Objective:To evaluate the clinical value of combined detection of ischemia modified albumin(IMA), N-terminal pro brain natriuretic peptide(NT-proBNP) and dynamicelectrocardiogram(DEG) in the diagnosis of silent myocardial ischemia.Methods: IMA, NT-proBNP and DEG of 114 patients with silent myocardial ischemia who were suspected coronary heart disease were detected, and then these results were compared and analyzed with the results of coronary angiography(CAG).Results: In 114 patients with suspected coronary heart disease, 68 cases(59.65％)were positive as the results of CAG. And there were 60 cases were positive as the results of IMA detection, and the specificity and sensitivity of IMA compared with CAG were 82.61％ and 88.24％, respectively. There were 63 cases were positive as the results of NT-proBNP, and the specificity and sensitivity of NT-proBNP compared with CAG were 80.43％ and 92.64％, respectively. There were 57 cases were positive as the results of DEG, and the specificity and sensitivity of DEG compared with CAG were 86.96％ and 83.82％, respectively. While there were 66 cases were positive as the combined detection of the three methods, and specificity and sensitivity of the combined detection compared with CAG were 95.65％ and 97.06％, respectively. Therefore, the specificity and sensitivity of combined detection were significantly higher than that of alone detection of IMA, NT-proBNP and DEG (F=140.637,F=255.467,P<0.05).Conclusion: The comprehensive analysis for the combined detections of IMA, NT-proBNP and DEG can increase both of the specificity and sensitivity of diagnosis, and it can be used as a important screening method for earlier finding silent myocardial.

OBJECTIVE: To discuss the diagnosis and treatment of esophageal perforation induced by esophageal foreign body. METHOD: Ten patients, who were diagnosed as esophageal foreign body and esophageal perforation, were retrospectively analyzed. One patient was operated in other hospital and transferred to our department post-operation. The foreign bodies were removed through rigid esophagoscope in 7 cases and through the tracheotomy in 1 case. The last case was admitted into hospital for abscess around the esophagus. The foreign body wasn't find during the examination of rigid esophagoscope and the patient vomited out a glass foreign body after the surgery. RESULT: In all cases, there were three date stones, two button batteries, one metal gear, one pin, one metal cans pull ring, one glass plate, one arc hard plastic sheet. Seven patients were cured after conservative treatment, and restored normal diet. For the rest 3 cases, patients were cured after the repair operation of tracheoesophageal fistula. CONCLUSION The esophageal perforation must be highly suspected of the esophageal foreign body with a long history, sharp shape or corrosive foreign body. The esophageal radiography may be taken to obtain the final diagnosis. The patients diagnosed as esophageal perforation must be treated with antibiotics, nasal feeding or feeding by gastrostomy, and followed-up closely. Small perforation can heal after a period of time by nasal feeding, while tracheoesophageal fistula was needed to repaire after a period of time for restoring a good physical condition in most cases.
Abscess ; Child ; Esophageal Perforation ; diagnosis ; surgery ; Foreign Bodies ; diagnosis ; surgery ; Humans ; Retrospective Studies ; Tracheoesophageal Fistula ; Tracheotomy

OBJECTIVE: To investigate the effects of compound preparation of Cordyceps sinensis and Tripterygium hypoglaucum (CSTHC) on survival time of grafted pigskin after allogeneic transplantation and its mechanism. METHODS: The pigskin was treated with CSTHC solution before allogeneic transplantation, and CSTHC ointment was applied for external use on the grafted pigskin after skin transplantation. Cyclosporine A (CsA) and normal saline were served as control. The survival time, the appearance and the histomorphological changes of the grafted pigskin were observed. The histomorphological changes of testicles in pigs were also examined. The CD4 and CD8 expressions in the grafted pigskins were measured by immunohistochemical method. The white blood cell count in peripheral blood and the liver and renal functions were also examined. RESULTS: The survival time of the grafted pigskin in the CSTHC-treated group was (28.50+/-3.26)d, which was much longer as compared with (10.60+/-1.52)d in the untreated group (P<0.01). The survival time of the grafted pigskin in the CsA-treated group was (28.33+/-3.50)d, and there was no remarkable difference in the survival time of the grafted pigskin between the CsA-treated group and the CSTHC-treated group. The expressions of CD4 and CD8 were lower in the CSTHC-treated group than those in the untreated group on the 7th and 14th day after skin graft (P<0.05), while there was no significant difference in the indices between the CSTHC-treated group and the CsA-treated group. The WBC count was higher in the untreated group than that in the CSTHC-treated group or CsA-treated group on the 7th day after skin graft (P<0.05). CONCLUSION: CSTHC can prolong the survival time of allogeneic grafted pigskin. Its mechanism of inhibiting the immunological rejection may relate to decreasing the expressions of CD4(+) and CD8(+) in the grafted pigskin and reducing the local inflammatory reaction.

AIM: To study effects of prolonged intensive endurance exercise and Panaxadiol saponins (PDS) on red blood cells (RBC) membrane fluidity in rats, as well as the mechanism. METHODS: By the membrane fluorence polarization, Pyrollol-NBT, TBA methods and Scanning Electron Microscope, RBC membrane fluidity,RBC-SOD and serum MDA were measured after 7 weeks prolonged intensive swimming. RESULTS: Fluorence polarization(P value) were significant higher and fluidity were lower( P

Objective To explore the MSCT findings of occipital condyle fracture (OCF) and improve its diagnostic accuracy. Methods Nineteen patients with OCF, selected from 110 patients suffering high energy injuries at the craniocervical junction, were enrolled into the study. The MSCT appearances of OCFs were retrospectively analyzed by two experienced radiologists. OCF had four types: type Ⅰ was a comminuted fracture, type Ⅱ was a extension of basilar skull fracture, type Ⅲ was an avulsion fracture at the attachment site of alar ligament on occipital condyle, type Ⅳ was a fracture of mixed pattern consisting of two or more above fracture types. Results In 19 patients, the left, right and bilateral OCFs were seen in 7,11 cases, and 1 case, respectively. Type Ⅰ was found in one case, which was a comminution of the left occipital condyle. Type Ⅱ was found in 5 cases, which involved the middle and posterior parts of occipital condyles with 2 on the left and 3 on the right, Type Ⅲ was found in 12 cases which showed various degree of fragment displacement with 3 occuring on the left, 8 on the right, 1 involving bilateral sides, 6 involving articular surfaces and 7 accompaning by enlargment of alar ligaments. Type Ⅳ was found in one case, with coexistence of Type Ⅱ and type Ⅲ. In addition, OCFs were accompanied by head and (or) cervical spine injuries in 14 cases, which included cranial fracture in 8 cases, epidural hematoma in 4 cases, subarachnoid hemorrhage in one case, cerebral contusion and laceration in one case, subfalcial hernia in one case, cervical spine fracture and dislocation in 9 cases, and so on. Conclusion OCFs can be accurately diagnosed by MSCT, which is important for selection of treatment protocols.

Objective To analyse the routes and MRI characteristics of disseminated intracranial gliomas after operation. Methods 10 patients of intracranial gliomas confirmed by pathology and intracranial dissemination after operation underwent MRI examina-tions including T_1 WI, FSE T_2 WI, FLAIR and fat-suppressed T_1 WI after intravenous injection of Gd-DTPA. In addition, 4 cases were also examinated with DWI, 1 case with SWI and DTI. Results In 10 cases,there were glioblastoma in 7 cases,grade Ⅱ astro-cytoma in 2 and grade Ⅲ astrocytoma in one. The disseminated tumors were found by MRI in 4 to 56 months after operation. The le-sions in all patients were confirmed with the comparison of contrast-enhanced MRI positive signs between preoperation and post-operation. Plain MR scanning showed line-like thicking with isointensity in 1/7 case/time (C/T)and multiple noduli in 5/7 (C/T) on T_1 WI respectively;shallowed cortical sulci and cistern in 2/7(C/T) and nodular in 5/7(C/T) on T_2 WI;shaUowed cortical aulci and cistern in 2/7 (C/T) and nodular in 6/7(C/T) on FLAIR. The signal intensity of noduli of disseminated tumors in 7 cases were in complete consistency with that of primary neoplasm , however, in 3 cases, it was inconsistent. Enhanced scanning showed 7 ca-ses with the signs of line-like thicking, 7 cases with noduli , 6 cases with :cast-like shape" sign and 6 cases with different extent of hydrocephalus. Conclusion Enhanced MRI can be used as a most useful and reliable monitoring tools for detecting dissemination of brain glioma.

Objective: To study the protective function of Gardenia yellow (GY) against CCl 4 induced hepatotoxicity in mice.Methods: Healthy Kunming male mice, weighting (20?2) g, 10 per group were randomized into 5 groups:control group, CCl 4 injured group, low dose group(CCl 4 injured+0.1 ml GY solution), medium dose group(CCl 4 injured+ 0.2 ml GY solution) and high dose group(CCl 4 injured+0.4ml GY solution). GY solution was given i.g. 5 d prior to CCl 4 injury. Serum glutamate pyruvate transaminase(SGPT) and glutamic oxaloacetic transaminase(SGOT) and lactic dehydrogenase(LDH) activities were determined 18 h after CCl 4 injury. Hepatic malondialdehyde(MDA), glutathione(GSH) and liver index were also detected. Results: In GY treated groups, the increases of serum SGOT, SGPT, LDH activities and liver GSH were inhibited obviously. The elevations of MDA and liver index were prevented significantly. The lesions in liver lobule were ameliorated obviously. Conclusion: Gardenia yellow can protect against CCl 4 induced hepatotoxicity.

Small cell lung cancer (SCLC) is an aggressive neuroendocrine carcinoma with a very high degree of malignancy. Currently, the standard treatment for SCLC is still chemoradiotherapy, and although SCLC is sensitive to chemotherapy in the early stage, recurrence and metastasis often occur due to drug resis-tance. In recent years, immunotherapy has made some progress in the study of SCLC. The immunodetection point programmed death-1 (PD-1) and its ligand (PD-L1) inhibitors, such as nivolumab, atezolizumab and pabolizumab, have shown good antitumor activity in clinical studies of SCLC, and PD-1/PD-L1 inhibitors combined with chemotherapy have shown better efficacy, providing a new strategy for the treatment of SCLC.

Objective To investigate the effect of emotional resilience group training on perceived stress,anxiety and depression in patients with gastrointestinal cancer.Methods 325 cases of patients with gastric cancer were divided into experimental group(n=163) and control group(n=162) by random digital table method.Two groups of patients were treated with chemotherapy and routine treatment and the experimental group was trained once a week for 8 weeks of emotional resilience group training.Chinese version perceived stress(CPSS),SDS and SAS were used to evaluate the effect of intervention before and after intervention.Results After 8 weeks of emotional elastic group training,the CPSS score((39.98±4.82) vs (33.96±5.02)),SAS score((48.83±4.58) vs (42.12±4.01)) and SDS score((49.23±4.12) vs (45.21±3.27))were lower than those before the intervention (all P＜ 0.05).The difference of CPSS ((-6.02 ± 3.74) vs (-0.19±2.78)),SAS((-6.71±3.86) vs (-0.39±5.62)) and SDS((-4.02±2.03) vs (-0.62±2.31)) before and after the intervention of the two groups were statistically significant(t=-9.325,-9.529,-6.132,P＜0.01).Conclusion Emotional resilience group training can effectively reduce the level of perceptual stress in patients with gastrointestinal cancer,and improve depression and anxiety.

Objective To explore the role of the visceral afferent nerve hyperesthesia and acid-sensing ion channel 1 (ASIC1) in rats with reflux esophagitis (RE).Methods Sixty male Sprague-Dawley rats were selected and animal model was established.Rats were divided into control group (n=20) and RE group (n=40).The esophageal mocosa biopsy were routinely performed in two groups.The esophageal specific DRG neurons were identified by 1,1'dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine perchlorate tracing method and the whole-cell patch clamp assay was performed.The expression of ASIC1 in esophageal mucosa and thoracic spine cord three to five segments at protein level and mRNA level were detected by Western blotting and quantitative real time-polymerase chain reaction (qPCR).Two independent samples t test was performed for statistical analysis.Results The body weight of RE group was significantly lower than that of control group ((179.41±-16.38) g vs (290.75 ±-22.20) g),and the difference was statistically significant (t=17.090,P＜ 0.01).Esophageal basal cell hyperplasia,papillary elongation,vascular dialation and congestion,inflammatory cells infiltration were found in RE group rats.The results of whole-cell patchclamp showed depolarization of the resting potential of esophageal-specific DRG neurons of RE group was more significant than that of control group (-(46.20 ± 1.92) mV vs-(51.60 ± 1.52) mV),and the difference was statistically significant (t=4.930,P＜0.01).The threshold current of RE group was much lower than that of control group ((18.00±13.04) pAvs (80.00±12.25) pA),and the difference was statistically significant (t=7.750,P＜0.01).When stimulated with two to three times the threshold current,the frequency of action potential of RE group significantly increased (5.80 ±1.48 vs 3.00 ±1.58,10.60±2.30 vs 5.20±1.92),and the differences were statistically significant (t=2.890 and 4.030,both P＜0.01).The results of Western blotting indicated that the expression of ASIC1 in esophageal mucosa of RE group was significatly lower than that of control group (0.614±0.120 vs 0.976±0.283),and the difference was statistically significant (t =2.885,P＜ 0.05),while there was no statistically significant difference in the expression of ASIC1 in DRG between RE group and control group (0.804 ± 0.182 vs 1.032±0.316;t=1.528,P＞0.05).The results of qPCR showed that the expression of ASIC1 mRNA in esophageal mucosa of RE group was lower than that of control group (0.694 ± 0.118 vs 1.036 ±0.137),and the difference was statistically significant (t=4.642,P＜0.01).However there was no statistically significant difference in ASIC1 at mRNA level between RE group and control group (1.002± 0.074 vs 0.985±0.120;t=0.294,P＞0.05).Conclusion The sensitivity of esophageal visceral afferent nerve of rats in RE group increases and ASIC1 may negatively regulate the formation of esophageal visceral hypersensitivity.