Objective To investigate the diagnosis rate of early gastric calleer(EGC)with mucosa biopsy after compound staining under gastroseopy.Methods Two hundreds and six pafients who suspected tO be EGC by gastroscopy were randomly divided into two groups,the mucosa in control group(n=103)was biopsy directly under gastrescopy,and the experimental group(n=103)was biopsy after compound staining.Compared the diagnosis rate of ECG between these two groups.Results Twelve cases were confirmed to be EGC by surgery plus pathology among all the patients.Two cases were from control group,the other ten cases were from experimental group.Type Ⅱ c+Ⅲ accounted for 58.3%of twelve EGG.Eleven cases(91.7%)were positive with helicobacter pylori(Hp).Conclusion Compound staining may improve diagnosis rate of ECG.There is significant deference between directed and mueosa biopsy after compound staining under gastrescopy(P=0.033).TypeⅡc+Ⅲwere main type in endoscope of EGC.Hp infection is closely related to early gastric cancer.

Objective To evaluate intraperitoneal Composix Kugel prosthetic patch repair of vental hernia. MethodsThe clinical data of 10 cases were reviewed for the surgical procedures and perioperative management in the use of this technique. ResultsMean operation time was 62 min(ranging grom 43 to 80 min). There was no postoperative wound hematoma and infection except for 1 case with seroma. Follow up of 2 to 19 months found no hernia recurrence. Conclusion Intraperitoneal Composix Kugel patch repair of vental hernia has the advantages of short operative time, minimal invasiveness and rapid convalescence.

Background Plasma membrane calcium ATPase 3 (PMCA3) participates in the regulation of Ca2+ level in lens epithelial cells (LECs),which may be associated with the pathogenesis of cataract.It has been proved that ultraviolet B (UVB) is one of causing-factors of cataract.However,the effect of UVB on the expression of PMCA3 in LECs is unclear.Objective This study was to investigate the effects of UVB irradiation on the expression of PMCA3 in human LECs B-3.Methods HLE B-3 cells were cultured and passaged.The cells were exposed to 0,5,10 and 20 mJ · s/cm2 UVB for 0,20,40,80 s,respectively and further cultured for 24,48 and 72 hours.MTT assay was used to detect the cell proliferation rate.JC-1 staining was used to detect the changes of mitochondrial membrane potential (△ψm) in the cells.The intracellular reactive oxygen species (ROS) level was detected by DCFH-DA staining,and cell apoptosis was evaluated using annexin V-FITC/PI staining.In addition,the intracellular calcium ion (Ca2+) concentration in the cells was assayed with Fluo-3/AM staining.The expression levels of PMCA3 mRNA and PMCA protein in the HLE B-3 cells were detected by real-time PCR and Western blot,respectively.Results The survival rates of the cells were significantly reduced with the increase of irradiated intensity of UVB and the lapse of time (Fgroup =72.411,P =0.000 ; Ftime =36.588,P =0.000),and the survival rates of the cells in the 10 mJ · s/cm2 and 20 mJ · s/cm2 UVB for 24 hours were (75.3 ± 2.2) ％ and (48.7 ±4.5) ％,respectively,which were significantly lower than those in the 0 mJ · s/cm2 UVB group ([100.0±0.0] ％) (P=0.001,0.000).The survival rates of the cells in the 5,10,20 mJ · s/cm2 UVB for 48 hours were (84.9± 1.2) ％,(69.3±17.4)％ and (32.8±4.5)％,showing significant declines in comparison with the 0 mJ · s/cm2 UVB group ([100.0±0.0] ％) (P =0.047,0.000,0.000).In 72 hours following 5,10,20 mJ · s/cm2 UVB irradiation,the survival rates of the cells were (55.1 ± 3.0) ％,(42.1 ± 1.9) ％ and (26.1 ±4.7) ％,respectively,with significant differences in comparison with the 0 mJ · s/cm2 UVB group ([100.0 ± 0.0] ％) (P =0.000,0.000,0.000).JC-1staining exhibited the intracellular red fluorescence in the normal cells group.However,in the 5 mJ · s/cm2 UVB group,weak green fluorescence was seen,and the green fluorescence was enhanced in the 10 mJ · s/cm2 and 20 mJ · s/cm2 UVB groups.After irradiated by 5,10 and 20 mJ · s/cm2 UVB,the ROS levels in the cells increased from 0.4％ to 35.8％,51.9％ and 76.7％,respectively.The apoptosis and necrosis rate of the cells was 2.0％ in the 0 mJ · s/cm2 UVB and 4.2％,7.6％,15.1％ in the 5,10,20 mJ · s/cm2 UVB groups,respectively.The Ca2+ level raised by (1.2±0.1) and (1.3±0.1) folds in the 10 and 20 mJ · s/cm2 UVB groups more than that in the 0 mJ · s/cm2 group (P =0.039,0.004).The expression levels of PMCA3 mRNA in the cells were significantly reduced (P=0.001,0.004,0.000),and the expression levels of the PMCA protein were declined in the 5,10 and 20 mJ · s/cm2 UVB groups compared with the 0 mJ · s/cm2 UVB group (P=0.000,0.000,0.001).Conclusions UVB irradiation causes cataract probably through downregulating the expression of PMCA3 in human LECs and inducing apoptosis of LECs in a dose-and time-dependent manner.

Objective To evaluate the clinical efficacy of modified Chen's biliojejunostomy technique in treating hilar cholangiocarcinoma.Methods The clinical data of the patients with hilar cholangiocarcinoma from January 2011 to June 2014 in the PLA general hospital and its first affiliated hospital were retrospective ly studied,and 17 of them underwent modified biliojejunostomy.There were 10 male and 7 female patients with a mean of 65 years old (range 34 ～82).Cases diagnosed as Bismuth-Corlette Type Ⅱ,Ⅲ a,Ⅲ b and Ⅳ were 2,6,4,and 5,respectively.Results Liver segment Ⅳ were resected from 2 patients,segment Ⅳ + Ⅴ from 7 patients and segment Ⅳ + Ⅴ + Ⅰ from 8 patients.No death was observed during the study period.One patient had mild bile leakage,2 patients had cholangititis,and another patient had biliary intestinal anastomotic bleeding.Three patients received resection and reconstruction of the portal vein.Three right hepatic arteries and 1 anterior branch of right hepatic artery were resected in combination with the tumor because of invasion.All the complications were alleviated under conservative treatment.Twelve cases had been followed up for a median time of 16 months (range 3 ～ 24).Two cases had cholangititis intermittently.One case underwent radiotherapy because of local recurrence in 2 years after the surgery.MRCP and relevant enzymes were within the normal range.Conclusion Modified Chen's biliojejunostomy is a simple,effective and safe method,which can be widely used when there are multiple biliary intestinal anastomoses.

Objective Non-alcoholic fatty liver ( NAFL) is a metabolic disease and levocarnitine can be used to improve the energy metabolism of the patient .This study aimed to evaluate the clinical efficacy of levocarnitine in the treatment of NAFL . Methods We retrospectively analyzed 85 cases of NAFL treated by lifestyle intervention (control group, n=40) or by lifestyle intervention +levo-carnitine medication (medication group, n=45).In addition to lifestyle intervention, the patients in the medication group received oral levocarnitine at 10 mL tid for 4 weeks followed by a reduced dose of 10 mL bid for another 8 weeks. Results Twelve weeks after treat-ment, 37 cases (82.2%) in the medication group showed remarkable improvement and the other 8 failed to respond.In the control group, 23 cases (57.5%) were improved and 17 cases remained unimproved .There were statistically significant differences in the rate of therapeutic effectiveness between the two groups of patients (P<0.01).No adverse effects were observed during the levocarnitine medi-cation. Conclusion Lifestyle intervention +levocarnitine medication can improve NAFL .

Objective To compare the efficacy and safety of naphthoquine, artemisinine and a combination of the two drugs in the treatment of faciparum malaria. Methods Of 230 patients, 100 patients were treated with combined regime (Co-NQ), 100 patients were treated with naphthoquine (NQ) and 30 patients were treated with artemisinine (QHS). All patients were hospitalized for 7 days and followed up for 28 days. Results The mean fever clearance time for Co-NQ, NQ, and QHS was (17.5 ?12.3)h, (32.7?17.7)h and (18.1?9.7)h respectively; the mean parasite clearance time was (30.0?8. 8)h,(45.5?10.0)h and (29.1?6.0)h respectively; and the 28 days cure rate was 97.0% ,100.0% and 66.7% respectively. Conclusion The Co-NQ possesses benefits of both naphthoquine and artemisinine, acting rapidly, with a short course of only one dose and a high cure rate. The regime is well tolerated by patients.

Objective To study the anticoagulation therapy of lower molecular weight heparin in the treatment of patients with acute pancreatitis.Methods Seventy-three patients with acute pancreatitis were divided into anticoagulation group(n=38)and control group(n=35).The serological indexes and prognosis of patients were detected.Results Anticoagulation treatment with lower molecular weight heparin significantly decreased the white blood cell count,increased the oxygen partial pressure in arterial blood,shoaened the duration of hospitalization,and reduced the aggravation rate,secondary operation rate and mortality of patients with acute pancreatitis.Conclusions Anticoagulation treatment with lower molecular weight heparin is safe,effective and can improve the prognosis of patients with acute pancreatitis.

Objective The control rate of blood pressure in hypertension patients is very low in our country , while follow-up intervention can significantly improve the situation .This study aimed to evaluate the clinical effects of anti-hypertension under follow-up intervention . Methods From October 2013 to October 2014 , 125 patients with hypertension were chose as the study objectives after first clinical anti-hypertension and were divided into intervention group (follow-up,n=65) and control group(no follow-up,n=60). Comparative analysis was made in blood pressure control , compliance with therapy and cardiovascular event incidence between the two groups after 12 weeks'intervention. Results After 12 weeks, diastolic and systolic blood pressure in intervention group was signifi-cantly lower than that in control group (P<0.05).Significant difference was also found in the compliance with drug-taking between in-tervention group and control group (73.8%vs 43.3%, P<0.01).During the follow-up period, 1 case in the control group suffered stroke and unstable angina pectoris hospitalized for treatment . Conclusion Follow-up intervention after clinical service can improve the efficacy of blood pressure control and encourage the patients to live healthy lifestyle .

Objective:To discuss the influence of bifid triple viable enteric-coated capsules on liver function and inflammatory fac-tor in the patients with non-alcoholic steatohepatitis ( NASH) . Methods:Totally 70 cases of patients with NASH were selected and di-vided into the control group and the observation group at random. The patients in the two groups were all given routine hepatoprotective therapy. The patients in the observation group were additionally given 420mg bifid triple viable enteric-coated capsules, three times a day for 4 weeks. Except for bifid triple viable enteric-coated capsules, the patients in the control group were given the same medical treatment as that in the observation group. The changes of liver function index, serum high sensitivity C reaction protein ( hs-CRP) , IL-6 and IL-8 levels in the two groups before and after the medical treatment were observed and the security was compared. Results:After the 4-week medical treatment, ALT, GGT, serum hs-CRP, IL-6 and IL-8 levels in the two groups were obviously declined than those before the treatment (P<0. 05 or P<0. 01), and the declining rate in the observation group was much higher than that in the control group (P<0. 05). Totally 6 and 4 cases of adverse drug reaction (ADR) respectively appeared in the observation group and the control group during the medical treatment with mild symptom, and the difference was without statistical significance (P>0. 05). Conclusion:Bifid triple viable enteric-coated capsules in the treatment of NASH can obviously reduce the serum hs-CRP, IL-6 and IL-8 levels, inhibit the intrahepatic inflammation and immunologic injury, and improve the liver function index with high security.

Objective To evaluate combined sampling at multiple sites of gastric mucosa for Helicobacter pylori (HP) culture.Methods A total of 258 patients with upper gastrointestinal symptoms received 13C-urea breath test between August 2014 and May 2015.During endoscopy,gastric mucosa biopsy samples from the lesser curvature of the antrum (A),the greater curvature of the antrum (B),gastric angle (C) and the body of the stomach (D) were collected to isolate HP strains.The positive rates of HP based on combined sampling and single site sampling were compared with a Nemenyi test.Results Consistency between 13C-urea breath test and HP culture was 82.56％.There was significant difference between the single site sampling and two-site sampling in the positive rate of HP,except for the body of the stomach (P＜0.05).There was significant difference in the positive rate of HP between the single site sampling and three-site sampling (P ＜ 0.05).There was no significant difference between any two-site sampling in the lesser curvature of the antrum and the body of the stomach,gastric angle and the body of the stomach,the greater curvature of the antrum and the body of the stomach,and any three-site sampling (P＞0.05).Conclusion The combined sampling of the lesser curvature of the antrum and the body of the stomach have the highest cost-effectiveness in HP culture compared with the single site sampling and three-site sampling.