Application of blunt dissection in ESD of a gastric submucosal tumor

We performed endoscopic submucosal dissection of a gastric fundus tumor.It was difficult to strip the tumor completely due to space limitation,and we used blunt dissection to remove the tumor quickly and safely.Firstly,the basal area of the 2.5 cm submucosal tumor located in the gastric fundus was cut open,and the mucosa was dissected.The tumor was difficult to peel,therefore,a snare was used and the tumor was pulled and tightened slightly.Short electronic coagulation was used during the procedure.The tumor was then bluntly dissected.This method ensured rapid and complete removal of the tumor.

Protective effect and mechanism of dexmedetomidine on lung injury in diabetic mice with myocardial ischemia reperfusion

Objective:To evaluate the protective effect of dexmedetomidine and its mechanism on the lung after myocardial ischemia reperfusion in diabetic mice.Methods:Adult diabetic db/db mice aged 15 weeks were selected.The sham operation group(S group),ischemic reperfusion group(IR group),dexmedetomidine post-treatment group(POST-D)and dexmedetomidine pre-treatment group(PRE-D)were set respectively.The IR group of mice underwent ligation of anterior descending branch of left coronary artery for 30min and readministration for 120min.The post-D group and the pre-D group were intraperitoneally injected with 50 ug/kg DEX before surgery and during reperfusion,respectively.Orbital blood was extracted at 120min of reperfusion,serum levels of creatine kinase isoenzyme MB and inflammatory cytokines IL-6,IFN-γand IL-10 were detected,then mice were sacrificed and lung tissue was taken,the ratio of wet and dry weight(W/D)was determined,lung histopathological morphology was observed under light microscope,superoxide dismutase(SOD)and malondialdehyde(MDA)contents were determined,Western Blot was used to detect the expressions of Sirt1,GRP78 and CHOP in lung tissue.Results:Compared with the S group,the IR group rats had severe lung injury,including increased lung W/D value,increased serum CK-MB、IL-6 and IFN-γlevels,decreased serum IL-10,increased serum MDA content,decreased SOD activity,down-regulated Sirt1 expression,up-regulated GRP78 and CHOP expression.Compared with IR group,lung histopathological injury was reduced in post-D group and pre-D group,lung W/D value was decreased,serum CK-MB、IL-6 and IFN-γlevels were decreased,serum IL-10 was increased,serum MDA content was reduced,SOD activity was rised,the expression of Sirt1 was up-regulated,and GRP78 and CHOP were down-regulated.Compared with the post-D group,the degree of lung tissue injury in the pre-D group was reduced,but the differences in various indicators were not statistically significant.Conclusion:Dexmedetomidine can alleviate acute lung injury after myocardial ischemia reperfusion in diabetic mice,and the mechanism may be related to the up-regulation of Sirt1 and the inhibition of endoplasmic reticulum stress.

A Tuberous Sclerosis Family with TSC1 （c.1030-1G〉A） Mutation Found through a Female Presenting as Multiple Ground Glass Nodules in Chest Computed Tomography Incidentally

Chest computed tomography （CT） screening is becoming more popular in China. Therefore, more and more rare diseases and early stages of lung diseases were found. Here, we reported a case who presented as multiple ground glass nodules incidentally found in chest CT scan who had been suspected as synchronous multiple primary lung cancer （SMPLC） and/or metastatic cancer. She was finally diagnosed as tuberous sclerosis complex （TSC）, an autosomal-dominant disorder characterized by the fort-nation of hanaartomatous lesions in the skin, eyes, kidney, and central nervous system. Tuberous sclerosis complex 1 （TSC1） gene mutation （c.1030-1G〉A） was found in her and her family members. This is a very rare report in China.