Portal hypertension is a common complication of chronic liver diseases and is responsible for most of the clinical consequences of cirrhosis.Accurate assessment of portal venous pressure is essential for the designing of treatment strategy and judging of prognosis.Measurement of hepatic venous pressure gradient (HVPG) is the gold standard for evaluating portal venous pressure, however, it is an invasive procedure and is hard to be performed routinely in clinical practice.Therefore, it is urgent to explore a noninvasive method for assessing portal venous pressure.Recent evidence highlights that biochemical parameters, transient elastography, CT, MRI and the conjoint analysis model of multiple parameters have the potential diagnostic value.This article reviewed the advances in study on noninvasive assessment of portal venous pressure.

Objective To discuss the clinical significance of anti-HBc-IgG(anti-HBc) only positivity of HBV markers in serum.Methods The total and the isolated anti-HBc positive rate were calculated retrospectively from 5 213 and 594 inpatients′ serum samples determined for five HBV markers including HBsAg,anti-HBs,HBeAg,anti-HBe and anti-HBc by microparticle enzyme immunoassay(MEIA),enzyme-linked immunosorbent assay(ELISA),respectively.The levels of anti-HBs were analysed in 167 five-HBV-marker negative and 124 anti-HBc-only positive subjects determined for five HBV markers by MEIA.Making a dilution with range from 2- to 30-fold with the phosphate buffer system containing 10% bovine calf serum to 97 serum samples with epidemiological anti-HBc only positivity screened from 594 inpatients determined for five HBV markers by ELISA,and anti-HBc of the dilute serum samples were determined by ELISA and MEIA,respectively.Results The total and the isolated anti-HBc positive rate with epidemiological and clinical significance by ELISA were 72.1%, 16.3 % and 62.6%,7.6%,respectively.The total and the isolated anti-HBc positive rate by MEIA were 78.1% and 13.2%,respectively.The difference of anti-HBs levels between five-HBV-marker negative and anti-HBc-only positive subjects determined for anti-HBs by MEIA was significant(?~2= 86.9 ,P

Objective To investigate epidemiological characteristics and differences in anklebrachial index (ABI) among the natural population in Shanghai and Inner Mongolia,and to observe the prevalence of lower extremity peripheral arterial disease (PAD).Methods A total of 2604 volunteers from Shanghai and Inner Mongolia were selected by stratified cluster random sample.ABI was measured and related data were collected.Results The A BI value in Shanghai was 1.074 ± 0.095,while it was 1.062 ±0.075 in Inner Mongolia (P ＜ 0.001).The prevalence of lower extremity PAD in Shanghai was 4.2％,while it was 1.9％ in Inner Mongolia (P ＜ 0.01).For males,the ABI value in Shanghai was 1.078 ±0.105,and it was 1.075 ± 0.080 in Inner Mongolia (P ＞ 0.05).For females,the ABI value in Shanghai was 1.073 ±0.089,while it was 1.052 ±0.070 in Inner Mongolia (P ＜0.001).For males,the prevalence of lower extremity PAD of the in Shanghai was 4.7％,while it was 2.0％ in Inuer Mongolia (P ＜ 0.05).For females,the prevalence of lower extremity PAD of in Shanghai was 4.0％,while it was 1.8％ in Inner Mongolia (P ＜ 0.05).The ABI values in age group of ＜ 50 years in Shanghai and Inner Mongolia were 1.037 ± 0.082 and 1.055 ± 0.068,respectively (P ＜ 0.05).The prevalences of lower extremity PAD in age group of ＜50 years in Shanghai and Inner Mongolia were 7.6％ and 1.2％,respectively (P ＜0.001).There were no significant differences in ABI value and the prevalence of lower extremity PAD between Shanghai and Inner Mongolia in both age group of 50-69 years and ≥70 years (all P values ＞ 0.05).Conclusions The ABI value in Shanghai is higher than that in Inner Mongolia and the prevalence of lower extremity PAD in both males and females in Shanghai is significantly higher than that in Inner Mongolia.But they are lower than the level of western countries.In different age groups,the difference of the prevalence of lower extremity PAD between Shanghai and Inner Mongolia is only displayed in the age group of ＜ 50 years,which may be related to the limited sample size.The natural population in Shanghai exposed artery atherosclerotic disease risk factors may increase and we need to pay more attention to the lower extremity PAD.

Objective To investigate the effects of dexmedetomidine on hemodynamics and tra-cheal intubation facility in general anesthetized patients.Methods Forty gynecological patients of se-lective operation under general anesthesia were randomly arranged into 2 groups:group D and group C.With high flow mask oxygen inhalation(5 L/min),dexmedetomidine was intravenously pumped in-to the patients in group D at 0.6μg/kg in 10 minutes while in group C saline were given instead.Both groups were then proceeded with rapid sequence induction (RSI)immediately.The values of MAP, HR,PaO2 and PaCO2 were recorded every minute from pumping start till 15 minutes,the bucking, intubation time and glottis exposure were evaluated as well.Results No significant differences were found in intubation time or glottis exposure between these two groups.After tracheal intubation group D showed higher MAP value than group C at 14,15 minutes,and a lower HR value (P <0.05).Even no significant differences were found in values of SpO2 and PaO2 ,the group D showed less bucking than the group C (P<0.05).Conclusion Dexmedetomidine administration at 0.6μg/kg in RSI can diminish the variation in hemodynamics and facilitate the tracheal intubation by less buc-king,but no affect the oxygen reserve.

Objective To evaluate the effects of spinal segmental stabilization exercises (SSE)at home on the quality of life for community dwelling elderly patients with lower back pain.Methods Eighty elderly patients with lower back pain were divided into two groups according to the random number method:the experimental group,which received intervention for three months,and the control group,which received no intervention.Evaluation was conducted using the Oswestry Disability Index (ODI) and the WHO Quality of Life-BREF (WHOQOL BREF).Results The ODI and WHOQOL-BREF scores for the control group were (0.32 ± 0.09) and (87.65 ± 8.63),respectively,before treatment,and (0.32± 0.07) and (87.98 ±8.15),respectively,three months after treatment; the scores for the experimental group were (0.32 ± 0.09) and (87.97 ± 8.71),respectively,before treatment,and (0.27 ± 0.09) and (92.30 ± 9.64),respectively,three months after treatment.No statistically significant difference was found in ODI and WHOQOL-BREF scores in the control group before and three months after treatment (t=0.311 and-0.672,respectively; P ＞0.05 for both),while statistically significant differences were detected before and three months after treatment (t =0.311 and-0.672,respectively; P＜ 0.05 for both).Differences in ODI and WHOQOL-BREF scores were also found between the experimental group and the control group three months after treatment (t=8.500 and-4.526,respectively; P＜0.05 for both).Conclusions Spinal segmental stabilization exercises can effectively relieve symptoms,improve body functions and uplift the quality of life for community-dwelling elderly patients with lower back pain.As a beneficial physical therapy option,SSE can be promoted in residential communities.

Objective To compare the epidemiological characteristics and differences in brachialankle pulse wave velocity (baPWV)among middle-aged residents between Shanghai and Inner Mongolia autonomous region (Inner Mongolia),and to observe the prevalence of arterial stiffness in the two populations.Methods A total of 922 volunteers aged between 45 and 59 from Shanghai and Inner Mongolia were selected by stratified cluster random sample method.BaPWV was measured and related data were collected.Results A total of 903 cases were enrolled in this study,including 441 from Shanghai and 462 from Inner Mongolia.The baPWV value of middle-aged residents in Inner Mongolia was higher than that in Shanghai [(1 548 ± 281) cm/s and (1 476 ± 254) cm/s,P ＜ 0.001].The abnormal rate of baPWV (baPWV ≥ 1 400 cm/s) in Inner Mongolia was also higher than that in Shanghai [67.5 ％ (312) and 57.4％ (253),P ＜0.001].The baPWV value of middle-aged men in Inner Mongolia was (1 568 ±299) cm/s,while it was (1 508 ± 260) cm/s in Shanghai,no statistical difference was found (P ＞ 0.05).The baPWV value of middle-aged women in Inner Mongolia was (1 534 ± 268) cm/s,which was higher than that of Shanghai [(1 468 ±252)cm/s,P ＜0.01].The abnormal rate of baPWV of middle-aged men in Inner Mongolia and Shanghai was 67.0％ (126/188) and 60.8％ (59/97),respectively (P ＞ 0.05).The abnormal rate of baPWV of middle-aged women in Inner Mongolia and Shanghai was 67.9％ (186/274) and 56.4％(194/344),respectively.Conclusions The difference of baPWV value and abnormal rate of baPWV of middle-aged residents between Inner Mongolia and Shanghai exists.Middle-aged people in Inner Mongolia should be more alert to the incidence of arteriosclerosis and cardio-cerebrovascular diseases.

Objective To investigate the effect of the artificial cycle on the prognosis after transcervical resection of adhesion (TCRA) and its mechanism .Methods 80 patients with intrauterine adhesion were randomly divided into the observation group and the control group .The observation group were performed TRCA and postoperative artificial cycle for successive 3 months :oral es-tradiol valerate(9 mg once daily) for 21 d ,adding oral medroxyprofgesterone acetate(10 mg once dialy) on 15 d ,then the medication discontinuation for 7 d ,which was taken as 1 cycle;the control group received only TCRA .The re-examination was performed after 3 months .The levels of follicle stimulating hormone(FSH) ,luteinizing hormone(LH) ,estradiol(E2 ) ,prolactin(PRL) ,progesterone (P) and testosterone(T) were examined by ELISA after TCRA three months .The expression of MMP-9 and TGF-β1 in adhesive endometrium were detected by real-time PCR and Western blot .Results Compared with the control group ,the artificial cycle thera-py combined with the operation could significantly increase the effective rate of TCRA for treating mild and moderate intrauterine adhesion(P<0 .05);the seum levels of FSH ,LH ,E2 ,PRL ,P and T had no statistical differences between the observation group and the control group(P>0 .05);the artificial cycle significantly improved the adhesive degree of intrauterine adhesion ,increased the MMP-9 expression and decreased the TGF-β1 expression .Conclusion Artificial cycle could improve the degree of uterine cavity ad-hesion after TCRA ,which the mechanism might be related to the increase of MMP-9 expression and decrease of TGF-β1 expres-sion .

Objective To study the effects of propofol used alone and in combined with opioids in gastroscopy,in order to select the more suitable anesthesia protocol.Methods A total of 285 pa-tients undergoing gastroscopy were selected in April ,201 5 in our hospital,including 105 males,180 females,ranging from 18 to 65 years old,weighing 40-90 kg,falling the category of ASA Ⅰ or Ⅱ. According to random number table,subjects were divided into four groups:dezocine group(group D, n =76),fentanyl group (group F,n =87),oxycodone group (group O,n = 71 )and control group (group C,n =5 1).Each group was implemented the corresponding anesthesia.SBP,DBP,HR,SpO 2 in baseline(T0 ),1(T1 ),3(T2 ),5(T3 )min after entering gastroscope were recorded.Choking cough, body movement,extra propofol,awakening time and inspecting time were observed.Results Among four groups,there was no statistical significance in age,gender,weight,blood pressure,heart rate and oxygen saturation and other general information.There were more cases given extra propofol in group C than in the other three groups (P <0.01 ).While for the experimental groups,there were more cases needing extra propofol in group O than in group D and group F (P < 0.01 ).The incidences of body movement and choking cough in group C were higher than those in the other three groups (P <0.01 ).Compared with the group C,dosage of propofol ,awakening time in the three groups,especially in group D,were much lower (P < 0.01 ).Conclusion Propofol in combination with opioids for sedation during painless gastroscopy can alleviate adverse reaction caused by propofol used alone.The more suitable anesthesia protocol is propofol with dezocine.

As a form of Tuina(Chinese therapeutic massage)Qigong exercises and an essential part of exercise therapy,static training has proven clinical efficacy.However,further evidence is required to reveal its mechanism of action provided by animal experiments.There are four major ways to establish static training animal models:pole climbing,hind-limb suspension,isometric-contraction weight bearing,and electrical stimulation.These models have been used to study diseases of the motor,circulatory,and endocrine systems,etc.,and the mechanism has got extensive exploration.It reviewed static training animal models and the research progress to provide theoretical evidence for static training's experimental research and mechanism exploration.

Background Laser peripheral iridoplasty (LPI) is widely used in the treatment of glaucoma by flattening the iris and widening angle of anterior chamber (AA).However,no evidence suggests the optimal site of LPI in iris.Objective This study was to compare the therapeutic effects of LPI at different sites of iris for glaucoma.Methods Glaucoma models were established in the right eyes of 40 healthy adult male pigment rabbits by intrachamber injection of 0.1 ml compound carbomer solution with 0.3％ carbomer and 0.025％ dexamethasone.The models were randomly divided into model control group,corneoscleral limbus group,one spot from corneoscleral limbus group and two spots from corneoscleral limbus group.LPI was performed at corresponding site of iris by 532 nm argon laser with the spot diameter 500 μm,energy 300 mW,exposure time 0.3 seconds and laser number 24 spots,and the rabbits in the model control group did not receive LPI.Intraocular pressure (IOP),coefficient of outflow facility (C value) were measured and calculated with Schi(o)tz tonometer before LPI and 2,4,7,14 and 30 days after LPI,and anterior chamber depth (ACD),AA,anterior chamber angle opening distance within 500 μm radius from scleral spur (AOD500) were measured with ultrasound biomicroscope (UBM).The eyeballs were extracted 30 days after LPI,and the chamber angle were observed under the optical microscope after hematoxylin and eosin staining.The use and care of the animals complied with the Guide for the Care and Use of Laboratory Animals of the National Institutes of Health.Results UBM showed that compared with the model control group,the anterior chamber angle was evidently widened in all the LPI groups,with the best effectiveness in the one spot from corneoscleral limbus group and the worst one in the two spots from corneoscleral limbus group.Compared with the model control group,the IOP was evidently reduced,and C values,AA and AOD500 were significantly increased in the corneoscleral limbus group,one spot from corneoscleral limbus group and two spots from corneoscleral limbus group after LPI,showing significant differences among the four groups (IOP:Fgroup =16.848,P ＜ 0.01;C value:Fgroup =9.629,P ＜ 0.01;AA:Fgroup =62.336,P＜0.01;AOD500:Fgroup =77.779,P ＜ 0.01).IOP was reduced and C value,AA and AOD500 were increased in 2,4,7,14 and 30 days after LPI as compared with before LPI,with significant differences over time (IOP:Ftime =3.041,P =0.011;C value:Ftime =4.311,P＜0.01;AA:Ftime =14.627,P＜0.01;AOD500:Ftime =20.378,P＜0.01).Compared with the model control group,the ACD was significantly increased in the corneoscleral limbus group and one spot from corneoscleral limbus group,and that in the two spots from corneoscleral limbus group was significantly reduced,and the ACD was insignificantly increased over time after LPI (Fgroup =18.017,P＜0.01;Ftime =0.022,P =1.000).Hematoxylin and eosin staining showed that the trabecular meshwork and adhesion of tissure were reopened and the anterior chamber angle was widened after LPI.Conclusions LPI can widen anterior chamber angle and lower the IOP.The best therapeutic outcome for glaucoma is displayed when LPI is performed at the iris site corresponding to one spot from the corneoscleral limbus.