The symptoms of gastroesophageal reflux may be induced by acid reflux, nonacidic or weakly acidic reflux, and also can occur with hypersensitive esophagus, esophageal motility disorders, or other organic/anatomical abnormalities of esophagus.Refractory gastroesophageal reflux disease (GERD) denotes the symptoms of GERD could not be remitted with the standard dosage proton pump inhibitor (PPI) therapy.In most patients with refractory symptoms the etiology is of non-reflux-related causes, such as eosinophilic esophagitis, esophageal motility disorders, gastroparesis, or concomitant functional gastrointestinal disorders.A careful and detailed understanding of patient's medical history, examination with endoscopy and biopsy pathology, and esophageal pH-impedance monitoring are very important for identifying the potential cause.

is of STC.Exogenous GDNF may improve the colon motor function by up-regulation of GDNF.

Objective To compare the effectiveness and safety of radiofrenquency ablation(RFA) with other therapeutic methods for patients with early hepatocelluar carcinoma(HCC). Methods Randomized clinical trials(RCTs)which compared the efficacy or safety of RFA with other therapeutic methods for primary hepatocellular carcinoma in Cochrane library,EMBASE,PubMed,OVID and CBM were searched.Trials were considered of high quality if methodological quality score was 3 or more according to Jadad standard.Statistical heterogeneity between trials was evaluated bv STATA 9.0 and considered to exist when P＜0.1.Heterogeneity of the included articles was tested and used to select proper effective model for calculation.Sensitivity analysis was performed and publication bias was investigated through visual inspection of funnel plots and Egger regression model.Results Six RCTs including 862 cases were analyzed.As compared with other therapeutic approaches,RFA significandy increased 3-year overall survival rate and reduced local recurrence rate of early hepatocelluar carcinoma:the total OR were 2.06(95%CI being 1.54-2.77,P=0.000)and 0.40(95%CI being 0.28-0.57,P=0.000)respectively.As compared with other therapeutic approaches,the total OR of new HCC recurrence rates,extrahepatic metastasis rate and major complications in patients with HCC treated with RFA were 0.92 (95%CI being 0.68-1.24),0.98(95%CI being 0.30-3.22),1.35(95%CI being 0.49-3.77)respectively,showing no significant differences(P＞0.05).Inspection of the funnel plots for all outcome measures did not reveal evidence of publication bias(P=0.670,0.160,0.884,0.087,0.317,respectively,by Egger regression model).Conclusions RFA is superior to other treatment methods with respect to local recurrence and 3 year overall survival in early HCC and is the preferred tberapeutic method for small HCC because it is minimally invasive,simple and convenient.

Objective To pool the data of studies and evaluate the efficacy and safety of TNFα blocking agents in the treatment of ulcerative colitis(UC).Methods The randomized clinical trials(RCT)that compared the efficacy or safety of TNFα in the treatment of UC were researched from Pubmed. OVID. EMBASE. Cochrane library, CNKI, Wanfang data and VIP Chinese Scientific and Technologic Periodical Database. Statistical heterogeneity between trials was evaluated by Revman 5.0 and was considered to exist when P＜0.1.Heterogeneity of the included articles was tested. which was used to select proper effect model to calculate. Publication bias was investigated through visual inspection of funnel plots. Results Nine RCT including 1226 cases were analyzed. Eight hundred and six cases had received TNFα treatment and 420cases had received placebo or glucocorticoid treatment. Compared with placebo or glucocorticoid groups, TNFα group achieved significantly higher rates of short-term clinical response, short-term clinical remission, long-term clinical response.10ng-term clinical remission and the total OR were 2.36(95%C,1.34-4.15),2.42(95%CI 1.22-4.81).3.22(95%CI2.28-4.55)and 2.82(95%CI1.91-4.16)respectively. TNFα group was less likely to undergo colectomy than placebo group and the total OR was 0.31(95%CI0.20-0.48).TNFα could not improve the mucosal healing and quality of lire. No significant difference was found in adverse effect between TNFα group and placebo or glueoeortieoid group(OR=1.07(95%CI0.55-2.09,P=0.84)).The rate of serious adverse effect in TNFα group was less than placebo or glueoeorticoid groups (OR=0.65,95%CI0.48-0.89,P=0.007).Inspection of the funnel plots for all dichotomous data measures had not revealed evidence of publication bias. Conclusions Patients with moderately to severely active UC treated with TNFαhave effective clinical response and clinical remission and are less likely to undergo colectomy than those receiving placebo or glucocorticoid. TNFα treatment is safe for UC but can not improve the mucosal healing and quality of life. Large-scale, high-quality RCTs ale needed to confirm or refuse the available evidence.

A growing body of evidence has indicated the important role of autophagy receptors in directing ubiquitinated or non-ubiquitinated cargos towards autophagy. Autophagy receptors bind to LC3 (microtubule-associated protein 1 light chain 3) on phagophore and autophagosome membranes, and recognize signals on cargoes in the delivery system of autophagy. However, the diverse domains in the receptor structures determine that their roles would never be limited to autophagy. Up to date, increasing numbers of the receptor proteins have been demonstrated to serve as a molecular link or switch participating in autophagic degradation, apoptosis or cell survival signals. Here, we highlight the non-autophagic roles of these receptor proteins to draw attention to this growing research topic.

A growing body of evidence has indicated the important role of autophagy receptors in directing ubiquitinated or non-ubiquitinated cargos towards autophagy. Autophagy receptors bind to LC3 (microtubule-associated protein 1 light chain 3) on phagophore and autophagosome membranes, and recognize signals on cargoes in the delivery system of autophagy. However, the diverse domains in the receptor structures determine that their roles would never be limited to autophagy. Up to date, increasing numbers of the receptor proteins have been demonstrated to serve as a molecular link or switch participating in autophagic degradation, apoptosis or cell survival signals. Here, we highlight the non-autophagic roles of these receptor proteins to draw attention to this growing research topic.
Apoptosis ; Autophagy ; Humans ; Microtubule-Associated Proteins ; physiology ; Signal Transduction ; Ubiquitination

Objective To evaluate the safety and efficacy of 125I radioactive seeds implantation combined with postoperative chemotherapy as a treatment option for thoracic advanced esophageal squamous cell carcinoma(ESCC). Methods A prospective cohort study was carried out between 2000and 2005. According to preoperative CT staging criteria,298 patients in phase Ⅱ-Ⅲ of ESCC, who had were admitted to Oncology Center Surgery of Nanjing First Hospital Affiliated to Nanjing Medical University and Thoracic Surgery of YanCheng Oncology Hospital, were randomly divided into three groups: intraoperative 125I seeds implantation combined with postoperative chemotherapy (group A, 98cases), postoperative chemoradiotherapy (group B, 100 cases) and surgery alone (group C, 100cases). All patients received radical resection of esophageal cancer. According to pTNM staging criteria after operation, 233 patients in phase Ⅱb-Ⅲ of ESCC were finally enrolled in the study (78 in group A, 75 in group B, and 80 in group C). With 0. 5 m Ci of single seed, total activity of 5-11 mCi and matched peripheral dose in 60-70 Gy, 10-22 125I seeds were implanted into the target of patients in group A under direct vision in accordance with treatment planning system. The validation and quality assessment of radioactive seeds were demonstrated according to CT scan or X-ray imaging. The postoperative complications were observed. The local recurrence of the cancer was demonstrated using CT scan. The survival rate of patients was followed up for 1-,3-,5- and 10 years. Results The satisfied quality assessment of 125I seeds was observed. There was no displacement or loss of seed. The local recurrence in group A, B and C was 11. 5%, 13. 3% and 38. 8%, respectively, with statistical significance (P ＜ 0. 05). There was no significant difference among three groups with respect to complications and 1-year survival (P＞0. 05). However, the overall survival rate 3-, 5- and 10-years was 64.8%,37. 7% and 25. 1% in group A respectively; 63.3%, 36.9% and 24.9% in group Brespectively; 43. 6i%, 25.0%, and 12.6% in group C, respectively (all P＜0. 05). The 3-,5- and 10-year progression free survival rates were 63.5 %, 37.4 % and 15.1% in group A respectively; 62.5 %,36.6% and 14. 4% in group B respectively; 42.5%, 25.6% and 6.2% in group C respectively (all P＜0. 05). Conclusions It is a safe, effective and simple method for intraoperative 125I seeds implantation combined with postoperative chemotherapy in treatment of advanced ESCC, which may reduce the local recurrence and improve survival rates in patients with ESCC.

OBJECTIVETo explore guiding role of three-column theory in manipulative reduction, small splint fixation and early rehabilitative exercises of Colles fracture.

METHODSFrom August 2011 to February 2012,47 patients with Colles fractures were treated by manipulative reduction small splinting fixation and early rehabilitative exercises under the guidance of three-column theory, including 21 males and 26 females aged from 40 to 76 years old with an average of (65.5 +/- 2.3). According to AO fracture classification, 27 patients were type A (including 18 cases with type A2 and 9 cases with type A3) and 20 patients were type C (including 10 cases with type C1, 6 cases with type C2 and 4 cases with type C3). Pain and recovery time of swelling, postoperative complications were observed and recorded, Gartland-Werley scoring system were applied for evaluate functional recovery and biomechanical analysis of wrist joint at 12 weeks after operation.

RESULTSAll patients were followed up for 3 to 9 months with average of 5 months. Pain relief time ranged from 5 to 15 d with average of (7.6 +/- 2.2) d,recovery time of swelling of opisthenar was for 6 to 13 d with an average of (8.9 +/- 1.9) d. Two patients occurred tension vesicle within 3 days after operation, but no other complications occurred. According to Gartland-Werley scoring system, 25 cases got excellent results, 18 cases good and 4 cases moderate at 12 weeks after operation.

CONCLUSIONUnder the guidance of three-column theory, treating Colles fracture by manipulative reduction, small splinting fixation and early rehabilitative exercises can reduce pain and swelling time, promote union of fracture, effectively rehabilitate wrist function, improve clinical efficacy, and fit for concept of biomechanics.

Adult ; Aged ; Colles' Fracture ; rehabilitation ; surgery ; therapy ; Exercise Therapy ; Female ; Fracture Fixation ; Humans ; Male ; Middle Aged ; Treatment Outcome

Objective To investigate the prevalence of low back pain among adults in Beijing.Methods The study design was a cross-sectional study,and the multi-stage sampling was used.A questionnaire survey was conducted in December 2010 to investigate prevalence of low back pain in adults who had lived in Beijing for over 6 months.Total prevalence and prevalence by region,gender and age were calculated.The chi-square test was used to compare results.Results A total of 3860 people were enrolled in this study.The one-year prevalence of low back pain was 26.09％ (1007/3860),and the point prevalence was 6.11％ (236/3860).The prevalence of different duration of low back pain (3 months,3-6 months,≥6 months) was 16.76％ (647/3860),4.12％ (159/3860) and 5.21％ (201/3860),respectively.The prevalence of females (28.83％) was higher than that of males (23.03％).The prevalence among different regions was significantly different.Prevalence in suburb and rural area (29.88％ and 27.54％,respectively) was higher than that in urban area (20.88％).No matter males or females,the prevalence in urban area was the lowest (17.48％ and 24.00％,respectively).With the increasing of age,the prevalence of low back pain became higher.In males,the prevalence of 55 to 59 years group was highest,while 60 to 64 years group was highest in females.In urban area and rural area,the prevalence of 60 to 64 years group was highest (34.43％ and 48.68％,respectively),while 55 to 59 years group was highest in suburb (47.26％).Conclusion The oneyear and point prevalence of low back pain among adults in Beijing are higher,with wide distribution.The chronic low back pain is more common.The prevalence of low back pain is higher in suburb and rural area.Females have a higher prevalence than males.Moreover,the prevalence of low back pain increases with age.

Objective: To investigate the efficacy and safety of oxycodone hydrochloride prolonged-release tablets and tramadol hydrochloride sustained-release tablets in the treatment of moderate cancer pain. Methods:Totally 290 cases of the patients with mod-erate pain were divided into the observation group with 148 cases and the control group with 142 cases. The observation group received oxycodone hydrochloride prolonged-release tablets, while the control group was given tramadol hydrochloride sustained-release tablets. The treatment course was 2 weeks, and the total efficiency and the incidence of adverse drug reactions( ADR) in the two groups were calculated and compared. Results:The total efficiency in the observation group and the control group was 92. 6% and 81. 7%, respec-tively, and the difference was statistically significant (P<0. 01). The incidence of ADR was 60. 1% and 57%, respectively with no significant difference (P>0.05). Conclusion: The effect of oxycodone hydrochloride prolonged-release tablets in the treatment of moderate cancer pain is better than that of tramadol hydrochloride sustained-release tablets.