Objective To evaluate the effect of endoscopic ultrasonography(EUS)in diagnosing e- sophageal and gastric varices in portal hypertension(PHT)patients.Methods Fifty-three patients with e- sophageal and gastric varices(EV、GV)of decompensation PHT and 20 patients without PHT as control were undergone EUS and esophagogastroduodenoscopy(EGD)simultaneously.EUS detected mainly the EGV,e- sophagus and stomach collateral veins.Results EUS identified EV endoscopically in 29(54.7%)patients. EUS detected GV in 24(45.3%)patients,compared with detection in 18(34.0%)patients by esopha- gogastroduodenoscopy(EGD)(P＜0.001).EUS detected PEV in 27(51%)patients.Distribution rates of PEV in F1,F2 and F3 are 0%,28.6% and 75% respectively.The comparison between groups shows sig- nificant difference(P＜0.001).Splenic vein can be seen in both control and experimental groups with di- ameter 7.5?1.35mm VS 11.5?3.5mm respectively,the difference between two groups is significant(P＜0.001).Proximal diameters of Azygos vein in two groups is 7.36?1.29mm VS 8.77?2.94mm respective- ly.Significant difference can be found(P＜0.05).Conclusion EUS had significant value in the diagnosis of PHT with EV and GV,and especially in detecting abnormalities of extra-luminal veins.

Objective To study the clinical application value of humidified high flow nasal cannula(HHFNC) on bronchitis in children.Methods Total 85 cases of bronchitis that needed oxygen therapy in our department from Oct 2015 to Feb 2016 were randomly divided into three groups,HHFNC group,NCPAP group and nasal cannula oxygen group(control group).According to the blood gas results,FiO2 was adjusted to maintain PaO2 in 50~70mmHg(1mmHg=0.133kPa),TcSO2 90% to 95%.The main symptoms and signs(wheezing,shortness of breath,three depression sign,wheezing rale) disappeared time,length of oxygen inhalation and stay,the change of PaO2,PaCO2,respiratory rate were compared among the three groups.Results Compared with control group,the clinical symptoms and signs disappeared time and length of oxygen inhalation and stay were significantly shorter in HHFNC group(P<0.05).The recovery of blood gas and respiratory rate in HHFNC group were better than those in control group(P<0.05).No statistically significant differences existed between HHFNC group and NCPAP group(P>0.05).Conclusion HHFNC can significantly improve the clinical symptoms,signs and blood gas results in children with bronchitis,reduce the length of oxygen inhalation and stay.HHFNC is an effective and well-tolerated treatment for bronchitis in children.

Objective To investigate the effect of daurinoline on basilar artery vascular smooth muscle. Methods The tension of isolated basilar artery ring of rabbit was measured. The effects of daurinoline on the basilar artery contracted by methoxamine,5-hydroxytryptamine(5-HT),KCl and Histamine( His)were also examined. Dose-response curves of 5-HT and KCl were observed as well. Results Daurinoline exerted obvious relaxation effect on the basilar artery vascular ring contracted by methoxamine,5-HT,KCl and His in a concentration-dependent manner. IC50 of daurinoline in methoxamine,5-HT,KCl and His-treated rabbits was 8.67×10-5,1.78×10-6,6.79×10-7 and 4.98×10-4 mol·L-1,respectively. The change of concentration-response curves of methoxamine,5-HT,KCl and His showed that daurinoline was a non-competitive antagonist. Conclusion Daurinoline exerts marked relaxation effect on basilar artery of rabbits through non-competitive antagonism. The mechanism of relaxation action may be related to blockage of voltage-dependent or receptor-dependent calcium channels.

Objective: To investigate the effects of three different types of dentin protective membranes (HyC, SBU and S3) on dentin adhesive properties. Methods: Fresh isolated molar teeth were collected, and smooth dentin surface was obtained after embedding, cutting and polishing. In the control group, dentin protective membrane was not applied, while the remaining three groups were coated with three different types of dentin protective membranes, and the preformed resin prosthesis was cemented with resin cement. A strip dentin-resin sample with a cross-sectional area of 0.9 mm×0.9 mm was obtained by a precision cutting machine. The tensile force was tested at the loading speed of 0.5 mm/min with a universal testing machine until the dentin-resin strip was broken. The maximum tensile force during the loading process was automatically recorded by the computer, and the microstructure and fracture mode of the section were observed by a scanning electron microscope. Results: After coating dentin protective membranes, the tensile strength of each experimental group was significantly increased compared with that of the control group (P<0.05), and the tensile strength of group HyC was significantly smaller than that of group SBU and group S3 (P<0.05). The tensile fracture mode shown by microstructure observation was mainly interfacial failure. Conclusion: Different types of dentin protective membranes can increase the adhesive properties between dentin and resin prosthesis. SBU and S3 can improve the adhesion strength more significantly than HyC.

BACKGROUND:Percutaneous vertebroplasty is a minimal y invasive treatment for spinal metastasis tumor, but the mechanism of the injected polymethylmethacrylate (PMMA) bone cement in the treatment of tumor is not ful y understood. OBJECTIVE:To explore the cytotoxicity of PMMA bone cement and its monomers on tumor cel s. METHODS:PMMA extracts in the wire drawing and curing periods and different mass concentrations of monomer dilutions were co-cultured with human lung cancer cel s spc-A1. The cel morphology was observed using inverted microscope, the absorbance (A) values were detected by cel counting kit-8 assay, the relative growth rate was calculated, and the toxicity of PMAA bone cement and its monomers was evaluated at 1 and 3 days of culture, respectively. RESULTS AND CONCLUSION:At 1 day of culture, the absorbance values in the 1 and 10 g/L groups were significantly lower than that in the negative control group (P<0.01). The absorbance values in the 1 g/L, 10 g/L, 100 mg/L and wire drawing extract groups were significantly lower than those in the negative control group at 3 days of culture (P<0.05). The relative growth rate in the 1 and 10 g/L groups was 26%-29%, and the level of toxicity was grade 4 after 1-day culture;at 3 days, the relative growth rate was decreased to 12%-16%, and the level of toxicity was grades 4-5. After 3-day culture, the level of toxicity reached to grade 2 in the 100 mg/L and wire drawing extract groups. These results indicate that PMMA bone cement in wiredrawing period and its monomers exert toxic effects on tumor cels.

Objective To investigate the clinical characteristics of acute pulmonary embolism in the elderly and its differences between the elderly and non-elderly patients,and explore the predictive effect of red blood cell distribution width(RDW)on chronic thromboembolic pulmonary hypertension (CTEPH)in patients with acute pulmonary embolism.Methods A total of 129 consecutive patients with acute pulmonary embolism admitted into Affiliated Hospital of Binzhou Medical College were selected from Jan.2009 to Dec.2013.Clinical data including the basic data,blood routine test,blood gas analysis,Doppler echocardiography during admission were retrospectively analyzed.All the patients were followed-up.Ancillary findings and changes of the disease were recorded in detail during the follow-up period.SPSS 19.0 was used to analyze the results.Results The incidences of CEPPH and venous thromboembolism(VTE)in APE patients were higher in the elderly than in non-elderly.The mean RDW and pulmonary arterial systolic pressure on admission in APE patients were higher in the elderly than in non-elderly [(14.22±2.11)％ vs.(13.48± 1.69)％,P=0.033,for mean RDW] and [(54.82± 21.77)mmHg vs.(42.20 ± 19.36) mmHg,P=0.010 for pulmonary arterial systolic pressure].The mean RDW was higher in CTEPH patients than in patients without CTEPH [(16.79 ± 3.08) ％ vs.(13.68± 1.68)％,P=0.016].Multivariate Logistic analyses showed that the increased RDW level was an independent risk factors for CTEPH in APE patients(OR=1.535,95％ CI:1.094-2.155,P=0.013).The area under receiver operating characteristics curve(AUC)of RDW level for predicting CTEPH in APE patients was 0.856(95％ CI:0.706-0.987,P＜0.001),the corresponding cut-off point was 14.85％,and the sensitivity and specificity were 88.9％ and 87.5％ respectively.Conclusions The increased RDW level could predict the risk of CTEPH to a certain extent in APE patients.

Objective:There are limited data describing the clinical characteristics and prognosis of culture negative pyogenic spondylitis.The aim of this study was to investigate the treatment,prognosis and clinical characteristics of culture negative pyogenic spondylitis.Methods: A retrospective study reviewed 74 patients who were diagnosed with spondylitis in Peking University First Hospital from January 2010 to December 2015.A total of 27 patients suffered from pyogenic spondylitis.According to the pa-thogenic culture results,the patients were divided into two groups: culture negative group and culture positive group.The clinical characteristics and treatment outcomes between the two groups were compared.Results: The elder were more vulnerable to pyogenic spondylitis,and of the 27 patients,12 patients were female and 15 male.All patients had no history of administration of antibiotics prior to obtaining culture samples.A causative germ was identified in 14/27 patients (51.9％) with Staphylococcus aureus being the most common pathogen.There was no significant difference between the two groups in the patient's age,gender,visual analogue score (VAS),predisposing factor,clinical symptom,sign and spinal segment (P>0.05).Erythrocyte sedimentation rate (ESR) (P=0.056) and C-reactive protein (CRP) (P=0.040) of culture negative group were lower in contrast to culture positive group.The incidence of vertebral abscess in culture negative group was higher than in culture positive group (P=0.046).After treatment,ESR dropped almost equally in both groups,and CRP dropped faster in the culture positive group (P=0.192).At last,there was no significant difference between the two groups in hospital stay,pain relief,open debridement operation rate,and recurrence rate of infection.Conclusion: ESR and CRP of the culture negative patient were lower than those of the culture positive patient,and the incidence rate of paravertebral abscess was higher than that of the culture positive patient.After administration of antibiotics,there was no significant difference between the two groups in duration of antibiotics,open debridement operation rate and recurrence rate of infection.So,culture negative may not necessarily be a negative prognostic factor for pyogenic spondylitis.However,we should watch out for the drug resistant bacteria or double infection,due to the long term use of wide-spectrum antibiotic in culture negative patients.

Objective:To observe the effects of moxibustion pretreatment on Glutathione Peroxidase(GSH-Px),Superoxide Dismutase(SOD),and Malondialchehyche(MDA)in gastric mucosa of rats with stress ulcer,and to investigate the mechanism of moxibustion pretreatment preventing the oxidized injury of gastric mucosa.Methods:Forty-eight healthy SD rats were randomly allocated into 4 groups,namely control group,model group,acupoint moxibustion group,and non-acupoint moxibustion group.The ulcer model was developed by restraint and water immersion stress,Ulcer index(UI)was calculated with Guth method,and the contents of GSH-Px,and MDA and SOD activity in the gastric tissues were measured with chromatometry method.Results:Compared those in the model group and nonacupoint moxibustion group,moxibustion at Zusanli(ST 36)could decrease the UI(P<0.01)and MDA(P<0.05)contents,and increase the activity of GSH-Px(P<0.01)and SOD(P<0.05).Conclusion:Pretreatment of moxibustion at Zusanli(ST 36)could promote the recovery of gastric injury in rats induced by restraint and water immersion stress by enhancing the activity of GSH-Px and SOD,and lower MDA content.

Objective To characterize the association between the mean CT value on a scout view and the dependent mA selection method, and to evaluate the clinical value of a mA selection method based on scout view mean CT value in obtaining individualized scan protocol and consistent image quality for patient population on 64-row MSCT CT coronary angiography (CTCA).Methods One hundred patients (group A) underwent CCTA consecutively using standard protocol with a fixed mA.The mean CT value of a fixed ROI (region of interest) from the scout AP view and the CTCA image noise (standard deviation on the root of ascending aorta) were measured.The correlation between CT values and noise was studied establish a formula and a list to determine the required mA for obtaining a consistent CTCA image noise based on the measured SV CT value.Another 100 patients (group B) were scanned using the same parameters as group A except the mA and the CT value was also measured.The mA was determined by the list established previously.The CTCA image quality (IQ) as well as the image noise (IN) and the effective dose (ED) from the two groups were statistically analyzed using t-test.The CT findings for the 32 patients in the group B were also compared with the selective coronary angiography (SCA) results.The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of CCTA for detection of significant stenosis were obtained.Results The formula between the required mA and the CT value was : XmA=FmA×[(K1×CTscout + C1)/INa]2.The CCTA images in B group had statistically higher IN (27.66±2.57,22.22±4.17,t=11.33, P=0.000), but no statistical difference between IQ scores for the two groups (3.29±0.66,3.37±0.67,t=0.009, P=0.990), and ED[(8.72±2.51) versus (12.53±0.90) mSv]was 30% lower for the B group (P<0.01).For the 32 patients in the B group who had SCA, the CCTA sensitivity, specificity, positive predictive value, negative predictive value, and stenosis detection accuracy were 94.92% (56/59), 92.13% (82/89) ,88.89% (56/63) ,96.47% (82/85) and 93.24% (138/148) wspectively for stenosis greater than 50%.Conclusion The mA selection method based on the SV CT value for CCTA in 64-row MSCT provides individualized protocol to obtain consistent image quality and to optimize dose delivery to patients.

Anti-cancer drug bleomycin (BLM) can cause acute lung injury (ALI) which often results in pulmonary fibrosis due to a failure of resolving acute inflammatory response. The aim of this study is to investigate whether toll-like receptor (TLR) 2 mediates BLM-induced ALI, inflammation and fibrosis. BLM-induced dendritic cells (DCs) maturation was analyzed by flow cytometry and cytokine secretion was detected by the ELISA method. The expression and activity of p38 and ERK MAPK were determined with Western blotting. The roles of TLR2 in ALI, inflammation and fibrosis were investigated in C57BL/6 mice administered intratracheally with BLM. The results demonstrated that BLM-administered mice had higher expression of TLR2 (P<0.001) and its signaling molecules. Blocking TLR2 significantly inhibited the maturation of DCs and reversed BLM-stimulated secretion of cytokines in DCs, such as IL-6 (P<0.001), IL-17 (P<0.05) and IL-23 (P<0.05). TLR2 inhibition attenuated BLM-induced increase of inflammatory cells in bronchoalveolar lavage fluid (BALF), and reversed the immunosuppressive microenvironment by enhancing TH1 response (P<0.05) and inhibiting TH2 (P<0.001), Treg (P<0.01) and TH17 (P<0.01) responses. Importantly, blocking TLR2 in vivo significantly protected BLM-administered mice from pulmonary injury, inflammation and fibrosis and subsequently increased BLM-induced animal survival (from 50% to 92%). Therefore, TLR2 is a novel potential target for ALI and pulmonary fibrosis.