Gastresophageal reflux disease(GERD)is a common morbidity in asthma patients.GRED is contributing factor for poor controlled asthma.GERD should be intergrated into the routine diagnostic procedure of asthma.Antireflux therapy may improve the outcomes of asthma with GERD.

With the development of endoscopic techniques in recent years,therapeutic endoscopic retrograde cholangiopancreatography has replaced surgery as the first approach to the extraction of common bile duct stones.Endoscopic sphincterotomy and endoscopic papillary bal-loon dilation have become established endoscopic techniques for stone removal.However,it remains a challenge for endoscopists to remove large common bile duct stones.Emerging endoscopic modalities,such as endoscopic papillary large balloon dilation and cholangioscopy-guided laser or electrohydraulic lithotripsy,have been shown to be safe and effective for management of large common bile duct stones.This paper reviews recent advances in the endoscopic management of large common bile duct stones.

0.05).Conclusion:HLA-DQA1*0102 and DQA1*0104 were associated with protection from chronic HBV infection and development of LC,respectively.There was no significant association between HLA-DQA1 and development of HCC in chronic HBV infection patients.

Totally 20 children with cerebral palsy of spastic type, aged 1.5-5.0 years, who were treated in Department of Children Nerve Rehabilitation, Nanhai Maternity and Kid Hospital Affiliated to Guangzhou University of Traditional Chinese Medicine, were selected from March to December 2005. Of them, 11 cases were moderate degree of cerebral palsy and 9 cases were severe. The diagnostic criterion of cerebral palsy referred to the diagnostic criterion established at the Countrywide Special Topic Proseminar of Cerebral Palsy in 2004. The method to diagnose cerebral palsy of spastic type referred to the method of Cerebral Palsy Academy of United States in 1956. Cerebral palsy was clinically characterized by the very brisk reflex of extending. The degree was graded by mild, moderate and severe according to the paralyzed part, mental development, speech development, activity of daily living and complication. The children were promoted to stand and walk by themselves mainly with standing promoting training and with restraining method as complement. The course of treatment was 6 months. The curative effect was evaluated by the abducent angle of the hip joint, the angle of popliteal fossa, the dorsiflexion angle of ankle, and the forth item of gross motor function measure, which were measured before and after the treatment. Theresult showed that the range of motion of 20 children was improved. The score of gross motor function measure of standing item improved evidently. A total of 8 cases had significant effect and 12 cases had valid effect. The total effective rate was 100%.

Objective To assess the clinical significance of three different noninvasive airway inflammatory indices in induced sputum and exhaled breath condensate ( EBC ) from persistent asthmatic patients.Methods Moderate and severe asthmatic patients were prescribed inhaled corticosteroids combined with long-acting β2 agonists for a month.The symptom scores and percentage of predicted value of forced expiratory volume in one second ( FEV1 ) ( FEV1% pred) were measured while the concentrations of H2O2,NO3-/NO2-,and cysteinyl-leukotriene E4(LTE4) in induced sputum and EBC were detected before and after therapy.Results A total of twenty-five subjects with moderate and severe asthma were enrolled.By combined therapy for one month the asthma aymptoms relieved and FEV1% pred improved significantly (P<0.01).The concentrations of H2O2,NO3-/NO2- arid LTE4in induced sputum and EBC declined significantly(P<0.01) although the concentrations were still higher than those at normal baseline.More marked reduction of H2O2 and NO3-/NO2- compared to LTE4was observed.It was revealed that the concentrations of H2O2 and NO3-/NO2- but not of LTE4in EBC were negatively correlated with FEV1% pred (P <0.01) and positively with symptom scores.Such correlations were also found in H2O2 in induced sputum with FEV1 % pred and symptom scores as well as NO3-/NO2- in induced sputum with FEV1 % pred.The improvement of FEV1 % pred after treatment was positively correlated with the reduction of H2O2 and NO3-/NO2- both in induced sputum and EBC.Correlation analysis also demonstrated three inflammatory indices were equivalent in induced sputum and EBC( correlation coefficient of H2O2,NO3-/NO2- and LTE4,0.759,0.826 and 0.653,respectively.P < 0.01 ).Conclusions (1) Combined therapy with inhaled corticosteroid plus long-acting β2 agonist significantly improves the clinical symptoms and lung function of patients with moderate and severe asthma companied with marked suppression of airway inflammation.(2) Both of EBC and induced sputum sampling are valuable noninvasive procedures for detecting asthma airway inflammation,however,EBC technique is superior in safety and reproducibility.(3) H2O2 and NO3-/NO2- seem to be more sensitive indices in diagnosis and monitoring asthma compared to LTE4.

Objective To study the DNA damage in hippocampal cells of rats induced by 1 800 MHz electromagnetic irradiation. Methods Wistar rats were randomly divided into four groups, 2 exposed groups and 2 controls. The experimental subjects were exposed to the 1 800 MHz (continuous wave, CW) electromagnetic fields for 21days (12 h/d), the power densities were 0.5 mW/cm2 and 1.0 mW/cm2, meanwhile, sham-control exposures were carried out, the DNA damage was examined by Comet assay. Results The tailed rate and the tail area of the hippocampal cells in 1.0 mW/cm2 group was higher or larger than those in the control and 0.5 mW/cm2 groups(P

Objective To know the influence of out-hospital nursing with no gap on the level of HbAlc for patients with diabetes.Methods Divided 80 patients with diabetes into the intervention group and control group randomly,there were 40 cases in the each group.Out-hospital nursing cares with no gap were used in the intervention group,while the routine nursing cares were used in the control group.Fellowed up 1 year.Compared the FPG,2 hPG and HbAlc between the two groups at the time points of the 3rd,6th,9th and 12th month when out of hospital.Results All the indexes which had monitored were better in the intervention group than those of in control group.Conclusions Out-hospital nursing with no gap can remain the indexes in the normal level,and then promote their quality of life,which should be developed in clinical field.

Objective To determine the diagnostic value of fractional exhaled nitric (FeNO) measurement in diagnosis of bronchial asthma. Methods The patients with unkown-cause respiratory symptoms including wheezing, cough, and breathlessness were enrolled from August to September in 2008. FeNO was measured by nitric oxide analyzer (NIOX; Aerocrine AB; Solna, Sweden). Bronchial challenge test (BCT) or bronchodilator test was defined as golden standard for asthma diagnosis. The value of FeNO was assessed and the optimal operating point of FeNO testing was determined by the means of the receiver operating characteristic (ROC) curves. Results A total of 101 patients were enrolled, in which 48 cases were diagnosed as asthma by positive yield in BCT (in 38 cases) or bronchodilator test (in 10 cases). The severity of airway hyperresponsiveness (AHR) judged by BCT was mild in 15 cases, moderate in 15 cases and severe in 8 cases. The levels of FeNO of asthma group were higher than those of non-asthma group [(68.19±43.00) pph vs (19.52±10.60) ppb, P < 0.05]. A linear correlation of FeNO with lnPD20 FEV1 was revealed in the cases with AHR. Area under ROC curve was 0.9. The optimal diagnostic cutoff point was 36.5 ppb which was capable of differentiating asthma and non-asthma with sensitivity of 92.7%, specificity of 83.3%, positive predictive value of 79.17% , negative predictive value of 94.34% and accuracy of 87.13%. Conclusion FeNO test may be helpful in the diagnosis of asthma with high sensitivity and specificity.

Objective To compare the appearances between chronic mastitis and breast cancer on MRI and investigate the differ-ential diagnostic value.Methods MRI data of 20 patients with chronic mastitis pathologically proved by biopsy or operation were ret-rospectively analyzed.30 cases of breast cancer were contemporaneously chosen as the control group.Morphological feature and dy-namic contrast-enhanced(DCE)manifestation of the lesions were evaluated and statistical difference was compared between mastitis and breast cancer.Morphological feature included configuration,spiculated sign,ring-like enhancement,peri-focal edema,skin thick-ening,nipple involvement and axillary lymph nodes enlargement.DCE manifestation contained calculating early enhancement ratio and drawing time-intensity curve (TIC).Results There were significant statistical differences among configuration,ring-like en-hancement and peri-focal edema between mastitis and breast cancer,respectively.No statistical differences could be found among spiculated sign,skin thickening,nipple involvement and axillary lymph nodes enlargement.Early enhancement ratio in the group of mastitis was 1.1 56±0.635 while 1.253±0.499 in the group of breast cancer and there was no statistical difference between them. There were 1 1 cases with type Ⅰ TIC,6 with type Ⅱ,3 with type Ⅲ in the lesions of mastitis,while 4 with type Ⅰ,1 1 with typeⅡ,1 5 with type Ⅲ in the lesions of breast cancer and significant statistical differences could be found between two groups.Conclu-sion Mastitis usually manifests as non-mass-like lesions on MRI.Ring-like enhancement,peri-focal edema and benign type TIC can be applied to discriminate mastitis from breast cancer.

Objective To analyze MRI imaging features of patients with Wernicke encephalopathy after major surgical operation.Methods Clinical data including cranial MRI features were reviewed on five patients of Wernicke encephalopathy after major surgical operation from Jan 2012 to Nov 2013.Results The clinical features of patients with Wernicke encephalopathy after major surgical operation were noncharacterized and most of them had no specific value for diagnosis except for a definite history of vit B1 insufficiency.MRI imaging showed abnormal signal in the medial thalamus,third ventricle,surrounding area of the aqueduct of midbrain,column of fornix and the dorsal midbrain and pons ; Lesions were showed with long T1 and long T2 signal intensity and high signal intensity on fluid-attenuated inversion recovery (FLAIR),and high signal intensity on DWI(b equals 1 000 s/mm2).ADC value in all lesions increased from [(0.46-0.59) ×10-3 mm2/s] before treatment to [(0.81-1.10) ×10-3 mm2/s] after vit B1 supplement.Conclusions Wernicke encephalopathy has typical MRI imaging presentations.Early diagnosis and timely supplement of vitamin B1 can improve the prognosis.