Objective:To observe the dynamic changes in serum gastroanteric hormones in patients with stroke complicating stress upper gastrointestinal hemorrhage in acute stage,the changes in acidity,and the changes in gastric empty and to investigate the pathogenetic link of stress pathological change of gastric mucous membrane in patients with stroke(Zhongzangfu,ZZF,中脏腑).Methods:In 20 cases with acute ZZF (Glasgow coma score 6-12 scores) who were all complicating upper gastroenteric bleeding within 24 hours of attack,the levels of motilin(MTL),somatostation(SS),and gastruins(GAS) were measured by radioimmunoassay at the first day (within 24 hours) and the fourth day (within 72-96 hours) respectively meanwhile the gastratube was plased and kept within 24 hours of attack to dynamically observe the pH of gastric juice and the condition of gastric emptying.Results:In comparison with control group the MTL level was significantly increased in patients at the first day of attack (P<0.05),the SS level significantly decreased (P<0.01),and the GSA level had not significant difference (P>0.05).Otherwise the pH (2.87±0.90） of gastric juice in comparison with control group has not significant difference (P>0.05).Among patients in 17 cases the gastric emptying time was prolonged.Even at the fourth day in patients the MTL level was still significantly increased (P<0.01),SS level decreased (P<0.05),and GAS level increased (P<0.01).Conclusions:The upper gastrointestinal hemorrhage in patients with acute ZZF is tightly associated with the changes in MTL and SS but the changes in GAS and gastric pH are not main factor.

OBJECTIVE: To evaluate nasal ventilation in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) after nasal cavity ventilation expansion techniques by using acoustic rhinometry. METHOD: Thirty-eight patients with mild OSAHS and 17 patients with moderate OSAHS who were diagnosis by PSG were selected. The acoustic rhinometry and rhinomanometry were used to assess the nasal cavity volumes (NCV), nasal airway resistance (NR), nasal minimal cross-section area (NMCA) and distance of nasal minimal cross-section area from nostril (DCAN) before and after the surgery (6 month later). RESULT: The state of mild OSAHS group in NCV, NMCA and NR: before surgery (2.41 ± 1.33) cm³, (0.37 ± 0.39) cm², (2.07 ± 1.48) cmH₂O/(L · min), after surgery (2.53 ± 1.54) cm³, (0.45 ± 0.34) cm², (1.69 ± 1.03) cmH₂O/(L · min), has significant difference (P < 0.05). The state of moderate OSAHS group in NCV, NMCA and NR: before surgery (2.03 ± 1.54)cm³, (0.29 ± 0.39) cm², (3.47 ± 2.56) cmH₂O/(L · min), after surgery (2.31 ± 1.47) cm³, (0.39 ± 0.33) cm², (1.89 ± 1.03)cmH₂O/(L · min), also has significant difference (P < 0.05), while DCAN in two group had no difference (P > 0.05). CONCLUSION There was an objective evaluation of nasal ventilation in OSAHS patients after surgery by using acoustic rhinometry.
Humans ; Nasal Cavity ; surgery ; Rhinometry, Acoustic ; Sleep Apnea, Obstructive ; surgery

Objective To evaluate the effectiviness and safety of rituximab in the treatment of immune thrombocytopenia .Meth-ods Standard doses and small doses of rituximab alone or combined therapy with other methods were used in 2 cases with immune thrombocytopenia who diagnosed and treated for the first time ,and 6 cases who diagnosed with refractory recurrent immune throm-bocytopenia .The recent curative effect ,adverse reactions were analyzed .Results The recent curative effect was well in the 2 cases who diagnosed and treated for the first time ,but 1 case recurrenced after 6 months .4 cases of effective in the 6 cases who diagnosed with refractory recurrent ,in which 1 case recurrenced after 2 years ,2 cases had no effect .All of the patients have no obvious adverse reaction in the near future .Conclusion Rituximab treatment of immune thrombocytopenic ,it is of good curative effect ,good safety and tolerability .

Objective To evaluate CT staging and resectability of esophageal carcinoma.Methods The esophageal barium examination,esophagoscopy and CT scan were performed in 42 cases with esophageal carcinoma.CT findings were put the stress on analyzed.Results CT clearly demonstrated the location, thickness, actual length and extent of esophageal carcinoma as well as its relation with surrounding structures in all 42 cases.According to staging standard of Moss and Reining there were four stages,Ⅰ stage 0 case,Ⅱ stage 33 cases,Ⅲ stage 6 cases,Ⅳ stage 3 cases.In all cases,operations were in 34 cases,detecting were in 3 cases,no-operations were in 5 cases.Conclusion CT imaging playes an important role in preoperative diagnosis,staging and the evaluation of resectability of esophageal carcinoma.

Objective To study the CT signs of bronchotracheal transparent foreign body and its diagnostic value.Methods The X-ray and CT findings of bronchotracheal trasparent foreign body in 46 cases were analysed comparativly.Results Among 46 cases,9 cases of trachea foreign body,13 cases of right bronchial foreign body,7 cases of left bronchial foreign body,2 cases of both sides of bronchial foreign body were showed directly by CT,and 8 cases of right bronchia foreign body,6 cases of left bronchia foreign body,1 case of both sides of bronchia foreign body showed indirectly on CT,the sensitivity was 100 percent,while the foreign body and its anatomical location could not be showed on X-ray film,but the indirect signs just like pulmonary emphysema,obstructive pulmonitis and drowned lung etc,could be showed by X-ray films in 34 cases.In another 12 cases were negative,the sensitivity was 73.9 percent.Conclusion The transparent foreign body can not be showed but indrect signs by X-ray film;While CT scan can not only shows the anatomical location of foreign body,but also the shape and size of the foreign body,it offers more information than X-ray films and has important refering value to clinicians to take out the foreign body.

Objective To determine the prevalence of gastroesophageal reflux disease (GERD) in patients with idiopathic pulmonary interstitial fibrosis (IPIF). Methods From December 2006 to January 2008, 24 consecutive patients with IPIF admitted to Beijing Chaoyang Hospital underwent 24-hour esophageal pH monitoring and esophageal manometry. Meanwhile, 23 patients with diffuse parenchymal lung disease (DPLD) (excluding IPIF) admired to the hospital in the same period served as a control group. Comparison of the prevalence of pathologic esophageal acid exposure GERD symptoms, and ineffective esophageal motility (IEM) between the two groups was made. In this study, nocturnal acid exposure is defined as acid reflux episodes occurring from 10pro to 6am. Results (1) 16 out of the 24 (66. 7%) patients with IPIF were demonstrated to have pathologic esophageal acid exposure; the prevalence of GERD in IPIF patients was significantly higher than that in other DPLD patients, whose prevalence was 26. 1% (P<0.05); (2) 87.5% patients with IPIF and GERD (GERD-IPIF) had nocturnal acid exposure episodes; (3) only 37.5% of the GERD-IPIF patients was found to have typical GERD symptoms such as heartburn and regurgitation; (4) The prevalence of IEM was similar in IPIF and other DPLD patients, being 42.9% and 39. 1% respectively (P >0. 05). Conclusions IPIF patients have higher prevalence of GERD and most of them usually do not show typical reflux symptoms. It is hereby suggested that IPIF patients should be screened with pH monitoring for GERD.

Objective To investigate the diagnosis and treatment of the patients with lung cancer hospital-ized in affiliated hospital of Hainan Medical College.Methods A retrospective study was performed from January 1st 2005 to December 31th 2009 in the Hospital.201 patients were enrolled in this study.Results The average onset age of patients with lung cancer was 66 years old.No difference in different gender.The incidence of male was 72.1%, which was higher than of female(27.9%).Male to female ratio was 2.6:1.70.3% of male patients with lung cancer had a history of smoking.146 cases(72.6%)were diagnosed by clinical data,only 55 cases(27.4%)were diagnosed by histopathology.134 cases(66.7%)hadn′t indications for surgery.only 17 cases(25.4%)agreed to have surgery among 67 cases (33.3%)with indications for surgery,50 cases(74.6%)didn't agree to have surgery.34 cases (16.9%)had no indications for chemotherapy.40 cases(24.0%)agreed to have chemotherapy among 167 cases (83.1%)with indications for chemotherapy,but only 14 cases(35.0%)had completed 4 to 6 cycles of chemotherapy, and 26 cases(65.0%)hadn't completed 4 to 6 cycles.8 cases(4.0%)agreed to have radiotherapy.3 cases(1.5%) agreed to have targeted therapy.3 cases (1.5%)transfered to other hospital.Conclusion The ratio of lung cancer patients in male is higher than female in the hospital.smoking is closely related to male patients.Clinical diagnosis rate of patients is high,whereas histopathologic diagnosis rate is low.The rate of the intervention that patients accepted is low and many patients give up available management after the diagnosis is made.

Objective: To explore the effect of caveolin-1 ( Cav-1 ) on lipopolysaccharide ( LPS )-induced airway mucous hypersecretion.Methods:16HBE human airway epithelial cells with Toll-like receptor 4(TLR4) inhibitor,nuclear factor-kappa B(NF-κB) inhibitor,Cav-1 siRNA or plasmid pr-treated,further stimulated with LPS.The cells were divided into 8 groups:the control group, the LPS group,the LPS+Cav-1 expression group,the LPS+Cav-1 siRNA group,the LPS +negative siRNA group,the LPS +empty vector group,the LPS +E5564 group, the LPS +PDTC group.Cell survival rate was detected by MTT assay.Transcription level of mucin(MUC)5AC was evaluated with RT-PCR.The level of MUC5AC protein was measured by ELISA.The expression of TLR4,Cav-1 and phosphorylated IκBα( p-IκBα) were measured by Western blot.MUC5AC protein changes were observed by immunofluorescence and confocal laser technology.Results:LPS remarkably increased MUC5AC,as well as TLR4,p-IκBα(P<0.05).These effects were prevented by E5564 and PDTC.We found that the overexpression of Cav-1 further enhanced the expression of TLR4, p-IκBαand MUC5AC.However,downregulation of Cav-1 inhibited the expression of TLR4,p-IκBα,MUC5AC.Conclusion: Cav-1 enhances LPS-induced MUC5AC hypersecretion through TLR4/NF-κB signaling pathway.

Objective To compare the different methods for treating aerobic vaginitis and mixed clinical effects of infection.Methods A randomized controlled method was used,298 cases of aerobic vaginitis and mixed infections were randomly divided into control group(149 cases):the use of combination anti -infective therapy,the treatment group(149 cases):the use of combination anti -infective at the same treatment plus lactobacillus vaginal medication.And the therapeutic effect was evaluated.Results The difference of the clinical efficacy of aerobic vagi-nitis treatment of mixed infections was not statistically significant (total effective rate of 95.3% in the treatment group,92.6% in the control group).With the time of treatment extended,the effective rate increased,the use of com-bination anti -infective therapy at the same time plus lactobacillus vaginal administration group of aerobic bacteria vaginosis and recurrence rate was significantly reduced in patients with mixed infection (recurrence rate was 6.0% in the treatment group and 12.8% was in the control group,χ2 =3.941 3,P <0.05).Conclusion The combination of anti -infective therapy at the same time plus lactobacillus vaginal drug treatment aerobic mixed infections and vagini-tis has slightly higher effective rate than the use of combination anti -infective treatment,the former relapse rate was significantly reduced.

Over the past two decades, multiple drug-resistant infections have escalated globally with the significantly increased morbidity and mortality due to the unreasonable uses of antimicrobial agents in areas such as animal husbandry, industry and medicine. As the situation of drug resistance has been progressively serious, anti-drug-resistant clinical strategies have attracted widely social concerns. This review will report the current status of antibiotic resistance and the mechanism of antibiotic-resistance all over the world. The anti-drug resistance strategies are the emphasis of our report, including the new indication of old antibiotics, the combination of existing antibiotics, the development of new antibiotics, nano-antibiotics, and non-infection treatment with immunomodulators and phage. This review aims to further understand the current situation of drug resistance, which optimizes the strategies of drug-resistant bacteria and clinical services.