Barrett’s esophagus is associated with esophageal adenocarcinoma and cardia cancer,although it has no significant influence on individual’s expectation of life and the canceration rate is comparatively low. However,Barrett’s esophagus has big burden on the psychology and economy of patients. At present,there are still some debates about the diagnosis and management of Barrett ’s esophagus. American Gastroenterological Association, British Society of Gastroenterology and Chinese Society of Gastroenterology have updated their guidelines on Barrett’s esophagus. In this review,we introduced the updated progress in diagnosis and management of Barrett’s esophagus according to these three new guidelines,and compared the similarities and differences between these guidelines.

In the acute phase of traumatic brain injury or cerebrovascular disease,disorders of hypothalamic-pituitary-cortical axis,hypothalamic-pituitary-thyroid axis and hypothalamic-pituitary-gonad axis may exist.The main cause is primary or secondary impairment of hypothalamus as well as pituitary after brain injury.Most of the variations of endocrine after acute brain injuries may be temporary and reversible,but some patients will accompany with hypopituitarism or neuroendocrine deficiency.It is important to set a guideline to decide who and when to test.Hormone replacement therapy should also be verified if it can improve the outcome of patients with brain injuries.

AIM: To explore the anatomical changes of the optic nerve head in cats after radial optic neurotomy (RON).METHODS: The normal anatomic data were obtained from 12 healthy cats. A total of 18 healthy cats were used in the experiment, which were divided into four groups: each operative group was executed at the :Lst, 15th, 30th, 90th day after undergoing RON unilaterally.(six in 1st group). The enucleated eyes of each operative group were cut section routinely and embedded in paraffin, the cross sections were stained by special staining.RESULTS: At the 1st day after operation, the incision came into being and connected with cerebral subarachnoid space of orbital optic nerve. At 15th day, incision was fusiform and hyperplastic neuroglial cells and fibroblasts aggregated at the incision. At 30th day, there was obvious proliferation of type fibril at the neurotomy. The aligned texture of collagen fibril of the lamina cribrosa near the incision was moved close to each other. At the 90th day, a discrete scar was noted at the site which reached the cribriform and sclera.CONCLUSION: RON can cut scleral ring and piamater of optic nerve sharply. The incision of RON connects with subarachnoid space of orbital optic nerve and becomes broaden gradually at the site of scleral ring. The potential role of incision of RON is relevant to the subject.

ObjectiveTo investigate the effect of age on long-term prognosis of patients with traumatic brain injury (TBI).Methods102 inpatients with TBI were evaluated by following-up, using Glasgow Outcome Scale (GOS), Functioning Item of Disability Rating Scale (DRS-F) , Employability Item of Disability Rating Scale (DRS-E) and Quality of Life Index (QLI).ResultsThe average age of 102 cases was 29.7±12.5. There were no significant differences among different groups in GOS and DRS-F (P>0.05), but the level of DRS-E or QLI showed much higher in <27 years old group than those in >45 years old group (P<0.01).ConclusionThe factor of age may affect the long-term prognosis of TBI, quality of life and employability of young patients are better than elder patients.

In order to investigate the lesion' s extention and the infiltrated deepth and the metastasis of the tumors preoperatively ,endoscopic ultrasonography (EUS) was performed in 28 patients with ampullary carcinoma and 18 patients with extrahepatic bile duct carcinoma. forty six patients underwent surgical ex- plorations. A radical resection with detailed pathological study was done for 22 resectable cases of ampullary carcinoma and all the 18 cases of extrahepatic bile duct carcinoma. Carcinoma of ampulla of Vater and ex- trahepatic bile duct were assessed and staged preoperatively according to the TNM staging system. The re- sults of EUS were compared with surgical explorations and pathological findings for evaluating the accuracy of preoperative staging of EUS. The accurate rate of EUS in assessing the extent of cancer invasion was 8l.8% for ampullary carcinoma, 72. 2% for extrahepatic bile duct carcinoma. The accuracy of EUS in pre- dicting regional lymph node metastasis was 59% for ampullary carcinoma , and 61.6% for extrahepatic bile duct carcionoma. invasion of portal vein was correctly predicted by EUS in 2 out of 3 patients of ampullary carcinoma. All the 3 cases of liver metastasis were not detected by EUS. EUS is a more accurate diagnostic method in judgement of invasive extent of ampullory carcinoma and extrahepatic bile duct carcinoma preop- eratively , but less accurate for metastasis of the tumors.

AIM: To report a case of wet age-related macular degeneration (AMD) treat with multiple transpupillary themotherapy (TTT) and choroidal neovascularization (CNV) disappeared but retinal pigment epithelial(PRE) and choroidal atrophy occurred with a low vision at the end point.METHODS: Clinical data including fundus hotographs, fundus fluorescein angiography (FFA), indocyanine angiography (ICGA) and optical coherence tomography(OCT) was reviewed.RESULTS: A 72-year-old man complained about blurred vision of his left eye and FFA revealed polypoidal choroidal vasculopathy (PCV) in the macula. His left eye had stable vision of 0.1 for 6 years without any treatment of CNV. About 2 years later, his right eye presented a piece of CNV. During the period of 3 years, the lesion remained more (3×5 PD) and less (1×2PD) in size with remarkable exudates and bleeding, and 7 sessions of TTT were applied with 80-280mW, 2mm of spot, and 60 seconds exposure and with the interval of 3 months or more. The CNV lesion finally disappeared, but there left a white area in the macula and vision decreased from 0.3 to 0.04.CONCLUSION: Although CNV lesion can be eliminated by TTT, obvious atrophy of RPE cells and the choroids can happen and this may not be of help for patient vision. It suggests that the parameters of TTT will be lower than 120 mW/mm and limited less two sessions if applicable, especially for Asia people.

30 patients with colorectal carcinoma underwent endoscopic ultrasonography(EUS)and microvessel counting for staging before operation.The accuracy of EUS in assessing depth of tumor in- filtration was 76.7%,that in detecting lymph node involvement being 73.3%.The correctness of pre- operative Duke's staging remained 70%.Microvessel counting correlated with depth infiltration and lymph node invasion.The microvascularity in tumor with serosal involvement was obviously abundant than that without,so as in tumor with and without lymphatic invasion.The results revealed that both EUS and microvessel counting can be considered as an essential evidence for preoperative staging of col- orectal cancer and thereby for predicting prognosis.

Idiopathic pulmonary fibrosis (IPF) is a specific form of chronic, progressive, fibrosing interstitial pneumonia of unknown etiology , a median survival time of which is 2 to 3 years.The diagnosis and treatment are important for IPF in time.Krebs von den lungen-6(KL-6), Surfactant protein-A(SP-A) and Surfactant protein-D(SP-D) are acceptable biomarkers in clinical for idiopathic pulmonary fibrosis in Japan,which have shown good sensitivity at diagnosis IPF and predict the prognoses for patients with IPF . However , the differential diagnosis of IPF from other interstitial lung diseases is still challenging .Other biomarkers are being developed , one of which would have the best specificity and sensitivity at diagnosis IPF.Those biomarkers about pathogenesis of IPF includes alveolar epithelial cell dysfunction , fibrogenesis and immune dysregulation are shown .They are potential to account for underlying disease mechanisms , accelerated drug development and advance clinical management.

Objective To investigate the effect of Icariin ( ICA) experimental IgA nephropathy in rats and to explore related mechanisms .Methods Experimental IgA nephropathy rat model was established and then model rat were treated with or without different doses of ICA .Then, urine RBC, Urine protein and urine NAG were analyzed; IgA precipitation was detected with immunofluorescence staining;the protein level of NF-κBp65 and MCP-1 were examined by immunohistochemical staining;the mRNA level of IL-4, IL-10 and IL-13 were determined by quantitative PCR .Results The concentrations of urine RBC, Urine protein and urine NAG were reduced after ICA treatment , as companied by a decrease of IgA precipitation .Moreover, ICA treatment also decreased the protein level of NF-κBp65 and MCP-1, and the mRNA level of IL-4, IL-10 and IL-13.Conclusions ICA exerts a certain degree of efficacy on the treatment of experimental IgA nephropathy through regulating NF-κBp65 and MCP-1 expression and the immunoregulation mechanism .

OBJECTIVE To investigate the effect of root saponins of Panax notoginseng(RPNS) on different voltage-dependent calcium and potassium ion channels. METHODS By using the two-elec?trode voltage clamp (TEVC), the effect of RPNS 0.01, 0.06, 0.1, 0.6, 1 and 4 g · L- 1 was investigated on Cav1.2,and the effect of RPNS 1 g · L-1 was evaluated on Cav2.1,Cav2.2,Cav3.1, KCNH2,KCNQ1,KCNQ1/KCNE1 and BK channel. All the ion channels examined were expressed in Xenopus laevis oocytes. RESULTS TEVC suggested that the effect of RPNS on Cav1.2 exhibited the concentration-response relationship and its EC50 was 0.048 g · L-1. Compared with cell control,TEVC also showed that RPNS 1 g·L-1 had obviously inhibitory effect on Cav1.2,Cav2.2 and Cav3.1,and the inhibitory rate of RPNS 1 g · L-1 on the peak current of Cav1.2,Cav2.2 and Cav3.1 was(57.1 ± 8.6)%, (17.2 ± 0.7)% and(50.2 ± 7.7)%(P<0.01),respectively. RPNS 1 g · L-1 had obviously activated effect on BK channel,and the activated rate of RPNS 1 g·L-1 on the peak current of BK channel was(37.9± 2.7)%(P<0.01). RPNS 1 g·L-1 showed no significant effect on Cav2.1,KCNH2,KCNQ1 and KCNQ1/KCNE1. CONCLUSION RPNS may effectively inhibit Cav1.2 and Cav3.1,activate BK channel,but have little effect on Cav2.1,Cav2.2,KCNH2,KCNQ1 and KCNQ1/KCNE1.