BACKGROUND:Bone marrow mesenchymal stem cel s can secrete neurotrophic factors in vitro, and can also be differentiated into neurons, thereby contributing to the repair of traumatic brain injury. However, the short life cycle of bone marrow mesenchymal stem cel s influences their protective effects on the damaged brain tissues. OBJECTIVE:To observe the effect of bone marrow mesenchymal stem cel transplantation combined with ganglioside in rats with traumatic brain injury. METHODS:Sixty Wistar rats were used to make severe traumatic brain injury models using a hydraulic head injury instrument, and then randomized into three groups:1 mL DMEM, 1 mL bone marrow mesenchymal stem cel suspension (1×1010/L), 1 mL bone marrow mesenchymal stem cel suspension (1×1010/L) combined with ganglioside solution (30 mg/kg) were injected respectively in model group, transplantation group and combined group, once a day, total y for 3 days. Neurological behavior scores were observed according to Longa method at 24 hours after modeling and at 3 days, 1, 2, 3, 4 weeks after cel transplantation. At 3 days after cel transplantation, RT-PCR and western blot assay were employed to detect aquaporin 4 mRNA and protein expressions. At 1 week after transplantation, hematoxylin-eosin staining was performed for pathological observation of the damaged brain tissues. RESULTS AND CONCLUSION:At 3 days, 1, 2, 3, 4 weeks after cel transplantation, the neurological behavior scores were ranked as fol ows:combined grouptransplantation group>combined group (P<0.05). Hematoxylin-eosin staining showed that the recovery of brain tissue was better in the combined group than the model and transplantation groups (P<0.05). These findings indicate that bone marrow mesenchymal stem cel s combined with ganglioside can significantly improve the neurological behavior function of rats with traumatic brain injury.

Objective To investigate the clinical effects of endoscopic pancreatic duct stent insertion.Methods The clinical data of 20 cases of endoscopic pancreatic stent insertion,including 12 cases of chronic pancreatitis,3 cases of recurrent pancreatitis,2 cases of papilla adenoma after resection,3 cases of pancreatic carcinoma,was retrospectively reviewed from June 2004 to September 2006.All the patients underwent endoscopic pancreatic sphincterotomy and pancreatic stent insertion after endoscopic retrograde cholangiopancreatography(ERCP).Results All the 20 patients received 23 procedures of pancreatic stent insertion.Stent-preserving time was 25-105 days(mean,64.5 days).2 cases experienced stent migration and no postoperative pancreatitis occurred.20 patients were followed up for 6 to 12 months,including 17 patients for 12 months.During a follow-up period of 3 months in the 12 cases of chronic pancreatitis,1 case received repair because of duodenal perforation induced by ERCP,and the symptoms of abdominal pain or discomfort disappeared or were distinctively relieved in 9 and 2 cases,respectively,with weight gain 2-5 kg(mean,3.2 kg).A follow-up period of more than 3 months showed that the remission rate of abdominal pain was 92%(11/12).The jaundice was alleviated(with the average of decrease of 61.8 percent of total bilirubin in serum) and weight gained in the 3 cases of pancreatic carcinoma after the biliary and pancreatic duct plastic stents were inserted at the same time.Patients with recurrent pancreatitis had no relapse in the follow-up period.Conclusions The endoscopic pancreatic duct stent insertion is a safe and minimal invasive procedure,and can prevent postoperative pancreatitis,but the main complication of stent migration should be considered.

Objective To evaluate the clinical value of transnasal gastroscopy in diagnosis and treatment of upper gastrointestinal diseases and the endurance of patients to the operation,as well as to measure the distance between the external naris and pectinate line. Methods Between January 2007 and April 2008,totally 3481 patients underwent transnasal gastroscopy in our hospital,meanwhile 3705 patients received routine gastroscopy; 109 patients who received transnasal gastroscopy and 106 patients that underwent routine gastroscopy were surveyed by questionnaires on their tolerance to the procedures. In the transnasal gastroscopy group,210 patients were selected for measuring the distance between the external naris and pectinate line,while 210 patients from the routine gastroscopy group were examined to determine the length from the front teeth to the pectinate line. Results Among the patients underwent transnasal gastroscopy,89.9% (98/109)of them had no or mild nausea and 97.2% (106/109)had no or mild vomiting; 85.5%(53/62) of the patients who had suffered routine gastroscopy reported less pain after transnasal gastroscopy,and 93.6%(102/109)of the patients would like to underwent transnasal gastroscopy again if necessary. The average length from the external naris to pectinate line was (43.1?2.6) cm,which was statistically significantly different from that measured from the incisor teeth to pectinate line by routine gastroscopy [(39.7?1.9)cm,t=15.290,P=0.000]. The diagnostic and differential diagnostic value of transnasal gastroscopy is same to that of routine gastroscopy. Therapies under transnasal gastroscopy were conducted in 38 cases without complications occurred. Conclusions The feasibility,tolerance,and safety of transnasal gastroscopy are superior to routine transoral gastroscopy. It can provide a more comfortable process for examination. The ability of diagnosis and differential diagnosis of transnasal gastroscopy resembles those of routine transoral gastroscopy.

Objective To investigate the effects of resveratrol on epileptic seizure and cognitive impairment and the role of CREB in rats with temporal lobe epilepsy (TLE). Methods TLE rat model was established by LiCl?pilocarpine injection and resveratrol was administrated at a dose of 15 mg/(kg · d) for 7 days. The rat behavior was evaluated by Racine scale and the CREB expression and phosphorylation in temporal cortex were detected with western blot. The Morris water maze was used to assess the learning and memory. Results Resveratrol administra?tion significantly reduced the Racine scales of TLE rats. The CREB phosphorylation in TLE group was increased compared with that in control group, which was remarkably inhibited by resveratrol. The escape latency of TLE group was increased at 4th, 5th and 6th day after training, and time in target quadrant was reduced compared with that in control group. Resveratrol significantly decreased latency time and increased target quadrant time of TLE rats. Conclusion In TLE rats, resveratrol administration suppresses epileptic seizure and improves cognitive function, which might be mediated by inhibition of CREB phosphorylation.

Objective To evaluate the value of percutaneous endoscopic gastrostomy (PEG) in the treatment of amyotrophic lateral sclerosis (ALS) patients with dysphagia. Method Sixty-five ALS patients underwent PEG from April 2005 to July 2010 were analysed retrospectively. Results All the 65 patients underwent PEG,and 2 patients failed because of dyspnea. Totally 63 patients were intubated successfully,the successful rate was 96.9%(63/65). The operation time was 8-17 min. Two patients had local infection.After 3 months, the body mass index was increased from (18.3 ± 1.0) kg/m2 to (19.7 ± 1.2) kg/m2(t = 15.8,P ＜ 0.01), without peritonitis, migration of the gastrostomy tube and other complications. Conclusions PEG is a safe method with a low complication for ALS patients to get enteral nutrition. Dyspnea is the main reason of failure.

Objective To evaluate the therapeutic effect and safety of forward-viewing,doublechannel endoscope in the process of ERCP in patients with bile duct diseases after Billroth-Ⅱ gastroenterostomy.Methods ERCP was applied to 46 patients with bile duct diseases using forward-viewing,doublechannel endoscope.All patients had the history of Billroth-Ⅱ gastroenterostomy.The success rate of selective cannulation,complication rate and the outcome of all the patients were recorded.Results The procedure succeeded in 38 patients with a success rate of 82.6％,and failed in 8.Of all the failing cases,the afferent loop couldn't be accessed in 6,failure in biliary cannulation in 2.Of 38 successful cases,bile duct stones were successfully removed in 31,metal stents placed for malignant bile duct obstruction in 4,and endoscopic balloon dilation for benign common bile duct stricture in 3.All patients recovered without complications of perforation,delayed bleeding or pancreatitis.Conclusion For patients with history of Billroth-Ⅱgastroenterostomy,ERCP with forward-viewing,double-channel endoscope yields to a higher success rate and lower complication rate.

Objective To explore the causation,diagnosis and management of iatrogenic bile duct injury(BDI) of laparoscopic cholecystectomy(LC).Methods A total of 1 656 patients undergoing laparoscopic cholecystectomy in our department during the last 7 years were included in this study for retrospective analysis.Results There were 274 patients with gallbladder polyps,168 patients with acute calculous cholecystitis and 1214 patients with chronic calculous cholecystitis.There were 15 BDIs associated with LC(0.91%).A total of 8 BDI patients were diagnosed during cholecystectomy.The remaining 7 BDI patients were diagnosed postoperatively.The intraoperative diagnosis of BDI was made on the discovery of bile leakage or double biliary stump during cholecystectomy.Clinical features,diagnostic abdominocentesis and imaging findings formed the basis of diagnosis of BDI postoperatively.One BDI patient was treated by repairing the injuried common bile duct with a T-tube drinage.Four BDI patients were treated by end-to-end anastomosis of injuried bile duct,and one of the four patients was reoperated with Roux-en-Y hepaticojejunostomy because of bile leakage.The remaining 10 BDI patients were treated by Roux-en-Y hepaticojejunostomy,and good results were achieved in all of these patients.Conclusions There is no relationship between the etiology of gallbladder disease and BDI during laparoscopic cholecystectomy.Good results can be achieved if BDI is diagnosed early and treated properly during or after operation.Roux-en-Y hepaticojejunostomy is the primary operation method for treating BDI.

Objective To explore the clinical value of interferon gamma release assays in early childhood diagnosis of latent tuberculosis infection.Methods 33 patients with suspected latent tuberculosis infection and 35 patients with active tuberculosis infection in our hospital from January 2012 to March 2013 were selected.During the same period selected 30 healthy children as a control group.Respectively were given sputum smear analysis,tuberculin skin test (TST)and vinterferon release assay (IGRA).Compare the positive rate of different methods. Results In suspected latent tuberculosis group,IGRA test results were significantly higher than TST and sputum smear method(P<0.05);in active tuberculosis infection group, IGRA test results were significantly higher than TST and sputum smear(P<0.05 );in healthy control group,TST test results were higher than the IGRA,it is because of patients had been vaccinated with BCG.Conclusion IGRA can be used as one way to diagnosis the latent tuberculosis infection.

ObjectiveTo evaluate the efficacy and safety of combination therapy of tamsulosin and solifenacin for benign prostatic hyperplasia ( BPH ) with overactive bladder ( OAB ).Methods82 patients with OAB and coexisting BPH were randomly divided into tamsulosin group ( n = 38 ) and combination group ( n = 44). The ages were from 50 to 75 y ( averaged, 56.8 ± 8.6). Inclusion criteria: the mean frequency of micturition ≥8 times per day, the frequency of nocturia ≥2 times per day, voiding volume ＜200 ml each time; for the overactive bladder symptom score ( OA BSS), the 3 rd score ＞ 2, total score ＞ 3. The tamsulosin group accepted tamsulosin 0.2 mg once daily, the combination group accepted tansulouxin 0.2 mg and solifenacin 0.2 mg once daily. Both groups were maintained the corresponding therapy for 12 weeks.The international prostate symptom score (IPSS), Qmax, residual urine volume, OAB score and adverse reactions were recorded.ResultsThe values of IPSS ( 19.5 ±2.2 vs 15.6 ±2.4, P =0.027), the voiding symptom score ( 15.6 ± 2.4 vs 3.4 ± 1. 7, P = 0. 022) and Qmax ( 13.7 ± 3.8 vs 16.6 ± 4.1, P = 0. 034 )improved significantly after treatment in tamsulosin group ( P ＜ 0. 05 ). The values of IPSS ( 19.7 ± 2.3 vs 9.7 ± 3.0, P ＜0. 001), the storage symptom score (13.8 ± 1.9 vs 5.6 ± 1.6, P ＜0. 001 ), OABSS (10.3 ±1.8 vs 5.3 ±1.3, P ＜0.001) and Qmax(14.1 ±4.1 vs 17.2 ±3.5, P=0.027) also improved significantly after treatment in combination group ( P ＜ 0. 05 ). The values of IPSS ( 9.7 ± 3.0 vs 15.6 ±2.4, P ＜ 0.001 ), the storage symptom score (5.6 ± 1.6 vs 12.0 ± 1.6, P ＜ 0.001 ) and OABSS ( 5.3 ±1.3 vs 9.7 ± 2.7, P ＜ 0. 001 ) improved significantly in combination group than those in tamsulosin group ( P ＜0.001 ). There were no difference between two groups in values of the voiding symptom score, Qmax and residual urine volume ( P ＞ 0.05 ). The incidences of adverse reactions in tamsulosin group and combination group were 7.9％ (3/38) and 20.5％ (9/44) without significant difference. There was no acute urinary retention in both groups.ConclusionsIt is effective and safe for patients with BPH and OAB to accept combination therapy of tamsulosin and solifenacin.

Objective To investigate the characteristics of etiology,efficacy of endoscopic management for recurrent idiopathic pancreatitis (RIP).MethodsThe clinical data of 58 cases of RIP diagnosed in our hospital from April 2005 to April 2011 were retrospectively analyzed.All the patients underwent endoscopic retrograde cholangiopancreatography (ERCP),and patients with suspected sphincter of Oddi dysfunction received manometry.According to the clinical and ERCP manifestations,the etiologies of RIP were determined and individualized endoscopic treatment was applied.The patients were followed-up postoperatively about the improvement of abdominal pain and recurrence of RIP.ResuItsFifty-eight patients (29 males,29 females) were suffered from acute pancreatitis from 3 to more than 10 times.The etiologies were as follows:29 cases of biliary microlithiasis,19 case of sphincter of Oddi dysfunction ( 16 cases of pancreatic type,3 cases of mixed type),4 cases of anomalous arrangement of the pancreaticobiliary duct,and 6 cases of normal manifestations at ERCP.Biliary sphincterotomy alone was performed in 33 patients,while both biliary and pancreatic sphincterotomy was performed in 8 patients,and pancreatic sphincterotomy alone was performed in 17 patients,after sphincterotomy,pancreatic stent insertion was performed in 24 patients.The follow-up data was obtained from 41 out of 58 patients,the follow-up period ranged from 3 ～ 67 months ( average 33 months).During this period,9(22.0％ ) patients suffered from RIP,and the treatment efficiency was 78％.ConclusionsBiliary microlithiasis and sphincter of Oddi dysfunction are the main causes of RIP.Drink could induce RIP.ERCP has definite treatment efficacy for RIP.