Objective To evaluate the feasibility, efficacy, and safty of endoscopic submucosal dissection (ESD) in treatment of uppergastrointestinal ectopic pancreas. Methods 36 uppergastrointestinal ectopic pancreas were treated with ESD from January 1 2012 to November 30 2014. The definitive histological diagnosis of ectopic pancreas was made after the endoscopic treatment. We analyzed the operation method, dissected tissue, complication, retrospec-tively. Results 34 cases were located in stomach, the other 2 in duodenum. All cases underwent ESD, the mean op-erating time was 66 min. The mean dissected tissue diameter was 21 mm × 16 mm in the 36 cases. The curative re-section rate was 100.00 %. Bleeding rate of ESD was 2.77 %(1/36). Perferation rate of ESD was 2.77 %(1/36). 2 cases suffered from low grade fever. None need surgical intervention. Recurrence rate was 0.00%. Conclusions ESD is a minimally invasive technique that allows resection of whole lesions and provides precise histological information, which is particularly suitable for uppergastrointestinal ectopic pancreas.

Aristolochic Acids ; adverse effects ; Child ; Drugs, Chinese Herbal ; adverse effects ; Female ; Humans ; Male ; Nephrosis ; chemically induced

Objective To evaluate the feasibility,safety and efficacy of ESD for precancerous lesions and early cancer of remnant stomach after partial gastrectomy.Methods ESD was performed in 11 cases of high grade intraepithelial neoplasia/early cancer of remnant stomach.The short-term and long-term indices including time of procedure,complication,En Bloc resection rate,R0resection rate,local recurrence rate as well as lymph node metastasis were recorded and analysed.Results ESD was completed in all patients with only one case of delayed massive bleeding which was controlled by endoscopy successfully.Average procedure time,En Bloc resection rate,R0 resection rate were 85.5 minutes,100％ and 90％,respectively.No local recurrence or lymph node metastasis was detected during post-ESD surveillance (15 ～ 51 months).Conclusion High grade intraepithelial neoplasia and early cancer of remnant stomach after partial gastrectomy might be indication for ESD because of its safety and definite effect.Additionally,careful management of the fibre tissue is the key to procedure success.

Objective To investigate the therapeutic efficacy and safety of endoscopic resection of giant gastric stromal tumors without explicit evidence of metastases.Methods A total of 12 giant gastric stromal tumors with no evidence of metastases diagnosed by endoscopic ultrasound (EUS) and computed tomography (CT) scan were managed by endoscopic resection.Operation time,blood loss and the incidence rate of perforation were recorded respectively.The diagnoses of tissue specimens were made by pathological examination and immunohistochemistry.In order to assess local recurrence and distant metastases,endoscopy and endoscopic ultrasound follow-up examinations were performed routinely at 2,6 and 12 months,and the whole abdominal CT scan was also performed at 12 months after operation.Results Endoscopic resections were successfully performed in 10 of 12 cases (83.3％),among which,6 underwent endoscopic submucosal excavation (ESE) without unexpected perforation and 4 endoscopic full-thickness resection (EFR)with intentional perforation.The rate of intentional perforation was 33.3％ (4/12),and all the perforations could be sealed by endoscopic methods.The blood losses were all more than 100 ml,which could be controlled by argon plasma coagulation,electrocoagulation or hemostatic clips.In the 10 encapsulated tumors,8 could be smoothly removed from esophagus,whose long diameter of the minimum cross section was less than 3.5 cm,however,2 tumors whose diameters were larger than 3.5 cm were taken out after segmentation.In the 10 tissue samples,9 were confirmed as low risk GIST,1 larger than 5 cm was pathologically confirmed as high risk GIST.During 1-year follow-up,no local recurrence or peritoneal metastasis was found.2 tumors,larger than 5.0 cm,could not be removed by endoscopic methods due to uncontrolled bleeding.The rate of uncontrolled bleeding was 16.7％ (2/12).The patients were transferred to surgery,and pathologically confirmed as having high risk GIST.Conclusion For low-risk giant gastric stromal tumors whose diameters were less than 5cm without evidence of metastases,endoscopic resection is considered as a safe and effective procedure.Tumors with long diameter of the minimum cross section less than 3.5 cm are more suitable for endoscopic resection,which can be smoothly taken out through cardia.However,for high-risk GIST larger than 5.0 cm,the rate of uncontrolled bleeding is high,so endoscopic resection should be adopted with discretion.

Fibrosis ; Hematoma, Subdural ; Humans ; Osteogenesis ; Subdural Space ; Tomography, X-Ray Computed

OBJECTIVETo investigate the correlation between four serum fibrosis markers and liver function in patients with infantile hepatitis syndrome (IHS), and to explore the clinical significance of these markers in the diagnosis of IHS and the assessment of disease severity.

METHODSA retrospective study was performed on 60 patients with IHS who were divided into hepatic fibrosis and normal groups based on ultrasound diagnosis. Levels of four liver fibrosis markers, i.e., hyaluronic acid (HA), type III procollagen (PC-III), type IV collagen (IV.C), and laminin (LN), were compared between the two groups, and the correlation between these markers and liver function was analyzed.

RESULTSLevels of liver function markers (alanine aminotransferase (ALT), glutamyl transpeptidase (GGT), total bilirubin (TBil), direct bilirubin (DBil), indirect bilirubin (IBil), and total bile acid (TBA)) in the hepatic fibrosis group were significantly higher than those in the normal group (P<0.05). Levels of HA and IV.C in the hepatic fibrosis group were significantly higher compared with those in the normal group (P<0.05). Furthermore, HA, IV.C, and PC-III levels were positively correlated with those of ALT, TBil, GGT, DBil, IBil, and TBA (r=0.25-0.49), and the strongest correlation existed between HA/IV.C and ALT/jaundice markers.

CONCLUSIONSAssay measuring serum fibrosis markers (HA, IV.C, and PC-III) in combination with liver function tests and ultrasound examination has an important clinical value in the early diagnosis of IHS and evaluation of disease severity.

Biomarkers ; blood ; Collagen Type III ; blood ; Collagen Type IV ; blood ; Female ; Hepatitis ; blood ; diagnosis ; physiopathology ; Humans ; Hyaluronic Acid ; blood ; Infant ; Laminin ; blood ; Liver ; physiopathology ; Liver Cirrhosis ; blood ; diagnosis ; Male ; Retrospective Studies ; Syndrome

OBJECTIVETo find out the status of human metapneumovirus (hMPV) infection in children under 14 years old with acute respiratory tract infections (ARI) in Guangzhou, analyze the epidemiology and clinical characteristics among the hMPV-infected children, and provide some basis for research of hMPV.

METHODSAll 521 throat and pharyngeal swabs were collected among the children with acute respiratory tract infections in outpatient departments and those admitted to the wards from September 2006 to August 2008. Then total nucleic acid was extracted from respiratory specimens. The 213 nucleosides of nucleoprotein gene were detected by RT-PCR and 16 strong positive samples were picked to compare with the sequence of hMPV in GenBank after the sequence of the amplification products were determined. Then applied statistical analysis to the data of the collected patients.

RESULTSAll 521 samples were detected by RT-PCR, and confirmed that N gene was positive in 39 samples with a detection rate of 7.49%, and the peak time was in October and April. The 16 amplification products were compared by using the analysis of gene sequence. The nucleocapsid protein (N) gene similarity to BJ1897 of Beijing was up to 99%, and to AY550156 of Thailand was up to 97%, genotype B was the most common genotype.

CONCLUSIONThere existed hMPV infection in children acute respiratory system diseases in Guangzhou areas, in which the children under the age of 6 years were accounted for the main group, however there was no difference in gender. The main symptoms of the patients with hMPV infection were high fever and cough symptom of catarrh. Co-infections other than respiratory virus with hMPV were detected as 41.03% of positive samples.

Adolescent ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Male ; Metapneumovirus ; genetics ; isolation & purification ; Molecular Sequence Data ; Nucleocapsid Proteins ; genetics ; RNA, Viral ; genetics ; Respiratory Tract Infections ; epidemiology ; virology

OBJECTIVETo investigate the significance of thyroid transcription factor-1 (TTF-1) in the histogenesis of pulmonary sclerosing hemangioma (PSH).

METHODSWith clinicopathologic data of 36 PSH patients obtained, all specimens were stained by immunohistochemical method with a panel of antibodies including TTF-1, SpA, CK, EMA, F-VIII, CD34, Claretinin, HBME, synaptophsin, chromogranin, actin and S-100.

RESULTSThe patients were mostly women with a mean age of 46.7 years and a median age of 48 years. All lesions were solitary and well circumscribed with a mean size of 3.3 cm and a median size of 3 cm. No multiple or metastasis was found. Surface cells (SC) and round cells (RC) were showed in PSH, with more than 90% showing TTF-1 and EMA by immunohistochemical method. CK and SpA were showed in SC, which were not showed in RC. Neuroendocrine cells scattered within RC of PSH were detected in a few cases. Mesothelial, vascular endothelial, neuroendocrine, and myoepithelial markers by immunohistochemical method were negative.

CONCLUSIONPulmonary sclerosing hemangioma, a benign tumor, originates from the alveolar pneumocytes. Its surface cells are more mature, while the round cells, being primitive respiratory epithelia, may undergo phenotypic differentiation and evolve into mucinous glands or neuroendocrine structure among other components.

Adult ; Aged ; Female ; Hemangioma ; metabolism ; pathology ; Humans ; Lung Neoplasms ; metabolism ; pathology ; Male ; Middle Aged ; Nuclear Proteins ; metabolism ; Sclerosis ; etiology ; Thyroid Nuclear Factor 1 ; Transcription Factors ; metabolism

OBJECTIVETo explore factors affecting occupational adaptability in nurses for offering basis to increase their occupational adaptability.

METHODSFive hundred and forty-five nurses were investigated with work ability index questionnaire and occupational stress instruments.

RESULTSThere were many risk factors affecting occupational adaptability in nurses. The main variables that influenced occupational adaptability included work-overtime, mental load, social support, physical environment, and job hazards. The social support was the factor increasing the occupational adaptability of the nurses (P < 0.01, OR = 0.912). Five factors including work overtime, mental load, social support, physical environment and job hazards were introduced in the Logistic equation. The established functions were: Logit (P) = -11.357 + 1.011x(1) + 0.335x(2) - 0.076x(3) + 0.260x(4) + 0.129x(5).

CONCLUSIONThere are many risk factors affecting occupational adaptability in nurses. Relevant measures should be taken to promote the occupational adaptability in nurses to reduce the risk factors.

Adaptation, Psychological ; Adolescent ; Adult ; Humans ; Logistic Models ; Middle Aged ; Nurses ; psychology ; Occupational Health ; Risk Factors ; Social Support ; Stress, Psychological ; epidemiology ; prevention & control ; Surveys and Questionnaires ; Workload ; psychology

Objective To explore the factors affecting the detection rate of colorectal polyps in repeated colonoscopy. Methods 400 patients from February 2016 to February 2017 were selected for repeated colonoscopy. Strict control of the objective factors in colonoscopy (endoscopic experience, endoscopic mode of operation, retraction time and the degree of intestinal cleaning, etc.), the number, size, shape, location and pathological types of polyps detected in the 400 randomly selected patients were compared between the two examinations, Logistic regression analysis was used to find the independent influencing factors of missed diagnosis. Results A relatively high missed rate could be happened in multiple polyps, small polyps ( ≤ 5 mm), stepless polyps, sigmoid polyps, transverse colon polyps and ascending colon polyps (all P < 0.05), and low missed rate in pathological types (P > 0.05). Logistic regression analysis showed that the number, size, shape and location of polyps were independent factors (all P < 0.05). Conclusion The number, size, shape and location of colorectal polyps are all important factors influencing the detection rate. With the advancement of clinical technology, it is possible to use the new technique to improve the detection rate of polyps.