Objective To evaluate a modified Suguira procedure for the treatment of variceal bleeding.Methods A modified Suguira procedure was performed in 62 patients with acute variceal bleeding (11 cases) that could not be controlled by endoscopic therapy or with a history of massive bleeding (51 cases) after endoscopic therapy.Results Perioperative mortality occurred in 2％ (1/62) patients.Esophageal anastomotic leak occurred in 2％ (1/62) patients,and anastomotic stenosis developed in 5％ (3/62) patients.Twelve months after operation,esophageal varices disappeared in 79％ (48/61) patients,diminished in size in 18％ (11/61),remained unchanged in 3％ (2/61) ; Fundal gastric varices disappeared in 98％ (60/61) patients,diminished in size in 2％ (1/62).The rebleeding rate was 3％ (2/61) and 8％ (5/61) in 3 years and 5 years,respectively.Conclusions The modified Suguira procedure is safe and effective for long-term control of variceal bleeding after a failed endoscopic therapy.

Objective To investigate the effects of Xiao Yao San on intracellular Ca2 + concentration in cultured rat hippocampal neurons in the state of chronic stress and study the mechanism of chronic stress injuring and XiaoYao San protecting. Methods MK-801 acts as tool,cultured rat hippocampal neurons were divided into seven groups, those were group 1 (control), group 2 (normal serum), group 3 (normal serum + Glu), group 4 (model serum + Glu), group 5 (model serum + Glu + MK-801), group 6 (Xiaoyaosan + Glu), group 7 (Xiaoyaosan + Glu + MK-801). to detect intracellular Ca2+ concentration in cultured hippocampal neurons in the simulated micro - environment of chronic stress and after intervention with the serum treated with Xiao Yao San by confocal laser microscope at the same period of time. Results Compared with group 1 (779.97 ± 36.81), concentration of Ca2+ intracellular of group 2 (1092.38 ± 36.41), group 3 (1472.49 ± 76. 19), group 4 (1509.52 ±104.69) and group 5 (1186.97 ±41.92) all increased significantly (P＜0.01) ,group 6 (908.74 ±40.24) increased too (P ＜ 0.05), compared with group 2, concentration of Ca2 + intracellular of group 3,4 and 5 all increased significantly (P ＜ 0.01), but group 7 (721.99 ± 60.33) decreased significantly (P ＜ 0.01). Compared with group 4, concentration of Ca2+ intracellular of group 6 and 7 decreased significantly (P＜ 0.01), group 5 decreased too (P ＜ 0.05), compared with group 6, concentration of Ca2 + intracellular of group 5 increased significantly (P ＜ 0.01),when group 7 decreased significantly (P＜0.01). Conclusion Serum of chronic stress treated with Xiao Yao San has the effect of inhibiting Ca2+ overload in hippocampal neurons,it may work through a variety of signaling pathways including Glu-NR-Ca2+ to maintain the steady-state of Ca2+ concentration in hippocampal neurons, and then to protect neurons from the neurotoxic effects of excitatory.

OBJECTIVE:To observe the efficacy and safety of different administration of dexamethasone in the treatment of se-cretory otitis media. METHODS:Data of 92 patients with secretory otitis media was retrospectively collected and divided into ob-servation group(43 cases)and control group(49 cases)by different administration. Observation group received 5 mg Dexametha-sone injection by injection in the eustachian tube in the assisted by video laryngoscope,once every 2 day. Control group received 5 mg Dexamethasone injection by injection in the eustachian tube,once every 2 day. 7-day was regarded as 1 treatment course. 1 more course for uncured patients,and no more than 4 courses. Clinical efficacy,and tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6),IL-10 levels before and after treatment,and 1-year cumulative recurrence rate after cured and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was signifi-cantly higher than control group,1-year cumulative recurrence rate after cured was significantly lower than control group,the dif-ferences were statistically significant(P<0.05). Before treatment,there were no significant differences in TNF-α,CRP,IL-6 and IL-10 levels between 2 groups(P>0.05). After treatment,TNF-α and IL-6 level in 2 groups were significantly lower than before, and observation group was lower than control group,the differences were statistically significant(P<0.05);there were no signifi-cant differences in CRP and IL-10 between 2 groups before and after treatment(P>0.05). And there was no significant difference in the incidence of adverse reactions between 2 groups(P>0.05). CONCLUSIONS:The efficacy of dexamethasone by injection in the eustachian tube in the assisted by electron-nasopharyngolaryngoscopy is superior to auripuncture administration,it can reduce re-currence rate,with good safety.

Objective To investigate the protective effect of taurine on HK-2 cells exposed to oxalate (Ox) and calcium oxalate monohydrate crystal (COM) in vivo.Methods HK-2 cells,a proximal tubular epithelial cell line,were cultured.Five groups were divided in this study:control group (only HK-2 cells) ; Ox and COM group (HK-2 cells + Ox + COM) ; Taurine group (HK-2 cells + Ox + COM + Taurine) ; Apocynin group (HK-2 cells + Ox + COM + Apocynin) ; Catalase group (HK-2 cells + Ox + COM +Catalase).After 6 hrs,the cultures medias from each group were tested for LDH,H2O2,8-isoprostane,and MCP-1 protein.Cellular expression of MCP-1 mRNA and P47phox mRNA were determined by reverse transcriptase-polymerase chain reaction.After 24 hrs,cells livability was investigated by MTT.Results Compared with the control,cells livability was reduced when exposed to Ox and COM (P ＜ 0.05),Treatment with Taurine,Apocynin and Catalase significantly increased the cells livability (P ＜ 0.05).Compared with the control,the expression of LDH,H2O2,8-isoprostane,and cellular expression of MCP-1 mRNA and P47phox mRNA were increased following exposure to Ox and COM (P＜0.01,P＜0.01,P＜0.01,P＜0.01,P ＜0.05).Treatment with Taurine,Apocynin and Catalase significantly reduced the expression of LDH,H2O2,8-isoprostane,as well as the cellular expression of MCP-1 mRNA.Expression of P47phox mRNA in Taurine group was not reduced significantly (P ＞ 0.05).Conclusions This study showed that Taurine protected the HK-2 cells from oxidative injury exposed to Ox and COM by the pathway that may not be in relation to the inhibition of P47phox mRNA expression.

Objective To evaluate the effectiveness of thoracic electrical bioimpedance(TEB)in monitoring the cardiac function of peritoneal dialysis patients.Methods One hundred and one patients with continuous ambulatory peritoneal dialysis (CAPD) and 30 healthy persons (control group)were included in the study.Thoracic electrical bioimpedance (TEB) noninvasive hcmodynamic monitoring and echocardiography were taken to analyze the correlation between indexes.Results Echocardiography showed that left atrial diameter (LAD),left ventricular end diastolic diameter (LVDd),left ventricular end systolic diameter (LVDs),interventricular septal thickness （IVST),interventricular septal thickness (PAP),left ventricle weight index (LVMI) of CAPD group were higher than that of the control group (all P ＜ 0.05),early and late wave of mitral valve flow (E/A) of CAPD group was lower than that of control group (P ＜ 0.05).TEB monitoring showed that cardiac output (CO),stroke volume (SV),acceleration index (ACI),ejection fraction (EF),velocity index (Ⅵ) of CAPD group were significantly lower than that of control group (all P ＜ 0.01),systolic time ratio (STR),SVR,TFC of CAPD group were significantly higher than that of control group (P ＜ 0.01).Correlation analysis show that left ventricular ejection fraction (LVEF) was negatively correlated with BNP (r =-0.467,P ＜ 0.01),LVMI was positively correlated with BNP (r=0.416,P ＜ 0.01),PEP,STR and TFC were positively correlated with BNP (r =0.404,P ＜ 0.01; r =0.572,P ＜ 0.01; r=0.471,P ＜ 0.01),EF was negatively correlated with BNP (r =-0.664,P ＜ 0.01).Correlation analysis between echocardiogaphy and TEB monitoring index showed there was significant correlation between EF and LVEF (r =0.451,P ＜ 0.01),SVR and TFC were positively correlated with LVMI (r =0.232,P ＜ 0.05; r =0.284,P ＜ 0.05),SV was positively correlated with E/A (r =0.285,P ＜ 0.05),pre-ejection period (PEP) and STR were negatively correlated with LVEF (r =-0.389,P ＜ 0.01; r =-0.446,P ＜ 0.01),TFC was positively correlated with LAD (r=0.279,P ＜ 0.05).Conclusion TEB monitoring can accurately evaluate the cardiac function with the advantage of dynamic monitoring and simple operation.It can partly replace the echocardiography test.

BACKGROUND:The risk of lower extremity deep venous thrombosis was high in patients with bone metastases. Major surgery is a major risk factor for thrombosis. There was no standard prophylactic regimen available.
OBJECTIVE:To investigate the efficacy and safety of low molecular weight heparins versus rivaroxaban in the postoperative prevention of lower extremity deep venous thrombosis in patients with bone metastases.
METHODS:From January 2010 to December 2013, a total of 73 patients with bone metastasis in spine, pelvis and lower extremities, who underwent open surgery in the Department of Musculoskeletal Tumor, Third Hospital, Hebei Medical University, China, were retrospectively analyzed. The patients were divided into low molecular weight heparins group (n=41) and rivaroxaban group (n=32) according to the prophylactic drugs after surgery.
RESULTS AND CONCLUSION:Nine cases (22%) in the low molecular weight heparins group were found lower extremity deep venous thrombosis, and six cases (19%) in the rivaroxaban group suffered from lower extremity deep venous thrombosis, showing no significant differences (χ2=0.11, P=0.74). The incidences of bleeding events in both groups were respectively 7.32%and 6.25%, showing no significant differences (correctionχ2=0.083, P>0.05). There were no significant differences regarding the levels of platelet, activated partial thromboplastin time and prothrombin time between both groups preoperatively or postoperatively (P>0.05). Therefore, the efficacy and safety of low molecular weight heparins and rivaroxaban in the postoperative prevention of lower extremity deep venous thrombosis were similar. Both could effectively reduce the incidence of deep venous thrombosis, with a relative low risk of bleeding.

Objective:To determine the law of dose variation in nasopharyngeal carcinoma patients treated with helical tomotherapy by observing the difference between the actual and planned doses of targets and at-risk organs in these patients. Methods:Ten naso-pharyngeal carcinoma patients were treated with helical tomotherapy. Each single dose distribution and the corresponding computed tomography (CT) images were transmitted to the commercial software MIMvista 6.50, which was used to perform deformable image registration on the CT images. The sum of the actual dose was then obtained by accumulating the single doses. The image-guided actu-al dose was denoted as Plan 2, and the initial plan was called Plan 1. The dose-volume histogram of the dose distribution of targets and at-risk organs in Plans 1 and 2 were compared. Results:The D98 and D95 doses of the planning gross target volume (PGTV) in Plan 2 were significantly lower than those in Plan 1. Compared with Plan 1, the Dmean and D50 doses of double parotids in Plan 2 were higher by 42.23%and 63.82%(P<0.001, P=0.001) on average, respectively, for the left parotid, as well as by 38.64%and 66.76%(P=0.002, 0.004), respectively, for the right parotid. The D2 dose of spinal cord in Plan 2 was significantly higher than that in Plan 1. The doses were higher by 16.49%on average (P=0.026). Conclusion:To achieve precise and individually adaptive radiotherapy, correcting the error between anatomy and placement during tomotherapy for nasopharyngeal carcinoma patients is necessary.

Objective To investigate the effects of heparanase and E-cadherin on the invasion and metastasis of gastric cancer. Methods Fifty specimens of gastric cancer which had been resected at Cancer Hospital of Liaoning Province from February 2005 to May 2007 were collected. The expression of heparanase mRNA and E-cadherin mRNA in these gastric cancer specimens was detected by RT-PCR, and the expression of E-cadherin in these gastric cancer specimens was detected by immunohistochemistry. Data were analyzed by t-test and variance analysis, and the enumeration data analyzed by chi-square test. Results There were significant differences in the expression of heparanase and E-cadherin between gastric cancer cells with high and low differentiation, presence and absence of metastasis, and TNM stages Ⅰ and Ⅱ versus Ⅲ and Ⅳ (t = 1.999, 4.258, 1.735 ; 1.286, 6.794, 3.091; χ~2 =6.273, 9.397, 5.640, P <0.05). The co-expression of heparanase (+) and E-cadherin (-) was correlated with tumor undifferentiation, lymph node metastasis and advanced TNM staging (χ~2 =11.306, 10.208, 8.420, P <0.05). Conclusions Heparanasc shows high expression while E-cadherin shows low expression in gastric cancer tissue. There is a synergistic effect between the abnormal expression of heparanase and E-cadherin, and the gastric cancer cells with coexpression of heparanase and E-cadherin have more malignant potential.

Objective To analyze geometrical uncertainties of the target and provide the margin enlarging from clinic target volume (CTV) to planning target volume (PTV) with HT.Methods Analysis set-up data of 220 cases include 97 cases of head and neck,45 cases of chest and 78 cases of abdomen and pelvic,calculating the systematic error (Σ) and the random error (σ) in the three-dimension and check whether the set-up data accord with the normal distribution or not,then acquire the values expand in the three directions based on formula 2.0Σ + 0.7σandμ ± 2.58σ.Results The systematic error (Σ) and random error (σ) of head and neck,the chest and abdomen and pelvic were (0.7-1.9 mm,1.1-1.4 mm),(0.8-4.2 mm,1.5-3.2 mm),(1.1-4.1 mm,1.8-4.1 mm),respectively,and the margin that expand in the direction of x,y,z were (5.2,6.5,7.7 mum),(7.5,16.2,10.3 mm),(7.6,17.1,15.7 mm),respectively.Conclusions The curative effect of this task need prove with a large sample during HT,but other should establish data of margin by yourself.

Objective To study the CT number and noise of HT MVCT on different dose rate and scanning thickness.Methods The CT number of different relative electron density were measured in the MVCT image of Cheesephantom with tissue substitute plugs scanned with different dose rate and slice thickness.The physical density corresponding to the CT number was plotted as the image value to density table (IVDT).The noise was measured in the MVCT image of Cheesephantom with solid water plugs scanned with different dose rate and slice thickness.Results There was a significant different of the CT number of the plugs with different dose rates (P =0.000),it shows a positive correlation between the varied CT number and density (R2 =0.846),there is larger impact on the high density number.There was still a significant effect on the noise with different dose rate (P =0.000 density),the noise increase as the dose rate decrease.There was no significant effect on IVDT (P =1.000) and noise (P =0.667) with different slice thickness.Conclusions The CT number and the noise vary with the dose rate,the QA of MVCT should be performed regularly to assure the quality of image and the accuracy of dose calculating on MVCT in adaptive.