Objective Laterally spreading tumor (LST) has a close relationship with colorectal cancer, its diagnosis and treatment are differed from those of ordinary protuded tumors. The aim of this study is to attract much attention to this particular tumor. Methods Four thousand two hundred and ten patients were examined with magnifying endoscope and mucosa staining from December, first 2000 to May 31 , 2002. Results In 34 patients with LST, there were 35 lesions, including granular type 15, nodular - mixed type 18, and pseudocaved 2; and there were 4 patients with intramucosa carcinoma and other 2 with serrated adenoma. The biggest lesion is 68 mm ? 85 mm, and the smallest 11 mm? 12 mm. Of the 35 lesions the diameters are 8 within 11 -20 mm, 13, 21 -30 mm and 14 above 31mm. The pit patterns of the 35 lesions are mainly IV pit patterns, about 62. 9% (22/35). The pathological diagnoses of 3 patients with VA pit patterns LST are intramucosa carcinoma, and 8 patients with Ⅲ L pit patterns are tubulovillous adenoma. All of the 35 lesions are resected by EMR or EPMR. Complication occurred in two patients during treatment of EMR such as hemorrhage and local peritonitis. Conclusion Mucosa staining and magnifying endoscopy is very useful in detecting LST. We must pay more attention to those signs, such as reddish and eneven mucosa or unclear or interrupted vascular network. Furthermore it is necessary to stain the mucosa with indigo carmine spray to get the evidences of flat tumor. Pit patterns of LST mostly are IV or ⅢL, and LST with Ⅳ pit patterns are mainly villous adenoma, ⅢL tubular adenoma, while LST with the Ⅴ pit pattern signifies the cancerated metaplasia.

Objective To investigate the clinical characteristics of colorectal cancer and its trend in Guangdong province.Methods The data from 6501 patients with pathologically confirmed colorectal cancer of 5 hospitals from 1990 to 2004 was analyzed.Results The mean age of 6501 patients with colo- rectal cancer was 59 years old,with the predominant age ranged from 61 to 70 years old.The proportion of young patients decreased from 7.1% to 3.5%.and the ratio between male and female was 1.47:1, which was gradually increased with increasing of age.The prevelence reached a high peak(60 years old) and dropped after that as a single peak curve.The ratio between rectal cancer and colon cancer was 1.1: 1,and the descending colon cancer accounted for 27.6%.With ageing,the rectal cancers decreased while the right hemi colon cancer increased gradually.Tubular adenocarinoma was predominant with his- tological typing,which accounted for 76.0%.The progressing stage(Dukes B,C,and D)was found in 93.9% of all cases.Conclusions The onset age of patients with colorectal cancer become close to west- ern country.The proportion of young patients are decreasing.The ratio between male and female dis- plays a single peak curve from rising to dropping.A tendency of decreasing percentage in rectal cancer and the gradual increasing in right hemi colon cancer emphasize the importance of colonoscopy in colorec- tal caner screening.

Objective The study was conducted to investigate the acute phase of convulsion related problem on the clinical manifestations,imaging and electroencephalograph (EEG) examination of purulent meningitis.Methods Cluster sampling method was employed to select children in our hospital,a total of 301 cases with purulent meningitis was analyzed retrospectively.Among them,62 cases had convulsion.The incidence of convulsion in the acute phase of the purulent meningitis,risk factors,and prognosis were analyzed.Results The convulsion incidence rate of acute purulent meningitis was 20.60％.The partial seizure was eight cases (12.90％).The secondarily generalized seizure following partial seizure was 15 cases (24.19％).The generalized seizure was 32 cases (51.61％).The convulsive status was 7 cases (11.29％).The EEG abnormality was significantly different between the convulsion group and the no convulsion group (P ＜ 0.05).The incidence of brain organic damage was significantly different between two groups (P ＜0.05).The multivariate unconditional logistic regression analysis showed,cause of disease,first symptom,disturbance of consciousness,obvious signs,and cerebrospinal fluid culture with convulsion were the relevant factors (P ＜ 0.01).Conclusions The most common seizure of purulent meningitis was the generalized seizure.Brain organic damage easily resulted in convulsion of purulent meningitis.The days of hospitalization,cause of disease,first symptom,disturbance of consciousness,obvious signs,and cerebrospinal fluid culture with convulsion were the positively relevant factors.Those positively relevant factors in combination of the clinical manifestations,imaging,and EEG examination in children would play an important role in diagnosis,treatment,and prognosis evaluation of convulsion derived from purulent meningitis.Moreover,convulsion affects the disease recovery in children with purulent meningitis.

Objective To study the clinical features of the variants of benign childhood epilepsy with central temporal spikes (BECT).Methods The clinical data of 12 hospitalized pediatric patients with BECT from Jan 2007 to Jan 2014 were retrospectively reviewed. Results There were 7 boys and 5 girls in 12 patients. The age of onset was from 3 to 9 years old. Two cases were dizygotic twins. The atypical symptoms included atypical absence of 10 cases, negative myoclonic seizure of 8 cases, speech expression disorders and oral-pharynx apraxia of 4 cases. The electroencephalography (EEG) of all 12 patients showed abundance of spike and waves (SW) in rolandic areas during wake-up and sleep. The SW index was 50%-85% during slow sleep in all patients.Conclusions The variants of BECT are often associated with EEG deterioration. Understanding the clinical featuress and EEG characteristics can help the diagnosis of BECT variants.

Objective To analyze the potential etiologies and risk factors of childhood stroke. Methods This study retrospectively reviewed the clinical data of 159 children who were admitted from Jan.2006 to Jan.2014. Results The 159 children were composed of 100 boys and 59 girls , with median onset age of 1.8 years (ranged from 1 day to 12 years old) and median peak age of 0.9 years (ranged from 3 months to 2.8 years old). Their initial symptoms included limb hemiplegia,language dififculties and convulsion. The common causes included infections found in 46 cases (central nervous system infection in 32 cases, respiratory and gastrointestinal tract infection in 14 case), head injury in 42 cases, vitamin K deifciency in 29 cases, Moyamoya disease in 8 cases, heart diseases in 11 cases, spontaneous hemorrhage in 11 cases and 12 cases of unknown reason. Infectious diseases were the most common cause of children acute ischemic stroke in toddler period;and vitamin K1 deifciency were the most common cause of children hemorrhage stroke in infancy. The most common region of infarction is basal ganglia and middle cerebral artery in neuronal imaging. The median age at the time of diagnosis was 1.4 days. The median time of inhospital was 28 days. The median apex time was 4.3 days. Conclusions Among 159 cases, acute ischemic stroke is much more common than hemorrhagic stroke in children stroke, and the major risk factors are infections and head injury;Vitamin K1 deifciency is a major risk factor in infants with hemorrhagic stroke.

Objective To evaluate the renal cortical blood perfusion changes in rabbits with acute renal failure (ARF) with gray scale contrast-enhanced ultrasound, and to explore the relationship between these changes and the blood creatinine (SCr), as well as the blood urea nitrogen (BUN). Methods Rabbit ARF models were established with 50% glycerin injected into the rabbits' thighs. Gray scale contrast-enhanced ultrasound was performed on the day before injection (T_0) and 1, 4, 8, 12 days (T_1, T_4, T_8, T_(12)) after injection. The renal cortex perfusion time-intensity curve (TIC) was analyzed, including parameters like arrival time (AT), time to peak intensity (TTP), amplitude of peak intensity (A) and slope rate of TIC (β) of renal cortex. Meanwhile the SCr and BUN were measured, the correlation between SCr, BUN and parameters were analyzed. Results Compared with the value of T_0, the value of TTP, A, β after injection (T_1, T_4, T_8) were statistically different, respectively (P<0.05), but the differences among T_1, T_4 and T_8 were various. No linear correlation between above parameters and SCr, BUN was found. Conclusion The renal cortical blood perfusion changes can be early observed with gray scale contrast-enhanced ultrasound, but there is no linear correlation between the changes of parameters and SCr, BUN.

To study the stimulation effect to the growth of Bifidobac te rium sp. A04, 4 kinds of oligosaccharide, 8 kinds of Chinese traditional medi cine and 4 kinds of food raw materials were used. The results indicates that so ya bean oligosaccharide is the most effective (P

Objective To establish a normal lumbar spine 3-dimensional(3D) finite element model(FEM) and discuss the biomechanics of the lumbar motions. Methods A geometrical model was constructed on the basis of a healthy adult male's lumbar CT image.The lumbar spine FEM was established by finite element analysis software.After setting the boundary and loading the burden,the lumbar spine's range of motion and stress distribution in different institutions such as anterior flexion,posterior extension,left or right bending and axial rotating were recorded. Results The lumbar spine FEM included 114 953 tetrahedron units.The results of the FEM matched the results of the in vitro experiment of biomechanics. Conclusion The lumbar spine FEM can imitate the motions of the lumbar spine.

Bronchi ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Middle Aged ; Pneumonectomy ; Pulmonary Sclerosing Hemangioma ; pathology ; surgery

ObjectiveTo investigate the safety and efficacy of carbon dioxide ( CO2 ) insufflation during ERCP.MethodsBetween January and August 2011,a total of 102 consecutive patients who underwent ERCP were randomized to accept CO2 insufflation ( n =52 ) of air insufflation ( n =50 ) during the procedure.ERCP was carried out with the same instrument by an expert endoscopist who was blinded to the insufflation gas used and the procedure was controlled at 30 minutes to 1 hour.The heart rate,oxygen saturation of the patient was continuously monitored during the procedure.Before the procedure and 1 hour after the end of operation,abdominal X-ray was taken to evaluate the width of intestine,and the degree of intestinal expansion was defined as normal,mild,moderate and severe according to the width increased.A questionnaire with 100 mm visual analogue scale (VAS) was used to quantify the abdominal pain and distention experienced at 1 hour,2 hours,and 6 hours after the procedure.The patients' vital signs,bowel dilatation,the average operating time,abdominal pain score and distention score on VAS,and complications in 2 groups were analyzed.ResultsThe baseline characteristics of 2 groups were comparable.ERCP was successfully performed in all the patients and no complication was observed.In CO2 group,the average operating time,mean heart rate and oxygen saturation were (45.2 ± 10.6) min,( 102.2 ± 10.3 ) bpm and ( 99.5 ± 0.5)％,which were (48.5 ± 11.2) min,( 100.3 ± 11.4) bpm and (98.9 ±0.6)％,respectively,in air group.There were no significant differences on these items between the 2 groups ( P ＞ 0.05 ).Moderate to severe intestinal expansion 1 hour after ERCP was found in 14 patients (26.9％ ) in CO2 group and in 28 patients (56.0％ ) in air group,and the latter was significantly higher than the former (x2 =11.61,P =0.009).Both of the mean abdominal pain and abdominal distention scores at 1 hour post-ERCP in CO2 group were lower than those in air group,but without significant difference (P ＞0.05).However,the mean abdominal pain scores at 2 hours and 6 hours post-ERCP in CO2 group were significantly lower than those of patients in air group (7.4 ±2.2 vs.18.7 ±4.6 at 2 hours post-ERCP,9.6 ±3.7 vs.20.1 ±4.5 at 6 hours post-ERCP,all P ＜ 0.05 ).Similarly,the mean abdominal distention scores at 2 hours and 6 hours post-ERCP in CO2 group were significant lower than those of patients in air group (7.6 ±3.6 vs.18.3 ±4.1 at 2 hours post-ERCP,8.9 ±3.7 vs.19.4 ±4.2 at 6 hours post-ERCP,all P ＜0.05).ConclusionThe use of CO2 insufflation instead of air during ERCP appears to be safe.Insufflation of CO2 during ERCP palliates the intestinal expansion,post-ERCP abdominal pain and distention comparison to insufflation of air.However,because of the single-center clinical observation with limited number of cases,the safety and efficacy of CO2insufflation during ERCP requires to be further evaluated.