Objective To assess the curative effect and safety of endoscopic therapy at duodenum elevated lesions. Methods We retrospectively studied the clinical data including general data, the procedure of performance, the lesions pathological characters, complications and recurrence after the treatment of patients who underwent endoscopic treatment. Results 111 patients of 112 patients were treated by endoscopic treatment successfully, 1 case was treated by surgery. 49 lesions were treated by electrocoagulation, 36 lesions were treated by polypectomy or endoscopic mucosal resection (EMR), 27 by endoscopic submucosal dissection (ESD). Complication rate was 16.96%(19/112), 1 case of active bleeding was treated by surgery in hemostasis difficulty. 6 cases of perforation, 2 cases of delayed bleeding, 2 cases of transient increase in amylase level and 1 case of delayed perforation. All the patients were successfully performed. Post-operation follow-up period was 1~12 months. Conclusion Endoscopic treatment holds advantages of minimally invasive, quick recovery, low cost, and less risk which may be play an important role in duodenal elevated lesions.

Objective To investigate the clinical efficacy of combined acupuncture and medicine plus ultrashort wave diathermy in treating post-stroke complicated urinary tract infection.Methods One hundred and twenty patients with post-stroke complicated urinary tract infection were randomly allocated to groups A, B and C, 40 cases each. Group A received acupuncture, ultrashort wave diathermy and treatment with anti-infective drugs; group B, ultrashort wave diathermy and treatment with anti-infective drugs; group C, treatment with anti-infective drugs alone. The clinical therapeutic effects and the recurrence rates were compared between the three groups.Results The total efficacy rate was 92.5% in group A, 90.0% in group B and 72.5% in group C. There was a statistically significant difference in the total efficacy rate between group A or B and group C (P<0.05). The recurrence rate was 8.1% in group A, 27.8% in group B and 31.0% in group C. There was a statistically significant difference in the recurrence rate between group A and group B or C (P<0.05).Conclusion Combined use of acupuncture and medicine plus ultrashort wave diathermy is an effective way to treat post-stroke complicated urinary tract infection.

Objective To investigate the effects and mechanisms of omega-3 polyunsaturated fatty acids (ω-3 PUFA) supplementation on colonic macroscopic and histological score , inflammatory response , and endo-plasmic reticulum stress ( ERS ) response in experimental rat models of colitis .Methods Experimental rat models of colitis were induced by trinitro-benzene-sulfonic acid (TNBS).Totally 100 male SD rats were ran-domly divided into 5 groups according to the random data tables:sham operation group ( Sham group ) , inflam-matory bowel disease group (IBD group),ω-3 PUFA supplementation group (IBD+ω-3 group), 5-aminosali-cylic acid group ( IBD +5-ASA group ) , and ERS activation 2-deoxy-D-glucose group ( IBD +ω-3 +2-DG group).Colonic macroscopic and histological scores were evaluated on days 1, 3, 7 and 14 after modeling.The serum levels of tumor necrosis factor-α(TNF-α), interleukin (IL) -1, and IL-6 were measured using en-zyme-linked immunosorbent assay , whereas ERS cytokines including glucose-regulated protein 78 ( GRP78 ) , inositol-requiring enzyme 1 (IRE-1), and C/EBP homologous protein (CHOP) were tested by Western blot. Results Compared with the Sham group , colonic macroscopic and histological score , the serum levels of in-flammation relatived factors (TNF-α, IL-1, IL-6) and ERS relatived factors (GRP78、 IRE-1, CHOP) were significantly increased on the rest of the four groups ( all P<0.001 ) .Compared with the IBD group , ω-3 PUFA supplementation reduced colonic macroscopic [7 d: 3.55 ±0.29 vs.4.37 ±0.39, P=0.03, 14 d:2.46 ±0.17 vs.3.86 ±0.21, P=0.04] and histological score [7 d: (2.56 ±0.27) scores vs.(3.45 ± 0.40) scores, P=0.02, 14 d: (2.23 ±0.20) scores vs.(3.06 ±0.26) scores, P=0.04].Meanwhile,ω-3 PUFA supplementation suppressed the expressions of inflammation [TNF-α:(43.71 ±11.39) pg/ml vs. (84.97 ±13.81) pg/ml, P=0.02, IL-1:(38.51 ±10.60) pg/ml vs.(73.04 ±12.48) pg/ml, P=0.01, IL-6:(28.91 ±7.27) pg/ml vs.(53.45 ±9.40) pg/ml, P=0.02] and ERS relatived factors (GRP78:2.41 ±0.29 vs.1.47 ±0.21, P=0.01, IRE-1:2.83 ±0.31 vs.1.23 ±0.20, P<0.001, CHOP:1.89 ± 0.17 vs.1.32 ±0.11 , P=0.04 ) .However , the salutary effects of ω-3 PUFA would been reversed by ERS activation 2-deoxy-D-glucose [ TNF-α: (72.67 ±10.37 ) pg/ml vs.(43.71 ±11.39 ) pg/ml, P =0.02, IL-1:(57.66 ±13.88) pg/ml vs.(38.51 ±10.60) pg/ml, P=0.02, IL-6: (46.10 ±9.67) pg/ml vs. (28.91 ±7.27) pg/ml, P=0.01, GRP78:1.47 ±0.21 vs.1.82 ±0.24, P=0.03, IRE-1:1.23 ±0.20 vs.2.21 ±0.23, P=0.02, CHOP:1.32 ±0.11 vs.1.61 ±0.16, P=0.04].Conclusion The salutary effects of ω-3 PUFA supplementation on the colitis induced by TNBS appear to be mediated by inhibited inflam -matory responses , which may suppress the activation of ERS response .

Objective·To investigate and compare the curative effect of rubber ring and dental floss combined with hemoclipping assisted endoscopic submucosal dissection(ESD) on gastrointestinal tumors.Methods·A total of 54 patients with gastrointestinal tumors were collected.Twenty-seven patients in rubber ring group accepted ESD assisted by rubber ring with hemoclipping,and the other 27 patients in dental floss group accepted ESD assisted by dental floss.with hemoclipping.Duration of the operation,installation time of the traction device,detachment frequency of hemoclipping,injury of mucosa,one-time complete resection rate,and complication rate were analyzed as key indicators.Results·The detachment frequency of hemoclipping in rubber ring group was significantly less than that in dental floss group (t=4.418,P＜0.05).There was no injury of mucosa in rubber ring group,while,three patients had mucosa injury in dental floss group.There was no statistically significant difference on duration of operation,installation time of traction device,one-time complete resection rate,and complication rate between two groups.After 2 ～ 12 months of follow-up,the wound healed well in all patients in rubber ring group.No evidence of tumor recurrence was noted.Conclusion·Compared with dental floss,rubber ring combined with hemoclipping is superior in assisted ESD,especially in the right half colon.It is an effective assist device with little trauma and adjustable direction.

Objective To investigate the bacterial distribution and antibiotic resistance situation of urinary tract infection (UTI) among the inpatients following stroke. Methods The clinical data of pathogens from UTI in the stroke patients in our hospital from March 2009 to March 2011 were collected and analyzed with WHONET software. Results Among 203 strains from UTI, the most common pathogens were Escherichia coli (35.5%), Enterococcus (27.1%), Klebsiella (8.9%) and Fungi (10.8%). The main Gram negative bacilli were found highly resistant to ampicillin, levofloxacin and cefotaxim. 38.9% of Escherichia coli and 44.4% of Klebsiella produced extended-spectrum β-lactamases (ESBLs) respectively. The rate of antibiotic resistance of Enterococcus was high to the most of antibiotics commonly used. The fungi were highly sensitive to the drugs. Conclusion Gram negative bacilli are the main pathogens of urinary tract infection in stroke inpatients. Drug resistant strains, especially those with severe multiple resistance, increase fast.

Objective To observe the effects of immune acupuncture and moxibustion on the infection in hospital and the outcome of re-habilitation after stroke. Methods From January, 2014 to January, 2016, 100 patients following acute stroke were randomly divided into ob-servation group (n=50) and control group (n=50). The control group accepted routine medications, rehabilitation and acupuncture, while the observation group accepted acupuncture and moxibustion on Guanyuan (RN4), Qihai (RN6) and Zusanli (ST36) in addition. The nosocomi-al infection rate was recorded 90 days after treatment, and the T lymphocyte subsets, scores of Fugl-Meyer Assessment (FMA) and modified Barthel index (MBI) were measured before and after treatment. Results The nosocomial infection rate was 20% in the observation group, less than 42% in the control group (χ2=5.657, P<0.05). The contribution of CD3+ and CD4+ T lymphocytes, and the scores of FMA and MBI increased after treatment in both groups (t>2.463, P<0.05), and increased more in the observation group than in the control group (t>2.225, P<0.05). Conclusion Immune acupuncture and moxibustion therapy can reduce the incidence of nosocomial infection, and promote the func-tion of the immune system and outcome in patients after acute stroke.

BACKGROUND:The effects and molecular mechanism of simvastatin on the proliferation and differentiation of osteoblasts remain unclear. Especial y, we do not know much about the effects of connexin 43.
OBJECTIVE:To evaluate the effects of simvastatin on the proliferation and differentiation of osteoblasts and the regulatory effect of simvastatin on the expression of osteogenic genes and connexin 43.
METHODS:Newborn Sprague-Dawley rats were chosen and the cranium digestion method was used to culture osteoblasts. The different concentrations of simvastatin (0.062 5, 0.125, 0.25, 0.5 and 1.0μmol/L) were used to deal with osteoblasts. The proliferative effect of simvastatin on osteoblasts was measured with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide. The effect of simvastatin on osteoblast differentiation was measured with alkaline phosphatase activities. The mRNA and protein expression of osteogenic genes and connexin 43 were measured by real time quantitative RT-PCR and western blot assay.
RESULTS AND CONCLUSION:There were no significant differences in absorbance values of simvastatin groups at 3 days (P>0.05). However, at 4 and 5 days, absorbance values were lower in the simvastatin groups than those in the control group (P<0.05). Compared with the control group, alkaline phosphatase activities of osteoblasts were greater in the simvastatin groups (P<0.05). Moreover, the effects of 0.25μmol/L simvastatin on alkaline phosphatase activities of osteoblasts were most significant. Osteocalcin, alkaline phosphatase activities, type I col agen and connexin 43 mRNA and protein expressions were increased after treatment with 0.25μmol/L simvastatin (P<0.05). These results indicated that simvastatin may inhibit the proliferation and improve the differentiation of osteoblasts by upregulating the mRNA and protein expression of osteogenic genes and connexin 43. These data may provide the new intervention target for osteoporosis treated with statins.

Objective To explore the effects of pretreatment of bone marrow mesenchymal stem cells (BMSCs) by ultrasound-exposed microbubbles (UM) on both homing to ischemic myocardium and cardiac function after acute myocardial infarction (AMI).Methods Rats of AMI model established by ligation of left anterior descending coronary artery were divided into four groups randomized:phospho-buffered saline (PBS) group,stem cells treatment (SCT) group,ultrasound and stem cells treatment (USCT) group,and UM stem cells treatment (UMSCT) group,and each group was injected with PBS,stem cells,US-pretreated stem cells and UM-pretreated stem cells through the caudal veins after AMI respectively.Homing of BMSCs to the ischemic myocardium was examined by confocal microscopy at 48 h after implantation,and cardiac function was examined by ultrasonic cardiogram (UCG) after 4 weeks.Masson staining was used to examine the changes of local ischemic cardiac tissues,and immunohistochemistry was used to detect the density of local neo-capillaries (CD31).Results 1) The numbers of CM-Dil-positive cells counted under confocal microscopy in the ischemic myocardial tissues of each groups 48 hours after implantation were not the same:there was no significant difference of the numbers of positive cells between USCT group (19.67 ±2.08) and SCT group (18.67 ± 2.08).However,the number of positive cells in the UMSCT group (39.33 ±3.06) was larger than that in USCT group and SCT group (P ＜0.05).2) UCG examinations showed that there was no significant difference of left ventricular systole function between the USCT group [LVEF (44.92 ± 2.77)％,LVFS (22.83 ± 1.79)％] and SCT group [LVEF (42.28 ± 2.82)％,LVFS (21.52 ±1.88) ％,P ＞0.05],but both were better than that in PBS group [LVEF (20.52 ± 1.88)％,LVFS (9.55 ±0.85) ％,P ＜0.05].The left ventricular systolic function in UMSCT group [LVEF (61.85 ± 3.15)％,LVFS (32.74± 2.45)％] was significantly higher than that in USCT group and SCT group (P ＜0.05),while which was still significantly lower than that in pseudo-surgery group [LVEF (75.88± 4.52)％,LVFS (42.76 ± 2.88)％,P ＜0.05].3) Pathological examinations showed the percentages of AMI areas in the USCT group (35.9 ± 1.1％) were not different compared with that in SCT group [(36.5 ± 1.3)％,P ＞0.05],while both were significantly smaller than that in PBS group [(45.2± 1.4)％,P ＜0.05].The percentages of AMI areas in the UMSCT group [(25.8 ± 1.0)％] were significantly smaller than that in USCT group and SCT group (P ＜0.05).The density of neo-capillaries (25.9 ± 1.3) in USCT groups had no difference compared with that in SCT group (25.2 ± 1.3),while both were significantly higher than that in PBS group (17.6 ± 1.1,P ＜0.05);the density of neo-capillaries (33.2 ± 1.6) was significantly higher in UMSCT group than that in both USCT group and SCT group (P ＜0.05),which were examined by immunohistochemistry.Conclusions Homing to ischemic myocardium of BMSCs transplanted intravenously could be promoted by UM pretreatment,which stimulates development of capillaries,reduces AMI areas,and improves the cardiac function after AMI.

Objective To report the effect of expanded neck and mastoid region flap in the reparation of facial scars.Methods Total 8 patients were included from January 2007 to May 2011.Tissue expanders were implanted in the neck and mastoid region after we selected suitable expander on the basis of an area of facial scars.Three to six months later,the expanded neck and mastoid region flap was used to repair large area of facial scars.Results From January 2007 to May 2011,we used expanded neck and mastoid region flap to resurface the facial scars in 8 patients.One patient appeared small size of necrosis (0.3 cm× 2.0 cm to 0.5 cm× 2.0 cm) in the distal area and healed after dressing changes.All the other patients healed completely.The period of follow-up was 6 months to 2 years.The flaps matched well to the surrounding skin in terms of color and good texture.Conclusions The method of combined expander neck and mastoid region skin flaps to repair facial scars is suitable.We believe this is a good option of repairing large area of facial scars.

Objective To analyze the imaging features of congenital spinal deformity (CSD) associated with split cord malformation (SCM) and other intraspinal abnormalities, and to investigate the relationship to neurological symptoms. Methods 105 cases CSD with SCM were retrospectively studied. Analysis the imaging features of SCM (including type of SCM, location of SCM, location and apical vertebrae, symmetry of divided cord) and other intraspinal abnormalities. To investigate the relationship of the factors and neurological symptoms using Chi?square test of one factor and multiple factors logistic regression analysis. Re?sults 28 cases (26.7%) were formation failure, 33 cases (31.4%) were segmentation failure, and 44 cases (41.9%) were combina?tion of 2 disorders. 41 cases had neurological symptoms, 64 cases were asymptomatic. The distribution of SCM combined with spi?nal deformities:thoracic (11 cases), thoracolumbar (18 cases) and lumbar (20 cases) in type I SCM, thoracic (31 cases), thoracolum?bar (20 cases) and lumbar (5 cases) in type II, none was in cervical. The location of SCM upper than apical vertebrae 29 cases, on apical vertebrae 25 cases, lower than apical vertebrae 51 cases. Spinal cord was splitted symmetric 27 cases and asymmetric 78 cases. 66 cases combined with other intraspinal abnormalities, lower conus 42 cases, syringomyelia 38 cases, meningocele 10 cas?es and sakrale zyste 5 cases. Associated with intraspinal abnormalities, the rate of neural symptoms was different. According to Chi?square test of one factor and multiple factors logistic regression analysis, lumbar SCM, spinal cord asymmetric and lower conus were related with neurological symptoms. Conclusion The predilection spinal deformity of type I is combination, type II SCM is segmentation failure. When SCM patients associated with other intraspinal abnormalities, the incidence of neurologic symptoms is increased. The lumbar SCM, hemicords asymmetry and lower lying conus have significant relationship with neurologic symptoms.