Endoscopic Ultrasonography in the Diagnosis and Treatment Strategy Choice of Esophageal Leiomyoma

OBJECTIVES: Esophageal leiomyoma is the most common benign tumor of the esophagus, and it originates from mesenchymal tissue. This study analyzed the clinicopathological characteristics of esophageal leiomyoma and aimed to evaluate the role of endoscopic ultrasonography in the diagnosis and treatment selection for these lesions. METHODS: Two hundred and twenty-five patients who had suspected esophageal leiomyomas in endoscopic ultrasonography were enrolled at the Endoscopy Center of The First Affiliated Hospital, Zhejiang University from January 1st, 2009 to May 31th, 2015. The main outcomes included the demographic and morphological characteristics, symptoms, comparisons of diagnosis and treatment methods, adverse events, and prognosis. RESULTS: One hundred and sixty-seven patients were diagnosed as having an esophageal leiomyoma by pathological examination. The mean patient age was 50.57±9.983 years. In total, 62.9% of the lesions originated from the muscularis mucosa, and the others originated from the muscularis propria. The median distance to the incisors was 30±12 cm. The median diameter was 0.72±0.99 cm. As determined by endoscopic ultrasonography, most existing leiomyomas were homogeneous, endophytic, and spherical. The leiomyomas from the muscularis mucosa were smaller than those from the muscularis propria and much closer to the incisors (p<0.05). SMA (smooth muscle antibody) (97.2%) and desmin (94.5%) were positive in the majority of patients. In terms of treatments, patients preferred endoscopic therapies, which led to less adverse events (e.g., intraoperative bleeding, local infection, pleural effusion) than surgical operations (p<0.05). The superficial leiomyomas presented less adverse events and better recovery (p<0.05) than deep leiomyomas. CONCLUSION: Endoscopic ultrasonography has demonstrated high accuracy in the diagnosis of esophageal leiomyomas and provides great support in selecting treatments; however, EUS cannot completely avoid misdiagnosis, so combining it with other examinations may be a good strategy to solve this problem.

Application of Balint special group training in the training of humanistic care for junior nurses / 现代临床护理

Objective To explore the effect of Balint group training on the humanistic caring ability of junior nurses. Methods About 96 junior nurses from the department of oncology were randomly assigned to an intervention group and a control group equally.Balint group training was given to the intervention group every 2 weeks in a year.The control group completed the humanistic care training according to the regular procedure in the department of the hospital.At the beginning of the study and at the end of the study,the nursing staff from the two groups and the patients under their continuous nursing care for more than 3 days were surveyed by the care efficiency scale,nursing care behavior scale and patient care perception questionnaire.Results Before the intervention,there was no significant difference between the groups in the care performance and behavior of nursing staff and the patients'care perception (P>0.05).After the intervention there was significant difference in the care performance and behavior of nursing staff and the patients' care perception (P<0.05). Conclusions Balint group training can improve the caring performance of junior nurses.Their ability to express care and establish the caring nurse-patient relationship can be improved by this group training.They become more voluntary to integrate caring behavior into the daily care and their caring behaviors can be more likely to be felt and recognize by the patients.

Effect of xianzhen tablet on content of advanced glycosylation end products (AGEs) and mRNA expression of AGE-specific cellular receptor in renal cortex of diabetic rats / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the effect of Xianzhen tablet (XZT, a Chinese patent compound recipe) on advanced glycosylation end products (AGEs) and mRNA expression of AGE-specific cellular receptor (RAGE) in renal cortex of diabetic rats in order to explore the mechanism of XZT in protecting kidney.</p><p><b>METHODS</b>The diabetic rat model with persistent hyperglycemic renal damage was reproduced by streptozotocin. Fluorescent assay and RT-PCR were used to determine the content of AGEs and expression of RAGE mRNA in renal cortex in model rats, which were treated with XZT and controlled by aminoguanidine (AG) administration.</p><p><b>RESULTS</b>The relative content of AGEs and RAGE mRNA expression in renal cortex of model rats 12 weeks after modeling were significantly higher than those in the normal group (P < 0.05), while those in model rats treated by XZT or AG were markedly lower than those in non-treated model rats (P < 0.05), the effect of the both groups showed insignificant difference (P > 0.05).</p><p><b>CONCLUSION</b>XZT could reduce the accumulation of AGEs in renal cortex of diabetic rats, down-regulate the over-expression of RAGE mRNA, with the effects similar to that of AG, the inhibition of XZT on protein non-enzymatic glycosylation might be one of the mechanisms of its effect in protecting kidney.</p>

Effect of wenjingtong composita on blood glucose and advanced glycosylation end products in sciatic nerve of streptozotocin-induced diabetic rats / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the effect of Wenjingtong Composita (WJTC) on blood glucose and advanced glycosylation end products (AGEs) in sciatic nerve of streptozotocin (STZ)-induced diabetic rats.</p><p><b>METHODS</b>STZ-induced diabetic rats were randomized to WJTC prevention group and WJTC treatment group. The levels of blood glucose and AGEs in sciatic nerve of the animals were checked after 12 weeks treatment and compared with that of aminoguanidine (AG) treatment group.</p><p><b>RESULTS</b>Blood glucose level in the WJTC prevention and treatment group, and AGEs in sciatic nerve of the WJTC prevention group and the AG group were lower than those of the non-treated group (P < 0.01). Blood glucose level in the AG group was higher than that in the WJTC prevention group (P < 0.05), but was not significantly different from that in the non-treated group (P > 0.05).</p><p><b>CONCLUSION</b>WJTC might prevent diabetic peripheral neuropathy by decreasing blood glucose and inhibiting AGEs formation in sciatic nerve in STZ-induced diabetic rats.</p>