Objective To analyze the clinical characteristics of children with cyclic vomiting syndrome (CVS), summarize the clinical experience, and improve the awareness,diagnosis and treatment level of CVS.Methods The clinical data and results of long-term follow-up of the children with CVS were collected and analyzed from 1995 to 2009 in our department.Results Forty-six children were enrolled in the study, including 22 boys and 24 girls.Mean onset age was 4.5 years(ranged from 1 to 11 years)and the mean age at final diagnosis was 8.5 years (ranged from 4.5 to 14.5 years).Sixty-six and seventy-four percent of patients had family history of migraine and motional sickness respectively,whereas 83% patients had triggers.The clinical manifestation of CVS was severe episodic vomiting.The episodes had a rapid onset and sudden ending,persisted for several hours to days,and were separated by symptom-free intervals.The incidental symptoms were pallor, lethargy,intractable nausea,abdominal pain,headache,photophobia and dizzy.Twenty-nine patients diagnosed were followed up for 5 years at average.Five patients were treated with valproate,4 with cyproheptadine, 5 with cyproheptadine and valproate,5 with amitriptyline,cyprohep tadine and valproate,and 3 with cyproheptadine and flunarizine.All treated patients recovered mean 10 months(1.5 months to 2 years) years later and displayed the reduced number of episodes or the severity of episodes except 3 patients.Twenty-eight percent (8/29) of patients progressed to migraine headaches.Conclusion CVS is a relatively common disease in children and awareness of the condition should be increased.CVS should be considered when patients had recurrent vomitting and were completely healthy between the two episodes after excluding other pathological conditions.

Objective To investigate the clinical effects of standard large trauma craniectomy in patients with acute posttraumatic brain swelling. Methods A cohort study was performed in 74 patients of acute posttraumatic brain swelling with midline shifting more than 5 mm, who were divided randomly into two groups: standard large trauma craniectomy group (n =37) and routine temporoparietal craniectomy group as control group (n =37). The vital sign, the intracranial pressure (ICP) and complications were observed during the treatment. The Glasgow outcome scale (GOS) and mortality rate as well as the complications were evaluated after treatment. Results The mean ICP in the large trauma craniectomy group at 24, 48, 72 and 96 hours was much lower than those of the control group ( P

Objective To evaluate the clinical application of CT virtual cystoscopy (CTVC). Me-thods Thirteen patients who had clinical indication were studied. Iodine contrast was intravenously injected after the bladder was voided. Thin-slice spiral CT scanning of the bladder area was started when the bladder became filled with contrast media. By using 3D navigator smooth software, CTVC images were obtained. The findings in all cases were compared with the cystoscopy and surgical results. Results Nine patients with CTVC were proved vesical tumor,3 patients with CTVC were proved benign prostatic hyperplasia, and they were confirmed by cystoscopy,1 patient with cystitis glandularis could not be diagnosed with CTVC.By CTVC, the diagnostic accordance rate was 92.3%,the coincidence rate was 100.0% in vesical tumor. Conclusions CTVC is highly sensitive in displaying the vesical lesions.Being a new and non-invasive technique, CTVC is very helpful in the diagnosis of introvesical diseases. It has fine value in the clinical practice.

Objective To study the surgical treatment of multilevel arterial occlusion of lower extremities. Methods Single or jumping arterial bypass using grafting and percuteneous transluminal angioplasty(PTA)and stenting combined with infrainguinal revascularization were used for the multilevel arterial occlusion in 25 lower extremities. Results 25 cases showed satisfactory results in 6 months to 3 years follow-up. Postoperatively,the ischemia symptoms of limbs were improved or disappeared,4 toes were amputared because of preoperative dry gangrene,the wounds received eurement in a 2 to 4 months,2 graftings became occluded in 6 months postoperation. There were no procedural or postoperative morbidity or mortality.The cumulative patency rate of grafting was 92%(23/25),The rate of curement was 100%.Conclusion According to the individual principle,it is an effective therapy method to choose single or jumping arterial bypass and PTA and stenting combined with infrainguinal revascularization for high risk patients with multilevel arterial occlusion.

Objective To appraise the postoperative anti-reflux function of vertical esophagogastic valve-plasty anastomosis for cardiac cancer.Methods Forty patients with cardiac cancer were randomly divided into study group and surgery control group,with 20 patients in each group.The study group underwent vertical esopagogastric valve-plasty anastomosis,while the surgery control group underwent conventional esophagogastrostomy.Ten healthy volunteers were recruited as normal control group.A 24-hour esophageal pH monitoring and endoscopy check-up was carried out in all experimental subjects at 90 days postoperatively.Results All of the pH monitoring indexes in study and surgery control groups were higher than those in normal control group(P

Object To develop a resonance scattering spectral(RSS) method for the determination of total flavone in Shuxuening Tablet, and study the cause of RSS enhancement. Methods The BSA Mo (Ⅵ) qucercetin (Qu) system was investigated by RSS method. Results There were two resonance sacttering peaks at 470 and 525 nm. The Qu concentration in the range of 0-2 4 mg/L is linear to the resonance scattering intensity I 470 nm , with a detection limit of 0 3 mg/L. Conclusion This method is simple, sensitive and suitable for the determination of total flavone in Shuxuening Tablet. The spectral results demonstrate that the formation of [BSA Mo Qu] n associated particle and the interface between the particle solid phase and water phase results to its enhanced RSS.

Objective To identify hepatitis C virus(HCV)-specific cytotoxicity T lymphocytes (CTL)epitopes by the combination of T epitopes prediction software and in vitro assays.Methods HCVspecific CTL epitopes were predicted by T epitope prediction software Rankpep and then candidate HCV-specific CTL epitopes were selected.Candidate HCV-specific CTL epitopes were used to stimulate PBMC of HCV-infected patients and healthy volunteers.and then enzyme-linked immunospot(ELISPOT)and intracellular cytokine staining(ICS)were used to measure the frequencies of IFN-γ-producing cells in total PBMC and the percentages of IFN-γ+CD8+T cells in total CD8+T cells,respectively.Results Five candidate CTL epitopes[NS3 450(TVPQDAVSR),NS3 594(GPTLLYRL),Ns4b 78(sMMAFSAAL),NS5a 416(SEENVSVVF)and NS5a 367(TVSSALAEL)]were used to stimulate PBMC of ten HCV-infected patients and two healthy volunteers.PBMC of seven HCV-infected patients secreted IFN-γ while PBMC of healthy volunteers did not produce IFN-γ.The frequencies of peptide-specific IFN-γ-producing cells ranged from 5 to 36 SFC/105 PBMC and the percentages of peptide-specific IFN-γ+CD8+T cells ranged from 0.02%-0.25%.Conclusion Resuhs of ELISPOT assay and ICS assay confirm that these five peptides NS3 450,NS3 594,NS4b 78,NS5a 416 and NS5a 367 are identified as Hovel HCV-specific CTL epitopes.

saline group(all P

BACKGROUND/AIMS: The motility change after peroral endoscopic myotomy (POEM) in achalasia is currently focused on lower esophageal sphincter (LES). This study aims to investigate the correlation of motility response between distal and proximal esophagus after POEM. METHODS: A total of 32 achalasia patients who received POEM and high-resolution manometry (HRM) were included for analysis. Eckardt score was used to assess symptom improvement. HRM was applied for studying motility. Main parameters analyzed were (1) LES: resting pressure (restP), 4-second integrated relaxation pressure; (2) esophageal body (EB): contractile integral of distal segment with myotomy (CI-DM) and proximal segment without myotomy (CI-PNM); and (3) upper esophageal sphincter (UES): relaxation pressure (UES-RP). RESULTS: There were 6 type I, 17 type II, and 9 type III achalasia patients included for analysis. (1) Eckardt score, LES tone, CI-DM, CI-PNM and UES-RP were reduced remarkably after POEM (P < 0.001). (2) no significant correlation was noted between LES tone and contractile intergral of EB. (3) a positive linear correlation of CI-DM and CI-PNM changes was detected (P < 0.001). (4) the change of UES-RP was positively correlated with the change of contractile integral of EB (P < 0.001). CONCLUSIONS: Myotomy of the distal esophagus would attenuate proximal EB contraction and assist UES relaxation in achalasia patients after POEM.
Esophageal Achalasia* ; Esophageal Sphincter, Lower ; Esophageal Sphincter, Upper* ; Esophagus* ; Humans ; Manometry ; Relaxation*

Objective The purpose of this study was to establish a rat model of thromboembolism for the study of hemorrhag -ic transformation after intravenous thrombolysis with the recombinant tissue plasminogen activator ( rtPA) . Methods Sixty Sprague-Dawley rats were randomly divided into a sham operation , a cerebral embolism, and an rtPA group.Thrombus was prepared in vitro with the rat femoral artery blood and injected into the internal carotid artery of the rats in the cerebral embolism and rtPA groups to es -tablish a model of embolic focal cerebral ischemia , while the animals of the sham operation group injected with BSA .Five hours later , the rats in the rtPA group received rtPA and those in the cerebral embol-ism and sham operation groups the injection of isotonic saline solu-tion.At 24 hours after embolus injection , the neurological deficit score was obtained .The rats were sacrificed after cardiac perfusion and their brains removed for triphenyltetrazolium chloride staining , assessment of the infarct volume and cerebral edema , and calculation of the hemorrhage volume by spectrophotometric hemoglobin assay . Results The hemorrhage volume was significantly higher in the rtPA than in the cerebral embolism group ([17.55 ±2.20] μL vs [3.82 ±0.86] μL, P<0.01), but there were no statistically significant differences between the two groups in the infarct volume ([29.29 ±4.204] %vs [27.89 ±3.91] %, P=0.810), cerebral edema ([12.43 ±1.66] % vs [7.13 ±2.04] %,P=0.063 2), and neurological deficit score (3.35 ±0.27 vs 2.80 ±0.28, P=0.174). Conclusion The rat model of thromboembolism, with a high stability and reproducibility , can be used for the pathogenesis-related studies of hemorrhagic transformation after thromboly-sis with rtPA.