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    Translational medicine
    2016, 36 (07):  945. 
    Abstract ( 322 )   PDF (1895KB) ( 558 )  
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    Original article (Basic research)
    Surrogate analyte-based quantitative measurement of the tyrosine level in cell culture media by HILIC-MS/MS
    LI Wen-bin, DONG Jiang-kai, MENG Shuang, LEI Hui-min,WANG Cong-hui, SHEN Ying, TANG Ya-bin, ZHU Liang
    2016, 36 (07):  949. 
    doi: 10.3969/j.issn.1674-8115.2016.07.001

    Abstract ( 714 )   PDF (1400KB) ( 714 )  

    Objective To non-invasively and dynamically monitor abnormal tyrosine metabolism in lung cancer cell lines by accurately measuring the tyrosine level in cell culture media. Methods The cell culture media samples were collected after cell lines 16HBE, PC9, and HCC827 were cultured for 24, 48, and 72 h. A HILIC-MS/MS method based on the surrogate analyte of tyrosine was developed to quantitatively measure the tyrosine level in cell culture media at different time points. Results This method showed a good linear correlation within the concentration range of 1-40 μg/mL (R=0.999 9) with relative recovery rates of 93.02%-102.53% and good repeatability (3.91%-8.69%). Conclusion This method is suitable for measuring the tyrosine level in cell culture media and can be used to observe specific tyrosine metabolism in lung cancer cell lines.

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    Expression of DNMT1 in gastric carcinoma tissue and its effects on proliferation and migration of gastric carcinoma cells
    ZHOU Yi, QIN Jian, LI Xu, ZHU Lin, LI Ji-kun
    2016, 36 (07):  956. 
    doi: 10.3969/j.issn.1674-8115.2016.07.002

    Abstract ( 815 )   PDF (2119KB) ( 984 )  

    Objective To explore the effects of DNA methyl transferase 1 (DNMT1) on the proliferation and migration of gastric carcinoma cells and its possible mechanisms. Methods The mRNA levels of DNMT1 in cancer tissues and adjacent normal tissues of 60 patients with gastric carcinoma were detected with qRT-PCR. Lentivirus packing was used to establish MKN45, SGC7901, and MKN28 gastric carcinoma cell lines expressing stable DNMT1-shRNA, which served as the transfection group. The untreated MKN45, SGC7901, and MKN28 cell lines served as the untransfected group and the MKN45, SGC7901, and MKN28 cell lines treated with lentivirus control served as the negative control group. Proliferation of MKN45, SGC7901, and MKN28 cells was detected by CCK8 method. The expression of CDC25B was measured by Western blotting. The effect of DNMT1 on the migration of gastric carcinoma cells was detected by cell migration assay. Results The mRNA levels of DNMT1 in 52 patients (86.7%,52/60) were up-regulated in cancer tissues than in adjacent normal tissues and the mRNA levels of DNMT1 in 17 of them (28.3%, 17/60) were up-regulated more than two times. The transcription level of DNMT1 in cancer tissues of patients with lymph node metastasis, vascular invasion, and TNM stage Ⅲ-Ⅳ was up-regulated significantly (P<0.05). The growth of MKN45, SGC7901, and MKN28 cells was significantly inhibited 3 d after DNMT1-shRNA transfection. The absorbance values of three cell lines in the transfection group were significantly lower than those in the untransfected group and the negative control group (P=0.000). The protein expression of CDC25B and the migration ability decreased in the transfection group as compared with the untransfected group and the negative control group (both P<0.05). Conclusion The expression of DNMT1 is significantly higher in gastric carcinoma tissues than that in adjacent normal tissues. DNMT1 can promote the proliferation and metastasis of gastric carcinoma cells, which may be associated with the regulation on CDC25B.

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    Regulatory effect of miR-424 on the osteogenic differentiation of human adipose derived mesenchymal stem cells
    YU Zhang, HUANG Ya-zhuo, YANG Xiao-xuan, XIAO Cai-wen
    2016, 36 (07):  962. 
    doi: 10.3969/j.issn.1674-8115.2016.07.003

    Abstract ( 731 )   PDF (2585KB) ( 642 )  

    Objective To explore the expression and biological effect of miR-424 during osteogenic differentiation of human adipose derived mesenchymal stem cells (hASC). Methods The expressions of miR-424 at different stages of osteogenic differentiation of hASC were detected with real-time PCR. miR-424 was over-expressed or miR-424 expression was inhibited via infection of hASCs with lentivirus particles in vitro. Western blotting, immunocytochemistry, and alkaline phosphatase (ALP) staining and alizarin red (ARS) staining were performed. The effects of miR-424 on osteogenic differentiation of hASCs induced with BMP-2 and osteogenic differentiation medium were investigated. The target gene of miR-424 was predicted and was verified with qPCR and Western blotting. Results The results of qPCR revealed that the expression of miR-424 declined with the time of osteogenic differentiation (P<0.05). The protein levels of ALP and osteopontin (OPN) decreased in the over-expression group and increased in the inhibition group with the induction of bone morphogenetic protein 2(BMP-2) (P<0.05). The results of immunocytochemistry revealed that over-expression of miR-424 significantly reduced the cell positive rate of bone sialoprotein (BSP)(P<0.05). ALP and ARS staining showed that the activity of ALP and capacity of mineralization in the over-expression group decreased, while the activity of ALP and capacity of mineralization increased in the inhibition group. Over-expression of miR-424 could decrease the mRNA and protein expression levels of Smad5 in hASCs and inhibition of miR-424 could increase the mRNA and protein expression levels of Smad5 (P<0.05). Conclusion The expression of miR-424 declines during the osteogenic differentiation of hASCs and miR-424 inhibits the osteogenic differentiation of hASCs.

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    Effects of Vitamin D on intra-amniotic lipopolysaccharides-induced alveolarization arrest in neonatal rats
    LIU Cheng-bo, YANG Yi-hui, LI Wen, ZHANG Yong-jun
    2016, 36 (07):  969. 
    doi: 10.3969/j.issn.1674-8115.2016.07.004

    Abstract ( 521 )   PDF (2200KB) ( 607 )  

    Objective To investigate the role of Vitamin D (VitD) on amelioration of chorioamnionitis-induced alveolarization arrest and possible mechanisms. Methods A neonatal rat bronchopulmonary dysplasia (BPD) model was constructed by intra-amniotic injection of lipopolysaccharides (LPS) in pregnant rats. Rats were randomly assigned to the Saline group, LPS+Saline group,LPS+VitD (L) group, and LPS+VitD (H) group. Neonatal rats in the LPS+VitD (L) group and the LPS+VitD (H) group were intraperitoneally injected with 0.5 and 3 ng/g 1, 25(OH)2D3 respectively once a day for 7 d. Meanwhile, neonatal rats in the Saline group and the LPS+Saline group were intraperitoneally injected with the same volume of normal saline. The pulmonary tissues of neonatal rats were harvested 1, 3, and 7 d after the final injection and were stained by H-E staining for observing pathological changes. The mRNA expressions of IL-1β and IFN-γ  were detected using real-time PCR. Results Different concentrations of VitD could improve the birth rate of neonatal rats (P=0.003). The LPS+VitD (L) group and the LPS+VitD (H) group had significantly higher alveolar counts (P=0.001, P=0.000), remarkably decreased mean liner intercept (P=0.000), and significantly decreased mRNA expressions of IL-1β and IFN-γ as compared with the LPS+Saline group 7 d after birth (P=0.000). Conclusion Administration of VitD can significantly decrease the expressions of IL-1β and IFN-γ in lungs of neonatal rats and alleviate the pathological changes of BPD.

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    Inhibition of advanced glycation end products-induced endothelial cells calcification by silencing S100A4
    YUE Wen-heng, LI Na, WANG Qin-qin, LIANG Chun
    2016, 36 (07):  974. 
    doi: 10.3969/j.issn.1674-8115.2016.07.005

    Abstract ( 637 )   PDF (2063KB) ( 638 )  

    Objective To investigate the effects of silencing the S100A4 gene of human umbilical vein endothelial cells (HUVECs) on advanced glycation end products (AGE)-induced vascular calcification. Methods Recombinant viruses were transfected into HUVECs cultured in vitro to inhibit the expression of S100A4. Transfected HUVECs were stimulated with AGE to construct a diabetic cell model. The calcification of HUVECs was assessed by measuring the calcium ion level in cells, detecting the expression levels of matrix Gla protein (MGP), bone morphogenetic protein-2 (BMP2), and alkaline phosphatase (ALP) with Western blotting, as well as alizarin red staining. Results The concentration of calcium ion in HUVECs was significantly increased by the stimulation of AGE. Silencing of S100A4 could reverse the AGE-induced high expression of MGP and AGE-induced low expressions of BMP2 and ALP (P<0.01 for all) and significantly reduce the area of alizarin red staining. Conclusion Silencing of S100A4 with recombinant viruses can reduce the calcification of HUVEC induced by AGE. S100A4 may be a potential target for the treatment of vascular calcification in diabetic patients.

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    Inhibiting effect of curcumin on the proliferation of colorectal cancer cell HCT116 via targeting PBK
    ZHANG Sheng-jun, LIU Min-li, CHANG Qi, LIU Yong-feng
    2016, 36 (07):  980. 
    doi: 10.3969/j.issn.1674-8115.2016.07.006

    Abstract ( 849 )   PDF (2549KB) ( 624 )  

    Objective To explore the molecular mechanism of inhibiting the proliferation of colorectal cancer cell HCT116 by curcumin. Methods The HCT116 cells were cultured in vitro and assigned to the control group, EGF group (using 20 ng/mL EGF alone) and EGF+curcumin groups. The effects of different concentrations of curcumin (0, 10, 20, 50, 100, and 200 μmol/L) on the proliferation rate of HCT116 cells were detected with MTT assay. The inhibiting effect of curcumin on the proliferation of HCT116 cells was detected with cell anchoring proliferation assay. The effects of curcumin on the activity of phosphorylase b kinase (PBK) were detected with in vitro kinase assay and beads binding assay. The effects of curcumin on the downstream signal pathways of PBK were detected by Western blotting and immunohistochemistry. Results Curcumin at a concentration <50 μmol/L had small effect on HCT116 cells, while the apoptosis of HCT116 cells increased significantly when the concentration of curcumin reached 100 μmol/L. The results of cell anchoring proliferation assay for HCT116 cells in soft agar showed that the size and number of clones of HCT116 cells in the EGF+curcumin groups decreased in a concentration dependent manner as compared with the EGF group. The in vitro kinase assay and beads binding assay suggested that curcumin could bind with PBK and inhibit the activity of PBK. Results of Western blotting and immunohistochemistry indicated that curcumin significantly down-regulated the phosphorylation of PBK downstream signal molecules ERK1/2 and H3 in a concentration and time dependent manner. Conclusion Curcumin has anti-proliferation effect on colorectal cancer cell HCT116 via inhibiting the activity of PBK.

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    Study on the quantitative structure-activity relationship of photosensitizer methylene blue and its derivatives
    TIAN Wei, SHEN Qian-cheng, SONG Kun, ZHANG Jian
    2016, 36 (07):  986. 
    doi: 10.3969/j.issn.1674-8115.2016.07.007

    Abstract ( 779 )   PDF (1254KB) ( 770 )  

    Objective To estimate the absorption peak of methylene blue and its derivatives and construct a quantitative structure-activity relationship (QSAR) model for the absorption peak and structure. Methods Structure and absorption peak data of methylene blue and 17 derivatives were collected. The Waikato Environment for Knowledge Analysis (WEKA) method was used to normalize the data and conduct the modeling and prediction. Results The constructed fitting model was tested via cross validation and an external test set. The values of derived correlation coefficient R of the model from two tests were 0.8 and 0.9. Conclusion A QSAR model for the structure and absorption peak of methylene blue and its derivatives has been successfully constructed via WEKA method. This model can provide evidence for developing these compounds into photosensitizer and transforming structures for some potential compounds.

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    Original article (Clinical research)
    Study on the value of serum PGE2 in patients with cirrhosis in decompensation stage for predicting infections
    HUANG Xiao-ping, WANG Yan, SUN Wei, HUANG Yan, CHEN Li, GAN Jian-he
    2016, 36 (07):  992. 
    doi: 10.3969/j.issn.1674-8115.2016.07.008

    Abstract ( 637 )   PDF (637KB) ( 691 )  

    Objective To measure the serum PGE2 level in patients with cirrhosis in decompensation stage and explore the value for predicting the risk of infections. Methods Serum PGE2 levels in 167 patients with cirrhosis in decompensation stage who were assigned to the non-infection group (n=133) and the infection group (n=34) and 65 patients with cirrhosis in compensation stage (the control group) were measured with ELISA. The value for predicting the risk of infections in patients with cirrhosis was analyzed. Results Significantly higher PGE2 levels were found in the non-infection group and the infection group than that in the control group (P=0.000 0). The PGE2 levels were significantly higher in the infection group than that in the non-infection group (P=0.000 0). The area under the receiver operating characteristic curve for predicting the risk of infections was 0.82 (95%CI: 0.76-0.90). The sensitivity and specificity of PGE2 of 2 637 pg/mL for predicting the infections in patients with cirrhosis in decompensation stage were 0.824 and 0.777, respectively. Conclusion PGE2 can reflect the state of immune function in patients with cirrhosis in decompensation stage to a certain extent. Increased PGE2 level suggests a higher risk of infections.

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    Analysis of prognostic factors for 129 patients with local advanced rectal cancer
    RONG Ling, ZHOU Di, DAI Li-yan, HOU Yan-li, BAI Yong-rui, SONG Shao-li
    2016, 36 (07):  996. 
    doi: 10.3969/j.issn.1674-8115.2016.07.009

    Abstract ( 699 )   PDF (1589KB) ( 715 )  

    Objective To explore the efficacy of postoperative radiotherapy and chemotherapy in patients with local advanced rectal cancer (LARC) and its prognostic factors. Methods A retrospective analysis of 129 patients with LARC (23 cases of ⅡA stage LARC, 10 cases of ⅡB, 7 cases of ⅡC, 5 cases of ⅢA, 60 cases of ⅢB, and 24 cases of ⅢC) receiving postoperative radiotherapy and/or chemotherapy from July 2005 to September 2010 was performed. The conformal or intensity modulated radiotherapy and fluorouracil-based chemotherapy were used. According to patients’ clinical, pathological, and therapeutic data, Kaplan Meier method was used to calculate the survival rate, log-rank single factor test was used to analyze the prognosis, receiver operating characteristic (ROC) curve method was used to calculate the cut-off point of positive lymph node rate, and Cox proportional hazards model was used to analyze the prognosis. Results The follow-up rate and median follow-up period in 129 patients were 99.23% and 39 months, respectively. The 1, 3, and 5 year overall survival (OS) rates were 90.7%, 57.4%, and 44.3% respectively and the 1, 3, and 5 year disease free survival (DFS) rates were 72.1%, 46.1%, and 41.0% respectively. Single factor analysis of the prognosis showed that lymph node grouping, CEA and CA199 levels before and after treatment, cancer nodule, differentiation, rate of positive lymph node, hemoglobin (HGB), and postoperative adjuvant chemotherapy were factors affecting the prognosis of rectal carcinoma. COX multivariate regression analysis of patients with LARC showed that there were 9 independent factors related to the prognosis, i.e. differentiation (P=0.041), depth of infiltration (P=0.046), cancer nodules (P=0.002), lymph node grouping (P=0.002), postoperative adjuvant chemotherapy (P=0.006), CA199 level before treatment (P=0.062), HGB level before treatment (P=0.001), CEA level after treatment (P=0.022), and CA199 level after treatment (P=0.000). The Wald value of lymph node grouping was the largest, followed by CA199 after treatment, HGB before treatment, cancer nodule, depth of infiltration, postoperative adjuvant chemotherapy, differentiation, CEA after treatment, and CA199 before treatment. Conclusion Before the implementation of multi discipline consultation (MDT) in our hospital, Patients with LARC who are unable to receive preoperative neoadjuvant therapy can benefit from postoperative radiotherapy combined with chemotherapy. Lymph node grouping, infiltration depth, differentiation, tumor nodule, and CEA, HGB, and CA199 levels are significantly correlated to OS and DFS.

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    Association between -23A/T variation of insulin gene and early-onset type 2 diabetes mellitus in Shanghai Han population
    GE Xiao-xu, LI Ming, LI Can, ZHANG Rong, ZHUANG Lan-gen, ZHAO Wei-jing, ZHENG Tai-shan, YIN Jun, LIU Li-mei
    2016, 36 (07):  1005. 
    doi: 10.3969/j.issn.1674-8115.2016.07.010

    Abstract ( 618 )   PDF (871KB) ( 818 )  

    Objective To explore the association between -23A/T variation of insulin gene (INS gene) and early-onset type 2 diabetes mellitus (T2DM). Methods A total of 116 Han patients with early-onset T2DM (the case group) and 135 non-diabetic controls (the control group) in Shanghai were enrolled. The -23A/T variation of INS gene was detected with PCR-direct sequencing. Differences in frequencies of genotypes and alleles of -23A/T, as well as other clinical variables between two groups were analyzed. Results  AA genotypic and A allelic frequencies significantly increased in the case group compared with the control group [P=0.015, OR=2.77 (95% CI 1.19-6.47); P=0.009, OR=2.86 (95% CI 1.26-6.46)]. In the case group, the fasting serum insulin (FINS) and HOMA-β levels of subjects carrying AA genotype were significantly lower than those of subjects carrying AT genotype (both P<0.05). Conclusion The A allele of -23A/T variation of INS gene is significantly associated with the FINS in patients with early-onset T2DM and is a risk factor for early-onset T2DM in Shanghai Han population. The INS gene-23A/T variation may be a potential genetic marker for predicting islet β-cell hypofunction in Chinese population with early-onset T2DM.

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    Application of competing risk model to clinic trials for tumor treatment
    ZHANG Li-na
    2016, 36 (07):  1011. 
    doi: 10.3969/j.issn.1674-8115.2016.07.011

    Abstract ( 964 )   PDF (1077KB) ( 841 )  

    Objective To apply the competing risk model to the analysis of clinical trials for tumor treatment. Methods A multi-center, randomized, double-blind, prospective, placebo parallel control design, phase Ⅲ clinical trial was preformed to evaluate the clinical synergism of a medicine served as chemosensitizer for the treatment of non-small cell lung cancer and breast cancer. The competing risk model was used to estimate the rates of cumulative remission and cumulative progression in both groups and comparison was conducted between groups with Gray test. The sub-distribution hazard model was used to perform the multivariate analysis. Results For non-small cell lung cancer patients, the differences in rates of cumulative remission and cumulative progression in two groups after chemotherapy were statistically significant (P=0.000,P=0.001). Medications, age, and tumor size were factors influencing the remission after chemotherapy, while medications, sex, age, and tumor size were factors influencing the progression after chemotherapy. For breast cancer patients, the difference in cumulative remission rate in two groups after chemotherapy was statistically significant and the difference in cumulative progression rate in two groups after chemotherapy was not statistically significant. Medications and tumor size were factors influencing the remission after chemotherapy, while age and tumor size were factors influencing the progression after chemotherapy. Conclusion Cumulative incidence function and sub-distribution hazard model should be used if the competing risk exists because the results are more in line with the actual situation.

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    Construction of predictive models for lower limb artery stenosis in patients with type 2 diabetes
    LU Jun, ZHANG Ji-chen, YOU Wen, YU Xue-mei, GU Ming-jun
    2016, 36 (07):  1018. 
    doi: 10.3969/j.issn.1674-8115.2016.07.012

    Abstract ( 703 )   PDF (909KB) ( 659 )  

    Objective To construct predictive models for lower limb artery stenosis in patients with type 2 diabetes. Methods A total of 4 368 patients with type 2 diabetes underwent ultrasonography examination of lower limb arteries and serum biochemical assay and were assigned to the stenosis group (the stenosis rate ≥50%) and non-stenosis group according to the results of ultrasonography examination of lower limb arteries. Risk factors for lower limb artery stenosis were rated according to the results of binary regression analysis. The model of general clinical characteristics and the model of general clinical characteristics combined with biochemical indices were constructed. Receiver operating characteristic (ROC) curves were used to analyze the predictive potency of two models. Results Multiple Logistic regression analysis indicated that gender, age, course of diabetes, hypertension, poor blood glucose control, and decreased HDL-C level were associated with lower limb artery stenosis. The areas under ROC curves of the two models were 0.77 (0.74-0.80) and 0.78 (0.75-0.81)(P=0.000), respectively. The difference in the area under ROC curve between two models was not statistically significant. Models with scores ≥7 and ≥10 had the best sensitivity (86% and 74%) and specificity (59% and 68%). Conclusion General clinical characteristics can effectively predict the lower limb artery stenosis. For scores ≥7, examinations such as lower limb artery ultrasonography are recommended to exclude the lower limb artery stenosis.

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    Value of the neutrophil-lymphocyte ratio for predicting the severity of acute pancreatitis based on the Revised Atlanta Classification
    ZHOU Tian-yun, PAN Ting-ting, LIU Jia-lin, QU Hong-ping
    2016, 36 (07):  1023. 
    doi: 10.3969/j.issn.1674-8115.2016.07.013

    Abstract ( 649 )   PDF (1413KB) ( 704 )  

    Objective To investigate the value of neutrophil-lymphocyte ratio (NLR) for predicting the severity of acute pancreatitis (AP) based on the Revised Atlanta Classification. Methods The clinical data of 118 patients with AP were retrospectively analyzed. Based on the Revised Atlanta Classification, the patients were assigned to 3 groups, i.e. the mild acute pancreatitis group, moderately severe acute pancreatitis group, and severe acute pancreatitis group. The dynamic changes in blood NLR levels in each group 1 and 7 d after admission and at discharge were observed, as well as differences across groups at each time points. The correlations between NLR and acute physiology, chronic health evaluation (APACHE) II score, length of ICU stay, and length of hospital stay were analyzed. The receiver operating characteristic curves (ROC curves) were plotted to compare the efficiency of NLR, BUN, APACHEII score, and NLR combined with BUN for predicting the severity of acute pancreatitis. Results The NLR in the severe acute pancreatitis group was the highest 1 and 7 d after admission, followed by the moderately acute pancreatitis group and the mild acute pancreatitis group (P=0.000). The correlations between NLR and APACHEII score,length of ICU stay, and length of hospital stay were positive (r=0.577,P=0.000;r=0.527,P=0.000;r=0.597,P=0.000, respectively). There was no statistical difference between the area under curve (AUC) of NLR and APACHEII score for predicting moderately-severe acute pancreatitis, but they were superior to BUN (0.876±0.032 vs 0.873±0.031, P=0.944; 0.876±0.032 vs 0.660±0.050, P=0.000). There were no statistical differences between NLR and APACHEII score, and NLR and BUN for predicting severe acute pancreatitis (0.794±0.053  vs  0.892±0.033, P=0.118; 0.794±0.053  vs  0.745±0.064, P=0.560). The combination of NLR and BUN could increase the area under curve and the diagnostic specificity. Conclusion NLR has certain clinical significance for predicting the severity of acute pancreatitis.

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    Comparison of the value of applying functional magnetic resonance imaging and CT imaging to T staging of esophageal cancer
    XIE Hua-ying, CHEN Hai-yan, ZHANG Feng, YIN Yan, LU Qing, CAO Zi-ang, BAI Yong-rui, WU Hua-wei
    2016, 36 (07):  1029. 
    doi: 10.3969/j.issn.1674-8115.2016.07.014

    Abstract ( 638 )   PDF (959KB) ( 605 )  

    Objective To explore the value of applying functional magnetic resonance imaging (MRI) and CT imaging to T staging of esophageal cancer. Methods Fifty-four patients with esophageal cancer who planned to undergo surgery were selected as subjects and received chest CT and MRI examination. The diagnostic value of diffusion weighted imaging (DWI) combined with high resolution T2-weighted imaging (HR-T2WI), HR-T2WI alone, and CT for T staging of esophageal cancer was compared according to postoperative pathological results. Results Of 54 patients, 1 had double primary lesions, 49 had squamous cell carcinoma, 1 had adenocarcinoma, 1 had poorly differentiated neuroendocrine carcinoma, and 4 had carcinoma in situ or high atypical hyperplasia. For T1-T4 stage of esophageal cancer, the accuracies of DWI combined with HR-T2WI, HR-T2WI alone, and CT for determining the stage were 89.1% (49/55), 83.6% (46/55), and 67.3% (37/55), respectively. The differences between DWI combined with HR-T2WI and CT, and HR-T2WI alone  and CT were statistically significant (P=0.005,P=0.038). For T1-T2 staging (including Tis stage) of esophageal cancer, the accuracies of the three methods were 70.6% (12/17), 64.7% (11/17), and 29.4% (5/17), respectively. The differences between DWI combined with HR-T2WI and CT, and HR-T2WI alone and CT were statistically significant (P=0.019,P=0.042). For T3-T4 staging of esophageal cancer, the accuracies of the three methods were 97.4% (37/38), 92.1% (35/38), and 84.2% (32/38), respectively. The differences between DWI combined with HR-T2WI and CT, and HR-T2WI alone and CT were not statistically significant. Conclusion The accuracy of DWI combined with HR-T2WI for diagnosing the T staging of esophageal cancer is better than that of CT, especially for patients with T1-T2 stage (including Tis stage) of esophageal cancer.

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    Value of abdominal aortic calcification for evaluating the prognosis of patients undergoing maintenance hemodialysis
    LI Lu-yao, DAI Hui-li, ZHANG Min-fang, FANG Yan, NI Zhao-hui
    2016, 36 (07):  1034. 
    doi: 10.3969/j.issn.1674-8115.2016.07.015

    Abstract ( 659 )   PDF (1147KB) ( 635 )  

    Objective To investigate the value of abdominal aortic calcification (AAC) for evaluating the prognosis of patients undergoing maintenance hemodialysis (MHD). Methods 164 patients were enrolled and their AAC was evaluated with abdominal lateral plain radiography. Patients were assigned to the AAC group and the non-AAC group according to whether AAC was presented and were followed up for a period of (54.51±13.80) months. Results Of 164 patients undergoing MHD, 113 (68.90%) developed AAC. Of 32 patients died (19.51%) during follow up period, 22 (13.41%) died from cardiovascular disease (CVD). Kaplan-Meier analyses showed that the all-cause mortality and the CVD mortality were significantly higher in the AAC group than in the non-AAC group (24.8% vs 7.8%, P=0.013; 18.6% vs 2.0%, P=0.004). Multivariate Cox proportional hazards analyses indicated that AAC, age, and albumin were independent risk factors for the all-cause mortality, while AAC and age were independent risk factors for the CVD mortality. Receiver operating characteristic (ROC) curves suggested that AAC had a higher value for predicting the all-cause mortality and the CVD mortality with areas under curves (AUC) of 0.719 (95%CI 0.617-0.821,P=0.000) and 0.743 (95%CI 0.640-0.847,P=0.000), respectively. Conclusion The incidence of AAC is higher in patients undergoing MHD. The all-cause mortality and the CVD mortality are significantly higher in patients with AAC than in patients without AAC. AAC has a favorable value for evaluating the prognosis of patients undergoing MHD.

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    Effect of treatment with 17% EDTA for different periods of time on the microstructure of root surfaces
    ZHANG Feng-jing, SHU Rong
    2016, 36 (07):  1039. 
    doi: 10.3969/j.issn.1674-8115.2016.07.016

    Abstract ( 789 )   PDF (1261KB) ( 578 )  

    Objective To explore the effect of treatment with 17% EDTA gel and solution for different periods of time on the microstructure of root surfaces and compare the effect between 17% EDTA gel and solution and 24% EDTA solution. Methods Thirty freshly extracted teeth from patients with periodontitis were treated with scaling and root planing (SRP), and dentin fragments and cementum fragments were prepared. These fragments were randomly assigned to the A group treated with saline solution for 3 min, the B group treated with 24% EDTA solution for 3 min, the C group treated with 17% EDTA gel for 3 min, the D group treated with 17% EDTA gel for 5 min, the E group treated with 17% EDTA solution for 3 min, and the F group treated with 17% EDTA solution for 5 min. Scanning electron microscopy was used to observe the microstructure of root surfaces. Results ①The dentin on root surfaces: There were no exposed dentin tubules on the surface of dentin in the A group. The number of open dentin tubules in the B group was the largest and the exposure was the clearest, followed by the D group and F group. The C group and E group had the fewest open dentin tubules, where many blocked tubules existed. ②The cementum on root surfaces: Root surfaces in all groups were clean and the smear layer was removed except the A group. The cementum demineralization in group B was presented significantly and collagen fibers were exposed clearly. The D and F groups showed partial cementum demineralization and collagen fibers on the surface of cementum were lumpish with no significant spatial conformation. The cementum demineralization in the C and E groups was not significant with no exposure of collagen fibers. Conclusion There is no significant difference in the treatment of root surfaces with 17% EDTA gel and solution. When extending the treatment time from 3 min to 5 min, the effect of 17% EDTA becomes better, but is still inferior to 24% EDTA solution.

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    Analysis of levels of five serum tumor markers and related influencing factors for elderly patients with type 2 diabetes
    XU Yuan-yuan, ZHAO Hong, ZHANG Yu, SUN Jiao, GU Qin, WANG Hai-dong, ZHU Jun-qiu
    2016, 36 (07):  1044. 
    doi: 10.3969/j.issn.1674-8115.2016.07.017

    Abstract ( 665 )   PDF (789KB) ( 608 )  

    Objective To analyze the levels of serum tumor markers CA199, CEA, CA153, CA125, and AFP in elderly patients with type 2 diabetes and related influencing factors. Methods Data of elderly patients with type 2 diabetes (the diabetes group with average age of 61.53±4.95, n=241) admitted between June 2012 and July 2014 were collected. The age-matched healthy individuals receiving physical examination at the same time period served as controls (the control group, n=178). The levels of five serum tumor markers were compared between two groups. The diabetes group was regrouped according to HbA1C level and age and the levels of serum tumor markers were compared between subgroups. Pearson correlation analysis and multi-factor Logistic regression analysis were used to analyze related influencing factors. Results The levels of serum CA199, CEA, and CA153 were significantly higher in the diabetes group than in the control group (P<0.05). The differences in serum CA199 and CEA levels in subgroups with different HbA1C levels were statistically significant (P<0.05) and the differences in serum CA199, CEA, and CA153 levels in subgroups with different ages were statistically significant (P<0.05). Logistic regression analysis showed that increased BMI and decreased serum albumin were risk factors for elevated serum CA199 level and increased age was a risk factor for elevated serum CEA and CA153 levels, while increased serum creatinine level and decreased serum albumin level were risk factors for elevated CA125 level. Conclusion Levels of some serum tumor markers increase in elderly patients with type 2 diabetes. HbA1C level and age should be taken into account for clinical interpretation. Long term follow-up is needed to avoid misdiagnoses and missed diagnoses.

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    Value of applying water swallowing test for patients with dysphagia after acute stroke
    WU Wen-juan, BI Xia, SONG Lei, LIU Zhi-hao, ZHANG Jin-ming, HUANG Qian
    2016, 36 (07):  1049. 
    doi: 10.3969/j.issn.1674-8115.2016.07.018

    Abstract ( 1558 )   PDF (696KB) ( 744 )  

    Objective To explore the value of applying the water swallowing test to screening the aspiration and diagnosing dysphagia for patients with dysphagia after acute stroke. Methods Forty-five patients with acute stroke who were admitted by the Rehabilitation Medicine Department at the Gongli Hospital in Pudong New District of Shanghai from April 2014 to November 2015 were enrolled. Patients underwent the water swallowing test and videofluoroscopic swallowing study (VFSS). The reliability of the water swallowing test and the consistency between water swallowing test and VFSS for screening the aspiration and diagnosing dysphagia were evaluated. The positive detection rates of the water swallowing test for screening aspiration and diagnosing dysphagia were compared. Results The sensitivity, specificity, positive predictive value, and negative predictive value of the water swallowing test for screening aspiration against the VFSS were 43.75%, 69.23%, 77.78%, and 31.03%. The Kappa value of the consistency test for water swallowing test and VFSS was 0.098, indicating no consistency existed (P=0.420). The sensitivity, specificity, positive predictive value, and negative predictive value of the water swallowing test for diagnosing dysphagia against the VFSS study were 97.50%, 20.00%, 90.70%, and 50.00%. The Kappa value of the consistency test for water swallowing test and VFSS was 0.237, indicating no consistency existed (P=0.073). The positive detection rate (40.00%) of the water swallowing test for screening aspiration was lower than that for diagnosing dysphagia (95.56%) and the difference was statistically significant (P=0.000). Conclusion The water swallowing test may be unreliable for screening the aspiration for patients with dysphagia after acute stroke, but is relatively reliable for diagnosing dysphagia.

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    Original article (Public health)
    Analysis of the efficiency of basic public health services in Chongqing in 2014
    WANG Peng, YANG Xian-xian, ZHOU Xi-peng, XUE Jian, PENG Bin, HU Bin, YIN Ling, QIU Jing-fu
    2016, 36 (07):  1054. 
    doi: 10.3969/j.issn.1674-8115.2016.07.019

    Abstract ( 546 )   PDF (661KB) ( 642 )  

    Objective To evaluate the efficiency of basic public health services of districts and counties in Chongqing in 2014 and provide reference for project implementation in the future. Methods The data envelopment analysis (DEA) was used to evaluate the comprehensive efficiency, pure technical efficiency, and scale efficiency for all districts and counties in Chongqing. Results The average comprehensive efficiency, average pure technical efficiency, and average scale efficiency of basic public health services in Chongqing in 2014 were 0.800, 0.890, and 0.899, respectively. Fifteen districts had valid DEA results and 20 districts had invalid DEA results. Of these 20 districts, 11 districts had progressively declined scale efficiency and 9 districts had progressively increased scale efficiency. Conclusion The efficiency of basic public health services in Chongqing needs to be improved. The development across functional districts is unbalanced. The flexibility of fund distribution and the flow of talent should be reinforced and the efficiency of resource utilization and output indexes need to be improved.

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    Analysis of factors influencing the quality of life in patients with chronic myeloid leukemia receiving imatinib mesylate treatment
    MA Yong-hua, ZHANG Kai-jin, LIU Gui-yuan, YU You-ren
    2016, 36 (07):  1059. 
    doi: 10.3969/j.issn.1674-8115.2016.07.020

    Abstract ( 672 )   PDF (561KB) ( 620 )  

    Objective To evaluate the quality of life (QOL) in patients with chronic myeloid leukemia (CML) receiving the imatinib mesylate treatment and explore relevant influencing factors. Methods Functional assessment of cancer therapy generic scale (FACT-BRM) was used to survey 144 patients with CML receiving the imatinib mesylate treatment in Jiangsu Province. The effects of relevant factors on QOL were processed with the variance analysis from the perspective of general demographic characteristics. The effects of relevant factors on the efficacy were explored with the multiple linear regression analysis. Results The total QOL score of patient with CML was 99.08±20.91. Scores of dimensions, i.e. physiological status, social/family status, emotional status, functional status, additional physiological status, and additional emotional status, were 19.52±5.36, 16.37±6.72, 15.89±4.72, 13.08±6.18, 18.98±4.63, and 15.24±4.28, respectively. The multivariate linear regression analysis indicated that age, education level, income, and type of medical insurance were major factors influencing the patients QOL. Conclusion The QOL in patient with CML was poor. QOL should be considered as an index for assessing the clinical efficacy of imatinib mesylate for the treatment of CML.

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    Analysis of operational efficiency of third level public hospitals in Chongqing from the perspective of technical heterogeneity
    TAN Hua-wei, ZHENG Wan-hui, ZHANG Yun, YAN Wei-hua, ZHU Xiao-ling, LIU Xian, ZHANG Pei-lin
    2016, 36 (07):  1063. 
    doi: 10.3969/j.issn.1674-8115.2016.07.021

    Abstract ( 769 )   PDF (975KB) ( 525 )  

    Objective To compare and analyze the operational efficiency of different types of third level public hospitals in Chongqing, estimate the degree of efficiency loss, and explore the causes of efficiency loss. Methods Data on major indexes of health care institutions in Chongqing from 2012 to 2014 were collected and analyzed by the non-parametric meta-frontier method. Results The average operational efficiency scores of third level public hospitals in Chongqing for meta-frontier and group-frontier were 0.763 and 0.854, respectively. The average operational efficiency score of Traditional Chinese Medicine (TCM) hospitals was the highest, followed by comprehensive hospitals and specialized hospitals. The average technique gap ratio of third level public hospitals in Chongqing was 0.894. The average technique gap ratio of comprehensive hospitals was the highest, followed by TCM hospitals and specialized hospitals. The average operational inefficiency score of third level public hospitals in Chongqing was 0.237. The average operational inefficiency score of specialized hospitals was the highest, followed by comprehensive hospitals and TCM hospitals. The contributions of technique gap inefficiency and management inefficiency in third level public hospitals in Chongqing were 38.20 and 63.80, those of comprehensive hospitals, TCM hospitals, and specialized hospitals were 38.20 and 63.80, 39.09 and 60.91, 67.68 and 32.32, and 25.64 and 74.36, respectively. Conclusion Third level public hospitals in Chongqing have significant technical heterogeneity and the technical heterogeneity in different types of third level public hospitals is significantly different. The causes of efficiency loss in different types of third level public hospitals are remarkably different. For comprehensive hospitals and specialized hospitals, the efficiency loss is mainly due to backward management level. While for TCM hospitals, the efficiency loss is mainly caused by backward technique level.

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    Reliability and validity of short form Quality Life Scale (SF-12) for elderly persons in countryside
    WANG Hong-yu, ZHANG Lin
    2016, 36 (07):  1070. 
    doi: 10.3969/j.issn.1674-8115.2016.07.022

    Abstract ( 1646 )   PDF (586KB) ( 827 )  

    Objective To evaluate the reliability and validity of SF-12 for elderly persons in countryside. Methods The stratified cluster sampling method was used to survey 789 elderly persons in countryside. Results The critical ratio of the extreme groups ranged from 3.012 to 10.060, the total correlation coefficient ranged from 0.105 to 0.742, the internal consistency coefficient ranged from 0.833 to 0.864, the amount of factor load ranged from 0.458 to 0.861, the overall internal consistency coefficient was 0.861, and the retest reliability was 0.814. Three factors with characteristic values greater than 1 were extracted and the cumulative contribution rate was 63.54%. The correlation coefficient of criterion validity was 0.715, the success rate of polymerization for 8 dimensions was 100%, and the discriminative power was 100%. Conclusion SF-12 has favorable reliability and validity and can be used to evaluate the quality of life for elderly persons in countryside.

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    Review
    Progresses of studies on genetics and clinical characteristics of paroxysmal nonkinesigenic dyskinesia
    TIAN Wo-tu, LIU Xiao-li, CAO Li
    2016, 36 (07):  1075. 
    doi: 10.3969/j.issn.1674-8115.2016.07.023

    Abstract ( 712 )   PDF (498KB) ( 651 )  

    Paroxysmal nonkinesigenic dyskinesia (PNKD) is a disorder characterized by intermittent attacks of involuntary movements that are induced by intake of tea, coffee, or alcohol and fatigue with clinical and genetic heterogeneity.Familial PNKD is mostly presented with autosomal dominant inheritance. PNKD1 (MR-1), PRRT2, PNKD2, KCNMA1, and SLC2A1 have been identified as the pathogenic genes for PNKD. This paper reviews advances in clinical and genetic studies on PNKD in order to contribute to the research on the pathogenesis of PNKD.

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    Research advances in expression regulation and clinical application of pyruvate kinase M2 in tumor metabolism and growth
    MIAO Yi, FENG You-ji
    2016, 36 (07):  1079. 
    doi: 10.3969/j.issn.1674-8115.2016.07.024

    Abstract ( 667 )   PDF (637KB) ( 733 )  

    Metabolic disorders are a common feature of tumor cells. Pyruvate kinase M2 (PKM2) is a key regulator of aerobic glycolysis in tumor cells. PKM2 expresses specifically in tumor cells and provides energy required for tumor cell growth, as well as materials for synthesis of biological macromolecular substances. PKM2 can not only express in the cytoplasm, but also enter tumor cell nucleus and act as a protein kinase, which can promote the proliferation of tumor cells. Tumor cells can regulate the expression of PKM2 via many ways, such as allosteric effect, transcription regulation, post-transcriptional modification, and interaction between proteins. PKM2 is not only an important kinase for regulating tumor metabolism, but also an important factor for regulating tumor growth. It is expected to play a crucial role in diagnosis and targeted therapy of tumor.

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    Research progresses of the role of Toll-like receptor-2 in inflammation-associated gastric carcinoma
    ZHOU Yi, LI Ji-Kun
    2016, 36 (07):  1084. 
    doi: 10.3969/j.issn.1674-8115.2016.07.025

    Abstract ( 696 )   PDF (685KB) ( 613 )  

    Inflammation is a part of the host defense system and can protect the host against invading pathogens. However, inflammation can also induce endogenous mediators via Toll-like receptors (TLR),which can promote the occurrence and development of tumor. Understanding the relationship between TLR2 and gastric carcinoma and the possible mechanisms may provide new methods for the treatment of inflammation-associated gastric carcinoma. This paper reviews the structure and function of TLR2, the relationship between TLR2 and inflammation-associated gastric carcinoma, and possible carcinogenic mechanism.

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    Research progresses of sleep disorder in perimenopausal women
    ZHENG Yan-wei, TAO Min-fang
    2016, 36 (07):  1088. 
    doi: 10.3969/j.issn.1674-8115.2016.07.026

    Abstract ( 755 )   PDF (735KB) ( 590 )  

    Sleep disorder is one of common symptoms in perimenopausal women with major manifestations of difficulty sleeping, frequently waking up at night, early morning waking up, and unable to fall asleep after waking up, which may be related to oestrogen level changes in this period and resulting in vasomotor symptoms and mood disorders. The incidence of sleep disorder related to menopause is greatly affected by race, genetic factors, environmental factors, chronic diseases, and medications, etc. The treatments of menopausal sleep disorder include general therapy and medications. The hormone replacement therapy has certain efficacy. This article reviews progresses of epidemiological studies, inducing factors, and intervention treatments of sleep disorder in perimenopausal women.

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    Research advances in the association between arsenic and the incidence of diabetes mellitus and the mechanisms of glucose metabolic disorders caused by arsenic
    SUN Hong-lin, LU Ying-li
    2016, 36 (07):  1093. 
    doi: 10.3969/j.issn.1674-8115.2016.07.027

    Abstract ( 794 )   PDF (623KB) ( 660 )  

    The role of environmental factors in the occurrence and development of diabetes mellitus has drawn more and more attention in recent years. A large amount of evidence has suggested a close association between arsenic exposure and the incidence of diabetes. The incidence of diabetes increases significantly in areas that drinking water is polluted by arsenic. More and more cell and animal experiments have indicated that arsenide can result in insulin resistance and impaired glucose uptake in peripheral tissues, which can cause impaired glucose tolerance. The paper reviews the association between arsenic exposure and the incidence of diabetes from perspectives of epidemiological study and pathogenesis.

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    Research progresses and applications of novel biomarkers in the diseases relevant to cardiac surgery
    YUAN Zhi-ze, YE Xiao-feng, ZHAO Qiang
    2016, 36 (07):  1098. 
    doi: 10.3969/j.issn.1674-8115.2016.07.028

    Abstract ( 618 )   PDF (528KB) ( 690 )  

    Cardiovascular diseases pose an increasingly serious threat to human health and surgical interventions are sometimes needed for some cardiovascular diseases, such as coronary atherosclerotic heart disease with severe triple vessel lesion. With the in-depth research on the pathogenesis, some biomarkers have been applied to screening, diagnosis, treatment, and prognosis evaluation of cardiovascular diseases. Early identification and intervention are crucial for decreasing cardiovascular events and improving prognosis. Cardiac surgery urgently needs novel biomarkers for providing early warnings for postoperative complications and prognosis. This paper reviews novel biomarkers relevant to the cardiac surgery that have been applied to the diagnosis of diseases or have the potential to be clinically applied in the future.

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    Advances in applying intravesical electrical stimulation therapy to the treatment of low urinary tract dysfunction
    FAN Lian-cheng, HUANG Yi-ran, ZHOU Li-xin, LI Jia-yi
    2016, 36 (07):  1102. 
    doi: 10.3969/j.issn.1674-8115.2016.07.029

    Abstract ( 771 )   PDF (442KB) ( 603 )  

    The low urinary tract dysfunction is mainly presented with frequent micturition, urgent micturition, urinary incontinence, dysuria, and urinary retention, etc. Traditional conservative treatments of neurogenic low urinary tract dysfunction can not always obtain favorable efficacy. The cure rate of surgeries is low with many complications. In recent years, with the clinical application of biofeedback electrical stimulation therapy, satisfactory efficacy has been achieved for the treatment of urinary incontinence, bladder excessive activity, and symptoms of low urinary tract. This is an efficient method for urologists. This paper reviews advances in applying intravesical electrical stimulation therapy to the treatment of low urinary tract dysfunction.

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    Brief original article
    Comparative study on endoscopic mucosal resection and endoscopic submucosal dissection for the treatment of elevated colorectal lesions
    XU Ying, KUAI Rong, LI Ji, YANG Da-ming, ZHOU Fen-li, JIN Yun-fei, PENG Hai-xia
    2016, 36 (07):  1105. 
    doi: 10.3969/j.issn.1674-8115.2016.07.030

    Abstract ( 740 )   PDF (581KB) ( 551 )  

    Objective To evaluate the efficacy and safety of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) for the treatment of elevated colorectal lesions and analyze the risk factors for the local recurrence after EMR in order to improve the indications of EMR and ESD treatments. Methods The clinical and surgical data of 427 patients (with 606 colorectal lesions) undergoing EMR and 70 patients (with 80 colorectal lesions) undergoing ESD were retrospectively summarized. The clinical and surgical data of 145 patients undergoing EMR and 30 patients undergoing ESD obtained from follow-up visits were analyzed. The complications and local recurrence rates of two groups were compared and the risk factors for the local recurrence in the EMR group were analyzed. Results The rates of surgical complications in the ESD group and the EMR group were 7.14% (5/70) and 2.58% (11/427), respectively. There was no statistical difference in the rate of complications such as perforation and massive hemorrhage between two groups (P=0.06). The local recurrence rate of the EMR group was 22.76% (33/145), which was significantly higher than 3.33% (1/30) of the ESD group (P<0.05). The multiple factor analysis showed that multiple colorectal lesions were the risk factor for the local recurrence after EMR. Conclusion The rate of complications of ESD is higher than that of EMR with more complete resection of lesions and lower local recurrence rate. For patients with multiple colorectal lesions, close follow-up is required after EMR.

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