Objective To explore the therapeutic effect of transabdominal paraesophagogastric devascularization plus esophageal transection for variceal bleeding.Methods From October 2002 to October 2006,26 patients of portal hypertension received the treatment in our hospital.Their clinical data were retrospectively analyzed.Results In the 26 cases,2 received emergency operation and 24 selective operation.After operation,no recurrent bleeding or hepatic encephalopathy took place in short term.The long-term follow-up was performed in 16 cases,of which recurrent bleeding rate was 3.84% in 1-3 years and liver function was improved to various degree.Conclusion The curative effect in near future of this operation is satisfactory.This operation is an effective method to treat variceal bleeding of oesophageal fundus and stomach in portal vein hyperbarism.

Objective To study the expression of collagenase Ⅳ and collagen type Ⅳ in papillary thyroid carcinoma (PTC). Methods Immunohistochemical staining(SP method)was used to detect the expression of collagenase Ⅳ and collagen typeⅣ. Results ⑴The positive expression rate of collagenase Ⅳ was 77 9%, 66 7%, 80 0%, 88 9% and 25 4% in PTC, papillary microcarcinoma, intra-thyroid, extra-thyroid carcinoma and tissues adjacent to tumor(P

Objective: To analyze the characters of occlusal contact in patients with bruxism.Methods: Occlusal contact was examined by a T-scan II occlusal analyser in 23 cases with bruxism and 13 controls in intercuspal occlusion position, canine protection position, protrusive-retrusive movement and lateral movement. The clusal time, the protrusive disclusion time, the lateral disclusion time and balanced occlusal contacts were calculated and compared between the two groups. Results: The clusion time in bruxism cases was shorter while the lateral disclusion time longer than those in the controls (P

Objective To study the use of fiberoptic bronchoscope in the positioning of double-lumen endobronchial tube in Chinese patients. Methods Ninety ASA Ⅰ - Ⅱ patients (60 male and 30 female) undergoing thoracic surgery requiring one-lung ventilation were enrolled in the study. Age ranged from 14-79 years (mean age 56 ?16) and the average height was 169? 6 cm (male) and 158?6 cm (female) respectively. Anesthesia was induced with fentanyl, propofol and vecuronium. Double-lumen endobronchial tube (Broncho-Cath, Mallincrodt Medical) was inserted following conventional procedure. Proper position of double-lumen tube(DLT) was determined by auscultation. Fiberoptic bronchoscope was made if needed. The fiberoptic bronchoscopy was repeated after lateral decubitus positioning of the patient. The depth of the tube inserted was recorded. Results The fiberoptic bronchoscopy revealed that the incidence of malpositioning of the left-sided DLT was 68% and of right-sided DLT was 62% . The most common malposition was that the tube was placed too deep. The dislodgement of DLT in lateral decubitus positioning of the patient occurred in 24% patients and in most cases the DLT was moved upward. The depth of insertion did not correlate with the patient' s height. Conclusion Fiberoptic bronchoscopy is a reliable technique for correct positioning of DLT and should be used routinely.

Carboxyl terminus of the HSP70-interacting protein (CHIP) is a co-chaperone of HSPs as well as an E3 ubiquitin ligase, and it is the connexin between heat shock proteins and ubiquitin-proteasome system. Recent research discovered that CHIP also possesses an intrinsic chaperone activity that enables it to recognize and bind nonnative proteins independently. CHIP regulates the HSPs expression and activity, and facilitates the client proteins ubiquitination and subsequent proteasome-dependent degradation. CHIP also inhibits apoptosis through MAPKs signaling pathways, and affects eNOS specific activity by means of the effects on Akt. Moreover, CHIP plays an important role in mitochondrial oxidative stress protection. With these above points, this paper reviews the function of CHIP in myocardial ischemia/reperfusion injury.

Objective To determine the effective target plasma concentration required to prevent tracheal intubation in 50% of patients (Cp50) anesthetized with propofol by TCI.Methods Twenty ASA Ⅰ or Ⅱ patients aged 18-45 yrs with body mass index

DNA microarray technology is a high throughout method that can analyze the expression of thousands of genes at the same time to form a complete cellular gene expression profile. It has been applied in immunological researches such as the development, maturation, activation and differentiation of immune cells, the regulation of immune responses, the molecular mechanism of allergy, the relation between phenotype and gene expression, and immunological pharmacology, etc. It has deepened our perception of the immune system. It will as well be helpful in the research of the regulative mechanism of traditional Chinese medicine (TCM) toward immune cells and immune responses, the therapeutic mechanisms of TCM toward allergy, the standardization of differentiation of syndrome and herbal pharmacology, etc. The data analysis of the results of DNA microarray experiments is aimed to compare the difference of gene expression levels of different samples and obtain diagnostic gene expression profiles. But there are controversies about the number of samples and choices of statistical methods. Researchers are striving in setting standards of DNA microarray experiments.

Objective To describe the clinical and radiological characteristics, diagnosis, and treatment of bronchobiliary fistula (BBF). Methods From December 1975 to June 2007, 6 patients with BBF were successfully diagnosed and treated in this hospital. A retrospective analysis was performed and literatures on the disease were reviewed. Results All the cases were acquired BBF. The etiologies included liver abscess (3 cases), trauma (2 cases), and postoperative complication of hepatic carcinoma (1 case). The main symptoms the patients complained of were fever (6 cases), cough (6 cases), biliptysis (6 cases), dyspnea (4 cases), abdominal pain in right quadrant (4 cases) and pleuritic chest pain (2 cases). On physical examination, tenderness in the right upper quadrant (4 cases), dull percussion (3 cases), abnormal breath sounds (3 cases), percussion tenderness over hepatic region (2 cases) were main abnormalities. All the 6 patients underwent antibiotics treatment and percutaneous transhepatic biliary/abscess drainage. One of them underwent radiological coil embolization of the fistula. All the patients showed clinical improvement. Follow-up survey showed 1 case of cure, 1 case of long-term drainage until death of biliary tract bleeding one year later, and 4 cases of lost in follow-up. Conclusion Bronchobiliary fistula is characterized by biliptysis. Minimally invasive treatment should be the first therapeutic option.

Objective To investigate the effects of midazolam on extracellular signal-regulated kinase 1 (ERK1),ERK2 and cyclic AMP response element binding protein (CREB) phosphorylation in hippocampal in rats.Methods Eighty male SD rats weighing 250-300 g were randomly divided into 2 groups ( n = 40) : group control (group C) and group midazolam (group M).The animals underwent a continuous multi-trial inhibitory avoidance training .The times of trial needed for each animal to attain the learning criterion ( 100 s) were recorded.Each animal was given intraperitoneal midazolam 3 mg/kg or normal saline 2 ml/kg at 15 min before training.The memory retention was tested at 0.5,1,2 and 24 h (n = 8,at each time point)after the training session and the memory latency was recorded.The animals were sacrificed 15 min after administration (T0) and after the memory testing (T1-4) and hippocampns was obtained for determination of phosphorylated ERK1 (p-ERK1),p-ERK2 and p-CREB expression.Results Compared with group C,the times of trial to attain the learning criterion were significantly increased,memory latency shortened at T2-4,ERK1 phosphorylation decreased at T0,3.4 while ERK2 and CREB phosphorylation decreased at T0-4.Conclusion Midazolam can inhibit ERK1,ERK2 and CREB phosphorylation in hippocampal in rats.

Objective To analyze and compare the clinical features of community-acquired pneumonia caused by Legionella in elderly (age≥60 years) and younger patients. Methods The epidemiological, clinical, laboratory data and the outcomes of 80 cases with community-acquired Legionella pneumonia (CALP) from January 2001 to October 2009 were studied retrospectively, and the differences between elderly and younger group were compared using univariate and multivariate analysis. Results (1) Underlying diseases, such as cerebrovascular diseases, chronic obstructive pulmonary diseases, diabetes mellitus and immunosuppressive therapy were significantly more frequent in elderly group than in younger group (all P＜0. 05). (2) No significant differences were observed between the two groups in legionella serotype. (3) Malaise, hyponatremia and hypophosphatemia were all more frequent in elderly group than in younger group (x2=5. 300, 5. 520, 4. 470; P=0. 021,0. 019, 0. 034, respectively). And elderly versus younger group had higher creatinine levels [(108.55±56.57) μmmol/L vs. (75.42±17.62) μmmol/L, t= -3. 062, P=0. 002], lower PaO2/FiO2 (＜300) (57.7% vs. 29.2%, x2=4. 120, P=0.042), less leucocyte counts [(8.34±3.65)×109/Lvs. (10.63±5.02)×109/L, t=-2.287, P=0.022]. (4) Elderly patients more likely complicated with congestive heart failure (P=0.037) and their length of staying in hospital was also longer (Z=-2.194, P=0.028). No significant differences were observed between the two groups in mortality, intensive care unit admission, and the need for corticosteroids or mechanical ventilation.Conclusions Elderly patients with CALP have a higher frequency of underlying comorbidities and more organs involvement than younger patients, although greater severity of illness at onset and outcome are not significantly different between the two groups.