Early esophageal cancer is derived from mucosa and submucosa without lymph node metastasis. They are detected generally during endoscopy or physical examination without clinical symptoms. Main treatment of early esophageal cancer is endoscopic resection,and the 5-year survival rate is over 90% . Once symptoms occur,local lymph node metastasis is often present and the prognosis is poor with a markedly reduced 5-year survival rate. Thus it is vital to diagnose and treat esophageal cancer at an early stage. With the development of endoscopic techniques,especially the proficiency of endoscopic ultrasonography(EUS),the detection rate of early esophageal cancer has been increased greatly. EUS also plays an important role in the staging of early esophageal cancer. This article reviewed the application of EUS in diagnosis and treatment of early esophageal cancer.

Abstract: Objective　To investigate the status of participation in highly active antiretroviral therapy (HAART) among individuals infected with human immunodeficiency virus (HIV)/patients with acquired immunodeficiency syndrome (AIDS) (hereinafter referred to as HIV/AIDS) in Hainan province, and to analyze the immunological outcomes and their influencing factors following treatment. Methods　In this study, HIV/AIDS patients treated in Hainan Province until 2022 from the antiretroviral treatment were selected from the antiviral treatment submodule of the China Disease Prevention and Control Information System. According to the inclusion and exclusion criteria, a total of 3 150 HIV/AIDS patients were enrolled. Logistic regression analysis was used to analyze factors affecting the immunological effect of antiretroviral therapy. Results　Of the 3 150 subjects, 2 906 achieved immunological success, accounting for 92.2%. The M（P25，P75） CD4+T lymphocyte count after treatment was 491 (351, 656) cells/μL. There were significant differences in the increase in CD4+ T lymphocyte counts after treatment compared to baseline across different CD4+T levels (P<0.001). Multifactorial logistic regression analysis showed that being divorced or widowed (OR=0.50, 95%CI: 0.31-0.79), age ≥60 years at the onset of treatment (OR=0.51, 95%CI: 0.29-0.90), the interval from diagnosis to treatment of 1 to <12 months (OR=0.55, 95%CI: 0.40-0.77), 12 to <60 months (OR=0.53, 95%CI: 0.34-0.80), and ≥60 months (OR=0.41, 95%CI: 0.23-0.75), as well as a CD4+ T cell count of 300 to <400 cells/μL (OR=0.36, 95%CI:0.22-0.58) and 400 to <500 cells/μL (OR=0.30, 95%CI:0.18-0.49) were negative correlation with immunological success (P<0.05). On the other hand, homosexual transmission (OR=3.46, 95%CI:2.03-5.90), heterosexual transmission (OR=1.91, 95%CI: 1.14-3.19), other/unknown transmission (OR=3.13, 95%CI: 1.50-6.53), treatment years count 2 to <4 years (OR=1.71, 95%CI: 1.13-2.58), 4 to <6 years (OR=2.86, 95%CI: 1.81-4.51), and ≥6 years (OR=2.21, 95%CI: 1.47-3.32) were positive correlation with immunological success (P<0.05). Conclusions　The highly active antiretroviral therapy has achieved good immunological effects among patients with HIV/AIDS in Hainan Province. It is essential to expand HIV monitoring and detection, to diagnose and treat at an early stage, and to continue strengthening medication compliance education to further improve the immunological effects of treatment.

BACKGROUND:Caspase plays a crucial role in the cellapoptosis, but the influence of different facial nerve injury on caspase 1, caspase 8, cyto-c protein expression and their correlation stil remain unclear.
OBJECTIVE:To construct facial nerve crush or distal transection injury models, observe the morphological changes of facial motoneurons, investigate death gene caspase 3, caspase 8, cyto-c expression, and analyze their correlation.
METHODS:Facial nerve crush or distal transection injury model was established in the right facial nerve of rats, while the left facial nerve served as normal controls. We observed the morphology and the death of facial motoneurons with toluidine blue staining and transmission electron microscope. Expressions of caspase 3, caspase 8 and cyto-c proteins were studied by immunohistochemistry analysis fol owing facial nerve injury.
RESULTS AND CONCLUSION:Both facial nerve distal transection and crush injury resulted in the death of facial motoneurons, and the death pattern was mainly apoptosis. Caspase 3, caspase 8 and cyto-c protein expressions were observed in the subnucleus of normal rat facial nucleus. cells of the distal transection group were stained more intensely than that of crush group. Expressions of these proteins began to increase at 3 days after the injuries. Caspase 3 and caspase 8 protein expression peaked at 14 days, whereas cyto-c protein expression peaked at 7 days after the injuries. Expressions of caspase 3, caspase 8 and cyto-c proteins were correlated with facial nerve injury type and injury time. Expressions of caspase 8 and cyto-c protein were correlated with expression of caspase 3 protein. The findings indicate that, caspase 8 and cyto-c contribute to activate caspase 3, and caspase cascade reaction plays an important role in the apoptosis of facial motoneurons.

Objective To identify the necessity to carry out optimization procedure in routine digital radiography (DR) by evaluating changes of patient radiation dose and image waste ratio before and after optimization.Methods Two hundred patients with near-standard body build were enrolled in the study.Half of them undertook routine examination,and the others undertook the examination with bestlyoptimized protocol.The dose-area product (DAP) and entrance surface dose (ESD) were recorded.The image waste ratios in 2 groups were calculated and the reasons for image waste were analyzed.The radiation dose and image waste ratio before and after optimization were compared.Results The ESD,DAP and image waste ratio in bestly-optimized radiography were significantly lower than those in non-optimized radiography (z =9.31,16.22,P＜0.05; x2 =36.5,P ＜ 0.05).Conclusion Using the bestlyoptimized digital radiography,the patient radiation dose and image waste ratio are effectively reduced.

Objective:To investigate the stability of flurbiprofen axetil lipid microspheres injection combined with 0. 9% sodium chloride injection or 5% dextrose injection, and provide theoretical basis for the clinical application. Methods:The content changes of flurbiprofen axetil in the mixture of flurbiprofen axetil lipid microspheres injection and 0. 9% sodium chloride injection or 5% dextrose injection were determined in 5 h at 25℃ away from light, and the changes in the appearance and particle size of flurbiprofen axetil lip-id microspheres were investigated. The changes in the appearance and particle size of flurbiprofen axetil lipid microspheres in the mix-ture of flurbiprofen axetil lipid microspheres injection and 0. 9% sodium chloride injection before and after freezing and thawing were also investigated. Results:The appearance, particle size and content had no significant changes in all mixtures in 5 h at 25 ℃ away from light. The appearance and particle size of flurbiprofen axetil lipid microspheres in the mixture before and after freezing and thawing had no significant changes as well. Conclusion:The mixture of flurbiprofen axetil lipid microspheres injection and 0. 9% sodium chlo-ride injection or 5% dextrose injection is stable in 5 h away from light.

Objective To investigate the infection status of A ngiostrongylus cantonensis in winkle from 9 cities in Guizhou Province.Methods The winkles were collected randomly from aquatic products wholesale market,agricultural market or restaurants in 9 cities (Guiyang,Zunyi,Tongren,Kaili,Anshun,Duyun,Xingyi,Bijie and Shuicheng) and classified in Guizhou Province,and the third-stage larvas of Angiostrongylus cantonensis were separated and detected with microscopy by tissue homogenization (Pomacea canaliculata was first checked with lung screening method,and then rechecked by tissue homogenization),and infection rate was calculated.Results Totally 2 177 winkles were tested,the overall infection rate of Angiostrongylus cantonensis was 1.5％ (32/2 177),among them,Pomacea canaliculata was 1 287,five was positive,and the infection rate was 0.4％; Achatinafulica was 240,positive 27,the infection rate was 11.3％; Bellamya lithophaga was 372 and all 278 Cipangopaludina chinensis was not positive.Conclusions There is a higher risk of infection with Angiostrongylus cantonensis if eating winkles.The third-stage larva in Pomacea canaliculata and Achatina fulica has been found in Guizhou Province.Market management,food-safety inspection of the winkles on sale,and public health education should be strengthened.

Objective　To investigate the current status and attrition among HIV-infected persons receiving antiretroviral therapy (ART), and to analyze factors affecting attrition in Hainan. Methods　In this study, HIV-infected patients who started ART treatment in Hainan Province from 2005 to 2022 were selected from the antiviral treatment submodule of China Disease Prevention and Control Information System.According to the inclusion and exclusion criteria,a total of 4 286 HIV-infected persons were receiving . A Cox proportional hazards regression model was used to analyze factors affecting attrition. Results　Among the 4 286 study subjects, 3 718 were males (86.7%), with a sex ratio of 6.55∶1. Unmarried individuals accounted for 58.4%, and the average age was (39.68±13.17) years. Transmission through homosexual contact accounted for 49.8%, and 84.3% were in WHO clinical stage I. Treatment regimens containing Efavirenz (EFV) accounted for 71.7%. During a follow-up of 19 677.44 person-years, the overall attrition rate was 0.80 per 100 person-years, with the first-year post-ART initiation attrition rate being 21.10 per 100 person-years. The results of Cox regression analysis showed that the time of treatment initiation in 2016-2022 (AHR=2.40, 95%CI: 1.40-4.10), and the last HIV viral load (VL) 20-<1 000 copies/mL (AHR=3.69, 95%CI: 2.08-6.54), the last HIV-1 VL≥1 000 copies/mL (AHR=15.98, 95%CI: 9.46-27.01), and no last HIV-1 VL test (AHR=92.90, 95%CI: 57.68-149.62), the time interval from diagnosis to treatment for 1-12 months (AHR=1.62, 95%CI: 1.12-2.36), and an interval longer than 12 months (AHR=1.68, 95%CI: 1.07-2.62) were the main factors that increased the risk of attrition. Treatment regimens containing Lopinavir/ritonavir (Lpv/r) (AHR=0.34, 95%CI:0.18-0.66) and treatment regimens containing integrase strand transfer inhibitors (INSTIs) (AHR=0.24, 95%CI: 0.09-0.58) were the factors that reduced the risk of attrition after antiretroviral therapy. Conclusions　The attrition of ART in HIV/AIDS patients in Hainan Province is related to a longer interval from diagnosis to treatment, treatment plan, and abnormal HIV viral load test results. Case-based measures should be taken to address factors influencing antiretroviral treatment attrition, while improving the timeliness of antiviral treatment and treatment management service quality to further improve the efficacy of antiviral treatment.

Purpose To investigate the expression of VEGF, NRP1 and the cancer stem cell marker CD44 in gastric carcinoma and their correlations. Methods High throughput technology of tissue microarray and immunohistochemical SP method were employed to investigate the expression of VEGF, NRP1 and CD44 proteins in 72 gastric carcinoma specimens and 52 normal gastric tissues. Immu-nohistochemistry records were reviewed, their correlations and the clinicopathological characteristics were evaluated. Results ( 1 ) The positive rates of VEGF, NRP1 and CD44 proteins were 76. 4%, 66. 7%, and 83. 3% in gastric carcinoma, respectively, with sig-nificant differences from normal gastric tissues (P<0. 01). (2) The positive expression of VEGF and NRP1 were closely correlated with infiltration depth, lymph node metastasis and TNM stage (P<0. 05). The positive expression of CD44 was closely correlated with Lauren type, differentiation degree, lymph node metastasis and TNM stage (P<0. 05). (3) In addition, the expression of CD44 was significantly correlated with VEGF and NRP1 in gastric carcinoma (rs =0. 578, rs =0. 278, rs =0. 316, P<0. 05). Conclusions VEGF, NRP1 and the cancer stem cell marker CD44 are highly expressed in gastric cancer, which are closely related to the biological behaviors of gastric cancer. Synergistic effects are observed between VEGF and NRP1, and they are closely related to the expression of the cancer stem cell marker CD44, which remains to be further studied.

Objective By using lung sound spectrum analysis, the clinical efficacy of asthma -relieving manipulation, which is a gentle massage therapy mainly on the acupoints, on acute exacerbation of children asthma was evaluated. Methods We collected the lung sound of 11 children with acute asthmatic attack before and after asthma-relieving manipulation, and then input to the computer for obtaining lung sound spectrum signal data. The sound intensity, average respiratory muscle strength ( RMS) power, total RMS power and the volume of every 25 Hz frequency spectrum were extracted for comparison. Results After asthma-relieving manipulation, the sound intensity, average RMS power, and total RMS power of the children with acute asthmatic attack were significantly lower than those before the manipulation (P<0.01). The results of lung sound spectrum analysis displayed that lung sound volume was significantly lower at frequency band 0~300 Hz after manipulation ( P<0.05 compared with that before the manipulation) . The difference of the lung sound volume was insignificant over frequency band 300 Hz before and after treatment ( P>0.05). Conclusion Lung sound spectrum analysis can be applied to monitor lung function of asthmatic children objectively and quantitatively, and it is a new sensitive method for clinical detection. Asthma-relieving manipulation shows certain effect on acute exacerbation of children asthma.

ABSTRACT:Objective To explore role of U0126,the specific inhibitor of ERK signaling pathway,in early brain injury (EBI)and the autophagy of nerve cells in hippocampus area in subarachnoid hemorrhage (SAH). Methods A total of 48 male adult SD rats were randomly divided into control group,SAH group,DMSO+SAH group,and U0126+SAH group,with 12 in each.We established SAH rat model by the puncture of internal carotid artery.The same amount of saline water,DMSO and U0126 solution of 0.5 mL per rat was injected respectively into the rats of different groups 30 min before modeling.The rats were killed at 24 h.To measure brain water content by Wet and dry method after 24 h,the morphological changes of hippocampus CA1 neural cells were observed by microscopy;the expression levels of ERK,Beclin-1 and LC3 were detected by using immunohistochemical method. Results Compared with that in sham group,brain water content increased obviously in SAH model group.The density of surviving neurons in SAH group was significantly lower than that in control group (P<0 .0 5 ).ERK signaling pathway was activated obviously,the expressions of Beclin 1 and LC3-Ⅱ were significantly higher than those in control group (P<0.05).Compared with SAH model group,in U0126 group brain water content increased obviously.Compared with those in SAH group,the density of surviving neurons was significantly lower (P<0.05), ERK signaling pathway was suppressed,the expressions of Beclin-1 and LC3-Ⅱ were significantly lower (P<0.05). Conclusion The U0126,the ERK signaling pathway inhibitor,can inhibit neuron autophagy and increase EBR of SAH.