Objective To investigate the characteristics of esophageal motility in patients with type Ⅱ achalasia and evaluate the clinical value of high resolution manometry (HRM).Methods A total of 20 patients with type Ⅱ achalasia(observation group) and 15 healthy controls(control group) were enrolled for high resolution manometry.The characteristics of esophageal motility of two groups were compared.Results The motor pattern of esophageal body of observation group was mostly non-conductive synchronous contraction(88.2％,176/200),but in control group it was normal esophageal peristalsis.Lower esophageal sphincter pressure,4 s integrated relaxation pressure(4s IRP) and upper esophageal sphincter residual pressure in observation group were (37.6 ± 12.8)mmHg,(31.5 ± 13.4)mmHg and (14.0 ± 3.8)mmHg,respectively,which were higher than those ot the control group,(23.7 ± 5.6) mmHg(t =3.925,P =0.000),(10.5 ±4.3) mmHg(t =5.835,P =0.000) and (7.9 ± 4.5) mmHg (t =4.325,P =0.000).The lower esophageal sphincter relaxation rate in observation group was(23.6 ± 19.6)％,which was lower than that of the control group(58.1 ±16.7)％ (t =-5.491,P =0.000).There was no significant difference in lower esophageal sphincter length and upper esophageal sphincter pressure between type Ⅱ achalasia group and control group (P ＞0.05).Conclusion The characteristics of esophageal manometry in type Ⅱ achalasia is non-conductive synchronous contraction and elevated 4s IRP,and HRM contributes to early diagnosis,reclassification and evaluation of expected outcome in achalasia.

Objective To investigate esophageal high-resolution manometry (HRM) combined with 24-hour pH monitor in detecting endoscopy-negative chest pain of esophageal origin.Methods Test results of esophageal HRM combined with 24-hour pH monitor from 40 patients with recurring chest pain of esophageal origin were retrospectively analyzed.Results In 40 patients,27 (67.5％) were diagnosed as gastroesophageal reflux disease with an average DeMeester scores at 18.3 ± 3.4,including 19 patients with esophageal body dismotility and 11 with reduced lower esophageal sphincter pressure (LESP) at a mean reduction of 5.7 mm Hg.There were 6 cases (15.0％) of achalasia,in which 1 (2.5％) was type Ⅰ and 5 (12.5％)was type Ⅱ,with an average relaxation ratio of lower esophageal sphincter (RRLES) at (30.1 ± 2.3) ％.There were 4 cases of diffuse esophageal spasm (DES),with an average contraction frontal velocity (CFV) of 12.3 ± 2.4 cm ·s-1 and abnormal contraction waves in esophageal body,spontaneous synchronous contraction waves were observed in 3 of 4 patients LESP increased in 1 patient with DES and remained normal in other 3.RRLES decreased in 2 cases with DES and remained normal in other 2.There were 2 cases (5.0％)of nutcracker esophagus,with an average distal contractile integral at 6745.5 ± 175.2 mm Hg·cm-1 ·s-1 and an average CFV at 4.3 ±0.4 cm·s-1.There was 1 case (2.5％) with absence of esophageal peristalsis,with a low LESP at 2 mmHg and DeMeester scores at 38.3.The patient was finally diagnosed as systemic sclerosis according to esophageal biopsy and other auxiliary examination.Conclusion HRM combined with 24-hour pH monitor is valuable in detecting endoscopy-negative chest pain of esophageal origin.

Purpose:To evaluate the effects of the implementation of “Guidelines of Diagnosis and Treatment for Common Cancers in China (Breast cancer)” in recent 10 years, and to provide evidence for decision making for Health Services.Methods:Continuously followed and randomly sampled hospitalized breast cancer cases in District hospitals and General hospitals, evaluated by clinical experts.Results:The rate of total agreement was 41.36%, the rate of essential agreement was 49.09% in 1996-1999. The sum of the two rates was 90.45%. The total agreement rates were without statistical difference among district hospitals, county hospitals and municipal general hospitals. There was no case of disagreement in municipal general hospitals. The disagreement rate in district hospitals went down from 7.69% in 1994 to 3.70% in 1999. The total agreement rate of cases with operation was 46.74%, higher than any group with other treatments. The proportion of cases with correct case stage classification was 47.33%.Conclusions:After implementation of the Guideline, the level of appropriate treatment was increasing. In order to raise the level of cancer diagnosis and treatment, and improve cure rate, survival rate and life quality, we must take measures on staff training, quality control, supportive environment, comprehensive patient management and patient transfer policies.[

Objective To explore the behavioral and electrophysiological characteristics of prefrontal executive control in macaca mulatas. Methods Three macaca mulatas were used for behavioral research. Neuronal activities of the prefrontal cortex were recorded in two monkeys while visual discriminated go/no go tasks were being performed. Results ① The response time was (419?18)ms, (376?26)ms and (540?21)ms in three monkeys while performing go/no go tasks; ② A total of 41 tetrodes penetrations were made in the PFC of two monkeys. A total of 92 task related neurons were sampled and categorized as 5 types: visual signal related neurons, decision making related neurons, go movement related neurons, reward related neurons and multi events related neurons; ③ When it was correct, the discharge rate of a neuron to a go signal was significantly higher than that to a no go signal during cue period; the discharge rate of a decision making neuron in a go task was significantly higher than that in a no go task. However, when it was wrong, the situation was on the contrary during delay period. Conclusions ① The prefrontal cortex contains various kinds of neurons; ② There are two types of errors in executing go/no go tasks: cue period error and delay period error.

Objective To establish the model of amyotrophic lateral sclerosis (ALS) with selective motor neuron disorder by organotypic spinal cord cultures, and analyze the role of astrocyte in the pathagenisis of ALS.Methods Organotypic spinal cord cultures were prepared using lumbar spinal cord slices from 8-day-old SD rat pups. The threohydroxyaspartate (THA) was applied into culture medium to establish ALS organotypic spinal cord cultures model. Motor neurons survival was evaluated by monoclonal SMI-32 immunohistochemical staining and glial fibrillary acidic protein staining to show astrocyte survival.Results Compared with the control group, there was significantly astrogliosis in the anterior horn and surrounding white matter in THA 100 μmol/L group, and the level of gliosis was increased followed the elongation of THA interference time. With the increasing of the number of astrocyte, the morphology of astrocyte was changed.Conclusion There is significantly astrogliosis in the anterior horn and the time of astrogliosis is markedly earlier than the time of motor neuron loss in the ALS model intervented with THA.

Based on M9 culture medium,the concentration of ingredients of culture medium was optimized for the fermentation of pNSR32/BL21(DE3),the engineering bacterial with spider silk protein,and lactose as an inducer.The condition of optimum culture medium was obtained for the expression of the high molecular weight recombinant spider silk protein by using orthogonal and individual factor experimental design.The result was showed that the optimum culture medium was consisted of 0.3% glycerol,3% yeast,0.75% tryptone,0.05%(NH_4)_2SO_4 and a little inorganic salt_.It was confirmed that the optimum culture medium will benefit the growth of bacterial and expression of recombinant spider silk protein.The production level of propose protein will attain at 20% of the total proteins in the fermentation.

Objective To evaluate the diagnosis and treatment of aortic dissection combined with chronic renal failure.Methods Ten cases were retrospectively analyzed who were diagnosed as aortic dissection combined with chronic renal failure between January 2012 and December 2014.The history of chronic renal failure was 1-6 years.According to Standford classification,one case was type A dissection and the other nine were type B.Results Seven type B dissection had endovascular stent implantation.Perioperative renal function monitor and hemodialysis was given.The other two patients with type B dissection had conservative treatment.One patient with type A dissection died in the day of diagnosis.Follow-up data showed seven patients with stent implantation were in good condition and two others with conservative treatment died due to dissection rupture three and eight months after diagnosis respectively.Conclusions The mortality of aortic dissection combined with chronic renal failure is high.For Standford B dissection,endovascular stent implantation is a reliable treatment method.

Through the Introduction of the visualization technology based on VREL and its application in ultrasound teaching,the teaching means has been changed,the teaching content enriched and the contact between basic and clinic knowledge enhanced,which indicates that the visualization technology exerts an important role in ultrasound teaching.

Objective To investigate the relationship between sleep quality and mental health in the nurses.MethodsThree groups subjects, 53 students of nursing college, 57 advanced students receiving clinical training and 61 clinical nurses, were investigated with the Pittsburgh Sleep Quality Index (PSQI) and Self Checklist-90 (SCL-90). The standard of having sleep problem was PSQI scores ≥8.ResultsThere were 20.05% of subjects having sleep problem. The total score of PSQI was significantly different among three groups ( P<0.001), but total score of SCL-90 of three groups was not different. The total score of PSQI was correlated positively with the total score of SCL-90.ConclusionSleep quality and mental health are affected each other, and sleep quality is declining gradually from students in nursing college to clinical nurses, but there aren't obvious changes in mental status.

This article introduces the way of making and using ultrasound multimedia courseware,which can improve teaching means,enrich teaching contents,activate classroom atmosphere and enhance the connection of basic and clinical knowledge.Meanwhile,the environment request of the demonstration courseware and interaction courseware as well as the necessity and significance of multimedia in ultrasound teaching are discussed.It is suggested that computer assisted instruction(CAI) plays an important role in ultrasound teaching.