ObjectiveTo investigate the applicability and superiority of modified Seldinger technique (MST).MethodsTotally 108 patients receiving peripherally inserted central catheter (PICC) through vascular ultrasound combined with MST technology were enrolled as MST group and another 108 patients receiving PICC using traditional direct vision method as control group.The first puncture success rate,PICC succesa rate,catheterization time required,and early complication rate were compared between these two groups.ResultsThe first puncture success rate was 88.89％ in MST group and 72.22％ in control group (P=0.002) ; the catheterization success rate was 82.41％ in MST group and 57.41％ in control group ( P =0.000).In the MST group,there were two cases where the catheter within neck was ectopic ( P =0.003 ),two cases experienced bleeding at the puncture sites (P =0.017),three cases had phlebitis (P =0.001 ),and one case suffered from catheter blockage (P=0.010).In the eontrol group,the corresponding numbers were 13,10,18,and 9.However,the time required for PICC showed no significant difference between these two groups (P=0.685).In the MST group,15 cases were catheterized in less than 15 minutes,72 cases between 15 and 25 minutes,and 21 cases for more than 25 minutes.In the control group,12 cases were catheterized in less than 15 minutes,70 cases between 15 and 25 minutes,and 26 cases for more than 25 minutes.ConclusionPICC through MST can be more effective in positioning the targeting blood vessels,increasing the success rate of catheter insertion,reducing various tissue damages,and lowering potential complications.

Object Four regenerated somatic cell hybrids between carrot and Bupleurum scorzonerifolium Willd. proved by chromosome analysis were analyzed at the molecular level. Methods RAPD analysis and 5S rDNA spacer sequence were adopted. Results In the electrophoresis pattern of the PCR products the four somatic cell hybrids had the characteristic bands of two parents and new bands. Conclusion Their hybrid nature was clarified at molecular level. This provides a firm foundation to further analyze the main active components, saikosaponin of somatic cell hybrids, and screen out efficacious hybrid cell lines.

Objective To explore somatic symptoms of patients with functional dyspepsia (FD) and effects of combined anti somatisation therapy on the quality of life in patients with FD.Methods Two hundred and nineteen patients with FD were enrolled.Patient Health Questionnaire-15 (PHQ-15) and Nepean Dyspepsia Index (NDI) were completed,and the relation between them was analyzed.Lansoprazole,mosapride and flupentixol melitracen (the anti-somatisation medication) were taken for four weeks by 131 FD patients who had poor response to four-week conventional treatment with proton pump inhibitors (PPI) and/or prokinetic medication and who got more than 4 scores in PHQ 15.And then therapeutic effects were observed and the changes of NDI before and after treatment were analyzed.The t test,chi-square test,Spearman's correlation and linear regression were performed for statistical analysis.Results The total PHQ-15 and NDI score of 219 patients with FD were 5.7±3.4 and 42.0± 10.4,and there was positive correlation between them (r=0.493,P＜0.05).Stomach pain,headache,chest pain,dizziness,shortness of breath,fatigue,sleeping disorder,thirst and so on were positively correlated with totalNDIscore (r=0.262,0.230,0.241,0.243,0.352,0.385,0.266,0.281,all P＜0.05).Chest pain,stomach pain,shortness of breath,dizziness and fatigue were the influence factors of NDI (t=2.340,2.488,5.278,2.167,2.443,all P＜0.05).Among 131 patients with FD who received anti somatisation combination therapy,six patients did not complete the therapy because of the side effects,and finally 125 patients were enrolled and analyzed.Before and four weeks after the treatment,the total PHQ-15 scores of 125 patients with FD were 7.3±3.2 and 2.9±2.2,respectively; and the difference was statistically significant (t =12.653,P＜0.01).There were significant differences in the influence of stomach pain,headache,chest pain,dizziness,shortness of breath,fatigue,sleeping disorder and thirst before and after the treatment (not bothered at all,bothered a little,bothered a lot) (x2=39.231,6.796,6.693,15.520,6.698,51.572,44.390 and 16.506,all P＜0.05).The total NDI score before and after the treatment were 44.3 ± 11.7 and 29.2 ± 6.9,and the difference was statistically significant (t=12.503,P＜0.01).Conclusions The quality of life in patients with FD is affected by somatic symptoms such as chest pain,stomach pain,shortness of breath,dizziness,fatigue and so on.For FD patients with poor response to conventional treatment,the quality of life could be improved by the combination of anti-somatisation therapy and the conventional therapy.

Objective To investigate the effects of total glucosides of paeony (TGP) on mice with experimental ulcerative colitis and the underlying mechanisms. Methods Forty-eight mice were equally randomized into 6 groups ( n = 8): normal control group, model group, salicylazosulfapyridine (SASP) group, low-dose TGP group one day after enama, the mice were treated with corresponding agent by oral gavage for3 days. The disease activity index (DAI) score was evaluated every day. After all the mice were scarified, the macroscopic and histological scores were evaluated. The tumor necrosis factor-α (TNF-α) level of the colon mucosa was measured by ELISA and the colonic expression of nuclear factor-κB (NF-κB) p65 was detected by immunohistochemistry. Results Compared with the normal control group, the DAI score was significantly higher in the model group (P ＜0. 01 ),but was similar to that in low-dose TGP group ( P ＞ 0.05 ). Compared with the model group, the DAI score was significantly decreased in SASP group, medium-dose TGP group, and high-dose TGP group (all P ＜ 0. 05). The macroscopic score, histological score, TNF-α level, and expression of NF-κB p65 were significantly higher in model group than in normal control group, SASP group, medium-dose TGP group, and high-dose TGP group ( all P ＜0. 01 ), but was similar to that in low-dose TGP group (P ＞ 0. 05). The efficacy of TGP was higher in high-dose TGP group than in SASP group. Conclusions TGP has certain therapeutic effects on experimental ulcerative colitis,which may be achieved by its inhibitory effect on the activation of NF-κB and the production of TNF-α.

Objective: To explore the correlation between depression severity and neurocognitive function in patients with late-onset depression . Methods: The patients with late-onset depression treated in Jinhua Second hospital from February 2015 to December 2017 were assigned into the mild,moderate and severe groups according to the severity of depression assessed by the Hamilton Depression Scale-17（HAMD-17）. At the same time,some healthy persons were selected as the control group. Wisconsin Card Sorting Test（WCST）,Verbal Fluency Test（VFT）and Stroop Test were carried out,and the scores of these tests were compared in the four groups. The correlations of WCST, VFT, Stroop Test and HAMD-17 scores were analyzed . Results: There were 32,28,35 and 35 subjects involved in the mild,moderate,severe and control group,respectively. The subjects of the mild group,moderate group and severe group had more total errors,perseverative responses and perseverative errors than the control group,and less percent conceptual level responses than the control group （all P<0.05）. The total errors,perseverative responses,perseverative errors and percent perseverative errors increased and the percent conceptual level responses decreased gradually with the severity of depression（all P<0.05）. The correct numbers of Stroop-consistent group and VFT in the severe group were less than those in the control,mild and moderate group（all P<0.05）,which was significantly different between the mild,moderate and control group （P>0.05）. The HAMD-17 scores were negatively correlated with the correct numbers of Stroop congruent group（r=-0.448,P<0.001）and VFT（r=-0.401,P<0.001）,and were positively correlated with perseverative responses in the WCST（r=0.784,P<0.001） . Conclusion The neurocognitive impairment in patients with late-onset depression aggravated with the severity of depression.

Objective:To evaluate the efficacy of monopolar radiofrequency combined with ultrasound for abdominal obesity.Methods:A total of 24 patients (4 males, 20 females, average age was 35 years) were given monopolar radiofrequency combined with ultrasound treatment four times at (10±4) day interval at Beijing Friendship Hospital during December 2015 to December 2016. Body weight and abdomen circumferences were recorded before and after each treatment. Subcutaneous adipose tissue thickness was measured with B ultrasound at baseline and after the last treatment. 2 months after the last treatment, a third party would assess the improvement; at the same time, volunteers would assess the outcome with Global Aesthetic International Scale. Blood lipid level, liver function and renal function were tested at baseline and after the third treatment. All the treatment related adverse effect would be noted as well.Results:There was no significant difference of body weight after the treatment. The abdomen circumferences were decreased at 2 month after the last treatment, especially for the navel one, which decreased from (96.14±11.92) cm at baseline to (93.82±10.77) cm, t=4.21, P<0.05. And the subcutaneous adipose tissue thickness also decreased from (25.56±4.3) mm to (24.31±3.77) mm, ( t=6.26, P<0.05). 2 months after the last treatment, 16 volunteers were graded as 1-25% improvement, 8 volunteers were graded as 26%-50% improvement. According to GAIS, 2, 18 and 4 volunteers assess the outcome was regarded as 0 score, 1 score and 2 score respectively. The treatments showed no influence to blood lipid level, liver function and renal function. The treatment processing was tolerated well and no side effect were noted. Conclusions:Monopolar radiofrequency combined with ultrasound treatment for abdominal obesity is effective and safe.

Background/Aims: Lyon consensus differentiates acid exposure time (AET) as physiological, borderline, and pathological. Mean nocturnal baseline impedance (MNBI) and post-reflux swallow-induced peristaltic wave index (PSPWi) are believed to increase diagnostic yield of gastroesophageal reflux disease (GERD) and correlate with symptom outcome of proton pump inhibitor (PPI) treatment. We aim to explore the clinical characteristics and the correlation of pH-impedance parameters with PPI response in Chinese patients with different AET levels. Methods: We retrospectively investigated 177 patients with typical reflux symptoms who received esophageal function tests. The demographics, GERD questionnaire scores, the proportion of esophagitis and PPI responders, and manometric and pH-impedance parameters were compared among patients with AET < 4%, 4-6%, and > 6%. In patients with AET ≥ 4%, manometric and pH-impedance parameters were compared between PPI responders and non-responders. Results: Among 177 patients, 69 (39.0%) had AET 4-6%, and 53 (29.9%) had AET > 6%. The demographics, esophagogastric junction type, and occurrence of ineffective esophageal motility were similar between patients with AET 4-6% and > 6%, but different from AET < 4%. MNBI and PSPWi were different among different AET levels, but similar between PPI responders and non-responders in patientswith AET ≥ 4%. Conclusions It is reasonable to set 4% as a threshold to define pathological AET in Chinese patients. MNBI and PSPWi could identify GERD patients, but may not correlate with PPI response of Chinese GERD patients.

OBJECTIVE To obser ve the efficacy and safety of rimazo lom for painless gastroscopy sedation in outpatients. METHODS Totally 84 patients who underwent painless gastroscopy were collected from the outpatient department of the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from March to June in 2021. By random number table method combined with envelope allocation concealment method ，they were randomly divided into observation group and control group ，with 42 cases in each group. The patients in the observation group were slowly injected with Sufentanil citrate injection 0.1 μg/kg+Rimazole toluenesulfonate for injection 0.2 mg/kg. Patients in the control group were slowly injected with Sufentanil citrate injection 0.1 μg/kg+ Propofol emulsion injection 2 mg/kg. Gastroscopy was performed after the patient ’s consciousness disappeared. The sedative efficiency，sedative onset time ，recovery time and the occurrence of adverse drug reaction were observed in 2 groups. The heart rate（HR），mean arterial pressure （MAP），pulse oxygen saturation （SpO2），modified observer ’s assessment of alertness/sedation （MOAA/S）score and Narcotrend score were recorded in 2 groups after entering the room （T0），after anesthesia induction （T1）， when gastroscope entered the throat （T2），at the end of gastroscope withdrawal （T3），5 min after gastroscopy （T4）. RESULTS There was no significant difference in the effective rate of sedation （100％），the incidence of respiratory depression ， nausea and vomiting between the two groups （P＞0.05）. The qq.com onset time of sedation in the observation group was longer than control group ，and the recovery time and the incidence ofhypotension，hypotension to be tre ated，injection pain and bradycardia in observation group were significantly shorter or lower than control group （P＜0.05）. At T 0，there was no significant difference in HR ，MAP，SpO2，MOAA/S score or Narcotrend score between two groups （P＞0.05）. From T 1 to T 4，the HR of control group was significantly lower than that of the same group at T 0，and significantly lower than observation group at the same time（P＜0.05）. From T 1 to T 3，the MAP of two groups were significantly lower than the same group at T 0（P＜0.05），but there were no significant differences between two groups and between T 4 and T 0（P＞0.05）. There was no significant difference in SpO 2 at different time points between two groups and HR at different time points in observation group （P＞0.05）. From T 1 to T 3，MOAA/S score and Narcotrend score of two groups were significantly lower than the same group at T 0，while the MOAA/S score and Narcotrend score at T 1 and T 3 and Narcotrend score at T 3 of observation group were significantly higher than control group at the same time （P＜0.05），and the Narcotrend score of observation group at T 2 was significantly lower than control group at the same time（P＜0.05）；at T 4，there were no significant differences in MOAA/S score and Narcotrend score between two groups （P＞ 0.05）. CONCLUSIONS Remazolam shows good sedative effect and safety for painless gastroscopy.