ObjectiveTo study the relationship between serum-asicites albumin gradient(SAAG) and the portal hypertensive ascites in order to appreciate the value of SAAG on the prediction of esophageal-gastric fundus variceal bleeding.Methods34 patients with cirrhotic ascites were examined with endoscopy.The patients were classified as high-gradient group and low-gradient group by the SAAG value of 11g/L.The relationship between SAAG and esophageal-gastric fundus varices was studied by Pearson correlation analyasis.Among the 34 patients studied,10 patients had esophageal-gastric fundus variceal bleeding and 24 patients had no esophageal-gastric fundus variceal bleeding.ResultsIn the 30 patients classified as high-gradient group,22 patients had esophageal-gastric fundus variceas.In the 4 patients classified as low-gradient group,no patient had esophageal-gastric fundus variceas.The results showed the direct correlation between the level of SAAG and the degree of esophageal-gastric fundus variceas ( r =0.81,P ＜0.01 ).The mean level of SAAG in bleeding group,consisting 10 patients,was (24.18 ±7.36) g/L.The mean level of SAAG in non-bleeding group,consisting 24 patients,was ( 18.19 ± 6.18)g/L.The results showed sig nificant difference between the bleeding group and non-bleeding group(P ＜0.05).ConclusionThere is correlation between the level of SAAG and the portal venous pressure.The level of SAAG is valueable on the prediction of esophageal-gastric fundus variceal bleeding.

Objective To exlpore the effect and safety of endoscopic pneumatic dilation in the treatment of the benign stricture of esophagus and carclia.Methods 35 patients with the benign stricture of esophagus,eardia and anastomosis were treated with painless endoscopic pneumatic balloon dilation.Results The rate of stricture improvement was 100％,and the entire anastomosis diameter was extended over 12 am,at the first time,difficulty in swallowing was obviously relieved.Following up three months,the total effecttive percentage of stricture improvement was 88.6％,and no serious complication occurred in all cases.Conclusion Endoscopic pneumatic balloon dilation is effective and safe to treat the benign stricture of esophagus and cardia

10.3969/j.issn.2095-4344.2013.24.006

Objective To introduce a new method to open bite.Methods Compound resin materials were used to make a bonding type deep-bite opening device on the lingual side of anterior teeth in 21 patients.Results 21 patients with deep overbite treatment by this method achieved satisfactory results.Average time in Ⅱ°deep bite pa tients was(3.5 ± 1.4)months,and(5.4 ± 1.2)months in Ⅲ°deep bite patients.Conclusion This device is favorable for rapidly opening deep-bite and is simple and effective.

Objective To investigate the association between apolipoprotein E (apoE) genotype polymorphism and cerebral palsy (CP) in Han Chinese children. Methods Two hundred and forty Han Chinese children were selected, including 120 children with cerebral palsy (CP group) and 120 normal children (control group).Polymerase chain reaction-restricted fragment length polymorphism analysis was used to determine the genotype and alleles of apoE genotype in the two groups. Results The genotype distributions of apoE in the two groups were consistent with the existence of a Hardy-Weinberg equilibrium. There were significant differences in the distributions of allelic frequency and apoE genotype between the two groups. Carrying the ε4 allele was related to cerebral palsy, and the overall risk for cerebral palsy was elevated about 5.5-fold among children carrying the ε4 allele.Conclusions There is an association between apoE genotype and cerebral palsy, and apoE's ε4 allele is the associated risk factor.

Objective To analyze the incidence of hospital-acquired infection and the distribution of pathogens through data from the hospital infection surveillance networks in Shandong. Methods A meta-analysis was made of the data submitted by the hospitals involved in the provincial surveillance networks from August 2001 to July 2004. Results The surveillance data involved 1 776 030 hospitalized patients, of whom 43 355 had a hospital-acquired infection, the incidence of hospital-acquired infection being 2.44‰. Respiratory-tract infections were most frequent, followed by gastroenteric-tract infections, urinary-tract infections and surgical-site infections. A total of 6 251 strains of pathogens were isolated, the most commonly identified pathogens being Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumoniae, Candida albicans and Staphylococcus epidermidis. Conclusion It is imperative to reinforce the sterilization of air and medical instruments, strictly abide by aseptic manipulation, and promote the rational use of antimicrobials. Hospital infection surveillance ought to be conducted by the combined method of prevalence surveys and the targeted surveillance of key sectors.

Objective To study if tumor retraction assessed by endiscopic uhrasonography (EUS) during radiotherapy has prognostic value in esophageal carcinoma, which may further predict the radiosensi-tivity. Methods The maximal tumor thickness was measured by EUS before radiotherapy and at 40 Gy in patients with esophaged carcinoma. Response was defined as at least 50% reduction in tumor thickness. Re-suits A total of 51 patients were included. The median follow-up time was 28.5 months. The median sur-vival time was 24.3 months. The treatment was radiotherapy alone, concurrent chemoradiotherapy and pre-operative treatment in 35, 10 and 6 patients, respectively. Tumor response was assessed by EUS in 18 pa-tients (34%). The 2-year overall survival (OS) and progression-free survival (PFS) were 69% and 59% for responders, comparing with 37% and 29% for non-responders (χ~2= 5.78, P = 0.016 and χ~2= 3.97, P =0.046, respectively). In radiotherapy alone group, the 2-year OS and PFS were significantly higher in responders (n = 11) comparing with non-responders (n =24)(60% vs 44% ,χ~2 =5.84,P =0.016 and 20% vs 10% ,χ~2 =4.20, P =0. 040). In preoperative radio (chemo) therapy group (n =6), pathological-ly complete response, partial response and minimal response were observed in 4, 1 and 1 patients, respec-tively. EUS detected tumor response in 4 of 5 (80%) patients with tumor regression, and non-response in 1 of 1 patient without tumor regression. Conclusions The prognosis is better in patients with esophageal car-cinoma responding to neoadjuvant treatment identified by EUS than that of non-responders.

Objective: To explore the diagnostic value of combined detection of blood osteopontin (OPN) and matrix metalloproteinase-9 (MMP-9) for in-stent restenosis (ISR) in patients after percutaneous coronary intervention (PCI). Methods: A total of 142 patients who received post-PCI coronary angiography (CAG) in our hospital were studied. The patients were divided into 2 groups based on if there were ISR condition: ISR group,n=21and Non-ISR group,n=121. The blood levels of OPN and MMP-9 were detected upon the follow-up CAG conduction and the basic clinical information with biochemical indexes were compared between 2 groups. Results: Blood levels of OPN and MMP-9 were signiifcantly higher in ISR group than those in Non-ISR group,P<0.001. Multivariate logistic regression analysis revealed that elevated levels of OPN and MMP-9 were the independent risk factors for post-PCI ISR occurrence (OR=2.861 and OR=3.343,P<0.01). The ROC area of OPN and MMP-9 for predicting post-PCI ISR occurrence were 0.821 and 0.887,P<0.001. Taking the optimal cut off value of OPN at 3.68 ng/ml and MMP-9 at 415.24 ng/ml, the combined detection could increase the sensitivity of detection (90.48%) and the negative predictive value (98.06%). Conclusion: Blood levels of OPN and MMP-9 are closely related to ISR occurrence in post-PCI patients, combined detection has certain predictive value for ISR occurrence, especially for negative predictive value.

Objective To investigate the therapeutic effect of esomeprazole,a new type 0f proton pump inhibitor(PPI),on patients with reflux esophagitis(RE).Methods 80 cases with RE diagnosed by endoscope were randomly divided into treatmeat group(n=40)and control group(n=40).The treatmeat group was treated with esomeprazole 20 mg bid,compared with the control group famotidine 20mg bid.The two courses of treatment both persisted for four weeks and included mosapride 5mg tid.At the end of therapy,the rate of relief of heartburn,acid reflux and substernal burning symptom,and the total effective rate confirmed by endoscope were recorded.ResuIts The clinical symptoms relief rates were 92.5%in the treatment and 62.5%in the control group raspectively and had obviously statistical difference(P＜0.05).The total effective rate was confirmed by endoscope were 82.5%and 55.0%respectively in two groups(P＜0.05).Conclusion Esomeprazole is a type of effective drug for patients with RE.

OBJECTIVE To find out epidemiological features of fulminant Acinetobacter baumannii nosocomial infection in cardiac SICU and the ways to prevent and treat this nosocomial infection. METHODS The case histories from 5 inpatients who developed A.baumannii nosocomial infection in cardiac SICU from July 8 to 26,2004 were studied retrospectively to find out the reasons of the epidemia and treatments based on the sputum culture results. RESULTS These 5 inpatients developed lower respiratory tract infection on top of their original severe disease.Within 15 days,their sputum cultures were positive for A.baumannii,4 of them recovered but one died. CONCLUSIONS The inpatients got the same nosocomial infection within the same period because of lowered resistance owing to unreasonable layout of cardiac SICU,their original weakness is due to various invasive operation like long duration mechanical ventilation,lack of isolation and sterilization,etc.