Objective To compare the influence of cardiopulmonary bypass(CPB) on brain injury in the infants with compli‐cated congenital heart disease(CHD) and simple CHD by analyzing and monitoring the perioperative cerebral electric impedance co‐efficient ,serum S‐100βprotein and neuron specific enolase (NSE) .Methods Forty infants with CHD were randomly selected and divided into two groups:the complicated group(n=20 ,13 cases of tertralogy of fallot ,7 cases of transposition of great arteries) and the simple group(n=20 ,8 cases of atrial septal defect ,12 cases of ventricular septal defect) .Blood samples were taken and the cere‐bral electric impedance coefficients before operation(T1 ) ,at 10 min after CPB(T2 ) ,immediately after aortic clamping(T3 ) ,aortic o‐pening(T4 ) ,end of CPB(T5 ) ,at 5 h(T6 ) and 24 h (T7 ) after CPB were measured by the BORN‐BE noninvasive brain edema moni‐tor .Serum levels of S‐100βprotein and NSE were detected by ELISA .Results There was no statistically significant difference in the cerebral electric impedance coefficient ,S‐100βprotein and NSE before surgery(P>0 .05) .The cerebral electric impedance coef‐ficient ,S‐100βprotein and NSE were significantly increased from the beginning to the end of CPB(P< 0 .05) ,and gradually de‐creased after CPB(P<0 .05) .The cerebral electric impedance coefficient ,S‐100βprotein and NSE were obviously higher in the com‐plicated group than those in the simple group at the same time points(P<0 .05) .The cerebral electric impedance coefficient was re‐spectively correlated with S‐100βprotein and NSE .Conclusion The influence of CPB on brain injury in complicating CHD infants is more serious than that in simple CHD infants .The BORN‐BE noninvasive brain edema monitor can be used during CPB periopera‐tive period in complicating CHD infants for conducting the real time monitoring in order to reduce brain damage .

Objective To investigate the gastric mucosal characteristics of Helicobacter pylori(Hp)-associated gastritis under high-resolution magnifying endoscopy. Methods Fujinon EG 485 ZH 850k CCD high-resolution electronic magnifying endoscopy was performed. Fifty patients were inspected by regular endoscopy with high-resolution magnifying function. Particular inspection was given on the collecting venules, the pit patterns of the gastric antrum and gastric body. Four pieces of biopsy specimen were taken, 1 each in antrum and body for RUT and the other two for pathologic examination as well as W-S stain. Both of the W-S stain and RUT being positive were confirmed as Hp infection. The Hp-positive patients received the triple therapy. Endoscopy with biopsies was repeated 4 weeks after the course of eradication treatment ended. The results were assessed by SPSS 8. 0 statistical package. Results Twenty-six patients were Hp-positive and 24 patients Hp-negative. In comparing with the results of W-S stain and RUT , the high-resolution magnifying endoscopy features and regular endoscopy findings had different outcomes. The sensitivity was 69. 23% Vs 34. 62% ; the accuracy 78.00% Vs 58. 00% respectively; the positive likelihood ratio and the negative likelihood ratio were 5. 54 Vs 2. 08 and 0. 35 Vs 0. 78 respectively. The Kappa value in high-resolution magnifying endoscopy was 0.563 whereas in regular endoscopy was 0. 176. Conclusions The advantage of high-resolution magnifying endoscopy relies on its ability to observe the fine gastric mucosal patterns. The gastric mucosal features of Hp-associated gastritis can be described as followings: collecting venules are irregular or disappeared; the gastric pits are enlarged or reddened, the sulciolar are deepened. Compared with regular endoscopy, the high-resolution magnifying endoscopy is better in sensitivity, accuracy and likelihood ratio. A high degree of interobserver agreement was obtained with the Kappa value. The pathologic findings get better soon after the eradication therapy, while the endoscopic changes are not prominent.

Objective To investigate the endoscopic feat ures and endoscopical treatment of gastric carcinoid tumors.Methods The clinical and endoscopic materials of 18 patients w ith gastric carcinoid tumors was retrospectively reviewed.Results Five of the 18 patients were benign and 13 were maligna nt. Benign gastric carcinoid tumors were found by biopsy at endoscopy ,and were resected by endoscopic mucosal resection(EMR).Their endoscopic appearance was mu ltiple polypoid masses. 13 malignant patients were confirmed by surgery. Their e ndoscopic appearance was ulcerating and infiltrating lesions.Conclusion Gastroscopy remains to be valuable to set correct di agnosis of gastric carcinoid tumors. EMR may be the first choice for benign gast ric carcinoid tumors.

Objective To investigate the characteristic findings of intestinal metaplasia revealed by magnifying endoscopy, and clarified their relationship with histopathological features. Methods One hundred and nine patients underwent magnifying endoscopy between March 2003 and November 2003. Patients with gastric adenocarcinoma, esophogeal and/or gastric varices, history of gastric surgery were excluded. Endoscopic examination was performed with a high-resolution magnification endoscope after methylene blue (1 % ) spraying. According to the differences in color and mucosal pattern, forms of endoscopic images were defined, and biopsies were taken (n = 115). Results Six patterns of endoscopic images were defined according to the microscopic findings. Pattern-4 and -5 were related to intestinal metaplasia. Histological features were used as the key standard. Conclusion High-resolution magnifying endoscopy is useful in detecting intestinal metaplasia of gastric mucosa pits from its normal shape changed into oval shape or villous like pattern. This procedure may improve the follow-up of individuals at high-risk of gastric cancer.

Objective To investigate the efficacy of breviscapine in the treatment of vascular cognitive impairment.Methods A self-controlled trial was carried out in 36 patients with vascular cognitive impairment.36 cases were treated with breviscapine injection 50mg intravenous infusion daily for 3 weeks.At the same time,all cases were also given citicoline 0.75g/d and enteric-coated aspirin 100mg/d as routine treatment.The means of the evaluation on therapeutic effect included MMSE and ADL,and the adverse reactions were also observed.Results After the treatment,the MMSE scales increased from(18.75 ± 3.25)to(21.62 ± 3.58)(t=2.52,P＜0.05),Meanwhile,ADL scales declined from(45.65 ±3.36)to(42.33 ±4.18)(t=3.71,P＜0.05).There was significant difference on the MMSE and ADL between the pre and post therapy.No obvious side effects were found.Conclusion The results indicated that the breviscapine injection is an effective medicine in the treatment of vascular cognitive impairment,while the adverse reactions were few.

Background and purpose:Hereditary nonpolyposis colorectal cancer(HNPCC) which related to inheritance is an autosomal dominant inheritance.There are many screening standards differing presently from country to country.The Amsterdam standard is internationally recognized.These screening standards are just based on family history and clinical manifestations which can not reflect the essence of the disease.At present,the golden standard for screening HNPCC is mismatch repair genes detection that is in the experimental stage.The purpose of this study was to investigate the expression of mismatch repair genes hMSH2 and hMLH1 in HNPCC and their clinicopathological signif icance,and to fi nd a simple,fast and economic method for screening HNPCC.Methods:Immunohistochemical staining was used to detect the expression of hMSH2 and hMLH1 in 20 cases with HNPCC(Group A),20 cases with ordinary hereditary colorectal cancer(Group B),20 cases with sporadic colorectal cancer(Group C),and 20 cases with colorectal polyps(Group D).Results:The expression rates of hMSH2 and hMLH1 in Group A,B,C and D were 35%(7/20),70%(14/20),95%(19/20) and 100%(20/20) respectively,which illustrated that the probability of HNPCC and the negative expression of hMSH2 and hMLH1 was reduced from Group A to Group D.There were signifi cant differences among these groups(P0.05).Conclusion:The negative expression of hMSH2 and hMLH1 was signifi cantly correlated with HNPCC and location and differentiation of colon carcinoma.Immunohistochemical staining may be useful for screening HNPCC.

Objective: To investigate the correlation of thrombospondin-1(TSP-1) expression and angiogenesis and clinical pathologic factors in breast cancer. Methods:Reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the expression of TSP-1 mRNA in the primary breast cancer tissues and the tissues set apart 5 cm from the tumor. Im-munohistochemistry was used to detect the expressions of vascular endothelial growth factor (VEGF), c-erbB2, estrogen receptor (ER), progesterone receptor (PR) and microvessel density (MVD). All data were statistically analyzed. Results: The positive rate of TSP-1 was significantly higher in breast cancer than that in tissues set apart 5 cm from tumor (P < 0.05). The expression of TSP-1 was positively correlated with tumor size only (P < 0.05). MVD was lower in TSP-1 positive group than that of negative group (P< 0.05). Conclusion: The MVD was decreased with up-regulation of TSP-1 expression. Thrombospondin-1 may repress the angiogenesis in breast cancer.

Objective To analyze the clinical efficacy of endovenous laser treatment combined with transilluminated powered phlebectomy for great saphenous varicosity and summarize the experiencein order to achieve better results.Methods From January 2014 to June 2015,45 patients (52 limbs,including 17 males and 28 females,aged 36 to 68 years) diagnosed as great saphenous varicosity received endovenous laser treatment combined with transilluminated powered phlebectomy.Thirty-eight cases was unilateral great saphenous vafcose veins,7 cases was bilateral large saphenous varicose veins.The clinical efficacy was analyzed.Results All cases were performed successfully.The mean operation time was (68.4 ± 15.1) minutes,the average bleeding volume was (23.5 ± 10.7) ml,the number of mean operative incision quantity was (5.8 ± 1.9) and the average hospitalization time was (5.9 ± 1.6) days.All patients had no serious complications.During a mean follow-up time of 22 months (12 to 30 months),only one patient recurred.Conclusions Endovenous laser treatment combined with transilluminated powered phlebectomy for great saphenous varicosity is effective and safe.It also has the advantages of shorter operation time,less bleeding,shorter hospitalization time,small trauma and better cosmetic results.

Objective To observe the efficacy of monosialotetrahexosy lganglioside (GM1) in the treatment of vascular cognitive impairment (VCI). Methods Sixty patients with VCI were randomly divided into either a treatment group or a control group. The patients in the control group received conventional treatment and those in the treatment control group were treated with conventional treatment plus continuous intravenous infusion of GM1 (80 mg/d) for 2 weeks. The efficacy was evaluated by the Montreal Cognitive Assessment (MoCA) before and after the treatment, and the safety of the treatment was observed. Results After 2 weeks of treatment, the MoCA scores were significantly higher than those before treatment in both groups (all P ＜ 0. 05). The MoCA scores of the treatment group were significantly higher than those of the control group (20. 82 ± 1. 96 vs. 19. 61 ±2. 02, t =2. 315, P =0. 023). No obvious adverse reactions were found. Conclusions The efficacy of GM1 is positive in the treatment of vascular cognitive impairment, and there is no obvious adverse reactions. It is worthy of using widely in clinical practice.

Objective To explore the effect of the unilateral lumbar anesthesia by hypobaric bupivacaine and general anesthe‐sia in elderly hip replacement and their influence on the stress response .Methods Forty elderly patients undergoing hip replace‐ment in our hospital from December 2013 to November 2014 were selected and randomly divided into the unilateral lumbar anesthe‐sia group and general anesthesia group according to the random number table ,20 cases in each group .Venous blood was collected to determine the levels of blood sugar ,serum catecholamine(CA) and cortisol(CORT ) at 10 min before anesthesia(T0 ) ,end of surgery (T1 ) and at postoperative 24 h(T2 ) .MAP ,HR ,SpO2 ,intraoperative adverse reactions and postoperative related complications were recorded at each time point ,and the comparative analysis was performed .Results All patients successfully completed surgery and the anesthetic effect was satisfied .The occurrence rates of intraoperative hypotension ,hypertension and bradycardia in the unilateral lumbar anesthesia group were lower than those in the general anesthesia group ,the differences had statistical significances (P>0 .05) .HR and MAP at T1 in the two groups were reduced ,but the differences between the two groups were no statistical signifi‐cance(P>0 .05);the levels of GLU ,CORT and CA were increased ,moreover the differences between the two groups were statisti‐cally significant(P<0 .05) .SpO2 at T2 in the general anesthesia group was obviously lower than that in the unilateral lumbar anes‐thesia group ,while CORT was higher than that in the unilateral lumbar anesthesia group ,the differences were statistically signifi‐cant(P<0 .05) .The occurrence rates of postoperative nausea and vomiting ,sore throat ,dizziness ,drowsiness and pulmonary infec‐tion in the unilateral lumbar anesthesia group were lower than those in the general anesthesia group ,the differences were statistical‐ly significant(P<0 .05) .Conclusion The unilateral lumbar anesthesia by using hypobaric bupivacaine and general anesthesia all could offer better anesthetic effect .The unilateral lumbar anesthesia by using hypobaric bupivacaine can effectively regulate the stress response in elderly patients with hip replacement .