Objective To evaluate the wrapper tube in emergency endoscopy for gastro-esophageal variceal hemorrhage. Methods A total of 62 patients diagnosed as having gastro-esophageal variceal bleeding were enrolled as the treatment group to accept wrapper tube assisted emergency endoscopic sclerotherapy. The therapeutic effect was compared with another group of 62 patients who also had gastro-esophageal variceal hemorrhage while treated by conventional emergency endoscopic sclerotherapy (control group). Results The rate of hemostasis with wrapper tube was 100%, which was significantly higher than that of the control group (80. 65%, P ＜0. 05). The rate of gastro-esophageal varices remission after sclerotherapy in treatment group was 59.32%, which was also significantly higher than that of the control group (7. 25%, P ＜ 0. 05 ). The rates of chest pain, esophageal ulcer, length of hospitalization, and total medical cost in treatment group were significantly lower than those of control group ( P ＜ 0. 05 ). Conclusion Wrapper tube in emergency endoscopy for gastro-esophageal varices bleeding can improve therapeutic effect and relieve patients' economic burden.

Objective To Investigate the safety and clinical significance of self-made wrapper tube assisted endoscopic mucosal resection for upper esophageal mucosal endometriosis.Methods A total of 53 patients with upper esophageal mucosal endometriosis and the corresponding symptoms, which was confirmed by endoscopy and pathology, underwent endoscopic treatment.The endoscope was inserted into the esophagus together with wrapper tube.Then the endoscope was retreated into the wrapper tube and pulled back together with the tube.When the tip of the wrapper tube reached at the oral side of the lesion, it was fixed, and submucosal resection was performed.All patients were followed up to 6 months.Results All lesions were completely resected, which was achieved by one session in 45 patients, by two in 5, and by three in 3 other patients, with a mean procedure time at 6.5 minutes (4.5-7.5).Symptoms were relieved in 43 patients (81.1%) at 3 months after the procedure, and in 45 patients (85%) at 6 months.No local recurrence was observed under endoscopy and biopsy.No complications including esophageal stenosis, perforation or cardiopulmonary accidence were recorded. Conclusion For upper esophageal mucosal endometriosis presented with local symptoms, wrapper tube assisted endoscopic mucosal resection is safe, less invasive, easy to manipulate and effective.

Objective To study psychological change on anxiety patients with coronary heart disease (CHD) after percutaneous coronary intervention and to explore the effect of psychological intervention on anxiety patients with CHD.Methods The selected 126 anxiety patients with CHD were randomly divided into three groups A,B,C,and 42 cases in each group.Group A of was the control group,group B was the anti-anxiety drug group,group C was the psychological intervention combinded with anti-anxiety drug,and all patients were treated for one month.The self-rating anxiety scale (SAS) scores were recorded in three groups before surgery,after one week and one month treatment.Resluts There was no significant difference in SAS scores in group A before the operation and after 1 week,1 month treatment(respectively(57.14 ±5.63),(55.86 ±5,46),(53.93 ±6.03),P＞ 0.05).After 1 week and 1 month treatment,the SAS score of group C (respectively (42.79 ± 5.82) points,(33.86 ± 5.05) points) and the SAS score of group B (respectively (49.93 ± 6.63) points,(40.93 ± 6.46)points) were lower than those of group A (respectively (55.86 ± 5.46) points,(53.93 ± 6.03) points),and there were significant differences among the three groups(P ＜ 0.05).Conclusion There is no significantly improvement in patient's anxiety after coronary revascularization.Anti-anxiety drug and psychological intervention significantly improve the patient's negative emotions and reduce the incidence of angina.

AIM: To express the synthesized human insul in like growth factor I (hIGF-1) gene in E.coli with high expression level a nd explore the way to increase the efficiency of factor Xa cleavage. METHODS: The gene of hIGF-1 was designed and synthesized accordi n g to the preference of E.coli. A fusion protein with a recognized site of fa ctor Xa between CBD (cellulose binding domain) and hIGF-1 was expressed and puri fied by cellulose affinity chromatography. MTT method was used to assay the bioa ctivity of CBD-IGF fusion protein. hIGF-1 was released by factor Xa. In order to improve the sensitivity of fusion protein to factor Xa, the short flexible pept ide (Gly-Thr-Gly- Gly-Gly-Ser-Gly) was added before the recognized site of fac tor Xa. RESULTS: SDS-PAGE results indicated that the CBD-IGF fusion prot ein was expressed and purified . Biological assay results indicated CBD-IGF fusi on protein could promote the growth of NIH3T3 cell. The short flexible peptide (Gly-Thr-Gly-Gly-Gly-Ser-Gly), which was added before the recognized site of f actor Xa, improved the sensitivity of fusion protein to factor Xa. CONCLUSION: CBD-IGF fusion protein with bioactivite are expresse d and purified. The amio acid sequences changes between the site recognize of fa ctor Xa can help to improve the cleavage efficiency of Factor Xa.

Objective To estimate the success rate of emergency endoscopic treatment in patients with esophagogastric variceal bleeding using self-made gastroscope outer casing and to investigate bow to prevent complications. Methods A total of 11 patients with esophagogastric variceal bleeding underwent endoscopic treatment with self-made gastroscope outer casing, which consisted of a wire reinforced plastic casing (1.05 cm in inner diameter, 1.35 cm in outer diameter and 50 cm in length), a 3.8 cm×3.8 cm balloon fixed on the casing head and its cavity connected to the gas pipeline placed in casing tail, an anti-reflux pad in the insert entrance of the endoscope tail as well.as a flushing hole. The endoscopy was introduced to the esophagus or stomch together with outer casing to wash and pump the hematocele out from the side of flushing hole. In patients with hemorrhagic lesion in esophageal vein, the balloon was used to press bleeding vein and intravascular sclerotherapy was performed simutanously. In those with hemorrhagic lesion in gastric vein, the balloon was pressed on esophageal vein near to the cardia and intravascular sclerotherapy was performed. Results During the process of examination, the hemorrhagic lesion was fully exposed because of flushing, and bleeding was controlted in all patients after sclerotherapy. No complication such as aspiration or perforation was seen. Conclusions For emergency endoscopic treatment of esophagogastric variceal bleeding, gastroscope outer casing is helpful in removing intragastric hematocele and maintaining a clear field of vision. It can be effectively improving the efficacy of sclerot herapy.

Objective To explore the relationship between R time in thrombelastography (TEG) and prognosis of traumatic brain injury (TBI).Methods The data of TBI patients were collected in Fourth Peoples Hospital in Shaanxi Province from January 2015 to June 2016.The patients were divided into two groups according to the prolongation of R time at admission,and the basic data and the outcomes were analyzed.Results In basic data,Glasgow coma scale (GCS) [(9.7 ± 4.4) scores vs (12.1 ± 2.2) scores] was lower,and injury severity score (ISS) [(32.4 ± 8.9) scores vs (21.7 ± 10.4) scores],head abbreviated injury scale (AIS) [(5.0 ±0.0) scores vs (4.1 ± 1.5) scores],hemorrhage volume [(6.2 ± 5.5) ml vs (1.1 ± 1.8) ml] and mean arterial pressure[(127.2 ± 28.1) mmHg vs (103.3 ± 17.0) mmHg] were higher in the prolonged R time group.In outcomes,the in-hospital mortality (42.9％ vs 17.2％) and the rate of neurosurgical intervention (71.4％ vs 37.7％) were higher,and the duration of mechanically ventilated [(9.3 ±3.2) d vs (4.1 ± 1.7) d],ICU stay [(10.2 ± 4.4) d vs (5.6 ± 2.1) d] and hospital stay [(22.4 ± 8.1) d vs (8.3 ± 4.7) d] were longer in prolonged R time group.The Logistic regression analysis results showed that GCS ≤8 scores,ISS ＞ 25 scores and R time ＞ 10 min were the possible risk factors of hospital mortality.Conclusion TBI patients with longer R time have worse prognosis and longer R time is the possible risk factor of hospital mortality,and the prediction efficiency of R time need to be explored and validated by more research.

Through looking up Chinese Pharmacopoeia and searching for unannounced inspection on the website of China food and drug administration and some GMP regulations and gudelines of European Union, the problems existing in the raw materials control of animal original biochemical drugs were discussed, and the relevant suggestions were put forward.

Objective To investigate the incidence of left-sided portal hypertension (LSPH) in chronic pancreatitis (CP) and other accompany conditions of CP and explore the diagnostic value of LSPH in chronic pancreatitis.Methods The clinical,pathological and imaging data of 125 CP patients received at least two imaging examination were retrospectively analyzed.The rates of abnormal pathologic findings,abnormal imaging findings and accompanying LSPH in CP were analyzed.The data were analyzed by chi-square test.Results Among 125 CP patients,29.6％ (37/125) received three or more than three kinds of imaging examinations.The pathological detection rates of pancreatic calcification or lithiasis,pancreatic ductal lesion,abnormal pancreatic morphology,pancreatic lesion and LSPH were 58.4％ (73/125),60.8％ (76/125),35.2％ (44/125),48.8％ (61/125) and 24.8％ (31/125),respectively.The sensitivities of imaging examination in those lesions were 68.5 ％(50/73),96.1％ (73/76),95.5％ (42/44),95.1％ (58/61) and 90.3％ (28/31),respectively.The detection rates of pancreatic calcification or lithiasis and pancreatic ductal lesion in pathological examination were significantly higher than those of the others,and differences were statistically significant (x2=33.764 and 37.932,both P＜0.01).The sensitivity of imaging examination in pancreatic calcification or lithiasis was lower than those of the others and the differences were statistically significant (x2 =36.526,P＜0.01).Among 125 CP patients with 223 pancreatic lesions detected by imaging examination,the rates of patients with 0,1,2,3,4 lesions accounted for pancreatic were 5.6％ (7/125),40.0％ (50/125),28.8％ (36/125),21.6％ (27/125) and 4.0％ (5/125),respectively.Of patients with pancreatic calcification or lithiasis,pancreatic ductal lesions,abnormal pancreatic morphology and pancreatic lesions detected by pathological examination,there were 23.7 ％(17/73),20.0％ (15/76),22.6％ (10/44) and 27.9％ (17/61) cases accompanied with LSPH,there was no difference between these groups (x2 =1.262,P=0.738).Conclusion LSPH may be a reference for CP diagnosis by imaging examination.

Objective The efficacies of four cholangiogrphies were compaired with each other in preventing bile duct injury during the procedure of LC. Methods Four cholangiogrphies were used in LC:1. Cold light cholangiography (CLCP); 2. Methylenum coeruleum cholangioguaphy (MCCP); 3. Intraoperative cholangiography (IOCP); 4. Intraoperative endoscopic retrogarde cholangiopancreatography (IERCP). Results The images of CLCP and MCCP were direct and could help operator to identify bile duct structure in LC. The images of IPCP and IERCP were indirect and could not be so helpful. Conclusions CLCP is the only technique that clearly and directly shows the location of the extra hepatic biliary system and may be useful in selected cases with abnormal or uncertain anatomy for the prevention of bile duct injury.

Objective To investigate the effect of Intedeukin-18 (IL-18) on Th1/Th2 balance and its antitumor mechanism in C57BL/6 mice Lewis lung cancer model. Methods 24 C57BL/6 mice were randomly divided into three equal groups: group A(IL-18 injec-tion group, n = 8), group B (Lewis lung cancer model, n = 8) and group C (normal control group, n = 8). The Lewis lung cancer cells were cultured and implanted subcutaneously into the group A and group B. IL-18 and NS were given to group A and B respectively by intrap-eritoneal injection on the 7th day (once every day, 7 times altogether), but group C was not given any treatment. Enzyme-linked immunosor-bent assay (ELISA) was used to detect the Th1/Th2 cytokines. Health status in all the animals was evaluated; the volume and weight ofsubcutaneous tumors were measured. Results The concentration of IFN-γ in group A and C were significantly higher than those in group B (P <0.05), and the concentration of IL-4 in group A and C were significantly lower than those in group B (P<0.05), but there was no significant difference between group A and C (P>0.05). The tumor growth inhibitory rate was 75%. Conclusion IL-18 can effectively induced IFN-γ and inhibit IL-4 production, regulate Th1/Th2 balance in the C57BL/6 mice Lewis lung cancer model, and elicit the antitu-mor immunity of the host, which could obviously inhibit the growth of tumor cells and decelerate the proliferation of tumor cells.