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.

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 optimize the culture medium for scarless wound healing in outbred fetal Kunming (KM) mice,and to locate and preliminarily analyze the region with active cell proliferation.Methods After 6 pregnant mice were sacrificed at the gestational age of 15 days,a total of 180 skin grafts were obtained from the back of 60 fetal mice,and wounds on the skin grafts were made uniformly with minimally invasive sterile device.Then,these skin grafts with wounds were randomly and equally divided into 6 groups to be treated with high-glucose Dulbecco's modified Eagle's medium (DMEM),DMEM + 5％ fetal bovine serum (FBS),DMEM + 10％ FBS,low-glucose Eagle's minimum essential medium (MEM),MEM + 5％ FBS,and MEM + 10％ FBS for 3 days,respectively.Then,these skin grafts were embedded in optimal cutting temperature (OCT) compound,and subjected to hematoxylin and eosin (HE) staining to select the optimal culture condition for wound healing.Under the optimal culture condition,the region with active cell proliferation was located by labeling and tracking cutaneous stem cells with 5-ethynyl-2-deoxyuridine (EdU),and activator protein-1 (AP-1) expression was detected by immunofluorescent staining.Results After 3-day cultivation,wound healing rates significantly differed among the DMEM group,DMEM + 5％ FBS group,DMEM + 10％ FBS group,MEM group,MEM + 5％ FBS group and MEM + 10％ FBS group (0,3.33％,6.67％,3.33％,46.67％ and 26.67％,respectively,x2 =41.39,P ＜ 0.05).Additionally,the MEM + 5％ FBS group showed a significantly higher wound healing rate than the other groups except the MEM + 10％ FBS group (all P ＜ 0.01).Logistic regression analysis showed that the type of basal medium (MEM:OR =11.717,95％ CI:3.274-41.934,P ＜ 0.001) and FBS concentrations (5％ FBS:OR =24.625,95％ CI:3.027-200.299,P =0.003;10％ FBS:OR =13.449,95％ CI:1.618-111.813,P =0.016) were factors influencing fetal wound healing.Under the culture condition of 5％ FBS + MEM,the dermis and epidermis healed well without epidermal thickening.The cutaneous stem cell labeling technique showed that the papillary dermis and basal layer of the epidermis were the two major regions with active cell proliferation in the wound of fetal mouse skin.Moreover,AP-1 was expressed abundantly in these two regions as well.Conclusions The culture condition of 5％ FBS + MEM is considered to be optimal for in vitro wound healing in fetal mice.The papillary dermis and basal layer of the epidermis are two major regions with active cell proliferation during wound healing in fetal mouse skin,and play important roles in wound healing process.

Objective To explore the correlation between the length of peristaltic break (LPB) and the severity of the symptoms in patients with non-erosive reflux disease (NERD) and negative pH monitoring.Methods A total of 35 patients with NERD and negative pH monitoring were enrolled,and at same time 10 healthy individuals were selected as controls.The LPB of esophageal body of both groups was measured by high resolution manometry (HRM).Meanwhile,the symptom of NERD patients with negative pH monitoring was scored.The LPB of esophageal body between the two groups was compared by t test.The correlation between the LPB and the severity of the symptoms in NERD patients with negative pH monitoring was analyzed by Pearson correlation analysis.Results The average LPB of esophageal body of NERD patients with negative pH monitoring was (3.3±0.9)cm,which was longer than that of healthy controls ((1.2 ± 0.4) cm),and the difference was statistically significant (t=9.17,P＜0.01).The symptom score of NERD patients with negative pH monitoring was 21.6± 7.8.There was a positive correlation between the LPB and NERD symptom score (r=0.894,P＜ 0.01).Conclusion The LPB of esophageal body is a kind of expression of esophageal motility dysfunction,which is correlated with the symptom of NERD.

Toassesstheeffectofpuerarinintreatingischemiacardiacdisease ,sixtycoronaryheartdisease(CHD) patientswith myocardialischemiawererandomlydividedinto 2 groups.Pueraringroup (30cases)wastreatedwithpuerarinpluswesternmedicine andcontrolgroup (30cases)withwesternmedicinealone .Thechangesofthetotalischemiaburden (TIB) ,ventricularpremature beat (VPB) ,heartrateandsystolicpressurelevelswereobservedbeforeandaftertreatmeat.Aftertreatmentwithpuerarinthe scoresofTIBlevelsweresignificantlydecreased (P 0 .0 5 ) .Thescoresofventricularprematurebeatlevelsweresignificantlydecreased (P

24 patients suffering from tertian malaria were treated with 600 mg of artesunate tablet as a total dose in a 5-day course. The result showed that all patients were clinically cured with symptoms and signs subsided quickly. Defervescence and parasite clearance times were 19. 9?15.8 and 56. 8?17. 4 hours respectively. The recrudescent rate was 54.2％ within 28 days.

Objective To explore the relationship between aural pre-attentive processing and non-rapid eye movement(NREM) sleep interictal epileptiform discharge (IED) in children with benign childhood epilepsy with central-temporal spikes (BECTS),in order to provide objective electrophysiological basis for early assessment of cognitive function lesion of BECTS children and intervention.Methods Twenty-nine children diagnosed as BECTS in the Second Affiliated Hospital of Xinxiang Medical University from February 2012 to November 2015 were selected,including 17 males and 12 females,and they were 4-14 years old with average age of (9.17 ±2.42) years,and the course of disease was 0.5-4.0 years.Twenty healthy children who had hospital routine check-up were selected as healthy control group,containing 14 males and 6 females,and they were 5-13 years old with average age of (8.55 ±3.09) years.Mismatch negativity (MMN) test was carried out in both groups,and the MMN amplitudes and latencies were analyzed.The long-term video electroencephalogram (VEEG) monitoring was conducted in the BECTS group to analyze the discharge phases (waking,sleep),locations and the IED indexes.The intergroup MMN indexes and the correlation between MMN and VEEG in the BECTS group were compared.Results The VEEG showed that the sleep structure of BECTS children did not change obviously.All children's epileptiform discharges were located in the Rolandic area,including 11 cases on the left side,8 cases on the right side,and 10 cases on both sides.Epilepsy discharge time:17 patients showed epileptiform discharges in sleep stages only and 12 patients showed epileptiform discharge in both sleep and waking stages.Epileptiform discharges of the 12 patients increased more significantly in sleep stage than thatin waking stage [(40.24 ± 25.15) times/min vs.(1.92 ± 1.38) times/rmin],and the difference was statistically significant (t =5.270,P =0.000).The sample IED index in stage 1 and 2 of NREM was (40.73 ± 10.69) times/min,in which 2 cases had IED indexes ＜ 5 times/min,the IED indexes of 3 cases ＞ 80 times/min who reached electrical status epilepticus during sleep,and others were 17.2-64.6 times/min.Clinical seizures in sleep stages were monitored in only 4 cases,which showed an electro-clinical segregation phenomenon from large quantities of sleep IED.The MMN amplitude was lower in the BECTS group than that in the healthy control group [(6.06 ± 1.89) μV vs.(7.28 ±1.64) μV],and the difference was statistically significant (t =2.346,P =0.025).Latency of BECTS group was longer than that in the healthy control group [(191.37 ±40.13) ms vs.(179.35 ±39.80) ms],but the difference was not statistically significant(t =1.037,P =0.355).Correlation analysis showed that the MMN amplitude was negatively related to discharge phases (r =-0.407,P ＜ 0.05) and the IED indexes (r =-0.644,P ＜ 0.01),and latency was positively related to the IED indexes (r =0.386,P ＜ 0.05),while the other VEEG indexes were not correlated with MMN.Conclusions The BECTS children have aural pre-attentive processing disturbance,especially unconscious automatic processing ability impairment,which weakenattention switch action of automatic processing switching to focused attention processing and fail to filter irrelevant information effectively.Sleep IED is an important factor in impairing the formation and reinforcement of acoustic discrimination and memory trace,interfering the acquisition,processing,storage and matching of new information,which induces children pre-attentive processing disturbance.The MMN may discover the electrophysiological changes of children pre-attentive processing disturbance in early stage.

Objective To explore the dynamic changes of serum S100B and glial fibrillary acidic protein (GFAP) levels and their clinical significance in patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP).Methods By means of enzyme-linked immunno-sorbent assay (ELISA),the serum S100B and GFAP levels from 33 DEACMP patients were assayed,and the condition changes were analyzed with three types of scale:the activity of daily living scale ( ADL),information-memory-concentration test (IMCT) and Hasegawa' s dementia scale(HDS).The comparison with 32 patients of acute carbon monoxide poisoning without DEACMP was also conducted.Results (1) The serum S100B( (0.60 ±0.21)ng/ml) and GFAP( (226.58 ±90.05 )ng/ml) in DEACMP group at acute stage were significantly higher than those in acute-CO-poisoning group ( (0.50 ± 0.20) ng/ml,( 183.04 ± 73.01 ) ng/ml) and those in DEACMP group at convalescent stage ( (0.51 ±0.16) ng/ml,(183.25 ±81.76)ng/ml) (all P values ＜0.05).(2)In DEACMP group,the serum S100B and GFAP at acute and convalescent stages were significantly correlated (at acute stage:r=0.466,P=0.006; at convalescent stage:r=0.365,P=0.037 ).(3)The S100B and GFAP in ineffective DEACMP patients at acute stage were significantly higher than those in the other groups ( all P values ＜ 0.05 ).(4) In DEACMP group,the ADL,HDS and IMCT scores( (45.21 ± 9.69),(8.26 ± 6.31 ),(9.91 ± 7.52) ) at acute stage were significantly different from those at convalescent stages( (33.67 ± 13.62),( 15.91 ± 10.83),( 19.06 ± 10.37 ) ) ( all P values ＜0.01 ).Conclusion There is secondary brain insult (SBI) in DEACMP; glial activation may play an important role.The S100B and GFAP levels may be associated with the prognosis of DEACMP.

Objective To observe the changes of brainstem auditory evoked potential (BAEP) and lower limb short latency somatosensory evoked potential ( SLSEP) in acute carbon monoxide poisoning patients and explore the predictive value of BAEP and SLSEP for delayed encephalopathy after acute carbon monoxide poisoning (DEACMP). Methods Sixty-six acute CO poisoning patients was divided into a DEACMP group and a non-DEACMP group according to their symptoms. At the same time, 60 healthy subjects were included in the control group. BAEP and lower limb SLSEP dynamic testing were conducted at different time points. Results The abnormal rates in the first test of BAEP and lower limb SLSEP in the acute CO poisoning patients were 31.8% and 68.2% respectively.The BAEP results in the acute stage and later in the DEACMP group were comparable to those of the non-DEACMP group and the normal control group. Interpeak latency of Ⅰ-Ⅲ was not significantly different, but the remaining indices were significantly longer. Compared to the control group, the lower limb SLSEP readings in the acute DEACMP group and the non-DEACMP group were significantly longer. Compared to the non-DEACMP group and the control group, the SLSEP results of the DEACMP group were significantly extended. The specificity index of the BAEP predicted DEACMP up to 85.7% , significantly more than SLSEP testing. Conclusions Early detection of BAEP can help predict DEACMP. This finding should be promulgated and applied.

OBJECTIVETo screen the allergens in patients with allergic rhinitis (AR) in Yibin, Zhaotong and some areas of the Changjiang River, and to study the distribution characteristics of inhaled allergens. METHODSThe clinical data of 661 patients with allergic rhinitis who diagnosed by skin prick test from March 2013 to June 2015 in the First people's Hospital of Yibin City were studied.RESULTSIn 661 patients, the top 5 allergens and their positive rates of skin prick test were Dermatophagoides farinae (76.5%), house dust mites (72.01%), Roach (35.85%), cat hair (11.35%) and dog hair (8.62%) respectively. There were no statistical difference of the positive rates of allergens among different seasons (χ2=4.568, 0.206). With the increasing age of the patients, the positive rate of allergens was decreased. CONCLUSION The dominated allergens in patients with AR are dust mites, house dust mites and cockroaches in Yibin, Zhaotong and and some areas of the Changjiang River. The prevention and control of AR in children should be toke more attention.