Objective To investigate the clinical characteristics of upper gastrointestinal diseases in very old people (aged ≥ 90 years),and to explore the necessity and safety of the gastroscopy for the super elderly people.Methods Clinical data of 50 very old people were retrospectively analyzed.Results The total detection rate of upper gastrointestinal disease was 76.0％ (38/50),in which the reflux esophagitis (RE) was the most common (26.0％),followed by erosive gastritis (20.0％),atrophic gastritis (18.0 ％),peptic ulcer (12.0 ％),gastrointestinal cancer (10.0％),duodenitis (8.0％) and fundic gland polyps (6.0％) respectively.RE lesions detected by gastroscopy were mainly mild and were divided into endoscopic grade LA-A (46.1％),LA-B (30.8％),LA C (7.7％),and LA-D (15.4％) according to the Los Angeles classification.The most common symptoms were abdominal distension and anorexia,and the both incidences were 12.0％.There was no significant difference in the prevalence of clinical symptoms between the elderly people with upper gastrointestinal disease and without abnormal gastroscopic findings [44.7％ (17/38) vs.41.7％ (5/12),x2 =0.035,P＞0.05].22 patients (44.0％) underwent gastroscopy under intravenous anesthesia.Conclusions The incidence of upper gastrointestinal disease is high in very old people,and mild reflux esophagitis is the most common.Clinical symptoms are little or asymptomatic in most very old people.Gastroscopy under intravenous anesthesia is safe and feasible for the very old people.

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Objective To analyze the correlation of perfusion parameters obtained by functional multi-slice computed tomography (fMSCT) with vascular endothelial growth factor (VEGF) detected with immunohistochemistry on rabbit model with VX2 breast cancer and noninvasively evaluate the vascularization of untreated VX2 breast cancer in vivo. Methods Sixteen New Zealand femal rabbits were selected and suspension (1 ml) of mass was injected around the breast areola. CT perfusion was performed after two weeks and perfusion parameters including blood flow (BF), blood volume (BV), mean transit time (MTT)and permeability surface (PS) were assessed. Expression of VEGF in neoplasm was detected with immunohistochemistry. Paried t test was used for the comparison of perfusion parameters between the tumor and muscle and Pearson correlation analysis was used to assess the correlation of VEGF with perfusion parameters. Results The mean value of BF, BV, MTT and PS were (228.21 ± 13. 13 ) ml · min-1100 mg-1 ,(13.45 ± 1.01) ml · 100 mg-1 ,(3. 50 ±0. 20) sand (7.85 ±1.18) ml · min-1 · 100 mg-1 in tumor, respectively. They were (66. 10 ±22. 11 ) ml · min-1 · 100 mg-1 , ( 1.88 ± 1.80) ml · 100 mg-1,(23. 87 ±0. 63)s,(1.55 ±0. 38)ml · min-1 · 100 mg-1 in muscular tissue, respectively. The mean value of BF, BV and PS in tumor were obviously higher than those in muscle, and the mean value of MTT in tumor was lower than that in muscle. There were significant differences in CT perfusion parameters between tumor and muscle (t = 61.83,13.63,27.72,20. 54, P ＜ 0. 01 ). The mean value of VEGF in tumor was 7. 33 ±0. 27 and there were positive correlation with BF ( r = 0. 712, P ＜ 0. 01 ), BV ( r = 0. 647, P ＜ 0. 01 ), PS ( r =0. 627 ,P ＜ 0. 01 ), and negative correlation with MTT ( r = - 0. 564, P ＜ 0. 05 ). Conclusion MSCT perfusion imaging can be used to noninvasively evaluate the vascularization in rabbits with untreated VX2 breast cancer in vivo.

Objective This study was undertaken to evaluate the safety of the polyglycolic/polylactic acid(PGLA)-coated Matrix detachable coils(Matrix) and analyze factors which may relate to the recanalization rate of the Matrix coils in the treatment of intracranial aneurysms. Methods 75 patients underwent 79 aneurysm treatments with Matrix coils from May 2003 to July 2005 were retrospectively investigated.Morphological changes were compared postoperatively with last-follow-up digital subtraction angiography(DSA)by using the Raymond scale. We defined incomplete recanalization or stable aneurysms as uncured , while those of progressive occlusion or complete occlusion aneurysms demonstrated on the last-follow-up imagings as cured. We also utilized Cox model for analyzing the relationships between factors including age, gender, degree of aneurysmal occlusion, stenting, aneurysm neck size, aneurysm maximum size and Matrix coils length(%)and the long-term angiographic follow-up results. Results The correlative surgical complications rate with Matrix coils was 13.3%. The total rate of recanalization was 11.4%. Large aneurysms treated with combined stenting got 40% recanalization. No statistic relationships were shown between the factors forementioned and the recanalization rate, but progressive occlusion was observed in 11(61%)incompletely treated aneurysms. Conclusions Matrix detachable coil technique is safe for intracranial aneurysm and would further decrease the recurrence of large aneurysm with combination of stenting but long term efficacy needs further follow-up and large scale randomized control study.

Aim To investigate the effect of irbesartan and spironolactone on expressions of connective tissue growth factor(CTGF),P-p38MAPK proteins during vascular remodeling in renovascular hypertensive rats(RHR).Methods Renovascular hypertension was induced by two kidney one clip(2K1C)operation.8 weeks later,RHRs were given irbesartan or(and)spironolactone for 8 weeks.After 8 weekstreatment,the morphometric measurements were performed in the mesenteric arterioles.Concertration of carboxyterminal propeptide of typeⅠprocollagen(PⅠCP)and N-terminal propeptide of type Ⅲ procollagen(PⅢNP)in blood serum was measured by enzyme linked immunosorbent assay method,and the media collagen area was assessed by collagne-specific Picro-sirius red staining with computerized video processing.Expressions of collagen type I,CTGF,P-p38MAPK proteins were detected using immunohistochemistry respectively.Results The arterial systolic pressure was attenuated significantly after the treatment of irbesartan,and this effect could not be enhanced by spironolactone.The media thickness over lumen ratio,media cross-sectional area over luminal area ratio of mesenteric arterioles,concertration of PⅠCP and PⅢNP,media collagen area,and expression of collagen typeⅠwere significantly increased in RHRs but ameliorated by irbesartan and spironolactone.Meanwhile,the expressions of CTGF,P-p38MAPK proteins were up-regulated in RHRs but blunted significantly after the treatment of irbesartan and spironolactone.The combined treatment had the synergic effects.Conclusions There is a synergistic effect of attenuating extracellular matrix(ECM)producing and amelioration of vascular remodeling(VR)by combined use of irbesartan and spironolactone.It maybe related to the expressions of CTGF and P-p38MAPK proteins down regulated by these two drugs.

Objective To investigate the influence of hypoxia on leptin expression in serum,CSF and brain tissue of C57BL/6J mice.Methods C57BL/6J mice were divided into 3 groups:the normal control,24-hour hypoxia group and 48-hour hypoxia group.The latter two groups exposed to hypoxia in the man-made auto pressure and hypoxia control cabin(XQ-I).Radioimmunoassay was used to detect the leptin level.Results The leptin level in the serum,CSF and brain tissue of mice exposed to hypoxia were higher than that of normal control,but no difference was found between 24-hour hypoxia group and 48-hour hypoxia group.Conclusion Hypoxia probably induces the increasing of leptin expression in fat tissue,as well as in the central nervous system.

DNA from 32 cases of tongue squamous cell carcinoma(TSCC)specimens and the neck lymph node metastasis specimens were processed by bisulfite treatment.The methylation of the specimens was examined by Q-MSP amplification.The consistency of p1 6 methyla-tion of primary TSCC with that of lymph node metastasis tumor was 90.62%(P <0.05).We assumed that p1 6 gene promoter CpG island methylation rates in primary TSCC and metastatic lymph nodes are consistent,p1 6 gene methylation status can be a methylation predictor be-tween premary and lymph node metstasized TSCC.

Objective To assess the value of endoscopic ultrasonography (EUS) and abdominal CT scan on preoperative T and N staging of advanced gastric cancer.Methods A total of 188 patients with advanced gastric cancer received EUS and CT scan to evaluate the T and N staging and lymphatic metastasis before surgical operation.The postoperative pathologic results acted as gold standard for comparison of the two methods.The results consistent with pathologic results were considered as correct otherwise were incorrect.The accuracy of EUS and CT and the each consistency of two methods with pathology were analyzed.Results For T staging, the accuracy of EUS and CT was 87.2%(164/188), 76.6%(144/188), respectively, and Kappa value of EUS and CT was 0.726 and 0.509, respectively.There was a statistical difference between the two methods(χ2=7.181,P=0.007).For lymph node metastasis, the accuracy of EUS and CT was 72.9%(137/188) and 79.8%(150/188), respectively, and Kappa value of EUS and CT was 0.397 and 0.487, respectively.No statistical difference was found between them(χ2=0.963,P=0.326).The consistency test between the two methods for T and N staging and lymph node metastasis revealed that the Kappa value was 0.507 and 0.649, respectively.The accuracy of EUS on T staging was 93.0%, 93.3%, 96.8% and 91.5% in cardiac cancer, gastric fundus cancer, gastric corpus cancer, and gastric antrum cancer, respectively.Corresponding Kappa value in the 4 different positions were 0.843,0.881,0.940 and 0.710, respectively according to consistency tests.The accuracy of gastric antrum cancer with pylorus invasion was 63.2% and the consistency test Kappa value was 0.340.Conclusion EUS is an accurate method for T staging and lymphatic metastasis of advanced gastric cancer, but there is a lower accuracy for T staging of gastric antrum cancer with pylorus invasion.

Objective To detect the ocular fundus hemodynamic changes in patients with rhegmatogenous retinal detachment before and after the scleral buckling procedure by Heidelberg retina flowmeter,and analyse the related influential factors. Methods Heidelberg retina flowmeter was employed to measure the volume,flow and velocity in retinal vessels of the impaired eyes in 47 patients with unilateral rhegmatogenous retinal detachments 1 day before and 1 week,1 month and 3 months after scleral buckling procedure.The contralateral eyes were served as controls. ResultsThere were significant differences in the volume,flow and velocity of retinal vessels between the impared eyes and controls preoperation and postoperation(P