Ad/PPARγvia tail vein for 5 day.The mice in the fourth group were firstly fed with Wy-14,643 diet for 3 days and then injected with Ad/PPARγvia tail vein for another 5 day.Mouse livers were collected and photographed.The effect of PPARαactivation on PPARγ-induced fatty liver was observed by H&E and Oil red O staining.Results Compared with the controls, wild-type mice treated with Wy-14,643 for 8 days exhibited marked hypertrophy of hepatocytes with increased cytoplasmic eosinophil-ia and proliferation of peroxisomes.The liver size was significantly increased in the wild-type mice treated with Ad/PPARγfor 5 days, and over-expression of PPARγstrongly induced hepatic steatosis.Importantly, the wild-type mice pretreated with Wy-14,643 for 3 days and then given Ad/PPARγinjection exhibited dramatically the increase of liver size, which might be due to the dual function of PPARa and PPARγ.Compared with the Ad/PPARγgroup, the Wy-14,643 pretreat-ment group showed a reduced hepatic steatosis.Conclusions Activation of PPARαby Wy-14,643 effectively improves PPARγ-stimulated hepatic steatosis, which provides a novel target for prevention and therapy of fatty liver.