Objective To explore the influence of modified Lawrence's reconstuction procedures following total gastrectomy for gastric cancer to alimentation of patients. Methods Retrospective analysis of nutritional status and symptoms of digestive tract in 76 patiens of total gastrectomy for gastric cancer while 3 and 6 month after modified Lawrence's reconstuction procedure. Results Examination was given in 48 patients 3 month after operation. Emptying time of barium was 60-100 min, barium meal backflowing to esophagus was not observed in all patients when they were in erect or decubitus position, no sign of narrow of anastomotic stoma. The hemoglobin, total protein, body weight and food-intake of patients 3 or 6 months after operation was as same as them before operation. Conclusion The patients undergoing this reconstuction procedure will recover normal food habits soon after operation, Lawrence's reconstuction procedures is a satisfactory choice in patients of total gastrectomy for gastric cancer because of its safety and convenient.

ObjectiveTo evaluate the role of nitric oxide (NO) in ischemia reperfusion injury (IRI) and acute rejection (AR) of intestinal transplantation in rats.MethodsThe rat orthotopic intestinal transplantation was performed. Animals were assigned to the following 4 groups with random methods:transplant control group,L-arginine (L-Arg) group,NG-Nitro-L-arginine methyl ester (L-NAME) Ⅰ group (group Ⅰ ) and L-NAME Ⅱ group (group Ⅱ ).The rats in different group were given saline,L-Arg (150 mg· kg-1 · d-1 ),L-NAME (4 and 8 mg· kg-1 · d-1 ) injection respectively from the operative day.The recipient survival time was observed.The pathologic changes were observed by HE staining.The activity of nitric oxide synthases (NOS) was measured by using immunohistochemistry.The abilities of glucose absorption and serum NO levels were tested.Results The recipient survival timein transplant control group,L-Arg group,group Ⅰ and group Ⅱ were (11.7 ± 1.2),(10.2 ± 1.0),( 12.3 ± 1.5) and ( 17.3 ± 1.9) days respectively,and the survival in group Ⅱ was prolonged significantly (P＜0.01).As compared with control group,the Park scores in L-Arg group and group Ⅰ were reduced,and IRI were attenuated; the Park score in group Ⅱ was increased (P＜0.01),the IRI was aggravated,but the AR was attenuated.As compared with control group,during the IRI period,the iNOS staining in group Ⅰ was decreased,and both iNOS and nNOS staining in group Ⅱ was decreased; during the AR period,the iNOS staining in group Ⅱ was decreased obviously.The serum NO levels were increased gradually in all groups.As compared with control group,the increase of serum NO level in group Ⅱ was delayed.As compared with control group,the glucose absorption levels in L-Arg group were increased significantly from 30 min after reperfusion to POD-3 (P＜0.01),and the postoperative glucose absorption levels in groups Ⅰ and Ⅱ maintained the low levels.ConclusionNO may play a dual role as both cytotoxic and cytoprotective effects in IRI,and aggravate mucosal damage in AR in rats intestinal transplantation.The glucose absorptive capacity of graft is promoted by supplementation of LArg at early postoperative period.

OBJECTIVETo observe the effect of Qianliean Pill (QP) on inflammatory factors such as IL-1β, IL-10, and tumor necrosis factor α (TNF-α) in chronic nonbacterial prostatitis (CNP) model rats, and to explore its therapeutic mechanism.

METHODSCNP rat model was established by castration and estradiol benzoate injection. Totally 50 rats were randomly divided into 5 groups, i.e., the model group, the positive medicine group, the high dose QP group, the medium dose QP group, and the low dose QP group, 10 in each group. Besides, 10 normal rats were recruited as a normal control group. Since the 8th day of castration, Pulean Tablet (PT) at 10. 80 g/kg was administered to rats in the positive medicine group by gastrogavage. QP at 11.00, 5.50, and 2.75 g/kg was administered to rats in high, medium, and low dose QP groups by gastrogavage. Distilled water at 2 mL/100 g was administered to rats in the model group and the normal control group by gastrogavage, once daily for 30 successive days. After 30 days of medication all rats were sacrificed and their prostate tissues were extracted. The prostatic index was calculated. Pathological changes of rat prostate were observed under light microscope. Meanwhile, levels of IL-1β, IL-10, and TNF-α were detected using enzyme linked immunosorbent assay.

RESULTSCompared with the normal control group, the prostate index obviously decreased, levels of IL-1β, TNF-α, and IL-10 in the prostate tissue significantly increased in the model group (P < 0.01). Compared with the model group, the prostate index obviously decreased in high and medium dose QP groups, and the positive medicine group (P < 0.01); levels of IL-1β, TNF-α, and IL-10 obviously decreased in each QP group and the positive medicine group (P < 0.01). Compared with the positive medicine group, the TNF-α level decreased more obviously in the high dose QP group (P < 0.05). Compared with the normal control group, inflammatory reactions occurred obviously in rats' prostate of the model group. Compared with the model group, inflammatory reactions were milder in rats' prostate of each QP group and the positive medicine group, and their degrees were improved to some extent.

CONCLUSIONQP could treat CNP, which might be achieved by regulating local immune state of the prostate, relieving inflammatory reactions of the prostate, and lowering levels of IL-β, TNF-α, and IL-10 in the prostate tissue.

Animals ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Humans ; Interleukin-10 ; metabolism ; Interleukin-1beta ; metabolism ; Male ; Prostatitis ; drug therapy ; metabolism ; Rats ; Tumor Necrosis Factor-alpha ; metabolism

Objective To investigate the p53,Bax,bcl-2 gene in NaAsO2-induced human embryonic lung fibroblasts(HELF)apoptosis.Methods HELF was divided into HELF cells transfected with p53 plasmid(p53 group),HELF cells transfected with PC plasmid(PC group)and normal cultured HELF cells(normal group).The mRNA expression of p53,Bax and bcl-2 gene was detected by real-time PCR,the protein expression of p53,Bax and bcl-2 was assessed by immunohistochemical SABC and the cell apoptosis of HELF was detected by flow cytometry(FCM),in a 6-well plate and cultured for 48 hours,which was exposed to different doses(0,3,9,15mmol/L)NaAsO2 for 24 hours.Results The p53 gene mRNA expression level of p53 group(0.51±0.29)was lower than that of the normal group and PC group [ (1.00 ± 0.20), (1.32 ± 0.26), all P < 0.05 ]. The p53 protein expression level of p53 group(4.10 ± 1.20) was lower than the PC group and normal group[ (8.00 ± 1.63), (7.90 ± 1.79), allP < 0.05]. In p53 group, PC group, normal group exposed to 0,3,9,15 mmol/L NaAsO2 doses, the apoptotic rate [(0.57 ± 0.28)%, (22.91 ± 4.86)%, (40.05 ± 3.93)%, (44.87 ± 3.58)%; (0.65 ± 0.24)%, (14.09 ± 3.49)%,(20.31 ± 3.66)%, (32.42 ± 3.63)%; (0.56 ± 0.25)%, (12.14 ± 3.70)%, (19.61 ± 3.63)%, (30.43 ± 2.83)%], Bax mRNA expression level[(12.73 ± 3.96), (25.12 ± 6.42), (104.96 ± 26.77), (154.04 ± 30.52); (14.63 ± 3.57),(36.75 ± 3.67), (272.26 ± 66.11), (846.12 ± 243.36); (14.75 ± 5.65), (37.22 ± 11.27), (278.51 ± 37.42),(861.67 ± 369.29) ], Bax protein expression level [ ( 15.07 ± 0.83 ) %, ( 23.79 ± 3.99 ) %, (38.51 ± 1.58 ) %, (53.86 ±1.74)%;(15.43 ± 1.45)%,(36.11 ± 1.37)%, (56.86 ± 1.97)%, (76.09 ± 2.01)%; (15.20 ± 1.03)%,(35.25 ±1.09)%, (55.56 ± 2.17)%, (74.48 ± 2.85)% ] was respectively increased in a dose-dependent manner with the increased concentration of NaAsO2(all P < 0.05). The bel-2 mRNA expression level [ (443.00 ± 244.47), (156.79 ±53.18), (62.13 ± 13.66), (23.10 ± 6.44); (420.55 ± 110.77), (48.15 ± 10.02), (14.91 ± 6.53), (7.54 ± 2.62);(577.75 ± 123.22), (49.68 ± 10.11), (12.41 ± 1.28), (7.22 ± 1.89)], bcl-2 protein expression level[(47.20 ±3.77)%, (41.80 ± 2.94)%, (36.00 ± 2.36)%, (29.00 ± 2.91)%; (45.90 ± 4.15)%, (35.70 ± 2.77)%, (29.80 ±2.78)%, (24.80 ± 2.66)% ; (46.70 ± 3.47)%, (36.20 ± 2.90)%, (30.10 ± 3.21)%, (25.10 ± 2.28)% ] wasdecreased in a dose-dependent manner with the increased concentration of NaAsO2(all P < 0.05 ). In 3,9,15 mmol/L NaAsO2, apoptotic rate of p53 group, mRNA expression of bcl-2, protein expression of bcl-2 was higher than that ofnormal group and PC group, respectively (all P < 0.05), but mRNA expression of Bax, protein expression of Bax was respeetivelylower than that normal group and the PC group(P < 0.05 ). Conclusion p53 gene reduced the apoptosis induced by NaAsO2 in HELF, possibly by changing the apoptosis pathway.

Objective To explore prevention and cure effects of the freeze-dried human fibrin glue as the way of the lacrimal duct embolization on xerophthalmia in perimenopausal female rabbit.Methods A total of 72 female rabbits,after anti infection treatment and were cut off third eyelid,were made into perimenopausal xerophthalmia rabbit models.After surgery,all of these rabbits were randomly divided into 6 groups (12 rabbits per group):No treatment group after surgery (group A),PBS prevention group (group B),freeze-dried human fibrin prevention group (group C);no treatment group after modeling (modeling time:Two weeks after surgery,group D),PBS treatment group (group E),freeze-dried human fibrin treatmentgroup (group F).The Schirmer test (SIT),corneal fluorescein (FL) and corneal confocal microscope were performed before and 2 weeks,4 weeks,6 weeks after injection.Results There were statistical differences in FL score and SIT in group A,group B and group C among different time points (F =27.346,10.608;P =0.000,0.001);There were statistical differences between FL scores and SIT among three groups (F =7.579,6.786;P =0.002,0.007);There was significant difference in FL scores and SIT trends among three groups(F =44.897,3.424;P =0.000,0.045).The FL score and SIT of group D,group E and group F were significantly improved after treatment for 2 weeks,4 weeks and 6 weeks,the differences were statistically significant (t =2.906,3.654,4.504;P =0.022,0.017,0.013.t =4.573,5.759,7.231;P =0.032,0.019,0.008);The difference between FL score and SIT in group E and group F was statistically significant after treatment (t =2.776,4.124,5.324;P =0.032,0.026,0.017.t =1.969,3.122,4.324;P =0.038,0.023,0.009).After injection of 6 weeks,the epithelial basal cells (F =17.306,P =0.002) and inflammatory cells (F =34.024,P =0.000) of group A,B and C were significant changed,the differences were statistically significant.After injection of 6 weeks,the epithelial basal cells (F =3.749,P =0.042)and inflarnmatory cells(F=8.806,P =0.005) of group D,E and F were significant changed,the differences were also statistically significant.Conclusion Lacrimal duct embolization with freeze-dried human fibrin glue is effective for the xerophthalmia.

BACKGROUNDPremature ventricular contraction (PVC) is one of the most common kinds of arrhythmias for which the treatment falls into dilemma. Previous clinical application showed that the traditional Chinese Medicine Shensongyangxin (SSYX) capsule is efficacious for the treatment of PVCs. This randomized clinical trial aimed to further evaluate the efficacy and safety of SSYX capsule on treating PVC.

METHODSThe subjects who had frequent PVCs with or without organic heart disease and normal cardiac function were enrolled in the study. The primary endpoint was the change of PVC numbers after eight-week medication with SSYX capsule. The secondary endpoints included change of clinical symptoms related to PVCs and the safety evaluation of SSYX capsule. Totally 188 PVC patients were randomly enrolled in the non-organic heart disease PVCs trial and orally took either SSYX capsules or analogues (three times per day, 4 capsules one time). A total of 671 PVCs patients were randomly enrolled in the organic heart disease PVCs trial, and orally took either SSYX capsules (three times per day, 4 capsules one time) or mexiletine tablet (three times per day, 150 mg one time). The PVCs were monitored and calculated with 24-hour Holter electrocardiogram. Routine blood, liver and kidney function were tested before and after medication with SSYX capsule.

RESULTSSSYX capsules significantly decreased the PVCs numbers and alleviated the related symptoms in patients with or without organic heart disease. In non-organic heart disease group, SSYX capsules and the placebos decreased the PVCs from 12,561.34 ± 9,777.93 to 4,806.87 ± 6,507.17, and 12,605.69 ± 8,736.34 to 10,364.94 ± 9,903.41, respectively. The total effective rate was 74.2% and 28.9% in SSYX and placebo groups (P < 0.001). In organic heart disease group, SSYX capsule and mexiletine decreased the PVCs from 8,641.01 ± 8,923.57 to 3,853.68 ± 7,096.42, 8,621.61 ± 8,367.74 to 5,648.29 ± 8,667.38, respectively. The total effective rate was 65.8% and 50.7% in SSYX and mexiletine groups (P < 0.001). In addition, SSYX capsule significantly alleviated PVCs-related symptoms such as palpitations, chest tightness, insomnia, fatigue, and night sweats. No adverse cardiac events were observed except some slight gastrointestinal side effects during the study.

CONCLUSIONSCompared with placebo or mexiletine, SSYX capsules have significant therapeutic efficacy in reducing PVCs numbers and alleviate PVCs-related symptoms.

Capsules ; therapeutic use ; Double-Blind Method ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Ventricular Premature Complexes ; drug therapy

Objective To find a reliable, simple, and easily-operated method for the screening of neonatal congenital heart disease (CHD). Methods A total of 7 105 neonates born from January 2017 to July 2017 were selected. The validity and reliability of physical examination, pulse oximetry screening (POS), and perfusion index (PI) in the screening of neonatal CHD were evaluated according to the diagnosis made by color Doppler echocardiography. Results When physical examination, POS or PI was used separately in screening for CHD, the sensitivities were in the range of 13.11%~73.77%, specificities 50.20%~99.34%, Youden indexes 0.12~0.70, the total coincidence rates 50.40%~98.86%, positive predictive values 1.27%~40.70%, and negative predictive values 99.29%~99.70%. When physical examination, POS and PI were combined (two or three indexes were positive) for screening, the sensitivities and Youden indexes were 85.25% and 0.82 respectively, which were higher than those of single indicators and suggested that the combination had higher authenticities. The total coincidence rate of the combination was 97.07%, and, although it was lower than POS group (98.86%) and PI screening group (98.58%), it still had a good reliability. Conclusions The combination of physical examination, POS and PI has a certain clinical value in neonatal CHD screening.

Summary: Glomerulosclerosis, defined as phenotype transition of mesangial cell and deposition of extracelluar matrix, remains a chronic disease with excessive morbidity and mortality. The molecular mechanism underlying the suppression of mesangial cell activation is not fully understood. Since activation of peroxisome proliferators-activated receptor γ (PPAR1,) has been proposed to decrease the effects of transforming growth factor-β (TGF-β) on glomerulosclerosis, we examined here whether and how telmisartan, an angiotensin Ⅱ type Ⅰ receptor blocker with PPARγ-modulating activity, inhibited TGF-β-induced giomerulosclerosis in rat glomerular mesangial cells. Protein levels of PPARγ were detected by Western blot. Activation of PPARγ response element (PPRE) was analyzed by luciferase assays. Deposition of extracelluar matrix was tested by confocol laser scanning. The results showed that telmisartan, but not valsartan, another angiotensin Ⅱ type Ⅰ receptor blocker,up-regulated PPARγ protein levels in a dose-dependent manner (P<0.05). Activation of PPRE, represented by luciferase activity, was also increased with higher concentration of telmisartan in a dose-dependent manner (P<0.05). Furthermore, telmisartan inhibited TGF-β-induced α-smooth muscle actin expression and collagen IV secretion in mesangial cells. GW9662, an inhibitor of PPAR-γ,blocked the inhibitory effects of telmisartan on TGF-β-induced glomerulosclerosis in mesangial cells. Our study indicates a benefit of telmisartan as a PPARγ agonist against TGF-β-induced mesangial cells activation in renal glomerulus. It may provide possibility that telmisartan works as a potential agent against diabetic nephropathy and hypertensive renal disease.

High degree atrioventricular block (HDAVB) is a serious complication of transcatheter closure of a perimembranous ventricular septal defect (PMVSD). We report one patient who developed transient HDAVB seven days after transcathter closure of PMVSD and had recurrent HDAVB 42 months after the procedure.
Atrioventricular Block ; etiology ; Heart Septal Defects, Ventricular ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Recurrence ; Septal Occluder Device

OBJECTIVETo evaluate the efficacy of left atrium linear lesion encircling pulmonary veins (PV) guided by EnSite-NavX and double-Lasso technique for paroxysmal atrial fibrillation (PAF).

METHODSTwenty-two patients (male 19, mean age of 48.5 years +/- 11.4 years) with symptomatic PAF were enrolled. After a geometry of the left atrium was reconstructed by EnSite-NavX system, PV ostia were marked on the map based on venography. Two Lasso catheters were placed within the ipsilateral superior and inferior PVs. Irrigated radiofrequency energy was applied at 0.5-1.0 cm of distance from the PV ostia. Continuous linear lesion was done to obtain the disappearance of pulmonary vein potentials. Patients were on propafenone and perindopril for three months after the procedure.

RESULTSThe endpoint for ablation was reached in 21 Patients and 1 patient was not successful because of cardiac tamponade. The mean procedure time was 6.6 h +/- 1.3 h and the mean X-ray exposure time was 56.1 min +/- 18.0 min. After a mean 5.3 months +/- 2.7 months of follow-up, 10 patients were free of symptoms. Two patients had no PAF recurrence after the second procedure. Three patients had clinical recurrence of PAF in the first month. The total success rate in this study was 81% (17/21). Mortality was 0% and the overall complication rate was about 9% (2/22).

CONCLUSIONLeft atrium circumferential linear ablation surrounding PV ostia guided by EnSite-NavX and double-Lasso technique is effective in PAF, but some patients will need more than one procedure in order to achieve a success.

Adult ; Aged ; Atrial Fibrillation ; surgery ; Catheter Ablation ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pulmonary Veins ; surgery