Objective To evaluate influencing factors of the long-term maintenance therapy in patients with gastroesophageal reflux disease (GERD).Methods 156 Patients with GERD were divided into on-demand therapy group and continuous therapy group by their treatment,according to symptom relief and improvement of quality of life in the course of therapy.The relationship between treatment and course,symptoms, esophageal motility,24-h pH monitoring and endoscopic findings were analysed.Results (1)5 Patients showed no response to acid suppression therapy and were excluded.For the 151 patients,92 were in on-demand therapy group,and 59 were in continuous therapy group.(2)The disease course and symptoms score in on-demand therapy group were significantly longer and higher than those of continuous therapy group (P

Objective To investigate the effect of autonomic nervous dysfunction on pathogenesis of gastro-esophageal reflux disease(GERD).Methods Autonomic nervous function(ANF) was assessed by cardiovascular reflex tests in healthy volunteers and patients with GERD;Based on the ANF test results,the relationship between the impairment degree of autonomic nerve and the esophageal motility or the reflux esophagitis or the score of reflux symptoms was investigated.Results ① 59.5% of patients with GERD have abnormal ANF and the rate in GERD patients is much higher than that in healthy volunteers,parasympathetic nerve impairment is predominant.② The score of reflux symptoms in patients with normal ANF is significantly lower than that in patients with abnormal ANF(6(2,7.6)vs 9(4.1,17),P

Objective To observe the effect of neuropeptide Y(NPY) on the levels of serum interleukins(ILs)in guinea pigs with experimental allergic encephalomyelitis(EAE).Methods 30 guinea pigs were divided randomly into normol control group,EAE group and NPY group.The NPY was injected into the intracerebroventricular in NPY group one week before the EAE model be made.The EAE molders were made by injecting the homogenate of rat's spinal cord into the plantar of guinea pigs in groups EAE and NPY.Then,the neurological deficits score was observed everyday,the incidence and the delitescence of EAE were observed too.The levels of serum IL-1?,IL-2,IL-4,IL-6 and IL-8 were detected,and the neuropathological examination was used when symotoms peak period of EAE models.Results(1)The incidences of the EAE in groups EAE and NPY were 100% and 90%,the delitescences of EAE were(10.0?4.8)d and(25.4?12.6)d,the neurological deficits scores at the symotoms peak period were(3.60?0.52) and(1.80?1.14),respectively.There were significantly differences between the two groups(all P

According to operative modalities,128 patients with unilateral benign thyroid disease were divided into hemithyroidectomy group (n =68) and subtotal thyroidectomy group (n =60).The operative duration of hemithyroidectomy group was (63 ± 14) min,intraoperative blood loss (54 ± 15) ml,postoperative drainage volume (64 ± 10) ml and hospitalization stay (5.9 ±0.8) days.The hospital charge of (8 335 ± 278) yuan was less than that of subtotal thyroidectomy group (P ＜ 0.05).The incidence rate of postoperative hoarseness,water bucking,low calcium and hypothyroidism had no significant inter-group difference (P ＞ 0.05).But the postoperative recurrence rate of hemithyroidectomy was significantly lower than that of subtotal thyroidectomy group (P ＜ 0.05).Treating patients of unilateral benign thyroid disease with hemithyroidectomy yield excellent efficacies.It is worthy of wider clinical application.

ObjectiveTo study the differences of tumor necrosis factor-α in different gestational period placentas and aging placentas and to analyze its significances. MethodsUsing immunohistochemistry to detect the expression and distribution of tumor necrosis factor-α in different gestational period placentas and aging placentas. ResultsThe expression of tumor necrosis factor-α was significantly higher in the third trimester of pregnancy placentas and aging group than in the first trimester of pregnancy placentas(P＜0.05),and than in the second trimester of pregnancy placentas(P＜0.05).The expression of tumor necrosis factor-α had no significant difference between the third trimester of pregnancy placentas and aging group(P＞0.05). ConclusionTNF-α should play an important role in placental aging.

Objective To explore whether the pathophysiological mechanisms are same or not in different subtypes of functional dyspepsia (FD) patients. Methods Severity of symptoms and (44.2± 14. 6) years. Multi-gastrointestinal functions were also tested. Results No statistical difference was found among epigastric pain syndrome (EPS), postprandial distress syndrome (PDS) and mixed type in the data of gastric emptying function, gastric myoelectrical activity, autonomic nerve function,simultaneous introgastric pressure and water loading test, and psychological status assessment as well (P＞0.05). There was a positive linear correlation between postprandial fullness and half gastric emptying time (correlation coefficient=11.5, P= 0. 043). Early satiation was negatively related to maximal water intaking volume (correlation coefficient=-6. 8, P=0. 033). Conclusions In this study, it suggested that the FD patients with different pathophysiologic mechanisms cannot be distinguished efficiently according to Rome Ⅲ criteria, and then be treated in a well-targeted manner.

Objective To investigate the feasibility and reliability of perfusion nutrient load test (P-NLT) in evaluating gastric accommodation and hypersensitivity.Methods Forty-one healthy volunteers randomly received either drinking nutrient load test (D-NLT) or P-NLT (through nasalgastric tube) in separate day within one week.Meanwhile,intragastric pressure (IGP) was recorded and 2D ultrasonography (2DUS) was used to measure both the proximal gastric area (PGA) and proximal gastric volume(PGV) during NLT.Visual analogue scale was used to evaluate satiety during NLT.Ten healthy volunteers experienced second P-NLT within 3 months.Results The amount of nutrition liquid was higher in P-NLT than in D-NLT at minimal and maximal satiety(P <0.01).However,there was no difference in the IGP between P-NLT and D-NLT at minimal and maximal satiety (P>0.05).The PGA and PGV at maximal satiety were significantly higher in P-NLT than DNLT (P <0.01),but no difference existed at minimal satiety between two methods (P >0.05).The amount of nutrition liquid at maximal satiety was significantly correlated with PGA and PGV at maximal satiety in both P-NLT and D-NLT (PGV:r = 0.771 vs r = 0.500;PGA:r = 0.600 vs r =0.430).In P-NLT group,there was no significant difference among age,BMI and gender with respect to IGP and maximal volume (MV) (P >0.05).Whereas no difference was found in threshold volume (TV) and MV between the first and the second P-NLT studies (P >0.05).Conclusions It suggests that P-NLT might be more accurate than D-NLT in predicting gastric accommodation in healthy volunteers without any influence such as swallowing air,taste and psychological disturbance.It has a good repeatability.P-NLT is a potential method in assessment of proximal gastric accommodation and MV might be more suitable for assessment gastric accommodation.

Objective To study the relationship between overlapping symptoms (OS) and psycho- mental factors in patients with functional dyspepsia (FD) in order to understand the possible mechanisms of OS.Methods One hundred and three FD patients diagnosed by Rome Ⅲ criteria were divided into with or without OS groups by Rome Modular Questionnaire.The emotional status,sleep status,anxiety and depression status were evaluated by Zung Anxiety and Depression Scale and quality of life was eveluated by SF-36 questionnaire.The results were compared between the two groups.Results The proportion of the patients with and without OS accounted for 62.5% and 37.5%,respectively.The patients with OS had a worse emotional status ("bad%" and "very bad%" being 39.1% and 20.2% vs.15.4% and 12.8%,P=0.018) and a worse sleep status (45.3% and 11.0% vs.19.1% and 7.7%,p=0.018)than those without OS.The proportion of the patients with anxiety (49 % ) and depression (68 % ) status in OS group was significantly higher than that in without OS group (19% and 44%,respectively,P＜0.05). The quality of life of the patients with OS was worse in the dimensions of psychological health (47.9), vitality (47.1) and mental component score (32.8)than those in without OS group (57.8,57.0,37.0, respectively,P＜0.05).Conclusions The psycho-mental factors are associated with overlapping symptoms in patients with FD,which suggests that abnormal psycho-mental factors may be involved in the mechanisms underlying overlapping gastrointestinal symptoms in FD.

In order to solve the problem of poor communication, low efficiency of consultation, and even affecting self-confidence caused by unskilled skills and insufficient cooperation with patients in the real clinic, and to solve the problem during the clinical thinking training that beginners do not know how to organize effective information and complete the process of diagnosis and differential diagnosis more efficiently. By applying the artificial intelligence (AI) virtual patient (VP) system to the process of teaching diagnostic knowledge and clinical thinking training. It provides the students with the experience of simulating the diagnosis and treatment of the clinical real scene. Let the students talk with the VP system for inquiry training and then go to the clinic to give the real patients inquiry and by simulating the process of treating the real patients, let the students take the initiative to complete the collection of medical records and clinical decision-making under the simulated scene to train the clinical thinking. This can not only solve the shortcomings of the previous simulation teaching and clinical teaching, but also stimulate students' interest in learning. According to the results of the questionnaire, students have a high acceptance of VP system simulation teaching. Through the results of homework and assessment and evaluation, the teaching results are better than before, and this teaching method should be further popularized.

Objective To determine the postprandial acid distributions in patients with gastroesophageal reflux disease (GERD), and their potential relationship with esophageal acid exposure. Methods Esophageal and gastric pH were recorded in a 1 h fasting segment and a 4 h postprandial segments using a triple-channel pH catheter with three antimony electrodes, which were positioned 5 cm proximal to the upper margin of LES(LES-5 cm), 5 cm and 10 cm distal to the upper margin of LES(LES+5 cm and LES+10 cm), respectively. Esophageal acid exposure and gastric integrated acidity (IA) were calculated for each ambulatory pH study. Ten healthy subjects (HS) and 10 patients with GERD were enrolled. Results (1) Total postprandial IA had a trend to be lower at LES+5 cm than at LES+10 cm in HS, but there was no significant difference between the two positions in patients with GERD. (2)Two hours after meal, there was no significant difference of gastric IAs and baseline in HS. Whereas gastric IAs in patients with GERD returned back to a higher level than baseline: LES+5 cm: 5.4 (1.8-6.8) mmol/L?h vs 1.8(0.3-3.1) mmol/L?h (P