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.

Objective To investigate effects of N-acetylcysteine (NAC) on changes of the behavior and the monoamine neurotransmitters in prefrontal cortex (PFC), striatum (ST), amygdala (AM) and hippocampus (HIP) in rat model of chronic unpredictable stress (CUS), and to explore the possible mechanisms related to the NAC. Methods Thirty-two male Sprague-Dawle (SD) rats were divided into CUS group, fluoxetine group (FLX), NAC group and control group (n=8 for each group). Rats in CUS group, NAC group and FLX group were all fed alone and received CUS for 6 weeks to establish CUS model. Rats in NAC group and FLX group were given NAC and FLX by daily intragastric administration respectively during the last 3 weeks, while rats in CUS group and control group were given the same volume of solvent. Behavioral assessment including weight measurement, sucrose water consumption test, and opened field test were used for evaluation before and after CUS, and before and after intervention. The concentrations of the monoamine neurotransmitters (NE, DA, 5-HT) in PFC, ST, AM and HIP were measured with Coul array HPLC. Results (1) There were more increases in weight gain, sucrose consumption, and distance of horizontal moving and number of up-right, while the number of feces was less, after intervention in control group, NAC group and FLX group than those of CUS group (P<0.05). (2) Neurotransmitters including NE, DA and 5-HT were significantly decreased in PFC, ST, AM and HIP in CUS group compared with that of control group (P<0.05). The monoamine neurotransmitter (NE, DA and 5-HT) were significantly increased in the brain region (PFC, ST, AM and HIP) in NAC group and FLX group than those of CUS group (P < 0.05). Conclusion NAC and fluoxetine can effectively improve the depressive behavior of the CUS rats, increase the contents of monoamine neurotransmitters including NE, DA and 5-HT in PFC, AM, ST and HIP brain regions.

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.

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.

Objective To evaluate the therapeutic efficacy of percutaneous transhepatic portal vein catheterization and thrombolysis on superior mesenteric vein thrombosis.Methods The treatment and therapeutic efficacy of 15 cases of patients with superior mesenteric vein thrombosis underwent percutaneous transhepatic portal vein catheterization and thrombolysis from January 2000 to April 2011 were retrospectively analyzed.Results Percutaneous transhepatic portal vein catheterization was performed successfully in 15patients,without pneumothorax,bile leakage and intra-abdominal hemorrhage after catheterization.Eleven patients had good thrombolytic effect,with majority or complete recanalization on superior mesenteric vein,portal vein and splenic vein.The rate of recanalization Was 73.3％,total mortality was 13.3％.The total amount of urokinase was not more than 500 million U,and there was no cases with systemic bleeding.From 6 months to 36months follow-up,there was no increased portal vein system thrombosis and recurrent cases.Conclnsion Thrombolysis technique of percutaneous transhepatic portal vein catheterization is easy to master,and with good effect of local infusion thrombolytic therapy and lower complication rate.It's a selectable treatment for superior mesenteric vein thrombosis.

ObjectiveTo explore the difference of the oxytocin Levels and cortisol levels between major depression patients and normal controls,and the relationship of symptoms severity of major depression with oxytocin levels and cortisol levels.MethodsTwenty 18 ～ 45years old major depression patients and twenty six normal controls were tested by an enzyme-linked immunosorbent assay to evaluate the oxytocin levels and cortisol levels,and the Hamilton Rating Scale for Depression-17 item was used to evaluate the symptoms severity of depression in patient group.ResultsMann-Whitney test showed there were significantly differences in oxytocin level between patients and controls ( ( 213.60 ± 164.29 ) pg/ml vs ( 112.27 ± 101.21 ) pg/ml,z =- 2.306,P =0.021 ),but there were no significantly differences in cortisol level between two groups.Within the depressive sample( (0.131± 0.089) vs (0.107 ± 0.077 ) pg/ul,z =- 0.920,P =0.358 ),the severity of depressive symptom was positive correlated to the value of oxytocin ( r=0.599,P=0.005) and cortisol( r=0.691,P=0.001 ),the value of oxytocin was also positive correlated to the value of cortisol( r =0.743,P ＜ 0.01 ),Multiple liner regression analyses showed that the value of oxytocin is an impact factor of the severity of depression.( adjusted R2 =0.358,F =11.578,P =0.003 ).ConclusionThis study indicated that the value of plasma oxytocin maybe significantly differences between depression and normal controls and the plasma oxytocin level maybe a factor which influence the severity of major depression,the relationship of the cortisol value and the severity of depression can not be confirmed.