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]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

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 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.

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 assess the usefulness of combined dual-energy CT pulmonary angiography (DE-CTPA) and indirect CT venography (CTV) in the diagnosis of venous thromboembolism (VTE).Methods Forty-nine patients with leg swelling suspected of pulmonary embolism (PE) underwent both DE-CTPA combined with CTV and lower extremity venous ultrasound (US) in 1-2 days prior to CT.Image quality of CTPA and dual energy lung perfusion image (DEPI) was rated using a 5-point scale and the coherence between CTPA and DEPI was analyzed by Kappa statistics.The ability of CTV and US in the diagnosis of deep venous thrombosis (DVT) was compared by Chi-square test.Results Twenty-nine of 49 patients were identified with PE by DE-CTPA,including 28 patients identified by CTPA and one more by DEPI,and 21 patients were found to have both PE and DVT.Both DE-CTPA and DEPI had positive findings for pulmonary embolism in 19 patients and both had negative findings in 18 patients.There was a moderate agreement between DEPI and DE-CTPA in the assessment of PE (Kappa value =0.7534).Thirty-eight patients with DVT were identified by US,while 35 patients were identified by CTV.Among the 35 patients with DVT identified by CTV,pelvic veins were involved in 25 patients,while the inferior vena cava was involved in 3 patients.There was no significant difference between CTV and US in the diagnosis of DVT(P =0.625).The detection rate of VTE with DE-CTPA combining CTV was 30.6％ higher than that with CTPA alone.Conclusions The combined DE-CTPA and CTV achievesone-stop examination.It not only provides evaluation of PE and DVT and increases detection of VTE,but also depicts perfusion defect of pulmonary parenchyma that corresponds to PE.

Objective To observe the diffusion characteristics and pathology changes with DTI in rabbit models with mild cerebral contusion and laceration (CCL). Methods Thirty rabbits were randomly selected and made into models of mild CCL by free fall, while other 10 rabbits were cut only in the skull as control. T2WI and DTI were performed 1, 3, 6, 12, 24, 48 and 72 h after the operation. DTI value of average diffusion coefficient (DCavg) and fractional anisotropy (FA) of mild CCL and its peripheral area were measured and compared. Histological examination was also performed. Results One hour after operation, CCL area showed high signal on T2WI, and no abnormal signal was found in the peripheral area, but both had abnormal color on DTI map. T2WI signal intensity in peripheral area of 22 rabbits (73.33%) increased gradually and had much abnormal color on T2WT map after 3 h. There was significant difference of FA and DCavg between CCL and the mirror region, the peripheral area and the mirror region (P<0.05). The value of FA decreased slightly since 12 h. More prominent tissue necrosis, edema and hemorrhage were found in CCL area than in the peripheral area with pathology examination. No abnormal manifestations of the brain were detected with both pathology and MR examination in the control rabbits. Conclusion DTI is sensitive for detecting mild CCL and can show it directly on color map, and thus may be used as a routine examination in the evaluation of mild CCL.

AIM: To study the isolation,purification and characterization of Ramulus Mori polysaccharide. METHODS: Ramulus Mori was extracted by boiling water. The raw extract was precipitated fractionally by alcohol deproteinized,passing through DEAE ion exchange cellulose ( DEAE-52) and SephadexG-100,obtained RMPS1 and RMPS2. The composition and characterization of Ramulus Mori polysaccharide were researched by TLC、IR、 GC、HPLC and smith degradation. RESULTS: The molecular weight of RMPS1 and RMPS2 were 5. 8 ? 105 and 6. 5 ? 105; RMPS1was made up of rhammose、arabinose、glucose and galactose with the molarity rate of 1. 08 ∶ 1 ∶ 1. 40 ∶ 1. 57; RMPS2 of rhammose、glucose and galactose with the molarity rate of 11. 38 ∶ 1 ∶ 1. 35. Smith degradation showed that the main linkage form in RMPS1 and RMPS2 was 1→2 and 1→4 glycosidic linkages,But some 1→3 glycosidic linkages also existed in the molecules; infrared spectrum showed that both had the polysaccharide characteristic absorption peaks. CONCLUSION: The structures of RMPS1 and RMPS2 are first determined from Ramulus Mori.

Thirty patients with objective benign paroxysmal positional vertigo (BPPV) (objective group) and 30 patients with subjective BPPV (subjective group) visiting Department of Neurology from January 2014 to June 2015 were enrolled in the study.There were no significant differences in semicircular canal,gender,age,related factors of secondary onset (P ＞ 0.05).Patients were evaluated with dizziness handicap inventory (DHI) before and after the maneuver therapy.The average DHI subscale scores before treatment of all patients were higher than those after treatment (11.8 ± 2.8 vs.2.5 ± 1.8,P ＜ 0.05);there was 11.9 ± 3.0 vs.2.5 ± 2.1 (P ＜ 0.05) for objective group and 11.6 ± 2.6 vs.2.5 ± 1.6 (P ＜ 0.05) for subjective group.The scores of PI,F5,P11,P13,P25 (mean rank order value) after treatment were decreased compared to corresponding initial scores in two groups(objective group:21.30 vs.39.70,19.55 vs.41.45,19.00 vs.42.00,18.65 vs.42.35,15.90 vs.45.10,respectively,subjective group:20.93 vs.40.07,18.07 vs.42.93,19.77 vs.41.23,18.57 vs.42.43,16.47 vs.44.53,respectively;all P ＜ 0.05).The results indicate that maneuver therapy is effective both for objective and subjective BPPV patients;and subscale of DHI can be used to evaluate the degree of illness in patients with BPPV.