Objective To investigate the clinical characteristics of upper gastrointestinal diseases in very old people (aged ≥ 90 years),and to explore the necessity and safety of the gastroscopy for the super elderly people.Methods Clinical data of 50 very old people were retrospectively analyzed.Results The total detection rate of upper gastrointestinal disease was 76.0％ (38/50),in which the reflux esophagitis (RE) was the most common (26.0％),followed by erosive gastritis (20.0％),atrophic gastritis (18.0 ％),peptic ulcer (12.0 ％),gastrointestinal cancer (10.0％),duodenitis (8.0％) and fundic gland polyps (6.0％) respectively.RE lesions detected by gastroscopy were mainly mild and were divided into endoscopic grade LA-A (46.1％),LA-B (30.8％),LA C (7.7％),and LA-D (15.4％) according to the Los Angeles classification.The most common symptoms were abdominal distension and anorexia,and the both incidences were 12.0％.There was no significant difference in the prevalence of clinical symptoms between the elderly people with upper gastrointestinal disease and without abnormal gastroscopic findings [44.7％ (17/38) vs.41.7％ (5/12),x2 =0.035,P＞0.05].22 patients (44.0％) underwent gastroscopy under intravenous anesthesia.Conclusions The incidence of upper gastrointestinal disease is high in very old people,and mild reflux esophagitis is the most common.Clinical symptoms are little or asymptomatic in most very old people.Gastroscopy under intravenous anesthesia is safe and feasible for the very old people.

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One hundred and eighty patients of shoulder periarthritis were treated by combined traction, acupuncture, physiotherapy, Tuina and functional exercise. After 10 treatments, 133 cases were cured, 36 cases got marked effectiveness, 8 cases got effectiveness, 3 cases had no effectiveness and the total effective rate was 98.3%. Combined therapy can relieve adhesion of soft tissues induced by various causes to achieve the purpose of accelerating recovery.

Objective To observe the clinical therapeu tic effect of hyperkinetic syndrome of childhood treated by electroacupuncture plus acupoint application. Method Sixty-five cases with hyperkinetic syndrome of childhood were treated by electroacupuncture plus acupoint application (electroacupuncture group); 53 cases were treated by acupuncture (acupuncture group) and 53 cases were treated by Ritalin (west drug group). The above three groups were compared with each other in therapeutic effect. Results The effective rate of treating hyperkinetic syndrome of childhood by electroacupuncture plus acupoint application was 87.7%; the effective rate in west drug group was 86.8% and in acupuncture group was 77.4%. A comparison among the three groups showed there was no significant difference in clinical ther apeutic effect ( P > 0.05 ). Conclusion Electroacupuncture plus acupoint application was an effective therapy of hyperkinetic syndrome of childhood.

Objective To investigate the effect of clinical nursing pathway on patients with cerebral infarction. Methods Two hundred patients with cerebral infarction were randomized by random digit table into the clinical pathway group and the conventional nursing group.The former was managed with the clinical nursing pathway and the latter received conventional nursing. The neurologic impairment and the activities of daily life were assessed respectively by national institute of health stroke scale(NIHSS) and Barthel index(BI).The two groups were compared in terms of hospital stay,medical expense,patient’s satisfaction and curative effect. Results Compared to the conventional nursing group,the clinical pathway group was shorter at hospital stay,lower at lower hospitalization cost,higher at patient’s satisfaction and higher in the score by Barthel index,compared to the conventional nursing group(all P<0.05). Conclusion The application of clinical nursing pathway in patients with cerebral infarction can improve the activities of daily living and the quality of care,shorten length of stay,reduce medical cost and increase patients’satisfaction drgree.

Objective To investigate the disease causing gene of Stargardt disease. Method Fifteen patients with Stargardt disease were analyzed with 11 primers of the 11 exons of ABCR gene by using PCR SSCP and DNA direct sequencing techniques. Results Three newly detected disease causing mutations were found. Among those mutations, one is a frameshift mutation and others are single base transition. Conclusion This research confirmed that ABCR gene is associated with Stargardt disease, and 3 new mutations of ABCR gene were found.

Objective To observe the morphologic features of neurons labeled with green fluorescent protein (GFP) gene recombinant Sindibis virus in the deep part of lamina Ⅲ in the medullary dorsal horn (MDH) of the rat. Methods Neurons were infected and labeled with GFP gene recombinant Sindibis virus injected into lamina Ⅲ.Immunohistchemical staining showed the labeling results.The morphologic features of the GFP labeled neurons were revealed after reconstruction. Results A few GFP-labeled single neurons were found in the distal portions away from the virus injection site within the deep part of lamina Ⅲ of the MDH.According to the morphological features,especially their axons and axonal collaterals,GFP labeled neurons were classified into projection neurons and intrinsic neurons.The axons and their collaterals of the projection neurons entered to the superficial part of lamina Ⅲ,lamina Ⅱ and/or the medullary reticular formation.Most of the axons and their collaterals of the intrinsic neurons extended mainly within lamina Ⅲ.Conclusions According to the morphological features of axons and their axonal collaterals,GFP labeled neurons were classified into projection neurons and intrinsic neurons in the deep part of lamina Ⅲ of the MDH.GFP gene recombinant virus labeling technique is an effective method to investigate the morphological features of neurons.

Calbindin-D28k (CB), calretinin (CR) and parvalbumin (PV) are the most common calcium-binding proteins (CaBPs). In the present study, FOS immunoreactivity was first induced in neurons of the medullary dorsal horn (MDH) of the rat by noxious orofacial stimulation; CaBPs (CB, CR and PV) in these neurons were then identified by imumunofluorescence histochemistry, and then, in addition, afferents to CaBPs/FOS double-labeled neurons were showed by immunofluorescence histochemical staining for the γ-aminobutyric acid (GABA) , glycine transporter 2 (GlyT2) , enkephalin (ENK) , serotonin (5-HT) or substance P (SP). Under the light microscope,we observed that: (1) neuronal cell bodies exhibiting FOS-immunoreactivity were present throughout all laminae of the MOH, with the highest concentration in lamina Ⅱ; (2) most CB-, CR- and PV-immunoreactive (IR) neurons were located in lamina Ⅱ , but some were also encountered in laminae Ⅰ and Ⅲ; (3) 5-HT-, GABA-, GlyT2-, ENK- and SP-IR fibers and terminals were also chiefly located in laminae Ⅰ and Ⅱ of the MDH; (4) some FOS-IR neurons showed CB-, CR-, or PV-immunoreactivity; (5) 5-HT-, GABA-, GlyT2- and ENK-IR terminals made close contacts with FOS/CB, FOS/CR or FOS/PV double-labeled neurons; (6) SP-IR terminals, as well as 5-HT-, GABA-, GlyT2- or ENK-IR terminals, closely contacted CB-, CR- or PV-containing neurons. Under the electron microscope, 5-HT-, GABA-, GlyT2- and ENK-IR terminals principally made symmetric (inhibitory) synaptic connections with CB-, CR- and PV-containing neurons were observed. These results suggest that 5-HT, GABA, glycine (Gly) and ENK may modulate transmission of orofacial noxious information by inhibiting nociceptive neurons that contain CaBPs in the rat MDH.

Objective　To apply high frequency ultrasound to laser treatment of children facial subcutaneous cavernous hemangiomas.Methods　Ten children with facial subcutaneous hemangiomas were treated with Nd:YAG laser, the process was supervised with high frequency ultrasound.Results　Before treatment,tumors showed low and inhomogenous echogenicity with blood flow signal;after treatment,the tumors appeared high and homogenous echogenicity with little or no blood flow signal. Conclusions　The high frequency ultrasound is helpful for laser treatment of facial subcutaneous cavernous hemangiomas in preoperative location and postoperative assessment.

Objective To discuss the influence of individualized health education based on combination of TCM and western medicine on the life quality of patients with diabetes mellitus in order to supply novel idea and method for carried out education about diabetes mellitus. Methods Hospitalized patients (140 cases) were randomized into the control group and the test group with 70 cases in each group. Both groups received routine diabetes drugs treatment. The patients and their family members received individualized health education based on combination of TCM and western medicine during their hospitalization days and 6 months after discharge. SF-36 inventory and diabetes cognitive questionnaire was adopted to investigate the two groups. Results The diabetes cognitive degree of the test group was higher than that of the control group (P<0.01). Six items such as social function, systemic health, body pain, psychological health, vigor and emotional role function of the test group was different from those of the control group (P<0.05). Conclusion Individualized health education based on combination of TCM and western medicine contributed to the improvement of patients' life quality.