CLE can be used to identify gastric superficial cancer/HGIN lesions with high validity and reliability.

CLE represents a useful and potentially significant improvement over standard endoscopy to examine the microalterations of the esophagus in vivo. Acidic reflux is responsible for the microalterations in the esophagus of patients with NERD.

BACKGROUND: Acriflavine is one of the commonly used staining agents in confocal laser endomicroscopy (CLE), a newly developed technique allows for real time histological observation of gastrointestinal mucosa, but the concentration is not unified. This study aimed to evaluate the effects of acriflavine with different concentrations on the CLE image quality and to find a sound concentration in clinical practice. METHODS: Twenty four consecutive patients who underwent upper gastrointestinal CLE were enrolled into this study. The patients randomly accepted acriflavine in four different concentrations which were the conventional 0.05% and 3 lower ones respectively: 0.02%, 0.01% and 0.005% spraying onto the same focal antrum mucosa during CLE procedures. Differences of Image quality were demonstrated by an objective score system. RESULTS: THERE WAS NO SIGNIFICANT DIFFERENCE ABOUT IMAGE QUALITY AMONG ACRIFLAVINE CONCENTRATIONS: 0.05%, 0.02% and 0.01%, but 0.005% decreased image quality significantly (P=0.012). And 0.005% was also the only one which decreased general assessment significantly (P=0.01). For the 3 diagnostic value assessment indices, there was no significant difference about nonspecific and even staining, while 0.02% showed significant better polar staining (P=0.03). CONCLUSIONS: Acriflavine concentration 0.02% is the best one applied in CLE with the best nuclei staining ability and preserved image quality.

BACKGROUND Malignant peritoneal mesothelioma (MPM) originates from the mesothelial and subcutaneous cells of the abdominal cavity. Its diagnose is difficult due to its nonspecific and vague symptoms, and it should be differentiated from alcoholic cirrhosis and liver and pancreatic cancers. Misdiagnosis and missed diagnosis can easily occur when MPM presents with other diseases. To the best of our knowledge, no case of MPM concurrent with alcoholic cirrhosis has been reported. CASE SUMMARY A 63-year-old man presented to our hospital with abdominal distension for 20days. He had a history of alcohol consumption for nearly 30 years and no history of special drug use or toxic exposure. After treatment for alcoholic cirrhosis in a community hospital, his symptoms did not improve significantly. The patient underwent exploratory laparotomy and surgical resection. Pathologic examination showed an epithelioid MPM. He was treated with chemotherapy and intraperitoneal hyperthermic perfusion after surgery. Currently, he is in a stable condition and tumor recurrence has not occurred. CONCLUSION Misdiagnosis and missed diagnosis of MPM can easily occur because of its insidious onset. Therefore, there is a need to understand. MPM in clinical practice, make the correct diagnosis, and provide timely and effective treatment.

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