Objective: To investigate the effect of urokinase on the expression of Matrix metalloproteinase 9 (MMP-9) in human endothelial cell and its mechanism. Methods: The human umbilical vein endothelial cell cultured in normal condition were divided into five groups: the first group was blank control,the second group was given urokinase,the third,fourth and fifth groups were treated with MEK inhibitor PD98059,NF-?B inhibitor PDTC,and AP-1 inhibitor Curcumin,respectively before urokinase was added in. The expression of MMP- 9 mRNA and protein in all the groups were detected by RT-PCR and Laser-Confocus respectively. Results: The mRNA and protein expression of MMP-9 in the second group were increased obviously,as compared with the first group. Compared with the second group,the mRNA and protein expression of MMP-9 in the third,fourth,and fifth groups were decreased significantly. Conclusion: Urokinase can upregulate the MMP-9 mRNA and protein expression of human endothelial cell. The mechanism is related to the Ras-Raf-MEK1/2-ERK1/2 signal transduction pathway,also to NF-?B and AP-1.

Objective To observe the influences of Yiqi-Humo recipe,A traditional Chinese prescription,on mucosa repair after endoscopic mucosal resction (EMR) and (or) endoscopic submucoal dissection (ESD).Methods 32 patients,who received EMR or ESD,were randomly recurited into a control group with 14 patients (omeprazole) and a experiment group with 18 patients (Yiqi-Humo recipe + omeprazole).Patients of both groups received treatment for a period of 4 weeks.Follow-up endoscopy was performed at 1 and 4 weeks after EMR or ESD,the index of symptom and mucosa signs were evaluated before and after the operation.Results At the 4 weeks after the procedure,the index of pain,pantothenic acid,anorexia,burning sensation in the experiment group [(0± 0.00)、(0± 0.00)、(2 ± 0.11)、(1 ± 0.06)] were lower than those in the control group [(12±0.86)、(6±0.43)、(15 ± 1.07)、(14± 1.00),P＜0.01].The index of hyperemia and edema of the experiment group [(3 ± 0.17)、(3 ± 0.17)] were less than those of the control group [(16± 1.14)、(15 ± 1.07),P＜ 0.01].Conclusion The prescription of Yiqi-Humo recipe promoted mucosa repair significantly after EMR or ESD.

Objective To investigate the prevalence of thyroid dysfunctions in the general population for routine physical examination in Taiyuan area. Methods Blood samples from 8125 individuals in Taiyuan were assayed for thyrotropin, free T 3, free T 4 and antithyroid antibodies. Results The prevalence of overt hyperthyroidism was 1.20%, that of subclinical hyperthyroidism was 0.87%. The prevalence of overt hypothyroidism was 1.03%, that of subclinical hypothyroidism was 0.95%. The prevalences of various thyroid dysfuctions were higher in females than those in males (P

Objective To study the diagnostic value of double-balloon endoscopy (DBE) and capsule endoscopy (CE) for small intestinal bleeding. Methods Overall detection rates of small intestinal bleeding with DBE, CE and the whole alimentary tract barium meal were compared. Positive rates of bleeding detection with DBE and CE were compared within the same patients. Influence of CE on one-procedure rate of DBE was analyzed. Results In 105 cases of small intestine bleeding, DBE detected 24 cases of Crohn's disease, 15 adenocarcinoma, 12 chronic nonspecific inflammation, 10 small intestinal ulcer of unknown reason, 8 entero-mesenchymoma, 8 polypus, 6 vascular deformation hemorrhage, 5 ancylostomiasis, 5 Mechel's diverticula ( including multiple diverticula), 3 lymphoma and 9 of no evident abnormalities. The positive detection rate of DBE is 91.4% (96/105). Disease detection rates of CE and whole alimentary tract barium meal were 75.0% (30/40) and 33.3% (25/75), respectively. The one-procedure rate of DBE is 90% (36/40) based on CE results, but it was only 69. 2% (45/65) according to clinic features and the whole alimentary tract barium meal. Conclusion The main causes of small intestinal bleeding are benign ulcers (including Crohn's disease) and tumor, as well as chronic inflammation. Polyps, vascular deformation, parasitosis, Mechel's diverticulum and lymphoma are the secondary causes.DBE is superior to CE in diagnosis of small intestine bleeding, but CE can increase the one-procedure rate of DBE.

Objective To compare the changes in myocardial fibrosis degree and left ventricular function before versus after percutaneous coronary intervention (PCI) in elderly patients with coronary heart disease (CHD).Methods 121 elderly patients diagnosed as CHD with a single vessel by coronary angiography were enrolled.All patients were treated with PCI guided by thrombolysis in myocardial ischemia (TIMI) grade,symptoms and fractional flow reserve (FFR) comprehensively,and reviewed by coronary angiography after 12 months.The changes in serum concentration of procollagen type Ⅰ (PC I),procollagen type Ⅲ (PC Ⅲ),laminin (LN),hyaluronic acid (HA) and aldosterone (ALD) before versus 3,12 months after PCI were detected by enzyme-linked immunosorbent assay (ELISA).Left ventricular ejection fraction (LVEF),left ventricular enddiastolic diameter (LVEDD),plasma N-terminal pro-B-type brain natriuretic peptide (NT-proBNP) level and 6-minute walk test (6MWD) were assessed before and 3,12 months after PCI.The correlations were analyzed between FFR and serum procollagen type Ⅲ level,between serum PC Ⅲ level and plasma NT-proBNP level,and between serum ALD level and serum levels of PC Ⅰ,PC Ⅲ,LN,HA.Results All patients were treated with PCI successfully.At 12 months after PCI,stenosis with different degree were found in implanted stents or some large vessels in 6 cases by coronary angiography FFR=0.56-0.82).The serum levels of PC Ⅰ,PC Ⅲ,LN,HA,ALD,LVEDD and the plasma levels of NT-pro BNP were lower at 3 months after PCI than at preoperative follow-up (all P＜0.05),but LVEF was higher at 3 months after PCI than at preoperative fellow-up (P＜0.05),and the change trends in above observations were more significantly at 12 months after PCI.Linear correlation analysis showed that there was negative correlation between FFR and PC Ⅲ (r=-0.67,P＜0.01).There were positive correlations between PC Ⅲ and NT-proBNP,between ALD and PCⅠ,PC Ⅲ,LN,HA respectively (r=0.67,0.52,0.55,0.46,0.51,all P＜0.01).Conclusions PCI comprehensively guided by TIMI grade,symptoms and FFR can reduce myocardial fibrosis,improve cardiac function and quality of life in elderly patients with single coronary heart disease.

Objective To observe the morphological changes of pancreatic tissue of thoracic duct ligated rats in fine and ultrastructural levels, and to determine whether lymph block animal model can affect pancreatic islet amyloid polypeptide(PIAP)deposit in rat pancreas. Methods At the 6th month after the operation, some pancreatic tissue sections of 16-month-old experimental rats were embedded in paraffin wax and stained with HE and Congo red;immunohistochemical staining was performed on some frozen sections, which were then observed with light microscope;transmission electron microscope (TEM) specimen preparation and observation were performed on other samples. Results HE and Congo red stained sections showed that the pancreatic glandular lobule space was widened, with significant connective tissue hyperplasia, and fat accumulation when the islet was stained indistinctly or vermeil and tissue space was broadened. The sections with immunohistochemical staining displayed the pancreatic islet as well as the tissues around it were stained into dark brown being positive with PIAP antigen. TEM observation showed the pancreatic glandular interlobule space was widened, while blood vessels and enlarged lymphatic vessels were visible;within widened pancreatic islet interstitial space, a great quantity of lipid droplets and some collagen fibril structures could be seen.Conclusion The ligation of thoracic duct can contribute to pancreatic lymph draining block, lymphagiectasis, connective tissue space and interstitial space widening, fat accumulation, and PIAP deposit in rat pancreas. These structural changes may affect the function of pancreatic islets.

Objective To measure the sizes of patent ductus arteriosus (PDA) by echocardiography,compare the results with those by X-ray angiography(XA),to analysis the correlation of measurements between echocardiography and XA,to explore the value of echocardiography on screening the size of PDA suitable for transcatheter occlusion.Methods One hundred and forty-one participants was included.The parameters of PDA including the length of PDA(PDAL),the aortic side diameter (PDADao) and the pulmonary side diameter of PDA(PDADpa) were measured from the parasternal great artery short-axis view (PSSA) and the suprasternal descending aorta long-axis view(SSLA) of echocardiography and left lateral projection of XA,and the other parameters such as the left ventriclular end-diastolic diameter index (LVEDDI),the main pulmonary artery diameter index(MPADI),the pressure drop of PDA shunt (△P) and the pulmonary artery systolic pressure index(PASPI) were measured by echocardiography.The sizes of PDA from PSSA,SSLA and XA were compared,and the correlations of the sizes of PDA between echocardiography and XA,the correlations between the other parameters by echocardiography and the PDADpa index(PDADIpa) by XA(PDADIpa-XA) and PSSA(PDADIpa-PSSA) were analyzed.Results ①The difference of the sizes of PDA:Between PSSA and SSLA had difference on mersurement of PDA(all P ＜ 0.05),except SSLA had no difference on measurement of PDADao with XA (P ＞0.05),others echocardiography parameters all had difference on measurement of PDA with XA (all P ＜ 0.05).②Correlation:Both PSSA and SSLA had positive correlations with XA (all P ＜0.01).And among these parameters,PDAL by SSLA,PDADao by SSLA and PDADpa by PSSA had better correlations with XA (r =0.92,0.87 and 0.91,respectively,all P ＜0.01).LVEDDI,MPADI and PASPI had positive correlations with PDADIpa (all P ＜0.01),the LVEDDI and MPADI had better correlations with PDADIpa-PSSA(r =0.76,0.72,all P ＜0.01),but the PASPI had a better correlation with PDADIpa-XA(r =0.70,P ＜0.01).PASP had a negative correlation with △P (r =-0.79,P ＜0.01).Conclusions There was difference between the sizes of PDA at different echocardiographic views,PDADpa by PSSA and the PDAL and the PDADao by the SSLA were more close to those parameters by XA.Multiplane views of echocardiography can evaluate all the more accurately the size of PDA and play an important role in guiding transcatheter occlusion of PDA.

Objective To translate the Eating Behavior Scale (EBS) into Chinese and test its reliability and validity. Methods The Chinese Version of the scale (C-EBS) was developed through translation, back-translation, cross-cultural adaption and pre-test. A convenient sample of 100 old people with dementia was investigated with C-EBS to test its reliability and validity. Results The Cronbach′s α, Guttman Spilt and test-retest reliability of C-EBS were 0.842, 0.865 and 0.840, respectively. The I-CVIand S-CVI of C-EBS were 1.00, and the score of C-EBS was negatively correlated to the total score of The Chinese Edinburgh Feeding Evaluation in Dementia scale(C-EdFED) (r = 0.727,P < 0.01). Conclusion The C-EBS is reliable and valid and can be used as a valid tool to measure the eating ability among the old people with dementia in China.

Objective To evaluate the efficacy of biliary tract prosthesis and pancreatic duct stents for advanced periampullary carcinoma. Methods A total of 36 patients were diagnosed as advanced periampullary carcinoma pathologically or clinically, with strictures both in pancreatic and biliary ducts confirmed by imaging. Teflon stents were firstly implanted through endoscopy to the narrowed pancreatic ducts, expansible metal prosthesis were then implanted to the biliary tract. If failed, the metal stents were given through percutaneous transhepatic biliary drainage (PTCD) pathway. Serum levels of liver enzymes, amylase and clinical manifestations were observed before and after operation. Results Teflon stents were successfully implanted into pancreatic ducts in all patients. Metal prostheses into bile ducts were endoscopically implanted in 29 cases, and via PTCD in 7, including 2 cases of Billroth Ⅱ gastrectomy. The levels of liver enzymes significantly decreased (P<0.01) after stents implacement. The levels of amylase (plasma and urine) and lipase increased in 15 cases, but they were corrected to normal levels after adequate treatments. Rates of abdominal pain relieving and diahhrea improvement were 82.4% (28/34) and 88.2% (15/17), respectively. Conclusion The combined implacement of biliary tract prosthesis and pancreatic duct stents is safe and effective in relieving malignant obstruction in periampullary carcinoma.

Objective To investigate the clinic effect of tunnel technique on endoscopic submucosal dissection(ESD)for massive colorectal laterally spreading tumor(LST). Methods A retrospective study was conducted on the data of patients with colorectal large area LST(the shortest diameter>4 cm) undergoing ESD by tunnel technique from January 2015 to June 2016 in Digestive Endoscopy Center of Jiangsu Province Hospital of Traditional Chinese Medicine. The size of resected specimens, operation time, complications, pathology results, the number of en bloc resection and curative resection were analyzed. Results A total of 14 cases were collected, including 7 males and 7 females. The longest diameters of resected specimens were from 4.0 to 7.0 cm with mean size of 5.18 ± 0.49 cm. The operation times were from 40 to 120 min with mean time of 63.57±12.95 min. Intraoperative perforation occurred in 2 cases but no delayed perforation and bleeding occurred. Postoperative pathology showed 1 patient with adenoma hyperplasia with crypt abscess,3 patients with low grade intraepithelial neoplasia,6 patients with high grade intraepithelial neophasia,1 patient with carcinoma in situ, 1 patient with carcinoma in M3, and 2 patients with carcinoma in SM1. The number of cases who received en bloc resection, complete resection, and curative resection were 13, 13, and 13, respectively. Conclusion ESD by tunnel technique is safe and effective in the treatment of colorectal large area LST,which is worth popularizing in clinics.