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

Objective] To observe the clinical effect of Shaoyao Gancao Decoction on treating children functional abdominal pain to offer reference for further observation. [Method] Choose 200 children patients in pediatric outpatient department of Changxing County TCM Hospital, randomly divide them into treatment and control groups in order, n=100. The treatment one was administered revised Shaoyao Gancao Decoction, the control one orally took Medilac-Vita; both for 4 courses, then observe the cure effects. [Result] In treatment group, total effective rate 94.00%; for control one, it was 86.00%. The comparison of both had difference of statistical meaning( P<0.05). On comparing their abdominal pain relieve, in treatment group, there's more in first 2w and showed marked summit value in the first week; while in control one, there's no marked summit value; so the treatment group was more obvious than other one on relieving pain in the first 2w(P<0.05). The side effect occurrence rate of treatment group was less than other one, the difference between them had statistical meaning(P<0.05). [Conclusion] The revised Saoyao Gancao Decoction has marked cure effect on children functional abdominal pain, worth clinical promotion.

Introducing information-knowledge-wisdom transformation law and its four sub processes including information acquisition,recognition,decision and implementation,the paper summarizes the process of Evidence-based Medicine (EBM) information services,analyzes the scope of carrying out EBM information services by the hospital library under the guidance of new perspective,and discusses the specific forms of EBM information services by exampling the practice of EBM information services carried out by the library of the First Affiliated Hospital of Chongqing University of Medical Sciences.

Objective To study the clinical and pathologic features of chromphobe renal cell carcinoma (ChRCC) and to evaluate the conventional pathologic prognostic parameters in prognosis.Methods Seventy-five cases (42 males and 33 females) with pathological confirmed ChRCC (36 on the left and 39 on the right kidney) after nephrectomy during 1998 to 2009 were retrospectively analyzed. Patient's age ranged from 25 to 74 years, with a mean age of 56 years. Evaluation of conventional prognostic parameters was carried out. Kaplan-Meier survival curve was used to study the survival relationship. Results The mean tumor diameter was 7.3 cm. The majority of tumor macroscopic surface color was gray and yellow or gray and red. The majority of tumor cells were big polygon chromphobe cell or small round eosinophils. The TNM stages of these ChRCC were as follows: 30 cases in T1N0M0, 1 in T1N0M1, 26 in T2N0M0, 1 in T2N0M1, 11 in T3N0M0, 3 in T3N0M1, 1 in T3 N1 M0, 1 in T4 N0 M1 and 1 in T4 N1 M1. The pathologic grade of ChRCC was G1 in 3 cases, G2 in 24cases, G3 in 46 cases and G4 in 2 cases. All the 75 cases were followed up for 9 to 93 months (mean 44months), 7 patients died and others were alive without recurrence and metastasis. 3-year and 5-year survival rates were 93.3% and 90. 7%, respectively. The univariable analysis showed that tumor size (P=0. 028), TNM stage (P＜0. 001) were associated with tumor progression. The multivariable Cox regression model revealed that TNM stage was an independent predictor of aggressive ChRCC. Conclusions The ChRCC tumors are generally larger than other types of RCC and with a favorable prognosis. Fuhrman nuclear grade is not suitable for ChRCC. TNM stage is an independent predictor of aggressive ChRCC.

Obstructive sleep apnea (OSA) is characterized by repeated intermittent hypoxia (IH), hypercapnia, sleep fragmentation and intrathoracic pressure change. IH is related to the clinical pathophysiological processes of hypertension, atherosclerosis, coronary heart disease, arrhythmia, stroke, heart failure and sudden death. IH from OSA can lead to metabol-ic dysregulation, endothelial dysfunction, systemic inflammation, oxidative stress and the change of nerve body fluids, which has been shown to increase the risk of cardiovascular diseases. This study mainly describes the pathogenesis of IH leading to the various cardiovascular diseases.

PurposePresent study investigated the role of metal on metal surface replacement of the hip in treating the young patients suffering rheumatoid arthritis or aseptic necrosis of femoral head.Methods Between Jan. 1995 and Dec. 1996.16 patients with 17 hips( rheumatoid arthritis 14, aseptic necrosis of femoral head 3) were resurfaced with hybrid metal on metal surface replacement prothesis. Patients were evaluated by self assessment form,hip function examination. Radiographs and Harris hip score. The average follow up time was 58.2 months. ResultsNo patient received revision. Radiographs showed that all implants were in position satisfyingly. No loosening were revealed. The result of self assessment showed that patients were satisfied with 16 hips. The Harris score rose from preoperative 44(31 - 52) to postoperative 91 (79- 96). ConclusionsThe metal on metal surface replacement of hip is a useful treatment to release pain and keep the hip function of young patients suffering rheumatoid arthritis or aseptic necrosis of femoral head.

Objective To explore the incidence and predictive factors of anemia induced by chemothera-py in early breast cancer patients. Methods 400 early breast cancer patients treated by taxane-based regimens from 2009 to 2011 in our hospital were analyzed to obtain the incidence of anemia. Univariate analysis and multivariate logistic regression analysis were used to search for risk factors linked to the occurrence of anemia. Results Incidence of anemia was 72.2% in early breast cancer patients undergoing chemotherapy. The occur-rence of anemia was related to 5 risk factors: chemotherapy regiments, Hb at baseline < 135.0 g/L, age > 60 years old, BMI ≤ 25 kg/m2 and HBV antigen positive. Conclusion The anemia incidence during chemothera-py is high in early breast cancer patients. Such factors,as chemotherapy regiments, Hb at baseline, age, BMI and HBV antigen, should be taken into account in identifying high risk patients and prevent anemia.

Clinical internships play an important role in higher medical education. According to the new standards in undergraduate medical education set by the MOE and MOH,we identified 4 main problems in our internships training,including lack of awareness of career planning,interns'absence from duty,lack of hands-on opportunities,psychological problems,etc. According to these problems,we carried out a series of solutions such as strengthening intern orientation,especially in aspects of professionalism and clinical skills training,optimizing the rotation schedule and improving the evaluation methods etc. Experiential evidence and perceptions of interns and their tutors showed that these changes were effective.

Objectives To compare the effectiveness and safety of local anesthesia and epidural anesthesia with ureteroscopic pneumatic lithotripsy at distal ureteral stone. Methods A total of 160 patients with distal ureteral stone treated with ureteroscopic pneumatic lithotripsy from December 2013 to February 2014 were included. They were divided equally into 2 groups by method of random sampling. Patients in group A (n=80) treated with local anesthesia were compared to those in group B(n=80),who were dealt with epidural anesthesia. Results The statistical difference was significant in terms of hospital stay after operation and overall cost of therapy(P<0. 05) respectively,on the other hand,it was not significant in respect of the operation time,the operation successful rate,the stone clearance rate and the complications incidence rate (P>0. 05)respectively. Conclusion For the identified patients,the local anesthesia in ureteral ureteroscopic pneumatic lith-otripsy is a safe,effective and economical method for distal ureteral stone.