Objective To evaluate the blue laser imaging (BLI) magnifying endoscopy combined with endoscopic submucosal dissection (ESD) in diagnosis and treatment of low grade intraepithelial neoplasia detected by normal endoscopic biopsy.Methods A total of 76 patients were diagnosed as having LGIN by preoperative biopsy.But 3 months later,BLI endoscopic re-examination showed that the lesions did not heal or even worsened.Patients who received ESD therapy were included in the retrospective study during January 2014 to January 2016 in Remin Hospital of Wuhan University.The efficacy and complications of ESD,and the consistence rate of diagnosis between general endoscopic biopsy,BLI magnifying endoscopy and pathologic diagnosis of total tumor after ESD were analyzed.Results The complete resection rate and curative rate of ESD were 100.0％ (76/76) and 97.4％ (74/76) respectively.The incidences of hemorrhage and perforation during the operation were 3.9％ (3/76) and 1.3％ (1/76),and there was no delayed bleeding or perforation.The consistence rates of diagnosis of common endoscopic biopsy and BLI were 55.3％ (42/76) and 92.1％ (70/76) respectively,with significant difference (x2 =51.987,P＜0.001).Conclusion Low-grade intraepithelial neoplasia of the upper digestive tract may be easily underestimated by ordinary endoscopy biopsy.For these underestimated low-grade intraepithelial neoplasia lesions,ESD can not only be used to confirm the diagnosis,but also give safe and effective treatment.The examination of BLI combined with magnifying endoscopy is recommended before ESD,because BLI endoscopy classification of the lesions has positive effects on ESD of upper gastrointestinal mucosa lesions.

Objective To study the distribution of drug resistance mutations and genotypes in the patients with chronic hepatitis B(CHB)in Taicang area.Methods 350 cases of CHB were selected and detect the drug resistance mutations and genotypes before using nucleoside(acid)anti-viral drugs.The correlation between the drug resistance mutations with genotypes in CHB patients was analyzed.Results Among 350 cases of CHB,the distribution of genotypes was genotype B in 172 cases,accounting for 49.14%, genotype C in 164 cases,accounting for 46.85%,genotype D in 9 cases,accounting for 2.57%,mixed genotype of B and C in 5 ca-ses,accounting for 1.42%,no other genotypes were found.In this study,the drug resistance mutations were detected in 58 cases,in-cluding 22 cases of genotype B,35 cases of genotype C and 1 case of genotype D,no drug resistance mutations were found in mixed genotype B and C.The drug resistance mutations sites:lamivudine resistance-associated mutations in 36 cases(10.28%),and adefo-vir resistance-associated mutations in 16 cases(4.57%)and entecavir associated resistance mutations in 6 cases(1.71%).Conclusion The genotype of CHB patients in Taicang area was dominated by genotype B and C,which accounting for more than 90% and the proportion of these two kinds of genotype is similar.The proportion of drug resistance mutation occurrence in the patients with gen-otype C is higher than that with genotype B.The lamivudine resistance-associated mutation has the highest proportion of drug re-sistance occurrence.It is suggested that the CHB patients with undefined medication history and recurrence treatment should be per-formed the drug resistance detection for selecting the targeted therapeutic schemes before accepting nucleoside(acid)drug therapy.

Proximal transparent cap of endoscope has an important effect in endoscopic diagnosis and treatment, including endoscopic submucosal tumor ligation, endoscopic mucosal resection, endoscopic removal of foreign body, endoscopic variceal ligation and sclerotherapy, endoscopic submucosal dissection, peroral endoscopic myotomy, endoscopic submucosal dissection through tunnel.This article reviewed the effect of different transparent caps in endoscopic diagnosis and treatment.

Cell Differentiation ; drug effects ; Cells, Cultured ; Culture Media, Conditioned ; Fetal Blood ; cytology ; Hepatocytes ; cytology ; drug effects ; Humans ; Stem Cells ; cytology ; drug effects

OBJECTIVE In order to supply the basis of reasonable use of antibiotics,investigation of the change in distribution and drug-resistance of isolated enterococci was made in our hospital.METHODS Enterococci were cultured,isolated and identified with ATB Expression microbe identification system.Drug-resistance was detected with ATB ENTEROC and was statistically analyzed.RESULTS A total of 1 354 strains of enterococci were isolated from 50 148 clinical specimens,the isolation rate was 2.7%.The main strain of enterococci was Enterococcus faecalis.E.faecium was the second one.The isolation rate of enterococci,which were the highest in urine specimens,was increasing in sputum specimens year by year.The drug-resistance rate of enterococci to erythromycin,rifampin,ciprofloxacin and levofloxacin was high,but it was still sensitive to vancomycin and teicoplanin.CONCLUSIONS Great changes have taken place in bacterial distribution and drug-resistance of isolated enterococci,and the drug-resistance of strains of enterococci differed greatly.To insure effective treatment and decrease the infection of enterococci in hospital,the antibiotics sensitive to enterococci should been used on the basis of drug-resistance test when the infection of enterococci was treated clinically.

Objective To describe the anxiety of caregivers and condition management of preschool asthma children ,and analyze the relation?ship between anxiety and disease management. Methods A total of 208 caregivers of asthma children from two hospitals in Shanghai were select?ed using convenient sampling,and surveyed by self?rating anxiety scale(SAS),condition management ability scale and condition management diffi?culty scale. Results The score of SAS were negatively correlated with the condition management ability and positively correlated with the condi?tion management difficulty. Hierarchical regression analysis showed that the model explained 26.6%amount and 35.1%amount of variation respec?tively. Conclusion The anxiety of caregiver of children with asthma may affect the disease management. Future interventions should be strength?ened on the caregivers'psychological problems,so as to improve disease management and control asthma more effectively.

The de novo transcription of hTERT gene represents a rate-limiting step in the activation of human telomerase.The expression of hTERT is strictly regulated with several oncogene products and tumor suppressor gene products in normal cells.The construction of a reverse-transcriptional virus vector that contains the promoter of hTERT without losing its specificity can dramatically augment the expressions of anticancer genes in telomerase-positive cancer cells,which prompts the use of an hTERT promoter for anticancer gene therapies.Firstly,we briefly introduce the structure and regulation of hTERT gene,and then we also review the present knowledge of its biological function in cancer progression.

AIM: To study the correlation of LTG concentrations between saliva and serum in children with epilepsy.METHODS:After informed consent was obtained from the parents or guardian of children,children with primary epilepsy were collected in Peking University First Hospital.When reaching the steady drug concentration,(1.0) ml blood samples were obtained by phlebotomy,and(0.5) ml saliva sample were collected at the same time.Serum and salivary LTG concentrations were determined by reversed-phase high performance liquid chromatography(RP-HPLC).Statistics software SPSS11.5 was used for data analysis.RESULTS:Linear regression analysis was made by LTG concentration (C) and the peak area ratio(Y) of LTG vs.internal standard(flurazepam),and the regression equation of serum concentration and saliva concentration were Y=(0.1824)C-(0.0080),r=(0.9998) and Y=(0.1816)C-(0.0119),r=(0.9997),respectively.We collected 39 patients and 53 serum and saliva concentrations samples,of whom,27 were male and 12 female,aged 1 to 15 years(the average was(7.86)).The correlation between LTG serum concentration(x) and saliva concentration(y) was y=(0.5607)x-(0.6074)(n=53,r=(0.9501),P

In recent years,studies have shown that galactose - deficient IgA1(Gd - IgA1)antibodies are im-portant in the pathogenesis of IgA nephropathy(IgAN). Serum levels of Gd - IgA1 antibodies are associated with levels of proteinuria and renal histological grading. Measuring the antibodies has guidance value in the diagnosis of IgAN,for its sensitivity and specificity can be up to 88% - 89% and 89% - 92% respectively. In addition,the antibodies play an important role in clinical prognosis,and it may provide a new direction for treatment in IgAN. Now,its role in prognosis of IgAN was reviewed.

Objective To study the production of ?-lactamase in multidrug-resistant Pseudomonas aeruginosa and to guide the proper use of antibiotics in clinical practice. Methods The modified three-dimensional extract test was employed to detect ?-lactamase in 30 multidrug-resistant Pseudomonas aeruginosa strains screened from antimicrobial susceptibility test in our hospital,and isoelectric focusing electrophoresis was performed on the enzyme-producing strains. Results No metalloenzyme was detected in all the 30 strains.Twenty-six strains produced ?-lactamase,among which 25 continuously yielded large amount of AmpC enzyme and the other one both AmpC enzyme and extended-spectrum ?-lactamases(ESBLs).86.7% of multidrug-resistant Pseudomonas aeruginosa produced enzyme. ConclusionThe majority of the multidrug-resistant Pseudomonas aeruginosa in our hospital yielded large amount of AmpC enzyme in a continuous way.The modified three-dimensional extract test can eliminate some interference such as the decrease of outer membrane permeability and overexpression of efflux pump,facilitating the effective and accurate detection of ESBLs in Pseudomonas aeruginosa.