OBJECTIVE Approach the cause of esophageal perforation and the analysis of diagnosis, therapy and its outcome in this disease. METHODS We retrospectively review 11 patients of esophageal perforation between1997 and 2004 in our department. There were 9 cases were taken out foreign bodies from their esophageal, another 2 cases haven't been found any foreignbodies and 1 of 2 was caused by iatrogenic reasons. Perforation occurred in the cervical esophagus was 4, and in the thoracic esophagus was 7. Their symptoms were dysphagia or pain, retrosternal-pain, dyspnea, subcutaneous emphysema, fever, hematemesis or melena. RESULTS 7/11 cases visited the clinic during 24 hours after foreign-body occured, 4/11 cases visited after 24 hours and the last visited clinic on 27th day late. Dysphagia was the most common presenting symptom specially with pain in eating, noted in 9 cases (81.8 %); retrosternal-pain and fever were noted in 8 cases (72.7 %), subcutaneous emphysema in 5 (45.5 %), dyspnea in 2 (18.2 %), hematemesis and melena.in 1 (9.1 %). 5 cases were died and the common mortality was 45.45 % (5/11). The mortality in primary repair with surgery treatment was 66.7 % (2/3); the mortality in conservative management was 37.5 % (3/8). The mortality of the perforation in cervical esophagus was 25 % (1/4), in thoracic esophagus was 57.14 % (4/7). The mortality of the visit time in 24 hours was 28.57 % (2/7),and out of 24 hour was 75% (3/4). CONCLUSION Sophageal perforation is usually caused by foreign body or iatrogenic in ENT-Head&Neck surgery. The esophageal perforation will been cured that decided in early visiting, taking away of foreign-boby, the right choice of antibiotic, nutritional support, primary healthy statement of esophagus. We regard that should perform non-operational conservative therapy in the patients who resulted in esophageal perforation except abscess or remain causing by foreign body. And the high risks in mortality of the repairing in surgery should been noticed.

0.05).Except imipenem and ampicillin,there was significant difference between the resistance of non-ESBLs-producing strains from CAP and from HAP to other eleven kinds of antibiotics(?2 test,P

Objective To investigate the evolution of nonspecific manifestations of pulmonary function in elderly people.Methods Retrospective analysis of the data of nonspecific pulmonary function(NSPF) on the initial PF testing in elderly people from the same PFT apparatus in Beijing Hospital were collected from January 2004 to December 2012.All the patients with complete clinical data and reexamination at least one time were enrolled into this analysis.NSPF was defined as normal FEV1/FVC and TLC combined with a decreased FEV1 or FVC or both.All the patients with complete clinical data were divided into blocking group,restricted group,NFSP group and normal group according to their PF.The comparison was performed among these groups.Kaplan-Meier was used for analysis of the turnover and outcome of elderly NSPF patients,log-rank test was used for comparing the difference of turnover and outcome and COX regression was used for analyzing single and multiple factors of different turnover and outcome.Results Overall 59 patients were diagnosed as NSPF,with male:female ratio of 52:7,the average age of(71.8 ± 8.8)years and at a median follow-up of 4 years.The statistically significant differences in age,sex,body mass index(BMI),smoking status,both the clinical manifestations and chest CT performance at first visit and during the following-up were not found among the groups(all P ＞0.05).The pulmonary functions of NSPF patients were transformed into an obstructive pattern(19.6 ％),into a restrictive pattern(7.6 ％)and into a normal pattern(8.8 ％) in 4 years cumulative incidence rate,with statistically significant in differences(x2 =7.411,P =0.024).An invariant pulmonary function in NSPF patients accounted for 64.0％ in the most,and the second was obstructive ventilation function disability.Monomial and multinomial Cox regression analysis showed that emphysema and bulla in the initial CT scan was the predictor of the change to the obstructive pattern from NSPF during follow-up(HR=4.325,P=0.045),age was the predictor of the change to the restrictive pattern(HR=1.143,P=0.020).And pleural thickening and disappearing of pleural effusion were the predictor of change to the normal pattern (HR =8.889,P =0.018) respectively.Conclusions Most NSPF in elderly people could exist consistently.Obstructive pattern is the maximal likelihood of NSPF changing to the other pattern.Emphysema and bulla in the initial CT scan is the predictor of the obstructive pattern.The change is related with emphysema and bulla in the initial CT scan.

Adult ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Prostatitis ; drug therapy ; prevention & control

Acute Disease ; Asthma ; drug therapy ; Bronchodilator Agents ; administration & dosage ; adverse effects ; therapeutic use ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infusions, Intravenous ; Male ; Theophylline ; administration & dosage ; adverse effects ; analogs & derivatives ; therapeutic use ; Treatment Outcome

Objective To observe the effects on rabbit corneas and retinas after single intravitreal injection of voriconazole at different doses.Methods According to the randomization table,25 healthy rabbits were randomly divided into control group,and voriconazole 50,100,200,and 400 μg groups.Therefore,there were 5 rabbits in each group.The eyes of control group received intravitreal injection of 0.1 ml balanced saline solution,and those treatment groups received 0.1 ml voriconazole injection of corresponding dose.Before the injection and 1,7,and 14 days after the injection,endothelial cell counts and corneal thicknesses were measured;full-field electroretinogram were performed and b-wave amplitudes in maximal combined reaction (Max-R) were recorded.On 14 days after the injection,histologic structures were observed by light microscope and transmission electron microscope.Results There was no significant difference in endothelial cell counts (F=0.320,0.291,0.467,0.649) and corneal thicknesses (F=0.214,0.284,0.360,0.225) with those of control group at any time points (P＞0.05).Before and 1 day after the injection,b-wave amplitudes of each voriconazole group had no significant difference compared with those of control group (F=0.220,0.106;P＞0.05).On 7 days after the injection,b-wave amplitudes decreased significantly at doses of 200 μg and 400 μg (P＜0.05).On 14 days after the injection,there was no significant difference between the the amplitude of 200 μg group and that of control group (P＞ 0.05).However,the amplitude of the 400 μg group decreased continuously and there was still significant difference (P＜0.05).Light microscopy did not reveal any corneal abnormality in both control group and voriconazole groups.The retinas were normal except that of the 400 μg group,which had a thinner and degenerated inner nuclear layer and disordered photoreceptor layer.Under transmission electron microscope,there were no ultrastructure damages of corneas in both control group and voriconazole groups,either.The rabbit retinas of the 50 μg and 200 μg group have normal inner nuclear layer and photoreceptor layer,but degrees of changes in both layers were observed in the eyes of 200 μg and 400 μg group.Conclusions There is no obvious effects on rabbit corneas and retinas after single intravitreal injection of voriconazole at he dose less than or equal 100 μg.There are no obvious effects on rabbit corneas at the dose of 200 μg and 400 μg,while there are damages to the retinas in both functions and histological structures.

Objective To study the relationship between apoE alleles and the occurrence of sporadic Alzheimer's disease (SAD) and to compare the alleles relating to the SAD and the vascular dementia (VD). Methods The polymorphism of apoE gene was detected using polymerase chain reaction restriction fragment length polymorphism(PCR RFLP) technique for 58 patients with SAD, 59 patients with VD and 60 normal controls. Results The frequencies of the ?4 and 3/4 genotype in SAD group(19 82% and 25 86%)were significantly higher than those in the controls(5 00% and 6 67%, ? 2=13 87, P 0 05). Conclusions The apoE ?4 allele is a genetic risk factor for the occurrence of SAD.

Objective To observe anomalous genotypes of 4 multi-copy RM Y-STRs in Han population in Hubei province. Methods 252 unrelated male samples were ampliifed using reported and newly designed primers, then detected and analyzed by AB 3130 genetic analyzer. Results A total of 25 anomalous multi-band patterns were observed in 20 samples corresponding to an incident rate of 7.94%. 5 anomalous genotypes were observed in DYF387S1 locus, 15 in DYF399S1, 1 in DYF403S1 and 4 in DYF404S1. Four samples showed extra alleles in more than one locus. Conclusion Anomalous genotype has high incident rates in RM Y-STR markers and requires extensive attention in forensic practice.

Objective To explore whether combined olmesartan angiotensin Ⅱ receptor type 1 blocker(ARB) and angiotensin-converting enzyme inhibitor(ACEI) temocapril have synergistic effect on reversal of left ventricular hypertrophy (LVH) in stroke-prone spontaneously hypertensive rats (SHRsp). Methods Fourty-four SHRsps and 11 Wistar-Kyoto rats(WKY) were divided randomly into 5 groups:WKY-control group, SHRsp-control group, SHRsp-olmesartan 10 mg/(kg?d)group, SHRsp-temocapril 10 mg/(kg?d)group, and SHRsp-Olmesartan 3 mg/(kg?d)+temocapril 3 mg/(kg?d) group for 6 weeks. Hearts weight were measured and histologically studied. The mRNA expression of angiotensin Ⅱ receptor type 1(AT1R) and integrin ?1 in myocardium was detected by RT-PCR. Results Olmesartan, temocapril and the their combination significantly reduced systolic blood pressure in a similar magnitude. Combination therapy was shown not greater effect in reversal of LVH than by olmesartan alone, although the effect by both of them was greater than temocapril monotherapy. The mRNA levels of AT1R and integrin ?1 in SHRsp were significantly decreased by treatment with olmesartan, temocapril, or combination therapy. Olmesartan and combination therapy result in greater decreases in expression of AT1R and integrin ?1 mRNA in myocardium than that by temocapril. Conclusion Compared with olmesartan alone, the combination of ARS and ACEI didn't show synergistic effect on reversal of left ventricular hypertrophy as were down-regulation of AT1R and suppression of integrin ?1 mRNA in myocardium.

Objective To study the bone turnover and its related molecular mechanism in STZ-induced diabetic rats. Methods Of 30 male SD rats studied, 15 were induced diabetics by intravenous injection of streptozotocin (50 mg/kg)and fed for 8 weeks. After the sacrifice of both the diabetic and control groups, serum Ca, P, alkaline phosphatase (ALP), and osteocalcin were determined, and 24 h urinary Ca and urinary cross-linked N-telopeptide of type Ⅰ collagen (NTx)and creatinine (Cr)ratio were also determined. The left tibia was dissected for bone histomorphometry analysis. Right femur and lumbar vertebrae (L1-L4) were reserved for bone mineral density (BMD) determination. The right tibia was separated for the study of bone tissue RANKL/osteoprotegerin, Core binding factor 1 (Cbfa1) ,osterix and osteocalcin mRNA level which was performed by real-time quantitative reverse transcription polymerase chain reaction assay. Results No significant difference was found in serum Ca, P, and ALP levels between 2 groups of rats. ST-Z-induced diabetic rats were characterized by extreme hyperglycemia, marked weight loss, polyuria, and hypercalciuria. A low-turnover osteopenia was evidenced in diabetic rats by decreased BMD in both femur [(0. 099±0.013) vs (0. 139 ± 0.013 g/cm~3) , P < 0.01] and lumbar vertebrae [(0. 107±0.011)vs (0. 149±0.009) g/cm~3, P<0.01] , reduced serum osteoealcin level [a marker of formation, (3.03±0.52) vs (6. 18±0.71) ng/ml ,P<0. 01]) ,decreased urine NTx/Cr ratio [(5. 67±0.86) vs (5.23±0.98) nmol/g Cr, P<0. 05], decreased trabeeular volume and thickness, and reduced bone label surface and bone formation rate [(0. 44±0. 11) vs (0. 78±0. 14) μm/d,P<0. 01] by bone dynamic study. The RANKL/ osteoprotegerin [(0.57±0.11)vs (0.89±0.13) ,P<0.01] ,osterix [(1.93×10~(-4)±0.65×10(~-4))vs (4.19×10~(-4)± 0.71×10~(-4)) ,P<0.01] ,Cbfa1 [(26.68×10~(-4)±6.53×10~(-4))vs (37.21×10~(-4)±7.14×10~(-4)) ,P<0.01] ,and osteocalcin [(2.25×10~(-4)±1.19×10~(-4))vs (3.43×10~(-4)±1.63×10~(-4)) ,P<0.01] mRNA expressions were declined in the bone tissue of the tibia in the ST-Z-induced diabetic rats, as compared with the control. Conclusion A low-turnover osteopenia is evidenced in STZ-induced diabetic rats by significant decrease of both osteoclastic marker(RANKL/ osteoprotegerin)and osteoblastic marker (osterix ,Cbfa1 ,osteocalcin)mRNA levels in tibia.