Objective To analyze the endoscopic and pathologic characters of acute graft versus host disease(aGVHD) after aUogeneie bone marrow transplantation.Methods The endoscopic and pathologic findings of 4 patients with acute aGVHD were retrospectively analyzed.Results The clinical manifestations of 4 patients were abdominal pain and diarrhea occurred 21～57 days after bone marrow transplantation.The eolonoseopy detected mucosa edema,erosion and multiple ulcers.The pathological findings included epithelial necrosis accompanied with infiltration of lympbocytes and plasmacytes,no cytomegalovirus was found in biopsies,and aGVHD was diagnosed.Three patients recovered after the treatment with corticosteroids,while the other one died.Conclusion The intestine is involved in aGVHD after allogeneie bone marrow transplantation,and the diagnosis depends on eolonoscopy and biopsy.

Objective To study the effects of Compound Di Gui Capsule (CDGC) on the levels of glucose and lipid in diabetic rats.Methods Rats models with diabetes mellitus were induced by intraperitoneal injection of streptozotocin (50mg?kg-1).Then the diabetic rats were divided into different groups at random.CDGC groups were given CDGC in the dosages of 2.4,1.2,0.6 g?kg-1?d-1 respectively by gastric gavage for 90 d.Levels of whole blood glucose,glycosylated hemoglobin,total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C),nitric oxide (NO),total antioxidation capacity (T-AOC) were determined.The insulin level and the pathological changes of pancreatic tissues were also observed.Results The glucose level of diabetic rat was decreased 2h after administration.After administration of CDGC for 90d,the glycosylated hemoglobin,TG,LDL-C and NO were markedly decreased,islet ?cells were protected and restored,and the insulin level and T-AOC were increased.Conclusion CDGC can regulate the metabolism of glucose and lipid in diabetic rats,and can protect and restore the pancreatic islet cells.

005) There was significant difference between pre-operation and 56 th day( P

Objective To investigate the feasibility of pancreatic DWI at a 3T MR imager and its value for the qualitative diagnosis of pancreatic tumors. Methods For 20 normal healthy volunteers and 47 patients with pancreatic tumors [21 pancreatic carcinoma (PC), 7 mass-forming chronic pancreatitis (MFCP)and 19 cystic lesions), routine pancreatic MRI and pancreatic DWI using b values (500 and 1000 mm2/s)were obtained, the DWI signal intensity (SI) and apparent diffusion coefficient (ADC) value of pancreatic lesions and adjacent tissue was measured. Results In the b = 500 and 1000 mm2/s DWI images, there was no significant difference in ADC value between different parts of normal pancreas. But PC and MFCP were shown as hyperintensity mass, in addition, the related SI1000 of PC at b = 1000 mm2/s DWI was significantly higher than that of MFCP (1.238 +0.448 vs. 0.371 +0.293, P＜0. 01). Compared with normal pancreas,beth PC and MFCP presented as decreased ADC500 and ADC1000 value. The ADC1000 of PC was significantly lower than that of MFCP [ ( 1. 087 + 0. 175 ) mm2/s vs. ( 1. 279 ± 0.213 ) mm2/s]. Pancreatic cystic lesions were shown as hyperintensity in DWI at b = 500 mm2/s, but were depicted as iso-intense signal or low-signal lesions in DWI using b = 1000 mm2/s. Both ADC500 and ADC1000 of pancreatic cystic lesions were higher than that of normal pancreas. Conclusions 3T-MR DWI is helpful to differentiate pancreatic lesions. High b value DWI is more valuable for the qualitative diagnosis of pancreatic mass.

OBJECTIVETo observe the clinical effect of low-dose once-daily tadalafil combined with Shuganyiyang Capsules in the treatment of mild-to-moderate erectile dysfunction (ED).

METHODSNinety patients with mild-to-moderate ED were equally randomized to groups A, B and C to receive Shuganyiyang Capsules, tadalafil, and tadalafil + Shuganyiyang Capsules, respectively. The scores of the patients on IIEF-5 and SF-PAIRS (15-Item Short Form of Psychological Interpersonal Relationship Scales) were recorded before and at 1 and 3 months after treatment.

RESULTSThe IIEF-5 scores of groups A, B and C were 10.13 +/- 1.55, 11.00 + 1.60 and 10.73 +/- 1.91 before treatment, and 13.77 +/- 2.11, 17.77 +/- 2.13 and 17.17 +/- 3.84 at 1 month after treatment, significantly higher in B and C than in A (P <0. 001) , but with no remarkable difference between B and C (P =0. 411). At 3 months after treatment, the IIEF-5 scores were 15.77 +/- 2.05, 18.07 +/- 2.24 and 19.37 +/- 3.76 in the three groups, dramatically higher in B and C than in A (P <0.001) as well as in C than in B (P<0.05). The scores on sexual self-confidence, sexual spontaneity and time concerns in SF-PAIRS were 3.90 +/-0.80, 8.67 +/- 1.94 and 14.43 +/- 1.92 before medication, 5.83 +/- 1.02, 9.90 +/- 1.75 and 11.17 +/- 1.68 at 1 month and 6.73 +/- 0.98, 11.07 +/- 2.08 and 10.67 +/-1.60 at 3 months after medication in group A; 4.17 +/- 0.87, 9.37 +/-1.43 and 14.47 +/-1.57 before medication, 6.47 +/-0.78, 10.83 +/- 2.18 and 10.20 +/-1.56 at 1 month and 6.83 +/-0.91, 11.30 +/- 1.88 and 9.47 +/- 1.57 at 3 months in group B; and 4.23 +/-0. 94, 9.50 +/- 1.89 and 14.67 +/- 2.91 before medication, 8.03 +/- 1.67, 13.43 +/-1.10 and 9.70 +/-1.21 at 1 month and 8.93 +/- 1.78, 14.70 +/- 1.26 and 8. 87 +/- 0. 97 at 3 months in group C. Compared with the baseline, the SF-PAIRS scores of the three groups were all significantly improved after treatment (P <0. 05) , and markedly higher in C than in the other two groups (P <0.05).

CONCLUSIONLow-dose once-daily tadalafil combined with Shuganyiyang Capsules is obviously effective in the treatment of mild-to-moderate ED, which not only improves the patients'erectile function, sexual self-confidence and sexual spontaneity, but also reduces their time concerns.

Adult ; Carbolines ; administration & dosage ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Erectile Dysfunction ; drug therapy ; Humans ; Male ; Tadalafil ; Treatment Outcome

OBJECTIVETo study diffuse alveolar hemorrhage (DAH) in patients with hematologic malignancies after chemotherapy and discuss the possible etiology and appropriate therapy.

METHODSSymptoms, physical examinations, laboratory examination, chest radiographs or computed tomographic (CT) scans, treatments and outcomes of two patients with acute lymphoblastic leukemia (ALL) and non-Hodgkin lymphoma (NHL) each after chemotherapy were presented.

RESULTSBoth of the patients developed cough, progressive dyspnea, a drop of hemoglobin level, hypoxemia and widespread pulmonary infiltrate on chest radiographs or CT scans after chemotherapy. Moreover, case 1 (ALL) had high fever and bloody fluid drained from the intubation of mechanical ventilation, case 2 (NHL) developed continual hemoptysis. They were diagnosed as DAH and improved significantly after intermediate- or high-dose corticosteroid therapy.

CONCLUSIONSDAH is a rare fatal acute noninfectious pulmonary complication in patients with hematologic malignancies after chemotherapy. Early accurate diagnosis, identifying the underlying cause and appropriate treatment are critical for the management of DAH.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Female ; Hemorrhage ; drug therapy ; etiology ; Humans ; Lymphoma, Non-Hodgkin ; drug therapy ; Male ; Methylprednisolone ; therapeutic use ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; Pulmonary Alveoli

Objective To investigate whether endoscopic nasobiliary drainage (ENBD) after endoscopic stone extraction could reduce post-operative complications.Methods Retrospective analysis of 697 patients with extrahepatic duct stones undergoing ERCP treatment was pedormed.They were assigned to ENBD group (n =538) and control group (n =159).Post-operative complications including pancreatitis,cholangitis and bleeding were observed and compared.Results There were no significant differences in incidence of pancreatitis and bleeding between 2 groups.Incidence of cholangitis in ENBD group was significantly lower than that in control group (1.3％ vs.3.8％,P ＜ 0.05).Conclusion ENBD after endoscopic stone extraction could reduce the incidence of postoperative cholangitis.

ObjectiveTo evaluate the feasibility and safety of endoscopic intraductal radiofrequency ablation (RFA) for unresectable malignant biliary strictures.MethodsA total of 12 patients with malignant biliary obstructions,who were unsuitable for surgical resection,were prospectively selected for this study.During ERCP,when successful biliary cannulation achieved,a bipolar radiofrequency probe was introduced into bile duct over a guidewire.RFA was given to the tumor lesion under fluoroscopy,followed by stent placement.The patients were closely observed and followed up after the procedure.ResultsSuccessful RFA was achieved in all patients before stents insertion ( plastic and metal stents in 6 respectively,additional pancreatic stents were given to 3).Mild complications of cholangitis and pancreatitis occurred in 1 patient respectively,which were cured with short-term management.Jaundice was promptly controlled in 7 patients (58.3％ ).During the mean follow-up duration of 3.4 (range 0.5-5.5) months,one patient died of cardiocerebral accident and others survived without obvious disconffort.The 1- month and 3- month stent patency was 100％ (12/12) and 80％ (8/10),respectively.ConclusionIt is technically feasible and safe to perform endoscopic intraductal RFA for the palliation of biliary malignancies.The short-term outcome is satisfying,however,long-term result and the better therapeutic schedule need further evaluation.

AIMProbe into protective action of taurine against exercise-induced myocardial damage in rats after exhaustive exercise.

METHODSUsing the model of exhaustive exercise, the present study researches into effects of taurine on the content of triiodothyronine (T3) and tetraiodothyronine (T4) in serum and myocardium as well as the activity of T(4) 5' deiodinase (T(4)5'-DI) and second messenger cAMP in myocardium of rats.

RESULTSThe content of T3 in serum and myocardium, T(4)5'-DI activity, second messenger cAMP in myocardium increased significantly (P < 0.01) while that of T4 in serum and myocardium did not change significantly after exhaustive swimming. The supplement of taurine might significantly inhibit above changes caused by exhaustive exercise.

CONCLUSIONTaurine could protect myocardium from exhaustive exercise induced damage by inhibiting hypermetabolism of thyroid hormone and change of second messenger.

Animals ; Male ; Myocardium ; metabolism ; Physical Conditioning, Animal ; Rats ; Rats, Sprague-Dawley ; Second Messenger Systems ; drug effects ; Taurine ; pharmacology ; Thyroid Hormones ; blood

Objective To evaluate the validity and reliability of the Chinese version of Alcohol Withdrawal Scale (AWS). Methods Totally 175 patients diagnosed as alcohol dependence according to the criteria of ICD-10 were studied. Intraclass correlation coefficient (ICC) analysis was applied for examining interrater consistency and Cronbach' s α for internal consistency. Factor analysis was used to examine the construct validity. Correlation analysis between AWS and CGI,Revised Clinic Institute Alcohol Withdrawal Syndrome Scale(CIWA-Ar) were conducted to evaluate the criterion validity. Based on clinical criteria,ROC curve was calculated so as to test the discriminative ability and establish the cut-off point of the scale. Results ( 1 ) Reliability: ICC value was 0.93,and Cronbach's α was 0.83,which indicated good interrater and internal consistency. (2) Validity:the correlation coefficients of the two subscale with the total scale score were 0.78,0.83 respectively. The correlation coefficients between the subscale were 0. 81 and factor analysis revealed that each item of the scale had relatively high load on the primary factor (0.409 ～0.926). At the time of admission,the total score of the AWS was positively correlated with that of CGI ( r = 0.71, P < 0.05 ). The total score of the AWS also was positively correlated with that of CIWA-Ar ( r = 0. 86, P<0. 05). As treatment went on,total score of the AWS showed a downward trend,at the end of the first week,the total score of the AWS was positively correlated with that of CGI ( r = 0.62, P<0.05). (3)The cut-off point of AWS for mild alcohol withdrawal state was determined as ≥3. With this cut-off point,AWS had both high sensitivity (92.1% ) and specificity (73.5% ) ,and the area under curve (AUC) was 0. 91. The cut-off point of AWS for moderate withdrawal state was determined as ≥7, and the sensitivity and specificity of AWS were 94.3 % and 89.7 % respectively, with the AUC of 0.94. The cut-off point of AWS for severe withdrawal state was determined as ≥ 10. With this cut-off point AWS had both high sensitivity (94. 9% ) and high specificity (92.6% ) .with the AUC of 0.93. Conclusion AWS has good reliability and validity and can reflect the change of the disease and the efficacy of treatment.