Objective To investigate the clinical efficacy and safety of endoscopic variceal ligation (EVL) combined with endoscopic variceal sclerosis (EVS) for treating patients with esophageal variceal bleeding (EVB).Methods Ninety patients with EVB were divided into observation group and control group by treatment methods with 45 patients each.The observation group was given EVL combined with EVS and the control group was given EVL.The elimination of varicosity after the first treatment,time and times required to eliminate,rehaemorrhagia,varicosity recurrence,complication and prognosis of the 2 groups were observed.Results The elimination rate of varicosity of observation group was 97.8％(44/45),the control group was 93.3％(42/45),there was no significant difference (P＞ 0.05).The elimination rote of varicosity after the first treatment of observation group was significantly higher than that of control group,the time and times required to eliminate were significantly lower than those of control group [71.1％(32/45) vs.48.9％(22/45),(17.24±5.65) d vs.(36.01 ± 11.81) d,(1.42 ±0.47) times vs.(1.87 ±0.61) times,P ＜ 0.05 or ＜0.01].The rates of early-onset rehaemorrhagia,delayed rehaemorrhagia and varicosity recurrence of observation group were significantly lower than those of control group [4.4％(2/45) vs.17.8％(8/45),6.7％(3/45) vs.22.2％ (10/45),2.2％ (1/45) vs.22.2％ (10/45),P ＜0.05].The rate of complication of observation group was significantly lower than that of control group [11.1％ (5/45) vs.42.2％ (19/45),P ＜0.01].Conclusion The EVL combined with EVS is an effective method for emergency hemostasis and preventing rehaemorrhagia in the patients with EVB.

Objective To evaluate the therapeutic effectiveness and toxicity of low-dose cisplatin chemotherapy combined with three-dimensional conformal radiotherapy for mid-advanced esophageal cancer.Methods 89 patients with advanced esophageal cancer either who were inoperable or refused operation were randomized into two groups: 45 cases in the study group and 44 cases in the compared group. The study group

Objective To compare effect and security between duloxetine combined with small-dose of mirtazapine and duloxetine alone in treatment of refractory depression in elder patients.Methods A total of 100 cases elder refractory depression patients were randamly divided into study group (duloxetine+mirtazapine, 50 cases) and control group(duloxetine, 50 cases).Compared HAMD,HAMA and CGI-SI between two groups, as well as the side reactions and TESS.Regression analysed mirtazapine blood concentration and HAMD subtraction rate.Results The effective rate of study group was 92.00%, while in control group was 76.00%, the difference was statistically significant(P<0.05).After treatment, the HAMD, HAMA and CGI-SI of each group significantly increased, and the difference of HAMD, HAMA and CGI-SI at 2w, 4w and 8w between two groups were statistically significant(P<0.05).The TESS and side reaction of two groups had no statistical difference.Conclusion Effect of duloxetine combined with small-dose of mirtazapine in treatment of refractory depression is better than duloxetine alone use, without significant side reaction.

This paper introduces a kind of vacuumizing system for X-ray machine head.The system function,structural composition and operation principle are expounded.It has such advantages as small empty volume,high vacuumizing speed,simple and convenient structure,etc.It shows high military,social and economic benefit because of its good maneuverability in timely and efficient maintenance on the spot.According to the feedback from maintenance department of field and local medical equipment,it is stable and reliable in working,easy to be operated and worthy of being popularized.

AIM: To investigate the influence of compatibitity in Fengshi Maqian Tablet [ABD group(Semen strychni,Bombyx batryticatus,Herba ephedrae,Scorpio,Rhizoma atractylodis,Radix et Rhizoma glycyrrhizae) E group(Olibanum;Myrrha)]. METHODS: In the use of orthogonal design(5 factors and 2 levels).HPLC method were used to determine the main chemical componets such as strychnine,brucine and ephedrine.And anti-inflammation was adopted as pharmacological experiment. RESULTS: In the inhibitive experiment of granuloma,ABD group was superb to E group.In the tumescence experiment,otherwise. CONCLUSION: The minister,assistant and guide herbs in Fengshi Maqian Prescription had a significant effect on the toxicity of monarch medicines-Semen strychni.

Objective To clarify the association of onset and maintenance of metabolic syndrome (MS) with energy metabolism imbalance,especially with dialysate glucose load in peritoneal dialysis (PD) patients.Methods Using retrospective self-controlled study,the changes of MS,dialysate glucose load and dietary energy intake (DEI) in 126 PD patients in about 1 year were collected and analyzed to define the effect of energy intake on MS.Resting energy expenditure (REE) was measured and physical activity level (PAL) was evaluated based on the activity records in PD patients with unchanged MS state and their impacts on MS were analyzed.Results The incidence of changing from non-MS to MS was higher in glucose load increasing group than that of glucose load unchanged or decreasing group.When glucose load increased,patients developing MS had significantly increased serum triglyceride (TG) level (P＜0.01) and significantly decreased serum high density lipoprotein cholesterol (HDL-C) level (P＜0.05),while the waist circumference and blood glucose level did not alter significantly.In patients changing from MS to non-MS,their serum C reactive protein (CRP) levels significantly decreased during the follow-up (P＜0.05).No significant difference was found in DEI in patients changing from MS to non-MS.However,in patients changing from non-MS to MS,their DEI decreased during the follow up (P＜0.05).In a subgroup analysis in 36 PD patients who maintained their metabolic status and did not change their glucose load,there was no difference in REE per body surface per day between the MS group and the nonMS group (t=0.840,P＞0.05).However,the PAL was lower in the MS group than that of the nonMS group (t=2.358,P＜0.05).Conclusions The increase of dialysate glucose load may be an important factor leading to the onset of MS,by altering serum TG and HDL-C level.Inflammation and the sedentary life also contribute to the MS state.

Objective To assess the correlations between muscle strength and amplitude of compound muscle action potential(CMAP)with blood potassium level in hypokalemic periodic paralysis after long exercise test(ET).Methods ET of abductor digiti minimi(ADM)was performed on 78 patients with hypokalemic periodic paralysis.Ulnar and median CMAP amplitude,blood potassium level,muscle strength of ADM,palmar interossei muscle and abductor pollicis brevis were measured before and 120 minutes after exercise.The correlations of muscle strength,CMAP amplitude and blood potassium level were analyzed.Results Ulnar CMAP amplitude was(4.6 ±2.7)mV after ET and(9.6 ±3.2)mV before ET(t =16.047,P =0.000)in 78 patients with hypokalemic periodic paralysis,respectively.Median CMAP amplitude was(10.9 ± 4.2)mV after ET and(11.2 ± 3.9)mV before ET(t =0.673,P =0.822),respectively.After ET,muscle strength of ADM decreased in 76 patients,score on MRC was less than Ⅲ in ADM but V in palmar interossei muscle and abductor pollicis brevis in 41 patients,the blood potassium level was tested in 10 of them,which was(3.8 ±0.3)mmol/L before ET and(3.9 ±0.4)mmol/L after ET(t =0.395,P =0.702).Conclusion In patients with hypokalemic periodic paralysis,blood potassium level is not the key factor affecting muscle strength and CMAP amplitude after ET.

Objective To explore the value of ultrasound in diagnosis and classification of pilomatricoma.Methods Ultrasonic features of 63 cases with pilomatricoma confirmed by operation and pathology were analyzed and summarized retrospectively.Results According to if there was calcification in the tumor,pilomatricoma cases were classified into two groups(calcific group and non-calcific group).In addition,there were three subgroups in the calcific group based on the size and disposition of calcification:subgroup Ⅰ,completely echogenic mass with strong posterior acoustic shadowing in the subcutaneous layer (n=17,26.98%);subgroupⅡ,hypoechoic nodules with tiny calcification diffused distributed(n=15,23.80%);subgroup Ⅲ,hypoechoic nodules with large calcification(n=8,12.70%).Twenty-three cases (36.51%)were distributed into non-calcific group.Conclusions Ultrasonography is valuable for diagnosis and differential diagnosis of pilomatricoma,and it is an essential examination method for the tumor before operation.

Objective To study the differential diagnostic value of interferon-γ inducible protein 10 (IP-10),macrophage inflammatory protein-1 α (MIP-1 α) and monocyte chemoattractant-1 (MCP-1) level in the tuberculous,malignant pleural effusion.Methods Enzyme-linked immunosorbent assay was used to detect the level of IP-10,MIP-1 α and MCP-1 in tuberculous pleural fluid (tuberculous pleural fluid group,43 cases) and malignant pleural fluid (malignant pleural fluid group,45 cases).The level of IP-10,MIP-1 α and MCP-1 and the significance were analyzed by ROC curve.Results The level of IP-10,MIP-1 α and MCP-1 were significantly higher in tuberculous pleural fluid group than those in malignant pleural fluid group,and there were significant differences(t =4.931,3.106,2.385 ; P =0.000,0.004,0.041).ROC curve analysis showed that the critical value of IP-10,MIP-1 α and MCP-1 in diagnosis of pleural effusion was respectively 1 589.73,213.50,1 452.63 ng/L.The sensitivity and specificity of IP-10,MIP-1 α and MCP-1 in pleural fluid were 68.8％,81.3％,87.5％ and 87.5％,68.8％,56.3％,respectively.Conclusion The level of IP-10,MIP-1 α and MCP-1 in tuberculous and malignant pleural fluid are significant for the early diagnosis and differential diagnosis.

Objective To investigate the effect of the combined use of ultrasound (US) elastography and color Dop-pler on the differential diagnosis and TNM staging of benign or malignant breast neoplasm. Methods A cohort of 58 biop-sy-proved cases, who underwent US elastographic and Doppler US imaging, were included in the current study. The pathological results after operation were considered the‘gold standard’of diagnosis. ROC curves were used to compare the changing rates of the diameter and area, elastographic indices and Doppler blood flow score in diagnosis of breast cancer. Re-sults Compared with other indices, the area changing rate showed the highest diagnostic ability with the AUC=0.914. More-over, the combined use of the elastography and color Doppler US increased the AUC to 0.981. The elastographic indices for neoplasm in the advanced-stage (stageⅡ~Ⅳ) were high than those of early-stage (stage 0~Ⅰ). The elastographic and Dop-pler scores increased with the progress of the TNM stages. Conclusion The changing rate of elastographic area can be used to accurately diagnose the breast neoplasm. Moreover, the combined use of US elastography and color Doppler US can in-crease the accuracy of the diagnosis, and may also provide useful information for the TNM staging.