Objective To compare the levels of four factors between gastric mucosa of Han and Tibetan patients with chronic gastritis residing in districts at the same altitude in Qinghai Province.Methods Levels of malonic aldehyde ( MDA) , superoxide dismutase (SOD) , nitric oxide ( NO) and xanthine oxidase (XOD) in gastric mucosa of Han and Tibetan patients with chronic gastritis resident in same altitude districts were examined, and a comparative study was performed.Results Levels of MDA and SOD were significantly higher in gastric mucosa of Han patients (2 2699 ± 1.58906 nmol/mgprot and 134.6313 ±48.35329 U/mgport, respectively) than those of the Tibetan (1.7095 ± 1.19474 nmol/mgprot and 109.5056 ± 28.26794 U/mgport, respectively) (P <0.05) , which indicated there were differences in metabolism of oxygen free radicals and antioxi-dant free radicals between 2 ethnics.However, there were no differences in NO and XOD levels between two ethnical groups, which suggested no ethnical difference in metabolism of the two factors.Conclusion There is ethnical difference in MDA and SOD metabolism in gastric mucosa of Han and Tibetan patients with chronic gastritis from same altitude district, which is presumably due to the different tolerance to the hypoxia at high altitude.

Objective To explore scanning technique in 64-slice spiral CT angiography, and to evaluate the clinical value of various of post-processing methods.Methods 45 patients were examined with CT angiography, including 4 cases of thoracic aorta, 15 cases of abdominal aorta,10 cases of pulmonary artery, which delay time was determined by bolus tracking. The delay time of others ,including 4 cases of cerebrovascular, 6 cases of cervicum blood vessel and 6 cases of lower limb artery were determined by artifical. The initial images were processed with MPR, CPR, MIP ,SSD and VRT.Results According to standard valuation of imaging quality ,the good images were 37 cases, the better were 8 cases and none was bad.Conclusion As far as the diagnosis of great vessels is concerned, 64-slice spiral CTA can instead of DSA. MIP and VRT are important methods in post-processing of image.

Objective To analyze the X-ray,CT and MRI appearances of primary synovial osteochondromatosis.Methods CT scanning was performed in 22 cases,of which 16 cases underwent X-ray examination and 2 cases underwent MRI scan.Results Of 22 cases of synovial osteochondromatosis,13 cases were male and 9 cases were female.The monoarticular involvment was found in 20 cases,and double-articular involvment in 2 cases.Variable size and number of the cartilaginous nodules with calcification and ossification within and surround the joints were showed in 20 cases.The soft mass with calcification were showed in 2 cases.Bone destruction were found in 2 cases,which were induced by compression of the cartilaginous nodules,this was confirmed by operations.Conclusion The cartilaginous nodules with calcification or ossification can be shown by X-ray and CT san.The cartilaginous nodules without calcification or ossification can be shown by MR san.

Objective To study wether dezocine (DZ) can attenuate neuropathic pain in rats and to investigate its mechanism.Methods Neuropathic pain was induced by tight ligation of the left L5 spinal nerve of the male SD rats. 24 Spinal nerve ligation (SNL) model rats were randomly divided into three groups:the first group (saline group, n=8), rats were given intraperitoneal injection of 1ml of saline 14 days after SNL surgery; the second group (dezocine group, n=8), rats were given intraperitoneal injection of 5mg/kg of dezocine in 1ml saline 14 days after SNL surgery;the third group (morphine group,n=8),rats were given intraperitoneal injection of 5 mg/kg of morphine 14 days after SNL surgery. Results Intraperitoneal injection dezocine and morphine had significant analgesic effect in neuropathic pain rats. This analgesic effect lasted for 4-6 hours.Continuous injection of morphine for 3 days produced significant tolerance, while continuous injection of dezocine for 7 days still had significant analgesic effect on neuropathic pain. Conclusion Intraperitoneal injection of dezocine and morphine can attenuate SNL neuropathic pain, continuous injection of morphine for 3 days can produce significant tolerance, while continuous injection of dezocine for 7 days still has significant analgesic effect on neuropathic pain.

ObjectiveTo compare the intraoperative wake-up test in patients undergoing scoliosis surgery with different anesthesia methods.MethodsForty ASA Ⅰ patients aged 13-18 yr with body mass index ＜ 30 kg/m2 scheduled for scoliosis surgery were randomly divided into 2 groups ( n =20 each): propofol combined sufentanil anesthesia group (group P) and sevoflurane combined sufentanil anesthesia group (group S).Anesthesia was induced with target-controlled infusion of sufentanil(target effect-site concentration 0.5 ng/ml),and iv injection of etomidate 0.3 mg/kg in both groups.Tracheal intubation was facilitated with 0.15 mg/kg cisatracurium when patients lost consciousness.The patients were mechanically ventilated.Anesthesia was maintained with target-controlled inhalation of sevoflurane (target end-tidal concentration 0.8％-1.5％ ) in group S,and target-controlled infusion of propofol (target plasma concentration 3-5 μg/ml) in group P,and target-controlled infusion of sufentanil (target effect-site concentration 0.2-0.3 ng/ml),and iv infusion of cisatracurium 0.1 mg· kg-1· h-1 in both groups.BIS value was maintained at 40-60.Cisatracurium administration was terminated and target effect-site concentration of sufentanil decreased to 0.1 ng/ml before wake-up test,5 min later,sevoflurane and propofol administration were terminated,and 5 min later wake-up test was performed.MAP and HR were recoreded during wake-up test.The wake-up time and advers effect (bucking,restlessness and awareness)were recorded.Results The wake-up time was significantly shorter in group S than in group P( P ＜ 0.05).MAP and HR were in normal range during wake-up test in both groups,and bucking,restlessness and awareness were not found in both groups.ConclusionTarget-controlled inhalation of ssvoflurane combined with sufentanil can be safely and effectively used for intraoperative wake-up test in patients undergoing scoliosis surgery,and the wake-up time is shorter than that with propofol combined sufentanil,and it is an apporiate anesthetic technique for the intraoperative wake-up test.

Objective To explore the image quality of 3.0 T Magnetic Resonance foot and ankle array coil on Achilles tendon ab-normalities for the clinical application.Methods 26 patients (with Achilles tendon symptoms)and 5 volunteers underwent MR exam-ination.The scanning sequences were used:T1 WI、PDWI、T2 WI-FS and STIR.Image diagnoses and clinical data of all patients were obtained and analyzed.Subjective scores on image quality were used.Degrees of comfort in coil were evaluated.Results 10 patients had Achilles tendon inj ury,6 patients with Achilles tendonitis,3 patients with part Achilles tendon rupture,1 patient with tendon xanthoma,and 6 patients were normal.Image scores in patients with T1 WI、PDWI and T2 WI-FS sequences were higher,the anatom-ic structures,lesions of whole Achilles tendon were clear.On the contrary,the lower scores were in STIR sequences.In the heel, images were distorted,the level of organization was disappeared and signal intensity was increased.The volunteers felt a slight dis-comfort at the coil entrance and support point of the heel.Conclusion Patients using 3.0T foot and ankle array coil for the Achilles tendon scanning could get high image quality and degrees of comfort.

Objective To evaluate the diagnostic value of gastrin?17( G?17) and pepsinogen( PG) for gastric cancer. Methods A multicenter cross?sectional study of patients with continuous stomach discomfort from four centers including Changhai Hospital Affiliated to Second Military Medical University, the First Hospital Affiliated to Anhui Medical University, Qinghai Provincial People′s Hospital and the First Hospital Affiliated to Zhejiang University of Chinese Medicine from May 2014 to September 2015 was conducted. Before gastroscopy, fasting serum gatrin?17 and pepsinogen were analyzed by enzyme?linked immunosorbent assay(ELISA). The efficacy of G?17 and PG were evaluated according to endoscopic and pathological results. Results Based on the results of the pathological diagnosis, 1 122 cases were enrolled and divided into chronic atrophic gastritis group ( 548 cases ) , chronic non?atrophic gastritis group ( 370 cases), and gastric cancer group(204 cases). Serum G?17 and PGⅡ levels significantly increased(P<0?05) and PGR significantly decreased( P<0?05) in gastric cancer group compared with other groups. There was no significant difference in PGⅠlevel among three groups. The cut?off value of G?17 to diagnose gastric cancer was 7 pmol/L. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of G?17 for gastric cancer were 59?31%, 70?59%, 68?54%, 30?95% and 88?65% respectively. The cut?off value of PG Ⅰ/PG Ⅱ( PGR ) to diagnose gastric cancer was 7. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PGR for gastric cancer were 41?18%, 83?01%, 75?40%, 35?00% and 86?39% respectively. The cut?off value of PGⅡto diagnose gastric cancer was 10 μg/L. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PGⅡfor gastric cancer were 73?53%, 53?05%, 56?77%, 25?82% and 90?02% respectively. If G?17>7 pmol/L and PGR<7 was regarded as the cut?off value of diagnosis of gastric cancer, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 25?00%, 91?29%, 79?23%, 38?93%and 84?56%respectively. If G?17>7 pmol/L and PGⅡ>10μg/L was regarded as the cut?off value, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 48?04%, 79?74%, 73?98%, 34?51% and 87?35% respectively. If PGR<7 and PGⅡ>10 μg/L was regarded as the cut?off value, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 33?82%, 84?86%, 75?58%, 33?17% and 85?23% respectively. Based on logistic regression analysis of the independent variables of high serum G?17 value(>7 pmol/L), low serum PGR value(<7) and high serum PGⅡvalue(>10 μg/L), their OR value were 2?592, 2?237 and 1?864 respectively, and high serum G?17 value showed the highest risk of gastric cancer. Conclusion High serum G?17 and PGⅡ, low PGR are indicators of gastric cancer. Combination of G?17 and PGR has the best diagnostic value for gastric cacer. Gastric cancer can be screened in large scale by combining G?17 and PGR in order to improve the early diagnostic rate of gastric cancer and reduce the mortality of gastric cancer in our country.

Objective To evaluate the detection of serum pepsinogen (PG) in screening of gastric cancer. Methods (1) To calculate the detection rate of gastric cancer in PG Positive patients from northeastern, noah-western and northern China. (2) To determine the PG positive rate in patients with chronic superficial and atrophic gastritis. (3) To calculate the detection rate of gastric cancer, H. pylori infection and esophageal cancer in PG positive patients from gastric cancer high risk areas. Results (1) The detection rate of gastric cancer in PC, positive patients from Changchun (northeastern China), Xihing (northwestern China) and Beijing ( northern China) was 22. 58%, 25. 2% and 0, respectively. The sensitivity of PG to seeen gastric cancer in Changchun and Xihing was 50. 9% and 35.6%, and the specificity was 82. 56% and 85.69%, respectively. (2) Only 25% of patients with chronic atrophic gastritis were PG positive. (3) The serum PG level was measured in 2346 cases from gastric cancer high risk areas, and PG positive rate was 27.02% (634/2346), in which 496 patients (76. 65%, 496/634) received endoscopy, and gastric cancer was detected in 10 (2. 02%, 10/496), including 9 cases of early gastric caner. The prevalence of gastric cancer was 0. 43% in common population and 1.58% in PG positive population. The infection rate of H. pylori was 70. 73% in 2346 subjects and 2 cases of esophageal cancer, including 1 case of early cancer was diagnosed. Conclusion Serum PG level cannot be used as a marker for gastric cancer or atrophic gastritis, while it may be of value for gastric cancer screening in high risk areas.

Objective To study the feasibility of diffusion tensor imaging(DTI) in assessment of lumbosacral neuropathy. Methods Eighteen patients with lumbosacral neuropathy (experimental group) and 20 healthy volunteers (control group) were enrolled prospectively in the neurological department by clinical symptoms and neuroelectrophysiology. The experimental group were divided into experimental subgroup A(demyelination group, 6 cases),subgroup B(axonal injury with demyelination group, 12 cases) based on electrophysiology.All of L4-SN nerves of the experiment group and the control group received DTI examination."Sowing points"as ROIs were placed in the proximal, middle and distal of bilateral L4-SN nerves by two experienced physicians.The average of the DTI parameters of 3 ROIs at each nerve were used as its final DTI parameters.Independent sample t test was used to evaluate the difference of the L4-SN DTI parameters between the experimental group and the control group.The differences of DTI parameters among the control group, the experimental subgroup A and the experimental subgroup B were compared by the nonparametric independent samples Kruskal-Wallis H test and the Nemenyi test. The ROC analysis was performed on the FA values and λ⊥values of the control and experimental groups.Results (1)The L4-SN FA values in the experimental group was significantly lower than those in the control group (t range from 4.11 to 6.36, P<0.05). The L4 and S1-SN ADC values of the experimental group were significantly higher than those of the control group (t range from - 4.77 to - 1.17, P<0.05). The L4-SN λ ⊥ values in the experimental group were significantly higher than those in the control group (t range from -5.30 to -2.57，P< 0.05). (2) L4-SN FA values (H values ranged from 18.5 to 30.6, P<0.05), λ⊥ values (H values ranged from 6.8 to 29.2, P<0.05) and L4, S1-SN ADC values (H values ranged from 6.8 to 19.6, P<0.05) were significantly different among control group, experimental subgroup A and experimental subgroup B. Nemenyi test showed there were significant differences in FA values (H values ranged from 18.4 to 30.1,P<0.05) and λ⊥ values (H values ranged from 6.2 to 29.0, P<0.05)) of L4-SN and in ADC values (H values ranged from 6.4 to 19.54, P<0.05) of L4，S1-SN between control group and experimental subgroup B. (3) The analysis of ROC of the experimental group and control group showed the AUC values of L4-SN FA values were 0.834, 0.745, 0.860, 0.772, 0.811 respectively, the sensitivity were 66.7%, 72.2%, 77.8%, 83.3% and 66.7% respectively, and the specificity were 91.7%,69.4%,80.6%,61.1% and 88.9% respectively. The AUC values of L4-SN λ⊥ values were 0.796, 0.656, 0.791, 0.701, 0.843 respectively, and the sensitivity were 55.6%, 50.0%, 66.7%, 97.2% and 88.9% respectively,and the specificity were 91.7% , 77.85% , 86.1% , 36.1% and 66.7% respectively. Conclusion DTI has the feasibility to evaluate lumbosacral neuropathy and it can identify patients with axonal injury with demyelination and healthy subjects.

Objective:To explore the clinical significance of standardized screening for diagnosis and treatment of early gastric cancer in Qinghai Province.Methods:Opportunistic early gastric cancer screening was conducted in outpatients of Digestive Department, Physical Examination Center and inpatients of Qinghai Provincial People′s Hospital from January 2016 to December 2020, according to the optimal cut-off values of serum pepsinogen (PG)Ⅰ, PGⅠ/PGⅡ ratio (PGR) and serum gastrin 17 (G17) obtained from the previous screening study of gastric cancer and precancerous diseases in different areas of Qinghai Province. At the same time, the standardized early gastric cancer screening program was applied in 10 municipal (county-level) hospitals in Qinghai Province. The detection rate, early diagnosis rate and endoscopic treatment rate of early gastric cancer in Qinghai Provincial People′s Hospital and the above 10 hospitals in the past five years were analyzed respectively.Results:In the five years, the total detection rate, early diagnosis rate and endoscopic treatment rate of early gastric cancer in Qinghai Provincial People′s Hospital were 0.214% (407/190 178), 17.54% (407/2 321) and 81.82% (333/407), respectively. The above indices in 10 other hospitals were 0.085% (264/309 217), 12.94% (264/2 040) and 37.12% (98/264), respectively. The overall detection rate of early gastric cancer was higher than 0.024% reported previously.Conclusion:The standardized early gastric cancer screening program can not only improve the diagnosis rate of early gastric cancer in Qinghai Province, but also save medical resources. It is an economical, efficient and feasible program, suitable for the highin-cidence area of gastric cancer in Qinghai Province.