Objective To investigate the diagnostic value of endoscopic ultrasonography(EUS)and contrast-enhanced endoscopic ultrasonography(CE-EUS)with sulfur hexafluoride microbubbles for injection in upper gastrointestinal submucosal tumors(SMT).Methods The subjects of this study were 82 upper gastrointestinal SMT patients from January 2021 to August 2023.All of them underwent EUS and CE-EUS using sulfur hexafluoride microbubbles as contrast agents.Features of EUS images of upper gastrointestinal benign SMT and gastrointestinal stromal tumor(GIST),and CE-EUS images using sulfur hexafluoride microbubbles as contrast agents were analyzed.EUS,CE-EUS using sulfur hexafluoride microbubbles as contrast agents,and combination of the two were compared in upper gastrointestinal benign SMT and GIST diagnosis based on surgical pathological findings as the golden standard.Results 82 cases of upper gastrointestinal SMT were confirmed by imaging examination and surgical results to have tumors located in the upper,middle,lower segments esophagus,cardia,fundus,body,antrum of stomach,and duodenal bulb,accounting for 7.32%,10.98%,10.98%,4.88%,29.27%,26.83%,6.10%,and 3.66%respectively.According to pathological results,there were 51 cases of upper gastrointestinal benign SMT,accounting for 62.20%and 31 cases of GIST,accounting for 37.80%.Among them,SMT in the upper gastrointestinal tract was mainly located in the esophagus and stomach,with leiomyoma being the most common.GIST was mainly located in the stomach and was more common in the fundus and body of the stomach.The proportion of benign SMT group with uniform echo,smooth surface mucosa,and regular edges was significantly higher than that of GIST group(P＜0.05).GIST group had much higher proportion in doppler rich blood flow signals and origination from the muscularis propria than benign SMT group did(P＜0.05).There was no difference between the two groups in terms of proportion of echo properties(P＞0.05).The proportion of homogeneous enhancement in the benign SMT group was significantly higher than that in the GIST group(P＜0.05).The proportion of arterial phase hyperenhancement,venous phase diffuse enhancement,and irregular blood vessels in the GIST group was significantly higher than that in the benign SMT group(P＜0.05).The sensitivity,specificity,and accuracy of EUS in distinguishing GIST and benign SMT were 64.52%,74.51%,and 70.73%respectively,those of the CE-EUS using sulfur hexafluoride microbubbles as contrast agent were 90.32%,88.24%,and 89.02%respectively,and those of EUS+CE-EUS using sulfur hexafluoride microbubbles as contrast agent were 100.00%,90.20%,and 93.90%respectively.Conclusion EUS and CE-EUS with sulfur hexafluoride microbubbles as contrast agents has high diagnostic value for upper gastrointestinal benign SMT and GIST.

BACKGROUND:Eupatilin,a flavonoid active component derived from Artemisia sinensis,has been reported to relieve inflammation and improve neurological scores in rats with subarachnoid hemorrhage,but its role and mechanism in learning and memory remain unclear.OBJECTIVE:To investigate the effects of eupatilin on learning and memory abilities and P38 mitogen activated protein kinase(p38 MAPK)/signal transducer and activator of transcription-3(STAT3)pathway proteins in rats with subarachnoid hemorrhage.METHODS:A total of 50 Sprague-Dawley rats were randomly divided into sham surgery group,model group,eupatilin group,hesperetin group,eupatilin+hesperetin group,with 10 rats in each group.Except for the sham surgery group,the rats in the other groups were used to construct a subarachnoid hemorrhage model through intravascular perforation.Two hours after successful modeling,the eupatilin group was injected with 10 mg/kg eupatilin via the tail vein,the hesperetin group was injected with 50 mg/kg hesperetin(p38 MAPK/STAT3 signaling pathway activator)via the tail vein,the eupatilin+hesperetin group was injected with 10 mg/kg eupatilin and 50 mg/kg hesperetin via the tail vein,and the sham surgery group and the model group were injected with 10 mL/kg saline via the tail vein.The drug treatment lasted for 24 hours.The neurologic deficit score and Morris water maze experiment were applied to detect the neurological function and learning and memory abilities of rats.Hematoxylin-eosin staining was performed to detect the histopathological changes of the hippocampus.TUNEL method was used to detect neuronal apoptosis.Immunohistochemical staining was conducted to detect the number of doublecortin-positive cells in hippocampal tissue.Western blot was applied to detect the expression of p38 MAPK/STAT3 protein in hippocampal tissue.RESULTS AND CONCLUSION:Compared with the sham surgery group,rats in the model group had lower neurological deficit scores,learning and memory abilities,and number of doublecortin-positive cells(P<0.05),and higher neuronal apoptosis rate and protein expression of p-p38 MAPK/p38 MAPK and p-STAT3/STAT3(P<0.05).Compared with the model group,rats in the eupatilin group showed higher neurological deficit scores,learning and memory abilities,and number of doublecortin-positive cells(P<0.05),and lower neuronal apoptosis rate and protein expression of p-p38 MAPK/p38 MAPK and p-STAT3/STAT3(P<0.05),while those in the nerolone group showed lower neurological deficit scores,learning and memory abilities,and number of doublecortin-positive cells(P<0.05),and higher neuronal apoptosis rate and protein expression of p-p38 MAPK/p38 MAPK and p-STAT3/STAT3(P<0.05).Compared with the eupatilin group,rats in the eupatilin+hesperetin group had lower neurological deficit scores,learning memory abilities,and number of doublecortin-positive cells(P<0.05),and higher neuronal apoptosis rate and protein expression of p-p38 MAPK/p38 MAPK and p-STAT3/STAT3(P<0.05).Hematoxylin-eosin staining showed that compared with the model group,the nerve cells were more neatly arranged in the eupatilin group,disorganized in the hesperetin group,and arranged in a similar way to the model group in the eupatilin+hesperetin group.To conclude,eupatilin may improve learning and memory abilities of rats with subarachnoid hemorrhage by inhibiting the p38 MAPK/STAT3 signaling pathway.

BACKGROUND:Eupatilin,a flavonoid active component derived from Artemisia sinensis,has been reported to relieve inflammation and improve neurological scores in rats with subarachnoid hemorrhage,but its role and mechanism in learning and memory remain unclear.OBJECTIVE:To investigate the effects of eupatilin on learning and memory abilities and P38 mitogen activated protein kinase(p38 MAPK)/signal transducer and activator of transcription-3(STAT3)pathway proteins in rats with subarachnoid hemorrhage.METHODS:A total of 50 Sprague-Dawley rats were randomly divided into sham surgery group,model group,eupatilin group,hesperetin group,eupatilin+hesperetin group,with 10 rats in each group.Except for the sham surgery group,the rats in the other groups were used to construct a subarachnoid hemorrhage model through intravascular perforation.Two hours after successful modeling,the eupatilin group was injected with 10 mg/kg eupatilin via the tail vein,the hesperetin group was injected with 50 mg/kg hesperetin(p38 MAPK/STAT3 signaling pathway activator)via the tail vein,the eupatilin+hesperetin group was injected with 10 mg/kg eupatilin and 50 mg/kg hesperetin via the tail vein,and the sham surgery group and the model group were injected with 10 mL/kg saline via the tail vein.The drug treatment lasted for 24 hours.The neurologic deficit score and Morris water maze experiment were applied to detect the neurological function and learning and memory abilities of rats.Hematoxylin-eosin staining was performed to detect the histopathological changes of the hippocampus.TUNEL method was used to detect neuronal apoptosis.Immunohistochemical staining was conducted to detect the number of doublecortin-positive cells in hippocampal tissue.Western blot was applied to detect the expression of p38 MAPK/STAT3 protein in hippocampal tissue.RESULTS AND CONCLUSION:Compared with the sham surgery group,rats in the model group had lower neurological deficit scores,learning and memory abilities,and number of doublecortin-positive cells(P<0.05),and higher neuronal apoptosis rate and protein expression of p-p38 MAPK/p38 MAPK and p-STAT3/STAT3(P<0.05).Compared with the model group,rats in the eupatilin group showed higher neurological deficit scores,learning and memory abilities,and number of doublecortin-positive cells(P<0.05),and lower neuronal apoptosis rate and protein expression of p-p38 MAPK/p38 MAPK and p-STAT3/STAT3(P<0.05),while those in the nerolone group showed lower neurological deficit scores,learning and memory abilities,and number of doublecortin-positive cells(P<0.05),and higher neuronal apoptosis rate and protein expression of p-p38 MAPK/p38 MAPK and p-STAT3/STAT3(P<0.05).Compared with the eupatilin group,rats in the eupatilin+hesperetin group had lower neurological deficit scores,learning memory abilities,and number of doublecortin-positive cells(P<0.05),and higher neuronal apoptosis rate and protein expression of p-p38 MAPK/p38 MAPK and p-STAT3/STAT3(P<0.05).Hematoxylin-eosin staining showed that compared with the model group,the nerve cells were more neatly arranged in the eupatilin group,disorganized in the hesperetin group,and arranged in a similar way to the model group in the eupatilin+hesperetin group.To conclude,eupatilin may improve learning and memory abilities of rats with subarachnoid hemorrhage by inhibiting the p38 MAPK/STAT3 signaling pathway.

Objective To investigate the diagnostic value of endoscopic ultrasonography(EUS)and contrast-enhanced endoscopic ultrasonography(CE-EUS)with sulfur hexafluoride microbubbles for injection in upper gastrointestinal submucosal tumors(SMT).Methods The subjects of this study were 82 upper gastrointestinal SMT patients from January 2021 to August 2023.All of them underwent EUS and CE-EUS using sulfur hexafluoride microbubbles as contrast agents.Features of EUS images of upper gastrointestinal benign SMT and gastrointestinal stromal tumor(GIST),and CE-EUS images using sulfur hexafluoride microbubbles as contrast agents were analyzed.EUS,CE-EUS using sulfur hexafluoride microbubbles as contrast agents,and combination of the two were compared in upper gastrointestinal benign SMT and GIST diagnosis based on surgical pathological findings as the golden standard.Results 82 cases of upper gastrointestinal SMT were confirmed by imaging examination and surgical results to have tumors located in the upper,middle,lower segments esophagus,cardia,fundus,body,antrum of stomach,and duodenal bulb,accounting for 7.32%,10.98%,10.98%,4.88%,29.27%,26.83%,6.10%,and 3.66%respectively.According to pathological results,there were 51 cases of upper gastrointestinal benign SMT,accounting for 62.20%and 31 cases of GIST,accounting for 37.80%.Among them,SMT in the upper gastrointestinal tract was mainly located in the esophagus and stomach,with leiomyoma being the most common.GIST was mainly located in the stomach and was more common in the fundus and body of the stomach.The proportion of benign SMT group with uniform echo,smooth surface mucosa,and regular edges was significantly higher than that of GIST group(P＜0.05).GIST group had much higher proportion in doppler rich blood flow signals and origination from the muscularis propria than benign SMT group did(P＜0.05).There was no difference between the two groups in terms of proportion of echo properties(P＞0.05).The proportion of homogeneous enhancement in the benign SMT group was significantly higher than that in the GIST group(P＜0.05).The proportion of arterial phase hyperenhancement,venous phase diffuse enhancement,and irregular blood vessels in the GIST group was significantly higher than that in the benign SMT group(P＜0.05).The sensitivity,specificity,and accuracy of EUS in distinguishing GIST and benign SMT were 64.52%,74.51%,and 70.73%respectively,those of the CE-EUS using sulfur hexafluoride microbubbles as contrast agent were 90.32%,88.24%,and 89.02%respectively,and those of EUS+CE-EUS using sulfur hexafluoride microbubbles as contrast agent were 100.00%,90.20%,and 93.90%respectively.Conclusion EUS and CE-EUS with sulfur hexafluoride microbubbles as contrast agents has high diagnostic value for upper gastrointestinal benign SMT and GIST.

Endoscopic data of 108 upper gastrointestinal elevated lesions caused by vascular or hemangioma compression by endoscopic ultrasonography (EUS) at the Second Affiliated Hospital of Soochow University, Changshu No.1 People's Hospital, Kushan Hospital of Chinese Medicine and Traditional Chinese Medicine Hospital of Changshu from December 2010 to June 2019 were retrospectively summarized. The results showed that lesions were mainly located in the esophagus [50.9% (55/108)] and stomach [47.2% (51/108)], especially in the middle [40.0% (22/55)] and upper esophagus [36.4% (20/55)], body [66.7% (34/51)] and fundus of stomach [31.4% (16/51)], respectively. The major etiology included splenic artery and aneurysm compression [29.6% (32/108)], aortic compression [23.1% (25/108)], isolated esophageal venous aneurysm compression [13.9% (15/108)] and gastric submucosal vein and venous aneurysm compression [12.0% (13/108)], with diverse endoscopic presentation. The above results suggest that elevated lesions of upper gastrointestinal tract caused by blood vessels and hemangiomas are mostly due to external vascular pressure outside the lumen, but ectopic submucosal arteries and isolated phlebangioma are not uncommon. The lesions are widely distributed with different gastroscopic manifestations. EUS is important for definite diagnosis, and can be combined with color Doppler technique, CT plain scan and angiographic reconstruction if necessary.

Objective To compare the diagnostic value of ultrasound,molybdenum target,magnetic resonance(MRI)and single examination for breast cancer.Methods From January 2017 to February 2018,100 patients with suspected breast cancer in Lishui Central Hospital were selected in the study.All patients were detected by ultrasound,mammography and MRI three ways for diagnosis.The results were verified with postoperative pathologic results as the standard.The diagnosis accuracy of three ways for breast cancer were analyzed.Results The detection accuracy of three ways joint detection in patients with breast cancer was the highest(91.00％),which was significantly higher than that of ultrasound(63.00％),mammography(72.00％)and MRI(72.00％)in single mode,the differences were statistically significant(χ2 =22.364,20.154,16.032,all P<0.05).Conclusion Ultrasonography,molybdenum target X ray and MRI have their respective advantages in the process of breast cancer differentiation and diagnosis,and the detection rate can be significantly improved if combined use.

BACKGROUND: The emergence of fosfomycin resistance and extended-spectrum β-lactamase (ESBL) genes is a serious threat to public health and a new challenge in shigellosis treatment. The purpose of this study was to identify fosfomycin resistance and characterize β-lactamase genes in fos-carrying isolates of Shigella flexneri from patients in China. METHODS: A total of 263 S. flexneri isolates were collected from 34 hospitals in the Anhui Province of China during September 2012-September 2015 and screened for fosA3, fosA, and fosC2 by PCR amplification and sequencing. The fos-carrying isolates were then screened for β-lactamase genes. The clonal relationships between fosA3-carrying isolates, the transmissibility of fosfomycin resistance, replicon types of plasmids carrying fosfomycin resistance genes and other associated resistance genes were investigated. RESULTS: Twenty-five of the 263 isolates (9.5%) showed resistance to fosfomycin, and 18 (6.8%) were positive for fosA3. None of the isolates was positive for fosA or fosC2. Seventeen of the isolates carrying fosA3 (94%) were CTX-M producers (seven CTX-M-55, five CTX-M-14, and five CTX-M-123), while three (16.7%) were TEM producers (TEM-1).Sixteen (88.9%) fosA3-carrying isolates exhibited multi-drug resistance. The replicon types of the 13 fosA3-carrying plasmids were IncF (n=13), IncHI2 (n=3), IncIl-Ir (n=2), and IncN (n=1). CONCLUSIONS: Our results indicated that fosA3 could spread through plasmids in S. flexneri isolates, along with the bla(CTX-M) and bla(TEM), which facilitate its quick dispersal. To the best of our knowledge, this is the first report of CTX-M-123-type ESBLs in S. flexneri isolates from patients in China.
China* ; Drug Resistance, Multiple ; Dysentery, Bacillary ; Fosfomycin* ; Humans ; Plasmids ; Polymerase Chain Reaction ; Public Health ; Replicon ; Shigella flexneri* ; Shigella*

No abstract available.
Aged ; Anti-Bacterial Agents/*pharmacology ; Bacterial Proteins/genetics ; Drug Resistance, Bacterial/*genetics ; Fluoroquinolones/*pharmacology ; Humans ; Male ; Microbial Sensitivity Tests ; Mutation ; Serratia Infections/*diagnosis/microbiology ; Serratia marcescens/*drug effects/genetics/isolation & purification

Objective To evaluate the clinical value of double-balloon enteroscopy( DBE)in as-sessing the effect of mucosal healing in patients with moderate small bowel Crohn's disease( CD)treated with low-dose azathioprine. Methods CD patients who were naive to any immunomodulators or biological a-gents with lesions mainly located in ileu were screened by multislice CT enterography and anal-route DBE at baseline. Lesions at 150 cm proximal to ileocecal valve were assessed by DBE with Simple Endoscopic Score for CD( SES-CD)after 12 and 24 months of low-dose azathioprine treatment,respectively. Results A total of 36 patients were enrolled and the average tolerated dose of azathioprine was(61. 8 ± 17. 2)mg/day. The total rates of complete,near-complete,partial and no mucosal healing in 36 patients were 19. 4%(7/36), 5. 6%(2/36),27. 8%(10/36),and 47. 2%(17/36)at month 12 and 30. 6%(11/36),25. 0%(9/36), 33. 3%(12/36),and 11. 1%(4/36)at month 24,respectively. The baseline SES-CD score(OR=2. 71, 95%CI:1. 11-6. 63,P=0. 029)and duration of disease(OR=1. 27,95%CI:1. 10-1. 47,P =0. 001) were two relevant factors associated with mucosal healing of small bowel CD. Conclusion DBE has a signif-icant advantage in assessing post-therapy mucosal healing for patients with small bowel CD. The optimal time point for the first follow-up by DBE is at least 12 months after low-dose azathioprine treatment.

Objective To investigate the role of double-balloon enteroscopy (DBE) in the evolution of detection and surgical treatment of small bowel stromal tumors (SBSTs),based on nine years experience.Methods In this retrospective study,193 patients with localized SBSTs were divided into the CT-enterography (CTE) and/or DBE group (n =100) and conventional modalities group (n =93).These patients were further divided into the open surgery group (n =126) and laparoscopy-assisted resection group (n =67).The development of clinical diagnosis and surgical treatment strategies were compared before and after the introduction of DBE.Results The average age and tumor size were significantly smaller in the CTE and/or DBE group than those in the conventional modalities group,respectively (age:50.9 ± 12.1 vs.56.9 ± 11.6 years; tumor size:3.6 ± 1.3 vs.6.1 ± 2.6 cm,P ＜ 0.01).Before the introduction of DBE (from January 2001 to December 2002),all patients underwent conventional modalities,and only 4 cases/year for open surgery.Afterward,from January 2003 to December 2004,84.6％ (11/13) of SBSTs were detected by DBE.From January 2005 to December 2008,50.0％ (23/46) of SBSTs were found by CTE combination with DBE.From January 2009 to December 2011,80.5％ (33/41) of SBSTs were diagnosed by CTE,and the number of patients underwent operation increased up to 25 cases/year,which was nearly 5.3 folds higher than that before the introduction of DBE.Sixty-seven patients were successfully operated by laparoscopy-assisted resection,82.1％ (55/67) of them were detected by CTE ands/or DBE,89.1％ (49/55) of whom had low-or intermediate-risk SBSTs.Conclusion DBE plays an important role in optimizing the algorithm of detection and treatment of SBSTs.