Objective To study the relationship between gastric bile reflux and the digestive symptoms. Methods The extent of bile reflux into the stomach during 24 hours was monitored by using ambulatory bilirubin monitoring technique in 76 persons among them 44 were complaining of digestive symptoms and 22 asymptomatic. Results The total time percentile of bile reflux,the total area of bile reflux and frequency of bile reflux in asymptomatic group and symptomatic group were 15 6%?14 0%, 20 6?18 7, 22 3 times?13 6 times, and 26 4%?21 3%, 48 7?60 8, 42 9 times?44 5 times. Conclusion Bile reflux into the stomach was significantly more frequent and intensive in symptomatic group compared with asymptomatic group

CB-HRP was injected into the ovary of the domestic hens of 75-90 days old to trace the originating neurons of the vagus nerve innervated the ovary. The results were as the following:1. The afferent vagus neurons innervated the ovary were located in the nodose ganglia and the jugular ganglia. The afferent fibers in the ovarian medulla were found chiefly in the solitary tract, the nucleus of the solitary tract and the commissural nucleus of Cajal also.2. The efferent vagus neurons were located mainly in the subnueleus ventralis parvicellularis (VP)and the subnueleus ventrolateralis (VL)of the dorsal vagal motor nucleus, and a small number of neurons extended from the subnueleus VP and VL to the neighbouring five subnuclei.

Objective Serum glycated albumin (GA) is associated with the levels of blood glucose and short term glycemic fluctuation. The aim of this study was to investigate the associations between GA and arterial stiffness in a health screening population. Method A total of 11 014 participants (men, 56.2%;mean age, 46.8±7.8 years) who attended physical examination were invited and had completed standardized questionnaires. Serum GA and homocysteine (HCY), brachial-ankle pulse wave velocity (baPWV), and central systolic blood pressure (cSBP) were measured. A series of single and multiple factor analyses and stratified analysis were performed. Result The mean level of serum GA was lower in men (13.69 ± 2.69) than in women (13.82 ± 1.92) (t=2.78, P=0.005). The values of baPWV (men: F=53.9, P for trend<0.001;women:F=37.7, P for trend<0.001) and cSBP (men:F=10.3, P for trend<0.001;women:F=13.5, P for trend<0.001) increased with quartiles of GA levels in both men and women. After adjustment for age, history of hypertension, diabetes, family history of diabetes, smoking status, body mass index, waist circumference, blood pressure, blood lipids, kidney function, fasting glucose, postprandial glucose, and hemoglobin A1c, GA was positively associated with baPWV (βestimate, 0.019;95%CI:0.002-0.036;P=0.032) and cSBP (βestimate, 0.251; 95% CI: 0.107-0.394; P=0.001) in men. Stratified analysis also showed that the positive associations of GA with baPWV and cSBP remained significant in men both with and without diabetes or hypertension (P<0.05). However, the association between GA and HCY was not significant in multifactor analysis and stratified analysis. The above results were similar in women. Conclusion Serum GA levels were positively associated with baPWV and cSBP not only in patients with diabetes or hypertension but also in participants without diabetes or hypertension after adjusting for conventional factors and glucose markers. The findings suggest that GA may help detect the development of arterial stiffness in the health screening population.

Objective To compare the clinicopathological characteristics and prognosis of primary Waldeyer's ring non-Hodgkin lymphoma.Methods From Jan 2008 to Dcc 2013, 50 patients with primary Waldeyer's ring non-Hodgkin lymphoma were retrospectively analyzed.Kaplan-Meier method was used for survival analysis.Log-rank method was used for univariate analysis.Results Waldeyer's ring diffuse large B-cell lymphoma (DLBCL) and extranodal nasal-type NK/T-cell lymphoma (ENKTCL) were the common pathological types of primary Waldeyer's ring non-Hodgkin lymphoma accounting for 56 ％ (28/50) DLBCL and 34 ％ (17/50) ENKTCL, respectively.The age at onset of ENKTCL patients was younger than that of DLBCL patients.Two groups had different primary sites, including 50.0 ％ (14/28) of DLBCL with tonsillar disease and 88.2 ％ (15/17) of ENKTCL with nasopharynx disease.The short phase effect of DLBCL group was higher than that of ENKTCL group.The overall survival (OS) and progression-free survival (PFS) rates had significant differences between DLBCL and ENKTCL (x2 =4.45, P =0.035;x2=6.47, P =0.011).Conclusion DLBCL and ENKTCL are different in clinical characteristics.The short phase effect and prognosis of DLBCL are obviously better than those of the ENKTCL.

Objective To observe the change of liver sinusoid in BALB/c mice infected with Schistosoma japonicum and explore its relationship between the degree of hepatic fibrosis and liver function. Methods A model was established in BALB/c mice infected with cercariae of Schistosoma japonicum. The liver specimens of mice were used for pathological examination with routine and picric acid-sirius red staining to know the degree of hepatic fibrosis by semi-quantity. The expressions of C-IV and vWF in liver sinusoid were assayed through the immuhistochemistry staining. The serum ALT and AST were detected by the automatic biochemistry analyzer, and the ultramicrostructure of the liver tissue was observed by a transmission electron microscope. Results The number and diameter of fenestrations in SEC reduced 4 weeks after the infection. The fenestrations were disappeared and the base membrane established 8 weeks after the infection. The expressions of C-IV and vWF in liver sinusoid and the degree of hepatic fibrosis increased with the time after infection. The levels of serum ALT and AST were not correlated with the infection time. Conclusions The phenotype alteration of the hepatic sinusoidal endothelium may be a vital issue triggering the liver fibrosis induced by Schistosoma japoncium.

Objective To observe the basic rhythm of myoelectrie activities of sphcter of Oddi (SO)and explore its biological significance.Methods Healthy adult rabbits(n=32)were randomized into 4 groups with 8 in each.The first group was for recording of myoelectric activities of SO after keeping fast for 18 hours.The second group was manipulated to observe the myoelectric activities of SO after food infusion through the stoma in stomach.The myoelectric activities of SO in the third group were monitored after the classical Nardi test was performed on these rabbits.The fourth group was used to observe the myoelectric activities of SO after the cholinergic receptors had been blocked.Using the double claw metal electrodes which were put into SO and duodenum through the plasma membrance,the myoelectric signal were recorded with RM6240 multi-channel physiologic recording and signal processing system and non-stop recording was conducted for 120-150 mins.Results 1)Spike Potentials of SO with the frequency was observed in rabbits that had been fasting.2)Myoelectronic activity of SO was observed in rabbits infused with 50 ml milk through stoma.3)After the administration of 1 mg morphine and 1 mg neostigmine i.v,the myoelectric activities of SO were noted as long-lasting persistent MASO.4)Administration of anisodamine 1 mg(i.v.)in the empty abdomen group dismissed SPSO and MASO.This state lasted for 120 min before SPSO gradually reconverted to the state of empty abdomen.Conclusion There are four patterns of myoelectric activities of SO,i.e,tensional waves under empty abdomen indicating a state in which the SO kept a basic tension level.Peristaltic waves under intake of food.Spastic waves under the stimulation of drugs and relaxant waves under the post-ganglionic block of cholinergic receptors were observed in the present study.Correspondingly,their mechanic locomotion is inferred as the basic tensional state to faciliate the deposition and condensation of bile,the peristalsis for the entry of bile into duodenum,the spasmus so that the bile can not be released into duodenum under pathological situation or the effect of drugs.the long lasting relaxant state after effective inhibition of post-ganglionic cholinergic receptors,respectively.The above results indicate that there are more than two states that is ON or OFF in SO and the concepts of contract and peristalsis of SO should be distinguished.

A questionnaire was used to survey the perspective of the 22 mentors,24 students, 27 graduate students and 27 public health units on the competence of MPH student. The result showed that the practice skill,analyzing skill,program plan and practice skill,and emergency reaction abil-ity got more attention. This suggested that to the training of MPH,the training objective should focus on the ability to resolve problems; the curriculum should focus on the characters of public health and on the practice training.

Purpose To investigate the application value of diffusion weighted imaging (DWI) in differential diagnosis of common liver lipid-containing tumors.Materials and Methods Sixty patients with pathologically confirmed liver lipid-containing tumors from January 2011 to August 2015 were retrospectively analyzed,including 25 cases ofhepatocellular carcinoma (HCC),20 cases of hepatic adenoma (HA) and 15 cases of hepatic angiomyolipoma (HAML).Apparent diffusion coefficient (ADC) value and ratio of ADCtumor/ADCliver (rADC) of tumors were respectively measured.Routine MRI findings were analyzed.Results The MRI findings of these three common liver lipid-containing tumors were with their own characteristics.For HCC,HA and HAML,the average ADC value was (1.225±0.221)×10-3 mm2/s,(1.318±0.212)×10-3 mm2/s and (1.317±0.297)×103 mm2/s,respectively,(b=800 s/mm2);the average rADC value was 1.004± 0.151,0.984 ± 0.146 and 1.027±0.223,respectively.There was no significant difference in ADC and rADC among these three tumors (P＞0.05).Conclusion ADC and rADC had no differential diagnosis value in common liver lipid-containing tumors.Routine MRI signals and enhanced imaging features are the main diagnostic basis.

Objective:To investigate the clinical efficacy of microscopic myringoplasty versus endoscopic myringoplasty in the treatment of tympanic membrane perforation caused by chronic suppurative otitis media. Methods:The clinical data of 91 patients with tympanic membrane perforation caused by chronic suppurative otitis media who received treatment in Jiaxing Second Hospital, China between February 2017 and March 2019 were retrospectively analyzed. These patients were divided into a control group ( n = 45) and an observation group ( n = 46) according to different surgery methods. The control group was given microscopic tympanoplasty, while the observation group was given endoscopic tympanoplasty under the otoendoscope. Results:Blood loss in the observation group was significantly lower than that in the control group [(7.2 ± 2.0) mL vs. (13.7 ± 3.1) mL, t = 11.912, P < 0.001]. Operation time in the observation group was significantly shorter than that in the control group [(59.4 ± 5.4) min vs. (91.5 ± 11.2) min, t = 17.474, P < 0.001]. Postoperative pain score in the observation group was significantly lower than that in the control group [(2.9 ± 0.7) points vs. (4.8 ± 1.3) points, t = 8.707, P < 0.001]. Hospital stay in the observation group was significantly shorter than that in the control group [(4.3 ± 1.0) d vs. (6.5 ± 1.5) d, t = 8.249, P < 0.001]. Pure tone hearing thresholds at 1, 2 and 4 kHz frequencies in the observation group were significantly higher than those in the control group (all P < 0.05). Patient satisfaction regarding the aesthetic effect of the surgical incision in the observation group was significantly higher than that in the control group [97.8% (45/46) vs. 77.8% (35/45), χ2 = 8.604, P = 0.003]. Conclusion:Endoscopic myringoplasty has the advantages including shorter operation time, less blood loss, lower degree of pain, better hearing improvement and higher patient satisfaction over microscopic myringoplasty in the treatment of tympanic membrane perforation caused by chronic suppurative otitis media.

Objective To study the accuracy of preoperative planning and postoperative satisfaction of prosthesis posi?tion by applying the personal surgical cutting guide (PSCG) to total knee arthroscopy (TKA) based on 3D printing technique. Meth?ods In this randomized study, 20 patients were selected from August 2014 to October 2015, who were randomly divided into two groups. In PSCG group, 4 males and 6 females were enrolled, with a mean age of 70.9±6.69 (from 59 to 78) years. In con?ventional instrumentation group, 2 males and 8 females were enrolled, with a mean age of 69.9 ± 6.35 (from 58 to 77) years. The conventional instrumentation group was treated with conventional TKA, while the PSCG group was treated with personal surgical cutting guides. Then the knee valgus angle of patients, the angle between prosthesis components on the coronal and the sagittal plane of two groups were evaluated. Subsequently the correlation of the actual osteotomy amount, the valgus angle, caster angle, external rotation angle between intra? and preoperative planning were compared in the PSCG group. Results Compared with the ideal value of each angle, the mean deviation of the hip?knee?ankle angle 0.77°±0.51°, frontal femoral compo?nent angle 0.37° ± 0.53° and frontal tibial component angle 0.11° ± 0.24° showed statistically significant difference between two groups (P<0.05). The mean deviation of the lateral femoral component angle and the lateral tibial component angle (respectively 8.26°±0.85°, 0.71°±0.77°) were smaller than that of the conventional instrumentation group, while the differences all had no statis?tically significant difference (P>0.05). The actual osteotomy amount, the valgus angle, caster angle, external rotation angle corre?lated well between intra?and preoperative planning (t=-2.547, 3.864, 0.537,-0.040,-1.290, P>0.05). Conclusion TKA assist?ed by PSCG can make lower extremity alignment and accuracy of prosthesis implantation more accurate compared with convention?al TKA, especially in hip?knee?ankle angle, frontal femoral component angle and frontal tibial component angle.