Objective To investigate the expression of kai1 and nm23 mRNA in esophageal carcinoma, and to explore the clinicopathological significance of kail and nm23 mRNA in the progression of esophageal carcinoma. Methods To detect mRNA expression of kai1 and nm23 in 46 cases of esophageal carcinoma and 34 cases normal esophageal tissues closely adjacent to carcinoma by in situ hybridization.Results The incidence of kai1 (91.3 %＞64.7 %, χ2 =8.65, P =0.003) and nm23 (43.5 %＞5.9 %, χ2=13.86,P ＜0.001) in esophageal carcinoma was significantly higher than in normal esophageal tissues . The expression of nm23 was correlated with the pathological stages (r =-0.379, P =0.009) and lymph node metastasis (χ2 =6.47, P =0.011). The expression of mRNA had positive correlation between kai1and nm23 in esophageal carcinoma (r =0.298, P =0.007). Conclusion The expression of nm23 may play an important role in the occurrence, development and clinicopathological features of esophageal carcinoma. Combined detection of kai1 and nm23 may be helpful in further directing the clinical therapy of esophageal carcinoma.

Objective To discuss the prevention and treatment of catheter fracture of implantable venous access port (IVAP).Methods A total of 878 adult patients,who received IVAP during the period from January 2012 to December 2012 in a single medical center,were collected.Among the 878 patients,catheter fracture occurred in 7 patients.The clinical data of the 7 patients were retrospectively analyzed.By referring to the related literature,the causes and the prevention measures for catheter fracture were discussed.Results As of November 31,2016,the catheter fracture rate of IVAP,which was implanted via internal jugular vein (IJV),was 0.8％ (7/878).The fracture occurrence time was 855-1412 days after implantation of IVAP,with a mean of 1133 days.The common fracture sites were catheter-IJV junction,catheter-IVAP base joint,and subcutaneous tunnel segment.Conclusion Catheter fracture is one of the serious complications which occur in the course of long-period use of IVAP after its implantation.Standardization of operative procedure,strengthening of the maintenance and nursing education,timely removal of IVAP,and other necessary measures can help reduce the incidence of IVAP catheter fracture and ensure the safety of patients.

Objective To compare the sedative efficacy with oral or rectal chloral hydrate in pediatric patients by using Meta-analysis method.Methods Ten randomized controlled trials about the sedative efficacy with oral or rectal chloral hydrate in pediatric patients were retrieved.Meta-analysis was carried out using the RevMan 5.0 software.Results The results showed that the sedative efficacy with rectal medication was better than that with oral way.Nausea and vomiting occurred in 95 children with oral chloral hydrate,bowel movement occurred in 57 children with rectal chloral hydrate.Conclusions The sedative efficacy with rectal chloral hydrate was better than that with oral way.The safety in pediatric sedation with chloral hydrate should be emphasized in order to avoid adverse reaction.

Objective:To describe the clinical results of a one-stage operation for posterior cruciate ligament reconstruction and a posterolateral corner reconstruction of popliteus tendon reconstruction,com-pared with an open popliteofibular ligament reconstruction.Methods:Our study included 33 patients who had undergone posterior cruciate ligament reconstruction with use of an achilles tendon-bone allograft and posterolateral corner reconstruction with arthroscopic anatomical reconstruction of popliteus tendon or open reconstruction of popliteofibular ligament.The patients were assessed for knee instability with use of the dial test at 30°and 90°,together with posterior stress radiography and KT-1000 measurement.Re-sults:The mean time of follow-up was more than 2 years.At the final follow-up evaluation,the tibial posterior translation as measured by stress radiography at 90°of knee flexion,the anterior-posterior trans-lation as measured by KT-1000,and the external rotation of tibia as measured by dial test were reduced postoperatively (P<0.001 )in both groups.Between the two groups,the preoperative tibial posterior translation as measured by stress radiography and the preoperative mean anterior-posterior translation as measured by KT-1000 in the popliteofibular ligament group were a little more than those in the popliteus tendon group (P=0.014,P<0.001).But the other comparisons were not significantly different (P>0.05).The final flexion losses were 3.33°±4.88°and 3.06°±3.38°for the two groups.Conclusion:Combined with posterior cruciate ligament reconstruction,anatomical posterolateral corner reconstruc-tion of the popliteus tendon and open reconstruction of popliteofibular ligament showed similar out-comes.This study demonstrated that both posterolateral corner reconstruction techniques were a reliable alternative method in addressing posterolateral corner and posterior cruciate ligament insufficiency of the knee.

Based on the teaching practice of literature retrieval of pharmaceutical subject in our school,the paper introduces the rationality of content design,using problem-based learning teaching mode,the connection of practice contents and special subject learning contents,improving the examine mode,offering computer operation and practice,in order to improve the students' comprehensive ability to do scientific research.

Objective To investigate the association between depression and clinical outcomes in elderly patients undergoing percutaneous coronary intervention (PCI).Methods Four hundred and fifty-one patients aged ≥ 60 years undergoing PCI in cardiovascular department of Anyang People's Hospital from January 2012 to June 2014 were prospectively analyzed in this study.Patients were divided into PCI without (SDS＜50) and with (SDS≥50) depressiongroup.They were tested by the self-rating depression scale (SDS) at discharge,and followed up for 1 year.And the 1-year mortality was compared between two groups.Multivariable Logistic regression analysis was used to confirm the independent risk factors for the 1-year mortality.Results The 1-year mortality was higher in PCI with depression group than in PCI without depression group (8.9oo vs.3.9％,P=0.035).As compared with PCI patients without depression,PCI patients with depression showed the increased odds ratio (2.55,95％ CI:1.05 ～ 6.17,P=0.039) for 1-year mortality by multivariable Logistic regression analysis.Conclusions Depression is an independent predictor for mortality in elderly patients undergoing PCI.

Objective To investigate the effects of Baicalin on intestinal mucosal injury in rats with partial common bile duct ligation (PCBDL).Methods Forty male Wistar rats were randomly divided into 4 groups equally:sham operation,PCBDL,PCBDL1 and PCBDL2.Rats in PCBDL,PCBDL1 and PCBDL2 groups were subjected to partial common bile duct ligation.Baicalin [80 mg/(kg · d)] was fed in PCBDL1 group (for 2 weeks) and PCBDL2 group (for 3 weeks),while for other groups,9 g/L saline in the same volume was fed.Ileum mucosa were prepared for microscopic examination.The intestinal mucosal injury in rats was observed and scored.The level of NF-κB mRNA expression by Fluorescent in Situ Hybridization,and the level of NF-κB protein were determined by immunohistochemistry.Results 1.Compared with PCBDL group (3.2 ± 0.5),the pathological severity scores of intestinal mucosa significantly declined (F =21.120,P ＜ 0.01) in PCBDL1 group (1.9 ± 0.2) and PCBDL2 group (1.5 ± 0.3).2.Compared with sham operation group(0.066 ± 0.006),PCBDL1 group (0.107 ± 0.011),and PCBDL2 group (0.098 ± 0.010),NF-κB expression in PCBDL group (0.155 ± 0.012) presented significantly up-regulation (F =76.8,P ＜ 0.01).3.Compared with sham operation,PCBDL1 group,and PCBDL2 group,the positive expression rates of NF-κB mRNA of intestinal mucosal epithelium in PCBDL group significantly increased.Conclusions It is suggested that Baicalin exert protective effects on the intestinal mucosal injury in rats with PCBDL,partially by inhibiting NF-κB mRNA,down-regulating NF-κB protein expression of intestinal mucosal epithelial cells.

Objective:To investigate the risk factors for delayed gastrointestinal hemorrhage after pancreaticoduodenectomy (PD).Methods:The retrospective case-control study was conducted. The clinicopathological data of 173 patients who underwent PD in the First Affiliated Hospital of Anhui Medical University from November 2017 to May 2020 were collected. There were 107 males and 66 females, aged (61±11)years. All patients underwent PD and patients with gastrointestinal hemorrhage after surgery were treated with non-surgical or surgical treatments. Observation indicators: (1) gastrointestinal hemorrhage after PD and treatment situations; (2) influencing factors for delayed gastrointestinal hemorrhage after PD. Measurement data with normal distribution were expressed by Mean±SD, and count data were expressed by absolute numbers or percentages. Univariate analysis was performed using the chi-square test, and multivariate analysis was performed using the Logistic regression model. Results:(1) Gastrointestinal hemorrhage after PD and treatment situations: of 173 patients, 15 cases had gastrointestinal hemorrhage after PD, including 2 cases with early gastrointestinal hemorrhage and 13 cases with delayed gastrointestinal hemorrhage. Among the 13 cases with delayed gastrointestinal hemorrhage, 3 cases were mild hemorrhage, 10 cases were severe hemorrhage, 4 cases were gastric mucosal hemorrhage, 3 cases were gastric ulcer hemorrhage, 3 cases were gastrointestinal anastomotic hemorrhage, 2 cases were cholangio-jejunal anastomotic hemorrhage, 1 case was biliary arteriovenous fistula hemorrhage. Of the 13 patients with delayed gastrointestinal hemorrhage, 4 cases were treated only with conservative treatment, 4 cases were treated with interventional treatment, 3 cases were treated with endoscopic treatment and 2 cases were treated with surgical treatment. Of the 13 patients with delayed gastrointestinal hemorrhage, 12 were cured and 1 died. (2) Influencing factors for delayed gastrointestinal hemorrhage after PD: results of univariate analysis showed that albumin, total bilirubin, pancreatic fistula and history of gastric ulcer were the influencing factors for delayed gastrointestinal hemorrhage after PD ( χ2=7.888, 6.555, 4.252, 6.253, P<0.05). Results of multivariate analysis showed that total bilirubin >200 μmol/ L, pancreatic fistula and history of gastric ulcer were independent risk factors for delayed gastrointestinal hemorrhage after PD ( odds ratio=4.122, 4.290, 5.267, 95% confidence interval as 1.009-16.844, 1.149-16.022, 1.195-23.221, P<0.05). Conclusion:Total bilirubin >200 μmol/L, pancreatic fistula and history of gastric ulcer are independent risk factors for delayed gastrointestinal hemorrhage after PD.

Objective To investigate the value of cardiac troponin Ⅰ (cTn Ⅰ) in diagnosis of multi-trauma patients combined with myocardiac contusion.Methods A retrospective review was made on 98 cases of multi-trauma patients combined with blunt chest trauma.The groups were identified according to whether the patients were associated with myocardiac contusion or not,including myocardiac contusion group (n =48) and non-myocardiac contusion group (n =50).The detection and diagnosis of myocardiac contusion in the use of different cut-off points of cTn Ⅰ and creatine kinase MB isoenzyme/creatine kinase (CKMB/CK) or their combination were compared between groups.Results cTn Ⅰ ≥0.60 ng/ml had a specificity of 90.0％,a sensitivity of 64.6％ and a Youden index of 0.54 in diagnosis of myocardiac contusion,indicating a best diagnostic accuracy as a single parameter.As compared with the single use of cTn Ⅰ ≥ 0.60 ng/ml or CKMB/CK ≥ 6％ in diagnosis of myocardiac contusion,the combined use of two parameters presented a significantly higher diagnostic sensitivity (85.4％ vs 64.6％ ; 85.4％ vs 27.1％ respectively,both P ＜ 0.05),but no markedly lower specificity (84.0％ vs 90.0％ ; 84.0％ vs 88.0％ respectively,both P ＞0.05).cTn Ⅰ level was positively correlated with ISS score of the multi-trauma patients combined with myocardiac contusion (r =0.534,P ＜ 0.01).Mortality rate in patients with severely increased cTn Ⅰ was much higher than that in patients with mild-moderately increased cTn Ⅰ (P ＜ 0.01).Conclusions cTn Ⅰ ≥0.60 ng/ml presents a high sensitivity and preferable specificity for diagnosis of multiple trauma patients combined with myocardiac contusion.It can be served as a biomarker for diagnosis of MC and its combination with CKMB/CK≥6％ improves the diagnostic sensitivity.cTn Ⅰ can be used as an assessment indicator for the early risk stratification and outcome in multi-trauma patients combined with myocardiac contusion.

Objective To explore the eating behaviors associated with refractory functional dyspepsia (RFD).Methods In this multicenter,prospective trial,1341 new outpatients with functional dyspepsia (FD) from three Guangdong hospitals who had been diagnosed according to the Rome Ⅲ criteria were enrolled from May to September in 2012.One hundred healthy volunteers were also enrolled as controls.A questionnaire was used to obtain data,and logistic regression analysis was used for analysis.Results ①RFD was diagnosed in 24.4％ of the FD patients.②Unhealthy eating behaviors were significantly greater in patients with RFD and non-RFD than in the normal controls.Patients with RFD skipped meals more often,ate extra meals,and preferred sweets and gasproducing foods (P ＜ 0.05).③A comparison among the non-RFD subtypes,showed that those with epigastric pain syndrome had a greater preference for spicy foods (47.5 ％ vs 35.7 ％,P ＜ 0.05),and those with postprandial distress syndrome had a greater preference for sweets(50.0％ vs 36.4％,P ＜ 0.05) and gas-producing foods (14.9％ vs 7.1％,P＜0.05).Those with both subtypes skipped more meals (30.1％ vs 17.0％,P ＜ 0.05),and ate extra meals (15.0％ vs 6.5％,P＜0.05).④Logistic regression analysis showed that meal skipping(95％ CI,1.177 ～2.272; P=0.003),eating extra meals (95％ CI,1.015 ～2.604; P =0.043),and a preference for sweets (95 ％ CI,1.040 ～ 1.757 ; P =0.024) and gas-producing foods (95 ％ CI,1.022 ～ 2.306 ; P =0.039) were risk factors for RFD.Conclusion Unhealthy eating behaviors,especially,meal skipping,eating extra meals,preferring sweets and gas-producing foods correlate with RFD and these behaviors may be the key reasons for the refractory characteristic of RFD.