Objective To summarize the experiences in diagnosing and removing foreign bodies in the upper gastrointestinal tract. Methods Eight hundred and two cases were examined endoscopically for their ingested foreign bodies from 1978 to 2003. Endoscopy and various instruments for grasping the foreign bodies were used. Results Altogether there were 1 198 pieces of foreign bodies, 424 of which were impacted in the esophagus, 662 in the stomach, and 112 in the duodenum. One thousand one hundred and ninity-eight pieces of foreigen bodies were successfully removed from 780 patients without any complications. But removal of 31 pieces in 22 patients failed because the foreign bodies were impacted in the gastrointestinal tract. The success rate was 97.3%. Among all the foreign bodies taken out, the largest one was 20cm in length and 4.2cm in width. Conclusion Endoscopy could be used safely and effectively in patients with ingested foreign bodies.

ObjectiveTo explore the surgical methods and its efficacy on severe chronic obstructive pneumonia disease (COPD) with spontaneous pneumothorax.MethodsClinical features and surgical efficacies of 16 cases of severe COPD were analyzed.Results No death occurred and all patients recovered and discharged.The lung function index including subjective symptoms,motor ability and endurance in 14 cases showed obvious improvement compared with those before combination of pneumothorax.Two patients improved to the level before surgery.ConclusionThe lung function index of patients with severe COPD and pnumothorax can be relatively less restricted and open-chest surgery should be performed as soon as possible.Linear nailing and simple lung volume reduction surgery are recommended to improve lung function,shorten operation time and reduce surgical risks.

Objective To evaluate the role of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography(ERCP)in bile duct injury. Methods Thirty-one patients with bile duct injury from March 1999 to March 2004 were managed by ERCP. Patients with indications of endoscopic therapy were treated by endoscopic sphincterectomy(EST)and plastic stent drainage. Results Twenty-two of 31 patients with bile duct injury received endoscopic therapy . The patients included 3 cases of common bile duct transection or ligation, 13 cases of bile duct stricture, and 15 cases of bile leakage. Seven of 13 patiens with bile duct stricture received plastic stent therapy, followed for 8-20 months, 4 cases with satisfaction and 3 cases with poor outcome. Fifteen cases of bile leakage accepted EST and endoscopic nasalbiliary drainage(ENBD) , in the first time,13 cases resulted in healing of the leakage,2 cases were of no effect. Seven cases of bile duct stricture were treated with plastic stent, maintaining for 4-12 months. No procedure related complications. Conclclusions ERCP is helpful not only for diagnosing and localizing localizing bile duct injury, but also for treating it in most of patients with relatively good and safe results.

Objective To study the diagnostic value of spiral CT pulmonary angiography(SCTPA) for pulmonary embolism(PE).Methods SCTPA scans were performed in 25 patients with PE,the contrast-enhanced SCT scans of the pulmonary arteries were performed,MPR,MIP and SSD were performed simultaneously.Results The 29 SCTPA scans were performed in 25 patients, including the central type in 23 cases(92%) and the peripheral type in 2 cases(8%).The rates of the main,the sinistral and dextral,the middle lobular,the lobular and the lingular pulmonary artery displayed were 100%,the rates of the segmental pulmonary artery displayed were 97.77% and the rates of the subsegmental pulmonary artery displayed were 68.00%.The lobular and segmental pulmonary artery were mainly embolized,the rates of PE were between 46.58% and 75.00%.Conclusion SCTPA has great value in earlier and clear and definite diagnosis of PE.

Objective To identify the role of microRNA-17(miR-17)in human glioma U87 cells invasion which may regulate expression of matriv metalloproteinase(MMP)-2.Methods U87 cells were cultured in vitro,while changes in cellular morphology were observed by phase contrast microscope.The miR-17 which might regulate the expression of MMP-2 was predicted by bioinformatics and identified using dual luciferase report system.Expressions of miR-17 and MMP-2 were determined using real-time PCR and Western blot after transfection of miR-17 mimics.The invasion of U87 cells was detected in vitro by Transwell chamber.Results Expression of MMP-2 was positive by immunofluorescence cytochemistry. Using dual luciferase reporter system,miR-17 could inhibit the expression of MMP-2 by binding to its mRNA 3′UTR. Results of real-time PCR and Western blot showed that over-expression of miR-17 down-regulated expression of MMP-2. The invasion of U87 cells was suppressed by over-expression of miR-17.Conclusion MiR-17 may negatively regulate expression of MMP-2 in human glioma U87 cells and inhibit cell invasion.

Objective To investigate the effects and possible mechanism of action of inhibiting hepatitis B virus X protein (HBx) expression on liver cancer metastasis. Methods The suppression of HBx expression in MHCC97H cells was performed by siRNA interference technique, and the effects of HBx suppression on the metastasis of MHCC97H cells were detected by Matrigel invasion assays and in a lung-metastasis mouse model. The expression levels of related epithelial-mesenchymal transition (EMT) and apoptosis proteins were examined by Western blotting. Results Introduction of HBx-siRNA into MHCC97H cells inhibited the expression of HBx and the ability to metastasize,downregulated the expression of Twist and N-cadherin, and upregulated E-cadherin expression. These changes resulted in inhibiting EMT of MHCC97H cells. Meanwhile, apoptosis involved in the Twist-P53 pathway was also found. Conclusions Inhibiting expression of HBx can decrease the metastatic a-bility of MHCC97H cells by changing EMT and inducing apoptosis.

Objective To quantify the incidental irradiation dose (ⅡD) to lymph node stations of esophagus when treating patients with T1-4N0 M0 thoracic esophageal squamous cell carcinoma (ESCC) with a dose of 60 Gy/30f.Methods Twenty-nine patients with medically inoperable T1-4N0M0 thoracic ESCC were treated with three-dimensional radiotherapy on involved-field.The conformal CTV was re-created using a 3 cm margin in the proximal and distal direction (following the course of the esophagus) beyond the barium esophagogram,endoscopic examination and CT defined GTV and a 0.5 cm margin in the lateral and anteroposterior directions of the CT defined GTV.The PTV encompassed 1 cm proximal and distal margins,0.5 cm radiaI margin on the basis of CTV.Cervical,mediastinal and abdominal lymph nodes were delineated respectively.Equivalent uniform dose (EUD) and other dosimetric paraneters were calculated for each nodal station.Nodal region whose metastasis rate is greater than 5％ was considered a high risk lymph node subgroups.Results Under a 60 Gy dose prescription,the median Dmean and EUD,V40 and V50 were ≥40 Gy,≥85％ and ≥75％ in most of the high risk nodal regions.For the subgroups whose EUD were less than 40 Gy,most of the ⅡD of these regions was significantly associated with the length and location of esophageal tumor (r =0.892,P =0.000).Conclusions Lymph node stations nearby of ESCC received considerable ⅡD with involved-field irradiation which could control subclinical lesions.But more clinical studies should be needed.

To improve physician-patient morality accomplishment is the basic project for construct a harmonious society,a harmonious physician-patient relationship,and a harmonious hospital,thus is of great realistic significance and value.The improvement of physician-patient morality accomplishment contributes to the construction of a harmonious society,while a harmonious society also lays a solid foundation for the improvement of physician-patient morality accomplishment.Thus the two depend on,contribute and interact with each other.

Objective To study the correlation of polyphenol oxidase(PPO) activity and baicalin synthesis in callus of Scutellaria baicalensisi.Methods PPO Activity was determined by ultraviolet spectrophotometry and the content of baicalin was detected by HPLC.The effects of various substances(ascorbic acid,sodium chloride,benzoic acid,polyvinylpyrrolidone,and copper sulfate) on PPO activity and the content of baicalin were studied.Results There was no baicalin accumulation in the first 20 d of growth period, while PPO activity was expressed slowly during this period.From 20 d to 35 d,PPO activity increased significantly and the baicalin secondary synthesis was restrained.Conclusion The high-level expression of PPO activity do harm the baicalin secondary synthesis.These chemical substances,such as ascorbic acid, sodium chloride,and benzoic acid could inhibit the PPO activity and improve the content of baicalin;It is obvious for ascorbic acid(0.02%) to improve the content of baicalin with 17.6%(82.3 mg/g) compared with the control.However,polyvinylpyrrolidone and copper sulfate could increase the PPO activity and greatly inhibit the baicalin accumulation.