Objective To investigate the effects of submucosal resection by guidance under esophageal endoscopic ultrasound. Methods 79 cases ofsuspected upper gastrointestinal submucosal tumors were found by endoscopic ultrasonography,transesophageal endoscopic ultra-sound showed lesions under muscularis mucosa,after informed consent,they were underwent endoscopic mucosal resection. Pathological diag-nose of the lesions were found out after resection. Results Compared with pathological results showed that endoscopic ultrasound accurately determine tumor location in the hierarchy;through endoscopic mucosal resection to remove all lesions,5 patients were found bleeding postop-erative,6 patients were found esophageal stricture,the prognosis was good after treatment. Conclusion Endoscopic ultrasonography can accu-rately determine submucosal myoma,it can be used to guide resection of submucosal myoma.

Objective To investigate the role of hydroxyapatite nanoparticle (nHAP) in the gene transfection of human colorectal cancer cell line SW480/M5 and the possible mechanisms.Methods The combination and protection of nHAP-Mg2+ to DNA were analyzed by gelose gelatin electrophoresis.Liposome and nHAP modified by magnesium chloride was combined,and the PEGFP-N1 plasmids were transfected into SW480/M5 cells.The gene transfection rate and the mean fluorescence intensity were observed by flow cytometry.The effect of nHAP-Mg2+ on the growth of the cells were studied by MTT.Results At appropriate proportion,nHAP-Mg2+ could combine the plasmids compeletly and protected the DNA.The gene could not be transferred by nHAP-Mg2+ alone.Combining the nanoparticles and liposome,the gene could be transferred very efficiently and the transfection rates were significantly higher than the liposome (P ＜ 0.05).The inhibition of cell growth was increased along with the concentration of nHAP-Mg2+ wether it was used alone or with the combination of liposome (P ＜ 0.05).Conclusions nHAP-Mg2+ has the ability to combining and protecting DNA and can be used to transfer gene as the adjunct carrier of liposome for the gene therapy of tumor cells to elevate the gene tansfection and expression rate and also enhance the anti-tumor effection.

AIM To study effects of desulfated and poly sulfated heparin derivatives on rat mast cell (MC) degranulation. METHODS Different methods were used to prepare different sulfated heparin derivatives: 2 O desulfated heparin (2DeSH),N desulfated reacetylated heparin (NDeSAcH),6 O desulfated heparin (6DeSH),poly sulfated heparin (PSH). Passive MC degranulation induced by ovalbumin in rats to was employed observe the effects of different sulfated derivatives on rats MC degranulation. RESULTS All the sample groups were found of obvious inhibition of MC degranulation( P

Objective:To investigate the efficacy of robot-assisted laparoscopic surgery in heminephrectomy in children.Methods:The clinical data of 54 children with heminephrectomy in the First Affiliated Hospital of Zhengzhou University from January 2017 to December 2019 was analyzed retrospectively, of which 42 cases underwent laparoscopic heminephrectomy (LH group) and 12 cases underwent robot-assisted laparoscopic heminephrectomy (RALH group). In LH group, there were 17 males and 25 females, with an average age of (71.74±34.57)months, 29 on the left and 13 on the right. In RALH group, there were 4 males and 8 females, with an average age of (76.83±37.33) months, 9 on the left and 3 on the right. There was no significant difference in age, sex composition and deformity side between the two groups ( P > 0.05). The clinical indexes such as operation time, intraoperative blood loss, postoperative drainage time, hospital stay and postoperative complications were compared between the two groups. Results:There were significant differences in operation time[(196.48±21.92)min vs.(171.50±24.91)min], intraoperative blood loss[(34.14±8.63)ml vs.(18.50±5.92)ml], postoperative drainage time[6.0(5.0, 7.0)d vs. 4.5(3.0, 6.5)d] and postoperative hospital stay[(8.93±1.70)d vs.(7.33±1.37)d] between LH and RALH groups ( P < 0.05). During the follow-up from 3 months to 2 years, the lower kidneys of the two groups developed well and the symptoms before operation such as urinary tract infection, intermittent voiding leakage and dysuria caused by ureterocele were gradually relieved and disappeared after operation. In the LH group, 2 cases were complicated with the symptoms as ureteral stump effusion, cyst formation and recurrent ureteral stump infection after operation, which were cured after reoperation. There was no case of ureteral stump effusion and cyst formation in the RALH group. Conclusions:Robot-assisted laparoscopic heminephrectomy in children has shorter intraoperative blood loss, postoperative drainage time and hospital stay, lower incidence of postoperative complications, and has better efficacy and safety.

Objective To explore the diagnosis, treatment and prognosis of testicular benign tumors in children.Methods The clinical data of 26 boys ( aged between 17 days to 12 years and average age was 2.5 years) with testicular benign tumors treated in our center between January 2008 and December 2015 were retrospectively analyzed.The tumors were on the left side in 17 cases, on the right side in 9 cases. Twenty patients presented with painless scrotal mass.3 with cryptorchidism, 2 cases with hydrocele, and 1 case with varicocele.These boys underwent ultrasound or CT examination, results the enlarged tests with space-occupying lesions in 20 cases,3 cases were presented as scrotal empty,3 cases were showed as cystic masses.Twenty-four boys had taken tumor marker detection,which including 3 cases of AFP rised, 2 cases of Neuron-specific enolase slightly higher, 1 case of Ferritin increased.26 patients were performed surgical treatment, 23 cases have taken testicular tumor resection, and 3 cases underwent orchiectomy because of abnormal morphology, according to the intraoperative findings and quick frozen pathological examination results.Results Postoperative pathological diagnosis showed of maturity teratoma in 14 cases, not maturity teratoma in 3 cases, gonadoblastoma in 3 cases, interstitial cell tumor in 2 cases, epidermoid cyst in 2 cases, fibrocellular tumor and testicular inflammatory granuloma in 1 case respectively.The 23 cases were followed up for 3-70 months.All respondents children were alive, and no complications were found such as residual tumor atrophy or tumor recurrence and metastasis.Conclusions Early diagnosis and treatment is the key to obtaining a good effect of testicular tumors. Detailed specialist examination, preoperative ultrasound, CT and determination of tumor markers are important ways to diagnose testicular cancer; rapid intraoperative frozen check may manifest nature of the tumors.For pediatric testicular benign tumor, testis-sparing surgery should be considered.

[Objective] From the five aspects of WANG Zhongqi medical case, such as Qi syndrome, vomiting, cough, epigastric pain, wet temperature and so on, WANG Zhong Qi's bitterness in the treatment of various diseases, in order to learn and inherit the essence of WANG's academic thought and the characteristics of clinical diagnosis and treatment. [Methods] On the basis of the medical case contained in "WANG Zhongqi's Medical Cases", combined with classic treatise and academic thought of "Neijing", "Treatise on Typhoid Fever", ZHANG Jingyue, LI Dongyuan, YE Guangxi and WANG Zhongqi, this paper illustrates WANG's experience in the treatment of disease with "bitterness method" and analyzes the characteristics of the diagnosis and treatment. [Results] WANG inherited the experience and understanding of ZHANG Zhongjing, YE Tianshi and other doctors in the use of the method of bitterness, but didn't learn without change, depression causing Qi stagnation and bitter opening the pivot; Qi reverse vomiting, bitter descending pungent openning and promoting Qi function; cough of Qi inverse, pungent and bitter having catharsis to purge the lung Qi; for epigastric stomach pain, bitterness regulating middle warmer; damp heat diffusing, light bitter micro pungent regulating Qi function. [Conclusion] WANG's referred to "Neijing", Zhongjing, Dongyuan and YE Gui and had many innovations and flexible methods. It is worthy of further study to apply the method of bittern to the treatment of a variety of dysfunctional diseases of Qi, through the effect of the gasification and blood flow for regulating Qi function, to remove the pathogenic pathogenic factors in the body.

Objective To assess the value of prenatal ultrasonography on fetal forearm and crus malformations by studying the ultrasonographic characteristic in relation to methods of examination. Methods All fetus were evaluated by using a systematic continuous sequence approach (SCSA) with ultrasonography. A close attention was paid on shapes, structures and movement of fetal forearm and crus, and fetus specimens after induced labor were rescanned by ultrasonography under the condition of mimic intra-uterus. Results Thirty of 33 cases (90.9%) with fetal forearm and crus malformations (totally 48 of 54 limb anormalies, 88.9%) were correctly diagnosed by prenatal ultrasonography. Six limb malformations of 3 cases were missed. Conclusion Our study demonstrates that the malformations of forearm and crus detected with prenatal ultrasonography are highly accordant with the malformations revealed in fetus in vitro. It is important to abide by the SCSA in ultrasonographic diagnosis of fetal forearm and crus malformation.

More and more clinical trials have proved the efficacy of targeted drugs in the treatment of hepatocellular carcinoma (HCC).With the development of science and technology,more and more targeted drugs have appeared.In recent years,targeted drugs such as regorafenib and ramucirumab have shown great potential in related clinical trials.In addition,there are ongoing clinical trials for second-linecandidate drugs,such as c-Met inhibitors tivantinib and cabozantinib and a VEGFR-2 inhibitor ramucirumab.This article summarizes the advances in targeted drug therapy for HCC and related trial data,which provides a reference for further clinical trials and treatment.

Gastric cancer among the world's most common malignant tumor in the fourth, the incidence of the previ-ous decline, but around the world the number of gastric cancer cases occur in China accounted for 42%, ranked the first to east Asia common types of cancer[1] At present,the stomach cancer patients can choose chemical treatment and surgical treatment, but the 5-year survival rate in 50%, cause its one of the leading causes of death are invasion and metastasis of carcinoma tissue [2] Visible, understand the occurrence, invasion and metastasis of gastric cancer related regulation and carries on the early prediction and early intervention, and to develop treatment, improve patient out-come is very beneficial. The study found that high mature gastric cancer cells expressing CXCR4, under the action of chemokines SDF-1 promote the activation of PI3K/Akt pathway in gastric cancer cells,so as to promote antiapoptotic effect of gastric cancer cells. In this paper,the high expression of CXCR4 and chemotactic factor CXCL12 signal shaft impact on PI3K/Akt pathway in gastric cancer cells and expression are reviewed.

Objective : To evaluate the safety and immunogenicity of a split-virion quadrivalent influenza vaccine. Methods : The healthy people aged three years or over in Wuyang County and Xiping County of Henan Province were divided into the experimental group, control group 1 and control group 2, and were vaccinated with split-virion quadrivalent influenza vaccines, split-virion trivalent influenza vaccines (without B/Victoria) and a split-virion trivalent influenza vaccines (without B/Yamagata) , respectively. The hemagglutination inhibition (HI) antibodies were detected before and after immunization. The incidence rate of adverse events following immunization (AEFI) , HI antibody positive conversion rate, the protection rate of HI antibodies and the growth of geometric mean titer (GMT) were calculated and compared with the standard of Food and Drug Administration (FDA). Results: Totally 2 924 people were recruited, with 975 in the experimental group, 974 in the control group 1 and 975 in control group 2. The incidence rate of AEFI in the experimental group was 11.7%, higher than 7.9% in control group 1 and 8.8% in control group 2 (P < 0.05) during 30 minutes and 8 days after inoculation. The positive conversion rates of HI antibodies of H1N1, H3N2, By and Bv in the experimental group were 78.5%, 53.3%, 78.3% and 62.9%, respectively. The rate differences of the positive conversion rates of HI antibodies of By between the experimental group and control group 2, and of Bv between the experimental group and control group 1 were 42.1% (95%CI: 38.0%-46.2%) and 33.2% (95%CI: 28.9%-37.5%) , with both lower limits of 95%CI more than -0.10. The GMT increase of HI antibodies was more than 2.5 times in the three groups. The protective rates of HI antibodies of H1N1, H3N2, By and Bv in the experimental group were 87.7%, 98.7%, 93.6% and 77.2%, respectively. The protective rates of HI antibodies of By in control group 2 and Bv in control group 1 were 71.1% and 51.0%, both lower than those in the experimental group (P < 0.05). Conclusions After the inoculation of the quadrivalent influenza vaccine, the positive conversion rates (>40%) , protection rates (>70%) and GMT increase (>2.5 times) of HI antibodies of H1N1, H3N2, By and Bv all meet the quality standards of FDA. The safety and immunogenicity of the quadrivalent influenza vaccine are not inferior to those of the trivalent influenza vaccine.