Objective To study on the efficacy and safety of treating achalasia by gastroscopic balloon dilation under anesthesia. Methods Fifteen patients with achalasia were given intravenous propofol and midazolam before dilation. Patient's feeling or distress and operative duration were recorded. The changes of blood pressure (BP) , heart rate ( HR) and blood oxygen saturation ( SpO2 ) were also recorded and analyzed. Results Patients did not complain of any discomfort or pain during gastroscopy. The time of recovery from anesthesia was 17 -27(23. 2) minutes. There were significant changes in clinical scores before and after dilation ( P

Objective To understand the intestinal nervous system(ENS) pathological change in rats with acute renal failure(ENS).Methods Rat acute renal failure model was established,the intracanthus blood was drew to determine the serum total creatinine(Scr) blood urea nitrogen(BUN) after 48h and 4th-day,then the rats was sacrificed at fourth day each rat's kidney tissue,duodenum,jejunum,ileum,colon and rectum were stained with hematoxylineosin(SE).Finaly, iNOS staining by immunohitochemstry,observed the numbers of the ENS nerve plexus, ENS nerve cell , and iNOS positive cell nerve plexus. Check whether there has hyperemia hydrops, degenerative necrosis, and inflammatory cell infiltration on the mucosa epithelium.Results ⑴Kidney histological change was occurred. The kidney tubules degenerative necrosis was found in all the ten cases of kidney failure, and the hyaline cast, mesenchyme hemorrhagic necrosis, and inflammatory cell infltration were seen. ⑵ HE coloration and microscope inspection;numbers of the ENS nerve plexus and nerve cell of the acute kidney failure group were less than the normal group, especially in the ileum and rectum .⑶The number of the iNOS positive cell nerve plexus in ENS of the rats with acute renal failure was apparently less than that of the normal group. In addition, the iNOS positive presentation was stronger than that of the normal group.Conclusions The findings suggest that toxic metabolites of uremic rat acts on the ENS,and thus leading to pathological changes of ENS,resulting in stomach and intestinal mortor function disorder.

Objective To investigate the gastric empty and electrogastrogram(EGG) in patients with renal insufficiency before and after hemodialysis, and to study the enteric nervous system (ENS) in experimental acute renal failure rats.Methods The comparisons of gastric emptying and EGG before and after hemodialysis were carried out in 15 patients with uremia who have gastrointerstinal symptoms. Acute renal failure models were also established. The neuroplexus of ENS and levels of some gut hormones were investigated. Results The EGG and gastric emptying were abnormal in patients with uremia before hemodialysis, but improved after dialysis. The neuroplexus of ENS with positive nitric oxide synthase(NOS) staining in rats with acute renal failure was significantly decreased. The levels of gastrin, vasoactive intestinal peptide and motilin in rats with acute renal failure were (159.1?55.6)?g/L, (121.6?48.9)pg/L, and (6.32?3.55)pmol/L, respectively, which were significantly different from those of the control group(P

A 1 3kb DNA fragment was amplified in DNA samples extracted from periwinkle showed yellows The amplified fragment was ligated into pGEM T easy vector and then transformed into JM109 strain of E coli Cloned DNA fragments were verified by PCR, restriction endonuclease ( Eco RI) digestion and sequence analysis The result revealed that the ribosomal protein gene of PY strain consists of 1244 base pairs, which contains the entire rp l22 gene encoding 129 amino acids and rps3 gene encoding 252 amino acids These two genes are overlap The character of ribosomal protein gene of PY strain is very resemble with that of other phytoplasmas

Adenine ; adverse effects ; analogs & derivatives ; Fanconi Syndrome ; chemically induced ; Hepatitis B, Chronic ; drug therapy ; Humans ; Hypophosphatemia ; chemically induced ; Organophosphonates ; adverse effects ; Osteomalacia ; chemically induced

BACKGROUND: Following trauma caused by seawater, cells often exhibit special pathological changes because of the special physico-chemical properties of seawater.OBJECTIVE: To observe corneal histopathological changes and interleukin-6 level in aqueous humor of a rabbit model of penetrating corneal trauma combined with seawater immersion.METHODS: The rabbit eye models of penetrating corneal trauma caused by firecrackers were established in 16 adult healthy grey rabbits. A 3-mm whole-layer incision was made in the cornea. The right eyes served as experimental sides and the left eyes served as controls. Seawater was injected into the aqueous humor of the right eyes via the corneal incision. The eye surface was flushed with seawater for 30 minutes. Physiological saline was used for the left eyes. RESULTS AND CONCLUSION: Optical microscopy results showed that at 1, 2, 3 days after model establishment, corneal cells on the experimental side exhibited severe necrosis and abscission, obvious swelling of substantia propria layer complicated by cellular infiltration. At 1 and 2 days after model establishment, the pathological changes on the control side were the same as the experimental side, but they were mild, but at 3 and 5 days, they were obviously alleviated. At 1, 2, 3 days after model establishment, interleukin-6 level in aqueous humor was significantly higher on the experimental side than on the control side (P < 0.05). These findings suggest that the degree of injury on the experimental side was more severe than that on the control side, indicating that seawater may be an important causative factor of corneal injury.

Objective To investigate the relationship between cardiovascular risk factors and arterial elasticity in elderly hypertensive patients.Methods 253 subjects were divided into two groups:hypertension group (n=141) and non-hypertension group (n =112).Carotid-femoral pulse wave velocity (C-FPWV),carotid-radial PWV (C-RPWV),height and weight were determined.Fasting plasma levels of blood glucose (BG),blood lipids,insulin,endothelins (ET),nitric oxide (NO) and high sensitivity C-reactive protein (hsCRP) were assessed.Results C-FPWV and CRPWV were higher in hypertension group than in non-hypertension group [(11.7±1.9) m/s vs.(9.7±1.1)m/s,(11.7±1.7) m/s vs.(9.4±1.1)m/s,t=8.43 and-6.30,both P＜0.01].Body mass index (BMI),systolic blood pressure (SBP),diastolic blood pressure (DBP),levels of triglyceride (TG),BG,ET,NO and hsCRP,HOMA-IR had significant differences between the two groups (t=-5.27,-4.18,-6.00,6.29,-4.18,-4.86,-3.41,respectively,all P＜0.05).Pearson correlation analysis showed that CFPWV was correlated with SBP,age,DBP,fasting BG,NO,ET,TG,HOMA IR,cholesterol (CHO),hsCRP (r=0.534,0.374,0.340,0.338,-0.306,0.242,0.228,0.225,-0.218,0.178,respectively,all P＜0.05); C-RPWV was correlated with age,DBP,SBP,NO,TG (r=0.312,0.319,0.241,-0.197,0.151,respectively,all P＜0.05).Multiple regression analysis demonstrated that C-FPWV=4.640 + 0.081× HOMA IR+ 0.047× age+0.035×SBP+0.29×TG-0.017×NO+0.014×ET+0.132×hsCRP,r2=0.514; CRPWV=3.161+0.034×age+0.033×DBP+0.313×fastingBG+0.013×ET-0.013×NO,r2=0.390.Conclusions The decreases of arterial elasticity are closely related with endothelial function,insulin resistance,levels of blood lipids and hsCRP in elderly patients with hypertension.

BACKGROUND:Cytomegalovirus is relatively common condition pathogenic virus after liver transplantation. It has many direct or indirect effects on the body, and seriously affects the long-term survival of patients. It should be paid more attention.
OBJECTIVE:To analyze and summarize the outcomes of the epidemiology, risk factors, effects on the body, clinical manifestation, diagnosis, treatment and prevention for cytomegalovirus infection after liver transplantation.
METHODS:Fitness database, PubMed database and China National Knowledge Infrastructure database were retrieved by computer for articles on cytomegalovirus infection after liver transplantation published from January 2006 to December 2013, and through manual refer to books. Articles were searched with the key words of“liver transplantation, cytomegalovirus infection, risk factors”in Chinese and English. A total of more than 200 articles were retrieved. Forty articles directly related to cytomegalovirus infection after liver transplantation and those published in authoritative magazines were included to review with good representativeness.
RESULTS AND CONCLUSION:The positive rate of serum cytomegalovirus-IgG is high in the population. Risk factors of cytomegalovirus infection after liver transplantation include donor-recipient cytomegalovirus serologic status, low serum creatinine clearance, female patients, graft rejection, the use of immunosuppressant and donor-recipient MBL-2 and FCN-2 gene polymorphism. There are direct and indirect effects of this posttransplant opportunistic infection, such as cytomegalovirus syndrome, organ invasion lesions, graft loss, accelerated recurrence of hepatitis C, an increased risk of acute or chronic rejection, predisposition to other opportunistic infections, compromised immunity, accelerated atherosclerosis and the interaction between beta herpes virus. Therefore, prevention and early treatment are very crucial. A combination of pp65 antigen assay for screening and real-time RT-PCR methods for confirmation provides an optimal, low-cost diagnostic regimen for cytomegalovirus infection. Ganciclovir is the first selection for antiviral treatment after liver transplantation, but oral valganciclovir and intravenous ganciclovir are safe, feasible options for preemptive treatment of cytomegalovirus infection after liver transplantation. The plasma levels of CXCL16, PTX3 and von Wil ebrand factor at the start of treatment are independently associated with virologic and clinical treatment failure during anti-cytomegalovirus therapy in solid organ transplant recipients. We should choose different prevention programs for the patients of different donor-recipient cytomegalovirus serologic status.

Objective To investigate the efficacy of tertiary liver transplantation.Methods The clinical data of 4 patients with hepatobiliary disease who were admitted to the General Hospital of Chinese People's Armed Police Forces from April 2002 to December 2012 were retrospectively analyzed.All the patients received orthotopic liver transplantation,and received tacrolimus + mycophenolate mofetil (MMF) + hormone after operation.All the patients were followed up till May 2014,and their prognosis was learned.The measurement data were analyzed using the t test.Results Three patients with benign hepatic disease received tertiary liver transplantation due to biliary complications and chronic rejection,and 1 patient with hepatic cancer received tertiary liver transplantation because of hepatic cancer recurrence.The average interval between the primary and secondary liver transplantation was 16.0 months,which was shorter than 22.5 months of the interval between the secondary and tertiary liver transplantation.The mean operation time in the secondary liver transplantation was (11.4 ± 1.0)hours,which was significantly shorter than (14.1 ± 2.2) hours in the tertiary liver transplantation (t =3.644,P ＜ 0.05).The median volumes of blood loss in the secondary and tertiary liver transplantation were 1 300 mL and 1 800 mL,and the median volumes of blood transfusion were 1 400 mL and 3 100 mL.The hepatic function of the 4 patients recovered smoothly at the early time after liver transplantation.Two patients (3 cases) were complicated with infection postoperatively (1 patient was infected by pseudomonas aeruginosa within 30 days after liver transplantation,and was cured by active antimicrobial treatment),and they were cured after anti-infectional treatment.One patient died of hepatic failure at the 80th month after the primary liver transplantation,1 died of hepatic cancer recurrence complicated by pulmonary,bone and retroperitoneal lymph node metastasis at the 107th month after the primary liver transplantation,and the other 2 patients survived for 104 months and 26 months after the primary liver transplantation,respectively.Conclusion Tertiary liver transplantation is effective for the treatment of biliary complications and chronic rejection after liver transplantation,and it can extend the life span of patients with hepatic cancer recurrence if there are insufficient donor resources.

Actins ; metabolism ; Adult ; Antigens, CD34 ; metabolism ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Hypertension ; etiology ; Juxtaglomerular Apparatus ; pathology ; surgery ; ultrastructure ; Kidney Neoplasms ; complications ; metabolism ; pathology ; surgery ; ultrastructure ; Nephrectomy ; Vimentin ; metabolism