Objective Summarize the experience of diagnosis and treatment of esophageal rupture.Methods Twelve cases of esophageal rupture were treated with surgical intervention and clinical data were analyzed retrospectively.Diagnosis was confirmed in all patients by chest X-cays,Closed thoracic drainage,upper gastrointestinal contrast,chest CT scan and gastroscopy.In this series,there were 6 cases of spontaneous esophageal rupture,2 cases of iatrogenic esophageal rupture,4 cases of foreign body in esophagus rupture.For surgical treatment of 8 cases,including emergency esophageal stitching issue and diaphragmatic muscle or greater omentum to cover 6 cases;Esophageal ligation and resection of rupture area on both closes of the near and far,phase ii gastroesophageal anastomosis of esophagus resection in 2 cases,including 1 case of esophagus repair failure after turning the operation).Esophageal resection of gastroesophageal anastomosis in 1 case (for into the outer court misdiagnosed patients);4 cases were conservative.Results Initial diagnosis of spontaneous esophageal rupture and iatrogenic esophageal rupture 7 patients were cured,17 to 53 days of hospital stay,Follow-up for 3 months to 5 years,no esophageal related complications.Exception 1 patient died of postoperative infection(misdiaguosed for a long time).4 cases of esophageal foreign bodies to rupture were cured and these cases' fissure were less than 5 mm by chest CT scan and gastroscope diagnosis.Conclusion Complete collection of medical history,chest X-cays,Closed thoracic drainage,upper gastrointestinal contrast,chest CT scan and gastroscopy may clear diagnosis.Choose the proper method according to the patients as early as possible by general closed gap is the key to the treatment,at the same time be adequate drainage,control of infection and nutrition support treatment.

Objective To investigate the potential relationship between the paroxysmal Atrial Fibrillation(PAF) and serum uric acid level.Methods Consecutive patients with (patient group,n =65) and without(control group,n =41) PAF,who were hospitalized in the Second Hospital of Tianjin Medical University from September 2011 to June 2012,were included in this study.We excluded subjects with congestive heart failure,acute coronary syndrome,congenital heart disease,valvular heart disease,cardiomyopathy,thyroid dysfunction and acute infection or inflammatory conditions.Baseline clinical data,complications and laboratory examination results were collected.Left atrium diameter (LAD),left ventricular end-diastolic dimension (LVEDD) and left ventricular ejection fraction (LVEF) were determined by echocardiography.Univariate and logistic regression was conducted to detect risk factors for PAF.Results Serum uric acid level were significantly increased in patients with PAF compared with controls ((360.2 ± 103.9) μmol/L vs (296.0 ±68.1) μmol/L,P =0.001).Multivariate logistic regression analysis showed that higher level of serum uric acid (OR:1.007,95％ CI:1.000-1.015) and LAD (OR:1.142,95％ CI:1.031-1.265) were independent risk factors for the occurrence of PAF.Conclusion High serum uric acid level is an independent risk factor for the development of PAF.Future larger studies should further evaluate this potential association as well as the underlying mechanisms.

Objective To detect the express of the pulmonary fibrosis factor CTGF,TGF-β1 and the senescence correlated β-Gal in the primary pulmonary bulla,and investigate the correlation of the pulmonary fibrosis factor,cell senescence and the development of the primary pulmonary bulla.Methods The expression of CTGF,TGF-β1 and β-Gal protein in the tissue of normal lung tissues and lung bullae were tested.The cell image extracted with the digital camera system was entered into the Image-pro Plus 6.0 morphology Image analysis system and analyzed with Semi-quantitative way.Results The expression level of TGF-β1 and CTGF in primary pulmonary bulla organization was obviously higher than that of normal lung tissue.There was a statistically significant difference(P ＜ 0.05).CTGF and TGF-β1 expression level had a significant correlation (r =0.965,P ＜ 0.01).β-Gal expression level of primary pulmonary bullae had no obvious difference with normal lung tissue.Conclusion CTGF and TGF-β1 may play an important role in the formation of primary pulmonary bulla.Both play a synergistic role in the formation of primary pulmonary bulla.Cell senescence is not relevanted with the formation of primary pulmonary bulla.

Objective To study the diagnostic and predictive values of amino-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients presenting acute dyspnea. Method A total of 533 patients with dyspnea were studied. According to the clinical characteristics and echocardiographic findings, the patients were divided into two groups, namely acute congestive heart failure group (ACHF) and non-ACHF group. NT-proBNP levels were assayed in all patients in order to evaluate the diagnostic value, and predictive value in patients of ACHF group by following up study to know the clinical destination of patients to be cardiac death or re-admission into hospital. Results There were 272 ACHF patients and 261 non-ACHF patients, and the levels of NT-proBNT were significantly different between two groups ( 2683.4±86.9) pg/mL vs. (238.6+8.7) pg/mL, P＜0.01) . A total of 220 patients were followed for 158 ±32. 8 days. The level of NT-proBNT in myocardium of patients in re-admission group was 2683 + 86. 9 pg/mL and in death group was 3283.4 + 105.7 pg/mL which both were higher than that in patients without cardiac events ( 1123. 5 + 72. 1 pg/mL) ( P ＜0. 01 ) . By using multivariate Cox analysis, log NT-proBNT was ( r = 0. 987, P = 0. 002), and atrial fibrillation (r = 0. 876, P = 0. 005 ) and ventriculat tachycardia ( r=0. 891, P =0. 005) were the valid predictors of cardiac events. Conclusions Routine determination of NT-proBNT in Emergency Department should be useful for quickly sorting patients with acute dyspnea. The NT-proBNT could be used as a good prognostic indicator of ACHF. In addition, log NT-proBNT and atrial fibrillation, ventricular tachycardia were the independent risk factors of cardiac events.

ObjectiveTo evaluate the therapeutic effect ofZishen decoction combined with standard treatment of western medicine for for stage IV diabetic nephropathy with Qi and Yin deficiency.MethodsA total of 112 patients with stage IV diabetic nephropathy and Qi and Yin deficiency were randomized to thestandard treatment and the combined treatment groups, 56 in each. The standard treatment group received conventional treatment, including blood glucose controlling, antihypertensive, blood lipid regulating and diet controlling. The combined treatment group receivedZishen decoction on the basis of conventional treatment. All the patients were treated for 3 months. The blood urea nitrogen (BUN), serum creatinine (SCr), total cholesterol (TG), triacylglycerol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and glycated hemoglobin (HbA1c) were measured by an automatic chemistry analyzer. The urinary albumin excretion rate (UAER) was measured by the enzyme-linked immunosorbent assay.ResultsCompared with the standard treatment group, the SCr (53.51 ± 18.12μmol/Lvs. 62.66 ± 21.14μmol/L;t=2.459,P<0.05), UAER(100.73±84.24μg/minvs. 156.24 ± 96.38μg/min;t=3.245,P<0.05), TG(1.73±0.22 mmol/Lvs. 2.06 ± 0.21 mmol/L;t=8.112,P<0.01), TC(4.56 ± 0.62 mmol/Lvs. 5.10 ±0.31 mmol/L;t=5.830, P<0.01), LDL-C (2.42 ± 1.05 mmol/Lvs. 3.31 ± 0.81 mmol/L;t=5.022,P<0.01) in the combined treatment group decreased significantly, and the HDL-C (1.67 ± 0.33 mmol/Lvs. 1.36 ± 0.41 mmol/L;t=4.460,P<0.01) increased significantly. ConclusionZishen decoction on the basis of conventional treatment can improve the SCr and UAER, and regulate the blood lipid in the patients with stage IV diabetic nephropathy and Qi-Yin deficiency.

Objective To evaluate the effect of the self-made Zishen decoction combined with conventional western medicine therapy and health education on the patients with early diabetic nephropathy. Methods The 112 patients with DN were randomly assigned to 2 groups (each group 56 patients) at a ratio of 1:1. The control group was treated with control of glucose, blood pressure, lipid, and diet therapy, and the treatment group was with self-made prescription of invigorating the kidney and health education based on the control group treatment. All patients were treated for 6 months. The SF-36 scale was used to assess the quality of life, and the clinical effect was determined based on the blood biochemical indexes. Results Total clinical effect of the treatment group was 85.7%(48/56), and the control group was 67.9%(38/56) (χ2=4.057, P=0.044). Compared with the control group after treatment for 6 months, the physical condition (72.17 ± 13.41 vs. 64.59 ± 11.83, t=3.172), social function (64.58 ± 14.54 vs. 58.94 ± 14.62, t=2.047), physical role function (55.82 ± 10.11 vs. 47.46 ± 10.18, t=4.360), emotional role function (60.43 ± 10.20 vs. 56.04 ± 11.44, t=2.143), energy (69.86 ± 11.43 vs. 62.47 ± 11.12, t=3.468), general health status (68.57 ± 11.25 vs. 62.45 ± 11.78, t=2.812) of the treatment group were significantly improved (P<0.01 or P<0.05). Conclusion The self-made Zishen decoction and health education combined with conventional western medicine can improve the clinical effect and quality of life of patients with DN.

Objective To extract the loci of murine MHC gene and construct plasmids.Methods The RNA of mice was extracted and reversely transcribed into cDNA.By using nested PCR,the products were connected with T vector,cloned,and sequenced.Subsequently,the genes were digested by endonucleases,connected with expression vector,and sequenced again to choose the correct clones.Results After the nested PCR,the products were approved by sequencing.After being connected with the vectors,they were approved again by sequencing and the correct clones were chosen.Conclusion All of the loci of the MHC gene can be obtained by nested PCR.The plasmids from the correct clone can be used in the further experiments of transferring the gene to mitigate the transplantation rejection.

OBJECTIVETo establish a HPLC-DAD method for the determination of axifolin, naringenin, quercetin and kaempferol in Cudrania tricuspidata and C. cochinchinensis in order to provide a scientific reference for species identification and quality evaluation, by establishing.

METHODThe determination was performed by HPLC-DAD on an Agilent C18 column (4.6 mm x 150 mm, 5 microm) by gradient elution (0-15 min, 35%-50% A; 15-30 min, 50% - 65% A) using methanol (A) and 0.1% phosphoric acid (B) as the mobile phase. The flow rate was 1 mL x min(-1). The detection wavelength was 290 nm for taxifolin and naringenin, 365 nm for quercetin and kaempferol with column temperature at 30 degrees C.

RESULTThe content of axifolin and quercetin in the root of C. tricuspidata were remarkably higher than that in the root of C. cochinchinensis, and the content in stem of C. tricuspidata was also higher than that in the stem of C. cochinchinensis, the content of axifolin and quercetin was variable in different species. The content of naringenin and kaempferol in the root of C. cochinchinensis was visibly higher than that in the root of C. tricuspidata, and the content in the stems of the two herbs was similar, the content of naringenin and kaempferol was visibly variable in different medicinal parts of the herb, but similar between the two herbs.

CONCLUSIONThere's some difference of the content of the four ingredients in different medicinal parts and different herbs, so clinical use should not be confused.

Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Flavanones ; chemistry ; isolation & purification ; Flavones ; chemistry ; isolation & purification ; Kaempferols ; chemistry ; isolation & purification ; Methanol ; Moraceae ; chemistry ; Organ Specificity ; Phosphoric Acids ; Plant Roots ; chemistry ; Plant Stems ; chemistry ; Plants, Medicinal ; Quercetin ; analogs & derivatives ; chemistry ; isolation & purification ; Reproducibility of Results ; Species Specificity

OBJECTIVETo compare the effects of olecranon plate and tension band in the treatment of olecranon fracture.

METHODSSixty-three patients with olecranon fracture were treated with olecranon plate and tension band. Thirty-five patients (21 male and 14 female, aged from 15 to 62 years, with an average of 48.9 years) were involved in tension band group and 28 patients (20 male and 8 female, aged from 25 to 67 years, with an average of 50.6 years)were involved in plate group. According to the Delee, JC classification in 1984, there were type 1A in 5 cases, type 1B in 8 cases, type 2 in 17 cases, type 3 in 7 cases and type 4 in 1 case in tension band group; there were type 1A in 3 cases, type 1B in 5 cases, type 2 in 6 cases, type 3 in 11 cases and type 4 in 3 cases in plate group.

RESULTSSixty-three cases were all followed up from 6 to 15 months. According to the criterion of PANG Gui-gen, the results were excellent in 20 cases, good in 7 cases, fair in 1 case and no bad in plate group; the results were excellent in 23 cases, good in 10 cases, fair in 21 case and no bad in tension band group. The therapeutic effect of two groups has no significantly statistic difference.

CONCLUSIONBoth olecranon plate and tension band are the effective treatments for olecranon fracture. The selection of two methods should depend on to the state of fracture.

Adolescent ; Adult ; Bone Plates ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Ulna Fractures ; surgery

OBJECTIVETo study the antiviral constituents in the stems and leaves of Pithecellibium clypearia.

METHODThe constituents of P. clypearia were systematically separated with various chromatographic techniques in combination with antiviral activity monitoring. Their structures were elucidated by physical and chemical properties and spectral data.

RESULTSix compounds were isolated from P. clypearia and were identified as: tricetiflavan (5, 7, 3', 4', 5'-pentahydroxylflavan) (1), myricitrin (myricetin-3-O-alpha-L-rhamnopyranoside) (2), quercitrin (quercetin-3-O-alpha-L-rhamnopyranoside) (3), quereetin (4), methyl gallate (5) and gallic acid (6).

CONCLUSIONCompound 1 approximately 5 were obtained from this plant for the first time. Compound 4 was found to show an obvious anti-respiratory syncytial virus (RSV) activity.

Antiviral Agents ; chemistry ; isolation & purification ; pharmacology ; Fabaceae ; chemistry ; Flavonoids ; chemistry ; isolation & purification ; pharmacology ; Gallic Acid ; analogs & derivatives ; chemistry ; isolation & purification ; pharmacology ; Inhibitory Concentration 50 ; Plant Leaves ; chemistry ; Plant Stems ; chemistry ; Plants, Medicinal ; chemistry ; Quercetin ; chemistry ; isolation & purification ; pharmacology ; Respiratory Syncytial Viruses ; drug effects