Objective To evaluate the diagnostic value of endoscopic ultrasonic elastography in lymph node staging of gastrointestinal tumors.Methods Thirty-nine abdominal lymph nodes and 26 mediastinal lymph nodes of 35 patients with gastric cancer or esophageal carcer were examined by endoscopic ultrasonic elastography of five-point elastic score.Lymph node at 1-3 points was regarded as negative(benign),while 4-5 points as positive(malignant).The diagnostic value of EUS elastography was determined by comparing the results with pathological findings.Results Of all the 65 lymph nodes,49 were diagnosed as positive and 16 negative.The sensitivity and specificity of EUSE in the diagnosis of malignant lymph nodes were 91.1%and 60.0%.respectively.Conclusion EUSE is helpful for diagnosis of malignant metastasic lymph nodes.

AIM: To evaluate the effects and safety of intravitreal injection of triamcinolone acetonide ( TA ) or conbercept combined with macular laser grid photocoagulation in the treatment of macular edema secondary to retinal vein occlusion( RVO) . ·METHODS: Fifty cases ( 50 eyes ) with macular edema secondary to retinal vein occlusion were selected and assigned to 2 groups: intravitreal injection of TA or conbercept, and laser photocoagulation after 7d. Best corrected visual acuity ( BCVA ) , fundus examination, optical coherence tomography ( OCT ) and intraocular pressure ( IOP ) were examined before intravitreous injection and 14d, 1 and 3mo after laser, fundus fluorescein angiography(FFA) were examined 3mo after treatment. The postoperative results at each time point were compared with preoperative values. · RESULTS: Two kinds of treatment compared with preoperative, the BCVA all increased in various degrees. At 14d after intravitreous injection, 1 and 3mo after laser, the ratio of vision improved in TA group was 76%, 80%, 68%, conbercept group was 88%, 92%, 88%, BCVA of two groups in each period all had varying degrees of increase than preoperative. The best BCVA acquired at 1mo after treatment. The macular thickness after treatment was significantly lower than preoperative in two groups. At preoperative, 14d, 1 and 3mo after treatment, the macular thickness in TA group was 557. 5 ± 150. 9,301. 7±120. 1, 262. 7 ± 131. 2, 338. 1 ± 146. 5μm; the macular thickness in conbercept group was 569. 4 ± 135. 9, 282. 3 ± 133. 5, 259. 5 ± 116. 4, 307. 8 ± 122. 6μm. The macular thickness of the two groups were significantly different between preoperative and postoperative. · CONCLUSION: The combination of intravitreous injection of TA or conbercept with macular laser grid photocoagulation can be an effective method in the treatment of macular edema secondary to RVO, conbercept treatment is more effective and security.

This study aims to perform a survey of genetic variation in neuraminidase (NA) gene of influenza A/H3N2 virus, as well as related resistance to NA inhibitors, in Qinghai Province of China, 2010 to 2012. Strains of influenza A/H3N2 isolated during an influenza survey from 2010 to 2012 in Qinghai were enrolled by random sampling. Viral RNA was extracted and amplified by RT-PCR. Purified PCR products were sequenced thereafter. Genetic analysis of nucleic acid and the derived amino acid sequences was performed by MEGA 4.0. Phylogenetic trees were also constructed. Strains isolated during 2010-2011 in this study clustered closely with World Health Organization (WHO) 2010-2012 reference vaccine strain A/Perth/16/2009 and 2008-2010 reference vaccine strain A/Brisbane/10/2007 on the phylogenetic tree, while the 2012 isolates were located on another branch. In analysis of derived amino acid sequences, the 2010 isolates mutated at K81T, the 2011 isolates mutated at I26V and D127N, while the 2012 isolates mutated at E41K, P46A, I58V, T71N, L81P, D93G, D127N, D151N, and I307M. The D151N mutation added a glycosylation site to the activity center of NA. No significant variation was discovered in H3N2 NA gene of 2010-2011 isolates in Qinghai, China. Isolates of 2012 were found with significant mutation, which has the potential of inducing minor resistance to NA inhibitors like zanamivir and oseltamivir.
Amino Acid Sequence ; China ; Humans ; Influenza A Virus, H3N2 Subtype ; classification ; enzymology ; genetics ; isolation & purification ; Influenza, Human ; virology ; Molecular Sequence Data ; Neuraminidase ; chemistry ; genetics ; Phylogeny ; Sequence Alignment ; Viral Proteins ; chemistry ; genetics

Thermogravimetry (TG), TG-MS, Fourier transform infrared spectroscopy (FTIR), scanning electron microscope (SEM)-energy dispersive spectrometer(EDS) were adopted to investigate the pyrolysis characteristics of calamina. According to the findings of the qualitative and quantitative studies on the changes in the content of relevant elements, the whole shape, the functional groups, and the volatile components of calamina before and after being pyrolyzed, the 200-360, 580-750 degrees C were two sensitive temperature ranges related to the changes in effective component during calamina processing. Thermal weight loss was observed for ZnCO3, Zn(OH)2 and ZnCO3-2Zn(OH)2-H2O under 200-360 degrees C and for CaCO3 under 580-750 degrees C. The results of studies on chemical reaction kinetics showed good linear relations. This experiment integrated relevant methods and theories of physical chemistry and science of traditional Chinese medicine processing, and interpretes calamina processing techniques and mechanism, in order to provide a good example for modem studies on other traditional Chinese medicine processing.
Drug Combinations ; Drug Compounding ; methods ; Ferric Compounds ; chemistry ; Kinetics ; Temperature ; Zinc Oxide ; chemistry

Objective To evaluate the therapeutic value of endoscopic band ligation in gastric stromal tumors.Methods Twenty-nine patients with small gastric stromal tumors(diameter<12mm)underwent endoscopic band ligation,and were followed up with routine endoscopy and EUS.Results Twentyeight patients recovered completely,with the surface healing up 4-6 weeks(average 4.8 weeks)thereafter.The neoplasm did not slough off in one patient,so he underwent a second ligation.Hemorrhage occurred in one patient three days after ligation,but was successfully managed with hemoclips.Other patients showed no complications.All the patients were followed up for 36 to 51 months,and there was one case of recurrence.Conclusion Endoscopic band ligation is an effective and safe treatment for small GISTs of less than 12 mm.

ObjectiveTo assess the diagnostic value of EUS for pancreatic neuroendocrine tumors.MethodsClinical data of 26 patients with final diagnosis of pancreatic neuroendocrine tumors,who had underwent EUS and EUS-FNA,were retrospectively analyzed.Results On EUS,pancreatic neuroendocrine tumors presented as hypoechoic masses with clear margins and rich blood flow.Of the 26 pancreatic lesions,3 were in the head,2 in unicate process,2 in neck,11 in body and 8 in tail.The tumors presented with function in 16 ( mean size 9 mm),and on function in 10 ( mean size 29 mm).EUS-FNA yeilded positive results in 22 patients and negative in 4.The accuracy rate of EUS for preoperative localization was 100％ in 23 patients who underwent surgery.ConclusionEUS can provide accurate preoperative localization and pathologic evidence for pancreatic neuroendocrine tumors.

Objective To evaluate the clinical effects and safety of double-channel forward-view endoscopy for lower-position biliary obstruction after Billroth-Ⅱ gastrectomy.Methods A total of 18 patients with lower-position biliary obstruction after Billroth-Ⅱ gastrectomy were enrolled and treated with doublechannel forward-view endoscopy.The process and the outcomes were recorded.Effectiveness and safety were evaluated.Results Double-channel forward-view endoscopic treatment was successfully performed in 13 of the 18 patients (72％),with stone removal or stents implantion to resolve biliary obstruction.The procedure failed in 5 patients,who were transferred to surgery or underwent percutaneous transhepatic cholangial drainage.Delayed bleeding occurred in 1 patient,and pancreatitis in 2,who were cured after standard treatments.Conclusion Double-channel forward-view endoscopy is effective and safe for lower-position biliary obstruction in patients after Billroth-Ⅱ gastrectomy.

Objective To investigate the optimal time for double balloon enteroscopy (DBE) in patients with obscure gastrointestinal bleeding (OGIB).Methods Data of 78 patients with OGIB who underwent DBE from January 2009 to November 2013 were retrospectively analyzed.They were classified into two groups:emergency DBE and non-emergency DBE.The demographic and clinical features and outcomes of DBE,the time of examination and complications were compared.Results The overall diagnostic yield of DBE was 48 lesions (61.54 ％).The overall diagnostic yield of emergency DBE group was 77.14％,which was significantly higher than that in non-emergency DBE group (48.83％) (P =0.019).The time of examination in emergency group was shorter than that of non-emergency group with significant difference (P =0.031).Conclusion Emergency DBE takes less time and yields a higher rate of detection.Patients withOGIB should receive DBE as soon as possible.

This study is to evaluate the effects of Shenmai injection on the temporal alterations of action potential (AP), early afterdepolarization (EAD) and delayed afterdepolarization (DAD) in papillary muscles. The action potentials were recorded by a glass electrode. APD at 90% repolarization (APD9 ) was measured, and spontaneous EAD and DAD were observed. The results show APD90 was significantly prolonged in model group compared with sham-operated group, whereas it was remained unchanged in Shenmai injec- tion treatment group and amiodarone group. The spontaneous EADs and DADs were frequently visible in model group. In conclusion, EAD, DAD and trigger activities increase gradually during pathological progression of rat cardiac hypertrophy, and Shenmai injection could improve the action potential change in rat cardiac hypertrophy.
Action Potentials ; drug effects ; Animals ; Blood Pressure ; drug effects ; Cardiomegaly ; physiopathology ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; Heart Ventricles ; drug effects ; physiopathology ; Injections ; Male ; Papillary Muscles ; drug effects ; physiopathology ; Rats ; Rats, Sprague-Dawley

Objective To investigate the incidence of electrocoagulation syndrome after endoscopic submucosal dissection (ESD) in the colorectal laterally spreading tumors (LST) and the risk factors. Methods Data of 51 patients with coloretral LST,treated with ESD from January 2010 to May 2014 at Shengjing hospital affiliated to China Medical University,were reviewed.The incidence of electrocoagulation syndrome was analyzed and logistic regression was used to evaluate risk.Results The incidence of electro-coagulation syndrome was 9.8%(5 /51).The incidence of tumors in the rectal area(7.1%,2 /28)was lower than that of the left half colon (12.5%,1 /8),and the right colon (13.3%,2 /15).Multivariable logistic regression analysis showed that the independent risk factors for the development of electrocoagulation syndrome were LST located in non-rectum area (OR =1.655,P <1.655),lesion size larger than 25 mm (OR =1.028, P <0.05),the operation time longer than 129 min (OR =1.016,P <0.05),age older than 62 year old (OR =0.987,P <0.05).Conclusion For the patients aged over 62 year old,lesion size larger than 25 mm,the operation time longer than 129 min and LST located outside the rectum,the mucous membrane should be separated from the muscularis propria in the ESD procedure to reduce electrocoagulation time as much as possible. In the postoperative period,patients need fasting,fluid replacement support,and prevention of post endoscopic submucosal dissection electrocoagulation syndrome (PEECS).