Superficial esophageal carcinoma(SEC)has traditionally been treated with endoscopic therapy and surgery.Surgical procedures have always been the standard approach for the management of esophageal tumors,but they are associated with high perioperative morbidity and mortality.In recent years,endoscopic submucosal dissection(ESD)has made significant advancements,offering an effective diagnostic and therapeutic modality for SEC.This article reviewed the comparison of therapeutic efficacy between ESD and surgery for SEC,and discussed the treatment strategies for SEC that extended beyond the indications for ESD,with the aim of enhancing clinicians'understanding of SEC management.

Objective:To investigate the current status of diagnosis and treatment of Helicobacter pylori ( H. pylori) infection in primary hospitals in Jiangsu Province, and to evaluate the capability of comprehensive prevention and management of H. pylori infection in the primary hospitals. Methods:From 2020 to 2022, a questionnaire survey was conducted among 430 primary hospitals, which participated in the Incubation Center Project of Primary Gastroenterology Specialty Department in Jiangsu Province. The questionnaire survey includedthe establishmment of endoscopy and department of gastroenterology, items of H. pylori detection, H. pylori treatment, eradication plans and treatment course. The questionnaire was filled by the director of the primary hospital. Descriptive analysis was used for statistical analysis. Results:A total of 413 valid questionnaires were received. Among the 413 primary hospitals, 286 (69.2%) were equipped with endoscopy centers, and 202 (48.9%) had departments of gastroenterology. In terms of diagnostic methods for H. pylori, 35.8% (148/413) of the primary hospitals did not have urea breath test equipment, of which 84 hospitals did not carry out any H. pylori testing items, 8 hospitals only had rapid urease test, 45 hospitals only had serum H. pylori antibody test, 7 hospitals had both rapid urease test and serum H. pylori antibody test, and 4 hospitals had fecal H. pylori antigen test. In terms of therapeutic drugs, all the hospitals could provide proton pump inhibitors, and 82.8% (342/413) of the hospitals had bismuth agents. According to diagnosis and treatment guideline for H. pylori infection at the primary care, 7 combinations of two antibiotics were recommended. A total of 14 (3.4%) hospitals could provide all the combinations, 369 (89.3%)hospitals could provide 2 to 6 combinations, 20(4.8%)hospitals could provide only one combination, and 10 (2.4%) hospitals could not provide any combination. For the selection of the eradication scheme and treatment course, the bismuth-based quadruple scheme was chosen in 248 (60.0%) hospitals, 14-day course was selected in 363(87.9%) hospitals, and 14-day course of bismuth-based quadruple scheme was selected in 232 (56.2%) hospitals. Conclusion:Improving the H. pylori testing equipment in primary hospitals, preparing all types of therapeutic drugs, and improving doctors′ knowledge of diagnosis and treatment of H. pylori in are of great significance for improving the prevention and treatment efficacy of H. pylori infection at the primary hospitals.

Objective:To establish the quality evaluation method of Perillae caulis formula granules based on the three kind of quality indexes of standard decoction. Methods:Eighteen batches of Perillae caulis were collected from different habitats according to different technical requirements, eighteen batches of standard decoction and three batches of formula granules were prepared and the paste-forming rates were calculated. The content of Caffeic acid and Rosmarinic acid were determined and calculated by Ultra High Performance Liquid Chromatography (UPLC). Then the fingerprints of standard decoction of and formula granules of Perillae caulis were established by UPLC . The similarity values of fingerprints between formula granules and standard decoction were calculated. Results:The average paste-forming rate of standard decoction was (7.16±1.97)%. The paste-forming rates of three batches of formula granules were 5.52%, 5.25% and 5.34%, respectively. The average content of Caffeic acid and Rosmarinic acid in standard decoction was (12.06±3.37)mg/g. The contents of three batches of formula granules were 5.52, 5.82, 5.77 mg/g, respectively. Seven common fingerprint peaks were identified in the fingerprints of standard decoction and formula granules, three of which were identified as Caffeic acid, N-Feruloyl Octopus amine and Rosmarinic acid by comparison of reference substance. The fingerprints similarity of Perillae caulis dispensing granules and standard decoction were 1.000, 0.995 and 0.997, respectively. Conclusions:The quality indexes of three batches of formulation granules are consistent with standard decoction. This method can provide basis for the establishment of quality standard of Perillae caulis dispensing granules.

Objective To investigate the clinical value of tumor specific grow th factor(TSGF),neuron specific enolase(NSE),cytokeratin 19 fragment(CYFRA21-1),squamous cell carcinoma antigen(SCCAg)in the diagnosis of lung cancer.Methods 20 patients with lung cancer,42 patients with lung benign diseases and 54 healthy people undergoing the physical examination in this hospital from September 2014 to November 2016 were served as the lung cancer group,benign diseases group and healthy control group respectively.The Abbott microparticle chemiluminescence instrument was used to detect CYFRA21-1 and SCCA levels,the Roche electrochemical luminescence instrument was used to detect the NSE level and the TSGF level was de-tected by using the Olympus 5400 biochemical analyzer.Then the detection results were statistically analyzed. Results The levels of serum TSGF and NSE in the lung cancer group were higher than those in the lung be-nign diseases group and healthy control group,and the differences were statistically significant(P< 0.05). The serum CYFRA21-1 level of the lung benign disease group was higher than that in the healthy control group(P<0.05).The sensitivity and specificity of TSGF,NSE,CYFRA21-1 and SCCAg combined detection were 90.00% and 93.00% respectively.The area under the ROC curve was 0.959.Conclusion TSGF posses-ses wide spectrum marker characteristics,has a certain value for screening lung cancer,moreover its combined detection with NSE,CYFRA21-1 and SCCAg can increase the accuracy in diagnosis of lung cancer.

Objective To explore the early diagnosis and treatment for transplant renal artery stenosis (TRAS) through single-center retrospective study.Methods Clinical manifestation,laboratory tests and imaging data in 287 patients underwent renal transplantation in our center were analyzed retrospectively.Ultrasound parameters in TRAS patients and non-TRAS patients was compared to discover the thresholds of some CDUS parameters.Changes of ultrasound parameter and serum creatinine in TRAS patients and non-TRAS patients were compared.The changes of blood pressure and serum creatinine before and after percutaneous transluminal angioplasty (PTA) were observed.Results Totally 13 cases had TRAS in the 287 patients.Renal artery PSV ＞ 250 cm/s,interlobar artery resistance index (RI) ＜0.51,PSV ratio of the renal artery to the interlobar artery ＞ 10 were considered as the color doppler ultrasound (CDUS) diagnostic threshold.Symptomatic TRAS patients and asymptomatic TRAS patients were treated by PTA,and the serum creatinine and mean arterial pressure significantly decreased (P ＜ 0.05).Conclusion Monitoring renal allograft blood flow and clinical manifestation after renal transplantation is helpful for early diagnosis of TRAS in the postoperatively follow-up.Transplant renal artery PSV ＞ 250 cm/s,interlobar artery RI ＜ 0.51 and PSV ratio of the renal artery to the interlobar artery ＞ 10 can be considered as the CDUS diagnostic threshold.

Objective To explore the early diagnosis and treatment for transplant renal artery stenosis (TRAS) through single-center retrospective study.Methods Clinical manifestation,laboratory tests and imaging data in 287 patients underwent renal transplantation in our center were analyzed retrospectively.Ultrasound parameters in TRAS patients and non-TRAS patients was compared to discover the thresholds of some CDUS parameters.Changes of ultrasound parameter and serum creatinine in TRAS patients and non-TRAS patients were compared.The changes of blood pressure and serum creatinine before and after percutaneous transluminal angioplasty (PTA) were observed.Results Totally 13 cases had TRAS in the 287 patients.Renal artery PSV ＞ 250 cm/s,interlobar artery resistance index (RI) ＜0.51,PSV ratio of the renal artery to the interlobar artery ＞ 10 were considered as the color doppler ultrasound (CDUS) diagnostic threshold.Symptomatic TRAS patients and asymptomatic TRAS patients were treated by PTA,and the serum creatinine and mean arterial pressure significantly decreased (P ＜ 0.05).Conclusion Monitoring renal allograft blood flow and clinical manifestation after renal transplantation is helpful for early diagnosis of TRAS in the postoperatively follow-up.Transplant renal artery PSV ＞ 250 cm/s,interlobar artery RI ＜ 0.51 and PSV ratio of the renal artery to the interlobar artery ＞ 10 can be considered as the CDUS diagnostic threshold.

Objective To study the pathological changes and expressions of NO and iNOS mRNA in the lung tissue of traumatic hemorrhagic shock rats under dry heat environment of desert and their relations to the lung injury.Methods A total of 140 male SD rats were randomly (random number) ivided into the room temperature (25 ℃) environment traumatic hemorrhagic shock group (room temperature group) and the dry heat traumatic hemorrhagic shock groups (dry heat group,temperature 40℃,humidity 10％),respectively,and each groups was further randomly divided into 7 subgroups:the control subgroup,post shock subgroups at 0,0.5,1,1.5,2and 3 h (n =10 in each subgroup).The rats of control subgroup were not treated,and rats of dry heat group were placed in dry heat environment for 60 min,then anesthetized,fixed,and insertion of intravenous indwelling needles and catherization of right carotid artery,jugular vein and the right femoral artery were performed.After stabilization for 10 min,2500 g iron wheel was used to be dropped from 30 m height and vertically hit the upper left femoral of SD rats in order to make comminuted fracture,wounds were quickly dressed after injury.Exsanguination from right femoral artery was kept until MAP maintained at (35 ± 5) mmHg,and resuscitation was carried out after continue monitoring for 60 min.After the establishment of traumatic hemorrhagic shock model in each environment,the rats were sacrificed at given intervals,and thoracotomy was performed to take broncho-alveolar lavage fluid (BALF) and lung tissue.Pathological changes of lung tissues were observed by using HE staining and NO concentration of lung tissue was detected by one-step method,and changes of the iNOS mRNA expressions were detected by using fluorescence quantitative PCR.Then t test,ANOVA and Pearson correlation analysis were used for the data analysis.Results The pathological change in dry heat group at each interval was more severe,and pulmonary histopathological injury score was higher,and the protein exudation was more profuse compared with the room temperature group.NO concentration in lung tissue homogenate of dry heat group was higher than that of room temperature group (t =2.472,P ＜ 0.05),and the difference in NO level between different intervals within the dry heat group was statistically significant (F =6.77,P ＜ 0.01).The NO concentration in dry heat group reached its maximum at 2 h (3.35 ± 0.23) μmol / g and the peak value emerged sooner than that in room temperature group.The difference was statistically significant in overall expression of iNOS mRNA between two groups analyzed with t test (t =3.619,P ＜ 0.01),and there was statistically significant difference between intervals within the dry heat group (F =12.34,P ＜0.01).The values of iNOS mRNA in the dry heat group were higher than those in the room temperature group at the same given intervals,and the peak value appears at 1.5 h in dry heat group,and the room temperature group it began to increase at 2 h.The concentration of NO and the expression of iNOS mRNA were positively correlated with each other in two groups (r =0.680,r =0.376).The expression of iNOS mRNA and lung histopathological injury score was positively correlated in two groups (r =0.846,r =0.899).Conclusions When traumatic hemorrhagic shock occurred in the dry heat desert environment,the lung injury was more severe and appeared sooner than that in the room temperature environment.NO and iNOS played important roles in the secondary lung injury in the wake of traumatic hemorrhagic shock in rats under the dry heat environmengt of desert.

Une new flavonoids named as notabilisin K (1), together with four known compounds, morusin (2), mulberrofuran A (3), neocyclomorusin (4) and mornigrol F (5) are separated from 95% ethanol extracts of the twigs of Morus notabilis. Compounds 2-5 are separated from this plant for the first time. Notabilisin I, notabilisin J exhibits certain effect against cells of HCT-116, HepG2 and A2780 with IC50 values ranging from 1.47 μmol x L(-1) to 5.46 μmol x L(-1). Morusin exhibits strong effect against five kinds of human cancer cells (BGC823, A2780, HCT-116, HepG2 and NCI-H1650) with IC50 values ranging from 0.74 μmol x L(-1) to 1.58 μmol x L(-1).

Ten flavonoids were isolated from the 95% ethanol extract of the seeds of Alpinia galanga Willd. with a combination of various chromatographic techniques, including silica gel, Sephadex LH-20 and preparative HPLC. On the basis of spectroscopic data analysis, they were elucidated as (2R, 3S)-pinobaksin-3-cinnamate (1), (2R, 3R)-pinobaksin-3-cinnamate (2), pinocembrin (3), pinobaksin (4), 3-O-acetylpinobaksin (5), galangin (6), galangin-3-methylether (7), kumatakenin (8), 3-methylkaempferol (9) and (2R, 3R)-3, 5-dihydroxy-7-methoxyflavanone (10). Among them, compound 1 is a new compound, compounds 2, 5 and 10 were isolated from the genus Alpinia for the first time, and others were isolated from this plant for the first time.

Objective To investigate the possible mechanism that hepatocyte growth factor (HGF) inhibits renal tubular epithelial-mesenchymal transition (EMT),and to determine whether Smurf2 expression induced by TGF-β1 can be reversed by HGF in normal rat kidney epithelial cells (NRK-52E).Methods Using rat NRK-52E cell line as an in vitro system,NRK-52E cells were incubated with 5 μg/L TGF-β1 for 0-24 h.Part of cells were pretreated with 20 μg/L HGF for 30 min or not,then incubated with or without 5 μg/L TGF-β1 for 1 h or 48 h.The other cells were transfected with pFlag-Smurf2 or Smurf2 siRNA for 24 h,then treated with or without 20 μg/L HGF for 24 h.The expressions of Smurf2,SnoN,E-cadherin,alpha-smooth muscle actin (α-SMA) and fibronectin (FN) were detected by Western blotting and indirect immunofluorescence staining assays.Results Compared to normal control,TGF-β1 could rapidly induce Smurf2 protein expression in a short time (P＜0.01).Meanwhile,the expressions of FN and α-SMA were significantly induced,and the expression of E-cadherin was reduced in NRK-52E cells by TGF-β1.In contrast,in the NRK-52E cells pretreated with HGF,HGF could obviously inhibit Smurf2 expression induced by TGF-β1,and reversed the down-regulation of SnoN (P＜0.01) and E-cadherin (P＜0.05),the up-regulation of α-SMA (P＜0.01) and FN (P＜0.01) induced by TGF-β1.Moreover,overexpression of Smurf2 in NRK-52E cells could partly inhibit the up-regulation of SnoN protein by HGF,while down-regulation of Smurf2 could up-regulate the expression of SnoN induced by HGF.Conclusions HGF can abolish EMT induced by TGF-β1 in renal tubular epithelial cells through down-regulating Smurf2 expression and suppressing ubiquitin-proteasome dependent degradation of SnoN.