Objective To evaluate the clinical application of transendoscopic Doppler ultrasonogra-phy in various gastrointestinal diseases. Methods Transendoscopic Doppler ultrasonography was performed in 59 patients with various gastrointestinal diseases. Results The Doppler signals were detected beneath the peptic ulcer base in 29 of 39 patients (74. 4% ) . For acute ulcer bleeding and non - bleeding, the Doppler - positive rates were 87. 5% and 65. 2% , respectively, and the measured depth of vessels were 0. 49 mm and 0. 65mm (P

Objective To explore the effect of donepezil combined with memantine in ameliorating the cogni-tive function and psychological behavior of patients with Alzheimers'disease(AD).Methods 214 AD patients were randomly divided into the control groupand observation group.The control group were treated with memantine,and the observation group were treated donepezil combined with memantine.Before and after treatment,MMSE and WHO -UCLA AVLT,BEHAVE -AD were utilized to assess the cognitive function,psychological behavior,respectively.The adverse effects were observed using TESS and laboratory examination.Results The scores of MMSE and its subitem, WHO -UCLA AVLT(Immediate memory,short -term memory and long -term memory)after treatment significantly increased as compared with those before treatment in the control group and the observation group(P <0.01 or P <0.05),while the cases of psychological behavior,the score of BEHAVE -AD and its subitem decreased(P <0.01 or P <0.05).The observation group showed statistically significant difference in the increasion of the scores of MMSE and its subitem,WHO -UCLA AVLT,and the decreasion of the cases of psychological behavior,the score of BE-HAVE -AD and its subitem comparison with the control group(t =-1.742,-1.431,-1.626,-2.173,-1.448,-1.026,-1.016,-1.279,-1.971,χ2 =12.295,7.609,8.917,t =0.778,1.139,2.004,1.153,0.822,1.944, P <0.01 or P <0.05).The total effective rate of the observation group was 90.65%,and 71.96% of the control group,there was a significant difference between the two groups(χ2 =12.299,P <0.01).There was no obvious side effects during the treatment in both groups.Conclusion Donepezil combined with memantine can significantly improve the cognitive function and psychological behavior of AD patients,and there are fewer adverse events.

Objective To describe a new classification of pelvic obliquity secondary to poliomyelitis,and investigate the operative indications and effective surgical modes. Methods Fifty-six adult pelvic obliquity secondary to polio were reviewed. The pelvic obliquity was divided into two types and three kinds according to the causes of deformity, X－ ray films of pelvic and gait. Six surgical methods were chosen respectively to correct the deformities. Results All the patients were followed-up for 10 to 80 months(mean 28 months). Complete correction of pelvic obliquity was obtained in 11 patients and major correction in 45 patients. The average corrective rate was 78.3％ . Conclusion Not all the patients with pelvic obliquity after polio need surgical treatment. This new classification has great help to surgical planning and to improve the operative effects.

Summing up years of experiences in teaching for seven-year program,we look on exerting students' enthusiasm and attaching importance to cultivating students' ability as our golden rules,and take some reformative measures to improve physiology teaching quality for long-term system,including adjustment of curricular structure,optimizing teaching methods,strengthening class discussion,performing summary lessons,reforming experiment courses and carrying out simple research design.

Objective To explore the correlation of posttraumatic growth with social support in patients with gastrointestinal neoplasms at the end of life.Methods Cluster random sampling was used to select 280 patients with gastrointestinal neoplasms who were predicted to survive no longer than 6 months in 10 first-class hospitals in Beijing and Tangshan,and they were investigated by Posttraumatic Growth Inventor (PTGI) and Social Support Rate Scale (SSRS).Results The total score of PTGI (61.13 ± 16.78)and the scores of appreciation of life (23.71±7.34),personal strength(10.67±3.55),new possibility(10.07±2.11),relating to others(12.54±5.14),spititual change(10.89±4.35)were higher than median value.The total score of SSRS(41.21±8.48) and objective support(10.27±2.75) were higer than the normal level((39.05±6.35),(8.42±2.27)) (P＜0.05).The appreciation of life was positively correlated with subjective support and the total score of SSRS (r=0.25,r=0.26,P＜0.05),personal strength was positively correlated with objective support,subjective support and the total score of SSRS(r=0.24,r=0.29,r=0.23,P＜0.05),new possibility was positively correlated with subjective support(r=0.21,P＜0.05),relating to others was positively correlated with objective support and the total score of SSRS (r=0.26,r=0.26,P＜0.05),spititual change was positively correlated with objective support and subjective support (r=0.28,r=0.31,P＜0.05).The total score of PTGI was positively correlated with subjective support and the total score of SSRS (r=0.29,r=0.29,P＜0.05).Conclusion Patients with gastrointestinal neoplasms at the end of life experience a certain extent of posttraumatic growth and high level of social support.Posttraumatic growth is positively correlated with social support.

Objective To compare the consistency and difference of optical coherence tomography angiography (OCTA) and traditional multimodal fundus imaging in the diagnosis and activity evaluation of choroidal neovascularization (CNV) in exudative age-related macular degeneration (AMD). Methods A total of 112 exudative AMD patients (130 eyes) were included in this retrospective study, 62 were men (71 eyes) and 50 were women (59 eyes). The mean age was (68.250±9.789) years (range 50–91 years). All patients were underwent traditional multimodal fundus imaging including fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and spectral domain optical coherence tomography (OCT);OCTA was performed at the same time. The CNV type was divided into active and non-active according to the results of traditional multimodal fundus imaging. The vascular pattern was divided into active and non-active according to the results of OCTA. Using traditional multimodal fundus imaging as the standard, the sensitivity and specialty of OCTA was evaluated. Results In 130 eyes, CNV was visualized on traditional multimodal fundus imaging in 109 eyes (83.8%);CNV was visualized on OCTA in 103 eyes (79.2%), which including 7 eyes of false negative and 1 eye of false positive. The sensitivity of OCTA for CNV diagnosis was 93.6%, with specificity of 95.2%. The CNV detection rate between two methods had no significant difference (Youden index=0.89, Kappa value=0.796, P=0.07). In 109 eyes diagnosed with CNV by traditional multimodal fundus imaging, 73 eyes (67.0%) were active CNV and 36 eyes (33.0%) were non-active CNV;the vascular pattern was active in 60 eyes (55.0%) and non-active in 49 eyes (45.0%). The sensitivity of OCTA for the detection of active CNV was 82.2%, with specificity of 100.0%. The active CNV detection rate between two methods had no significant difference (Youden index=0.82, Kappa value=0.753, P=0.00). Conclusion In the diagnosis and activity evaluation of CNV in exudative AMD, there is remarkable consistency between OCTA and traditional multimodal fundus imaging.

OBJECTIVE:To establish the method for the simultaneous determination of clopidogrel (CLO) and its active metabolites (CATM) and inactive metabolites (CCAM),and to conduct pharmacokinetic study. METHODS:The plasma sam-ple had been derivatized by 2-bromine-3′-methoxy acetophenone(MPB),and was precipitated by acetonitrile. Using carbam-azepine as internal standard,UPLC-MS/MS was adopted. The separation was performed on Waters ACQUITY UPLC HSS T3 column with mobile phase consisted of water(containing 0.1% formic acid)-acetonitrile(containing 0.1% formic acid)using a gradient elution program at the flow rate of 0.50 ml/min. The ESI was equipped and quantitative analysis was operated in posi-tive ion and MRM mode. The mass transition ion-pairs were followed as m/z 322.1→211.8(CLO),m/z 504.1→155.0(the alkyl-ation derivatives of CATM,CATMD),m/z 308.3→198.0(CCAM),m/z 273.2→194.3(internal standard). RESULTS:The lin-ear calibration curves for CLO,CATMD and CCAM were obtained in the concentration range of 0.03-20.00 ng/ml,0.30-200.00 ng/ml and 10.00-10 000.00 ng/ml in plasma,respectively;intra-day and inter-day RSD for them were all less than 15%,and relative error(RE)ranged from -3.5% to 5.7%. Main pharmacokinetic parameters of CLO,CATMD and CCAM in 5 healthy volunteers after oral administration of CLO 300 mg were as follows:cmax were(7.89±5.46),(15.58±8.08),(8 023.33± 1 047.39)ng/ml;tmax were(1.25 ± 0.43),(1.25 ± 0.43),(1.67 ± 0.29)h;t1/2 were (2.31 ± 0.61),(0.64 ± 0.08),(6.53 ± 2.55)h;AUC0-t were(17.19±14.59),(21.39±9.58),(30 648.85±8 026.63)ng·h/ml. CONCLUSIONS:The established method is sensi-tive,rapid and convenient,which is suitable for pharmacokinetic study and plasma concentration determination of CLO and its metabolites.

Objective To evaluate the effect of extremity ischemic preconditioning on the expression of aquaporin 1 (AQP1) in the lung tissues of patients undergoing pulmonary lobectomy.Methods Forty-six American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients,aged 30-64 yr,weighing 50-80 kg,scheduled for elective pulmonary lobectomy performed via a thoracoscope,were randomly divided into 2 groups (n =23 each) using a random number table:control group (group C) and extremity ischemic preconditioning group (group R).After induction of anesthesia,the patients were intubated with the double-lumen tube.Correct position of the tube was verified with the fiberoptic bronchoscope.In group R,ischemic preconditioning was induced by 3 cycles of 5-min lower extremity ischemia followed by 5-min reperfusion after induction of anesthesia.Lung tissues were obtained when the lobe of the lung was removed during surgery for determination of AQP1 expression (by Western blot) and wet/dry lung weight ratio and for microscopic examination of pathologic changes which were scored.Immediately after onset of one-lung ventilation,at 30 and 60 min of one-lung ventilation,and at 1 h after restoration of two-lung ventilation,arterial blood samples were collected for blood gas analysis,and the oxygenation index was calculated.The development of postoperative complications and length of postoperative hospital stay were recorded.Results Compared with group C,the expression of AQP1 was significantly up-regulated,and oxygenation index at 30 and 60 min of one-lung ventilation and 1 h after restoration of two-lung ventilation were significantly increased,the pathologic score,the wet/dry lung weight ratio and incidence of postoperative pneumonia and atelectasis were significantly decreased,and the length of postoperative hospital stay was significantly shortened in group R (P＜ 0.05).Conclusion Extremity ischemic preconditioning can reduce lung injury through up-regulating AQP1 expression in the patients undergoing pulmonary lobectomy.

Objective To explore the epidemiological characteristics of malaria in Liaoning Province from 1951 to 2014,so as to provide the evidence for further control of the disease. Methods The data of registered malaria cases in Liaoning Province from 1951 to 2014 were collected and analyzed with epidemiological methods. Results From 1951 to 2014,there were report-ed malaria cases each year. The peaks of incidence were in 1953,1962 and 1973,the incidence rates were 136.67/100000, 256.81/100000 and 35.89/100000 respectively and the numbers of patients were 27862,65460 and 11523,respectively. From 1977 to 2014,the incidence rates were all less than 1/100000. From 1951 to 1980,the occupations of patients were main-ly farmers,and from 1981 to 2014 were mainly workers,farmers and exported laborers. Conclusion The malaria endemic situ-ation in Liaoning Province experienced the periods from outbreaks to basically elimination,and the long-term surveillance will be the further working emphasis.

Objective To discuss the clinical value of Protein induced by Vitamin K Antagonist-Ⅱ (PIVKA-Ⅱ) and alpha-Fetoproteins (AFP) in diagnosing hepatocellular carcinoma (HCC) and monitoring the treatment effects.Methods Patients were recruited by the Affiliated Hospital of Qingdao University,from August 2013 to March 2014.Serum levels of PIVKA-Ⅱ and AFP were measured by both chemiluminescence assay (CLIA) and electrochemiluminescence assay (ECLA) in patients with HCC (n =148),intrahepatic cholangiocellular carcinoma (n =37),gastric cancer and colorectal cancer (n =44),cirrhosis (n =63),chronic hepatitis B (n =38) and healthy subjects (n =57).To analyze the areas under the receiver operating characteristic curves (ROC-AUC) and to compare the sensitivity and specificity of single PIVKA-Ⅱ or AFP assay,and the combined detection.To analyze the correlation of PIVKA-Ⅱ and both tumor size and TNM staging,so do AFP,respectively.To compare the serum level changes of the two indicators in HCC patients before and after treatment.Results The serum levels of both PIVKA-Ⅱ and AFP in HCC group were higher than that in intrahepatic cholangiocellular carcinoma,gastric cancer and colorectal cancer,cirrhosis,chronic hepatitis B and healthy subjects groups (PIVKA-Ⅱ:U =866.50,424.00,958.00,292.00 and 448.00 ; AFP:U=713.00,440.50,1 182.00,614.00 and 399.00,P ＜0.001).The ROC-AUCs of the single PIVKA-Ⅱ or AFP assay and the combined detection in HCC group were not statistically different (P ＞ 0.05).The sensitivity of PIVKA-Ⅱ (87.16％) was higher than that of AFP (68.92％,x2 =4.73,P ＜ 0.05) in diagnosing HCC ; the sensitivity of the combined detection of PIVKA-Ⅱ and AFP(93.24％) was higher than that of PIVKA-Ⅱ itself (87.16％,adjusted x2 =64.70,P ＜ 0.01) ;while the specificities among them did not show statistical significance (P ＞ 0.05).Tested by Spearman rank correlation,the serum levels of PIVKA-Ⅱ and AFP were both positively related to tumor size (r =0.716,0.475 respectively,P ＜ 0.001).The serum levels of PIVKA-Ⅱ and AFP in HCC patients increased gradually correlated with tumor size (H =72.70,37.02 respectively,P ＜ 0.001) and the positive rates of PIVKA-Ⅱ and AFP were gradually improved (x2 =26.74,21.62 respectively,P ＜ 0.01),too.Based on the International TNM Staging System,the serum levels of PIVKA-Ⅱ and AFP (H =46.63,21.38 respectively,P ＜0.001) and the positive rates of PIVKA-Ⅱ and AFP (PIVKA-Ⅱ:x2 =20.40,P ＜0.01 ;AFP:x2 =8.33,P ＜0.05) in HCC patients from Ⅰ-Ⅳ stages were increased as TNM stages elevated.The serum levels of PIVKA-Ⅱ and AFP in HCC patients were both dropped sharply compared with preoperative levels (Z =-4.59,-4.22 respectively,P ＜ 0.001) and also both dropped in each of the Ⅰ-Ⅳ TNM stages (PIVKA-Ⅱ:Z =-2.85、-2.98、-2.70 respectively,P ＜ 0.05 ; AFP:Z =-2.48、-3.82、-2.50 respectively,P ＜ 0.05) compared with serum levels before treatment.Conclusion PIVKA-Ⅱ and AFP both have high clinical application values in diagnosing HCC and monitoring treatment effects.The sensitivity of PIVKA-Ⅱ in diagnosing HCC is significantly higher than AFP,and the sensitivity can be elevated by the combined detection in diagnosing HCC without reducing the specificity.