Objective To investigate the effect of magnifying endoscopy with narrow-band imaging (ME-NBI) in diagnosis of early gastric neoplastic lesion. Methods 151 patients with suspected gastric cancer underwent endoscopic examination in digestive endoscopy center from January 2013 to June 2016 were enrolled the study. They firstly received conventional white light endoscopy (WLE), then ME-NBI (including intervening part) and targeted biopsy. And all patients were divided into early cancer group (high grade intraepithelial neoplasia, intramucosal carcinoma and submucosal carcinoma, n = 72) and non-early cancer group (low grade intraepithelial neoplasia, n = 79). The area under receiver-operating characteristic curve (AUC) was performed to evaluate prognostic value of each index in early cancer. Results The incidences of the demarcation line, irregular microvascular pattern, irregular microsurface pattern and increasing intervening part in early cancer group were significantly higher than that in the non-early cancer group (P < 0.05). The AUC of ME-NBI for early gastric cancer was 0.947 and higher than 0.832 of WLE. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Youden index were 97.2%, 84.8%, 85.4%, 97.1% and 0.820, respectively. The AUC of intervening part for early gastric cancer was 0.907 and higher than 0.889 of the traditional VS classification, and AUC, sensitivity, specificity, PPV, NPV and Youden index of VS type combined with intervening part were 0.933, 95.8%, 83.5%, 84.1%, 95.7% and 0.794, respectively. Conclusions ME-NBI is an important method for diagnosis of early gastric cancer, and intervening part has the advantages of strong objectivity, simple and easy to operate, good repeatability, and it could be used to assist traditional VS classification in judging the nature of lesions.

Objective To identify the role of the IKK / NF-kappa B signaling pathways in the acquisition and consolidation of extinction memory in conditioning fear.Methods Aduh SD rats were treated with nuclei buried surgery.After a week recovery from nuclei buried surgery,adult SD rats accepted auditory fear conditioning training.Before the extinction training,bilateral intra-BLA infusion of sulfasalazine(SSZ),an inhibitor of IKK/NFκ B,and Vehicle were done.The freezing time were tested on the 24h and 1w after the extinction.Results After training,all the rats showed higher percentage of freezing time than the baseline(Vehicle:pre-CS 21.16％,post-CS 71.23％,P＜0.01 ; SSZ:pre-CS 22.23％,post-CS 72.14％,P＜0.01).The percentage of freezing time had no significant difference(SSZ 47.52％,Vehicle 46.20％,P＞0.05)between Vehicle and SSZ at the end of extinction training.However,SSZ groups showed significantly higher percentage of freezing time than the control group on the 24h(Vehicle 41.03％,SSZ 60.51％,P＜0.01) and the same was found on 1 weck test(Vehicle 34.17％,SSZ 57.21％,P＜ 0.01).The rats injection with SSZ showed significant fear response for the auditory fear condition.Conclusion All above results suggest that interference of IKK/NF-κ B signaling pathway impaire the consolida tion but have no effect on the acquisition of fear extinction memory in conditioning fear.The available date could provide us some clinical guidance in the treatment of post-traumatic stress disorder and panic disorder.

Objective To explore the childhood abuse impact on clinical and personality characters among anxiety associated depressive patients.Methods A case-control method was taken among 86 anxiety associated depression patients,36 cases with childhood abuse and controlled with 50 cases without childhood abuse.HAMD,HAMA,CECA-Q,MMPI were used to evaluate the participants,and the scores of the results were compared between the two groups.Results For the HAND,the group with CA were significantly higher than the group without CA(t=7.079,P＜0.05).From the point of factor scores,there was not a significant difference between the two groups among the factors such as anxiety somatization,cognitive impairment,and hopelessness.From the point of view of the total scores of HAMA (t=3.108) and spiritual anxiety (t=4.037),somatic anxiety (t=2.742) the CA group was significantly higher than group without CA(P＜0.05).In the patients with CA the psychoticism(P) (t=2.794) and neuroticism (N) (t=3.217) factors were significantly higher than patients without CA (P＜0.05).MMPI evaluation results showed accept ance T points in addition to lie(L),calibration(K),male woman(Mf),light mania(Ma),the CA group were significantly higher than the group without CA(P＜0.05).T points to compare two groups of MMPI additional factor scale,the adaptation to the society (A),emotional intelligence (EQ),decisionmaking ability (DE),CA group were lower than the group without CA,violence (VL),traffic accident (DR) and addiction(SA) with CA group was higher than the group without CA(P＜0.05).The regression analysis showed that the emotional neglect score and HAMD scores were positively related in the relationship of the childhood abuse and depression.Y =3.729+0.887 X(P=0.000).Sexual abuse score and HAND scores were related,regression analysis showed that the Y =9.799 + 0.655 X (P =0.000).Conclusions The clinical patients with CA have more severe symptoms than the patients without CA.Personality is extraversion more emotionally unstable.Their emotional intelligence and decision-making comprehensive ability is low,and violence tendency is obvious.Emotional neglect and sexual abuse have an important impact in the pathogenesis of the disease.

Integrating medical instruments with medical information systems becomes more and more important in healthcare industry. To make medical instruments without standard communication interface possess the capability of interoperating and sharing information with medical information systems, we developed a medical instrument integration gateway based on Integrating the Healthcare Enterprise Patient Care Device (IHE PCD) integration profiles in this research. The core component is an integration engine which is implemented according to integration profiles and Health Level Seven (HL7) messages defined in IHE PCD. Working with instrument specific Javascripts, the engine transforms medical instrument data into HL7 ORU message. This research enables medical instruments to interoperate and exchange medical data with information systems in a standardized way, and is valuable for medical instrument integration, especially for traditional instruments.
Equipment and Supplies ; Health Level Seven ; Humans ; Information Systems ; Software

ObjectiveTo identify the effects of venlafaxiue on the acquisition and consolidation of fear extinction memory in conditioning fear memory extinction model.MethodsMale Sprague-Dawley rats were treated with fear conditioning training in the A environment.Before the extinction training,all the experimental rats were given different doses of venlafaxine intraperitoneal injection.After 24 hours,all the rats test in the B environment.ResultsRepeated-measures ANOVA were conducted on the percent of freezing time for between-session extinction,test condition (F2,44 =458.958,P＜0.001 ) and VEN dose(F2,22 =43.026,P＜0.001 ) and a Test condition * Treatment interaction (F4,44 =31.363,P ＜ 0.001 ).For the within-session,post hoc comparisons indicated that the three groups that received different dose of VEN (0,20 and 40 mg/kg) did not differ from each other (P ＞ 0.05 ),indicating similar extinction following the post-conditioning.The rats injected with high-dose venlafaxine (40 mg/kg) intraperitoneally before extinction training showed pro,motion of between-subjects extinction of fear memory,but does not affect the within-subjects extinction.There was no significant catabolism in the rats injected with middle-dose (20 mg/kg).ConclusionThe available date indicate that venlafaxine could promote the extinction of fear memory and there is a dose-dependent relationship of venlafaxine in the facilitation of fear memory.Our results could provide some clinical guidance for the treatment of post-traumatic stress disorder and panic disorder.

Immunological alterations and changes in neurotransmission are considered to be crucial in the pathological process of depression. An immune activation including increased production of proinflammatory cytokines has repeatedly been described in depression, which shines a clue for new anti-depression therapy. Immune activation will lead to depression through serotonin and glutamate systems. This paper is attempted to review the immune mediated alterations on serotonin and glutamate systems.

Objective To determine the volume reduction of the primary olfactory cortex (POC) in patients with Alzheimer disease (AD) and investigate the potential relationship of functional olfactory activation and anatomical atrophy changes. Methods Twelve patients with AD, eight patients with mild cognitive impairment (MCI) and twenty normal controls (NC) underwent standardized UPSIT (University of Pennsylvania smell identification test) behavior smell test and neuropsychological tests. Then all of the subjects underwent the high resolution MRI and an olfactory fMRI scan on a 3T system. Volumetric measurement of the POC was conducted and the areas were also saved as a ROI which would be used during the processing of fMRI data to get the activation voxels in local region. The Kruskal-Wallis rank test was used to examine the significance of POC volume and activation in three groups, If P-value was less than 0.05,Bonferroni method was used for multiple comparisons. The correlation between the anatomical volume and functional activation was analyzed with partial correlation adjusted for age. Results The POC volume of NC, MCI and AD groups were 3024--4734, 1409--4553 and 1561--3759 mm~3, and the medians were 3749, 2752 and 2156 mm~3. The activation voxels of each group were 0--2360, 0--2160 and 0--100 mm~3, while the medians were 430, 40 and 0 mm~3. There were significant differences of both POC volume atrophy and activation between the three groups, with a trend of reduction from NC to MCI to AD group (H is 14.942 and 16.587, both P<0.05). The volume of olfactory activation at POC was highly correlated with the volume of POC (r=0.364, P=0.023). Conclusions In this study, we explored the morphological and functional changes in the POC. It is revealed that POC suffers prominent local atrophy and dysfunction as well as hippocampus in AD. These results can provide neuropathological and neurofunctional bases for olfactory deficit in Alzheimer Disease.

A description of the implementation strategy and methodology of clinical medicine as a discipline in terms of building clinical technology features, making scientific research centering on clinical questions, building technical and academic branding, and building discipline bases.Authors also emphasized human resource cultivation, and held that the clinical discipline development should be carried out by means of organization and culture management for the discipline.

ObjectiveTo study the anatomy of the soleus muscle perforator flap and its clinical application.MethodsIn 6 cadavers specimen with 12 lower limbs,the cutaneous branches and soleus muscle perforator artery were dissected and their measurements were recorded.Fourteen patients with skin and soft tissue defects from July 2002 to October 2010 were repaired by the soleus muscle perforator flap.Of the 14 patients,eight for dorsal and anterior defects of foot,two for anterior defects of malleolus,two for hand defects,two for elbow defects.The size of the flaps was 5 cm × 6 cm - 12 cm × 20 cm.Flap success rates and postoperative course were evaluated. ResultsThe soleus musclocutaneous perforators mostly appeared within 5 - 24 cm length below the head of fibula.The diameter of the artery cutaneous perforator was( 1.08 ±0.22)mm,vena concomitants was (1.20 ± 0.32)mm.All flaps were survived completely and the wounds got primary closure in 14 cases.The flaps were not overstaffed,and their shape,texture and color were similar to normal.All of the 14 cases were evaluated as satisfactory after 6 months to 12 months follow-up. ConclusionThe free soleus muscle perforator flap is an ideal flap for repairing skin and soft tissue defects with the merit of simple procedure,minimal trauma and more physiological circulation established.

Objective To explore the role of histone H3 acetylation modification of brain derived neurotrophic factor (BDNF) in the pathogenesis of Alzheimer's disease (AD).Methods 2 months and 8 months SAMP8 mice were used as AD model.Morris water maze was used to detect the impairment of learning and memory.Western blot was used to detect BDNF protein expression in the hippocampus,and chromatin immunoprecipitation (CHIP) was applied to study the changes of histone H3 acetylation in different BDNF promoters.Results The results of water maze test showed that the time across the target quadrant in 8 months SAMP8 mice(0.9±0.4) was significant declined compared with that of 2 months SAMP8 mice(3.7 ± ±0.9) and 8 months SAMR1 mice (3.3±0.6)(all P＜0.05).Meanwhile,compared with 2 months SAMP8 mice ((23.9±4.0) s) and 8 months SAMR1 mice ((21.5± 2.3) s),target quadrant time in the 8 months SAMP8 mice((11.7±2.8) s) was also significantly reduced(both P＜0.05).The western blot showed the expression of BDNF in the hippocampus of 8 months SAMP8 mice was significantly decreased compared with that of 2 months SAMP8 mice and 8 months SAMR1 mice(P＜0.05).Lastly,CHIP assays showed that histone H3 acetylation of BDNF exon Ⅳ and Ⅵ in the hippocampus of 8 months SAMP8 mice were remarkably decreased(P＜0.05) compared with that of 2 months SAMP8 mice and 8 months SAMR1 mice.There was no significant change of histone H3 acetylation of BDNF exon Ⅰ and Ⅲ among all groups(P＞0.05).Conclusion Histone H3 acetylation of BDNF exon Ⅳ and Ⅵ is reduced during the development of AD,which may be the mechanism underlying the impairment of learning and memory in AD.