To elucidate the signal transduction mechanism of systemic inflammatory response syndrome induced by LPS,Western blot analysis was used to assay the protein expression and phosphorylation levels of ERK, JNK,and p38 MAPK in murine KC which were stimulated by LPS. It was found that LPS treatment resulted in no significant change in their protein expression, but a rapid transient increase in their phosphorylation levels, which peaked at 30, 45,and 20 minutes,respectively; The values returned to mear baseline within 2 hours. Kinase phosphorylation levels of these three MAPKs induced by LPS were found to be dose dependent in a range of 10 pg/ml to 100ng/ml. No phosphorylation was observed in unstimulated cells. Among them, p38 MAPK shoned fastest and highest phosphorylation levels. The results show that LPS can markedly activate ERK, JNK,and p38 MAPK in KC, and p38 MAPK may play a more important role in LPS induced kupffer cell activation than ERR and JNK.

Objective To study the effects of three kinds of endoscopic therapy on gastric varices. Methods In this study, the efficacies of endoscopic band ligation ( EVL) , endoscopic injection of tissue adhesives (histoacryl) and sclerotic agent (EIS) for gastric varices were assessed. Forty consecutive, non-randomized patients with gastric varices were prospectively studied. EVL was done for 11 cases, Histoacryl 15 cases, and EIS 14 cases, to control and prevent relapse of bleeding. Results In the following-up ( six months) period, the effective rate of EVL, histoacryl and EIS were 100. 0% , 100. 0% and 72. 7% ; the e-radicative rate 25. 0% , 30. 8% ,0 (P

ObjectiveTo investigate the short-term effect of health education intervention on the recovery of new schizophrenia patients. Methods82 patients were randomly divided into observation group, in which patients accepted routine antipsychotic medication, general nursing and system health education intervention, and control group, in which patients accepted antipsychotic medication and general nursing. Brief psychiatric Rating Scale (BPRS) and Positive And Negative Syndrome Scale (PANSS) were used to assess the effects. ResultsThere was no difference in the score of every factor before intervention (P>0.05), but it became different after intervention (P<0.01 or P<0.05). ConclusionHealth education intervention can improve the effect on schizophrenia.

Objective To explore the effect and safety of transcranial approach for spheno-orhital meningioma. Design Retro- spective case series. Participants Thirty-two patients being operated with transcranial approach. Twenty-four cases were meningothelial meningiomas, 3 cases were fibrous meningiomas, 1 case was psammomatous meningioma, 2 cases were atypital meningiomas, 2 case were malignant meningiomas. Methods All patients underwent frontal-temporal craniotomy, the involved sphenoid wing bone and peri- orbit were removed to prevent recurrence. The superior orbital fissure and optic canal were decompressed, the dural and periorbital de- feet were repaired by autogenous temporal fascia or artificial dura. Main Outcome Measures Preoperative and postoperative exoph- thalmus and eyeball movement, the extent of tumor resection, the ratio of recurrence. Results The extent of tumor resection: 8 cases were Simpson gradeⅡ, 20 cases Simpson gradeⅢ, 4 cases Simpson grade IV. After surgery, proptosis were improved in all patients, ophthalmoplegia was found in 6 eases. There was no operation-related death or other significant complication. Tumor recurred in 6 cas- es. Conclusions Adequate exposure of the tumor and bony decompression of the cranial nerves can result from transcranial approach, all the involved bone should be removed in order to prevent recurrence. This approach is relatively safe and the ptoptosis are improved significantly. Complete surgical resection is difficult because of the involvement of the orbital apex, superior orbital fissure and cav- ernous sinus.

Acupuncture Therapy ; Adult ; Aged ; Female ; Gastroesophageal Reflux ; therapy ; Humans ; Male ; Middle Aged ; Treatment Outcome

Objective To evaluate the clinical efficacy of endoscopic variceal ligation (EVL) combined with injection of tissue adhesive for esophageal and gastric varices bleeding.Methods Data of 452 patients with esophageal and gastric varices bleeding who received EVL and injection of tissue adhesive were retrospectively studied.Results The instant hemostatic rate was 100.0％ (145/145).Early rebleeding rate was 1.8％ (8/452).Incidence of early adverse reactions was 50.0％ (226/452).The total incidence rate of complications was 12.4％ (56/452).Efficiency and effectiveness of EVL were 32.5％ (145/446)and 40.4％(180/446) respectively.Efficiency and effectiveness of injection of tissue adhesive were 32.5％ (136/419) and 27.4％ (115/419) respectively.With an average of 18 months' follow-up (ranging from 9 to 37 months),the rate of rebleeding was 10.1％ (43/426),six-month and one-year survival rate was 97.9％ (417/426) and 89.9％ (383/426) respectively.Conclusion EVL combined with injection of tissue adhesive for esophageal and gastric varices is effective,convenient,and less invasive.They can be used not only for emergency hemostasis but also for secondary prophylaxis.

Objective The study was performed to analyze the diagnosis and treatment of blue rubber bleb nevus syndrome of Chinese patients by evaluating the researches in China.Methods Chinese Journal Full-text Database,Wangfang Data and Weipu Chinese Medical Journal Database were searched for the clinical data of the patients with blue rubber bled nevus syndrome.Results Among the 50 patients,31 cases were male,and 19 cases were female.All patients (100％) had the venous malformations of the skin.Thirty-five (70％) cases had melena,13 (26％) cases had bloody stool,and 35(70％) had dizziness and palpitation.Blue rubber bled nevus syndrome were diagnosed with gastroscopy (40/48,83.33 ％),coloscopy (30/41,73.17％) and small intestinal examination (23/25,92％).Fourteen cases received symptomatic treatment.Twelve cases received therapeutic endoscopy,which lesions were located in stomach and colon.Sixteen cases received operation,and 2 cases were treated by laparoscopy and endoscopy.Conclusions Blue rubber bleb nevus syndrome is a rare disease.The skin and gastrointestinal system are involved in all patients with blue rubber bleb nevus syndrome in China.The routine examination for diagnosis of blue rubber bleb nevus syndrome should include examination of the small intestine.It still needs further research about effective treatment of blue rubber bleb nevus syndrome.

To retrospectively analyze the clinical data of 42 patients at our department with bulbar myasthenia gravis.They underwent video-assisted thoracoscopic extended thymectomy (VATET) from May 2003 to August 2010.Another 42 patients treated with medications alone were selected as controls.Compared with the control group (4.32 ± 0.23),postoperative dysphagia scores improved significantly in patients undergoing VATET(9.21 ±0.41).And so did the dysphagia assessment classification (P ＜0.05).Thus VATET could effectively and definitely relieve dysphagia in patients with bulbar myasthenia gravis.

Aim To observe the retinal angiogenesis and detect the altered expression of genes related with angiogenesis and oxidative stress during the develop-ment of oxygen-induced retinopathy ( OIR) in newborn mice. Methods OIR was established in newborn mice according to the protocol of Smith et al. Newborn mice at 7 days old were placed into 75 . 5% oxygen for up to 5 days, and then they were put in room air for another 5 days. Retinal neovascularization was ob-served by immunofluorescence staining with cluster of differentiation 31 ( CD31 ) . Gene expression was de-tected using Real-time PCR analysis. Retinal CD31 immunofluorescence staining assay showed that relative hypoxia induced retinal neovascularization in OIR mice after hyperoxia-induced subside of retinal microvascu-lar. Results Real-time PCR analysis showed that vas-cular endothelial growth factor ( VEGF) and its recep-tor ( VEGFR) such as VEGFA, VEGFD, VEGFR1, VEGFR2 gene expression were increased in OIR mouse as compared to control. Platelet-derived growth factor ( PDGF) and its receptor ( PDGFR) such as PDGFA, PDGFB, PDGFRa, PDGFRb gene expression was also increased in OIR mouse as compared to control. Matrix metalloproteinases ( MMPs ) such as MMP2 gene ex-pression were increased in OIR mouse as compared to control. Gene expressions of nuclear factor-related fac-tor ( Nrf2 ) and its downstream genes such as the two subunits of glutamate-cysteine ligase ( GCL):the cata-lytic subunit ( GCLC) and regulatory subunit ( GCLM) were both decreased in OIR mouse as compared to con-trol. Conclusion Our research demonstrates that the expression of genes related with angiogenesis is in-creased in retinas in the development of OIR in mice, whereas the expression of Nrf2 and its downstream genes is all decreased.

Objective To determine the safety and clinical value of secondary ERCP to a failed intubation procedure.Methods A total of 212 patients with difficult intubation during ERCP procedures were enrolled.Patients with failed conventional intubation accepted precut sphincterotomy.The operation stopped after one hour of effort.A secondary selective ERCP was performed at a appropriate time.The operation success rate and complication rate of first ERCP and secondary ERCP were compared.Results The success rate of first ERCP was 67.0％ (142/212),and the total success rate was 90.6％ (192/212).The total success rate is significantly higher than that of first ERCP operation(x2 =35.263,P ＜0.05).The complication rate of first ERCP,secondary ERCP and total complication rate was 8.96％ (19/212),4.29％ (3/70),10.38％ (22/212),respectively.Complication rates of total ERCP and secondary ERCP were not significantly different from the first ERCP (P ＞ 0.05).Conclusion It is safe and effective for patients with failed ERCP intubations after precut to receive a secondary ERCP at a appropriate time.