Objective To study the effects of chronic intra-abdominal hypertension (IAH) on the functions of vital organs. Methods From January 2004 to January 2008, 30 chronic massive ascites related IAH patients were enrolled including 12 colonic cancer cases, 7 pancreatic cancer cases, and 11 gastric cancer cases. Control group included 30 cases of gastrointestinal carcinoma without ascites hence no IAH. The specific malignances in this group were colonic cancer in 15 cases, pancreatic cancer in 8 cases, and gastric cancer in 7 cases. Age, gender and cancer stage were matched between the two groups. Symptoms in digestive, respiratoy and circulatory system and liver and kidney functions were recorded and KPS scores were compared respectively. Results The symptoms of abdominal distention in chronic IAH group and control group were presented respectively by 15 cases(50%) and 5 cases (17%) (P < 0.01). Symptoms of heart-throb or hypotension in the two groups by 10 cases (33%) and 3 cases (10%) respectively(P<0.05). Symptoms of asthma or chest distress in the two groups by 9 cases(30% ) and 1 cases (3%) respectively (P< 0.01). Liver function were abnormal in 16 cases (53%) and 6 cases (20%) respectively (P < 0.01 ), kidney functions were abnormal in 14 cases (47%) and 1 case( 3% ) respectively ( P <0.01 ) . There were 22 cases (73 %) and 7 cases (23 %) respectively ( P < 0.01 ) in the two groups with KIS score being lower than 40. Conclusions Chronic IAH causes malfunctions of vital organs deteriorating patients general status and even leading to abdominal compartment syndrome.

Objective To study clinical feature of diagnosis of pancreatic cancer,in order to reach early diagnosis.Methods 70 cases of pancreatic cancer from ours in-patients 1990 to 2000 were reviewed and analyzed.Results The number of patients with stage Ⅰ～Ⅱ were only 8 cases(11 4%). 40 patients (57 1%) hospitalized within one month after they felt ill.19 cases(29 1%) were diagnosed as pancreatic cancer within one month,including 5 patients(26 3%) with stage Ⅰ or Ⅱ .Abdominal pain(73 4%),jaundice(10 1%) and discomfort of upper abdominal(5 8%) were the most common initial symptoms.misdiagnosis were 40(57 1%) cases .The most common misdiagnosis were chronic gastritis(21 4%),chromic cholecystitis(7 14%) and peptic ulcer(5 71%).The serum levels of CA199,CA125 were higher in 16/18 cases (88 9%) and 6/7 cases (85 7%) respectively. Three cases in stage I or II were found higher serum CA125 and other tumor marker normal.Five patients were diagnosed as diabetes within five months before the diagnosis of the cancer.Conclusions For most of the patients with pancreatic cancer ,usually they were definite diagnosis in moderate or advanced stage. So the status of the diagnosis of pancreatic cancer is disappointed . Hospitalizing late,being misdignosed and developing quickly were the main causes;The most common misdiagnosis are chronic gastritis, cholecystitis and peptic ulcer;elevation of serum CA199 and CA125 are sensitive to diagnose pancreatic cancer. Detections of CA125 and hyperglycemia may favour earlier diagnosis of pancreatic cancer.

Objective To study the recurrence of colon adenoma after endoscopic high-frequency electric polypectomy.Methods The data of 238 patients undergoing endoscopic polypectomy between 2000 and 2008 were retrospectively analyzed.The cumulative recurrence rates at 0-2 years,＞2-5 years and ＞5-8 years after polypectomy,median recurrence time and main risk factors for recurrence were identified based on the features of adenomas detected on initial colonoscopy.Results The cumulative recurrence rates of adenoma at the surveillance examination were 61％,81％,and 84％ for the three intervals,respectively.On multivariate analysis,gender,age,extra-colonic tumor history,alcohol drinking history and adenoma number at initial examination were the independent risk factors of adenoma recurrence.Conclusion We suggest a 2-year surveillance interval for Chinese patients with colonic adenoma after the initial endoscopic polypectomy,a 20-month surveillance interval for males over 60 years old who have more than 2 sdenomas at the initial colonoscopy,and an even shorter interval for those with exira-colonic tumor history or alcohol drinking history.

37 kU/L) than those in normal-CA19-9 group(P

Objective:To study the efficacy and influencing factors of ursodeoxycholic acid (UDCA) in the treatment of cholesterol gallstone, so as to provide reference for the treatment of cholesterol gallstone by internal medicine.Methods:From March 1, 2017 to March 31, 2018, at outpatient department of gastroenterology of 9 Beijing medical centers including Peking University People′s Hospital, the Sixth Medical Center of PLA General Hospital, Beijing Huaxin Hospital, PLA Rocket Force Characteristic Medical Center, Peking University Aerospace Center Hospital, Beijing Youan Hospital of Capital Medical University and Beijing Tiantan Hospital of Capital Medical University, Beijing Tongren Hospital of Capital Medical University, and Beijing Shijitan Hospital of Capital Medical University, the data of patients with cholesterol gallstone treated by UDCA were collected. The inclusion criteria were that the largest diameter of stone was ≤10 mm and the stone was not detected under X-ray. The treatment plan was taking UDCA orally for 6 months at a dose of 10 mg·kg -1·d -1. The basic information of patients, the ultrasound examination results before treatment and 6 months after treatment, and scores of biliary abdominal pain and dyspepsia symptom were collected. Univariate and multivariate logistic regression were used to analyze the influencing factors of the efficacy in gallstrone dissolution by UDCA, and Wilcoxon signed rank test was used for statistical analysis. Results:A total of 215 patients were enrolled. The complete dissolution rate of gallstone was 19.5% (42/215) and partial dissolution rate was 50.7% (109/215), and the total effective rate was 70.2% (151/215). The complete dissolution rate of sandy stone was significantly higher than that of lumped stones (37.0%(17/46) vs. 14.8%(25/169); OR=3.377, 95% confidence interval (95% CI) 1.621 to 7.035, P=0.001). In lumped stones, the complete dissolution rate of the stones with diameter ≤5 mm was significantly higher than that of the stones with diameter >5 mm (37.5%(9/24) vs. 11.0%(16/145); OR=4.837, 95% CI 1.823 to 12.839, P=0.002). The complete dissolution rate of patients with higher body mass index ( OR=0.872, 95% CI 0.764 to 0.995, P=0.043) and longer disease course ( OR=0.942, 95% CI 0.912 to 0.973, P<0.001) was low. The results of multivariate logistic analysis indicated that long disease course of gallstone ( OR=0.940, 95% CI 0.908 to 0.974, P=0.001), rough gallbladder wall ( OR=0.438, 95% CI 0.200 to 0.962, P=0.040) and lumped stone ( OR=0.236, 95% CI 0.101 to 0.550, P=0.001) were independent risk factors of influencing the efficacy of stone dissolution by UDCA. As for lumped stones, the independent risk factors included long disease course of gallstone ( OR=0.926, 95% CI 0.877 to 0.978, P=0.006) and stone diameter >5 mm ( OR=0.142, 95% CI 0.043 to 0.470, P=0.001). After 6 months of UDCA treatment, score of biliary abdominal pain decreased from 0 (0 to 6) to 0 (0 to 0) and the score of dyspepsia symptom decreased from 1 (0 to 2) to 0 (0 to 0), and the differences between before treatment and after treatment were statistically significant ( Z=-8.50, and -9.13, both P<0.001). Conclusions:UDCA has a certain efficacy in cholesterol gallstone dissolution and can ease biliary abdominal pain and dyspepsia symptom. Long disease course of gallstone, rough gallbladder wall and stone diameter >5 mm are independent risk factors of poor efficacy in gallstone dissolution by UDCA.

Objective:To investigate the expression changes of farnesoid X receptor (FXR) in the evolution of normal intestinal mucosa, colorectal adenoma (CRA) and colorectal cancer (CRC), and the correlation of FXR expression with clinicopathological features and prognosis of patients with colorectal tumors.Methods:The UALCAN website tool was used to analyze the expression level of FXR gene transcripts of CRC and normal colorectal tissues in The Cancer Genome Atlas (TCGA) database. The patients undergoing colonoscopy and treatment in the Aerospace Center Hospital from January 2019 to September 2020 were selected, and the immunohistochemistry was used to detect the expression of FXR protein in 100 CRA tissues, 47 CRC tissues and 11 normal colonic mucosal tissues from healthy people (healthy control). Combining with clinical data, the relationship between FXR protein expression and clinicopathological characteristics of patients with colorectal tumors was analyzed. According to the Kaplan-Meier Plotter online database, the median expression level of FXR gene transcripts in CRC patients was analyzed, and the patients were divided into FXR low-expression group and high-expression group, the relationship between the expression of FXR gene and prognosis of CRC patients was investigated.Results:The analysis of data from TCGA database showed that the expression level of FXR gene transcripts in CRC tissues was lower than that in normal colorectal tissues ( P < 0.01). Immunohistochemical examination of the collected tissues showed that the positive rate of FXR protein gradually decreased from the cecum to the rectum. The positive rates of FXR protein in healthy control, CRA patients and CRC patients were 90.9% (10/11), 24.0% (24/100), 6.3% (3/47), and the difference was statistically significant ( χ2 = 35.56, P < 0.01); the positive rate of FXR protein in cancer tissues from CRC patients was lower than that in normal tissues adjacent to cancer [6.3% (3/47) vs. 65.2% (15/23)], and the difference was statistically significant ( χ2 = 27.98, P < 0.01). There was no statistical difference in the positive rate of FXR among CRA patients with different gender, age, maximum diameter of adenoma, and aggression (all P > 0.05). There was also no statistical difference in the positive rate of FXR among CRC patients with different gender, age, tumor site, maximum diameter of tumor, degree of differentiation, TNM staging, and vascular tumor thrombus (all P > 0.05). According to the survival analysis of Kaplan-Meier Plotter online database, the recurrence-free survival of CRC patients with high expression of FXR was better than that of patients with low expression of FXR ( P = 0.003). Conclusions:The expression level of FXR gradually decreases in the intestinal tissues of healthy people, CRA patients and CRC patients. The prognosis of CRC patients with low FXR expression is poor.

ObjectiveTo explore the effect of aquatic treadmill training on abdominal muscle thickness and balance function in patients with hemiplegia after stroke. MethodsFrom March to October, 2021, 60 patients with hemiplegia after stroke were randomly divided into control group (n = 20), suspension group (n = 20) and aquatic treadmill group (n = 20). On the basis of comprehensive rehabilitation training, the control group received treadmill training, the suspension group received skyrail suspension walking training, and the aquatic treadmill group received treadmill training in water, for four weeks. The curative effect was evaluated by musculoskeletal ultrasound with muscle thickness of bilateral external oblique, internal oblique and transverse abdominal muscles. And they were assessed with Postural Assessment Scale for Stroke Patient (PASS) and Timed 'Up & Go' Test (TUGT) before and after treatment. ResultsAfter treatment, the thickness of external oblique and internal oblique muscles on the unaffected side, the PASS score and the TUGT time improved in all the three groups (|t| > 2.135, P < 0.05); while the thickness of external oblique, internal oblique and transverse abdominal muscles in the aquatic treadmill training group increased (|t| > 5.567, P < 0.001). The PASS score, the TUGT time, and the thickness of external oblique and internal oblique muscles on the affected side improved more in the aquatic treadmill training group than in the control group and the suspension group (P < 0.05). ConclusionThe aquatic treadmill training is more effective in strenghthening abdominal muscle to improve balance function.

Objective To observe the clinical efficacy of simple knee trainer on active knee flexion in patients with hemiplegia after stroke.Methods From March, 2020 to May, 2021, 46 hemiplegics after stroke in Beijing Bo'ai Hospital were randomly divided into control group (n = 23) and experimental group (n = 23). Both groups accepted routine rehabilitation training, and the experimental group accepted knee flexion exercise training in sitting position through the simple knee trainer, for eight weeks. They were measured active knee flexion angle in sitting position and maximum flexion angle in walking before and after training, as well as Holden Functional Ambulation Category (FAC).Results Both active knee flexion angle in sitting position and maximum flexion angle in walking significantly increased in both groups after training (|t| > 6.991, P < 0.001), and increased more in the experimental group than in the control group (t > 2.185, P < 0.05). The grade of FAC also improved in both groups (|Z| > 2.828, P < 0.01), and no significant difference was found between groups (Z = -0.821, P = 0.412).Conclusion The application of simple knee trainer can effectively improve the active range of motion of knee, which may be used in clinic- and community-based rehabilitation.

ObjectiveTo investigate the relationship among spontaneous turning direction, balance ability and fall risk in patients with stroke during walking. MethodsFrom December, 2021 to November, 2022, 94 patients with stroke were recruited from Beijing Bo'ai Hospital. They were assessed with simple Timed 'Up and Go' Test (TUGT, TUGT1), TUGT with a cup in hand (TUGT2), and TUGT with calculation task (TUGT3). The spontaneous turning directions at the turn point were recorded, and the patients were divided into no-same group (n = 34) and same group, and the same group was further divided into affected group (n = 33) and unaffected group (n = 27), according to the spontaneous turning direction. After a spontaneous turning of each TUGT, the patients were asked to finish another TUGT turning to the opposite direction. And then, they were assessed with single leg standing test, Functional Reach Test (FRT), 360° turning test and the Morse Fall Scale (MFS). ResultsThere were the most patients with left hemiplegia in the affected group (χ² = 7.995, P < 0.05). The time of TUGT1, TUGT2 and TUGT3 was the most in the affected group and the least in the unaffected group (F > 4.009, P < 0.05), and it was more in the affected group than in the unaffected group as post-hoc test (P < 0.05). The one leg standing time (H = 9.403, P = 0.009) and FRT distance (F = 4.300, P = 0.016) were the least in the affected group and the most in the unaffected group, and it was less in the affected group than in the unaffected group as post-hoc test (P < 0.05). The turning time (F = 4.134, P = 0.019) and turning steps (F = 5.611, P = 0.003) were the most in the affected group and the least in the unaffected group, and it was more in the affected group than in the unaffected group as post-hoc test (P < 0.05). The score of MFS was the most in the affected group and the least in the unaffected group (H = 8.192, P = 0.017), and it was more in the affected group than in the unaffected group as post-hoc test (P < 0.05). ConclusionThe stroke patients spontaneously turning to the affected side during walking usually are poorer in balance function, and in a risk of fall.

ObjectiveTo observe the protective effect of Shenlian prescription on acute lung injury induced by particulate matter （PM） exposure in rats and explore the mechanism. MethodFifty male SD rats were randomly divided into the control group， model group， Shenlian low-dose group （4.32 g·kg^-1）， Shenlian high-dose group （8.64 g·kg^-1）， and roflumilast group （3.46 mg·kg^-1）， with 10 in each group. Pre-administration with drugs by gavage was performed for one week. On the 8^th and 11^th days， the control group was instilled with normal saline in the trachea and the other groups with PM suspension to establish a rat model of acute lung injury induced by PM exposure. After modeling， drugs were given continuously until the end of the experiment. Forty-eight hours after the last exposure， the lung function of rats was detected. Then the rats were sacrificed and the lung morphological changes and pathological changes by hematoxylin-eosin （HE） staining were observed. CD68 expression in lung was detected by immunohistochemistry， and the levels of lung injury markers surfactant protein A （SP-A） and Clara cell protein16 （CC16） in serum were detected by enzyme-linked immunosorbent assay （ELISA）. The mRNA expression of interleukin-1α （IL-1α）， IL-6， IL-18， and monocyte chemoattractant protein-1 （MCP-1） in lung tissue was measured by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. ResultCompared with those in the control group， the rats in the model group had decreased lung function and obvious structural damage of lung tissue， PM deposition， and infiltration of CD68 positive cells. The expressions of IL-1α， IL-6， IL-18， and MCP-1 in lung tissue were increased （P<0.01）. Compared with the model group， Shenlian prescription low and high doses restored the rats' lung function injury（P<0.05，P<0.01）， improved lung morphological and pathological structure， and reduced PM deposition. Infiltration of CD68 positive cells in lung was not significantly decreased. The levels of inflammatory factors IL-1α， IL -6， IL-18， and MCP-1 in lung were lowered （P<0.01）. ConclusionShenlian prescription could protect the rats' lung injury caused by PM exposure， improve lung morphology， and reduce PM deposition and inflammatory factor expression.