Objective:To differentitate the myogenic from arthrogenic component of knee contracture resulting from being immobilized in extension for 4 weeks. Method:Ten rabbits were used as experimental animals. The right hindlimbs were immobilized with knee in extension for 4 weeks, while the left severed as controls. The range of motion ( ROM ) of both knees were measured before and after myotomy. Result:In immobilized and control hindlimbs, the mean ROM of the knee were 79.5°and 138.5°, respectively. The gain of ROM after myotomy in immobilized and control hindlimbs were 8.7° ±0. 45°, 11.6° +0.58°, respectively. Only 14.75% of the limitation of motion in ROM were accounted for by the myotomy component. Conclusion:After immobilizing for 4 weeks, the ROM of knee was significantly limited. However, the myogenic part was small and not different from normals.

Objective To differentiate the myogenic and arthrogenic components of knee contracture resulting from being immobilized in extension for 4 weeks.Method Ten rabbits were used as experimental animals. The right hindlimbs were immobilized with the knee in extension for four weeks, while the left served as controls. The range of motion (ROM) of both knees was measured before and after myotomy.Result In immobilized and control hindlimbs, knee mean ROM were 79.5° and 138.5° respectively. The gain of ROM after myotomy in immobilized and control hindlimbs were (8.7± 0.45)° , (11.6± 0.58)° respectively. Only 14.75％ of the limitation of motion in ROM was accounted for by the myotomy component. Conclusions After immobilized for 4 weeks, the ROM of knee was limited.However,the myogenic part was small and not different from normals.Because this study reports on only one time point,further investigations are needed.

Objective As estrogen increases visceral hypersensitivity induced by water avoidance stress in female rats,further experiment was designed to determine whether the influence of estrogen involves NR2B.Methods Healthy adult female Wistar rats were bilaterally ovariectomized,and then housed individually.Implantation of cannula into lateral cerebroventricle and electrodes into the abdominal muscle had been done.After 5 days recovery,rats with abnormal behavior and ehctromyography were excluded,finally a total of 48 rats were eligible,and were equipped for abdominal muscle electromyography and submitted to water avoidance stress(WAS).Visceromotor response(VMR)to 20,40,60 and 80 mmHg colorectal distension(CRD)was recorded in rats intracerebroventricular-infused with either 17β-estradiol,normal saline,AP5(NMDA receptor-antagonist)or Ro25-6981(NR2B antagonist).NR2B mRNA in anterior cingulate cortex or dorsal root ganglia were compared by real-time PCR between the rats treated with 17β-estradioI and that with normal saline.Results Bilaterally ovarieetomized rats treated with 17β-estradiol,exhibited more visceral hypersensitivity after WAS than that with normal saline on 40,60 and 80 mmHg CRD(P=0.039,P=0.033,P=O.001).The VMR on 40 and 60 mmHg CRD in 17β-estradiol treated group was not significantly different from that in 17β-estradiol plus Ro25-6981 treated group.Whilst,significant differences of VMR were noted between 17β-estradiol treated group and 17β-estradiol plus Ro25-6981 treated group on 80 mmHg CRD,17β-estradiol treated group and 17β-estradiol plus AP5 treated group on 60,80 nmmHg CRD,respectively.17β-estradiol increased NR2BmRNA in anterior cingulate cortex(0.57±0.41 vs 0.21±0.13,P=0.048),but not in dorsal root ganglia(0.35±0.45 vs 0.38±0.31,P=0.465). Stress-induced visceral hypersensitivity in the hormonally-restored visceral hyper-responsiveness of bilaterally ovariectomized rats was antagonized by AP5 or Ro25-6981.Conclusions Estrogen may be mediated through NR2B activation to enhance visceral sensitivity in female stressed rats,that probably related with the increased expression of NR2B mRNA in anterior cingulate cortex.

Irritable bowel syndrome( IBS)is a commonly seen chronic functional bowel disease,the prevalence showed a rising trend in recent year in China. At present,the etiology and pathogenesis of IBS have not yet been fully elucidated,and may be related to intestinal gas. Intestinal gas is usually composed of 59% N2 ,21% H2 ,9% CO2 ,7%methane(CH4 )and 4% O2 ,in which H2 and CH4 are produced only by intestinal bacteria metabolism. IBS patients usually manifested as having abdominal distension and symptoms of flatulence,suggesting the occurrence of accumulation of intestinal gas. In recent years,the relationship between symptoms of IBS and intestinal gas has attracted much attention. This article reviewed the progress in study on symptoms of IBS and intestinal gas.

Objective To investigate the change situation of serum pepsinogen (PG) and gastrin-17(G-17) levels change in gastric cancer,and on this basis diagnostic significance of combined detection of carbohydrate antigen 72-4 (CA72-4) and 13C urea breath test (13C UBT) detection in early gastric cancer.Methods The enzyme-linked immunosorbent (ELISA) method was used to detect serum PG Ⅰ,PG Ⅱ and G-17 levels in healthy people,atrophic gastritis group and gastric cancer group.Firstly the changes of above three indicators were compared;then according to PG Ⅰ and G-17,the carcinoma group was divided into the group A,B,C and D,these four groups were detected the helicobacter pylori infection status by 13C UBT.Finally the CA72-4 levels were performed the statistics by using the tumor markers detection results.Results Serum PG Ⅰ level and PG Ⅰ/PG Ⅱ ratio in the control group,atrophic gastritis group and gastric cancer group was gradually declined,the difference was statistically significant (P＜0.05);serum G-17 level in the control group,atrophic gastritis group and gastric cancer group was gradually increased,the difference among 3 groups was statistically significant (P＜0.05);in early gastric cancer rate ratio among 4 groups,which in the group B was highest,the difference was statistically significant (P＜0.05);in the comparison of positive rates of 13 C UBT and CA72-4 level in early gastric cancer among 4 group,the 13 C UBT positive rate and CA72-4 level in the group B were higher than those in the group A,C and D,the differences were statistically significant (P＜0.05).Moreover the CA72-4 level in the group B had significant difference between early gastric cancer and advanced gastric cancer (P＜0.01).Conclusion Serum PG Ⅰ reduce and G-17 increase combined with CA72-4 high level and 13C UBT positive have an important forewarning value for the diagnosis of gastric cancer.

Iatrogenic gastrointestinal perforation is one of the severe adverse events of endoscopic therapeutic procedure. For acute iatrogenic perforation,management by endoscopic techniques is a simple and rapid modality to close the perforation with minimal invasiveness and avoiding the traditional surgical trauma. Endoclips,suture with special instruments,covered stents,degradable sheets combined with tissue adhesive,and combined endoscopic techniques such as snares combined with endoclips,are the major endoscopic therapeutic modalities for closure of iatrogenic gastrointestinal perforation. In this article,the current status and progress of endoscopic management for acute iatrogenic gastrointestinal perforation were reviewed.

Objective To investigate the efficacy and safety of covered stent in treatment of esophageal perforation. Methods Observe and analyzed the effect and complications of covered metallic stent in esophageal perforation. In all of 40 cases, the most common causes were iatrogenic, esophageal cancer, and foreign body. Results All patients with esophageal perforation got successful esophageal stent placement. All of them recovered smoothly in eating. The stents were removed 4 days to 1 month later. Gastroscopy and angiography confirmed esophageal perforation has healed. 3 cases of esophageal cancer patients with dysphagia obviously relieved after stent placement. The main complications in stent and stent migration for chest pain after operation. 6 cases (15 %) of patients with stent displacement, while 2 cases (5 %) of esophageal cancer patients with food obstruction and stent displacement. Conclusion Treatment of esophageal perforation with covered metal stents endoscopically is effective and safe.

Objective To evaluate the feasibilities and advantages of different concentrations of sodium alginate (SA) solutions as a submucosal injection solution for endoscopic submucosal dissection (ESD). Methods In vitro study, different concentrations of sodium alginate solutions and normal saline were injected into submucosal of resected porcine esophagus and stomach respectively, then observe and measure the heights of each injection induced mucosal elevations, and their changes over time. In vivo study, the mimic ESD were conducted in healthy pigs to evaluate the mucosal elevation effect and other assistant effects of sodium alginate as a submucosal injection solution. Results The elevation heights of the experiment groups injected with SA solutions were much higher than the control group injected with normal saline. Specially, the elevation created by 1 % SA in porcine esophagus was significantly higher than that of normal saline (P < 0.01) and the elevation created by 3 % SA was significantly higher than that of normal saline in porcine stomach (P < 0.001). In the mimic ESD experiment, mucosal elevation with clear margin occurred immediately after injection with SA solution. And the durable submucosal fluid cushion created by SA protected deeper tissues while facilitating ESD procedure. Conclusion The elevation heights created by SA solutions were greater and more durable than that created by normal saline, which were crucial for ESD. The viscosity property enabled SA to form a stable protective cushion and prevent bleeding by squeezing tissue around the wound, which may decrease perforation and bleeding rate during ESD procedure. Therefore, sodium alginate can be an ideal clinical submucosal injection solution.

Objective To compare the clinical efficacy of 25G+and 27G+pars plana vitrectomy(PPV)in the treat-ment of idiopathic epiretinal membrane(iERM).Methods A total of 50 iERM patients(50 eyes)who were admitted to the Third Affiliated Hospital of Xinxiang Medical University from December 2019 to August 2022 were selected as the research subjects.These patients were divided into the control group and observation group based on different surgical methods,with 25 patients(25 eyes)in each group.Patients in the control group received 25G+PPV treatment,while patients in the observation group received 27G+PPV treatment.The surgical duration and postoperative 1-day incision subconjunctival hemorrhage and e-dema of patients in two groups were compared;central macular thickness(CMT)was measured by optical coherence tomo-graphy before surgery,1 day,1 week,1 month,and 3 months postoperatively in the two groups.Visual acuity of patients in both groups was assessed according to the early treatment diabetic retinopathy study(ETDRS)visual acuity chart.Intraocular pressure was measured by using a non-contact Callon tonometer.Complications,such as intraoperative macular injury,retinal hole,postoperative choroidal detachment,retinal hemorrhage,retinal detachment,and intraocular infection,were observed in both groups.Results The surgical duration of patients in the observation group was significantly shorter than that in the control group(t=2.314,P＜0.05).The extent of subconjunctival hemorrhage and edema of patients in the observation group was significantly smaller than that in the control group(t=13.706,P＜0.01).The ETDRS visual acuity of patients at 1 day,1 week,1 month,and 3 months after surgery in both groups was significantly higher than that before surgery(P＜0.05).There was no signifi-cant difference in ETDRS visual acuity of patients between the two groups at 1 day,1 week,1 month,and 3 months postoperatively(P＞0.05).At 1 day after surgery,the intraocular pressure of patients in the observation group was significantly higher than that in the control group(P＜0.05).At 1 week,1 month,and 3 months after surgery,there was no significant difference in intraocular pressure of patients between the two groups(P＞0.05).Two patients in the control group experienced transient ocular hypotension 1 day after surgery,while no such complication was observed in the observation group.Patients in both groups presented with varying degrees of retinal nerve epithelial layer traction,retinal edema,thickening,and vascular distortion before surgery.At 1 day after surgery,epiretinal membrane traction was relieved in both groups,and there was a significant improvement in the anatomical structure of the macular area compared to preoperative conditions.At 1 day,1 week,1 month,and 3 months after surgery,the CMT of patients in both groups was reduced compared to preoperative values(P＜0.05);there was no significant difference in CMT of patients between the two groups at 1 day,1 week,1 month,and 3 months after surgery(P＞0.05).In the control group,18 eyes(72.0％)were sutured at the scleral puncture sites due to leakage,while no suturing was performed in the observation group.Patients in both groups completed the surgery successfully,without any intraoperative complications such as macular injury or retinal hole.During the 3-month follow-up,no postoperative complications such as choroidal detachment,retinal hemorrhage,retinal detachment,or intraocular infection were observed in both groups.Conclusion Both 27G+PPV and 25G+PPV have good clinical effects and high surgical safety in the treatment of iERM.Compared with 25G+PPV,27G+PPV can shorten the surgical duration,better maintain postoperative intraocular pressure stability,and reduce the range of subconjunctival bleeding and edema.