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Background Ultrasound-guided fine needle aspiration (UGFNA) has been widely used in clinical practice. Many patients may still worry about UGFNA-related metastasis. The aim of this article was to analyze the potential association between UGFNA and cervical lymph node metastasis (CLNM) of papillary thyroid microcarcinoma (PTMC) and whether UGFNA influences the long-term prognosis of PTMC. Methods A total of 367 adult patients with PTMC who underwent thyroidectomy in our hospital between January 2014 and December 2015 were enrolled in this retrospective cohort study. Univariate and multivariate analyses were conducted to explore the potential risk factors for CLNM. Propensity score (PS)-based 1:1 nearest neighbor matching was performed to select patients with homogeneous baseline characteristics. Then, the rate of CLNM was compared between matched samples with chi-square (χ2) tests. Survival analysis was performed with the Kaplan–Meier method in the PS-matched cohort. The recurrence-free survival (RFS) rate was compared between groups with the log-rank test. Results Multivariate analysis showed that male sex (OR = 3.997, 95% CI 2.148 ~ 7.439, P P P > 0.05), capsular invasion (OR = 1.218, 95% CI 0.415 ~ 3.572, P > 0.05), multifocality (OR = 1.949, 95% CI 0.905 ~ 4.196, P > 0.05) and Hashimoto's thyroiditis (HT) (OR = 0.824, 95% CI 0.401 ~ 1.696, P > 0.05) were not independent risk factors for CLNM. In the PS-matched cohort, the CLNM rate showed no significant difference between the UGFNA and non-UGFNA groups (29.5% vs. 23.7%, P > 0.05). With a median follow-up of 63.8 months (range 3.1–84.9 months), the 5-year cumulative RFS rate was 99.3% in the UGFNA group and 97.7% in the non-UGFNA group. After PS matching, the Kaplan–Meier curves showed no significant differences between groups (P > 0.05). Conclusions UGFNA is a very safe diagnostic tool that does not influence the CLNM rate or long-term prognosis of patients with PTMC. The fear of UGFNA-related metastasis should not deter UGFNA of the thyroid.

Esophageal carcinoma (EC) is recognized as one of the most frequently occurring malignancies worldwide, and its high morbidity rate motivates efforts to identify potential therapeutic targets. Notably, forkhead box (FOX) family genes are highlighted as possible biomarkers for diagnostics, prognostics, and therapeutics of various malignancies, including EC. Our present study was performed to investigate the underlying mechanism of FOXO6 on the development of EC. We observed a significant upregulation of FOXO6 in EC tissues, contributing to the migration and proliferation in EC cells through gain- and loss-of-function assays. FOXO6 directly interacted with the ubiquitin-specific processing protease 7 (USP7) gene promoter and enhanced its transcriptional activity, which resulted in suppressed cancer cell apoptosis as revealed by chromatin immunoprecipitation (ChIP)-qPCR. USP7 enhanced the ubiquitination of Jumonji domain-containing protein D3 (JMJD3), elevated JMJD3-promoted growth of EC cells, and transcriptionally activated clusterin (CLU) expression at the promoter region via histone H3 lysine 27 tri-methyl (H3K27me3) demethylation, according to immunoprecipitation and ubiquitination assays. Finally, we verified that FOXO6 mediated effects on the USP7/JMJD3/CLU axis to exert an oncogenic role in vivo, which was blocked by USP7 and JMJD3 inhibitor. Our findings demonstrate an important role of the FOXO6/USP7/JMJD3/CLU pathway in EC progression and thus provide attractive potential therapeutic targets for EC patients., Graphical Abstract, This study aimed at researching the function of FOXO6 on EC. FOXO6 overexpression or JMJD3 overexpression was observed to promote the development of EC. FOXO6 promoted USP7 expression, which enhanced JMJD3 ubiquitination and promoted CLU expression. This study highlights that the FOXO6/USP7/JMJD3/CLU axis may be a novel therapeutic target for EC.

The robot-assisted insertion surgery plays a crucial role in biopsy and therapy. This study focuses on determining the optimum puncture pattern for robot-assisted insertion, aiming at the matching problem of needle insertion parameters, thereby to reduce the pain for patients and to improve the reachability to the lesion point. First, a 6-degrees of freedom (DOFs) Computed Tomography (CT)-guided surgical robotic system for minimally invasive percutaneous lung is developed and used to perform puncture experiments. The effects of four main insertion factors on the robotic puncture are verified by designing the orthogonal test, where the inserting object is the artificial skin-like specimen with high transparent property and a digital image processing method is used to analyze the needle tip deflection. Next, the various phases of puncture process are divided and analyzed in detail in view of the tissue deformation and puncture force. Then, short discussion on the comparison of puncture force with different effect factors for the same beveled needle is presented. The same pattern can be observed for all of the cases. Finally, based on the experimental data, the formulations of the puncture force and needle deflection which depends on Gauge size, insertion velocity, insertion angle, and insertion depth are developed using the multiple regression method, which can be used to get an optimum puncture pattern under the constrains of minimum peak force and minimum needle tip deflection. The developed models have the effectiveness and applicability on determining the optimum puncture pattern for one puncture event, and which can also provide insights useful for the setting of insertion parameters in clinical practice.

Objective: The fundus of the stomach is a challenging region for endoscopic resection of gastrointestinal stromal tumors (GISTs), especially in the anterior wall of the fornix at the side of the greater curvature. The aim of this study was to introduce using the “6”-turn of gastroscopy along the greater curvature wall (6TGS) technique in operation on the gastric fundus and provide evidence of its advantages.Methods: The clinical data of patients with stromal tumor in muscularis propria at the gastric fundus (STMF) at the Fourth Hospital of China Medical University between July 2016 and Dec 2020 were reviewed. The novel 6TGS technique was used in the procedure. The beneficial effects, suitability, applicable lesion site, influencing factors, and success rates of 6TGS were analyzed.Results: Ten cases in total were reviewed, and the 6TGS technique was successfully performed in 7 cases (70%). In all 7 patients, the gastroscope’s tip could access the location just below the gastric cardia, and all angles/sites of the fundus of the stomach could be operated on. The lesion was easily accessed, and the gastroscope was stable with good left-right movement ability and moderate forward and backward movement ability. Conclusion: 6TGS can improve the safety of gastroscopy resection of STMF and facilitate the excision of tumors in challenging sites in the gastric fundus. Patients need to be under general anesthesia with endotracheal intubation in the supine position to perform the 6TGS technique after distending the stomach with less air.

The purpose of this research is to improve the analysis of grade evaluation of soil corrosion rate for pipeline. With the characteristics of the existing mathematical models and the factors of pipeline soil corrosion, a combined mathematical model of the rough set, the decision tree and support vector machine (RS-DT-SVM) is proposed to evaluate the grade of soil corrosion rate for pipeline. This method utilizes the rough set (RS) and decision tree (DT) to manage by standardization analysis of the data of pipeline soil corrosion in the early stage. According to the characteristics of solving the problems of over learning, local minima, nonlinearity and dimension disaster, support vector machine (SVM) is used to build the intelligent evaluation of rate grade of soil corrosion. With algorithm characteristics of machine learning, it can be built without determining the specific function expression. Taking the actual and objective corrosion data of loam as an example, the model has a relative superiority in the evaluation grade analysis of multi-factor control system. It also provides a method guidance of evaluation grade of soil corrosion rate for pipeline.

To study the value of using the cardiogenic shock (CS) stages developed by the Society of Cardiovascular Imaging and Intervention (SCAI) in predicting the mortality of CS patients in cardiac intensive care unit (CICU).We retrospectively collected (Jan., 2011-Jan., 2018) the information of inpatients who were admitted to the CICU of West China Hospital of Sichuan University on consecutive days, and conducted analysis on those with CS. The patients were divided into groups C, D and E, according to the corresponding SCAI stages, and the primary outcome indicator was in-hospital mortality. Logistic regression was done to determine the association between SCAI staging and in-hospital mortality before and after multivariate adjustment. The receiver operating characteristic curve was used to assess the value of SCAI stages of CS in predicting in-hospital mortality.We studies 839 CS patients who met our inclusion criteria. The proportions of patients of SCAI stages C (Classic), D (Deteriorating), and E (Extremis) were 43.3% (363 cases), 38.7% (325 cases) and 18.0% (151 cases), respectively. The unadjusted in-hospital mortality rates were 22.9% (83 cases), 44.0% (143 cases) and 53.6% (81 cases), respectively (In CICU patients with CS, the SCAI stages of CS can be used as a stratified method for rapid assessment of disease risks upon admission. In patients with acute coronary syndrome and CS, SCAI stages combined with GRACE scores improved the ability to predict risks of death.

The purpose of this research is to improve the analysis of the external anti-corrosive security conditions under multi-factor characteristics of pipeline corrosion and protection. With the analysis of multivariate connection in the set pair theory (SPA), the formula of four-elements connection degree of targeted corrosion and protection is proposed to improve the limitations and disadvantages of existing evaluation methods. It can consider the connection between indicators and reaches the comprehensive quantitative evaluation for the two aspects of pipeline corrosion and protection situation. The security tendency of SPA for the quantitative evaluation of the system is proposed to reasonably describe the system’s dynamic characteristics. With the field excavation comprehensive test data, evaluation results were verified, and it was consistent with the actual situation. This method might be helpful for the reasonable selection of pipeline safety investment. It also provides a basis for making scientific and efficient plans for pipeline maintenance with safety and economic consideration.

Polyoxometalates (POMs) have fascinating structures and promising properties. The arsenomolybdates, as an important branch of POMs, are outstanding photocatalysts for organic dyes. In this work, we selected organic dyes to evaluate the photocatalytic activity of arsenomolybdates under UV light, containing compared with photocatalytic activity of different structural arsenomolybdates, stability, and the photocatalytic reaction mechanism of arsenomolybdates as photocatalyst. The arsenomolybdates may be used to as environmental photocatalysts for the degrading of organic dyes and solving the problem of environmental pollution.

Esophageal cancer (EC) is a serious digestive malignancy which remains the sixth leading cause of cancer-related deaths worldwide. Emerging evidence suggests the involvement of long non-coding RNAs (lncRNAs) in the tumorigenesis of EC and thus, in this study we explored the potential effects of lncRNA LINC01270 on EC cell proliferation, migration, invasion and, drug resistance via regulation of glutathione S-transferase P1 (GSTP1) methylation. First, we screened out the EC-related differentially expressed lncRNAs, and the expression of our top candidate LINC01270 was quantified in EC tissues and cells. To define the role of LINC01270 in EC progression, we evaluated the proliferation, migration and invasion of EC cells when the LINC01270 was overexpressed or knocked down, in the presence of the GSTP1 methylation inhibitor SGI-1027 and 5-fluorouracil (5-FU). In addition, interaction between LINC01270 and methylation of the GSTP1 promoter was identified. Finally, we assessed transplantable tumor growth in nude mice. LINC01270 was up-regulated and GSTP1 was down-regulated in EC tissues and cells. Silencing of LINC01270 inhibited migration and invasion, and enhanced the sensitivity of 5-FU in EC cells. We found that LINC01270 recruited the DNA methyltransferases DNMT1, DNMT3A and DNMT3B initiating GSTP1 promoter methylation, thereby leading to the proliferation, migration, invasion and drug resistance of EC cells. Moreover, GSTP1 overexpression was observed to reverse the effects of LINC01270 overexpression on EC cells and their response to 5-FU. Taken together, this study shows that inhibition of LINC01270 can lead to suppression of EC progression via demethylation of GSTP1, highlighting this lncRNA as a potential target for EC treatment.

BACKGROUND Bladder cancer is a major widespread tumor of the genitourinary tract. Around 30% of patients with superficial cancers develop invasive and metastatic pathology. MATERIAL AND METHODS Some new heterocyclic 4-methyl coumarin derivatives were designed using molecular modeling studies to evaluate their potential against bladder cancer lines T24 and RT-4. The designed compounds that showed good binding affinity to T24 and RT4 were synthesized, with excellent yield. The synthesized compounds after structural evaluation were further evaluated for their antiproliferative activity by cell viability assay, cell cycle analysis, and apoptosis assay. RESULTS The compound BC-14 exhibited the best cytotoxicity against T24 cells, but were not highly active against RT4 cells. CONCLUSIONS The results of the present study may suggest the selectivity pattern of the synthesized compounds. These results should be explored further with chemical modification for other cancer types.

Objective. To analyze the types and properties of cystic lesions originating from the muscularis propria of the gastric cardia (CLMPGC), explore the growth pattern and anatomical characteristics, and evaluate the safety, feasibility, and clinical efficacy of endoscopic esophageal submucosal tunnel dissection (ESTD). Methods. From September 2013 to July 2018, we treated 6 patients with CLMPGC whom we had diagnosed using endoscopy, endoscopic ultrasound (EUS), and Computed Tomography (CT) before the operations. ESTD was the best option for treatment for all these patients. Postoperative observation and follow-ups were performed, and the operational, clinical data, and treatment results are analyzed. Results. The mean age of the patients was 50.67 ± 11.59 years (male : female = 1 : 1). The only clinical manifestations the patients exhibited were upper abdominal discomfort. The diameter of the masses was 2.05 ± 0.73 (1.1–3.0) cm. The duration of the ESTD operation was 93.5 (82–256) mins, and the length of hospital stay was 7.50 ± 1.38 days. Postoperative pathology showed 4 cases of an epithelioid cyst, and 2 cases of mucocele with xanthogranuloma. There were no complications, such as hemorrhage, pneumothorax, and pleural effusion during and after the operation. No recurrence during the follow-ups was observed. Conclusion. The CLMPGC were mainly mucocele and epidermoid cyst, in an expansive growth pattern, and these lesions had no distinct borders with the muscularis propria. The muscularis propria formed a complete wall of the lesion. There was no direct blood supply to the lesions from big blood vessels. Endoscopic esophageal submucosal tunnel dissection was a safe, feasible, and effective treatment for CLMPGC.

Angiolipoma in the region of the hypopharynx-esophageal introitus is a rare occurrence. Surgical treatment was performed in the few cases reported in the literature. Endoscopic submucosal dissection (ESD) is a minimally invasive treatment for hypopharyngeal and esophageal lesions. Our objective was to evaluate the feasibility, safety, and efficacy of ESD for treatment of angiolipoma at the hypopharynx-esophageal introitus. The patients with submucosal tumors at the hypopharynx-esophageal introitus were diagnosed as angiolipoma by preoperative evaluation with endoscopy, endoscopic ultrasonography, and computed tomography (CT). The patients who were diagnosed with angiolipoma agreed to undergo endoscopic submucosal dissection. Under general anesthesia and endotracheal intubation, ESD was used to remove the lesions. Preoperative, intraoperative, and postoperative data were collected and analyzed to evaluate the feasibility, safety, and effectiveness of endoscopic submucosal dissection. From January 2013 to December 2018, 6 cases of angiolipoma were treated with ESD with a success rate of 100%. The average operation time was 107.0±69.4 minutes. Intraoperative blood loss is the main risk. Endoscopic thermocoagulation successfully stopped bleeding in all cases. Pharyngeal pain and painful swallowing were the main clinical signs. There was no stricture at the hypopharynx-esophageal introitus after the operation. ESD treatment of angiolipoma at hypopharynx-esophageal introitus is feasible, safe, and effective.

Objective To investigate endoscopic ultrasonography diagnosis and classification of gastric fundus-cardiac tumors originated from the muscularis propria. Methods One hundred and two patients with gastric fundus-cardiac submucosal tumors originated from the muscularis propria were diagnosed by endoscopic ultrasonography from Jan, 2011 to Jun, 2015. All patients were treated by endoscopy or surgery, and diagnosed by postoperative pathology and immunohistochemistry staining. These cases were analyzed retrospectively. Results The 102 patients with gastric fundus-cardiac tumors originated from the muscularis propria included 39 men and 63 women. Their ages were from 25-85 years old, average 56.22±11.98 years. The tumor sizes were from 0.4 to 10.4cm, average 3.72±2.18cm. The patients were diagnosed having leiomyoma in 81 and interstitialoma in 21 by preoperative endoscopic ultrasonography. Postoperative pathology and immunohistochemistry staining confirmed that leiomyoma was misdiagnosed as mesenchymoma in 5 patients. The misdiagnosis rate of endoscopic ultrasonography for gastric fundus-cardiac tumors originated from the muscularis propria was 4.9% (5/102). In leiomyomas, isolated nodular type was seen in 29 cases, earthworm type in 21, and multiple nodular type in 36. Conclusion Endoscopic ultrasonography is a safe effective important method for diagnosis and classification of gastric fundus-cardiac submucosal tumors originated from the muscularis propria. DOI: 10.11855/j.issn.0577-7402.2016.08.09

Stromal cell-derived factor-1 (SDF-1) and CXC chemokine receptor 4 (CXCR4) have been found to be tightly correlated with the progression of prostate cancer (PC). In this study, we investigated the effects of an SDF-1α/CXCR4 inhibitor, AMD3100, on cell progression and metastasis potential of human PC cells. Human PC cell lines (LNCaP, PC3, and DU145) were cultured to detect SDF-1α/CXCR4, which showed higher SDF-1α and CXCR4 expression than the normal human prostate epithelial cell line, RWPE-1. AMD3100 was confirmed to be an inhibitor of SDF-1α, and to detect the effect of SDF-1α/CXCR4 inhibition on PC, PC cells were treated with AMD3100 or/and CXCR4 siRNA. The results suggested that inhibition of the SDF-1α/CXCR4 pathway could promote the E-cadherin level but inhibit the levels of invasion and migration of vimentin, N-cadherin and α5β1 integrin. Finally, tumor formation in nude mice was conducted, and the cell experiment results were verfied. These data show that AMD3100 suppresses epithelial-mesenchymal transition and migration of PC cells by inhibiting the SDF-1α/CXCR4 signaling pathway, which provides a clinical target in the treatment of PC.

Herein, two Wells -Dawson-type arsenomolybdates, formulated as [Cu(pyr)

Objective To assess the curative effect of endoscopic resection in patients with non-ampullary descending duodenal tubulovillous adenoma. Methods The clinical data of 9 patients with non-ampullary descending duodenal tubulovillous adenoma from Jan. 2004 to Dec. 2012 in the Department of Endoscopy of General Hospital of Shenyang Command were retrospectively reviewed. All patients were diagnosed with endoscopy, ultrasound endoscopy and preoperative pathology, and all of them underwent endoscopic dissection. Pathological examination and follow-up were carried out after operation. Results Nine patients, including 4 men and 5 women aged 45-78 (59.6±11.5) years old were involved. Tubulovillous adenomas were found in descending duodenum of all patients, with the size of 1.8 to 2.5cm, with a mean of 2.03±0.24cm. Endoscopic resection (EMR) was used in all patients successfully. No complication was found during operation and after operation. Postoperative pathology confirmed that all the tumors were tubulovillous adenomas. Low-grade intraepithelial neoplasia was found in 4 cases, and high-grade in 5 cases. Mucosal focal carcinoma was confirmed in one case, without involvement of muscularis mucosae. The position emission tomography (PET) showed no abnormal radionuclide accumulation. There were no hemorrhage or death during and after the operation. The average follow-up time was 6-58 (25.6±16.4) months. Metastases and recurrence had not been found. Conclusion Endoscopic mucosal resection is a safe, adequate method for non-ampullary descending duodenal tubulovillous adenomas. DOI: 10.11855/j.issn.0577-7402.2013.11.012

The purpose of this paper is to identify the characteristic endoscopic findings in patients with esophageal cavernous lymphangioma and assess the efficacy of endoscopic techniques in the management of this disease. We retrospectively analyzed data from 6 patients who were diagnosed with esophageal cavernous lymphangioma by endoscopy and histologic evaluation. All patients underwent endoscopic resection of the tumor at our hospital between January 2010 and June 2011. Four male and 2 female patients, with a mean age of 48.2 ± 15.2 years (range, 35 to 77 y) with esophageal cavernous lymphangioma, who underwent endoscopy followed by endoscopic resection were included in this report. The lesions varied from 0.4 to 1.2 cm in diameter, with a mean size of 0.78 ± 0.26 cm. Endoscopy revealed dilated lymphatic channels beneath the surface epithelium of the lesion in all patients. An endoscopic ultrasound revealed that all lesions were multicystic and located in the submucosal layer. Histologic examination confirmed the initial diagnosis in all patients. Endoscopy plays an important role in the diagnosis of esophageal cavernous lymphangioma, with dilated lymphatic channels beneath the surface epithelium of the lesion being a characteristic endoscopic feature. Endoscopic ultrasonography is a useful tool to differentiate cavernous lymphangioma from other esophageal tumors. Endoscopic resection of esophageal cavernous lymphangioma was safe and effective in all of the analyzed cases.

Objective To evaluate the efficacy of Soehendra stent retriever as used as a dilator for the patients with high grade stricture of pancreatic or bile duct. Methods Forty-eight patients, who underwent endoscopic retrograde cholangiopancreatography (ERCP) from Jan. 2010 to Oct. 2012 in Endoscopy Department of General Hospital of Shenyang command, were found to have pancreatic or bile duct stricture. Dilation was then attempted using a dilating sound. Once the stricture could not be traversed, the Stent Retriever was inserted over the sound to dilate the stricture. Results A total of 554 patients were diagnosed to suffer from pancreatic or bile duct stricture with the aid of ERCP. Among them dilatation of stricture with catheter failed in 48 cases (8.7%) and Soehendra stent retriever was then used for dilatation. Of the 48 cases, ERCP revealed common bile duct stricture in 8 patients, common hepatic duct stricture in 6 patients, porta hepatis stricture in 5 patients, stricture at neck of pancreas stricture in 18, stricture at body of pancreas in 4, stoma stricture after liver transplant in 4, and occlusion of metallic stent in 3 patients. For these cases, Soehendra stent retriever was used to dilate the stricture prior to setting stent or endoscopic nasobiliary drainage (ENBD) with a success rate of 100%. No related complication was found. Conclusion Pancreatic and bile duct stricture can be dilated successfully with the Soehendra stent retriever. The procedure is of low risk and highly effective.

BACKGROUND To investigate the advantages and disadvantages of various endoscopic resection methods for rectal carcinoid tumors. METHODS A retrospective analysis of 3 types of endoscopic resection techniques for rectal carcinoid tumors was performed. The surgical time and the complication rate were compared between 30 patients who underwent conventional endoscopic mucosal resection (EMR), cap-assisted endoscopic mucosal resection (EMR-C), or endoscopic submucosal dissection (ESD). All rectal carcinoid tumors were under 1 cm and were treated in our center between January 2002 and January 2008. RESULTS Ten patients underwent each surgical approach. All cases were pathologically diagnosed as rectal carcinoid tumors. One-time complete resection rates using the conventional EMR, EMR-C, and ESD were 80%, 100%, and 100%, respectively. The operation time ranged from 5 to 53 minutes for the conventional EMR group, from 4 to 7 minutes for the EMR-C group, and from 16 to 35 minutes for the ESD group. The average follow-up time for the 30 patients was 18.43 ± 9.76 months. There were no recurrent or metastatic cases. CONCLUSIONS Endoscopic resection for rectal carcinoid tumors below 1 cm was safe. Considering the clinical efficacy, surgical time, and intraoperative complication rate, EMR-C may be the best endoscopic excision method.

Objective To probe the value of endoscopic retrograde cholangiography (ERC) through jejunostomy in patients in whom ERC could not be performed via the mouth after Roux-en-Y anastomosis on the upper gastrointestinal tract. Methods In two patients suffering from acute obstructive suppurative cholangitis after a radical operation for cholangiocarcinoma, ERC could not be performed through the mouth due to the presence of a long non-functional jejunal loop. A jejunostomy was first done in the afferent loop of the jejunum, and a gastroscope was then inserted via the jejunostomy and passed retrogradely, to find the stoma of the cholangiointestinal anastomosis. ERC was then successfully performed, and followed by endoscopic retrograde biliary drainage (ERBD). Results The operation was successful. It was found that cholangio-jejunostomy stoma was narrow, and a large amount of purulent mucus was present in the enlarged intrahepatic duct. ERC was done to enlarge the stoma, and a stent was placed into the main branch of the intrahepatic duct. Two patients achieved surgical success and smooth recovery after the operation. Conclusion ERC through a jejunostomy in the patients who had Roux-en-Y cholangiojejunostomy following radical resection for cholangiocarcinoma, is a safe and effective surgical procedure.

Objective To discuss the clinical efficacy of endoscopic resection of duodenal Brunner's gland adenoma. Methods Eighteen patients with duodenal Brunner's gland adenoma were removed by endoscopic resection between Mar. 2009 and Dec. 2011. All the patients underwent endoscopic ultrasonography for preoperative diagnosis, and it was confirmed by postoperative pathological examination. A retrospective analysis was performed. Results Endoscopic resection was successful in all patients. The tumors presented as tubercular in 16 cases, earthworm like in 1 case, and disciform in 1. Blood oozing from the wound surface occurred in 2 cases during operation, and it was stopped by thermocoagulation successfully. No postoperative complication or fatality occurred in any patient. These adenomas were confirmed to be parenchymatous in 12 cases, cystic and solid in 3, and cystic in 3 by endoscopic ultrasonography and postoperative pathology. Follow-up for 12-45 (25.6±10.1) months did not find recurrence. Conclusions Endoscopic ultrasound examination is an effective preoperative diagnostic method in the patients with duodenal Brunner's gland adenoma. Endoscopic resection is safe and effective treatment for this tumor. DOI: 10.11855/j.issn.0577-7402.2014.12.13

Aim of the study Nymphaea stellata willd. flowers (NSF) are used as a traditional medicine in India and Nepal to treat diabetic disease. Different works have demonstrated that NSF extract showed antihyperglycemic effect on alloxan-induced diabetic rats. In the present work we evaluated in vitro intestinal α-glucosidase inhibition as the possible mode of action of NSF extract on suppressing postprandial hyperglycemia for curing diabetic mellitus. In addition, NSF extract was studied to assess its possible acute oral toxicity and genotoxicity. Materials and methods Rat intestinal crude enzyme preparation and Caco-2 monolayer were used to evaluate α-glucosidase inhibitory activity of NSF extract. The main α-glucosidase inhibitors were detected by HPLC. For acute toxicity test, NSF extract was administered at doses of 2000, 5000 and 10,000 mg/kg body to three groups of 10 ICR mice each, and then clinical symptoms including mortality, clinical sign and gross findings were observed once a day for 14 days. In Ames test, histidine-dependent auxotrophic mutants of Salmonella typhimurium (strains TA97, TA98, TA100, TA102 and TA1535) were used and incubated in the presence and absence of S9 metabolic activation using NSF extract with concentrations of 150–5000 μg/plate. The chromosome aberration test was conducted with Chinese hamster lung (CHL) cells treated with NSF extract at doses of 150–5000 μg/ml in the presence and absence of S9 metabolic activation. In the in vivo mouse micronucleus assay, 9-week-old male and female ICR mice ( n = 90, 25–30 g) were administered daily by oral gavage at doses of 2.5, 5.0 and 10.0 g/kg body for 1 or 2 days. Bone marrow smears were prepared from each treatment group 24 h after last administration and then polychromatic erythrocytes (PCEs) and normochromatic erythrocytes (NCEs) were identified. Results NSF extract showed potent rat intestinal α-glucosidase inhibitory activity for maltose hydrolysis with ED 50 value of 0.1 mg/ml. In Caco-2 monolayer, α-glucosidase activity for the maltose hydrolysis was down-regulated by NSF extract at a concentration of 0.05 mg/well level, showing 74% inhibition compared to the saline treated control. NSF was rich in phenol contents and the main α-glucosidase inhibitor, 1,2,3,4,6-penta-O-galloyl-β- d -glucose, was identified together with two phenolic compounds of gallic acid and corilagin. In acute toxicity test, NSF extract did not produce any toxic signs or deaths and the LD 50 value of this extract could be greater than 10,000 mg/kg body weight. These results of genotoxicity assessment showed that NSF extract did not cause genotoxic effects in Ames test, in the in vitro chromosomal aberration assay and in the in vivo micronucleus assay. Conclusion The current study shows that the extract from Nymphaea stellata flowers exhibits significant intestinal α-glucosidase inhibitory activity, without showing any acute toxicity or genotoxicity, which may be useful in suppressing postprandial hyperglycemia in diabetics. The results presented here suggest that the use of NSF in folk medicine as a natural antidiabetic treatment could be safe as well as beneficial.

A novel two-dimensional layered iron(II) phosphate, NaFeII2(PO4)(HPO4), has been synthesized under mild hydrothermal conditions. Its structure was determined by single-crystal X-ray diffraction and further characterized by FTIR, elemental analysis, inductively coupled plasma (ICP) analysis, powder X-ray diffraction, and magnetic susceptibility measurements. Its anionic network is based on strictly alternating FeIIO4 tetrahedral units and P-centered units including PO4 and PO3(OH) tetrahedra linked through their vertices to form a double layered structure that contains columns of double six-membered rings and 1D tubes by four-membered rings sharing faces. The sodium atoms reside in the interlayer region. The title compound crystallizes in the triclinic system, space group P1, with the following cell parameters: a = 5.1200(10) A; b = 8.6232(17) A; c = 8.7958(18) A; α = 96.93(3)°; β = 100.45(3)°; γ = 105.75(3)°; V = 361.58(12) A3; Z = 2; Dc = 2.991 Mg/m3.

Objective To assess the clinical value of sodium hyaluronate,levarterenol and indicarmine solution used in endoscopic submucosal dissection(ESD).Methods Sixteen patients were involved in present study who were diagnosed as precancerous lesion or submucosal tumor in digestive tract by chromoendoscopy and endoscopic ultrasonography from Nov,2010 to Feb,2011 at General Hospital of Shenyang Command.The injected solution was mixed with 0.2% indicarmine 10ml,levarterenol 10mg,sodium hyaluronate 20mg,and 0.9% normal saline 200ml.The liquid pad was formed under the submucosal layer by the injection of the mixture.Hybrid knife was employed to perform the injection,cutting and coagulation with no interruption during the procedure of ESD.Satisfactory degree was assessed,and the total solution volume,success rate,bleeding rate,perforation rate,operation duration,and length of stay in hospital were recorded.The recurrence and healing condition were observed at following-up.Results The length of lesion was 0.8~4.5cm with mean of 2.2cm.The operation duration was 45~240 min with an mean time of 95.4 min.The mean dosage of the mixed solution for submucosal injection was 102.4ml.Success rate of endoscopic submucosal dissection was 87.5%.The satisfactory degree was high.Intractable bleeding occurred in 2 cases with lateral spreading tumor(LST) during the procedure,but it was controlled after high temperature coagulation without producing perforation.The dissection surface was covered by aluminum phosphate gel in all cases,and metal clips were applied in some cases for closure.The mean length of stay in hospital after ESD was 3.8 days.Conclusions The mixture of sodium hyaluronate,levarterenol,indicarmine and normal saline,when used for submucosal injection in ESD,is safe and satisfactory.

Objective To evaluate the effectiveness of endoscopic transpapillary drainage in the treatment of infected pancreatic pseudocyst complicating pancreatitis.Methods The data of 18 cases of pancreatitis with infected pancreatic pseudocyst having undergone endoscopic transpapillary drainage from Jan.2004 to Jun.2006 were retrospectively analyzed.All patients were diagnosed and then checked postoperatively by endoscopic retrograde cholangiopancreatography(ERCP) and CT.All patients were treated by endoscopic sphincterectomy(EST),endoscopic pancreatic sphincterectomy(EPS),or endoscopic nose-pancreatic pseudocysts drainage(ENPPD).Extraction of pancreatic duct stones and dilatation of pancreatic duct stricture were performed selectively.Results During the treatment,removal of pancreatic stones was performed in 6 cases.Pancreatic duct dilatation was performed in 9 cases with pancreatic duct narrowing,and 8 cases received pancreatic stents drainage.Postoperatively,clinical symptoms were evidently alleviated in 18 patients,and with a large amount of purulent pancreatic fluid drained.Symptom of infection,including abdominal pain and fever,were within 48 hours after drainage,and were controlled within 1 week.Pancreatic pseudocysts disappeared in 16 cases,and conspicuously shrank in 2 patients.Pancreatic function recovered gradually following endoscopic transpapillary nose-pancreatic pseudocyst drainage.Conclusions In the treatment of pancreatitis with infected pancreatic pseudocyst,endoscopic transpapillary nose-pancreatic pseudocysts drainage is a preferred method for its safety,less trauma,lower expenditure,convenient and conspicuous curative effect.

Objective To assess the effect of treatment of rectal carcinoid tumors through endoscopy.Methods Endoscopic dissection was performed for patients during Jun.2005 to Dec.2009,in whom an elevated lesion in rectal mucosa as seen through colonoscopy,and highly suspected to be rectal carcinoid by endoscopic ultrasound(EUS),with the diameter of the lesion smaller than 1.0cm,was excised through endoscope.After being proved to be totally excised,endoscopic biopsy was performed at 4 to 6 sites along borderline of the tumor.Accurate rate of EUS was evaluated by postoperative pathology.Invasion and entirety of excised tumor were analyzed by pathological examination.Colonoscopy and liver ultrasound were carried out one time every half a year during the follow-up.Results 27 patients with elevated lesion in rectal mucosa were investigated.Rectal carcinoid was highly suspected in these patients and met the indication for endoscopic excision.The elevated lesion in rectal mucosa was excised successfully by endoscopy in all cases.Postoperative pathology confirmed that corvect diagnosis of rectal carcinoid was 92.6%(25/27).Interstitialoma was found in 1 patient,and granular cell tumor in another patient.All the 25 patients with rectal carcinoid were followed up with an average follow-up time of 33.7±12.5 months.Metastases and recurrence had not been found.Conclusions EUS has a good diagnostic specificity in the elevated lesion of rectal mucosa,and can accurately assess the indication of endoscopic excision.Endoscopic excision is a safe and effective method for rectal carcinoid which is smaller than 1.0 cm.

Pipe jacking is widely used in the underground construction, but few studies are focused on the pipe wall stability and no specify rule is presented in the codes. According to this situation, theoretical and numerical analysis is applied in research. Through numerical simulation, the inner force and deformation of steel pipe can be obtained, but the control criterion of wall thickness is still in lack. Based on the result of numerical analysis, the deformation of steel pipe is characteristic of arch, so the stability theory of arch in the material mechanics is lead to compute the critical pressure. Comparing the critical pressure with the actual force of steel pipe, the stability of pipe wall can be determined. The steel pipe of intake pipe design of a heat-engine plant is studied as project case, and the stability of pipe wall under different wall thickness is studied using the methods presented. The analysis and optimum design shows that the 22mm can be determined as the proper wall thickness instead of the original design thickness—34mm, and the project cost will be decreased significantly.

To assess the combating performance of complex operational system dynamically, and to fix quantify various performance parameters of system, a evolving topological model based on the interacting and non-linear priority growth of new nodes and internal edges which substitutes real military system and the dynamic development has been abstracted, with reference to social network an complex network theory, such as Transit-Stub model based on hierarchical structure, BA model based on the degree of node, GLP and PFP models and multi-local world model. And this model was established and simulated by MATLAB software according to various rules defined in model. Many topological properties are discussed after evolving with different conditions and time. Finally, evolvement process of system's characters is acquainted and applied to the practice of military construction. By analytical-numerical method and experimental simulation, it draws the conclusion that operational system is a scale free network while the feature of small world is unobvious. This may because the military is a well-organized system, and has a stronger self-adapting power compared with Internet.