Objective To evaluate the feasibility and safety of interventional microinvasive techniques in the management of high level cervical esophageal strictures.Methods Among 20 cases of high level cervical esophageal strictures,13 cases of strictures at the level of C_7~T_3 were given an oral placement of nitinol metal stents woven by single thread under fluoroscopic guidance,while 7 cases of strictures at the level of C_7 and above were given a percutaneous gastrostomy(PG) under endoscopic or fluoroscopic guidance.Results All the operations were successfully accomplished without complications.Out of 13 cases of intraesophageal stent implatation,the improvement of dysphagia was classified as grade 0 in 10 cases and as grade Ⅰ in 3 cases.Esophago-tracheal fistula was completed occluded in 5 cases.Slight downward stent shift was found in 2 cases and no further management was carried out.Follow-up in 11 cases for 1~30 months(mean,18 months) revealed 3 cases of recurrence of esophageal stricture and 8 fatal cases.No stentinduced esophago-tracheal fistula occurred.Of 7 cases of percutaneous gastrostomy,liquid diet was given 2 days after operation.Infection with redness and swelling in the area of fistula wound was noted in 1 case at 1 week postoperatively and the fistula tube was found loosened in 1 case at 5 months postoperatively.No intraabdominal infection,peritonitis,or internal fistula occurred.Follow-up in 7 cases for 1~18 months showed 5 fatal cases.Conclusions Stent implantation should not be contraindicated in patients with high level cervical stricture of esophagus.Radiologically guided percutaneous gastrostomy is safe and feasible,which is preferred as the first choice of treatment.

Objective To study diagnostic methods for early renal injury in hypertension patients. Methods Urinary microalbumin (mALB) and ? 2 microglodulin(? 2 MG) levels were measured with rate nepherometry. Total quantitative enzyme immunoassay was employed to measure urinary retinol binding protein (RBP) levels, rate for urinary N acetyl beta D glucosaminidase (NAG), and Jaffes rate for urinary creatinine (Cr). Results The levels of urinary RBP, mALB, ? 2 MG, NAG in hypertension patients were significantly higher than those in controls ( P

Objective To explore the morbidity, manifestation, pathogenesis and diagnosis of acquired immune deficiency syndrome( AIDS)-related lesions in digestive system. Methods The complete history interview, physical examination and diagnostic test were made in a total of 1000 heroin addictors with intravenous injection. Seventy-two of them were selected as AIDS based on the diagnosis criteria on HIV/AIDS of Centers for Disease Control(CDC) (CD4+ T cell count lower than 400/?l and human immunodeficiency virus ( HIV) load higher than 400 copies/ml). Results Main clinical manifestations of AIDS were persistent low fever, diarrhea, progressive exhaustion, opportunistic infection, tumorgenesis and multiple organ impairment. The morbidity of AIDS-related lesions in digestive system ranged from 1.4% to 98. 6%. Oropharyngeal and gastrointestinal lesions occurred in 71 cases (98.6%), while hepatic, biliary and pancreatic impairment occurred in 59 cases (81. 9%). Conclusions AIDS-related lesions in digestive system are common in AIDS patients which are mainly caused by HIV invasion, opportunistic infection, tumorgensis and immune system impairment.

Objective To study CEAmRNA、CK19mRNA and CK20mRNA in peripheral blood of lung cancer patients by Real-time RT-PCR,consequently discussing those result′s clinical significance.Methods 48 lung cancer patients,8 benign lung disease patients and 30 healthy volunteers of CEAmRNA,CK19mRNA and CK20mRNA in peripheral blood were detectd by Real-time RT-PCR.Results The levels of 48 lung cancer patients CEAmRNA in peripheral blood reach (16 264?28 765) copies/ml,of which 26 patients,results are positive; The levels of 48 lung cancer patients CK19mRNA in peripheral blood reach (14 891?27 244) copies/ml,of which 27 patients,results are positive; The levels of 48 lung cancer patients CK20mRNA in peripheral blood reach (10 924?21 678) copies/ml,of which 20 patients,results are positive. Among of 8 benign lung disease patients,there is just CK20mRNA was detected in one patient,both CEAmRNA and CK19mRNA were not detected in their peripheral blood. As for those 30 healthy volunteers,there is none of the mRNA was detected. Moreover,there is a marked positive correlation between the levels of CEAmRNA,CK19mRNA and CK20mRNA,the levels of CEAmRNA,CK19mRNA and CK20mRNA were correlated to the physiological cause or degree of lung cancer.Conclusion CEAmRNA,CK19mRNA and CK20mRNA in peripheral blood can be as auxiliary index for diagnosing lung cancer micrometastasis,also can monitor the lung cancer micrometastasis by quantity it.

OBJECTIVE:To study the chemical components of Swertia nervosa. METHODS:Silica gel column chromatogra-phy was used for purification and analysis of compounds’structure based on physicochemical properties and spectral data. RE-SULTS:Five compounds were isolated and identified in petroleum ether portion of S. nervosa,involving 1-hydroxy-3,7,8-trime-thoxyxanthone (1),1,8-dihydroxy-3,7-dimethoxyxanthone (2),1,8-dihydroxy-3,5-dimethoxyxanthone(3),1-hydroxy-3,5-dime-thoxyxanthone(4)and β-sitosterol(5). CONCLUSIONS:Compound 1,3 and 4 are isolated from S. nervosa for the first time,and the study has laid a foundation for the quality evaluation of S. nervosa.

Objective To evaluate the effect and safety of trans-arterial chemotherapy embolization (TACE) in the treatment of primary hepatic carcinoma ( PHC ) with portal vein tumor thrombus. Methods There were 83 PHC patients complicated with portal vein tumor thrombus, age ranging from 29 to 76 years. Fifty-three cases underwent TACE ( Group A) , 30 receiving trans-arterial chemotherapy infusion only (TAI, Group B). Results The survival rate in group A at 6,12,24 and 36 months was 97. 8% , 85.2%,45.8% and 4.4%, respectively, significantly higher than that in group B (37. 6% ,5. 3% ,0,0, P

Objective:To study the clinical value of lectin reactive alpha fetoprotein(AFP) detection in primary hepatocellular carcinoma (PHC) and benign liver diseases.Methods:According to the different affinity with AFP, AFP L 3 was detected by affinity immunoelectrophoresis blotting method, AFP detected by Chemiluminescent Immunoassay.Results:Taking AFP L 3≥15% as the diagnosis criteria of PHC,the sensitivity was 91.1%,the specificity in differential diagnosis in chronical liver diseases was 95.0%,the levels of AFP L 3 has no correlation to serum AFP levels and the sizes of PHC.Conclusion:It is of great clinical value to detect AFP L 3 and serum AFP levels for PHC in early diagnosis and benign differential diagnosis in liver diseases. [

OBJECTIVE To study the distribution and antimicrobial resistance of Acinetobacter baumannii infection in our hospital.METHODS Five hundred and sixty-nine strains of A.baumannii isolated from patients with infection from Jan 2001 to Dec 2005 were collected and antimicrobial susceptibility tests were performed.RESULTS Two hundred and seventy-five strains(48.3%) of A.baumannii were from intensive care unit(ICU).Four hundred and five strains(71.2%) of A.baumannii were examined from sputum.A.baumannii had various drug resistances to 12 antibiotics,which were monitored and proved tending to strengthen.The resistance rate in the ICU was distinctly higher than the others with significant difference(P

Objective To investigate the effect of hepatitis C virus (HCV) genotype on antiviral therapy in patients with human immunodeficiency virus (HIV)/HCV coinfection in Henan province.Methods A total of 129 patients were coinfected with HIV and HCV, among whom, 70 were HCV 1b genotype and 57 HCV 2a genotype.And 131 patients were HIV single infection.Immunological failure rate, virological suppression, CD4+ T lymphocyte counts and liver and renal function after antiretroviral therapy (ART) were compared among the three groups.Flow cytometry was used to count CD4+ T lymphocytes and polymerase chain reaction amplification was used to detect HIV RNA.The liver and renal function were tested by automatic biochemical analysis.Statistical analysis was conducted by χ2 test, analysis of variance and LSD-t method.ResultsImmunological failure rate in HCV 1b group, HCV 2a group and HIV single infection group were 7.14% (5/70), 15.79% (9/57) and 9.92% (13/131), respectively.There was no significant statistical difference among the three groups (χ2=2.59, P>0.05).The CD4+ T lymphocyte counts in three groups were (614±258), (529±245), and (518±243) cells/μL, respectively.The difference was statistically significant (F=3.17, P<0.05).The virus inhibition rates of three groups were 87.0% (HCV 1b), 78.2% (HCV 2a), and 82.3% (HIV single infection).The HIV virus failure rates were 8.6% (HCV 1b), 14.5% (HCV 2a), and 13.1% (HIV single infection).There was no significant difference among three groups (χ2=1.967, P>0.05).The levels of aspartate transaminase, alanine aminotransferase and total bilirubin in HCV 1b group and HCV 2a group were all significantly higher than those in HIV single infection group (F=27.38, 15.22 and 7.33, respectively, all P<0.05), while there was no significant difference between HCV 1b and HCV 2a groups (t=1.27, 0.29 and 1.59, respectively, all P>0.05).Conclusions The main HCV genotypes in patients with HIV/HCV coinfection by blood transmission are HCV 1b and HCV 2a in Henan province.HIV/HCV coinfection does not affect the effect of ART, but could aggravate the liver damage in acquired immune deficiency syndrome patients.

Objective To analyze the risk factors for healthcare-associated pneumonia (HAP) in patients with orthopedic injury,provide the basis for making prevention and control measures.Methods HAP occurred in patients with orthopedic injury and admitted to the department of orthopedics of a hospital from June 2011 to May 2015 were investigated retrospectively,risk factors were analyzed by univariate and multivariate logistic regression methods.Results A total of 2 578 patients with orthopedic injury were investigated,92 patients developed HAI,incidence of HAP was 3.57％.107 strains of pathogens were detected,the major were Klebsiella pneumoniae (n =22,20.56％),Escherichia coli (n =14,13.08％),and Acinetobacter baumannii (n =13,12.15％).Risk factors for HAP in patients with orthopedic injury were length of hospital stay≥15 days,smoking history≥3 years,bedridden ≥7 days,associated with underlying diseases,complications,indwelling catheter≥7 days,surgical operation,mechanical ventilation,admitted to intensive care unit,open injury,blood sugar≥11 mmol/L,plasma albumin＜30 g/ L,hemoglobin concentration＜90 g/L,and use of glucocorticoid≥4 days (all P＜0.05).Multivariate logistic regression analysis showed that smoking,bedridden,surgery,mechanical ventilation,glucocorticoid use,and anaemia were independent risk factors for HAP in patients with orthopedic injury.Conclusion The occurrence of HAP in patients with orthopedic injury is related with multiple factors,the major are surgical operation,mechanical ventilation,glucocorticoid use,long term smoking,bedridden,and anaemia.