Adenocarcinoma ; classification ; pathology ; surgery ; therapy ; Cardia ; Chemotherapy, Adjuvant ; Esophageal Neoplasms ; classification ; pathology ; surgery ; therapy ; Esophagectomy ; methods ; Esophagogastric Junction ; surgery ; Gastrectomy ; methods ; Humans ; Neoplasm Staging ; Radiotherapy, Adjuvant ; Stomach Neoplasms ; classification ; pathology ; surgery ; therapy

Objective To investigate the value of plasma H-FABP level and Acute Physiology and Chronic Health Evaluation(APACHE Ⅱ) in severity and prognosis estimation for patients with acute pumonary embolism(APE).Methods Totally 160 APE patients were hospitalized from January 2010 to January 2015 and enrolled in this study.According to the severity of the disease,these patients with APE were divided into low-risk group,moderate-risk group and high-risk group.According to clinical prognosis,these patients with APE were divided into survival groups and death groups.Plasma levels of H-FABP were measured by enzyme linked immunosorbent assay(ELISA),and APACHE Ⅱ score were analyzed.The differences of Plasma H-FABP levels and APACHE Ⅱ score were compared and which the relationship with severity and the prognosis of APE were also assessed.Results With the increased severity in patients,the H-FABP and APACHE Ⅱ score were significantly increased (P ＜ 0.05);the H-FABP and APACHE Ⅱ score were significantly higher in death group as compared with survival group(P ＜0.05).The H-FABP levels and APACHE Ⅱ score were positive correlated(r =0.71,P =0.000).ROC curves analysis results showed that the area under curve of H-FABP was 0.854 (95 ％ CI:0.784-0.927),and optimal operating point (OOP)was 13.3 μg/L,which had 81.0％ sensiticity and 79.4％ specificity;ACU of APACHE Ⅱ was 0.861 (95％ CI:0.812-0.932),and OOP was 19.2,which had 77.8％ sensiticity and 80.4％ specificity.The AUC was 0.914 (95％ CI:0.825-0.948),and the sensitivity was 88.9％,specificity was 87.6％ when the two cutoff values were both achieved,which were higher than the single H-FABP and APACHE Ⅱ score.Conclusion The H-FABP and APACHE Ⅱ score can effectively assess severity and prognosis of APE patients,meanwhile,it provide an objective basis for the clinical individual treatment and reducing the mortality rate of APE patients.

Objective To investigate the emergency treatment and correlation factors of aqueous misdirection during glaucoma and cataract surgery in glaucoma patients.Design Retrospective case series.Participants 126 cases(132 eyes)of angle-closure glaucoma patients with aqueous misdirection during surgery,100 cases(100 eyes)of angle-closure glaucoma patients without aqueous misdirection during surgery and 100 cases(100 eyes)of senile cataract patients.Methods We performed pars plana vitreous water-bag aspiration or anterior vitrectomy on glaucoma patients with aqueous misdirection during surgery.All the factors in observation group and control groups were compared and analyzed by logistic regression.Main Outcome Measures Preoperative highest intraocular pressure(HIOP),intraocular pressure after maximum dose(IOP),anterior chamber depth(ACD),lens thickness(LENS),axial length (AXL),mean keratometry(K),intraocular lens diopter within-0.5D corrected by SRK-T formula(IOLD).Results Among all the 132 angle-closure glaucoma eyes whose posterior chamber pressures were increased during surgery,we performed pars plana vitreous water-bag aspiration in 123 eyes(93.18%),and anterior vitrectomy in 9 eyes(6.8%).Postoperative complications included shallow anterior chamber in 20 eyes(7 eyes with malignant glaucoma,9 eyes with choroidal detachment,4 eyes with delayed local suprachorodal hemorrhage),and vitreous local hemorrhage in 1 eye.Means of all the observation indexes on three groups showed significant difference(all P

Objective: We present our preliminary experience on the treatment of intracranial arterial lesions with covered stent in a series of patients. Methods: 20 patients have been treated by using Jostent coronary covered stent deployed in the parent artery across the lesions, which included aneurysms, iatrogenic or traumatic arterial injury, and traumatic carotid-cavernous fistula (TCCF). The profile of stent was determinded with the diameter of parent artery and the length of lesion. 5 cases of intradural vertebral aneurysms, 7 internal carotid artery (ICA) aneurysms (1 petrous, 2 cavernous, 2 ophthalmic, 2 supracliniodal segment), 1 iatrogenic ICA injury, 3 traumatic ICA aneurysms, 3 traumatic carotid cavernous fistula and 1 ICA cavernous segment stenosis with spontanous CCF were treated. 21 Jostent covered stent had been used. Combination of bare stent and covered stent were used in 3 cases. Results: Technical success were achieved in 17 cases. Each case had one lesion. Lesions were excluded from circulation in 14 cases. There were 3 cases with lesion reminants or endoleakage just after treatment, but disappeared soon in the follow-up angiography. No complication was found in successful cases. Covered stent deployment were failed in 3 cases. One had transient slight paraplegia. There was no severe complication or death. Conclusion: Excluding the lesion from circulation with covered stent has been proved to be an effective reconstructive treatment of intracranial arterial lesions. Further research and development are needed to make the indication even broader.

Objective To investigate the expression of aquaporin-3 (AQP3) in tongue tissues of rats with experimental severe acute pancreatitis (SAP) and regulating effects of emodin. Methods Rat models with SAP were established by injecting 5% sodium taurocholate retrogradely into gallbladder and pancreas. SD male rats were randomly divided into sham-operation group, model group, and emodin group. After model establishment, rats in the emodin group received gavage with emodin 20 mg/kg each day, while rats in the model group and sham-operation group received gavage with normal saline. The mental state, thick greasy tongue fur and mortality of rats were observed every day after model establishment, and 5 days later, protein and genetic expression of AQP3 were detected by Western blot and RT-PCR. Results Compared with the model group, the mortality and the thick greasy tongue fur significantly decreased, the protein and genetic expression of AQP3 significantly decreased in the emodin group (P<0.05). On the 5th day, 11 rats in the model group survived, and 5 rats had thick greasy tongue fur. Compared with the sham-operation group, the protein and genetic expression of AQP3 in the model group were higher (P<0.05). Conclusion Emodin can improve the severity of SAP and decrease the incidence of thick greasy tongue fur significantly by reducing the protein and genetic expression of AQP3.

Objective To optimize human acellular dermal matrix(ADM) and evaluate its biological characters. Methods Human skin was treated with hypertonic saline followed by NaOH maceration(group A), hypertonic saline followed by sodium dodecyl sulfate (SDS) detergent(group B) or Dispase Ⅱ followed by Triton X-100(group C), the resulting ADM were sectioned, and then were stained by special immunohistochemistry method. The cytotoxicity of them were evaluated by methyl thiazolyl tetrazolium (MTT) colorimetry and then cell compatibility was analyzed by cell culture;The optimized ADM resulted was choosen for use. Fibrablasts(FBs)were transfected with adenovirus vector encoding green fluorescent protein gene(Ad-GFP)and the growth of them on the optimized ADM was observed by fluorescent microscopy. Results Collagen and elastic fibers can still be observed in three kinds of ADM. The cells in dermis can be disintegrated both in group A and C, but not in group B. The cytotoxicity scores of the ADM prepared in group A and B were grade 0 or grade 1, while that of group C was more than grade 1.The ADM prepared by NaCl-NaOH maceration had good biocompatibility. There was statistical difference in adhering number of NIH3T3 cells in group A and B. NIH3T3 cells grew well in group A and the resulted ADM was optimized. FBs transfected with Ad-GFP grew well in the optimized ADM. Conclusion The ADM prepared by NaCl-NaOH maceration was a good tissue engineering biomaterial with a little cytotoxicity and rich in resouce.

OBJECTIVETo analyze the effect of Chinese herbs used by Prof. LI Tao on peripheral blood T subsets in treating multiple sclerosis (MS) by using association rules and statistical methods, thereby providing evidence for optimizing prescriptions.

METHODSData of MS inpatients and outpatients recorded by data collecting system, Xiyuan Hospital, China Academy of Chinese Medical Sciences were resorted. The relationship between Chinese herbs and T cell subsets were analyzed using SPSS17.0 and Aprior module in SPSS Clementine 12.0.

RESULTSRadix bupleuri, Radix Paeoniae alba, Fructus Aurantii, Atractylodes, and Radix Glycyrrhizae were most commonly used herbal combinations.Radix Aconiti lateralis preparata and Rhizoma Smilacis glabrae were often added. Radix Aconiti lateralis preparata was associated with decreased Th1 cells (confidence level 83.78%, supportive level 36.26%). Decreased Th1 cell was associated with Radix Aconiti lateralis preparata (confidence level 71.26%, supportive level 36.26%).Radix Aconiti lateralis preparata was obviously associated with decreased Th1 cells. Radix Bupleuri, Radix Paeoniae alba, bitter orange, Atractylodes , Radix glycyrrhizae, and Radix Aconiti lateralis preparata could reduce peripheral blood Th1 subsets of MS patients and elevate Th2 subsets (all P < 0.01).

CONCLUSIONSThe herbal combination of Radix Bupleuri, Radix Paeoniae alba, Fructus Aurantii, Atractylodes, Radix Glycyrrhizae, Rhizoma Smilacis glabrae, and Radix Aconiti lateralis preparata could lower peripheral blood Th1 cells and elevate Th2 cells, and prevent the relapse of MS possibly by reducing Th1 cells and elevating Th2 cells. Especially Radix Aconiti lateralis preparata played important roles in aforesaid changes of Th1 and Th2.

Aconitum ; chemistry ; Atractylodes ; chemistry ; Bupleurum ; chemistry ; China ; Drugs, Chinese Herbal ; therapeutic use ; Fruit ; chemistry ; Glycyrrhiza ; chemistry ; Humans ; Multiple Sclerosis ; therapy ; Paeonia ; chemistry ; Plant Roots ; chemistry ; Rhizome ; chemistry ; Smilacaceae ; chemistry ; T-Lymphocyte Subsets ; drug effects

Objective To construct recombinant full length genotype B and C hepatitis B virus (HBV)and to examine HBV DNA replication and hepatitis B surface antigen(HBsAg),hepatitis B e antigen(HBeAg)expressions in Huh7 cells. Methods The full length genotype B and C HBV DNA were extracted and amplified from two HBV infected patients. The recombinant plasmids were constructed by inserting the amplified HBV fragments into the eukaryotic expression vector,pHY106,which were then transfected into Huh7 cells. The cells transfected with blank pHY106 vector were used as control. HBV DNA replication at 72 hours of transfection was detected by Southern blot. The HBV DNA levels in Huh7 cells at 24,48,72,96 and 120 hours of transfection were determined by real-time polymerase chain reaction(PCR).Meanwhile, the HBsAg and HBeAg expression levels in the supernatants at 24,48,72,96 and 120 hours were determined by enzyme linked immunosorbent assay(ELISA).Results The recombinant plasmids expressing genotype B or C HBV DNA were successfully constructed.The HBV replicative intermediates in HBV core particles,including rcDNA dsDNA and ssDNA,were detected by Southern blot.HBV DNA level could reach 8 lg copy/mL which was by real-time PCR. HBsAg and HBeAg levels determined by ELISA peaked at 72 hours after transfection and then declined gradually. Conclusions The recombinant plasmids inserted with genotype B or C HBV DNA are constructed successfully, which can express high levels of HBsAg and HBeAg in Huh7 cells. This system provides a platform for studying the pathogenesis of B and C genotype HBV, the interaction between HBV and host, as well as exploiting new drugs against HBV.

Objective To evaluate the clinical value of transesophageal echocardiography (TEE) on minimally invasive surgical closure of heart septal defects. Methods Thirty-four patients with atrial septal defect (ASD) and 38 patients with ventricular septal defect(VSD) were selected by transthoracic echocardiography (TTE) prepared for minimally invasive surgical closure. TEE was performed to choose appropriate occluder and guide occluder release during the procedure. The immediate closure effect also evaluated by using TEE. A week follow-up was done by using TTE. Results Successful occlusion was in 32 patients with ASD and 29 patients with VSD. On 1 week follow-up,neither displacement for the occluders nor residual shunt except minimal residual shunt in 3 patients. The ventrieular remodeling was improved, the valvular regurgitation and pulmonary arterial pressure decreased. Conclusions TEE is important in minimally invasive surgical closure of atrial, ventricular septal defects, especially in choosing the candidate for the procedure and occluder, guiding occluder released and evaluating the procedure.