Objective: To observe the clinical effects of comprehensive treatmenton cutaneous region for low back pain.
Methods: One hundred and twenty outpatients with low back pain who met the diagnostic criteria were randomly divided into a cutaneous region group or a medication group, 60 cases in each group. The cases in the cutaneous region group were treated by Nie-pinching up the skin of the lumbosacral region, cupping and acupuncture. Those in the medication group were treated by oral administration of Celecoxib capsule. The visual analogue scale (VAS) and Oswestry disability index (ODI) were used to assess the therapeutic effects.
Results: After treatment, the VAS scores of both groups were different from those before treatment, showing statistical significances (allP<0.01). The D-valuse of VAS scores of both groups were different from those before treatment, showing statistical significances (allP<0.01). The D-value of OID scores in the cutaneous region group was significantly different from that in the medication group(P<0.01). After treatment, the total effective rate was 91.7% in the cutaneous region group versus 76.7% in the medication group, there was a significant difference in comparing the clinical effect (P<0.01).
Conclusion: Both comprehensive treatment on the cutaneous region and Celecoxib capsule can obviously relieve low back pain. But comprehensive treatment on the cutaneous region is better than Celecoxib capsule in the therapeutic effects.

The techniques for endoscopic diagnosis and treatment of biliary and pancreatic diseases mainly include endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography,which have achieved great progress in recent years.Meanwhile,new techniques including combined therapy with endoscopy and laparoscopy and natural orifice transluminal endoscopic surgery have gradually been applied in clinical practice.In the future,it is necessary to cultivate interdisciplinary experts in the field of endoscopy who master various endoscopic techniques and integrated talents with experience in both transluminal operation and gastrointestinal surgery outside lumens.At present,there are still controversies over the application of new techniques in the treatment of biliary and pancreatic diseases.The diagnosis and treatment of biliary and pancreatic diseases can be further improved by promoting the application of biliary and pancreatic endoscopy and standardization,accumulating experience and improving devices,evaluating clinical research,and promoting the bench-to-bedside translation of new techniques.

The β-adrenergic receptor has close relationship with the occurrence and development of tumor.The β-adrenergic receptors were expressed in a variety of tumors.Its activation can stimulate tumor growth by promoting cell proliferation,inhibite apoptosis,promote angiogenesis,and enhance tumor invasion and metastasis.The β-adrenergic receptor blockers can suppress the tumor growth,which may become one of the effective methods of cancer prevention and treatment.

Patients with long-standing history of ulcerative colitis have an increased risk of developing colitis-associated colorectal cancer.The risk factors include longer duration of colitis,greater anatomic extent of colitis,degree of inflammation of the bowel,family history of colorectal callcer,the presence of primary sclerosing cholangitis.etc.The two kinds of molecular pathogenesis that contribute to colon carcinogenesis are chromosomal instability and microsatellite instability.In order to reduce cancer morbidity,colonescopic surveillance and chemoprevention should be carried out in patients with ulcerative colitis especially in those high risk patients.New endoscopic techniques increase the sensitivity and shed a new light on tumor surveillance.

Objective To observe the changes of postoperative blood high sensitive C-reactive protein (hs-CRP), tumor necrosis factor(TNF)-o, P-selectin levels in patients with acute coronary syndrome (ACS) who had an atorvastatin intensive treatment before operation, and investigate its clinical significance.Methods Seventy-eight cases of ACS patients who intended to undergo percutaneous coronary intervention were divided into two groups by random digits table:39 patients comprising the standard treatment group (given atorvaatatin 20 mg/d, conventional treatment), 39 patients comprising the enhanced group (given atorvastatin 40 mg, 20 mg separately at preoperative 12 h, 2 h on the basis of conventional treatment).Among them, 28 cases of the standard treatment group and 29 cases of the enhanced group finally underwent the test. The hs-CRP,TNF-α ,P-selectin levels at preoperative 1 day,postoperative 6 h,postoperative 12 h were detected and then the changes of three factors were analyzed. Results There was no significant difference in hs-CRP,TNF- α, P-selectin between the two groups at preoperative 1 day. The values of the two groups markedly increased at postoperative 6 h, 12 h and the difference was statistically significant (P ＜0.05). The values of the standard treatment group were markedly higher at postoperative 12 h than those at postoperative 6 h,and the difference was statistically significant [hs-CRP: (10.29 ± 0.77) mg/L vs. (6.34 ±1.23) mg/L;TNF-α: (58.15±5.19) ng/L vs. (36.12 ± 3.89) ng/L;P-selectin: (49.58 ±4.92) μg/L vs.(31.47 ± 3.71) μ g/L] (P ＜ 0.05). However, the values of the enhanced group were higher at postoperative 12 h than those at postoperative 6 h but the difference was no statistically significant [hs-CRP: (6.83 ± 1.46)mg/L vs. (5.95 ± 1.17) mg/L; TNF- o: (42.18 ± 7.79) ng/L vs. (34.07 ± 8.79) ng/L; P-selectin: (33.57 ±4.63) μ g/L vs. (29.78 ± 5.61) μ g/L] (P ＞ 0.05). Three factors in standard treatment group were elevating significantly at postoperative 6 h, 12 h compared with those in the enhanced group, but the difference was no statistically significant (P ＞ 0.05). Conclusion Short-term intensive therapy of atorvastatin in ACS patients who intend to do PCI, can reduce the hs-CRP, TNF-α, P-selectin levels effectively.

Objective To investigate the infection status of Helicobacter pylori (Hp) in a Lhasa hospital.Methods A retrospective survey of Hp infection from 2009 to 2013 was conducted in Lhasa People's Hospital.The data of 14C-urea breath test and gastroscopy were analyzed.Results A total of 2 908 patients were enrolled,1 518 (52.20％) were Hp positive,including 1 061 males (1 061/1 939,54.72％) and 457 females (457/969,47.16％).The Hp infection rate in males was higher than that in females (x2 =14.788,P =0.000).The Hp infection rate by years from 2009 to 2013 was 55.97％ (267/477),49.79％ (239/480),54.66％ (375/686),52.06％ (291/559) and 49.15％ (347/706),respectively.The infection rate in 2013 was significantly lower than that in 2009 and 2011 (P =0.021,0.040).There were no significant differences in Hp infection rates among Tibetan,Han and Hui ethnic groups.In 2020 cases who underwent endoscopic examination,1 098 had Hp positive (54.36％).The Hp infection rate in chronic superficial gastritis group(39.91％) was significantly lower than that in erosive gastritis (x2 =30.143,P =0.000),gastric ulcer (x2 =22.434,P =0.000),gastric polyps (x2 =9.627,P=0.002),gastric cancer (x2 =9.506,P =0.002),duodenal ulcer (x2 =54.158,P =0.000),duodenitis (x2 =14.966,P =0.000) and compound ulcer groups (x2 =8.582,P =0.003).The Hp infection rate in duodenal ulcer group (68.42％) was significantly higher than that in chronic superficial gastritis (x2 =54.158,P =0.000),erosive gastritis (x2 =6.733,P =0.009),atrophic gastritis (x2 =21.496,P =0.000) and gastric ulcer groups (x2 =8.940,P =0.003).Conclusion Hp infection rate appears a decreasing trend in Lhasa area in last 5 years; among various gastro-duodenal diseases patients with duodenal ulcer have a highest Hp infection rate.

Objective To explore the effect of creatine phosphate combined with salvia miltiorrhiza polyphe-nols acid salt in treatment of coronary heart disease heart failure.Methods 114 cases of patients with coronary heart disease heart failure were selected as research objectives,who were treated in our hospital from August 2012 to August 2014.And they were randomly divided into control group(55 cases)and research group(59 cases)according to the number table method.Routine therapy of heart failure were given in both groups and the research group were added creatine phosphate combined with salvia miltiorrhiza polyphenols acid salt.The clinical efficacy of two groups of patients were observed and compared.Results The total effective rate in research group was 96.61%(57 /59), significantly higher than 85.45%(47 /55)in control group,the difference was statistically significant(χ2 =4.427, P =0.035).Before treatment,the left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter (LVEDD),left ventricular end systolic diameter(LVESD)and 6min walking distance between two groups had no sig-nificant difference(P >0.05).After treatment,the LVEDD and LVESD of research group were decreased and LVEF and 6 minutes walking distance of two groups were increased,the difference was statistically significant(P <0.05), the LVEDD and LVESD of research group were lower than that of the control group and LVEF and 6 minutes walking distance were higher than that of control group,the difference was statistically significant(P <0.05).No complications or side effects related to the treatment were found in both groups.Conclusion On the basis of routine therapy of heart failure,the effect of creatine phosphate sodium combined with salvia miltiorrhiza polyphenols acid salt in treat-ment of coronary heart disease heart failure can improve cardiac function of the patients with the indicators,and the clinical effect is obvious,and side effects is rarely observed.

With the development of endoscopic techniques in recent years,therapeutic endoscopic retrograde cholangiopancreatography has replaced surgery as the first approach to the extraction of common bile duct stones.Endoscopic sphincterotomy and endoscopic papillary bal-loon dilation have become established endoscopic techniques for stone removal.However,it remains a challenge for endoscopists to remove large common bile duct stones.Emerging endoscopic modalities,such as endoscopic papillary large balloon dilation and cholangioscopy-guided laser or electrohydraulic lithotripsy,have been shown to be safe and effective for management of large common bile duct stones.This paper reviews recent advances in the endoscopic management of large common bile duct stones.

Objective To investigate the attention bias characteristics of first-episode depressive patients.Methods Forty two patients in our hospital from June 2011 to May 2014 with first-episode depressive and 42 healthy people for physical examination were selected.The reaction time and error number were recorded.Results The reaction time in observation group was significantly longer than control group.Difference between negative and neutral words of observation group was showed (P ＜ 0.01).Conclusions First-episode depressive patients have obviously attention bias in negative related stimulation.

Objective To evaluate the value of narrow band imaging(NBI) in the diagnosis of early squamous esophageal cancer and precancerous lesions.Methods Four thousand and fifty-six patients were examined by routine endoscopy,NBI and iodine chromoscopy,one hundred and fourteen lesions in 82 patients were screened.Of all lesions were detected by NBI with magnification and targeted biopsy.The differences among routine endoscopy,NBI and iodine chromoscopy,and the consistency between IPCL and histological findings were assessed.Results Compared to NBI and iodine chromoscopy,especially flat lesions,there was a high missed diagnosis rate in diagnosis of early squamous esophageal cancer and precancerous lesions by routine endoscopy.With NBI and iodine chromoscopy,the incidence rate of lesions was 78.0% and 79.8%,respectively.For iodine staining,85.7% Grade Ⅰ was high grade intraepithelial neoplasia(HGIN),and 66.0% Grade Ⅱ/Ⅲ was low grade intraepithelial neoplasia(LGIN).For NBI,80.4% Grade Ⅰ was HGIN,but there was no specificity in diagnosis LGIN.In appearance of IPCL,92.9% Type Ⅳ/Ⅴ was HGIN,89.4% Type Ⅱ/Ⅲ was LGIN,and it has a relatively better consistency in IPCL with histological findings.Conclusion There is a high detection rate in diagnosis of early squamous esophageal cancer and precancerous lesions by Lugoul's iodine staining and NBI endoscopy.It's probably that IPCL patterns by NBI with magnification can provide scientific basis for both the endoscopic theraphy of early esophageal cancer and the omen of postoperative recurrence.