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

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.

10.3969/j.issn.2095-4344.2013.24.006

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 assess the mid-term result of laparoscopy in resection of choledoehal cyst,hepaticojejunostomy and discuss the technical improvement.Methods Retrospectively analyzed the data of 31 patients who had undergone laparoscopic choledochal cyst excision from November 2010 to November 2012.Under laparoscopic guidance,intraoperative cholangiogram was performed,Rorx-Y jejunojejunostomy was performed extracorporeally through umbilical incision,then the dilated bile duct were completely excised and a hepaticojejunostomy was carried out intracorporeally.Results Twenty-nine patients successfully underwent laparoscopic choledochal cyst resection,while 2 patients were converted to open surgery because of severe adhesion.The mean operation time was 260 minutes (range from 200 to 460 minutes).A follow-up of 3 to 27 months were achieved in all patients.Three patients developed early complications:one bile leakage,one incision port hemorrhage and one intestinal torsion.The laboratory tests were normal and no dilation of the bile duct was detected in all patients.Conclusions Laparoscopic total cyst excision with Roux-Y hepaticojejunostomy was effective and safe procedure with satisfied results.

OBJECTIVE To investigate the trends of susceptibility of Enterobacter cloacae isolates to antimicrobial agents from Shandong provincial nosocomial infection surveillance system. METHODS The data from Shandong provincial nosocomial infection surveillance system from Aug 2001 to Jul 2004 were summarized and analyzed.(RESULTS) In the period of study from Aug 2002 to Jul 2004,231 strains of E.cloacae were collected.The (sputum),(urine) and wounds were major specimens,and accounted for 55.41%, 10.82% and 9.96% from total(specimens),respectively.The resistant rates of E.cloacae isolates to antimicrobials,except imipenem,increased to some extend.CONCLUSIONS Antimicrobial resistance of clinical isolates of E.cloacae threatens the success of(infectious) disease treatment.It is very important to promote the rational use of antimicrobial agents for control of resistance and to take effective measures for the prevention of infections.

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.