Objective To evaluate the efficacy and safety of single forcep endoscopic purse-string suture closing the wound of cardia and gastric fundus after endoscopic full-thickness resection (EFTR) for patients with submucosal tumor (SMT).Methods The clinical data of 32 patients with wound in the cardia and gastric fundus after EFTR for SMT undergoing single forcep endoscopic purse-string suture in Endoscopy Center of Renmin Hospital of Wuhan University from January 2015 to January 2016 were collected.Completion of operation, postoperative complication and follow-up results of these patients were retrospectively analyzed.Results All of the patients successfully received EFTR and purse-string suture.The maximal diameter of tumors was 1-4 cm.The suture time was 10-15 min, and postoperative hospital stay was 5-10 d.Low fever and upper abdominal pain were found in 13 and 20 cases respectively, and all cases were alleviated or restored after conservative treatment.All patients underwent gastroscopy during follow-up of 1 month, and titanium clip and nylon rope were found on the wound surface in 29 cases (90.6%).Three months after operation, 28 patients underwent gastroscopy, and titanium clip but no nylon rope was detected in 15 cases (46.9%).Conclusion Single forcep endoscopic purse-string suture can effectively treat the postoperative wound in the cardia and gastric fundus of patients with submucosal tumors after EFTR.

Objective To asses the value of detecting bacterial DNAs in rat's blood with PCR for early diagnosis of colonic anastemotic leakage.Methods 48 healthy female Wistar rats were random divided into three groups: Group A(n=8,sham operation group),Group B(n=20,colonic anastomosis group),Group C(n=20,colonic anastomotic leakage group).Group B and C rats underwent standardized colon resection 3cm away from the ileocecal junction 10cm,Group B rats were done with a complete anastomosis(end-to-end single layer anastomosis with 0# silk sutures) while Group C rats were done with an anastomosis leaving a 5mm opening in colonic anterior wall.lml and 3ml venous blood samples were collected from Group A,B and C.DNAs were extracted from these blood samples and PCR techniques were used to amplify lacZ genes from Escherichia coli and 16S ribosomal RNA genes(16SrRNA genes) 3 days after operation.The data were analyzed by chi square test.Specimens of the experimental intestine were HE stained for pathological studies.Results The positive ratios of expressing lacZ genes in peripheral blood(PB) with PCR in Group C were significantly higher than that in Group B(P<0.05),hut there were no differences between the two groups in expressing 16SrRNA genes(P>0.05).Conclusions It could be a useful way to detect lacZ genes of Escherichia coli from PB by PCR but not 16SrRNA genes for diagnosis of colonic anastomotic leakages.

0.05),but the positive ratio of 16SrRNA genes expression in PB in Group C and Group E was significantly higher than that in group B and Group D respectively(P0.05).Conclusions(1)Detecting 16SrRNA genes from PB with PCR has certain significance for early diagnosis of jejunal anastomotic leakage and ileal anastomotic leakage,(2)PCR might be a useful tool for early diagnosis of jejunal anastomotic leakages and ileal anastomotic leakages by detecting lacZ genes or 16SrRNA genes from ascites.

Objective To explore the feasibility of the ultrasonic atomization surface anesthesia with lido-caine for awake fiberoptic endotracheal intubation in patientsˊautonomous position -display before general anesthesia and to evaluate its advantages.Methods 68 adult patients who needed prone position for elective surgery under general anesthesia were selected and randomly divided into two groups,the control group and the treatment group,each group in 34 cases.In control group patients were received surface anesthesia of cricothyroid membrane puncture.In treatment group,nebulized 2% lidocaine with ultrasonic nebulizer was used for topical anesthesia.Patients lied in the prone position according to their own comfort with the guide of the medical staff in the waking state after an awake fiberoptic endotracheal intubation.The statistics of mean arterial pressure (MAP)and heart rate (HR)were recorded respectively in the basal state(T0),in the time instantly after intubations(T1 ),in the 3 minute after intubations(T2 ) and in the time instantly after the body turning(T3 ).Choking cough response were recorded during endotracheal intubation.Patients were asked the efficacy of surface anesthesia and the tolerance for awake intubation after operation.Results Patients in both two groups completed the whole process smoothly.MAP and HR had no signifi-cant differences between the two groups in the same time point (all P >0.05).There were no statistical significance between the two groups in choking cough response,the time of surface anesthesia and intubation,neither (all P >0.05).Conclusion The surface anesthesia with lidocaine by continuous ultrasonic atomizing inhalation is a good and simple method deserving generalization with plenty merits and is practicable for patients to display position autonomously. This method have the advantages of small operation,it will and can replace cricothyroid membrane puncture.

Objective To observe the synthesis of melanin and tyrosinase activity of the cultured normal human melanocytes after treated with baicalin and NB-UVB, and to provide theoretical evidence for study on the new therapy method of vitiligo.Methods The normal human menlanocytes cultured in vitro were divided into control group,different concentrations of baicalin groups,different doses of NB-UVB group and baicalin combined NB-UVB group.The proliferation rate of melanocytes was measured by MTT assay,the level of melanin was tested by NaOH pyrolysis,and the tyrosinase activity was measured by dopa oxidization.Results Compared with control group,the proliferation rates in 10-4 mol·L-1 baicalin group and 30 mJ·cm-2 NB-UVB group had no significant difference(P>0.05 ). Compared with control group, the levels of melanin and tyrosinase activities in baicalin group,NB-UVB group and combined group were increased (P<0.05 or P<0.01);compared with baicalin group and NB-UVB group,the level of melanin and tyrosinase activity in combined group were increased(P<0.01). Conclusion Baicalin combined with NB-UVB has better promotion effect on melanin synthesis than used alone.

An indexing system is constructed,based on the implementation of prevention and control technology for chronic non-communicable diseases in community health service institutions,using both literature review and Delphi method,and using the Analytic Hierarchy Process (AHP) to calculate the weight of the indexing system.The system comprises three level-1 indexes,8 level-2 indexes and 33 level-3 indexes.The research proposed a transition from emphasis of therapeutic means to prevention,and emphasis on prevention and control technologies to the high-risk population in the prevention and control technology of chronic non-communicable diseases,along with development of techniques and measures to encourage behavioral changes of the population with chronic diseases.

Objective To evaluate the therapeutic effect of bone marrow mesenchymal stem cells (BMSC) transplantation via renal artery in treating experimental rats with adriamycin-induced chronic nephro -pathy.Methods A total of 50 male Sprague-Dawley (SD) rats were used as experimental animals.Two rats were used for the isolation and culture of BMSC.Twelve rats were designed as blank control group (group N);in other 36 rats adriamycin was injected through caudal vein to establish rat models of chronic nephropathy,these 36 rats were randomly and equally divided into three groups with 12 rats in each group:control group (group C,n=12),BMSC transplantation via renal artery group (group A,n=12),and BMSC transplantation via caudal vein group (group V,n=12).For the rats of group N,the same amount of normal saline was injected through caudal vein.Results At each observation point,the levels of blood urea nitrogen,serum creatinine,24 h urinary protein and 24 h urinary microprotein in group A,V and C were remarkably higher than those in group N (P＜0.01).One and two weeks after BMSC transplantation,the 24 h urinary microprotein level in group A was significantly lower than that in group C (P＜0.01);the serum creatinine level in group A was significantly lower than that in group C and group V (P＜0.01).One week after BMSC transplantation,both the 24 h urinary protein level and 24 h urinary microprotein level in group A were strikingly lower than those in group V (P＜0.01),but two weeks after BMSC transplantation these differences between group A and group V became not statistically significant.Conclusion BMSC transplantation via renal artery can improve cell-homing efficiency and improve the repair of damaged tissue as well.

Objective To investigate the clinical effects of different doses of propranolol in treatment of infantile mixed and deep hemangioma,and to provid theoretical and experimental evidence for the treatment of hemangioma. Methods The selected 62 patients with mixed and deep hemangioma were divided randomly into low dose (1.5mg·kg-1 ·d-1 )and high dose (3.0 mg·kg-1 ·d-1 )of propranolol groups,3 times a day,6 months as a course,the changes in hemangioma size and the incidence of adverse reactions were recorded.Results The efficacy was evaluated using Achauer system.The total effective rate was 80.65% in low dose of propranolol group and 93.55% in high dose of propranolol group,including 6 cases of class Ⅰ (poor),9 cases of class Ⅱ (moderate), 11 cases of classⅢ (good),and 5 cases of class Ⅳ (excellent)in low dose propranolol group;while 2 cases of class Ⅰ (poor),4 cases of class Ⅱ (moderate),10 cases of class Ⅲ (good)and 15 cases of Ⅳ (excellent)in high dose of propranolol group.The efficacy in high dose of proprandol group was significantly better than that in low dose of proprandol group (P<0.05),there were no significant differences in the efficacies between different sites and different types (P>0.05)and there was no significant difference in the incidence of adverse reaction between two groups (P>0.05).Conclusion The efficacy of oral 3.0 mg·kg-1 ·d-1 propranolol in treatment of infantile mixed and deep hemangioma is increased significantly, and there is no significant adverse reactions after increasing doses.Therefore,high dose of propranolol should be recommended in order to improve the therapeutic effect.

ABSTRACT:Objective To explore the risk factors for maternal adverse pregnancy outcomes.Methods An unmatched case-control study based on hospital was performed.Univariate and multivariate Logistic regression were used to analyze the related factors of maternal adverse pregnancy outcomes,including general condition,history of fertility,abnormal symptoms and diseases during pregnancy.Results Univariate analysis results showed that high education level of gravida might be the protective factors of adverse pregnancy outcomes.The risk factors for adverse pregnancy outcome might include advanced maternal age,intensive workload,frequent pregnancy,history of spontaneous abortion,severe morning sickness,and sickness during pregnancy or progestation.Multivariate Logistic regression analysis showed that high education level of gravida (OR=0.63,95% CI:0.50-0.80)was the protective factor of adverse pregnancy outcomes;severe morning sickness (OR=2 .1 3 ,9 5% CI:1 .6 3-2 .7 9 )and sickness during progestation (OR=2.25,95% CI:1.06-4.77)were the risk factors for maternal adverse pregnancy outcomes.Conclusion The level of maternal education should be improved.We should attach great importance to preventive education and thorough treatment of severe morning sickness. Couples should be encouraged to have physical examination before marriage and pregnancy.Corresponding pregnancy care guidance should be given to pregnant women with different physical conditions so as to effectively reduce the occurrence of adverse pregnancy outcomes.

Objective To establish the normal reference intervals of whole blood trace elements among pregnant women in Han‐gzhou area to provide the clinical diagnostic basis for ensuring the health of pregnant women and their fetuses .Methods A total of 122 whole blood samples in pregnant awaiting delivery in a general hospital of Hangzhou City during 2015 were collected randomly . The levels of lead(Pb) ,cadmium(Cd) ,copper(Cu) ,zinc(Zn) ,nickel(Ni) ,chromium(Cr) ,beryllium(Be) ,manganese(Mn) ,cobalt (Co) ,arsenic(As) ,molybdenum(Mo) ,thallium(Ti) and thallium(Tl) were determined with ICP‐MS .And the results were statisti‐cally analyzed .Results The detection results of whole blood Cu ,Cr ,Mn and Ti showed a normal distribution .The 5% -95% refer‐ence interval was determined according to x ± 1 .96s ,the normal reference intervals for these 4 elements were 255 .37 -668 .23 , 56 .09-151 .93 ,18 .46-54 .60 and 800 .90 -2 632 .02 μg/L respectively .Conclusion Formulating the normal reference values of whole blood microelements levels has an important significance for clinical doctors to provide the nutritional health care guidance and master the heavy metal pollution level .