With the improvement of endoscopic technology,an increasing number of early esophageal cancer is diagnosed by gastroscopy.Regardless of the size or submucous fibrosis of esophageal cancer,endoscopic submucosal dissection (ESD) allows en bloc resection and histologically complete resection of the tumor.ESD has been recognized as an optimal treatment modality for early esophageal carcinoma.Currently,short-term curative effects of early esophageal cancer after ESD have been proved satisfactory,but the long-term outcomes remain unclear.This paper reviews the research advances about the long-term outcomes of ESD,and focuses on the postoperative stenosis,the recurrence,metastasis and survival rates of patients,to provide treatment reference for clinicians.

Objective To observe the clinical efficacy of electroacupuncture plus puncturing the thirteen ghost points in treating diabetic gastroparesis.Method Sixty patients with diabetic gastroparesis were randomized into a treatment group and a control group, 30 in each group. The treatment group was intervened by electroacupuncture plus puncturing the thirteen ghost points, while the control group was by electroacupuncture alone. The clinical efficacies were then compared.Result The total effective rate was 93.3% in the treatment group versus 83.3% in the control group, and the difference was statistically significant (P<0.05). Conclusion Electroacupuncture plus puncturing the thirteen ghost points is an effective approach in treating diabetic gastroparesis.

Objective To investigate the relationship of professional identity and social support among nursing undergraduates. Method Overall 286 nursing undergraduates participated in the survey by the professional identity scale and social support scale. Results The average score on the social support was (38.12 ± 4.70), and the average score on the professional identity of undergraduate nursing students was (107.29 ± 15.01), which was in the medium level. There was significant positive correlation between nursing undergraduates′social support and professional identity as well as other dimensions (P<0.05, P<0.01). Conclusions Nursing undergraduates′social support is closely related to its professional identity. It is suggested that the nursing undergraduates should be provided a variety of psychological and behavioral support and they should be helped to fully use social resources , so as to improve their professional identity.

The single colonel composition of pituitary adenomas of human attests to the molecular basis of pituitary tumorigenesis. This review offers a specific overview of the involvement of alternation of tumor oncogenes and tumor suppressor genes (TSGs) in the pathogenesis of human pituitary adenomas. Mutations of gsp and H ras oncogenes genes and amplification of PKC have been identified in pituitary adenomas. Especially the mutation of gsp has been detected in 40% human GH secreting pituitary adenomas. The role of TSGs(tumor suppressor genes) including MEN 1, p53, Rb and p16 in pituitary adenoma formation and progression has yet be observed. Providing evidence proves that activation of oncogenes and inactivation of tumor suppressor genes seem to be at least one mechanism by which human pituitary adenomas origin and progress.

5-HT immunoreactive cells(EC cells)in the gastrointestinal tract were studiedby immunogold silver staining method and PAP method in sixty human fetuses aged8-38 weeks of gestation.The results indicated that the appearance of EC cells wasas early as 8 weeks of gestation in the epithelium of duodenum.After 12 weeks ofgestation,the EC cells can be found in the whole human fetal gut.The number ofEC cells(EC cells with visible nucleus per visual field)at all period of gestationalways decreased in an order from the mucosa of duodenum,jejunum,ileum,ap-pendix,colon and stomach respectivly.EC cells in the mucosa of antrum often po-ssessed long processes contacted with other types of glandular cells.The EC cellswere open typed cells except those in the fundic mucosa.Grouped EC cells can alsobe seen in the mucosa of appendix and the intestinal glands.

Objective To investigate the interrelation between microtubule associated protein 5 and lysosome in cultured spinal neurons. Methods Neuron culture, immunofluorescence cytochemistry, laser confocal scanning microscope were used. Results In cultured spinal neurons, both of MAP5 and calthepsin D were distributed in cytoplasm and processes. In merged pictures, the distribution of MAP5 and calthepsin D was almost similar. When nocodazole was employed, the distribution of MAP5 and calthepsin D changed simultaneously. Both fluorescence distributed in cytoplasm was uneven and the process was shorter. When PMA was employed, the distribution of red and green fluorescence became reticulum and spread toward membrane. The soma enlarged and the process displayed certain direction accompanying adjacent processes interlinked.Conclusion In cultured spinal neurons, the distributions of MAP5 and lysosomes were almost similar. Both were in cytoplasm and process. Nocodazole and PMA caused reverse change for the distribution of MAP5 and lysosomes. The distribution of MAP5 and calthepsin D treatel with Nocodazole was unregulated, while PMA was regulated and loose. These results suggested that MAP5 and lysosomes were interrelated between structure and function. Both of them were depended on the integrity of microtubule.

Objective To investigate the incidence and risk factors of hallucination in patients with Parkinson’s disease (PD) by using a questionnaire. Methods Ninety-one patients with PD from outpatient and inpatient departments of Neurology and 38 healthy subjects were recruited. Mini-mental state examination (MMSE), unified Parkinson's disease rating scale-Ⅲ(UPDRS-Ⅲ), Hoehn-Yahr, interleukin 6 (IL-6) and C-reactive protein (CRP) were examined in all PD. According to the PPQ-B scores, the PD patients were divided into two groups:the hallucination group (PPQ-B≥1) and non-hallucination group (PPQ-B=0). Logistic regression model was used to explore the risk factors. Results Twen?ty-nine of 91 patients had hallucination and the incidence was 32%. Age and the levels of IL-6 and CRP were signifi?cantly higher in hallucination group than in non-hallucination group. Meanwhile, the duration of illness and MMSE were significantly higher in hallucination group than in non-hallucination group. Logistic regression revealed that the age and duration of illness were independent risk factors of hallucination and the Odds Ratios (OR) were 1.09 (95% CI:1.04~1.32, P<0.05) and 1.43 (95%CI:1.21~1.87, P<0.05), respectively. The risk of hallucination increased by 51%and 59%for each doubling of IL-6 and CRP levels in PD patients and the ORs were 1.51 (95%CI:1.13~2.11, P<0.05) and 1.59 (95%CI:1.07~2.66, P<0.05), respectively. Conclusions Controlling the levels of serum IL-6 and CRP plays an impor?tant role in delay or prevention of the hallucination of PD patients.

Objective To study the relationship between thyroid function and disease severity or insulin resistance in patients with type 2 diabetes.Methods A total of 500 patients with type 2 diabetes and 60 normal controls were enrolled in our study.Fasting blood free three iodine thyroid original thyroid hormones(FT3) and free amino acid(FT4),thyroid stimulating hormone(TSH),thyroid related antibodies(thyroid peroxidase antibody(TPOAb) and thyroglobulin antibody(TGAb)) of two groups of selected objects were detected.In patients with type 2 diabetes group,blood insulin,glycated hemoglobin(HbA1c),and the determination of trace albumin urine creatinine(UCr) and (UMA) were assayed.Results FT3 and TSH of control group was (4.14±1.52) pmol/L,(2.10±1.33) mIU/L,but the level of case group was (4.53±0.72) pmol/L,(1.78±0.97) mIU/L respectively,the difference between case group and control group of serum FT3 and TSH were statistically significant(P=0.03,0.025).The serum FT3 significantly decreased in patients with high blood sugar,the difference between HbA1C>11% group(FT3=(3.76±0.78) pmol/l) and HbA1C≤7%(FT3=(4.37±0.78) pmol/l),7-9%(FT3=(4.24±0.62) pmol/l),9-11% (FT3=(4.36±1.68) pmol/l) groups were statistically significant(P=0.014,0.009,0.000).The higher urine MA/Cr,the more serum FT3 decreased,the difference between urine MA/Cr<30 mg/g group(FT3=(4.31±0.18) pmol/l) and 30 mg/g≤MA/Cr<300 mg/g(FT3=(4.00±0.79) pmol/l),MA/Cr≥300 mg/g (FT3=(3.50±0.76) pmol/l) groups were statistically significant(P=0.041,0.001).The differences between MA/Cr≥300 mg/g group and 30 mg/g≤MA/Cr<300 mg/g group was statistically significant(P=0.044).In addition,we found a correlation between serum TSH and insulin resistance index(HOMA-IR)(r=0.302,P=0.001).Conclusion As a sign of serious high blood sugar,it can predict the severity of diabetic nephropathy.There is intimate relationship of serum TSH and HOMA-IR.

Objective To discuss the correlation of serum TNFR level with renal function injury in patients with type 2 diabetes mellitus (T2DM)and normal albumin excretion.Methods 90 T2DMpatients with normal albu-min excretion(24h urine albumin excretion rate <20μg/min)were divided into three groups according to the esti-mated glomerular filtration rate level:eGFR >90mL · min -1 · (1.72m2 )-1 ,eGFR 60 -90mL · min -1 · (1.72m2 )-1 and eGFR <60mL·min -1 ·(1.72m2 )-1 ,30 cases in each group.The serum TNFRs level and related clinical data were measured and analyzed statistically.Results The levels of serum TNFR1,TNFR2 were negatively correlated with eGFR(r =-0.428,-0.335,all P <0.05),and positively correlated with Scr(r =0.476,0.225,all P <0.05)in patients with T2DM and normal albumin excretion.The course of disease and the levels of BUN,Scr, CysC,α1 -MG,β2 -MG were increased as the degree of renal function injury.All these index had statistically signifi-cant differences in three groups(F =3.758,5.851,71.738,25.751,7.530,13.735,all P <0.05).Logistic regres-sion analysis showed that the levels of serum TNFR1,TNFR2 were independent risk factors for renal impairment in patients with T2DMand normal albumin excretion(OR =2.009,1.143,all P <0.05).Conclusion TNFRs may be involved in the development and progression of renal impairment,and may become a new conventional indicator for DN because of reflecting the degree of renal function injury in some extent in T2DMpatients with normal albumin excretion.

OBJECTIVE:To observe clinical efficacy and safety of pidotimod combined with montelukast sodium in the treat-ment of children with bronchial asthma. METHODS:120 children with bronchial asthma were randomly divided into control group and observation group,with 60 cases in each group. Both group were given routine treatment as aerosol inhalation of glucocorticoid and anti-infective treatment. Control group was additionally given Montelukast sodium chewable tablet 5 mg orally,qd,at bed-time;observation group was additionally given Pidotimod capsule 0.4 g,qd,on the basis of control group. Both group received treatment for consecutive 3 months. Clinical efficacies of 2 groups were observed as well as IL-4,IFN-γ,IgE,T lymphocyte sub-set and lung function indexes of 2 groups before and after treatment. The occurrence of ADR were compared between 2 groups. RE-SULTS:The effective rate of observation group was 88.3%,which was significantly higher than that of control group (61.7%). There was no statistical significance in IL-4,IFN-γ,IgE,T lymphocyte subset and lung function indexes between 2 groups before treatment(P>0.05). After treatment,IL-4,IFN-γ,IgE,CD4+,CD4+/CD8+ and lung function of 2 groups were improved signifi-cantly,and the observation group was significantly better than the control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Pidotimod combined with monte-lukast sodium is effective for children with bronchial asthma,and can significantly relieve airway inflammation,enhance immunity and improve lung function with good safety.