OBJECTIVE:To observe the efficacy of small dose of uremic clearance granule combined with colon enema on aged patients with chronic renal failure(CRF) . METHODS:60 aged CRF patients were randomly divided into treatment group(n=30) and control group(n=30) . Two groups were given essential treatment. Control group were treated with medicinal carbon additionally. Treatment group were additionally treated with uremic clearance granule(p.o.) combined with colon enema. The course of treatment was 15 days and curative effects were compared between two groups after 30 days of treatment. RESULTS:30 days later clinical symptom of patients in treatment group was obviously improved and the levels of blood urea nitrogen,serum creatinine,blood uric acid and serum potassium were lower than before treatment with significant difference. CONCLUSION:Small dose of uremic clearance granule combined with colon enema show satisfactory effect on CRF in aged patients as well as simple,practical and good compliance. This therapy is worth of spreading and putting into application.

Objective The clinical features of elderly patients with severe acute pancreatitis (SAP) were atypical and these patients were often misdiagnosed as having paralytic ileus. The clinical presentations of elderly patients with SAP whose first diagnosis as paralytic ileus were analyzed. Methods 18 patients of elderly SAP who were misdiagnosed as having paralytic ileus were included and the clinical data were compared with 58 elderly patients with SAP. Results Among the misdiagnosis group, the first symptom onset were fleus, abdominal distension, vomiting, constipation, abdominal pain, diarrhea for 5, 4, 3, 3, 2, 1 case, respectively. Among SAP group, the first symptoms onset were 2, 31, 9, 3, 11, 2 cases, respectively. For misdiagnosis group, 13 cases were correctly diagnosed by CT scan, 3 cases by ultrasound and 2 cases by serum amylase test. For SAP group, 32, 15, 11 cases were diagnosed by CT scan, ultrasound and serum amylase, respectively (P < 0.05). 4 and 13 patients died in misdiagnosis and SAP group, respectively; among these 13 patients, 10 were female and 3 were male. Conclusions The elderly patients with paralytic ileus should consider the possibility of SAP, and CT scan was valuable for correct diagnosis.

Gap junction has been considered allowing direct transfer of small metabolites between cells to maintain homeostasis in multicellular organisms. Deficient gap junction involved in genesis and development of many central neurological disorder, and may be a potential target for the treatment of them.

Objective To investigate the clinical significance of preoperative colonoscopy for patients with benign anal diseases,and to compare the success rates of examination done by sedated colonoscopy and conventional colonoscopy.Methods The clinical data of 333 patients with benign anal disease who received preoperative colonoscopy at the Six Affiliated Hospital of Sun Yat-Sen University from April 2010 to March 2011 were retrospectively analyzed.All the patients were divided into the lesion group (120 patients) and normal group (213 patients)according to the results of colonoscopy.The measurement data and count data were analyzed using the t test and chi-square test,respectively.Results The age of patients in the lesion group was (48 ± 14) years,which was significantly older than (42 ± 14) years (t =3.75,P ＜ 0.05).The constituent ratio of patients older than 40 years in the lesion group was 72.50％ (87/120),which was significantly higher than 39.44％ (84/213) in the normal group (x2=33.59,P ＜0.05).The proportions of male and female patients were 71.67％ (86/120) and 28.33％ (34/120) in the lesion group,and 62.44％ (133/213) and 37.56％ (80/213) in the normal group,with no significant difference between the 2 groups (x2 =2.90,P ＞ 0.05).The benign anal diseases in the lesion group included polyp (80 cases),enteritis (30 cases),malignant tumor (7 cases),infflammatory bowel disease (7 cases),diverticulum (5 cases) and ulcer (1 case).The application rates of sedated colonoscopy in the lesion group and the normal goup were 51.67％ (62/120) and 54.93％ (117/213),respectively,with no significant difference between the 2 groups (x2=0.33,P ＞0.05).The success rate of terminal ileum intubation was 99.44％ (178/179) in patients who received sedated colonoscopy,which was significantly higher than 95.45％ (147/154) of patients who received conventional colonoscopy (x2 =5.61,P ＜ 0.05).Conclusion Patients with benign anal disease might complicated with colorectal lesions,and sedated colonoscopy is recommended for preoperative diagnosis,especially for patients who are older than 40 years.

Objective To explore the diagnostic value of magnetization transfer imaging (MTI) and DWI for detecting intestinal wall property of crohn's disease (CD). Methods Forty four patients with CD were prospectively enrolled in the study, and MR enterography (MRE), MTI and DWI were performed. According to MRE findings, patients were divided into three subgroups:acute inflammatory group, chronic fibrotic group and combined inflammatory with fibrotic group. Intestinal wall T2WI signal, magnetization transmisson rate (MTR) and ADC value were measured on MRE, MRI and DWI imagings, respectively. The differences of MTR and ADC among the three groups were analyzed by one-way ANOVA;the differences of T2WI scores were analysed by Kruskal Wallis;the differences of MTR and ADC values between normal and pathological intestinal wall were analyzed by paired t test;ROC curve were used to evaluate the CD fibrosis and inflammation diagnostic efficiency of MTI ana DWI based on MRE signs. Results Among the 44 cases, 11 cases were in the acute inflammatory group, 18 cases were in the chronic fibrotic group and other 15 cases were in the combination group. The T2WI score, MTR and ADC among the three groups showed significant differences (all P<0.01).The mean MTR and ADC of pathological intestinal wall of the 44 cases were (40.77±6.05)%and (1.04±0.18)× 10-3mm2/s, and the adjacent normal bowel were (21.75±4.17)%and (1.97 ± 0.23) × 10- 3mm2/s, respectively. Moreover, the difference of the above values showed significant differences (t=19.12,-21.80 respectively, all P<0.01). There was a negative correlation between MTR and T2WI score (r=-0.71,P<0.01). While ADC value was positively correlated with T2WI score (r=0.80, P<0.01). Using ROC curve analysis to differentiate the CD fibrosis from acute inflammation, the area under the curve (AUC) of MTR and ADC were 0.97 and 0.96 ,respectively. Conclusions Both MTI and DWI can be used to assess the properties of intestinal wall, which has the same diagnostic efficacy to identify the acute inflammation and fibrosis.

Objective To observe the changes of artery elasticity in patients with High-Normal Blood Pressure(HNBP) by ET, and search bound values in diagnosis by ROC. Methods Comparative analysis of artery IMT and β, Ep, AC, PWVβ with HNBP and normal group, which were analyzed by ROC. Results Compared with the normal group, β, Ep, PWVβ were increased in HNBP group, AC was lower significantly. Conclusion The peripheral artery elasticity have reduced before the artery IMT didn′t appear morphological change.

Objective To explore the application of team-based learning (TBL) and problem-based learning (PBL) method in clinical teaching of laparoscopic surgery in general surgery. Methods 48 students of surgery in our department were selected as the subjects to conduct the clinical teaching study. These students were divided randomly into two groups. The experimental group (24 students) adopted the method that combined TBL and PBL method, while the control group (24 students) adopted the traditional teaching method. We compared the efficacy of two groups in term of theoretical knowledge, surgical practice, com-prehensive surgical grade, and questionnaire survey. Results The score of theoretical knowledge and sur-gical practice on clipping soybean and making suturation and instrumental tie of two groups were obviously higher than that before teaching. After finishing teaching, the score of experimental group on theoretical knowledge, making suturation and instrumental tie and comprehensive surgical grade were higher than that of control group. The score of clipping soybean was similar between two groups. In addition, in term of questionnaire survey on the consciousness of independent study, the depth and width of study, and satisfac-tions to teaching, the TBL and PBL group had a better score than the control group. Conclusion The new teaching method which combines TBL with PBL enhances the teaching effect on theoretical knowledge and laparoscopic surgery practice. It is an effective method to train medical students.

Objective:To investigate the effect of human growth hormone releasing hormone receptor splice variant type 1 (GHRHR SV1) on the proliferation of human liver cancer HepG2 cells,and to clarify the proliferation effect of GHRHR SV1 on the human cancer cells.Methods:The GHRHR SV1 plasmids were transfected into the human HepG2 cells to construct the HepG2-SV1 cell line.HepG2 group(HepG2 cells),HepG2-empty group(HepG2-pcDNA3.0 cell line) and HepG2-SV1 group(HepG2-SV1 cells) were set up.PCR and Western blotting methods were used to identify the HepG2-SV1 cell line;CCK-8 method was used to detect prolifernation rate of cells;colony formation assay was used to detect the colony formation rate of cells;cell wound healing assay was used to evaluate the migration rate of cells.Results:The PCR and Western blotting results showed the HepG2-SV1 cell line expressed GHRHR SV1 steadily.The CCK-8 results showed that the proliferation rate of the HepG2-SV1 cells in HepG2-SV1 group was higher than that of the HepG2-pcDNA3.0 cells in HepG2-empty group(P<0.05).The colony formation assay results showed that the colony formation rate of HepG2-SV1 cells in HepG2-SV1 group was 3.5 times higher than that of the HepG2-pcDNA3.0 cells in HepG2-empty group(P<0.05).The cell wound scratch assay results showed that the migration rate of the HepG2-SV1 cells in HepG2-SV1 group was higher than that of the HepG2-pcDNA3.0 cells in HepG2-empty group(P<0.05).Conclusion:GHRHR SV1 could increase the proliferation of HepG2 cells.

Objective To compare T and N staging of esophageal and cardia cancer by endoscopic ultrasonography (EUS) and computed tomography (CT) before operation, and to evaluate clinical value of EUS.Methods Twenty-eight patients received examination of EUS and CT preoperatively, and the T and N staging was determined. The accuracy rates of both T, N staging were compared by the postoperative pathological results, at the same time, the accuracy rates of lymph node metastasis were compared, and the value of application of EUS was investigated. Results In the twenty-eight cases, the accuracy rates of EUS were higher than that of CT by 89.3% ( 25/28 ) to 46.4% ( 13/28 ) in T staging. And the difference had statistical significance( P = 0. 004 ,P ＜ 0.01 ). The N stagings of both were 82.1% (23/28) and 50.0% ( 14/28), and the difference had statistical significance ( P = 0. 035, P ＜ 0. 05 ). The accuracy rates of lymph node metastasis of both were 88.7% and 72.2% respectively, and the difference had statistical significance (χ2 = 7.031,P = 0.008, P ＜ 0. 01 ). Conclusions EUS has very important value in preoperative staging for esophageal cancer and cardia cancer, and the T staging of EUS is better than that of CT. The short axis and the ratio of short to long axis (S/L) combined with the lymph node ultrasonography image can improve the accuracy rates of lymph node metatsasis and N staging.

Objective To investigate the safety and efficacy of microsurgery for glossopharyngeal neuralgia in aged patients by analyzing short-term and long-term follow-up outcomes.Methods Clinical data of 55 glossopharyngeal neuralgia patients treated with microsurgery were retrospectively analyzed.Among them,25 patients aged over 65 years were assigned into the observation group,and 30 patients under 65 years were assigned into the control group.Clinical characteristics,postoperative complications,short-term efficacy and long-term prognosis were compared between the two groups.Results There was a significant difference in the average age between the observation group and the control group[(71.88 ± 5.95) years vs.(52.57 ± 5.88)years,(t =12.052,P＜0.001)].The incidence of concomitant diseases was higher in the observation group than in the control group (56.0 ％ vs.13.3 ％,x2 =9.421,P =0.001).No significant difference was found in length of hospital stay or postoperative complications between the two groups(t =0.268,P=0.551;x2=0.068,P =0.562).There was no significant difference in short-and long-term prognosis at 1,3,6 months and 1 year after microsurgery (P ＞ 0.05).Conclusions Clinical characteristics,prognosis after microsurgery and surgery risks in aged glossopharyngeal neuralgia patients are comparable to those in younger glossopharyngeal neuralgia patients.Therefore,microsurgery is safe and effective in treating glossopharyngeal neuralgia in aged patients and should be encouraged in clinical practice.