Objective To evaluate the effect of Sengstaken-Blakemore tube in assisting cyanoacrylate injection combined with sclerotherapy and variceal ligation under emergency endoscopy in treating escophageal and gastric variceal bleeding. Methods 60 patients were randomly selected, and were evenly divided into 2 groups single blindly. Endoscopic cyanoacrylate injection, sclerotherapy and variceal ligation were performed in control group, and additional Sengstaken-Blakemore tube were used in experimental group. Results All the 30 patients in study group got effective hemostasis (30 of 30, 100.00 %), whereas only 23 patients in control groups stopped bleeding (23 of 30, 76.67 %) (P < 0.05). escophageal and gastric variceal were cured 19 patients in the experimental group (19 of 30, 63.33 %) , and only 4 were cured in the control group (4 of 28, 14.28 %) (P < 0.05). Meanwhile, occurence of fever, chest pain, hospital days and hospitalization costs of experimental group was significantly lower than that in control group (P < 0.05). Conclusions Treating the escophageal and gastric variceal bleeding, using endoscopic cyanoacrylate injection, sclerotherapy; and variceal ligation under emergency endoscopy combined with Sengstaken-Blakemore tube could significantly increase the therapeutic efficiency as well as reduce complications and therapy cost.

Objective To investigate the optimization of therapeutic regimen through the adjustment of the minimum sub-field area in intensity-modulated radiotherapy (IMRT) for cervical cancer,under the premise of no influence on the dose to target volume or organs at risk.Methods A total of 12 patients with pathologically confirmed cervical cancer were enrolled,and the prescribed dose to the planning target volume (PTV) was 50 Gy in 25 fractions.The Pinnacle 8.0m treatment planning system was used for all patients,and 16 IMRT plans were developed for each patient,with the application of 9 evenly distributed fixed incidence directions (0°,40°,80°,120°,160°,200°,240°,280°,and 320°),a minimum sub-field number of 80,and a minimum sub-field hop count (MU) of 5 MU.The range of sub-field area was 2-81 cm2.Direct machine parameter optimization was used for inverse-planned optimization calculation,and all the plans met the requirements of the clinical prescribed dose.The dose-volume histogram was used to evaluate the dose distribution in target volume and organs at risk.Results With the sub-field area increasing from 2 cm2 to 81cm2,the total hop count of IMRT plan was reduced from (1405±170) MU to (490±47) MU (P=0.000),and when the sub-field area increased above 6 cm×6 cm,the total hop count was reduced significantly (P=0.000).In the IMRT plan with a minimum sub-field area of 2-49 cm2,there was no significant difference in dose between the target volume and the organs at risk (P＞0.05).The dose to the rectum,the bladder,and both femoral heads showed no significant differences across the IMRT plans with different minimum sub-field areas (P＞0.05).Conclusions When the Pinnacle 8.0m treatment planning system is used to develop IMRT plans for cervical cancer,the requirements for clinical dose can still be met with a minimum sub-field area reaching 7 cm×7 cm,and there are significant reductions in sub-field hop count and total hop count.

Objective To explore the effects of erythropoietin (EPO) on the expression of signal transducer and activator of transcription (STAT) 1,phosphorylated STAT1 (P-STAT1),STAT3,P-STAT3 and cell apoptosis in rat models of focal cerebral ischemia-reperfusion.Methods Eighty male SpragueDawley rats were randomly and evenly divided into four groups by completely random design method: shamoperation (group A),cerebral ischemia-reperfusion (group B),cerebral ischemia-reperfusion ± saline (group C) and cerebral ischemia-reperfusion ± EPO (group D).The model of focal cerebral ischemiareperfusion injury was established by blocking the left middle cerebral artery.All rats underwent MRI for the detection of the changes of infarct area between 2 h post ischemia and 24 h of reperfusion.Western blot was used to observe the expression of STAT1,P-STAT1,STAT3,P-STAT3.Terminal oxynucleotidyl transferase mediated dUTP biotin nick end labeling (TUNEL) was used to evaluate the cell apoptosis including the relative area (ROI area/whole brain area of the same layer × 100％) of abnormal signal region,relative optical density (rOD) and apoptotic index.One-way analysis of variance and q test were used to analyze the data.Results On T2WI imaging,rats in group B and group C presented large hyperintense areas in the cortex and subcortex of left hemispheric ((28.00±4.60)％ and (29.70±4.80)％ respectively).Group D presented less hyperintense areas in the cortex and subcortex of left hemispheric compared with group B and group C ((21.10±2.40) ％; F=11.285,P＜0.01).The expression of STAT1 and STAT3 proteins was not significantly affected by ischemia-reperfusion and EPO intervention compared with normal brain tissue (F=0.806,1.558,both P＞0.05).However,the level of P-STAT1 was low in group A (rOD =0.75±0.13) but increased after cerebral ischemia-reperfusion.Compared with group B and group C,P-STAT1 expression was lower in group D (B-D: 2.08±0.15,2.05±0.16,1.92±0.05; F=3.274,P＞0.05).The level of P-STAT3was also low in group A (rOD=1.02±0.09).Compared with group B and group C,P-STAT3 expression in group D was significandy higher (B-D: 2.22±0.13,2.04±0.14,4.21±0.21 ; F=40.719,P＜0.01).The apoptotic index of group B and group C was (42.00±1.30)％ and (41.20±2.50)％,respectively,which was significantly higher than that of group D ((20.90± 1.46) ％ ; F=378.704,P＜0.01).Conclusion Intraperitoneal injection of EPO can reduce the cerebral ischemic area and the number of apoptotic cells in the ischemic penumbra in rat ischemia-reperfusion models through increasing P-STAT3 and decreasing P-STAT1 levels.

Objective To evaluate the clinical and pathological features of eosinophilic cystitis (EC),and to discuss its diagnosis and treatment.Methods The clinical and pathological data of one case of eosinophilic cystitis were reported.An 86-year-old male with gross hematuria and urinary urgency for 15 days was admitted on 16 March 2015.A computed tomography scan showed uneven thickening of the bladder wall and a nodular soft tissue on the anterior wall protruding into the bladder cavity.Results Cystoscopic examination showed diffuse thickening of the bladder with polypoid red lesions on the anterior wall.Transurethral biopsies revealed infiltrating eosinophils,which was consistent with the diagnosis of EC.The patient was then treated with anti-inflammatory drugs,corticosteroids and anti-histamine drugs.At 6 months of follow-up,the patient was asymptomatic and had no evidence of local recurrence by ultrasonography.Conclusions Eosinophilic cystitis is a rare disease without specific clinical and imaging features,which can mimic bladder tumor.The final diagnosis of this disease depends on the pathology.Transurethral resection of the lesion along with postoperative hormone and antihistamines administration are the main choices of treatment.

Objective In this study,we aimed at investigating the clinical,laboratory and management characteristics of adolescent-onset SLE patients compared with adult-onset SLE patients.Methods 470 fe- male patients with SLE were divided into two subgroups:adolescent-onset SLE patients and adult-onset SLE patients.The analyzed variables included clinical,laboratory parameters,damage index and outcome charac- teristics.Results In 470 female patients with SLE,there were 98(20.85%)adolescent-onset SLE patients. The following manifestations occurred more frequently in adolescent-onset SLE patients:malar rash,cutaneous vasculitis,proteinuria and abnormal liver function.Adolescent-onset SLE patients had more severe disease features and had significantly higher mean value of SLEDAI.Mortality was higher in adolescent-onset SLE pa- tients than aduh-onset SLE patients.Renal and blood system were the organs that most frequently involved. Conclusion Adolescent-onset SLE patients accounts for roughly 20.85% of all SLE cases.It is necessary to pay more attention to adolescent-onset SLE patients because the management for them is usually more difficult and the prognosis is usually poorer than aduh-onset SLE patients.

Objective The aim of this study was to analyze the effect of gender and age on shoulder and hip range of motion (ROM) and to determine the differences of ROM of normal side shoulder and hip joints between the data we collected and the published standards (Guideline of Examination for Body Impairment in Clinical Forensic Medicine SF/ZJD0103003-2011) in China. Methods We collected cases with unilateral injury of shoulder or hip from clinical forensic medicine. The differences of ROM of normal side joint between the data we collected and the published standards were studied. Descriptive statistics was calculated between male and female subjects in ifve age groups including 0~25, 26~40, 41~50, 51~60 and >60 years, and the ROM changes with age were also studied. Results The data collected in this study was signiifcantly different from the published standard. With age growth, the ROM of shoulder and hip were decreased and a significant difference between genders in partial activity direction of shoulder and hip was found in the individuals who were over 50 years. Conclusion Gender and age appear to be inlfuential factors to determine the normal ROM of the shoulder and hip joint, and there is signiifcantly difference of ROM of normal side shoulder and hip joints between the data we collected and the published standards (Guideline of Examination for Body Impairment in Clinical Forensic Medicine SF/ZJD0103003-2011).

OBJECTSTo investigate the distribution of vitamin D receptor (VDR) genotypes among the Hans of a lead contaminated mine in Shanxi and explore the relationship between blood lead levels and the genetic polymorphism of VDR gene.

METHODSVDR genotypes were determined by polymerase-chain-reaction and restrictive fragment length polymorphism (PCR-RFLP) and the blood lead level was measured by using the graphite furnace atomic absorption spectrometry in a population of 120 pre-school children aged 5 - 6 years who were from the mine kindergarten and were unrelated Hans. An environmental questionnaire in relation to blood lead level was filled for each subject.

RESULTS(1) The gene distribution of the VDR phenotypes in these children was VDRBB, 1.7%; VDRBb, 9.2%; VDRbb, 89.2%. (2) The mean blood lead level of the children who had VDR B allele [(0.910 8 +/- 0.265 0) micromol/L] was significantly higher than that whose VDR genotype was bb [(0.740 1 +/- 0.270 1) micromol/L (mean +/- standard deviation)] (t = 2.155, P < 0.05). (3) Many factors were found to affect the blood lead levels, such as the VDR genotype, the type of fuel, educational level of mothers and so on. After controlling the possible confounding variables by multiple regression, the contribution of the VDR phenotype to the blood lead levels was still statistically significant.

CONCLUSIONThese results indicated that the frequency distribution of the VDR genotype in these children was apparently different from that in Caucasians who had high frequencies of VDR B. The results also indicated that the individuals carrying the VDR B allele were more susceptible to lead poisoning.

Child ; Child, Preschool ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Lead ; blood ; Lead Poisoning ; genetics ; Multivariate Analysis ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length ; Receptors, Calcitriol ; genetics ; Regression Analysis ; Surveys and Questionnaires

Objective:To explore the value of different MRI sequences in the diagnosis of breast lesions. Methods:Using Philips Achieva 1.5T Nova Dual MRI with SENSE～ breast coil, MRI scanning was performed on 21 patients clinically suspected suffering from breast cancer. MRI sequences included T1WI/TSE,T2WI/TSE (turbo spin echo), short TI inversion recovery(STIR),diffusion weighted whole body imaging with background body signal suppression (DWIBS) and dynamic contrast-enhanced MRI scanning THRIVE. MRI findings were compared with histopathological results. Results:The detection rates of breast lesions of the five sequences were 53.85%, 65.38%, 80.77%, 88.46% and 100%. The sensitivity, specificity and accuracy of dynamic contrast-enhanced MRI scanning were 100%, 77.78%, and 92.31% respectively, which were better than other sequences in the differential diagnosis of the lesions. Conclusion:Dynamic contrast-enhanced MRI scanning could accurately show the numbers of the lesions, describe the morph and size of the lesions and provide more information for the surgeons. DWIBS and STIR could detect the breast lesions more sensitively than T1WI/TSE and T2WI/TSE sequences.

Objective To explore the nursing mode of percutaneous coronary intervention (PCI) in field minimally- invasive interventional shelter for treating closed hepatic trauma and hemorrhage. Methods 8 animal modes of closed hepatic trauma were established by beagles. Then, the animals with damaged hepatic arteries were treated by emergency angio-interventional embolic treatment. And specific nursing mode, which was different from in-hospital, was performed in perioperative period. Results All the animal modes of closed hepatic trauma and hemorrhage were rescued successfully, and no operative complications were found. Conclusions With the cooperation of specific nursing mode, the emergency angio-interventional embolic treatment of closed hepatic trauma and hemorrhage in field minimally-invasive interventional shelter under the complex outdoor environment is feasible.

To compare the curative effects of two surgical treatment methods for open angle glaucoma and cataract patients.
●METHODS: Totally 69 patients with primary open angle glaucoma and cataract were divided into two groups:group A and group B. Thirty- four patients (34 eyes) in group A underwent small incision non -phacoemulsification cataract surgery combined with trabeculectomy, just combined operations, 35 patients (35 eyes) in group B underwent small incision non -phacoemulsification cataract surgery beyond 6mo after trabeculectomy, just two stage operations. Postoperative intraocular pressure at 1wk and 3mo, postoperative corrected visual acuity and filtering bleb at 3mo were observed, and intraoperative and postoperative complications were compared. All the patients were followed up for 3-6mo.
● RESULTS: All the visual acuity were increased compared with that before surgery in two groups, the difference was not statistically significant. All the intraocular pressure was controlled in two groups, the difference was not statistically significant, and the difference about the filtering bleb was neither statistically significant ( P > 0. 05 ). There were no serious intraoperative and postoperative complications in two groups.
● CONCLUSlON: The two stage operations and the combined operations both can control theintraocular pressure and improved visual acuity of open angle glaucoma and cataract. The two stage operations may prevent a second operation for post trabeculectomy cataract, allowing earlier visual rehabilitation.