ObjectiveTo use the rapid screening of low vision and cataract of Zhangjiakou agricultural region by free pupil hole bottom digital camera,to approach cataract needed operation and rural cataract of Zhangjiakou by free pupil hole bottom digital camera.MethodsTo screening of low vision and cataract of above 55 years the crowd of Zhangjiakou 10 suburban county.ResultsThe actual screening 438000 persons,lower visual acuity 41787persons,total number of screening 9.5％,binocular parallax 22305 persons,total number of screening 5.09％,All of the low number of total vision 64092 persons( 14.6％ ).The screening was also found,cataract 12439 persons,total number of screening 2.74％,cataract needed operation 4623 persons,total number of screening 1.06％.ConclusionUsing non-mydriatic fundus digital camera Zhangjiakou agricultural regions of low visual acuity and cataract rapid screening was feasible,Zhangjiakou agricultural area cataract prevention should focus on Zhangbei,Hong Bao,Shangyi County in a remote mountainous area,Zhangjiakou agricultural areas to establish an information sharing,efficient operation of multiple departments linkage mechanism.

Objective To investigate the expression of E26 transformation-specific-1 (E26ts-1),matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in choroidal melanoma and the correlation with the tumor′s infiltration and metastasis. Methods Immunohistochemistry was used to detect the expression of E26ts-1,MMP-1and TIMP-1 in 78 cases of choroidal melanoma who were divided into shuttle-cells,paraepithelial-cells and mixed-cells type according to the configuration of tumor cells.The patients were followed up and their average existing time was calculated.The results were statistically computed with statistic SPSS 10.0 package. Results In the 78 cases,shuttle-cells type was found in 21,paraepithelial-cells type in 34,and mixed-cells type in 23. Expression of TIMP-1was low in uveal melanoma,while expression of E26ts-1 and MMP-1 was obviously found in the three types of choroidal melanoma;the sequence of expression intensity was shuttle-cells,mixed-cells and paraepithelial-cells type.Among 37 cases who had been followed up,the shuttle-cells type was in 18 with the average existing time of (78.33?24.69) months,the mixed-cells type was in 10 with the average existing time of (61.44?20.46) months,and the paraepithelial-cells type was in 9 with the average existing time of (36.76?12.19) months.The existing time was negative correlated with the intensity of expresion of E26ts-1 and MMP-1. Conclusion The high expression of E26ts-1 and MMP-1and low expression of TIMP-1may relate to the choroidal melanoma′s infiltration and metastasis.

Objective To investigate the clinical characteristics of fundic gland polyps (FGPs).Methods Data of patients with FGPs diagnosed from January 2005 to May 2010 were collected and retrospectively analyzed.Results A total of 485 patients were found to have FGPs during routine upper endoscopy,accounting for 0.6％ of total upper endoscopy examinations at the same time period.It was most frequently seen in middle aged females.Clinical symptoms included abdominal distention and discomfort ( 182/485,37.5％ ),gastroesophageal reflux symptoms ( 83/485,17.1％ ) and upper abdominal pain (102/485,21.0％ ).51.3％ (249) of the polyps were located at fundus and 168 (34.6％ ) were at corpus,with most of FGPs (62.3％,302/485) were single polyp with broad base (less than 5mm),and 22.7％ (110/485 ) were multiple ones scattering throughout the fundus.The pathology typically showed cystic lesions in the fundic glands,with dysplasia in 8 and intestinal metaplasia in 3,accompanied by duodenal polyps in 11 and gastric cancer in 1.H.pyloriinfection was detected in 47.8 ％ subjects which was similar to the rate of general population (56.1％ ) in the same period (P =0.422 ).In addition,immunohistochemisty staining for adenomatous polyposis coli and cyclooxygenase-2 was performed in 12 patients,which showed all polyps were positive for adenomatous polyposis coli and 9 of them were cyclooxygenase-2 positive.Conclusion FGPs may not be correlate to H.pyloriinfection.It can be accompanied by dysplasia,intestinal metaplasia and duodenal polyps.Pathological and immunohistochemical studies may promote a better understanding and standardized diagnosis and treatment for this disease.

Objective To investigate the effects of peroral endoscopic myotomy (POEM) on esophageal dynamics in patients with achalasia (AC) and appraise the role of high resolution manometry (HRM)in assessment of POEM therapy.Methods From July 2011 to September 2012,20 patients with achalasia underwent POEM in the department of gastroenterology,Tianjin Medical University General Hospital.Preoperation esophageal dynamics of all the patients were evaluated by high resolution manometry (HRM) system and one month after POEM operation the test was repeated.Data of lower esophageal sphincter (LES)and esophageal body were analyzed,with 15 healthy volunteers as a contrast study.Results Mter POEM,the LES pressure (LESP) and 4-second integrated relaxation pressure (4sIRP) significantly decreased:LESP [pre-operation (24.5 ± 13.1) mm Hg vs.post-operation (8.5 ± 3.1) mm Hg,P ＜ 0.05] ; 4sIRP [pre-operation (20.7 ± 6.8) mm Hg vs.post-operation (5.0 ± 3.4) mm Hg,P ＜ 0.05].The LES relax rate (LESRR) significantly elevated [pre-operation (12.7 ± 9.8) ％ vs.post-operation (39.6 ± 18.1) ％,P ＜ 0.05].However,the esophageal aperistalsis remained after POEM.The total of 20 patiems were all type Ⅰ achalasia and responded well to POEM therapy.Post-operation data on the symptom scores markedly decreased and a significant correlation was found between the decreasing level of symptom scores and LESP,as well as the scores 4sIRP in the 20 patients (LESP:r =0.751,P ＜ 0.05 ; 4sIRP:r =0.500,P ＜ 0.05).Conclusion POEM can significantly improve esophageal dynamics in patients with achalasia and the treatment outcome is definite.HRM plays an important role in evaluation of POEM therapy on achalasia.

Objective To evaluate the effectiveness of M2A capsule endoscopy in the diagnosis of obscure gastrointestinal bleeding of elder patients. Methods Capsule endoscopy was used in 27 elderly patients, who were suspected of small bowel bleeding because of obscure gastrointestinal bleeding. About 20 of the 27 patients underwent gastroscopy, colonoscopy or air-baricum double contrast examination, but none of the examinations confirmed the bleeding sites, whereas the other 5 patients didn't receive any examination because of their intolerance. Results M2A capsule endoscopy disclosed the sites of small bowel disorders in 20 out of the 27 patients, the positive rate was about 74. 1%. The pathological findings consisted of angiodysplasia in 6 cases, mutipolypi in the intestine in 4, and 1 of them was diagnosed rare Cronkhite-Canada syndrome, prominency in the intestine in 4, single or multiple ulcers in the intestine in 7, diffuse mucosa lesion in the intestine in 9 and diverticulum in 1, arteriolar bleeding in gastric in 2, gastric mucosa erosion or ulcer in 5, whereas 7 patients were in negative findings. There were 12 patients in whom appeared at least 2 sites of pathological changes. Conclusions This study demonstrates that capsule endoscopy provides an excellent visualization way for the small intestines, especially when the elder patients suffers obscure gastrointestinal bleeding. It is safe and usefull for evaluating the suspected small bowel bleeding.

Objective To evaluate the valuse of endoscopic ultrasonography ( EUS ) for upper gastrointestinal submucosal lesions and the role of Photoshop in differentiating leiomyoma and stromal tumors. Methods Data of 656 patients with upper gastrointestinal submucosal lesions evaluated by EUS and receiving endoscopic submucosal dissection ( ESD ) from April 2010 to March 2015 were collected and retrospectively analyzed. The goldern standard for lesions size and origin was the intraoperative diagnosis of ESD, and that of the type of lesions ( leiomyoma, stromal tumor, ectopic pancreas, lipoma, etc.) was pathological and immunohistochemical finding. The consistency of diagnosis of the EUS was evaluated. In addition, Photoshop was used to differentiate diagnosis of leiomyoma and stromal tumors which were confirmed by pathology and immunohistochemistry. Results The consistency in diagnosing the size and lesion origins was 92?56%(560/605) and 88?43%(535/605)between EUS and ESD intraoperative result. The consistency in pathological types of EUS was 79?34%(480/605). Photoshop was used to analyze the EUS images of 177 stromal tumor and 241 leiomyoma. The gray value of stromal tumor was significantly higher than that of leiomyoma(59?97 VS 39?39, t=43?27, P<0?05).The echo of stromal tumor was higher. The standard deviation of gray value of leiomyoma were significantly lower than that of the stromal tumor ( 4?81 VS 5?42, t = 2?83, P < 0?05 ) , indicating the echo uniformity of leiomyoma was better. Conclusion EUS shows high accuracy rate for upper gastrointestinal submucosal lesions, providing more accurate basis for endoscopic therapy. EUS combined with Photoshop is helpful for differentiating stromal tumor from leiomyoma.

Objective:To compare the effect of three different titanium alloy surface topographies on the biological character fibro-blasts.Methods:Three different titanium alloy Ti6Al4V surface topographies were created by machining(M),direct current electro-chemical etching(DC)and alternating current electrochemical etching(AC)respectively,and standard sized samples were prepared. The surface topographies were observed field emission scanning electron microscopy(FE-SEM).Mouse L929 fibroblasts were cultured on different surfaces.The attachment of cells was examined by acridine orange staining and observed under fluorescent microscope.The proliferation of cells was measured using MTT assay.Results:Tubles with the diamete of 5 -20 μm were observed on the surface of the sample of group DC,and more evenly distributed tubles on that of group AC.Micro-sulci were observed and no microtuble was found on the sample surface of group M.L929 cells were attached on the surface of all the samples in the 3 groups.More adhered and better strached cells were observed on AC treated surface.The proliferation of fibroblasts on AC and DC surfaces was superior to that on M treated surface and at the 3 -5 day the proliferation of fibroblasts on the AC surface was higher than that on DC treated surface.Con-clusion:AC treated surface with the micro-submicro-nano hierarchical topography of titanium alloy has a superior biocompatibility and can promote the early attachment and proliferation of the fibroblasts.

Objective To explore the therapeutic effects and mechanism of bone marrow mesenchymal stem cells (MSC) transplantation in mice autoimmune hepatitis (AIH).Methods AIH model was established in 44 C57BL/6 mice,which were induced by homologous series liver-specific antigen S-100 and Freund's complete adjuvant.After modeling,six mice were collected for AIH model confirming.The other 38 mice were divided into three groups.Fourteen mice of MSC transplantation group (group A) were treated by MSC tail vein injection,12 mice of dexamethasone (DXM) group (group B) were treated by DXM intraperitoneal injection,and 12 mice of PBS control group (group C) received phosphate buffer saline (PBS) intraperitoneal injection.Eighteen mice of healthy control group (group D) weren't modeled and received no treatment.At the 5th and 9th week,the mice weights and serum alanine aminotransferase (ALT) level were tested,mice liver tissues of each group were estimated by pathological examination and Knodell scoring,and spleen T lymphocytes of mice were isolated for proliferation-inhibition examination.The data were analyzed by rank sum test,ANOVA and t test.Results After treatment,mice weights of both group A and B showed upward trend (F=15.678,P＜0.01; F=3.730,P=0.037).Before and after treatment,there was no significant difference in group C (P＞0.05).At the 5th and 9th week,the ALT level of group A and B gradually decreased,there was statistical significance between the time points (F=20.267,P＜0.01; F=4.277,P=0.034).Before and after treatment,there was no significant difference in ALT level of group C (P＞0.05).At the 5th and 9th week,the degree of mice serum ALT reduction of group A was larger than that of group B,and the difference was statistically significant (t=3.566 and 3.218,both P＜0.05).At the 5th and 9th week,the Kondell scores of group A and B gradually decreased,there was statistical significance between the time points (F=8.070,P=0.003; F=6.547,P=0.009).Before and after treatment,there was no significant difference in Kondell scores of group C (P＞0.05).At the 9th week,there was statistical significance in Kondell scores among group A,group B and group C (F =4.477,P =0.029).The in vitro spleen lymphocytes proliferation-inhibition experiment demonstrated that the supernatant of MSC could significantly inhibit the proliferation of T lymphocytes stimulated by S-100 antigen and concanavalin A,the absorbance values were0.267±0.167 vs.0.217±0.128 and0.165±0.187 vs.0.082±0.051 respectively,the differences were statistically significant (t =7.187 and 4.602,both P＜ 0.01).Conclusion MSC transplantation may play a therapeutic role in mice AIH through inhibiting T lymphocyte proliferation.

Objective To investigate the characteristics,treatment and prognosis of the gastrointes-tinal iatrogenic perforation resulting from endoscopic operations.Methods The clinical data of the 107 pa-tients with gastrointestinal iatrogenic perforations caused by endoscopic operations from October 2003 to Octo-ber 2013 were retrospectively studied,and the characteristics,treatment and prognosis of these patients were analysed.Results The incidence of the gastrointestinal iatrogenic perforation resulting from endoscopic oper-ations was 0.041%(107 /263 549,among which 0.006% was diagnostic(13 /232 011),and 0.298% was therapeutic (94 /31 538).A total of 107 patients with gastrointestinal iatrogenic chose conservative medical management,endoscopic clipping or surgery according to different conditions after perforations.All patients had good prognosis.Conclusion Endoscopic therapeutic operations are more likely to lead to the occurrence of iatrogenic gastrointestinal perforations compared with diagnostic operations.And most patients could get good prognosis as long as the appropriate treatment is performed when the perforation occurs.

Objective To explore the effects of emotion on cognitive function in patients with depression.Methods Self-rating anxiety scale(SAS),self-rating depression scale (SDS) and the typical one-back task were done by 397 patients with depression in Peking University Sixth hospital out-patient and hospitalization during 2012 June to 2013 October.Results Both of the SAS standard score (51.81 ± 11.50) and SDS standard score (62.94 ± 13.06) were significantly related (r=0.125,P＜0.05.r=0.176,P＜0.01) to the reaction time of one-back task ((590.27±213.96)ms),and the correlation between SAS standard score and SDS standard score was significant (r=0.682,P＜0.01).The results of regression analysis suggested that,only SDS score could predict the reaction time of one-back task.Conclusion The emotion of anxiety and depression in patients with depression are correlated with cognitive function,and the emotion of depression is the main factor to affect the cognitive function.