Objective To study the clinical application of self-expanding nitinol stent in benign and malignant esophageal obstruction as well as in postoperative anastomotic stenosis and anastomotic leakage. Methods 22 cases of benign or malignant esophageal stenosis were treated by placing metallic stents inserted into the stenosis segment through per-oral intubation under the fluoroscopic guidance. Results The degreee of dysphagia was improved, Stooler′s staging of dysphagia was down from 3.1 preoperatively to 1.2 postoperatively. 2 cases of anastomotic leakage and 1 case of esophagorespiratory fistula were cured. All have been followed up for one to twelve months. 3 cases died with carcinoma cachexia and one succumbed to severe hemorrahage of digestive tract. The other 18 cases are still followed up. Conclusions Placement of esophageal expandable stent is one of the ideal methods to treat benign and malignant esophageal stenosis and anastomotic leakage. It can also play an important role in the improvement of the patients' life quality and prolongation of life.

Objective:To observe the clinical efficacy of acupuncture plus turtle-shell-partitioned moxibustion in treating diarrhea- predominant irritable bowel syndrome (IBS-D). Methods:Seventy-six patients were randomized into two groups: 39 cases in the observation group were intervened by acupuncture plus turtle-shell-partitioned moxibustion, while 37 cases in the control group by the same acupuncture treatment, once a day, 10 d as a treatment course, for 2 courses in total. The improvements of symptoms were observed at the end of the intervention in both groups. Results:The total effective rate was 89.7% in the observation group versus 67.6% in the control group, and the difference was statistically significant (P<0.05).Conclusion:Acupuncture plus turtle-shell-partitioned moxibustion can significantly improve the symptoms of IBS-D, and can produce a more significant efficacy than acupuncture alone.

OBJECTIVE: To explore the expression levels of three T-type calcium channel receptors (α1G; α1H; α1I) in the cochlea and spiral ganglion neurons of C57BL/6J mice with different ages. METHOD: Thirty cases of C57BL/6J mice were divided into three groups (6-8 W, 24-26 W, 42-44 W) according to the age. The expressions of three T-type calcium channel receptors were quantified by RT-PCR after hearing thresholds measured by ABR. RESULT: Three receptors were detected in the cochlea and spiral ganglion neurons of 6-8 W C57BL/6J mice. The quantitative results showed that the expression levels of α1H and α1I were highest among three receptors in spiral ganglion neurons and in the cochlea respectively. The expression levels of three receptors significantly decreased with age,especially at the age of 4244 W. CONCLUSION The expression of T-type calcium channel receptors reduced with age in the inner ear of C57BL/6J mice.
Animals ; Calcium Channels ; Calcium Channels, T-Type ; biosynthesis ; Cochlea ; metabolism ; Ear, Inner ; Mice ; Mice, Inbred C57BL ; Neurons ; Receptors, Calcium-Sensing ; Spiral Ganglion ; metabolism

Objective To evaluate the clinical effect of intervertional devascularization and surgical devascularization in treatment of patients with upper gastrointestinal hemorrhage .Methods Ninety-nine cases treated with intervertional devaacularization or surgical devascularization were retrospectively studied including 48 cases in intervertional group and 51 cases in surgical group.The postoperative resection, complications and rebleeding time were compared by X2 test and t test between two methods.Results The 12 months, 24 months and 36 months cumulative rebleeding rates after intervertional devascularization were 12.5% (6/47) ,24.5% (11/45), 27.9% (12/43) respectively.The rate after surgical devaacularization were 29.2% (14/48) ,44.7% (21/47), 48.9% (22/45) respectively.There were statistically significant differences between the intervertional and surgical groups (X2=3.843,4.150,4.083, P < 0.05).The complications of intervertional devascularization included fever 85.4% (41/48), bellyache 81.3% (39/48), portalvein thrombosis 4.2% (2/48), intraabdominal hemorrhage 2.1% (1/48), infection 2.1% (1/48) and death 2.1% (1/48).The complications of surgical devaacularization included fever 68.6% (35/51), bellyache 62.7% (32/51), generous hydroperitoneum 25.5% (13/51), portalvein thrombosis 37.3% (19/51), splenic vein thrombosis 11.8% (6/51), hepatic encephalopathy 3.9% (2/51), hepatorenal syndrome 2.0% (1/51), intraabdominal hemorrhage 2.0% (1/51), death 3.9% (2/51) and infection 15.7% (8/51).There were statistically significant differences of fever, bellyache, generous hydroperitoneum, portalvein thrombosis, splenic vein thrombosis between the intervertional and surgical groups(X2=4.174,3.098,16.199,6.011,5.536,14.085,P <0.05).Conclusions The intervertional devascularization procedure is simple, safe and effective method for treating upper gastrointestinal hemorrhage for portal hypertensive.The clinical effect is better than that of surgical devascularization.

BACKGROUND: Muscarine receptor plays a key role in adjusting contraction of detrusor muscle cell, and M3R, isoforms of its receptor, can mediate contraction of detrusor muscle cell directly. Ca2+ is the direct factor in stimulating contraction of detrusor muscle cell. Of several 10 kinds of Ca2+conjugable receptors protein, Ca2+ conjugated with different receptor proteins can adjust various reactions.OBJECTIVE: To investigate the effect of Ca2+-calmodulin (Ca2+-CaM) on contraction of M3R-mediated detrusor muscle cell.DESIGN: Compared observation .on the basis of detrusor muscle cell.SETTING: Ourological Center of Southwest Hospital of the Third Military Medical University of Chinese PLA.MATERIALS: The experiment was completed at Central Laboratory of Southwest Hospital of the Third Military Medical University of Chinese PLA. Healthy Wistar rats were selected in this study.METHODS: The primary cultured detrusor muscle cells were divided into experimental group and control group. Cells were inoculated in 6-well plate, and 10-4 mmol/L carbachol and M2R antagonist were added to cells of the experimental group during 70% confluence to block M3R and M2R respectively. Ca2+ concentration and CaM activity were detected by Ca2+ test kit and CaM test kit respectively.MAIN OUTCOME MEASURES: Changes of [Ca2+]I concentration and CaM activity of cells in both groups.RESULTS: The mean channel fluorescence values (log) of [Ca2+]I and CaM were higher in the experimental group than those in the control group(3.26±0.38, 2.06±0.12; 2.87±0.34, 2.14±0.24, P ＜ 0.05).CONCLUSION: Results in this study suggest that Ca2+-CaM participates in adjusting contraction of M3R-mediated detrusor muscle cells through signal transduction.

Objective To evaluate the value of interventional embolism therapy for metastatic carcinoma of adrenal gland.Methods Fifty four patients with metastatic carcinoma of adrenal gland were treated with interventional catheterization perfusion and embolism therapy.Results Except one case with failure of finding the feeding artery, totally 76 sessions of interventional therapy were performed on 53 patients. Technical successful rate was 98.1% with 100% of complete release of clinical sign in 14 patients. Good deposition of iodized oil in tumor area reached 75.4% in three months after the procedure. Severe complication rate ocurred in 1.88%. Conclusion Interventional therapy seemed to be safe and effective for patients with metastatic carcinoma of adrenal gland.

Objective To discuss the method, safety and clinical value of biliary stenting combined with 125I seed implantation intracavitary irradiation in treating malignant obstructive jaundice. Methods A total of 36 patients with malignant obstructive jaundice were enrolled in this study. PTCD was carried out in all patients, which was followed by biliary stenting combined with 125I seed implantation intracavitary irradiation treatment. The results were analyzed. Results During the interventional management, displacement of the stent and 125I seeds were observed in two cases, and the displaced stent and 125I seeds were replaced to the right position with the help of biliary biopsy forceps. The technical success rate was 100%, and the remission rate of the jaundice was 100%. All the patients were followed up for 1-23 months. No radioactive particles leaking or complications such as radiation enteritis occurred. No in-stent obstruction due to tumor recurrence was observed although slight dilatation of intrahepatic bile duct was detected in 25%of patients, which was resulted from intimal hyperplasia at the stent mesh and/or biliary stone formation. The median survival time was 10.9 months. Conclusion For the treatment of malignant obstructive jaundice, biliary stenting combined with 125I seed implantation intracavitary irradiation is safe, reliable and effective. This technique can prolong stent patency time as well as the patient’s survival time.

OBJECTIVETo observe the clinical efficacy differences between acupuncture combined with dynamic moxibustion and acupuncture alone for adult ankylosing spondylitis (AS) at early-to-mid stage based on medication.

METHODSFifty-five cases of adult AS were randomly divided into an acupuncture-moxibustion group (28 cases) and an acupuncture group (27 cases). The two groups were treated with oral administration of sulfasalazine tablets. In addition, the acupuncture-moxibustion group was treated with acupuncture at Jiaji (EX-B 2), Shenshu (BL 23), Dachangshu (BL 25), Weizhong (BL 40) as well as dynamic moxibustion at the first line of bladder meridian of foot-and governor vessel from Dazhui (GV 14) to Yaoshu (GV 2). The acupuncture group was treated with acupuncture, the acupoints and manipulation of which were identical to acupuncture-moxibustion group. The treatment was given once a day, five days per week; one session was consisted of one-month treatment, and totally three sessions were given. The bath ankylosing spondylitis functional index (BAFI) and bath ankylosing spondylitis disease activity index (BASDAI) were compared before and after treatment in the two groups; also the clinical effective rates were compared between the two groups.

RESULTSThe total effective rate was 96.4% (27/28) in the acupuncture-moxibustion group, which was superior to 88.9% (24/27) in the acupuncture group (<0.05). Compared before treatment, the BASFI and BASDAI were reduced after treatment in the two groups (all<0.05), which were more significant in the acupuncture-moxibustion group (both<0.05).

CONCLUSIONSBased on medication, acupuncture combined with dynamic moxibustion could improve the clinical symptoms of AS, which is superior to simple acupuncture.

Objective:To assess the value of spiral CT in diagnosis and treatment of chronic otitis media.Methods:The spiral CT findings of 74 cases including 93 ears proved by operation and pathology were studied.Results:The lesions such as the disruption of the ossicular chain showed in spiral CT or three-dimensional image were in accord with those seen in the operation,the accuracy was 95.7%,the disruption of the ossicular chain and bony erosion in the tympanic cavity and antrum were severe in the typeⅢ chronic otitis media.Conclusion:Spiral CT is helpful to diagnose and definite the chronic otitis media,three-dimensional image can provide valuable information for surgery.

Objective To investigate the therapeutic effect of post-traumatic complex posterior urethral stricture in the male patients.Methods Clinical data of 479 male patients with post-traumatic complex posterior urethral stricture were reviewed.One-stage resection of the stenosis and end-to-end anastomosis was performed in 422 patients and scrotal flap with blood pedicle posterior urethroplasty in 57.Results The mean operation time was 115 minutes(range,90-140 minutes).The mean blood loss was 225 ml(range,100-300 ml).No intraoperative blood transfusion was needed.The mean follow-up time was 15 months(range,12-24 months).Among the 422 patients performed end-to-end anastomosis,386 patients had good voiding and 36 had dysuria because of the formation of anastomotic stoma valve(21 patients)or stricture ring(15 patients).The problem was resolved by transurethral valve/stricture ring resection.Among 57 patients undergone posterior urethroplasty,45 patients had good voiding nine patients were found with anterior urethra-skin tube anastomotic stoma stricture,of which four patients were treated by urethral dilatation and five by endourethrotomy; three patients were found with posterior urethra-skin tube anastomotic stoma stricture,of which one patient was treated by urethral dilation and two by endourethrotomy.Conclusions One-stage resection of the stenosis and end-to-end anastomosis is the main treatment for post-traumatic complex posterior urethral stricture.If the condition of the patients does not allow the end-to-end anastomosis,posterior urethroplasty can be an alternative.