Objective To explore the endoscopic characteristics of bile reflux gastritis,and to analyze its etiological factors retrospectively.Methods 361 patients were examineed by gastroscopy,and those whose mucous lake stained yellow or cohered bilious spots were detected by pathohistology and quick urease test were performed.Results The ratio of bile regurgitation in chronic gastritis patients was 65.1% while the ratio of gastric pit accrementition and Hp positiv were 4.7% and 25.3% respectively.Conclusions Bile regurgitation was a common phenomenon in chronic gastritis patients,while the characteristic change of pathologic histology wasn't gastric pit accrementition,and the infection rate of Hp in patients with bile reflux gastritis was low.

Objective To analyze the clinical prognosis and its influencing factors in elderly patients with myelodysplastic syndrome.Methods A total of 36 elderly patients with myelodysplastic syndrome were included in this study,who were diagnosed and treated at our hospital from January 2013 to August 2016.The Kaplan-Meier method was used to analyzed the survival of these patients,and the effects of gender,age,WHO classification,white blood cell count,platelet count,hemoglobin and IPSS grouping on survival were analyzed.The independent risk factors associated with the clinical prognosis of patients were identified by using multivariate Cox regression analysis.Results Patients were followed up until March 31,2017 with a follow-up time ranging from 8 to 31 months.During the follow-up period,19(58.3％)deaths and 17(41.7％) survivals were reported.The average survival time was(19.17±1.47)months.Kaplan-Meier survival analysis showed that age,WHO classification,white blood cell count,platelet count and IPSS grouping were closely associated with survival in elderly patients with myelodysplastic syndrome.Multivariate Cox regression analysis showed that age and IPSS grouping were independent prognostic factors in elderly patients with myelodysplastic syndrome.Conclusions Age,WHO classification,white blood cell count,platelet count and IPSS grouping are closely related to the prognosis of myelodysplastic syndrome in elderly patients.

Objective To evaluate the therapeutic effect of combined therapy of hepatocyte growth-promoting factor(HGF)and ademetionine on complication with severe anringinous in chronic hepatitis B.Methods 160patients were randomly divided into treatment group A(54),control group B(53) and group C(53).The treatment group were treated with hepatocyte growth-promoting factor and Transmetil,the group B were treated with KUHUANG injection and HGF,the group C were treated with Potassium magnessium aspartape and HGF.The therapeutic courses were 30 days.Results The liver function(Tbil,AST,ALT,AKP,r-GGT),climical symptom and physical sign were compared before and after being treated.The recovery rates of liver function in treatment group were higher singnificantly than that of control group.The levels of liver function in treatment group after being treated is lower significantly than that of before(P

Objective To discusse the acupuncture treatment of blood-stasis syndrome of liver meridian based on the ancient medical records. Methods Medical records on treatment of blood stasis syndrome of liver meridian were searched in Chinese Medical Classics. Frequency analysis and comprehending analysis were used to study the treatment strategies and methods. Results Among 231 medical records, single acupoint treatment accounts for 47.28%, followed by multi-acupoints treatment accounting for 32.16%. The most used single points are Taichong (15.96%) and Ganshu (11.70%). Yanglingquan point and Zusanli point are used mostly in two-combined acupoints treatment, while Sanyinjiao is mainly used in multi-acupoints treatment. And the liver channel of foot-Jueyin is mainly used in the meridians, accounting for 24%, followed by the bladder meridian of foot-Taiyin. Conclusions The acupuncture treatment is very effective, while the single acupoint and two-combined acupoints are easily used. It can improve the clinical effects.

Objective To evaluate the clinical value of SAA by detecting their expression levels in patients with lung cancer and the analysis of the relativity of SAA for early diagnosis.Methods There are 243 cases specimens obtained from lung cancer patients who were newly diagnosed and without any treatment in Zhejiang Cancer Hospital from April 2014 to June 2015.The 243 lung cancer individuals were 147 male, and 96 female, their ages ranged from 29 to 85 years, with an average age of 63 years.The distribution of pathological type was as follows:95 patients were adenocarcinoma, 102 patients were squamous carcinoma, and 46 patients were small cell carcinoma.The distribution of TNM staging systems was as follows: 59 patients in stage 1and stage 2, 54 patients in stage 3, and 130 patients in stage 4.While 179 cases physical examination as the control.There were 94 individuals male, and 85 individuals female.Their ages ranged from 26 to 86 years, with an average age of 61 years.By using latex enhanced immune turbidimetric method, serum SAA concentrations in patients with lung cancer and healthy controls were checked on the Hitachi-7600 automated chemistry analyzer ( Hitachi ).The comparisons of all analyses values between healthy controls and lung cancer were estimated by two independent samples nonparametric tests ( Mann-Whitney U).The association between SAA and lung cancer prognostic factors such as age, smoking status and metastasis, was evaluated by spearman correlation and multivariate analysis.Results The median and interquartile spacing of SAA concentration was 42.36 mg/L (9.35, 74.22) in lung cancer patients.While 24 mg/L ( 3.25, 21.45 ).The median level of SAA in lung cancer patients (42.36 mg/L) were significantly higher than in healthy controls (11.24 mg/L), and difference reached statistically significant (Z=-2.403,P=0.006).Nevertheless, there was no significant difference in SAA concentrations among the different pathological types(Z=-1.013, P=0.339), ages (Z=0.578, P=0.458) and gender(Z=0.726, P=0.246) of lung cancer patients.While the level of SAA in has smoking status (Z=-2.282, P=0.013) and distant metastasis (Z=-2.138, P=0.017) of lung cancer was higher.By drawing ROC curve, the cut off value of SAA in distinguishing lung cancer with healthy control was 14.48 mg/L.Meanwhile, the AUC was 0.811, the accuracy is 89.12% and the sensitivity was 88.73%.Serum concentration was positively related with smoking status ( r =0.331, P =0.018 ) and distant metastasis ( r =0.372, P=0.015 ) by Spearman correlation analysis .Conclusion Serum SAA concentrations may contribute to the auxiliary diagnosis of lung cancer, evaluate the clinical stage and distant metastases of lung cancer.

Benzene ; Benzene Derivatives ; Bile ; Chromatography, Gas ; Gallbladder ; Gas Chromatography-Mass Spectrometry ; Humans ; Toluene

Objective To study the risk factors of pulmonary embolism and comparison of the effect of different therapy.Methods Risk factors of 182 patients with pulmonary embolism were analyzed retrospectively.The patients were randomly divided into simple drug group and drug joint intervention group.Simple drug group was given heparin and warfarin,or jiont urokinase fibrinolytic therapy.The drug joint intervention group was given the same drug therapy joint vena cava filter implantation and/or catheter broken bolt therapy.After different treatment,the clinical prognosis was compared between the two groups.Results Of 182 patients with pulmonary embolism,the elderly and smoking prevalence rate increased significantly,deep vein thrombosis,cardiovascular disease,cancer,blood system diseases,trauma and surgery,chronic lung disease,fracture and orthopaedic surgery were the main risk factors.The effective rate and mortality between the pure drug therapy group and drug joint intervention group had no significant differences(x2 =0.145,P ＞ 0.05).Conclusion The incidence of pulmonary embolism is closely related to the risk factors.Cancer is one of the important diseases caused by pulmonary embolism.In a timely manner to give the antithrombotic drug treatment has great significance to the prognosis of pulmonary thromboembolism,there was no significant difference compared with the antithrombotic joint intervention.

The da Vinci robotic surgical system has the advantages of three-dimensional vision and high degree of accuracy,flexibility and repeatability,which makes surgical procedures such as digestive tract anastomosis easier to conduct under minimally invasive conditions.In this article,the feasibility and principle of digestive tract anastomosis and the procedures of pancreaticojejunostomy and pancreaticogastrostomy by the da Vinci robotic surgical system are introduced,so as to improve the quality of anastomosis and reduce the incidences of postoperative complications.Compared with traditional laparotomy,da Vinci robotic surgical system simplified the surgical procedures and reduced the trauma,which is suitable for digestive tract anastomosis in pancreatic surgery.The method of pancreatic anastomosis should be selected in consideration of the condition of patients,surgical procedure and the experience of surgeons.

Objective To evaluate the clinical efficacy and safety of iMliximab (IFX) in the treatment of Crohn's disease (CD).Methods From February 2009 to March 2013,the clinical data of 62 CD patients with IFX treatment were retrospectively analyzed.At week 14th after IFX injection and the end of follow-up of this study (March 2013) were two observation points.At week 14th after IFX injection (three times of IFX injection),C reactive protein (CRP) level,Crohn's disease activity index (CDAI) score and clinical remission were investigated.At the end of follow-up,clinical remission,fistula closure,mucosal healing and side effects were inspected.Normal distribution data were expressed as 2±s,which were compared with t test.Non normal distribution data were expressed as M (QL-QU) and compared with Wilcoxon test.Results Four cases without complete three times of IFX injection and one case lost to follow-up were eliminated.And nine postoperation cases with IFX treatment to prevent recurrence after surgery were excluded.A total of 48 cases of CD in active period were enrolled in this study on efficacy.At week 14th,CRP level of 48 patients [1.9(0.5,5.4) mg/L]decreased compared with that before treatment [28.9(6.4,51.1) mg/L] (Z=-5.468,P＜0.01);CDAI score (87.0±35.8) also decreased compared with that before treatment (245.1±59.1) (t=18.579,P＜0.01).At week 14th,46 patients in active period achieved clinical remission and the remission rate was 95.8％.By the end of follow-up,38 patients were still in remission period and the remission rate was 79.2％.Among 26 patients with anal fistula before IFX treatment,seven cases (26.9％) were completely closed,17 cases (65.4％) was partially closed and two cases was responseless.Fifteen patients were reviewed by colonoscopic examination after more than six times of IFX treatment.The median of simple endoscopic score for Crohn's disease (SES-CD) was 3 (0,5)after treatment,which decreased compared with that before treatment (8(7,9),Z=-3.306,P=0.001).Twenty-two of 48 cases in active period received,step-up strategy and 26 cases received with top-down strategy.At week 14th,20 cases (90.9％) of group with step-up strategy and 26 cases (100.0％) of group with top-down strategy were in remission period.By the end of follow-up,14 cases (63.6％) of group with step-up strategy and 24 cases (92.3％) of group with top down strategy maintained remission.Among 26 cases with anal fistula,two cases without response were treated with step-up strategy and seven cases with complete closure were all with top-down strategy.Among 62 patients,five had side effects,three of whom had acute infusion reaction,one had delayed infusion reaction and the other had anemia.Conclusions IFX had good clinical efficacy in controlling inflammation,inducing clinical remission,promoting fistula closure and mucosal healing in CD patients.For some CD patients with high risk,the initial top-down strategy showed good clinical efficacy.

Objective:To observe and identify the inhibitory effect of oncostatin M (OSM) combined with dacarbazine (DTIC) on mouse melanoma cells B16 in vitro and in vivo. Methods:The inhibitory effect of OSM combined with DTIC on the proliferation and apoptosis of B16 melanoma cell line B16 were determined through MTT assay and flow cytometry, respectively. The change in nu-cleus morphology of B16 cells was observed under a fluorescence microscope by Hoechst staining method. The effects of single agents OSM and DTIC, as well as OSM-DTIC joint treatments, on tumor in mice in vivo were observed by inoculating B16 cells into C57 BL of six mice. Results:The OSM, DTIC, and combined OSM-DTIC treatments inhibited the proliferation of B16 cells by (11.2±2.3)%, (25.3±4.6)%, and (32.5±3.8)%, respectively (P<0.05). Apoptosis of B16 occurred at (1.32±0.42)%, (10.64±2.13)%, and (15.86±2.76)%, respectively (P<0.05). Cell morphology showed a significant increase in nuclear fragmentation, as proven by OSM-DTIC combined treatment. In the in vivo experiment, DTIC caused an apparent inhibition on the growth of mouse melanoma compared with the control group, and the joint treatment showed that the addition of OSM enhanced the tumor suppression effect of DTIC. Conclusion: OSM combined with DTIC has a synergistic effect that inhibits proliferation and apoptosis of B16 in vitro. This approach suggests a new po-tential treatment for melanoma.