Objective:To analyze the clinical characteristics of functional esophagogastric junction outflow obstruction (EGJOO) and to improve the knowledge of functional EGJOO.Methods:From January 2015 to December 2019, at the Gastrointestinal Motility Center of The First Affiliated Hospital with Nanjing Medical University, 91 patients who underwent high resolution esophageal manometry (HREM) and met the EGJOO criteria of Chicago Classification for esophageal motility disorders, 3rd edition and excluded organic diseases by examination such as gastroscopy or upper gastrointestinal radiography were collected. The clinical manifestations, treatment methods, effect and clinical outcome of patients with functional EGJOO, the HREM parameters of patients with different clinical manifestations as well as symptoms and HREM parameters of patients with different treatments were analyzed. Least significant difference test or Tamhanes T2 test, Mann-Whitney U or Wilcoxon test, chi-square test or Fisher exact test were used for statistical analysis. Results:The most common symptom of 91 functional EGJOO patients was dysphagia (34/91, 37.4%). The lower esophageal sphincter pressure (LESP) and the intrabolus pressure during relaxation of the lower esophageal sphincter (IBP LESR) of patients with dysphagia were both higher than those of patients without dysphagia (30.95 mmHg (26.27 mmHg, 39.37 mmHg) (1 mmHg=0.133 kPa) vs. 27.35 mmHg (24.60 mmHg, 34.87 mmHg); (8.25±4.64) mmHg vs. (5.69±4.65) mmHg), and the differences were statistically significant ( Z=2.076, t=2.539; P=0.038, 0.013). Thirty patients (33.0%) had no special treatment, 52 patients (57.1%) were treated with medication, and nine patients (10.0%) underwent peroral endoscopic myotomy (POEM). The incidence of dysphagia before treatment and maximum intrabolus pressure of patients who underwent POEM were both higher than those of patients without special treatment and medication treatment (8/9 vs 43.3%, 13/30 and 25.0%, 13/52; 21.80 mmHg (15.45 mmHg, 28.95 mmHg) vs. 12.20 mmHg (10.00 mmHg, 18.10 mmHg) and 13.70 mmHg (11.07 mmHg, 17.82 mmHg)), and the differences were statistically significant (Fisher exact test, Fisher exact test; Z=2.814, 2.390; P=0.023, P<0.01, P=0.005, 0.017). The incidences of delayed esophageal emptying or esophageal dilation of patients who underwent POEM, without special treatment and with medication treatment was 6/9, 5/14 and 3/18, respectively, and the differences were statistically significant among three groups (Fisher exact test, P=0.039). Among them, the incidence of delayed esophageal emptying or esophageal dilation of patients received POEM before treatment was higher than that of patients with medication treatment (Fisher exact test, P=0.026). The symptoms of 24.2% (22/91) was spontaneously relieved, and two patients (2.2%) developed type Ⅱ achalasia during follow-up. Conclusions:The main manifestation of patients with functional EGJOO is dysphagia. Patients with significantly increased LESP and IBP LESP are more likely to have dysphagia. Patients with obvious signs of esophageal gastric junction obstruction are more inclined to choose POEM treatment. Some patients with functional EGJOO can relieve themselves, and a few patients can develop achalasia.

Objective To determine staging accuracy of double contrast-enhanced ultrasonography (DCUS)after neoadjuvant chemotherapy,and to evaluate effect during neoadjuvant chemotherapy for advanced gastric carcinoma(AGC).Methods A total of 29 patients with AGC diagnosed by endoscopy were examined and staged using ultrasound after taking oral contrast agent and bolus injection of SonoVue (DCUS)pre-and post-neoadjuvant chemotherapy.T-stage accuracy of post-neoadjuvant chemotherapy and pathological T status of postoperative were compared.All of the subjects were divided into two groups according to RECIST(Response Evaluation Criteria in Solid Tumors):chemotherapy benefit group(22cases,including:complete response 0 cases.partial response 14 cases,stable disease 8 cases)and progressive group(7 cases).The findings of DCUS of AGC tissues were assessed by auto-tracking contrast quantification(ACQ)software.The baseline intensity(BI)and peak intensity(PI)of gastric carcinoma tissues were measured automatically,and the enhanced intensity(EI)of gastric carcinoma tissues was calculated manually(EI =PI-BI).The quantitative analysis findings of DCUS of each patient pre-and postneoadjuvant chemotherapy between two groups were compared adopting repeated measures method.Results The overall accuracy of T staging in AGC patients after neoadjuvant chemotherapy were 65.52％ by DCUS,and 0,42.86％and 92.86％respectively for T2 stage,T3 stage and T4 stage.The agreement of this method was weak between T-stage accuracy post-neoadjuvant chemotherapy and pathological T status of postoperative.The Kappa value was 0.33.The difference value of PI and EI between pre-and postneoadjuvant chemotherapy in AGC patients for benefit group was more than that in progressive group.The main effect of BI in AGC tissues between pre-and post-neoadjuvant chemotherapy was no significant difference between two groups(P＞0.05).Conclusions Restaging by DCUS after neoadjuvant chemotherapy in AGC patients was found to be inaccurate.However,the difference value of PI and EI between pre-and post-neoadjuvant chemotherapy in AGC tissues for benefit group was more than that in progressive group.Thus,the value of PI and EI by ICUS may be a useful clinical parameter with which to evaluate the effect during neoadjuvant chemotherapy and guide therapeutic regimen for AGC patients.

Objective To observe the destroyed architecture of splenic lymphoid follicles in mice infected with Schistosoma japonicum by immunohistochemistry. Methods The mice infected with S. japonicum(20 cercariae/mouse)for 8 weeks were sacrificed,and the splenic samples were paraffin embedded and sliced. The sections were first stained by hematoxylin and eosin to observe the massive structure of splenic lymphoid follicles,and then B cells,follicular dendritic cells(FDC)and germinal center cells were labeled with anti-B220,anti-CD21 or anti-Ki67 antibodies respectively by immunohistochemistry to observe the distribution of the specific cells of lymphoid follicles. Results The results of HE staining showed that the structure of lym-phoid follicles in spleens of infected mice was blurred,the number and area of follicles were significantly reduced compared to those of the normal mice. The immunohistochemical staining showed that the splenic T/B lymphocyte segregation ,FDC network and germinal centers of the infected mice all disappeared. Conclusion The structure of splenic lymphoid follicles in the mice infected with S. japonicum is obviously damaged.

0.05).Serum absorbance value of progesterone injected virgin mice(0.299) was significantly higher than that of no-injectedvirgin mice(0.191)(t=2.955,P0.05).Conclusion Pregnancy has a synergetic effect on immune response of mice against T.spiralis infection,which may be related with the increased level of serum anti-Trichinella antibody and enhanced ability of sera in mediating the death of pre-encapsulated larvae in ADCC.

Aim To study the effect of 2,3,4′,5-tetrahydroxystilbene-2-O-?-D glucoside(TSG) on vascular smooth muscle cells(VSMCs) proliferation induced by fetal bovine serum and explore the underlying mechanisms.Methods VSMCs were cultured from rat aorta using explant technique.VSMCs proliferation was analyzed by 5-bromo-2-deoxyuridine(Brdu) incorporation assay.Cell cycle phase distributions were determined by flow cytometry.The expression of proliferating cell nuclear antigen(PCNA) was evaluated by Western blot analysis.The level of intracellular reactive oxygen species(ROS) was estimated through fluorescence assay.The intracellular activities of superoxide dismutase(SOD),catalase(CAT),and glutathi one peroxidase(GSH-px) were measured using biochemical method.Results TSG in the experimental concentration 0.1～100 ?mol?L~-1 exhibited no apparent cytotoxocity.10 ?mol?L~-1 and 100 ?mol?L~-1 TSG significantly inhibited the proliferation of VSMCs induced by serum,cell cycle transition from G0/G1phase to S phase,PCNA expression in nucleus of VSMCs and level of intracellular ROS.100 ?mol?L~-1 TSG markedly increased the activities of SOD and GSH-px.Conclusions Certain concentration of TSG can prevent VSMCs proliferation effect mediated by serum;the mechanism about TSG effect may be associated with arresting G0/G1 to S progression,decreasing PCNA expression and improving the antioxidation of VSMCs.

Objective To compare the differences of personality in patients with depression between Uighurs and Han Chinese.Method Hospitalized depressed patients were selected including 44 cases of Uygur people,73 cases of Han people and Han people with normal control 41 cases.Using Minnesota Multiphasic Per-sonality Inventory(MMPI), Eysenck Personality Questionnai(EPQ) and Cattell's 16 Personality Factor (16PF) to make the survey.Results In MMPI : Uighur depression group's factors F,Hs, D,Hy,Pt,Pa and Sc's T score were all higher than 70,and Han depression group' s factors Hs, D,Hy,and T score of Pa were all higher than 70.Only F (76.98±16.01 vs 67.16±13.51, P＜0.01), Pt(72.09± 14.22 vs 66.82± 11.12, P＜0.05) and Sc (73.43± 13.02 vs 68.62± 11.14, P＜0.05) had statistically significant differences between the two groups.Comparing Han depression group with Han normal control group,only Pd score was not significantly different,the other nine scales were statistically significant (P＜0.01).In EPQ: comparing Uighur depression group with Han depression group,the 4 kinds of scale (extroversion, psychoticism, neuroticism and conceal) differences were not statistically significant (P＞0.05).And Han depression group compared with the Han control group, four scales were statistically significant differences (P＜0.01).In 16 PF: comparing Uighur depression group with Han depression group, only the wisdom of B (P＜0.01) and the independence of the Q2 (P＜0.05) between the two groups were statistically siguificant,other personality dimensions had no significant difference (P＞0.05).Comparing Han depression group with Han normal control group, the factors of gregariousness A, stability C, excitability D,perseverance G, boldness H, sensitivity I,skeptical L,anxiety and O,self-discipline Q3,tension Q4 (P＜0.0l) and experimental Q 1 (P＜0.05) differences were statistically significant, and the factors of Wisdom of B, aggressiveness E, fantasy M, sophisticated sex N, independence Q2 were not statistically significant (P＞0.05).Conclusion The personality model of depression between the Uygur and Han nationality has the consistency of national culture,and differences with normal people.Prompt Uygur and han depression may have a common characteristic of pathological personality model.Uighur and han ethnic differences in national culture and personality is the character of diversity,is not a Uighur and Han the pathological basis of personality of depression.

ObjectiveTo investigate left ventricular (LV) radial dyssynchrony and LV rotational change of isolated complete left bundle branch block (CLBBB) and CLBBB with heart failure (HF).Methods Twenty-six isolated CLBBB patients,twenty-four CLBBB patients with HF and twenty healthy controls were studied.Two-dimensional speckle tracking imaging (2D-STI) was applied to short-axis views to calculate LV radial dyssynchrony and LV rotational and twist degree and time to peak rotational and twist degree.ResultsLV radial dyssynchrony and LV rotation and twist degree were intermediately damaged in isolated CLBBB patients and was significantly damaged in CLBBB patients with HF,compared with healthy controls.ConclusionsFor isolated CLBBB patients,even if LV ejection fraction was in the normal range,another parameters of cardiac mechanic had changed and 2DSTI could be used to evaluate these alterations.

OBJECTIVE:To explore the clinical efficacy of 131I in the treatment of hyperthyroidism.METHODS:131I therapy for 784 cases of hyperthyroidism was analyzed retrospectively.The dose of 131I(?Ci) was calculated with formula:?Ci=the weight of thyroid(g)?80-120(?Ci?g-1)/the highest absorbed iodine rate(%).Clinical efficacy was evaluated according to the results.RESULTS:394 cases were relieved completely after once therapy,523 cases after twice therapies and 547 cases after three times of therapies.577 patients were visited at random and 94.80% of them were cured.Early-stage toxic reaction had been found in 46 cases with incidence of 7.97%.Hyperthyroidism crisis had not been developed.Temporary hypothyroidism had been found in 68 cases with incidence of 11.79%,while permanent hypothyroidism had been found in 146 cases with incidence of 25.30%.CONCLUSION:131I has an obvious effect on hyperthyroidism with one disadvantage of high incidence of hyperthyroidism.However,131I is an effective therapy which is safe,economical,simple and convenient.

Objective To evaluate left ventricular (LV) myocardial contraction patterns and function by analyzing the distribution of peak value of segmental area strain and time sequence to the peak value.Methods 31 healthy subjects were involved.Real-time three dimensional full volume images of LV were acquired and analyzed with EchoPAC.LV volume and function parameters,as well as segmental and global systolic area strain and time to peak value were measured.The distribution of peak segmental area strain and time sequence to the peak value,interobserver and intraobserver variability of area strain parameters,as well as the relationship between global area strain and ejection fraction were evaluated.Results The peak segmental area strain was lower in the basic inferior and apical segments,and the peak value was reached earlier in the basic inferior,anteroseptal,and septal segments.Intraobserver and interobserver reliability of area strain parameters were good.Furthermore,a negative correlation was observed between global area strain and ejection fraction (r =-0.688,P =0.000).Conclusions The area strain measured by 4D strain can be used to evaluate the LV myocardial motion pattern and function.

Objective To study the effect of early enteral nutrition (EEN) with ω-3 polyunsaturated fatty acid on nutritional status and body immunity of postoperative patients with colorectal cancer.Methods Forty patients with colorectal cancer were randomly divided into EEN group and parenteral nutrition (PN) group by systematic sampling method with 20 cases of each.The patients in EEN group were given complete enteral nutrition with ω-3 polyunsaturated fatty acid 1-7 d after operation,while the patients in PN group only were given nutrient by regular PN.Nutritional status,body immunity before operation and 1-7 d after operation,and intestinal function recovery time,untoward reaction were determined.Results The postoperative anus first exhaust time and defecate time of patients in EEN group were significantly shorter than those in PN group [(48.0±5.6) hvs.(51.0±6.7) h,(53.0±4.8) h vs.(72.0±3.6) h,P＜0.05].Serum albumin and prealbumin 1 d after operation in 2 groups were significantly lower than before operation (P ＜0.05),but 7 d after operation were significantly higher than 1 d after operation (P ＜0.05).Serum albumin and prealbumin 7 d after operation in EEN group were significantly higher than PN group(P ＜ 0.05).IgG,IgA,IgM,CD3,CD4,CD8,CD4/CD8 1 d after operation in 2 groups were significantly lower than before operation (P ＜ 0.05).IgG,IgA,CD4,CD4/CD8 7 d after operation in EEN group were significantly higher than PN group (P＜ 0.05).Conclusions Compared with the PN,EEN with ω-3 polyunsaturated fatty acid can remarkably improve nutritional status and body immunity in postoperative patients with colorectal cancer.It can accelerate the recovery of intestine function and worthy of recommending.