Objective To evaluate the efficacy and safety of endoscopic balloon dilatation for patients with achalasia. Methods Patients with achalasia, were treated by single or double esophageal balloon dilatation under endoscopy,f ollowed up survey by gastroduodenal endoscopy and esophageal barium radiography as well as their symptoms were investigated periodically. Results The dysphagia symptoms remitted in all of the 43 patients,and mucosal lacerations,abrasions a nd oozing of blood, were found in this process but without complication of perf oration,haematemesis and melena.The following up ranged from 3 months to over 4. 8 yrs,and average was 2.6 yrs.The rate of remission of dysphagia symptoms 90.7 ％ (39/43) at six months,85.3％ (29/34) at 1 yr,82.6％ (19/23) at 2 yrs and 82.4 ％ (14/17) at 3 yrs,and the rate of recurrence of symptoms was 9.3％ (4/43)、 1 4.7％ (5/34)、 17.4％ (4/23)、 17.6％ (3/17),respectively.In addition,there were 37.2％ (16 cases)of patients with acid－ reflux symptoms,30.2％ (13 cases)heart burn and 14.0％ (6 cases)reflux esophagitis during the followed－ up. Conclusion Endoscopic esophageal balloon dilatation for achalasia is an effective and saf e method not only in the short－ term but also in the long－ term.

[Objeetive] To develop the recombinant human bone morphogenetic protein-2(rhBMP-2)loaded amorphous calcium phosphate(ACP)delayed release nano-sized material,investigate its cytotoxicity of cell,and provide a reference for the experiment of composite material in vivo.[Method]The rhBMP-2/ACP delayed release nano-sized material were prepared by chemical wet method and cultured on rabbit bone marrow-derived mesenchymal stem cells(BMSCs)in vitro.Then the adhesion,proliferation,growth and functional expression of BMSCs were measured.[Result]Cytotoxicity test demonstrated that rhBMP-2/ACP delayed release nano-sized material had not affect the percentage of cell's proliferation with material-extracted liquid cultured with BMSCs and the cytotoxicity was graded zero.The adhesion,proliferation,configuration of the cells on the surface of this material were identical to the control group.[Conclusion]It was suggested that rhBMP-2/ACP delayed release nano-sized material might have good cellular biocompatibility,no cytotoxicity and not effected the normal functional expression of BMSCs in vitro.

[Objective]To study the biocompatibility and security of the recombinant human bone morphogenetic protein-2(rhBMP-2) loaded amorphous calcium phosphate(ACP) delayed release nano-sized material and investigate the feasibility of the clinical use as a kind of bone substitute in bone engineering.[Method]The in vitro hemolyzation,cytotoxicity,microkernel test in marrow smear,acute systemic toxicity,pyrogenicity,subcuticular stimulation reaction and short-term intramuscular implantation,as well as endosseous implantation were performed on the rhBMP-2/ACP delayed release nano-sized material.[Result]The material-extracted liquid induced no hemolyzation,no toxic effects of genetic,no pyrogenic reaction in rabbits,no cytotoxicity cultured in rabbit bone marrow-derived mesenchymal stem cells(BMSCs) in vitro and no acute toxicity in mice.The intramuscular implantation and endosseous implantation in rabbits induced no inflammatory reaction,tissue necrosis and the material was degraded gradually,fused organically with tissues.[Conclusion]The biocompatibility and security of the rhBMP-2/ACP delayed release nano-sized material could meet the requirements given in biological standards for implanted biomaterials ISO10993 and GB/T16886,suggesting that it could be a good bone substitution for the clinical trial.

Objective To investigate the clinical efficacy,operative essentials and indications of hybrid spinal fusion surgery for cervical spondylotic myelopathy.Methods From August 2008 to December 2011,thirty-eight patients with cervical spondylotic myelopathy underwent hybrid spinal fusion surgery in our hospital.There were 27 males and 11 females,aged from 33 to 70 years (average,51 years).A total of 86 segments were treated (fusion 48 vs.non-fusion 38).Twenty-eight patients underwent a two-level surgery,and ten patients received a three-level surgery.The Japanese Orthopaedic Association (JOA) score and Visual analogue scale (VAS) were used to evaluate pre-and post-operative neurological function and pain,respectively.The pre-and post-operative range of motion of the cervical spine was measured according to Xrays.Moreover,the surgical complications were recorded and analyzed.Results Thirty-seven patients were followed up for 15 to 55 months (average,29.1 months).The improvement of neurological function was obtained in 36 patients.The JOA score was improved from preoperative 10.5±1.57 to 14.3±1.97 at final follow-up,with an improvement rate of 58.46％,and the results were excellent in 16 cases,fair in 20 cases and poor in 1 case.The VAS was improved from preoperative 7.3±1.04 to 3.2±1.41 at final follow-up.The Cobb angle changed from preoperative 25°±3.21°to 20°±2.56°at final follow-up.After operation,the neurological function was not restored in 1 case; hoarseness and bucking occurred in 2 cases; sore throat occurred in 22 cases; anterior displacement of prosthesis (PCM) occurred in 3 cases.Other patients had no complications,such as displacement,loosening and heterotopic ossification.Conclusion In hybrid spinal fusion surgery,the lesions segments are decompressed fully,the severely degenerative segments are fused,and the motion of the non-fusion segments is reserved.As a result,not only the stability of the cervical spine is achieved,but also an obvious improvement of symptoms and a satisfactory short-term efficacy can be obtained.Therefore,this method is an alternative procedure for cervical spondylosis myelopathy.

Objective To analyze the usual death causes of cardiovascular disease and the differences in gender and age .Methods By adopting the retrospective study method ,the clinical data of death cases in cardiovascular disease were collected and analyze on the situation suffering from cardiovascular disease ,direct death causes ,gender and age difference .Results (1) among 181 cases of cardiovascular disease death ,coronary heart disease(115/181 ,64% ) and hypertension(96/181 ,53% ) were the most common dis-ease ,lung infection(104/181 ,57% ) was the most common complication ;(2)There was no significant difference in the situation suf-fering from basic diseases between male and female(P>0 .05);(3)The basic diseases in cardiovascular death cases aged over 60 years old were dominated by coronary heart disease and hypertension ;the proportion of complicating pulmonary infection was grad-ually increased with age increase ;(4) in the direct death causes ,the top 3 places were sudden cardiac death (44/181 ,24 .3% ) ,multi-ple organ dysfunction syndrome(24/181 ,13 .3% ) and cardiogenic shock(24/181 ,13 .3% ) .Conclusion Strengthening the manage-ment of diagnosis and treatment on elderly patients with coronary heart disease ,hypertension ,especially those complicating diabe-tes ,strengthening the treatment intervention of lung infection in cardiovascular disease population and conducting the emphasis pro-tection on the target organ function may reduce the mortality of cardiovascular inpatients .

Objective To investigate the expression of humanβ-defensin 2 (HBD-2) in gastric mucosa of Helico-bacter pylori (H. pylori) associated gastric mucosa-associated lymphoid tissue (MALT) lymphoma, and the role of HBD-2 in gastric MALT lymphoma. Methods Forty gastric mucosa specimens from patients with H. pylori associated gastric MALT lymphoma were collected. And 36 gastric mucosa specimens from chronic superficial gastritis without H. pylori infection were included as control group. The expression of HBD-2 was detected by immunohistochemistry staining. Results The ex-pression of HBD-2 was significantly higher in H. pylori associated gastric MALT lymphoma than that of control group. (P＜0.01). The expression of HBD-2 was significantly decreased after the eradication of H. pylori (P＜0.01). The expression of HBD-2 was significantly higher in H. pylori associated gastric MALT lymphoma than that of lymphoma cells (P＜0.01). There was no expression of HBD-2 in lymphoma cells. Conclusion HBD-2 is possibly involved in the pathogenesis of H. pylori associated gastric MALT lymphoma. But whether it has anti-tumor effect is not clear.

Objective:To learn the cognition and attitudes of psychometric ethics of graduate students whose major was clinical psychology or counseling psychology,and to investigate whether ethics training could influence their cognition and attitude.Methods:Researchers distributed the questionnaire online regarding cognition and attitudes of psychometric ethics among clinical and counseling psychology graduate students.Seventy-six feedbacks were collected (4 students were learning ethics courses,27 students had learned ethics courses,45 students hadnt learned ethics courses).The questionnaire included the Psychometric Cognition Questionnaire (PCQ),Situational Judgement Questionnaire (SJQ) and Psychometric Attitude Questionnaire (PAQ).The first two sets of questionnaires reflected ethics knowledge.The last one showed ethics attitudes and behavioral tendencies.Results:The correct rates in participants who had learned or were learning ethics were 76.5％ and 75.1％ at the first and second set of questionnaires,while were 73.9％ and 74.2％ in other participants.The correct rates of three major clauses in PCQ were 90.3％,67.7％ and 74.2％,significantly higher than participants who never learned ethics,whose correct rates were 88.9％,66.7％,and 44.4％ (Ps ＜ 0.05).There were no significant differences in SJQ between those who had learned or was learning ethics and those who had never learned ethics (Ps ＞0.05).Participants who had learned or were leaning ethics scored in sum in PAQ that had no significant differences with those who had never learned ethics(Ps ＞ 0.05).Conclusion:Clinical and counseling psychology graduate students master considerable level of knowledge on ethics and attitude.Ethics training is essential for acquiring psychometric ethics.

Objective To investigate the relationship of high sensitivity C reactive protein (hs-CRP), interleukin-6 (IL-6)and soluble IL-6 receptor (sIL-6R)with the severity of clinical symptoms and coronary artery lesions in coronary heart disease (CHD)patients.Methods A total of 522 CHD patients were recruited and divided into three groups:stable angina pectoris (SAP),unstable angina pectoris (UAP)and acute myocardial infarction (AMI)groups.Another 102 healthy individuals served as normal controls (NCs).We calculated Gensini score according to the result of coronary angiography (CAG),collected clinical data and compared the groups. Multiple linear regression analysis was used to investigate the relationship of hs-CRP,IL-6 and sIL-6 R with Gensini score.Results The plasma hs-CRP,IL-6 levels were significantly higher and sIL-6R level was signficantly lower in SAP,UAP and AMI groups than in NC group (P<0 .0 5 ).There was a positive correlation between IL-6 level and Gensini score but a negative correlation between sIL-6 R and Gensini score presented by multiple linear regression analysis (P<0.05 ).Conclusion In CHD patients,plasma hs-CRP,IL-6 and sIL-6R levels are significantly related to the severity of clinical manifestations and coronary artery stenosis.These indicators may help predict the severity of CHD.

Objective To explore the role and relationship of N-terminal pro-brain natriuretic peptide (NT-proBNP) and matrix metalloproteinase-9 (MMP-9 ) in risk stratification and prognosis assessment of non-ST elevation acute coronary syndrome (NSTE-ACS).Methods We recruited 114 patients with NSTE-ACS and classified them into three groups according to the GRACE risk stratification:high-risk,intermediate-risk and low-risk groups.Another 5 8 patients were recruited as controls.Arterial blood was collected before angiography for the measurement of serum NT-proBNP and MMP-9 .Gensini score was used to evaluate the degree of coronary artery stenosis.All the patients were followed up for 6 months and MACE was observed and recorded.Results ① The levels of lg NT-proBNP and MMP-9 significantly differed between the groups (P<0.05).② ROC curve analysis showed that lg NT-proBNP could predict MACE of NSTE-ACS;area under the curve was 0.795,the cutoff value was 2 .0 6 9 ,corresponding to the NT-proBNP value of 1 1 6 .5 6 ng/L.MMP-9 could predict MACE of NSTE-ACS;area under the curve was 0 .6 9 6 ,the cutoff value was 3 2 .4 9 ng/ml;both of the abnormal indexes could predict MACE with the sensitivity of 80.41%,specificity of 82.19%,and Youden’s index of 0.63.③ Cox regression analysis showed that abnormal MMP-9 and NT-proBNP levels were independently related to the incidence of MACE by the value of OR as 3.751.Conclusion MMP-9 and NT-proBNP may be used as serological indicators in risk stratification of NSTE-ACS. The combined use of NT-proBNP and MMP-9 increases the power of predicting MACE.

Objective To investigate the relationship between body mass index (BMI), blood lipid level and cancer de?tection in prostate biopsy. Methods A total of 214 patients undergoing a prostate biopsy during 2013.2—2014.8 were re?viewed retrospectively. They were divided into prostate cancer and non-cancer groups by biopsy results. The differences of age, prostate-specific antigen (PSA) level, prostate volume (PV), blood lipid level and BMI were analyzed between two groups. Risk factors for cancer detection of biopsy were also analyzed. Results Compared with non-cancer patients, pros?tate cancer patients were older, had higher level of PSA and BMI, but smaller PV and lower level of HDL-C ( P<0.05). Lo?gistic regression analysis showed that older, higher level of PSA and BMI were risk factors for prostate biopsy positive, but larger PV and higher level of HDL-C were protective factors (P<0.05). Conclusion Comprehensive assessment of BMI and blood lipid levels can provide important reference for prostate cancer screening at early time and establishment of pros?tate biopsy scheme, which also provide significant evidence for the prevention, diagnosis and treatment of prostate cancer at early stage for high risk population.