Clinical effects and pathological characteristics of gastric tumors of fundic gland type treated with endoscopic submucosal dissection / 中华消化内镜杂志

To evaluate the clinical effects and pathological characteristics of gastric tumors of fundic gland type treated with endoscopic submucosal dissection (ESD), data of 7 patients who treated by ESD and whose postoperative pathology indicated gastric adenocarcinoma of fundic gland type or gastric oxyntic gland adenoma in Endoscopic Center of Beijing Chao-Yang Hospital of Capital Medical University from August 2018 to June 2022 were collected. The clinical characteristics, surgical complications, preoperative and postoperative pathological data and follow-up data were evaluated. The lesions of the 7 patients were all located at gastric fundus, and were treated by ESD successfully. No bleeding, perforation or other complications occurred during and after the operation. Postoperative pathology showed that tumor cells originated from deep mucosa with an invasive growth pattern. Most of tumor surfaces were covered with normal concave epithelium. Tumors infiltrated into submucosa in 4 patients, and submucosa infiltration depth was more than 500 μm (550 μm) in 1 patient. Immunohistochemistry showed that MUC-6 was diffusely positive, indicating that the tumor originated from the main cell source. The expressions of MUC-2, MUC-5AC, CDX-2, CD10, and CgA were negative in all cases. With the mean follow-up time of 21 months, the ulcer healed well after the operation, with no recurrence. Gastric tumors of fundic gland type have relatively unique biological characteristics, and ESD is the preferred treatment. In addition, the histological characteristics can be used to differentiate from other gastric tumors by immunohistochemistry.

Protective effect and mechanism of esculetin on oxidative damaged ARPE-19 cells / 中华实验眼科杂志

Objective:To study the protective effect and the mechanism of esculetin on oxidative-stressed human retinal pigment epithelial cells (ARPE-19) induced by tert-butyl hydroperoxide (t-BHP).Methods:The ARPE-19 cells were divided into blank control group, model control group, 20 μmol/L esculetin group, 40 μmol/L esculetin group, 80 μmol/L esculetin group and 100 μmol/L esculetin group.The cells in the blank control group were normally cultured.The cells in the model control group were treated with 900 μmol/L t-BHP for 4 hours.The rest four groups were treated with 900 μmol/L t-BHP+ different molar concentrations of esculetin respectively for 4 hours.The cell viability of the each group was detected by MTS method.The activity of reactive oxygen species (ROS) was detected by fluorescence staining, and the activity of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) as well as the levels of malondialdehyde (MDA) of the cells from each group were measured with each corresponding assay kit, respectively.Results:The relative viabilities of the cells in the blank control group, model control group, 20 μmol/L esculetin group, 40 μmol/L esculetin group, 80 μmol/L esculetin group and 100 μmol/L esculetin group were (100.00±1.58)%, (49.19±1.06)%, (76.82±3.48)%, (103.90±1.60)%, (111.70±3.36)% and (113.40±3.08)%, respectively.There was a significant difference among the groups ( F=95.44, P<0.01). Compared with the blank control group, the viability of the cells in the model control group was decreased significantly ( P<0.01). Compared with the model control group, the cell viabilities in different concentrations of esculetin groups were increased significantly (all at P<0.01). There were significant differences between the groups in the relative value of ROS fluorescence intensity, MDA level, SOD activity, CAT activity and GSH-Px activity ( F=575.20, 40.61, 1 802.00, 41.62, 38.31; all at P<0.01). Compared with the model control group, the levels of ROS and MDA were decreased significantly, while the activities of SOD, CAT and GSH-Px were increased significantly in different concentrations of esculetin-treated groups (all at P<0.01). Conclusions:Esculetin can protect the oxidative damaged ARPE-19 cells by up-regulating the expression of antioxidant enzymes or antioxidant proteins.

Comparison between endoscopic retrograde biliary drainage and endoscopic nasobiliary drainage in treatment of acute cholangitis / 中华消化内镜杂志

Objective To compare the safety and effectiveness of endoscopic retrograde biliary drainage ( ERBD ) and endoscopic nasobiliary drainage ( ENBD ) in treatment of acute cholangitis. Methods A retrospective analysis was performed on data of 272 patients with acute cholangitis who underwent emergent endoscopic retrograde cholangiopancreatography ( ERCP ) in Beijing Chaoyang Hospital from January 2009 to June 2017. Patients were divided into ERBD group ( n=143) and ENBD group ( n=129) according to the drainage measures. In the ERBD group, there were 63 cases of gradeⅠ(mild) acute cholangitis, 51 of grade Ⅱ ( moderate) , and 29 of grade Ⅲ ( severe) , and the corresponding cases in the ENBD group were 54, 37 and 38, respectively. The rate of improvement of inflammation, ERCP-related complications and interventions to drainage were compared between the two groups in all patients and each grade. Results The rates of improvement of inflammation in the ERBD group and the ENBD group were 89. 5％ (128/143) and 94. 6％ (122/129), respectively, in overall patients (χ2=2. 399, P=0. 126), 93. 7％ (59/63) and 98. 1％ (53/54), respectively, in grade Ⅰ patients (χ2 =0. 548, P=0. 459), 90. 2％ (46/51) and 94. 6％ (35/37), respectively, in grade Ⅱ patients (χ2=0. 125, P=0. 724), and 79. 3％ (23/29) and 89. 5％ (34/38), respectively, in grade Ⅲ patients (χ2=0. 657, P=0. 418). The incidence of ERCP-related complications in the ERBD group and the ENBD group were 11. 9％ ( 17/143) and 7. 8％ ( 10/129) , respectively, in overall patients (χ2=1. 298, P=0. 225) , 9. 5％ ( 6/63) and 7. 4％( 4/54) , respectively, in grade Ⅰ patients (χ2=0. 006, P=0. 939) , 13. 7％ ( 7/51) and 8. 1％ ( 3/37) , respectively, in grade Ⅱ patients (χ2=0. 230, P=0. 632), and 13. 8％ (4/29) and 7. 9％ (3/38), respectively, in grade Ⅲ patients (χ2=0. 144, P=0. 705) . There were no significant differences in the rate of improvement of inflammation and ERCP-related complications between the two groups. The incidences of interventions to drainage in the ERBD group and the ENBD group were 10. 5％ ( 15/143 ) and 3. 1％(4/129), respectively, in overall patients (χ2=5. 699, P=0. 017), 6. 3％ (4/63) and 1. 9％ (1/54), respectively, in grade Ⅰ patients (χ2 = 0. 548, P = 0. 495 ) , 9. 8％ ( 5/51 ) and 5. 4％ ( 2/37 ) , respectively, in grade Ⅱ patients (χ2=0. 125, P=0. 724), and 20. 7％ (6/29) and 2. 6％ (1/38), respectively, in grade Ⅲ patients (χ2 = 3. 965, P= 0. 046 ) . There were significant differences in the incidence of interventions to drainage between the two groups in overall and gradeⅢpatents. Conclusion ERBD and ENBD are equally safe and effective in treatment of different grades of acute cholangitis, but ENBD can reduce the incidence of interventions to drainage.

The value of platelet count in predicting the efficacy of rituximab treatment in adult patients with chronic primary immune thrombocytopenia / 中华血液学杂志

Objective@#To investigate the value of platelet count in predicting the efficacy of rituximab treatment in chronic primary immune thrombocytopenia (ITP).@*Methods@#A retrospective study was conducted in 103 chronic ITP patients hospitalized in our medical center between January 2011 and December 2014. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of platelet count in different time points were analyzed for the predictor of treatment response. Optimal cutoff values were established using ROC analysis.@*Results@#A total of 103 patients were included in the study. There were 46 males and 57 females, with a median age of 30 (18-67) years. At day 1, 3 and 7 after the first dose of rituximab, there was no significant difference in platelet counts between the success group (PLT≥50×109/L after treatment) and the failure group (PLT≤50×109/L after treatment) (P>0.05). At day 14 after rituximab treatment (PTD 14), platelet counts became significantly different in the success and failure groups[41(8-384)×109/L vs 23(0-106)×109/L, P=0.003], and remained different thereafter, with increasing significance in the subsequent follow-ups. Patients were divided further using an optimal cut-off platelet count of 50×109/L on PTD 14, PTD 30, and PTD 60, and PPV and NPV values were calculated for predicting eventual success and failure.@*Conclusion@#Response can be predicted by obtaining platelet counts at 14, 30 and 60 days after rituximab treatment. The study proposed a protocol that guides patient monitoring and management planning.

Clinical value of double guidewire technique for perforation of duodenal papilla by guidewire in endoscopic retrograde cholangiopancreatography / 中华消化内镜杂志

Objective To evaluate the efficacy and safety of double guidewire technique in perforation of duodenal papilla caused by guide wire during endoscopic retrograde cholangiopancreatography ( ERCP ) intubation. Methods A retrospective analysis was performed on data of 57 patients whose duodenal papilla were perforated by guidewire in ERCP from January 2008 to September 2016. Among the 57 patients, 30 patients were cannulated with double guidewire technique ( double guidewire group ) and 27 patients were performed with traditional technique ( standard group ) for continue. The biliary intubation success rate, intubation time, and post-ERCP complication rate were compared between the two groups. Results The rate of successful intubation of the double guidewire group was significantly higher than that of the standard group[96. 7％ (29/30) VS 74. 1％ (20/27),χ2=5. 545, P=0. 019]. The intubation time of the double guidewire group was significantly shorter than that of the standard group (21. 8±7. 8 min VS 40. 7 ±8. 4 min, t=8. 076, P=0. 000). The double guidewire group had a similar incidence of post-ERCP complication compared to the standard group[ 13. 3％ ( 4/30) VS 11. 1％ ( 3/27) ,χ2=0. 292, P=0. 596] , and the complication in two groups was hyperamylasemia. Conclusion Double guidewire technique is safe and effective for difficult biliary cannulation because of perforation of duodenal papilla with a higher success rate and less time compared to classic technique.

Study on changes of C-reactive protein and D-dimer in hyperlipidemic and biliogenic acute pancreatitis patients / 重庆医学

Objective To investigate the changes of C-reactive protein(CRP)and D-dimer in the patients with hyperlipidemic acute pancreatitis(HLAP)and biliogenic acute pancreatitis(BAP).Methods One hundred fifty-five inpatients with acute pancreati-tis in our hospital from Jan.2012 to Dec.2014 were divided into the HLAP group and BAP group by etiology.Also the patients were divided into mild acute pancreatitis(MAP)subgroup and moderately severe acute pancreatitis(MSAP)subgroup by disease se-verity.Blood routine,liver and kidney function,glucose(Glu),calcium,blood lipids,CRP and D-dimer were measured.Results Platelet,Glu and blood lipid indicators in the HLAP group were significantly higher than those in the BAP group.But alanine amin-otransferase(ALT),r-glutamyl transferase(GGT),alkaline phosphatase(ALP),total bilirubin(TBIL),direct bilirubin(DBIL),calci-um(Ca)and creatinine(Cr)in the HLAP group were significantly lower than those in the BAP group(P <0.05).CRP in the HLAP group was significantly higher than that in the BAP group with statistical difference(P <0.01).CRP had statistical difference be-tween the HLAP group and BAP group in the MAP and MSAP subgroups (P <0.01).CRP and D-dimer had statistical difference between in the MAP and MSAP subgroups of the HLAP group(P <0.05).Increased CRP and D-dimer in the HLAP group were the risk factors for MSAP occurrence(OR =1.121,3.716,P =0.025,0.001 ).In the BAP group,only increased D-dimer was the risk factor for MSAP occurrence(OR=2.717,P =0.002).Conclusion CRP and D-dimer in HLAP and BAP are increased with dis-ease severity aggravation,moreover CRP increase is more obvious in HLAP patients.

Relationship of thyroid hormone, thyroid stimulating hormone and blood calcium in patients with hyperlipidemic acute pancreatitis / 中国医师进修杂志

Objective To investigate the relationship of thyroid hormone (TH), thyroid stimulating hormone (TSH) and blood calcium in hyperlipidemic acute pancreatitis (HLAP) patients. Methods Fifty patients with HLAP were selected, among whom 37 patients with mild acute pancreatitis (MAP) were enrolled into MAP group, and 13 patients with moderately severe acute pancreatitis (MSAP) were enrolled into MSAP group. The albumin, blood glucose, creatinine, blood lipids, blood calcium, free tri-iodothyronine (FT3), free thyroxine (FT4) and TSH levels were measured and analyzed. Results The blood calcium, FT3 and TSH levels in MAP group were significantly higher than those in MSAP group:(2.02 ± 0.26) mmol/L vs. (1.75 ± 0.27) mmol/L, (1.88 ± 0.46) ng/L vs. (1.52 ± 0.35) ng/L and (0.28 ± 0.20) mU/L vs. (0.17 ± 0.12) mU/L, but the blood glucose and triglycerides (TG) levels were significantly lower than those in MSAP group: (13.36 ± 5.83) mmol/L vs. (19.99 ± 7.97) mmol/L and (24.01±12.46) mmol/L vs. (34.76 ± 20.39) mmol/L, and there were statistical differences (P0.05). The correlation analysis result showed: in patients with HLAP, TSH and albumin had a positive correlation with blood calcium (r=0.344 and 0.372, P=0.014 and 0.008), LDL-C and TG had negative correlation with blood calcium (r=-0.315 and-0.444, P=0.026 and 0.001), and other indexes had no correlation with blood calcium (P>0.05). Conclusions Blood calcium, FT3 and TSH levels are decreased with severity of HLAP. Decreased blood calcium may be one of reasons for decreased TSH in HLAP patients.

Changes and differences of serum calcium and intact parathyroid hormone in patients with hyperlipidemic or biliogenic acute pancreatitis / 中华胰腺病杂志

Objective To investigate the correlation and differences of serum calcium ( Ca) and intact parathyroid hormone ( i-PTH) in patients with hyperlipidemic or biliogenic acute pancreatitis ( AP) .Methods From Jan 2012 to Jan 2014 , total 80 AP patients admitted to Bejing Chaoyang Hospital were enrolled . According to the etiology , AP patients were divided into 2 groups, hyperlipidemic acute pancreatitis ( HLAP) group and biliogenic acute pancreatitis (BAP) group.Blood routine, function of liver and kidney , blood lipids, Ca, and i-PTH were measured .Differences between Ca and i-PTH in HLAP group and BAP group were analyzed, and found the correlation with disease severity of AP .Results 80 AP patients included 43 HLAP and 37 BAP patients, 55 mild acute pancreatitis(MAP) and 25 moderately severe acute pancreatitis (MSAP) patients.HLAP group had 34 male and 9 female patients, average age was 37 years, 31 MAP and 12 MSAP patients.BAP group had 17 male and 20 female patients, average age was 58 years, 24 MAP and 13 MSAP patients.proportion of males was significantly higher in HLAP group than BAP group .on the contrary, average age was significantly lower (P<0.01 and <0.01, respectively).No significantly difference was found in MAP/MSAP ration.Level of serum Ca in HLAP group was significantly decreased than BAP group (1.92 ± 0.24 mmol/L vs 2.14 ±1.99 mmol/L, P<0.05).No significantly difference was found in i-PTH between two groups.Level of serum Ca in MAP and MSAP subgroup in HLAP group were 1.98 ±0.20 mmol/L and 1.76 ± 0.27 mmol/L.Accordingly, Level of serum Ca were 2.23 ±0.15 mmol/L and 1.98 ±0.19 mmol/L in BAP group. i-PTH in MAP and MSAP subgroup in HLAP group were 43.41 ±18.40 ng/L and 56.07 ±33.61 ng/L.Accordingly, i-PTH was 39.22 ±17.19 mmol/L and 52.73 ±29.42 mmol/L in BAP group.Compared to MAP, Ca in MSAP group was significantly decreased in HLAP and BAP group ( P<0.01 and <00.5, respectively).In HLAP group, Ca was a negative correlation with low density lipoprotein cholesterol (LDLC-) and triglycerides(TG) (P<0.05 and <0.01, respectively).In BAP group, Ca was a negative correlation with i-PTH(P<0.05).Conclusions Serum Ca is decreased with severity of HLAP and BAP .Decreased Ca has correlation with increased LDL-C, TG in HLAP and increased i-PTH in BAP.

The relationship between fibrinolysis, anticoagulation system indexes and serum albumin in patients with liver cirrhosis / 中国医师进修杂志

Objective To study the relationship between fibrinolysis,anticoagulation system indexes and serum albumin (ALB) in patients with liver cirrhosis.Methods One hundred and thirty-seven patients with liver cirrhosis were enrolled.Serum ALB,D-dimer (D-D),tissue plasminogen activator (t-PA),plasminogen activator inhibitor-1 (PAI-1),protein C (PC),protein S (PS) and antithrombin-Ⅲ (AT-Ⅲ) levels were measured.Results D-D level was increased with deterioration of liver function.D-D levels were (0.38 ± 0.24),(0.58 ± 0.43) and (0.90 ± 0.55) mg/L in Child-Pugh class A,B and C,respectively.PC,PS and AT-Ⅲ levels were decreased with deterioration of liver function.PC levels were (3.29 ± 1.04),(2.50 ± 1.27) and (2.29 ± 1.05)mg/L in Child-Pugh class A,B and C,respectively.PS levels were (20.74 ± 5.91),(17.97 ± 5.26) and (17.79 ± 5.12) mg/L,respectively.AT-Ⅲ levels were (104.62 ± 8.59)％,(101.76 ± 10.08)％ and (92.91 ± 10.48)％,respectively.D-D showed negative correlation with ALB (r =-0.402,P ＜ 0.01).On the contrary,PC,PS and AT-Ⅲ levels showed positive correlation with ALB (r =0.266,0.286 and 0.405,P ＜0.01).Conclusions Fibrinolysis and anticoagulation system indexes are changed with deterioration of liver function and are related with ALB directly.The indexes may be a helpful tool to evaluate the liver function in patients with liver cirrhosis.

Clinical characteristics and risk factors for major thrombosis in 604 Chinese patients with low-risk essential thrombocythemia / 中华血液学杂志

<p><b>OBJECTIVE</b>To analyze clinical and molecular characteristics of low-risk essential thrombocythemia (ET) in a large cohort of Chinese patients and to explore risk factors for major thrombosis and treatment strategies.</p><p><b>METHODS</b>Medical records of patients with an initial diagnosis of ET from March 1982 to May 2012 in our hospital were retrospectively analyzed.</p><p><b>RESULTS</b>A total of 604 low-risk ET patients were enrolled with a median follow-up of 49 months (range:0-338). 43(7.1%) patients experienced major thrombotic events. Cox proportional hazards regression revealed JAK2 V617F mutation (HR=2.279; P=0.035) and cardiovascular risk factors (CVF) (HR=2.541; P=0.006) to be risk factors for total thrombotic events, while only CVF (HR=2.633; P=0.008) was risk factor for arterial thrombosis. None of the evaluated factors was related to venous thrombosis. Patients with both JAK2 V617F mutation and CVF had a worse thrombosis- free survival than those with only one risk factor (P<0.05). In patients with JAK2 V617F or CVF alone, antiplatelet treatment (P=0.016) significantly decreased the risk of thrombosis, while those with both JAK2 V617F and CVF could benefit from cytoreductive agents (P=0.018).</p><p><b>CONCLUSION</b>Chinese low-risk ET patients have a lower risk of thrombosis than Caucasian low-risk ET patients. JAK2 V617F mutation and CVF are the most significant risk factors for thrombosis. Existence of both risk factors further increases the thrombotic risk. Treatment strategies on low-risk ET patients should be made based on presence or absence of risk factors.</p>

Relationship between carotid arteries atherosclerosis and subclinical hypothyroidism in patients with type 2 diabetes mellitus / 中国医师进修杂志

Objective To investigate the relationship between carotid arteries atherosclersis and subclinical hypothyroidism in patients with type 2 diabetes mellitus (T2DM).Methods From January to December 2010,408 patients with T2DM were enrolled in this study.The patients were divided into euthyroidism group (376 patients) and subclinical hypothyroidism group (32 patients).The incidence of carotid arteries atherosclerosis in two groups was compared and the risk factors were analyzed by Logistic regression analysis in patients with T2DM.Results There was no significant difference in age,course of disease,body mass index,fasting plasma glucose,total cholesterol,high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol,triacylglycerol and glycosylated hemoglobin between two groups (P ＞ 0.05).The incidence of carotid arteries atherosclerosis in subclinical hypothyroidism group was higher than that in euthyroidism group [81.2％ (26/32) vs.61.4％ (231/376)],and the difference was significant (P =0.026).Logistic regression analysis showed that age and thyroid stimulating hormone (TSH)were risk factors (OR =1.178 and 1.227,P =0.000 and 0.019) and HDL-C was protective factor (OR =0.284,P =0.003) in T2DM with carotid arteries atherosclerosis.Conclusion Higher incidence of carotid arteries atherosclerosis is found in T2DM patients with subclinical hypothyroidism and increased TSH are independent risk factors that has not previously been described.

Multivariate analysls of the portal vein thrombosis in patients with liver clrrhosis / 中国医师进修杂志

ObjectiveTo investigate the related risk factors ot the portal vein thrombosis (PVT) in patients with liver cirrhosis.MethodsThirty-seven liver cirrhosis patients with PVT (PVT group) and 100 liver cirrhosis patients without PVT (control group) from Jan.2007 to Dec.2009 were enrolled.The clinical data of these patients were collected and the related risk factors of PVT were analyzed.ResultsThe increase of D-dimer,severe esophageal varices(EV) and portal hypertension gastropathy(PHG) were the risk factors of PVT in liver cirrhosis patients(OR =12.872,3.916 and 2.851).No significant correlation was found between sex,platelets,albumin and PVT.ConclusionsThe increase of D-dimer,severe EV and PHG are the main risk factors of PVT.The above examinations should be used to monitor patients with liver cirrhosis for early prevention and diagnosis of PVT.

Analysis of the relationship between thrombomodulin changes and the score of the model for end-stage liver disease in liver cirrhosis patients / 中国医师进修杂志

Objective To investigate the relationship between thrombomodulin(TM), fibrinolytic system changes and the score of the model for end-stage liver disease(MELD)in liver cirrhosis patients.Methods Eighty-five liver cirrhosis patients admitted from January 2008 to December 2009 were included in this study. TM, D-dimer, tissue plasminogen activator(t-PA), plasminogen activator inhibitor -1(PAI-1),serum creatinine, serum total bilirubin and international normalized ratio(INR)on all patients were measured and then the score of the MELD was calculated. Results The score of the MELD was 1-29(11.35 ± 6.02)scores. The score of the MELD ≤ 9 scores was 40 cases(47.1%), 10- 19 scores was 32 cases (37.6%),20-29 scores was 13 cases(15.3%).TM and D-dimer were progressively increased with MELD score. There was significant difference among the three groups(P＜0.01). The levels of TM and D-dimer had positive correlation with the score of the MELD(r = 0.706,0.425,P ＜ 0.01). Conclusions The levels of TM and D-dimer have positive correlation with the score of the MELD in liver cirrhosis patients. These indices can help predicting the degree of liver function disorder and prognosis.

Clinical study on fast track surgery in the rib internal fixation of multiple rib fractures / 中国综合临床

Objective To evaluate the application of fast track surgery (FTS) in the rib internal fixation of multiple rib fractures. Methods Forty-eight chest trauma with multiple rib fractures patients from March 2008 to March 2010 were divided into FTS group and traditional care group randomly. Meanwhile two groups accepted FTS and conventional management of perioperative period respectively. The degree and duration of the chest pain, early exercise tolerance, intravenous infusion time, the length of postoperative hospital stay,chest scar and postoperative complications were observed and compared between the two groups. Results The duration of chest pain was significantly shorter in FTS group than in the traditional care group([ 112. 46 ±23. 24 ] mins vs [ 180. 23 ± 51.56 ] mins, t = 4. 23 ,P ＜ 0. 05); the early exercise tolerance was longer([ 68. 35 ±9. 30 ] mins vs [ 33.48± 5. 18 ] mins,t = 2. 87, P ＜ 0. 05) ;the intravenous infusion time was shorter ([ 10. 83 ±1.87 ] d vs [ 13. 30 ± 2. 12 ] d, t = 2. 38, P ＜ 0. 05); the length of postoperative hospital stay was shorter([ 12. 35 ± 2.03 ] d vs [ 16. 48 ± 3. 18 ] d, t = 3.04, P ＜ 0. 05); the less postoperative complications(8.3% vs 37. 5 %, x2 = 5. 005,P ＜ 0. 05); chest pain was relieved([ 3.43 ± 0. 45 ] cm vs. [ 6. 62 ± 0. 62 ] cm, P ＜ 0. 05);the scar healed well. All patients were successfully discharged. Conclusion The perioperative idea of fast track surgery was feasible and effective in the chest trauma with multiple rib fractures patients. FTS can improve the patients long term living quality.

Combination of endoscopic tissue adhesive injection and variceal ligation in esophageal and gastric varices bleeding / 中华消化内镜杂志

Objective To evaluate the clinical efficacy of emergent endoscopic injection of tissue adhesive (N-oclyl-a-cyanoacrylate) combined with endoscopic variceal ligation (EVL) for esophageal and gastric varices bleeding. Methods Data of 21 patients with acute esophageal and gastric varices bleeding who received emergent endoscopic injection of tissue adhesive and EVL were retrospectively studied. Results The instant hemostatic rate was 95% (20/21) with no severe complications. Conclusion Emergent endoscopic injection of tissue adhesive combined with EVL is an effective and safe therapy for esophageal and gastric varices bleeding.

A study of platelet parameter changes in patients with Graves disease / 中国医师进修杂志

feature of GD that has not previously been described.

A study of coagulation and fibrinolytic system changes in liver cirrhosis patients with and without portal vein thrombosis / 中国医师进修杂志

Objective To investigate the coagulation and fibrinolytie system changes in liver cirrhosis (LC) patients with and without portal vein thrombosis (PVT). Method Twenty-six cases of LC with PVT (PVT group) and 61 eases of LC without PVT (control group) were chosen. Platelet(Pt), prothrpmbin time (PT), activated partial thromboplastin time (APTT), fibrin (Fib), D-dimer, tissue plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-l) were determined. SPSS 11.5software was used for statistic analysis. Results In PVT group, the average level of D-dimer was (0.97±0.53 ) mg/L,signifieantly higher than that in control group (0.61±0.40) mg/L. No significant difference was found between the two groups in Pt PT, APTT, Fib, t-PA and PAI-1. PT and APTT were progressively prolonged from Child-Pugh grade A to B and then to C. Fib was progressively decreased from Child-Pugh grade A to B and then to C. Decreased Pt and increased t-PA, PAI-1 were found in LC patients, but had no sighifieant difference. Conclusions The changes determined of coagulation and fibrinolytie system in patients with LC are abnormal. The average level of D-dimer is higher in LC patients with PVT than that in LC patients without PVT. D-dimer may be a helpful tool to rule out the presence of an underlying PVT in LC patients.

The association of anticardiolipin antibody and protein C with portal vein thrombosis / 中华消化杂志

Objective To investigate the changes of anticardiolipin antibody(ACA) and protein C(PC) in cirrhotic patients with or without portal vein thrombosis(PVT). Methods During Jan. 2006 to Dec. 2007, 60 cirrhotic patients with (n=20) or without (n=40) PVT were analyzed. The concentrations of prothrombin time (PT), activited patial thromboplastin time (APTT), fibrogen, ACA and protein C (PC) were determined. Results The positive rate of ACA was 35% (7/20) in PVT group and 10% (4/40) in control group (P=0.045). The average level of ACA-IgG was significantly higher in PVT group [(10.15±5.31)U/ml] than that in control group [(6.70±3.75) U/ml]. The concentration of PC was significantly lower in PVT group [(2.47±0.62) mg/L] than that in control group [(2.93±0.88)mg/L]. No difference was found in APTT, levels of fibrogen and ACA-IgM between two groups. PT and APTT were progressively prolonged and fibrogen and PC were decreasing with the severity of Child-Pugh, respectively. The levels of ACA-IgG and ACA-IgM were increasing with the severity of Child-Pugh. Conclusions The coagulation and anticoagulation system is abnormal in patients with PVT who has higer ACA-IgG level and lower PC level. It is indicated that the ACA and PC may play an important role in formation of PVT.

Expression and clinical significance of hypoxia-inducible factor-1α，vescular endothelial growth factor and survivin in colorectal cancer / 中华消化杂志

Objective To evaluate the expressions of hypoxia-inducible factor-1α(HIF-1α),vescular endothelial growth factor(VEGF)and survivin in developing colorectal cancer,and the association among them.Methods The protein expressions of HIF-1α,VEGF and survivin were detected in specimens obtained from 69 patients with colorectal cancer and 20 normal controls by immunohistochemistry.The correlations of HIF-1α,VEGF and survivin with clinicopathologic features were analyzed.Results The expression of HIF-1α,VEGF and survivin proteins in patients with colorectal cancer were 56.52%,66.67% and 46.38%,respectively,and little expressed in normal controls(P＜0.01).The expressions of HIF-1α,VEGF and survivin were closely related to the differential grade of adenocarcinoma,he in volvment of penetration,lymph node metastasis and Dukes stage(P＜0.05).In addition,HIF-1α protein expression had positive correlations with both VEGF and survivin(P＜0.05),and the expression ofVEGF also had positive correlation with survivin(P＜0.05).Conclusions HIF-1α may involve in thepathogenesis of colorectal cancer through up regulating the expressions of VEGF and survivin,which mayhave synergetic effects in the pathogenesis of colorectal cancer.

Study on fluorescence quantitative RT-PCR with two-probes for detection of HCV RNA / 临床检验杂志

Objective To establish a fluorescence quantitative-reverse transcription-polymerase chain reaction (FQ-RT-PCR) with two-probe for quantification of HCV RNA loads,and to optimize the experimental conditions to increase sensitivity and specificity.Methods HCV RNA loads in 89 cases with positive anti-HCV and 220 cases with negative anti-HCV were quantified by FQ-RT-PCR with double probe,and the results were compared with another two commercial HCV RNA quantificationkits simultaneously.Results For the 2 groups (89 cases with positive anti-HCV and 220 cases with negative anti-HCV), the positive rate of HCV RNA was 91.0%(81 cases) and was 2.27%(5 cases) respectively by FQ-RT-PCR with two-probe, while it was 82.0% (73 cases)and 0.45% (1 cases)), 79.7%(71 cases))and 1.81%(4 cases) respectively by using the two commercial kits.Conclusion FQ-RT-PCR assay with two-probe may increases the sensitivity and specificity for the detection of HCV RNA loads comparing with commercial kits.