Gastroesophageal reflux disease(GERD)is a commonly seen digestive disease. So far,there is no golden standard for the diagnosis of GERD. The main diagnosis methods used in clinical practice include gastroscopy,24 h esophageal pH monitoring and proton pump inhibitor test,however,these methods are either invasive or complex in procedure and with low diagnostic accuracy rate. Gastroesophageal reflux disease questionnaire(GerdQ)possesses multiple advantages such as simple,non-invasive and easily acceptable. This article reviewed the use of GerdQ in diagnosis of GERD.

Treatment of sacral fractures,unstable ones in particular,has attracted more and more attention.Despite numerous classification systems for sacral fractures,the commonly used ones are Denis and Tile classifications.Stable sacral fractures deserve conservative treatment,but unstable ones should be treated surgically,by operative reduction,internal fixation to reconstruct stability of the pelvis,and prevention or relief of nerve compression.There are many methods of internal fixation for unstable sacral fractures,and each has its own advantages and disadvantages.This review summarizes the progress in surgical treatment of unstable sacral fractures and makes comments on the latest surgical strategies.

ObjectiveTo evaluate the status of ANCA(antineutrophil cytoplasmic antibodies) positivity in Uygur nationality and Han nationality patients with ulcerative colitis (UC); and the possibility of the ANCA as a genetic marker of susceptibility between Uygur and Han nationality patients with ulcerative colitis in the same area. MethodsSerum samples from 39 Uygur and 31 Han patients with UC, 30 Uygur and 30 Han patients with diarrhea of other causes, 30 Uygur and 30 Han subjects as healthy controls were examined for ANCA using indirect immunofluorescence. Results ANCA was detected in 24 of 39(61.5%) Uygur patients with UC, 11 of 30( 35.5%) Han patients with UC, 1 of 30(3.3%) Uygur patients with diarrhea of other causes, none of 30 Han patients nor in the two healthy controls. It showed that the positive rate in Uygur patients with UC was significantly higher than in Han patients with UC (P0.05). Conclusions ANCA is useful in distinguishing patients with UC from other diarrhea diseases. ANCA may be a potential marker of genetic susceptibility to UC.

Early gastric cancer is the gastric cancer limited to mucosa or submucosa no matter there is lymph node metastasis or not,and its prognosis is relatively good. China is the high morbidity area of gastric cancer,most patients with gastric cancer are diagnosed at an advanced stage losing the chance of operation and the survival rate is low. Therefore, early diagnosis and treatment is crucial for improving the survival rate of patients with gastric cancer. This article reviewed the progress in study on diagnosis of early gastric cancer from the following aspects:serology,imaging,endoscopy and genetics.

Objective To investigate the expression of VEGF-C in breast cancer and its relationship with lymph node metastasis. Methods VEGF-C expression was assessed by immunohistochemistry in 78 cases of breast cancer. The relationship between expression of VEGF-C and lymph node status and clinicopathological features in breast cancer was analyzed. 20 cases of breast fibroadenoma was taken as control group. Results The expression of VEGF-C was significantly higher in breast cancer group than that in fibroadenoma group(P<0.01). VEGF-C was significantly higher in axillary lymph node-positive group than that in axillary lymph node-negative group(P<0.05). No relativity was found between VEGF-C and patient age, tumor size, estrogen receptor status, progesterone receptor status, and clinical stage. Conclusion The high expression of VEGF-C has a relativity with lymph node metastasis of breast cancer and may be important for the breast cancer's prognosis.

To study the pathological process and renal patho morphology of crush syndromed.The rabbit model of crush injury crush syndrome was established.Transmission electron microscopy(TEM),biochemistry,radioimmunoassay and immuohistochemistry were employed.The results demonstrated that the serum K + and BUN increased,The serum CO 2CP decreased after crush injury.The degeneration and necrosis of the epithelial cells of the renal tubule and myoglobin casts in the renal tubules were observed in crush syndrome,the serum K + increase was absent.Our results may be regarded as criteria for the diagnosis of the crush injury crush syndrome.The serum K + increase was the cause of death in early stage after crush injury.

AIM: To analyzed the effect of keratoconjunctivitis sicca treated by different medicines after phacoemulsification in patients with diabetes.METHODS: Totally 78 diabetic patients 78 eyes with keratoconjunctivitis sicca (KCS) after phacoemulsification from March 2015 to March 2016 were selected and divided into two groups using random number table.In Group A, 39 eyes were treated with pranoprofen eye drops + artificial tears + Qiming granules.In Group B, 39 eyes were treated with pranoprofen eye drops + artificial tears.the two groups were observed for clinical symptoms, tear film break up time(BUT), corneal fluorescein staining and adverse reaction and so on before and after treatment.RESULTS: Total effective rate of Group A was 97%, significantly higher than that of Group B (64%)(P<0.05).After treatment, symptoms and signs scores of the two groups were significantly lower, BUT were significantly prolonged.At 1, 2wk and 1mo after treatment, symptoms and signs scores of Group A were significantly lower the BUT was longer than those of Group B (P<0.05).Corneal fluorescein staining of Group A at 2wk was lower than that of Group B (P<0.05).CONCLUSION: The combined therapy, pranoprofen eye drops + artificial tears + Qiming granules, is able to quickly and effectively improve the clinical symptoms and signs, with no serious adverse reactions for keratoconjunctivitis sicca after phacoemulsification in patients with diabetes.

Objective To evaluate the outcomes of pregnancy of unknown location (PUL) with serial of serum β-human chorionic gonadotropin (β-hCG) and transvaginal sonography.Methods A retrospective study was performed to analyze the relationship between serial serum β-hCG and transvaginal sonography among 315 women who were diagnosed with nonvisible intrauterine pregnancy during Jan 2015 to Dec 2015.Results The pregnancy outcomes of 315 women included 254 intrauterine pregnancies,43 ectopic pregnancies,and 18 spontaneously resolving miscarriages or spontaneously resolving ectopic pregnancies.The serial serum β-hCG curve was classified as rising hCG levels,declining or plateauing hCG levels.Different pregnancy outcomes could exhibit as rising or declining hCG curves.Conclusions It is critical to perform two or more serial serum β-hCG examinations followed by transvaginal sonography to establish the correct diagnosis for PUL.

OBJECTIVETo explore the effect of dorsalis pedis parallel flaps in repairing perforating skin and soft tissue defects of the palms.

METHODSEighteen patients with perforating skin and soft tissue defects of the palms were hospitalized from July 2008 to November 2010. The area of skin defect ranged from 2.0 cm x 1.5 cm to 5.0 cm x 2.5 cm. The dorsalis pedis parallel flaps were used to repair these defects, with the area ranging from 2.0 cm x 2.0 cm to 5.5 cm x 3.0 cm. The donor sites were covered with autologous full-thickness skin from inner thigh.

RESULTSAll the 18 flaps and skin grafts of donor sites survived completely. Seventeen patients were followed up for 6 to 23 months, with mean time of 10 months, and one patient was lost to follow-up. The texture, elasticity, and appearance of all the 17 flaps were satisfactory, with no obvious pigmentation or cicatricial contracture. At the last follow-up, the distance of two-point discrimination of flaps ranged from 6 to 9 mm, with mean distance of 7.4 mm, and the sensation of flaps reached S3 in 13 patients who had nerve anastomosis.

CONCLUSIONSThe dorsalis pedis parallel flap, with reliable blood supply and flexible design, is a good choice for repairing perforating skin and soft tissue defects of the palms.

Contracture ; Foot ; surgery ; Hand Injuries ; surgery ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Skin ; Skin Transplantation ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; Treatment Outcome ; Wound Healing ; Young Adult

Objective To investigate the diagnostic value of treadmill exercise tests (TET), Hoher electro-cardiogram in coronary artery disease(CAD) patients. Methods 144 patients who clinically diagnosed as CAD,un-derwent TET and Hoher electrocardiogram. Then the patients with the positive results were examined by coronary arte-riography(CAG). According to the results of CAG the diagnostic value of TET and Hoher electrocardiogram was per-formed with comparative analysis. Results The sensitivity, specificity and evaluated accuracy rates of TET were 93.3% ,72. 2% and 73. 8% respectively. But the sensitivity,specificity and positive evaluated accuracy rates of Hol-ter electrocardiogram to examine myocardial iachemia were 76.7%, 88.4%, 57.1%. Conclusions The combined examination of TET and Holter electrocardiogram could preliminarily estimate the stenosis site of coronary artery. For the patients with unconditional GAG, those two examinations could increase the diagnostic reliability of positive rate of myocardial isehemia, and on this basis to enhance the diagnostic level of the stenosis site of coronary artery.