The effects of tetramethylpyrazine ( TMPZ ) on the contraction of isolated guinea pig trachea induced by leukotrienes,histamine,prostagladin F2a , acetylcholine were observed. It was found that TMPZ exerts an inhibitory effect on the contraction induced by these asthmogenic mediators. It is non-competitive antagonist.

Objective To study and evaluate various therapeutic means for upper urinary tract calculi. Methods 3 218 cases of upper urinary tract calculi were reviewed.1 365 were pure kidney stones,651 complicated kidney stones,558 group Ⅰ ureteral stones,452 group Ⅱ ureteral stones and 192 group Ⅲ ureteral stones. Results ESWL (extracoporeal shock wave lithotripsy) has been the treatment of choice for pure kidney stones and for groupⅠ ureteral stones.Open surgery has been the best for complicated kidney stones and group Ⅱ,Ⅲ ureteral stones.1 164 patients underwent lithotomy and 1 923 ESWL.131 cases of group Ⅱ ureteral stones in the middle or lower segment of ureter were treated by ureteroscopic lithotripsy.Of the complicated kidney stones,residual stones were observed in 57 (8.8%).1.8%( n =12) of such cases underwent nephrectomy.The complete stone elimination rate in 3 months after ESWL was 81.6% whereas open operation was needed in 18.4%.Ure teroscopic lithotripsy yielded the poorest outcome,nephrectomy being undertaken afterwards in 0.8% and lithotomy in 6.1%. Conclusions ESWL,ureteroscopic lithotripsy,ballast lithotripsy or the combined use of 2 methods makes the surgical management of upper urinary tract calculi easier with less suffering to the patients.The use of double internal stent could reduce the surgical complications.Stone street after ESWL should be well taken care of and inflammation should be well controlled.Skilled technique is needed for ureteroscopic lithotripsy.

Objective To investigate the importance for early operation in severe acute pancreatitis (SAP) treatment. Method We retrospectively compared the mortality of 37 cases of SAP gradeⅡthat were treated by non-operative and early operative methods.Result The mortality of the nonoperative group was significantly higher than operative group (88.9% to 42.1%). Conclusion In the early course of SAP, nonoperative treatment should not overemphasized and,operation should be considered as a therapeutic method according to different pathophysiological changes.

The present study was to develop and design a new sonography rigid bronchoscopy and corollary vacuum-assisted biopsy device system with less injury and complication. The system combined ultrasonic-probe with ultrasound catheter, a new medical ultrasound technique, and rigid bronchoscopy (RB) which is improved with an auxiliary vacuum-assisted biopsy device. The principle of the device is vacuum suction and rotary knife. The reduced outer diameter of the RB led to less pain and lower complications for the patient. With the help of ultrasonic-probe (30 MHz), lesions and blood vessels can be identified clearly and unintentional puncture and damage to blood vessels can be avoided. Plenty of lesions can be obtained quickly through the vacuum-assisted biopsy device without getting puncture needle in and out repeatedly. The novel endobronchial sonography rigid bronchoscopy and matched vacuum-assisted biopsy device has many remarkable advantages. It can enlarge the applied range of the RB from endobronchial to mediastinal lesions, avoiding unintentional puncture of vessels. Obtaining multiple samples with a higher accuracy rate than that by other sampling techniques, minimizing operation time, alleviating pain and decreasing the complication rate, the system makes up the technical deficiency for the diagnosis and treatment of the mediastinal lesions, to a certain degree.
Biopsy, Needle ; instrumentation ; Bronchoscopy ; instrumentation ; Equipment Design ; Humans ; Mediastinum ; pathology ; Ultrasonography ; instrumentation ; Vacuum

Objective To investigate mRNA expression level changes of dopamine transporter gene (DAT1) and dopamine receptor gene(DRD4) in attention deficit hyperactivity disorder(ADHD) children's peripheral blood before and after methylphenidate treatment,and to explore associations between the mRNA expression level and symptom severity,as well as methylphenidate response.Methods Forty five ADHD children by DSM-Ⅳ diagnostic criteria,aged six to fifteen years old participated in a six-week drug titration treatment of metbylphenidate.ADHD-RS-Ⅳ Home Version, WCST and VCPT were used to evaluate the ADHD clinical symptoms and cognitive functions.RNA Simple Total RNA Kit was used to extract the total RNA.After reverse transcription, the obtained c-DNA was used in the following qRT-PCR to evaluate relative mRNA expression of the candidate genges before and after medication.Results The DRD4 mRNA relative expression level after taking methylphenidate was significantly higher than that before methylphenidate treatment (0.23 ± 0.23 vs 0.16± 0.18, P =0.041).There was no significant difference between DAT1 mRNA relative expression level before (0.43 ± 0.40) and after (0.43±0.40) methylphenidate treatment.No significant difference was found on eitber basal DAT1/DRD4 mRNA expression or fold change of DAT1/DRD4 mRNA expression before and after medication between methylphenidate treatment responders and non-responders groups.There was a positively significant correlation between baseline DRD4 mRNA relative expression level and erroneous T score of CPT(r=0.424, P=0.025) , however, no other statistically significant correlation was found between basal DRD4 mRNA relative expression level and ADHD-RS-Ⅳ total score,WCST conceptual level, CPT missing T score, and CPT reaction T sco~ (all P＞0.05).There was also no statistical significant correlation between basal DAT1 mRNA relative expression level and ADHD-RS-Ⅳ total score,WCST conceptual level,and CPT T scores(all P＞0.05).Conclusion DRD4 gene function may be increased after methylphenidate treatment and play an important role in impulsivity behavior of ADHD.Therefore, DRD4 mRNA expression level might be a biomarker for ADHD diagnosis and a predicting indicator of drug efficacy.

Objective To compare the safety,feasibility,and long-term outcomes between combined thoracoscopic and laparoscopic esophagectomy (TLE) and open three-field esophagectomy (OE) for esophageal cancer.Methods The data of 183 patients with esophageal cancer who accepted TLE (n =94) or OE (n =89) from February 2009 to December 2011 were retrospectively collected and compared.Results Demographics,pathologic data in each cohort were almost identical.No significant differences were observed in operative time,the number of lymph node harvested,rates of anastomotic leak,thoracic abscess,chyle chest,re-operation,vocal cord paralysis,gastric emptying dysfunction and morbidity.A significant difference was observed in blood loss (86.6 ±38.3 ml in TLE group vs.217.4 ±87.2 ml in OE group,P=0.000),rate of transfusion (1.1％ vs.6.7％,P =0.045),hospital stay (13.9 ±7.5 d vs.17.1 ±10.2 d,P =0.017),rate of overall surgical complications (23.4％ vs.38.2％,P =0.030),rate of pulmonary complications (9.6％ vs.27.0％,P =0.002) and rate of arythmia (4.1％ vs.12.4％,P =0.046).Median follow-up time was 28.0 ±2.0 months (95％ CI:24.2-31.8).No difference between the two groups concerning survival was observed (P =0.954).Conclusion The TLE for esophageal cancer is safe and feasible.Although it cannot improve the survival of long-term,it is worth spreading in intraoperative and postoperative advantages compared with OE group.

AIM: To study the change of cellular immunological function in patients with locally advanced lung cancer before and after operations. METHODS: A lung cancer group of 20 cases with locally advanced lung cancer (group A), a benign disease group of 20 cases with lung benign disease (group B) and a normal group of 20 cases from healthy volunteers (group C) were set up. The levels of the peripheral blood T lymphocyte subsets (CD~+_3, CD~+_4, CD~+_8, CD~+_4/ CD~+_8 ratio) were detected in the group A before operation and on the 10th day and 17th day after operation by indirect immuno-fluorescence assay and contrasted with the group B and group C. RESULTS: The levels of T lymphocyte subsets in group A were abnormal before operation, CD~+_3, CD~+_4/ CD~+_8 ratio were significantly lower than those in group B and group C (P

Objective To evaluate the short?term efficacy and safety of endoscopic photodynamic therapy ( PDT ) for esophageal squamous cell carcinoma ( ESCC ) and precancerous lesion. Methods Retrospective analysis was performed on 30 patients with early ESCC or precancerous lesions who received PDT between September 2013 and April 2015 in Endoscopy Center, Henan Tumor Hospital,and its indications were summarized. The main outcomes including histological complete response rate ( CR ) , recurrence rate and adverse events after treatment of one year were analyzed. Results Three patients with middle grade dysplasia( MGD) , 18 with high grade dysplasia( HGD) and 4 with squamous cell carcinoma in situ, all negative lymph node metastasis, received PDT. CRs were 72?0%(18/25) and 88?0%(22/25)after one PDT session in 3 months and 12 months, respectively. One?year follow?up showed 3 recurrences ( 12?0%) ,4 ( 16?0%) severe strictures, and no perforation. Five patients with advanced squamous cell carcinoma received palliative PDT. Partial remission rate was 60?0%( 3/5) after one PDT session in 3 months, and 40?0% ( 2/5) after 12 months. Two died of tumor metastasis, one died of gastrointestinal bleeding one year after PDT. No perforation occurred. Conclusion Endoscopic photodynamic therapy for esophageal squamous cell carcinoma and precancerous lesions is safe and feasible, with remarkable short?term effect. As for the patients with advanced squamous cell carcinoma, it is equally safe and effective in the short term.

Objective To investigate the application value and feasibility of enhanced recovery after surgery (ERAS) in thoracoscopic and laparoscopic esophagectomy for esophageal cancer.Methods The clinical data of 304 patients with esophageal cancer who were admitted to the Affiliated Cancer Hospital of Zhengzhou University from December 2013 and July 2014 were retrospectively analyzed.All the patients underwent esophagogastric partial resection, esophagogastric cervical anastomosis and 2-field lymph node dissection under general anesthesia.The management of 195 patients guided by ERAS were allocated to the ERAS group and 109 patients receiving perioperative traditional treatments were allocated to the control group.Observing indicators included : (1) enteral and parenteral nutritional support treatments;(2) nutrient indexs: levels of serum albumin (Alb) and prealbumin;(3) the recovery of gastrointestinal function: time to anal exsufflation and defecation;(4) postoperative complications and the grading according to Clavien standard;(5) duration of postoperative hospital stay and treatment expenses;(6) risk factors affecting postoperative complications by multivariate analysis;(7) independent risk factors affecting occurrence rate of postoperative complications by univariate analysis.Measurement data with normal distribution were presented as (x) ± s and analyzed using the t test.Nonnormal distribution data were analyzed by the Wilcoxon rank sum test.Comparison of repeated data was analyzed by the repeated measures ANOVA.Categorical variables were analyzed using the chi-square test or Fisher's exact probability.The multiple linear regression analysis and Logistic regression were used to measure the multivariate analysis of continuous variables and binary variable, respectively.Results (1) During the enteral and parenteral nutritional support treatments, 11 patients with surgery-related complications in the ERAS group didn't receive oral intake at postoperative day 1,26 proceeded the intravenous rehydration at postoperative day 4 due to calorie intake less than 80％ of calorie requirement, and enteral nutritional support treatment was well-tolerated in the control group.(2) Comparison of nutrient indexs : the levels of serum Alb and prealbumin at postoperative day 1, 3 and 5 were (37.2±3.9)g/L, (39.1 ±3.5)g/L, (38.5 ±3.0)g/L and (0.20 ±0.06)g/L, (0.13 ±0.04)g/L, (0.13 ±0.04)g/L in the ERAS group, (37.7 ±2.8)g/L, (39.0 ±3.6)g/L, (38.4 ±3.8)g/L and (0.18 ± 0.06) g/L, (0.13 ± 0.04) g/L, (0.13 ± 0.04) g/L in the control group, respectively, showing no significant difference in the postoperative changing trends between the 2 groups (F =0.357, 0.453, P ＞ 0.05).(3) The recovery of gastrointestinal function : time to first anal exsufflation and first defecation were (2.1 ± 0.8) days and (3.4 ± 1.2) days in the ERAS group, (3.2 ± 0.9) days and (5.5 ± 1.5) days in the control group, respectively,showing significant differences between the 2 groups (t =-10.505,-13.174, P ＜0.05).(4) There was no death in the perioperative period.The overall incidences of postoperative complications and number of patients with severe complications were 26.15％ (51/195) and 8 in the ERAS group, 30.28％ (33/109) and 8 in the control group, with no significant difference between the 2 groups (x2=0.594, 1.469, P ＞ 0.05).Eight and 10 patients in the ERAS and control groups underwent gastrointestinal decompression, 6 and 8 patients in the ERAS and control groups underwent retreatment in the intensive care unit (ICU), 3 and 2 patients in the ERAS and control groups were readmitted to the hospital at 3 weeks after discharge, with no significant difference in the above indexes (x2=0.185, 2.892, P ＞0.05).(5)The duration of postoperative hospital stay and treatment expenses were (6.8 ±2.4)days and (25 088 ±10 336)yuan in the ERAS group, (11.1 ±3.4)days and (38 819± 14 854)yuan in the control group, showing significant differences between the 2 groups (t =-12.782,-9.452,P ＜ 0.05).(6) The age, gender, preoperative weight loss ＞ 10％, tumor staging, tumor differentiation,neoadjuvant chemotherapy and time of food intake were risk factors affecting incidence of postoperative complication in patients with esophageal cancer by the univariate analysis (x2=2.484, 2.333, 0.061, 8.553,2.459, 0.163, 3.462, P ＜ 0.05).(7) The age, preoperative weight loss ＞ 10％, tumor staging and neoadjuvant chemotherapy were independent risk factors affecting incidence of postoperative complication in patients with esophageal cancer by the multivariate analysis (OR =0.365, 10.761,0.290, 8.140, 95％ confidence interval :0.198-0.671, 4.122-28.095, 0.130-0.645, 3.946-16.791, P ＜0.05), but time of food intake was not an independent risk factor (OR =0.540, 95％ CI: 0.280-1.041, P ＞ 0.05).Conclusions ERAS in the esophageal minimally invasive surgery for esophageal cancer is safe and feasible, with the advantages of shorter recovery time of gastrointestinal function and duration of hospital stay, lower treatment expenses and a better application value compared with traditional treatment.