ObjectiveTo study the relationship between serum-asicites albumin gradient(SAAG) and the portal hypertensive ascites in order to appreciate the value of SAAG on the prediction of esophageal-gastric fundus variceal bleeding.Methods34 patients with cirrhotic ascites were examined with endoscopy.The patients were classified as high-gradient group and low-gradient group by the SAAG value of 11g/L.The relationship between SAAG and esophageal-gastric fundus varices was studied by Pearson correlation analyasis.Among the 34 patients studied,10 patients had esophageal-gastric fundus variceal bleeding and 24 patients had no esophageal-gastric fundus variceal bleeding.ResultsIn the 30 patients classified as high-gradient group,22 patients had esophageal-gastric fundus variceas.In the 4 patients classified as low-gradient group,no patient had esophageal-gastric fundus variceas.The results showed the direct correlation between the level of SAAG and the degree of esophageal-gastric fundus variceas ( r =0.81,P ＜0.01 ).The mean level of SAAG in bleeding group,consisting 10 patients,was (24.18 ±7.36) g/L.The mean level of SAAG in non-bleeding group,consisting 24 patients,was ( 18.19 ± 6.18)g/L.The results showed sig nificant difference between the bleeding group and non-bleeding group(P ＜0.05).ConclusionThere is correlation between the level of SAAG and the portal venous pressure.The level of SAAG is valueable on the prediction of esophageal-gastric fundus variceal bleeding.

Objective To exlpore the effect and safety of endoscopic pneumatic dilation in the treatment of the benign stricture of esophagus and carclia.Methods 35 patients with the benign stricture of esophagus,eardia and anastomosis were treated with painless endoscopic pneumatic balloon dilation.Results The rate of stricture improvement was 100％,and the entire anastomosis diameter was extended over 12 am,at the first time,difficulty in swallowing was obviously relieved.Following up three months,the total effecttive percentage of stricture improvement was 88.6％,and no serious complication occurred in all cases.Conclusion Endoscopic pneumatic balloon dilation is effective and safe to treat the benign stricture of esophagus and cardia

Objective To investigate the factor that related to neoplasm from the clinicopathologic character of gallbladder polyps, and identify the reciprocal effectiveness of these factors. Method Three hundred and forty-seven patients who were underwent operation with gallbladder polypoid lesions were reviewed. Results Logistic regression analysis showed, only 5 parameters were significant for the prediction of neoplastic lesions, including age of the patient (P =0.015), the number of polyps (P=0.018), the maximal diameter (P=0.000), echo property (P=0.000), as well as the position of polyps (P=0.030),of which the maximal diameter was the best one to predict the neoplasm polyps. Further analysis with HOC curve showed that 0.925 cm, the diameter of polyps, was the critical point to calculate the polyp was neoplasm or not. Conclusions Age of the patient , the number of polyps , the maximaldiameter, the position of polyps, and echo property are independent factors in predicting gallbladder neoplastic lesions. The size of the polyps is the most significant one among the factors to predict gallbladder neoplasm with its critical point of 0.925 cm.

Objective To investigate the possible roles of cellular immunosuppression induced by phenotypic and functional changes of peripheral CD4+CD25+ regulatory T cells (Tregs) in the pathogenesis of condylomata acuminata. Methods Three-color flow cytometry was performed to examine the expression of transcription factor Foxp3 in, along with several inhibitory membrane molecules, i.e. cytotoxic T lympho-cyte associated antigen-4 (CTLA-4), glucocorticoid-induced TNF receptor family-related gene (GITR) and programmed death-1 (PD-1) on peripheral CD4+CD25+ T cells from 46 patients with condylomata acuminata and 43 normal human controls. Meanwhile, high purity of CD4+CD25+ T cells were isolated from peripheral blood using imrnunomagnetic beads, and stimulated to produce intracellular suppressor cytokines such as interleukin-10 (IL-10) and transforming growth factor-beta (TGF-beta), which were detected by flow tyro-metric analysis. Results The number of peripheral CD4+CD25+ Foxp3+ Tregs increased significantly in patients with condylomata acuminata than that in the normal controls (7.37% ± 2.43% vs 5.96% ± 2.09%,P ＜ 0.001). The expressions of CTLA-4 and PD-1 were 1.86% ± 1.13% and 2.41% ± 1.12%, respectively,in the patients, which were significantly higher than those in the normal controls(1.36% ± 0.90% and 1.70%± 0.97%, P ＜ 0.05 and 0.01, respectively). The number of TGF-beta-positive CD4+CD25+ T ceils from peripheral blood were increased in patients than that in, the controls (1.57% ± 0.91% vs 0.78% ± 0.24%, P ＜0.001). Conclusions Human papillomavirus infection can induce the activation and proliferation of CD4+CD25+ Tregs, enhance the expression of negative costimulatory molecules and secretion of suppressor cytokines, and inhibit antiviral immune response through multiple mechanisms.

Objective To investigate the therapeutic effect of esomeprazole,a new type 0f proton pump inhibitor(PPI),on patients with reflux esophagitis(RE).Methods 80 cases with RE diagnosed by endoscope were randomly divided into treatmeat group(n=40)and control group(n=40).The treatmeat group was treated with esomeprazole 20 mg bid,compared with the control group famotidine 20mg bid.The two courses of treatment both persisted for four weeks and included mosapride 5mg tid.At the end of therapy,the rate of relief of heartburn,acid reflux and substernal burning symptom,and the total effective rate confirmed by endoscope were recorded.ResuIts The clinical symptoms relief rates were 92.5%in the treatment and 62.5%in the control group raspectively and had obviously statistical difference(P＜0.05).The total effective rate was confirmed by endoscope were 82.5%and 55.0%respectively in two groups(P＜0.05).Conclusion Esomeprazole is a type of effective drug for patients with RE.

Objective To investigate the influence of plasma exchange with acupuncture point injection therapy on liver fibrosis indexes in patients with severe hepatitis. Methods Sixty patients with severe hepatitis were randomly divided into group A with 29 cases receiving plasma replacement and group B of 31 cases receiving astragalus injection at Zusanli point in addition to plasma replacement. Changes of liver fibrosis indexes including serum hyaluronic acid (HA), laminin (LN), collagenⅣ(Ⅳ-C), typeⅢpre-collagen (PCⅢ) were observed, which were compared with those from group C with 30 healthy subjects. Results Before treatment, there was no statistical significance in comparison of liver fibrosis index in group A and B (P>0.05), but all the indexes were higher than those in group C (P<0.001). After treatment, the level of each index in group A and B was down with a more significant change in group B and the comparison of both groups indicated statistical significance (P<0.05 or P <0.001);Compared with those in group C, changes ofⅣ-C, PCⅢin group B showed no significant difference (P>0.05). Conclusion Plasma exchange with astragalus injection at Zusanli point can effectively improve liver fibrosis indexes in patients with severe hepatitis and then improve the prognosis of patients.

ObjectiveTo observe the clinical efficacy of plasmapheresis plus acupoint injection in treating severe hepatitis. MethodSixty patients with severe hepatitis were randomized into a treatment group of 31 cases and a control group of29 cases. The two groups both received plasmapheresis in addition to the comprehensive internal medicine treatment, while thetreatment group simultaneously received acupoint injection withHuang Qi(Radix Astragali) at Zusanli (ST 36). After the intervention, the symptoms, signs, liver function, blood coagulation, and blood ammonia were observed in the two groups.ResultAfter the intervention, the symptoms, signs, and biochemical indexes were significantly improved,and theindexes in the treatment group were significantly different from that in the control group (P<0.05,P<0.01), and the total effective rate of the treatment group was markedly higher than that of the control group (P<0.05).ConclusionPlasmapheresis plus acupoint injection can effectively improve the short-term condition of the patients, enhance therapeutic efficacy, with fewer adverse reactions.

Purpose Recently the incidence of bone and joint degeneration is increased,with the increasing of cardiovascular disease complication.This study aims to utilize realtime three-dimensional echocardiography (RT-3DE) in evaluating left ventricular remodeling index (LVRI),to guide treatment and improve the survival rate.Materials and Methods Fifty-seven cases of healthy volunteers (normal control group) and sixty-seven patients with bone and joint degeneration (research group) were respectively divided into two subgroups according to the age.Both groups underwent conventional echocardiography and RT-3DE.The LVRI,left ventricular end diastolic volume index (LVEDVI),left ventricular mass index (LVMI),left ventricular end systolic volume index (LVESVI) and left ventricular ejection fraction (LVEF) measured by different methods were analyzed,and the differences and correlations between groups and within each group were compared.Results The age of normal control group and research group was not significantly different (P＞0.05).The LVMI and LVRI in research group were significantly higher than those in the normal control group with same age (P＜0.05).The LVEDVI,LVMI and LVRI measured by two-dimensional echocardiography and M-mode echocardiography were higher than those measured by RT-3DE,and the difference was statistically significant (P＜0.05).Bland-Altman agreement analysis showed good agreement of measured LVRI using 2D echocardiography and RT-3DE.Conclusion Patients with bone and joint degeneration have left ventricular remodeling.RT-3DE can accurately assess LVRI with the advantages of convenience and lack of radiation,which can be widely used in clinic.

ObjectiveTo realize the relevance between hypertension and serum uric acid (SUA) in residents in Baise City.MethodsTwenty one thousand,five hundred and eighty eight Baise residents were examined.The body weight,height,waist circumference,hip circumference,blood pressure(BP) were recorded and blood lipidlevels,blood glucoseand serum uric acid (SUA) were tested.The relevance between hypertension and hyperuricemia (HUA) was analyzed by multi-factor variance analysis,x2 test,t test,linear regression and Logistic regression analysis.ResultsHypertension prevalence rate was 31.5％,the frequency of HUA was 12.0％,and 5.8％ residents had both.For patients with both hypertension and HUA,when compared to those with normal serum uric level,their mean diastolic blood pressure(DBP) was(84±10),(72±6) mm Hg res-pectively,there mean systolic blood pressure (SBP) was(151±12),(127±6) mm Hg respectively,and pulse pressure (PP) was (50±12),(37±8) mm Hg respectively.The average BMI of those two groups was (23.9±2.6),(21.7±2.4) kg/m2 respectively.The average TC level was (6.0±1.3),(5.2±1.1)mmol/L respectively,the average TG level was(2.3±2.2),(1.5±0.7) mmol/L respectively,and the average LDL-C level was(3.4±1.3),(3.0±1.1) mmol/L respectively.All these parameters were higher than those people without hypertension or HUA(P＜0.01).However,the situation of HDL-C[ (1.2±0.4),(1.5±0.5)mmol/L] was the opposite (P＜0.01).Regression analysis had shown that age,BMI,waist-hip ratio,SUA,blood glucose,TC,TG,HDL-C and LDL-C were independent risk factors for hypertension,while people with HUA was 3.1 times more when compared to those without HUA.The prevalence rate of HUA in people with hypertension was 2.6 times higher than that of the control group.ConclusionHypertension and HUA are two public health problems that prevalent in the residents in Baise City.Obesity,high blood glucose level and hyperlipidemia are thebasis for the development of hypertension and HUA.Hypertension can be the cause of HUA and verse versa.They may have mutual interactions.The adverse effect of HUA on-cardiovascular system should be taken into consideration clinically.

There were 3 000 Zhuangs,1 102 Miaos, and 1 283 Yaos in Baise City of Guangxi,who were enrolled in this population sampling stratfying survey. Height, weight, blood pressure, fasting blood glucose, and lipids were determined, and compared with those of 2 000 Hans of the same town. The prevalence of hypertension and metablic syndrome in Zhuang inhabitants was high, so were the disorders of glycemia and lipidemia, while in Miao and Yao minorities, the prevalences were comparatively lower. The awareness, treatment, and control of hypertension in these minorities were insufficient.