Objective To evaluate the efficacy, safety and risk factors of endoscopic treatment for patients with early gastric cancer. Methods A retrospective study was conducted in a single center and data was collected from 186 early gastric cancers in 168 pathologically confirmed patients who received endoscopic treatment in Peking Union Medical College Hospital from January 2006 to December 2015. The cases were divided into different groups according to indications of endoscopic treatment. The curative resection rate and complication rate were analyzed. Post-resection outcomes were evaluated by long-term surveillance. Results The curative resection rate was 86. 9%( 73/84) in the group with absolute indications, 61. 7%(50/81)in the group with expanded indications, and 33. 3%(7/21) in the group beyond indications (P＜0. 01). Multivariate analysis revealed that the significant independent predictors for curative resection included lower third location of stomach, no ulceration,≤2 cm at diameter, no adhesion, and well-differentiation in histopathology. In the expanded indications group, discordance of differentiation type and deeper invasion mainly resulted in non-curative resection in en bloc lesions. The rate of bleeding and perforation was 4. 8%( 9/186) and 3. 8%( 7/186), respectively. The perforation rate was significantly lower in the lesions located in the lower third of stomach, without adhesion or performed by en bloc resection. During a median follow-up period of 22. 3 months, 154 patients were followed successfully. The incidence of synchronous and metachronous gastric cancers in curative resected lesions was 7. 5%( 8/106) and 0. 9%(1/106), respectively. Conclusion Endoscopic resection is an optimal treatment with high curative resection rate for early gastric cancer patients with absolute indications. Patients with expanded indications should take precise preoperative evaluation to avoid higher risk of non-curative resection endoscopically. Close follow-up is necessary for synchronous and metachronous gastric cancers after endoscopic resection.

Objective To analyse the negative predictive value of endoscopic ultrasonography (EUS)for detecting pancreatic cancer and to evaluate its clinical value of ruling out malignant cancer. Methods The medical records of patients who were referred to pancreatic EUS with suspected pancreatic cancer and normal EUS findings from January 2005 to December 2013 were reviewed. Moreover,the follow-up data were reviewed to evaluate whether the patient developed pancreatic cancer or other malignancy that could cause the abnormality mentioned above. The follow-up data were obtained by examining the inpatient/outpatient records as well as conducting brief telephone interviews. Results A total of 122 patients were in-cluded in our study. The follow-up data of 108 were accessible,and the mean follow-up period was 52. 4 months. One patient was histopathologically diagnosed as having pancreatic cancer 6 years after the proce-dure,and 107 other patients with a normal pancreatic EUS were free of pancreatic cancer as well as other malignancy during the follow-up period. The negative predictive value of pancreatic EUS was 99. 1%(107/108). Conclusion For patients with suspected pancreatic cancer but normal EUS findings,there is no need for further exploratory surgery. However,if there is a high suspicion of malignancy in the pancreas,a repeat-ed EUS is necessary in case of a false negative EUS result.

Objective To investigate the effect of povidone iodine irrigation combined with levofloxacin eye drops on the inflammatory indexes, NO and antioxidant indices in serum and tear fluid of patients with diabetic cataract.Methods 50 cases of pati ents with diabetic cataract and admitted into the hospital during January 2013 to January 2015 were selected as the research objects all of whom received cataract surgery.According to the randomized double blind method, the patients were divided into two groups with 20 cases in each group.The control group received levofloxacin eye drops intervention before surgery while the observation group were treated withpovidone iodine irrigation, based on the control group.The inflammatory indexes (IL-2, sIL-2R, IL-6), NO, antioxidant indexes (TAC, SOD, CAT) and condition of postoperative infection were compared between the two groups before and after irrigation.ResuIts In the observation group, the sIL-2R, IL-6 and NO levels in serum and tear fluid after irrigation were significantly lower than those in the control group while IL-2, TAC, SOD and CAT were significantly higher than those in the control group.The differences were statistically significant (P<0.05).The postoperative infection rate of the observation group was 0.0% which was significantly lower than 16.0% of the control group.The difference was statistically significant ( P<0.05 ) .ConcIusion Povidone iodine irrigation combined with levofloxacin eye drops can significantly reduce the inflammatory reactions in patients with diabetic cataract and improve their antioxidant level.

Objective To explore the clinical effents of bevacizumab on the recrudescence of the limbal corneal epithelial cell auto-graft transplantation in treating patients with pterygium.Methods The clinical data of 75 cases(99 eyes) with pterygium were retraspectively reviewed,and they were divided into 3 groups by different conservative treatment.A group:the limbal corneal epithelial cell auto-graft transplantation combined with bevacizumab.B group:the limbal corneal epithelial cell auto-graft transplantation combined with MMC.C group:the limbal corneal epithelial cell auto-graft transplantation.After follow-up for 3 months,the curative effect and recurrence were compared between the two groups.Results The recurrence of three groups was significantly different( x2 =12.267,P ＜ 0.05 ).The reccurrence rate of A,B,C group were 12.1％,15.2％,45.5％.The recurrence rate of A group and B group wasn't significantly different(x2 =2.117,P ＞0.05).The recurrence rate of B group and C group wasn't statistically different( x2 --3.930,P ＜ 0.05 ).The recurrence rate of A group and C group was significantly different( x2 =4.155,P ＜ 0.05 ).After 1 week,all patients had different degrees of eye pain,photophobia or tearing,and disappeared after 1 week;2 patients in group B found that limbal shallow scleral necrosis,superficial punctate keratitis.The average time of removal of stitches in group A was 5.9d,group B was 7.0d and group C was 7.5d.Conclusion Bevacizumab could obviously reduce the recrudescence of the limbal corneal epithelial cell auto-graft transplantation in treating patients with pterygium.It was safe with less complications and good prognosis.It was worthy for being widely used in treatment of pterygium.

Objective To evaluate endoscopic ultrasonography (EUS) for TN restaging and predicting response to advanced gastric cancer after neoadjuvant chemotherapy. Methods A total of 22 patients,15 males and 7 females, mean age 64 (36-80 years ), with advanced gastric cancer were recruited to the study from June 2007 to December 2009 with written informed consents. All patients underwent 3 cycles of neoadjuvant chemotherapy ( Folfox 6 ), and subsequent surgery ( R0 resction) in 3-4 weeks after chemotherapy. EUS was performed 1-2 weeks before and 1-2 weeks after chemotherapy. EUS TN staging was compared with pathological findings. The correlation of peri-chemotherapy EUS TN staging with postoperative pathological response was evaluated. Results After chemotherapy, the overall accuracy of EUS T staging was 63.6% (14/22), with overstaging (36. 4%, 8/22) more frequent than understaging (0). The overall accuracy of N staging was 54. 5% (12/22) with 4 ( 18. 2%, 4/22) overstaging and 6 ( 27. 3%, 6/22 ) understaging. EUS revealed T and/or N downstaging ( concyrrence of T and N downstaging was accounted once) after chemotherapy in 10 patients, with 9 T downstaging (4 from T3 to T2, 5 from T4 to T3) and 4 N downstaging (4 from N1 to N0). TN downstaging was correlated with pathological response, with 7 patients achieving pathological response 2 and 1 patient 3. Conclusion T and N restaging by EUS after neoadjuvant chemotherapy in patients with locally advanced gastric cancer is not accurate enough. However, T and/or N downstaging confirmed by EUS is well correlated with a better degree of pathological response to chemotherapy.

Objective To evaluate magnifying endoscopy combined with narrow-band imaging ( ME-NBI) for diagnosis of early gastric cancer (EGC).Methods A total of 150 focal lesions from 143 patients over 35 years old identified by white light endoscopy (WLE) from March 2010 to December 2010 in our tertiary referential institution were recruited in the prospective study with written informed consent.Focal lesions were defined as any small local mucosa with abnormal shape or color based on an assessment of findings of WLE without any specified criteria, including superficial, depressed and elevated lesions.The patients with local advanced gastric cancer, submucosal lesions and history of gastrectomy were excluded from the study.All the patients received ME-NBI.Based on literature, national criteria of early diagnosis with ME-NBI were established.All the lesions underwent biopsy and pathological examination.Diagnostic accuracy of ME-NBI for EGC was assessed with reference to histopathology.Results In 150 focal lesions, 19 were pathologically diagnosed as EGC, 8 of which were treated by endoscopic resection and 11 were resected surgically.The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of conventional WLE for diagnosing EGC were 94.7%, 53.4%, 22.8%, 98.6% and 58.7%, respectively.The counterparts of ME-NBI for diagnosing EGC were 73.7%, 99.2%, 93.3%, 96.3% and 96.0%, respectively.The diagnostic accuracy of ME-NBI was significantly better than that of conventional WLE (96.0% vs.58.7%, P＜0.05).With regard to the findings of EGC on ME-NBI, irregular or absent microsurface pattern and microvascular pattern were characteristic features of EGC.Conclusion Conventional WLE is still an important and mandatory screening modality, which is significant for further procedures of suspected lesions, preferably accompanied with biopsy.ME-NBI achieved superior accuracy in the differential diagnosis of focal lesions detected with conventional WLE, but needs further verification.

Objective To investigate the effect of intermedin (IMD) on tubular cells apoptosis induced by renal ischemia/reperfusion (I/R) injury and its associated mechanism.Methods A total of twenty-four male Wistar rats were randomly divided into four groups (control group, I/R group, empty plasmid group and IMD group). One week after the removal of right kidney, ultrasound plasmid was used to transfect empty or IMD plasmid into the left kidney. Renal I/R model was made by clasping the left renal artery for 45 minutes. Tubular cell apoptosis was determined by TUNEL. Expression of Bax, Bcl-2, Fas was detected by semi-quantitative RT-PCR.Activity of caspase-8 and caspase-9 was evaluated with commercially available kits respectively.Protein level of caspase-3 was measured by Western blotting analysis. Results Compared with control group, apoptosis of tubular epithelial cells, expression of Bax and Fas, activities of caspase-8 and caspase-9, as well as protein level of caspase-3 were all significantly increased in I/R group (all P＜0.05). IMD pre-treatment significantly inhibited all these effects (all P＜0.05). There were no differences of above parameters between empty plasmid group and I/R group. Conclusion IMD pre-treatment protects against renal I/R injury by inhibion of tubular epithelial cell apoptosis.

Objective To analyze the characteristics of EUS imaging in the patients with autoimmune pancreatitis(AIP).Methods Eleven cases of AIP were studied retrospectively,and features of EUS were analyzed.Results EUS revealed diffuse or focal enlargement of pancreas along with hypoechoic parenchyma and a wavy margin.In addition to dilation,the bile duct had a prominently thickened wall with homogenous mild hypoechoic image.Peripancreatic lymph nodes could be enlarged.No pancreatic duct dilation.calcification or cysts were found.No peripheral vessels were involved.Conclusion EUS could demonstrate specific images which is helpful in diagnosis of AIP.

Objective To evaluate the efficacy of non-Hodgkin's lymphoma(NHL)treated by high does MTX,autologous peripheral stem cell transplantation and biotherapy for 67 cases.Methods Sixty-seven NHL patients from June,2003 to March,2007 were treated by three times HD-MTX,APBSCT and biotherapy of IL-2.Results There were 36 cases(87.8%)in complete relase(CR)period;5 cases(12.2%)in relapse(RE)period and 1 patient(2.4%)died in CR group;in PR group,there were 15 cases(57.7%)in CR period;11 cases(42.3%)in RE period and 5 patients(19.2%)died.Conclusion These preliminary results suggest that the therapy can be performed safely.It is an efficacious therapeutic measure for the patients with non-Hodgkin's lymphoma.

Objective To evaluate clinical effect of autologous peripheral blood stem cell transplantation(APBSCT)on the treatment of hematologic malignancies.Methods Totally 231 patients(ALL in 45 cases,AML in 34 cases,NHL in 100 cases,HD in 31 cases,MM in 21 cases)with hematologic malignancies received APBSCT from March 2001 to February 2007.Therapeutic effect and complication were oberserved.Results Totally 230 patients obtained hematopoietic reconstitution quickly,one case failed.ALL CR1(first time CR):13 in DFS,4 alive with disease(LWD),11 in death;ALL CR2(second time CR):3 in DFS,4 in LWD,10 in death;AML CR1:12 in DFS,3 in LWD,6 in death;AML CR2:6 in DFS,2 in LWD,6 in death;NHL CR:43 in DFS,7 in LWD,9 in death;NHL CR2:18 in DFS,5 in LWD,7 in death;NHL NR:2 in DFS,4 in LWD,5 in death;HD CR1:10 in DFS;HD PR:12 in DFS,3 in LWD;HD RE:3 in DFS,2 in LWD,1 in death;MM:7 in DFS,6 in LWD,8 in death.Conclusion APBSCT is a safe and effective therapy method for treating hematologic malignancies.