Objective To evaluate the role of Lugol’s s taining in detecting early esophageal cancer.Methods 2% Lugol’s solution was adopted to stain esophageal m ucosa in 111 cases with esophageal superficial lesions. And multiple biopsies we re taken for pathological study.Results Among the 111 cases with Lugol’s staining, the results in normal, light, deep and non-stained were 4, 68,11 and 28 cases respectively . Pathology result: no cases of esophageal cancer or cell dysplasia in normal an d deep stained groups, 3 cases of severe dysplasia and 1 case of canceration in light stained group, 17 cases of esophageal squamous cell carcinoma and 5 cases of severe dysplasia in un-stained group.Conclusion The cancerous and precancerous lesions are liable to occur in cases with non- and light Lugol’s staining groups. The rate of detec ting early esophageal cancer increased when Lugol’s staining and biopsy are use d in combination.

Aim To study the effects of pioglitazone on the hypertrophic myocardial cells induced with high glucose and high insulin. Methods Using cultured myocardial cells as a model, The protein content was assayed with Lowrys method; The contracting frequency was counted by the inverted microscope;The protein synthesis was assayed with leucine intake method;The cardiomyocytes volumes was measured by computer photograph analysis system; the cellular hypertrophy was observed. Results Compared with verapamil, Pioglitazone significantly inhibited the protein content, cellular protein synthesis and volumes of cultured hypertrophic myocardial cells induced with high glucose and high insulin. Meanwhile pioglitazone and verapamil inhibited myocardial cells contracting frequency too. Conclusions Pioglitazone inhibited cardiac hypertrophy of cultured myocardial cells induced with high glucose and high glucose. The mechanism of the effect of pioglitazone on cardiac hypertrophy needs further study.

Achieving the millennium development goals and world peace and development are closely linked objectives, and WHO having been made great achievements and progress in the health sector through its related ob -jectives.All health-related millennium development goals such as maternal and child health , HIV/AIDS prevention and control , malaria and tuberculosis , safe drinking water and sanitation , and foreign medical assistance had been basically reached in China .This success was mainly due to the government attention and commitment , legal protec-tion, health information technology-informatization, effective projects and measures , but there are still differences in health status between regions and population groups , and increasing needs of health services quality improvement and chronic diseases control and prevention should be paid great attention in the future .

Objective:To assess the efficacy and the safety of the radiofrequency catheter ablation (RFCA) for the septal accessory pathway (AP) in children.Methods:From September 2013 to March 2019, 626 patients plan to underwent RFCA for paroxysmal supraventricular tachycardia (PSVT) in Shanghai Children′s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine.Among them, 74 consecutive patients with right or left septal APs were included in the study and their clinical and RFCA data were analyzed.Results:The age of these 74 children (45 males, 29 female) was (7.8±3.5) years, ranging from 10 months to 13 years.The body weight (BW) was (27.7±14.4) kg, with 3 patients BW<15 kg.A discordant ventricular wall motion (DVWM) was found in 5 patients, and the combined congenital heart diseases were discovered in 2 patients.A three dimensional mapping system was applied in 69 ablations, and 3 ablations were performed only with the fluoroscopy monitor of 5 cases.According to the AP location, the number of cases located in the anteroseptal, the midseptal, the mouth of coronary sinus, the left posteroseptal and the right posteroseptal, were 28, 18, 10, 10 and 8, respectively.The ablation operations were applied in 72 patients.The initial acute success reached in 67 (93.1%) patients.The ablation energy was (18.0±1.8) W, the fluoroscopy time during the ablations was (4.7±2.7) minutes, and the procedure duration was (151.5±58.6) minutes.One inadvertent complete atrioventricular block (AVB) was noted as the ablation-related complication.All 5 children with the pre-DVWM were recovered after ablations.During a follow-up of (23.8±10.8) months, 4 patients experienced the recurrence of preexcitation syndrome atrioventricular reentrant tachycardia.Conclusions:With the 3D-mapping system, the RFCA of septal APs can be performed safely and effectively in pediatric patients of paroxysmal supraventri-cular tachycardia.However, as the ablation-related complication, AVB should not be ignored.

Objective: To investigate the epidemiological characteristics of hepatitis A and hepatitis E in Jiaxing City, Zhejiang Province from 2005 to 2021, so as to provide insights into prevention and control of hepatitis A and hepatitis E. Methods: Data of hepatitis A and hepatitis E reported in Jiaxing City from 2005 to 2021 were collected from the Chinese Disease Prevention and Control Information System. The temporal, spatial and population distribution of hepatitis A and hepatitis E were analyzed using a descriptive epidemiological method, and the trends in incidence of hepatitis A and hepatitis E were evaluated using annual percent change (APC). Results: Totally 1 830 hepatitis A cases were reported in Jiaxing City from 2005 to 2021, with an annual average incidence of 2.44/105, and 2 deaths were reported, with a fatality rate of 0.11%. The incidence of hepatitis A appeared a tendency towards a decline from 2005 to 2012 (APC=-37.807%, P<0.05) and was relatively stable from 2012 to 2021 (APC=-1.277%, P>0.05), and the incidence peaked from July to September, with a monthly average incidence of 0.30/105. Higher annual average incidence of hepatitis A was seen in urban areas than in rural areas (3.91/105 vs. 1.92/105; P<0.05), among people at ages of 30 to 39 years (4.19/105), and among men than among women (3.00/105 vs. 1.93/105; P<0.05). Farmers were the predominant occupation (759 cases, 41.31%). Totally 2 176 hepatitis E cases were reported in Jiaxing City from 2005 to 2021, with an annual average incidence of 2.91/105, and 7 deaths were reported, with a fatality rate of 0.32%. The incidence of hepatitis E was relatively stable from 2005 to 2011 (APC=3.421%, P>0.05) and appeared a tendency towards a decline from 2011 to 2021 (APC=-4.294%, P<0.05), and the incidence peaked from January to March, with a monthly average incidence of 0.38/105. Higher annual average incidence of hepatitis E was seen in urban areas than in rural areas (3.50/105 vs. 2.70/105; P<0.05), among people at ages of 70 to 79 years (6.20/105), and among men than among women (3.74/105 vs. 2.05/105; P<0.05). Farmers were the predominant occupation (1 079 cases, 49.59%). Conclusions The incidence of hepatitis A and hepatitis E appeared a tendency towards a decline in Jiaxing City from 2005 to 2021. The incidence of hepatitis A was high in summer, and cases were mainly males, young and middle-aged people and farmers. The incidence of hepatitis E was high in winter, and cases were mainly males, elderly people and farmers.

Objective: To investigate the epidemiological characteristics of human brucellosis in Jiaxing City from 2010 to 2021, so as to provide insights into the development of the brucellosis control strategy. Methods: The epidemiological and clinical data of brucellosis patients and epidemiological data of brucellosis outbreaks in Jiaxing City from 2010 to 2021 were collected from Chinese Disease Control and Prevention Information System, and the epidemiological features and outbreaks of brucellosis were analyzed descriptively. Results: Totally 160 brucellosis patients were reported in Jiaxing City from 2010 to 2021, and the incidence of brucellosis appeared a tendency towards a rise (χ2trend=28.564, P=0.002), with annual mean incidence of 0.29/105. No deaths due to brucellosis occurred in Jiaxing City from 2010 to 2021. Brucellosis cases were reported each month, which were concentrated in the first and second quarters, and the greatest number was seen in May (27 cases, 16.88%). The brucellosis cases were predominantly reported in Tongxiang City (114 cases, 71.25%), and 75.00% were male (120 cases) and 70.63% were occupational populations (113 cases). The patients had a median (interquartile range) age of 57 (12) years at onset, and the median duration (interquartile range) from onset to definitive diagnosis was 18 (28) days. The clinical manifestations mainly included fever and weakness, and a total of 18 Brucella melitensis isolates and one B. bovis isolate were cultured. Conclusions The incidence of brucellosis was rising in Jiaxing City from 2010 to 2021. The brucellosis patients were predominantly reported in Tongxiang City in the first and second quarters, and young, middle-aged men and occupational populations were at a high risk of brucellosis.

Objective: To evaluate the clinical effect and summarize the experience of radiofrequency catheter ablation (RFCA) for children suffered from premature ventricular contractions (PVCs). Methods: This retrospective study was conducted by descriptive analysis. A total of 108 cases with frequent PVCs from Shanghai Children's Medical Center were treated with RFCA under the guidance of CARTO3 system from January 2011 to December 2016. The immediate success rate of the procedure, the recurrence rate and the perioperative complications were summarized. The constituent ratio of different PVCs origins, the trend of overall procedure time and success rate in recent years were analyzed. Statistical analyses were performed using F test. Results: Immediate success of RFCA was achieved in 104 cases (96.3%, 104/108) and 4 cases (3.7%, 4/108) failed. The PVCs recurred during follow-up of over 6 months in 5 cases (4.8%, 5/104) . There were no severe complications related to the procedure. The sites of PVCs origin, in 52 cases originated from right ventricular outflow track (48.2%, 52/108) , 17 cases originated from left ventricular outflow track (15.7%, 17/108) and 26 cases originated from tricuspid annulus (24.1%, 26/108) . Among the three predilection sites of PVCs, the operation time was (141±46) min for right ventricular outflow track, (155±50) min for left ventricular outflow track, and (166±57) min for tricuspid annulus. However, the difference was not statistically significant (F=1.79, P=0.17) . X-ray exposure time was (14±8) minutes for right ventricular outflow track ablation, (32±14) minutes for left ventricular outflow track ablation and (16±8) minutes for tricuspid annulus ablation respectively. The exposure time for the ablation on left ventricle was significantly longer than the other two sites (F=5.12, P=0.018) . Conclusion RFCA is safe and effective for PVCs in children with high success rate and low recurrence and complication rates.

Objective: To access the feasibility, effectiveness and safety of transcatheter closure of ventricular septal defect (VSD) with right coronary cusp bulge. Methods: The study population consisted of 40 children (22 boys and 18 girls) undergoing transcatheter intervention for VSD with right coronary cusp bulge in Shanghai Children′s Medical Center from August 2013 to June 2017. All patients were examined using transthoracic echocardiography and cardiovascular angiography before occlusion and received transcatheter closure of VSD by placing an occlude. During the operation, angiography and transthoracic echocardiography were used to detect residual shunts, new-onset or aggravation of aortic regurgitation, and surface electrocardiogram was used to assess the impact of occlusion on the conduction system. The children were followed up to evaluate the degree of aortic regurgitation and the presence of heart block by transthoracic echocardiography and electrocardiogram in outpatient department. Comparative analysis between two groups was used by t test. Results: The average age of the patients was (5.1±3.2) years, weight(20.6±10.7) kg. The diameter of defect shunt was (3.3±0.9) cm. The VSD of all 40 patients were successfully occluded immediately, and three patients (8%) with filament residual shunt were observed during the operation. No major surgical complication such as death, pericardial tamponade, embolism of important organs, infective endocarditis occurred during the perioperative period. During the follow-up period, the positions of all the occluders were good, the residual shunt in three patients disappeared, and no new-onset or aggravated aortic regurgitation occurred. Electrocardiogram did not reveal any atrioventricular block, and one patient suffered from an incomplete right bundle branch block. There were significant differences between pre- and post-occlusion regarding the left ventricular end diastolic diameter ((3.8±0.5) vs. (3.7±0.5) cm, t=2.092, P=0.043), the left ventricular end systolic diameter ( (2.4±0.3) vs. (2.2±0.4) cm, t=2.068, P=0.045), and the QRS interval ((75.4±10.4) vs. (79.8±11.4) ms, t=-2.277, P=0.028). No significant differences were found between pre- and post-operation regarding the left ventricular ejection fraction (67.8%±4.7% vs. 68.1%±4.6%, t=-0.447, P=0.657) and the PR interval ((125.6±14.7) vs. (122.6±14.2) ms, t=1.540, P=0.132). Conclusions Interventional closure of VSD with right coronary cusp bulge has small impact on aortic valve activity in children. With appropriate indications and methods, transcatheter interventional occlusion should be considered because it is effective for children diagnosed with VSD combined with right coronary cusp bulge.

Sacral tumors are surgically challenging and at a high risk of complications. In recent years, robotic-assisted resection has been gradually applied in sacral tumors, but it is difficult to remove bone tissue by present robotic instruments, which limits the application of surgical robot in sacral tumor. The present study aimed to explore the application range and therapeutic effect of minimally invasive ultrasonic osteotome in robotic-assisted sacral tumor resection. Eighteen patients underwent robotic-assisted sacral tumor resection in the First Affiliated Hospital of Sun Yat-Sen University from May 2015 to March 2021 by the Da Vinci robotic surgical system. Among them three patients who underwent osteotomy with minimally invasive ultrasonic osteotome were enrolled. There were 2 males and 1 female, aged 24, 32, 71 years, respectively. The tumors included 2 schwannomas and 1 ganglioneuroma. The operation time, bleeding volume and postoperative hospitalization days were recorded. The recurrence and complications were evaluated during follow-up. The operative time of the 3 patients was 80, 240 and 300 minutes, and the intraoperative bleeding volume was 30, 30 and 100 ml. Complete resection was performed in 2 cases and intralesional resection in 1 case. The postoperative hospital stay was 5, 3 and 7 days respectively. The follow-up time was 58, 17 and 31 months respectively. No tumor recurrence was found during the follow-up. As regards complications, only one patient had left foot pain after operation, and there were no other intraoperative or postoperative complications. The therapeutic advantages of ultrasonic osteotome combined with the Da Vinci robotic surgical system can achieve precise osteotomy, reduce intraoperative bleeding and accelerate postoperative recovery for certain patients with sacral tumors.

Background: The revised Atlanta classification (RAC) and determinant-based classification (DBC) are widely used in assessing the severity of acute pancreatitis (AP). However, studies on comparison between RAC and DBC are scarce. Aims: To explore the accuracy of RAC and DBC in the assessment of AP severity. Methods: The clinical data of 481 AP patients from September 2015 to September 2019 at Taizhou People's Hospital were collected and severity were stratified according to RAC and DBC. The treatment and prognosis of each subgroup were compared. Results: On the basis of RAC, 269 (55.9%), 174 (36.2%) and 38 (7.9%) patients were classified as mild AP (MAP), moderate severe AP (MSAP) and severe AP (SAP), respectively. There were significant differences in mortality, ICU monitoring rate, ICU stay, operation rate and hospital stay among the above groups (P<0.05). On the basis of DBC, 319 (66.3%), 117 (24.3%), 34 (7.1%) and 11 (2.3%) patients were classified as MAP, MSAP, SAP and critical AP (CAP), respectively. There were significant differences in mortality, ICU monitoring rate, ICU stay, operation rate and hospital stay among the above groups (P<0.05). The ICU monitoring rate (100% vs. 63.2%, P=0.014), median ICU stay (35 days vs. 15 days, P=0.001), hospital stay [(50.36±21.54) days vs. (22.78±14.56) days, P=0.038] were significantly increased in CAP patients (classified by DBC) than those in SAP patients (classified by RAC), however, no significant differences in mortality and operation rate were found between the two groups (P=0.136; P=0.202). Conclusions: Both RAC and DBC can accurately stratify the severity of AP. SAP patients (classified by RAC) complicated with infected necrosis should be further classified into CAP.