Objective To investigate the pathogenesis of gastroesophageal reflux (GERD) diseaserelated risk factors.Methods A questionnaire survey of 1213 patients in our hospital gastroenterology clinic visits was conducted,including irregular feeding time,eating too full,eating before going to bed,like greasy food,spicy food and alcohol consumption,and smoking.The results of the investigation were rated;95 patients were selected as the observation group,another 30 healthy volunteers were selected as the control group.Esophageal and gastric pressures were measured on the observation group and control subjects,respectively.Results Multivariate logistic regression analysis showed that often eating to satiety (OR =11.5322,P =0.0135),before going to bed eating (OR =14.6537,P =0.0005),like greasy food (OR =11.6547,P =0.0089),spicy food (OR =12.5674,P =0.0031),heavy drinking (OR =10.9874,P =0.0003),and smoking (OR =10.3846,P =0.0013) were important factors affecting the incidence of GERD; length of lower esophageal sphincter (LESL) mean of the observation group was (3.27 ±0.29)cm,intragastric pressure (GP) mean (1.63 ± 1.12) kPa,lower esophageal sphincter pressure/intragastric pressure (LESP/GP) =0.55 ±0.41,LESP-GP mean (-0.33 ±0.34) kPa,with the control group [(3.90 ± 0.42) cm,(1.12 ± 0.94) kPa,1.72 ± 0.82,(0.88 ± 0.41) kPa] were statistically significant (t' =8.99,P ＜0.05,t =2.43,P ＜0.05,t' =8.18,P ＜0.05,t =7.91,P ＜0.01).Conclusions Eating too full,eating before going to bed,like greasy food,spicy food,heavy drinking,smoking,and other bad diet and lifestyle were important risk factors of GERD.The lower esophageal sphincter dysfunction and esophageal clearance capacity play important role in the pathogenesis of gastroesophageal reflux disease.

BACKGROUND: Bone marrow mesenchymal stem cells (BMSCs) as a genetic carrier are beneficial to keep a genetic stability of exogenous gene. BMSCs can transfer human vascular endothelial growth factor (hVEGF) gene into the myocardial infarcted area. It is possible to obtain a cooperation of gene and cell therapy. OBJECTIVE: To investigate the angiogenesis at myocardial infarcted area of rats undergoing the transplantation of BMSCs transfected with hVEGF gene and in vivo expression of VEGF gene. DESIGN, TIME AND SETTING: A randomized control experiment was performed at the Institute of Paediatrics of Hunan Children's Hospital and Central Laboratory of Xiangya Second Hospital of Central South University from 2004 to 2007. MATERIALS: Male clean inbred strain Wistar rats were selected in the study. Rat models of myocardial infarction were established by ligation of coronary artery. METHODS: BMSCs were harvested from rats by density gradient centrifugation and adherent culture. Plasmid PeDNA3. 1-hVEGF 165 were transfected at 80%-90% cell confluence. Rat models of myocardial infarction, constructed by ligation of the left anterior descending coronary artery, were randomly divided into 4 groups. 2 weeks after the ligation,BMSCs transfected with hVEGF gene were injected into rat models in the combination group at the myocardial infarction zone. BMSCs were injected into cell group. Liposome-pcDNA3.1-VEGF165 DNA compound was injected into gene group. Culture medium was injected into control group. MAIN OUTCOME MEASURES: Capillary density and VEGF gene expression in the myocardial infarcted area of rats in each group four weeks after injection. RESULTS: Capillary density was the highest at rat myocardial infarcted area in the combination and gene groups, followed by the cell group (P=0.001, 0.029) and the control group (P=0.028).Reverse transcriptase-polymerase chain reaction (RT-PCR) showed that the hVEGF165 gene was expressed in the combination, gene, cell and control groups from higher level to lower level in order. CONCLUSION: BMSCs as the vector of VEGF gene are beneficial to its stable expression.Transplantation of BMSCs transfected with hVEGF gene is helpful for angiogenesis at myocardial infarcted area of rats. Its outcome is better than gene or cell therapy alone.

Objective To investigate the operative procedure for complicated patent ductus arteriosus.Methods 87 cases of complicated patent ductus arteriosus who received operation from Oct 1993 to Aug 2001 were studied retrospectively.Results Operations supported by cardiopulmonary bypass for closure of complicated patent ductus arteriosus and other concomitant cardiothoracic procedures were performed on the all patients at the same time. There were 5 cases of deaths, with dead rate of 5 7%, which mainly caused by heart failure. 82 survivals were followed up at mean period of 3 years and 7 months, and no operative complications occurred.Conclusions Closure for complicated patent ductus arteriosus with correction of concomitant cardiothoracic malformation supported by cardiopulmonary bypasss is a effective treatment of complicated patent ductus arteriosus.

Objective To investigate the value of roentgen stereophotogrammetric analysis (RSA) in assessing early migration of femoral implant after total hip arthroplasty (THA) with modular prostheses.Methods From May 2009 to April 2010,37 patients underwent THA with modular prostheses inour hospital,including 25 males and 12 females,aged from 58 to 72 years (average,60.23±5.64 years).There were 32 cases of degenerative osteoarthritis,3 cases of femoral neck fracture and 2 cases of developmental dysplasia of the hip.The Harris hip score and RSA were used to assess the clinical results and the migration of femoral implant at 3,6,12,24 months postoperatively,respectively.Results The average Harris hip score improved from preoperative 26.36 ±10.56 to 78.24±12.72,84.51±16.05,86.72±9.34,and 87.55±8.97 at 3,6,12,and 24 months after operation,respectively,and the differences between pre-and post-operative Harris score were significant.There was no prosthetic revision,and slight thigh pain occurred in 3 patients.According to RSA,the degree of initial migration of femoral implant had large individual differences,and the initial migration was higher from 3 to 6 months after operation.Clinical and biological stabilization was achieved in 36 patients,while progressive migration was found in 1 patient.There was a positive correlation between the distal migration and posterior migration within 24 months after operation (r=0.3,P=0.01).The distal migration and posterior migration/rotation mainly occurred within 3 months after operation.There was no correlation between prosthetic size/offset and degree of migration of implant.Conclusion RSA provides an objective reference for assessing the migration of femoral implant after THA with modular prostheses,which is a reliable method to evaluate early implant stability.

Objective To investigate effects of three kinds of neutral,happy,sad emotional faces stimulus on sustained attention task using N170 in depression patients to analysis the correlation of depression in patients with depression,anxiety severity and the amplitude and latency of N170.Methods Twenty-eight patients with depression aged from 22 to 69 years (case group),and 31 healthy controls (control group) aged from 20 to 61 years were recruited for the study.Subjects were asked to perform tasks in the selection of attention following randomly presented three kinds of happy,neutral and sad emotional faces stimuli.Brain auditory evoked potential including N170 amplitude and latency were recorded during the tasks.HAMD and HAMA were used to assess the severity of depression and anxiety.Results There was significant difference between case group and control group in N170 latency by three kinds of happy,neutral and sad emotional faces stimulation in the local skull (T5,T6,O1,O2) (P＜0.05).But the difference was not significant in N170 amplitude (P＞0.05).The total score of HAMD in case group had a positive correlation with N170 amplitude by neutral facial emotion stimulation in part of T5 (r=0.443,P=0.018).Conclusion There is significant change in the initial cognitive processing of different emotional faces in the patients with depression.And the severity of depression is related to the N170 amplitude induced by the neutral emotional faces stimulation in some parts of brain.

Abstract: Objective To analyze the correlation between the thromboelastography (TEG) indexes and the indexes related to liver injury in patients with heat stroke, and explore the diagnostic value of TEG indexes for liver injury in patients with heat stroke. Methods A total of 95 patients with exertional heat stroke (EHS) admitted to 924 Hospital of the Joint Service Support Force of the People's Liberation Army of China from August 2020 to July 22 were selected, and divided into a non-liver injury group (55 cases) and a liver injury group (40 cases) according to whether there was liver injury. TEG instrument was used for the detection of thromboelastography to record the TEG parameters, including reaction time (R), agglutination time (K), α angle, maximum amplitude (MA value), and coagulation complex index (CI). The levels of glutamic transaminase (AST), alanine aminotransferase (ALT), total bilirubin (TBil), albumin (ALB) were detected by automatic biochemical analyzer. Pearson's method was applied to analyze the correlation between thromboelastography indexes R, K, α angle, CI and liver function indexes AST, ALT, TBil, ALB in patients with heat stroke after liver injury. Receiver operating characteristic curve (ROC) was applied to analyze the predictive value of thromboelastography indexes R, K, α angle, CI and combined detection for liver injury in patients with heat stroke. Results Compared with the non-liver injury group, the AST, ALT and TBil levels in patients with heat stroke in the liver injury group were higher (t=26.174, 16.923, 18.414, P<0.05), while the ALB level was lower (t=24.596, P<0.05); compared with the non-liver injury group, the R and K of patients with heat stroke in the liver injury group were higher (t=58.014, 52.862, P<0.05), and the α angle and CI were lower (t=46.853, 60.717, P<0.05); R was positively correlated with AST and ALT (r=0.532, 0.610, P<0.001), and negatively correlated with ALB (r=-0.551, P<0.001) in patients with heat stroke complicated with liver injury; K was positively correlated with AST, ALT and TBil (r=0.661, 0.531, 0.504, P<0.001); α angle was negatively correlated with AST and ALT (r=-0.473, -0.448, P<0.01), and positively correlated with ALB (r=0.539, P<0.001); CI was negatively correlated with AST, ALT and TBil (r=-0.458, -0.505, -0.549, P<0.001); the area under the curve (AUC) of thromboelastography indexes R, K, α angle and CI in predicting liver injury in patients with heat stroke was 0.807 (sensitivity of 70.0%, specificity of 81.6%), 0.831 (sensitivity of 77.5%, specificity of 85.5%), 0.747 (sensitivity of 67.5%, specificity of 74.5%), and 0.788 (sensitivity of 77.5%, specificity of 83.6%), respectively. The AUC of combined detection to predict liver injury in patients with heat stroke was 0.967 (sensitivity of 92.5%, specificity of 91.9%). Conclusions The thromboelastography indexes are correlated with the indexes related to liver injury in patients with heat stroke, and the thromboelastography indexes are helpful to diagnose liver injury in patients with heat stroke.

Objective To study the feasibility and safety of limb remote ischemic preconditioning (RIPC) in infants and explore the protective effect on myecardium ischemia reperfusion injury for infants undergoing cardiac operation under cardiopulmonary bypass. Methods 60 infants weight less than 7 kilograms with ventricular septal defect were enrolled into the study. 30 of them (RIPC group) were ischemic preconditioned two times (24 hours and 1 hour preoperatively) by three cycles of iscbemia (5 minutes for each) and reperfusion on the left upper arm using a blood pressure cuff. Serum lactate dehydrogenase (LDH), creatine kinase (CK) and its isoenzyme (CK-MB), and tro-ponin I (TnI) ; malondialdehyde (MDA) and superoxide dismutase (SOD) was preoperatively detected. The expression of heat shock pro-tein 70 (HSP 70) in cardiomyocytes was determined by western blot analysis. The surgical outcome including limb movement and sensory function was also recorded. Results No limb disability or sensory disturbance or no other surgical complications was found in all infants. LDH, CK, TnI at the beginning of operation in RIPC group was higher than those in control group. After operation, leakage of heart enzymes were attenuated in RIPC group, and the serum concentration of enzymes were lower than those in the control group. The RIPC group had low coronary sinus venous concentration of MDA but high SOD. The expression of HSP70 was upregulated in cardiomyocytes of RIPC group. Conclusion The limb RIPC can be done easily and safety in infants, and BIPC can reduce the leakage of myocardial enzymes and upregu-late the expression of HSP, which possess protective effect on myocardial IRI.

Objective To discuss the effect of group social skills training on improving psychiatric symptoms and disability and the family relationship in patients with schizophrenia.Methods 101 followup patients of rehabilitation with schizophrenia in mental health center of a top three hospital and in a community were chosen from June 2011 to August 2012.Based on the principle of voluntary,45 and 56 patients were grouped into the control group and the intervention group,respectively.The scores of psychiatric symptoms,mental disability and family relationship were compared between two groups by independent sample test.Results At the end of six months,the score of positive and negative symptoms and mental disability were lower in the intervention group,and there was significant difference in different measuring time,the interaction existed between the intervention and the measuring time.Meanwhile,the total score of family concern in the intervention group was higher than that in the control group,and there was significant difference in different measuring time,no interaction existed between the intervention and the measuring time.Conclusions Group training of social skills could improve psychiatric symptoms and the family relationship of patients with schizophrenia,reduce mental disability and promote recovery of patients.

Objective To explore the changes of plasma corticotrophin releasing factor (CRF) levels in the young rats with hypoxic-ischemic brain damage.Methods Two hundred and forty young rats were randomly divided into three groups:hypoxic-ischemic brain damage group ( model group,n =80),sham-operated group ( n =80),and normal control group ( n =80).The plasma CRF levels of rats in three groups were detected at 1 h,3 h,6 h,12 h,l d,3 d,5 d and 18 d after hypoxia-ischemia,per ten rats for each time point.Plasma CRF levels were measured by radioimmunoassay.Results Plasma CRF levels of model group,shamoperated group and normal control group showed no significant difference in the young rats after 1 h,3 h,6 h,12 h of hypoxia-ischemia ( P ＞ 0.05 ).But plasma CRF levels in the model group were respectively significantly lower than those of sham-operated group and normal control group after 1 d and 3 d of hypoxia-ischemia ( P ＜0.001 ),and then recovered to the control group levels after 5 d and 18 d of hypoxia-ischemia ( P ＞0.05 ).Conclusion Hypoxia-ischemia affects plasma CRF levels in the young rats,which is related with the duration after hypoxia-ischemia.

ObjectiveTo introduce a new technique to create a pulmonary valve biorifice for reconstruction of right ventricular outflow tract in tetralogy of Fallot (TOF),and to summarize its initial clinical experience and therapeutic effect.MethodsThe new technique regarding reconstruction of right ventricular outflow tract with a pulmonary valve biorifice was used in a total of 53 TOF cases (the observation group).The conventional technique regarding reconstruction of right ventricular outflow tract was used in other 50 TOF cases (the control group).The clinical dates of all cases were reviewed retrospectively.ResultsThe ages,weights,cardiopulmonary bypass time,cardiac arrest time,as well as the post operation ventilation support time were not different significantly between two groups.Compared with the contrul group,patients from the observation group had shorter duration of ICU stay.After operation,in the observation group,only 2 cases had large amount of pleural effusion,1 case meddle,and 8 cases little amount of pleural effusion; whereas,in the control group,the corresponding numbers were 1,5 and 17,respectively.At the time point of 1 week after operation,all patients were rechecked by echocardiography,no pulmonary valve stenosis was found.Moderate pulmonary valve regurgitation was found in 8 cases,mild regurgitation in 15 cases from the observation group; and severe regurgitation in 3 cases,moderate regurgitation in 17 cases,and mild regurgitation in 16 cases from the control group.A total of 33 cases from the observation group were rechecked at the time point of half year after operation,and moderate - mild pulmonary regurgitation were found in 3 cases.A total of 18 cases of them were rechecked 1 - year latter,no pulmonary regurgitation was found.ConclusionsThe new technique to create pulmonary valve biorifice can reduce the pulmonary valve regurgitation and postoperative pleural effusion,and improve the early outcomc.