Objective To compare the effect of different gastrointestinal motility drugs on capsule endoscopy. Methods Seventy-one patients with suspected small bowel disease were randomly divided into metoclopramide group (24 patients), mosapride group(25 patients) and control group (22 group). The patients in metoclopramide group swallowed capsule endoscopy immediately after intramuscularly injecting 10 mg metoclopramide, the patients in mosapride group swallowed capsule endoscopy 15 min after taking 5 mg mosapride, and the patients in control group did not take any of the gastrointestinal motility drugs. Three groups had the same bowel preparation before checking. The finishing rate of small bowel examinations, stomach and small intestinal transit time, intestinal cleanliness and the detection rates of lesions in three groups were compared. Results The total small bowel examination finishing rate was 94.4%(67/71). The small bowel examination finishing rate in metoclopramide group, mosapride group, and control group was 95.8%(23/24), 96.0%(24/25), and 90.9% (20/22), and there was no significant difference(P>0.05). The stomach transit time in metoclopramide group, mosapride group and control group was(27.5 ± 20.7), (28.1 ± 20.9) and (52.3 ± 33.5) min. The stomach transit time in metoclopramide group and mosapride group had no significant difference (P>0.05), but it was significantly lower than that in control group (P<0.05). The small intestinal transit time in three groups had no significant difference (P>0.05). The image class scores in metoclopramide group, mosapride group and control group was (2.5 ± 0.4), (2.7 ± 0.4) and (1.7 ± 0.3) scores.The scores in metoclopramide group and mosapride group had no significant difference (P>0.05), but they were significantly higher than that in control group (P<0.05). The detection rate of lesions in metoclopramide group, mosapride group and control group was 45.8%(11/24), 56.0%(14/25) and 18.2%(4/22). The detection rate of lesions in metoclopramide group and mosapride group had no significant difference (P>0.05), but it was significantly higher than that in control group (P<0.05). Conclusions The use of gastrointestinal motility drugs before capsule endoscopy can improve the quality of inspection, and metoclopramide and mosapride shows no significant difference.

Objective To explore the risk factors of sepsis complicated with hepatic insufficiency in elder patients.Methods With retrospective case-control study method,according to whether or not complicated with hepatic insufficiency,a total of 384 elder sepsis patients were divided into case group (91 patients) and control group(293 patients),then single factor analysis and multiple factors Logistic regression methods were used to screen the risk factors.Results Single factor analysis identified 6 kinds of significant variables,including age(P =0.000),history of alcohol(P =0.006),chronic diseases(P =0.001),arterial blood lactate level (P =0.035),mechanical ventilation (P =0.009) and acute physiology and chronic health evaluation Ⅲ score (APACHE-Ⅲ) scores(P =0.004).Multiple factors Logistic regression analysis showed that age,history of alcohol,chronic diseases,arterial blood lactate level,mechanical ventilation,APACHE-Ⅲ scores were correlated with sepsis complicated hepatic insuffciency in elder patients (P ＜ 0.01 or ＜ 0.05).Conclusion The risk factors which closely relate to sepsis complicated with hepatic insufficiency in elder patients are age,history of alcohol,chronic diseases,arterial blood lactate level,mechanical ventilation,APACHE-Ⅲ scores.

Objective To evaluate the detection rate of lesions of patients with Crohn’s Disease(CD)tusing combining the con-ventional MR and Cine MRE(MR enterography).Methods MRI images of twenty-nine patients with CD confirmed by clinic were analyzed retrospectively.Scan sequences include coronal Cine MRE,and standard MR protocol (FIESTA,SS-FSE,LAVA C+). Two radiologists analyzed the images with double blind method to explored whether there were significant differences existing be-tween having or having not Cine MRE on lesion detection rate (wall thickness,stenosis,comb sign,adhesions,fistulas).Results The number of lesions detected by standard MR combined with Cine MRE compared with standard MR alone were 82/80 (P =0.1 6) for wall thickening,52/43 (P =0.03)for stenosis,6/7 (P =0.36)for the comb sign,5/7(P =0.66)for adhesions,2/2for fistulas re-spectivily.Conclusion It is meaningless to combine Cine MRE with standard MR in lesions detection in patients with CD,Cine ima-ges can accurately determine diseased bowel stenosis,and show the adhesive location.On the basis of standard MR,Cine MRE can be added in patients with CD when necessary.

Objective: Based on the analysis of the ancient literatures about chest stuffiness and pains in Chrono-Medicine of traditional Chinese medicine,to study the content of timing medication in chest stuffiness and pains. Methods: According to the database of Chinese Medical Code, searching the ancient literatures and establishing the database, extracting the contents of chest stuffiness and pains’s prescription which covering timing medication. And the statistical analysis and content discussion were carried out according to the choice of taking medicine. Results: The 67 kinds of traditional Chinese medicine included were qi regulating agent, dispelling cold agent, expectorant agent and blood regulating agent. Besides,the time of taking medicine is used to be3:00-5:00,7:00-9:00,11:00-13:00,17:00-19:00, 19:00-21:00, 21:00-23:00.Take medicine once a day in the morning, twice a day, three times a day, three times a day and once a night. It is recommended that timing medication in clinical should be increased in time of 21:00-23:00 and 11:00-13:00, and paying more attention to the heart channel corresponding and the heart pericardium channel in time of 11:00-13:00 and 19:00-21:00. Conclusion Timing medication is beneficial to the optimization of therapeutic effect and minimization of toxicity of traditional Chinese medicine, which needs to provide the best evidence for further multi-center clinical trial research, and promote the popularization of timing medicine in clinical practice.

The fasting and 2 h levels of glucagon, somatostatin ( SS), and C-peptide during 75 g oral glucose tolerance test in 60 patients with type 2 diabetes and 34 normal subjects were determined. Compared with control group, the fasting levels of glucagon and SS and 2 h levels of SS after glucose loading significantly decreased,while the fasting and 2 h levels of C-peptide increased in diabetes group. The 2 h levels of these hormones were significantly higher than the fasting levels in two groups. Compared with control group, the increased folds of glucagon ( 1.40±0.48 vs 1.20±0. 30, P＜0. 05 ) and SS( 2.79±2. 17 vs 1.14±0. 22, P＜0. 01 ) levels after glucose loading were higher and that of C-peptide level ( 3.58 ±3. 10 vs 8. 33 ± 6. 99, P＜0. 01 ) was lower in diabetes group. The levels of fasting glucagon were positively correlated with that of fasting SS in two groups( both P＜0. 01 ). These results suggest that disturbance exists in hormones from α and δ cells besides the dysfunction of β cells in patients with type 2 diabetes.

Objective:To investigate the association between metabolic factors,such as obesity,blood pressure,blood glucose,serum lipid profile,and the histopathological characteristics of renal cell carci-noma.Methods:The medical records of 382 consecutive renal cell carcinoma patients who underwent radical or partial nephrectomy at Peking University People’s Hospital from January 2009 to January 2015 were retrospectively reviewed.Metabolic factors were collected from the records,including weight,body mass index,waist circumstance,blood pressure,fasting blood glucose,serum total triglyceride,serum total cholesterol,serum low-density lipoprotein-cholesterol and serum high-density lipoprotein-cholesterol. The patients were divided into different groups according to tumor grade,stage and diameter.Statistics analysis,such as t test,Mann-Whitney U test and Logistic analysis,were performed to investigate the as-sociation between metabolic factors and grade,stage and tumor diameter of renal cell carcinoma.Re-sults:A total of 80 (20.94%)of the tumors were classified as high grade disease,63 (16.49%)were classified as advanced disease and 153 (40.05%)tumor diameter more than 4 cm.The patients in high grade group were found to have lower high-density lipoprotein-cholesterol level than in low grade group (P =0.015),body mass index,total cholesterol and high-density lipoprotein-cholesterol were found to be lower in advanced disease than in localized disease (P =0.022,P =0.005 and P =0.006,respec-tively),and low-density lipoprotein-cholesterol was found to be lower in larger tumors (P =0.030). Other factors were comparable between the different groups.The results of Logistic analyses showed that, body mass index (OR =0.906,95%CI:0.852 -0.986,P =0.023)and total cholesterol (OR =0.660,95%CI:0.492 -0.884,P =0.005)were associated with the tumor stage,high-density lipopro-tein-cholesterol level was significantly associated with tumor grade (OR =0.293,95% CI:0.108 -0.797,P =0.016)and stage (OR =0.204,95%CI:0.065 -0.635,P =0.006),and low-density lipoprotein-cholesterol level was significantly associated with tumor diameter (OR =0.756,95% CI:0.586 -0.975,P =0.031).Conclusion:The results of our study indicate that metabolic factors,espe-cially obesity and serum lipid profile,are closely related with the histopathological characteristics of renal cell carcinoma.

Objective:To explore the clinical effect of the second toenail flap with the dorsal bone of the phalange in repairing the defect of fingernail bed.Methods:From January, 2012 to June, 2019, 10 patients with large area of fingernail bed defect were treated by the second toenail flap with bone on the back of the phalanx. The survival of the flap was observed after the operation, and the fracture healing, the shape of the nail and the flexion and extension function of the finger joint were observed in the outpatient follow-up.Results:All flaps of the second toenail survived. The average follow-up period was 8 (4-12) months. The fractured ends of 10 patients' phalanges healed well without nonunion, good appearance of toenail and deformity of toenail. The recovery of hand function was evaluated according to the evaluation standard of upper limb function of Hand Surgery Society of Chinese Medical Association, 9 cases were excellent, and 1 case was good.Conclusion:The second toenail flap with dorsal bone of the phalanx preserved is easy to cut, simple to operate, and has good clinical effect. It is a good method to repair the defect of the fingernail bed.

BACKGROUNDBisphosphonates have been used to treat many bone diseases in clinic. Bisphosphonates have also been proven useful in the management of bone metastasis in patients with breast and prostate carcinoma as demonstrated in a number of trials in vitro and in vivo, but, it is little known that the effect of bisphosphonates on lung cancer, one of the most common bone metastatic malignant tumors. This study is to investigate the effect of several bisphosphonates on inhibiting proliferation of different lung cancer cell lines in vitro, and to validate whether this inhibitive effect is comprehensive or selective.

METHODSThe cytotoxic effect of bisphosphonates on lung cancer cells and human normal liver cells was determined by sulforhodamine B (SRB) assay.

RESULTSAfter incubation of lung cancer cells with bisphosphonates for 72h, the proliferation was inhibited in different degrees. The inhibiting activity of medronate (MDP) was the lowest, while the activity of ibandronate and incadronate (YM175) was between MDP and alendronate. The effects of bisphosphonates on human normal liver cells were different. The toxicity of MDP, ibandronate and YM175 was low, while alendronate had high toxicity. The sensitivity of lung cancer cells to bisphosphonates was also different. The sensitivity of H446 and SPC-A1 was comparatively lower, while H460 and A549 were more sensitive.

CONCLUSIONSBisphosphonates can inhibit the proliferation of lung cancer cells and human normal liver cells in different degrees. The inhibiting effect is associated with the kind and concentration of bisphosphonates, and also the kind of lung cancer cells.

Objective To investigate the endoscopic prevalence of erosive esophagitis (EE) among 13 hospitals in Guangdong province of China. Methods Retrospectively reviewed all the cases (63459 cases) that received oesophagogastrodeuodenoscopy in 13 main hospitals in Guangdong province of China in 2003. Los Angeles criteria for classification of erosive esophagitis were employed as the basis of analysis. Results One thousand two hundreds and sixty-three patients (age range 3-90yr, mean 50. 2 ?17. 1 ) were found to have EE. The overall prevalence of EE was 1. 99% (1263/63459). The prevalence of EE in A, B, C, and D grade were 0. 94% , 0. 69% , 0. 21% and 0. 14% respectively. Age correlated positively on endoscopic grading of EE (F=22. 932, P

Objective:Through the analysis of the ancient books for pectoral stuffiness pain, to explore the relevant Chinese herbal medicine prescriptions, the main syndrome factors corresponding to the prescriptions and the content of medication nursing.Methods:We used the database of Chinese Medical Code (5th Edition) as the data source, and established a database, extracted relevant contents. In the end we carried out statistical analysis and discussion.Results:Four main syndrome factors were extracted from the 102 kinds of prescriptions, which were cold coagulation, qi stagnation, blood stasis and turbid phlegm. The corresponding medication nursing measures mainly contained five aspects, including the temperature, time, frequency, solution of taking medicine and medication taboo. Among them, the temperature of taking medicine was mainly warm and hot; the time of taking medicine was mainly before eating, after eating, empty stomach, before breakfast, at noon, Before sleep and regardless of the time; the frequency of taking medicine was mainly two times a day, three times a day, three times a day and once a night; the solution of taking medicine was mainly wine, porridge, ginger decoction, orange peel decoction, Chen-pi decoction, vinegar decoction and so on; the medication taboo was mainly onions, pork, cold, cabbage, mutton and so on.Conclusion:The study of medication nursing for pectoral stuffiness pain based on the theory of syndrome factors is beneficial to promote the theoretical and clinical research for the disease. It can promote the standardization of medication nursing, improve the nursing staff's ability of syndrome differentiation nursing, and provide a reference for clinical medication nursing of Traditional Chinese Medicine.