Camptothecin/*pharmacology ; Liver Neoplasms, Experimental/*immunology ; Neoplasm Transplantation ; Sarcoma, Experimental/*immunology ; Transplantation, Isogeneic

Objective To explore the clinical significance of application of trans-abdominal Heller combined with Dor fundoplication for esophageal achalasia in the elderly.Methods Clinical data of 9 patients with esophageal achalasia undergoing trans-abdominal Heller combined with Dor fundoplication from Oct.2009 to Dec.2013 were collected.The postoperative effects and complications were analyzed.Results The operations were successful in the 9 patients with no conversion to open operation and no complications.The maximum esophageal diameter was reduced to (1.94 ± 0.76) cm from (3.69 ±-1.34) cm (P＜ 0.05).Rest lower esophageal sphincter pressure declined by 12.18 mmHg in average (1 mmHg=0.133 kPa,P＜0.05).Dysphagia score fell to 2.49 points from 7.88 points (P＜0.05).There were no retrosternal pain and dysphagia,stenosis and food retention in the lower esophagus and cardia place,and obvious expansion in esophageal.There were statistically significant differences in the above indexes.Conclusions The trans-abdominal Heller combined with Dor fundoplication can significantly improve the symptoms of esophageal achalasia in elderly patients,and effectively prevent postoperative gastroesophageal reflux,and has the characteristics being minimally invasive and fast,and fewer complications.

A colorimetric self-indicating probe for glucose was constructed by self-assembly of MnO2 nanosheets (MnO2 NSs) and glucose oxidase(GOD) in this paper.Under the weak acidic medium,glucose oxidase specifically catalyzes glucose into gluconic acid and hydrogen peroxide.The by-product of hydrogen peroxide could efficiently dissolve the MnO2 nanosheets,resulting into a significant decrease of the characteristic absorbance at 374 nm assigned to MnO2 NSs.Furthermore,the absorbance difference was linearly proportional to the concentration of glucose ranging from 1 to 20 μmol/L The fitted curve could be used for quantification of glucose with a correlation coefficient of 0.990 1.And the detection limit as low as 0.1 μmol/L could be reached based on the definition of three times of the deviation of the blank signal (3σ) and there was negligible interference with other co-existing amino acids,anions,cations and protein,which indicated high sensitivity and selectivity of the hybrid probe.The construction strategy of designated probe is readily generalized in principle for detection of numerous analytes in view of reactive property of MnO2 and the diversity of enzymes.

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Objective To analyze the clinical application of detecting anti Mullerian hormone (AMH) in the patients with polycystic ovary syndrome (PCOS).Methods A total of 480 cases with PCOS and 500 cases of healthy females were selected in the study.The levels of AMH in the patients with PCOS were compared between the two groups.Results The levels of AMH,luteinizing hormone (LH),testosterone (T) in patients with PCOS were significantly higher than those in the healthy control group (P＜0.05).Differences of the levels of estradiol (E2) and follicle-stimulating hormone (FSH) in patients with PCOS and thosein healthy control group had no statistical significance(P＞0.05).As the age increased,the level of AM H obviously declined.Conclusion The level of AMH in patients with PCOS is obviously higher than that in the healthy ones,it declines with the age increasing.

Objective To explore the change of signal value in the fetal frontal lobe with gestational age in normal second-third trimester fetuses.Methods MRI findings of 125 normal second-third trimester fetuses were divided into 5 groups according to gesta-tional age (unit:week)including 1 7-21,22-26,27 -31,32 -36,37 -40,respectively.The signal values were measured in inferior frontal,middle and upper,respectively.Results The signal value of fetal frontal lobe in 5 groups were 387.38 ± 1 66.75,354.46 ± 1 74.78,342.24±141.23,338.90±1 10.94,310.23±1 18.62,respectively.The signal value was 341.77 ±149.22,35 1.00±145.1 6, 342.85±140.61 in inferior frontal,middle and upper,respectively.The signal value of frontal lobe was 350.34±147.68 in the left and 340.73±144.29 in the right.There were no significant statistical differences on fetal frontal lobe signal value in each group (P>0.05).But the signal value in the frontal lobe had a gradually decreasing trend with fetal age,along with the signal value in the central frontal was higher than the other two parts of the frontal lobe and the left is slightly higher than the right.Conclusion The signal values in frontal lobe of normal second-third trimester fetuses were gradually decreased as gestational age increasing,with the signal values in central frontal lobe was higher than that of in margin of frontal lobe,and the left side was slightly higher than the right.

Objective To regulate standardized ICD-10 case classification name and coding,and common clinical diagnosis name or expression of mapping rules,to systematically improve the quality of DRGs key data,and to assess the impact of medical diagnostic data quality on DRGs and the indicators based on the DRGs.Methods Extension of the glossaries of clinical diagnosis synonyms or near-synonyms,and establishment of a standardized maintenance procedure of ICD-10 dictionary.Adjustment of the impact extent of DRGs disease makeup on case classification,comparison of the consistency of principal diagnosis classification,and the consistency of DRGs grouping,as well as changes of such indicators as DRGs grouping reduction in variance (RIV) and case mix index (CMI).Results Data of the obstetrics,gynecology and pediatrics disciplines of a maternity and children hospital from 2012 to 2013 (72 005 cases)and 2014 to 2015 (77 705 cases) were chosen for prior-after comparison.The encoding consistency rate was 59.60％ before the improvement,with the improved standardized consistency rate rising to 66.38％afterwards;beforehand the DRGs grouping consistency rate was 69.30％,with the improved standardized consistency rate rising to 88.00％ afterwards;beforehand the cost RIV was 0.515,with the cost RIV rising to 0.576 afterwards;the CMI variations of individual campuses of healthcare institutions appear more reasonable.Conclusions Diagnostic quality control and improvement project can improve the data accuracy of coding.This empowers the RIV and CMI indexes calculated on such basis to better describe the complexity of clinical settings,conducive to establishing a value-oriented prepayment system which is more transparent,fair and reasonable.

Objective To evaluate application value of choledochoscope and nasal bile duct drainage in the treatment of complicated liver echinococcosis combined biliary fistula.Methods The anthors retrospectively summarized and analyzed the clinical data of 144 patients with complicated liver echinococcosis combined biliary fistula.Treatment group (n 68) underwent liver hydatid internal capsule remove + intraoperative choledochoscopy and nose biliary drainage,control group (n-76) underwent the traditional internal capsule remove.The average length of hospital stay,residual cavity drainage catheter time,residual cavity bile leakage and residual cavity infection index of two groups were measured.Results The rate of T tube utilization,residual cavity infection,the incidence of biliary fistula in treatment group were significantly lower than the control group (P＜0.05).The length of hospital stay,the rate of discharge with drainage tube and the average length with tube were significantly less than control group (P＜0.05).Conclusion Intraoperative choledochoscopy and nasal bile duct drainage treatment of complicated liver hydatid,can reduce liver hydatid content residual and biliary fistula,reliable to deal with biliary fistula,part of a primary suture common bile duct,biliary fistula and residual cavity infection rate is low,patients recover quickly,shorter time of hospital stays,is worth popularizing.

AIM: To study the expression and the role of ERK1/2 and JNK1/2 of MAPKs pathways in the development of neural tube defects induced by hyperthermia. METHODS: The animal models of golden hamster were produced by hyperthermia. The expression of ERK1/2 and JNK1/2, and levels of their phosphorylation were measured by Western blotting in control group and hyperthermia group. RESULTS: p-ERK1/2 steadily expressed in each control group, and the expression of p-ERK1/2 significantly decreased, which was different from that in the corresponding control group (P<0.05). The activity of p-JNK1/2 increased in hyperthermia group and the amount of p-JNK1/2 increased as compared to control group. The peak appeared at 16 h after exposed to hyperthermia (P<0.05). CONCLUSION: Hyperthermia, which induces a decrease in p-ERK1/2 expression and increases the expression of p-JNK1/2 of MAPKs pathway, results in the unbalance of cell proliferation and apoptosis, and induces neural tube defects.

Objective To investigate the analgesic efficacy and safety of parecoxib-sodium in patients undergoing laparoscopic cholecystectomy. Methods Ninety patients received laparoscopic cholecystectomy were divided into parecoxib-sodium group,flurbiprofen group and control group by random digits table, 30 cases in each group, all patients received the drug by vein 30 minutes before surgery. The postoperative pain intensity (VAS score), satisfaction of patients, changes of blood coagulation function and maximum agglutination rate (MAR) of platelet agglutination test before and after treatment and the incidence of postoperative adverse reaction were observed and compared. Results Pestoperative VAS scores and psychiatric symptoms at different time in parecoxib-sodium group and flurbiprofen group were significantly lower than those in control group (P ＜ 0.05), analgesic satisfaction rate were 93.3% (28/30) in parecoxibsodium group and 90.0% (27/30) in flurbiprofen group, which were significantly higher than that in control group [20.0%(6/30)] (P＜0.05). There were no significant difference in blood coagulation function and MAR before and after treatment among three groups (P ＞ 0.05). Conclusion Parecoxib-sodium displays significant analgesic effects and low rate of adverse events for the patients undergoing laparoscopic cholecystectomy, it is worthy of clinical application.