Objective To evaluate the efficacy and safety of repeated endoscopic sclerotherapy injection(ESI) and endoscopic variceal ligation(EVL) in eradication of esophageal varices among patients who survive an episode of first variceal hemorrhage with a high risk of rehaemorrhagia and death. Methods The correlated literatures were identified from Medline,Embsae,the Library Cochrance,PubMed and CNKI.RevMan 4.2 Software provided by the Library Cochrance was used for data analysis. Results A total of 4 randomized controlled trials were included.It was demonstrated that there was no significant difference in the esophageal varices eradication rate between repeated ESI and EVL(OR=0.75,95%CI: 0.48-1.15;P=0.19).However,the rehaemorrhagia rate of EVL after emergency hemostasis was significantly lower than that of ESI(OR=2.19,95%CI:1.44-3.31;P=0.000 2).Meanwhile,there was no significant difference in mortality between ESI and EVL(OR=1.34,95%CI:0.82-2.17;P=0.24).Little publication bias was found with funnel plot analysis. Conclusion EVL outperforms ESL in prevention of rehaemorrhagia in treatment of esophageal varices,while does no better than ESL in eradication of esophageal varices and mortality.

ObjectiveTo explore the possible pathogeny of tension headache(TH) as well as some emotional and cognitive function impediment.Methods53 cases with tension headache were given coronal CT or MRI examination and cervix X-ray examination.Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS) and Mini-Mental State Examination(MMSE) were used to assess their emotion and cognition.ResultsThere were 14 cases of magnitude mental events induced anxiety and/or depression,23 cases of work tensions induced anxiety,14 cases of work tensions induced depression,and 12 cases of lightly cognitive impediment.ConclusionTension headache patients usually related with continued convulsion of cervical muscle induced by hard work and life.Most of them represent more or less emotional impediment,part of them represent lightly cognitive impediment.

Objective To study the influence of cholangiocarcinoma cells on endothelial cells in a co-culture system. Methods A co-culture system of eholangioeareinoma cell line QBC939> and endothelial cells was established in vitro (co-culture group). Endothelial cells were cultured individually during the same time (control group). The mixed supematant of cholangiecareinoma cells and endothelial cells was in the mixed group. Light microscopy and transmission electron micrescopy were used to observe the morphology of the endothelial cells. Changes in expression of ppI25FAK, MMP-2, MMP-9 and uPA of the endothelial cells were detected by mmunofluorescence, and the activities of MMP-2 and MMP-9 were detected by gelatin zymography. All the data were analyzed by paired t test. Results The intercellular space between endothelial cells in co-cuhure group was wider than in the control group. The expression of pp125FAK, MMP-2, MMP-9 and uPA was 394 ±51,455±82, 377±48,422±55 in control group, and was 1096±128,931±72,815±76,801±56 in the eo-euhure group. The difference between the 2 groups had statistical significance (t = 6.53,4.32, 3.61,3.45, P < 0. 05). The values of gray-scale scanning of MMP-2 and MMP-9 in the mixed group were 240.2±15.2 and 2.4±0.8, respectively. The values of gray-scale scanning of MMP-2 and MMP-9 in the co-culture group were significantly increased, they were 687.4 ± 43.6 and 150.9 ± 13.2, respectively (t = 4.89, 5.43, P < 0.05). Conclusions The intercellular space between endothelial ceils and the expression of the proteolytie enzymes are increased after co-culturing endothelial cells with eholangiocarcinoma cells. Proteolytie enzymes may be involved in the process of degradation of subendothelial matrix, and promotes the metastasis of cholangiocarcinoma.

Acute Lung Injury ; metabolism ; Animals ; Extremities ; blood supply ; Group II Phospholipases A2 ; metabolism ; Male ; Rats ; Rats, Wistar ; Reperfusion Injury ; metabolism ; Taurine ; pharmacology

Objective To investigate the effect of different concentrations of dexmedetomidine on the apoptosis of hippocampal neurons in neonatal rat induced by propofol in vitro. Methods Hippocampal neurons of primary cultured neonatal SD rat were divided randomly into three groups. Group C (control group)was normal cultured without any treatment for 12 h; group P (Propofol group)was incubated with 12 μg/mL propofol for 12 h and group DP (Dexmedetomidine + propofol group)was incubated with 0.002 5 ~ 25 μg/mL dexmedetomidine for 30 min, and then further incubated with 12 μg/mL propofol for 12 h. Results Compared with that of group C, the apoptosis rate of hippocampal neurons increased in group P and DP (P < 0.05 or P < 0.01); Compared with that of group P, the apoptosis rate of neurons decreased with the increase of dexmedetomidine concentration in group DP (P<0.05 or P<0.01). The result of transmission electron microscope indicated that compared with group C , group P showed obvious neuronal damage; the nerve cells damage alleviated in group DP, which were negatively associated with the concentration. Conclusions With the concentration ranging from 0.002 5 to 25 μg/mL, dexmedetomidine set pre-incubation and breeding can reduce apoptosis of hippocampus neuron of neonatal rats induced by propofol and the effect is concentration dependent.

Objective To investigate the application of delayed sternal closure (DSC) following neonatal cardiac surgery.Methods We retrospectively analyzed clinical data of 360 neonatal patients underwent cardiac surgery through median sternotomy in Guangdong General Hospital between June 2009 and June 2014.These neonates were divided into 2 groups:DSC group (190 cases) and non-DSC group(170 cases).Comparing the differences between 2 groups,we analysed the application of DSC following neonatal cardiac surgery and the effect of DSC on surgical site infection.Results The cardiopulmonary bypass time,cross clamp time and mechanical ventilation time were longer in DSC group than in non-DSC group.The mortality rate in the DSC group(20.53％) was markedly higher than that in the non-DSC group(5.29％).However,there was no statistical difference in the incidence of sternal wound infection between 2 groups.Conclusion As an effective treatment for neonates with severe cardiac surgery,DSC doesn' t increase the incidence of surgical site infection.

Objective To understand the gene carrying rate ,gene mutation types and distribution characteristics of thalassemia in the northeast area of Chongqing .Methods 28 633 specimens collected from the patients and individuals with physical examina‐tion in our hospital from January to December 2013 were performed the RBC parameters detection and hemoglobin electrophoresis screening .The specimens with phenotype positive were definitely verified the thalassemia type by using Gap‐PCR and reverse dot blot(RDB) .Results Among 28 633 specimens ,1 358 specimens were finally diagnosed as thalassemia with the thalassemia carrying rate of 4 .74% ,including 589 cases(2 .06% ) of α‐thalassemia and 741 cases (2 .59% ) of β‐thalassemia cases .Among the α‐thalasse‐mia genotypes ,‐αα/‐‐SEA genotype(1 .38% ) was most common ,the next was ‐αα/‐α3 .7 genotype (0 .37% ) and αα/‐α4 .2 genotype (0 .20% ) .Among the β‐thalassemia genotypes ,CD41‐42 genotype (1 .27% ) had the highest constituent ratio ,followed by IVS‐2‐654 genotype(1 .27% ) and CD17 genotype(0 .30% ) .28 cases were found to be the double heterozygote with α‐thalassemia and β‐thalassemia .Conclusion The northeast area of Chongqing is a region with the high incidence rate of thalassemia and complicated heredity .Therefore this research provides the reference information for the prevention of thalassemia ,genetic counseling and prena‐tal diagnosis .

Tibetan medicineLiu-Wei Mu-Xiang(LWMX) pill, a traditional compound medicine, has special therapeutic effects in the treatment of gastrointestinal anabrosis, especially chronic gastric ulcer. It has been widely applied in the clinics in Tibetan region. Nevertheless, the current standards for quality control are insufficient and incomplete, which makes it difficult to ensure its quality. This review focused on two closely related perspectives, which were the effective material basis and quality control, to summarize and review the recent advancement in relevant studies. This review also pointed out that the burning questions for Tibetan medicine standards were the origin confusion and“different medicines with the same name”. It offered meaningful suggestions for the consideration to improve its quality standards.

Objective To investigate the changes of glucocorticoid receptor (GR) gene expression in the hippocampus of rats following scald burn stress and the role of N methyl D aspartate (NMDA) receptor in this change. Methods Adult male Wistar rats inflicted with 30% TBSA full thickness scalding were applied as severe scalding stress model. GR mRNA levels in the hippocampus were detected with RT PCR. Results A significant decrease of GR mRNA levels was observed in the hippocampus 2 h after the scalding stress. The decrease could be inhibited when MK 801, an NMDA receptor antagonist, was administered prior to stress, and be augmented with the administration of NMDA, an NMDA receptor agonist, but not be affected by normal saline. Conclusion NMDA receptors are involved in the scalding stress induced down regulation of GR gene expression in the rat hippocampus.

Key trial activities include: development of the trial protocol;development of standard operating procedures;development of support systems and tools;generation and approval of trial information documents;selection of trial sites and the selection of properly qualified,trained,and experienced investigators and study personnel;ethics committee review and approval of the protocol;review and approval by applicable regulatory authorities;enrollment of subjects into the study: recruitment,eligibility,and informed consent;the investigational product(s): quality,handling,and accounting;trial data acquisition: conducting the trial;trial data acquisition: conducting the trial; safety management and reporting;monitoring the trial;managing trial data;quality assurance of the trial performance and data;reporting the trial.