Objective To investigate the prevalence of gastroeaophageat reflux disease(GERD)in the end stage renal disease patients(ESRD)with maintenance hemodialysis and the pathogenetic factors of GERD.Methods 60 cases who had heart burn and acid regurgitation symptoms were enrolled,31 cases of them were ESRD patients with maintenance hemodialysis,29 patients who were renal diseases free as control group.GERD was diagnosed by three methods:endoscopy,24h esophageal pH monitoring,endoscopic esophageal biopsy.GERD was established if any of these tests was positive.HP infection and serum gastrin were assessed too.Results (1)The prevalences of GERD in two groups were 83.9%,79.3% respectively and had no significant difference(P＞0.05).(2)The prevalence of HP infection in the ESRD group was significantly lower than control group(19 4% vs 51.7%,P＜0.05).(3)The concentration of serum gastrin in the ESRD group and control group was(102.61±30.80)ng/ml and (83.41±20.61)ng/ml,two group had significant difference(P＜0.05).Conclusion The prevalence of GERD inthe ESRD patients was higher than expected,and was correlated with absence of HP infection and hypergastinemia.

Objective To observe the effects of hepatocyte-like cells differentiated from human umbilical cord mesenchymal stem cells (HuMSCs) on the liver function of the rats with liver cirrhosis.Methods Carbon tetrachloride was used to prepare rat model of liver cirrhosis.Then the rats in the experimental group received portal vein injection of 1 ml differentiated hepatocyte-like cells (1 × 107) ; the mesenchymal stem cell (MSC) group was injected with the same volume and number of MSCs; the model group was injected with the same volume of saline (NS) ; the normal rats were treated as control group.After transplantation,the rat angular vein blood and liver tissue were obtained for testing.Results One week after transplantation,compared with the model group,levels of serum alanine aminotransferase (ALT),aspartate aminotransferase (AST) and total bilirubin (TBil) in the experimental group significantly decreased (P ＜0.05),while the albumin (Alb) level increased significantly (P ＜0.05).Compared with the MSC group,the level of Alb in the experimental group also significantly increased (P ＜ 0.05),but there were no differences between the two groups of ALT,AST and TBil.4 weeks after transplantation,compared with the model group,levels of serum ALT,AST and TBil in the experimental group also significantly decreased (P ＜ 0.05),while Alb level increased significantly (P ＜ 0.05).Compared with the MSC group,the differences of the levels of Alb,ALT,AST and TBil were all statistically significant (P ＜ 0.05).Real-time PCR test results showed that the expressions of four liver-related genes of the MSC group and experimental group significantly increased comparing with the model group (P ＜ 0.05).And the experimental group showed higher expression level comparing with the MSC group (P ＜ 0.05).Conclusion The differentiated hepatocyte-like cells could improve hepatic function of patients with liver cirrhosis to a certain degree and showed greater advantage than MSC.

Myocardial ischemia/reperfusion(MI/R) injury refers to restoring blood perfusion after myocardial ischemia for a relatively long time, but the tissue appears more obvious and severe myocardial damage and dysfunction than before reperfusion, this phenomenon mainly relates to inflammation, oxidative stress, cell apoptosis, cell autophagy and so on.NF-κB is a nuclear transcription factor involved in regulating a variety of pathophysiological processes, which also plays an important role in all aspects of MI/R injury.The in-depth study of NF-κB in MI/R injury and clinical application of related research will provide new ideas and methods for treating MI/R injury.

Objective The aim is to inquiring into the diagnosis and discrimination of systemic lupus erythematosus (SLE) complicated with centric nervous system (CNS) infection.Method The retrospective analysis of 14 patients with SLE and CNS infection was made.Results These patients were treated by corticosteroid for a long time before CNS infection.There were 4 patients with cryptococcal meningitis,3 with suppurative meningitis,5 with tuberculosis meningitis,1 with encephalopyosis and 1 with unclear diagnosis.Conclusion Pathogenic microbiological assay of cerebrospinal fluid is a reliable basis for diagnosis of SLE with CNS infection.The diagnosis of patients without pathogenic organism depends on original infection,manifestations,difference of cerebrospinal fluid and head CT.The differentiation of SLE complicated with CNS infection from SLE encepalophathy is important.

BACKGROUND: At present, most of the literature on joint replacement focus on the causes and countermeasures of long-term complications, but seldom focuses on causes of postoperative short-term complications, such as wound exudation and delayed union. Whether the incidence of sustained exudation and delayed wound healing in patients with hypertension after hip replacement is higher than that in patients with normal blood pressure is not reported at present.OBJECTIVE: To identify the correlation of hypertension with persistent wound exudation and delayed wound healing in patients after femoral head replacement.METHODS: Data of 205 elderly patients with femoral neck fractures were retrospectively analyzed. All patients underwent femoral head replacement. In accordance with the hypertension diagnostic criteria of 2010 Chinese Guidelines for the Management of Hypertension, patients were divided into hypertension group and control group.Intraoperative blood loss, postoperative blood loss, the days of prolonged wound exudation, the wound dehiscence, and the prevalence of delayed wound healing were compared between the two groups. Then, we analyzed the relationship of hypertension with wound exudation and delayed wound healing.RESULTS AND CONCLUSION: (1) The average systolic blood pressures were 153.55 mmHg and 128.82 mmHg in the hypertension and control groups, respectively (P < 0.05). (2) No significant difference in age, gender, MNA-SF score, diabetes, body mass index, intraoperative blood loss, and postoperative blood loss was found between the two groups (P > 0.05). (3) The time of persistent wound exudation was 4.03 days and 2.08 days in the hypertension group and control group, respectively (P < 0.05). (4) The prevalence of delayed wound healing was significantly higher in the hypertension group than that in the control group (P < 0.05). (5) Hypertensive patients had a higher risk of prolonged wound exudation and delayed healing than their normotensive counterparts, and the hypertension is one of the important influence factors for delayed wound healing.

The purpose of the present study was to examine the effects of oxidative stress on ventricular arrhythmias in rabbits with adriamycin-induced cardiomyopathy and the relationship between oxidative stress and ventricular arrhythmia. Forty Japanese white rabbits were randomly divided into four groups (n=10 in each): control group, metoprolol (a selective β1 receptor blocker) group, carvedilol (a nonselective β blocker/α-1 blocker) group and adriamycin group. Models of adriamycin-induced cardiomyopathy were established by intravenously injecting adriamycin hydrochloride (1 mg/kg) to rabbits via the auri-edge vein twice a week for 8 weeks in the adriamycin, metoprolol and carvedilol groups. Rabbits in the control group were given equal volume of saline through the auri-edge vein. Rabbits in the metoprolol and carvedilol groups were then intragastrically administrated metoprolol (5 mg/kg/d) and carvedilol (5 mg/kg/d) respectively for 2 months, while those in the adriamycin and control groups were treated with equal volume of saline in the same manner as in the metroprolol and carvedilol groups. Left ventricular end diastolic diameter (LVEDd) and left ventricular ejection fraction (LVEF) were measured by echocardiography. Plasma levels of N-terminal pro B-type natriuretic peptide (NT-proBNP), malondialdehyde (MAD) and superoxide dismutase (SOD) were detected. The left ventricular wedge preparations were perfused with Tyrode's solution. The transmural electrocardiogram, transmural action potentials from epicardium (Epi) and endocardium (Endo), transmural repolarization dispersion (TDR) were recorded, and the incidences of triggered activity and ventricular arrhythmias were obtained at rapid cycle lengths. The results showed that TDR and the serum MDA and NT-proBNP levels were increased, and LVEF and the serum SOD level decreased in the adriamycin group compared with the control group. The incidences of triggered activity and ventricular arrhythmia were significantly higher in the adriamycin group than those in the control group (P<0.05). In the carvedilol group as compared with the adriamycin group, the serum SOD level and the LVEF were substantially increased; the TDR, and the serum MDA and NT-proBNP levels were significantly decreased; the incidences of triggered activity and ventricular arrhythmia were obviously reduced (P<0.05). There were no significant differences in the levels of MDA and SOD, LVEF, TDR and the incidences of triggered activity and ventricular arrhythmia between the adriamycin group and the metoprolol group. It was concluded that carvedilol may inhibit triggered activity and ventricular arrhythmias in rabbit with adriamycin-induced cardiomyopathy, which is related to the decrease in oxygen free radials.

Objective To observe the iffectiveness of comprehensive rehabilitationinterventions on stroke patients with unilateral spatial neglect (USN). Methods A total of 245 cases if strijd were examined to diagnose USN. Of the 245 patients,86 cases were diagnosed as being with USN, and divided into a control group(n=43 cases) and a treatment group (n=43 cases) randomly. The control group was treated with Bobath and Rood techniques in addition to routine clinical medical interventions, while the treatment group was treated with a comprehensive rehabilitation protocol for USN in addition to the same interventions for the control group. Both groups were assessed with regard to motor, balance function, walking performance, and USN severity as well as the activities of daily living (ADL) performance. Results After 8 weeks of treatment,both groups improved, but there showed a significantly statistical difference between the 2 groups in terms of Fugl-Meyer motor function scores (P＜0.01), balance function scores (P＜0.01) Holden walding function classifications (P＜0.01), Barthel index(P＜0.001) and USN severity scores(P＜0.01). Conclusion Comprehensive USN rehabilitation intervention could improve motor, balance, walking functions and ADL performance and alleviate the USN severity in stroke patients with USN.

Objective: To evaluate the false positive rate and false negative rate of the Chinese version of the 12-item General Health Questionnaire (GHQ-12) and the related factors in the epidemiological survey of mental ill-nesses in Zhejiang Province. Method: A total of 15000 subjects were randomly selected from the province-wide using multi-stage stratified cluster randomization. Analyses for this paper were made in the quality control sample,10% of the total 15000 subjects (1510 subjects) in which the Chinese version of Structured Clinical Interview for DSM-Ⅳ Axis Ⅰ Disorders (SCID) was used as a golden criterion, and a cutoff score of the GHQ-12 was set to ≥ 3 to define GHQ-12 cases. Results: Totally 1449 subjects (96.0%) completed both the GHQ-12 and the SCID. Adjusted for sampling effects, the false positive and negative rates of the GHQ-12 were respective 14.6% and7.8%. Adjusted for other considered correlates and sampling effects, the adjusted odds ratios (AORs) of GHQ-12 false positive with living in less economically developed urban areas (urban type Ⅱ), with self-reportedly poor physical health, with having ever sought help because of mental problems and with being currently married/co-habited were respective 2.23 (95% CI:1.24～4.01), 2.36(1.36～4.10), 1.53 (1.10～2.14) and 0.51 (0.30～0.86) while AORs of GHQ-12 false negative with being aged 35～49 year group and living in less econom-ically developed rural areas (rural type Ⅲ) were respective 2.59 (1.18～5.67) and 2.72 (1.21～6.14). Conclusion:Factors related to the GHQ-12 false positive and negative are different. The cutoff scores of the GHQ-12 should be used based on the characteristics of subjects during identifying or screening mental illnesses.

Objective To investigate the clinical and genetic characteristics in two patients with androgen insensitivity syndrome. Methods Clinical features and laboratory data were collected from the patients and their families. All exons of the androgen receptor gene were amplified by PCR and PCR products were sequenced. Results Patient 1 presented with unambiguous female external genitalia, unilateral gynecomastia and primary amenorrhea. He did not have axillary hairs or pubic hairs. Patient 2 presented with undervirilization including scanty body hairs, gynecomastia and hypospadias. A missense mutation of

BACKGROUND: Measuring the slope of proximal tibiofibular joint may elucidate the anatomical structure and type of proximal tibiofibular joint, and evaluate the stability of proximal tibiofibular joint. OBJECTIVE: To investigate the measurement methods and clinical significance of the joint slope by comparing the slope measurement of bilateral proximal tibiofibular joint surface on X-ray and 64-row spiral CT reconstruction.METHODS: One hundred normal adult volunteers, including 50 males and 50 females, aged 18-90 years, were photographed in double knees via internal rotation to 30°, 45° and 60°, respectively and scanned with 64-row spiral CT, tibiofibular bone (including knee joints) was reconstructed. The included angle between proximal tibiofibular articular surface and the longitudinal axis of the fibula shaft, between the proximal tibiofibular articular surface and the horizontal line, were measured using an angle square.RESULTS AND CONCLUSION: There were great variations of the data in the same proximal tibiofibular joint measured by X-ray and spiral CT. X-ray results are affected by the site of photograph position, and the slope of articular surface is estimated, so the 64-row spiral CT is an accurate and convenient method to reconstitute the slope of proximal tibiofibular joints. Spiral CT could be used to distinguish the dislocation and instability of the proximal tibiofibular joint, accordingly reduce the clinical misdiagnosis.