Objective Endoscopic ultrasound (EUS) guided fine-needle aspiration (FNA) of pancreatic lesions is being increasingly used. The aim of the study was to evaluate its safety, accuracy, and clinical utility in the diagnosis of pancareatic diseases. Methods EUS-guided FNA was performed in 21 patients (13 men and 8 women) with pancreatic lesions (16 head/neck, 5 body/ tail) detected by CT scanining, unltrasonography or clinically suspected diagnosis.Three patients with unresectable pancreatic cancer underwent EUS-guided celiac plexus neurolysis(CPN) for pain-relieving. Results The lesions detected by CT scanning (19 cases) and ultrasonography(16 cases) were all confirmed by EUS. Adequate specimens were obtained by EUS-guided FNA in 18 of 21 lesions and final diagnosis in these subjects was pathologically confirmed. EUS-guided FNA had a sensitivity of 85.0%, specificity of 100.0% and accuracy of 85.7% for diagnosis of pancreatic lesions. The final diagnosis was not obtained in three patients due to inadequate specimens. Three patients with pancreatic carcinoma were decreased in pain scores after EUS-CPN. Two cases with complication of mild pancreatitis or post-FNA fever were found. Conclusions EUS-guided FNA of the pancreas was a safe and effective modality for diagnosis and treatment of pancreatic lesions.

Objective:To compare the effects of different polishing techniques on the surface roughness of ceramic surfaces,provi-ding reference to restoration polishing in clinic.Methods:70 disc-shaped ceramic specimens were randomly divided into 7 groups(n=10).The glazing treated samples were served as the controls(group 1),the rest samples were treated by white aluminum oxide stone only(group 2)or followed by the polishing head of Ceramiste(group 3),Ceramiste and Ceramaster(group 4),Komer porcelain (group 5),Komer zirconium oxide(group 6)and EVE zirconium oxide,respectively.Roughness of the ceramic samples(including Ra,Rz and Rp)was measured with surface profilometry after different process and the data were analyzed by one way ANOVA.The surface characteristics of the specimens were observed by scanning electron microscopy.Results:The Ra and Rp of group 2 and 3 was higher than those of group 1(P <0.05).The Rz of group 2,3,4 and 5 was higher than that of group 1(P <0.05).Conclusion:Polishers interspersed with diamond grit may achieve a finish equal in smoothness to the glazed surface.

Objective:To assess the effect of accelerated aging on the color and opacity of veneers bonded resin.Methods:28 discs were made with IPS e.max Press A1 shade with the thickness of 0.4 mm.Ceramic discs were divided into 4 groups(n=7). BEAUTIFIL Flow A1 ,DEO-Link SE Transparent,Panavia F Light color and Viriolink N transparent resin cements were applied on the porcelain discs with a thickness of 0.1 mm.Curing was performed with a calibrated LED curing-light for 40 seconds.Color and opac-ity differences of the porcelain substructures after 65 h(150 kJ/m2 )of UV ageing test were examined with a colorimeter.The results were analysed statistically with One-way ANOVA,LSD(L)test.Results:All samples showed significant changes in color and opaci-ty.The ΔE of all materials ranged from 0.6 to 2.29.DEO-Link SE showed the highest color change,while BEAUTIFIL Flow the lowest.The opacity changes ranged from 0.46 to 2.55 and its variation was not significant among groups except for Panavia F.Con-clusion:The accelerated ageing may lead to color changes of ceramic veneer bonded by resins in a clinically acceptable range(ΔE<3).

Objective To explore the effect of age on the fracture healing through bioinformatical analysis of gene ex?pression data in GEO, and to screen critical molecular targets and pathways involved in this process. Methods Through R programming language, we identified different expressed genes between 26/52 week old rats and 6 week old rats in every time points of the experiment (No fracture;3 days, 1 week, 2 weeks, 4 weeks and 6 weeks after fracture). By comparison of these different expressed genes, those genes that may contribute to fracture healing were identified. Function annotation was conducted based on DAVID database and PPI network that was constructed via STRING database. Results Compared with 6 week old rat, 52 week old rat show more different genes at 2, 4 and 6 weeks after fracture as well as more than intact rats. At the time point of 6 weeks after fracture, 26 week old rat present 4 different genes while 52 week old rat present 99 differ?ent genes compared with 6 week old rat. We totally found 99 genes that might play important roles in the process of fracture healing. These genes involved in biological process related to bone healing, immune, inflammatory and etc. Also, two screened gene enriched KEGG pathways were identified: ECM-receptor interaction and Arachidonic acid metabolism. Through the analysis of PPI network, Pcna, Fn1, Casp3 and etc, who present high density connectivity in PPI network, were screened out. Conclusion Pcna, Casp3 and Fn1 and etc might play important roles in fracture healing through affecting ECM-receptor interaction and Arachidonic acid metabolism.

Objective To evaluate the effects of laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy on weight control in morbidly obese patients.Methods 48 patients with morbidly obesity underwent obese surgery (laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy) from Dec.2013 to Dec.2015,and 1-year follow-up study.The general situation of obesity and biochemical indicators were compared and analyzed.Results There were 20 cases in gastric bypass group and 28 cases in sleeve gastrectomy group.The excess weight loss percentage(％EWL)was 73±0.04 in gastric bypass group and 59±0.05 in sleeve gastrectomy group(P=-0.03).There was no statistical difference in weight change between the two groups.Low density lipoprotein cholesterol (LDL) level in gastric bypass group was significantly lower than that in sleeve gastrectomy group at 1 year after surgery (2.42±0.16 vs 3.29±0.20,P=0.006),while folic acid level was significantly higher than that in sleeve gastrectomy group(15.58±1.99 vs 7.59±1.59,P=0.022).Conclusions The one-year follow up shows there is no significant difference in the efficacy of weight control between the two groups.Gastric bypass group may be superior to gastrectomy group in nutrition indexes.However,it is just a short-term postoperative efficacy in morbidly obese patients,long-term weight control effects and obesity related diseases control need to be further explored.

ObjectiveTo evaluate the efficacy and safety of submucosal tunneling endoscopic resection (STER) for upper gastrointestinal (GI) submucosal tumors (SMTs) originating from the muscularis propria (MP) layer.MethodsA total of 26 upper GI-SMTs originating from the MP layer were treated by STER after endoscopic ultrasonography (EUS) and CT examination.The lesions were localized endoscopically and a submucosal tunnel was created to expose the tumor.The lesion was then resected under direct endoscopic view and the mucosal incision site was closed with hemostatic clips.ResultsOf the 26 SMTs,14 were located at esophagus,7 at cardia and 5 at stomach,with 11 originated from superficial MP layer and 15 from deep MP layer ( including 2 gastric SMTs adherent with serosa).All lesions were successfully resected by STER with an en bloc resection rate of 100％.The average operation time was 68.5 min ( range 25-145min).Four to six (mean five) hemostatic clips were used to close the mucosal incision site.The average lesion size was 1.8 cm ( range 1.0-3.2 cm).The pathology results were 17 leiomyomas,7 stromal tumors (GISTs),1 glomus tumor and 1 Schwannoma.All resected lesions showed both lateral and vertical tumorfree margins.Subcutaneous emphysema occurred in 2 patients (7.7％ ).One patient (3.8％ ) developed left pneumothorax and subcutaneous emphysema,and 2 others (7.7％) pneumoperitoneum.All of them recovered uneventfully on conservative treatments.No delayed bleeding,GI tract leakage or secondary peritoneal/thoracial infection occurred.None of the 26 cases developed submucosal hematoma or infection.No tumor residual or recurrence was found during follow-up period (range 3-9 months).ConclusionSTER is a safe,efficacious and feasible new method for providing accurate histopathological evaluations,as well as radical treatments for upper GI-SMTs from the MP layer.It can regain the mucosal integrity of the GI tract,preventing leakage and secondary infection.

Objective To evaluate the efficacy and the feasibility of peroral endoscopic myotomy (POEM) for achalasia (AC). Methods The clinical data of 8 patients diagnosed as having AC and receiving POEM at our center from August 2010 to December 2010 were reviewed. The patients were 16-62 years old, mean 43yr, whose disease courses lasted for 2-20 years, mean 8.4 years. The key procedures of POEM were as the following, esophageal mucosal incision, submucosal tunneling by endoscopic submucosal dissection ( ESD), endoscopic myotomy of the circular muscle and closure of mucosal entry by hemostatic clips. Results All the 8 patients underwent POEM successfully. The mean operation time was 68.5 min ( ranging 45-115 min). The mean submucosal tunneling length was 9.5 cm ( ranging 8-13 cm). The average length of endoscopic myotomy of inner circular muscle was 8.5cm ( ranging 7-11 cm). No severe complications related to POEM occurred. Patients were followed up for 1-4 months ( mean 2. 5 months). Dysphagia was relieved significantly during the follow-up in 7 patients. But dysphagia and vomiting re-occurred in one patient 15 days after the operation. Endoscopy revealed a submucosal fistula, which was managed by incision. Conclusion As a new minimally invasive therapy for AC, POEM is very effective to relieve dysphagia in a short term. However, further observation is needed to evaluate long-term efficacy and complications.

OBJECTIVETo generate a candidate HPV16 vaccine for experimental and therapeutical use for cervical cancer.

METHODSThe mutants of HPV16 early E6 and E7 genes were inserted into a vaccinia virus expression vector. A strain of recombinant vaccinia virus was constructed through homologous recombination.

RESULTSShowed that the mutant E6 and E7 genes were located at TK gene region of vaccinia virus Tiantan strain in a head to head orientation under the control of early/late promoters, H6 and 7.5K respectively. Studies in mice indicated that VmE6E7 could elicit specific antibodies against E6 and E7, and retarded or prevented tumor development in a proportion of C57 BL/6 mice challenged by syngeneic HPV16E6 and E7 transformed tumor cells.

CONCLUSIONSThe success in constructing VmE6E7 provides a basis for the further development of HPV16 therapeutic vaccine.

Animals ; Female ; Genes, Viral ; genetics ; Genetic Vectors ; genetics ; immunology ; Mice ; Mice, Inbred C57BL ; Mutation ; Neoplasms, Experimental ; prevention & control ; Oncogene Proteins, Viral ; genetics ; Papillomaviridae ; genetics ; Papillomavirus E7 Proteins ; Recombination, Genetic ; Repressor Proteins ; Transfection ; Vaccinia virus ; genetics ; immunology

OBJECTIVETo generate an HPV16 prophylactic vaccine candidate for cervical cancer.

METHODSHPV16 major capsid protein L1 gene and minor capsid protein L2 gene were amplified using PCR. These genes were mutated by PCR site-directed mutagenesis for removal of sequence motifs (TTTTTNT) which would cause transcription termination when expressed from a vaccinia virus early promoter, then inserted into a vaccinia virus expression vector. A strain replication-deficient recombinant vaccinia virus containing the mutant sequences was obtained through a homologous recombination and identified.

RESULTSThe nucleotide sequence remained the correct amino acid sequence of the L1 and L2 proteins after mutated. Full-length L1 and L2 proteins were generated in cells infected with the recombinant virus. The virus strain propagated at very low titer or could not reproduce in some kinds of cell derived from different human tissues.

CONCLUSIONSThe authors have generated a strain replication-deficient recombinant vaccinia virus expressing HPV16 L1 plus L2 proteins as an HPV16 prophylactic vaccine candidate for cervical cancer.

Capsid ; Capsid Proteins ; genetics ; Cell Line ; Cloning, Molecular ; Female ; Gene Expression ; Genetic Vectors ; Humans ; Oncogene Proteins, Viral ; genetics ; Papillomaviridae ; genetics ; physiology ; Papillomavirus Infections ; prevention & control ; Transfection ; Tumor Virus Infections ; prevention & control ; Uterine Cervical Neoplasms ; virology ; Vaccinia virus ; genetics ; physiology ; Virus Replication

Objective To explore the application effect of concept map teaching of group-discussing mode in standardized nursing training. Methods A total of 80 standardized training nurses in Wuxi No.2 People's Hospital from January 2016 to December 2016 were selected by purposive sampling and randomly divided into the intervention group and the control group, with 40 students in each. The control group was taught according to the conventional teaching method, and the intervention group was taught with the concept map teaching of group-discussing mode. The scores of the independent learning ability assessment scale and the scores of theoretical examination were compared before and after the intervention. The scores of the feedback evaluation scale of concept map teaching of group-discussing mode in the intervention group were observed. Results The score of each dimension and the total score of the independent learning ability assessment scale of the intervention group after intervention were higher than those in the control group, and the difference was statistically significant (P<0.05). The score of theoretical examination in the intervention group was higher than that in the control group with statistical difference (P<0.001). The nurses in the intervention group had a better feedback on the concept map teaching of group-discussing mode. Conclusions The concept map teaching of group-discussing mode obtains good application results in clinical nursing teaching and training, and it can improve the nurses' independent learning ability.