Objective To study if tumor retraction assessed by endiscopic uhrasonography (EUS) during radiotherapy has prognostic value in esophageal carcinoma, which may further predict the radiosensi-tivity. Methods The maximal tumor thickness was measured by EUS before radiotherapy and at 40 Gy in patients with esophaged carcinoma. Response was defined as at least 50% reduction in tumor thickness. Re-suits A total of 51 patients were included. The median follow-up time was 28.5 months. The median sur-vival time was 24.3 months. The treatment was radiotherapy alone, concurrent chemoradiotherapy and pre-operative treatment in 35, 10 and 6 patients, respectively. Tumor response was assessed by EUS in 18 pa-tients (34%). The 2-year overall survival (OS) and progression-free survival (PFS) were 69% and 59% for responders, comparing with 37% and 29% for non-responders (χ~2= 5.78, P = 0.016 and χ~2= 3.97, P =0.046, respectively). In radiotherapy alone group, the 2-year OS and PFS were significantly higher in responders (n = 11) comparing with non-responders (n =24)(60% vs 44% ,χ~2 =5.84,P =0.016 and 20% vs 10% ,χ~2 =4.20, P =0. 040). In preoperative radio (chemo) therapy group (n =6), pathological-ly complete response, partial response and minimal response were observed in 4, 1 and 1 patients, respec-tively. EUS detected tumor response in 4 of 5 (80%) patients with tumor regression, and non-response in 1 of 1 patient without tumor regression. Conclusions The prognosis is better in patients with esophageal car-cinoma responding to neoadjuvant treatment identified by EUS than that of non-responders.

Objective To identify endoscopic and the endoscopic ultrasonography (EUS) features of esophageal tuberculosis.Methods We retrospectively analyzed the data of 39 cases (mean age 50.7) of esophageal tuberculosis diagnosed by endoscopy and EUS in past 6 years.Results A total of 29 lesions were found in the middle part of esophagus,and 5 in upper and lower part,respectively.The lesions under endoscope demonstrated as protrusion in 30 and ulceration in 9.EUS found esophageal wall thickness in 9 cases,intra-wall occupying lesion in 17,mediastinum occupying lesions involving esophagus in 13,and calcified lymph nodes in mediastinum which was integrated with esophageal outer wall in 28 cases.Conclusion The esophageal tuberculosis occurs mainly in the middle part of the esophagus,and appears as protrusion and ulceration under endoscopy.EUS can find occupying lesions intra-or out of the esophageal wall,and full layer thickness,which can accompany calcified lymph nodes in meidastinum,and can be the basis of diagnosis.

Acute Disease ; Administration, Inhalation ; Adolescent ; Asthma ; drug therapy ; Budesonide ; administration & dosage ; Child ; Child, Preschool ; Female ; Humans ; Male ; Oxygen ; Terbutaline ; administration & dosage

Objective To investigate the effects of a training program based on virtual reality on static and dynamic balance perfor-mance in patients with Parkinson's disease (PD). Methods From June, 2014 to June, 2016, 46 patients with PD were randomly divided into control group (n=23) and experimental group (n=23). The control group received routine balance training, while the experimental group re-ceived balance training of virtual reality, for six weeks. They were assessed with Unified Parkinson's Disease Rating Scale part 3 (UP-DRS3), Berg Balance Scale (BBS), TimedUp and GoTest (TUGT) and Hamilton Depression Scale (HAMD) before and after training. The envelope area, anteroposterior standard deviation (AP-SD), mediolateral standard deviation (ML-SD) of centre of pressure (COP) were also measured with posturography. Results The scores of BBS, TUGT and HAMD improved in both groups after training (t>2.657, P<0.05), and improved more in the experimental group than in the control group (t>2.426, P<0.05). The score of UPDRS3 and the parameters of pos-turography improved in the experimental group (t>2.626, P<0.05), and improved more than that in the control group (t>2.112, P<0.05). Con-clusion Virtual reality rehabilitation is more effective than routine balance training on the static and dynamic balance function in patients with PD, and may release their depression.

Abstract A novel luminol electrochemiluminescence strategy based on titanium dioxide/carbon nanotubes ( TiO2/CNTs) nanocomposites for detection of glucose was developed. First, the TiO2/CNTs nanocomposites were prepared by a sol-gel method and modified on the glassy carbon electrode. The electrochemiluminescence ( ECL) signal could be greatly enhanced when the electrode was established by the nanocomposites, which finally resulted in the increased sensitivity. Glucose oxidase calalyzed the oxidation of glucose to form H2 O2 , and the H2 O2 reacted with luminol to produce the ECL signal. Thus the above system was proved to be efficient for glucose detection. The modified electrode exhibited excellent ECL signals and a good linear range of 1. 0í10-7-5. 0í10-6 mol/L with a detection limit of 5. 2í10-8 mol/L towards glucose detection. This strategy was successfully demonstrated as a sensitive, rapid, simple and cost-effective method to detect glucose. Meanwhile, the TiO2/CNTs nanocomposites offered a novel material for the signal enhancement in electrochemiluminescence sensor.

Objective To screen for the potential protein biomarkers in serum for the diagnosis of idiopathic Parkinson's disease (PD) using proteomic fingerprint technology. Methods Proteomic fingerprint technology combining weak cation exchange (WCX) magnetic beads with MALDI-TOF-MS was used to identify and compare the serum proteins from 61 patients with idiopathic PD, 29 patients with other neurodegenerative diseases (OND) and 30 healthy blood donors. Model of biomarkers and proteomics patterns associated with PD was analyzed by Biomarker Patterns Software. The model also was validated by 40 newly recruited PD cases. Results A total of 17 discriminating M/Z peaks which were related to PD were identified ( nonparametric test, Z:-4.039--2.633, P<0.01 ). Five biomarkers with M/Z of 6121, 5234, 2961,4309 and 8170 respectively generated an excellent model of distinguishing between PD and healthy groups. The sensitivity was 98.4% and the specificity was 83.1%. Blind testing in 40 newly recruited cases demonstrated a sensitivity of 85.0% (17 of 20 PD) and a specificity of 70. 0% (14 of 20 controls). Conclusions Combination of WCX magnetic beads with MALDI-TOF-MS is a useful method in establishing proteomic patterns associated with PD. It also may be used to construct a diagnostic model with PD Biomarkers. Although this model of biomarkers fails to distinguish between PD and OND controls, it is able to differentiate PD from healthy controls.

Objective To investigate the differences of histopathological diagnosis between the endoscopic mucosal resection (EMR) specimens and the biopsy specimens,and to evaluate the value and the limitation of EMR in diagnosis of early esophageal cancers and its precursor lesions.Methods A retrospective analysis on 217 lesions with early esophageal cancers or the precursor lesions treated by EMR was performed.The differences between pathological diagnoses of biopsy and EMR were compared.Results Compared with pathologic diagnosis after EMR,the yield of biopsy consisted of 41.9％ (91/217) as under-diagnosed,15.7％ (34/217) as over-diagnosed,and 42.4％ (92/217) as consistent.EMR diagnosis also explicated the differentiation,the grade,the invasive depth and the lympho-vascular infiltration of the lesions.Conclusion The endoscopic biopsy diagnosis is limited for the pathological diagnosis of early esophageal cancer and precancerous lesions,while the EMR sample can provide objective diagnosis and provide the guideline for the further treatment.

Objective:To determine risk factors for postoperative esophageal refractory stenosis after endoscopic submucosal dissection (ESD) of large-scale early esophageal carcinomas and precancerous lesions.Methods:Two hundred and twelve early esophageal carcinomas or precancerous lesions in 186 patients who underwent ESD larger than 3/4 the total esophageal circumference in Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, between July 2013 and December 2017 were divided into two groups according to session number of endoscopic balloon dilatation (EBD), the refractory stenosis group ( n=69, ≥6 EBD sessions) and non-refractory stenosis group ( n=117, ≤5 EBD sessions). Student′s t-test or Mann-Whitney U test was used for univariate analysis and χ2 test and Fisher exact test were used for comparison of categorical variables. Logistic regression was used for multivariate analysis. Results:Compared with the non-refractory stenosis group, the refractory stenosis group had statistically significant differences in the longitudinal diameter of lesions, the longitudinal diameter of artificial ulcer, lesion location, the circumferential range of lesions and the composition of the muscular layer injury (all P<0.05). After eliminating the factor of the vertical diameter of artificial ulcer (because there was significant correlation between the vertical diameter of artificial ulcer and the longitudinal diameter of lesion in clinical practice), multivariate logistic regression analysis showed that the longitudinal diameter of lesion>5 cm (VS ≤5 cm: P=0.003, OR=3.531, 95% CI:1.547-8.060), the location of lesion in the upper thoracic segment (VS lower thoracic segment: P=0.001, OR=36.720, 95% CI:4.233-318.551), in the cervical segment (VS lower thoracic segment: P=0.003, OR=24.959, 95% CI:2.927-212.795), the whole circumferential lesion (VS ≥3/4 but not the whole circumference: P<0.001, OR=10.082, 95% CI:4.196-24.226) and the presence of muscular layer injury ( P<0.001, OR=7.128, 95% CI:2.748-18.486) were more likely to lead to esophageal refractory stenosis after ESD. Conclusion:The longitudinal lesion diameter of more than 5 cm, the circumferential extent of esophageal ESD, cervical or upper-thoracic esophageal lesions, and muscular layer damage are independent risk factors for postoperative esophageal refractory stenosis after ESD for large-scale esophageal cancer and precancerous lesions.

Objective To evaluate the endoscopic and pathologic characteristics and etiological ex-amination of viral esophagitis. Methods The data of 16 patients with viral esophagitis, including endoscop-ic, pathological and immunohistochemical findings were retrospectively studied. Results Endoscopic find-ings of viral esophagitis were characterized by single or multiple round and oval ulcers, located at the upper and middle esophagus. The surface of the ulcer was clean, and the boundary was distinct. Pathologic findings included degeneration and necrosis in squamons epithelium, accompanied by ulcer, infiltration of neutrophils and lymphocytes, hyperplasia of capillaries and basal cells and formation of granulation tissues, Immunocyto-chemical examination showed HSV-1 was positive in biopses, while CMV, EBV, HHV8 were negetive. Con-dusion Viral esophagtitis exhibited distinctive endosoopic and pathological features, and etiology can be confirmed by immunohistochemical examinations.

Background A virtual reality simulator provides a novel training model for improving surgical skills in a variety of fields.They can simulate a variety of surgical scenarios to improve the overall skills required for endoscopic operations,and also record the operative process of trainees in real-time and allow for objective evaluation.At present,some simulators for transurethral resection of the prostate (TURP) are available.The utility of virtual reality simulators in training of transurethral prostatectomy was investigated.Methods Thirty-eight urologists were randomly selected to take part in a simulation based training of TURP using the TURPSimTM system.Pre and post-training global rate scale (GRS) scores and objective parameters recorded by the simulator were assessed.Then,questionnaires were filled out.Results Compared with baseline levels,the GRS scores of trainees increased (18.0±4.0 vs.12.4±4.2,P＜0.001),while the rate of capsule resection (26.3％±0.6％ vs.21.2％±0.4％,P ＜0.001),amount of blood loss ((125.8±86.3) ml vs.(83.7±41.6) ml,P ＜0.001),external sphincter injury (3.6±2.9 vs.2.0±2.0,P ＜0.001)decreased significantly after training.Most trainees were satisfied with the simulator based training and believed that the simulator accurately mimicked actual surgical procedures and could help improve their surgical skills.Conclusions As a new method of training on transurethral prostatectomy skills,training of TURP using a virtual simulator can help urologists improve their surgical skills and safety.Therefore,the application of the TURPSimTM system in education and training of urologic surgery is warranted.