Objective To evaluate the clinical usefulness of manometry of esophgeal varices with endoscopic balloon technique. Methods The variceal pressure was measured by endoscopic balloon technique in 26 patients with portal hypertension, at the same time , laboratory parameters of liver function were determined. ResultsDetermination of variceal pressure was successful in 23/26 patients, while no side effects was observed. The intraobserver coefficient of variation was 7.18% ?2.64%,and there was a significant(P

Gallbladder cancer is the most common malignant neoplasm in biliary system,with a high degrade of malignancy,invasion and metastasis.The prognosis is heartbreaking.Radical surgery is the only possible way for curing.The current understanding of China's doctors at all levels on radical surgery of gallbladder cancer is chaotic.Based on the latest version eighth TNM staging of the American Joint Committee on Cancer(AJCC)of gallbladder cancer,making a review of the literature,combined with the author's personal experience,we have interpreted the reasonable selection of hepatectomy of gallbladder cancer,in order to improve the doctors at all levels to regulate the understanding of hepatectomy and the prognosis of gallbladder cancer.

Objective To explore the role of intravenous nutrition and enteral nutrition in the treatment of gastroplegia after gastrectomy. Methods The clinical data of 63 cases of gastroplegia after gastrectomy were retrospectively analyzed. Among the 63 cases, 30 were treated by gastrodynamic drugs and intravenous nutrition(intravenous nutrition group), and the other 33 cases were treated by gastrodynamic drugs and enteral nutrition(enteral nutrition group). Gastrointestinal decompression amount and recovery time of gastroplegia between the two groups were compared. Results Enteral nutrition group had a short recovery time of gastroplegia and less gastrointestinal decompression amount compared with intravenous nutrition group(P

[Objective]Extracellular signal-activated kinases(ERK),c-Jun N-terminal kinase(JNK) and P38 signal transduction pathway were three members of the MAPK family which mediated cellular proliferation,differentiation and apoptosis.The purpose of this study was to investigate the effects of ERK,JNK and P38 MAPK on pathogenesis and progression of human osteosarcoma.[Method]EnVisionTM immunohistochemical technique was used to detect the expressions of ERK,JNK and P38 protein among the 48 osteosarcoma and 25 osteoblastic benign tumor samples,and their differences were compared.[Result]The positive rates of ERK,JNK and P38 protein were 83.3%(40/48),72.9%(35/48) and 85.4%(41/48) respectively in 48 osteosarcoma,and 16.0%(4/25),12.0%(3/25) and 20.0%(5/25) in 14 osteoblastic benign tumor,the statistical analysis of the positive rates were performed using analysis of variance with P

With the strengthening of nuclear weapon development and the expanding of neutron application in economic area,the injury accidents of neutron radiation are happening from time to time.Neutron exposure,with high linear energy transfer,has high casualty rate,severe symptom and poor prognosis.In comparison with low-LET radiation damage,neutron irradiation induced injuries are more difficult to rescue.This review focused on the recent research progresses of radiation effects,intrinsic mechanisms and clinical prevention measures of neutron radiation,and to provide a theoretical clue for establishing an effective prevention protocol of neutron radiation damage.

Objective To investigate the diagnostic values of ultrasound in rheumatoid knee arthritis and the clinical significance of ultrasonic scoring system.Methods From July 2013 to December 2015,500 cases of patients with rheumatoid knee arthritis in two grade A class 3 hospitals of Lishui City were collected as the observation group and contemporaneous 500 healthy adults were collected as the control group.The knee joint synovial thickness,vascular detection rate in hyperplasia synovium,ultrasound score,rheumatoid arthritis disease activity score,erythrocyte sedimentation rate (ESR),C reactive protein (CRP),suprapatellar bursa effusion,infrapatellar bursa effusion,joint effusion,knee joint cartilage and bone surface were observed in the two groups.Results Compared with the control group,the observation group got a significant increase in knee joint synovial thickness [(0.50±0.19)cm vs.(0.13±0.05) cm,P=0.000)];depth of suprapatellar bursa fluid [(0.62±0.27)cm vs.(0.23±0.05) cm,P=0.000];depth of infrapatellar bursa fluid [(0.58±0.12)cm vs.(0.21±0.04) cm,P=0.000];joint fluid depth [(0.48±0.28)cm vs.(0.12±0.08) cm,P=0.000];ESR [(43.29±12.58)mm/h vs.(12.95±4.39) mm/h,P=0.000)];CRP level [(8.95±3.29)mg/L vs.(3.29±1.54) mg/L,P=0.000)];vascular detection rate in hyperplasia synovium (84.20% vs.13.00%,P=0.000).Moreover the ultrasound score was positively corrected with rheumatoid arthritis disease activity score,CRP level,ESR,suprapatellar bursa fluid depth,infrapatellar bursa fluid depth and joint fluid depth in the patients with rheumatoid arthritis (r=0.583,0.258,0.383,0.219,0.228,0.248;P<0.05).Conclusion Ultrasound has good diagnostic value in the patients with rheumatoid arthritis,and the ultrasonic scoring system can better reflect the severity of the disease.

In order to realize an individualized and specialized rehabilitation assessment of remoteness and intelligence, we set up a remote intelligent assessment system of upper limb movement function of post-stroke patients during rehabilitation. By using the remote rehabilitation training sensors and client data sampling software, we collected and uploaded the gesture data from a patient's forearm and upper arm during rehabilitation training to database of the server. Then a remote intelligent assessment system, which had been developed based on the extreme learning machine (ELM) algorithm and Brunnstrom stage assessment standard, was used to evaluate the gesture data. To evaluate the reliability of the proposed method, a group of 23 stroke patients, whose upper limb movement functions were in different recovery stages, and 4 healthy people, whose upper limb movement functions were normal, were recruited to finish the same training task. The results showed that, compared to that of the experienced rehabilitation expert who used the Brunnstrom stage standard table, the accuracy of the proposed remote Brunnstrom intelligent assessment system can reach a higher level, as 92.1%. The practical effects of surgery have proved that the proposed system could realize the intelligent assessment of upper limb movement function of post-stroke patients remotely, and it could also make the rehabilitation of the post-stroke patients at home or in a community care center possible.
Algorithms ; Arm ; physiopathology ; Artificial Intelligence ; Humans ; Movement ; Recovery of Function ; Reproducibility of Results ; Software ; Stroke Rehabilitation

Objective To prospectively compare the efficacy of omeprazole and esomeprazole on H. pylori eradication related to cytochrome P450 (CYP) 2C19 polymorphism in Chinese Han poputafion. Methods A total of 240 patients with peptic ulcer were randomly assigned to receive either EAC (amoxicillin, clarithromyein and esomeprazole) treatment or OAC (amoxicillin, clarithromycin and orneprazole) treatment for one week with 120 each. Then, the patients were sustained treated with esomeprazol or omeprazole for 3 weeks. The endoscopic evaluation was performed 2 weeks after treatment. At the end of the treatment, a carbon-13 (13C) urea breath test (13C-UBT) was performed to determine H. pylori status. Polymerase chain reaction and restriction fragment length polymorphism were used to detect CYP2C19 genotypes including extensive metabolizer (EM), poor metabolizer (PM), homozygous (homEM) and hetEM. Results Two hundred and twenty five of 240 patients completed the study. H. pylori eradication was 79.2% with OAC regimen and 88.3% with EAC regimen by intention to-treat (ITT) analyses without difference (P>0.05). Whereas H. pylori eradication was 87.20/00 with OAC regimen and 91.4% with EAC regimen by per-protocol (PP) analyses without difference (P>0. 05). However, both ITT and PP analysis showed that there was significant difference in H. pylori eradication between EAC regimen (91.9% and 97.1%) and OAC regimen (71.8% and 77.8%) in patients with homEM genotype (P= 0.037 and P=0.028). Two weeks after treatment, the percentage of ulcer healing was 79.2% or 81.9% in EAC group and 69.2% or 76.1% in OAC group by ITT or PP analysis, respectively (P> 0.05). Low side effects were noted in EAC or OAC groups (3.3% vs. 7.5%,P>0.05). Conclusion The high eradication will be achieved by esomeprazole-based triple regimen which is superior to omeprazole-based triple regimen in treatment of patients with homEM genotype.

Objective To prospectively study the main risk factors of variceal bleeding in cirrhotic patients. Methods Fifty-seven patients with liver cirrhosis and esophageal varices who had never experienced variceal bleeding were followed up for 12 months. The patients underwent measurements of esophageal variceal pressure by non-invasive endoscopic balloon technique. The endpoint of the study was the presence of a variceal hemorrhage. The relationship between variceal hemorrhage and endoscopic findings including varices, variceal pressure, Child-Pugh status, ascites, and etiology of cirrhosis was studied. Results Thirty-four patients (59.6% ) developed a variceal hemorrhage. In univariate analysis, the level of variceal pressure (P= 0. 001), the size of varices (P=0. 006), and the endoscopic red color sign on the variceal wall (P=0. 012) predicted higher risks of variceal hemorrhage. The multiple logistic regression revealed that variceal pressure was a major predictor of the risk for a first variceal bleeding (OR=2. 817, P=0. 003). The area under the receiver operating characteristic (ROC) of variceal pressure for predicting variceal bleeding was 0. 98, and the variceal pressure cutoff value was 25.3 mm Hg (1 mm Hg=0. 133 kPa) with both specificity and sensitivity of 91 %. Conclusion The level of variceal pressure is a major predictor for variceal bleeding in cirrhotic patients.

Purpose To explore the relationship between the mutations of epidermal growth factor receptor ( EGFR) and KRAS genes and clinicopathological characteristics in patients with non-small cell lung cancers (NSCLC). Methods Clinical samples from 431 NSCLC patients were obtained for EGFR and KRAS gene analysis. PCR based direct DNA sequencing was used to investigate mutations in exon 18-21 of EGFR gene and codon 12 and 13 of exon 2 of KRAS gene. Results The overall EGFR mutation rate of primary NSCLC was 53. 6% (231/431) in this study cohort and eight cases showed double EGFR mutations. Mutation rates in female and male were 65. 2% (122/187) and 46. 9% (98/209), respectively. The mutation rate was higher in patients with non-smokers and adeno-carcinoma and adenosquamous carcinoma subtypes than in their counterparts (P<0. 05), with the percentage of 57. 2% (124/216), 60. 3% (199/330), 42. 9% (6/14), respectively. In squamous cell carcinomas and other subtypes, EGFR mutation rates were 11. 6% (5/43) and 11. 1% (1/9), respectively. The EGFR mutation types included exon 18 point mutations (4. 0%, 9/227), exon 19 deletion mutations (4. 5%, 101/227), exon 20 insert or point mutations (9. 7%, 22/227) and exon 21 point mutations (41. 4%, 94/227). Activating mutations of KRAS gene were detected in 7. 8%(31/396) of NSCLC. Twenty-eight patients showed codon 12 mutations ( G>T, G>A, G>C) , and three patients had codon 13 mutations ( G>A, G>T) . Most of these mutations were G to T transversion (64. 5%, 20/31). Conclusion Polymerase chain reaction-direct sequencing is a reliable and effective method for the detection of the EGFR and KRAS gene mutation in NSCLC patients. The mutation rate of EGFR is higher in Chinese patients, especial-ly in non-smoking female patients with adenocarcinoma.