Objective To investigate the effects of somatostatin combined with omeprazole in treatment of digestive tract hemorrhage and the intervention effect in cirrhosis. Methods According to the different treatment methods will be January 2015 to January 2017 in Taizhou Hospital treatment of gastrointestinal bleeding in patients with cirrhosis 80 cases groups: control group was treated with omeprazole and omeprazole and somatostatin in the treatment of observation group; two groups were recorded in the experimental data, and the data were analyzed, the effect of somatostatin combined with omeprazole in treatment of digestive tract hemorrhage and the intervention effect in patients with liver cirrhosis. Results The observation group clinical treatment effect is better than that of control group clinical treatment groups was statistically significant the difference between (P< 0.05). Conclusion The bleeding patients choose somatostatin omeprazole treatment effect on liver cirrhosis digestive adverse little response.

OBJECTIVE: To explore the diagnosis, treatment and surgical approaches of parapharyngeal space tumors. METHOD: This retrospective study consisted of 112 patients with parapharyngeal space tumors underwent surgeries. The data included clinical symptoms and signs, pathological types, imaging examinations, surgical approaches and postoperative complications. RESULT: Computerized tomography (CT), magnetic resonance imaging (MRD and digital subtraction angiography (DSA) made clear the tumor size, localization and its relation to adjacent structures. The postoperative histopathology varied and showed benign in 98 cases consisting of salivary gland tumors (52 cases), neurogenic tumors(33 cases) and other types (13 cases). During the 3 years follow-up period, local recurrence appeared in 3 patients with salivary pleomorphic adenoma and 1 patient with neurofibromatosis. These recurrent tumor cases were cured with second surgery. In 14 patients with malignant tumors reported, 8 cases survived for 5 years, 2 cases (1 adenoid cystic carcinoma and 1 carcinoma in pleornorphic adenoma) recurred in the two and a half years cured with second surgery affiliated radiation therapy through 3 years follow-up time and the rest were followed up 1 to 3 years without recurrence. Peripheral facial paralysis was observed in 25 patients, and 3 patients experienced hypoglossal nerve palsy. Only 1 patient encountered vagus nerve injury, and 2 patients appeared Horner's syndrome, and 4 patients endured Frey syndrome. Gills leakage was discovered in 3 cases and cavity infection was noted in 1 patient. CONCLUSION CT, MRI and DSA were important in the diagnosis and differential diagnosis of parapharyngeal space tumors. The key to successful treatment is knowing the anatomy of the parapharyngeal space, preoperative assessment and appropriate surgical approach.
Adenoma, Pleomorphic ; complications ; Carcinoma, Adenoid Cystic ; complications ; Diagnosis, Differential ; Facial Paralysis ; complications ; Horner Syndrome ; complications ; Humans ; Magnetic Resonance Imaging ; Neoplasm Recurrence, Local ; Pharyngeal Neoplasms ; diagnosis ; therapy ; Pharynx ; pathology ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Salivary Gland Neoplasms ; complications ; Tomography, X-Ray Computed

AIM:To explore the protective effects of atorvastatin on blood brain barrier (BBB) in cerebral is-chemia-reperfusion ( IR) injury and the potential mechanisms involved .METHODS: SD rats were divided into sham group, IR group and atorvastain group .Intraluminal suture method was used to establish cerebral IR model , and the ische-mic brain was reperfused for 72 h after the occlusion.The rats in atorvastatin group were administered with atorvastatin (20 mg? kg-1? d-1 ) by gavage once a day for 3 consecutive days after operation .At 72 h after reperfusion , neurological func-tion scores, the water content of the brain tissue , Evans blue (EB) content of ischemic hemisphere , the expression of tight junction ( TJ )-associated protein occludin and inflammation factor phosphatidylinositiol 3-kinase-p110 gamma ( PI3K-p110γ) were tested and analyzed .RESULTS: In IR group, the rats showed elevated neurological function scores ( P<0.01), brain tissue water content (P<0.01) and EB content (P<0.01), accompanied with the down-regulation of oc-cludin expression (P<0.01) and up-regulation of PI3K-p110γ(P<0.01) at 72 h after reperfusion.Compared with IR group, decreased brain edema (P<0.01) and EB leakage (P<0.01) were observed in atorvastatin group , accompanied with increased occludin expression (P<0.01) and decreased PI3K-p110γexpression (P<0.01).However, no statistical difference of the neurological function scores between the 2 groups was observed .CONCLUSION:Atorvastain attenuates cerebral IR injury , which may be associated with the inhibition of inflammatory reactions and the up -regulation of TJ-asso-ciated proteins to maintain the stability of BBB .

Objective To observe the short -term effect and safety of entecavir in the treatment of 50 patients with decompensated liver cirrhosis.Methods 92 patients with decompensated liver cirrhosis met the inclusion criteria in our hospital were selected as study subjects.The patients were randomly divided into the observation group (46 cases)and the control group(46 cases).The control group received routine treatment,including the liver,liver, diuretic,jaundice,symptomatic and supportive treatment and prevention of complications.The observation group was given entecavir for 48 weeks on the basis of the control group,0.5 mg /times,qd.The clinical effects were assessed after treatment.Results The HBV -DNA,ALT,TBIL,Child -Pugh score of the observation group and the control group after treatment were (2.05 ±0.32)log10 IU /mL and (3.11 ±0.36)log10 IU /mL,(32.1 ±8.5)U /L and (90.3 ±12.6)U /L,(27.8 ±7.1 )μmol/L and (35.3 ±8.2)μmol/L,(6.42 ±1.24)points and (9.20 ± 1.46)points,which were significantly lower than before treatment (t =6.563 and 5.341,11.266 and 7.044,7.346 and 6.013,6.252 and 4.423,all P <0.05).The ALB levels were (38.5 ±2.9)g/L and (34.4 ±3.0)g/L,which were significantly higher than before treatment(t =4.812 and 3.701,all P <0.05).The HBV -DNA,ALT,TBIL, Child -Pugh score of the observation group after treatment were significantly lower than the control group (t =3.335, 3.431,3.411,3.204,all P <0.05).The ALB of the observation group after treatment was significantly higher than the control group (t =3.034,P <0.05).There were two cases of deaths(4.45%)in the observation group,8 cases of deaths(17.39%) in the control group because of progressive deterioration,there was significant difference in treatment outcome between the two groups(χ2 =4.039,P <0.05).Conclusion Entecavir can delay progression, effectively reducing HBV -DNA,improve liver function and Child -Pugh score in the treatment of patients with decompensated liver cirrhosis,it can be used as first -line drug use.

Objective To evaluate the differences of clinical features,neuroimaging,angiography and laboratory findings between different stroke subtypes according to TOAST criteria in elderly patients.Methods 91 patients (aged ≥ 80 years) with acute ischemic stroke were retrospectively reviewed in Departement of Neurology from April 2009 to August 2010.Subtypes of ischemic stroke were analyzed according to the classification of TOAST.Risk factors,clinical manifestations,complications,prognosis,neuroimaging,cerebrovascular lesions,and laboratory findings of different TOAST subtypes were compared.Results Large-artery atherosclerosis (LAA) (34/91) was the most common cause of acute ischemic stroke in elderly patients,and most criminal lesions (25/34) located at the intracranial arteries.In the LAA group,patients with intracranial (25/34) or extracranial (12/34) occlusive diseases were more than those in other groups.Patients with cardioembolism (CE) had lower lipid levels.In the CE group,patients with poor shortterm prognosis (7/15) were more than in the LAA or small-artery occlusion (SAO) group,and patients with severe cerebral edema (4/15) were more than those in other groups.In patients of the SAO group,complications occurred infrequently (4/20),and none had poor short-term prognosis.Conclusions There were some differences among different TOAST subtypes in clinical features,neuroimaging,cerebrovascular diseases,and laboratory findings.The clinical significance of our findings needs to be explored further.

ObjectiveTo investigate the characteristic of pathology in Chinese patients with Nonaka myopathy.MethodsThirteen patients (7 males and 6 females) diagnosed with Nonaka myopathy in our laboratory from January 2002 to March 2011 were included in this study.Their mean age was 39.5 years old and the mean duration of illness was 4.15 years.The most common symptoms were weakness of raising feet with sparing of quadriceps femoris muscles in the early stage of disease.One patient presented the initial symptoms of upper limb weakness. Muscles biopsies were obtained from all these 13 patients. Histology study including immunohistochemical (IHC) staining with antibody against amyloid 3,phosphorylated tau protein,ubiquitin,glucose-regulated protein of molecular weight 78 000(GRP78),calnexin,caspase-12and Bax were performed.Skeletal muscle samples from 3 chronic fatigue syndrome patients,2 myofibrillar myopathy patients were used for control in the IHC staining. All coding exons of uridinediphospho-N-acetylglucosamine 2-epimerase gene were directly sequenced in genomic DNA from these patients.Results The main pathological changes of tibialis anterior muscle in 12 cases were muscle dystrophy with rimmed vacuoles.The rimmed vacuoles were positive for anti-β-amyloid,tau protein and ubiquitin in IHC studies.In the atrophy fibers,IHC showed the increased expression of endoplasmic reticulum stress related proteins GRP78 and calnexin,and apoptosis proteins of caspase-12 and Bax.ConclusionsThere is accumulation of abnormal proteins in muscle fibers in Chinese patients with Nonaka myopahty.These proteins may stimulate endoplasmic reticulum stress and apoptosis,which may be a mechanism responsible for muscle damage.

Objective To explore the enhancement patterns of pulmonary carcinomas by contrast-enhanced ultrasound(CEUS).Methods Thirty-eight patients with pulmonary carcinomas proven by pathology[28 with peripheral pulmonary carcinomas and 10 central pulmonary carcinoma with obstructive atelectasis(OA)]were examined by baseline ultrasound and contrast-enhanced ultrasound,then the arrival time(AT),time to peak(TTP)were analyzed with time-intensity curve analysis software and the dynamic enhancement pattern of each lesion was assessed.Results Twenty-four peripheral pulmonary carcinomas demonstrated delayed AT about 6-16 s after application of contrast medium,three lesions demonstrated early AT about 4-5 s and one lesion demonstrated absence of contrast enhancement.The lesions exhibited hyper-,hypo- and non-enhancement were 14,13 and 1,respectively.Seventeen lesions were heterogenous enhanced with non-enhanced necrosis areas and enhanced septa,while ten lesions homogeneous enhanced and one lesion no enhanced.Ten central pulmonary carcinoma with OA demonstrated a characteristic pattern:OA appeared a short AT(mean AT 4.8 s)until enhancement and strong contrast enhancement,while the central tumors appeared a delayed AT(mean AT 10.5 s)and faint enhancement.Conclusions CEUS can be useful in differentiation between solid and cystic pulmonary lesions,and detection of the latent lesions underlying the atelectasis.

Objective To study activation effect of a natural compound baicalein on cystic fibrosis transmembrane conductance regulator(CFTR) chloride channel.Methods A cell-based fluorescence assay was used to determine CFTR-mediate iodide influx rate/dt(mmol?L-1?s-1)] activated by baicalein(the concentrations were 0.18,0.55,1.65,5,15,44,133 and 400 ?mol?L-1).Results The Ka of flavonoid baicalein stimulating CFTR was about 16 ?mol?L-1.The half of maximal activity was reached in ten minutes and the activation disappeared in 20 min after baicalein was washed out.The activation of baicalein was not affected obviously under different concentrations of Forsklin(0,20,50 and 100 nmol?L-1)and the activation could be totally inhibited by CFTRinh-172.Conclusion Baicalein can stimulate CFTR-mediated iodide influx in a dose-dependent way and its activity manifests a rapid and reversible characteristic.It might work in both elevating CFTR protein phosphorylation and direct binding way.

Objective To explore the application of CT value in calculating the proton incident energy in proton treatment planning system. Methods Bethe-Block formula and the formula for calculating the proton range were analyzed to study the correlation of the range of proton beam ( 70-250 MeV ) between a variety of radiation equivalent material and water. Procedure of Monte Carlo SRIM2008 was used to verify the possibility of a constant proportional coefficient of range ( Ci ). The proportional coefficient ( Ci ) of range in radiation-equivalent material and the CT value were fitted by using Origin 8.0 software to study the functional relation of CT value and Ci. The actual range of proton was equivalent to a range of water and incident proton energy could be calculated. Results There was a constant range of Ci of proton beam (70-250 MeV) between a variety of radiation equivalent material and water. There was a functional relation between CT value and Ci ( r = 0.999). The actual range of proton in radiation equivalent material can be equivalent to a range of the water. Conclusions CT values and a range of proportional coefficient ( Ci ),and the actual required range of the tumor could be used to accurately calculate the water equivalent range,and the incident proton energy to the position of Bragg peak. A new exploration for using CT technology in proton treatment planning system could be obtained.