To determine the relationship between Barrett's esophagus (BE) and features of gastroesophageal acid reflux, 24 h esophageal pH monitoring was performed in 90 patients. The patients were divided into 3 groups: 31 subjects with BE, 21 with mild esophagitis and 38 with severe esophagitis. The following parameters were evaluated: the percentage time of pH < 4; the number of reflux episodes over 5 min; the duration of longest episodes and DeMeester score over total period and the auterior three parameters in erect and supine position. All these parameters in BE were significantly different from those with mild esophagitis (P < 0.01) and not significantly different from those with severe esophagitis (P > 0.05). During supine position all the above parameters in BE were significantly different from those with reflux esophagitis (P < 0.05). It is concluded that the quantity of acid reflux is not an important factor in development of BE in gastroesophageal reflux (GER), and the acid reflux in supine position might be important in development of BE in GER.
Barrett Esophagus/etiology ; Barrett Esophagus/*physiopathology ; Esophagitis, Peptic/etiology ; Gastroesophageal Reflux/*complications ; Hydrogen-Ion Concentration ; Supine Position

ObjectiveTo explore the influence of gender,age and types of peer acceptance on the ability of theory of mind among rural parent-absent children.Methods 312 rural parent-absent children participated in the study (including 162 boys,150 girls; 102 members of 8 year-old,119 members of 9 year-old,and 91 members of 10 year-old).Their ability of theory of mind and types of peer acceptance were examined by the 2nd-order False-beliefs Tasks and Peer nomination.The date were analyzed by Multivariate analysis of variance (ANOVA),LSD checkout and Simple effect analysis.ResultsThere were statistically significant effects on ages in theory of mind,types of peer acceptance ( F=4.57,P=0.011 ; F =3.82,P =0.005 ) and the interaction among gender,ages and types of peer acceptance(F=3.20,P =0.042; F =2.50,P =0.043 ).The least significant different(LSD) assay of the ability of theory of mind age and types of peer acceptance shows:there were statistically significant lies in the divergence of age 8 and age 9 group,and also in age 9 and age 10 group,(I-J =-0.51,P =0.016;I-J =- 0.90,P =0.000 ).In the same way,there were also statistically significant lies in the divergence of the ability of theory of mind performance-popular and rejected ( I-J =1.05,P =0.001 ) ; popular and neglected ( I-J =0.84,P =0.003 ) ; popular and controversial( I-J =1.03,P =0.002) ; rejected and average ( I-J =- 0.66,P =0.02 ) ; controversial and average ( I-J =- 0.64,P=0.034).Results of simple effect shows:there were statistically significant lies in the gender divergence of the 9 age group (F =4.98,P =0.026),the age divergence of girls (F =7.50,P =0.001 ),the gender divergence of controversial groups (F=5.76,P =0.017 ),the peer acceptance divergence of boys(F=4.97,P =0.001),and also the peer acceptance divergence of girls(F =2.54,P =0.04).Conclusion There is substantial connection between the ability of theory of mind of rural parent-absent children and ages and types of peer acceptance.

Drug delivery system in tumor targeting research has always been a difficult problem.Apoptosis in vitro experiments and body pharmacokinetic experiments can not reflect the targeting of drug delivery system indirectly.Imaging techniques both in vivo and in vitro solve the problem,researchers can not only observe the drug delivery system in the target organ,the target tissue and target cell directly,but also analyze quantitatively and qualitatively.

Peripheral T-cell lymphoma (PTCL) is a kind of highly aggressive lymphoma which contains a collection of subgroups. The patients with PTCL have poor prognosis under current chemotherapy regimens, so the treatment of PTCL remains a big challenge. Brentuximab vedotin combined with CHP regimen, pralatrexate in combination with romidepsin and other regimens have set up more options for patients with PTCL. Novel agents, such as PI3K inhibitors, which entered into clinical trials, bring good news to PTCL patients.

[Objective]To summarize results of treating complex proximal tibia fractures with less invasive stabilization system(LISS),and to explore the concept and technology of LISS.[Method]From January 2004 to March 2006,39 cases of complex proximal tibia fractures were treated with less invasive stabilization system,including 26 male and 13 female.The mean age of the patients was 34.8 years(range 22 to 54 years).According to the AO/OTA fracture classification,there were 19 cases in type 41-A3,12 cases in type 41-C2,4 cases in type 41-C3,4 cases in proximal type 42.Seven cases were open fractures and were classified as 3 grade Ⅰ,4 grade Ⅱ open fracture according to the system of Gustilo.Eleven patients were multitraumatic patients.[Result]All the cases were followed up for averaging 15.6 months(10～21 months).The mean operation time was 75 min(60～130 min).All fractures healed,the averaging healing time was 13 weeks(11～16weeks).The averaging blood lost was 300 ml(170～500 ml).The postoperative alignment of 33 fractures was satisfactory,5 cases had 6?～ 8 ?valgus auglation,one case had 5?varus auglation in coronal plane.The mean time of weight bearing was 14.2 weeks(11～18 weeks).The range of movement was 100?～120?.All the cases had no infection,breakage of screws and plates,failed fixation and so on.According to HSS scores system,there were 26 excellent cases,7 good cases,5 fair cases,1 poor case,the excellent and good rate was 84.6%.[Conclusion]Less invasive stabilization system,providing stable fixation and optimizing early bone union and functional rehabilitation,is a realistic therapy in treatment of complex proximal tibia fractures.Exact comprehension of LISS concept and procedure,adjustment according to cases,are very important to assure satisfactory results.

Cancelling drug price addition is one of public hospital reform content, under the condition of insufficient financial input, public hospitals should enhance the drug cost management, taking measures to reduce drug proportion, to deal with all kinds of hospital operation problems produced by hospital income decline due to the cancellation of drug addition. Through years of exploration and practice, Affiliated Hospital of Jining Medical University has controlled the rising of drug cost effectively and received better effect, which built a good foundation of public hospital reform.

Teaching in the course of anesthesiology for college students not majoring in anesthesiology was reformed and optimized by inducing various approaches such as development of interest,heuristic teaching,multimedia teaching,clinical simulation teaching and anesthesia experience in the First Affiliated Hospital,Sun Yat-sen University.Students' fundamental knowledge of clinical anesthesiology and abilities of clinical thinking and active learning were improved.Based on the summary of teaching practice,teachers should cultivate students' interest in anesthesiology,emphasize interactive teaching and learning and take fundamental knowledge of clinical anesthesiology as main teaching objectives in the clinical practice course of anesthesiology.

Cystic liver metastasis, which lacks specific clinical manifestations and standardized treatment, rarely occurs after radical gastrectomy. This study presented two gastric cancer cases with cystic liver metastasis treated in Wuxi People's Hospital from September 2008 to November 2012. The two female patients were 66 and 65 years old, respectively. Poorly differentiated ulcerated adenocarcinoma classified as stage III B [Tumor, Node, and Metastasis Classification (T4aN2M0)] and clinical manifestations of abdominal distension and ascites were detected in both patients. Cyst fluids were subjected to cytological analysis. Results confirmed the presence of liver metastasis of gastric cancer. The two patients benefited from local intracavitary chemotherapy or systemic intravenous chemotherapy.

Objective To study the clinical features of follicular occlusion triad, and whether it is a hereditary disease. Methods Based on the clinical examination of a case who developed squamous cell carcinoma secondary to follicular occlusion triad, the pedigree of the patient was surveyed and analyzed. Results There were a total of thirteen patients in this pedigree, the age of onset was about 20 years old. The clinical features and laboratory examination of the proband was consistent with follicular occlusion triad. Conclusions Hereditary factor is important in the pathogenesis in follicular occlusion triad,and the disease maybe an autosomal dominant inherited disease.

OBJECTIVE:To study the process of acetylized racemization of D-penicillamine in the acidic condition. METHODS:The acetylized racemic mixture of D-penicillamine was prepared by racemizing acetyl chloride in acetic acid solu_tion with D-penicillamine as feedstock.The preparation process was optimized with the quantities of solvent and acetyl chloride,the reaction temperature,the reaction time etc.as parameters.The influence of reaction temperature,reaction time on the specific optical rotation in the acetylized process was determined and the kinetic equation of acylation process was computed. RESULTS:The optimal condition for racemization was the following,the quantity ratios of D-penicillamine-acetic acid -acetyl chloride were 1∶7∶2,the reaction temperature was 80℃ and the reaction time was 5h.The kinetic equation of acylation process fitted first order linear relation. CONCLUSION:This preparation process is mild and simple,and it offers direct feedstock for the preparation of D,L-penicillamine.