By using a micro-sensor through an endoscope,the esophageal variceal pressure in 94 patients with cirrhosis was measured.The results of the measurement were as follow:in 5 cases with Ⅱ-degree,it was 2.68?0.18 kPa,varices in 26 cases with Ⅲ-degree,it was 2.90?0.23 kPa,while in 63 cases of Ⅳ-degree varices,it was 3.51?0.33 kPa.The results suggested that there was a significant correlation between the pressure of esophageal varices with the degree of varices (r=0.313,P=0.01).The method seemed to be a valuable non-invading technic for evaluating the degree of varices.

This article reports on 217 patients with cirrhosis before sclerotherapy. It was observed that there was relationship between the 10 indexes and bleeding, i.e. the diameter of portal vein in bleeding group 1.60?0.29 cm, portal venous flow 986.5?117.8 ml/min, free portal pressure 3.76?0.28 kPa, the esophageal variceal pressure 3.56?0.25 kPa. In the patients with no bleeding, the value were 1.40?0.16 cm, 831.7?53.6 ml/min, 2.79?0.33 kPa, and 2.75?0.31 kPa, respectively. Differences between two groups were significant (P

Objective To explore the value of MRI and iron oxide particle labeling in stem cell therapy of stroke model. Methods Nine rats with middle cerebral artery occlusion were randomly selected and underwent Neurological Severity Scoring(NSS), MRI and pathological examination. The results of the 3 evaluation criteria were correlated. Bone marrow stromal cells were labeled with superparamagnetic iron oxide particles. Eighteen models were screened and divided into 3 groups based on different transplantation sites. MRI was performed at different time points. The MR appearance of labeled stem cell transplantation sites was observed. The relative infarct volume of the models in three groups were recorded and compared. Results Significant correlations among the NSS, MRI and pathological examination were found. Different MR sequences could depict local transplanted labeled stem cells and gradient echo sequence was the most sensitive method, while the T2WI showed its advantage of better temporal resolution. MR images showed the morphological changes of transplanted stem cells. The change of the relative infarct volume showed no significant differences among the three groups. Conclusion MRI is an ideal tool to evaluate the rat stroke model. MRI together with iron oxide particle labeling technique helps to in vivo track and monitor the transplanted stem cells.

Objective To observe the activities of ChAT + neurons in subventricular zone (SVZ) after ischemic stroke and their effects on angiogenesis in peri-infarction region and related signaling pathways. Methods C57BL/6 mice were randomly assigned into sham group,middle cerebral artery occlusion (MCAO) group and atropine group. Ischemic models were made by permanent coagulation of the distal middle cerebral artery. The expression of ChAT,AChE in SVZ and VEGF,VEGFR2,pERK in peripheral regions of ischemic injury was evaluated by Western blotting and immunofluorescence. 5-bromodeoxyuridine(BrdU)/CD31 double-labeled cells were also tested by immunofluorescence. Results At 14 d after the surgery,the ratio of ChAT/AChE in SVZ increased after stroke(P < 0.05). Compared with those in Sham group,the levels of VEGF,VEGFR2 and pERK were higher in MCAO group(P<0.05)and VEGFR2-positive and BrdU/CD31-positive cells increased significantly. However,lower expression of VEGF,VEGFR2 and pERK and less VEGFR2-positive and BrdU/CD31-positive cells were found in atropine group when compared with that in MCAO group. Conclusions The activities of ChAT +neurons in SVZ are enhanced after ischemic injury and they can promote angiogenesis in peripheral region of ischemic injury via upregulating VEGF-VEGFR2 signaling pathway and improving the brain function restoration.

Objective Investigate the behaviors of cerebral ischemic rats after treatment with bone marrow mesenchymal stem cells(BMSCs).Methods Bone marrow was collected and BMSCs were separated and cultivated.Twenty-four adult male Sprague-Dawley rats were performed transient(2 hours) middle cerebral arterial occlusion(MCAO) and then divided into treated group(n=12) and control group(n=12).All rats received corresponding behavioral training before surgery,15 ?L hBMSCs(2?1010cells/L) and D-hanks(15 ?L) were injected into the brain cortex after 24 h of MCAO.Morris water maze test,NSS,Rotarod test and adhesive-removal test were performed serially and cyclically from the 4th day after transplantation.Results Since the 8th day after transplantation,the mean escape time and the mean swimming distance of treated group significantly are shorter than control's in Morris water maze test(P

Objective:To establish the normal values of water-perfused high resolution esophageal manometry (HREM)(GAP-36A) at resting period, water swallowing, semisolid swallowing and solid swallowing in Chinese population.Methods:From September 1, 2019 to June 30, 2020, 91 healthy volunteers receiving water-perfused HREM (GAP-36A) at resting period, water swallowing, semisolid swallowing and solid swallowing were selected from 9 hospitals (Union Hospital, Tongji Medical College, Huazhong University of Science and Technology; the First Affiliated Hospital of Dalian Medical University; the Second Hospital of Hebei Medical University; the Second Affiliated Hospital, Naval Medical University; the First Affiliated Hospital, Sun Yat-sen University; the First Affiliated Hospital, University of Science and Technology of China; Aviation General Hospital of China Medical University; the Affiliated Hospital of Medical School of Nanjing University and the First People′s Hospital of Yichang). Parameters included the position of the upper and lower edges of the upper esophageal sphincter (UES) and lower esophageal sphincter (LES), the length of the LES and UES, the position of the pressure inversion point (PIP), the resting pressure of UES and LES and swallow-related parameters such as the distal contraction integral (DCI), 4 s integrated relaxation pressure (IRP), distal latency (DL) and UES residual pressure. One-way analysis of variance, post-hoc test and sum rank test were used for statistical analysis.Results:A total of 87 healthy volunteers were enrolled, including 40 males and 47 females, aged (38.5±14.2) years old (ranged from 19 to 65 years old). The position of the upper and lower edges of the LES was (42.7±2.8) and (45.6±2.8) cm, respectively, the length of the LES was (2.9±0.4) cm, and the position of PIP was (43.3±2.8) cm. The position of the upper and lower edges of the UES was (18.1±3.0) and (22.6±2.0) cm, respectively, and the length of the UES was (4.8±1.0) cm. The resting pressure of LES and UES was (17.4±10.7) and (84.1±61.1) mmHg (1 mmHg=0.133 kPa), respectively. The DCI value at solid swallowing was higher than those at water swallowing and semisolid swallowing ((2 512.4±1 448.0) mmHg·s·cm vs. (2 183.2±1 441.2) and (2 150.8±1 244.8) mmHg·s·cm), and the differences were statistically significant ( t=-4.30 and -3.74, both P<0.001). The values of 4 s IRP at semisolid swallowing and solid swallowing were lower than that at water swallowing ((4.6±4.1) and (4.9±3.9) mmHg vs. (5.4±3.9) mmHg), and the differences were statistically significant ( t=3.38 and 2.09, P=0.001 and 0.037). The DL at water swallowing was shorter than those at semisolid swallowing and solid swallowing ((8.5±1.8) s vs. (9.8±2.2) and (10.6±2.8) s), and the DL at semisolid swallowing was shorter than that at solid swallowing, and the differences were statistically significant ( t=-10.21, -13.91 and -4.68, all P<0.001). The UES residual pressure at water swallowing was higher than those at semisolid swallowing and solid swallowing (9.5 mmHg, 6.5 to 12.3 mmHg vs. 8.0 mmHg, 4.5 to 11.7 mmHg and 5.5 mmHg, 2.0 to 9.3 mmHg), and the UES residual pressure at semisolid swallowing was higher than that at solid swallowing, and the differences were statistically significant ( t=3.48, 10.30 and 6.35, all P<0.001). Conclusions:The normal values of water-perfused HREM (GAP-36A) in Chinese population at resting period, water swallowing, semisolid swallowing and solid swallowing can provide a reference basis for clinical diagnosis and treatment for patients receiving water-perfused HREM examination.

Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.