Objective:To explore the effectiveness and recurrence prevention of esomeprazole at different doses in the patients with reflux esophagitis ( RE) . Methods:Totally 240 patients with RE were divided into mild or severe group with 120 cases in each accord-ing to the illness severity. The two groups were respectively divided into four groups according to the random number table, namely the full dose treatment group, half dose treatment group, intermittent treatment group and on-demand treatment group. The groups were fol-lowed up for 6 months, and GERD-HRQI scores, the recurrence rate and incidence of adverse reactions in all the groups were com-pared. Results:After the 6-month follow-up, the differences in the GERD-HRQI scores, recurrence rate and incidence of adverse re-actions among the groups with different doses were statistically significant (P<0. 05). The GERD-HRQI scores and RE recurrence rate in on-demand treatment group were significantly higher than those in the other groups(P<0. 05), and the incidence of adverse re-actions in the total dose treatment group was significantly higher than that in the other groups (P<0. 05). Conclusion: Intermittent treatment with esomeprazole at small dose can effectively prevent RE recurrence, reduce the incidence of adverse reactions and treat-ment costs, which is worthy of promotion.

Objective To study the effects of treating intracranial hypertension(ICP) with different dosage Mannitol alone or combined with Furosemide.Methods 60 patients with high ICP after all kinds of operations on cranium and brain were divided into 4 groups according to the dosage of Mannitol alone or combined with Furosemide: 0.5 g/kg Mannitol(group A),1.0 g/kg Mannitol(group B),0.5 g/kg Mannitol and 20 mg Furosemide(group C),1.0 g/kg Mannitol and 20 mg Furosemide(group D).The effective power,rebound ratio,average effective time,average amplitude of decreasing ICP,plasma osmolarity and renal function were evaluated by monitoring intracranial pressure.Results In response of the effective power,rebound ratio of ICP and average effective time,groups C and D were more noticeable than groups A and B(all(P

Objective To study the preventive effect of recombinant streptokinase (r-SK) on cerebral vasospasm (CVS) after subarachnoid hemorrhage(SAH).Methods Rabbit models of SAH were made by double blood injection into cisterna magna. A tube was inserted into lateral ventricle after 24 h. In group treating one, 1.25 mg r-SK were injected into lateral ventricle, and the tube was opened for drainage after closed 6 h, and then 6 h later, injection, closed pipe and drainage were recycled for another 2 times. In the group SAH , 1 ml normal saline (NS) was injected into lateral ventricle, and then the way was the same as group treating one. In group treating two, 3.75 mg r-SK were injected for once. 6 h, 12 h ,1 d, 3 d, 5 d and 7 d later, 1 ml CSF was drained from the lateral ventricle in groups SAH , treating one and treating two ,respectively. The level of OxyHb in CSF was detected, angiograms of basilar artery(BA) were performed before and after 7 d of SAH,calculation the rate of calibre and histological examinations were also performed. Results (1)The level of OxyHb in CSF of group SAH was increased gradually while decreased in groups treating one and treating two. Compared with group SAH, the levels of OxyHb were significant lower in groups treating one and treating two at 1～7 d after administration(P

Objective To study the effects of bone marrow mesenchymal stem cells(BMSCs) transplantation combined with artesunate(Art) on rat model of liver fibrosis.Methods 20 rats from 120 SD rats were selected randomly as normal control group.10 rats from those were executed and extracted marrow to culture BMSCs.The other 90 rats were injected intraperitoneally with CCl4 to make liver fibrosis rat models.10 rats from the 90 rats were selected randomly to ensure the liver fibrosis model was made successfully after 10 weeks.Then,the rest 80 rats were divided randomly into 4 groups:model group,Art treated group,BMSCs transplantation group and Art + BMSCs transplantation group.Fibrous degeneration of the hepatic tissue was detected by Masson stain.The mRNA expression of α-SMA,TGF-β1 in liver were detected by RT-PCR.The hydroxyproline(Hyp) level in liver was detected by enzyme digestion method.Serum TNF-αand TGF-β1 were detected by ELISA.Serum hepatic fibrosis parameters were detected by chemiluminescence and serum liver functional parameters were detected by biochemistry method.Results Liver functional parameters of Art + BMSCs transplantation group were better than those of the other groups.ALB in Art + BMSCs transplantation group was (29.13 ± 3.48) g/L,which was significantly higher than (26.31 ± 2.42) g/L in Art treated group (24.35 ±3.12)g/L in BMSCs transplantation group and (20.14 ±2.86) g/L in model group.There were significant differences among the 4 groups(q =6.27 ～ 19.01,all P ＜ 0.05).Liver fibrosis parameters of Art + BMSCs transplantation group were better than other groups.Hyp in Art + BMSCs transplantation group was (1.03 ±0.16) μg/L,which was significantly lower than (1.56 ± 0.19) μg/L in Art treated group,(1.45 ± 0.24) μg/L in the BMSCs transplantation group and (3.57 ±0.91) μg/L in the model group.There were significant differences among the 4 groups (q =20.47 ～ 27.70,all P ＜ 0.05).The expression of TGF-β1 mRNA of Art + BMSCs transplantation group was lower than other groups.The index of TGF-β1 mRNA expression in Art + BMSCs transplantation group was (20.16 ± 5.21),which was lower than (58.15 ±9.16) in Art treated group,(46.31 ±6.82) in the BMSCs transplantation group and (97.08 ± 14.23) in the model group.There were significant differences among the 4 groups (q =20.35 ～ 44.93,all P ＜ 0.05).Conclusion There're synergistic effects between Art and BMSCs in the treatment of liver fibrosis.

Objective To establish the model and software for quality assessment of fetal nuchal translucency ultrasound image using computer image recognition technology.Methods The proposed approach firstly divided the input image into four sub-image blocks:the nasal bone(NB) area,the nuchal translucency (NT) area,the midbrain area,and the jaw and chest area.For each sub-image block,the algorithm compared the image block with the corresponding area of the standard training image set,and then determined whether the current image block was the qualified one using the the Gabor feature and Bayesian decision.The input ultrasound image was determined to be qualified only if it had four qualified sub-image blocks.Results The difference between our automatic method and the manual screening by experts wasting small,the method obtained Kappa =0.795 and P ＜0.001.Moreover,the efficiency of our method was much higher than the manual screening method.Conclusions Image recognition technology can effectively assist the sonographer to assess the quality of fetal NT of ultrasound image.The proposed approach can reduce the subjectivity and randomness of the manual evaluation of NT image.

Objective To guide bracing treatment for adolescent idiopathic scoliosis (AIS). Methods A total of 68 AIS patients with apex vertebrae (AV) under T6 had received the improved Cheneau bracing treatment between March 2008 and June 2010. All patients were divided into two groups. There were 16males and 35 females, with a mean age of 13.6 years (range, 10.6-17.2) in the intervention group. The mean Cobb angle was 29.5° (range, 20°-38°); Risser sign was 2-4; Vertebralrotation degree was 0-2 in the group;while there were 6 males and 11 females, with a mean of 13.2 years (range, 10.8-16.8) in the control group.The mean Cobb angle was 28.7° (range, 20°-37°); Risser sign was 2-4; Vertebralrotation degree was 0-2 in the control group. All patients in control group were informed standardized bracing treatment method. But we gave patients in intervention group two copies of "The Form of Guiding Bracing Treatment" treatment of patients with AIS, and informed that they carried out the bracing treatment according requirement of the form.Cobb angle was measured before the treatment and at 6th, 12th, 18th month after treatment. Results Sixtyfive cases were followed up for 18-27 months. However, one female in control group and two females in intervention group were lost during follow-up. Coefficient and intraclass correlation coefficient of form were both over 0.60. The acceptance rate of the table was 97.54%(199/204), qualified rate was 100.00%( 199/199), and with good content validity. The mean Cobb angle decreased gradually from 28.71° to 25.76° in control group and from 29.47° to 21.59° in intervention group. Four cases in control group and 34 cases in intervention group had reduced more than 5° at 18 months after treatment. There was significant difference regarding Cobb angle between two group. Conclusion The form of guiding bracing treatment has good reliability and validity and can guide bracing treatment of AIS correctly and effectively.

Objective To evaluate the clinical factors of recurrent intracranial aneurysm with endovascular embolization.Methods DSA was performed in 70 cases with 74 intracranial aneurysms after endovascular embolized treatment,of them,8 cases(9 aneurysms)were detected having recurrent.The geometry form of aneurysms,embilized method,material of endovascular embolization and DSA images pre-and post-embolized were analysed.Results In all recurrent intracranial aneurysms,five located at posterior communicating artery,two at anterior communicating artery and two at the first crotch of right middle cerebral artery.Four were wide-necked aneurysms,five were irregular aneurysms in form.Before recurrence,three aneurysms were embolized completely,six were proportion occlusion.Conclusion Aneurysms localized at the branching region of artery,being wide-neck,large,irregular form and residual neck are facility factors for intracranial aneurysm recurrence after endovascular embolization.

Objective To explore the diagnosis and treatment of non traumatic chylothorax in non-Hodgkin's lymphoma (NHL) and to understand the differences in diagnosis and treatment between chylothorax and pseudochylothorax. Methods The patient aged 83 years was confrimed as chylothorax and NHL after lymph node biopsy.We reviewed literatures about chylothorax in NHL to analyse the possible mechanism,its diagnosis and treatment. Results The patient was sufferring from unilateral chylothorax diagnosed as true chylothorax by thoracentesis,and progressed to bilateral chylothorax after 1 year.PET/CT examination showed intrathoracic and right cervical lymph nodes enlargement and an increasing metabolic activity.Cervical lymph node biopsy revealed diffuse large B cell type non-Hodgkin's lymphoma.The patient refused any other treatment except the diet therapy and died after 19 months.We searched 19 cases with NHL chylothorax in associated literatures about the treatments including radiotherapy (6/6 improved),chemotherapy (6/11 improved),thoracic duct ligation (I/1 improved),thoracic duct ligation and drug pleurodesis(1/1 improved). Conclusions PET/CT is useful in finding the hidden clues of chylothorax in NHL.There is no standard mangement for NHL chylothorax and the treatment must be individualized. The overall prognosis of NHL chylothorax is similar to that of non-Hodgkin's lymphoma and the patient needs early diagnosis and general treatment in order to prolong the survival time.

Objective To analyze the effect of cervical.curvature and intervertebral height on the surgical outcome of posterior decompression in patients with multi-level cervical spondylotic myelopathy.Method A total of 50 patients with multi-segment cervical spondylotic myelopathy (≥ 3 segments),treated with posterior decompression from June 2006 to January 2009 were retrospectively analyzed.Twenty six patients underwent cervical omni-posterior decompression and lateral mass screw internal fixation (group A); 24patients underwent expansive open-door laminoplasty (group B).The effects of changing of cervical curvature and intervertebral height on JOA score and VAS score were analyzed.Results All patients were followed up for 8 months to 4 years (average,24 ±5.5 months).There were statistical differences of cervical curvature angles between preoperative and 3 days postoperatively in group A,while no statistical differences in group B.There were no statistical differences of cervical curvature angles between 3 days,6 months and 3 years postoperatively in group A,while there were differences in group B After further analysis of the loss of cervical curvature and intervertebral height,the result showed that JOA score and VAS score in the low-loss group were better than those in the high-loss group.Conclusion Lateral mass screw internal fixation after cervical omni-posterior decompression had many advantages such as reducing the change of cervical curvature,the loss of intervertebral height and incidence of cervical axial symptoms.

Objective To investigate the levels and clinical significance of monocyte chemoattractant protein (MCP)-1 and tissue factor (TF) in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Forty-nine elderly patients with AECOPD(AECOPD group) and 30 healthy controls (control group) were selected,and AECOPD group was divided into procalcitonin (PCT) increased group (PCT ≥ 0.5 μ g/L,19 cases) and PCT normal group (PCT ＜ 0.5 μ g/L,30 cases) according to the level of serum PCT.The levels of plasma TF,serum MCP-1 and PCT were determined by enzyme linked immunosorbent assay.Results The levels of plasma TF and serum MCP-1 were (203.6 ± 92.9),(152.8 ±99.9) ng/L in AECOPD group,and (136.9 ±24.3),(87.5 ±41.5) ng/L in control group.There were significant differences in the levels of plasma TF and serum MCP-1 between AECOPD group and control group (P＜0.01).The level of plasma TF was positively correlated with serum MCP-1 (r =0.673,P=0.029).The levels of plasma TF and serum MCP-1 were (215.3 ±71.2),(181.1 ±61.6) ng/L in PCT increased group,and (192.4 ±79.7),(137.3 ±74.4) ng/L in PCT normal group.There were significant differences in the levels of plasma TF and serum MCP-1 between PCT increased group and PCT normal group (P＜0.05).Conclusions In patients with AECOPD,hypercoagulability state is activated,and it is more severe in the patients with increased PCT.The level of plasma TF is positively correlated with serum MCP-1 in patients with AECOPD.To monitor the levels of plasma TF and serum MCP-1 is particularly important for elderly patients of AECOPD with hypercoagulability state to prevent cardiovascular,lungs and cerebrovascular thrombotic disease.