Objective To discuss the clinical effects of anal cushion suspensory and external hemorrhoid airfoil-shaped suture in treatment of ring-ship mixed hemorrhoid,improve the level of the surgical treatment of ring-ship mixed hemorrhoid.Methods One hundred and twenty patients with ring-ship mixed hemorrhoid were divided into treatment group (60 cases treated by anal cushion suspensory and external hemorrhoid airfoil-shaped suture) and control group (60 cases treated by Milligan-Morgan operation) according to the operation method.The postoperative pain,hospitalization time,wound healing time,postoperative complications,etc were observed and compared.Results The cure rate was 100.0％ (60/60) in treatment group and 70.0％ (42/60) in control group,and there was significant difference between two groups (P ＜ 0.05).The hospitalization time,wound healing time was (8.58 ± 0.89),(14.00 ± 0.72) d in treatment group,(10.20 ± 0.30),(19.00 ± 0.21) d in control group,and there was significant difference between two groups (P ＜ 0.05).The incidence of postoperative complications and the degree of postoperative pain in treatment group was lower than that in control group,and there was significant difference between two groups (P ＜ 0.05).Conclusion Anal cushion suspensory and external hemorrhoid airfoil-shaped suture in treatment of ring-ship mixed hemorrhoid has advantage of shorter wound healing time,less postoperative pain,less postoperative complications.

Objective To analyze the characteristics of cardiovascular two-dimensional (2-D) and Color Doppler echocardiography for patients with Marfan's syndrome. Method 23 cases of Marfan's syndrome were examined by transthoracic 2-D and Color Doppler echocardiography.Results Aneurysms of the ascending aorta and aortic sinusal were found in all of these cases. Aortic regurgitation and left ventricular enlargement coexisted with all of these cases. Fourteen cases complicated with type A and three with type B aortic dissection. Conclusions 2-D and Color Doppler echocardiography is a rapid non-invasive,reproducible, comprehensive medical imaging technique and can be regarded as an initial imaging model to screen and diagnosis of Marfan's syndrome.

This study aimed to construct full-length cDNA clones of the Japanese encephalitis virus (JEV). SA14-14-2 strain and discuss the feasibility of constructing chimeric viruses for exogenous gene expression based on the JEV genetic skeleton. Long-fragment RT-PCR techniques were applied to amplify JEV cD-NAs, and two amplified fragments with corresponding restriction endonuclease sites at both ends were cloned into the pACYC184 vector sequentially. Using standard molecular techniques, the enhanced green fluorescent protein (EGFP) gene was inserted into the 3' non-coding region of JEV as a reporter gene. After in vitro transcription and transfection procedures, wild-type JEV and chimeric JEV that expressed the EGFP as the reporter gene were successfully rescued. The recovered viruses were characterized by RT-PCR, plaque assays, and direct fluorescence microscopy. After six serial passage generations, the stability of the recovered viruses were studied in terms of virus growth characteristics and structural gene expression. The results showed that cDNA clones of rJEV and rJEV-EGFP were successfully constructed and rescued in BHK-21 cells after in vitro transcription and transfection. Each generation of the recovered viruses was stable and the chimeric virus rJEV-EGFP could stably express EGFP. The findings of this study indicate that both rJEV and rJEV-EGFP could be constructed and rescued in BHK-21 cells, and the JEV SA14-14-2 strain could be obtained as a viral vector to express foreign genes.
Cloning, Molecular ; DNA, Complementary ; genetics ; metabolism ; Encephalitis Virus, Japanese ; genetics ; metabolism ; Encephalitis, Japanese ; virology ; Gene Expression ; Genetic Vectors ; genetics ; metabolism ; Green Fluorescent Proteins ; genetics ; metabolism ; Humans ; Vaccines, Attenuated ; genetics ; metabolism ; Viral Vaccines ; genetics ; metabolism

Objective To describe the characteristic endoscopic ultrasonography (EUS) features of gastric ectopic pancreas.Methods Totally 23 patients were diagnosed pathologically as having gastric ectopic pancreas.The EUS images of the lesions were retrospectively reviewed regarding layer of origin,size,growth pattern,margin,and internal echo pattern.Results The coincidence of EUS and pathologic diagnosis was 91%(21/23).EUS revealed that the lesions originated from the second,third,and/or fourth layers of the gastric wall.Most lesions were heterogenous,mainly isoechoic.The borders of the lesions were indistinct in 70%(16/23) patients. Anechoic cystic or tubular structures within the lesions appeared in 10 of the 23 lesions(43%).The mean longest/shortest diameter ratio of ectopic pancreas was 1.7.Conclusions Characteristic EUS features of gastric ectopic pancreases include:mural lateral growth pattern,third layer (submucosa) origin,indistinct margin,intermediate echogenecity,anechoic areas,and fourth-layer thickening.Careful assessment of the EUS findings may be a useful aid in the diagnosis of gastric ectopic pancreas.

Objective To evaluate the efficacy of narrow-band imaging (NBI) in diagnosis of color-ectal neoplasm. Methods A total of 96 colorectal neoplasm from 78 patients were observed under NBI, and the findings were compared with those from magnifying chromo-endoscopy and pathologic examinations. Re-suits The sensitivity of conventional colonoscopy in diagnosis of polyps was 78. 7%, which was increased to 99% (P < 0. 05) under NBI, with the clear identification of the shape and boundary of the lesions. Magnif-ying NBI colonoscopy provided images of pit patterns similar to those from chromo-endoscopy in diagnosis of type Ⅱ , ⅢL, Ⅳ and ⅤN, which showed better recognition than conventional colonoscopy, but less sensitiv-ity than chromo-endoscopy. Superficial vascular morphologic features could be better classified with NBI, with sensitivity of 100% and specificity at 87. 8%, which was superior to conventional colonoscopy but infe-rior to chromo-endoscopy. Conclusion Both chromo-endoscopy and NBI colonoscopy have better sensitivity and specificity in detection of colon polyps, while chromo-endoscopy reveals clear superficial structure of le-sion and pit pattern, and NBI demenstrates capillary morphology, which can distinguish neoplasm from non-neoplasm colorectal lesions. NBI, easy and convenient to switch, is an effective technique to make early di-agnosis of colorectal neoplasm.

Objective To investigate protective activity against Aβ25-35-induced cytotoxicity in PC12 cells of different extracts and ursolic acid, which were isolated from pyrola decorata. Methods Aβ25-35-induced cytotoxicity in PC12 cells was established as the model in vitro. The cultured PC12 cells were divided into blank control group, DMSO control group, model control group, different extract groups of pyrola decorate and ursolic acid(UA) group. The different extract groups included ether extract (PE), acetidin extract (AE), n-butanol extract (BE), the water extract (WE), 50% ethanol extract (HEE). MTT assay was used to test the optimum concentration, and the number of viable cells in culture medium was measured by ELISA at 490 nm wavelength. Results The cell viabilities in different extracts groups(PE, AE, BE, WE, HEE) were respectively 89.3%, 77.2%, 79. 2%, 75. 1% ,74. 0% at the concentration of 5. 0 mg ? mL-1 . Moreover, ursolic acid showed the best neuroprotective activity (88.9%) at the concentration of 500 μg?L-1 . Compared with model control group, the survival rate of each group was remarkably increased, and the protective activities of PE and UA were more significant among them. Conclusion Different polar extracts of pyrola decorata and isolated ursolic acid have neuroprotective effects on Aβ25-35-induced cytotoxicity in PC12 cells in certain degrees.

Chronic viral hepatitis B (CHB) is a major infectious disease greatly harmful to the health of Chinese people. Chinese medicine has its speciality and advantages in treating it depending syndrome-differentiation. The objectified researches regarding Chinese medical syndromes in CHB heretofore were reviewed in this article. Moreover, aiming at existing problems and taking the angle of "disease-syndrome combining" study, authors put forward research approach, and approaches for studying systemic biology based biological basis of Chinese medical syndrome in hepatitis B with reductionism and holism, cybernetics and system theories in combination.
Hepatitis B, Chronic ; diagnosis ; Humans ; Medicine, Chinese Traditional ; methods

OBJECTIVETo explore the effects of Wenyang Huazhuo Tongluo Recipe (WYHZTLR) containing serum on transforming growth factor β1 (TGF-β1)/Smad signaling pathway of skin fibroblasts in systemic sclerosis (SSc).

METHODSTotally 36 SSc patients were randomly assigned to Chinese medicine (CM) group, Western medicine (WM) group, and integrative medicine (IM) group according to random digit table, 12 in each group. Patients in the CM group took WYHZTLR decoction (one dose per day). Patients in the WM group took penicillamine tablet (0. 125 g each time, bid) and Prednisone Acetate Tablet (PAT 20 mg, qd). Patients in the IM group took penicillamine, PAT, and WYHZTLR decoction (in the same dosage of corresponding drugs as aforesaid). All patients were treated for one month to get drug containing serum. Besides, 10 untreated SSc patients' serum was taken as the control group. Healthy subjects' skin fibroblasts were originated from healthy skin tissue of the upper arms of 2 female patients undergoing plastic surgery. Corresponding serum of each group was added in the culture system of SSc patients' and healthy subjects' dermal fibroblasts respectively. Expression levels of TGF-β1 receptor type I (TGF-β1 RI), TGF-β1 receptor II (TGF-β1 RII), p-Smad2/3 and Smad7 protein were examined by Western blot. Expression levels of collagen type I and collagen type III (Col-I, Col-III) mRNA were examined by reverse transcription PCR. Contents of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinases-1 (TIMP-1) in the supernatant of SSc, skin fibroblasts were examined by ELISA.

RESULTSCompared with the control group, expression levels of TGF-β1 R I and p-Smad2/3 protein significantly decreased, but expression levels of Smad7 protein significantly increased in skin fibroblasts of SSc patients and healthy subjects of WM, CM, and IM groups (P <0.05, P <0. 01). Meanwhile, the expression level of TGF-β1 RII decreased in the IM group (P <0. 05, P <0. 01). Compared with the WM group, expression levels of TGF-β1 RI and p-Smad2/ 3 protein significantly decreased, but that of Srnad7 protein significantly increased in IM groups (P <0. 01). mRNA expression levels of Col-I and Col-II in SSc skin fibroblasts significantly decreased more in WM, CM, and IM groups than in the control group (P <0. 05, P <0. 01). Besides, the expression level of Col-III mRNA was significantly lower in the IM group than in the WM group (P <0.01). Compared with the control group, serum levels of MMP-9 and MMP-9/TIMP-1 ratios increased more obviously in WM, CM, and IM groups (P <0.05, P <0.01). But expression levels of TIMP-1 decreased significantly in CM and IM groups (P <0.01). Expression levels of MMP-9 and MMP-9/TIMP-1 ratios increased more in the IM group than in the WM group (P <0. 01). Expression levels of TIMP-1 decreased more in CM and IM groups than in the WM group (P <0.01).

CONCLUSIONWYHZTLR containing serum could reduce expression levels of Col-I and Col-III possibly through regulating key signal molecules, such as TGF-β1 RI, p-Smad2/3, and Smad7 in TGF-β1/Smad signaling pathway of SSc skin fibroblasts, and inhibiting transduction of TGF-β1/Smad signaling pathway.

Collagen Type I ; Collagen Type III ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Fibroblasts ; Humans ; Matrix Metalloproteinase 9 ; Scleroderma, Systemic ; drug therapy ; metabolism ; Signal Transduction ; drug effects ; Smad2 Protein ; Smad7 Protein ; Transforming Growth Factor beta1 ; metabolism

Objective To investigate the efficacy of pancreatic duct guidewire pre-occupying in ERCP with difficult biliary cannulation.Methods During a four-year study period from June 2008 to June 2012,a total of 3505 patients were included in this retrospective analysis.Initial biliary cannulation method consisted of single-guidewire technique for up to 5 attempts,followed by double-guidewire technique when repeated unintentional pancreatic duct cannulation had taken place.Pre-cut papillotomy technique was reserved for when double-guidewire technique had failed or no pancreatic duct cannulation had been previously achieved.Biliary cannulation success and post-ERCP complication rate were compared.Results Single-guidewire technique was characterized by statistically significant higher success rate (93.4％),compared with the double-guidewire technique (54.8％,P ＜0.001),pre-cut failed double-guidewire technique (81.3％,P ＜0.001) or precut as first step method (84.6％,P =0.011).Pre-cut failed double-guidewire technique and pre-cut as first step method offered a statistically significantly more favorable outcome compared with the double-guidewire technique (both P ＜ 0.001).The incidence of post-ERCP pancreatitis did not differ in a statistically significant manner among the four methods.Numbers of patients who got bleeding in pre-cut papillotomy technique and sphincterotomy after successful single-guidewire technique were 5 and 2 respectively.One case of perforation was recorded using pre-cut papillotomy technique.There was no procedure-related mortality within 30 days.Conclusion Although double-guidewire technique success rate proved not to be superior to singleguidewire technique or pre-cut papillotomy,it is considered highly satisfactory in terms of safety in order to avoid the risk of a pre-cut when biliary therapy is necessary in difficult-to-cannulate cases.

Objective To explore the duration of blood blocking effect and recovery process induced by low-frequency ultrasound combining microbubbles (USMB) on prostate cancer xenografts.Methods A total of 88 nude mice undergoing USMB was studied.Contrast enhanced ultrasound,Hemotoxylin and eosin staining,and modified Martius-Sarlet-Blue staining were used to compared the average peak intensity(API),time to peak intensity(TP) and histological alteration before and after treatment.Results Immediately after the treatment,the tumor contrast perfusion completely disappeared,API dropped from 68.63±5.25 to 18.01±2.73 (P<0.001,vs pre-treatment) and TP increased from (32.28±6.18)s to (72.63±7.47)s (P<0.001,vs pre-treatment).At 30 minutes and 1 hour after treatment,the tumor perfusion remained defect.At 2 hours after treatment,rarely dotted enhancement was showed.The differences among the three groups in API and TP at 30 minutes,1 hour and 2 hours after treatment were not significant (all P>0.05).From post-3 hours after treatment ,the tumor perfusion began a process of perfusion recovery,and showed nodular or large patch of heterogeneous enhancement.API at 3 hours after treatment was 51.99±6.20 (P<0.001,vs post treatment immediately),and TP decreased to (50.41±6.51)s (P<0.001,vs post treatment immediately).At 4 hours,5 hours,6 hours,12 hours and 24 hours after treatment ,CEUS showed homogeneous and rich enhancement,and there was no significant difference in both API and TP,compared with those pre-treatment (all P>0.05,vs pre-treatment).Histological examinations showed that,immediately after treatment,microvessels severely dilated,ruptured and intravascular and extravascular thrombi formed.At 30 minutes,1-hour and 2-hour after treatment,extravascular thrombi and hematomas gradually disappeared.From 3-hour after treatment,vessel dilation was lessened,and intravascular thrombi gradually shrank.At 12-hour after treatment,microvessels had almost fully recovered as pre-treatment.Conclusions USMB could block blood perfusion of prostate cancer xenografts in nude mice for 2 hours.The blood reperfusion is probably mainly caused by thrombolysis in microvessels.