Objective To explore the potential role of ineffective esophageal motility(IEM) in the pathogenesis of gastroesophageal reflux disease(GERD).Methods The esophageal manometry and ambulatory pH monitoring findings from patients with GERD were analyzed to identify the prevalence of IEM in patients with GERD.And comparison of esophageal acid exposure,esophageal acid clearance (EAC) and endoscopic esophagitis in GERD patients with IEM were made.Results Of 86 patients with GERD,59 (68.6%) were found to have nonspecific esophageal motility disorder (NEMD);55 of the 59 (93.2%)patients with NEMD met the diagnostic criteria for IEM.The overall incidence of IEM in GERD patients was 63.95%.Patients with IEM demonstrated significant increase in total,upright and recumbent mean percentage of time of pH

Objective To investigate curative effects of video-assisted thoracoscopic sympathectomy for the treatment of palmar hyperhidrosis. Methods Under general anesthesia with double-lumen endotracheal intubation,the patient was maintained at a 45? semi-sitting position with two upper limbs fixed on 90? abduction.An incision 0.5~1.5 cm in length was made on the midaxillary line at the fifth intercostal space to introduce the thoracoscope.Another incision 0.3~0.5 cm in length was made on the anterior axillary line at the third intercostal space as manipulation hole.Under video-assisted thoracoscopy,the sympathetic trunk on the T_2~T_4 level was amputated for treating palmar hyperhidrosis.Results The patient's palms became dry and warm immediately after surgery in all 50 patients.The temperature of the palm was increased by 0.2~4.6 ℃.Slight pneumothorax was encountered in 3 patients(lung compression,10%~20%).Compensated hyperhidrosis occurred in 31 patients within 3~15 days after operation,including mild hyperhidrosis in 11 patients and moderate hyperhidrosis in 20 patients.The hyperhidrosis was located at the chest in 13 patients,back in 11 patients,abdomen in 2 patients,thigh in 4 patients,and shank in 1,respectively.There were no Horner's syndrome and other severe complications after operation.None of patients recurred in follow-up observations.Conclusions(Video-assisted) thoracoscopic sympathectomy is a safe and reliable approach for the treatment of palmar hyperhidrosis.

Objective The monoclone antibody against insulin was prepared and used to measure plasma level of insulin in patients with type 2 diabetes mellitus. Methods Balb/c mice were immunedwith cross-linking insulin-BSA as immunogen. Four monoelone cell strains stably secreting insulin monoclone antibody were prepared by applying hybridoma technique. The valence, subclass and affini-ty constant of the monoclone antibody were analyzed. The serum insulin content was measured with competitive inhibition ELISA in 90 patients with type 2 diabetes mellitus and 90 healthy controls. Re-suits The affinity constant of the established monoclone antibody reached to 1011. The subclass of 1 strain was Igab(k),and the other 3 strains were Ig1(k) srbclass.The mean level of insulin was significantly lower in patients with type 2 diabetes mellitus than that of healthy controls. Conclusion These results implicated that the insulin insufficient might be due to the depletion of the pancreatic be-ta cell function of patients with type 2 diabetes mellitus, and the pathogenetic condition might be alle-viated by supplying insulin. About 10% patients are with higher insulin level than healthy controls,which may be due to insulin resistance. It is inadvisable to treat these patients with insulin therapy.

Pyogenic arthritis, pyoderma gangrenosum and acne (PAPA) syndrome is a rare autoinflammatory bone disease, which caused by proline-serine-threonine phosphatase interacting protein 1 (PSTPIP1) gene mutations.Due to a lack of awareness of it among clinicians, PAPA syndrome is hard to diagnose and easy to be misdiagnosed or miss-diagnosed clinically.In this paper, twin brothers with recurrent fever and joints pain were reported.They were diagnosed with suppurative arthritis by many hospitals, but after receiving the joint cavity incision operation with negative pressure drainage for several times and antibiotics treatment, their conditions were not improved.Genetic tests showed that the twin brothers had a heterozygous mutation p. E250K (NM003978.3; c.748 G>A; p.Glu250Lys) on the PSTPIP1 gene.They were finally diagnosed with PAPA syndrome and improved with glucocorticoid therapy.

Objective To explore the relationship of the level of serum selenium and infantile diarrhea,provide foundation for establishing the therapeutic criteria.Methods Seventy-eight diarrhea children was enrolled in this study,6 -24 months old.Thirty children with acute diarrhea (AD group),26 children with persistent diarrhea (PD group) and 22 children with chronic diarrhea (CD group).The level of serum selenium was measured and compared with another 30 healthy children (control group) of matched sex and age.The level of serum selenium of CD group was compared before and after the recovery.Results The level of serum selenium in AD group and PD group had no significant difference compared with control group [ (51.34 ± 4.84),(48.14 ± 3.05 ) μ g/L vs.(55.08 ± 5.59 ) μ g/L ] (P＞0.05 ).But the level of serum selenium in CD group was significantly lower than that in control group [ (42.13 ± 5.16) μ g/L vs.(55.08 ±5.59) μg/L] (P＜0.05).After treatment for 1 month,the level of serum selenium in CD group was significantly increased than before treatment [ (53.76 ± 8.38 ) μ g/L vs.(42.13 ± 5.16) μ g/L ] (P＜0.05 ).Conclusions The nosogenesis of chronic diarrhea may relate with the level of serum selenium decrease.Therapeutic selenium supplement is important in children with chronic diarrhea.

OBJECTIVETo observe the acupoint distribution and clinical efficacy of lumbar disc herniationi (LDH) with different sensitive types.

METHODSEighty patients with LDH were randomly divided into a heat-sensitive moxibustion group (group A), a heat-sensitive acupuncture group (group B), a force-sensitive acupuncture group (group C) and a force-sensitive moxibustion group (group D), 20 cases in each one. In the group A and the group B, moxibustion and acupuncture were applied at two or three heat-sensitive acupoints separately. In the group C and the group D,acupuncture and moxibustion were used at two or three force-sensitive acupoints respectively. The treatment was given once a day, totally 10 times. The distribution law of the heat-sensitive acupoints and the force-sensitive acupoints and the change of M-JOA before and after treatment were recorded in the four groups.

RESULTSThe frequent heat-sensitive acupoints areas of LDH were at Yaoyangguan (GV 3), Dachangshu (BL 25), Zhiyang(GV 9), Guanyuanshu(BL 26) and Weizhong(BL 40). The major force-sensitive acupoints areas were at Shenshu (BL 23), Dachangshu (BL 25), Tianshu (ST 25), Guilai (ST 29) and Weizhong (BL 40). After treatment, the heat-sensitive acupoints in the group A and the group B were all reduced than those before treatment and the force-sensitive acupoints in the group C and the group D were declined as well (P < 0.01, P < 0.05). The M-JOA scores were obviously lower than those before treatment in the four groups (all P < 0.01). The score in the group A was reduced more apparently than that in the group B (P < 0.05). The score in the group C was declined more markedly than that in the group D (P < 0.05).

CONCLUSIONThere are diverse acupoints for LDH patients due to different sensitive types. All forms of stimulation can change the functional state of acupoints. Moxibustion is more suitable for heat-sensitive acupoints and acupuncture is optimal for force-sensitive acupoints.

Acupuncture Points ; Acupuncture Therapy ; methods ; Adult ; Aged ; Female ; Humans ; Intervertebral Disc Displacement ; therapy ; Male ; Middle Aged ; Moxibustion ; methods ; Treatment Outcome

OBJECTIVE:To find the optimal extraction method for Danshen granules METHODS:According to the orthogonal design L9(34),four factors in extraction were optimized,i e soak duration,decocting times,decocting duration and amount of water added The content of salvianolic acid and the weight of solids were taken as indices RESULTS:The best extracting condition was that 20 mesh size of particles was soaked in eight times amount of water for 1 5h,decocted for 1 5h at first,and then six times amount of water for 1 0h CONCLUSION:This technique is highly repeatable in pilot-experiment

Objective To study the dynamic changes of soluble intracellular adhesion molecule-1 (sICAM-1), and to assess its role in the pathogenesis of hemorrhagic fever(HFRS) with renal syndrome. Methods A total of 30 patients with HFRS(case group) and 20 healthy subjects (control group) from Worker Hospital of Finance & Commerce of Qiqihar city were included in the study during 2006 - 2007. Double-antibody sandwich ELISA method was used to measure the level of sICAM-1 in serum samples. Results The serum levels of sICAM-1 in patients with HFRS in early stage, critical stage, convalescent stage were(47.56±6.51), (94.23±15.36), (54.19±8.42)ng/L,respectively. The serum level of sICAM-1 in control group was (22.63±3.40)ng/L. The above values were compared between any two groups, differences were statistically significant (all P < 0.01). The serum level of urea nitrogen in patients with HFRS in early stage, critical stage, convalescent stage were (5.16±0.12), (33.84±9.24),(8.20±1.30)mmol/L, respectively. The serum level of urea nitrogen in control group was (4.20±0.56)mmol/L.The above value were compared between any two groups, the differences were statistically significant (all P< 0.01). Conclusions sICAM-1 is involved in the pathogenesis of HFRS as protective factors. Cellular immune playes an important role in the pathogenesis of HFRS.

OBJECTIVETo analyze the relationship between symptoms and signs of temporomandibular disorders (TMD) and the patients' quality of life (QOL).

METHODSA total of 492 TMD patients were included in this study. The clinical examination results were recorded using Fricton index of temporomandibular joint function. "Visual analog scale (VAS) evaluation of QOL disturbance" was designed to quantitate patients' QOL, to evaluate the degree that the patients QOL was affected.

RESULTSChewing, daily life and emotion among all 8 items of QOL were frequently affected by TMD, and joint clicking had the least influence on QOL. Intermittent closed lock had more severe interference with QOL than joint clicking only. Severe and moderate pain or limited mouth opening affected the QOL more severely than mild pain or mild limited mouth opening. The simple linear relationship between Fricton index and patients' QOL was poor (r < 0.4).

CONCLUSIONSPain is the most frequently seen symptom in TMD. TMD could affect patients' QOL, including both physical and social-psychological functions. The results suggest that the patients' QOL as well as TMD symptoms and signs should be considered in the management of TMD.

Adult ; Facial Pain ; etiology ; Female ; Humans ; Male ; Quality of Life ; Temporomandibular Joint Disorders ; complications

Objective To explore the role of LiCl in microbial suppurative keratitis .Methods Western-blot assay was used to detect the efficacy of LiCl .Inflammatory cytokine levels were examined using Real-time PCR .Cell apoptosis was detected by using TUNEL and flow cytometry assays .Results LiCl promoted corneal resistance to PA infection .Real-time PCR data showed that LiCl enhanced IL-10 expression ,but suppressed TNF-expression .TUNEL and flow cytometry data showed that LiCl promoted the apoptosis of infiltrating cells .Conclusion LiCl promoted host resistance against microbial suppurative keratitis ,via regulating in-flammatory cytokine expression and cell apoptosis .