Reflux esophagitis is considered as a commonly-seen esophageal disease.In recent years,certain advances were archived internationally in researches about its pathogenesis,treatment,complications,etc.This article reviewed advances in researches of reflux esophagitis in the year 2016.

The pathological changes of hallux valgus are diversity, including adduct of metatarsus primus, increasing of the intermetatarsal angle between the first and second metatarsal bones, increasing of hallux valgus angle, dislocation of sesamoides, lost of soft tissue balancing. X-ray is the most important method to measure the pathological changes of hallux valgus. The multiformity of hallus valgus pathological changes makes manner of repairing variety. The main methods include operation on soft tissue, osseous surgery, fusion of joint and figuration of joints. The selection of the surgical methods should be individualization according to the idiographic pathological changes of hallux valgus patients.

BACKGROUND:Deep venous thrombosis has already been recognized as an important serious postoperative complication because it can cause fatal pulmonary embolism and long-term deep venous dysfunction. With the constant development of artificial joint operation and the popularization of such surgery, much attention has been paid to the formation of deep venous thrombosis following artificial joint replacement.OBJECTIVE: To observe the anatomical property of acetabular surrounding arteries and veins, as well as their injury during total hip replacement,so as to explore the cause of deep venous thrombosis in lower limbs following artificial total hip replacement.DESIGN: Single sample observation and before-after self-control.SETTING: Gross anatomy was carried out in the anatomical laboratory of the Medical School of Huzhou Teachers' College; total hip replacement was carried out in the Orthopedic Department, Xinhua Hospital of Zhejiang Traditional Chinese Medicine College.PARTICIPANTS: Pelvic samples were collected from 60 normal adult corpuses (30 from men and 30 from women); meanwhile, 30 patients (18 males and 12 females) received total hip replacement in the Orthopedic Department of Xinhua Hospital, Zhejiang Traditional Chinese Medicine College, between March 2002 and August 2003.METHODS: Gross anatomy was carried out at the anatomical laboratory in the Medical School of Huzhou Teachers' College between March and May 2003. The running course of bilateral external iliac artery and vein, as well as the relationship between the branches of femoral artery and vein and acetabulum were observed on 60 pelvic samples. In order to make the observation easier, 12 o'clock division mode chart of acetabulum was established, that is, a line drawn from anterior superior iliac spine toanterior inferior iliac spine, with the crossing point of its extension line and acetabular edge taken as 12 o'clock, therefore the other points should be arranged clockwise. Totally 30 patients received artificial total hip replacement by acetabular lateral-posterior approach. One week later, bilateral deep venous radiography was performed to observe the state of deep venous thrombosis in lower limbs.MAIN OUTCOME MEASURES: ① The anatomical relationship between the branches of external iliac artery and vein, femoral artery and vein and acetabulum. ② The formation rate of deep venous thrombosis in lower limbs after total hip replacement. ③ Adverse events and side effects.RESULTS: Totally 60 adult normal pelvic samples and other 30 pelvic samples of patients who received total hip replacement remained in the results analysis. ① Anatomical observation of external iliac artery and vein,as well as femoral artery and vein: the branches of femoral artery and vein: Medial and lateral circumflex femoral arteries were found running across acetabulum and entering acetabulum; the safe position for the retractor was from 12 o'clock to 3 o'clock and from 5 o'clock to 9 o'clock. However, 9o'clock to12 o'clock and 3 o'clock to 5 o'clock were taken as fragile regions. ② The incidence of deep venous thrombosis following total hip replacement: Bilateral deep venous radiography was carried out after operation and revealed that 11 patients developed deep venous thrombosis with the incidence of 37%. ③ Adverse events and side effects: Postoperative bleeding of over 1 000 mL occurred in 3 cases. In order to fully expose operative field, the retractor should be used to hold off muscles and other tissues, which contributed to long-term vascular compression and blood flow retardation.CONCLUSION: Artificial total hip replacement is liable to injure the internal wall of acetabular vessels, thereby leading to blood flow retardation and platelet aggregation, and ultimately thrombosis. In addition, the massive bleeding during operation will increase blood mucosity, which also increases the risk for thrombosis. From the mode chart of fragile regions and safe regions, we can deduce that deep venous thrombosis in lower limbs can be reduced.

BACKGROUND: At present, the artificial total hip replacement(THR) is the first choice of the hip joint disease for the old, and the choiceness rate is 84% according to the Harri' s grade, and the therapeutic effect is content. The occurrence rate of the sciatic nerve injury in the THR is reported to be 0.46% in and 0. 08%-9.7% abroad.OBJECTIVE: To study the influencing factors of the sciatic nerve injury in the THR through the anatomical location analysis.DESIGN: Single sample study based on the human anatomical samples.SETTING: Human Anatomy Laboratory in the Medical Department of the Huzhou Normal University.PARTICIPANTS: The study was completed in the Human Anatomy Laboratory in the Medical Department of the Huzhou Normal University from March to May in 2003. There were 56 pelvis samples of the normal human adult cadaver, 27 males and 29 females.METHODS: The origins and the pathways of the sciatic nerves and the relation of the sciatic nerve and the acetabulum were analyzed, and the sciatic nerve injury induced by the clasp and the screw fixation in the THR was measured and analyzed.MAIN OUTCOME MEASURES: The location relation of the sciatic nerve and the acetabulum.RESULTS: The distance between the sciatic nerve and the bottom of the acetabulum was(6.00 ±0. 85) mm on the left and(6.00 ±0. 71) mm on the right. The distance between the sciatic nerve and the edge of the acetabulum was(13.00 ±0. 75) mm on the left and(14.00 ±0.06) mm on the right. The SN circumference on the edge of the acetabulum was(32.00 ± 0. 28) mm on the left and(31.00 ± 0.68) mm on the right. The distance between the bottom of the acetabulum and the greater sciatic foramen was(29.00 ±0. 36)mm on the left and(29.00 ±0.24) mm on the right.CONCLUSION: It is confirmed that the clasp and the screw fixation can be done on the safe region at the 1-3 o' clock and the 5-6 o' clock. The obsolete fracture and dislocation of the acetabulum, the unsuitable clasp location and the unsuitable location of screw fixation may induce the iatrogenic sciatic nerve injury.

Objective　To evaluate the effect of vascular endothelial growth factor (VEGF) on tumor angiogenesis, and its usage in tumor therapy. Methods　The recent literatures about VEGF and angiogenesis were reviewed and analyzed. The advances of VEGF study were summarized. The effects of anti-angiogenesis in tumor biological therapy were introduced.Results　Angiogenesis had been identified as an important factor for promoting tumor growth. VEGF was a basic and pivotal factor in tumor angiogenesis. The anti-angiogenesis treatments aimed at VEGF, including the applications of VEGF inhibitor and gene therapy of adenovirus medium, had got great progress. Conclusion　 VEGF is a leading factor of tumor angiogenesis, the anti-angiogenesis therapy aimed at VEGF has probably provided a new chance to malignant tumor treatment.

Cancer has become a great menace to public health in China.Tumor markers play a unique role in diagnosis and treatment of cancer.However,there lacks a systematic evidence-based guideline in conformity with national conditions on clinical application of tumor markers.Recommendation for the use of the tumor markers in clinical practice will guide the appropriate usage of tumor markers and exhibit profound positive impact on their clinical application in China.

The auther Sum up clinical experience of hospice care and put forward. problem on Hospicecare.

Objective:To investigate the effect of synthetic oligodeoxynucleotide containing CpG motifs (CpG ODN) on antibody production to recombinant hepatitis B surface antigen (rHBsAg) or hepatitis B vaccine respectively. Methods:The antigens were injected into the back leg tibialis anterior(TA) muscle of all the mice (Km breed and Balb/c breed) for two times.The serum anti HBs titers were detected by ELISA.Results:The anti HBs titers of additional CpG ODN groups are obviously higher than those of rHBsAg group or vaccine group alone, the antibody persistent time is some longer. Nevertheless, the anti HBs titers of pure breeding mice are significantly higher than those of non pure breeding mice. Conclusion:CpG ODN has enhanced efficacy for anti HBs production in immunized mice and synergetic effect can be observed in alum adjuvant of hepatitis B vaccine.

OBJECTIVE:To study the effect of Shenfu injection(SFI)on the expression profile of myocardial miRNA in rats with chronic congestive heart failure (referring to heart failure). METHODS:40 rats were randomly divided into sham operation group (normal saline,ip),model group (normal saline,ip),valsartan group (positive control,10 mg/kg,ig) and SFI group (0.75 mL/kg,im),10 in each group. Except for sham operation group,another groups were reduced heart failure. After modeling, rats in other groups received related medicines,once a day. Affymetrix miRNA V4.0 chip technology was conducted to analyze the miRNA expression in myocardial tissue of rats with heart failure after administration for 28 d,and screen the miRNA on common differential expression in myocardial tissue of rats in each group. The miRNA associated with heart failure was analyzed by thresh-old of differential gene expression multiple value greater than or equal to 1.1. Gene Ontology (GO) analysis was used to analyze functional classification and biological signaling pathway of differentially expressed genes. RESULTS:There were totally 29 miR-Nas on common differential expression and 7 miRNAs associated with heart failure (rno-miR-30c-1-3p, rno-miR-125b-5p, rno-miR-133a-5p,rno-miR-199a-5p,rno-miR-221-3p,rno-miR-146a-5p and rno-miR-1-3p). SFI can significantly downregulate the expressions of rno-miR-125b-5p,rno-miR-133a-5p,rno-miR-221-3p,rno-miR-1-3p in myocardial tissue of rats (P<0.05 or P<0.01). Results of GO analysis showed,miRNAs on differential expression were mainly related to signal transduction,cytoplasm and nucleotide binding. CONCLUSIONS:SFI plays the role of anti-heart failure by participating in the downregulation of miRNAs associated with heart failure process and then affecting related signal pathways transduction after the combination of cyto-plasm and nucleotide.

In order to study the factors which affect the synthesis ability of medical students,the investigation was made on 200 junior students and 12 related teachers in Tianjin medical University,the relationship of the factors influencing the cultivation for comprehensive ability of medical students was analyzed by the ISM(Interpretative Structural Modeling),the related countermeasures and suggestions were proposed,and the implementation effect was studied by fuzzy comprehensive evaluation method.The study shows that it is the time to carry out the teaching reform by defining the cultivation goals and perfecting the education systems,and introduce the teaching idea of combing the professional education with professional learning so as to improve the teaching quality,stimulate the students`study and practical enthusiasm for their professional development and attain,the ultimate goals for the effective education of the excellent medical talents and improvement for the students`clinical comprehensive skills and ability.