Acute non-variceal upper gastrointestinal bleeding (ANVUGIB)is one of the most common medical emergencies in China and worldwide. In 2009,we have issued the Guidelines for the diagnosis and treatment of acute non-variceal upper gastrointestinal bleedingin China;however,numerous studies on the diagnosis and treatment of ANVUGIB have been conducted in the past years,and the management of ANVUGIB needs to be updated. Finally,the 2015 version of Guidelines for the diagnosis and treatment of acute non-variceal upper gastrointestinal bleedingwas issued. We hope to provide information and help for understanding the new guidelines by clinicians.

Catheterization ; Endoscopy ; Esophageal and Gastric Varices ; complications ; drug therapy ; surgery ; therapy ; Gastrointestinal Hemorrhage ; drug therapy ; etiology ; surgery ; therapy ; Humans ; Octreotide ; therapeutic use ; Somatostatin ; therapeutic use ; Vasopressins ; therapeutic use

Objective To summarize treatment experiences of microsurgical clipping for anterior communicating artery aneurysm via pterional approach.Methods Clinical data of 82 cases undergoing microsurgical clipping for anterior communicating artery aneurysm via pterional approach in the first affiliated hospital of Kunming Medical University from October 2008 to December 2014 were collected and retrospectively analyzed.The patients were divided into different groups by Hunt-Hess illness grading scale,with 11 cases for level 0,7 cases for level Ⅰ,30 cases for level Ⅱ,25 cases for level Ⅲ,8 cases for level Ⅳ,and 1 cases for level Ⅴ.Twenty-one patients underwent operation at early stage of SAH (＜3d),15 at late stage of SAH (4d～2W),and 35 at prolonged stage of SAH (＞2W).The prognosis of patients was evaluated according to GOS classification criteria at discharge.Results A total of 85 ACoAA were found in 82 patients and all of them were clipped and,at the same time,3 aneurysms were resected and 11 thrombuses were punctured,cut and removed.In the operation,15 (17.6％) aneurysms ruptured again and temporary blocking happened for 73 times,with the shortest blocking time of 2 rmin,the longest of 40 rmin,and the average of 9.26min.According to GOS score,good recovery rate was 79.3％ (65/82),moderate disability rate was 12.2％ (10/82),severe disability rate was 3.7％ (3/82),vegetative state rate was 0％,and death rate was 4.9％ (4/82).Good recovery rates for the operations at early,late and prolonged stage of SAH were 85.7％,73.3％ and 82.3％ respectively and for level 0 to level Ⅴ were 90.9％,85.6％,86.7％ and 84.0％,25.0％ and 0.0％ respectively.Results of DSA or CTA re-examination upon 55 patients followed-up at discharge or three months after discharge showed that tumor pedicle were clipped and aneurysm disappeared.Fifty cases were followed up from four months to seven years after the operation,with one case of aneurysm recurrence.Another thirty-two cases were lost to follow-up.ConclusiornS Microsurgical techniques and microdissection are keys to successful operation.Pterional approach can guarantee successful clipping of aneurysms with different directions,locations and sizes.It is also an easy,effective and reliable approach with less postoperative complications.Operation for anterior communicating artery aneurysm should be performed as early as possible.

Objective To explore the effects of hypoxia on expression of signal transduction and activators of transcription (STAT3) gene and proliferation of rat pulmonary arterial smooth muscle cells (PASMCs). Methods RT PCR and western blot were used to assess the levels of STAT3 mRNA and tyrosine phosphorylated STAT3 protein after primarily cultured rat PASMCs were exposed to hypoxia for 2h, 6h, 12h, 24h respectively. 3 H TdR incorporation was used to observe the cell proliferation. Results The expression of STAT3 mRNA was increased after exposure of PASMCs to hypoxia for 2h, and peaked when exposed for 6h, then declined when exposed for 12h, but still higher than that in PASMCs when exposed to normal oxygentension. The level of tyrosine phosphorylated STAT3 was increased when exposed for 6h,peaked after 12h and delined after 24h in PASMCs exposed to hypoxia. With prolongation of time of hypoxia, 3 H TdR incorporation in PASMCs was significantly higher, and reached a maximum after 24h. Conclusion The results suggested that hypoxia could induce the expression of STAT3 mRNA and activation of STAT3 protein in PASMCs, implying that STAT3 gene might play an important role in the early stage of hypoxia induced PASMCs proliferation

We have trcated 40 cases of active peptic ulcer with Omeprazolc from Jun. 1990 to Mar. 1991. Compared with it, We have treated 40 cases of active peptic ulcer with Ranitidine during the same time. 80 patients with active peptic ulcer were divided into two groups. The age, scx and size of ulcer between the two groups have been compared. The ulcer diameter was from 3 to 20mm. The number of the ulcer was from 1 to 5.40 patients were treated with Omeprazole 20～40mg p. o. everyday. After a course of two weeks trcatment, the healing rate was 95%; 40 patients were treated with Ranitidine 300mg p. o. everday. After a course of six weeks the healing rate was 63%, The difference of the two groups was marked (P

Objective To investigate the effects of obesity on functional residual capacity ( FRC ) , ventilatory function and gas exchange during and after cholecystectomy. Methods Twenty ASA Ⅰ or Ⅱ patients of both sex aged 26-58yr undergoing elective cholecystectomy were divided into 2 groups according to the body mass index (BMI): control group BMI 30 (n = 10) . The patients were premedicated with intramuscular luminal 1.0 g and atropine 0.5 mg. Anesthesia was induced with midazolam 2-3 mg, fentanyl 5?g?*kg-1, propofol 1.5-2.0 mg?kg and vecuronium 0.1 mg?kg-1 and maintained with infusion of propofol (at 8-10 mg?kg-1?h-1) and fentanyl (at 1-2 ?g?kg-1?h-1) and intermittent i.v. boluses of vecuronium after tracheal intubation. The patients were mechanically ventilated (VT 10ml?kg-1,I:E=1:2, FiO2 100%) and PETCO2 was maintained at 35-40 mm Hg by adjusting the respiratory rate. Pethidine 1 mg?kg-1 was given i.m. every 8 h after operation for analgesia. BP, HR, ECG, SpO2, PET CO2 , FiO2, VT , RR were monitored during anesthesia. Arterial blood samples were taken before anesthesia (T0, baseline), 15 min after induction of anesthesia (T1), 30 min after skin incision (T2) and 6, 24 h after operation (T3,4) for blood gas analysis. FRC (closed-circuit helium dilution method), forced vital capacity (FVC), forced expiratory volume at 1 second (FEV10) and maximal mid-expiratory flow volume (MMF) were measured before and 6 h and 24 h after operation.Results FRC was significantly decreased after induction of anesthesia, during and after operation compared with the baseline value (T0) in both groups and the decrease in FRC was significantly larger in obesity group than in control group (P

Objective To study the differentially expressed proteins and their biological behavior in colorectal carcinoma tissues and the normal colonic mucosa by proteomics and molecular biology techniques. Methods The technique of fluorescence two dimension differential gel electrophoresis (2-D DIGE) was used to analyze the expression of differential proteins in normal colorectal mucosa and primary cancer foci. Liquid chromatography with electrospray ionization tandem mass spectrometry (LC-ESI-MS/MS) was used to identify the differential proteins. Transfection experiment of colorectal cancer cells was performed with the differential protein cDNA, and the changes in cytobiological behavior were observed. Results Significant differences of protein expression levels were found by two-dimension electrophoresis. Eight differential protein spots were analyzed and identified. Human carbonic anhydrase Ⅱ and protein disulfide isomerase were detected in normal colorectal mucosa, but not in primary cancer foci. Phosphoglycerate kinase 1, fumarate hydratase and aldolase A were expressed in primary cancer. After transfection with human carbonic anhydrase Ⅱ cDNA, the abilities of Lovo cells were obviously reduced in invasiveness, chemotaxy motor and drug resistance. Conclusions Differences on protein expression levels are found between normal colorectal mucosa and primary cancer foci by 2-DE DIGE. The pathogenesis of colorectal carcinoma is related to the reduced expressions of carbonic anhydrase II and protein disulfide isomerase and enhanced expression of aldolase A. The technique of differential proteomics is useful in reaching a indepth understanding of the pathogenesis mechanisms of human colorectal cancer.

Age-related macular degeneration (AMD) has become a leading cause of irreversible visual loss in senior population and a serious issue of public health as the aging of society worldwide,especially wet AMD.Wet AMD is characterized by choroidal neovascularization(CNV)with a rapidly developing process andsevere impairment of visual acuity.The effective therapy that can destroy choroidal neovascularization and improve visual acuity for very long time is lack.In the recent 20 years,more attentions focuse on the treatment of choroidal neovascularization.From bench to bedside,the research on targeted treatment of angiogenesis brings the bloom of wet AMD medical therapy.This paper will summarize the update information of wet AMD.

To observe the changes of interferon-γ (IFN-γ) and interleukin-4 (IL-4), factors related to T helper 1/T helper 2 (Th1/Th2), in airway inflammation in an asthmatic model of mice and the effects of Pingchuan Formula (PCF), a compound traditional Chinese herbal medicine.

Humans ; Medicine, Chinese Traditional ; methods ; Tongue ; metabolism ; pathology