Objective To discuss the microcosmic elements and syndromes distribution of H pylori-related gastritis. [Method] Choose 100 cases, under gastroscope report, make statistics of frequency of disease nature elements and location elements, combine the nature and location for common syndromes. [Result] The H pylori-related gastritis has main disease location elements in stomach, esp. the sinuses ventriculi;the disease nature elements mainly concern hot, wet, sputum stasis, deficiency and blood stasis; the common syndromes: hot stomach, sputum and stasis blocking stomach, wet-hot accumulated in stomach, deficient stomach, wet stranding stomach and stasis blocking gastric col aterals. [Conclusion] Over the inconsistent syndromes in clinical H pylori-related gastritis, the microcosmic elements differentiation can further standardize syndromes and guide the treatment.

Objective To explore the preventive and therapeutic role of silencing type Ⅰ rat platelet-binding protein motifs depolymerization protein-like metalloproteinase 2(ADAMTS2)by siRNA on experimental liver fibrosis in vitro.By studying the mechanism of siRNA silencing of ADAMTS2,we also aim to evaluate the feasibility of ADAMTS2 as a target for anti-liver fibrosis therapy.Methods Three pairs of siRNAs targeting ADAMTS2 mRNA 2237,2597 and 690 targets were designed and synthesized by utilizing RNA design software.The most effective siRNA was chosen to transfect HSC-T6 cell line to test the tendency of hepatic stellate cell(HSC)activation and ex pression of ADAMTS2,COL1α1,COL(I),α-SMA,TGF-β1,MMP-2 and TIMP-3.These were quantified using real time-PCR,Western blotting,and MTT assays.Results Of the same dosage and time of injection,siRNA 2237 inhibited ADAMTS2 gene expression significantly more than other siRNAs.siRNA-ADAMTS2 2237 markedly inhibited ADAMTS2 gene and protein expression of HSCT6 with more than 80％ efficiency.Conversely,siRNA-ADAMTS2 2237 markedly reduced the gene and protein expressions of COL(I),α-SMA and TGF-β1 on HSC-T6 and inhibited the proliferation of HSC.Conclusions siRNA-ADAMTS2 2237 could effectively knockdown the gene and protein expression of ADAMTS2 in HSC-T6 cell lines.Silencing ADAMTS2 by siRNA significantly inhibited the activation,proliferation of HSC and the gene and protein expressions of COL(I),α SMA,and TGF-β1,and it may have a potential anti-fibrotic effect.ADAMTS2 might be an efficient target for anti-fibrotic therapy.

In 1989, Fitz defined and classified severe acute pancreatitis (SAP) and he thought that surgical treatment of SAP is feasible. Since then, the strategy of treating SAP was a controversial issue over past decades. Currently, relevant literatures reported that medical or minimally invasive treatments are superior to surgical treatment, while it is too early to make the final conclusion because of the complexity of SAP. From 1989 to 2008, 1852 patients with acute pancreatitis were treated at the General Hospital of PLA, and the clinical data of 18 patients who died of SAP were retrospectively analyzed. Based on the analysis, we concluded that medical conservative therapy and surgical operative therapy should not be opposed to each other. Selecting ideal timing and appropriate operation on the basis of pathological changes of retroperitoneum and pancreatitis should be considered seriously, and the new concept of "miniaturization of trauma" should also be introduced in treating SAP.

Objective To investigate the feasibility and clinical value of pulmonary carcinoma in middle-advanced stage bypercutaneous intratumor carboplatin injection(PCI) under CT guided in combination with bronchial artery infusion(BAI) and intrathoracic artery infusion(IAI).Methods There were totally 58 cases with central bronchial carcinoma in stage Ⅲ and Ⅳ.Of them,30 cases(treatment group) were treated by BAI+IAI and PCI,while 28 patients(control group) were treated by BAI and PCI.Therapeutic effect was evaluated according to the improvement of the following variables:CT,life quality and survival period after treatment.Results The responsive rate in the treatment group(73.3%) was significantly higher than that in the control group(46.4%),the life quality and survival period were much improved.Conclusion Percutaneous intratumor carboplatin injection in combination with BAI and IAI is a effective method for bronchial carcinoma in Ⅲ and Ⅳ stages,it can not only improve the shorten effect,prolong survival period,but also can improve patients life quality.

Objective To investigate the relationship between the polymorphism of transforming growth factor-β1 (TGF-β1 ) gene and risk of chronic hepatitis B virus(HBV)infection progressing to hepatocellular carcinoma(HCC).Methods 120 patients with chronic HBV infection(case group)and 100 age-and sex-matched healthy individuals(healthy control group)were randomly enrolled to this study.The polymerase chain reaction-restriction fragment length polymorphism technique was adopted to detect the single nucleotide polymorphism of TGF-β1 gene(T29C),and made the comparative analysis combined with TGF-β1 mRNA level. Results The risk of HCC occurrence in the patients carrying genotype CC was decreased than that in the patients carrying geno-type TT (OR=0.317,95%CI =0.110-0.913,P =0.033;OR=284,95%CI =0.093 -0.866,P =0.027),the risk of HCC in pa-tients carrying allele C was significantly decreased compared with that in the patients carrying allele T(OR =0.570,95%CI =0.341 -0.953,P =0.032;OR=0.548,95%CI =0.320-0.936,P =0.028).In the HCC group,the patients carrying genotype CC had the lower lever of TGF-β1 mRNA.Conclusion TGF-β1 gene polymorphism(T29C)may be related to the risk of chronic HBV infection progressing to HCC.

Objective To research the physiology of visual cortex activated by rotating grating with functional-MRI(fMRI), and to identify the components of the activation. Methods Functional MRI was performed in 9 healthy volunteers by using GRE-EPI sequences on a 1.5 T MR scanner. In the block designing, rotating grating, static grating, and luminance were plotted as task states, while static grating, luminance, and darkness were set as control states. The stimuli tasks included six steps. Imaging processing and statistical analysis was carried out off-line using SPM99 in single-subject method. Results Some respective areas of visual cortex were activated by the various stimuli information supplied by rotating grating. The strong activation in the middle of occipital lobe located at primary vision area was related to the stimuli of white luminance. Its average maximum points were at 13,-98,-2 and 11, -100,-4. The bilateral activations of Brodmann 19th area located at MT area were related to visual motion perception. Its average maximum points were at 46,-72,-2 and -44,-74, 0. The mild activation in the middle of occipital lobe was related to form perception. Its average maximum points were at -12,-98,-6 and -16,-96, (-6.) Conclusion The plotting of control state is important in bock design. The effective visual information of rotating grating includes components of luminance, visual motion perception, and form perception. FMRI has potential as a tool for studying the basic physiology of visual cortex.

Objective To explore the clinical efficacy of three dimensional (3D) laparoscopic sleeve gastrectomy (LSG) in the treatment of obesity combined with type 2 diabetes mellitus.Methods The retrospective cross-sectional study was conducted.The clinical data of 28 patients with obesity combined with type 2 diabetes mellitus who were admitted to the Qinghai Red Cross Hospital between January 2013 and April 2016 were collected.All the patients underwent 3D LSG.Observation indicators:(1) surgical and postoperative recovery situations;(2) follow-up and metabolic indexes changes.Follow-up using outpatient examination and telephone interview was performed to detect complications of patients after discharge and usages of antidiabetic drugs or insulin up to February 2017.Body mass,body mass index (BMI),hemoglobin (Hb),albumin (Alb),fasting serum C-peptide,fasting blood sugar,2-hours postprandial blood glucose (2HPBG) and glycosylated hemoglobin (GHb) were detected at month 1,3,6 and 12 postoperatively.Measurement data with normal distribution were represented as (x)±s.Repeated measurement data were analyzed by the repeated measures ANOVA.Count data were evaluated by the proportion.Results (1) Surgical and postoperative recovery situations:28 patients underwent successful 3D LSG,without conversion to open surgery.Operation time,volume of intraoperative blood loss,time of postoperative gastrointestinal function recovery and time of postoperative drainage tube removal were (133 ± 20) minutes,(45 ± 22) mL,(2.5 ± 1.2) days and (3.4 ± 0.9) days,respectively.There were no postoperative complications and perioperative death.Duration of hospital stay was (7.1 ± 1.5) days.(2) Follow-up and metabolic indexes changes:28 patients were followed up for 6-12 months,with a median time of 8 months.During the follow-up,there was no death or severe complications.Body mass,BMI,Hb,Alb,fasting serum C-peptide,fasting blood sugar,2HPBG and GHb from pre-operation to month 1,3,6 and 12 post-operatively were decreased from (113±26) kg to (78± 14) kg,from (44±6) kg/m2 to (35±5) kg/m2,from (157±19) g/L to (140±13) g/L,from (43±5)g/L to (40±4)g/L,from (2.50±0.37) μg/L to (1.20±0.33) μg/L,from (10.5±2.0)mmol/L to (5.6±0.5)mmol/L,from (16.3±3.1)mmol/L to (7.9±0.9) mmol/L,from 9.2％± 0.9％ to 6.8％ ±0.6％ with statistically significant differences between preoperative and postoperative indicators (F=396.47,328.20,111.10,21.28,161.06,127.80,243.40,234.64,P＜0.05),and showing a downward trend.Of 28 patients,25 had complete remission of type 2 diabetes mellitus at 12 months postoperatively and 3 had partial remission,with an effective rate of 100.0％ (28/28).The excess weight loss was 63％± 16％.Conclusion 3D LSG is safe and effective in the treatment of obesity combined with type 2 diabetes mellitus,with a good shortterm outcome.

Objective To investigate the value of CD5 molecule-like protein(CD5L) and partial pressure of CO2 in arterial blood(PaCO2) in predicting the survival of patients with severe asthma and mechanical ventilation.Methods From Jan.2013 to Jan.2016,a total of 38 patients with severe asthma and mechanical ventilation were enrolled.Acute Physiology and Chronic Health EvaluationⅡ(APACHE II)were used to assess the severity.Enzyme linked immunosorbent assay was used to detect serum levels of CD5L at admission and 6 h after treatment.PaCO2 were also detected.Pearson correlation analysis was used to analyze the correlation between APACHEⅡ score and CD5L and PaCO2 levels.Receiver operation characteristic(ROC) curve was used to evaluate the value of CD5L and PaCO2 in predicting the survival of patients.Results APACHEⅡscores of survival patients were significantly higher than dead patients(P<0.05).CD5L level of survival patients after treatment was significantly lower than dead patients,while PaCO2 level was significantly higher(P<0.05).APACHEⅡ score was negatively correlated with serum CD5L level(r=-0.347,P<0.05),while positively correlated with PaCO2 level(r=0.573,P<0.05).ROC curve analysis showed that serum CD5L and PaCO2 were with predictive value for prediction the survival of patients,with sensitivity of 93.33%,specificity of 75.00%,accuracy of 89.47%,positive predictive value of 93.33%,and negative predictive value of 75.00% for CD5L,and those for PaCO2 were 90.00%,87.50%,89.47%,97.42% and 70.00%.Conclusion With the decreasing of CD5L level and increasing of PaCO2 level,severity of disease in patients with severe asthma and mechanical ventilation could be more serious condition,indicating poor prognosis.CD5L and PaCO2 could be with fine predictive value of survival of patients with severe asthma and mechanical ventilation.

Objective To explore the effects of silencing DDR2 expression by siRNA on CCl4-induced liver fibrosis and its mechanism in rats. Methods Liver fibrosis model was induced by intraperitoneal injection of CCl4 twice a week for 6 consecutive weeks. Some rats were administered siRNA targeting DDR2 (0. 3 mg/kg), saline or control siRNA every three days from the beginning of CCl4 injection via tail vein injection, while other rats were treated in the same pattern after 2-week CCl4 injection. Quantitative real-time polymerase chain reaction (QRT-PCR) and Western blot were used to detect the mRNA and protein expressions of DDR2, MMP-2 and COL Ⅰ . Meanwhile, the pathological changes of liver tissues and the levels of liver function were also observed. Results QRT-PCR showed that the DDR2, MMP-2 and COL Ⅰ mRNA in the chemically synthetic cholesterol-modified siRNADDR2 group were significantly decreased as compared with those in the control group (P＜0.01) ,and the protein expressions of DDR2, MMP-2 and COL Ⅰ were also significantly decreased (P＜0. 01,4 wand 6w). In addition, in comparison with those in the control group, the pathological changes of liver tissues in the siRNA-DDR2 treated group were markedly attenuated, and the levels of ALT(1356.17 ±83.80 nkat/L vs 2532. 70±145.11 nkat/L,4w,1367. 60±321.76 nkat/L vs 2604.37±255.02 nkat/L,6w,P＜0. 01 ) and AST (2460. 80 ± 207. 58 nkat/L vs 3983. 70 ± 253. 08 nkat/L, 4w, P＜ 0. 01,2383.27±290.16 nkat/L vs 3227.70±353. 34 nkat/L,6w,P＜0. 05)were also significantly lowered,while the level of TBIL (7. 97 ± 1.60 μmol/L vs 3.80± 0.60 μmol/L, 4w, 10.40±1.61 μmol/L vs 6.10±0.79 μmol/L,6w,P＜0. 01)was markedly increased. Conclusion Systemic administration of cholesterol-modified siRNA targeting DDR2 could significantly suppress the expression of DDR2, decrease the contents of the extracellular matrix,and thus has a potential antifibrotic effect.

Karoshi rem ains one of the m ost troublesom e issues in forensic identification. It is rather a social m edicine than a clinical disease. Japanese scholars pioneered exam ining the relation betw een sud-den cardiac death (SCD ) and chronic fatigue from long tim e and/or high-tension work. In the current case, a 55-year-old m an, w hose job w as loading and carrying heavy cem ent bags, w as found dead after 11 days of continuous hard work. H is fam ily m em bers sued the cem ent factory for his death and claim ed for com pensation.The problemw as the difficulty of identifying the causative relation w ithout the precedent or the relevant regulations. H ow ever, the forensic problems were finally acknow ledged after autopsy and calculation of labor intensity.The law suit w as w on as the first case pertaining to Karoshi in the Chinese court.