食管胃黏膜异位内镜检出率的影响因素分析

目的探讨影响食管胃黏膜异位(HGME)内镜检出率的影响因素,以提高HGME的内镜检出率。方法回顾性分析2018年1月-2018年12月在柳州市人民医院行胃镜检查的患者19948例。记录患者年龄、性别、胃镜检查方式、胃镜检查模式和胃镜医师级别等,分析HGME检出率的影响因素。结果检出HGME 282例,总检出率为1.41%(282/19948)。不同组别发现的HGME病例数如下:无痛胃镜组226例(1.53%),普通胃镜组56例(1.07%);NBI组89例(3.06%),普通白光组193例(1.13%);按胃镜医师级别分组,住院医师及低年资主治医师组37例(0.89%),高年资主治医师组93例(1.48%),副主任医师及以上组152例(1.59%)。经统计学分析,胃镜检查方式、胃镜检查模式和医师分级对HGME检查率均有影响(P<0.05),而患者年龄和性别对HGME检出率无明显影响。结论HGME检出率与胃镜检查方式、胃镜检查模式和医师分级相关,无痛胃镜、NBI模式、内镜医师经验的积累均能明显提高HGME的检出率。

Novel circular RNAs expressed in brain microvascular endothelial cells after oxygen-glucose deprivation/recovery

Circular RNAs (circRNAs) are generated by head-to-tail splicing and are ubiquitously expressed in all multicellular organisms. Their important biological functions are increasingly recognized. Cerebral ischemia reperfusion injury-induced brain microvascular endothelial cell dysfunction is an initial stage of blood-brain barrier disruption. The expression profile and potential function of circRNAs in brain microvascular endothelial cells is unknown. Rat brain microvascular endothelial cells were extracted and cultured in glucose-free medium for 4 hours with 5% CO2 and 95% N2, and the medium was then replaced with complete growth medium for 6 hours. The RNA in these cells was then extracted. The circRNA was identified by Find_circ and CIRI2 software. Functional and pathway enrichment analysis of genes that were common to differentially expressed mRNAs and circRNA host genes was performed by the Database for Annotation, Visualization and Integrated Discovery Functional Annotation Tool. Miranda software was used to predict microRNAs that were potentially sponged by circRNAs. Furthermore, cytoscape depicted the circR-NA-microRNA interaction network. The results showed that there were 1288 circRNAs in normal and oxygen-glucose deprived/recovered primary brain microvascular endothelial cells. There are 211 upregulated and 326 downregulated differentially expressed circRNAs. The host genes of these differentially expressed circRNAs overlapped with those of differentially expressed mRNAs. The shared genes were further studied by functional enrichment analyses, which revealed that circRNAs may contribute to calcium ion function and the cyclic guanosine 3′,5′-monophosphate (CAMP) dependent protein kinase (PKα) signaling pathway. Next, quantitative reverse transcription polymerase chain reaction assays were performed to detect circRNA levels transcribed from the overlapping host genes. Eight out of the ten circRNAs with the highest fold-change identified by sequencing were successfully verified. Subsequently, the circRNA-microRNA interaction networks of these eight circRNAs were explored by bioinformatic analysis. These results demonstrate that altered circRNAs may be important in the pathogenesis of cerebral ischemia reperfusion injury and consequently may also be potential therapeutic targets for cerebral ischemia diseases. All animal experiments were approved by the Chongqing Medical University Committee on Animal Research, China (approval No. CQMU20180086) on March 22, 2018.

全角膜羊膜覆盖和绷带型角膜接触镜用于较大翼状胬肉切除术的疗效比较

目的:针对较大翼状胬肉,采用胬肉切除、角膜缘干细胞移植联合全角膜羊膜覆盖术,或胬肉切除和角膜缘干细胞移植术后配戴绷带型角膜接触镜进行治疗,观察两种方法的临床效果。方法:将侵及瞳孔区的较大翼状胬肉40眼随机分成两组,一组行翼状胬肉切除、角膜缘干细胞移植术联合全角膜羊膜覆盖术(羊膜组),另一组行胬肉切除和角膜缘干细胞移植术后配戴绷带型角膜接触镜(绷带镜组),每组各20眼。比较两组患者手术时间,以及术后第1、3d,1、3wk眼部舒适程度和角膜愈合情况与随访复发情况等。结果:平均手术时间:羊膜组为61.4±5.2min,绷带镜组为34.5±2.7min,绷带镜组手术时间明显缩短,两组差异有统计学意义(P<0.05)。两组患者的眼部舒适度在术后第1d无明显差异,但在术后第3d和术后1wk,绷带镜组患者的眼部舒适度明显优于羊膜组(P<0.01),至术后3wk时两组间差异无统计学意义(P>0.05)。术后3wk时两组患者的角膜愈合率评分分别为0.85±0.18分和1.15±0.18分,两组差异无统计学意义(P=0.25)。羊膜组有1眼胬肉复发。结论:在侵及角膜的较大翼状胬肉治疗中,胬肉切除和角膜缘干细胞移植术后联合全角膜羊膜覆盖或术后配戴绷带型角膜接触镜均有助于缓解眼部不适症状和促进角膜创面修复,使用绷带型角膜接触镜患者更舒适,治疗更便捷。

Multi-slice spiral computed tomography in differential diagnosis of gastric stromal tumors and benign gastric polyps,and gastric stromal tumor risk stratification assessment

BACKGROUND The biological characteristics of gastric stromal tumors are complex,and their incidence has increased in recent years.Gastric stromal tumors(GST)have potential malignant tendencies,and the probability of transformation into malignant tumors is as high as 20%-30%.AIM To investigate the value of multi-slice spiral computed tomography(MSCT)in the differential diagnosis of GST and benign gastric polyps,and GST risk stratification assessment.METHODS We included 64 patients with GST(GST group)and 60 with benign gastric polyps(control group),confirmed by pathological examination after surgery in PLA General Hospital,from January 2016 to June 2021.The differences in the MSCT imaging characteristic parameters and enhanced CT values between the two groups before surgery were compared.According to the National Institutes of Health’s standard,GST is divided into low-and high-risk groups for MSCT imaging characteristic parameters and enhanced CT values.RESULTS The incidences of extraluminal growth,blurred boundaries,and ulceration in the GST group were significantly higher than those in the control group(P<0.05).The CT values and enhanced peak CT values in the arterial phase in the CST group were higher than those in the control group(P<0.05).The MSCT differential diagnosis of GST and gastric polyp sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,and areas under the curve(AUCs)were 73.44%,83.33%,26.56%,16.67%,0.784,respectively.The receiver operating characteristic curves were plotted with the arterial CT value and enhanced peak CT value,with a statistical difference.The results showed that the sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,and AUC value of arterial CT in the differential diagnosis of GST and gastric polyps were 80.18%,62.20%,19.82%,37.80%,and 0.710,respectively.The sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,and AUC value of the enhanced peak CT value in the differential diagnosis of GST and gastric polyps were 67.63%,60.40%,32.37%,39.60%,and 0.710,respectively.The incidence of blurred lesion boundaries and ulceration in the high-risk group was significantly higher than that in the low-risk group(P<0.05).The arterial phase and enhanced peak CT values in the high-risk group were significantly higher than those in the low-risk group(P<0.05).CONCLUSION Presurgical MSCT examination has important value in the differential diagnosis of GST and gastric benign polyps and can effectively evaluate the risk grade of GST patients.

Contact performance analysis of pressure controller's sealing interface in deep in-situ pressure-preserved coring system

The sealing performance of contact interfaces plays the most important role in the design and operation of the in-situ pressure-preserved coring system.To meet the demand of ultra-high pressure-retained coring for oil and gas exploration in deep reservoirs,a quantitative analysis of the contact mechanical behavior of the pressure controller was performed.Based on the micro-contact theory of rough surfaces,a three-dimensional numerical model of the rough contact interface between the valve cover and the valve seat was constructed,and the micro-contact behavior of the metal contact surfaces was comprehensively studied.The results show that the actual contact area of the valve interface increases with the increase of surface roughness before the critical contact point,but decreases after that.Compared with the real contact model with double rough surfaces,although the simplified hard-contact model with a single rough surface can reflect the micro-contact behavior of the rough surface to a certain extent,it cannot truly reveal the microchannel morphology between the sealing interfaces under pressure.Therefore,the realistic double-rough-surface model should be recommended to evaluate the sealing performance of coring tools,particularly for high pressure conditions.The material properties of valves have a significant effect on the contact characteristics of rough surfaces,which suggested that the actual contact area decreases with the increase of the elastic modulus of the contact material under the same loading conditions.The knowledge of this work could help to enhance the seal design of pressure controllers for in-situ pressure-preserved coring.

Granuloma of graphite foreign body in conjunctiva simulates melanoma: a case report and literature review

Dear Editor,We present a rare case of conjunctival foreign body granuloma simulating melanoma caused by longterm retained pencil core.The pigmented conjunctival mass and eye injury caused by writing instruments are not rare.

Saturable Absorption Enchantment of Au Nanorods Based on Energy Transfer between Longitudinal and Transverse Energy Levels

Four kinds of Au nanorods（NRs）with different aspect ratios are designed to adjust the relationship between resonance energy level of longitudinal（L）and transverse（T）modes.During the femto-second Z-scan experiments,huge saturable absorption phenomena are observed while the energy level T is located between one to two times of the energylevel L.This means that the energy may transfer between longitudinal and transverse energylevels in the same and/or different Au NRs.It effectively depresses the production of revised saturated absorption and increases the saturable absorption efficiency.This method is significant for the preparation of high-efficiency saturable absorption devices.

Magnetic resonance imaging features of minimal-fat angiomyolipoma and causes of preoperative misdiagnosis

BACKGROUND Minimal-fat angiomyolipoma(mf-AML)is often misdiagnosed as renal cell carcinoma before surgery.AIM To analyze the magnetic resonance imaging(MRI)features of mf-AML and the causes of misdiagnosis by MRI before operation.METHODS A retrospective analysis was performed on ten patients with mf-AML confirmed by surgical pathology,all of whom underwent preoperative MRI examination to analyze the morphological characteristics and MRI signals of the tumor.RESULTS MRI revealed a circular-like mass in 4/10(40%)patients,an oval mass in 6/10 patients(60%),a mass with a capsule in 9/10 patients(90%),and a mass with a lipid component in 7/10 patients(70%).The diameter of the masses in all ten patients was from 11 to 47 mm;the diameter was between 11 mm and 40 mm in 8/10(80%)patients and between 40 mm and 47 mm in 2/10(20%)patients.CONCLUSION An oval morphological characteristic is strong evidence for the diagnosis of mf-AML,while a capsule and lipids are atypical manifestations of mf-AML.

Risk factors and drug resistance in early-onset neonatal group B streptococcal disease

In recent years,group B streptococcus (GBS) has become an important pathogen that causes infections in many neonatal organs,including the brain, hmg,and eye (Ballard et al.,2016).A series of studies performed on GBS infections in western countries have revealed that GBS is one of the primary patho-gens implicated in perinatal infection,and GBS infections are a major cause of neonatal morbidity and mortality in the United States (Decheva et al.,2013).

Role of T-type Calcium Channels in Generating Hyperexcitatory Behaviors during Emergence from Sevoflurane Anesthesia in Neonatal Rats

In the current study,we sought to investigate whether T-type Ca^(2+)channels(TCCs)in the brain are involved in generating post-anesthetic hyperexcitatory behaviors(PAHBs).We found that younger rat pups(postnatal days 9-11)had a higher incidence of PAHBs and higher PAHB scores than older pups(postnatal days16-18)during emergence from sevoflurane anesthesia.The power spectrum of the theta oscillations(4 Hz-8 Hz)in the prefrontal cortex was significantly enhanced in younger pups when PAHBs occurred,while there were no significant changes in older pups.Both the power of theta oscillations and the level of PAHBs were significantly reduced by the administration of TCC inhibitors.Moreover,the sensitivity of TCCs in the medial dorsal thalamic nucleus to sevoflurane was found to increase with age by investigating the kinetic properties of TCCs in vitro.TCCs were activated by potentiated GABAergic depolarization with a sub-anesthetic dose of sevoflurane(1%).These data suggest that(1)TCCs in the brain contribute to the generation of PAHBs and the concomitant electroencephalographic changes;(2)the stronger inhibitory effect of sevoflurane contributes to the lack of PAHBs in older rats;and(3)the contribution of TCCs to PAHBs is not mediated by a direct effect of sevoflurane on TCCs.

Dependence of Generation of Hippocampal CAI Slow Oscillations on Electrical Synapses

Neuronal oscillations in the hippocampus are critical for many brain functions including learning and memory.The underlying mechanism of oscillation generation has been extensively investigated in terms of chemical synapses and ion channels.Recently,electrical synapses have also been indicated to play important roles,as reported in various brain areas in vivo and in brain slices.However,this issue remains to be further clarified,including in hippocampal networks.Here,using the completely isolated hippocampus,we investigated in vitro the effect of electrical synapses on slow CA1 oscillations(0.5 Hz-1.5 Hz)generated intrinsically by the hippocampus.We found that these oscillations were totally abolished by bath application of a general blocker of gap junctions(carbenoxolone)or a specific blocker of electrical synapses(mefloquine),as determined by whole-cell recordings in both CA1 pyramidal cells and fast-spiking cells.Our findings indicate that electrical synapses are required for the hippocampal generation of slow CA1 oscillations.