Reflux esophagitis is considered as a commonly-seen esophageal disease.In recent years,certain advances were archived internationally in researches about its pathogenesis,treatment,complications,etc.This article reviewed advances in researches of reflux esophagitis in the year 2016.

BACKGROUND:Deep venous thrombosis has already been recognized as an important serious postoperative complication because it can cause fatal pulmonary embolism and long-term deep venous dysfunction. With the constant development of artificial joint operation and the popularization of such surgery, much attention has been paid to the formation of deep venous thrombosis following artificial joint replacement.OBJECTIVE: To observe the anatomical property of acetabular surrounding arteries and veins, as well as their injury during total hip replacement,so as to explore the cause of deep venous thrombosis in lower limbs following artificial total hip replacement.DESIGN: Single sample observation and before-after self-control.SETTING: Gross anatomy was carried out in the anatomical laboratory of the Medical School of Huzhou Teachers' College; total hip replacement was carried out in the Orthopedic Department, Xinhua Hospital of Zhejiang Traditional Chinese Medicine College.PARTICIPANTS: Pelvic samples were collected from 60 normal adult corpuses (30 from men and 30 from women); meanwhile, 30 patients (18 males and 12 females) received total hip replacement in the Orthopedic Department of Xinhua Hospital, Zhejiang Traditional Chinese Medicine College, between March 2002 and August 2003.METHODS: Gross anatomy was carried out at the anatomical laboratory in the Medical School of Huzhou Teachers' College between March and May 2003. The running course of bilateral external iliac artery and vein, as well as the relationship between the branches of femoral artery and vein and acetabulum were observed on 60 pelvic samples. In order to make the observation easier, 12 o'clock division mode chart of acetabulum was established, that is, a line drawn from anterior superior iliac spine toanterior inferior iliac spine, with the crossing point of its extension line and acetabular edge taken as 12 o'clock, therefore the other points should be arranged clockwise. Totally 30 patients received artificial total hip replacement by acetabular lateral-posterior approach. One week later, bilateral deep venous radiography was performed to observe the state of deep venous thrombosis in lower limbs.MAIN OUTCOME MEASURES: ① The anatomical relationship between the branches of external iliac artery and vein, femoral artery and vein and acetabulum. ② The formation rate of deep venous thrombosis in lower limbs after total hip replacement. ③ Adverse events and side effects.RESULTS: Totally 60 adult normal pelvic samples and other 30 pelvic samples of patients who received total hip replacement remained in the results analysis. ① Anatomical observation of external iliac artery and vein,as well as femoral artery and vein: the branches of femoral artery and vein: Medial and lateral circumflex femoral arteries were found running across acetabulum and entering acetabulum; the safe position for the retractor was from 12 o'clock to 3 o'clock and from 5 o'clock to 9 o'clock. However, 9o'clock to12 o'clock and 3 o'clock to 5 o'clock were taken as fragile regions. ② The incidence of deep venous thrombosis following total hip replacement: Bilateral deep venous radiography was carried out after operation and revealed that 11 patients developed deep venous thrombosis with the incidence of 37%. ③ Adverse events and side effects: Postoperative bleeding of over 1 000 mL occurred in 3 cases. In order to fully expose operative field, the retractor should be used to hold off muscles and other tissues, which contributed to long-term vascular compression and blood flow retardation.CONCLUSION: Artificial total hip replacement is liable to injure the internal wall of acetabular vessels, thereby leading to blood flow retardation and platelet aggregation, and ultimately thrombosis. In addition, the massive bleeding during operation will increase blood mucosity, which also increases the risk for thrombosis. From the mode chart of fragile regions and safe regions, we can deduce that deep venous thrombosis in lower limbs can be reduced.

BACKGROUND: At present, the artificial total hip replacement(THR) is the first choice of the hip joint disease for the old, and the choiceness rate is 84% according to the Harri' s grade, and the therapeutic effect is content. The occurrence rate of the sciatic nerve injury in the THR is reported to be 0.46% in and 0. 08%-9.7% abroad.OBJECTIVE: To study the influencing factors of the sciatic nerve injury in the THR through the anatomical location analysis.DESIGN: Single sample study based on the human anatomical samples.SETTING: Human Anatomy Laboratory in the Medical Department of the Huzhou Normal University.PARTICIPANTS: The study was completed in the Human Anatomy Laboratory in the Medical Department of the Huzhou Normal University from March to May in 2003. There were 56 pelvis samples of the normal human adult cadaver, 27 males and 29 females.METHODS: The origins and the pathways of the sciatic nerves and the relation of the sciatic nerve and the acetabulum were analyzed, and the sciatic nerve injury induced by the clasp and the screw fixation in the THR was measured and analyzed.MAIN OUTCOME MEASURES: The location relation of the sciatic nerve and the acetabulum.RESULTS: The distance between the sciatic nerve and the bottom of the acetabulum was(6.00 ±0. 85) mm on the left and(6.00 ±0. 71) mm on the right. The distance between the sciatic nerve and the edge of the acetabulum was(13.00 ±0. 75) mm on the left and(14.00 ±0.06) mm on the right. The SN circumference on the edge of the acetabulum was(32.00 ± 0. 28) mm on the left and(31.00 ± 0.68) mm on the right. The distance between the bottom of the acetabulum and the greater sciatic foramen was(29.00 ±0. 36)mm on the left and(29.00 ±0.24) mm on the right.CONCLUSION: It is confirmed that the clasp and the screw fixation can be done on the safe region at the 1-3 o' clock and the 5-6 o' clock. The obsolete fracture and dislocation of the acetabulum, the unsuitable clasp location and the unsuitable location of screw fixation may induce the iatrogenic sciatic nerve injury.

Objective To explore effect of miR‐302a on proliferation and apoptosis in folate deficiency mouse embryonic stem cell (mESC) .Methods The cases were divided into complete culture medium group (control group) ,folate‐deficient culture medi‐um group (folate‐deficient group) ,folate‐deficient culture medium plus miR‐302a mimic group (miR‐302a group) .The expression of miR‐302a was examed by RT‐PCR in control group and folate‐deficient group .To construct miR‐302a mimic and then was trans‐fected into the folate‐deficient culture medium mESC .Effect of miR‐302a mimic on mESC viability was detected by MTT assay ,the effect of miR‐302a mimic on mESC apoptosis was examed by Annexin V‐FITC/PI flow dual‐staining method ,the effect of miR‐302a mimic on mESC cycle was examed by flow cytometry .The activation of phosphatidylinositol 3 kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) and expression of CyclinD1 ,p21 and p27 was assayed by Western blot . Results The expression of miR‐302a was lower in folate‐deficient group(P<0 .01) .Compared with control group ,the viability of mESC was lower ,the apoptosis of mESC was higher ,the cell cycle was arrested in G1 phase ,the level of phosphorylation of AKT and mTOR was lower ,the expression of CyclinD1 was lower ,the expression of p21 and p27 was higher in folate‐deficient group , with statistical significance (P<0 .01) .Compared with folate‐deficient group ,the viability of mESC was higher ,the apoptosis of mESC was lower ,G1 phase was shortened ,the level of phosphorylation of AKT and mTOR was higher ,the expression of CyclinD1 was higher ,the expression of p21 and p27 was lower in miR‐302a group with statistical significance (P<0 .01) .Conclusion These results suggested miR‐302a exerted anti‐apoptosis and promote cell proliferation in folate‐deficient culture medium ,which might be related to PI3K/AKT/mTOR signal pathway .

Objective To investigate infection status and distribution characteristics of human immunodeficiency virus (HIV)infection among voluntary blood donors in Xiangyang area in 2009-2014,and provide evidence for re-cruiting blood donors from low-risk population. Methods Blood specimens of 326 856 voluntary blood donors in Xiangyang area between January 2009 and December 2014 were detected anti-HIV with enzyme linked immunosor-bent assay(ELISA),positive specimens in HIV screening were performed confirmatory testing,epidemiological analysis was conducted on the positive detection results.Results 41 (0.13‰ )voluntary blood donors were con-firmed positive for HIV in Xiangyang area,positive rate among each year was significantly different (χ2 =27 801.87,P<0.01). Except marital status and infection routes,difference in positive rates among donors of dif-ferent gender,age,area,occupation,educational attainments,and number of blood donation were all significantly different(all P<0.01). Among HIV-infected voluntary blood donors,87.80% were male,41.46% and 31.71%were aged between 18-25 and 36-45 respectively,56.10% were through heterosexual transmission,and 43.90%were through male homosexual transmission. The percentage of workman and public service personnel infected with HIV were high,accounting for 21 .95% and 17.07% respectively,60.97% of confirmed positive HIV were from city area,56.10% only received junior middle school/technical secondary school education,65.85% of HIV-infec-ted persons were infected at the initial donation.Conclusion In order to ensure blood safety,blood center should in-crease publicity efforts,carry out health consultation before blood donation,and recruit blood donors from low-risk populations,nucleic acid detection should be carried out to shorten HIV detection window period.

Objective:To investigate the Th1 type immune response effects of CpG oligodeoxynucleotide(CpG ODN) immunized with recombinant hepatitis B surface antigen(rHBsAg).Methods:The CpG ODN and rHBsAg were injected into the back leg tibialis anterior(TA) muscle of BALB/c mice for two times.The serum anti-HBs IgG sub-class ratio of IgG2a/IgG1 were detected by ELISA.The level of IFN-?,IL-2 and IL-12 in the supernatant of induced splenocyte with bioactived assay.The serum IL-4 and IL-10 level were detected by ABC-ELISA.Results:The anti-HBs IgG sub-class IgG2a titer of additional CpG ODN groups are obviously higher than those of other groups;The result showed that high level of Th1 type cytokines including IL-2,IFN-? and IL-12 were induced in CpG ODN groups,where the level of Th2 type cytokines such as IL-4 and IL-10 were inhibited obviously.Conclusion:CpG ODN has enhanced efficacy of rHBsAg for anti-HBs IgG sub-class production of IgG2a and induced the expression of Th1 type cytokines wherease inhibited the expression of Th2 type cytokines.

Objective:To investigate the effects of lymphocyte proliferation using the synthetic oligodeoxynucleotide containing CpG motif(CpG ODN) as immunal adjuvant immunized with the recombinant hepatitis B surface antigen(rHBsAg) in mice.Methods:BALB/c mice were randomly divided into five groups,injected into back leg tibialis anterior(TA) muscle for two times.The spleen and thymus lymphocytes proliferation was tested by MTT and()~3H-TdR incorporation respectively.Results:Analytical study showed that all groups compared with control the proliferation of spleen and thymus lymphocytes was increased obviously,except the specific proliferation of thymus lymphocyte there didn't obviously difference in CpG ODN plus vaccine group and the vaccine group.Meanwhile,the proliferation of the groups plus CpG ODN was much stronger than the not-CpG ODN groups in all the tests.Conclusion:CpG ODN has the ability stimulating the lymphocyte proliferation in mice obviously anti could have potential adjuvant effectiveness.

Objective To study the breast augmentantion by a large amount of auto fat granule injection. Methods The author selected the fat patients who wanted both breast augmentation and liposection. Large amount of auto fat granule, the fat suspended solution, was obtained from patient's abdomen or buttocks and thighs. The fat suspended solution had been washed by normal saline solution repeatedly, in order to get rid of blood, serum and liquefied fat. Then the auto fat granule solution was injected into breast glands and their underneath and behind pectoral majority muscle. The quantity of fat suspended solution injected was 150～305 ml in each side of breast. Total of 21 cases had been performed by auto fat granule solution injection in our department from Oct.1997 to April 2001. Results Breast augmentation by auto fat granule solution injection were successful and positive, without any complications. The results were satisfied both from patients and surgeons. It showed that the contouring of breast were improved and more chubbiness than that before operation. Conclusions The auto fat granule injection for the breast augmentation is an effective and practical method. It can also be used to inject into the other parts of the body to fill in soft tissue defects.

OBJECTIVE:To investigate the effects of aerosol inhalation of budesonide combined with Compound ipratropium bromide on therapeutic efficacy and safety of patients with pneumoconiosis during perioperative period of massive whole-lung la-vage (WLL). METHODS:One hundred and fifty male patients with pneumoconiosis receiving WLL under general anesthesia se-lected from our hospital during Dec. 2014-May 2016 were divided into treatment group and control group in accordance with ran-dom number table,with 75 cases in each group. Both groups received WLL under general anesthesia as well as pure-oxygen manu-al positive pressure ventilation alternating with negative pressure drainage keeping interval and respiratory rate of ventilator synchro-nization. Treatment group was given Budesonide suspension 2 mL,bid+ Compound ipratropium bromide solution 2.5 mL,tid,by aerosol inhalation from 3 d before surgery to 3 d after surgery. The levels of arterial blood gas indexes(pH,PaO2,PaCO2,BE)at different lavage stages,lung function indexes (FVC,MVV,FEV1/FVC),blood gas indexes and clinical symptom score 3 d be-fore surgery and 7 d after surgery were observed in 2 groups,and the occurrence of ADR was recorded. RESULTS:After two-lung ventilation for 20 min following unilateral/bilateral lung lavage,PaO2 of 2 groups were all increased significantly compared to be-fore surgery,with statistical significance (P<0.05);but there was no statistical significance between 2 groups (P>0.05). three days after surgery,FVC,MVV,FEV1/FVC and PaO2 of 2 groups were all increased significantly,PaCO2 and clinical symptom score were all decreased significantly. FVC,FEV1/FVC,PaO2 and clinical symptom score of treatment group were significantly bet-ter than those of control group,with statistical significance(P<0.05). The incidence of airway spasm,hypoxemia and airway pres-sure increasing in treatment group were significantly lower than in control group,with statistical significance(P<0.05). CONCLU-SIONS:During perioperative period of WLL,the aerosol inhalation of budesonide combined with Compound ipratropium bromide for patients with pneumoconiosis can improve clinical efficacy of WLL and reduce the occurrence of ADR during surgery.

Evidence based medicine(EBM)makes practitioner of the main current medical science change their attitude to alternative medical science, and provides the technology of studies for Traditional Chinese Medicine (TCM) clinical trials. The method of EBM will provide enormous development space and chance for TCM, and promote the proceeding of the modernization and globalization of TCM. At the same time, the research of TCM should not follow the EBM technology completely, it should keep TCM itself characteristic.To know the EBM defect,it can be better utilized.