MicroRNA-29a-3p regulates osteoblast differentiation and peri-implant osseointegration in a rat model of hyperlipidemia by modulating Frizzled 4 expression / 华西口腔医学杂志

OBJECTIVE@#This work aimed to study and identify the influence and target gene of microRNA-29a-3p (miR-29a-3p) in the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) in a high-fat environment in vitro and in vivo.@*METHODS@#1) In vitro: BMSCs were randomly allocated into two groups and were then induced to undergo osteogenic differentiation in a normal or high-fat environment. Next, a miR-29a-3p mimic/inhibitor was transfected into the two groups of cells. The mRNA expression levels of alkaline phosphatase (ALP), Runt related gene 2 (Runx2), and miR-29a-3p and the protein expression levels of ALP and Runx2 were detected before and after transfection through reverse transcription-quantitative real-time polymerase chain reaction (RT-qPCR) and Western blot analyses. Moreover, Frizzled (Fzd) 4 was predicted as the target gene of miR-29a-3p by using an online database (Target Scan, MiRNA.org). The interactive relationship between miR-29a-3p and Fzd4 was confirmed through dual-luciferase assays. 2) In vivo: Rats were randomly divided into two groups and fed with a standard or high-fat diet. Titanium implants were grown in rats. Then, the expression levels of miR-29a-3p, ALP, and Runx2 were detected in bone tissues surrounding implants. Moreover, hard tissue sections were subjected to methylene blue-acid magenta staining and observed under microscopy to study bone formation around implants. In addition, miR-29a-3p-overexpressing lentiviral vectors were transfected into rats, and the expression levels of ALP, Runx2, and miR-29a-3p in bone tissues surrounding implants were detected at 3 and 10 days after transfection.@*RESULTS@#The expression levels of ALP, Runx2, and miR-29a-3p and the osteogenic differentiation of BMSCs were suppressed in high-fat groups in vitro and in vivo.@*CONCLUSIONS@#MiR-29a-3p plays a positive role in the regulation of BMSCs in a high-fat environment. It can increase ALP and Runx2 expression levels in bone tissues surrounding implants in hyperlipidemia models. This result implies that miR-29a-3p can promote implant osseointergration in a rat model of hyperlipidemia.

Study on the current situation and allocation equity of China's nursing human resources / 中国卫生政策研究

Objective:To analyze the current situation of Human resources distribution of registered nurses in China, this study aims at providing evidence for the government departments to enact proper strategies from the aspects of quantity, structure and distribution equity, and to explore the problems existing in the nurturing of nursing talents. Methods:Descriptive analysis was used todescribe the quantity and quality of the registered nurse personnel during the period from 2010 to 2015, and the configuration fairness was evaluated by Gini Coefficient according to the population and size of geographical areausing data from China Health Statistics Yearbook and China Health and Family Planning Statistics Yearbook. Results :The results showed that from 2010 to 2015, the number of registered nurse personnel presented an increasing trend, and the personnel structure was further optimized and showed an overall trend of younger. From the perspective of distribution equity, the China's nursing personnel have a Gini coefficient which is less than 0. 2, and this highlights a good fairness according to the distribution of the population ; the Gini coefficient of the geographical area allocation was a-round 0.6, which shows great disparity. Conclusions :Remarkable results have been achieved in nursing human resource construction in China,but there are also many problems such as unreasonable nursing talent echelon and the uneven development across regions cannot be ignored too. It is recommended to expand the scaleof nurse training, strengthen the nursing education, improve the nursing efficiency and reasonably allocate the nursing human resources.

Analysis of imaging misdiagnosis of patients with ductal adenocarcinoma of pancreas / 第二军医大学学报

Objective To summarize the experience of imaging misdiagnosis in patients with ductal adenocarcinoma of pancreas (DACP), to investigate the reasons of misdiagnosis and improve the imaging diagnosis of DACP. Methods The 51 patients who were misdiagnosed by imaging in this study included 13 men and 38 women, with ages ranging from 37-79 years old and the median being 54 years old. All patients underwent CT and MRI examination before they were confirmed as DACP by pathological examination after surgery. The imaging data and pathological results were reviewed and the reasons of misdiagnosis were analyzed. Results Twenty poorly differentiated DACP without cysts were misdiagnosed as “cystic tumor of pancreas” or “pancreatic cyst” due to no obvious enhancement in images; 16 cases of DACP associated with pseudocysts were misdiagnosed as “pancreatitis associated with pseudocyst” due to that the tumors were masked by pseudocysts; and 15 cases of DACP associated with obstructive pancreatitis were misdiagnosed as “focal pancreatitis” due to the tumors’ small volume and pancreatitis mask. Indefinite-edge masses which documented no or slight enhancement were seen in all cases (100%); 43 cases (84%) documented the dilated main pancreatic duct were “interrupted”; and 100% of bile ducts were blocked by masses located in the pancreatic head. Conclusion Knowing the local anatomy of pancreas and histopathological features of DACP and understanding imaging characteristics of the secondary changes of DACP can help to avoid imaging misdiagnosis.

Impact of multidisciplinary team working on the management of colorectal cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The continual and rapid development of techniques which are used for diagnosis and treatment makes management of colorectal cancer more difficult depending on single discipline. Colorectal cancer multidisciplinary team (MDT) working model is recommended by UK and other countries, but there is little information on the impact of MDT working on management of colorectal cancer in China. The aim of this study was to assess the effect on management of colorectal cancer after the inception of an MDT.</p><p><b>METHODS</b>A total of 595 consecutive colorectal cancer patients were referred to the Department of Gastroenterological Surgery, the pre-MDT cohort include 297 patients, recruited from January 1999 to November 2002, and the MDT cohort had 298 patients enrolled from December 2002 to September 2006. Information recorded included: TNM stage from histological reports, degree of differentiation, the number of examined lymph nodes and CT TNM staging performed or not, and its accuracy, including local and distant recurrence.</p><p><b>RESULTS</b>The number of examined lymph nodes and the accuracy of TNM staging by CT in the MDT group were significantly more than those in pre-MDT group. CT TNM staging was more accurate in the MDT group compared to the pre-MDT group (P = 0.044). The rate of tumor recurrence in the MDT group was lower than pre-MDT group (log-rank test, P < 0.001). Multivariate analysis revealed that age (P = 0.001), management after inception of the MDT (P = 0.002), degree of differentiation (P = 0.003), number of examined lymph nodes (P = 0.002), and TNM stage (P = 0.000) were important factors that independently influence overall survival.</p><p><b>CONCLUSIONS</b>The inception of MDT working improved the diagnostic accuracy and overall survival of colorectal cancer patients. MDT working promoted communication and cooperation between disciplines and ensured high-quality diagnosis, evidence-based decision making, and optimal treatment planning.</p>

Clinical application of high resolution manometry for examining esophageal function in neonates / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To examine the esophageal function of neonates by high resolution manometry (HRM), and to provide preliminary data for research on the esophageal function of neonates.</p><p><b>METHODS</b>Esophageal HRM was performed on neonates using a solid-state pressure measurement system with 36 circumference sensors arranged at intervals of 0.75 cm, and ManoView software was used to analyze esophageal peristalsis pattern.</p><p><b>RESULTS</b>Esophageal HRM was performed successfully in 11 neonates, and 126 occurrences of complete esophageal peristalsis were recorded. Complete esophageal peristalsis with pressure increase was recorded in some neonates but most neonates showed a different esophageal peristalsis pattern compared with adults. Some neonates had no relaxation of the upper esophageal sphincter (UES) when pharyngeal muscles contracted in swallowing, some neonates had multiple swallowing without esophageal peristalsis and some neonates had relatively low pressure of esophageal peristalsis. Full-term infants could have relatively low UES pressure and esophageal sphincter (LES) pressure but some preterm infants showed relatively high UES pressure and LES pressure. Longitudinal contraction of the whole esophagus and elevation of LES after swallowing were recorded in some neonates.</p><p><b>CONCLUSIONS</b>Esophageal HRM is safe and tolerable for neonates. HRM shows that esophageal peristalsis after swallowing may not occur or may be incomplete in neonates. The esophageal function of neonates has not yet been developed completely, with large individual differences in esophageal peristalsis. Large sample data are needed for further analysis and research on the esophageal function of neonates.</p>

Clinical manifestations of patients with systemic lupus erythematosus and coronary artery disease / 中华心血管病杂志

<p><b>OBJECTIVE</b>To analyze the clinical characteristics of patients with systemic lupus erythematosus (SLE) and coronary artery disease (CAD).</p><p><b>METHODS</b>Clinical data of 3911 SLE patients were retrospectively analyzed and CAD was diagnosed by coronary angiography in 26 (0.7%) SLE patients (10 stable angina pectoris, 5 unstable angina pectoris, 8 STEMI and 3 non-STEMI). The tradition risk factors, first onset of cardiac events, blood biochemistry index, treatment and activity of SLE, coronary angiographic features were compared with 552 CAD patients without SLE.</p><p><b>RESULTS</b>Compared with CAD patients without SLE, CAD patients with SLE were younger [(50.4 ± 15.2) years vs. (60.6 ± 11.6) years, P < 0.01], the mean number per patient of Framingham tradition risk factors was less (1.11 ± 1.18 vs. 2.50 ± 1.28, P < 0.05). CAD patients with SLE were prone to premature coronary artery disease [76.9% (20/26)], and ACS was the most common manifestation in SLE patients with premature coronary artery disease [65.0% (13/20)], the duration of steroid use was significantly longer [24.00 (3.75, 57.00) months vs. 1.00 (0.00, 2.00) months, P < 0.05] and 24 hours total urine protein [(1.93 ± 1.97) g vs. (0.76 ± 0.75) g, P < 0.05] was significantly higher in the ACS patients with SLE than non-ACS patients with SLE. Coronary stenosis was evidenced in most of the SLE patients with CAD [76.9% (20/26)] and incidence of coronary thrombotic occlusion was significantly higher in SLE patients with CAD than CAD patients without SLE [30.8% (8/26) vs. 11.8% (65/552), P < 0.05].</p><p><b>CONCLUSION</b>The incidence of CAD in SLE patients is low and the major form of CAD in SLE patients is premature coronary artery disease and mostly induced by coronary thrombotic occlusion.</p>

Preliminary experience using transthoracic echocardiography guiding percutaneous closure of ruptured right sinus of Valsalva aneurysm / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In the 21st century, minimally invasive treatment is one of the main developmental directions of medical sciences. It is well known that the echocardiography plays an important role during interventional treatments of some structural heart diseases. Because the ruptured right sinus of the Valsalva aneurysm (RRSVA) is a rare disease, there were few reports about percutaneous catheter closure of RRSVA. This study aimed to sum up our experience with transthoracic echocardiography (TTE) during percutaneous catheter closure of RRSVA.</p><p><b>METHODS</b>Five RRSVA cases were treated with percutaneous catheter closure. The whole procedure was guided and monitored by TTE and fluoroscopy. The maximum diameter of the RRSVA was measured by TTE before and after the catheter passed through the rupture site. A duct occluder 2 mm larger than the maximum diameter was chosen. The closure effects were evaluated with TTE and fluoroscopy immediately after the occluding device was deployed. All patients were followed up by TTE for 8 to 30 months.</p><p><b>RESULTS</b>Before the catheter passed through the rupture site the maximum diameter of the RRSVA measured with TTE and aortography were (7.9 ± 2.1) mm and (7.8 ± 1.8) mm. After the catheter passed through the rupture site the maximum diameter measured with TTE was (11.2 ± 3.2) mm, which was significantly larger than before the procedure (P < 0.05). The percutaneous catheter closure was successful in four cases and failed in one. Compared to the aortography the TTE was better at distinguishing residual shunts from aortic valve regurgitation immediately after the occluding device was deployed. There were no complications during 8 to 30 months of follow-up.</p><p><b>CONCLUSION</b>Transthoracic echocardiography can play an important role during percutaneous catheter closure of RRSVA, especially for estimating the size of the RRSVA after the catheter passes through the rupture site, and differentiating residual shunt from aortic valve regurgitation immediately after the occluding device is deployed.</p>

Clinical manifestations of 43 patients with acute myocardial infarction complicated by free wall rupture / 中华心血管病杂志

<p><b>OBJECTIVE</b>To analyze the clinical characteristics of patients with acute myocardial infarction (AMI) complicated by free wall rupture (FWR) and to define the independent risk factors for FWR.</p><p><b>METHODS</b>Clinical and angiographic data of 6192 AMI patients admitted to our department between January 1995 and January 2010 were retrospectively reviewed, FWR was confirmed in 43 patients by post-mortem examination. Multivariate logistic regression analysis was performed to identify risk factors for FWR.</p><p><b>RESULTS</b>Rupture occurred at a median of 3.58 days after symptom onset. Risk factors associated with FWR were older age, female gender, delayed hospital admission, hypertension at admission and increased serum creatine level. Although patients with FWR had more single-vessel disease, their in-hospital mortality was very high (97.7%). Undue physical efforts were documented in 41.9% patients with FWR.</p><p><b>CONCLUSION</b>Old age, female gender and prolonged time from the onset of symptoms to hospital, hypertension and high level of serum creatine at admission are independent factors of FWR.</p>

Synthesis and biological evaluation of nitrate-oleanolic acid hybrids as inhibitors of HepG2 cell apoptosis / 药学学报

To find novel antihepatitis drugs, a series of nitrate-oleanolic acid (OA) hybrids (10a, 10b, 11a-11e and 12a-12c) were designed and synthesized on the basis of previous studies using OA as lead compound, which is widely found in natural plants and liver-specific metabolism. In the present study, ten novel NO-releasing derivatives of OA were synthesized by connecting nitrate to the OA-3-OH through varying lengths of linkers containing antioxidants which were designed to increase the ability of these target compounds to scavenge free radicals. The structures of these objective compounds were determined by IR, MS, 1H NMR and elemental analysis. Their protective effects on anti-Fas mediated HepG2 cell apoptosis were in vitro evaluated by LDH assay. Compound 12a is the most potent inhibitor. Its effect on anti-Fas mediated HepG2 cell apoptosis and amount of NO-releasing in vitro are similar to those of positive control NCX-1000.

Colonoscopy in the diagnosis of intestinal graft versus host disease and cytomegalovirus enteritis following allogeneic haematopoietic stem cell transplantation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Gastrointestinal graft versus host disease (GI-GVHD) and cytomegalovirus (CMV) enteritis are important complications following allogeneic haematopoietic stem cell transplantation (allo-HSCT). We explored the role of colonoscopy in the diagnosis of GI-GVHD and CMV enteritis following allo-HSCT to identify the endoscopic manifestations of GI-GVHD and CMV enteritis was made.</p><p><b>METHODS</b>A retrospective analysis of the colonoscopic manifestations of GI-GVHD, CMV enteritis and GI-GVHD with concurrent CMV enteritis (GconC) and their related clinical issues.</p><p><b>RESULTS</b>Forty-seven patients underwent 50 colonoscopies with diagnoses of 32 GI-GVHD, 7 CMV enteritis and 11 GconC. Both GI-GVHD and CMV enteritis had colonic mucosal lesions with various manifestations under colonoscopy. Tortoise shell like changes of the mucosa (12 of 32) and deep ulcers (2 of 7) were specific endoscopic manifestations for GI-GVHD and CMV enteritis, respectively, while mucosal oedema, erythema, congestion, erosion and shallow ulcers could not be used to differentiate GI-GVHD from CMV enteritis. GconC patients were prone to have oozing bleeding of the end ileal mucosa and typhlodicliditis. Of the biopsed specimens for GI-GVHD, CMV enteritis and GconC, 64%, 70% and 44% were taken from the rectum and sigmoid colon respectively.</p><p><b>CONCLUSIONS</b>Following allo-HSCT, tortoise shell like changes and deep ulcers of the colonic mucosa are characteristic changes for GI-GVHD and CMV enteritis, respectively, while the other lesions are not. Most of the GI-GVHDs and CMV enteritis cases can be diagnosed by left colon examination and tissue biopsy, but total colon examination to the terminal ileum is preferred.</p>

Characteristics of anorectal motility spectrum and preliminary approach to treatment of functional constipation in children / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the characteristics of anorectal motility spectrum in children with functional constipation in comparison with healthy children and determine the efficacy of treatment measures based on the results of anorectal manometry.</p><p><b>METHODS</b>Anorectal manometric indexes were detected by the multi-functional manometry in eight patients with functional constipation aged (11.4 +/- 4.8) yrs and ten healthy children aged (10.5 +/- 3.5) yrs from May 2004 to June 2005. The patients received combined treatment including probiotics (Bifid. triple viable), prebiotics (Lactulose) and regular defecation according to the results of anorectal manometry in patients with functional constipation. The efficacy of these conservative measures were estimated during the course of treatment.</p><p><b>RESULTS</b>No statistical differences were found in the indexes of effective length of anal sphincter, maximal systolic pressure and the duration of more than 50% of maximal systolic pressure between two groups. But minimal sensitivity and maximal tolerated volume between the two groups were significantly different. Seven of eight patients got better with the conservative treatment.</p><p><b>CONCLUSION</b>Abnormal features exit in the anorectal motility spectrum of the children with functional constipation. The clinical efficacy of the conservative treatment measures based on the results of anorectal manometry is significantly good.</p>

Fermentation process monitoring and fault detection based on dynamic MPCA / 生物工程学报

A dynamic multiway principle component analysis for on-line batch process monitoring and fault detection was proposed. It integrates the time-lagged windows of process dynamic behavior with the multiway principle component analysis (MPCA). Using multi-model instead of single model, the dynamic MPCA approach emphasizes particularly on-line process performance monitoring and fault defecting. On-line process monitoring of cephalosporin C fermentation was studied, the results demonstrate that the dynamic MPCA method is able to efficiently monitor performance of the fermentation process and exactly detect faults which results in extraordinary behavior of processes.

Effects of two test-meals on transient lower esophageal sphincter relaxation in patients with gastroesophageal reflux disease and mechanism of gastroesophageal reflux / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the effects of standard meal and fat meal distending the fundus on transient lower esophageal sphincter relaxation (TLESR) and esophageal motility and to explore the mechanism of gastroesophageal reflux (GER) in patients with gastroesophageal reflux disease (GERD).</p><p><b>METHODS</b>Eight patients with GERD (3 male, 5 female; median age: 43.5 ys) were enrolled in the study. All received 2 times of esophageal manometry and pH monitoring simultaneously for 30 min during fasting and 2 h after two different test-meals, including standard meal (SM) and fat meal (FM) on separate day at least 1 week apart.</p><p><b>RESULTS</b>The frequency of TLESR significantly increased after 2 test-meals (P < 0.05). There were no significant difference in the frequency and duration of TLESR between SM group and FM group 1 h after meal (P > 0.05). However, the frequency of TLESR in FM group 2 h after meal was more than that in SM group and during fasting (P < 0.05). Lower esophageal sphincter pressure (LESP) significantly decreased in FM group than in SM group (P < 0.05). The contractive amplitude of post lower esophageal sphincter relaxation and the contractive amplitude of the distal esophagus had no difference after FM and SM. Acid reflux episodes and duration of pH < 4 were larger after FM than after SM (P < 0.05). A total of 50.2% of GER occurred during decreased LESP and 37.8% during TLESR after FM, while 61.7% of GER occurred during TLESR after SM.</p><p><b>CONCLUSIONS</b>Both the SM and FM can increase the frequency of TLESR in patients with GERD. Decreased LESP and increased frequency of TLESR after FM are the major mechanism of GER, while reflux after SM may attribute to the increased frequency of TLESR.</p>

The enteral feeds in very low birthweight infants / 中华儿科杂志

<p><b>OBJECTIVE</b>The study aimed to investigate the clinical characteristics of enteral feeding in very low birthweight infants (VLBWI), to determine the risk factors associated with feeding intolerance, and to analysis the beneficial factors in order to improve gut motility and maturation.</p><p><b>METHODS</b>The study was carried out in 38 VLBWI, birthweight (1,314 +/- 180) g, in the NICU of authors' department. They were divided into feeding tolerance and intolerance groups, and earlier enteral feeding and later groups. Comparison was made between two groups about the associate factors.</p><p><b>RESULTS</b>The incidence of feeding intolerance was 55 per cent. There was a significant difference in two groups about the clinical factors (gestational age, birth weight, the age of the first feeding, time of full enteral feeding and the hospitalized days). The significant risk factors associated with feeding intolerance were the smaller gestational age, umbilical catheterization, theophylline therapy, and delay of the time when the first feed was commenced.</p><p><b>CONCLUSION</b>If vital signs are stable, trophic feeding in VLBWI should be commenced as soon as possible during the first 6 days of life. Early trophic feeding, slowly increase the feeding volume, carefully fast, and moving bowel were suggested and will improve feeding tolerance and gastrointestinal maturation.</p>

Expression of Shh, Ptc1, Ptc2 mRNA in the cap stage of mouse molar / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the expression of Shh and its receptors Ptc1 and Ptc2 mRNA in the cap stage of mouse molar and discuss its role in early tooth morphogenesis.</p><p><b>METHODS</b>The embryonic mouse heads of early tooth development (E10.5 - E15.5) were obtained and 5 micro m serial sections were made. Immunohistochemical staining of PCNA was carried out by SP method. The expression pattern of Shh, Ptc1, and Ptc2 mRNA was analysed by in situ hybridization.</p><p><b>RESULTS</b>E14.5, outer dental epithelium, inner dental epithelium, stellate reticulum and underlying dental mesenchyme were PCNA positive. Most of the enamel knot cells were PCNA negative. A few of the enamel knot cells were PCNA positive. Shh, Ptc1, and Ptc2 mRNA were strongly expressed in outer dental epithelium, inner dental epithelium, stellate reticulum and the enamel knot.</p><p><b>CONCLUSION</b>In the cap stage, Shh as a paracrine and autocrine signaling molecule might stimulate epithelium and mesenchyme proliferation.</p>

Expression of homeobox gene Msx-1, Msx-2 and Dlx-2 during murine mandibular first molar development / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To observe the expression of homeobox gene Msx-1, Msx-2 and Dlx-2 during murine mandibular first molar development.</p><p><b>METHODS</b>The murine heads or mandibles on embryonic days 11-18 (E11-18) and postnatal day 1-3 (P1-3) were removed, fixed and embedded, 5 micro m serial sections were cut in the coronal plane. Msx-1, Msx-2 and Dlx-2 RNA probes were synthesized by in vitro transcription and labeled with digoxigenin. Msx-1, Msx-2 and Dlx-2 mRNA expression was observed after in situ hybridization.</p><p><b>RESULTS</b>During molar development Msx-1 transcripts appeared only in mesenchymal cells, not in epithelial cells. Msx-2 and Dlx-2 both expressed in the epithelial and mesenchymal cells. At the initiation stage of the molar development Msx-2 and Dlx-2 had similar expression. At the bud stage (E13-14) Msx-2 mRNA signaling was intensive in the enamel organ and slight in the dental mesenchyme; Dlx-2 signaling was stronger in the dental papilla. At cap stage (E15-16) Msx-2 showed prominent mRNA signaling in enamel knot and Dlx-2 was maximal in the dental papilla. At the late bell stage (P2-3) Msx-2 transcripts were observed in odontoblasts but not labeled in ameloblasts, and Dlx-2 transcripts appeared in ameloblasts but no labeling was seen in odontoblasts.</p><p><b>CONCLUSIONS</b>Msx-1, Msx-2 and Dlx-2 are expressed in various patterns during murine mandibular first molar development, suggesting they possibly play a role in the interaction between the epithelium and mesenchyme during the molar development.</p>

Roles of diaphragmatic crural barrier and esophageal body clearance in patients with gastroesophageal reflux disease / 中国医学科学院学报

<p><b>OBJECTIVE</b>Aim of this study was to investigate functions of lower esophageal sphincter (LES) barrier and esophageal clearance in fasting and postprandial stages in gastroesophageal reflux disease (GERD).</p><p><b>METHODS</b>Eight patients with confirmed GERD and 8 healthy subjects (HS) were observed in the study. The esophageal pH and manometry were recorded simultaneously for 1 h during fasting and 2 h after a meal (1,675 kJ) using pneumohydrolic capillary perfusion system.</p><p><b>RESULTS</b>(1) The esophageal pH monitoring showed that median of percentage of pH < 4 at postprandial in HS and patients with GERD was 0.45% and 11.2%, respectively (P < 0.05). (2) Pressure of lower esophageal sphincter (LESP) significantly decreased after a test meal in GERD (P < 0.001) and in HS (P < 0.001). (3) The amplitude of post-LES relaxation related to swallow (post-LESRA) in GERD was much lower than in HS either during fasting or postprandial stage (P < 0.05). (4) The tension of crural diaphragm at resting (Dia-A0) in GERD was lower than in HS during fasting and postprandial stage(P < 0.05). (5) The tension of crural diaphragm at deep inspiration (dia-AM) in GERD and HS increased 3 or 4 times at pressure at gastroesophageal junction (GEJ). (6) The peristaltic amplitude of the distal esophagus in GERD were much lower than that in HS in both pre- and postprandial periods.</p><p><b>CONCLUSIONS</b>(1) Impaired clearance of Post-LESRA and esophageal body, function of diaphragmatic crural play an important role in development of GERD. (2) The tension of crural diaphragm at deep inspiration can increase the pressure at GEJ.</p>