At present, the level of diagnosis and treatment of early gastrointestinal cancer has a larger gap between China and developed countries. In recent years, the advent of new endoscopic imaging techniques has improved the detection rate of early gastrointestinal cancer. Along with this, endoscopic submucosal dissection(ESD) enables radical resection for early cancer. In this article, we discuss how to improve the level of endoscopic diagnosis and treatment of early gastrointestinal cancer.
China ; Endoscopy, Digestive System ; Gastrointestinal Neoplasms ; diagnosis ; surgery ; Humans

As introduced in the paper,Australian government subsidize the public hospitals with all their budget needs as compensation,with the two levels of governments constituting the largest buyer of health products and services in the country.In addition,the government supports the hospitals with their facilities.A rational government investment mechanism is proposed with reference to such a model for the ongoing reform of public hospitals in China.

Background Cytokines play a crucial role in mediating immune tolerance or immune rejection of corneal transplantation.However,the study on the expression of cytokines in corneal graft is seldom.ObjectiveThe purpose of the study is to investigate the change of cytokine expression in allografts at different time points after corneal transplantation.Methods BALB/c and C57BL/6 mice aged 6 to 8-week old were used to establish autologous and allografts keratoplasty models.BALB/c mouse was use as donor and receipt in autologous group,and the cornea of C57BL/6 mouse was used to graft on the BALB/c mouse in the allografts group.The graft inflammation was clinically scored,and graft inflammatory scores of ≥5 or opaciflcation scores of ≥2 were identified as rejection.BALB/c mice were randomized into normal control group(3 mice)and allografts group(15 mice).Reverse transcriptPCR (RT-PCR) was used to detect the expression of interleukin-4 (IL-4) mRNA,interferon-γ (IFN-γ) mRNA,IL-10mRNA and tumor necrosis factor(TNF-α) mRNA in graft 6 hours and 1 day,3,7,14 days after operation.Results The corneal graft opacification score was ＜2 and inflammatory score was ＜5 in the 10 mice with autologous keratoplasty until 60 days with the survival rate 100％.The edema,opacification and new blood vessel were seen in the BALB/c mice received allografts keratoplasty.The inflammatory score was ≥ 5 and the opacification score was ≥2 24 days after surgery with the rejection rate 100％,in the allografts group,and the graft survival time was (17.80±4.66)days.RT-PCR showed that IL-4 and IFN-γ were positively expressed,and IL-10 and TNF-α were absently expressed in normal mouse cornea.In the allografts keratoplasty mice,positive responses for IL-4,IFN-γ and IL-10 were found in 6hours after operation,but TNF-α was absent.From 1 day through 3 days after operation,the expressions of IL-4,IFN-γand TNF-α were enhanced but IL-10 was disappeared in the graft.IL-10,IFN-γ and TNF-α were expressed till the 7th day,but on the 14th day,only IL-10 was detected in graft in the allografts keratoplasty mice.Conclusions TNF-αis a main factor among the variety of cytokines that may influent corneal allograft rejection locally.

Objective To investigate the effects of clinical pharmacist intervention in the clinical application of antibiotics combined with the index management.Methods The data of antibiotics usage rate and intensity, the microbial test sample submission rate, and the clean incision preventive usage rate of inpatients and outpatients were analyzed by chi-square test in the same period before (2015) and after (2016) the clinical pharmacist intervention.Results After intervention, the antibiotics usage rate of inpatients and outpatients were lower than that of 2015 (50.02% and 25.72%, P<0.05).In 2016, the usage intensity of antibiotics was 50.59%, while it was 62.39% in 2015.At the same time, the microbial test sample submission rate increased from 13.96% to 27.49%(P<0.05).In 2016, the clean operation preventive usage rate of antibiotics decreased month by month.In the meantime, the reasonable rate of delivery timing, variety selection, and administration time of clean operation preventive usage of antibiotics were on the rise.Conclusions The professional intervention of clinical pharmacistis benefit for the routine, standardization, and professionalization of clinical antibiotics application.It also promotes the rational use of drugs and the progress of hospital pharmacy.

Objective:To explore the correlation with neonatal congenital cytomegalovirus infection,maternal primary infection and secondary infection.Methods: 48 neonates with congenital CMV infection were assigned to infection group with their mothers.And the other 30 couples without congenital CMV infection were assigned to negative group with their mothers.The level of CMV-IgM/IgG and affinity of CMV-IgG in peripheral blood were tested by CLIA,and CMV-DNA in mother′s milk,peripheral blood and urine of the newborn was tested by fluorescent quantitation PCR.We also analyzed the differences of the test results between the two groups and performed a retrospective analysis to compare the levels of CMV-IgG of the mother with early pregnancy with the result of this test.Results: In the infection group,the level of CMV-IgG in peripheral blood and CMV-DNA in milk was significantly higher than those in the negative group,the difference was statistically significant(P<0.01).Ratio of CMV-IgG antibody in newborn babies and their mothers in the infection group was lower than the other group,the difference was statistically significant(P<0.01).There was negative correlation of IgG level between the newborn babies and their mothers in the infection group,the difference was statistically significant(P<0.01);While in the positive correlation in the negative group,the difference was statistically significant(P<0.01).The CMV-IgG concentrations of the mothers with early pregnancy was significantly lower than that of this infection group,the difference was statistically significant(P<0.01);but in the negative group,there was no significant difference between the CMV-IgG level of the mothers with early pregnancy and the results of this test(P>0.05).Conclusion: It is a high-risk factor for neonatal congenital cytomegalovirus infection that CMV-IgG level of the pregnant women is promted by the reactivation or reinfection of cytomegalovirus.It is important to monitor CMV-IgM/IgG during pregnancy.

12E7 Antigen ; Adolescent ; Alkaline Phosphatase ; metabolism ; Antigens, CD ; metabolism ; Cell Adhesion Molecules ; metabolism ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Gonadoblastoma ; pathology ; Humans ; Immunohistochemistry ; Isoenzymes ; metabolism ; Neoplasms, Germ Cell and Embryonal ; metabolism ; pathology ; surgery ; Ovarian Neoplasms ; metabolism ; pathology ; surgery ; Proliferating Cell Nuclear Antigen ; metabolism ; Sex Cord-Gonadal Stromal Tumors ; metabolism ; pathology ; surgery

Objective To unmask clues for the investigation of PIH pathogenesis by detecting the altered gene expression profile of placentas from PIH patients. Methods Clinical data and placentas were collected from 42 PIH patients and 22 normotensive pregnancies in seclective cesarean section to construct PIH database from Mar. 2001 to Sep. 2002 in Xi’an district. Suppression subtractive hybridization (SSH) was performed to set the subtractive cDNA library and differential screening was used to identify the positive clones;insertion of positive clones were sequenced by T7 primer method. RT-PCR and immunohistochemistry were employed to confirm the putative gene inhibin A expression. Results A database was set up that consists of pre- and postpartum clinical data and placenta samples of 42 preeclamptic pregnancies and 22 normotensive ones From which,150 features of placental tissue microarray were made. One hundred and three positive clones were isolated by SSH and differential screening. Sequencing and BLAST analysis showed that 90 insertion shared more than 95% homology with sequences in the GenBank/EMBL database. We identified 36 putative genes including pregnancy-specific glycoproteins gene (BC005924),serine protease inhibitor gene (BC012868),VEGFR-1 gene (AF063657),cytokeratine 7 gene(CK7) (AF509887),etc. Inhibin beta A gene was highly expressed in placentas in PIH patients. Conclusion The gene expression profile in PIH placenta was greatly changed;it might be necessary to investigate the role of VEGFR1,serine protease inhibitor,inhibin and CK7 in the pathogenesis of PIH.

Objective To observe the effects of hyperbaric oxygen therapy(HBOT) on Glasgow coma scale(GCS) in patients with traumatic brain injury(TBI) and the influences of course and initiating time of HBOT on the therapeutic effects.Methods 105 cases of TBI patients,which performed HBOT more than 30 days in HBOT Center of Southwest Hospital,were analyzed retrospectively.The GCS improvements were compared with 29 cases of TBI patients without HBOT during the same period.They were also compared between patients with different severity,initiating times and courses of HBOT.Results The GCS improvement of patients with HBOT was 3.97?2.65,especially in severe TBI patients(5.22?2.49),Both were higher than that without HBOT(2.38?2.16)(P

OBJECTIVETo investigate methods and short-term effects on tantalum metal block for reconstruction of Paprosky type III severe acetabulum bone defect.

METHODSTwelve patients (12 hips) with Paprosky type III severe acetabulum bone defect,treated with tantalum metal block in revision of total hip arthroplasty, were retrospectively analyzed from March 2009 to December 2012. Among the patients, there were 5 males and 7 females aged from 45 to 78 years old with an average of 64 years old; the courses of disease ranged from 3 to 32 months with an average of 16 months. According to classification of Paprosky, all patients were Paprosky type III acetabulum bone defect. All patients were used tantalum metal block in revision of total hip arthroplasty, and large diameter biological acetabulum cups were used in combination. Operative time,blood loss and postoperative complications were recorded and compared, Harris score were used to evaluate clinical effects.

RESULTSEleven patients ( 11 hips) were followed up from 9 to 36 months with an average of 25 months, 1 case was lost to follow-up for dying in car accident. The incisions were healed at stage I . Operative time ranged from 2 to 6 h with an average of 3 h; blood loss was 300 to 1 600 ml with an average of 900 ml. No deep venous thrombosis, periprosthetic femoral fracture and infection, sciatic nerve injury occurred after operation. Harris score were improved from (46.25 ± 8.99) before operation to (83.75 ± 6.76) after operation. There was significant difference in Harris score before and after operation (t = 3.14, P = 0.00 < 0.05), and 7 cases got excellent results, 2 good and 2 moderate. CONCLUCSION: Tantalum metal block is suitable for revision of Paprosky III acetabulum bone defect, could repair different kinds of acetabulum cup defect, could fill up inclusive defect of inner wall combined with particulate bone graft, induce bone growth pressured between metal block and metal cup, provide a new further choose for the treatment of Paprosky type III severe acetabulum bone defect.

Acetabulum ; surgery ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Tantalum

Adult ; Bacteremia ; Hematopoietic Stem Cell Transplantation ; Humans ; Male ; Nontuberculous Mycobacteria ; Postoperative Complications