This paper develops an application and appraisal system for new technologies and projects based on No.1 Military Medical Project. With this system, all application and appraisal work can be performed through network so that the appraisal efficiency is raised and the traditional management of scientific research is infused new energy.

Objective To explore the therapeutic effect of combined endoscopic embelization and variceal ligation (EVL) for management in cirrhotic patients with gastroesophageal variceal bleeding. Meth-otis One hundred and fifty-six cases of active gastric fundal variceal bleeding combined with esophageal var-ices of over degree Ⅱ, and with other causes leading to upper digestive tract bleeding excluded, were ran-domized into therapeutic group (n = 80) and control group (n = 76). For the therapeutic group, endoscopic cyanoacrylate injection for embelization of gastric fundal varices and EVL for esophageal varices were per-formed simultaneously. For the control group, EVL was performed 2 months after embolization. Results There was no complication in beth groups. The rate of hemostasis in therapy group was 96. 3% (77/80), and that in control group was 97. 4% (74/76, P >0.05). There was significant difference between two groups, regarding the rates of early re-bleeding [6. 4% (5/78) vs 21.3% (16/75), P < 0. 05] and re-bleeding at 6 months [13.0% (9/69) vs 25. 4% (17/67), P < 0. 05]. There was no significant difference between two groups, regarding the effective rate in disappearance of gastric fundus varices (61.6% vs 59. 1%), and in that of esophageal varices (74. 0% vs 67.9%). Conclusion Endescopic embelisation of gastric fundus vaxices, combined with EVL for esophageal varices, is a safe and effective procedure for the treatment of gastroesophageal variceal bleeding, and it can reduce the rate of re- bleeding.

Objective To develop a portable endoscopic thermal device which possesses the merits of compact structure,convenient operation,security and good compatibility.Methods Rapid heating elements and several materials are used,which are excellent insulation,heat conduction and can withstand high temperatures.The production process of miniaturization,anti-conglutination and constant temperatureare adopted.Results: The size of Heat probe is about 2.4mm in outer diameter and 8 mm in length.The maximum temperature will reach 250℃,heating time within 10s,output 4.5～6.5W.Conclusion Heat Probe can be compatible with various types gastrointestinal endoscopic channel.Besides hemostasis of upper gastrointestinal,it can also be applied to small polyps,erosive gastritis,etc.

Objective To determine the value of ERCP and EST after Billroth gastroenterostomy. Methods ERCP was used in 31 patients after Billroth- Ⅰ gastroenterostomy, 12 of whom received EST. It was in 137 patients after Billroth-Ⅱ gastroenterostomy, of the 34 received EST and 4 EPBD.Results Billroth- Ⅰ gastroenterostomy ERCP was successfully performed in 28 out of the 31 patients and EST in 11 out of the 12 patients. Billroth- Ⅱ gastroenterostomy ERCP was successfully performed in 109 out of the 137 patients and EST in 31 out of the 38 patients. There were no serious complications in patients receiving endoscopic treatments. Concluasion The success rates of ERCP and EST are high in patients with bile duct lithiasis after Billroth-gastroenterostomy. Endoscopic treatment or cholangioduodenostomy has good therapeutic effects.

Objective To investigate the angiogenesis effects of Salvia miltiorrhiza in heterotopically grafted frozen-thawed mouse ovaries. Methods The ovaries thawed after cryopreservation were xenografted into the donated kidney capsules of 8- to 12-week adult male mice. The mice were divided into two groups, saline and Salvia miltiorrhiza groups, the mice either in the saline or in Salvia miltiorrhiza groups were administered I.p. Daily either saline(0.5ml) or Salvia miltiorrhiza(0.5g)respectively, from the day prior transplantation. The two groups were sacrificed 1 day,2 days and 7 days after transplantation respectively, the grafts from thawed,1 day,2 days,7 days were removed for follicle counting, immunohistochemical studying and detecting of the mRNA expression of vascular endothelial growth factor(VEGF). Results The number of follicles and survival rates in grafts after transplantation of Salvia miltiorrhiza group were more than that of saline group (P<0.05);the expression of VEGF increased after transplantation,peaked on day 7,there was no difference between the two groups (P>0.05);the apoptosis index of Salvia miltiorrhiza group was less than that of saline group (P<0.05), the mRNA expression of VEGF188 and VEGF164 of Salvia miltiorrhiza group was more than that of saline group on 48 hours after transplantation(P<0.05). Conclusion Salvia miltiorrhiza may provide benefits for folliculogensis and decreasing the apoptosis index of follicles. Nevertheless,a increase in the VEGF188 and VEGF164 isoform in the Salvia miltiorrhiza group may suggest the positive effect of exogenous Salvia miltiorrhiza therapy in the early stage of angiogenesis.

Objective To discuss the influence of microRNA(miR)-155/miR-21 on toll-like receptor 4 (TLR4) in children with sepsis.Methods Fifty children with sepsis who were hospita-lized in Pediatric Intensive Care Unit,Shenzhen Children's Hospital,were enrolled in the study,and 15 healthy children at the same age were selected as healthy control group.Expression levels of TLR4 protein and human leukocyte antigen(HLA)-DR in CD14 + monocytes (MC) were detected by using flow cytometry,and sepsis patients were divided into 2 groups according to whether they exceeded the value of HLA-DR by 30％ or not.Expression level of programmed cell death factor 4 (PDCDM) and inositol phosphatases 1 containing SH2 (SHIP1) were detected at the same time.MC were separated by CD14 + immune magnetic bead,and expression level of miR-155,miR-21 and tumor necrosis factor-α (TNF-α),interleukin-10 (IL-10) mRNA in CD14 + MC were detected by using real-time fluorescent quantitative PCR.Results Sepsis group consisted of 27 male and 23 female,and their ages were (2.34 ± 0.79) years old,among whom 9 patients died.There were 36 patients in the HLA-DR increase group and 14 patients in the HLA-DR decrease group.Expressions ofTLR4(2.33±0.90),miR-155[(7.19±3.75) ×10 3] and TNF-α[(21.98±14.15) ×10-2 pg/L] in CD14 + MC were higher in the HLA-DR increase group than those in the HLA-DR decrease group [1.24±0.60,(4.83 ±1.17) × 10-3,(14.18±5.45) ×10-2 μg/L] and healthy control group[1.57±0.55,(3.99 ± 1.29) × 10-3,(1.61 ± 0.84) × 10 2 pg/L],and the differences were statistically significant(F =11.943,7.583,18.538,all P ＜0.05),while the expressions of miR-21 (12.10 ±5.66),IL-10[(29.74 ± 12.55) × 10-4 μg/L] in CD14 + MC were lower in the HLA-DR increase group than those in the HLA-DR decrease group[4.68 ± 2.07,(12.50 ± 5.73) × 10-4 μg/L] and healthy control group [2.39 ± 0.86,(2.04 ± 0.92) × 10-4 μg/L],and the differences were statistically significant(F =41.673,54.991,all P ＜ 0.05).The levels of SH1P1 and PDCD4 decreased in sepsis compared with healthy control group[0.70 ±0.36)vs.(1.59 ±0.48);(1.55 ±0.56) vs.(3.01 ±0.70)],and the differences were statistically significant (t =7.682,8.339,all P ＜ 0.05),but SHIP1 decreased more significantly in the HLA-DR increase group than that in the HLA-DR decrease group [(0.60 ± 0.34) vs.(0.97 ± 0.26)],and the difference was statistically significant (F =39.214,P ＜ 0.05).PDCD4 decreased more significantly in the HLA-DR decrease group than that in the HLA-DR increase group (0.94 ±0.19 vs.1.79 ±0.47),the difference was statistically significant(F =65.367,P ＜ 0.05).Conclusions Regulation imbalance of miR-155/miR-21 may be one of the reasons for abnormal expression of TLR4 in children with sepsis,and it plays a role in enlarged or inhibited expression of TLR4 in the sepsis process which results in different immune status in sepsis patients.

Objective To evaluate gastric varices embolization by endoscopic ultrasonography (EUS). Methods One hundred and eighty-five hepatic cirrhosis patients complicated with gastric varices were divided into two groups, the EUS group, 109 patients and the control group, 76 patients. Ninty-nine patients with confirmed gastric varices by EUS in the EUS group were treated by Histoacryl. All of the patients were examined by EUS soon after the embolization and at three months later. While 76 cases confirmed by endoscopy in the control group were treated by Histoacryl who only examined by EUS three months later. Results The rate of hemostasic both were 100% and rebleeding never occurred within three weeks in EUS group while the rate of the early rebleeding in the control group was 11. 8% (9/76). There was significant difference between the two groups (P

Objective To evaluate the diagnostic efficiency of double-balloon enteroscopy in small bowel Crohn’s disease. Methods In sixty five patients with suspected small bowel Crohn's disease double-balloon enteroscopy were performed, and some of them received enteroscopy and enteroclysis, capsule endoscopy as well.Results The first enteroscopy was performed via mouth in 20 of 65 cases, and the lesions were detected in 11 cases (55%), 5 of 9 cases(55.6%) had lesions detected in enteroscopy via anus while nothing was found in mouth route. Among 45 cases examed by enteroscopy firstly via anus, 34 cases had lesions detected (75.6%), 8 of 11 cases(72.7%) had lesions found in following exam via mouth. Totally 58of 65 had lesions detected through enterosocpy examination, the overall diagnostic yield was 89.2%. Twenty four of 46 cases had positive findings with enteroclysis. The diagnosis of Crohn's disease was comfirmed in 14 of 22 patients(63.6%) underwent capsule endoscoy. The diagnosis was finally confirmed by enteroscopy only in 11 patients(78.6%).Conclusion The entire small intestine could be examined by enteroscopy with combination of mouth and anus route. Double-balloon enteroscopy was an ideal diagnostic modality for small bowel Crohn's diseases, which was also valuable in assessment on extent and severity of the disease. Small bowel enteroclysis was a useful screening alternative for selecting procedure route in DBE.

Objective To investigate the effects of miR-155/miR-21 on the expression of TLR4 in patients with Kawasaki disease (KD).Methods Forty-five children with acute KD were enrolled into the study.Children were divided into the group with coronary artery lesions (KD-CAL+) and the group without coronary artery lesions (KD-CAL-).The age-matched twenty healthy children were included as the control group.The levels of TLR4 expression were analyzed by flow cytometry.The CD14+ monocytes in the peripheral blood were separated by CD14+ immunomagnetic beads.Real-time polymerase chain reaction (PCR) were performed to evaluate the expression of miR-155,miR-21 and interleukin (IL)-10,tumor necrosis factor (TNF)-α,IL-6,IL-1β in CD14+ monocytes at mRNA level.The concentration of matixmetalloproteinase (MMP)-9,HSP60,high mobility group box-1 protein (HMGB1) were measured by enzyme-linked immunosorbentassay (ELISA).T test was used to compare the differences between groups and P＜0.05 was considered to be statistically significant.Results The levels of Toll-like receptor 4 (TLR4) expression in children with acute KD were significantly higher than those in the control group [(12.4±5.1)％ vs (4.6±1.6)％,t=5.55,P＜0.05],and the levels of TLR4 expression in the KD-CAL+ group were remarkably elevated compared with the KD-CAL+group [(17.1±4.6)％ vs (9.6±2.7)％,t=5.89,P＜0.05].The plasma concentrations of HMGB11 [(10.2±7.6 vs 3.2±1.0) ng/ml,t=3.55,P＜0.05] and HSP60 [(56±23 vs 18±7) ng/ml,t=4.90,P＜0.05] in the KD group were increased(P＜0.05),but significantly decreased aftcr treatment with IVIG (P＜0.05).The levels of miR-155 [(21.0±27.0)×10 vs (4.6±3.1)×10-3,t=2.57,P＜0.05] and miR-21 (11.6±4.0 vs 8.7±2.2,t=2.78,P＜0.05)expression in the KD group were significantly higher than those in the controls (P＜0.05).The level of miR-155 expression in the KD-CAL+ group was apparently higher than that in the KD-CAL-group [(4.2±3.0)×10 vs (11.0±1.5)×104,t=4.07,P＜0.05] and the expression of miR-21 was lower than that in the KD-CAL-group (8.8±2.5 vs 12.8±4.0,t=3.46,P＜0.05).Compared with the controls,the levels of IL-10 mRNA expression in the KD group were significantly increased [(34.9 ±17.5)×10 vs (1.0±9.4)×10 4,t =5.62,P＜0.05),and IL-10 expression in the KD-CAL-group was higher than that in the KD-CAL+ group [(26.6±13.4)×104 vs (39.5±1.8)×10,t=2.36,P＜0.05].The plasma concentrations of MMP-9 in the KD group were remarkably higher than those in the controls [(1 141±541) pg/ml vs (304±94) pg/ml,t=4.83,P＜0.05],the concentration of MMP-9 in the KD-CAL+ group was higher than that in the KD-CAL-group [(1 350±625) pg/ml vs (945±370) pg/ml,t=2.21,P＜0.05].Conclusion The dysregulation of miR-155 and miR-21 may be one of the reasons that result in over-expression of TLR4 in patients with acute KD,and the persistently increased HSP60 and HMGB1 may trigger or amplify TLR4 expression.

OBJECTIVETo clone and study the polymorphism within interleukin-4 (IL-4) proximal promoter of asthmatic children.

METHODSThe IL-4 proximal promoter segments were amplified and selected by polymerase chain reaction (PCR) and single strand conformation polymorphism (SSCP) with genomic DNA from ten healthy children and forty patients with dominantly allergic familial histories as templates. The selected PCR segments were cloned into recombinant plasmids pIL-4-Jx2. The PCR inserts were sequenced by dideoxy chain termination method.

RESULTSSeven aberrant bands were found in SSCP analysis from forty asthmatic patients. The sequencing results showed that four variant sites were found within or adjacent to the known IL-4 regulatory element. A C to A transversion located at -229 position was just within the positive regulatory element-I (PRE-I) in one patient. A C to T transition adjacent to the negative regulatory element-II (NRE-II) and an extra G adjacent to TATA box were found in two patients. A five base nucleotide deletion was found near signal transducers and activators of transcription-6 responsive element (STAT-6 RE) in one patient.

CONCLUSIONThere were polymorphisms within the IL-4 proximal promoter of allergic asthmatic patients and these polymorphisms might result in aberrant expression of IL-4 gene and asthma.

Asthma ; genetics ; Base Sequence ; Child ; Child, Preschool ; Cloning, Molecular ; Humans ; Interleukin-4 ; genetics ; Molecular Sequence Data ; Plasmids ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Single-Stranded Conformational ; Promoter Regions, Genetic ; STAT6 Transcription Factor ; Trans-Activators ; metabolism