Objective To investigate the effects of apoptosis, Fas/FasL and Bax/Bcl-2 in rat liver allograft immune response. MethodsDifferent rat allograft models were established:(1)Acute liver allograft rejection group: PVG liver to Lewis rats; (2) Liver allograft tolerance group: PVG liver→DA rats; (3) F1(P/D)→D group: F1(PVG-DA) liver to DA rats; (4)HLTx(P/2→D)group: PVG/2 liver→DA rats. Liver samples were collected on days 1, 3, 5, 7 postoperatively (each n=3). Apoptosis was monitored by TUNEL(terminal deoxynucleotidyl transferase(TdT) mediated dUTP nick-end-labeling). The expressions of Fas/FasL and Bcl-2/Bax mRNA were examined by means of immunohistochemistry and in situ-hybridization respectively. Results Compared with liver allograft tolerance group, in acute liver allograft rejection group, the apoptosis cell numbers increased in hepatocytes, FasL expression was high in infiltrated cells in portal tract areas and low in hepatocytes, and the expression of Fas and Bax mRNA increased. The expression of molecules detected in F1(P/D)→D group was similar with those in acute liver allograft rejection. The expression of molecules detected in HLTx(P/2→D)group was similar with those in liver allograft tolerance group. On the fifth day postoperatively, the apoptosis index in portal tract areas had a positive correlation with the expression of FasL in hepatocyte and a negative correlation with the expression of Fas and Bax. Conclusions The high expression of FasL in infiltrated cells of portal tract areas, Fas and Bax in hepatocytes may be involved in rejection response. The high expression of apoptosis in infiltrated cells of portal areas, FasL in hepatocytes may relate with the establishment of tolerance.

Objective To determine the diagnostic value of 8-hour pH monitoring in gastroesophageal refulux disease(GERD)and compare its sentivity and specificity with that of 24-hour monitoring.Methods Patients had been given esophageal manometry and ambulatory 24-hour pH monitoring.The 8-hour datas were analyzed from the standard ambulatory 24-hour pH recording.GERD was confirmed if DeMeester Score was no less than 14.72 according to the routine pH monitoring,then DeMeester score was reanalyzed according to 8-hour period,the same dignosis cirteria was used for 8-hour pH monitoring.Results Totally 221 patients met the entrance criterion.The 8-hour test had a sensitivity of 93.5% when compared to the 24-hour test and a specificity of 95.9%.Kappa test and Mc-nemar test verified the two monitor periods were with considerable consistency.The Pearson coefficient correlation was 0.929 with P value less than 0.001.Conclusion The 8-hour analysis is as sensitive and specific as the routine test for demonstrating GERD.By using this method,patients may suffer less discomfort and appear enhanced compliance.

Objective To study the effects of apoptosis associated factors Fas/Fas, Bcl-2/Bax, adhesion molecules including ICAM-1, VCAM-1, PECAM-1, P-selectin, L-selectin and E-selectin in rat heart allograft immune response at different time points. Methods Rat acute cardiac allograft rejection model (PVG heart to DA rats) were established. Heart samples were collected on the day 1, 3, 5, 7 postoperatively ( n =3 in each group). Apoptosis was monitored by TUNEL. Fas, FasL, ICAM-1 and Selectin was examined by means of immunohistochemistry. The expression of Bcl/Bax mRNA, VCAM-1 mRNA, PECAM-1 mRNA was detected by means of situ-hybridization. Results In acute cardiac allograft rejection group, the expression of apoptosis, Fas/FasL, Bax, ICAM-1, VCAM-1 and PECAM-1 was increased. Apoptosis, Fas/FasL and Bax were mostly detected in cardiomycotes and ICAM-1, VCAM-1 and PECAM-1 were mostly detected in vascular endothelium and infiltrated cells. There was no expression of apoptosis associated factors and adhesion molecules in normal rat heart.Conclusion The high expression of apoptosis, Fas/FasL, Bax, ICAM-1,VCAM-1, PECAM-1 may be related with cardiac allograft rejection.

Objective To investigate the influential factors of cognitive impairment after lacunar brain infarction(LBI).Methods The neuropsychological tests including mini-mental state examination(MMSE) scale,clock-drawing test(CDT),execute function(EF)in ADAS-cog were applied in 136 LBI patients(LBI group) and 60 gender,age and concomitant chronic diseases matched controls(control group).Those results were compared between the two groups.The influence of the LBI patients's age,the number of cerebral lesion and concomitant disease(hypertension,diabetes,hyperlipidemia) on the scores of the above tests were analyzed.Results(1)The incidence of cognitive impairment in LBI group(55.8%) was distinctly higher than that in control group(15%);the scores of total MMSE and CDT in LBI group were significantly lower than those in control group;while the EF score was higher(all P

Objective To study abnormal defecation in patients with posterior vaginal prolapse combined with anorectal manometry. Methods From Jan. 2008 to Nov. 2009, clinical documents and examination of anorectal manometry of 40 patients with posterior vaginal prolapse were studied retrospectively. Anal physiologic testing was performed for 40 patients. These patients were classified into group A ( stage 0 and [posterior vaginal prolapse, represented normal) and group B ( stage Ⅱ - Ⅳ ).Results of anorectal manometry, constipation and symptoms of defecation were compared. Results The average anal canal resting pressure and squeeze pressure of 40 patients were (40 ±21 ) and (96 ±33) mm Hg (1 mm Hg =0. 133 kPa). In group A, the anal canal resting pressure and squeeze pressure were (37 ±21) and (78 ±43) mm Hg, rectal sensation threshold and rectal maximum volume were (106 ±61 ) and (183 ± 51 ) ml. In group B, the anal canal resting pressure and squeeze pressure were (42 ± 21 ) and (102±30) mm Hg, rectal sensation threshold and rectal maximum volume were (90±44) and (171 ±61) nl.Apart from maximum squeeze pressure ( P = 0. 039 ), the other clinical index did not show statistical difference (P ＞ 0. 05 ). Rectal sensation threshold, intended volume and maximum capacity of (116 ± 69 ),( 170 ± 90), ( 191 ± 75 ) ml in patients with constipation were higher than (84 ± 31 ), ( 121 ± 37 ), ( 169 ±45) ml in patients without constipation. In addition to maximum capacity (P = 0. 281 ), the other clinical index reached statistical difference between patients with and without constipation (P ＜ 0. 05 ). Patients with defecation symptoms have higher rectal sensation threshold, intended volume and maximum capacity than those of patients without defecation symptoms. Conclusions As gradually increased in the degree of prolapse, resting pressure and squeeze pressure tend to be increased, while the rectal sensation threshold and rectal maximum volume tend to be decreased. Patients with defecation symptoms and constipation have increased the initial feeling of volume and maximum tolerated volume.

SUMMARY Behcet’sdisease(BD)isachronicvascularinflammatorydiseaseofunknowncauses.Itis called intestinal BD,when digestive tract is involved.To investigate small bowel feature of intestinal BD, we now report 5 intestinal BD cases undergone capsule endoscopy from December,2010 to April,2014 in Peking University People’s Hospital.General information,clinical feature and endoscopic feature were presented,and literatures were reviewed.There were 3 male and 2 female patients.Age range was from 23 to 55 years old (median age 40 years old).Disease course was from 3 days to 28 years (median course 9 years).4 patients were diagnosed as systemic BD,and the rest independent intestinal BD.4 systemic BD patients all presented as recurrent oral aphthous as initial symptom and had history of vulvar ulcer and skin lesion.They all had gastrointestinal symptoms,including retrosternal pain (2 cases),he-matochezia (3 cases),diarrhea (3 cases)and abdominal pain (2 cases).1 patient had a history of fis-tula of ileocecal junction and underwent caecectomy.5 patients all underwent whole digestive tract exami-nation by endoscopy,including gastroscopy,colonoscopy and capsule endoscopy.Except of 1 normal re-sult of colonoscopy,all endoscopy results revealed lesions.Capsule endoscopy results of all patients were abnormal.Types of small intestinal lesion were various,including ulceration,erosion,protrusion and vasculopathy.All digestive tract can be involved in BD patients.Capsule endoscopy can evaluate lesions throughout whole digestive tract,especially in small intestine.As a consequence,it is helpful to explain gastrointestinal symptom,increase early diagnostic rate.Intestinal BD (IBD)mainly involves small bow-el,and ileum is the major involved segment,not only limited in ileocecum.The updated perspective of IBD lesion distribution will contribute to differential diagnosis between IBD and Crohn’s disease.This is the first time to report capsule endoscopic feature of BD patients in China.

AIM: The purpose of this study was to evaluate the mechanism of high altitude pulmonary edema (HAPE) and high altitude acute response (HAAR). METHODS: Pulmonary function and partial oxygen pressure were measured in 10 patients with HAAR and 6 patients with HAPE before and after bronchoalveolar lavage (BAL),10 high altitude healthy volunteers were served as control subjects. RESULTS: The partial oxygen pressure of HAAR and HAPE significantly decreased before BAL compared with control; DLCO%, DLCO/VA%, PaO_2 of HAPE increased significantly [from 76.01%?6.29%, 150.30%?15.20%, (31.73?3.01) mmHg before BAL to 103.31%?9.23%, 176.04%?16.10%, (45.31?3.56) mmHg after BAL]. The above parameters were also changed in HAAR and controls, but had no statistical significance. CONCLUSION: High concentration of proteins and cells in BAL fluid for HAPE, gas exchange impairment and PaO_2 increase after BAL suggest accumulation of protein-rich fluid and cells in the alveolar space plays a crucial role in the development of HAPE.

Objective To investigate the effects of simethicone on the quality of video capsule endoscopy (VCE) examination.Methods A prospective study was performed in 90 patients received VCE examination from February 2010 to October 2014.The randomized table was set according to different dosage of simethicone the patients received,by which patients were divided into three groups.Group 1 (35 cases) received 15 mL simethicone,group 2 (30 cases) received 30 mL simethicone and control group (25 cases) received no simethicone.The small intestinal visualization quality of VCE was scored by segments.Segment A was proximal small intestine (one hour after VCE passing pylorus).Segment B was distal small intestine (one hour before VCE passing ileocecal valve).Segment A and B were scored according to the air bubbles and degree of cleanliness.Gastric transit time,small bowel transit time and VCE completion rate were recorded.Student's t test,Mann Whitney rank sum test and chi square test were performed for statistical analysis.Results The average scores of segment A of group 1,group 2 and control group were 0.58,0.33 and 1.67,respectively,and the average socres of segment B were 0.25,0.00 and 1.17,respectively.The lesion detection rates of group 1,group 2 and control group were 68.6％ (24/35),80.0％ (24/30) and 52.0％ (13/25),respectively,and the differences was statistically significant (x2 =8.238,P=0.016).The detection rate of group 2 was significantly higher than those of group 1 and control group (x2 =7.354 and 9.349,P=0.034 and 0.005).The detection rates of small intestinal erosion of group 1,group 2 and control group were 22.9％ (8/35),70.0％ (21/30) and 32.0％ (8/25),respectively,and the differences was statistically significant (x2=8.714,P=0.013).The detection rate of group 2 was significantly higher than those of group 1 and control group (x2 =10.600 and 7.380,P=0.005 and 0.025).There was no statistically significant difference in the detection rates of ulcer,vascular malformation and protrusion among the three groups (all P＞0.05).The detection rates of lesions＜0.5 cm of group 1,group 2 and control group were 37.1％ (13/35),66.7％ (20/30) and 32.0％ (8/25),respectively,and the differences was statistically significant (x2 =8.242,P=0.016).The detection rate of group 2 was significantly higher than those of group 1 and control group (x2 =9.250 and 7.842,P =0.011 and 0.017).Conclusion Oral adminstration of 30 mL simethicone could obviously decrease air bubbles in small intestine,and increase lesion detection rate of VCE.

Objective To analyze the antibiotic resistance of pathogenic bacteria recovered from bronchial secretions by bronchofiberscope in bronchiectasis patients complicated with infection for improving antibacterial therapy. Methods A total of 97 bronchiectasis patients complicated with infection treated in Liyuan Hospital during the period from June 2013 to December 2015 were included in this analysis. The pathogens were recovered from bronchial secretions by bronchofiberscope and subjected to antimicrobial susceptibility testing by Kirby-Bauer disc method. The data were analyzed with WHONET 5.5 software. Results Pathogenic organisms were isolated from 53 (54.6%) of the 97 patients, including 49 (92.4%) strains of gram negative bacilli, mainly Pseudomonas aeruginosa, followed by Acinetobacter baumannii, Klebsiella pneumoniae, 3 (5.7%) strains of?gram?positive?cocci,?specifically?2?strains?of?S. aureus and 1 strain of S. pneumoniae, and 1 (1.9%) strain of Candida albicans. Antimicrobial susceptibility testing showed that most P. aeruginosa isolates (>71.8%) were susceptible to tobramycin, amikacin,cefepime, and aztreonam, but 100% resistant to levofloxacin. More A. baumannii isolates were susceptible to tobramycin and amikacin (both 85.7%), followed by imipenem (>42.9%). More than half (>50%) of the K. pneumoniae isolates were resistant to cefotaxime, gentamycin, ciprofloxacin, and levofloxacin.Conclusions Gram negative bacilli are dominant in the pathogenic organisms recovered from bronchial secretions in bronchiectasis patients complicated with infection. Most of the pathogens are relatively susceptible to tobramycin and amikacin, but resistant to ciprofloxacin?and?levofloxacin.

Objective To evaluate the effect of trimetazidine pretreatment on myocardial injury induced by propofol in rats.Methods Forty healthy Sprague-Dawley rats,weighing 240-250 g,aged 2.5 months,were randomly divided into 4 groups (n =10 each):fat emulsion group (group L),propofol group (group P),and different doses of trimetazidine groups (TL and TH groups).In group L,10％ fat emulsion was infused intravenously for 12 h at a rate of 30 mg·kg-1 ·h-1.In group P,1％ propofol was infused intravenously for 12 h at a rate of 30 mg·kg-1 ·h-1.In TL and TH groups,trimetazidine 2 and 5 mg/kg were injected intravenously,respectively,and 1.5 h later propofol was infused intravenously for 12 h at a rate of 30 mg·kg-1 ·h-1.At 6 and 12 h after beginning of administration,blood samples from the internal jugular vein were taken for determination of the levels of serum creatine kinase (CK),creatine kinase isoenzyme-MB (CK-MB),lactate dehydrogenase (LDH),α-hydroxybutyric acid dehydrogenase (α-HBDH),cardiac troponin Ⅰ (cTnⅠ),triglycerides (TG),low-density lipoprotein (LDL) and high-density lipoprotein (HDL).After blood sampling at 12 h after beginning of administration,myocardial specimens were obtained for microscopic examination of the pathological changes with light and electron microscope.Results Compared with group L,the serum CK,CK-MB,LDH,α-HBDH,cTnⅠ and TG levels were significantly increased,HDL was decreased,and no significant changes were found in LDL concentrations in P and TL groups,and the serum TG,HDL and LDL were increased,and no significant changes were found in the other parameters in group TH.Compared with group P,the serum CK,CK-MB,LDH,α-HBDH,and cTnⅠ levels were significantly decreased in TL and TH groups,the serum TG level was increased in TL group,and the serum TG,HDL and LDL levels were increased in TH group.Compared with group TL,the serum CK,CK-MB,LDH,α-HBDH and cTnⅠ levels were significantly decreased,and the serum TG,HDL and LDL levels were increased in group TH.Conclusion Trimetazidine pretreatment can attenuate myocardial injury induced by propofol,but it induces increase in blood lipids.