Objective To evaluate the effect of mechanical dilation on cardia achalasia under an endoscope.Methods A total of 62 patients with cardia achalasia were treated with mechanical dilation by using a self-designed dilator under a gastroscope.Of the cases,one had experienced a failure of heller surgery,and four had received ballon dilation before the gastroscopy.Results Among the cases,2 were convered to open thoracic surgery becaues of rupture of the esophagus,1 patient could not tolerate the operation,1 received a second dilation because of unsatisfied outcome of the first attempt.In the other 58 patients,the surgery was completed in the first attempt.The mean dilation time was 3.5 minutes(ranged from 2 to 5 minutes).Slight mucosal hemorrhage was observed during the operation,while no continuous bleeding occurred.Cold liquid diet was given to the patients 2 hours after the dilation,and then semiliquid diet was prescribed in 6 hours,after that the patients began to take normal diet gradually.The patients were followed up for 2 to 11 years with a mean of 7.5.All of them were cured without recurrence.Conclusions Endoscopic mechanical dilation is microinvasive,safe,and effective for cardia achalasia.It is worth being widely used because of a low cost and reliable long-term outcomes.

Objective To explore the effect of oral care on the prevention of ventilator associated pneumonia in patients with severe traumatic brain injury by aspiration of subglottic secretion combined with 2% acetic acid chloride solution. Methods A total of 100 cases of ICU patients with mechanical ventilation for longer than 48 hours were divided into group B and group C using a random number table method according to tracheotomy mechanical ventilation time sequence number from January 2014 to June 2015. Another 50 ICU patients in group A (as the case for retrospective analysis, from April to November , 2013) were treated by routine tracheal suction, normal saline cotton for oral care, group B were treated with aspiration of subglottic secretion, normal saline cotton for oral care, group C were treated with aspiration of subglottic secretion combined with 2% acetic acid chloride solution for oral cleaning. And then VAP occurrence rate, plaque index, plaque clearance were evaluated. Results The incidence rates of early onset VAP in three groups were 14% (7/50), 8% (4/50), 4% (2/50), and incidence rates of late onset VAP were 22% (11/50),12% (6/50), 8% (4/50) respectively, the differences were significant (χ2=3.65, 3.88,P<0.01). The plaque index and plaque clearance rates of the three groups on the third day were 2.14± 0.35, (40.12 ± 13.11)%, 2.10 ± 0.33, (39.17 ± 14.21)%, 1.03 ± 0.24, (60.12 ± 15.07 )%(F=12.21,χ2=3.82,P<0.01);while on the 7th day, they were 1.76 ± 0.47, (41.12 ± 13.34)%, 1.80 ± 0.32, (39.37 ± 12.21)%, 0.99 ± 0.15, (60.33 ± 14.25)%(F=13.14,χ2=4.20,P<0.01). Conclusions The incidence rate of VAP can be decreased by the combination of aspiration of subglottic secretion and oral cleaning with 2%acetic acid chloride solution.

Objective:To analyze the delay in the publication of medical postgraduates' research papers and provide them with a guidance for the management of academic articles.Methods:A total of 293 articles were chosen from the Journal of Medical Postgraduates published from 2005 to 2006,of which,229 were original articles and 45 were reviews,including 184 funded and 109 non-funded research papers,and their delay in publication in different periods was statistically analyzed by SPSS13.0 software.Results:The total delay in the publication of the articles was(234.7 ? 116.9) d,including(57.0?36.8) d in manuscript examination,(109.4 ? 96.4) d in editing and(61.8 ? 52.4) d in suspension.The original articles were less delayed than the reviews,(224.2 ? 7.4) d vs(272.8 ? 19.3) d,P

Objective To discuss the clinical application of feeding-artery embolization in treating massive hemoptysis.Methods The feeding-artery angiography was performed in 72 patients with massive hemoptysis.Based on the angiographic findings polyvinyl alcohol(PVA)or spring coil were selected as the embolization materials.The therapeutic results were retrospectively analyzed. Results Hemoptysis was completely controned almost immediately after the embolization procedure in 46 cases,while it was obviously alleviated in 13 cases.In 11 cases the hemoptysis disappeared completely after 2-4 times of embolization treatment,and in 2 cases surgery had to be employed.Conclusion Embolization of feeding-artery with PVA particles or spring coils is an effective and safe treatment for massive hemoptysis.The key point for decreasing reoccurrence is to occlude all feeding.arteries as far as possible.

This paper analyzed medical dispute litigation from the view of game theory.The adoption of mediation strategy for both hospital and patient was the Pareto optimal of this model.The adoption of court decision for both hospital and patient was the Nash equilibrium and its overall benefit was the Pareto suboptimal of this model.The communication of patient's lawyer can prompt the reconciliation between hospital and patient.On the one hand,it let the hospital realize the responsibilities they should bear,on the other hand let patients be willing to make concessions on the basis of the original claims,and finally made the two sides reach a reconciliation agreement,thus to make conflict between hospital and patient end in litigation and the overall benefits maximize.

Objective To develop a one-step PCR assay for rapid discrimination of six Brucella species and some intraspecific biovars.Methods Using 6 pairs of primers in one-step PCR to differentiate six classical Brucella species and some biovar in ordinary PCR instrument.The tested strains including 27 reference strains of six Brucella species and 239 Brucella strains were estimated by the PCR assay and biological identification methods.Results The six Brucella species could be precisely differentiated by the onestep PCR assay from the tested strains.Five biovars and vaccine strain of B.suis species could be determined,and biovars 1,3,4 and biovars 2,5,6,7,9 of B.abortus species could be identified at the level of their biovar,moreover,biovars 1,2 and 3,and vaccine strain Rev 1 of B.melitensis species were also discriminated at the biovar and strain level.The accurate rates of the biological identification method and the PCR assay were 98.33％ and 100％ respectively.Conclusion One-step PCR assay was a rapid,specific,and low cost method for identification of Brucella species and discriminating biovars in ordinary PCR instrument.

Objective To establish a RP- HPLC method for quantitative determination of puerarin in Laige Granules. Methods The separation was performed on Econosphere C18 column (4.6 mm? 250 mm,5 ? m) with mobile phase of methanol and 1 % acetic acid solution (25 ∶ 75) at a flow rate of 0.8 mL/min. The UV detection wavelength was 250 nm and the column temperature was 40 ℃ . Results The linear range of puerarin was 0.2～ 1.0 ? g, r = 0.999 7. The mean recovery was 100.56 % (RSD=1.21 % , n = 5 ). Conclusion This method is simple, accurate, sensitive and with good reproducibility .

Objective To explore the application of tissue-explant technique in culturing rat submandibular gland cell(RSGC)and the characteristics of RSGC.Methods RSGCs were cultured using tissue-explant technique.The cells were purified by enzymatic digestion and differential adhesion.The cell phenotype was identified by cytokeratin-8 immunohistochemical staining.Cellular morphology was observed and photographed under inverted microscope.The cell viability and growth were determined by a double-staining procedure using FDA-PI and MTT assay,respectively.Results Cytokeratin-8 was positive stained in the immunohistochemical staining.The cell viability was more than 95%.The cell growth curve showed that RSGCs were in logarithmic phase since day 5.Conclusion Tissue-explant technique is an easy way to purify plentiful RSGC with normal functions,and it can be used in further research of tissue engineering of submandibular gland.

Objective To investigate the affect of body positions on biochemical indexes. Methods By autogenous contrast and cross matched survey, 107 volunteers divided into 3 season patches of winter, spring and summer, blood samples were drawn from the same part in both standing and lying positions。From19 persons, blood samples were collected respectively after standing and sitting for 15 min, lying for 15 min and 30 min and then sitting for another 15 min。 The blood samples were analyzed for 32 biochemical indexes on analyzer。Results 25 biochemical indexes in sitting position were significantly different from those in lying position (P0。05)。Conclusions Changing body position can result in obvious physiological variation of 28 biochemical indexes, particularly of those related to protein. Such result may lead to abnormality in some marginal values. It suggests body position should not be neglected in analyzing laboratory data.

Objective To investigate the effect of liver cirrhosis on the potency of propofol for sedation in rats. Methods Fifty-eight male SD rats, aged 10-12 weeks, weighing 180-220 g, were randomly divided into 3 groups: control group (group C, n = 18), mild liver cirrhosis group (group M1, n =20) and severe liver cirrhosis group (group M2, n = 20). The model of liver cirrhosis was established using four factors described by Chen et al. After successful establishment of the model, propofol was injected intravenously. The dose of propofol was determined by up-and-down sequential method for loss of righting reflex. The dose of propofol was 5.912 mg/kg in the first rat and the ratio of the doses between the two consecutive rats was 0.85. ED50 of propofol was calculated using up-and-down sequential method. Results ED50 of propofol was significantly lower in group M1 and M2 than in group C and in group M2 than in group M1 ( P ＜ 0.05 or 0.01 ). Conclusion The liver cirrhosis can enhance the potency of propofol for sedation in rats.