Objective To evaluate the effect,adverse reaction and coat of sequential therapy (including lansoprazole,amoxicillin,clarithromycin and tinidazole) and standard triple therapy (including lansoprazole,amoxieillin and clarithromycin) for eradication of Hehcobacter pylori (Hp).Methods Eighty-six patients with Hp positive peptic ulcer and chronic gastritis were randomized into two groups.Study group (45 cases) were treated with lansoprazole plus amoxicillin at first 5 days,lansoprazole,clarithromycin and tinidazole at the second 5 days.Control group (41 cases) were treated with lansoprazole,amoxicillin and clarithromyein for 10 days.Results The eradication rates of Hp in study group were 88.89% (40/45,95% CI 76.00%-96.00%) and 93.33% (42/45,95% CI 82.00%-98.00%),and those in control group were 78.05% (32/41,95% CI 78.04%-90.72%) and 85.37% (35/41,95% CI 85.37%-96.19%) with intention-to-treat and perprotocol analysis respectively.The differences between two groups were significant (P＜0.05).The incidence rate of adverse reaction was 4.44% (2/45) in study group and 14.63% (6/41) in control group respectively.The cost in study group was cheaper than that in control group.Conclusion Ten days sequential therapy is higher in eradication rate of Hp,well-tolerated and cheaper.

Objective To analyze scanned image optimization based on the multifractal soectrum and image fractal algorithm of 64-slice spiral CT in brain of infant. Methods The image data of Toshiba Aquilion 64-slice CT scanning using 10 mAs were imported to image processing toolboxs of Matlab 7.1. The evaluation of muhifractal spectrum and image denosing were performed, and compared with image quality of conventional low-dose CT using 50 mAs. Results The low-contrast scanned image used 10 mAs is the valueless medical image because of serious noise. Image denoise based on the fractal model had superior characteristic of image detail preserving and better contrast-to-noise ratio(CNR). There existed a group difference in the score of image quality between the rude imaging noise and optimized image based on the muhffraetal spectrum algorithm, though the score was still significantly lower than the normal dosage scanned image(F = 38.85, P < 0.01). The group difference was also manifested the image quality of infants can achieve basieaUy the request of clinical diagnosis by suitable model denoising algorithm. Conclusions Image denoising based on the multifraetal spectrum model can be used on the low-dose and low-contrast CT image optimization. It improved the CNR of the pathological region. The radiation dose of CT scanning in infants would be declined significantly by its further application in the future.

Objective To assess the diagnostic value of cytokeratin 18 fragment M30 (CK18-M30) and Fas in patients with nonalcoholic fatty liver disease (NAFLD),especially nonalcoholic steatohepatitis (NASH).Methods Among 58 patients with NAFLD,36 patients with NAFLD received liver biopsy.According to NAFLD activity score (NAS) and liver fibrosis score,patients were divided into NASH group (24 cases) and non-NASH group (12 cases).And at the same period,15 healthy individuals were set as healthy control group.The serum level of CK18 M30 and Fas were measured with enzyme-linked immunosorbant assay (ELISA).Rank sum test was performed to analyze the differences in the level of CK18-M30 and Fas between groups.The diagnostic value of CK18 M30 and Fas were assessed by the receiver operating characteristic (ROC) curves.Results The level of serum CK18-M30 of NAFLD group was significantly higher than that of healthy control group (97.24 U/L (86.06 to 113.12 U/L) vs 78.41 U/L (74.29 to 80.76 U/L),Z=-4.206,P＜0.01)).The level of serum CK18-M30 of NASH group was higher than that of non-NASH group (111.06 U/L (94.30 to 142.68 U/L) vs 89.00 U/L (83.56 to 106.50 U/L),Z=-2.233,P＜0.05)).The area under the ROC curve (AUC) of CK18-M30 in the diagnosis of NASH was 0.73 (0.56,0.90),and the sensitivity and specificity of CK18-M30 in diagnosis of NASH was 79.2％ and 58.3％,respectively.The AUC of Fas in diagnosis of NASH was 0.58 (0.38,0.77),while the sensitivity and specificity of Fas in diagnosis of NASH was 54.2％ and 66.7 ％.The serum level of Fas increased in FAFLD group compared with healthy control group,and in NASH group compared with non-NASH group,however the differences were not signifincant (both P＞ 0.05).Conclusions The level of CK18-M30 has certain value in the diagnosis of NASH.The diagnostic value of Fas in NASH needs more samples in further study.

OBJECTIVE:To observe the clinical efficacy and safety of citalopram in the treatment of functional gastrointesti-nal disorders complicated with anxiety or depression. METHODS:62 patients with functional gastrointestinal disorders complicat-ed with anxiety or depression were randomly divided into treatment group(34 cases)and control group(28 cases). Control group was given routine treatment,treatment group was additionally given Citalopram tablet with initial dose of 10 mg,qd,increasing to 40 mg qd,according to the situation of patients,on the basis of control group. Treatment course of 2 groups lasted for 3 months. The gastrointestinal symptom integral,HAMD and HAMA were compared between 2 groups before and after treatment,and clini-cal efficacy and the occurrence of ADR were observed. RESULTS:There was no statistical significance in gastrointestinal symptom integral,HAMD and HAMA between 2 groups before treatment (P>0.05). After Treatment,above scores of 2 groups decreased significantly,and the treatment group was lower than the control group,with statistical significance(P<0.05). Total effective rate of treatment group was significantly higher than that of control group (94.12% vs. 67.86%),with statistical significance (P<0.05). Olny 4 patients of treatment group suffered from mild ADR. CONCLUSIONS:Citalopram shows significant therapeutic effi-cacy in the treatment of functional gastrointestinal disorders complicated with anxiety or depression,and can improve digestive tract symptom and anxiety or depression,and help to improve patients’gastrointeseinal symptoms with good safety.

Objective:To amplify full-length expressing sequence of human granzyme B(GrB) and perforin(PFP) firstly,then to construct a co-expression vector of pVAX1-PIG and to analyze the expression of human GrB and PFP in Hep-2 cells.Methods:The human PFP and GrB expressing sequences were amplified by RT-PCR.The expression vector pVAX1-PIG was constructed.The recombinant vector was transfected into human Hep-2 cells and their expressions were detected by RT-PCR and indirect immunofluorescent antibody assay.Results:The GrB and PFP cDNA fragment were cloned into the vector of pVAX1 in the right direction.The target proteins were detected in the transfected Hep-2 cells.Conclusion:The vector of pVAX1-PIG was constructed successfully and expressed in Hep-2 cells line.The perforin/granzyme B protein can induce cell apoptosis.These results provide some foundation in gene therapy for tumor by making use of PFP and GrB gene.

This study was designed to explore the mechanism of signal transduction on BBB damage in brain injury. 75 male SD rats were randomly devided into 5 groups: control, sham operation, injury only, injury with Forskolin-treatment and H7 treatment.Evans blue permeation was observed qualitatively with an epifluo resence and mesured quantitatively with a spetrophotometer.The result shcwed that Evans blue significantly permeated in injuried group,and noticeably decereased in H7 treatment group and Forskolin treatment group. It indicated that Forskolin and H7 can effectively prevent BBB opening,and suggest that Forskoling and H7 may provide new ways on BBB protection.

This study was designed to explore the mechanism of signal transduction on BBB damage in brain injury. 75 male SD rats were randomly devided into 5 groups: control, sham operation, injury only, injury with Forskolin-treatment and H7 treatment.Evans blue permeation was observed qualitatively with an epifluo resence and mesured quantitatively with a spetrophotometer.The result shcwed that Evans blue significantly permeated in injuried group,and noticeably decereased in H7 treatment group and Forskolin treatment group. It indicated that Forskolin and H7 can effectively prevent BBB opening,and suggest that Forskoling and H7 may provide new ways on BBB protection.

BACKGROUND:The anatomical strucure of acetabulum is smal and shal ow in adult acetabular dysplasia patients. The large amount of cal us and scar tissues in the acetabulum make it difficult to identify and instal the acetabular cup during arthroplasty. The comprehensive understanding of the acetabulum before arthroplasty is the premise for selecting the appropriate acetabular prosthesis and making the acetabular reconstruction program. OBJECTIVE:To evaluate the application value of three-dimensional reconstruction technique in choosing the size of acetabular cup before total hip arthroplasty for acetabular dysplasia. METHODS:Spiral CT was carried out in the 11 acetabular dysplasia patients who waiting for total hip arthroplasty. The acetabulum was multi-planar reconstructed, and the size of the acetabular cup was determined through digitized acetabular cup template implantation, and then the mathching degree assessment was performed to compare with the actual size. RESULTS AND CONCLUSION:Spiral CT could clearly show the acetabular morphology, and the 71.4%of the acetabular size chosen in the three-dimensional preoperative plan was the same as actual one, the intraclass correlation coefficient was 0.888. The agreement was much higher than that of two-dimensional preoperative plan based on X-ray plain film. For the patients with acetabular dysplasia, the acetabulum became saml er and shal ower, and there were various extents of bone defects in the superior-lateral acetabulum. Three-dimensional multi-planar reconstruction can effectively evaluate the acetabular morphology, and three-dimensional preoperative plan can provide useful information for the choice of implant.

Objective To detect apoptosis of transplanted lung adenocarcinoma cells in nude mice after 125I brachytherapy by 99Tcm-Annexin V combined with diffusion weighted MRI (MR-DWI).Methods Twenty-five BALB/c-nu nude mice models subcutaneously transplanted with A549 cells were divided into experimental group (EG,n=13) and control group (CG,n=12) by random number table method.One 125I seed with apparent activity of (24.8±6.3) MBq was implanted into each mouse in EG,while CG underwent cold seed implantation.Both of 99Tcm-Annexin V imaging and MR-DWI were performed within 7-10 d after brachytherapy,then all mice were sacrificed and tumor cell apoptosis was detected by terminal oxynucleotidyl transferase mediated dUTP biotin nick end labeling (TUNEL) immunofluorescence,Survivin expression was assayed by SP.Two-sample t test,x2 test and Pearson correlation analysis were used for data analysis.Results Positive rate of cell apoptosis by 99Tcm-Annexin V imaging was 69.2％(9/13) and 8.3％(1/12) respectively in EG and CG (x2 =12.73,P＜0.01).The uptake ratio of 99Tcm-Annexin V,apparent diffusion coefficient(ADC) value and apoptosis index(M) of the tumor in EG were 2.91±0.85,(2.03±0.44)×10-3 mm2/s and (49± 18) ％,respectively,which were significantly higher than those of CG (1.26 ± 0.37,(1.29 ± 0.21) ×10-3 mm2/s and (11±4)％ respectively,t=5.930,5.452,7.606,all P＜0.05).Survivin expression in EG and CG was (46± 13) ％ and (15±7) ％ respectively (t =5.158,P＜0.05).The value of ADC was correlated with AI and uptake ratio(r=0.756,0.788,both P＜0.05).Uptake ratio was correlated with AI (r=0.754,P＜0.05),while Survivin expression was negatively correlated with AI (r =-0.772,P＜0.05).Conclusions Down-regulation of Survivin expression may play an important role in apoptosis induced by 125I brachytherapy.99Tcm-Annexin V combined with MR-DWI could effectively evaluate apoptosis of lung adenocarcinoma cells in a non-invasive way,thus it might be helpful in evaluation of early efficacy of 125I brachytherapy.

Objective To compare the clinical value of different endoscopic methods for infiltration depth of early esophageal cancer. Methods Patients with suspected esophageal cancer, examined in Sichuan Provincial People′s Hospital from August 2013 to February 2016 were enrolled to this study. The patients underwent narrow band imaging( NBI) with magnifying endoscopy( including IPCL?type and B?type methods) and endoscopic ultrasonography(EUS) to estimate infiltration depth and then underwent iodine staining and biopsy. All lesions, which included the identified moderate?severe hyperplasia, high?grade intraepithelial neoplasia and early esophageal cancer and those which were diagnosed as possible cancer by white light and NBI with the negative pathological results, were given endoscopic or surgical procedure depending on patients′ choices. A total of 54 cases were diagnosed as early esophageal cancer, with pathological results as the gold standard. The diagnostic accuracy of invasion depth of these patients was compared by the statistic kappa values. Results Type B of NBI was highly consistent with the final pathological results(Kappa=0?802). White light endoscopy and IPCL type had poorer results(Kappa=0?596, Kappa = 0?601 ) compared with the final pathological results. However, EUS had the lowest consistency with the final pathological results( Kappa=0?132) . For the mucosal layer( M1?M2) infiltration of the esophageal cancer, type B showed the highest accuracy ( 86?7%, 26/30 ) , followed by white light endoscopy(76?7%, 23/30) and IPCL type(73?3%, 22/30). And EUS showed the lowest diagnostic accuracy(30?0%, 9/30) and the highest over?diagnostic rate(70?0%,21/30). For the cancer infiltration depth( M3?SM1 ) , type B also showed slightly higher accuracy rate ( 89?5%, 17/19 ) than IPCL type (78?9%, 15/19) and white light endoscopy (73?7%, 14/19). And EUS still showed the lowest accuracy rate( 42?1%, 8/19 ) and the highest over?diagnostic rate ( 52?6%, 10/19 ) . Conclusion White light endoscopy is still valuable for the invation depth of early esophageal cancer. But B type and IPCL?type of NBI are superior to white light endoscopy. B type presents higher accuracy rate than others, and it seems much easier to operate than IPCL?type for beginners. Accuracy rate of EUS is unsatisfactory, and the over?diagnostic rate is much higher than others. Diagnosis with EUS alone is not recommended.