Gastroesophageal reflux disease(GERD),a common disorder in the West,is less seen in Asian countries.No nationwide epidemiological study of GERD has been conducted in China up to now and the population distribution of GERD remains unknown.Many factors are believed to be responsible for GERD.In addition to some recognized factors,the influences of factors like obesity,smoking and so on are till unclear.Furthermore,GERD is believed to be associated with many diseases.This article reviews the disease distribution,risk factors and associated diseases of GERD.

OBJECTIVE:To provide reference for antibiotics use. METHODS:A retrospective study was conducted to analyze the detection of pathogens and antibiotics use in 93 children with bronchiolitis in our hospital between Jan. 2013 to Dec. 2014. Pathogens detection mainly included respiratory virus,pneumonia mycoplasma IgM antibody and pneumonia chlamydia IgM anti-body and sputum culture. RESULTS:Among 93 cases,22 cases (23.66%) were positive in respiratory virus IgM antibody test, mainly for respiratory syncytial virus;17 cases(18.28%)were positive in sputum culture test,mainly for the Moraxella catarrha-lis,Haemophilus influenza and Streptococcus pneumonia;10 cases(10.75%)were positive in Atypical pathogens test,mainly for mycoplasma pneumonia. There were 47 cases(50.54%)of antibiotics;Among them,only 12.77%(6/47)had clear indications for using antibiotics;the children who were 1-3 months old had the highest percentage of antibiotics,accounting for 81.82% at the same age;the duration of disease was significantly prolonged in the cases who used antibiotics,with average duration of(8.27± 3.32) d. CONCLUSIONS:Bronchiolitis is still usually caused by virus infection in our hospital,the ratio of antibiotics use are high and most of them don't have bacterial infection indications.

Objective To investigate the clinical features of X-linked agammaglobulinemia (XLA)in children,and to improve the early diagnostic rate.Methods The medical records of 11 children with XLA between Dec 2003 and Nov 2011 were reviewed.Results The smallest age of 11 cases with XLA presenting the first symptoms was 0.4 years old and the oldest age was 4 years old with a mean of 2.4 years old.The first diagnosis time was at the age of 3.5 to 13 years old,with a mean of 7 years old.The age at first diagnosis in 63.6％ ( 7/11 ) of patients was more than 7 years old.Two patients ( 18.2％ ) had the family history of the similar disease.Two patients were died from the infection and 1 patient was missed.The other 8 patients were survived.Respiratory infections occurred in 100％ of the 11 patients.54.5％ (6/11 )of the patients were suffered with otitis media and digestive infections were seen in 36.4％ (4/11 ) of the patients.The levels of lgA,IgM and IgG in the serum of the pauents were all decreased.The levels of IgG in the serum of 9 patients were less than 2 g/L and in the serum of the other 2 patients were less than 2.4 g/L.The levels of CD19 in the serum were all less than 1％ and an inversed ratio of CD4/CD8 was observed in 9 patients.Eight patients were diagnosed as XLA by gene detection.Conclusion The age presenting first symptoms in children with XLA in this study is earlier than the reported data and the age at first diagnosis is later.Respiratory infection is the most common manifestation.High prevalence of otitis media and digestive infections are common.The patients with XLA rarely have the family history.The early diagosis and long-term treatment with the intravenous immunoglobulin may improve the prognosis of XLA.

Prof. SUN Guang-rong holds that how to define the representative clinical case records out of regular ones,what to learn from it,and how to direct other people to learn from it are the key questions to answer before moving to the study; in research process of the project of the Representative Clinical Case Records Collection and Study of Contemporary Eminent and Experienced Chinese Medicine Practitioners,conventional study method and modern information technology are used in conjunction on all the clinical case records of the screened eminent and experienced doctors from all over the country,the defined representative case records are studied and sorted out according to disease or symptom,highlights before and notes and comments following the case record details,guiding people easily to read each great Chinese medical talents,their academic thought and clinical technology; the academic analysis on each eminent and experienced practitioner is the most important part of the project and with it the academic whole story can be seen in a natural and close related way.

The effects of positive end-expiratory pressure (PEEP) on pulmonary shunt were studied during gen- eral anesthesia and postoperative period.Twenty cholecystectomy patients were randomly divided into experiment group (group P) and control group (group Z). PEEP and ZEEP were used separately after induction. Artery blood and mixed blood from the right ventricle were taken for blood gas analysis and determine the amount of pulmonary shunting before anesthesia. half and hour, one and half an hour and two and half an hour after anesthesia and one hour after the operation.The results showed that shunt in group P decreased gradually during general anesthesia and returned to the level of preoperation at an hour after operation. Shunt in group Z was increased continually and the level was significantly higher than preoperation an hour after operation. Shunt between two groups was significant difference (P

The purpose of this study was to investigate the cytotoxicity of the nickel ion and provide with basic data for the biological evaluation of those medical devices containing nickel. Seven cell lines were chosen. They were L929, h9c2(2-1), 293[HEK-293], hFOB1.19, THLE-3, H9 and IM-9 respectively. According to the principle of biological evaluation of medical devices, MTT method was chosen to test the cytotoxicity in different concentrations of nickel ion. For each cell line, the relative growth rate (RGR) was obtained and the cytotoxic grade was classified. Besides, IC50 values were calculated. As a result, it was found that the sensitivity was different among all cell lines. H9 was the most sensitive one, while the L929 was the most tolerant one. The concentration which is not above 1.25 mg/L was safe for all seven cell lines, because the cytotoxicity for all cells exposed in this concentration were not higher than grade 1. According to the criteria for medical devices, the concentrations not above 5 mg/L were safe for L929 cells. This result helps us to roughly assess the cytotoxicity and systematic toxicity caused by nickel contained in medical devices.
Cell Line ; Equipment and Supplies ; HEK293 Cells ; Humans ; Ions ; toxicity ; Nickel ; toxicity

ObjectiveTo describe the status of depressive symptom among children and adolescents with type 1 diabetes mellitus(T1DM) and explore the related factors.MethodsThis was a multi-plot cross-sectional survey.136 cases in Hunan province were investigated by questionnaires.The questionnaires included General Information Questionnaire,Depression Self-Rating of Children( DSRS),Quality of Life Scale for Children and Adolescents.ResultsThe DSRS score of all subjects was (9.51 ± 5.19),24 cases suffered from depressive symptom (17.6％).The multi-factor non-condition logistic regression analysis showed that age(OR =2.831 ),current education status (OR =9.822 ),parents' current marital status (OR =0.061 ),yearly household income (OR =0.415 ),hospitalization in the past 6 months (OR =8.797 ),peer relationship (OR =0.133 ),parent-child relationship(OR =0.182 ),FBS(OR =0.061 ) and sample source(OR =8.366 ) were factors which independently predicted depressive symptom in children and adolescents with T1DM.ConclusionThe influential factors of depressive symptom among children and adolescents with T1DM include age,current education status,parents' current marital status,yearly household income,hospitalization in the past 6 months,peer relationship and parent-child relationship,FBS and sample source.

Analyzing and discriminating incorrect cases is a good method in medical statistics teaching,which can not only help students review the knowledge they have learned but also guide their self-learning.Teachers can start teaching based on the reverse thinking,propose incorrect cases with moderate difficulty and in accordance with the reality and arouse students' creativity through introducing the incorrect cases,reviewing the incorrect cases and conducting group discussion.

Objective:To study the differences of gene expression between Tca8113 and Tca8113/CBP tissues in nude mice. Methods:Tca8113 cells were injected subcutaneously in both sides of armpits of nude mice at the concentration of 5?106 cells/0.1 ml. Two weeks after injection, Carboplatin was used subcutaneously around the tumor 0.01 mg/g (weight) each day in Tca8113/CBP group while Tca8113 group was injected with physiologic saline as control. Mice were sacrificed 10 weeks after drug injection. The two kinds of tissues were investigated by human 16k cDNA v2.1 SBC-R-HC-100-21 gene chip. Results:Among the 16 000 target genes, there were 719 genes whose expression levels showed differences between the two kinds of tumor tissues. Conclusion:Microarray technique can simultaneously screen different genes from above-mentioned two kinds of tissues. Further analysis of the obtained genes will be helpful to understand the molecular mechanism of multidrug resistance.

Objective To investigate the changes in intrapulmonary shunting during controlled hypotension induced by sodium nitroprusside(SNP)in patients undergoing naso-endoscopic operation.Methods Forty ASAⅠorⅡpatients of both sexes(23 male,17 female)aged 16-50 yrs weighing 50-75 kg undergoing naso-endoscopic operation under general anesthesia with muscle relaxation and mechanical ventilation were studied.Radial artery was cannulated for direct BP monitoring and blood sampling.Right internal jugular vein was cannulated and the catheter was advanced into right ventricle.Blood sample taken from right ventricle was used as mixed venous blood instead of blood from pulmonary artery.ECG,MAP,HR and P_(ET) CO_2 were continuously monitored during operation Cardiac output was monitored with noninvasive cardiac function monitor(NC-COM.)based on impedance principle.SNP infusion was started at the beginning of operation at 1-3?g?kg~(-1)?min~(-1) and was then adjusted.MAP was reduced by 30%-40% and maintained at this level until the end of operation.Blood samples were taken from artery and right ventricle simultaneously before SNP infusion(T_1,baseline)at 30 and 60 min of hypotension(T_2,T_3)and at 20 min after BP returned to the baseline level(T_4)for blood gas analysis.Qs/Qt was calculated.Results Qs/Qt was significantly increased during controlled hypotension at T_2 and T_3 as compared to the baseline value(P＜0.01)and returned to the baseline level at T_4.HR was increased and cardiac output and stroke volume was significantly reduced during hypotension as compared to the baseline value.Conclusion The intrapulmonary shunting is increased and the hemodynamics is depressed during SNP-induced controlled hypotension and they return rapidly to baseline level after SNP is discontinued.No hypoxemia develops during SNP- induced hypotension.