0.05).In addition,the external iliac artery significantly more closer to the iliac spine in left internal iliac artery than in right internal iliac artery.The distance from iliolumbar artery located closer to bone wall with(6.97?0.17) mm.CONCLUSION:The anatomic characteristics of sacroiliac joint determined failure probability of injured vessels.The measured results showed that failure probability of common iliac artery is less when the cacroiliac joint dislocation or fracture.There is less possibility to injure the vessel when cacroiliac joint fracture due to long distance between external iliac artery and bone wall.The internal iliac artery is closer to cacroiliac joint,so stretch injury may occure when sacroiliac joint dislocation accompanied with semi-pelvic shifting.The lateral sacral arteries,which resided closer to bone wall,is easy to injuried when fracture occurred at I area of sacrum.The iliolumbar artery easily damaged when sacroiliac joint dislocation accompanied with semi-pelvic shifting.

Objective To investigate the pathophysiology mechanism in belching by using high resolution manometry combined with impedance monitoring.Methods Ten belching patients (four male and six female,ages ranged from 28 to 50 years) received high resolution manometry combined with impedance monitoring.The characters of esophageal motility at rest,swallowing and belching and the possible mechanism of belching were analyzed.Results Nine of 10 patients had esophageal peristaltic dysfunction,displaying as non-peristaltic contraction such as non-conduction contraction,interrupt contraction and dropping contraction.The pressure of the lower esophageal sphincter (LES) of three patients decreased.LES of one patient had incomplete relaxation.Nine of 10 patients were supragastic belching,in which air moved rapidly into esophagus and reversed exited from the mouth in one second.Among nine supragastic belching patients,the pleural pressure of seven patients increased during inspiration,upper esophageal sphincter relaxed and air was mistaken into the esophagus.The pharyngeal muscle contracted in two patients and the air was forced into esophagus.Of all the patients,intragastric and esophageal pressure increased through abdominal muscles and diaphragm contraction and air exited from the mouth.Conclusions The results of this study indicated that there was esophageal peristaltic dysfunction in belching patients.There was no frequently air swallowing in excessive belching patients,the typical belching model was supragastic belching.

Objective To investigate the effect of autonomic nervous dysfunction on pathogenesis of gastro-esophageal reflux disease(GERD).Methods Autonomic nervous function(ANF) was assessed by cardiovascular reflex tests in healthy volunteers and patients with GERD;Based on the ANF test results,the relationship between the impairment degree of autonomic nerve and the esophageal motility or the reflux esophagitis or the score of reflux symptoms was investigated.Results ① 59.5% of patients with GERD have abnormal ANF and the rate in GERD patients is much higher than that in healthy volunteers,parasympathetic nerve impairment is predominant.② The score of reflux symptoms in patients with normal ANF is significantly lower than that in patients with abnormal ANF(6(2,7.6)vs 9(4.1,17),P

Objective To study X-ray and CT findings of retroperitoneal fibrosis and their value for diagnosis of this disease.Methods X-ray and CT findings and clinical data of 5 cases confirmed with retroperitoneal fibrosis by clinicopathology were retrospectively analysed in combination with literature review.Results X-ray and CT manifestations of retroperitoneal fibrosis included diffuse mass at retroperitoneum,the neighboring organs were enveloped by masses,and one or bilateral renal pelvis and the ureter expansion.Conclusion X-ray and CT have vital clinical significance in diagnosing the retroperitoneal fibrosis.

Objective To evaluate influencing factors of the long-term maintenance therapy in patients with gastroesophageal reflux disease (GERD).Methods 156 Patients with GERD were divided into on-demand therapy group and continuous therapy group by their treatment,according to symptom relief and improvement of quality of life in the course of therapy.The relationship between treatment and course,symptoms, esophageal motility,24-h pH monitoring and endoscopic findings were analysed.Results (1)5 Patients showed no response to acid suppression therapy and were excluded.For the 151 patients,92 were in on-demand therapy group,and 59 were in continuous therapy group.(2)The disease course and symptoms score in on-demand therapy group were significantly longer and higher than those of continuous therapy group (P

In the clinical practice,critically ill patients are in great risk of delirium because of the impact of psychological,surroundings,illness,and medications,with the incidence rate as high as 45％-87％.Delirium could result in bad prognosis and clinical consequences of cognitive function in late stage.Dexmedetomidine (DEX) is a novel and highly selective 2-adrenoceptor agonist.It offers beneficial pharmacological properties and has been widely used in intensive care unit (ICU).In order to provide scientific and effective references for clinical practice,this paper reviewed the development of DEX intervention for the prevention of delirium in ICU both in China and abroad refereed to the pharmacological characteristics and the efficiency in clinic and the influence factors ofthe efficiency;and also discussed the possible mechanisms,such as modulating the neurotransmitters,and attenuating stress response and inflammation.

Objective To determine the postprandial acid distributions in patients with gastroesophageal reflux disease (GERD), and their potential relationship with esophageal acid exposure. Methods Esophageal and gastric pH were recorded in a 1 h fasting segment and a 4 h postprandial segments using a triple-channel pH catheter with three antimony electrodes, which were positioned 5 cm proximal to the upper margin of LES(LES-5 cm), 5 cm and 10 cm distal to the upper margin of LES(LES+5 cm and LES+10 cm), respectively. Esophageal acid exposure and gastric integrated acidity (IA) were calculated for each ambulatory pH study. Ten healthy subjects (HS) and 10 patients with GERD were enrolled. Results (1) Total postprandial IA had a trend to be lower at LES+5 cm than at LES+10 cm in HS, but there was no significant difference between the two positions in patients with GERD. (2)Two hours after meal, there was no significant difference of gastric IAs and baseline in HS. Whereas gastric IAs in patients with GERD returned back to a higher level than baseline: LES+5 cm: 5.4 (1.8-6.8) mmol/L?h vs 1.8(0.3-3.1) mmol/L?h (P

Objective To investigate the efficacy of umbilical cord mesenchymal stem cells (UC-MSCs) transplantation in the treatment of the MRL/lpr mice. Methods Twenty four 18-week-old MRL/lpr female mice were divided into 3 groups:group 1 (G1) were transplanted with 1×106 UC- MSCs through caudal vein, group 2 (G2) were transplanted with 1×106 UC- MSCs three times and group 3 (G3) were treated with 0.5 ml normal saline as controls. Enzyme linked immunosorbent assay (ELISA) was used to measure the levels of serum anti-dsDNA antibodies. Twenty-four hours proteinuria and body weight were assessed every two weeks. The histopathology changes of the kidneys and lungs were observed. Results ① At the 25th weeks, the 24 hours proteinuria in group G1 (2.3±1.9) mg and G2 (1.8±1.4) mg was decreased than that in the control group (3.8±2.1) mg (P<0.05), and at the 27th weeks, that of groups G1 (2.5±1.5) mg and G2 (1.9±1.2) mg was also significantly decreased than in the control group (5.4±2.4) mg (P<0.01); ② From the 24th week, the body weight of groups G1 and G2 increased significantly than that of the control group (P< 0.05). At week 29, serum creatinine decreased significantly in both groups G1 (7.2±3.2) μmol/L and G2 (6.2±2.8) μmol/L than in the control group (12.5±2.3 ) μmol/L (P<0.05); ③One week after transplantation, the levels of anti-dsDNA antibodies in group G1 (46±11)×102 U/ml and G2(49×43)×102 U/ml were bothsignificantly decreased than those of the control groups (99±42)×102 U/ml (P<0.05) and the difference between group G2 (36±15)×102 U/ml and the controls (68±32)×102 U/ml was statistically significant; ④The nephron crescent formation in group G1 (0.12±0.07) and G2 (0.08±0.02) was significantly lower that of the control group (0.20±0.06) (P<0.05) and that of group G2 was significantly less that of froup G1 (P<0.05); ⑤ The interstitial pneumonitis was singnificantly milder in group G1 than group G2. Conclusions UC- MSCs is very effective in treating MRL/lpr mice. It is safe and free of rejection reactions.

Objective To investigate the feasibility and reliability of perfusion nutrient load test (P-NLT) in evaluating gastric accommodation and hypersensitivity.Methods Forty-one healthy volunteers randomly received either drinking nutrient load test (D-NLT) or P-NLT (through nasalgastric tube) in separate day within one week.Meanwhile,intragastric pressure (IGP) was recorded and 2D ultrasonography (2DUS) was used to measure both the proximal gastric area (PGA) and proximal gastric volume(PGV) during NLT.Visual analogue scale was used to evaluate satiety during NLT.Ten healthy volunteers experienced second P-NLT within 3 months.Results The amount of nutrition liquid was higher in P-NLT than in D-NLT at minimal and maximal satiety(P <0.01).However,there was no difference in the IGP between P-NLT and D-NLT at minimal and maximal satiety (P>0.05).The PGA and PGV at maximal satiety were significantly higher in P-NLT than DNLT (P <0.01),but no difference existed at minimal satiety between two methods (P >0.05).The amount of nutrition liquid at maximal satiety was significantly correlated with PGA and PGV at maximal satiety in both P-NLT and D-NLT (PGV:r = 0.771 vs r = 0.500;PGA:r = 0.600 vs r =0.430).In P-NLT group,there was no significant difference among age,BMI and gender with respect to IGP and maximal volume (MV) (P >0.05).Whereas no difference was found in threshold volume (TV) and MV between the first and the second P-NLT studies (P >0.05).Conclusions It suggests that P-NLT might be more accurate than D-NLT in predicting gastric accommodation in healthy volunteers without any influence such as swallowing air,taste and psychological disturbance.It has a good repeatability.P-NLT is a potential method in assessment of proximal gastric accommodation and MV might be more suitable for assessment gastric accommodation.

BACKGROUND:Total knee arthroplasty is the main treatment for end-stage knee disease.However,knee prostheses are mostly imported from overseas,making the price expensive.Furthermore,ethnic differences mean that these prostheses designed for westerners are not designed to meet the needs of Orientals.OBJECTIVE:To verify the efficacy and safety of this novel knee prosthesis in total knee arthroplasty.METHODS:We propose to conduct a prospective,single-center,randomized,positive parallel controlled,non-inferiority,clinical trial at Shiyan Taihe Hospital,China.Seventy-two patients with knee disease who are scheduled to undergo knee arthroplasty will be equally randomized into the trial group or the control group using a randomized block design.The trial and control groups will undergo knee arthroplasty with knee prostheses purchased from Wuhan Yijiabao Biomaterial Co.,Ltd.,Wuhan,China (newly developed) and Beijing AKEC Medical Co.,Ltd.,Beijing,China (approved by the China Food and Drug Administration),respectively.All patients will be followed up for 12 months.The primary outcome will be the recovery of knee function as assessed by the rate of excellent and good Hospital for Special Surgery knee scores at postoperative 12 months (± 15 days).The secondary outcomes will be:the morphology of the knee as revealed by anteroposterior and lateral radiographic views taken preoperatively,and at postoperative 2 weeks (± 5 days),6 weeks (± 15 days),3 months (± 15 days),6 months (± 15 days),and 12 months (± 15 days);the incidence of adverse reactions at postoperative 2 weeks (± 5 days),6 weeks (± 15 days),3 months (± 15 days),6 months (± 15 days),and 12 months (± 15 days);and the correlation between various types of adverse reactions and each knee prosthesis type.This trial has been registered at ClinicalTrials.gov (identifier:03184129).The study protocol has been approved by the Ethics Committee of Taihe Hospital of China (approval number:2016 (34)).All protocols will be performed in accordance with the Ethical Principles for Medical Research Involving Human Subjects in the Declaration of Helsinki.Written informed consent was provided by each patient and their family members after they indicated that they fully understood the treatment plan.DISCUSSION:Participant recruitment began in February 2017 and will be finished in September 2017.Data analysis will be completed in November 2018.Wuhan Yijiabao Biomaterial Co.,Ltd.has developed a new knee prosthesis system.This system uses cobalt-chrome-molybdenum and high cross-linked polyethylene as the active friction interface,which has excellent wear resistance.This trial is designed to verify the efficacy and safety of this novel knee prosthesis in total knee arthroplasty.