The symptoms of gastroesophageal reflux may be induced by acid reflux, nonacidic or weakly acidic reflux, and also can occur with hypersensitive esophagus, esophageal motility disorders, or other organic/anatomical abnormalities of esophagus.Refractory gastroesophageal reflux disease (GERD) denotes the symptoms of GERD could not be remitted with the standard dosage proton pump inhibitor (PPI) therapy.In most patients with refractory symptoms the etiology is of non-reflux-related causes, such as eosinophilic esophagitis, esophageal motility disorders, gastroparesis, or concomitant functional gastrointestinal disorders.A careful and detailed understanding of patient's medical history, examination with endoscopy and biopsy pathology, and esophageal pH-impedance monitoring are very important for identifying the potential cause.

Objective To compare the effectiveness and safety of radiofrenquency ablation(RFA) with other therapeutic methods for patients with early hepatocelluar carcinoma(HCC). Methods Randomized clinical trials(RCTs)which compared the efficacy or safety of RFA with other therapeutic methods for primary hepatocellular carcinoma in Cochrane library,EMBASE,PubMed,OVID and CBM were searched.Trials were considered of high quality if methodological quality score was 3 or more according to Jadad standard.Statistical heterogeneity between trials was evaluated bv STATA 9.0 and considered to exist when P＜0.1.Heterogeneity of the included articles was tested and used to select proper effective model for calculation.Sensitivity analysis was performed and publication bias was investigated through visual inspection of funnel plots and Egger regression model.Results Six RCTs including 862 cases were analyzed.As compared with other therapeutic approaches,RFA significandy increased 3-year overall survival rate and reduced local recurrence rate of early hepatocelluar carcinoma:the total OR were 2.06(95%CI being 1.54-2.77,P=0.000)and 0.40(95%CI being 0.28-0.57,P=0.000)respectively.As compared with other therapeutic approaches,the total OR of new HCC recurrence rates,extrahepatic metastasis rate and major complications in patients with HCC treated with RFA were 0.92 (95%CI being 0.68-1.24),0.98(95%CI being 0.30-3.22),1.35(95%CI being 0.49-3.77)respectively,showing no significant differences(P＞0.05).Inspection of the funnel plots for all outcome measures did not reveal evidence of publication bias(P=0.670,0.160,0.884,0.087,0.317,respectively,by Egger regression model).Conclusions RFA is superior to other treatment methods with respect to local recurrence and 3 year overall survival in early HCC and is the preferred tberapeutic method for small HCC because it is minimally invasive,simple and convenient.

is of STC.Exogenous GDNF may improve the colon motor function by up-regulation of GDNF.

Objective To pool the data of studies and evaluate the efficacy and safety of TNFα blocking agents in the treatment of ulcerative colitis(UC).Methods The randomized clinical trials(RCT)that compared the efficacy or safety of TNFα in the treatment of UC were researched from Pubmed. OVID. EMBASE. Cochrane library, CNKI, Wanfang data and VIP Chinese Scientific and Technologic Periodical Database. Statistical heterogeneity between trials was evaluated by Revman 5.0 and was considered to exist when P＜0.1.Heterogeneity of the included articles was tested. which was used to select proper effect model to calculate. Publication bias was investigated through visual inspection of funnel plots. Results Nine RCT including 1226 cases were analyzed. Eight hundred and six cases had received TNFα treatment and 420cases had received placebo or glucocorticoid treatment. Compared with placebo or glucocorticoid groups, TNFα group achieved significantly higher rates of short-term clinical response, short-term clinical remission, long-term clinical response.10ng-term clinical remission and the total OR were 2.36(95%C,1.34-4.15),2.42(95%CI 1.22-4.81).3.22(95%CI2.28-4.55)and 2.82(95%CI1.91-4.16)respectively. TNFα group was less likely to undergo colectomy than placebo group and the total OR was 0.31(95%CI0.20-0.48).TNFα could not improve the mucosal healing and quality of lire. No significant difference was found in adverse effect between TNFα group and placebo or glueoeortieoid group(OR=1.07(95%CI0.55-2.09,P=0.84)).The rate of serious adverse effect in TNFα group was less than placebo or glueoeorticoid groups (OR=0.65,95%CI0.48-0.89,P=0.007).Inspection of the funnel plots for all dichotomous data measures had not revealed evidence of publication bias. Conclusions Patients with moderately to severely active UC treated with TNFαhave effective clinical response and clinical remission and are less likely to undergo colectomy than those receiving placebo or glucocorticoid. TNFα treatment is safe for UC but can not improve the mucosal healing and quality of life. Large-scale, high-quality RCTs ale needed to confirm or refuse the available evidence.

A growing body of evidence has indicated the important role of autophagy receptors in directing ubiquitinated or non-ubiquitinated cargos towards autophagy. Autophagy receptors bind to LC3 (microtubule-associated protein 1 light chain 3) on phagophore and autophagosome membranes, and recognize signals on cargoes in the delivery system of autophagy. However, the diverse domains in the receptor structures determine that their roles would never be limited to autophagy. Up to date, increasing numbers of the receptor proteins have been demonstrated to serve as a molecular link or switch participating in autophagic degradation, apoptosis or cell survival signals. Here, we highlight the non-autophagic roles of these receptor proteins to draw attention to this growing research topic.
Apoptosis ; Autophagy ; Humans ; Microtubule-Associated Proteins ; physiology ; Signal Transduction ; Ubiquitination

A growing body of evidence has indicated the important role of autophagy receptors in directing ubiquitinated or non-ubiquitinated cargos towards autophagy. Autophagy receptors bind to LC3 (microtubule-associated protein 1 light chain 3) on phagophore and autophagosome membranes, and recognize signals on cargoes in the delivery system of autophagy. However, the diverse domains in the receptor structures determine that their roles would never be limited to autophagy. Up to date, increasing numbers of the receptor proteins have been demonstrated to serve as a molecular link or switch participating in autophagic degradation, apoptosis or cell survival signals. Here, we highlight the non-autophagic roles of these receptor proteins to draw attention to this growing research topic.

Objective To evaluate the safety and efficacy of 125I radioactive seeds implantation combined with postoperative chemotherapy as a treatment option for thoracic advanced esophageal squamous cell carcinoma(ESCC). Methods A prospective cohort study was carried out between 2000and 2005. According to preoperative CT staging criteria,298 patients in phase Ⅱ-Ⅲ of ESCC, who had were admitted to Oncology Center Surgery of Nanjing First Hospital Affiliated to Nanjing Medical University and Thoracic Surgery of YanCheng Oncology Hospital, were randomly divided into three groups: intraoperative 125I seeds implantation combined with postoperative chemotherapy (group A, 98cases), postoperative chemoradiotherapy (group B, 100 cases) and surgery alone (group C, 100cases). All patients received radical resection of esophageal cancer. According to pTNM staging criteria after operation, 233 patients in phase Ⅱb-Ⅲ of ESCC were finally enrolled in the study (78 in group A, 75 in group B, and 80 in group C). With 0. 5 m Ci of single seed, total activity of 5-11 mCi and matched peripheral dose in 60-70 Gy, 10-22 125I seeds were implanted into the target of patients in group A under direct vision in accordance with treatment planning system. The validation and quality assessment of radioactive seeds were demonstrated according to CT scan or X-ray imaging. The postoperative complications were observed. The local recurrence of the cancer was demonstrated using CT scan. The survival rate of patients was followed up for 1-,3-,5- and 10 years. Results The satisfied quality assessment of 125I seeds was observed. There was no displacement or loss of seed. The local recurrence in group A, B and C was 11. 5%, 13. 3% and 38. 8%, respectively, with statistical significance (P ＜ 0. 05). There was no significant difference among three groups with respect to complications and 1-year survival (P＞0. 05). However, the overall survival rate 3-, 5- and 10-years was 64.8%,37. 7% and 25. 1% in group A respectively; 63.3%, 36.9% and 24.9% in group Brespectively; 43. 6i%, 25.0%, and 12.6% in group C, respectively (all P＜0. 05). The 3-,5- and 10-year progression free survival rates were 63.5 %, 37.4 % and 15.1% in group A respectively; 62.5 %,36.6% and 14. 4% in group B respectively; 42.5%, 25.6% and 6.2% in group C respectively (all P＜0. 05). Conclusions It is a safe, effective and simple method for intraoperative 125I seeds implantation combined with postoperative chemotherapy in treatment of advanced ESCC, which may reduce the local recurrence and improve survival rates in patients with ESCC.

OBJECTIVETo explore a simple but novel method of strengthening gypsum material by cyanoacrylate infiltration. To evaluate the influence of cyanoacrylate on the mechanical properties of dental gypsum models.

METHODSGypsum specimens were polished to the dimension of 35 mmx4 mmx4 mm. Butyl-cyanoacrylate was diluted with chloroform at different concentrations, namely 20% and 30% cyanoacrylate. Gypsum specimens were infiltrated by diluting one component of cyanoacrylate at different concentrations for 8 h and then dried for analysis. The changes in elastic modulus, fracture toughness, compressive strength, biaxial strength, brinell hardness were measured. The data were analyzed using software OriginPro 8.

RESULTSThe viscosity measurements indicated that diluted cyanoacrylate were Newtonian fluids and the viscosity increased slightly within the 48 hours of preparation but still similar as water at room temperature, which could be used to infiltrating gypsum. The gypsum infiltrated with cyanoacrylate exhibited good physicochemical properties. The biaxial strength, fracture toughness, compressive strength and brinell hardness of the gypsum were improved by 39%, 30%, 63% and 18%, respectively.

CONCLUSIONCyanoacrylate can significantly improve the strength of gypsum model which indicates the potential clinical application.

The efficacy of standard triple therapy for Helicobacter pylori (Hp) eradication has been significantly decreased, or even less than 80%.Abroad studies have shown that Hp eradication rate of sequential therapy is significantly higher than that of triple therapy.At home, we lack a large sample of data analysis to clarify the efficacy of sequential therapy.Aims: To systematically review the efficacy of sequential therapy and triple therapy in Hp eradication at home and abroad.Methods: PubMed, Medline, Embase, Cochrane Library, CNKI, Wanfang, VIP and CBMdisc were retrieved to collect the randomized controlled trials (RCT) comparing sequential therapy and triple therapy in the treatment of Hp infection in last 7 years.Article selection, data extraction and quality evaluation were conducted independently by two reviewers.Meta-analysis was conducted by RevMan 5.3 software.Results: A total of 31 RCT involving 8 371 subjects were included.Meta-analysis showed that Hp eradication rate of sequential therapy was significantly higher than that of triple therapy (83.3% vs.74.7%;RR=1.13, 95% CI: 1.09-1.16).Sixteen domestic studies showed that Hp eradication rate of sequential therapy was significantly higher than that of triple therapy (88.1% vs.78.0%;RR=1.13, 95% CI: 1.10-1.16), fifteen abroad studies showed that Hp eradication rate of sequential therapy was significantly higher than that of triple therapy (79.0% vs.71.8%;RR=1.13, 95% CI: 1.06-1.20).No significant difference in incidence of adverse reactions was found between sequential therapy and triple therapy (20.7% vs.22.0%;RR=0.94, 95% CI: 0.86-1.03).Conclusions: Sequential therapy achieves higher Hp eradication rate than standard triple therapy, and no significant difference in incidence of adverse reactions is found between sequential therapy and triple therapy.Hp eradication rate of sequential therapy is significantly higher than that of triple therapy and is higher than 80% in China, which can be recommended as a Hp eradication supplement of bismuth quadruple therapy.

In this study, we tested the hypothesis that volatile anesthetic enhancement of muscle relaxation is the result of combined drug effects on the nicotinic acetylcholine receptors. The poly A m RNA from muscle by isolation were microinjected into Xenopus oocytes for receptor expression. Concentration-effect curves for the inhibition of Ach-induced currents were established for vecuronium, rocuranium, and isoflurane. Subsequently, inhibitory effects of NDMRs were studied in the presence of the isoflurane at a concentration equivalent to half the concentration producing a 50% inhibition alone. All tested drugs produced rapid and readily reversible concentration-dependent inhibition. The 50% inhibitory concentration values were 889 micromol/L (95% CI: 711-1214 micromol). 33.4 micromol (95% CI: 27.1-41.7 nmol) and 9.2 nmol (95% CI: 7.9-12.3 nmol) for isoflurane. rocuranium and vecuronium, respectively. Coapplication of isoflurane significantly enhanced the inhibitory effects of rocuranium and vecuronium, and it was especially so at low concentration of NMDRs. Isoflurane increases the potency of NDMRs, possibly by enhancing antagonist affinity at the receptor site.
Androstanols/*pharmacology ; Anesthetics, Inhalation/pharmacology ; Drug Synergism ; Isoflurane/*pharmacology ; Neuromuscular Blocking Agents/*pharmacology ; Neuromuscular Junction/drug effects ; Neuromuscular Nondepolarizing Agents/*pharmacology ; Oocytes ; Receptors, Nicotinic/*drug effects ; Vecuronium Bromide/pharmacology ; Xenopus laevis