Endoscopic ultrasound was initially introduced in 1980s as a diagnostic modality combining echoendoscopes with radial scanning, which permitted reconstruction of cross-sectional images similar to computed tomography. Many studies showed that endogastric ultrasonography is more accurate than endoscopy or CT in evaluating the depth of invasion ( T category) and the involvement of lymph nodes (N category) in patients with gastric carcinoma. In addition to being very useful in tissue acquisition for diagnostic purposes, the principles behind endoscopic ultrasound-guided fine needle aspiration ( FNA) paved the way for the development of therapeutic endoscopic ultrasound, which improve the prognosis of patients with gastric cancer.

The progressive loss of skeletal muscle protein observed in cancer cachexia may have a negative impact on both the quality of life and the survival time of patients. In recent years, accumulating evidences suggest that the ATP ubiquitin proteasome pathway may be crucial in muscle cachexia. The review is mainly about the role of the ATP ubiquitin proteasome pathway in the degration of skeletal muscle protein during cancer cachexia.

Objective To investigate the clinical characteristic and prognosis of nonsteroidal antiinflammatory drugs( NSAIDs)and aspirin associated peptic ulcer bleeding. Method All patients with peptic ulcer bleeding were studied by the same researcher after admission and discharge. Results Fifty-one cases with NSAIDs and aspirin medication of the total peptic ulcer bleeding patients ( 147 cases) were included (34. 7% ). Compared with patients not associated with NSAIDs and aspirin medication, they are older [(41.2 ± 1. 9 ) years vs ( 59.4 ± 2. 2 ) years, P ＜ 0. 001], more commonly associated with hypertension ( 10. 4% vs 39. 2% ,P ＜0. 001 ), coronary heart disease ( 10. 4% vs 17.6% ,P ＜0. 001 ) ,diabetes (4. 2%vs 19. 6%, P = 0. 005 ); and had more severe anemia (7. 3% vs 23. 5%, P = 0. 008 ). Fewer patients in NSAIDs group had epigastric pain (61.5% vs 27.5%, P ＜ 0. 001 ), while there was more re-bleeding (9.4% vs 15.7%, P = 0.034). In all bleeding patients, factors associated with re-bleeding, surgical intervention and death included NSAIDs and aspirin medication, and low platelet count. In patients with NSAIDs and aspirin medication, re-bleeding was associated with previous ulcer history ( P ＜ 0. 05 ).Conclusion Peptic ulcer bleeding patients with NSAIDs and aspirin medication were more severe ill, and less likely to present with epigastric pain.

Objective To study the effect of Sirtuin1 (Sirt1) on the pathological process through its activity of deacetylation to improve the clinical outcome of acute sepsis. After searching data base, microRNA-211 (miR-211) was found to have action potentially targeting at Sirt1.The present study aimed to find the interaction between miR-211 and Sirt1 in the pathogenesis of hypoxic injury to cardiomyocytes in the presence of lipopolysaccharide ( LPS ) . Methods Primary neonatal rat cardiomyocytes ( NRC ) isolated from neonatal SD rats and H9c2 ( cardiomyocytes after culture with 10% fetal serum of cattle and DMEM under 37 ℃ and 5% CO2 ) cell line were used in the experiments.The miR-211 expression was quantified by qRT-PCR after LPS exposure for 4 hours, and the changes in Sirt1 protein level were also detected in both NRC and H9c2 by western blot.At the same time, CCK-8 assay and TUNEL staining were also performed to measure cell proliferation and apoptosis activation when either treated with LPS alone or followed by exposure to hypoxia.Results Compared to the control group, the doses of 20μg/mL, 40μg/mL LPS treatment for 4 hours had no significant effects on H9c2 cell proliferation at 24 h, 48 h, 72 h, but it could significantly induce the cell apoptosis of neonatal rat cardiomyocytes and H9c2 cells after hypoxia, and the apoptosis rate increased all over 100% in both NRC and H9c2.At the same time, LPS treatment could significant up-regulate miR-211 expression which was closely associated with decrease in Sirt1 protein levels.Conclusions LPS enhanced cardiomyocytes injury after exposure to hypoxia which was closely associated with up-regulating miR-211 expression and in turn to suppress Sirt1 expression.

Objective To evaluate the concordance on cardiac index (CI) measured with arterial pressure based cardiac output (APCO) and pulmonary artery catheter (PAC) during cesarean section in parturients with congenital heart disease combined with severe pulmonary hypertension.Methods Forty-five congenital heart disease combined with severe pulmonary hypertension parturient who scheduled for cesarean section were selected,APCO and PAC were used for cardiac output and other parameters of hemodynamics monitoring during operation in all patients.Continuous epidural anesthesia was performed.CI was recorded immediately before epidural administration (T1),at 5 and 10 min after epidural administration (T2,T3),immediately before delivery (T4),and at 2 and 5 min after delivery (T5,T6).The correlation of CI between APCO and PAC (A-CI and P-CI,respectively) was tested by Pearson correlation analysis and agreement test.Results The P-CI was significantly higher than A-CI,there was statistical difference (P ＜ 0.05).Compared with T1,no significant differences between A-CI and P-CI were found at T2-T4 and T6 (P ＞ 0.05),The A-CI at T5 [(4.5 ± 1.1) L/(min·m2) vs.(4.2 ± 0.8) L/(min ·m2)] and P-CI [(6.2 ± 1.5) L/(min·m2) vs.(5.4 ± 1.2) L/ (min· m2)] were significantly higher,there were statistical differences (P ＜ 0.05).The correlation analysis showed that there was positive correlation between A-CI and P-CI at T1-6 (r =0.931,0.955,0.945,0.892,0.960,0.913 ; P ＜ 0.05).Bland-Altman analysis showed poor agreement between CI measured with the two methods.Conclusion CI value obtained with APCO agrees poorly with that obtained with PAC during cesarean section in parents with congenital heart disease combined with severe pulmonary hypertension,but agrees well in monitoring the changing trend of CI.

A monoclonal antibody (McAb) 3H11 against gastric cancer with high positive rate, high selectivity and high affinity was obtained. 131 I Labeled McAb 3H11 was injected into gastric cancer-bearing nude mice, and the tumor/liver ratio, localization index, ID%/g could reach 8.26?1.26, 6.08 + 1.51, 11.00?2.62, respectively. Moreover, McAb 3H11 conjugated with 131 I could increase the cytotoxicity to tumor xenografts and decrease the side effects. The radioimmunoimage was carried out in 19 cases with gastric cancer, and positive image was obtained in 16 cases (84.2%). The radioimmunoguided surgery of gastric cancer was successfully done by submucous injection of labeled McAb 3H11 through endoscope. The sensitivity, specificity and accuracy for evaluation of tumor infiltrated gastric walls were 94.6%, 96.7% and 95.9%, respectively. The sensitivity, specificity and accuracy for identification of metastatic lymph nodes were 99.2% ,97.7% and 98.8%, respectively.

Objective To report the clinical outcome of dual plating in treating humeral intercondylar fractures. Methods From February 2002 to June 2003, 22 cases of humeral intercondylar fractures were treated with dual plating. It involved 15 males and 7 females, whose average age was 42.2 years with a range from 19 to 67 years. According to the AO classification, 5 cases were of type C1, 11 of C2 and 6 of C3. The posterior midline approach was selected, and the intercondylar fracture ends were exposed through the trans-olecranon osteotomy. The intercondylar fragments were fixed first, in 6 cases with C3 type fractures, the auto-grafting from the iliac bone was performed because of comminution, then the supracondylar fracture was fixed with dual plating. The semi-tubular plates was applied on the medial epicondylar crest of the humerus; and the reconstruction plate was implanted on the postero-lateral side, the two plates were kept in 90? with each other. The osteotomized ends were fixed with tension band. Results All the 22 patients were followed up for 13-29 months ( mean, 20.2 months ). By the end of the first postoperative month, the elbow flexion averaged 86.2?( range, 80?-105?), and the loss of extension averaged 40.7?(range, 30?-45?). But at the 12th month, the flexion improved to 117?(range, 95?-135?), and the extension loss decreased to 23.2?( range, 10?-35?). The averaged union time was 15.7 weeks with a range of 12 to 20 weeks. Assessed by the Jupiter scoring system, 3 cases were rated as excellent, 15 as good and 4 as fair. Complications included 4 cases of incision exudation, 3 K-wires withdrawal, 1 ulnar neuropathy and 3 heterotopic ossification. But no incision necrosis, deep infection, loosening or breakage of the internal fixators occurred. Conclusion The dual plating is able to provide stable and durable fixation for the humeral intercondylar fractures. In addition, it can prevent malunion or nonunion effectively, and decrease the related complications significantly. This method is helpful to improve the functional recovery of the elbow joint satisfactorily.

Objective To investigate the relationship between hepatitis B virus pre-core region 1896 site mutation in cases of chronic hepatitis B and IFN-alpha treatment.Methods 200 patients with chronic hepatitis B were randomly divided into experimental group(n=100) and control group(n=100).The patients in experimental group were treated with regular liver-protective drugs and IFN-alpha,while Control group patients received only regular liver-protective drugs for 6 months.PCR-RFLP were used to detect hepatitis B virus(HBV)DNA with pre-C region 1896 site mutation in two grops pre and post treatment.Results The mutation rates before interferon treatment were 20%(20/100) and 18%(18/100) in experimental group and control group,respectly.After treatment,the effective rates in experimental group were 60%(12/20) and 50%(40/80) in Patients with Chronic Hepatitis B variant and wild strain virus Infection,respectly.The effective rate in experimental group was significantly higher than that in control group.Conclusion IFN-alpha therapy was not correlated with genomic variability of the core region.

Objective To guide the treatment of acute exacerbation of chronic obstructive puhnonary diseases (AECO- PD) through studing the principally related factors of AECOPD.Methods 190 AECOPD patients were investigated through retrospective study.First,we studied the thirty-two possible factors with single-factor analysis,then procee- ded to perform multiple-factor analysis with Logistic regression among the factors which P value was below 0.2 in single -factor analysis,and analyzed the principally related factors with two-factor correlation.Results According to Mul- tiple-factor analysis with Logistic regression analysis,there were eight factors that showed significance,which were us- age of respiratory excitant,LBC,usage of antioxidant,heart failure,Cr,selection of antibiotics respectively,WBC and Hb.Correlative analysis of the principally related factors showed no correlation between WBC and LBC.Conclusion The principally related factors of AECOPD prognosis were their recited in results.

ObjectiveTo evaluate the neuroprotective effect of gradient perfusion-rewarming after deep hypothermia circulatory arrest (DHCA) in piglets.Methods12 Shanghai piglets (3-4 weeks old) were randomly divided into two groups of A (experiment group) and B (control group),average weight (9.78 ±0.93)kg.Animal CPB model is completed with microinvasive technique.DHCA duration is 90 min in two groups.During the rewarming period,group A was rewarmed with gradient perfusion strategy,maintain the temperature for 15 min every 5 ℃ elevation of the core temperature.Group B was rewarmed according normal consistent rewarming strategy.PH-stat management is adopt in both groups.Blood gas analysis,rectal temperature,heart rate,ECG,blood flow rate of carotid artery,glumatic acid/aspartate level of jugular vein and protein NFB of brain tissue are monitored during and/or after the cardiopulmonary bypass (CPB).ResultsDuration of rewarming in group A is (67.3 ± 7.8) min,and (41.8 ± 3.6)min in group B (P ＜ 0.05).Sample collected at the beginning of CPB,15 min of rewarming,30 min of rewarming and 45 min of rewarming show that there is no difference between the blood flow rate at 15 min of rewarming; difference are shown at the 30 min and 45 min of rewarming (P ＜ 0.5 ).High performance liquid chromatography ( HPLC ) analysis show the obvious difference of glumatic acid level of jugular vein at 30 min of rewarming and 45 min of rewarming ( P ＜ 0.5),this kind of difference of aspartate can only be seen at the 45 min of rewarming.Histologic evaluation shows gradient rewarming has a better effect on preservation of CA1 area neuron in hippocampus,however,Immunohistochemistry doesn't find the same effect.ConclusionControlled gradient perfusion-rewarming strategy can improve the neuroprotective effect during DHCA,keeping the balance of the blood flow,cerebral local temperature and brain metabolism might be the mechanism.