Objective To investigate the effects of catheter balloon dilatation on patients with dysphagia caused by neurogenic cricopharyngeal achalasia.Methods Thirty-two patients with dysphagia caused by neurogenic cricopharyngeal achalasia were divided randomly into a treatment group (n =16) and a control group (n =16).The treatment group received catheter balloon dilatation therapy and routine dysphagia rehabilitation training; the control group was treated with routine dysphagia rehabilitation training only.Both groups were tested before treatment,after 3 weeks of treatment (after treatment) and at 6 months after treatment (follow-up).All cases were evaluated using Saitoh's 7-grade swallowing assessment and videofluoroscopy.Results After treatment,5 cases in the treatment group had been cured (31％) and 8 cases showed marked effectiveness (50％) ; in the control group,1 case was cured (7％) and 5 cases showed marked effectiveness (31％).These differences were statistically significant.At follow-up,5 cases in the treatment group had been cured (31％) and 9 cases showed marked effectiveness (56％) ; for the control group,1 case was cured (7％) and 6 cased showed marked effectiveness (38％).Those differences were also statistically significant.After treatment and also at follow-up,the average time for a bolus to pass the pharynx in the treatment group was significantly shorter than that in the control group.Conclusion Catheter balloon dilatation therapy is effective for treating neurogenic cricopharyngeal achalasia in both the short and long term.

ObjectiveTo study the effect of adding various doses fentanyl to 0.75％ bupivacaine for spinal anesthetic in the population undergoing inguinal hernia repair surgery. MethodsThe population of 100 patients belonging to ASA class Ⅰ and Ⅱ ,scheduled for elective inguinal hernia repair, were randomized to receive a spinal anesthetic with 2 ml 0.75％ bupivacaine and 1.0 ml saline (group B),or 50 μg/ml fentanyl 0.1,0.2,0.4,0.6 ml(group BF5, group BF10, group BF20,group BF30),each group with 20 cases.Subarachnoid block was established in the left lateral position in L2-3 space by use of a midline approach. The volume of injected drug was kept constant at 3 ml. The time to the highest level of sensory block, the time for regression until T12 level, the time for complete motor recovery, the maintenance duration of the analgesia,the anesthesia effect of the groups, duration of surgery, drug-related side effects were assessed and recorded.ResultsThe time of the highest level of sensory block in group BF30 was shorter than that in group B,group BF5, group BF 1 0, group BF20 (P ＜ 0.05 ), but group B and group BF5 was longer than group BF10,group BF20, group BF30(P ＜ 0.05 ). The time of regression to T12 level in group BF20 was longer than that in group B, group BF5, group BF10, group BF30 (P＜0.05),but group B and group BF5 was shorter than group BF10, group BF20, group BF30(P＜ 0.05 ). The time for complete motor recovery and the maintenance duration of the analgesia in group B and group BF5 was shorter than that in group BFI0,group BF20, group BF30 (P ＜ 0.05 ). The occurrence of pruritus in group B (0) was lower than that in group B F5 (8 cases),group BF10 (3 cases), group BF20 (6 cases), group BF30 (6 cases)(P＜0.05). There were no cases of respiratory depression in five groups. ConclusionsIt suggests that in the population receiving spinal anesthetic for hernia repair surgery, addition of 10 μ g fentanyl to 0.75％ bupivacaine significantly improves the quality and duration of analgesia. No further advantage occurs if the dose of fentanyl is increased among 30 μg.

Adolescent ; Adult ; Female ; Histiocytic Necrotizing Lymphadenitis ; diagnosis ; therapy ; Humans ; Lymph Nodes ; Male ; Middle Aged ; Neck ; Young Adult

Child ; DNA Mutational Analysis ; Dystrophin ; genetics ; Exons ; Humans ; Male ; Muscular Dystrophy, Duchenne ; genetics ; Mutation

Aim To investigate the protective effects of omapatrilat on human umbilical vein endothelial cells (HUVECs) injury induced by angiotensin Ⅱ (AngⅡ) in culture. Methods Cultured HUVECs were randomly divided into 4 groups:①control; ②AngⅡ;③omapatrilat and ④AngⅡ+omapatrilat. Lactate dehydrogenase (LDH) leakage was evaluated by spectrophotometer and cell cycle by flow cytometry (FCM); Nitric oxide (NO) was measured by colorimetry and endothelin-1 (ET-1) by radioimmunoassay. Results 10 -7 mol?L -1 AngⅡ significantly increased LDH leakage and ET-1 release, and this increase was inhibited by omapatrilat (10 -6 mol?L -1). Omapatrilat promoted HUVECs proliferation and NO release. Conclusion Omapatrilat can protect human umbilical vein endothelial cells injury induced by angiotensin Ⅱ in culture, suggesting that it may play an important role in prevention and treatment of vascular diseases.

Objective To investigate the association of age,precipitating factors and seasons of symptom onset of urinary stones with patients who have or have no family history. Methods The questionaires were used to survey 360 urinary stone cases with family history,1200 cases without family history and 1000 normal controls in Chongqing Area. Results In the 360 patients with family history,the morbidity rates of the first degree relatives and second degree relatives were 10.71%(147/1372) and 1.68%(54/3214), respectively.But in those without family history,the morbidity rates of the first degree relatives and second degree relatives was 0.66%(23/3480) and 0.12%(9/7345),respectively.Among the patients with family history,the mean age of morbidity for the males (26.35 years) was younger than that of the females (36.4 years, t=1.75,P 0.05).There was no significant difference of the precipitating factors and symptom onset seasons between patients with or without family history,while the enviropmental factors had significant effects on the morbidity of urinary stone patients,without regard to family history(? 2=0.23, P

The molecular delivery vectors used in gene therapy need provide the features of safety,stability, efficiency and capacity. The current studies on the structure and action mechanism of pRNA, a packaging RNA of phage?29, showed that pRNA with multiple binding sites can through cell membrane easily and escort exogenous molecules to target cell, without inducing immune reaction. As an ideal nano-scale gene therapy vehicle, pRNA presents a promising application in delivering multiple therapeutic components to detect and treat human diseases.

Objective To investigate the survival rate and the influencing factors in lupus nephritis (LN) patients with neuropsychiatric systemic lupus erythematosus (NPSLE). Methods Clinical characteristics and biochemical markers of 78 patients including 59 variances were analyzed. Patients were followed up from the onset of NPSLE to death. Patient survival rate was estimated by Kaplan-Meier method. Cox regression model was used to analyze influencing factors. Results Sixteen (20.5%) of 78 patients died of SLE or its complications. Infection was the main cause of death (31.3%). One-, 3-, 5- and 10-year survival rates were 83.2%, 81.7%, 76.7% and 76.7%, respectively. Hypertension (RR =6.965,95% CI:1.578-30.746, P= 0.010), pulmonary infection (RR=8.171,95% CI:1.954-34.177, P=0.004)and acute renal failure (RR=6.978,95%CI:2.063-23.609, P=0.002) were risk factors of mortality, while cyclophosphamide (CTX) impulse therapy (RR =0.130,95 % CI:0.031-0.541, P=0.005) and resolution of NPSLE (RR= 0.169, 95%CI:0.042-0.679,P=O.012)were protective factors. Conclusions Infection is the main cause of death in patients of LN complicated with NPSLE. Survival rate of LN patients with NPSLE in this study is lower than those of LN and NPSLE alone reported by other authors. Hypertension, pulmonary infection and acute renal failure are risk factors of mortality, while CTX impulse therapy and resolution of NPSLE reduce the mortality and improve the prognosis.

Objective To investigate the therapeutic effect of the hemilaminectomy approach in intraspinal tumor with the help of intraoperative ultrasound,high-speed drill and ultrasound knife.Methods Clinical data of 35 cases with the intraspinal tumor were analyzed retrospectively.All the patients were treated by hemilaminectomy approach,the position of the lesions were fixed by preoperative X-ray and intraoperative ultrasound,root of the spinous process were removed in order to achieve adequate visual field by high-speed drill and ultrasound knife.Electrophysiologic monitoring were used if the lesions were in the spinal cord.Results Total surgical resection was achieved in 32 cases,gross total resection was in 3 cases.Twenty-eight of the 35 cases were followed up.The symptom alteration of the first period ( 1 - 3 months postoperative):improved in 25 cases,no changed in 2 cases,aggravated in 1 case.The symptom alteration of the second period (6-24 months postoperative):no changed in all cases,no stability change of the vertebral column had been found.Conclusions Followed with the development of the electrophysiologic monitoring,high-speed drill,intraoperative ultrasound,the indication of the hemilaminectomy and have no influence of the spinal stability.However,to spinal meningioma which have a wide base,the hemilaminectomy approach may not adapt.

Objectives To investigate the clinical characteristics and prognosis of late-onset group B streptococcal (GBS) sepsis. Methods From Jan. 2007 to Dec. 2011, iffteen neonates diagnosed with late onset GBS sepsis at discharge from NICU were retrospectively analyzed, meanwhile, thirty-four neonates diagnosed with late onset non-GBS Gram-positive bacteria sepsis at discharge were selected as controls during the same period. Results There were signiifcant differences in occurrence rates of shortness of breath, convulsion and apnea between late onset non-GBS sepsis group and late onset GBS sepsis group (P<0.05). The percentages of neonates with white blood cell count (CSF)>100×106/L, high-sensitivity C-reaction protein (hsCRP)>100 mg/L and glucose in CSF<3.11 mmol/L in late onset GBS sepsis group were higher than those in late onset non-GBS sepsis group (P<0.05). GBS was sensitive to penicillin, ampicillin, ceftriaxone, piperacillin/tazobactam, levolfoxacin and vancomycin. The rates of GBS resistance to erythromycin and gentamycin were both 87.5%. There were signiifcant differences in occurrence rates of meningitis, hydrocephalus and ependymitis between late onset GBS sepsis group and late onset non-GBS sepsis group (P<0.05), while no difference in mortality was found between two groups (P>0.05). Conclusions The late onset GBS sepsis is in-sidious, atypical, with many complications and sequelae. It is important for the suspicious neonates to use effective antibiotics as early as possible.