Objective To evaluate the efficacy of comprehensive rehabilitation on cervical syndrome(CS).Methods 112 patients with CS were randomly divided into two groups.The cases in comprehensive rehabilitation group(n=56) were treated with traction,ultrashort wave and massage,while those in the control group(n=56) were treated with traction only.Results The efficient rate of comprehensive group were 91.1% 3 weeks after treatment,and the symptom scores improved significantly compared with the control group(P<0.01).Conclusion The comprehensive rehabilitation is efficient on cervical syndrome with few side-effects and complication.

OBJECTIVE To study the status of five pathogen mixed infection in sexually transmitted diseases(STDs) and analyze the clinical meaning.METHODS We detected five common pathogens by fluorescence polymerase chain reaction,which were Neisseria gonorrhoeae(NG),Chlamydia trachomatis(CT),Ureaplasma urealyticum(Uu),human papilloma virus(HPV),Candida albicans(Ca),and herpes simplex virus.RESULTS We analyzed the status of infection among 4 601 patients,got 279 mixed infection cases,accounted for 6.1% in all cases;and the population with ages from 21 to 40 years was accounted for 89.6%. CONCLUSIONS Fluorescence polymerase chain reaction is a simple,rapid,high sensibility technique for quantitation testing of STDs pathogens,and we should pay great heed to its effective control.

Objective:To explore the clinical value of dynamic posturography in the diagnosis of peripheral vertigo. Method:One hundred and sixty peripheral vertigo patients with full clinical documents in vertigo clinic of our hospital from May 2007 to May 2008 were retrospectively analyzed in this study. All the patients firstly underwent the inspection of static and dynamic posturography and then were subjected to caloric test using videonystagmogra-phy. The results were conducted a comparative analysis. Surface of the statokinesigram (SSKG) was selected as assessment parameter of static posturography. The result of sensory organization test (SOT) were selected as assessment parameters of dynamic posturography. The unilateral weakness was selected as assessment parameter of caloric test. Twenty normal subjects were selected as control. Result: Among the 160 cases with peripheral vertigo, results of SOT in dynamic posturography were abnormal in 144 cases, with a sensitivity of 90. 0%; caloric test was abnormal in 110 cases, with a sensitivity of 68. 8%; static posturography was abnormal in 76 cases, with a sensitivity of 47. 5%. There existed a statistically significant difference between dynamic posturography and caloric test or static posturography. There were 40 patients(25. 0%) who had normal caloric test results in which dynamic posturograph findings were abnormal. Among the 20 cases of normal people, results of SOT in dynamic posturography were abnormal in only one case(5. 0%). Conclusion:With its superior sensitivity and specificity, dynamic posturography has been an objective and reliable approach in the diagnosis of peripheral vertigo. It can help to confirm the presence of abnormalities in some peripheral vertigo patients whose caloric results are normal.

Objective To evaluate the diagnostic value of endoscopic ultrasonography-guided fineneedle aspiration(EUS-FNA)for pancreatic occupying lesion,especially pancreatic cancer.Methods From year of 2005,37 patients with suspected pancreatic cancer by means of uhrasound,CT or MRI received EUS-FNA.Amylase and tumor markers(CEA,CA19-9 and CA125)in cyst fluid were analyzed if applicable.The patients were followed up till July 2008,and the results of EUS-FNA were compared with those confirmed during the follow-up.Results The EUS-FNA yielded diagnosis of 16 cases of pancreatic duetal adenocarcinoma,1 metastatic:renal cancer,5 suspicious malignancy,6 atypia,6 normal pancreatic tissue,and 3 normal non-pancreatic tissue.During the follow-up,25 cases of pancreatic cancer and 10 benigh lesions,including 4 chronic panereatitis,4 cyst-adenoma and 2 pseudocyst,were confirmed,and the other 2 cases still remained un-determined.The sensitivity,specificity,positive predictive value and negative predictive value of EUS-FNA were 80.0%(95% CI:59.0-93.0),100.0%(95% CI:60.0-100.0),100.0%(95% CI:80.0-100.0),and 55.6%(95% CI:27.0-79.0),respectively.No severe procedurerelated complication was observed.Conclusion EUS-FNA is a safe and effective medality for diagnosis of pancreatic occupying lesions,especially pancreatic cancer.

ObjectiveTo prospectively assess the efficacy and safety of endoscopic ultrasoundguided celiac plexus neurolysis (EUS-CPN) in the management of pain caused by pancreatic carcinoma.MethodsPatients with confirmed un-resectable pancreatic malignancy were treated with EUS-CPN once or twice.The data including age,gender,pain duration,opioid consumption,tumor location,pain scores before and after the procedure,number of treatment,duration of pain relief and survival time were collected.ResultsA total of 27 cases with cancerous abdominal pain were recruited.The median pain scores were significantly lower after EUS-CPN,and pain relief was obtained in 81.5％ (95％ CI,66.8％ -96.1％ ) patients with a median duration of 56.0 days (95％ CI,17.1-94.9),whose confidence interval was comparable to that of survival time (97.0 days,95 ％ CI,82.7-111.3 ).No clinical factors could predict post-procedure duration of pain relief (x2 =6.757,P =0.239).Procedure-related transient diarrhea and fever were noted only in 1 patient.No major complications occurred.ConclusionEUS-guided CPN is safe and effective in alleviating abdominal pain associated with pancreatic cancer,even at the late stage.Moreover,no clinical factor could predict post-procedure degree or duration of pain relief.

Objective To investigate the therapeutic efficacy and safety of endoscopic resection of giant gastric stromal tumors without explicit evidence of metastases.Methods A total of 12 giant gastric stromal tumors with no evidence of metastases diagnosed by endoscopic ultrasound (EUS) and computed tomography (CT) scan were managed by endoscopic resection.Operation time,blood loss and the incidence rate of perforation were recorded respectively.The diagnoses of tissue specimens were made by pathological examination and immunohistochemistry.In order to assess local recurrence and distant metastases,endoscopy and endoscopic ultrasound follow-up examinations were performed routinely at 2,6 and 12 months,and the whole abdominal CT scan was also performed at 12 months after operation.Results Endoscopic resections were successfully performed in 10 of 12 cases (83.3％),among which,6 underwent endoscopic submucosal excavation (ESE) without unexpected perforation and 4 endoscopic full-thickness resection (EFR)with intentional perforation.The rate of intentional perforation was 33.3％ (4/12),and all the perforations could be sealed by endoscopic methods.The blood losses were all more than 100 ml,which could be controlled by argon plasma coagulation,electrocoagulation or hemostatic clips.In the 10 encapsulated tumors,8 could be smoothly removed from esophagus,whose long diameter of the minimum cross section was less than 3.5 cm,however,2 tumors whose diameters were larger than 3.5 cm were taken out after segmentation.In the 10 tissue samples,9 were confirmed as low risk GIST,1 larger than 5 cm was pathologically confirmed as high risk GIST.During 1-year follow-up,no local recurrence or peritoneal metastasis was found.2 tumors,larger than 5.0 cm,could not be removed by endoscopic methods due to uncontrolled bleeding.The rate of uncontrolled bleeding was 16.7％ (2/12).The patients were transferred to surgery,and pathologically confirmed as having high risk GIST.Conclusion For low-risk giant gastric stromal tumors whose diameters were less than 5cm without evidence of metastases,endoscopic resection is considered as a safe and effective procedure.Tumors with long diameter of the minimum cross section less than 3.5 cm are more suitable for endoscopic resection,which can be smoothly taken out through cardia.However,for high-risk GIST larger than 5.0 cm,the rate of uncontrolled bleeding is high,so endoscopic resection should be adopted with discretion.

Objective To investigate the clinic effect of the Salvia miltiorrhiza combined with dextran to prevent veno-occlusive disease after hematopoietic stem cell transplantation. Methods In the process of the pretreatment of the hematopoietic stem cell transplantation, patients were treated with salvia miltiorrhiza (20 ml/d), dextran(250 ml, twice a day) by venous transfusion and the drugs to protect the liver cell was used in the same time. When the count of platelet dropped to 30×109/L, salvia miltiorrhiza and dextranware stopped applying forever. Results Veno-occlusive disease and hemorrhage has not occurred during 85 times of the hematopoietic stem cell transplantation treated with salvia miltiorrhiza and dextran. Conclusion We conclude that the combined treatment with salvia miltiorrhiza and dextran is safe and effective to prevent veno-occlusive disease after hematopoietic stem cell transplantation.

Objective To assess the efficacy of percutaneous transhepatie variceal embolization (PTVE) in treating esophageal and gastric variceal bleeding after esophageal-gastric devascularization with splenectomy in patients with liver cirrhosis. Methods Twenty-two patients, who had history of esophageal-gastric devascularization with splenectomy, were either underwent PTVE with TH glue (n=10) or endoscopic injection of sclerosis (EIS, n = 12) for treatment of esophageal or gastric variceal rebleeding between Nov. 2006 and Sep. 2008. The patients were followed-up for recurrent bleeding, mortality, grade of esophageal and gastric varices and liver function. Portal vein pressure was measured before and after collateral embolization in PTVE group. Results ① The patients were followed-up for 12.5 months in PTVE group and 13.4 months in EIS group. There was significant difference (P<0.05) between PTVE and EIS groups in rebleeding rate (1/10 vs 7/12) and mortality (0 vs 3/12). ② The degree of esophageal and gastric varices after embolization or EIS was improved significantly. ③ For patients with portal vein thrombosis, combination of PTVE with portal vein balloon plasty could markedly improve portal vein blood supply. ④ Neither PTVE nor EIS aggravated the liver cirrhosis. Conclusion Compared with EIS, PTVE with TH glue may be a more effiective method in the treatment of rebleeding of patients with liver cirrhosis who had accepted esophagealgastric devascularization with splenectomy.

Objective To assess the value of pulmonary artery CT obstruction index for the evaluation of the severity of pulmonary embolism (PE),and to investigate the relation between pulmonary artery CT obstruction index and D-dimer levels.Methods 125 patients were diagnosed as PE by computed tomographic pulmonary angiography (CTPA)and D-dimer.Patients were separated into high-risk group and non-high risk group.CT obstruction index,D-dimer levels,diameter of the pulmonary artery were compared between two groups. Spearman’s rank correlation coefficients were used to assess the correlation between the CT obstruction index and the D-dimer levels,diameter of the pulmonary artery.Results CT congestion index of high-risk PE group was obviously higher than that of the non-high risk group (P=0.000).The diameter of pulmonary artery in high-risk PE group was obviously greater than that of the non-high risk group,the difference was statistically significant (P=0.000).No statistically significant difference was found in D-dimer levels between the two groups (P=0.103).There was no correction with CT congestion index and D-dimer levels(P=0.71).Conclusion The D-dimer levels of serum was a predictor of pulmonary embolism,cannot evaluate the severity of PE.CT obstruction index can reflect the severity of PE in some extent as an indicator of PE,there was no correlation with CT obstruction index and D-dimer levels.

Objective To investigate the early diagnosis and treatment of primary gastrointestinal malignant lymphoma( PGIML). Methods The clinical materials of 33 cases with PGIML from 1997 to 2005 were retrospectively studied. Results The diagnosis rate of gastroenteroscopy was 44. 4% . The most common immune phenotype was B-cell lineage (90. 9% ). Of the 33 PGIML patients, 30 were treated with operation, 2 with H. poli elimination and 1 gave up treatment. Among the operation cases and operation plus chemotherapy cases 19/21 cases (90. 5% )and 6/9 cases (66. 7% ) survived more than 2 years respectively, the other 6 cases died. Conclusion It is hard to diagnose PGIML in early stage. The effectiveness of surgery on treating PGIML should be further confirmed by profound prospective randomized trials.