Objective To investigate a sonic wave device including micro-oscillator and microphone for real-time monitoring the situation of the esophageal motility of lower esophageal sphincter (LES). Methods A micro-oscillator that can actively send sound waves was located at one side of LES, and a microphone located at the other side can be to capture the sound generated from the oscillator. This device was tested in vitro by utilizing a LES simulator in quiet and noisy environment, as well as in vivo in a pilot model corresponding to moments A-D. Results In the in vitro test, the sound can be captured by the microphone, and its power strength was correlated with closing and opening of LES. The measurements showed statistically significant Pearson correlation coefficients. In the in vivo test, the LES was open and closed by an endoscope, which was monitored in real-time by another endoscope inserted into the distal stomach from the duodenum. The sound power strength corresponding to moments A-D were (-89.63 ± 0.79) dB, (-84.74 ± 0.97) dB, (-82.37 ± 1.93) dB and (-89.86 ± 0.75) dB. Conclusion The LES dynamics can be monitored by the acoustic interrogation device, which has the potential to become an effective minimally-invasive technique for studying LES dysfunction.

BACKGROUND: Craniofacial hard tissue structures vary in age, gender, regional and racial differences. Some researchers have conducted X-ray cephalometric measures of malocclusion deformity in some domestic cities, and obtained normal cephalometric measures of craniofacial hard tissue structure. However, little data have been available concerning cephalometric measures of craniofacial hard tissue structure of Tibetan youth in Tibet region. OBJECTIVE: To observe structural features of craniofacial hard tissue of permanent tooth occlusal period in the adolescent of Lhasa. DESIGN, TIME AND SETTING: Stratified cluster sampling survey was performed at Naqu, Tibet from June to August 2008. PARTICIPANTS: A total of 200 adolescents at permanent tooth occlusal period, 100 males and 100 females aged 11-14 years were selected from middle and primary schools of Lhasa in 2003. The inclusion criteria included: teeth in order, neutral occlusal adjustment, normal maxilla and mandible appearance and relationship, normal teeth number and overbite and overjet, concordant face, and no history of orthodontic management. METHODS: According to the requirements and standards for the irradiation, 200 subjects underwent X-ray cephalometric measures, and the results were compared with normal values of the same age. MAIN OUTCOME MEASURES: SNA angle, SNB angle, ANB angle, 1-SA angle, 1-NA angle, 1-NA, T-MP angle, Y axial angle, NP-FH angle, NA-PA angle, 1-T angle, MP-SN angle, Po-NB, T-NB angle, T-NB, and MP-FH angle. RESULTS: No significant differences were found between Lhasa adolescents and normal values in terms of SNA angle, SNB angle, ANB angle, 1-SN angle, 1-NA angle, 1-NA, T-MP angle, Y axial angle, NP-FH, NA-PA, 1-T, and MP-SN. Po-NB was slightly greater than normal value and T-NB angle, T-NB and MP-FH were significantly less than normal values. CONCLUSION: Lhasa adolescents have significantly different craniofacial hard tissue structure from normal values: forward protrusion of mental region, flat mandible angle, straight mandible anterior teeth, upward and forward rotated mandible, and straight face type.

BACKGROUND:Craniofacial hard tissue structures vary in age,gender,regional and racial differences.Some researchers have conducted X-ray cephalometric measures of malocclusion deformity in some domestic cities,and obtained normal cephalometric measures of craniofacial hard tissue structure.However,little data have been available concerning cephalometric measures of craniofacial hard tissue structure of Tibetan youth in Tibet region.OBJECTIVE:To observe structural features of craniofacial hard tissue of permanent tooth occlusal period in the adolescent of Lhasa.DESIGN,TIME AND SETTING:Stratified cluster sampling survey was performed at Naqu,Tibet from June to August 2008.PARTICIPANTS:A total of 200 adolescents at permanent tooth occlusal period,100 males and 100 females aged 11-14 years were selected from middle and primary schools of Lhasa in 2003.The inclusion criteria included:teeth in order,neutral occlusal adjustment,normal maxilla and mandible appearance and relationship,normal teeth number and overbite and overjet,concordant face,and no history of orthodontic management.METHODS:According to the requirements and standards for the irradiation,200 subjects underwent X-ray cephalometric measures,and the results were compared with normal values of the same age.MAIN OUTCOME MEASURES:SNA angle,SNB angle,ANB angle,1-SA angle,1-NA angle,1-NA,?-MP angle,Y axial angle,NP-FH angle,NA-PA angle,1-? angle,MP-SN angle,Po-NB,?-NB angle,?-NB,and MP-FH angle.RESULTS:No significant differences were found between Lhasa adolescents and normal values in terms of SNA angle,SNB angle,ANB angle,1-SN angle,1-NA angle,1-NA,?-MP angle,Y axial angle,NP-FH,NA-PA,1-?,and MP-SN.Po-NB was slightly greater than normal value and ?-NB angle,?-NB and MP-FH were significantly less than normal values.CONCLUSION:Lhasa adolescents have significantly different craniofacial hard tissue structure from normal values:forward protrusion of mental region,flat mandible angle,straight mandible anterior teeth,upward and forward rotated mandible,and straight face type.

Ulcerative colitis is an inflammatory disease of colon and rectum whose etiology is still unclear.Infliximab is an anti-tumor necrosis factor antibody,which has been approved recently by the United States FDA for the treatment of ulcerative colitis to reduce signs and symptoms,to induce clinical remission and healing of the intestinal mucosa.Total proctocolectomy with pouch-anal anastomosis are the standard operation for ulcerative colitis now.The perioperative infliximab use,operation timing and procedures are the important factors affecting prognosis of patients in the era of infliximab therapy.

OBJECTIVETo explore the auricular point specificity of the electric determination in stroke so as to provide the evidence for the objective study on the auricular point diagnosis in stroke.

METHODSThirty patients of stroke were selected in an observation group; 30 patients of non-stroke internal medicine disorder were in a control group A; 30 persons of healthy examination were in a control group B. In the observation group.and the control group A, beside the conventional treatment, acupuncture was applied to all the cases. In the observation group, Jianyu (LI 15), Quchi (LI 11), Shousanili (LI 10), Hegu (LI 4), Waiguan (TE 5), Liangqiu (ST 34), Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3) were selected on the affected side. In the control group A, Yin-tang (GV 29), Baihui (GV 20), Sishencong (EX-HN 1), Fengfu (GV 16), Dazhui (GV 14), Fengchi (GB 20), Tianzhu (BL 10), Jiaji (EX-B 2) C4-C7 were selected. Acupuncture was given once a day in the two groups. The; treatment of one week made one session, and continuously 2 sessions were required. In the control group B, the convention physical examination was provided without any medication and acupuncture involved. The CLRH-A auricular point detector was used to detect the entire auricular point area in the subjects and the positive reaction sites of auricular points in the subjects of each group before and after treatment separately. The auricular point positive detecting score and positive point frequency were observed in the subjects.

RESULTSBefore treatment, the auricular points detecting score in the observation group was obviously higher than that in the control group A and control group B (both P<0. 05). The difference in the score between the control groups was not significant in' comparison (P>0. 05). In two weeks of treatment, the auricular points detecting score in the observation group was reduced apparently (P<0. 05). The difference was not significant before and after treatment in either the control grolip A or the control group B (both P>0.05). In the observation group, the first 15 points with high frequencies of positive reaction were naogan (AT3,4i), pizhixia (AT4), e (AT1), xin (CO15), gan (CO12), nie (AT2), zhen (AT3), shen (CO10), jiaogan (AH6a), pi (CO13) shenmen (TF4), wei (CO4), neifenmi (CO18), shenshangxian (TG2p) and erjian (HX6,7i). The differences were significant in the frequencies of positive reaction at 9 auricular points as compared with the control group A and the control group B respectively, named naogan (AT3,4i), pizhixia (AT4), e (AT1), xin (CO15), gan (CO12), nie (AT2), zhen (AT3), shen (CO10) and jiaogan (AH6a) (all P <0. 05).

CONCLUSIONThe pathological degree of positive reaction about auricular points in stroke patients is higher than those in the patients of non-stroke internal medicine disease and the healthy people. It is verified that the auricular diagnostic method is specific in stroke. naogan (AT3,4i), pizhixia (AT4), e (AT1), xin (C15), gan (GO12), nie (AT2), zhen (AT3), shen (CO10) and jiaogan (AH6a) are correlative with stroke.

Acupuncture Points ; Acupuncture, Ear ; Adult ; Aged ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Stroke ; therapy ; Treatment Outcome

Objective: To systematically evaluate the relationship between neck circumference and hypertension of primary and secondary school students. Methods: Web of science, PubMed, Scopus, CNKI and WanFang databases were searched by computer, and the retrieval time was from inception to December 2019. Two researchers independently screened the literature, extracted the data and evaluated the quality, and then performed Meta-analysis using Stata 14.0 software. Results: A total of 8 studies were included, including 20 475 subjects. Meta-analysis results showed that the risk of hypertension increased by 35% in people with a high neck circumference compared with the normal population(OR=1.35, 95%CI=1.20-1.51, P<0.01). The results of subgroup analysis showed that the correlation between neck circumference and hypertension of obese primary and secondary school students was 1.41 times higher than that of normal weight students(OR=1.41, 95%CI=1.23-1.61, P<0.01). The correlation between the neck circumference and the risk of hypertension of primary and secondary school students in Europe and America was more significant than that in Asia(OR=1.31, 95%CI=1.11-1.53, P=0.01). When the mean value of neck circumference was greater than 28.5 cm(OR=1.29, 95%CI=1.02-1.64, P=0.03), it was associated with the incidence of hypertension. Conclusion The neck circumference of primary and middle school students is related to the risk of hypertension, especially in obese people. Blood pressure monitoring and health education should be strengthened to prevent hypertension.

Objective To observe the effect of electrical stimulation on the movement of rabbits esophagus, and to promote effective esophageal peristalsis and determine the best electrical pacing parameters. Methods After anesthesia, 24 healthy rabbits underwent open surgery and the lower esophagus was exposed. The esophagus was stimulated with the multi-channel signal generator, and the changes of esophagus pressure and the length of esophageal contraction with high resolution manometry were recorded. (1) The effects on contraction pressure of esophagus body and lower esophageal sphincter (LES) after single site electrical stimulation under different parameters were observed. The stimulation modes utilized were electric current 3 mA, 5 mA and 8 mA, frequency 5 Hz, 10 Hz and 20 Hz, pulsewidth 0. 25 ms, 25 ms and 50 ms, waveform of single phase and double phase. (2) The esophagus was sequentially stimulated. The stimulation mode utilized was electric current 5 mA, frequency 20 Hz, pulsewidth 25 ms, stimulation duration 3 s, single phase square wave. Results At electrical stimulation on the esophagus body and LES, contraction delay was 13. 00±1. 54 ms and 12. 00±0. 73 ms respectively. The contraction pressure of esophageal body was significantly positively related tothe electric current (R=0. 968, P<0. 01), the pulse width(R=0. 971, P<0. 01), and the frequency (R =0. 947, P <0. 01). The length of contraction in 10 Hz group was shorter than that of the 20 Hz group(1. 33±0. 06 cm VS 1. 80±0. 00 cm, P<0. 05). The contraction pressure of LES was also significantly positively related to the electric current(R=0. 965, P<0. 01),the pulse width (R=0. 973, P<0. 01), and the frequency (R=0. 842, P<0. 01). The pressure of lower esophageal sphincter of single phase square wave was greater than that of the double phase square group (P<0. 05). Under the same parameters, the contraction pressure of LES group was lower than that of the esophageal body group (27. 33±1. 15 mmHg VS 104. 00±6. 00 mmHg, P<0. 05). Esophageal sequential contraction was induced by multi-points sequential electrical stimulation. Conclusion Single point electric stimulation can cause esophageal contraction immediately without obvious delay. Within a certain range, the esophageal contraction pressure is positively correlated with electric current, frequency and pulse width. The contraction pressure of single square phase wave is greater than that of the double square phase wave. The contraction pressure of esophageal body is greater than that of LES after electric stimulation. Multi-points sequential electrical stimulation can promote sequential movement of esophagus.

Background:Besides typical gastroesophageal reflux symptoms,some reflux esophagitis( RE)patients also complain“morning sour taste in mouth”,but related studies are rare. Aims:To study the pathophysiology of RE with sour taste in mouth. Methods:Fifty-two RE patients with typical regurgitation symptom and confirmed by endoscopy from Mar. 2013 to Oct. 2013 at Tianjin Medical University General Hospital were enrolled. Patients were divided into two groups according to whether there was an existence of morning sour taste in mouth. Results of esophageal manometry and 24-hour esophageal impedance-pH monitoring were analyzed. Nine healthy volunteers who had esophageal manometry performed were served as controls. Results:Length of lower esophageal sphincter( LESL)was shortened and LES pressure( LESP)and effective peristalsis of esophageal body were decreased in both RE groups when compared with controls( P ﹤ 0. 05 ). Upper esophageal sphincter pressure( UESP)was significantly lower and more nocturnal reflux episodes occurred in RE group with sour taste than those without( P ﹤ 0. 05 );however,no significant differences in other manometric and reflux parameters were found between RE groups with and without sour taste(P﹥0. 05). Conclusions:Esophageal motility and reflux events in RE patients with morning sour taste in mouth are somewhat different from those without sour taste. Decrease in UESP might be an important pathophysiological mechanism of sour taste in mouth in RE patients.

ObjectiveTo explore the clinical outcome of one stage posteroanterior decompression and bone implant in the treatment of severe lower cervical spinal bony canal stenosis. Methods The study involved 29 patients with severe lower cervical spinal bony canal stenosis treated with one stage posteroanterior decompression and bone implant from April 2006 to March 2009. There were 11 patients with old fractures, seven with posterior longitudinal ligament ossification and 11 with cervical disc calcification. The course of disease ranged from 2 months to 3.2 years, average 1.4 years. The nerve function was rated as grade B in two patients, grade C in 19 and grade D in eight according to Frankel scale. The average Japanese Orthopaedic Association (JOA) score was 9.8. ResultsAll patients were followed up for 7-28 months (average 15.2 months), which showed bony fusion five months after operation, with fusion rate of 100％. The Frankel grade was increased for average 1.2 grades and the nervous symptoms alleviated remarkably. Mean postoperative JOA score was 13.8 and increased for mean 4.0, with mean amehoration rate of 55.6％. ConclusionsOne stage posteroanterior decompression and bone implant is a safe and effective method for treatment of lower cervical spinal bony canal stenosis, when the intraoperative electrophysiological monitoring can assure the operative safety.

BACKGROUND:Studies have demonstrated that tetrandrine has protection on acute spinal cord injury,but the specific mechanism remains poorly understood.OBJECTIVE:To study the protection of tetrandrine on rat acute spinal cord injury and to study its mechanism from apoptosis pathway.METHODS:A total of 100 rats were randomly divided into 4 groups.All rats were prepared for spinal cord injury models using modified Allen method except that in the sham-surgery group.Methylprednisolone and tetrandrine was injected into rats in the methylprednisolone and tetrandrine groups by tail intravenous injection prior to and at 24,48 hours after model preparation.The same volume of physiological saline was injected in the sham-surgery and model groups.Basso-BeatUe-Bresnahan(BBB score)was recorded at 8 hours,1,3,7 and 14 days after model preparation.The morphological changes of spinal cord injury sites were observed by hematoxylin-eosin staining and the expressions of bcl-2 and bax were determined by immunohistochemistry.RESULTS AND CONCLUSION:The BBB score of methylpradnisolone and tetrandrine groups were significantly higher than that model group at 7 and 14 days(P<0.05),but there were no significant difference between the methylprednisolone group and tetrandrine group(P>0.05).Hematoxylin-eosin staining showed that the spinal cord injured severely at 3-7 days,the injury degree in the methylpradnisolone group and tetrandrine group was slighter than that of the model group,with smaller bax expression and greater bcl-2 expression(P<0.01).The findings demonstrated that,tetrandrine is able to protect neurons from apoptosis and promote the nerve function recovery by inhibiting the expression of Bax and promoting the expression of Bcl-2.Its effect is not inferior to methylprednisolone.