Objective To study the clinical characteristics and treatment of esophageal injury caused by button battery foreign bodies in children, then improve the diagnosis and management level of this hazardous problem of children. Methods 15 patients with esophageal injury caused by button battery foreign bodies were retrospectively analyzed the clinical characteristics, treatment and prognosis. Results 12 button battery foreign bodies were removed successfully with rigid esophagoscope, 3 with electronic gastroscope. 12 cases occurred serious esophageal lesions, 10 patients were fully recovered after nasal feeding, anti-inflammatory and supporting therapy. Serious complication such as esophageal perforation occurred in 2 cases, one of them occurred tracheo-esophageal fistula. Conclusion Button battery embedded in the esophagus is easy to cause serious esophagus injury, early detection is the key of the management, and its prompt removal is mandatory. Button battery have a distinctive appearance on radiography, chest radiographs can be used as the first choice of diagnosis. The reasonable treatment can obtain better curative results and avoid serious complications according to the course of the disease and esophageal damage degree. Physicians must recognize the hazardous potential and serious implications such as esophageal perforation and tracheo-esophageal fistula.

Objective To investigate the combined inhibition effect and the potential mechanism of rapamycin (mammalian target of rapamycin inhibitor) and PD98059 (mitogen-activated protein kinase/extracellular signal-regulated kinase kinase (MEK) inhibitor) on mouse colorectal cancer (CRC). Methods S-ICR mice were subcutaneously injected with 20 mg/kg of 1,2-dimethylhydrazine dihydrochloride in the nape for 20 weeks to induce CRC. From the 16th week, the mice were treated with alone or combined injection with 0.25 mg/kg rapamycin and 2.5 mg/kg PD98059. The drugs were administered for 8 weeks. Subsequently, the animals were sacrificed and dissected, the tumor sizes were measured, and the tumors were harvested for pathological assay. Furthermore, the phosphorylation of mTOR, p70S6K, and 4E-BPl proteins was detected by using immunohistoehemistry. Results The mice treated with rapamycin (44. 44 %) or PD 98059 (either alone (38.89%) or combination treatment (6.67%) were significantly less likely to develop cancer compared with mice receiving none of them (77.78%, P<0. 05). The average size of tumors was (6.15±2. 192), (8.85±3. 983), (2.917±0. 191), (16.36±6.855) mm3 respectively (P<0.05).The anti-cancer effect of the combination treatment was substantially significant. The proteins of phospho-mTOR, phospho-p70s6K and phospho-4E-BPl were significantly down-regulated after treatments (all P values < ,0.05). Conclusions Combined treatment was more effective than single-drug treatments of rapamycin or PD98059 alone for the prevention and treatment of mouse CRC. The mTOR signal pathway might be involved in the inhibitory mechanism.

Objective To explore clinical features and the drug treatment of the geriatric depression.Methods The clinical data of 520 patients with depressive symptoms admitted to our hospital from January 2014 to December 2017 were retrospectively analyzed.Patients were divided into elderly group(aged ≥60 years,n =320) and non-elderly group(aged＜ 60 years,n=200).Differences in clinical characteristics and the drug treatment were compared between the two groups.Results The incidences of somatic diseases and anxiety symptoms were significantly higher in the elderly group than in non-elderly group(75.0％ vs.44.5％,and 76.9％ vs.62.0％,x2 =49.267 and 13.268,respectively,both P =0.000).While the incidence of life events was lower in the elderly group than in non elderly group(62.5％ vs.77.5％,x2 =12.784,P =0.000).The incidences of somatic symptoms,emotional changes and suicidal ideation were higher in the elderly group than in non-elderly group (68.8％ vs.47.0％,78.4％ vs.60.0％,and 45.3％ vs.18.0％,x2 =24.339,20.466 and 40.460,respectively,all P =0.000).Conclusions The incidence rates of somatic diseases-induced depression are significantly higher in elderly group than in non-elderly group.The elderly group versus non-elderly group is more likely to combine with anxiety symptoms.

Objective: To learn the willingness and influencing factors of influenza vaccination among the community managed diabetic patients in Keqiao District, Shaoxing, so as to provide the basis for influenza vaccination promotion. Methods: A self-compiled questionnaire survey was conducted from October to December 2017 among all the managed diabetic patients in Keqiao District. The contents of questionnaire included the basic information of the respondents, awareness of influenza vaccine, vaccination status and vaccination intention. Logistic regression model was used to analyze the influencing factors for the willingness of influenza vaccination. Results: A total of 15 060 questionnaires were sent out and 13 781 valid ones were retrieved, the response rate was 91.51%. There were 3 888 patients with the awareness of influenza vaccine, accounting for 28.21%; 4 259 patients with the willingness to be vaccinated, accounting for 30.90%; 630 previously-vaccinated patients, accounting for 4.57%. The patients who were female (OR=1.157, 95%CI: 1.064-1.258) , were married (OR=1.242, 95%CI:1.107-1.393), were with other chronic diseases (OR=1.199, 95%CI: 1.103-1.303) , believed diabetic patients were more susceptible to influenza (OR=1.251, 95%CI: 1.102-1.419) , believed influenza aggravate diabetes status (OR=1.640, 95%CI: 1.445-1.860) , believed that the vaccination effectively prevent influenza (OR=3.129, 95%CI: 2.866-3.416) , knew about influenza vaccine (OR=1.111, 95%CI: 1.105-1.216) and ever received influenza vaccination (OR=1.316, 95%CI: 1.103-1.570) were more willing to be vaccinated. Conclusions The willingness of influenza vaccination among the community managed diabetic patients in Keqiao District is low. The patients＇gender, married status, other chronic diseases, awareness of influenza vaccine and the history of vaccination can affect the willingness of influenza vaccination.

Objective To observe the effect of Qixian Tongluo Formula on contralateral corticospinal tract(CST)remodeling and motor functional recovery in rats with cerebral infarction,and to explore its potential molecular mechanism from the perspective of regulating factors related to never remodeling.Methods The rat middle cerebral artery occlusion(MCAO)model was established by silk thread ligation.Fifty model rats were randomly divided into model group,citicoline group(0.054 g·kg-1),Qixian Tongluo Formula low-,medium-and high-dose(7.83,15.66,31.32 g·kg-1)groups,and sham operation group,with 10 rats in each group.The intervention administration was started on the 3rd day after operation once a day for 26 consecutive days.On the 3rd,14th and 28th day after operation,the gross motor function was evaluated by Longa score,and the fine motor function was evaluated by beam-walking test(BWT)score.The contralateral motor cortex was injected with the nerve tracer biotin dextran amine(BDA)on the 14 th day after operation to anterogradely trace the CST.On the 28th day after operation,the expression of axonal growth associated protein-43(GAP-43)and BDA positive fibers in the contralateral motor cortex and cervical spinal cord were detected by immunohistochemistry.The co-localization areas of BDA positive fibers and presynaptic marker protein vesicular glutamate transporter 1(VGLUT1)in the cervical spinal cord gray matter were detected by immunofluorescence.The expressions of brain-derived neurotrophic factor(BDNF),glial cell-derived neurotrophic factor(GDNF),nerve growth factor(NGF)and nerve remodeling-associated inhibitory factor[Nogo-A,oligodendrocyte myelin glycoprotein(OMgp)and myelin-associated glycoprotein(MAG)]in the contralateral motor cortex were detected by Western Blot.Pearson correlation analysis was used to analyze the correlation between Longa score or BWT score and BDA/VGLUT1 co-localization area,respectively.Results Compared with the sham operation group,rats in the model group had obvious symptoms of motor function deficits,and the Longa scores were significantly increased(P＜0.01)and the BWT scores were significantly decreased(P＜0.05,P＜0.01)at each time point.The expression of GAP-43 in the contralateral motor cortex and cervical spinal cord was up-regulated(P＜0.05),the number of edge-crossing fibers from the posterior funiculus in cervical cord was increased(P＜0.05),the co-localization area of BDA/VGLUT1 in the gray matter of the cervical spinal cord was increased(P＜0.05),the expressions of BDNF,GDNF and NGF in the contralateral motor cortex were up-regulated(P＜0.05),while the expressions of Nogo-A,OMgp and MAG were down-regulated(P＜0.05).Compared with the model group,the Longa scores in each administration group on the 14th and 28th day after MCAO operation were significantly decreased(P＜0.01),the BWT scores were significantly increased(P＜0.01),the expression of GAP-43 in the contralateral motor cortex and cervical spinal cord was significantly up-regulated(P＜0.01).The number of edge-crossing fibers from the posterior funiculus in cervical cord was significantly increased(P＜0.01),the co-localization area of BDA/VGLUT1 in the gray matter of the cervical spinal cord was significantly increased(P＜0.01).The expressions of BDNF,GDNF and NGF in the contralateral motor cortex were significantly up-regulated(P＜0.01,P＜0.05),while the expressions of Nogo-A,OMgp and MAG were significantly down-regulated(P＜0.05),and the most significant effect was observed in the high dose group.The Longa score was negatively correlated with the co-localization area of BDA/VGLUT1(r=-0.89,P＜0.01),and the BWT score was positively correlated with the co-localization area of BDA/VGLUT1(r=0.84,P＜0.01).Conclusion Qixian Tongluo Formula can improve motor function through promoting contralateral CST remodeling in MCAO rats after cerebral infarction,and the molecular mechanism may be related to the regulation of the expression of nerve remodeling-associated factor in the contralateral motor cortex.