Objective To evaluate the short-term effects and complications of transoral endoscopic suturing in the treatment of gastroesophageal reflux diseases (GERD). Methods Sixteen patients with GERD, confirmed by gastroscopy, upper gastrointestinal barium meal examination, and esophageal pH value examination, received gastroesophageal suturing by using an endoscopic suturing device (manufactured by Bard Co.). The site of suturing was 1cm below the dentation line, with a suture interval of 1.5cm and a knot interval of 2.0cm. Symptom severity scoring, esophageal 24-hour pH monitoring and the degree of esophagitis before and 1 month after the operation were compared respectively. Results A total of 42 sutures and 21 knots were made in the 16 cases. The mean operation time was 30 min. The sum of heartburn scores and regurgitation scores before the treatment were 39 (mean, 2.44) and 32 (mean, 2.0), and those after the treatment were 11 (mean, 0.68) and 10 (mean, 0.63), respectively, with statistical significances between preoperation and postoperation ( ? 2 =19.5 and 16.33; P

Traditional sequences of magnetic resonance imaging (MRI) such as T1-weighed imaging, T2-weighed imaging, and fluid-attenuated inversion recovery (FLAIR) imaging can sensitively detect the subacute and chronic intracranial hemorrhage; gradient echo sequence can detect various stages of intracranial hemorrhage, but there is no correlation between the signal intensity of the hematoma and the time of the presence of hematoma. Diffusion-weighted imaging and apparent diffusion coefficient may provide more information about the center and surrounding areas of hematoma, as well as the hemorrhagic tendency after infarction.

Objective To explore the mechanisms of TGF-? 1?TGF-? 1RⅡ and NF-?B on the angiogenesis in patients with hepatocellular carcinoma.Methods The expression of TGF-? 1 ?TGF-? RⅡ and NF-?B protein in 36 cases of HCC and surrounding HCC tissue was separately detected using immunohistochemistry technique.To observe the relationship of TGF-? 1 protein and MVD, TGF-? 1RⅡ protein and MVD, NF-?B and TGF-? 1 protein, using CD34 labelling vessel endothelial cell. Results The expression of TGF-? 1 and MVD in HCC tissue was higher than that in surrounding HCC tissue (P

Objective To study the technique of placemen t of Nitinol stent for relieving malignant pylorus or duodenal obstruction, and to assess its clinical effectiveness.Methods In this group the strictures were caused by gastric car cinoma at the antrum (n=2), anastomosis site of previous gastrojejunostomy (n=2 ), gastric carcinoma at the cardia (n=4), colon cancer (n=1), pancreatic cancer (n=3) and duodenal cancer (n=4). Under fluoroscopic guidance the Nitinol stent w as inserted into pylorus or duodenal obstruction sites via oral cavity in all ca ses. Complications and clinical status were investigated during the study period .Results Successful stent placement was achieved in 15 cases. Tw o patients had undergone double stent placement (pylorus stent and bile duct ste nt). The rate of improvement in abdominal distention and vomiting 1 week after p rocedure was 73 3% and 86 7% respectively. Procedure-related complications ne ver occurred.Conclusion Nitinol alloy network stent is a safe and efficaciou s method for palliating malignant pylorus or duodenal obstruction, and improves patient's living quality.

In order to control the quality of all parts of the process for culturing,preparing and using clinically the human embryo olfactory ensheathing cells (OECs),the conduct standard of culturing human OECs from olfactory bulb is formulated. Because the strict conduct process can reduce the human factor as much as possible and ensure the stability of the cell quality. Therefore,during the culturing process of human embryo OECs, as for the embryo sample of OECs from olfactory bulb,the standard of lab condition and cell culture must be set strictly. The key steps of conduct process must be regulated,the freezing and resuscitating process of OECs must be controlled,the test method for microbial contamination during cell culture must be proposed and the risk must be reduced,then the quality of the human OECs from olfactory bulb can be guaranteed during the clinical application.

Objective To investigate the effect of aspirin on the incidence of thromboembolism in hypertensive patients associated with paroxysmal atrial fibrillation.MethodsFour hundred hypertensive patients with paroxysmal atrial fibrillation (mean age 59 years) free of thromboembolic events were randomized assigned to receive aspirin (0.3 g/d) or placebo. Cerebral thromboembolism,including transient ischemic attack and embolism of peripheral arteries were defined as primary outcomes. Event-free survival curves were estimated by Kaplan-Meier curve. Results During 3.6 years follow-up,primary outcomes occurred in 61 patients (4.3% per year). Aspirin significantly reduced the incidence of primary outcome as compared with placebo group( 9.0% vs 21.5%,P

Objective To evaluate the efficacy and safety of endoscopic versus open component separation technique (CST) for abdominal hernia.Methods Systematic review was carried out to identify the controlled clinical studies comparing endoscopic CST with open CST for abdominal hernia.The Meta-analysis was performed with RevMan 5.2 software.Results The selection criteria was met in five studies.A total of 185 patients with abdominal hernia were included.Analysis of the data suggested that there was no significant differences in recurrence rate between endoscopic CST and open CST(P =0.84,risk difference =-0.01,95％ CI-0.12 to 0.10).However,endoscopic CST compared with open CST was associated with a significant reduction of postoperative wound complications (P ＜ 0.000 1,odds ratio =0.19,95％ CI 0.09 to 0.41).And there was no significant differences in operation time,intraoperative blood loss and postoperative hospital stay (all P ＞ 0.05).Conclusions As compared to open CST,endoscopic CST show equivalent clinical effects with similar recurrence rate.However,endoscopic CST was associated with a significant reduction of postoperative wound complications,and there was no significant differences in in operation time,intraoperative blood loss and postoperative hospital stay.

Objective To investigate the effects of macrophage inflammatory protein-1α (MIP-1α) combined with molecule 4-1BB L on the tumorigenicity of hepatocellular carcinoma cells in vivo. Methods Mouse MIP-1α (mMIP-1α) expressed Hepa 1-6 cells were transfected with m4-1BBL recombinant retrovirus, the anti-histidinol cells clones were selected and amplified. The expression of m4-1BB L was confirmed by flow cytometry. The growth curve of Hepa 1-6 cells transfected with mMIP-1α and m4-1BBL alone or together was drawn and compared. C57B/L Mice were randomly divided into 7 groups, 9 mice in each group, injected with mMIP-1α+m4-1BB L Hepa 1-6 cells, m4-1BB L Hepa 1-6 cells, mMIP-1α Hepa 1-6 cells, Hepa 1-6 cells, pLXSHD Hepa 1-6 cells or PBS respectively. The tumorigenicity of hepatocellular carcinoma cells and the mice survival rate were compared between each groups. Results Hepa 1-6 mMIP-1α+m4-1BB L cells which expressed both mMIP-1α and m4-1BB L were successfully established. The expression of mMIP-1α and m4-1BB L alone or together did not affect the growth curve of Hepa 1-6 cells. Observed for 5 weeks, no tumor developed in Hepa 1-6 mMIP-1α+m4-1BB L injected mice. The tumorigenicity of Hepa 1-6 mMIP-1α+m4-1BB L was lower than that of Hepa 1-6 mMIP-1α or Hepa 1-6 m4-1BB L in vivo. The survival rate of Hepa 1-6 mMIP-1α+m4-1BBL injected mice(9/9) was higher than that of Hepa 1-6 m4-1BB L injected mice (6/9)or Hepa 1-6 mMIP-1α injected mice (1/9). Conclusion Chemokine MIP-1α combined with costimulatory 4-1BB L lowered the tumorigenicity of hepatocellular carcinoma cells in vivo, and prolonged the mice survival period.

BACKGROUND: The frequency of body ailments combined with depression is relatively higher, and hence post stoke depression(PSD) has gained more and more concentration.OBJECTIVE: To investigate the morbidity, related factors and pathophysiological mechanism of PSD.DESIGN: Case analysis and observation study.SETTING: Department of eurology in a hospital of a university; Third department of internal medicine in a hospital of Chinese People' s Armed Police Force; Department of neurology in a province hospital.PARTICIPANTS: This study was carried out at the Neurological Department of First Clinical Hospital Affiliated to Harbin Medical University and the General Hospital of Armed Police Army in Heilongjiang Province from January 2001 to May 2004. A cohort of 312 stroke patients was followed up in this study.METHODS: All 312 patients scored for Hamilton rating scale for depression (HAMD) and European stroke scale(ESS) within 48 hours of hospitalization. Meanwhile their clinical presentations and social-psychological factors were also collected.MAIN OUTCOME MEASURES: The stroke morbidity in patients with different sex, age, personality, educational degree, as well as stroke type, lesion location and extent of neurological functional deficit.RESULTS: The morbidity of PSD was 40. 1%, predominated by mild and medium stroke; amongst which PSD was found more frequent in women than men( P ＜ 0.01), as well as in elders than youngers( P ＜ 0.01); Patients who has diffidence personality are liable to suffer from PSD; and it was found more common in patients with over middle school education than those received only elementary school education ( P ＜ 0.01 ); depression was more frequent in left-sided stroke than right-sided stroke( P ＜ 0.01 ), especially in frontal lobal stroke; PSD was found negatively correlated with the scores for ESS(r= -0.846, P ＜0.05).CONCLUSION: As the result of the interaction of multiple factors, the development of PSD is found accorded with biology-psychology-society mode.