The Etiological Study of Three Hunter Syndrome Families in Southern China / 中山大学学报(医学科学版)

ObjectiveTo reveal the molecular pathogenesis of Hunter syndrome in three families in southern China and to clarify the correlation between phenotype and genotype， so as to lay a foundation for future prenatal or preimplantation genetic diagnosis. MethodsOn the basis of initial clinical diagnosis and pedigree analysis， qualitative detection of glycosaminoglycans in urine was performed first， and then anticoagulant blood samples were collected from the children and their relatives. DNA was extracted and the IDS gene sequence was analyzed by PCR and Sanger sequencing. Various methods such as RT-PCR and bioinformatics analysis were used to identify the pathogenicity of the new variants. ResultsThe urine test results of the patients in the three families were all strongly positive（++）. Probands were all male， with hemizygous mutations in IDS gene from their mothers， and the mutation sites were c.615_622delCATACAGT， c.847_848delGT and IVS7 ds+1 G>A， respectively. The cross-species conservation analysis showed that the amino acid of IDS gene mutation site was highly conserved during species evolution. Compared with the normal protein， mutant proteins exhibited significant differences in the predicted results of advanced structure. The variants identified in the three families were classified as pathogenic by ACMG criteria. ConclusionsThe three probands were diagnosed with Hunter syndrome. The c.615_622del（p.Il206Valfs*18）， c.847_848del（p.Val283Alafs*57） and IVS7 ds+1 G>A （p.G336Dfs*12） of IDS gene are all novel pathogenic mutations， which are the underlying causes of morbidity in children. This study has further enriched the mutation spectrum of IDS gene.

Thoughts on path of R&D and registration of innovative traditional Chinese medicine with synchronous transformation of "series prescriptions" / 中国中药杂志

Since the implementation of drug registration in China, the classification of Chinese medicine has greatly met the needs of public health and effectively guided the transformation, inheritance, and innovation of research achievements on traditional Chinese medicine(TCM). In the past 30 years, the development of new Chinese medicine has followed the registration transformation model of " one prescription for single drug". This model refers to the R&D and registration system of modern drugs, and approximates to the " law-abiding" medication method in TCM clinic, while it rarely reflects the sequential therapy of syndrome differentiation and comprehensive treatment with multiple measures. In 2017, Opinions on Deepening the Reform of Review and Approval System and Encouraging the Innovation of Drugs and Medical Devices released by the General Office of the CPC Central Committee and the General Office of the State Council pointed out that it is necessary to " establish and improve the registration and technical evaluation system in line with the characteristics of Chinese medicine, and handle the relationship between the traditional advantages of Chinese medicine and the requirements of modern drug research". Therefore, based on the development law and characteristics of TCM, clinical thinking should be highlighted in the current technical requirements and registration system of research and development of Chinese medicine. Based on the current situation of registration supervision of Chinese medicine and the modern drug research in China, the present study analyzed limitations and deficiency of " one prescription for single drug" in the research and development of Chinese medicine. Additionally, a new type of " series prescriptions" was proposed, which was consistent with clinical thinking and clinical reality. This study is expected to contribute to the independent innovation and high-quality development of the TCM industry.

Enhancer-Gene Interaction Analyses Identified the Epidermal Growth Factor Receptor as a Susceptibility Gene for Type 2 Diabetes Mellitus

BackgroundGenetic interactions are known to play an important role in the missing heritability problem for type 2 diabetes mellitus (T2DM). Interactions between enhancers and their target genes play important roles in gene regulation and disease pathogenesis. In the present study, we aimed to identify genetic interactions between enhancers and their target genes associated with T2DM.MethodsWe performed genetic interaction analyses of enhancers and protein-coding genes for T2DM in 2,696 T2DM patients and 3,548 controls of European ancestry. A linear regression model was used to identify single nucleotide polymorphism (SNP) pairs that could affect the expression of the protein-coding genes. Differential expression analyses were used to identify differentially expressed susceptibility genes in diabetic and nondiabetic subjects.ResultsWe identified one SNP pair, rs4947941×rs7785013, significantly associated with T2DM (combined P=4.84×10−10). The SNP rs4947941 was annotated as an enhancer, and rs7785013 was located in the epidermal growth factor receptor (EGFR) gene. This SNP pair was significantly associated with EGFR expression in the pancreas (P=0.033), and the minor allele “A” of rs7785013 decreased EGFR gene expression and the risk of T2DM with an increase in the dosage of “T” of rs4947941. EGFR expression was significantly upregulated in T2DM patients, which was consistent with the effect of rs4947941×rs7785013 on T2DM and EGFR expression. A functional validation study using the Mouse Genome Informatics (MGI) database showed that EGFR was associated with diabetes-relevant phenotypes.ConclusionGenetic interaction analyses of enhancers and protein-coding genes suggested that EGFR may be a novel susceptibility gene for T2DM.

Chemical constituents from the leaves of Cinnamomum camphora var. linaloolifera and their anti-inflammatory activities / 中国中药杂志

Thirteen compounds were isolated and purified from the leaves of Cinnamomum camphora by the macroporous resin,silica gel,and Sephadex LH-20 column chromatographies. Those compounds were further identified by IR,UV,MS,and NMR techniques:( 2 S)-1-( 3″,4″-methylenedioxy phenyl)-3-( 2',6'-dimethoxy-4'-hydroxyphenyl)-propan-2-ol( 1),( 2 R,3 R)-5,7-dimethoxy-3',4'-methylenedioxy flavanol( 2),9-hydroxysesamin( 3),sesamin( 4),piperitol( 5),kobusin( 6),(-)-aptosimon( 7),acuminatolide( 8),1β,11-dihydroxy-5-eudesmene( 9),lasiodiplodin( 10),vanillin( 11),p-hydroxybenzaldehyde( 12),and p-hydroxybenzoic acid ethyl ester( 13). Compound 1 was a novel compound,and compounds 2,6,7,9 and 10 were isolated from Cinnamomum plants for the first time. Compounds 4,7 and 10 were found to possess good inhibitory effect on IL-6 production in LPS-induced BV2 cells at a concentration of 20 μmol·L-1 in the in vitro bioassay,with inhibition rates of 51. 26% ± 4. 13%,67. 82% ± 3. 77% and85. 81%±1. 19%,respectively.

Effect of Canine-assisted Therapy on Family Function of Autism Spectrum Disorder / 中国康复理论与实践

Objective:To evaluate the effect of canine-assisted therapy on family function of autism spectrum disorder. Methods:The randomized controlled trials (RCT) about the effect of canine-assisted therapy on family function of autism spectrum disorder were retrieved from the Cochrane Library, PubMed, Web of Science, CNKI, CBM, VIP, and Wanfang Data from establishment to February, 2021. Brief Family Assessment Measure-III-General Scale (FAM-III-GS) was used to access the family function, and Children's Depression Inventory-Second Edition (CDI-2) and Spence Children's Anxiety Scale (SCAS) were used to access the psychological behavior. The quality of included studies was evaluated according to the method recommended by the Cochrane Collaboration and Joanna Briggs Institute Reviewers' manual. RevMan 5.4 software was used for meta-analysis. Results:Finally, four RCTs involving 190 patients were included. There were too less RCTs to do a meta-analysis. Two RCTs showed that the score of FAM-III-GS improved in the experimental group than in the control group. Conclusion:Canine-assisted therapy might improve the family function of patients with autism spectrum disorder.

Enhancer-Gene Interaction Analyses Identified the Epidermal Growth Factor Receptor as a Susceptibility Gene for Type 2 Diabetes Mellitus

BackgroundGenetic interactions are known to play an important role in the missing heritability problem for type 2 diabetes mellitus (T2DM). Interactions between enhancers and their target genes play important roles in gene regulation and disease pathogenesis. In the present study, we aimed to identify genetic interactions between enhancers and their target genes associated with T2DM.MethodsWe performed genetic interaction analyses of enhancers and protein-coding genes for T2DM in 2,696 T2DM patients and 3,548 controls of European ancestry. A linear regression model was used to identify single nucleotide polymorphism (SNP) pairs that could affect the expression of the protein-coding genes. Differential expression analyses were used to identify differentially expressed susceptibility genes in diabetic and nondiabetic subjects.ResultsWe identified one SNP pair, rs4947941×rs7785013, significantly associated with T2DM (combined P=4.84×10−10). The SNP rs4947941 was annotated as an enhancer, and rs7785013 was located in the epidermal growth factor receptor (EGFR) gene. This SNP pair was significantly associated with EGFR expression in the pancreas (P=0.033), and the minor allele “A” of rs7785013 decreased EGFR gene expression and the risk of T2DM with an increase in the dosage of “T” of rs4947941. EGFR expression was significantly upregulated in T2DM patients, which was consistent with the effect of rs4947941×rs7785013 on T2DM and EGFR expression. A functional validation study using the Mouse Genome Informatics (MGI) database showed that EGFR was associated with diabetes-relevant phenotypes.ConclusionGenetic interaction analyses of enhancers and protein-coding genes suggested that EGFR may be a novel susceptibility gene for T2DM.

Quantifying the impacts of human mobility restriction on the spread of coronavirus disease 2019: an empirical analysis from 344 cities of China / 中华医学杂志(英文版)

BACKGROUND@#Since the outbreak of coronavirus disease 2019 (COVID-19), human mobility restriction measures have raised controversies, partly because of the inconsistent findings. An empirical study is promptly needed to reliably assess the causal effects of the mobility restriction. The purpose of this study was to quantify the causal effects of human mobility restriction on the spread of COVID-19.@*METHODS@#Our study applied the difference-in-difference (DID) model to assess the declines of population mobility at the city level, and used the log-log regression model to examine the effects of population mobility declines on the disease spread measured by cumulative or new cases of COVID-19 over time after adjusting for confounders.@*RESULTS@#The DID model showed that a continual expansion of the relative declines over time in 2020. After 4 weeks, population mobility declined by -54.81% (interquartile range, -65.50% to -43.56%). The accrued population mobility declines were associated with the significant reduction of cumulative COVID-19 cases throughout 6 weeks (ie, 1% decline of population mobility was associated with 0.72% [95% CI: 0.50%-0.93%] reduction of cumulative cases for 1 week, 1.42% 2 weeks, 1.69% 3 weeks, 1.72% 4 weeks, 1.64% 5 weeks, and 1.52% 6 weeks). The impact on the weekly new cases seemed greater in the first 4 weeks but faded thereafter. The effects on cumulative cases differed by cities of different population sizes, with greater effects seen in larger cities.@*CONCLUSIONS@#Persistent population mobility restrictions are well deserved. Implementation of mobility restrictions in major cities with large population sizes may be even more important.

Recent advances of traditional Chinese medicine on the prevention and treatment of COVID-19 / 中国天然药物

Coronavirus disease-2019 (COVID-19) is a new highly infectious disease caused by a novel coronavirus. Recently, the number of new cases infected pneumonia in the world continues to increase, which has aroused great concern from the international community. At present, there are no small-molecule specific anti-viral drugs for the treatment. The high mortality rate seriously threatens human health. Traditional Chinese medicine (TCM) is a unique health resource in China. The combination of TCM and Western medicine has played a positive and important role in combating COVID-19 in China. In this review, through literature mining and analysis, it was found that TCM has the potential to prevent and treat the COVID-19. Then, the network pharmacological studies demonstrated that TCM played roles of anti-virus, anti-inflammation and immunoregulation in the management of COVID-19 via multiple components acting on multiple targets and multiple pathways. Finally, clinical researches also confirmed the beneficial effects of TCM on the treatment of patients. This review may provide meaningful and useful information on further drug development of COVID-19 and other viral infectious diseases.

Preparation of vincristine loaded low density lipoprotein nanoparticles modified by T7 peptide and evaluation of therapeutic effect on glioma / 药学学报

The purpose of this study was to prepare T7 peptide modified vincristine loaded low density lipoprotein (T7-LDL-VCR) nanoparticles to penetrate through blood brain barrier for targeting the brain tumor cells. Firstly, the low density lipoprotein (LDL) nanoparticles were extracted and separated from human serum by density gradient centrifugation method, and then was loaded into the nanoparticle's lipid core by the dry film method, T7 peptide was covalent modified on the surface of the nanoparticles. T7-LDL-VCR was characterized by particle size, entrapment efficiency and peptide attachment efficiency. The fluorescent probe DiR was used to track the brain biodistribution of T7-LDL-VCR in mice bearing intracranial C6 glioma by means of in vivo imaging. The therapeutic effect of nanoparticles was observed with magnetic resonance imaging (MRI). Finally, relative tumor volume and survival curve were determined in mice. The results showed that the mean size of the prepared T7-LDL-VCR nanoparticle was about 30 nm, encapsulation efficiency was 30.1%, and peptide attachment efficiency was 63.88%. As expected, the prepared preparation has good brain targeting and good effect on the treatment of glioma in mice:the relative tumor volumes of T7-VCR-LDL, LDL-VCR and VCR were 30%, 51.50% and 79.25%, respectively; the median survival time (36 days), which was 2, 1.85 and 1.38 fold higher than that of physiological saline, free VCR and LDL-VCR, respectively. This study suggests that dual modified hposomes possessed a better ability penetrating the blood brain barrier to target the brain tumor with significant antitumor activities.

Detecting Salmonella with matrix assisted laser desorption ionization time of flight mass spectrometry / 中国人兽共患病学报

In order to optimize the matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF-MS) method for Salmonella identification,study the target board pollution situation of different pretreatment methods,and establish a safe and effective method for detection of Salmonella,we applied MALDI-TOF-MS technique to detect 4 standard strains-of Salmonella under different culture conditions and sample preparation method,and established optimization program.MALDI target board was detected under different preparation treatments.The optimization method was used to detect 33 strains Salmonella which isolated from diarrhea patients' stool.Identification results were compared with serological results.The study found that MALDI-TOF-MS method could accurate identify of Salmonella in different pretreatment methods and culture medium.Thirty-three strains of Salmonella identified by MALDI-TOF-MS method were all accurate appraisal in genus level,19 strains of them were completely consistent with the serotyping identification results,14 strains of them were not consistent with the serotyping identification results.There was no bacteria growth on the target board in different pretreatment methods.MALDI-TOF-MS method can in a fast,convenient,safe and accurate way identify Salmonella,and it can become an effective means for identification of Salmonella.

Clinical Analysis of 41 Patients with Burkitt's lymphoma / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To summarize the clinical characteristics of Burkitt's lymphoma.</p><p><b>METHODS</b>Clinical data of 41 Burkitt's lymphoma patients, treated from Jannuary 2009 to June 2014 in Chinese PLA General Hospital, were analyzed retrospectively.</p><p><b>RESULTS</b>Out of the 41 patients, 33 were males and 8 were females, with a median age of 13 (range, 1-67), 18 cases (43.9%) were in Ann Arbor stage I/II, and 23 cases (56.1%) were in stage III/IV. The commonest pathologicalal sites were head and neck (23 cases, 56.1%), and then the abdominal (41.5%), bone marrow (22.0%) and central nervous system (22.0%) could also be involved, while 7 cases (17.1%) were patients transformed into acute lymphocytic leukemia-type L3, 18% cases (3/16) were infected by EBV and 29.9% cases (6/38) were infected by HBV, 29 cases were treated with chemotherapy, their overal remission rate was 93.1(27/29 cases), 2-year overall survival rate(OS) was 83.3%(10/12 cases); 13 cases were treated with rituximab, their remission rate was 92.3%(12/13 cases), and 2-year OS was 66.7%(4/6 cases).</p><p><b>CONCLUSION</b>The 41 cases are more similar to the sporadic Burkitt's lymphoma, but the median age of its occurence is more younger, while the most common pathological sites are head and neck, and the short-term and high intensive chemotherapy with rituximab can obviously elevate remission rate for adult patients and prolong their survival time.</p>

Treatment of castration-resistant prostate cancer: Evidence-based clinical practice / 中华男科学杂志

<p><b>OBJECTIVE</b>To introduce the framework of evidence-based practice with a case of castration-resistant prostate cancer (CRPC) as an example.</p><p><b>METHODS</b>A clinical question was formulated according the clinical scenario. A systematic search was conducted for the published literature in the databases of PubMed, EMBASE, Cochrane Library, Clinical Trial Registries, and Web of Knowledge up to Dec 2014. The identified literature was reviewed for quality appraisal before the evidence was applied to clinical practice.</p><p><b>RESULTS</b>The treatment was effective and the patient achieved disease remission.</p><p><b>CONCLUSION</b>Evidence-based practice should be integrated with clinical scenario, current evidence, and patients' willingness, and follow a systematic framework.</p>

Clinical research of reduced-intensity allogeneic hematopoietic stem cell transplantation for multiple myeloma / 中国实验血液学杂志

This study was purposed to explore the efficacy and feasibility of reduced-intensity allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the treatment of multiple myeloma (MM). Three patients with MM from January 2011 to January 2012 in General Hospital of Beijing Military Area were treated by reduced-intensity allo-HSCT. All donors are compatriots and affinity HLA identical. Donors were mobilized with granulocyte colony-stimulating factor (G-CSF), the MM patients were given combined transplantation of bone marrow and peripheral blood stem cells. Preconditioning regimen consisted of fludarabine combined with melphalan and anti-human thymocyte globulin, and the classic cyclosporin A (CsA) combined with methotrexate (MTX) was used to prevent graft-versus-host disease (GVHD). The preventive donor peripheral blood stem cell infusion in dose 0.2×10(8)/kg mononuclear cells (MNC) was applied after 3 months of transplantation, then the toxicity, GVHD and disease-free survival (DFS) in patients were observed after transplantation. The results showed that 3 patients got hematopoietic reconstitution, the average time of neutrophils ≥ 0.5×10(9)/L and platelets ≥ 20×10(9)/L was 14.3 d and 15.3 d respectively, the detection of implanting efficacy displayed 100% complete donor hematopoiesis. Follow-up to January 2013, the median follow-up time was 13 months (12 to 15 months), As a result, none of the patients got GVHD, infection and other serious complications, all patients are still in complete remission (CR), the longest DFS time has reached to 15 months. It is concluded that the reduced-intensity allogeneic hematopoietic stem cell transplantation is the effective method for MM, this method has the high safety and efficacy, as well as high complete remission rate in early transplantation, the MM patients may get a long-term survival. This method can be used as a key technology in clinic for treating MM.

Narrow band imaging versus iodine staining for margin determination of early esophageal cancer during endoscopic submucosal dissection / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the clinical value of narrow band imaging (NBI) and iodine staining for margin determination of early esophageal cancer during endoscopic submucosal dissection (ESD).</p><p><b>METHODS</b>Clinical data of 87 patients with early esophageal cancers undergoing endoscopic submucosal dissection (ESD) were analyzed retrospectively. Patients were assigned to NBI group and iodine staining group according to the staining method before ESD operation. Clinicopathological features, esophageal spasm ratio, operation time, en bloc resection rate, complications, local recurrence, and distant metastases were compared between the two groups.</p><p><b>RESULTS</b>There were 37 patients in NBI group while 50 patients in iodine staining group. Location and size of the lesions between two groups were not significantly different. The ratio of moderate-severe esophageal spasm in NBI group was significantly lower as compared to iodine staining group [10.8%(4/37) vs. 32.0%(16/50), P<0.05]. The average operation time in NBI group was significantly shorter than that in iodine staining group [(42.2±19.5) min vs. (53.3±30.9) min, P<0.05). All the tumors were resected in an en bloc fashion and the R0 resection rate was 100%. Perforations in 2 patients and delayed bleeding in 1 patient were successfully treated by endoscopic methods. Esophageal strictures occurred in 3 patients of NBI group and 4 patients of iodine staining group, who were treated by endoscopic dilation and retrievable stents. During mean 13.2 months (range 4 to 20 months) follow-up periods, local recurrence occurred in 2 patients of NBI group and 2 patients of iodine staining group. These patients received ESD or other surgery.</p><p><b>CONCLUSION</b>Compared with iodine staining, using NBI for margin determination of early esophageal cancer during ESD is more convenient and fast because of distinctly lower degree of esophageal spasm.</p>

Demethylating agent decitabine induces autologous cancer testis antigen specific cytotoxic T lymphocytes in vivo / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Cancer testis antigens (CTAs) are a novel group of tumor associated antigens. Demethylating agent decitabine was reported to be able to up-regulate CTAs through its hypomethylation mechanism, thus enhance the immunogenicity of leukemia cells. However, few researches have ever focused on the questions that whether this immunostimulatory effect of decitabine could induce autologous CTA specific cytotoxic T lymphocytes (CTLs) in vivo, and if so, whether this effect contributes to disease control. In this study, we aimed to show that decitabine could induce specific autologous CTLs against some mouse CTAs in leukemia cells in vitro and in vivo.</p><p><b>METHODS</b>Several mouse CTAs were screened by RT-PCR. CTL specific to one of the CTAs named P1A was detected and sorted by P1A specific dimer by flow cytometry. The activity of specific CTLs was measured by real time RT-PCR.</p><p><b>RESULTS</b>We firstly screened expression of some CTAs in mouse leukemia cells before and after decitabine treatment and found that decitabine treatment did up-regulate expression of many CTAs. Then we measured the CTLs' activity specific to a mouse CTA P1A in vivo and showed that this activity increased after decitabine treatment. Finally, we sorted these in vivo induced P1A specific CTLs by flow cytometry and demonstrated their cytotoxicity against decitabine treated leukemia cells.</p><p><b>CONCLUSIONS</b>Our study showed the autologous immune response induced by decitabine in vivo. And more importantly, we firstly proved that this response may contribute to disease control. We believe that this immunostimulatory effect is another anti-cancer mechanism of decitabine, and this special effect would inspire new applications of decitabine in the field of leukemia treatment in the future.</p>

Chemical constituents of Rabdosia japonica var. glaucocalyx and their anti-complementary activity / 中国中药杂志

To study the chemical constituents of Rabdosia japonica var. glaucocalyx and their anti-complementary activity on the basis of preliminary studies. Target isolation guided by anti-complementary activity test, compounds in the chloroform and n-butanol fractions were isolated and purified by silica gel and Sephadex LH-20 column chromatographies, and preparative HPLC. The structures were identified by various spectroscopic data including ESI-MS, 1H-NMR and 13C-NMR data. The compounds were evaluated for anti-complementary activity in vitro. Eleven compounds were isolated from the chloroform and n-butanol soluble fractions and identified as stigmasterol (1), stigmas-9 (11) -en-3-ol (2), glaucocalyxin D (3), kamebakaurin (4), maslinic acid (5), corosolic acid (6), minheryins I (7), diosmetin (8), caffeic acid ethylene ester (9), caffeic acid (10) and vitexin (11). Isoquercetrin, rutin, quercetin, 3-methylquercetin, luteolin, 7-methylluteolin, and apigenin which were isolated from the preliminary studies together with compounds 9 and 10 showed inhibition of the complement system by the classical pathway. Compounds 2, 4, 6-9 and 11 were obtained from this plant for the first time. Caffeic acid (10) showed the strongest activity in vitro with a CH50 value of 0.041 g x L(-1).

Endoscopic sclerotherapy of gastric varices by tissue adhesives / 中华胃肠外科杂志

The diagnosis and treatment of gastric varices is a clinically concerned issue. With the development of endoscopic technology. The success rate of controlling bleeding from gastric and esophageal varices has been improved a lot. It is efficacious and safe to treat gastric and esophageal varices by endoscopic injection of tissue adhesives and to prevent re-bleeding. There is few acute and long-term complications of this modality. It has been the first line treatment for gastric varices.

Value of endoscopic submucosal dissection for duodenal lesions in 78 patients / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To assess the clinical value of endoscopic submucosal dissection(ESD) for duodenal lesion.</p><p><b>METHODS</b>A total of 78 patients with duodenal lesion were treated with ESD from November 2006 to August 2010. The clinical data were retrospectively analyzed.</p><p><b>RESULTS</b>There were 46 male and 14 female patients. The mean age was(54±9) years. The lesion location included the duodenal bulb(n=39, 50%), the junction of bulb and descending part(n=19, 24.4%), and the descending part(n=20, 25.8%). The mean diameter of the lesions was(2.1±1.7) cm. Fifty-one(65.4%) lesions originated from the mucosa, including inflammatory/ hyperplastic polyps(n=22, 28.2%), villous/tubular adenoma(n=26, 33.3%), and hamartomas polyps(n=3, 3.8%). Twenty-five(32.1%) lesions originated from the submucosa, including Brunner's glands adenoma(n=15, 19.2%), ectopic pancreas(n=3, 3.8%), carcinoid tumor(n=3, 3.8%), lipoma(n=2, 2.6%), myxoinoma(n=1, 1.3%), and angio-lymphangioma(n=1, 1.3%). There were two lesions originated from the muscularis propria(n=2, 2.5%), and both were ectopic pancreas. All cases received ESD successfully. The mean operative time was(37±41) min and the mean blood loss was(23±15) ml. The perioperative complication rate was 35.9%(28/78), including intraoperative perforation(n=6), delayed perforation(n=3), intraoperative hemorrhage(n=10), delayed bleeding(n=7), and transient elevation of serum amylase(n=2). Postoperative pathological examination showed vascular invasion with tumor cells in one patient, who received extended resection later. The remaining 77 patients showed no recurrence during the followed up(rang, 3-23 months) using endoscopy.</p><p><b>CONCLUSION</b>ESD is an effective, safe, minimally invasive method for the management of duodenal lesions.</p>

Use of endoscopic tissue adhesive injection for gastric varices / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the long-term efficacy and safety of endoscopic tissue adhesive(N-octyl-α-cyanoacrylate) injection for the treatment of gastric varices.</p><p><b>METHODS</b>A retrospective study was performed to review the clinical and follow up data of 169 patients with gastric variceal who received tissue adhesive injection at the Fudan University Affiliated Zhongshan Hospital between April 2004 and December 2011.</p><p><b>RESULTS</b>There were 128 males and 41 females with a mean age of 56.8(37-85) years old. One hundred and thirty-one patients received one injection, 38 received two injections or more with a mean of 1.12 per patient. Volume of injection ranged from 1 to 3 ml(mean, 1.7 ml). Eighty-three patients received adhesive injection alone, 231 received injection combined with ligation, 50 received combined sclerotic agent injection. All the patients had follow up ranging from 1 to 78 months(mean, 3.4 months). The treatment outcome was satisfactory in 130 patients(76.9%), good in 36(21.3%), and ineffective in 3(1.8%). The rate of ectopic embolization was 3.0%, and the rate of early re-bleeding was 1.2%. Postoperatively there were no septic complications or esophageal stricture. There were no deaths within 2 weeks.</p><p><b>CONCLUSION</b>Injection of tissue adhesive under endoscopic guidance for treatment of gastric varices is convenient, safe and effective.</p>