It's difficult to diagnose precancerous lesion and early cancer for a long time, because both of them haven't typical morphological characteristics. As a novel diagnostic modality, fluorescence endoscopy can accurately reflect minimal changes in human's tissue, thus making a meaningful progress for cancer diagnosing. 200 patients were examined by fluorescence endoscopy to evaluate the diagnostic value. The overall accuracy, sensitivity and specificity for detecting malignant gastrointestinal tumor was 94.0%, 94.6% and 93.5%, respectively. Thus, fluorescence endoscopy can be used to diagnose malignant gastrointestinal tumors with high validity and reliability, and is advantageous over conventional white light endoscopy especially in detecting the atypical and suspicious lesions. Furthermore, fluorescence endoscopy can also guide target biopsy, is significant to improve the early cancer detection rate, has a broad development prospect.
Endoscopy ; instrumentation ; Fluorescence ; Gastrointestinal Neoplasms ; diagnosis ; Humans ; Sensitivity and Specificity

Objective:To analyze the mistakes in the application of tuina therapy in the rehabilitation of stroke,in order to elevate the clinical effects in the treatment of stroke by tuina.Methods:The issues are found out by searching and analyzing the relevant articles on tuina treatment of stroke.Results:In the tuina treatment of stroke,mistakes exist in the intervening time of the treatment,in the emphasis of tuina with negligence of rehabilitation,in the assessment of therapeutic effects,in the selection of the manual techniques and acupoints,and in the negligence of health education.Conclusion:In the tuina treatment of stroke,it is advisable to start treatment in the early stages,use the manual techniques in different phases,to cooperate with rehabilitation at the proper time and to emphasize health education,in order to avoid or reduce the occurrence of misuse syndrome,and eliminate the appearance of disuse syndrome,for displaying the unique advantage of tuina therapy fully and promoting the innovation and development of TCM rehabilitative techniques.

OBJECTIVE To evaluate the therapeutic effect of intranasal endoscopic surgery on inverted papilloma of the nasal cavity and paranasal sinuses in stage Ⅰ-Ⅲ. METHODS According to the staging system developed by John H.Krouse,30 cases with inverted papilloma in the nasal cavity and paranasal sinuses in stage Ⅰ-Ⅲ were analyzed retrospectively. All patients were treated by intronasal endscopic surgery and were followed up for 24 months. RESULTS The inverted papilloma was removed completely and no serious complications occurred. One case recurred at 10 month after surgery and pathologically proved to be cancerated. Another 2 case recurred at 6 and 7 month after surgery respectively. Recurred tumors were removed again, no recurrences occurred in the following up period. The recurrence rate was 10 % and canceration rate was 3.3 %. CONCLUSION Endoscopic surgery is an effective method in management of the inverting papilloma in nasal cavity and paranasal sinuses in stage Ⅰ-Ⅲ.

The mechanism and principles of autofluorescence imaging based on autofluorescence technique are reported. The threshold value of fluorescence spectrum ratio applied can be quantitative and objective and the reliable measurement method that may provide intuitive method of autofluorescence imaging in the gut mucosa. The suspected lesion may be found rapidly according to the imaging color difference, therefore the results of clinical study of the digestive tract cancer diagnosis indicated that the sensitivity, specificity, and diagnostic accuracy were 94%, 95.5% and 94.8% respectively, and it has very high value in clinical application.
Digestive System Neoplasms ; diagnosis ; Early Detection of Cancer ; instrumentation ; methods ; Endoscopy, Digestive System ; instrumentation ; Fluorescence ; Humans ; Photofluorography ; Sensitivity and Specificity

Objective To analyze the influence of validating the parental origin to the interpretation of clinical pathogenicity of total 54 copy number variations(CNV)with different clinical significance in 46 patients undergo chromosomal microarray analysis(CMA).Methods A retrospective study.This study enrolled 46 patients conducted in Department of Pediatric Endocrinology and Genetics of Shanghai Xinhua Hospital during the period of August 2014 to December 2015,involving 54 different CNVs detected by CMA.The parental origin of CNVs was examined by CMA or quantitative real-time polymerase chain reaction.Results Totally 54 different CNVs were found in 46 patients by CMA.Seventeen out of the 54 CNVs were pathogenic variations.After validating the parental origin,14 CNVs were proved de novo mutation,while 3 CNVs have maternal origin including 1q21.1 deletion syndrome,Xq27.3q28 and Xq22.1q22.3 duplications which inherited from maternal X chromosome.CNVs of 1q21.1 deletion syndrome often inherited from parents,and no phenotype appears on mother which may be due to the deactivation mechanism of duplications on mother′s X chromosome.Therefore,these 17 pathogenic variations were still considered to be clinical pathogenic significance after validating the parental origin.Ten out of 54 CNVs were variants of uncertain significance-likely pathogenic.After parental original validation,3 CNVs were proved de novo mutation considering likely pathogenic significance,while 7 CNVs have parental origin still judged to be unknown clinical pathogenicity.Twenty-seven out of 54 CNVs were variants of uncertain significance.After validating the parental origin,only 1 CNV was proved de novo mutation considering likely pathogenic significance,while all the others had parental origin considered to be variations likely benign.Conclusion CNVs reported as likely pathogenic should be validated the parental origin in order to further study their clinical pathogenicity,while variants of uncertain significance can preliminary clear its nature by validating parental origin.

Ovarian carcinoma(OC)is the most lethal malignant tumor among all gynecological tumors.Due to its low early diagnosis rate and high chemotherapy resistance,the mortality rate of OC has been high.Circular RNA(circRNA)is a kind of non-coding RNA that exists in various tissues and cells.Owing to the specific molecular structure,circRNAs are generally highly stable.In recent years,the roles of circRNAs in tumor diagnosis and treatment has become a research hotspot,including OC related circRNAs.circRNAs regulate gene expression at the transcriptional and post transcriptional level,indicating that circRNAs play an important role in the genesis and progression of tumors.Therefore,circRNAs are expected to be a potential diagnosis or prognosis marker for OC.This article will summarize the roles of circRNAs in the occurrence and development of OC and review the research progress of circRNAs in the diagnosis and treatment of OC.

It’s difficult to diagnose precancerous lesion and early cancer for a long time, because both of them haven’t typical morphological characteristics. As a novel diagnostic modality, fluorescence endoscopy can accurately reflect minimal changes in human’s tissue, thus making a meaningful progress for cancer diagnosing. 200 patients were examined by fluorescence endoscopy to evaluate the diagnostic value. The overal accuracy, sensitivity and specificity for detecting malignant gastrointestinal tumor was 94.0%, 94.6%and 93.5%, respectively. Thus, fluorescence endoscopy can be used to diagnose malignant gastrointestinal tumors with high validity and reliability, and is advantageous over conventional white light endoscopy especial y in detecting the atypical and suspicious lesions. Furthermore, fluorescence endoscopy can also guide target biopsy, is significant to improve the early cancer detection rate, has a broad development prospect.

Objective To retrieve and evaluate the evidences for fall prevention in elderly inpatients, and to summary the best evidence. MethodsGuidelines, evidence summaries and systematic reviews related to fall prevention of elderly patients were retrieved in guideline websites and databases by computer from building database to 31st December 2018. Literatures' quality evaluation and evidence grading were carried out with the Chinese version of appraisal of guidelines for research and evaluationⅡ (AGREEⅡ), "2016 Joanna Briggs Institute quality assessment tool on validity evaluation of systematic reviews" and "2014 Joanna Briggs Institute quality level of evidence and grade of recommendation system". ResultsA total of 6 documents were included with 3 guidelines and 3 systematic reviews. Based on evaluation and results extracted, 14 items of the best evidences on fall prevention were summarized in two parts including assessment and prevention, and in 6 aspects involving the medication, facility, environment, functional training, informational support and multifactorial intervention. ConclusionsMedical staff should guide patients to take standardized fall preventive measures to guarantee the safety of patients based on evidence-based medicine.

Objective To assess and summary the guideline best evidence on malnutrition risk screening in adult inpatients so as to provide a reference for malnutrition risk screening of adult inpatients. MethodsGuidelines on malnutrition risk screening in adult inpatients were systematically retrieved in nutrition association official website, guideline website and database and were screened. All of the guidelines were assessed by 4 trained researchers with the Appraisal of Guidelines for Research and Evaluation (AGREEⅡ). Guidelines with level C were excluded, and guidelines with level A and B were selected to extract, translate and summary the recommendations. ResultsA total of 213 guidelines were retrieved and 140 were selected after eliminating repetitive guidelines. Finally, 13 guidelines were included after eliminating 128 guidelines by reading titles and abstracts. AGREE Ⅱ evaluation results showed that there were 3 guidelines with level A and 10 guidelines with level B. Analysis and summary showed that a total of 16 items of 3 classes best evidence on malnutrition risk screening in adult inpatients were selected including screening qualification, population, time and tools. ConclusionsIn this study, guidelines best evidence on malnutrition risk screening in adult inpatients provides a credible reference for clinical practice. Population with high risk of malnutrition should be assessed in comprehensive nutrition and should be treated in nutritional department when necessary.

OBJECTIVETo study the effect and safety of Kudiezi injection on patients with acute ischemic stroke.

METHODSeven hundreds patients were divided into two groups by central randomization system. The study group, 346 cases, was treated with kudiezi injection plus traditional Chinese medicine (TCM) synthesis rehabilitation project, and the control group, 354 cases, was treated with synthetic rehabilitation project. The patients were treated for 10 to 21 days. Before treatment and at the 7th, 14th and 21th day of treatment, the indexes include NIHSS used for evaluating the neurological deficit degree and the motor function score (Fugl-Meyer) for evaluating motor function were observed. The safety index is defined by adverse observation event and laboratory test. The incidence of adverse events and laboratory tests results were observed before and after treatment at the same time.

RESULTApplication of generalized estimating equation model, we found that as the treatment time, NIHSS score and FMI score of the two groups showed a trend of improvement. And at the 14th days and 21th days of treatment, compared to the control group the treatment group showed significant statistical difference on the impact of NIHSS and FMI (P<0.05). No serious adverse events were observed.

CONCLUSIONKudiezi injection plus TCM rehabilitation project of ischemic stroke showed some superiority to western medicine rehabilitation program on improving the neurological deficit and motor function. Kudiezi injection is safe and effective in the treatment of acute ischemic stroke.

Aged ; Brain Ischemia ; drug therapy ; Drug-Related Side Effects and Adverse Reactions ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Female ; Humans ; Injections ; Male ; Medicine, Chinese Traditional ; adverse effects ; Middle Aged ; Product Surveillance, Postmarketing ; Stroke ; drug therapy