Achalasia is an esophageal motility disorder with impaired relaxation of lower esophageal sphincter.Its clinical manifestations are progressive dysphagia, retrosternal pain, regurgitation of undigested food, weight loss.Medication, endoscopic treatment and surgery are the main treatments of achalasia.Peroral endoscopic myotomy (POEM) is an endoscopic mini-invasive technique which has smaller surgical injury, remarkable curative effect, lower cost, and lower recurrence rate when compared with the traditional treatment of achalasia.This article reviewed the advances and prospects of POEM in treatment of achalasia.

OBJECTIVE:To discuss the management targets of hospital drug sto rehouse.METHODS:Theory of physical distribution management was applied in combination with the actual situation of hospitals,the professional characteristic of hospital pharmacy,the functional characteristic of pharmaceutical legislation and the commercial characteristic of drug distri?bution were analyzed.RESULTS&CONCLUSION:The management targets of hospital drug storehouse must accord with the mission of hospital and embody its social effects as well as the economic returns.

AIM: To optimize the extraction process for Banxiaxiexin Decoction (Rhizoma pinelliae, Radix Scutellariae, Rhizoma coptidis, Radix Ginsenp, Rhizoma zinpiberis, Fruents Jujubae, and Radix Glycyrrhizae). METHODS: The content of berberine、baicalin and total solid in extract liquor were determined by orthogonal design and single factor experiment in combination with glycyrrhizic acid content and identification of Rhizoma zingiberis, Radix Ginseng and Rhizoma Pinelliae. RESULTS: The extracting was arrived at in the condition of adding eighteen times of 70% alcohol as much as crude drug and refluxing 2 times, 2h and 1h, respectively. CONCLUSION: The extraction is stable and feasible.

Objective The purpose of this study was to discuss the therapies for hemorrage caused by the fissuration of pancreatojejunal stoma and pancreatic leakage after pancreatoduodenectomy.Methods After three cases of pancreatoduodenectomy,the disruptions of pancreatojejunal stoma resulted in serious pancreatic leakage and the hemorrage in abdominal cavity.During all the second operations,the drainage-tube insertions into the main pancreatic ducts were used to lead the pancreatic juice into the neighboring loop of jejunum.Results Afer the operations,the supportive treatment,continuous irrigation of peritoneal cavity and pancreatic enzyme inhabition were given to the patients of these cases and all of the patients were successfully cured.Conclusions The bridge-crossing internal drainage which inserts drainage-tube into the main pancreatic duct was a convenient and effective therapy and method to rescue the hemorrage caused by the fissuration of pancreatojejunal stoma and pancreatic leakage after pancreatoduodenectomy.While the patients' lives were saved,their functions of pancreas were preserved and the qualities of life were improved after the operations.

Objective To identify the role of survivin and VEGF in angiogenesis of colorectal tumor by investigating tissue expression of survivin, VEGF and CD34 in human colorectal tumors. Methods Immunohistochemical staining for the paraffin sections by using the polyclonal antibodies of survivin, monoclonal antibodies of VEGF and CD34, was performed by the standard avidin-biotin-peroxidase technique. The percentage of positive cell and quantitative analysis were made by image analysis system, which also helped to calculate the amount of MVD. Results The immunoreactivity of survivin significantly increased in the transition from adenoma with low dysplasia to adenoma with high dysplasia (P <0.01). Similar changes in protein expression were observed for VEGF and MVD. The expression of survivin was closely related with that of VEGF. Both were positively correlated with MVD. Conclusion Survivin promotes angiogenesis of colorectal tumor together with VEGF. VEGF may be the potential causes of reexpression of survivin during colorectal tumorigenesis.

Objective To evaluate the role of Restriction fragment length polymorphism (RFLP) analysis in detection of the fragment of GEF1α/a gene which are both located at ct and a mating type loci in identification of species, varieties, genotypes and mating types of Cryptococcus neoformans species complex(Cryptococcus neoformans and Cryptococcus gattii). Methods The GEF1α/a gene was selected from 20 genes which both located at α and a mating type loci for RFLP analysis, according to the requirements of sequence similarities and primer design in PCR-RFLP analysis. Primer pair was designed from the conserved regions of GEF1α/a genes of distinct genotypes and mating types of reference strains to amplify a fragment of GEF1α/a gene from Cryptococcus neoformans and Cryptococcns gattii strains tested. Sequence alignment,restriction maps analysis, endonucleases selection and electrophoresis stimulation were conducted by using DNAMAN and Vector NTI software. EeoT14 Ⅰ and Hap Ⅱ endonucleases were selected for RFLP analysis of the GEF1α/a fragments amplified from 125 isolates of Cryptococcns neoformans and Cryptococcus gattii. Results An approximate 1 300 bp fragment was amplified from total 82 Cryptococcus neoformans and 43 Cryptoceccus gattii isolates. However, negative PCR results were found in the reference strains of Cryptococcus laurentii, Candida albicans, Candida tropicalis, Candida parapsilosis, Candida krnsei,Candida glabrata, Trichosporon asahii, Aspergillus fumigatns and Aspergillus flavus. RFLP analysis successfully identified the species, varieties, genotypes and mating types of total 125 isolates of Cryptococcus neoformans and Cryptococcns gattii tested in this study. Condusion PCR-RFLP analysis of the GEF1α/a fragment has the potential value in identification of species, varieties, genotypes and mating types of Cryptococeus neoformans species complex simultaneously and rapidly, and may be a useful tool in molecular epidemiological analysis.

Objective To evaluate the efficiency of PCR-restriction fragment length polymorphism (PCR-RFLP)aiming at the structure gene g6341,versus PCR fingerprinting analysis in the genotyping of Cryptococcus neoformans MethodsEight reference strains and 68 clinical and environmental isolates of C.neoformans were genotyped by PCR-RFLP and PCR fingerprinfing.In PCR fingerprinting,the minisatel lite-specific core sequence of wild-type phage M13 was used as a single primer.The structure gene g6341 was selected for PCR-RFLP analysis by sequence alignments of multiple genes,a pair of pnmers were developed based on the conserved region of g6341 gene.PCR products were digested with the appropriate restriction endonucleases,and RFLP profiles were analyzed.Partial sequence analysis of g6341 gene was performed for different genotypes of C.Neoformans.Phylogenetic analysis was done to study the relatedness between these genotypes.Results As sequence homology analysis showed,g6341 gene was suitable for RFLP analysis.In the case of enotyping of 76 C. Neoformans strains,the results obtained from PCR-RFLP were consistent with those from PCR fingerprinting.Sequence analysis of g6341 gene revealed a homology of 84%-97%among the eight genotypes as well as a consistency of 99%-100%within a same genotype.In the phylogenetic tree,genotypes VNⅠ,VNⅡ,VNⅢand VNⅣ belonged to one cluster,and genotypes VGⅠ,VGⅡ,VGⅢ and VGⅣ to another cluster.Conclusions PCR-RFLP analysis aiming at the structure gene g6341 is a useful tool to genotype C.neoformans.Sequence analysis of g6341 gene can disclose the relatedness among different molecular types of C.neoformans.

Objective To identify the AD hybrid strains and its hybrid types within Cryptococcus neoformans.Methods Difierent hybrid types of AD strains were analyzed by PCR 0f STE20 and MF genes within MAT locus and CIA4 and GPal genes out of MAT locus.The PCR-RFLP analysis of g6341 gene was also performed.Results The mating types of 18 AD strains were precisely identified by PCR of STE20 gene,whereas those of H strain were not identified.CL44 gene was better than the GPal gene in PCR identification of the AD hybrids.In the RFLP analysis of g6341 gene,AD strains were grouped into 2 distinct RFLP patterns based on the mating type on serotype A allele.The mating types of AD strains were not identified by the molecular analyses based on the CL44,GPal and g6341 genes.Conclusion It is necessary to use multi-locus analyses of genes within and out of the MAT locus in precise identification of the AD strains and their hybrid types of Cryptococcus neoformans.

Objective To assess the subgenotypes of pathogenic Cryptococcus gattii isolates from China and to elucidate the epidemiological links between these domestic isolates and those from other parts of the world. Methods DNA was extracted from 9 clinical isolates of Ctyptococcus gattii from China. The partially variable regions of the three unlinked loci, namely IGS1, PLB1 and GEF1, were amplified and sequenced, and the bioinformation at these loci was obtained from GenBank for multi-locus sequences alignment and phylogenetic analysis. Results Of these 9 clinical isolates, 8 were genotype VG Ⅰ and mating type α with the same sequences at the tested regions as the reference strain WM276, which was a representative isolate of an independent subgenotype; 1 was of genotype VG Ⅱ and mating type α, which was the first report in China, with the tested sequences consistent with those of the referrence strain R272. Sequencing and phylogenetic analysis of GEF1 gene, which was located at mating type locus, successfully identified the genotypes and mating types of all the Cryptococcus gattii isolates involved here. Conclusions Multi-locus sequence analysis shows that causative Cryptococcus gattii isolates of genotype VG Ⅰ in China carry similar sequences at the tested loci in IGS1, PLB1 and GEF1 genes, to a widely distributed subgenotype in the world, and the sequences of the first VG Ⅱ genotype isolate from China resemble the less virulent subgenotype VG Ⅱ b found in Vancouver islands.

Objective Dipole source analysis was employed to investigate the transient changes in brain mechanisms at earlier latencies.Methods Fourteen healthy volunteers were recruited in this research and evoked event-related potentials (ERPs) of unimodal and bimodal visual auditory stimuli were recorded by 64-electrodes electroencephalograph (EEG) recording system.All these earlier phases of the stimuli were divided into several subphases by specific time window for source analysis.Results The results showed that ERPs sources were mainly generated from visual and audio cortex,and there were changes in the location and strength of the dipole sources in each sub-phase.Conclusions The result of this study implies a serial processing of sensory information in human cortices in early phase of visual and auditory stimuli.