Gastroesophageal reflux disease(GERD)is a commonly seen digestive disease. So far,there is no golden standard for the diagnosis of GERD. The main diagnosis methods used in clinical practice include gastroscopy,24 h esophageal pH monitoring and proton pump inhibitor test,however,these methods are either invasive or complex in procedure and with low diagnostic accuracy rate. Gastroesophageal reflux disease questionnaire(GerdQ)possesses multiple advantages such as simple,non-invasive and easily acceptable. This article reviewed the use of GerdQ in diagnosis of GERD.

Objective To investigate the risk factors of dual anti-platelet treatment in upper gastrointestinal hemor-rhage after percutaneous coronary intervention (PCI). Methods Clinical data of 2004 PCI patients with dual anti-platelet treatment were collected,including gender,age,body mass index (BMI),history of drug therapy, history of digestive disease, history of smoking and drinking,history of hypertension,history of diabetes,history of cerebrovascular disease and history of combined treatment with a proton pump inhibitor (PPI). The different characteristics of gastrointestinal bleeding were com-pared. The risk factors of upper gastrointestinal bleeding were analyzed. Results The risk factors for PCI patients with up-per gastrointestinal bleeding were age>65 years of old, history of smoking, history of hypertension,abnormal platelet count, creatinine and hemoglobin. The combined treatment with a proton pump inhibitor was a protective factor associated with gas-trointestinal bleeding. Conclusion We should pay attention to the upper gastrointestinal bleeding induced by dual anti-platelet treatment, and take appropriate measures to reduce the incidence of gastrointestinal bleeding in PCI patients.

[Objective]To compare the effects of continuous femoral nerve block(CFNB) and epidural analgesia(CEA) on rehabilitation after total knee arthroplasty(TKA) surgery. [Methods]Fifty patients undergoing unilateral TKA surgery were randomly divided into group CFNB(n=25) and group CEA(n=25).All patients were received unilateral spinal anesthesia with 0.5% dicaine and given analgesia with 0.2 % ropivacaine with 1ug/ml sufentanil.VAS pain scores during rest and continuous passive movement(CPM) at each time point was recorded.Other parameter such as the angle of initiative flections,blood loss at 6 h post operation,the concentration of serum hemoglobin at 24 h,48 h and side effect were recorded.[Results]The VAS pain scores during test had no significant difference between two groups.The VAS scores of CPM at 24 h and 48 h in group CFNB were obvious lower(3.68?0.93 and 3.93?0.78) than those in group CEA.The initiative flections were similar at 12 and 24 hours after operation.The concentration of hemoglobin at 6 h after operation was lower than that before operation.After reinfusion it was increased but did not reach the level before operation.The incidence of side effects was not noted in both groups.[Conclusion]After TKA surgery,the continuous femoral nerve block can provide better pain relief.No adverse impact on rehabilitation movement of operated legs or blood loss and has less side effect.Therefore,it should be considered an alternative analgesia method after TKA.

AIM: To compare the efficacy and safety between quetiapine and clozapine. METHODS: There were 85 patients with first on-set schizophrenia in this study,43 patients treated with quetiapine 425? 56 mg?d -1 and 42 patients treated with clozapine 350? 73 mg?d -1 . The study lasted for 8 wk. The Positive and Negative Symptom Scale (PANSS) and Treatment Emergent Symptom Scale (TESS) were used to evaluate therapeutic and side effects. RESULTS: The PANSS scores in both groups decreased significantly after treatment with those two drugs(P

Objective To observe the clinical curative effect of Xintong decoction in treating unstable angina pectoris(UAP) and impact on serum matrix metalloproteinase 2(MMP-2) of patients with syndrome of phlegm and blood stasis,qi stagnation and obstruction of heart meridian,and probes into its intervention mechanism on UAP.Method Patients were randomly divided into treatment group(30 cases,treated with Xiaotong decoction + routine western medicine) and control group(30 cases,treated with routine western medicine).The course was four weeks.The clinical curative effect was observed and serum MMP-2 before and after treatment was detected.Results TCM syndrome score,angina pectoris,nitroglycerin discontinue rate,serum concentration of MMP-2 in the treatment group were significantly better than the control group.Conclusion Xintong decoction has good curative effect in treating UAP.It can reduce the serum level of MMP-2 of patients with UAP,so as to slowing the progress of plaque and stabilizing plaques.

Objective: To explore the pathogenesis of phlegm-blood stasis syndrome in mice model of coronary heart disease based on PPAR gamma pathway. Methods: Healthy SPF C57BL/6J mice were used in the control group and the sham operation group, and ApoE-/-mice were used in the blood stasis group, phlegm turbid group and phlegm-blood stasis group. The phlegm turbid group and the phlegm-blood stasis group were fed with high-fat diet for 12 weeks, and the other groups were fed with normal feed for 12 weeks. At the end of the 8th week, the left anterior descending coronary artery was ligated in the blood stasis group and the phlegm-blood stasis group. The sham operation group was not ligated. The levels of IL-6, ET, Ang II and PPARγ in serum were measured by enzyme linked immunosorbent assay, the levels of PPARγ, ABCA1 and CD36 protein in liver tissue were detected by Western blotting, and the levels of CD40, MMP-9 and NF-κB protein in aorta were detected by immunohistochemistry. Results: Compared with sham operation group, there was no significant change in serum IL-6, the content of serum ET in the group of phlegm and blood stasis was increased significantly (P < 0.01), the content of Ang II in blood stasis group was increased significantly (P < 0.05), the content of serum Ang II in phlegm turbid group and phlegm-blood stasis group was increased significantly (P < 0.01), and the content of PPARγ was decreased. In liver tissue, the expression levels of PPARγ and ABCA1 protein in blood stasis group, phlegm turbid group and phlegm-blood stasis group were decreased significantly (P < 0.01), the expression of CD36 protein was increased. CD40, MMP-9 and NF-κB levels in aorta tissue were increased significantly (P < 0.01). Conclusion: The phlegm-blood stasis syndrome of coronary heart disease can cause more serious atherosclerotic plaque in the course of its onset. Its mechanism may be through activating PPARγ pathway.

The effects of renal ischemic preconditioning (RIP) on ischemia-reperfused myocardium were examined in the urethane-anesthetized rabbit to determine whether RIP may provide cardioprotection and to observe the role of the renal nerve in such condition. The results obtained are as follows: (1) During 45 min myocardial ischemia and subsequent 180 min reperfusion, blood pressure, heart rate and myocardial oxygen consumption decreased progressively. Epicardial electrographic ST-segment was elevated significantly in the period of ischemia and returned to the baseline gradually in the course of reperfusion. The myocardial infarct size occupied 55.80±1.25% of the area at risk. (2) RIP significantly reduced the myocardial infarct size to 36.51±2.80% (P<0.01), indicating the cardioprotective effect of such an intervention. (3) Renal nerve section (RNS) completely abolished the cardioprotection afforded by RIP, though RNS per se did not affect the myocardial infarct size produced by ischemia-reperfusion. (4) During 10 min renal ischemia, the averaged multi-unit discharge rate of the renal afferent was increased from 0.14±0.08 to 0.65±0.12 imp/s (P<0.01). (5) Pretreatment with an adenosine receptor antagonist 8-phenyltheophylline (10 mg/kg) markedly attenuated the discharge rate of the renal afferent induced by transient renal ischemia, implying that adenosine released in ischemic kidney activated the renal afferent. It is suggested that activation of renal afferents by transient renal ischemia-reperfusion plays an important role in the cardioprotection afforded by RIP.

Objective To investigate the hepatocyte targeted specific property of galactosylated chitosan-graft-polyethyleneimine (GC-PEI)/DNA complexes in vitro and in vivo.Methods With the plasmid expressing enhanced green fluorescent protein (pEGFP-C1) as the reporter gene,the formation of GC-PEI/DNA complexes was induced to self-assemble in 0.01 mol/L phosphate buffered saline(PBS),150 mmol/L NaCl,or 5% glucose solution (GS).The complexes were characterized by the particle size,Zeta potential,DNA binding and protection capacity,and further tested for cytotoxicity and hepatocyte targeted degradation of DNaseⅠand the serum,which presented as a well-formed sphere or compacted nucleocapsid structure at a diameter of 50-200 nm.The GC-PEI copolymer showed no obvious toxicity in the tested cell lines.Acute toxicity assay revealed that the mice grew well in 2 weeks with GC-PEI dosage from 50 to 300 μg.The assay by flow cytometry and fluorescent microscope showed that the transfection efficiency in hepatocyte lines (L02,QSG7701/core) was higher than that in non-hepatocyte lines (SGC7901,HBE) in vitro.In vivo,the GFP was obviously expressed in the liver tissue and not expressed in other organs 48 h after the transfection.Conclusion GC-PEI copolymer may carry the exogenous gene specifically to hepatocytes in vitro and in vivo,which has very good liver targeted specific property.

AIM: To investigate the clinical effects of intravitreal Bevacizumab for 26 cases with retinopathy of prematurity (ROP) in Zone Ⅰ.
METHODS:A retrospective study. Totally 26 ROP infants between September 2013 and October 2014 diagnosed as high - risk ROP in Zone Ⅰ had been treated with intravitreal bevacizumab. They were divided into three groups, pre - threshold ROP, threshold ROP and acute posterior ROP ( APROP ). Postoperative effects were compared.
RESULTS:There were 26 infants (52 eyes) diagnosed as ROP in Zone Ⅰ, including 3 infants( 6 eyes) with pre -threshold ROP, 15 infants (30 eyes) with threshold ROP and 8 infants (16 eyes) with APROP. The first operation recovery rate of three groups respectively were 100% (6 /6), 60% ( 18 / 30 ) and 75% ( 12 / 16 ), which were not significantly different (P>0. 05).
CONCLUSION:Intravitreal bevacizumab for ROP in ZoneⅠ seems effective and has some advantages over conventional laser treatment, which could be first line treatment for high-risk ROP in Zone Ⅰ.