objective To retrospectively evaluate the accuracy of endoscopic ultrasonography (EUS)and CT in preoperative tumor,and nodal metastasis(TN)staging of esophageal carcinoma.Methods TN stages of 87 cases diagnosed with preoperative EUS and CT were compared with postoperative pathological results.No patient underwent radiotherapy or chemotheraphy.The radial echoendoscope was used,and balloon dilation was required in 5 cases with stricture.Results The total accuracy of T staging with EUS was 85.1%.CT could not differentiate Tl from T2.The sensitivity of EUS for N staging was 85.0%,higher than that of CT(60.8%).However,some lymph nodes which were not detected by EUS could be revealed by CT.Accuracy of EUS plus CT in T staging is 85.1%.and that in N staging is 90.8%.Conclusion EUS is the most accurate measure in assessing the depth of tumor invasion,whereas the combination of EUS and CT is capable of an overall evaluation for TNM staging.

ObjectiveTo study the effects and mechanisms of hypoxia-ischemia (HI) on long-term learning and memory abilities and astrocytes in hippocampal formation and the efficacy of nimotop in treating hypoxic-ischemic brain damage. MethodsThe rats were subjected to right common carotid artery ligation followed by exposure to 8% oxygen at 37℃ for 2 h and then 13 rat pups received an introperitoneal injection of nimotop per day immediately following cerebral hypoxia-ischemia for 5 days. When the rats were 80-day-old, they were given test of Y-maze to determine their learning and memory abilities, and then their brain tissues were studied by immunohistochemistry for glial fibrillary acidic protein (GFAP) that marked astrocytes. ResultsThe learning and memory abilities of the HI group were lower than those of the normal control and nimotop treated group (P<0.01), nimotop significantly increased Y-maze learning abilities (P<0.05) of rats received HI, but did not affect their memory abilities. The numerical density of GFAP-positive cells in CA1 radiatum stratum of hippocampal formation were markedly higher in the HI group than those in the other two groups (P<0.01), but the others strata showed no difference. ConclusionHypoxic-ischemic brain damage cause rats to disorders of learning and memory that may be correlated with increase astrocyte in hippocampal formation which became easy to be damaged of declining regulation abilities of neurons microenvironment. Nimotop may be effective to counteract hypoxic-ischemic brain damages.

Objective To develop a simple method of determination of sorafenib in serum by reversed-phase high performance liquid chromatography (RP-HPLC) and to explore its application in sorafenib therapeutic drug monitoring (TDM).Methods Sorafenib extracted by ethyl ether-petroleum (9∶1) with internal standard of erlotinib from serum was wiped off in 60 ℃ water bath.Sorafenib was redissolved by mobile buffer and analyzed by 40 μl.Chromatographic column was Symmetry Rp18 (5 μm,4.6 mm×250 mm,waters) column in normal temperature.The mobile buffer was 28 mmol/L acetate buffer (pH 5.8)-acetonitrile (37∶63).Sorafenib and erlotinib were detected in 249 nm and 335 nm,respectively.Results The concentration range of sorafenib was 0.50-20.00 μg/ml (r =0.9999).The within-day and between-day accuracies of sorafenib were less than 4.77 ％ and 8.79 ％,respectively.The average recovery rate was 98.48 ％.Sorafenib was stable in serum or after extraction.The concentrations of sorafenib in two patients were detected.Conclusion Detection of sorafenib in serum by RP-HPLC is simple and accurate,which is available to determine sorafenib in serum.The TDM of sorafenib has clinical significance.

Objective To explore the feasibility of visually assessment of angiogenesis in a murine model of subcutaneous matrigel plugs with ultrasound molecular imaging(UMI) using microbubbles(MB)targeted to endothelial αv-integrins. Methods Matrigel angiogenesis was created by subcutaneous implantation of FGF-2 enriched matrigel in 10 mice. On day 10, UMI of the matrigel was performed in all mice at 6 minutes after intravenous injection of either αv-integrin targeting microbubbles(MBα) or isotype control microbubbles(MBc) in random with 30 min interval,and the video intensity(Ⅵ) was measured. To further test the specificity of the signal coming from MBα,antibody against αv-integrin was injected 10 min before microbubbles injection. Following UMI,all matrigels were harvested for histological analysis. Results As expected,VI of the matrigel was significantly higher ( P ＜0.05) for MBα (20. 5 ± 3.3)U as compared with MBc (4. 8 ± 1.5)U. After blocking with antibody against αv-integrin,a great decrease was observed in the MBα group [VI (4.6 ± 1.2) U, P ＜0.05] while no significant difference was noted for MBc [VI (4. 9 ±1.5)U, P ＞ 0.05 ]. Neovessels within matrigel was positive for αv-integrin. Conclusions UMI with microbubbles targeted to αv-integrins can be effective and specific in evaluating the angiogenesis in a murine model of subcutaneous matrigel plugs.

Objective To develop nanometer-scale bubbles with surfaces of N-palmitoyl chitosan(PLCS) as ultrasound contrast agent and evaluate its characteristics and acoustic effects in vivo. Methods The PLCS nanobubbles were prepared using a cutting technique at differential high-frequency of shear speed. Both optical and transmission electron micrography were performed to determine the nanobubble size and morphology. Concentration, size-distribution and zeta potential of the PLCS nanobubbles were measured by cell counting chamber, Malvern lazer particle analyzer and zeta-sizer at 1-day, 45-day and 90-day. The acoustic effects of the PLCS nanobubbles on myocardium and renal tissue in 6 normal rats were observed using bolus infusion of the nanobubbles intravenously. The maximum video intensity(VI) was measured.Results The PLCS nanobubbles with nice round-shape and uniform site-distribution were demonstrated.The mean diameter,concentration and zeta potential of the PLCS nanobubbles were (617 ± 12) nm, (7.2 ±0.6) × 109/ml and (52.9 ± 1.3)mV at the 1-day,and all of parameters did not change significantly in 45-day and 90-day ( P ＞ 0. 05). A significant contrast-enhancement was noted on myocardium and renal tissue during infusion of the nanobubbles. VI on both tissues was (15.6 ± 1.1)GU and (27.3 ± 2.5)GU,respectively. The visual contrast-enhancement last up to (10 ± 2)min. Conclusions The PLCS nanometerscale bubbles have excellent physical-features and contrast-enhanced ultrasound effects in vivo. It may develop as a novel contrast ultrasound agent which could cross endothelial cell membrances.

Objective To study the clinical value of electronic bronchoscope in diagnosis and treatment of recurrent dyspnea in neonates.Method From October 2014 to October 2017,the clinical data of recurrent dyspnea receiving electronic bronchoscopy examination and treatment in the neonatal intensive care unit of our hospital were retrospectively selected.Their clinical characteristics and treatment effects were summarized and analyzed.Result A total of 171 infants of neonatal recurrent respiratory infections were examined using electronic bronchoscope.The top four causes included endo－tracheo－bronchitis in 78 cases (45.6%), laryngomalacia, and tracheobronchomalacia in 22 cases (12.9%), airway stenosis in 14 cases (8.2%) and esophagotracheal fistula in 12 cases ( 7.0%).The complications of intraoperative and postoperative included decline of percutaneous oxygen saturation and /or heart rate (20.5%, 35/171), mucosal bleeding (12.3%, 21/171 ), and fever after bronchoalveolar lavage.Electronic bronchoscopy examination confirmed all the 171 neonates′diagnosis and some of them recovered after corresponding treatment.78 cases of infants with endo－tracheobronchitis were all cured.22 cases of laryngomalacia and tracheobronchomalacia and nine patients with airway stenosis improved and were discharged after treatment . One patient with subglottic stenosis received bronchoscopic holmium laser ablation therapy and the airway significantly expanded.No re－stenosis was found during follow－up.Conclusion Electronic bronchoscopy is an important method to determine the cause of recurrent dyspnea in newborns , and it′safe,reliable and can play a therapeutic role in some neonates.

Objective To evaluate the role of calcineurin ( CaN)/nuclear factor of activated T cell cytoplasmic 4 protein ( NFATc4) signaling pathway in inflammatory responses in lung tissues of rats with ventilator-induced lung injury ( VILI) . Methods Twenty-four clean-grade healthy male Wistar rats, aged 5-8 weeks, weighing 220-250 g, were divided into 3 groups ( n=8 each) using a random number table method: control C (group C), VILI group and cyclosporine A plus VILI group (group CsA+VILI). The animals were anesthetized with pentobarbital and tracheostomized. The rats were mechanically ventilated for 6 h with the tidal volume set at 40 ml/kg and respiratory rate at 40 breaths/min to establish the model of VI-LI. The rats kept spontaneous breathing in group C. CaN specific inhibitor cyclosporine A 10 mg/kg was in-traperitoneally injected at 1 h before ventilation in group CsA+VILI. Rats were sacrificed immediately after ventilation, lung tissues were obtained and stained with hematoxylin and eosin to evaluate lung injury, broncho-alveolar lavage fluid was collected for determination of tumor necrosis factor-alpha ( TNF-α) , inter-leukin-1beta ( IL-1β) and IL-6 concentrations by enzyme-linked immunosorbent assay, and the lungs were removed for determination of the wet to dry weight ratio ( W/D ratio) , expression of intercellular adhesion molecule-1 ( ICAM-1) and vascular cell adhesion molecule-1 ( VCAM-1) ( by real-time polymerase chain reaction) , and expression of calcineurin and NFATc4 in lung tissues ( using Western blot ) . Results Compared with group C, the W/D ratio, lung injury scores and concentrations of IL-1β, IL-6 and TNF-αin BALF were significantly increased, and the expression of CaN, NFATc4, ICAM-1 mRNA and VCAM-1 mRNA was up-regulated in group VILI ( P＜0. 05) . Compared with group VILI, the W/D ratio, lung injury scores and concentrations of IL-1β, IL-6 and TNF-αin BALF were significantly decreased, and the expres-sion of CaN, NFATc4, ICAM-1 mRNA and VCAM-1 mRNA was down-regulated in group CsA+VILI ( P＜0. 05) . Conclusion CaN/NFATc4 signaling pathway mediates inflammatory responses in lung tissues of rats with VILI.