Objective To analyze the relationship between the varicosity of esophagus and portal hypertensive gastropathy(PHC) in patients with upper gastrointestinal hemorrhage of hepatocirrhosis. Methods The damage degree of esophageal varicosity was divided into four grades and the PHG were divided into three groups according to the McCormack standards by emergency gastric endoscopy. Results Among 200 patients with upper gastrointestinal hemorrhage,100 cases(50. 0%) were caused by esophageal varicosity explosion and 44 cases(22. 2% ) were induced by PHG,38 cases (19. 0%) were due to gastric ulcer, 18 cases (9. 0%) were duo to other causes. Comparison between etiology and liver function of A-class(except for other reasons group) were significantly different(X2 =4. 23 ,X2 =4. 15 ,X2 =4. 18,X2 =4. 07,P＜0. 05 ;X2 =6. 83 ,X2 =7. 01 ,P＜0. 01 ) ;The portal vein diameter＞1.5cm bleeding incidence(32. 5% ) were significantly higher than the diameter＜1. 1cm bleeding incidence( 12. 5% ) (X2 =4. 73 ,P ＜0. 05 ) ;The degree of PHG in severe esophageal varices (55. 6% ) were significantly higher than the mild esophageal varices( 11.1% )( X2 = 7.73, P＜0. 01 ). The correlation between PHG degree and esophagus varicosity were positive related(r=0.455,X2 = 4.01,P＜0.05). Conclusion The esophageal varicosity explosion and PHG are two major factors to cause hepatocirrhosis complicated with upper gastrointestinal hemorrhagein. The more severe the damage degree of esophageal varicosity is,the higher incidence and the more severe the PHG will be.

Objective To value of economic with emergency endoscopy in the diagnosis and treatment of massive upper gastrointestinal hemorrhage. Methods I00 patients with upper gastrointestinal hemorrhage were ran-domly divided into emergency endoscopy group (group A) 48 cases and non emergency endoscopy group (group B) 52 cases. Then the correct diagnosis rates, rebleeding rates, complication rates, mean hospitalization days, the en-doscopy costs, the blood transfusion costs, the drugs costs and the total hospitalization costs of two groups were evalu-ated and the cost effect ratio (C/E) was calculated. Results Thecorrect diagnosis rates in A group (100. 0%) were higher than the B group(90. 2%)(x2 =4.01,P <0. 05) ;The endoscopy costs of group A (714. 78±263.54) yuan were higher than the group B (383.57 ±251.72) yuan(t = 2. 778, P < 0. 01) ; Rebleeding A group (6. 7%) were sig-nificantly lower than B group(26. 8%) (x2 = 4. 13 ,P < 0. 05) ; The total hospitalization costs in group A (2785.76 ± 353.26) yuan were lower than group B (3527. 76 ± 555.62) yuan (t = 2. 898, P < 0. 01) ; The C/E of group A (2785.76) yuan per patient were lower than the group B(3527.76) yuan per patient (t = 2. 239 ,P < 0. 01). Con-dusion Emergency endoscopy is economical in the diagnosis and treatment of massive upper gastrointestinal hereof-rhea.

Objective:To explore th five year survivals and some prognostic factors for bres at cancer patients in the north areas of China,and the indentification or differ e nces on these variables among breast cancer patients between in China and in Can ada.Methods:All Data were collected from the hospital records of 1 002 breast cancer patients who were initially treated at the First Hospital of Jilin Uni versity (116 cases FTH,Changchun China) and the Sain t-Sacrement Hospital (886 cases in SSH,Quebec Canada) respectively by use of Historical Cohort survey,and the survival propotions were calculated and comp ared stradly by use of Kaplan-Meier method.Results:Age at diagnosis was substantially lower (average of age about 10 years less) among breast cancer patients seen at FTH compared to those treated at SSH (P<0.0001).Patients in the two hospitals differed in respect to tumor size at pathology (P=0.036).The proportion of women with lymph node involvement was greater at FTH (61.1%) than that at HSS(37.3%)(P<0.0001).Surgical treat ment of breats cancer was varied considerably:the radical mastectomy was frequen tly performed for andy stage of breast cancer patients in Changchun,but the part ial mastectomy was mainly used for patients with stage Ⅰ or Ⅱ in Quebec.The fi ve year survival was 74.2% among breast cacer patients seen at FTH compared to 7 6.3% among women treated at HSS,and there was no singnificant differrence (P =0.302). Conclusion:Five year survival of breast cancer patients treated surgically in C hangchun,China,was similar to that of patients treated surgically in Quebec,Can ada except for differences in age at diagnosis,tumor size and lymph node involve ment

Objective To investigate the cut-off point value of 1-hour plasma glucose of oral glucose tolerance test in the diagnosis of the T2DM and IGR.Methods Three hundred and fifty-four subjects (6.0mmol/L≤ FPG ＜ 7.0mmol/L) were participated in the OGTT.To get the cut-off point value of 1-hour plasma glucose in the diagnosis of the T2DM and IGR by applying the receiver operator characteristic curve,and compare it with the WHO diagnostic criteria.Results (1)The cut-off point value of screening T2DM by ROC curve was 12.90mmol / L,whose specificity was 77.1％ and sensitivity was 90％.Meanwhile the cut-off point value of screening IGR was 10.83mmol / L,whose specificity was 73.2％,and the sensitivity was 73.5％.(2)Among the 136 patients with type 2 diabetes mellitus that diagnosed by WHO criteria,115 patients could be diagnosed by 1hPG that more than FPG which could diagnose 81 patients.And the difference was statistically significant (P ＜ 0.05).Meanwhile,It was more than 106 patients that diagnosed by 2hPG,but there was no statistically significant.According to the diagnostic criteria of 2hPG ≥11.1mmol/L,there were 106 cases of T2DM.Among these patients,95 cases and 51 cases could be diagnosed respectively by 1 hPG and FPG,and there was statistically significant (P ＜ 0.01).(3)Application of the cut-off point of 1 hPG,NGT,IFG,CGI and DM re-grouped.FPG,2hPG increased gradually in order to NGT,IGR,DM.(4) No matter the blood glucose levels,1hPG and 2hPG had good correlation,(P =0.000).A significant correlation could be found between FPG and 2hPG only in hyperglycemia.The correlations between 1 hPG and FPG disappeared only in a normal level of blood glucose.Conclusion The cutoff point value of 1hPG is 12.90mmol/L which has advantage to diagnosis of type 2 diabetes mellitus.It is a useful complement to the WHO Diagnostic criteria.

0.05).The ADCs of low-grade(gradeⅠ～Ⅱ) astrocytomas were significantly higher(P

This paper analysed the rhinoscope's clinical value in microsurgical treatment of intracranial aneurysms. Application of the rhinoscope in 87 patients, only 2 patients had ruptured during operation. However, 11 cases had ruptured in 94 cases without using rhinoscope, P < 0.05, they had a significant difference. By DSA follow-up review, 82 cases of used rhinoscope only 2 cases had remained the aneurysm neck, but 9 cases had the aneurysm neck in 77 cases which had not used the rhinoscope in the microsurgical treatment, P < 0.05, they also had significant difference. The application of rhinoscope in microsurgical treatment of intracranial aneurysms intraoperative, can reduce the risk of the intraoperative aneurysm rupture. It can achieve better clinical effect.
Adult ; Aged ; Endoscopy ; Female ; Humans ; Intracranial Aneurysm ; surgery ; Male ; Microsurgery ; Middle Aged ; Nose ; surgery ; Treatment Outcome

0.05),the average costs of antibiotics,all other drugs and hospitalization in trial group were lower than those in control group(P

Objective To compare inter-hospital transport and clinical outcome in severe acute respiratory distress syndrome(ARDS)patients whom were transported either on extracorporeal membrane oxygenation(ECMO) or on conventional ventilation,and to investigate the optimal means of inter-hospital transport. Methods Eleven patients with severe ARDS who were invalid under conventional ventilation and were transported from other hospitals to Tianjin Third Central Hospital from November 2009 to January 2014 were analyzed. Five patients were transported on ECMO(observation group)and 6 on conventional ventilation(control group). The clinical characteristics,outcomes, transportation,vital signs before and after transportation,respiratory parameters,and Murray score between two groups were compared. Results Patients in observation group were significantly older than those in control group〔years:73(46,77)vs. 34(23,46),Z=-2.293,P=0.022〕. There was no significant difference between observation group and control group in acute pathologic and chronic health evaluationⅡ(APACHEⅡ)score,Murray score,oxygenation index(PaO2/FiO2)before transportation,transit time,and transit distance〔APACHEⅡscore:36(33,39)vs. 27(23,35),Z=-1.830,P=0.067;Murray score:3.5±0.3 vs. 3.4±0.2,t=0.667,P=0.524;PaO2/FiO2(mmHg, 1 mmHg=0.133 kPa):61±14 vs. 63±14,t=-0.249,P=0.809;transit time(minutes):24(18,74)vs. 79(41, 86),Z=-1.654,P=0.098;transit distance(km):12.9(8.3,71.8)vs. 72.4(39.5,86.8),Z=-1.651,P=0.099〕. There was no significant difference between two groups in vital signs and respiratory parameters before transportation. When arrived in ECMO centre,heart rate,respiratory rate,fractional inspired oxygen,inspiratory pressure and Murray score in observation group were significantly lower than those in control group〔heart rate(beat/min):102±16 vs. 136±8, t=-4.374, P=0.002;respiratory rate(beat/min):23±3 vs. 37±2,t=-7.967,P=0.000;fractional inspired oxygen:0.40±0.05 vs. 0.96±0.09,t=-12.152,P=0.000;inspiratory pressure(cmH2O, 1 cmH2O=0.098 kPa):21±1 vs. 34±4,t=-6.887,P=0.000;Murray score:2.7±0.2 vs. 3.8±0.2,t=-8.573, P=0.000〕,but PaO2/FiO2 was higher than that of control group(mmHg:278±65 vs. 41±5 ,t=8.075,P=0.001). Four patients were survived in observation group,and one died from the shortage of oxygen induced lung injury deterioration during transportation. Three patients died in control group,which was directly associated with lung injury deterioration. Conclusion For patients with severe ARDS who need the support of ECMO,ECMO-assisted transfer is safer than conventional ventilation,but transfer should be implemented by experienced team.

Network pharmacology is an emerging discipline based on the Disease-Gene-Drug multilevel network. And it has been used to forecast the drug targets and improve the efficiency of drug discovery. Its research ideas are similar to the overall efficacy of traditional Chinese medicine (TCM), which attracts more and more medical re-searchers to look for the joint point of TCM and network pharmacology. A series of approaches on disease-related genes, predicting the information of target and active ingredients of TCM emerge. In this paper, the network pharma-cology research tools, databases and their applications were summarized and introduced. This paper also proposed scientific strategies to separate active ingredients of TCM using network pharmacology, so as to improve the efficiency and speed of finding active ingredients of TCM.

Objective To explore the protective role of lipoxin A4 (LXA4) during early process of atherosclerosis formation in rats with juvenile metabolic syndrome (MS).Methods Rat models of juvenile MS were established with 3-week Sprague-Dawley (SD) rats fed on high-carbonhydrates and high-fat diet for 6 weeks.The other qualified ones were randomly grouped into model group,LXA4 low-dose group,LXA4 middle-dose group,and LXA4high dose group,and a control group fed with normal forage.The low,middle,high-dose groups were injected different doses of LXA4 daily,while the model group and control group were injected with the same dose of isotonic NaCl solution for 2 consecutive weeks.After 2-week medication,the visceral adipose tissue were isolated by laparotomy and heart blood collected by thoracotomy under anesthesia,followed the fixation of thoracic and abdominal aortas in the immobilized rats.The mRNA expression level of inflammation cytokines interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α),C-reactive protein (CRP) in the adipose tissue were determined by semi-quantitative reverse transcription PCR (RT-PCR),respectively.Secretions of IL-6,and TNF-α in serum were determined by enzyme linked immunosorbent assay (ELISA).Immunocytochemistry was used to label endomembrane and middle-membrane of thoracic aorta,and endothelial cell layer in each group and the ratios of thickness of endomembrane and middle-membrane were compared.Results Compared with the control group,weight,body length and abdominal circumference of juvenile MS rats increased significantly (all P ＜ 0.05),and levels of fasting plasma glucose (FPG),triglyceride (TG),high density lipoprotein cholesterol (HDL-C) and insulin in models increased significantly (P ＜ 0.05).RT-PCR showed that the mRNA expressions of inflammatory cytokines IL-6,TNF-α and CRP in adipose tissue in model rats were upexpressed (all P ＜ 0.05).Compared with model rats,mRNA of IL-6,TNF-oα,and CRP in mid,high-dose rats were downexpressed (all P ＜ 0.05),mRNA of TNF-α in low-dose rat downexpressed (all P ＜ 0.05),and there were no significant differences between mRNA expressions of IL-6,CRP in low-dose and model rats according to statistics (all P ＞0.05).Compared with control group,inflammatory cytokines IL-6,TNF-α secreted in serum of model rats were increased significantly (all P ＜ 0.05),and inflammatory cytokines secreted in serum of intervention rats were decreased significantly compared with model rats (P ＜ 0.05).Pathological changes were as follows:HE staining:compared to model group,aortic tunica intima of model rats were remarkably thickened and endothelial cell layer was fragmented and incomplete,which was attenuated in each intervention group.The ratios of endomembrane and middle-membrane in rats:at the end of consecutive medication for 2 weeks,the ratios of endomembrane and middle-membrane in model rats were significantly greater than those of control group (P ＜ O.05),and the ratios of endomembrane and middle-membrane in high-dose intervention rats were significantly smaller than those of the model group (P ＜ 0.05),but still greater than control group,while there were no statistical differences between the ratios in low,middle-dose intervention rats and model rats (P ＞ 0.05).Conclusions The increasing inflammatory cytokines are involved in early process of atherosclerosis formation in rats with juvenile MS.LXA4 by reducing the expression of inflammatory factor level in adipose tissue,thereby reducing the inflammatory cytokines in serum,alleviate the damage of arterial wall.