Background/Aims: Lyon consensus differentiates acid exposure time (AET) as physiological, borderline, and pathological. Mean nocturnal baseline impedance (MNBI) and post-reflux swallow-induced peristaltic wave index (PSPWi) are believed to increase diagnostic yield of gastroesophageal reflux disease (GERD) and correlate with symptom outcome of proton pump inhibitor (PPI) treatment. We aim to explore the clinical characteristics and the correlation of pH-impedance parameters with PPI response in Chinese patients with different AET levels. Methods: We retrospectively investigated 177 patients with typical reflux symptoms who received esophageal function tests. The demographics, GERD questionnaire scores, the proportion of esophagitis and PPI responders, and manometric and pH-impedance parameters were compared among patients with AET < 4%, 4-6%, and > 6%. In patients with AET ≥ 4%, manometric and pH-impedance parameters were compared between PPI responders and non-responders. Results: Among 177 patients, 69 (39.0%) had AET 4-6%, and 53 (29.9%) had AET > 6%. The demographics, esophagogastric junction type, and occurrence of ineffective esophageal motility were similar between patients with AET 4-6% and > 6%, but different from AET < 4%. MNBI and PSPWi were different among different AET levels, but similar between PPI responders and non-responders in patientswith AET ≥ 4%. Conclusions It is reasonable to set 4% as a threshold to define pathological AET in Chinese patients. MNBI and PSPWi could identify GERD patients, but may not correlate with PPI response of Chinese GERD patients.

Objective:To explore the differences in intravascular ultrasound results in elderly coronary heart disease(CHD)patients with different uric acid levels.Methods:A total of 145 elderly patients diagnosed with CHD in our hospital from December 2017 to May 2020 were included as study subjects.Uric acid levels were measured and intravascular ultrasound examination was conducted in all patients.They were divided into different groups based on uric acid levels: Group A(uric acid≤199 μmol/L), Group B(uric acid 200~399 μmol/L)and Group C(uric acid≥400 μmol/L). Data from intravascular ultrasound-derived indexes were analyzed and compared between the three groups.Results:There was no significant difference in the degree of left main stenosis between Group A and Group B, but it was less severe in both groups than in Group C( F=5.625, P=0.039). Plaque fibrous cap thickness showed no significant difference between Group B and Group C, but it was smaller than in Group A( F=7.825, P=0.020). Group C had the largest plaque area and maximum thickness among the three groups, followed by Group B[(11.12±1.73)mm 2 and(1.76±0.24)mm]and Group A[(8.29±3.14)mm 2 and(1.38±0.09)mm]( F=6.384 and 6.827, P=0.028 and 0.015). Conclusions:Elevated uric acid levels in elderly CHD patients can increase the area and thickness of plaques, and reduce plaque fibrous cap thickness, leading to an increased risk of formation of unstable plaques, which can be life-threatening for these patients.Thus, monitoring and managing uric acid levels should be stressed in elderly CHD patients.

Objective:To prepare and identify the mouse anti-human monoclonal antibodies ( mAbs) using leukocytes as im-munogens. Methods: The mice were immunized using human peripheral blood leukocytes. Then, use of B lymphocyte hybridoma technology preparation of mAbs,followed screening by immunocytochemistry and limited dilution. The secreted mAbs were identified by immunoprecipitation,mass spectrometry,Western blot,ELISA and immunohistochemistry. Results:The 35 positive polyclonal cells were obtained,of which 11 strains secreted mAbs against S100A9. And one strain was used to prepare monoclonal antibody. The purified mAb against S100A9 were purified and identified as IgG1 subtype,with the titer,purity and affinity constant was 1∶3. 18×105,95% and 3. 54×108 L/mol,respectively. This mAb generally had 0. 12% crossed reactivity to S100A8 ,and showed little or no cross reactivity to S100A12 and S100A13. The prepared monoclonal antibodies can specifically recognizes the S100A9 antigen in human breast cancer tissues. Conclusion:Successful preparation of mAb against S100A9,which can secrete specific mAb against S100A9 protein with high titers and specificity have been established successfully,which laid the foundation for the immunology application.

Objective To study the clinical characteristic of non puerperal mastitis and estimate the effect of anti-mycobacterial agents for non puerperal mastitis .Methods 22 cases of periductal mastitis and gran-ulomatous mastitis receiving anti-mycobacteria drugs therapy from Mar .2012 to Mar.2014 were retrospectively analyzed.Results All patients were female.The mean age was 30 years(ranging from 24 to 46 years).The main clinical manifestation of the 22 patients were 18 patients(81.8%)with mass, 20 patients(90.9%)with abscess, 15 patients(68.2%)with fistula and 9 patients(40.9%)with all of the above 3 symptoms.6 patients had incision and drainage of abscess and 2 patients had tumor resection before anti-mycobacterial therapy .All of the 8 patients had postoperative recurrence .All patients underwent anti-mycobacterial therapy with 3 to 16 months.11 cases (50.0%)patients were cured without recurrence until now .7 cases(31.8%) patients were improved markedly and they still received drug treatment .2 cases(9.0%)patients with tumor size reduced to 2 cm were ready to sur-gical resection.2 cases(9.0%)were lost to follow-up.Conclusion Patients with refractory non puerperal masti-tis can be treated with anti-mycobacterial agents with relatively long treatment time and can also avoid mastecto-my.

Objective To investigate a practical scientific method for measurement of thyroid remnant in endoscopic thyroidectomy via breast approach.Methods The clinical data of 95 hyperthyroid patients were reviewed and analyzed.The patients were submitted to endoscopic thyroidectomy via breast approach and bilateral subtotal thyroid resection were performed.Thyroid remnant were assessed by naked eyes in 32 cases,thyroid remnant measuring tape in 63 cases.The therapeutic effect was observed.Results All the operations were successfully performed.There was no dyspnea,bleeding,recurrent laryngeal nerve and thyroid gland injury,postoperative recovery was well.The function of thyroid gland was reviewed after operation every 2-3 months,and reviewed by color ultrasound after operation every 6 months.Followed up for 1.8-6.0 years.In 32 patients whose thyroid remnant were assessed by naked eyes,3 patients showed relapse after operation 3 months,2 patients developed hypothyroidism.In 63 patients whose thyroid remnant were assessed by thyroid remnant measuring tape,there had no relapse and hypothyroidism.Conclusion Using thyroid remnant measuring tape in endoscopic thyroidectomy,according to 3.0,2.0,0.5 measurement method,make 1.06 g/cm3 as standard,is scientific,practical and clinical feasible.

Objective To explore the expression of BCSG 1 in the triple negative breast cancer and the non-triple-negative breast cancer and its significance .Methods The clinical data from 170 patients were retrospectively analyzed,which including 160 breast cancer and 10 benign breast disease .We checked the expression of BCSG 1 in the specimens by the immunohistochemistry to analysis the similarities and differences the BCSG 1 between the triple negative breast cancer and the non-triple negative breast cancer .Results The expression rate of the BCSG 1 was 41.0%in the non-triple negative breast cancer , which was lower than 57.5% in the triple negative breast cancer (χ2 =4.2,P=0.04).Conclusion The expression rate of the BCSG1 in the triple-negative breast cancer is higher than that in the non-triple-negative breast cancer.and it was statistically significant (P<0.05),so the expression of BCSG1 in triple negative breast cancer is unique .It prompt that BCSG1 can be a new treatment target in the triple negative breast cancer .

Objective To analyze and evaluate the reliability and validity of a 30-items initial survey scale concerning the knowledge , attitude and behavior in cancer patients with peripherally inserted central catheters ( PICC) .Methods The initial items were analyzed and thirty items were screened out by combining extreme group discrimination method , correlation analysis and factor analysis .The reliability and validity of 30-items survey scale was also evaluated .Results The Cronbach’s alpha coefficients of knowledge , attitude, and behavior were respectively 0.729, 0.826 and 0.765, the split-half reliability of knowledge , attitude, and behavior were 0.705, 0.774 and 0.735, the Cronbach’s alpha coefficients of overall scale was 0.834, and the split-half reliability of overall scale was 0.725.The correlation coefficients of each item in content validity of knowledge, attitude, and behavior were among 0.346-0.584, 0.652-0.735 and 0.567-0.673.According to the theoretical model , three common factors were extracted by exploratory factor analysis .By using two factor analysis and orthogonal rotation , the cumulative variance contribution rate of three common factors from 24 items was 40.388%, factor loading value of each item was more than 0.4 and communality of each item was more than 0.2.Conclusions Self-designed survey scale of the cancer patients with PICC has met the criteria of statistics after rigorous psychometric analysis , and has the potential to be used in clinic but also still needs for further improvement .

Objective To observe the therapeutic effects and complication of combined endoscopic trerapy of the acute biliary pancreatitis(ABP). Methods 70 cases of acute biliary pancreatitis were treated in our hospital in recent 7 years.37 cases(group E) admitted undergone emergency endoscope procedure were treated with endoscopi- cretrograde cholongiopancreatography ( ERCP ), endpscopic sphincterotomy ( EST ) and endoscope naso-biliary drainage(ENBD) in 24h after be hospitalized. 33 cases(group C) were treated with conservation treatment or opera-tion treatment. Results Achievement ratio of endoscopic management was 92 %. There was no severe complication or mortality in group E. The duration of symptoms and hospitalization in endoscopy group were significantly shorter than those in group C(P<0.01). The change of serum and urine amylase was not significant between two groups in the first day after treatment(P > 0.05). But the serum and urine amylase of group E were significantly lower than those in group C in the second day(P< 0.05) and more significantly lower in the third day after treatment(P< 0.01 ). Conclusion Early endoscopic therapy is safe and effective in ABP patients. It is a valuable method to treat a- cute biliary pancreatitis.

Objective To evaluate the therapeutic effect of endoscopic treatment for acute biliary pancreatitis. Methods Thirty-six cases of acute biliary pancreatitis were treated in our hospital in recent 4 years. Tweent cases (group E) underwent emergency endoscopic retrograde cholongiopancreatography(ERCP),endoscopic sphincterotomy(EST) and endoscopic naso-biliary drainage (ENBD) within 24h of hospitalization; 16 cases (group C ) were treated conservatively or by operation. Results Successful rate of endoscopic management was 95.24%. There were no severe complications nor mortality in group E. The duration of symptoms and hospitalization in endoscopic group was significantly shorter than those in group C(P0.05). But the serum and urine amylase in group E were significantly lower than those in group C in the second day(P

Objective To investigate the early diagnosis and rational treatment of traumatic retroperitoneal hematoma(TRPH). Methods Retrospective analysis was done on the clinical data of 96 cases of TRPH admitted in our hospital in the past 10 years. Results Eighty two patients received operation, of whom,73 combined with other celiac organ injuries.The other 14 patients were treated by non surgery.Two patients combined brain trauma and 1 with hemorrhagic shock died during operation,and 2 died of multiorgan failure postoperatively. Conclusions Early diagonsis depends on clinical appearance, abdominocentsis, B ultrasonography and CT. Operation should be done immediately,if the patient has the following condition:(1)apparant hemorrhagic shock after blunt trauma;(2) comfirmed celiac viscera trauma or blood vessel trauma;and (3)retroperitoneal hematoma caused by penetric trauma. Kidney surrounding hematoma or hematoma in pelvis area needs no immediate operation.