Objective To evaluate the clinical efficacy of endoscopic esophageal variceal ligation (EVL) for esophageal variceal bleeding (EVB) in elderly patients with hepatic cirrhosis.Methods From July 2007 to July 2013,clinical data of 198 patients who had been diagnosed with liver cirrhosis presenting with EVB were retrospectively analyzed.Among them,167 patients who had received EVL were divided into the elderly EVL group (n=97,age≥60 years) and the non-elderly EVL group (n=70,aged ＜ 60 years).The other 31 cases (aged ≥ 60 years) had received propranolol therapy.Treatment effectiveness,adverse effects,complications and the one-year survival rate of each group were analyzed.Results The efficacy rates and variceal recurrences were 77.3％ (75/97) and 78.6％ (55/70) in the elderly EVL group and 19.6％ (19/97) and 18.6％ (13/70) in the non-elderly EVL group,respectively,with no significant difference between the two groups (each P＞0.05).The re-bleeding rate was higher in the propranolol treatment group than in the elderly and non-elderly EVL groups [58.1％ (18/31) vs.24.7％ (24/97) vs,22.9％ (16/70),x2 =14.76,P =0.00].One-year survival rates in the elderly group,the non-elderly EVL group and the propranolol treatment group were 86.6 (84/97),88.6％ (62/70),64.5％ (20/31),respectively,with statistically significant differences between the three groups (x2 =10.24,P=0.01).Conclusions EVL is effective for the treatment of hepatic cirrhosis with EVB and can be used as a secondary prophylaxis measure for EVB in elderly patients with hepatic cirrhosis.

Objective To evaluate the efficacy of endoscopic variceal ligation(EVL)in esophageal variceal bleeding (EVB)in elderly patients with hepatic cirrhosis,and the safety of endoscopic operation under anesthesia.Methods From July 2007 to July 2013,170 patients diagnosed as liver cirrhosis complicated with EVB were retrospectively analyzed.Among them,139 patients who received EVL were divided into elderly anesthesia group (n=52,age≥60 years),elderly non-anesthesia group (n=45 ,age≥60 years)and non-elderly anesthesia group (n=42,age<60 years);the other 31 cases (age≥60 years) received propranolol therapy.The degree of satisfaction of visual fields and esophageal peristalsis under the gastroscope,the effect,adverse effects and complications of EVL,the recurrence of EVB and mortality of each group were analyzed.Two-way analysis of variance and crosstabs chi square test were performed for statistical analysis.Results The satisfaction rate of visual fields and esophageal peristalsis under the gastroscope were 82.5 % (104/126)and 89.7% (113/126)in elderly anesthesia group;82.6% (71/86) and 89.5 % (77/86)in non-elderly anesthesia group;40.3% (29/72)and 44.4% (32/72)in elderly non-anesthesia group.The satisfaction rate of visual fields and esophageal peristalsis under the gastroscope in anesthesia group were better than those in non-anesthesia group (χ2 =47.46,64.28;both P <0.01 ). The efficacy rates of EVL in elderly anesthesia group,elderly non-anesthesia group and non-elderly anesthesia group were 84.6%(44/52 ),68.9%(31/45 )and 81 .0%(34/42 ),respectively.The variceal recurrence rates were 19.2% (10/52 ),20.0% (9/45 )and 19.0% (8/42 ),respectively.There was no significant difference among them (all P > 0.05). Rebleeding rate of medication treatment group was 58.1%(18/31),which was obviously higher than that of elderly anesthesia group (19.2%,10/52 ), elderly non-anesthesia group (31 .1 %,14/45 )and non-elderly anesthesia group (23.8%,10/42 ),and the difference was statistically significant (χ2 =15 .10,P <0.01 ).No case of hepatic encephalopathy was found in elderly anesthesia group or non-elderly anesthesia group after EVL.The incidence of pneumonia in elderly non-anesthesia group was 4.2%(3/72),which was higher than that of elderly anesthesia group and non-elderly anesthesia group,and the difference was statistically significant (χ2 =8.93,P =0.01). The mortality within a month after EVL in elderly anesthesia group,elderly non-anesthesia group and non-elderly anesthesia group was 0,8.9% (4/45 )and 0,and the difference was statistically significant (χ2 =9.27,P =0.01).Conclusion The efficacy of EVL under anesthesia in EVB in elderly patients with liver cirrhosis was good,with no induction or aggravation of hepatic encephalopathy or irreversible complications were found.

0.05) and systolic velocity of regional myocardium, the difference between Ven and Vep, and mitral valve annulus have improved during the follow up study( P

Objective To observe the cardioprotective effect of ginseng-monkshood extract injection on ischemia-reperfusion injury in rats'isolated working hearts.Methods The heart models of ischemia-reperfusion injury were built by Langendorff isolated heart perfusion technology.The different concentrations of nitrogen saturated Ginseng-monkshood extract injection were used for infusion,and the indexes of heart rate,coronary flow and myocardial enzymes were observed in reperfusion 20 min and 40 min.Results Infusion of ginseng-monkshood extract injection can improved heart rate and flux of coronary artery and inhibit the leak of lactic dehydrogenase and creatine kinase during ischemia reperfusion.Conclusions Ginseng-monkshood extract injection has obviously protective effect on myocardial ischemia reperfusion injury.

Objective To explore the regulation of PI3K-mTOR signaling pathways on autophagy of hippocampus nerve cells after subarachnoid hemorrhage (SAH)in rats.Methods We randomly divided 72 male Sprague-Dawley rats into sham group,SAH model group and LY294002 group with 24 rats in each group.We established SAH model with the secondary injection of blood method while the sham group was not injected with blood.PI3K signaling pathways specific inhibitor LY294002 was injected with 500μmol per rat 30 minutes before modeling.After 6,24,72 and 144 h morphologic changes of hippocampus CA1 neural cells were observed by microscopy;the expression levels of PI3K,mTOR,Beclin-1 and LC3-Ⅱ were detected by immunohistochemical method.Results The density of survival neurons in the SAH group was significantly lower than that in the control group (P<0.05),PI3K-mTOR signaling pathways were activated obviously,and the expressions of Beclin 1 and LC3-Ⅱ were significantly higher than those in the control group (P<0.05 ).The number of survival neurons significantly decreased in the LY294002 group compared with the SAH group at each time point (P<0.05),PI3K-mTOR signaling pathways were suppressed.The expressions of Beclin-1 and LC3-Ⅱ were significantly lower than those in the SAH group (P<0.05).Conclusion PI3K-mTOR signaling pathways protect neurons by activating the autophagy of neurons after SAH.

Objective To investigate the effect of BQ-123 on the ability of learning and memory and nerve cell autophagy in hippocam-pus in rats with subarachnoid hemorrhage (SAH). Methods 72 male Sprague-Dawley rats were randomly divided into sham group, SAH model group (SAH group) and BQ-123 group with 24 rats in each group. SAH model was established by injecting the autologous blood into cisterna magna twice. The sham group was not injected blood. BQ-123 group received intracerebroventricular injection with BQ-123 18μg 30 minutes before modeling. 6, 24, 72 and 144 hours after modeling, the passive avoidance latency (PAL) and active avoidance reaction rate (AARR) were tested with Shutter Box Test, the nerve cell morphological changes of hippocampus were observed with HE staining, and the expressions of Beclin-1 and LC3-II were detected with immunohistochemical staining. Results Compared with the sham group, the PAL pro-longed, the AARR decreased (P<0.05), the nerve cells in the hippocampus reduced (P<0.05), and the expressions of Beclin-1 and LC3-II in-creased (P<0.05) in SAH group. Compared with SAH group, PAL shortened (P<0.05), AARR increased (P<0.05), the nerve cells in the hip-pocampus increased (P<0.05), and the expressions of Beclin-1 and LC3-II increased (P<0.05) in BQ-123 group. Conclusion BQ-123 can promote the recovery of learning and memory ability, which may relate to the activation of nerve cell autophagy in the hippocampus.

Objective To develop a radionuclide parameter database on internal contamination in nuclear emergencies. Methods By researching the radionuclides composition discharged from different nuclear emergencies, the radionuclide parameters were achieved on physical decay, absorption and metabolism in the body from ICRP publications and some other publications. The database on internal contamination for nuclear incidents was developed by using MS Visual Studio 2005 C# and MS Access programming language. Results The radionuclide parameter database on internal contamination in nuclear emergency was established. Conclusions The database may be very convenient for searching radionuclides and radionuclide parameter data discharged from different nuclear emergencies, which wonld be helpful to the monitoring and assessment of internal contamination in nuclear emergencies.

Objective To assess the factors affecting survival of malignant pheochromocytoma/malignant paraganglioma.Methods The clinical data of 85 malignant pheochromocytoma/malignant paraganglioma patients were analyzed retrospectively.All the patients were followed up,the duration from 2 months to 283 months,the median time was 48 months.The overall survivals of 5 years and 10 years were calculated.The possible affecting factors,such as gender,age,tumor function,metastatic sites,metastatic fields,incipience or recurrence,the time to recur,were analyzed.Survival differences between groups were compared with the log rank test.Multivariate analysis was performed by using Cox regression analysis to detect variables independently associated with survival.All P values were 2 tailed with P ＜ 0.05 considered statistically significant.All statistical analysis was done by SPSS 17.0 software package.Results The overall median survival time was 62 months,5-year survival rate was 44.7％,10-year survival rate was 11.8％.Gender (P =0.649),age (P =0.228),incipience or recurrence (P =0.217) had no significant effect on the survival time.Significance was found in tumor function (P =0.034),metastatic sites,metastatic fields (P =0.009),the time to recur (P =0.003).The median survival time of patients with nonfunctioning tumor and functioning tumor was 90 months and 37 months.The median survival time of patients with multiple system metastases and single system metastasis was 37 months and 117 months.For the patients with single system invaded,there were 15 cases (26.8％) of bone metastasis,10 cases (17.9％) of lymph node metastasis,8 (14.3％) of liver metastasis,7 (12.5％) of lung metastasis,6 (10.7％) of renal metastasis,6 (10.7％) of intestine metastasis and 4 (7.1％) of brain metastasis.The median survival time was 110,77,28,14,26,8 and 19 months.The median survival time of patients with lung,liver,intestine metastasis were shorter than the other patients (P ＜ 0.05).Fifty-five patients were found recurrence after operation,recurrent time was from 4 to 65 months,and the median time was 22 months.The survival time of patients with recurrence within 2 years was shorter than patients above 2 years (P =0.003).Conclusions The prognosis of malignant pheochromocytoma/malignant paraganglioma is poor.Gender,age,incipience or recurrence could not affect the overall survival time.The survival time has relationship with the function of tumor,metastatic field,metastatic sites and time to recurrence.The patients with nonfunctioning tumor have longer survival time than those with functioning tumors.The survival time of patients with single system invaded is longer than ones with multiple systems invaded.The common metastatic sites are bone,lymph node,liver,lung,kidney,intestine and brain.Patients with intestine metastasis have worst prognosis.The patients with only bone and lymph node metastasis have best prognosis.Patients with recurrence above 2 years have a better prognosis than those within 2 years.

Objective To develop the software for the assessment of radionuclide concentration and doses from atmospheric dispersion. Methods Based on procedures for radionuclide atmospheric dispersion and dose assessment in IAEA publications (safety series reports No. 19), a parameter database was constructed using Microsoft Access, and the dispersion model and dose assessment methods were computerized using Microsoft Visual Basic 6.0, then we got the dose assessment software for radionuclide atmospheric dispersion. Results Atmospheric radionuclide concentration and public effective dose in a year could be estimated rapidly with the present software. Conclusion The present software provides a practical and rapid tool for evaluation and assessment the influence of radionuclide atmospheric dispersion, which can be used in the evaluation of atmospheric radionuclide concentration in routine monitoring or nuclides/radiological emergency, and also can be used as the screening evaluation in environmental surveillance.

Objective To improve the diagnosis and treatment of von H ippel-Lindau (VHL) disease.Methods The clinic data of one kindred with VHL disease type Ⅱ B was reviewed including clinical manifestation,imaging,pathology and therapy.A 40-year-old male complained of the left upper extremity numbness for 6 months,and a variety of visceral tumors were found 3 months ago.Contrast-enhanced MR imaging showed multiple brain tumors.CT showed left kidney tumor,pancreatic tumor,pars-aortic tumor and left adrenal tumor.Fundoscopy showed multiple retinal hemangioblastoma.PET-CT discovered abdominal multiple tumors.And pedigree analysis was to determine the family medical history,and 6 members got genetic screening.Results In the kindred with VHL disease type Ⅱ B,9 members (30％) out of 40members in 4 generations got the disease.Six members got genetic screening,and the result showed 5 (5/6) members had mutation.Three (3/5) members with 3 sites genetic mutation showed clinical manifestation,1 (1/5) members with 3 sites genetic mutation without clinical manifestation found brain tumors by MRI,and 1 ( 1/5 ) member with 1 site genetic mutation did not find disease by comprehensive checkup.The main mutation located at exon 1 in chromosome 3p25 of VHL gene.All mutation was hetcrozygous mutation.The 295,337 and 337 nucleotide thymine of the VHL gene were substituted by cytosine,cytosine and adenine,which made the 98th,112th and 112th tyrosine substituted by histidine and asparagines.One member with 1 site mutation had 98th tyrosine substituted by cytosine.The first operation was to remove brain tumor,and the second operation was to remove adrenal tumor,para-aortic tumor and renal tumor.Pathology of the brain tumors showed hemangioblastoma,and the retroperitoneal tumors were clear cell carcinoma,paraganglioma and pheochromocytoma.Followed up for 6 months after operation,no relapse occurred.Conclusions VHL disease is a relatively rare autosomal dominant disorder.Comprehensive management of patients should also include genetic counseling and screening for other manifestations of the disease process.Genetic testing might be helpful in early detection of asymptomatic VHL patients.Members having gene mutation should be followed up strictly.Surgical management of VHL disease should be decided on the base of comprehensive assess.Multiple lesions could be cut off in one operation.For patients with pheochromocytoma,pheochromocytoma shuld be handled first.