Objective To evaluate the value of the transnasal esophagogastrodudenoseopy(EGD)in clinical diagnosis and therapy.Methods The study includes 1000 patients referred for diagnostic and therapie EGD.All patients were received the examination after 2%lidocaine was administered into the uaris.We obtained biopsy specimens from 824 patients.Results Among the 1000 patients,971 were completed successfully by transnasal EGD,and the remaining was completed by classical transoral EGD.During the examination,we extracted the esopha6eal foreign body in two patients.and performed the pyloric stenting in one patient.Enteral feeding tubes were placed in 18 pafients.We found that the endoscopic manifestation is consistent with the histopathologic examination(the concordance rate is 84%).Conclusion The transnasal EGD has the goodish value in the clinical diagnosis and therapy.

Objective Little is known about the influence of congenital heart disease on the phannacodynamies of neuromuscular blocking agents. The aim of this study was to compare the pharmacodynamics of rocuronium in children with cyanotic and acyanotic heart disease. Methods The study was conducted in two parts. In part Ⅰ , 36 children with congenital heart disease scheduled for open heart surgery were allocated into 3 groups (n=12) : acyanotic group; slightly cyanotic group and severely cyanotic group. Neuromuscular blockade was monitored after administration of 0.6 mg ? kg-1 rocuronium. In part Ⅱ , 40 children with congenital heart disease were allocated into acyanotic and cyanotic group ( n = 20). The children in each group were further divided into 4 subgroups of 5 patients according to the dose of rocuronium the children received : 120, 180, 240 and 300 ?g? kg-1 . The dose- response curve for neuromuscular blockade was constructed and ED50 , ED90 and ED95 were calculated. SPSS 8.0 software was used for statistical analysis.Results In part Ⅰ the onset time (the time from injection of rocuronium to 95% depression of neuromuscular transmission) was significantly longer in severely cyanotic group [(2.25 ? 1.27) Min] than in acyanotic group [(1.17 ? 0.15) min] . There was no significant difference in the duration of action and recovery time among the 3 groups. In part Ⅱ the dose-response curve shifted to the right in cyanotic group compared with acyanotic group. ED50, ED90 and ED95 were significantly higher in cyanotic group than in acyanotic group. Conclusion The onset time of rocuronium is prolonged and the sensitivity of the patients to rocuronium is decreased in patients with cyanotic heart disease.

Objective To systematic review the efficacy of Bifidobacterium preparation in Helicobacter pylori ( HP ) eradication therapy. Methods We systematically reviewed clinical research about the efficacy of probiotics in Helicobacter pylori eradication in multiple data-base( PubMed, EMBASE, Medline, OVID, Web of Science); After screening and assessing the quality of the data, we used RevMan 5.3.5 software and Stata 12.0 software for data analysis, then we used GRADE pro3.6.1 software assessing the quality of results.Results Six studies were included with 1396 patients,there were 690 patients in experimental group and 706 patients in control group.Compared with control group, the eradication rates calculated by per-protocol analysis [RR=1.19,95%CI(1.12,1.26),Z=5.87 (P<0.00001)]and intention-to-treat analysis[RR=1.18,95%CI(1.07,1.31),Z=3.33(P=0.0009)]in experimental group was higher,the number of diarrhea[RR=0.43,95%CI(0.23,0.79),Z=2.73(P=0.006)]/the number of nausea[RR=0.67,95%CI(0.56,0.81),Z=4.19 (P<0.0001)]/the number of taste disorders[RR=0.61,95%CI(0.32,1.13),Z=1.57(P=0.12)]in experimental group was lower.The quality of results:the eradication rates calculated by per-protocol analysis was high quality, intention-to-treat analysis and the number of nausea and the number of diarrhea was moderate quality,the number of taste disorders was low quality.Egger’s test showed there was no evidence of substantial publication bias.Conclusion Bifidobacterium preparations during standard triple HP therapy may improve the eradication rate and reduce adverse reactions.

Lung cancer is ranked the first among all malignant neoplastic diseases because of its high morbidity and mortality rate. Thus, lung cancer seriously threatens human health. More than 80%of lung cancer cases are non-small cell lung cancer (NSCLC). Unfortunately, the majority of NSCLC patients are already at the terminal stage of the disease when they seek medical attention. Such patients miss the optimal opportunity of surgery;thus, medical treatment becomes the main choice for them. Recently, molecular-target-ed therapy has made tremendous progress in clinical practice and provides a new potential treatment for patients at the terminal stage. In this review, the authors introduced some molecular-targeted therapeutic drugs to provide benefits for the individualized treatment of patients.

[Objective]To investigate the reasons of misdiagnosis of colon cancer complicated with appendicitis and to sum up the experience of diagnosis. [Methods] Between May 1995 and September 2005, 1060 cases with appendicitis were undergone appendectomy. However, of them, 9 cases complicated with colon cancer had confirmative diagnosis during the operation or after, performed successfully suitable operations. [Results] All of 9 cases were misdiagnosed as appendicitis and undertook appendectomy for similar clinical traits. According to the signs of exploration in the appendectomy and the analysis of patient history, clinic characteristic and some radiologic features, we acquired confirmative signs of carcinoma and put up reasonable surgical intervention. [Conclusion] There are some imperative measures to decrease misdiagnosis by analyzing clinical manifestations comprehensively, observation dynamically, exploration in the appendectomy, and effective examination. Among them, the key to reduce misdiagnosis rate is exploration during the period of appendectomy.

[Objective] To observe the curative effect of integrated Traditional Chinese Medicine and western medicine on the disease of cystic hyperplasia of breast.[Method] The 214 cystic hyperplasia of breast cases were randomly divided into two groups.125 cases in the integrated Traditional Chinese Medicine and western medicine group(observed group).Control group(89 cases)were treated in common practiced western medicine.[Result]In observed group,70 cases fully recovered from illness,40 cases were excellent,6 cases were effective,9case were ineffective.Total effective rate was 92.8%.In control group,27 cases were fully recovered from illness,22 cases were excellent,20 cases were effective,9 cases were ineffective.Total effective rate was 77.4%.The differences between two groups were significant(P

Objective To evaluate the effect of oral mesalazine combined with metronidazole enema in the treatment of patients with ulcerative colitis and the impact on interferon-γ (IFN-γ),interleukin-4 (IL-4),interleukin-8 (IL-8).Methods A total of 80 patients with ulcerative colitis were selected and randomly divided into control group and observation group,40 cases in each group.The control group was treated with oral mesalazine.The observation group was treated with oral mesalazine and metronidazole retention enema.4 weeks as a course of treatment,the patients were treated for 2 courses.The clinical efficacy,disease activity index(DAI) score before and after treatment,as well as peripheral blood erythrocyte sedimentation rate (ESR),levels of IFN-γ,IL-4,IL-8 changes was compared between the two groups.Results The total effective rate was 90.00％ in the control group,which was significantly higher than 75.00％ in the control group,the difference was statistically significant (x2 =23.52,P ＜ 0.05).Before treatment,there were no significant changes in diarrhea,colonic mucosal inflammation,bloody stool and DAI scores (t =0.32,0.08,0.03,0.05,all P ＞ 0.05).After treatment,there were significant decline in each integral of the two groups,the integral of the observation group declined more than those in the control group,the differences were statistically significant(t =15.35,5.8,11.25,14.12,all P ＜0.05).Before treatment,there were no significant changes in ESR,IL-4,IL-8,IFN-γ of peripheral blood in the two groups (t =0.60,-0.95,0.03,-0.06,all P ＞ 0.05).After treatment,ESR,IL-8,IFN-γ of peripheral blood declined in the two groups,IL-4 was increased,and the changes were more significantly in the control group than those in the control group(t =10.02,4.70,10.23,22.82,all P ＜ 0.05).Conclusion Oral mesalazine enema combined with metronidazole enema has significant clinical effect in patients with ulcerative colitis,it is better than treating with oral mesalazine only,and can effectively improve the clinical symptoms and possibly plays a role by regulating IL-8,IFN-γ,IL-4,and it deserves further clinical application.

Objective:To evaluate the association of glutathione S-transferase M1 (GSTM1 )polymorphism,smoking and alcohol drinking with oral cancer susceptibility in Asians by meta-analysis.Methods:A literature search of PubMed,Chinese BioMedical, Wanfang,VIP and CNKI databases from inception to July 30th,2013 was conducted.Crude odd ration (OR)with 95% confidence intervals (95%CI)was calculated.Results:27 case-control studies were assessed,and the results showed that the association be-tween GSTM1 null genotype and oral cancer susceptibility was significant in Asians (OR=1.31,95%CI:1.18-1.45,P<0.001), especially in South Asians (OR=1.35,95%CI:1.20 -1.52,P<0.001).Significant associations between oral cancer risk and smoking and alcohol drinking were found in East Asians (Smoking:OR=1.70,95%CI:1.36 -2.13,P<0.001;Alcohol drink-ing:OR=1.54,95%CI:1.24 -1.90,P<0.001).Conclusion:GSTM1 null genotype may be associated with increased oral cancer risk in Asians.Smoking and alcohol drinking confer significant susceptibility to oral cancer in East Asians.

Objective To study anaphylactoid reactions induced by traditional Chinese medicine injections (TCMI) of Qingkailing (QKL) and Xuesaitong (XST) with RBL-2H3 cells;To provide some reference for improving the screening system of TCMI induced anaphylactoid reactions.Methods The IC50 induced by QKL and XST injections was determined by MTT assay. RBL-2H3 cells were stimulated with TCMI at different concentrations or with C48/80 or culture medium. Thirty minutes later, the supernatant was collected to determine the release of histamine andβ-hexosaminidase. The cell degranulation rate and the ultrastructure changes were observed. The ICR mice were given single injection of TCMI containing Evans Blue through tail vein. The number of the animal with blue ear, the total number of blue ears and the quantity of Evans Blue of extravasation were determined 30 minutes later.Results The IC50 of both QKL injection and XST injection was 12.5μL/mL. These two injections promoted RBL-2H3 cells to release histamine andβ-hexosaminidase at higher concentrations (P<0.05,P<0.01) in a dose dependent manner. Cell morphology showed a decrease of villous on the cell surface and an increase of the internal vacuolated structure. Both injections caused the blue ears of all animal with a rate of 100%. The quantity of Evans Blue of the extravasation was significantly increased (P<0.01). The results in vitro study were in close agreement with that in vivo.Conclusion Both QKL injection and XST injection may potentially cause anaphylactoid reactions. The RBL-2H3 cell model may be valuable to evaluate the anaphylactoid reactions induced by TCMI.

Objective To explore the clinical effects of biofeedback (BF) therapy on functional constipation (FC) caused by pelvic floor dys-synergia (PFD).Methods Forty patients with FC caused by PFD were enrolled and given BF therapy twice a week for 5 weeks.Constipation symptom scores and anal motility were recorded before and after the therapy.Results All the patients enrolled finished the BF therapy,with a total effectiveness rate of 80％.Both the constipation symptom scores and anal residual pressure during defecation had decreased significantly after therapy.Rectal gradient pressure,however,had increased significantly.Conclusion Biofeedback can relieve the clinical symptoms of FC and improve pelvic floor coordination during defecation.It is worth applying in clinical practice.