One hundred and eighty two outpatients with functional dyspepsia (FD)were enrolled.The cognitive questionnaire and the short form Nepean Dyspepsia Index (NDI) were used for survey.Spearman analysis showed that the cognitions of symptoms affected by emotion (r =0.284,P =0.006),somatisation symptoms induced by other diseases (r =0.211,P =0.045),and fears of cancer (r =0.217,P =0.039) were positively correlated with NDI scores.Multiple linear regression analysis demonstrated that cognition of symptoms affected by emotion (β =3.709,P =0.009),somatisation symptoms induced by other diseases (β =3.259,P =0.020),need of hospitalization (β =4.533,P =0.006),and need of medication for several years (fβ =-3.207,P =0.029) were associated with NDI scores.These results suggest that the quality of life might be effected by cognitive factors,and the correction of cognitive mistakes may improve quality of life of FD patients.

Objective To investigate the influence of duodenal diverticula on cannulation time and complication in patients undergoing ERCP.Methods Data of 3 265 patients undergoing ERCP in Drum Tower Hospital affiliated to Nanjing Medical University between January 1,2008 and December 31,2014 were enrolled.The patients' information and endoscopic pictures/videos were collected.The duodenal diverticula,cannulation time,postoperative complications were analyzed.Results There were 2 599 (79.6％) cases of non-diverticula,445(13.6％) cases of one-diverticula,122(3.7％) patients with two or more diverticula,and 99 (3.0％) intradiverticular papilla.Patients with duodenal diverticula accounted for 20.4％ (666/3 265) of all patients who received ERCP procedure.The mean cannulation time was 6.62 minutes in all cases,6.30 minutes in non-diverticula group,7.63 minutes in one-diverticula group,8.07 minutes in two-or-more group,8.58 minutes in intradiverticular papilla group,respectively.There were significant differences in cannulation time and complication rate between the groups.Conclusion Duodenal diverticula may be one of the factors that affect the cannulation time.It may enhance the cannulation complications and prolong the cannulation time,especially in those with intradiverticular papilla.

Objective To explore somatic symptoms of patients with functional dyspepsia (FD) and effects of combined anti somatisation therapy on the quality of life in patients with FD.Methods Two hundred and nineteen patients with FD were enrolled.Patient Health Questionnaire-15 (PHQ-15) and Nepean Dyspepsia Index (NDI) were completed,and the relation between them was analyzed.Lansoprazole,mosapride and flupentixol melitracen (the anti-somatisation medication) were taken for four weeks by 131 FD patients who had poor response to four-week conventional treatment with proton pump inhibitors (PPI) and/or prokinetic medication and who got more than 4 scores in PHQ 15.And then therapeutic effects were observed and the changes of NDI before and after treatment were analyzed.The t test,chi-square test,Spearman's correlation and linear regression were performed for statistical analysis.Results The total PHQ-15 and NDI score of 219 patients with FD were 5.7±3.4 and 42.0± 10.4,and there was positive correlation between them (r=0.493,P＜0.05).Stomach pain,headache,chest pain,dizziness,shortness of breath,fatigue,sleeping disorder,thirst and so on were positively correlated with totalNDIscore (r=0.262,0.230,0.241,0.243,0.352,0.385,0.266,0.281,all P＜0.05).Chest pain,stomach pain,shortness of breath,dizziness and fatigue were the influence factors of NDI (t=2.340,2.488,5.278,2.167,2.443,all P＜0.05).Among 131 patients with FD who received anti somatisation combination therapy,six patients did not complete the therapy because of the side effects,and finally 125 patients were enrolled and analyzed.Before and four weeks after the treatment,the total PHQ-15 scores of 125 patients with FD were 7.3±3.2 and 2.9±2.2,respectively; and the difference was statistically significant (t =12.653,P＜0.01).There were significant differences in the influence of stomach pain,headache,chest pain,dizziness,shortness of breath,fatigue,sleeping disorder and thirst before and after the treatment (not bothered at all,bothered a little,bothered a lot) (x2=39.231,6.796,6.693,15.520,6.698,51.572,44.390 and 16.506,all P＜0.05).The total NDI score before and after the treatment were 44.3 ± 11.7 and 29.2 ± 6.9,and the difference was statistically significant (t=12.503,P＜0.01).Conclusions The quality of life in patients with FD is affected by somatic symptoms such as chest pain,stomach pain,shortness of breath,dizziness,fatigue and so on.For FD patients with poor response to conventional treatment,the quality of life could be improved by the combination of anti-somatisation therapy and the conventional therapy.

Objective To identify the expression of PTEN ,vascular endothelial growth factor(VEGF)and (matrix) metalloproteinase 9(MMP-9) in gastric carcinoma and its relationship to the biological behavior of (gastric) carcinoma. Methods The expression of PTEN ,VEGF and MMP-9 in 71 cases of gastric carcinoma tissue and 37 cases of gastric mucosa distant from carcinoma were detected by streptavidin peroxidase (immunohistochemistry). Results The expression of PTEN in gastric carcinoma tissues(71.8%) was (significantly) lower than its expression in gastric mucosa distant from carcinoma(100%)(P0.05).The expression of VEGF in gastric carcinoma(62.5%) was sigificantly higher than in gastric mucosa distant from carcinoma(29.7%)(P0.05).The expression of MMP-9 in gastric (carcinoma)(69%) was significantly higer than in gastric mucosa distant form carcinoma(40.5%)(P0.05).The expression of PTEN in gastric carcinoma was inversely correlated with expression of VEGF and MMP-9(P

Objective To compare the effects and complications of lumboperitoneal shunt ( LP ) and ventriculoperitoneal shunt ( VP ) in the treatment of post?traumatic hydrocephalus. Methods Eighty patients with post?traumatic hydrocephalus treated in the neurosurgery department of Zhangjiagang Hospital of Traditional Chinese Medicine from March 2014 to March 2010 were retrospectively analyzed. The patients were randomly divided into two groups,40 patients treated with LP were assigned into the LP group and 40 patients undergone VP treatment were seen as the VP group. All patients were followed up for 1 year to investigate and compare the symptom improvement rate,neurological deficit score and the incidence of complication of the two groups. Results The total effective rate of hydrocephalus disappearance in the LP group was 41. 50% ( 37/40) and 87. 50%( 35/40) in the VP group. The difference between the two groups was not statistically significant (χ2=0. 556,P=0. 456);the neurological deficit scores before treatment in the LP group and VP group were (28. 35±8. 64) points and (29. 13±7. 98) points,there was no significant difference between the two groups (t=0. 419,P=0. 676) . The difference in the scores of neurological deficit after treatment in the LP and VP group was not statistically significant ( (19. 32±5. 34) points vs. (21. 62±4. 86) points,t=1. 480,P=0. 143),the average scores of neurological deficits in the two groups were significantly better than those before treatment ( t=5. 623, 5. 084,P<0. 001 ) . There was no significant difference in the average score of improvement of urinary incontinence between the two groups before and after treatment ( t=0. 376,1. 265,P>0. 05) ,the average score of urinary incontinence improvement after treatment in both groups were better than those before treatment ( t=4. 891,5. 370,P<0. 001) . In the LP group,the incidence of bleeding,infection,shunt related complications and shunt abnormality were all 2. 50% ( 1/40 ) , the overall complication rate was 10. 00%, the incidence of bleeding,infection,shunt related complications and shunt abnormality in the VP group were 7. 50% (3/40), 10% ( 4/40 ) , 5% ( 2/40 ) 10%, ( 4/40 ) , the overall complication rate was 32. 50%, there was significant difference between the two groups (χ2=6. 050,P=0. 014) . Conclusion LP and VP have significant curative effect on the treatment of post?traumatic hydrocephalus,but the overall incidence of LP complication after 1 year is significantly lower than that of VP,and is worth popularizing widely in clinical practice

The endophytic bacteria of the mangroves were studied in this paper. The results show that there are 1.728 (0. 195 -4.225)?104cfu/g (fw) bacterial endophytes in the variety of mangroves, the most population of the endophytic bacteria was found in Rhizophora stylosa, the figure was4. 225?104cfu/g (fw) , the next was Bruguiera gymnorrhiza, Aegiceras corniculatum, Kandelia candel and Avicennia marina. In parts of the mangroves, the contents of the bacteria in stem was the most, the figure was 1. 649?10 cfu/g (fw) , then the root and the leaf. Of the bacteria, about 43. 53% strains expressed the antagonism against the growth of the plant pathogens, such as Fusarium oxyspontm f. sp. cubense , Colletotrichum sp. and Rahtonia solanaceance etc. and these bacteria were identified as Bacillus sp. . The results also showed that 9 of the 13 strains (69. 23% ) could promote the growth of the tomato, while 4 strains (30. 77% ) restrained the tomato's growth.

A 2,4 -dichlorophenol degrading Pseudomonas strain GI241-1 was isolated from a soil sample. The dienelactone hydrolase gene, designated as dcpD which encodes dienelactone hydrolase involved in transforming cis-2-chloro-dienelactone into 2-chloromaleylacetic acid, was cloned from this bacterium strain. The gene cloning strategy was to construct genomic library after location of its neighbouring gene by Southem blot and to screen the aim transformant by dot blotting. Sequencing results showed that length of dcpD is 702bp. The sequence of dcpD and the deduced amino acid are different from the relative sequences registered in the GenBank.

Emergency medicine and critical care medicine are the new contents in standardized training of residency.The system of standardized training residency lacks for a traditional way to refer.According to the characteristic of the subjects and the practical situation,this paper discusses the methods of training in studying basic theory,idea education,improving technology and strain capability on improving the capability of standardized training residency in internal intensive medicine.

Objective To investigate the effects of early rehabilitative training program on patients with acute myocardial infarction(AMI).Methods One hundred and twenty-two patients with AMI were randomly divided into early rehabilitation group(n=62)and control group(n=60).In addition to routine treatment,patients in rehabilitation group received early rehabilitative training mainly by walking exercise for two weeks.Results There were no significant differences in ventricular arrhythmia(Lown≥Ⅲ), extension of infarction and heart rate variability(HRV)between the two groups(P＞0.05).Forty of 62 patients(64.5%)in rehabilitation group had their left ventricular ejection fraction(LVEF)more than or equal to 50% in the 3~(rd)～4~(th)week after admission,significantly higher than that in control group(45.0%, 27/60 ;P＜0.01 ).By the end of the 4~(th)week after admission,25.8% of the patients in rehabilitation group showed positive in treadmill test,significantly lower than that in control group(38.3%,P＜0.01). Occurrence of angina pectoris and reinfarction and fatality in rehabilitation group were significantly lower than those in control group(P＜0.05)during their hospitalization and follow-up period.Patients in rehabilitation group stayed at hospital for(16?3)days in average,significantly less than that in control group[(27?4) days],with statistically significant difference(P＜0.05).Conclusion Early rehabilitative training for patients with uncomplicated AMI is not only safe and feasible,but also useful in improvement for their prognosis and quality of life.

The performance evaluation is an effective method to guide the public hospitals behavior and pro-mote their sustainable development.The introduction of disease severity could make the performance evaluation sys-tem more scientific and reasonable, and encourage the hospitals to improve their technical skills and services ability. Based on the Shanghai diagnosis related groups system, a case-mix index ( CMI) was introduced and a severity score of disease was developed after the relative weight ( RW) adjustment to evaluate different types of disease severity in hospitals.The results have shown that CMI effectively reflects the patients'disease severity and the intensity of treat-ment in those hospitals taken into consideration.Therefore, the scientific indicators should be selected and the evalu-ation system should be improved thereby establishing an effective monitoring and dynamic adjustment mechanism and further developing the diagnosis related group application.