[Summary] The mechanisms of gastroesophageal reflux disease ( GERD) include abnormal antireflux function and esophageal mucosa attacked by regurgitation .Gastroesophageal flap valve ( GEFV) located in the gastroesophageal junction is one mechanism of the antireflux barrier .An increased GEFV grade is associated with an increased incidence of erosive esophagitis and Barrett ’ s epithelium.With abnormal esophageal acid exposure and prevalence of a mechanically defective sphincter , patients usually have severe symptoms and lower efficiency of medication .Therefore , GEFV is valued in the diagnosis and treatment of GERD .This review summarized the relationship between GEFV and GERD .

Objective To explore the influence of no drainage on pelvic lymphocyst following laparoscopic radical hysterectomy and pelvic lymphadenectomy . Methods A total of 105 patients with cervical cancer undergoing laparoscopic radical hysterectomy and pelvic lymphadenectomy in this hospital from January 2012 to February 2016 were divided into either non-drainage group (50 cases) or drainage group (55 cases) according to whether the pelvic drainage tube was placed after surgery .Comparative analyses on the incidence of postoperative complications such as pelvic lymphocyst were made between the two groups . Results No significant difference in lymphocyst rate was found between the two groups [27.3%(15/55) vs.24.0%(12/50), χ2 =0.147, P=0.702].The incidence of pelvic infection was lower in the non-drainage group (2.0%, 1/50) than that in the drainage group (14.5%, 8/55), but the difference was not statistically significant (χ2 =3.781, P=0.052).Other postoperative complications including urinary retention , urinary fistula, and deep venous thrombosis of lower limb had no statistical differences between the two groups (P>0.05). Conclusions Drainage after radical hysterectomy and pelvic lymphadenectomy for cervical cancer does not make a difference to the incidence of lymphocyst .Non-drainaging doesn ’ t increase the risk of infection .

Background Epipolis laser in situ keratomihusis(Epi-LASIK) is an potential surgery for myopia because it synthesize advantages of LASEK and LASIK. But its clinical effectiveness and safeness is remarkable.Objective This study was to evaluate the clinical curative effects and safeness of Epi-LASIK for myopia in different diopter of population. Methods Retrospective study was designed for 208 eyes of 104 patients who underwent EpiLASIK for the correction of myopia. The patients were divided into two groups according to preoperative diopter:lower myopia group( ≤ -6.00 D, 111 eyes) and high myopia group ( ＞-6.00 D,97 eyes). The time of epithelial healing, postoperative syndrome, postoperative visual acuity, refraction, intraocular pressure (IOP) , the safe index, the efficacy index and haze were evaluated at 1,3,6,12 months postoperatively. The written informed consent was obtained from each individual before surgery. Results After operation, 20 eyes ( 18.02% ) of lower myopia group and 29 eyes (29.90%) of high myopia group had obvious pain, presenting statistically significant difference between two groups (X2 = 4. 060, P＜0.05 ). The mean time of epithelial healing was (5.49±0. 83 )days in lower myopia group and (5.85± 0.68 )days in high myopia group with a delayed epithelial healing time in high myopia group( u= 3. 377 ,P＜0.05 ).One year after the treatment,the uncorrected visual acuity( UCVA ) ≥ 1. 0 was 90. 99% ( 101 eyes) in lower myopia group and 75.26% ( 73 eyes) in high myopia group, and 9.91% ( 11 eyes) and 15.46% ( 16 eyes) of the eyes improved byl line or more in best spectacle corrected visual acuity(BCVA) ;whereas 3.60% (4 eyes)and 6. 18% (6 eyes)lost a line or more. 91.89% ( 102 eyes) and 85.57% (83 eyes) in both groups gained within 1.00 D of the attempted correction. The safety index and efficacy index were 1.04 and 0. 98 in lower myopia group,and 1. 01 and 0. 96 in high myopia group without statistically significant difference( P＞0. 05 ). haze occurred in 6 eyes in lower myopia group and 9 eyes in high myopia group and the difference in haze grading was not statistically significant between two groups ( P＞0. 05 ). The high intraocular pressure appeared in 10 eyes and 9 eyes in low myopia group and high myopia group respectively during the fellow up duration and back to normal after topical use of timolol. Conclusion Epi-LASIK is an effective and safe method for correction of different diopters of myopia because of its mild symptom and lower incidence of haze.

Triple-negative breast cancer (TNBC) is a subtype of breast cancer known for the poor prognosis due to its strong invasiveness, high recurrence rate, and lack of effective treatment. Therefore, there is an urgent need to find targeted therapy for TNBC. Cathepsin A (CTSA) is an acidic serine carboxypeptidase that is highly expressed in various tumor tissues. However, the role and molecular mechanism of CTSA in TNBC are still unclear. This study found that the expression of CTSA was upregulated, and the high expression of CTSA was positively correlated with the poor prognosis of TNBC. The results further showed that knocking down CTSA inhibited the proliferation, invasion, and colony formation of TNBC cells, improved drug sensitivity of cells, and inhibited the progression of TNBC. Mechanistically, CTSA inhibited the ubiquitination and degradation of the promyelocytic leukemia protein (PML) protein by blocking the interaction between PML and its E3 ubiquitin ligase RNF4, thus maintaining the stability of PML nuclear bodies (PML-NBs). The inhibitor of CTSA had a positive therapeutic effect on inhibiting the characteristics of TNBC stem cells. In conclusion, this study demonstrates that inhibiting CTSA to decrease the stability of PML protein may be a promising therapeutic strategy for TNBC. All animal experiments in this experiment were approved by the Ethics Committee of Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College (approval number: IMB-20240326D502).

AIM: To observe the effect of angiotensinⅡ subtype 2 receptor (AT_2 receptor) on the cultured rat aortic vascular smooth muscle cells. METHODS: The plasmid contained the cDNA of AT_2 receptor was transfected into cultured rat vascular smooth muscle cells. The effects of AngⅡ, Ang Ⅱ+losartan, Ang Ⅱ+PD123319 on the expression of PCNA, the NOS activity and the cell number were observed. RESULTS: The cell number and the expression of PCNA decreased after the cells were treated with losartan. When treated with PD123319, the cell number and the expression of PCNA increased, but the expression of NOS decreased. CONCLUSIONS: These data suggest that when being activated, AT_2 receptor inhibits the proliferation of vascular smooth muscle cells and antagonizes the effect of AT_1 receptor, such an effect may be related to the activation of NOS. [

Hydrophidae, one of the precious traditional Chinese medicines, is generally drily preserved to prevent corruption, but it is hard to identify the species of Hydrophidae through the appearance because of the change due to the drying process. The identification through analysis on gene barcode, a new technique in species identification, can avoid the problem. The gene barcodes of the 6 species of Hydrophidae like Lapemis hardwickii were aquired through DNA extraction and gene sequencing. These barcodes were then in sequence alignment and test the identification efficency by BLAST. Our results revealed that the barcode sequences performed high identification efficiency, and had obvious difference between intra- and inter-species. These all indicated that Cyt b DNA barcoding can confirm the Hydrophidae identification.
Animals ; Base Sequence ; China ; Cytochromes b ; genetics ; DNA Barcoding, Taxonomic ; Elapidae ; classification ; genetics ; Molecular Sequence Data ; Phylogeny ; Reptilian Proteins ; genetics ; Sequence Analysis, DNA

OBJECTIVETo evaluate clinical outcomes of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction under arthroscopy and repair of the injured posteromedial complex structure of the knee joint in the treatment of posterolateral knee dislocation with multiple ligament injuries.

METHODSFrom March 2008 to August 2012,22 patients (16 males and 6 females, ranging in age from 20 to 53 years old, with an average of 30.5 years old) with posterolateral dislocation of the knee were treated with primary reconstruction of ACL and PCL, combined with the repair of injuries in the posteromedial complex and soft-tissue. Eight patients had injuries caused by sports,5 patients road accidents and 9 patients falling down. The ACL was reconstructed using the gracilis and semitendinosus tendons. The PCL was reconstructed using LARS artificial ligaments (14 cases), or gracilis and semitendinosus tendons (8 cases). Suture repair was performed in 17 patients with posteromedial ligament injuries,and self-semitendinosus strengthening operations were performed in 5 patients. Continuouspassive montion (CPM) and active exercises were executed after operation at early stage. The IKDC and Lysholm system were used to evaluate therapeutic effects.

RESULTSAll the patients were regularly followed up, and the duration ranged from 11 to 56 months (averaged, 39 months). According to the IKDC scale,9 patients got a grade A result, 10 got a grade B result, and 3 got a grade C result. The IKDC subject score was 89.6±3.1 and the Lysholm scores was 90.7±1.8 at the latest follow-up, which were both better than those before operation.

CONCLUSIONReconstructing the ACL and PCL and repairing injured posteromedial complex of the knee followed by an active rehabilitation is an effective method to treat posterolateral knee dislocation.

Adult ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Arthroscopy ; methods ; Female ; Humans ; Knee Dislocation ; surgery ; Male ; Middle Aged ; Posterior Cruciate Ligament ; injuries ; surgery ; Reconstructive Surgical Procedures ; methods

Objective To evaluate the effects of pretreatment with different doses of phosphocreatine on hepatic ischemia-repeffusion (I/R) injury in rats.Methods.Thirty male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 5 groups (n =6 each):sham operation group (group S),hepatic I/R group (group I/R),and pretreatment with different doses of phosphocreatine groups (groups P1-3).Hepatic I/R was induced by 90 min occlusion of the hepatic artery and portal vein entering the middle and left lobes of the liver followed by 4 h reperfusion in anesthetized rats.Phosphocreatine 50,150 and 450 mg/kg were injected via the tail vein at 60 min before ischemia in groups P1-3,respectively.In groups S and I/R,the equal volume of normal saline was given instead.Blood samples were taken from the abdominal aorta at 4 h of reperfusion for determination of plasma alanine aminotransferase (ALT),aspartate aminotransferase (AST),TNF-α and IL-1β concentrations.The rats were then sacrificed and the livers were removed for determination of myeloperoxidase (MPO) activity (by ELISA),intercellular adhesion molecule-1 (ICAM-1) expression (by immunohistochemistry),and cell apoptosis (by TUNEL) and for microscopic examination (by electron microscopy).Results The MPO activity in liver tissues,plasma ALT and AST activities,TNF-α and IL-1β concentrations and the number of apoptotic cells were significantly higher in groups I/R and P1-3 than in group S,while lower in groups P1-3 than in group I/R (P ＜ 0.05).The parameters mentioned above were decreasedin turn in groups P1-3 (P ＜ 0.05).Conclusion Phosphocreatine pretreatment can attenuate the hepatic I/R injury in rats in a dose-dependent manner and inhibition of the inflammatory responses is involved in the mechanism.

Objective To evaluate the effect of the lactate clearance rate as a guide of the fluid resuscitation in multiple trauma patients with hemorrhage shock .Methods Sixty‐three multiple trauma patients with hemorrhage shock were divided into two groups ,which were group A (32 patients) and group B (31 patients) .In group A ,the central venous pressure (CVP) between8 and 12 mm Hg ,and the mean arterial pressure (MAP) (65 ± 5) mm Hg served as the goals of the fluid resuscitation .The B group ap‐plied the same goals of the CVP and MAP as group A .In addition ,the calculated lactate clearance rate (≥10% ) was used as the treatment target .The percent of patients reaching resuscitation goals and the ratio of the lactate clearance rate (≥10% ) at 2 hours after surgery ,the volume difference of infusion during the first 24 hours ,the incidences of organ dysfunction ,and the average days in ICU were compared between the two groups .Results The percent of patients reaching resuscitation goals at 2 hours after sur‐gery of group A was significantly higher than that of group B(P<0 .01) .The volume of the infusion of 24 hours in group A was less than that in group B(P< 0 .01) .There was no difference in the percent of patients reaching the lactate clearance rate at 24 hours after surgery(≥10% )and the infusin of red blood cells and plasma volume at 24 hours after surgery between the two groups (P>0 .05) .The incidence of organ dysfunction of group A was higher than that of group B (P<0 .05) .The average days in ICU of group A were longer than that of group B(P<0 .01) .Conclusion Based on monitoring CVP and MAP ,fluid resuscitation under the guidance of the lactate clearance rate(≥10% )may decrease the incidences of organ dysfunction and the days of patients in ICU .

Objective The effect of electronic cigarettes (e-cigarettes) on smoking reduction,cessation and human health remains controversial,meanwhile,studies tocused on e-cigarettes are limited.We conducted this meta-analysis in purpose of helping figuring out the controversy.Methods PubMed, Medline,Embase,Cochrane library,CNKl and Wanfang Databases were searched for articles published up to May 2014.All studies discussing the relationship between e-cigarettes and smoking reduction,smoking cessation or human health were included.The fixed or random-eftect model was used to pool the relative risk(RR).Outcome 4 articles were included based on the inclusion and exclusion criteria,there were totally 7 002 subjects.Meta-analysis indicated that there was significant difference in e-cigarettes and smoking reduction,RR=1.88,95％ CI:1.07-3.32,P=0.09.The Meta-analysis showed that e-cigarettes were available in smoking cessation.RR=1.55,95％ CI:1.24-1.95,P=0.001.Conclusion Tiffs meta-analysis indicated that e-cigarettes were helpful in smoking cessation.Nonetheless,the articles included were too few to credibly support the outcome.Hence,more high-quality,randomized blind and large sample experiments are needed to verify the results.