Objective To determine the value of EUS- guided fine needle aspiration biopsy (FNAB)for the diagnosis of submucosal lesions.MethodsWe found 28 patients with upper gastrointestinal tract solid submucosal lesions by endoseopies. EUS was performed to assess the lesions arised from the specific layer of the wall and the lymph node metastasis. After excluding extrinsic normal tissues compressing the gastrointestinaltract, EUS guided FNAB were carried out. Results Among these patients, two were extrinsic normal tissues compressing the gastrointestinal tract and all other 26 patients were examined by EUS guided FNAB. EUS- guided FNAB failed in only 3 patients. Among the other 23 patients, cytology demonstrated malignant tumors in 4 patients(lymphoma, n=2; leiomyosarcoma, n=2) and benign lesions in 19 patients(leiomyoma, n=1;lipoma, n=1 ). The results of EUS-guided FNAB were validated by surgery (n=20), endoscopic treatment (n=1) or clinical follow-up (n=7). Conclusion EUS guided FNAB is a safe and accurate method for di-agnosis of submucosal lesions.

Objective To determine the value of endoscopic ultrasonography (EUS)-guided fine needle aspiration biopsy (FNAB) for differential diagnosis of pancreatic lesions. Methods EUS was performed in 23 patients with pancreatic lesions detected by CT, MRI, or US to assess the shape, size, and position of the lesions and the status of lymph nodes metastasis. After excluding blood vessel between the lesions and the fine needle by EUS, EUS guided FNAB was carried out. Results All patients were performed EUS-guided FNAB and only 2 patients failed. Among the other 21 patients, cytology and pathology demonstrated tumors in 10 patients (pancreatic carcinoma, n=8; pancreatic cystadenoma, n=1; non functional neuroendocrine tumor, n=1). The results of EUS-guided FNAB were evaluated by surgery (n=16), or clinical follow-up (n=7). The sensitivity was 83%, and speciality was 100%, and no complication occurred. Conclusions EUS-guided FNAB is a safe and accurate method for differential diagnosis of pancreatic lesions.

Acute hepatic failure was induced in rats with intraperitoneal administration of D-galactosamine.Serum and tissue amino acid profiles of the animals were studied. Except for arginine, serum levels of all amino acids were elevated. This is in variance with the findings of Fischer and other investigators. In their studies, the decreased levels of BCAA could be related to the administration of dextrose. In our study, the serum BCAA/AAA ratio was decreased and it was correlated negatively with the dosage of D-galactosamine (r =-0.789). Amino acid profiles in the liver,kidney and muscles were significantly altered. The chracteristics of the changes indicated that enhanced proteolysis of tissue proteins was the major factor accounting for the elevation of serum amino acid levels. Hepatic coma might be related to the increase of aromatic amino acids in the brain. It is usually difficult for glycine, cystine, asparagine and threonine to penetrate the blood-brain-barrier. Elevation of their levels in the brain might be a consequence of increased permeability of the blood-brain-barrier. Further studies are needed to clarify the role of GABA in hepatic coma.

Objective:To develop an evidence-based nursing program for a patient with oral complications of dysphagia due to cerebral infarction.Methods:According to the principle of PICO, and the problem of patients' clinical manifestations, using the method of combining subject words and free words, the database of Uptodate, NICE, SIGN. RNAO, medical pulse guide network, BMJ, Cochranc library, PubMed, EMbase, CINAHL, China National Knowledge Infrastructure were searched and collected the clinical guidelines, systematic evaluation and randomized controlled trial of oral complications in patients with dysphagia of cerebral infarction.Results:Totally 1 clinical decision, 5 clinical guidelines, 4 expert consensus, 2 systematic evaluations, 1 Meta-analysis, 3 randomized controlled trial (RCT) were included. Based on the search results and the patient′s condition and wishes, nurses performed swallowing function tests every two days according to the Standard Swallowing function rating Scale (SSA), raised the head of the bed 40°~45° and holded it for 1 hour. Three times a day, the teeth were brushed with chlorhexidine oral care solution under negative pressure. Sputum scab was removed by mechanical scrubbing. The back of tongue was scrubbed by 6x tongue scraping technique every night. After the infection was controlled, the teeth were washed twice a day with 0.9% sodium chloride solution. Oral condition and swallowing function were evaluated daily. High flow humidification oxygen therapy and mask spray atomization inhalation were used. Swallowing training was performed on the third day after admission. Seven days after the evidence was applied to clinical practice, the oral mucosa was moist without peculiar smell and sputum scab, and the swallowing function was changed from grade IV to grade II.Conclusion:Nursing cerebral infarction patients with dysphagia, nurses should timely assess the patient's oral cavity and swallowing function, the application of chlorhexidine and 0.9% sodium chloride solution oral care solution mechanical scrubbing method and negative pressure washing brushing method can effectively remove sputum scab, use 6x tongue scraping technology to scrub the back of tongue, can reduce micro organisms, reduce halitosis; the application of nasal mask high flow humidification oxygen therapy and spray atomization inhalation humidification effect is obvious Therefore, early swallowing training can reduce the incidence of oral complications.

Objective: To study the distribution,combination law of syndrome factors and characteristics of base syndromes of pneumonia based on document data.Methods: Combined methods of computer retrieval and man-made retrieval were adopted,the document data from 1981 to 2004 on lower respiratory tract infection was gathered by way of document database index.And the data was analyzed by description,Logistic regression and clustering analysis.Results: 32 documents and 141 items were used for analysis.The results indicated that among the 17 syndrome factors related to syndrome differentiation of pneumonia,the highest frequency of location syndrome factor was lung;the frequency of f ire,heat and yin-def iciency was higher;pathogenic wind,pathogenic heat and phlegm were the main etiological factors.In the document study,there were four patterns in the combinative model of syndrome factors,the combination of two syndrome factors and the combination of three syndrome factors were the main patterns,the cumulative percentage was 95.7%.Meanwhile,the main symptoms and the sub-symptoms of the mainly syndromes were screened out by adopting statistical description,logistic regression and clustering analysis.Conclusion: The main syndrome types and their inscapes of pneumonia can provide enough references for the next step research.

BACKGROUND: There have been no reports available about the direct effect of beer on serum enzyme activity.OBJECTIVE: To observe the changes of the activity of various serum enzymes of the subjects in the in vivo and in vitro experiments after drinking bear.DESIGN: An observational controlled experiment.SETTING: The Institute of Basic Medicine of Taishan Medical College.PARTICIPANTS: The experiment was performed at the Institute of Basic Medicine of Taishan Medical College between March 2005 and April 2005.We selected 17 college students, aged 19 to 35 years, from Taishan Medical College, including undergraduate students and graduate students. In formed consents were obtained from the subjects before the experiment was conducted.METHODS: ① In vivo experiment: 3 mL of venous blood was collected from the subjects 3 hours after the ordinary diet as the control. Then, the subjects drank beer at an amount of 4 mL/kg according to their body mass immediately. 3 mL of blood was collected respectively 15, 30, 45, 60, 90,120, 80 minutes later to measure the changes of the activity of alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transpeptidase, al kaline phosphatase, creatine kinase , lactate dehydrogenase, diastase and lipase. ② In vitro experiment: 17 fresh serum samples were added into two test tubes separately with 0.5 mL of serum in each tube. 20 μL of normal saline was added to the tube of the control and 20 μL of beer was added into the test tube. The direct effect of beer on the activity of various enzymes was observed.MAIN OUTCOME MEASURES: The changes of the activity of alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transpeptidase, al kaline phosphatase, creatine kinase , lactate dehydrogenase, diastase and lipase of the serum on the in vivo and in vitro experiment .RESULTS: Totally 17 students were involved and all the students entered the stage of result analysis with no loss in the midway. ① In vivo experiment: Beer significantly decreased the activity of serum aspartate aminotransferase (418.08 ±58.68,383.41 ±63.01)nkat/L, significantly in creased the activity of serum alkaline phosphatase, (367 8.57±436.25,396 2.96±400.91)nkat/L (x2=19.00-20.00,P ＜ 0.01). The activity of other enzymes was all increased at different degrees. ② In vitro experiment: Beer inhibited the activity of various enzymes in vitro to a certain degree.CONCLUSION: Beer has some effect on enzyme activity in vivo and in vitro, thus affecting the body metabolism. Over drinking beer can affect health. In the routine detection of serum enzymes, attention should be given to avoid the interference caused by over drinking beer to make sure the experimental results are precise and reliable.

BACKGROUND: Long-term excessive intake of beer might lead to change of intra-corporal tissue or activity of serum enzyme.OBJECTIVE: Observation on relations between intake of beer and fat synthesis of rats and activity of enzyme correlated with catabolism in rats.DESIGN: Matched observations randomly of animal experiments.SETTING: Basic Medical Institute of Taishan Medical College.MATERIALS: The experiments were completed in Basic Medical Institute of Taishan Medical College from December 2004 to February 2005. Totally 60 SD rats were selected and categorized into 6 groups with 10 rats in each group. The rats were perfused with 9 mL/kg, 18 mL/kg, 27 mL/kg, 36 mL/kg, and 45 mL/kg beer respectively according to their fat; The rats in control group were fed with water in stead of beer.METHODS: All rats in each groups were narcotized and executed after continuous feeding 1 week, biochemical analysis and enzyme assay were made respectively after blood samples were adopted, and liver, subcutaneous fat, mesentery fat tissue and gastrocnemius muscle were preserved.MAIN OUTCOME MEASURES: ① The level of fat, blood glucose, insulin and blood-lipid of rats in each group after feeding 1 week . ② The enzymatic activity of liver and fat tissue of rats in each group after feeding 1 week . ③ The activity of hormone sensitive lipase and lipoprotein lipase (LPL) of rats in each group after feeding 1 week.RESULTS: Totally 60 rats were channeled into result analysis without any loss. ① Comparison of the levels of fat and biochemical specifications of rats in each group after feeding 1 week: The contents of fat, serum free fatty acid (FFA), high-density of lipoprotein (LP) cholesterol, hepar triacylglycerol and liver cholesterol in beer 36 mL/kg group were higher than those in control groups (x2=19.44-20.01, P ＜ 0.01). ② Comparison of the levels of the enzymatic activity of liver and fat tissue of rats in each group after feeding 1 week: The activities of liver, subcutaneous fat, and liver microsome, I.e. Triacylglycerol alternation protein, phosphatidyl phosphohydrolase, malic enzyme, glucose-6-phasphate dehydrogenase (G6PD) of mesentery tissue in beer 36 mL/kg group were higher than those in control groups (x2=15.02-16.00, P ＜ 0.05). ③ The comparison on level of the activity of hormone sensitive lipase and lipoprotein lipase (LPL) of rats in each group after feeding 1 week: The activity of gastrocnemius muscle of hormone sensitive lipase in beer 36 mL/kg group were prominently lower than those of control groups (P ＜ 0.01), but the activity of lipoprotein lipase (LPL) (P ＜ 0.01) of subcutaneous fat were prominently higher than those in control groups (P ＜ 0.01). The activities of lipoprotein lipase (LPL)of mesentery fat tissue, subcutaneous fat and gastrocnemius muscle tissue in beer 36 mL/kg group were prominently higher than those in other beer groups and control groups (x2=19.00-20.00, P ＜ 0.01).CONCLUSION: The intake of a certain amount of beer (36 mL/kg) might promote the capability of liver in synthesis and the transport of triacylglycerol in rats. The acceleration of lipid synthesis and storage of fat tissue such as mesentery fat tissue and the increase of fat decomposition and mobilization in peripheral tissue such as muscular tissue and subcutaneous fat would finally lead to the increase of fat.

Through comparing two textbooksAcupuncture-Moxibustion Science(first edition)and A-B Classic of Acupuncture and Moxibustion, the characterizes of the two books were analyzed. The former book is comprehensive and concise. Textbook writing is a process of continuous improvement. By combing textbook of acupuncture and moxibustion science, we summarizes the theoretical features,in order to provide a reference for feature textbooks compilation.

AIM:To explore the expression and possible function of histamine H3 receptor (H3R) in striated myogenesis and the differentiated C2C12 cells.METHODS: H3R and myogenesis late marker myosin heavy chain (MHC) were detected at mRNA and protein levels during C2C12 myogenesis.H3R antagonist ciproxifan was added and the expression of the myogenesis early marker desmin, intermediate markers myogenin and MHC was detected.Differentia-ted myoblasts were loaded with Fluo-4 calcium indicator dye and the effect of R-( a)-methylhistamine ( RMeHA) on the cy-toplasmic calcium concentration was determined under the 200 mA electrical stimulation.RESULTS: The expression of H3R and MHC was increased during myogenesis.Ciproxifan incubation had no influence on the 3 striated myogenesis mar-kers (P>0.05).In C2C12 myoblasts, RMeHA (10 nmol/L~100 μmol/L) effectively diminished cytoplasmic calcium peak when the cells were electrically paced (P<0.05).The best inhibitory effect of RMeHA was observed at dose of 100 nM for 10 min and 20 min, which was higher than that for 5 min (P<0.05).CONCLUSION: H3R might have little effect on the myogenic differentiation, but diminishes cytoplasmic calcium peak of the differentiated myoblasts under electri-cal stimulation.

Objective To explore the application value of real time three-dimensional echocardiography (RT-3DE) on right ventricular systolic function in patients with moderate and severe pulmonary hypertension (PH).Methods Twenty-five patients with moderate PH (group Ⅱ) and 25 patients with severe PH(group Ⅲ) were selected,30 normal cases were selected to be control group(group Ⅰ).Tricuspid annular systolic peak velocity (S'),right ventricular Tei index(RIMP),tricuspid annular planet systolic excursion(TAPSE) and right ventricular fractional area change(RVFAC) were measured by conventional ultrasound echocardiography.Right ventricular end diastolic volume (RVEDV),right ventricular end systolic volume (RVESV),right ventricular stroke volume (RVSV) and right ventricular ejection fraction (RVEF) were measured by RT-3DE.The correlation between all the parameters and pulmonary artery systolic blood pressure (PASP),and the correlation between RVEF and S',RIMP,TAPSE,RVFAC were analyzed respectively.Results The differences of RVEDV,RVESV,TAPSE,RVFAC in each group were all statistically significant (all P ＜0.01);RIMP,RVEF between group Ⅰ and group Ⅱ,as well as between group Ⅰ and group Ⅲ were statistically significant (all P ＜0.01);S',RVSV only between group Ⅰ and group Ⅲ was statistically significant (P ＜0.01).The correlation coefficients of RVEF and RIMP,S',TAPSE,RVFAC were-0.707,0.402,0.574,0.763,respectively (all P ＜ 0.01).The best parameters associated with RVEF in each group were RVFAC,RIMP,RVFAC,which correlation coefficients were 0.787,-0.679,0.744,respectively (all P ＜0.01).Conclusions RT-3DE is a objective and accurate method to evaluate the right ventricular volume and RVEF in patients with moderate and severe PH,and it can select out the sensitive indicators to evaluate those patients' right ventricular systolic function from conventional echocardiographic parameters,provide important reference value for clinical.