Objective To evaluate the efficacy and safety of endoscopic mucosal resection (EMR) for rectal carcinoid tumors. Methods From January 2006 to January 2009, EMR was performed in 28 patients with rectal carcinoids, who were followed up to evaluate the therapeutic effect and safety. Results Tumor diameters varied from 0.4 cm to 1. 2 cm (mean 0.7± 0. 2 cm). Negative resection margin was a-chieved in 26 cases (92. 9% ), tumor margin within 0. 1 cm of resection margin in 1 (7. 1% ) , and two margins coincided in 1 patient (7. 1% ). Hemostasis was performed with metal clips in 14 patients (50% ) and argon plasma coagulation (APC) in 9 (32. 1% ). Except for rectal bleeding in 1 patient (3. 6% ) , no other complications were observed. There was no recurrence in any patients during a follow-up of 6-36 months. Conclusion EMR is a useful and safe method for treatment of small rectal carcinoid tumor which does not cross submucosal layer.

Objective The study was performed to analyze the diagnosis and treatment of blue rubber bleb nevus syndrome of Chinese patients by evaluating the researches in China.Methods Chinese Journal Full-text Database,Wangfang Data and Weipu Chinese Medical Journal Database were searched for the clinical data of the patients with blue rubber bled nevus syndrome.Results Among the 50 patients,31 cases were male,and 19 cases were female.All patients (100％) had the venous malformations of the skin.Thirty-five (70％) cases had melena,13 (26％) cases had bloody stool,and 35(70％) had dizziness and palpitation.Blue rubber bled nevus syndrome were diagnosed with gastroscopy (40/48,83.33 ％),coloscopy (30/41,73.17％) and small intestinal examination (23/25,92％).Fourteen cases received symptomatic treatment.Twelve cases received therapeutic endoscopy,which lesions were located in stomach and colon.Sixteen cases received operation,and 2 cases were treated by laparoscopy and endoscopy.Conclusions Blue rubber bleb nevus syndrome is a rare disease.The skin and gastrointestinal system are involved in all patients with blue rubber bleb nevus syndrome in China.The routine examination for diagnosis of blue rubber bleb nevus syndrome should include examination of the small intestine.It still needs further research about effective treatment of blue rubber bleb nevus syndrome.

OBJECTIVETo explore the potential effect of Guizhi plus Gegen Decoction (GGD) in improving learning and memory of lipopolysaccharides (LPS) induced neuroinflammatory mice and its possible mechanisms.

METHODSTotally 63 male ICR mice were randomly divided into 5 groups, i.e., the normal control (n = 13), the model group (n = 13), the low dose GGD group (n = 10), the high dose GGD group (n = 14), and the positive control group (n = 13). Mice were intraperitoneally injected with LPS (0.33 mg/kg) to induce Alzheimer's disease (AD) model. Mice in the high and the low dose GGD groups were administered with 12 g/kg or 6 g/kg by gastrogavage for 4 successive weeks. Mice in the control group were intraperitoneally injected with minocycline (50 mg/kg) for 3 days. By the end of treatment LPS were injected 4 h before behavior test each day, and then behavior test was conducted in mice of each group. Effect of GGD on learning and memory of AD mice was observed by using open field test, novel object recognition task, and Morris water maze.

RESULTSOpen field test showed there was no statistical difference in the movement time and the movement distance among all groups (P > 0.05), suggesting that LPS and GGD had no effect on locomotor activities of mice. In novel object recognition test, AD mice spent significantly shorter time to explore novel object after they were induced by LPS (P < 0.05), while for AD mice in the low and high dose GGD groups, their capacities for exploration and memory were significantly improved (P < 0. 05, P < 0.01). Results of Morris water maze showed that AD mice exhibited increased escape latency (P < 0.05) and spent much less time in swimming across the original platform (both P < 0.05). However, AD mice in the low and high dose GGD groups had obvious shortened latency and increased time percentage for swimming (P < 0.05, P < 0.01).

CONCLUSIONGGD possessed certain improvement in learning and memory disorder of LPS induced AD mice.

Alzheimer Disease ; chemically induced ; drug therapy ; psychology ; Animals ; Drugs, Chinese Herbal ; therapeutic use ; Lipopolysaccharides ; adverse effects ; Male ; Memory Disorders ; prevention & control ; Mice ; Mice, Inbred ICR ; Neuritis ; chemically induced ; drug therapy ; psychology ; Phytotherapy

Objective To investigate the effect of selenium on proliferation and apoptosis of chondrocytes of articular cartilage cultured in vitro in Kaschin-Beck disease(KBD) patients and normal person, to explore the role of selenium in control of KBD, and to provide evidence for selenium's effect on the growth of normal cartilage cells. Methods The articular cartilage samples of grade Ⅱ and Ⅲ KBD patients were selected according to the national "Clinical Diagnosis of KBD" (GB 16003-1995). Chondrocytes of 5 KBD and 5 non-endemic normal accidentswere separated and cultured in vitro. KBD group and control group were given different doses of selenium (0,0.0125,0.0250,0.0500,0.1000,0.2500,0.5000,1.0000 mg/L, respectively). Methyl thiazolyl tetrazolium (MTT),flow cytometric analysis, and immunocytochemical staining were used to observe the effect of selenium on cell growth and apoptosis in KBD and normal persons. Results MTT results showed that the cell proliferation rate in each dosage group of the control group at the 6th day(0.086 ± 0.025,0.077 ± 0.012,0.073 ± 0.027,0.071 ± 0.017,0.058 ± 0.028,0.052 ± 0.028 and 0.046 ± 0.037) was significantly lower than that of 0 mg/L group(0.138 ± 0.026,all P ＜ 0.05);the average cell proliferation rate was negative( - 0.001 ± 0.001, - 0.003 ± 0.000, - 0.003 ± 0.001and - 0.004 ± 0.001 ) in 0.1000 - 1.0000 mg/L dose group, which was significantly lower than that of the 0 mg/L group(0.025 ± 0.003, all P ＜ 0.05);compared with 0 mg/L group(0. 115 ± 0.011), the KBD 0.2500 mg/L dose group promoted cell proliferation(0.128 ± 0.037, P ＜ 0.05), the KBD 1.0000 mg/L dose group inhibited cell growth (0.071 ± 0.019, P ＜ 0.05). The apoptotic rate of 0.0500 - 1.0000 mg/L dose control group [ (18.88 ± 0.02)%,(17.58 ± 0.01)%, (17.09 ± 0.04)%, (56.00 ± 0.02)%, (57.85 ± 0.03)% ] were higher than that of the 0 mg/L group[(13.51 ± 0.01)%, all P ＜ 0.05];compared with 0 mg/L group[(25.84 ± 0.02)%], the apoptotic rate in KBD 0.0250 - 0.2500 mg/L dose group [ ( 13.69 ± 0.02) %, ( 15.96 ± 0.03 ) %, ( 16.68 ± 0.03 ) %, ( 16.67 ± 0.02) % ]were lower, and the apoptotic rate in 0.5000, 1.0000 mg/L dose group [ (59.58 ± 0.03)%, (73.48 ± 0.04)% ] were significantly higher(all P ＜ 0.05). The Fas expression in KBD 0.0500 - 0.2500 mg/L dose groups[ (41.2 ± 1.5)%,(40.3 ± 2.0)%, (50.2 ± 2.5)%] were lower than those of the same dose control group with selenium intervention [(52.4 ± 1.0)%, (67.2 ± 4.0)%, (75.1 ± 5.0)%, all P ＜ 0.05], the caspase-3 expression in KBD 0.0500,0.1000 mg/L dose groups[ (40.8 ± 1.1 )%, (45.1 ± 2.1 )%] were lower than those of the same dose control group with selenium intervention[ (68.0 ± 3.0)%, (70.6 ± 3.5)%, all P ＜ 0.05 ]. Conclusions Appropriate dose of selenium supplementation (0.1000 - 0.2500 mg/L) could promote the growth of KBD chondrocyte, decrease cell apoptosis,but have a damage when the dose of selenium ＞ 0.5000 mg/L;doses of selenium that could promote the growth of KBD chondrocyte does not mean to promote the growth of normal cartilage cells in vivo.

ObjectiveTo investigate the prevalence of nutritional risk and perioperative nutritional support status in the gastrointestinal cancer surgical patients.Methods Adult inpatients from the gastrointestinal cancer surgery department of our hospital were consecutively enrolled from May to September 2010.Nutritional Risk Screening 2002 ( NRS 2002) was performed at admission,and data of the nutritional support and complications during hospitalization were collected.The relationship between nutritional risk and postoperative complications was analyzed.ResultsA total of 195 patients were eligible.At admission,43.6％ (85/195) patients were at riskOf the patients at risk,totally 11.7％ (10/85) patients received preoperative nutritional support,and 100％ (85/85) patients received postoperative nutritional support; of the patients not at risk,no patients received preoperative nutritional support,and 84.5％ (93/110) patients received postoperative nutritional support.The overall rates of postoperative complications were 19.1％ ( 13/68 ) in the patients at risk while 7.1％ (9/127 )in the patients not at risk ( P =0.02).ConclusionsNutritional risk in gastrointestinal cancer surgical patients was high.The application of nutritional support was inappropriate in these patients.The nutritional risk is associated with higher postoperative complications.Dissemination of evidence-based guidelines should be enhanced.

ObjectiveTo evaluate magnesium sulfate and compound polyethylene glycol electrolyte in bowel preparation before capsule endoscopy.MethodsA total of 81 patients were randomly divided into two groups.Group A (n =41 ) received compound polyethylene glycol electrolyte,and group B (n =40) received magnesium sulfate combined with compound polyethylene glycol electrolyte. Positive detection rate,intestinal preparation score,the incidence of capsule retention and solution quality,liver and kidney function were compared between those two groups.ResultsThe positive detection rates of capsule endoscopy were 65.9％ (27/41) in group A and 62.5％ (25/40) in group B,which were nonsignificantly different (x2 =0.099,P ＞ 0.05).The intestinal preparation scores of 19 patients in group A were ≤4 and those of 22 patients were ≥6,while those of 28 patients in group B were ≤4 and of 12 patients were ≥6,which were significantly different (x2 =4.653,P ＜ 0.05). The rates of capsule retention of group A and B were 2.4％( 1/41 ) and 5.0％ (2/40) respectively,which were not significantly different (x2 =0.372,P ＞ 0.05 ).Obvious abdominal pain,nausea or vomitting occurred in no patients of the two groups.There was no difference in electrolyte level or liver and kidney function between those two groups (P ＞ 0.05 ).ConclusionMagnesium sulfate combined with compound polyethylene glycol electrolyte is applicable for the bowel preparation before capsule endoscopy.

Background and purpose: Cervical nodal metastasis in nasopharyngeal carcinoma plays an important role in the definition of radiotherapy area and clinical staging, it is also one of the main factors influencing prognosis. So this study was designed to explore the pattern of metastatic lymph nodes for patients with nasopharyngeal carcinoma, which may provide a basis for clinical treatment and research. Methods: From Jun. 2005 to Sep. 2007,779 histologically diagnosed nasopharyngeal carcinoma patients had routine MRI scan before radiation therapy at Fujian Provincial Cancer Hospital. Diagnostic radiologists and radiation oncoiogists together assessed the nodal distribution according to the guideline CT-hased delineation of lymph node levels. Then, Chi-sqnare test was used to analyze the correlation between T stage and nodal metastasis rate and between nodal diameter and nodal extracapsular invasion. Results: Of 779 patients, 592(76.0%) had nodal involvement. The distribution was as follows: 1 in level Ⅰ,384 in level Ⅱa, 499 in level Ⅱ_b, 184 in level Ⅲ, 33 in level Ⅳ, 67 in level V_a, 21 in level V_b, 597 in retropharynx.In these patients, a total of 1 479 postive nodes, including 973 (65.79%) extracapsular spread nodes, were detected.The rate of nodal extracapsular invasion was higher when the axial diameter increased. Leap metastasis rate was 1.0%. No significant correlation was found between T stage and nodal involvement. Conclusion: The level Ⅱ and retropharyngeal node were the most frequently involved regions, they had similar metastatic rate and were both the first echo node to metastases of nasopharyngeal carcinoma. Level Ⅰ metastasis was lower. The proportion of extracapsular spread of metastatic lymph nodes increased with axial diameter of lymph nodes-dependent. The cervical node involvement of nasopharyngeal carcinoma was spread orderly down the neck, and the incidence of skip metastasis is rare. The relationship between T stage and nodal involvement has no statistical significance.

Objective To carry out a comparative study between the Chinese 2008 and'92 staging system of nasopharyngeal carcinoma (NPC). Methods A total of 777 patients presented with untreated nondisseminated NPC who had received MRI scan of nasopharynx and neck were studied retrospectively. The clinical materials and information of imaging were collected. All patients were restaged according to the Chinese 2008 and 92 staging system of nasopharyngeal carcinoma. Distribution of T, N stage, survival and prognostic value were compared. 513 patients of the 777 cases were treated with conventional radiotherapy,264 cases with intensity modulated radiation therapy. Results The 3-year follow-up rate was 97.6%. The consistency of T stages was 95.0%. T, N and clinical stage distributions in two systems were similar ( Kappa = 0. 93, P = 0. 000; Kappa = 0. 58, P = 0. 000; Kappa = 0. 74, P = 0. 000). Local failure-free survival and disease specific survival were also similar. There was no difference of distant metastasis between N0 and N1(x2 = 1.94,P=0. 164), and a marginal difference between N1 and N2(x2 =3.83,P=0.051) in the Chinese'92 staging system. However, although there was also no difference of distant metastasis-free survival between No and N1a(x2 =0. 07,P =0. 797), ) the difference of overall survival among N1b, N2, and N3 were significant ( x2 = 4. 95, P = 0. 026; x2 = 6. 74, P = 0. 009) in the Chinese 2008 staging system. Conventional radiotherapy or intensity modulated radiation therapy was not a prognostic factor for survival ( x2 = 3.60,P =0. 058). It is reasonable for the Chinese 2008 staging system integrated lymph node characteristics such as laterality, level and extranodal neoplastic spread into the N staging criteria ( x2 = 6. 59, P = 0. 010; x2 =4.78,P=0. 029;x2=9.32,P=0. 002). Conclusions For the Chinese 2008 staging system, it was reasonable to simplify the previous T stage. The N stage showed a better predictive role of distant failure.The role of retropharyngeal lymph node in stage system needs further investigation.

Objective To explore the association between fibrinogen gene polymorphism(rs1049636) and serum γ′ fibrinogen level and ischemic stroke (IS) .Methods 421 IS patients and 421 age‐and gender‐ matched healthy controls ,including 283 males and 138 females ,were recruited in this assay .The plasma γ′fibrinogen concentration was measured by enzyme‐linked immunosor‐bent assay (ELISA) .Fibrinogen gene polymorphism(rs1049636) were genotyped by using PCR‐LDR assay .Results γ′fibrinogen concentrations in IS patients[(159 .4 ± 97 .4)U/dL] were significantly higher than that in control group[(114 .2 ± 73 .0)U/dL] with statistically significant difference(P<0 .001) .Single nucleotide polymorphism(SNP) analysis showed that rs1049636 C allele was significantly associated withγ′fibrinogen level ,but not associated with increased risk of IS(P=0 .077) .Conclusion An associ‐ation between increasedγ′fibrinogen level and IS existed in Chinese Han population .However ,no association between rs1049636 C allele and IS risk was observed in our study .

Objective To explore the relative factors of unstable plaques of carotid atherosclerosis in ischemic eerebrovascular patients.Methods Carotid arteries of a total of 132 cases with ischemic cerebrovascular disease of carotid artery system were inspected by color Doppler ultrasound.The plaques discovered were classified according to ultrasonic appearance and their stability was judged.The relation between hypertension,diabetes,hyperlipemia, smoking and unstable plaques of carotid atheroselerosis was analyzed.Results The most common site of plaque for- mation was the bifurcate of the common carotid artery(56.99%),and the second commonest was carotid artery (23.12%).The incidence of unstable plaques in the patients with smoking,hypertension and diabetes was higher than those without them(P