Objective To investigate the risk factors of postoperative complications of delayed hemorrhage,perforation and digestive tract stenosis after endoscopic submucosal dissection (ESD).Methods The complete data of 793 patients with digestive tract disease who underwent the endoscopic submucosal dissection in the Department of Digestive Surgery in our hospital from January 2011 to December 2014 were retrospectively analyzed.All of the patients were divided into delayed hemorrhage group (n =67) and nonbleeding group (n =726);perforation group (n =47) and non-perforation group (n =746);and digestive tract stenosis group (n =38) and non-stenosis group (n =755).The clinical basic data,lesion related data,and operation related data were independent risk factor and analyzed by single factor analysis and Logistic multiple factor regression analysis.Results The incidence of delayed bleeding,perforation and stenosis in patients with ESD were 8.45％,5.93％,and 4.79％,respectively.The results of single factor analysis:the risk factors for delayed bleeding were long-term use of anticoagulant drugs,gastric sinus disease,lesion diameter,and lesion excision (P ＜ 0.05).The risk factors for postoperative perforation were the diameter of the lesion and the time of operation (P ＜ 0.05).The risk factors of digestive tract stenosis were the esophageal lesions,the diameter of the lesion,and the depth of the lesion to the intrinsic muscle layer (P ＜ 0.05).The results of multi factor Logistic regression analysis:the risk ranking of risk factors for delayed bleeding was gastric antrum occurrence lesion ＞ lesions graded resection ＞ long-term use of anticoagulants ＞ lesion diameter (≥5 mm).The risk ranking of risk factors for perforation was operation time (≥90 mm) ＞ lesion diameter (≥5 mm).The risk ranking of risk factors for digestive tract stenosis was esophageal lesion ＞ lesion diameter (≥ 5 mm) ＞ lesions depth to the muscularis propria.Conclusions For long-term anticoagulation,gastric antrum and fractional resection lesions of patients should pay attention to delayed bleeding.Patients with long operation time are easy to cause postoperative perforation.For long-term anticoagulation,gastric antrum and fractional resection lesions of patients should pay attention to delayed bleeding.

Objective: Observe the curative effect of basic recipes for removing phlegm and activating blood circulation in experimental model of non-alcoholic fatty liver in rats.Methods: Experimental animal model of non-alcoholic fatty liver in rats were established,then treated with Erchen decoction,TaohongSiwu decoction and the combination decoction.Basic biochemical indexes of rats were tested after treatment.Results: Erchen decoction can reduce the level of liver organ coefficient,cholesterin and aspartate aminotransferase(AST)(P

Group A,the differences among the three groups were statistically significant(P0.05). TCR,CCR,DAP,OD,BRC in Groups B and C showed trends of increasing,the differences in terms of the contents of BMP-RⅠamong the 3 phases were statistically significant(P0.05);the ER in Group B and C showed a trend of decreasing,thee difference between 4- and 8-week and 4- and 12-week were signifieantly dif- ferent(P0.05).Conclusion After application of glucocorticoid for a short term,pathological changes maintained and showed trends of inereasing in early stage.HBO can reverse these changes.The outcome of 3-course HBO therapy is better than that of 1-course therapy.

Chromatography, Gas ; methods ; Chromatography, High Pressure Liquid ; methods ; Humans ; Hypnotics and Sedatives ; blood ; Pentobarbital ; blood ; Pharmaceutical Preparations ; blood ; Sensitivity and Specificity

Hair Cells, Auditory, Inner ; cytology ; Synapses ; physiology ; ultrastructure

Objective To compare the lipid lowing effect and the clinical safety between intensive therapy with Chinese medicine Zhihitai and atorvastntin in patients with moderate and high risk of atherosclerosis. Methods All the patients were randomly divided in to a Zhibitai group (n = 85) receiving 480 mg of Zhibitai orally twice a day or an atorvastatin group (n = 84) receiving 10 mg atorvastatin orally once daily. Blood lipoproteins, myocardial enzymes, fiver and renal function were measured before treatment and at the fourth and eighth week after therapy , while high sensitive creactive protein (hs-CRP), P-selectin, matrix-metall proteinase-9 (MMP-9) and soluble intercellular adhering molecule-1 (SICAM-1) were detected before treatment and eighth week after therapy in all patients. Results TC and LDL-C were significantly decreased while HDL-C was increased in both groups after 4 and 8 weeks treatment (P < 0. 05). TG was decreased in Zhibitai group after 4 and 8 weeks of treatment, but it was decreased in atorvastatin group only after 8 weeks of treatment. Inflammatory factors such as hs-CRP, P-selectin, MMP-9, SICAM-1 were decreased significantly (all P < 0. 01), but there was no significant difference between the two groups. There were no difference in liver and kidney function, myocardial enzymes and incidence of muscle-ache and digestive system side reaction. ConclusionsBesides the lipoprotein disorder, inflammatory factors in patients with moderate and high risk of atherosclerosis could be regulated with intensive therapy of Zhibitai. Most importantly, it is safe to use Zhibitai clinically.

Objective　To discover and discuss the charac ter and statistics of frequency distribution of thyroid volume (TV) in Chinese c hildren aged 8,9,10 years for setting up an effective strategy to control the endemic goiter in China.Methods　The TV is measured by B-ultrasonography.The da ta of a great sample collected from all country are treated with computer centra lly in Chinese Research Center for Endemic Disease Control.Results　①In 1999,the statistics of TV(ml) of children aged 8,9,10 years in China are 3.6 of mean,3.4 of median,3.0 of mode,5.9 of 95% point and 7.9 of 99% point.②The values of 95% point in frequency distribution of TV in 8,9,10 years of boy in order are 4.8,5.6 and 6.3,and in girl they are 5. 2,5.8 and 6.5.③The disparity in medians of TV of children is very significant between the studied provinces;the lowest is Shanghai,the mediums are Anhui and Sh anxi,and the higher ones are Chongqing,Guizhou and Xinjiang,and the medians of the TV in these three categories are 1.2,3.7 and 4.0 in order.④Differential effe cts of palpation method in detection of TV are discussed carefully in this paper .Conclusions　The cause inducing to the significant diffe rences of children TV in several regions in China is not known yet,but it is not the nutritional problem of iodine certainly.

Objective　To observe the characteristics and statistics in the bi-variable distribution of thyroid volume (ml) and urine iodine level (μg/L) of children aged 8,9,10 years in China,1999.Methods　Classing analysis.Results　①Data of 12982 cases collected from all country are analyzed with cluster method and three clusters are delimitated as follows;②in first cluster,according to the calculation of median,the volume of thyroid gland is small (2.2ml) and the level of urinary iodine is high (369.1μg/L);③in second cluster,the volume of thyroid gland is middle size (3.4ml) but the level of urinary iodine is significantly lower (88.0μg/L) than that in the first cluster;④in third cluster,the thyroid volume is highest (4.1ml) and the level of urine iodine is high (363.4μg/L),too;⑤the meanings of the classifying results are discussed in detail.Conclusions　The results of the cluster analysis reported here and the typical analyses of the previous papers suggested that no low iodine problems be found out but the correlation between the increasing of thyroid volume and the higher level of urine iodine be observed by us in the studies.

Objective To investigate the impact of hs-CRP and IVUS on major adverse cardiac event in patients who after coronary artery intermediate lesions stent implantation.Methods 82 patients with clinical diagnosis of coronary heart disease who had a segmental stenosis degree is 40％ ～ 70％ in one major coronary artery on coronary angiography,all of the patients do intravascular ultrasound,patients had minimal lumen area(MLA) of intermediate lesions ≤ 4mm2( the left main coronary artery)or≤ 6mm2( left main coronary artery) who received percutaneous coronary intervention(PCI),and the patients were divided into 2 groups,hs-CRP rise group(≥3mg/L) and hs-CRP normal group(＜3mg/L),compared the rate between the two groups in hospital and follow up periods by typical angina,nonfatal myocardial infarction,cardiac death and target-vessel revascularization and other major adverse cardiac events (MACE).Results The rate on major adverse cardiac event in hs-CRP rise group was significantly higher than the normal group(P ＜0.01 );the restenosis rate in hs-CRP rise group higher than hs-CRP normal group(P ＜0.01 ).Conclusion hs-CRP could predict the rate on major adverse cardiac event in patients with after coronary artery intermediate lesions stent implantation,the patients of hs-CRP rise group should strengthen antiplatelet,anti-inflammatory treatment etc.

Chromatography, Gas ; methods ; Ethanol ; blood ; Humans ; Methanol ; blood