BacKground:AchaIasia of cardia is categorized into 3 subtypes by Chicago cIassification criteria defined by high-resoIution manometry( HRM). These different subtypes present different cIinicaI and esophageaI dynamic characteristics. Aims:To study the cIinicaI and esophageaI dynamic characteristics of patients with achaIasia of cardia categorized by Chicago cIassification criteria. Methods:Twenty-five untreated achaIasia of cardia patients from January 2012 to ApriI 2014 at Beijing Friendship HospitaI,CapitaI MedicaI University were enroIIed. CIinicaI data incIuding cIinicaI symptoms, manifestations of endoscopy and barium meaI radiography and data of HRM were anaIyzed retrospectiveIy. Results:Of the 25 patients,5 patients(20. 0%)were cIassified as type Ⅰ,15(60. 0%)as type Ⅱ and 5(20. 0%)as type Ⅲ. AII patients compIained as having dysphagia,and 26. 7%( 4/15 ) of type Ⅱ patients had chest pain. Incidences of regurgitation in typeⅠ,ⅡandⅢwere 60. 0%(3/5),53. 3%(8/15)and 20. 0%(1/5),respectiveIy,no significant difference was found among the three types(P>0. 05). Incidences of diIatation of esophagus in type Ⅰ,ⅡandⅢwere 60. 0%(3/5),73. 3%(11/15)and 20. 0%(1/5),respectiveIy,no significant difference was found among the three types (P=0. 11). No differences in Iength of Iower esophageaI sphincter(LES),abdominaI LES Iength,LES resting pressure, upper esophageaI sphincter( UES)resting pressure and integrated reIaxation pressure( IRP)among the three types were found(P>0. 05). Incidences of muItipIe swaIIowing and spontaneous UES reIaxation were 32. 0%(8/25)and 24. 0%(6/25),respectiveIy,no significant difference was found among the three types(P>0. 05). Conclusions:Of the patients with achaIasia of cardia ,typeⅡis more common. Large-sampIe muIticenter studies are needed for further research.

OBJECTIVE:To observe the clinical efficacy and safety of Buzhong yiqi wuling decoction combined with western medicine in the treatment of chronic congestive heart failure(CHF). METHODS:120 CHF patients were divided into observation group and control group by random number table method,with 60 cases in each group. Control group received conventional western medicine treatment as rest,low salt diet and diuretics. Observation group was additionally given Buzhong yiqi wuling decoction,one dose a day,at twice,on the basis of control group. Treatment course of 2 groups lasted for 2 weeks. Average TCM symptom score, level of plasma NT-proBNP,6 min walk test(6MWT)distance before and after treatment,clinical efficacy and the occurrence of ADR were compared between 2 groups. RESULTS:Before treatment,there was no statistical significance in average TCM symptom score,level of plasma NT-proBNP and 6MWT distance between 2 groups(P>0.05). After treatment,average TCM symptom score and level of plasma NT-proBNP of 2 groups were decreased significantly,and the observation group was more significant than the control group,with statistical significance(P<0.05);6MWT distance of 2 groups were improved significantly compared to before treatment,and the observation group was significantly longer than the control group,with statistical significance(P<0.05). After treatment,total effective rate of observation group(93.33%)was significantly higher than that of control group(83.33%),with sta-tistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Buzhong yiqi wuling decoction is an ef-fective prescription to treat CHF,and can relieve clinical symptoms,improve the cardiac function,decrease NT-proBNP level and en-hance the patient exercise tolerance with good safety.

OBJECTIVETo observe the clinical efficacy difference between segmentation scraping and conventional acupuncture for cervical spondylosis (CS) so as to provide effective treatment method.

METHODSEighty-five cases of cervical type of CS were randomly divided into a scraping group (44 cases) and an acupuncture group (41 cases). The segmentation scraping therapy was used in the scraping group. The scraping group was treated with focusing on scraping the head and joint part of neck and occiput in the upper cervical spine injury, and focusing on scraping the lower section of cervical and shoulder in the lower cervical spine injury, once every seven days, totally for 3 times. In the acupuncture group, Fengchi (GB 20),Wangu (TE 5), Tianzhu (BL 10),Neck-Jiaji (EX-B 2), etc. were selected,once daily,for 15 days. The visual analogue scale (VAS) was used to evaluate the immediate analgesic effect after the first treatment and the clinical efficacy was observed after the end of treatment.

RESULTSAfter the first treatment, the score of VAS was decreased significantly in the scaping group (P < 0.01), but there was no significant difference in the acupuncture group compared with those before treatment (P > 0.05); the score of VAS in the scaping group after the first treatment was lower than that in the acupuncture group (3.66 +/- 0.74 vs 5.43 +/- 0.35, P < 0.01). Compared with before treatment, the scores of VAS were decreased significantly after treatment in two groups (both P < 0.01), but without significant difference between two groups (P > 0.05); the effective rate was 95.5% (42/44) in the scaping group and 87.8% (36/41) in the acupuncture group, the curative effects were similar (P > 0.05).

CONCLUSIONBoth of scraping and acupuncture therapies have good analgesic effect for cervical spondylosis, and overall effects are similar, but the immediate analgesic effect of scraping thrapy is better than that of conventional acupuncture.

Acupuncture Points ; Acupuncture Therapy ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Neck Pain ; therapy ; Spondylosis ; therapy ; Treatment Outcome

Objective To study the effect of curcumin on rat model of N-methylnitrosourea ( MNU) -induced bladder cancer and its mechanism. Methods One hundred SD rats were randomly divided into four groups:control group (n=10), model group (n=10), intervention group (n=40) and treatment group (n=40). Rats in the control group re-ceived intravesical infusion of distilled water. Rats in the other three groups were given MNU (1 mg/mL) in 2 mL saline at 2nd, 4th, 6th and 8th weeks to induce bladder cancer. In the model group, the rats were injected with distilled water in the bladder. The rats in the intervention group received 2 mL curcumin solution (400 μmol/L) at the 1st, 3rd, 5th, 7th and 9th weeks, and were sacrificed at the 11th week. In the model group, the rats were injected with distilled water in the bladder. In the treatment group, the rats had intravesical instillation of curcumin in the bladder (400 μmol/L, 2 mL) at 10, 12, 14, 16, and 18 weeks, and sacrificed at the 19th week. Bladder tissue samples were taken for pathological exami-nation using hematoxylin and eosin ( HE) staining. TUNEL staining assay was used to detect the apoptosis in tumor tissue. The expression of apoptosis-related proteins was detected by Western blot. Results The incidence of bladder cancer was 90% (9/10) in the model group, 12. 5% (5/40) in the intervention group and 92. 5% (37/40) in the treatment group at the 10th week, showing a significant difference between the intervention group and model group (P<0. 05), indicating an obvious interventional effect of curcumin on the bladder cancer. The incidence rate of bladder cancer in the treatment group was 78. 4% (30/37) at the 19th week, and compared with the 10th week before treatment, showing that curcumin can de-lay the recurrence of bladder cancer. TUNEL staining assay confirmed that curcumin significantly promoted the apoptosis in bladder cancer cells and inhibited their proliferation. The Western blot analysis showed that curcumin inhibited the activa-tion of NF-κB and effectively down-regulated the expression of NF-κB-regulated gene product. Conclusions Curcumin has a significant interventional effect on MNU-induced bladder cancer in the rat models. The mechanism may be through inhibi-tion of NF-κB activation and effective down-regulated NF-κB regulation of the gene products, and to regulate the expression of related proteins in bladder cancer, i. e. , inhibition of proliferation, induction of apoptosis, and further play a role of an-ti-cancer intervention and prevention of bladder cancer recurrence.

OBJECTIVETo explore the clinical effect of Agkistrodon antithrombogenase (AAT) in the treatment of rheumatoid arthritis (RA) and its possible mechanism.

METHODSBesides the conventional non-steroid anti-inflammatory agents and disease-modifying anti-rheumatic drug, patients were treated supplementally with intravenous injection of AAT. The intracutaneous test showed allergic to AAT patients were treated with Salvia injection and taken as control group. Changes of related clinical indexes in the two groups were observed.

RESULTSAfter 3 weeks treatment, condition of patients in both groups were improved clinically in joint swollen index, joint tenderness index, morning stiffness time, pain assessment (VAS) and health assessment questionnaire (HAQ) on daily life activity as well as ESR level (P < 0.05 or P < 0.01), with the VAS, HAQ and fibrinogen levels more significantly improved than those of control (P < 0.05 or P < 0.01), and the total effective rate higher in the AAT treated group than those in the control group (P < 0.05).

CONCLUSIONAAT has good effect on easing clinical symptoms of RA possibly through anti-inflammation and improving the microcirculation with less toxic and adverse reaction, so is worthy of recommendation.

Adult ; Ancrod ; therapeutic use ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Arthritis, Rheumatoid ; drug therapy ; Crotalid Venoms ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies

Objective To investigate the effect of bacillus Calmette-Guérin(BCG)on bladder cancer cells and their metabolites, and to preliminarily explore the possible mechanisms of BCG in the treatment of bladder cancer. Methods The rat model of bladder cancer was induced by intravesical instillation with N-methylnitrosourea(MNU). Bladder cancer cells and normal transitional epithelial cells were isolated and primarily cultured, and were divided into 5 groups according to the different components of the culture medium. The concentration of tumor necrosis factor-α(TNF-α) and interleukin-10(IL-10)in the supernatant of each group was detected by enzyme linked immunosorbent assay (ELISA). The concentration of BCG to inhibit the cancer cell growth was determined by MTT assay. Apoptosis of bladder cancer cells was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling(TUNEL). Results Among the 15 rats,2 rats died after 2 times of instillation, and 3 rats died after 3 times of instillation, without obvious tumors found at autopsy. The other 10 rats were killed after completion of the intravesically instillation of MNU, and obvious tumors were found in 8 of them after dissection. The results of MTT assay showed that BCG had an inhibitory effect on the growth of bladder cancer cells,and the inhibitory rate was positively correlated with the concentration of BCG. The results of ELISA showed that the concentrations of TNF-α in the supernatant of groups B and D were(160.654 ± 5.775) ng/L and(124.443 ± 4.972)ng/L, respectively, with significant differences from those of the other three groups. The concentrations of IL-10 in the groups B and E were(16.973 ± 3.428)ng/L and(20.327 ± 2.721)ng/L, significantly higher than those of the other three groups. Apoptosis of cancer cells was not found in all groups. HE staining of the primary bladder cancer cells showed that the volume of cell nucleus was increased, and the nucleo-cytoplasmic ratio was increased. The number of nucleoli in some cells was increased and some nuclei appeared like ink drops with prominent nucleoli. Conclusions BCG has an inhibitory effect on the growth of rat bladder cancer cells. IL-10 and TNF-α secreted by the tumor cells might be involved in this regulatory process. However,apoptosis does not show an obvious effect on this inhibitory process.

OBJECTIVE: Amplitude modulation of auditory cortical responses was evaluated with functional MRI (fMRI) in subjects of unilateral sensorineural hearing loss (USNHL) and those of normal hearing (NH). METHOD: Twenty-one subjects with USNHL and 11 with normal hearing were examined with fMRI in response to amplitude modulation tones of 500 Hz with the modulation frequency at 8 Hz. An event related design was combined with a sparse clustered volume acquisitioning paradigm in data collection in order to reduce the influence of acoustic scanner noise. SPM2 software was used for offline data analyzing. RESULT: Significant activation, including volume and intensity, were found in the temporal lobe of control subjects, and significant differences in the volume and intensity were noted between the contralateral and ipsilateral activated auditory cortexes in them, exhibiting clearly contralateral predominance. When the normal ear with unilateral sensorineural hearing loss received signals, while significant activations in bilateral auditory cortexes, greater activation in the contralateral auditory cortexes was found in the normal ear. CONCLUSION The difference in the lateralization between the two groups suggests the plasticity of auditory cortex with unilateral sensorineural hearing loss.
Adult ; Aged ; Auditory Cortex ; physiology ; physiopathology ; Case-Control Studies ; Female ; Hearing Loss, Sensorineural ; physiopathology ; Hearing Loss, Unilateral ; physiopathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Young Adult

OBJECTIVE: To investigate the transfection condition of Type 2 recombinant adeno-associated virus ( rAAV2) in human dendritic cells(DCs) which were induced from the bone marrow CD34+ hematopoietic stem /progenitor cells. METHODS: CD34+ hematopoietic stem /progenitor cells were purified from the bone marrow mononuclear cells by immunomagnetic beads, and the cells were cultured with IL-4 and GM-CSF and maturated by TNF-alpha on the 5th day. The rAAV2 /GFP was transfected into the induced cells at different time.The DCs were identified by electronic microscope. The expression of GFP was evaluated by flow cytometry and fluorescence microscope. RESULTS: The DCs were induced successfully. The typical morphologic characteristics of DCs were observed under the light microscope and transmission electronic microscope, and the typical phenotypes of DCs could be detected by flow cytometry. The expression rate of GFP gene on the 3rd day, the 5th day and after adding TNF-alpha was 0.45%, 13.54%, and 0.25%, respectively. CONCLUSION DCs can be induced from the human bone marrow CD34+ hematopoietic stem /progenitor cells, and infected with the rAAV2 /GFP successfully. The longer the induction time of DCs, the higher the transfection efficiency of DC. The transfection efficiency of immature DC is higher than that of mature DC.
Antigens, CD34 ; Bone Marrow Cells ; cytology ; Cell Differentiation ; Dendritic Cells ; cytology ; Dependovirus ; genetics ; Genetic Vectors ; Green Fluorescent Proteins ; genetics ; Hematopoietic Stem Cells ; cytology ; Humans ; Transfection

OBJECTIVETo explore the molecular mechanism of exocrine immune inflammatory injury of Sjögren's Syndrome and the intervention of Banxia Qinlian Decoction (BQD).

METHODSTotally 18 female NOD mice were randomly divided into the model group, the positive drug group, and the BQD group, 6 in each group. Six female BALB/c mice were recruited as a blank control group. Mice in the blank control group and the model group were gavaged with deionized water at the daily dose of 0.1 mL/10 g body weight. Tripterygium Tablet was administered by gastrogavage to mice in the positive group at the daily dose of 10 mg/kg. BQD was administered by gastrogavage to mice in the BQD group at the daily dose of 60 g crude drugs/kg. After 12 weeks of medication, mice were sacrificed. Their eyeballs were excised and blood collected. Tissues of bilateral parotids and submandibular glands were kept. mRNA transcriptional levels of IL-17, IL-6, type 3 muscarinic acetylcholine receptors (M3R), aquaporin protein-5 (AQP5) were detected by RT-PCR. Expression levels of M3R and AQP5 protein were detected by Western blot. Protein expression levels of IL-17 and IL-6 were detected by ELISA.

RESULTSCompared with the normal group, mRNA transcriptional levels and protein expression levels of IL-17, IL-6, M3R, and AQP5 were significantly up-regulated in the model group (P < 0.01). Compared with the model group, mRNA transcriptional levels and protein expression levels of IL-17, IL-6, M3R, and AQP5 were significantly down-regulated in the positive drug group and the BQD group with statistical difference (P < 0.01, P < 0.05). Compared with the BQD group, mRNA-transcriptional levels of IL-17, IL-6, and M3R, as well as M3R and AQP5 protein expression levels were significantly down-regulated in the positive drug group (all P < 0.01).

CONCLUSIONThe molecular mechanism of BQD in inhibiting SS exocrine neurotoxic injury might be possibly related to regulating Th17/IL-17 immune inflammatory way.

Animals ; Aquaporin 5 ; metabolism ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Interleukin-17 ; metabolism ; Interleukin-6 ; metabolism ; Mice ; Mice, Inbred BALB C ; Mice, Inbred NOD ; Sjogren's Syndrome ; drug therapy ; immunology ; Submandibular Gland ; Th17 Cells ; Up-Regulation

OBJECTIVETo discuss the technical points, advantages, follow-up results and mechanism of endovenous holmium laser treatment for varicose veins.

METHODSEndovenous holmium laser procedures were performed for 96 patients (99 legs) with primary varicosity of lower extremities. Perioperative Duplex was used for preoperative diagnosis, intraoperative guide and postoperative follow-up. The time of procedure and clinical results were observed. The mean follow-up time was 7 months.

RESULTSSixty-seven in 99 legs with saphenous vein occluded immediately during operation. All saphenous veins were confirmed to be occluded 7 days after the procedure. There was no recanalization with Duplex finding during the follow-up period. No wound complications. Two cases were with minor skin burn. One case was with saphenous nerve injury. Three cases were with thigh ecchymosis.

CONCLUSIONPreliminary results show endovenous holmium laser treatment for varicose veins is safe and effective in treating varicose veins with cosmetic appearance and quicker recovery.

Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Holmium ; therapeutic use ; Humans ; Laser Coagulation ; methods ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Saphenous Vein ; surgery ; Treatment Outcome ; Ultrasonography, Doppler, Duplex ; Varicose Veins ; diagnostic imaging ; surgery