Research progress in screening of early esophageal cancer in China / 中华胸心血管外科杂志

China is a country with high incidence of esophageal cancer. Precision screening and early diagnosis of esophageal cancer is the premise and key of precise treatment, and also an effective measure to improve the prognosis of esophageal cancer; The mode of combining key screening of high risk groups with screening of opportunistic individual, endoscopy assisted with iodine staining and indicative biopsy is feasible strategy and effective method to screen early esophageal cancer in the stage. Artificial intelligence and molecular biology technology is the research direction and has the development prospect.

Correlation between esophageal and gastric mucosal manifestations and Helicobacter pylori infection under white light gastroscopy / 中华消化内镜杂志

Objective:To investigate the correlation between morphology of esophageal and gastric mucosal and Helicobacter pylori ( HP) infection under white light gastroscope. Methods:A retrospective analysis was performed on data of 1 339 patients who underwent 13C-urea breath test and white light gastroscopy at the same time in the Southwest Hospital of Army Medical University from September 2018 to August 2019. Chi-square test or Fisher exact probability method was used to analyze the difference on detection rates of 22 indexes of gastroscopic mucosal manifestation between the HP infection group ( n=422) and the non-infection group ( n=917). Then the indexes with difference were further analyzed by binary logistic regression. The receiver operating characteristic (ROC) curve was drawn, and the area under the curve and the sensitivity, specificity, positive predictive value and negative predictive value of prediction of HP infection was calculated. Results:The diffuse redness, spotted redness, mucosal swelling, enlarged folds, sticky mucus, digestive tract ulcer, nodularity, hyperplastic polyp, xanthoma, atrophy, intestinal metaplasia, and depressive erosion were more common in patients with HP infection (all P<0.05). Binary logistic regression analysis showed that diffuse redness ( P<0.001, OR=75.974, 95% CI: 32.551-177.327), spotted redness ( P=0.002, OR=3.360, 95% CI: 1.536-7.349), mucosal swelling ( P<0.001, OR=3.150, 95% CI: 1.654-5.996) were independent risk factors for HP infection. ROC curve analysis showed that the area under ROC curve of diffuse redness, spotted redness, mucosal swelling, enlarged folds, sticky mucus, peptic ulcer, and depressive erosion predicting HP infection were all greater than 0.5 ( P<0.05), among which, the area under curve of diffuse redness, spotted redness and mucosal swelling predicting HP infection were greater than 0.7. The sensitivities corresponding to the three indicators were 0.735, 0.512, and 0.445, the specificities were 0.992, 0.983, and 0.971, the positive predictive values were 0.978, 0.931, and 0.874, and the negative predictive values were 0.890, 0.814, and 0.792, respectively. Conclusion:Morphological manifestations of esophageal and gastric mucosa, especially diffuse redness, spotted redness, and mucosal swelling, are excellent indicators for HP infection under white light gastroscopy.

Current status and research progress of precision diagnosis of pulmonary nodules in China / 中华胸心血管外科杂志

Pulmonary nodules are a manifestation of early lung cancer, trend of detection rate increased year by year. It is the perplex and challenge faced by thoracic surgeons. Early detection and accurate diagnosis can improve the cure rate and reduce the mortality rate of lung cancer. This article reviews the current situation and research progress of early screening and Precise diagnosis of pulmonary nodules in China.

Current status and research progress of precision diagnosis of pulmonary nodules in China / 中华胸心血管外科杂志

Pulmonary nodules are a manifestation of early lung cancer, trend of detection rate increased year by year. It is the perplex and challenge faced by thoracic surgeons. Early detection and accurate diagnosis can improve the cure rate and reduce the mortality rate of lung cancer. This article reviews the current situation and research progress of early screening and Precise diagnosis of pulmonary nodules in China.

Clinical efficacy of endoscopic resection versus laparoscopic resection and open resection for gastric stromal tumor / 中华消化外科杂志

Objective To investigate the clinical efficacy of endoscopic resection,laparoscopic resection and open resection in the treatment of gastric stromal tumor (GIST).Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 254 GIST patients who were admitted to the First Affiliated Hospital of Army Medical University between January 2007 and June 2017 were collected.The endoscopic submucosal dissection (ESD) and laparoscopic or open wedge resection of GIST were performed according to the patients' conditions.Observation indicators:(1) surgical and postoperative recovery situations;(2) postoperative pathological examination;(3) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect postoperative adjuvant therapy and survival up to June 2017.Measurement data with normal distribution were represented as-x±s.Measurement data with skewed distribution were described as M (range).Results (1) Surgical and postoperative recovery situations:of 254 patients,112 underwent ESD,including 111 with successful operation and 1 with intraoperative conversion to open surgery due to excessive bleeding-induced blurred operating view,93 underwent successful laparoscopic wedge resection of GIST and 49 underwent successful open wedge resection of GIST.The operation time,volume of intraoperative blood loss,time for initial fluid diet intake,duration of hospital stay and hospital expenses were respectively (75±21) minutes,(6.9±0.5)mL,(2.8±0.9)days,(5.5 ± 0.2)days,(22 167±1 364) yuan in patients with ESD and (137±65) minutes,(48.1±2.6)mL,(3.9±1.4) days,(8.3 ± 2.2)days,(32 937±1 823) yuan in patients with laparoscopic operation and (168± 60) minutes,(157.2± 10.3) mL,(5.8± 1.7) days,(11.3 ± 3.5) days,(38 462± 1 961) yuan in patients with open operation.Two patients with ESD had subcutaneous emphysema and didn't receive special treatment,and then emphysema disappeared after 2 days.No complication was detected in patients with laparoscopic or open operations.(2) Postoperative pathological examination:tumor diameter in patients with ESD,laparoscopic operation and open operation was respectively (2.6± 1.6)cm,(6.1 ±2.2)cm and (6.4±2.3) cm.The cases with positive CD117,discovered on GIST-1 (DOG1),CD34 and smooth muscle actin (SMA) were 106,105,86,17 with ESD and 89,87,59,11 with laparoscopic operation and 46,47,30,8 with open operation,respectively.The extremely low risk,low risk,medium risk and high risk were respectively detected in 67,42,3,0 patients with ESD and 16,36,23,18 patients with laparoscopic operation and 7,20,14,8 in patients with open operation.(3) Follow-up and survival situations:210 of 254 patients were followed up for 6.0-120.0 months,with an average time of 36.0 months,including 86 with ESD,82 with laparoscopic operation and 42 with open operation.During the follow-up,of patients with ESD,3 patients with medium risk respectively received imatinib therapy for 7.0 months,1.5 years and 2.0 years,and postoperative gastroscopy reexaminations every 6 months,without tumor recurrence;81 with extremely low risk and low risk received postoperative gastroscopy reexaminations every 6 months and didn't receive targeted therapy,without tumor recurrence;2 died of non-stromal tumor.The postoperative average survival time,1-,3-and 5-year survival rates were respectively 56.3 months,98.8％ (81/82),91.5％ (75/82),74.4％ (61/82) in patients with laparoscopic surgery and 52.4 months,97.6％ (41/42),85.7％ (36/42),81.0％ (34/42) in patients with open surgery.Conclusions According to patients' conditions,endoscopic resection,laparoscopic resection and open resection are safe and feasible in the treatment of GIST.Endoscopic resection of GIST should be selectively applied to patients with smaller diameter,with advantages of lower hospitalization expenses and better long-term prognosis.

Comparison of clinical efficacy of peroral endoscopic myotomy and pneumatic dilation on treatment of achalasia / 中华消化内镜杂志

Objective To compare the advantage and disadvantage of peroral endoscopic myotomy (POEM)and pneumatic dilation(PD)for the treatment of achalasia of cardia(AC). Methods Patients with confirmed AC undergoing endoscopic therapy in Southwest Hospital, Third Military Medical University between January 2011 and September 2014 were divided into POEM treatment group(n=56)and PD treatment group(n = 30), according to the decision of the patients and their families. Postoperative improvement of clinical symptoms, changes in the maximum esophageal diameter, complications, hospital stay,and inpatient expenses were compared between the two groups. Results No significant differences were observed in general preoperative data between the two groups,including gender,age,body mass index (BMI),maximum esophageal diameter, Eckardt score and disease duration(all P>0.05). The Eckardt score showed a significant decrease in 1, 6, and 12 months after operation compared to the pre?operation score in both groups(P<0.05). No matter 1 month or 6 months after operation, the Eckardt score had no significant difference between the two groups(P>0.05). Six months after operation, the response rate between the two groups was no significantly different[93%(52/56)VS 80%(24/30), χ2=0.115, P=0.076],but the maximum esophageal diameter of the POEM group was smaller than that of the PD group (25.39±7.12 mm VS 32.12±9.99 mm,t=3.612,P=0.001). Twelve months after operation,the Eckardt score of the POEM group was lower than that of the PD group(0.44±0.85 score VS 1.26±1.74 score,t=2.940,P= 0.004), and the response rate was higher in the POEM group[93%(52/56)VS 80%(24/30),χ2=0.115, P=0.076]. The incidence of pneumatic complications was 32%(18/56)in the POEM group,but none occurred in the PD group(χ2=12.195,P=0.000). The hospital stay of the POEM group and the PD group was 12.33±4.13 days and 6.50±2.28 days, respectively(W=616, P=0.000). The inpatient expense of the POEM group and the PD group was 8 013.283± 4 322.695 yuan, and 1 571.018±1 590.193 yuan,respectively(W=505,P=0.000).Conclusion Both POEM and PD showed good short?term efficacy for AC.POEM is more effective,and its treatment outcome lasts longer,whereas PD has more widely indications because it is easier to operate with less complications,shorter hospital stay,and lower costs.Trail registration Chinese clinical trial registry,ChiCTR?OOC?15005889.

Current status and research progress of choroidal metastasis of lung cancer in China / 中华胸心血管外科杂志

Objective Choroidal metastasis of lung cancer is rare in clinical,it is easy to missed diagnosis or misdiagnosis,special research and discussion are not much.This article searched and reviewed associated literature and summarized the morbidity status,clinical characteristics,diagnosis and treatment of research progress of choroidal metastasis of lung cancer in China.It is expected to attract the attention of thoracic surgeons and help to early diagnose and rational treatment for improve the quality of life and prolong the life period.

Clinical value of narrow-band imaging magnifying endoscopy in early esophageal carcinoma / 局解手术学杂志

Objective To explore the diagnosis value of narrow-band imaging magnifying endoscopy (NBI-ME) in the early esophageal cancer and precancerous lesions while estimating the quality,depth and treatment strategy.Methods One hundred and eleven cases of patients with suspected early esophageal cancer and precancerous lesions,who underwent ESD treatment,were selected as the study subjects.To estimate the diagnosis value of NBI-ME in the quality,depth and treatment strategy with pathological histology as gold standard.Results While estimating quality,there was no low grade intraepithelial neoplasia(LGIN) cases with NBI-ME.A total of 33 cases were diagnosed as high grade intraepithelial neoplasia(HGIN),including 30 cases of HGIN and 3 cases of LGIN after ESD treatment,and the other 78 cases were diagnosed as early esophageal cancer,including 5 cases of LGIN,22 cases of HGIN,and 51 cases of early esophageal cancer.Compared with the pathology results,the quality consistency of NBI-ME is general:K=0.498.While estimating depth,there was no LGIN cases with NBI-ME.A total of 33 cases were diagnosed as HGIN,including 30 cases of HGIN and 3 cases of LGIN after ESD treatment,67 cases were diagnosed as intramucosal carcinoma,including 5 cases of LGIN,22 cases of HGIN,30 cases of intramucosal carcinoma,and 10 cases of submucosal carcinoma after ESD treatment,and 11 cases were diagnosed as submucosal carcinoma.Compared with the pathology results,the depth consistency of NBI-ME is general:K=0.469.Most of the patients shoud be treated by ESD except 8 cases of LGIN.Conclusion The study shows general diagnosis value of NBI-ME in estimating quality,depth and treatment strategy of early esophageal cancer and precancerous lesions.

Current research status and progress of primary esophageal gastrointestinal stromal tumors in China / 中华胃肠外科杂志

Primary esophageal gastrointestinal stromal tumors (GIST) is a rare independent disease with clinicopathological and molecular features different from other mesenchymal tumors. Authors searched and reviewed associated reports and summarized the morbidity trends, characteristics, diagnosis and treatment of esophageal GIST in China. Data show that the incidence and detection rate of esophageal GIST presents the rising trend. Imaging has some characteristics. Ultrasonography and CT are main methods and effective examinations to detect and prompt diagnosis of esophageal GIST. Pathology and immunohistochemistry are the evidence for a definite diagnosis. Risk classification is the important basis for selecting surgical methods and predicting prognosis. Surgery is the mainstay treatment. Very low and low risk patients with tumors less than 3 cm can choose endoscopic resection. For tumors of 3 to 5 cm, tumor resection must be considered. Thoracoscopy appears to be the first choice for surgery. Medium and high risk patients with tumors >5 cm should be treated with partial resection of esophagus. Surgery combined with targeted therapy and neoadjuvant therapy is the main treatment pattern and research direction.

A dynamics model describing edema and its physiological analysis / 生物医学工程学杂志

Edema is a common pathological symptom, but its development mechanism is unknown. Based on the bearings of pressure upon interstitium structure and substantial exchange between plasma and interstitial fluid, a dymamics model describing the development of edema was set up. The model's theoretical results showed that the variations of interstitium pressure and structure due to imbalance of substantial exchange may lead to the development of edema, which is in accordance with recent clinical researches. Discussions on the dynamic mechanism of the development of edema proposed that the best way to prevent edema is instituting treatment before the interstitial structure being destroyed.

Research and development on the dynamic system for detecting the force of acupuncture needle during the acupuncture process in the clinical practice of traditional Chinese medicine / 生物医学工程学杂志

Manipulations are essential to the acupuncture curative effect. With the technique limited, the researches on acupuncture manipulations can only be carried out with respect to the senses and experience of doctors and patients, thus seriously impeding the modernization and internationalization of acupuncture. Both the modern integration technology of transducer and the biomechanical principles are applied to develop a detection system that can measure the interaction force between the manipulator and the manipulated patient on the needle at each kind of manipulation. Through clinical practice, the force waveforms acting on needle with the manipulations of symmetrical twirling-rotating and symmetrical lifting-inserting were recorded so as to realize the quantitative, objective and real-time detection of the force during the acupuncture process, which provided a new experimentation means and analysis method for the improvement of clinical curative effect and quantitative research of acupuncture and meridians.

Overexpression and its clinical significance of multi-drug resistance associated genes in lung cancer tissues / 中国肺癌杂志

<p><b>BACKGROUND</b>To investigate the expression level and its clinical significance of the multi-drug resistance (MDR) associated protein in lung cancer specimens.</p><p><b>METHODS</b>The expression levels of Pgp, MRP, GST-π and TopoII of MDR associated protein were detected in 60 lung cancer samples and 30 paracancerous tissues by S-P immunohistochemistry method.</p><p><b>RESULTS</b>The positive rate of Pgp, MRP, GST-π and Topo II in the lung cancer tissues was 40.0% (24/60), 61.7% (37/60), 45.0% (27/60) and 81.7% (49/60) respectively, which was significantly higher than those in paracancerous tissues (P < 0.01). No significant correlation was observed among the expression of multi-drug resistance-related protein and TNM staging, pathological type, cell differention and lymph node metastasis status (P > 0.05).</p><p><b>CONCLUSIONS</b>Lung cancer has overexpression of multi-drug resistant-related genes during the oncogenesis. Combined detection of these genes may be useful for guiding the lung cancer chemotherapy.</p>

Endoscopic ultrasonography in diagnosis and therapy of gastrointestinal submucosal tumors / 中华消化内镜杂志

Objective To evaluate the diagnostic value of Endoscopic ultrasonography(EUS) and endoscopic therapies in gastrointestinal submucosal tumors under the guidance of EUS.Methods Patients underwent endoscopy for dyspepsia at our unit. Two hundred and thirty eight patients were found to have a presumed submucosal tumor(SMT) and all subjected to Endoscopic ultrasonography(EUS). Endoscopic therapy including endoscopic mucosal resecation(EMR), endoscopic mucosa strip removal(EMSR), snare cauterization,sclerotherapy or surgery operation had been taken according to the different deriving layers of submucosal tumors. The ultimate diagnosis was confirmed by histology.Results Seventy three stromal tumors derived from muscularis mucosa,7 carcinoid in mucosa propiria; 6 cysts, 13 lipomas, 17 etopic pancreases in stomach and 5 varices in gastric fundus derived from submucosa; 95 benign stromal tumors and 21 malignent stromal tumors derived from muscularis propria,1 carcinoid invaded muscularis propria. 61 benign stromal tumors derived from muscularis mucosa , 8 benign stromal tumors derive from muscularis propria, 8 lipomas, 4 cysts, 8 etopic pancreases and 7 carcinoids were resected by endoscopy; 33 benign stromal tumors from muscularis propria, 18 malignent stromal tumors, 2 lipoma and 2 etopic pancrease,1 carcinoid were resected surgically. Submucosal tumors 97.97% diagnosed by EUS were identified by pathology.Conclusion Different layers of gastrointestinal tract with submucosal tumors can be distinguished clearly by EUS, leading to definite diagnosis of submucosal tumors. EUS is important in selecting treatment procedures of submucosal gastrointestinal tumors and should routinely be performed on all presumptive submucosal tumors prior to attempt at removal.

Preparation and Clinical Use of Rosa Roxburghii Tratt's SOD Oral Liquid / 中国药房

OBJECTIVE:To introduce the preparation of Rosa roxburghii tratt's SOD oral liquid and its therapeutic effect on insomnia.METHODS:To mix Rosa roxburghii tratt's juice with Rhizoma Aractyloidis's decoction in proper proportion.To control the quality by detecting activity of SOD .The therapeutic effect on insomnia was observed in 34 patients .RESULTS:The quality was not changed obviously after storage for 18 months;The effective rate for insomnia was 88.2%. CONCLUSION:The preparation is safe,stable and effective.

Study on morphology of gastric mucosa in rats with portal hypertension / 中国普通外科杂志

Objective To investigate the pathogenesis of portal hypertensive gastropathy(PHG). Methods Two rat models with portal hypertension(PHT) and a sham operation group were established to detect the pathological changes in histology and ultrastructure of the gastric mucosa as well as quantitative changes in histological morphology by graphic analysis computer system. Results Prominent edema, scattered red dots/ecchymosis were found in gastric mucosa in rats with PHT. Light and scan electron microscopy showed swelling or exfoliating of the epithelium cell, reduction of gastric gland number, thin of gastric mucosa, while infiltration of inflammatory cells, epithelium metaplasia were not found. The most characteristic findings were the changes of the mucosal capillaries and venules in both mucosal basal lamina and submucosa layer light microscopically, as well as the transmutation, stenosis and loose intercellular joining of the capillaries on electron microscopy. Ultrastructure observation revealed numerous pinocytes in epithelial cells as well as proliferation and hyperplasia of smooth muscle, collagenous fiber and extracellular matrix in venules. Quantitative analysis showed that the ratios of the cross sectional area and the vascular wall area between the gastric wall area(CSA/GWA & VWA/GWA) was higher in liver cirrhosis(LC) and portal vein stenosis(PVS) groups than that in sham operation(SO) group. There was a positive correlation between portal vein pressure and the ratio of the length of damaged mucosa and the length of mucosa(LDM/LM that was higher in LC group than in PVS group). Conclusions In rats with cirrhotic portal hypertension, distinct gastric microvascular morphological changes are the major etiological factor of PHG as a part of pathological changes in portal hypertension.

A LONGITUDINAL STUDY ON THE PHYSICAL GROWTH OF INFANTS DURING THE FIRST SIX MONTHS OF LIFE AND THEIR BREASTMILK, ENERGY AND PROTEIN INTAKES / 营养学报

A longitudinal study was carried out on fifty infants selected from both urban and rural areas of Beijing for their body weights, heights, head and mid-upper arm circumferences, tricep and abdomen skinfold thicknesses, and breatmilk and energy and protein intakes at the 1st, 3rd and 6th month of life. The results revealed that the breastmilk intakes of these infants were ranged from 600-800 g/day during this period of time, the breastmilk intakes of the rural infants were higher significantly than that of the urban infant throughout the study period (P

STUDIES OF THE RELATIONSHIP BETWEEN IRON STATUS AND DIETARY PATTERNS IN PRESCHOOL CHILDREN / 营养学报

A nutrition survey, covering a total of 4801 preschool children in 6 provinces, autonomous regions and municipalities, has been carried out. The objective was to determine the effects of various dietary patterns on the blood hemoglobin, free erythrocyte proporphyrin, and serum ferritin values. The results indicated a high prevalence of iron deficiency (average 51.9%). Iron deficiency anemia was detected in 16.4% of the children examined and the incidence rate was particularly high among infants at the age group of 6 months and one year, which was 28.7% and 22.9% respectively. The dietary patterns were different in the above geographic areas. The results of dietary survey revealed that a low incidence of iron deficiency was found in those children who consumed more animal food and protein.

THE RELATIONSHIP BETWEEN THE DIET AND THE GROWTH OF INFANTS DURING THE WEANING PERIOD (6-18 MONTHS) / 营养学报

The growth curves and diet of 185 babies in rural area near Beijing from 6 months to 18 months old have been studied. Infants were divided into 3 groups according to their diet taken:(1) 89 babies had breast milk only;(2) 66 babies took more than 250g animal milk per day besides breast milk;(3) 30 babies who did not have breast milk and only animal milk was taken. All the babies were gradually transferred to an ordinary cereal based diet during the weaning period. To half of them a soybean and cereal based formula fortified with minerals and vitamins was supplied, which would provide 6.6g protein and 141 kcal and some other nutrients per day.The results showed that the growth curves of body weight and height of children were much better than the data obtained in 1975, but still lagged behind that of the urban children, especially for the body weight. The weight curves of the babies who took animal milk seemed higher than the other groups. Female babies who were fed with breast milk and supplemented with the weaning food have a better weight and height curves than non-supplemented ones, but this was not seen in males. The hemoglobin contents of the babies who took animal milk when they were 18 months old were lower than that of the 6 months old, but there were no differences in the breast milk groups, and the lowering of the hemoglobin level in the animal milk groups could be corrected by adding weaning food in the diet. When the babies were 6 months old, 39.3% of them had a hair zinc content below the lower limit of the normal range, and it became to 47.6% when they were 18 months old. So zinc deficiency of the babies were present in this local area, and it should be fortified into the weaning food.