Objective To sum up the trend of changes in symptoms of prolonged symptomatic gastroesophageal reflux(GERD), and discuss the relationship between reflux symptoms and the medical treatment in the elderly patients with GERD. Methods 98 elderly GERD patients over 60 years old were followed up for 5 years through questionaires. The changes of reflux symptoms and effect of medication were analyzed. Results Reflux symptoms were improved in 71 subjects (72.4%), disappeared in 10, worsened in 9, and remained unchanged in 18. The symptom improvement rate of medication group was significantly higher than that of non-medication group(P0.05). In 62 subjects who modified their life styles and diet habits, 53 of them had their symptoms improved (85.5%), and 9 of them had their symptoms unchanged (14.5%). Among 98 patients who underwent endoscopic examination, 44 were found to have erosive esophagitis, and were diagnosed as reflux esophagitis(RE). Although the other 54 subjects complained of typical "heart burn" and regurgitation symptoms, no erosive esophagitis was found with endoscopy, and they were regarded designated as having non-erosive reflux disease(NERD). The symptom improvement rate of NERD group was significantly higher than that of RE group(P

Bronchogenic Cyst ; Humans ; Laryngeal Diseases ; Male ; Middle Aged

China ; Developed Countries ; Insurance, Health ; Occupational Health

Objective Four cases of screen epilepsy were reported Methods Clinical analysis of four cases of TV epilepsy Results Of the four cases, two had the seizures evoked by changing channel of TV set only, one evoked by watching TV, and the other had the seizure triggered by video game. The seizures of two cases showed GTCS, one case showed partial seizure with secondarily generalized seizure, and the other showed partial seizure and absence Conclusion Screen epilepsy may have several seizure types, not only have GTCS but also have partial seizure and absence.

This paper outlines the major animal epidemic emergency management system in the United States, involving the responsibilities of United States Department of Agriculture (USDA), Department of Homeland Security (DHS), and Department of Health and Human Services ( DHHS ) .Besides the main commanding and coordinating departments, the system also involves procedures in surveillance, early warning, preparation, response and ending in case of serious animal emergency.We have also summarized and analyzed the characteristics of the American response mode, such as net-worked laboratories, special corps,budgets and national animal identification systems.

Objective To explore the extent of agreement between measurements of temporal and spatial gait parameters made with portable gait analysis equipment and in the laboratory.Methods Fifteen healthy young people submitted to laboratory gait analysis using 3D motion analysis apparatus and then on the same day to analysis using the Gait Watch portable apparatus.Cadence,stride length,walking speed and step length were recorded.Intraclass correlation coefficients (ICCs) and Bland-Altman plots were used to evaluate the agreement between the two gait analyses.Results Test-retest comparisons with the Gait Watch apparatus generated ICCs for the temporal and spatial parameters ranging between 0.80 and 0.98,indicating good test-retest reliability.Bland-Altman plots comparing the two measurement systems also showed good agreement.According to paired simple t tests,the stride length,walking speed,and step length assessments with the two systems showed significant differences.All exceeded the minimum detection threshold (stride length =0.05 m,walking speed =0.12 m/s,left step length =0.03 m,right step length =0.04 m).Conclusions Measurements of cadence,stride length,walking speed and step length with the two systems yield acceptable agreement,and either can be used in clinical walking assessment.

Objective To investigate the clinical characteristics,surgical indications and methods of children sylvian cistern arachnoid cysts complicated with subdural hematoma.Methods Fifty childhood cases of sylvian cistern arachnoid cyst complicated with subdural hematoma were retrospectively analyzed,who were all surgically treated in the First Affiliated Hospital of China Medical University from July 2005 to August 2015.Among them,20 childhood cases were subacute subdural hematoma,30 childhood cases were chronic subdural hematoma.All patients underwent microscopic cyst excision,cystocistern fenestration plus hematoma removal surgery.During the surgery,firstly we resected the cyst wall tissue as far as possible,and then we communicated the cyst with subarachnoid space and cisterns,which could make the cerebrospinal fluid flowed unobstructedly.Results The course of every operation was smooth,and there was no severe complication postoperatively.Original symptoms and imaging manifestation resolved or improved in all patients.During a mean follow-up period of 5.7 years,there were no recurrent cases.Conclusion Children sylvian cistern arachnoid cyst can induce subdural hematoma.In this situation,microscopic cyst excision,cystocistern fenestration plus hematoma removal surgery is safe and effective.

Objective To estimate the effects of different surgical treatments of giant cell tumor of bone(GCTB) of long bone in children.Methods The effects of surgical treatment of 15 cases suffered from GCTB were observed.The tumors were rated according to the system of Enneking classification,stageⅠwas managed with a curettage combined with local adjuvant treatment and filled by allograft bone or with curettage and filled by cement of bone.StageⅡb was treated by en bloc resection followed by reconstruction with large segment bone of allograft.The follow-up was given in all patients.Results The follow-up period was 7 years(ranged 2-16 years).In all 15 children patients with GCTB,there were 13 children in stageⅠ,9 patients with curettage combined with local adjuvant treatment and allograft bone showed good bone knitting and rehabilitation without deformity and functional problem and locally recurred;4 patients with curettage and filled by cement of bone showed 2 cases locally recurred.Two children in stageⅡb treated by en bloc resection followed by reconstruction with large segment bone of allograft were perfectly incorporated without evidence of obvious immune rejection,collapse,fracture and locally recurred,but the limb-suffered was short about 2 cm.Conclusions Stage Ⅰtreated by a curettage combined with local adjuvant treatment and filled by allograft bone can get good effect,but only treated by a curettage and filled by cement of bone has 50% locally recurred.TheⅡb treated by en bloc resection followed by reconstruction with large segment bone of allograft might influence the limb growth,but without locally recurred.

Background The application of femtosecond laser in the corneal refractive surgery has made great progression recent years,but the morphology characteristic of corneal stroma surface after making-flap of femtosecond laser is closely concerned.Objective This study was to analyze the influence of photodisrnption of femtosecond laser on the corneal stroma surface and to investigate the effect of different laser pulse energy on the sudace ultrastructure of corneal stroma.Methods Corneal flaps were made with Visu Max femtosecond laser in 16 fresh porcine eyes with the pulse energy 125 nJ,155 nJ and 195 nJ respectively,and Moria-M2 microkeratome was used as control.Scanning electron microscopy (S-3400N Hitachi High-Technologies Corp) was used to observe and compare the ultrastructural characteristic of corneal stroma bed surface after making of corneal flap.Results The corneal strnma was evaporated and created a smooth surface when photodisrnption happened in the femtosecond laser group.Residual tissue bridges could been exhibited among the cavitation bubbles under the scanning electron microscope.Corneal strnma surface was smooth in the 125 nJ pulse energy group,but some tissue bridges still were visible.In the 155 nJ pulse energy group,much more smooth surface was seen without tissue bridges and mechanical damages on the corneal surface.However,the surface quality was worse and many tissue bridges and grooves existed in the 195 nJ pulse energy group.In addition,different sizes of slots caused by big cavitation bubbles were visible with the round and oval shape.The edges were regular and sharp with small damage zone after cutting with femtoseeond laser.However,many elevated fibril tissues could be seen on the corneal surface after making of flap with microkeratome.Many crimp and irregularity tissues were found on the surface.Blunt surface and indentations appeared in the cutting edge.Conclusions The mierostrueture of corneal stroma surface is more smoother after making of corneal flap with fentosecond laser in comparison with microkeratome.Pulse energy of 155 nJ is preferably during the making-flap with femtosecond laser.

Studies have shown that women's menopause caused by permanent cessation of ovarian function is closely related to lipid metabolism disorders. Er-xian Decoction has been used in the clinical treatment for gynecological diseases and has a good effect on diseases related to reduced sex hormone function. In this study, metabolomics was performed on bilateral ovariectomized model rats within 12 weeks after modeling to mimic the physiological state of menopausal women in different menopausal stages and Er-xian Decoction dosed model rats. The results of liver oil red O staining sections showed lipid metabolic disorder of bilateral ovariectomized model rats and the regulating effects of Er-xian Decoction. 46 potential biomarkers (6 steroid hormones, 3 sphingolipids, 11 phospholipids and 26 glycerides) in plasma and 32 potential biomarkers (1 steroid hormones, 20 phospholipids and 11 glycerides) in liver were obtained based on lipidomics analysis. Then, we analyzed the differential metabolic pathways and construct the lipid metabolism network significantly regulated by Er-xian Decoction. The results provided valuable information for in-depth understanding of the gradual changes on lipid metabolism disorders under menopausal conditions and the characteristics and mechanisms of compound Er-xian Decoction's regulatory effects. The study complied with the procedures established by the Animal Experiment Ethics Committee of the Institute of Materia Medica, Chinese Academy of Medical Sciences and passed the animal experiment ethics examine (No. 00000918).