Gastroesophageal reflux disease( GERD)is caused by dysfunction of lower esophageal sphincter( LES), which allows the contents of stomach and duodenum to reflux into esophagus. Currently,medical and surgical therapies are the main treatment for GERD,but patients need to take life-long acid suppression and the surgical treatment has the risks of potential side effects. Endolumenal therapy as a minimally invasive approach to GERD can safely and effectively relieve the symptoms of GERD,especially Stretta radiofrequency procedure,transoral noninvasive fundoplication( TIF ) and LinX reflux management system. This article reviewed the advances in study on endolumenal therapy for GERD.

Objective To establish a novel method for the determination of betaine in serum by high performance liquid chromatography with UV detection.Methods Pre-column derivatization of serum was performed directly in acetonitrile without extraction with p-bromophenacyl bromide and 18-crown-6 ether as catalyst.The p-bromophenacyl ester derivatives were then separated by Supelcosil LC-SCX, using an was 0.8 ml/min and the effluent was monitored at 259 nm. Betaine was used for preparation of standard curve and quantification with external standards.Results The linearity of this method was 6.25-200.00 μmol/L,the regression was 0.999 8.The detection limit was 3.0 μmol/L.The within-day imprecision was 1.88%-3.79% ( average 3.24% ), the between-day imprecision was 3.14%-6.76% ( average 4.39% ), the recovery rates were 95.89%-102.86% (average 99.16% ).Conclusion This method is sensitive, rapid, accurate and suitable for the research and routine clinical practice.

Objective To study the phenylpropanoid constituents from the roots of Euphorbia hylonoma Hand-Mazz. Methods The chemical constituents were isolated and purified by silica gel and Sephadex LH-20 column chromatography,and the structures were elucidated on the basis of chemical properties and spectral data. Results Three phenylpropanoid constituents were isolated from the acetone extracts of the roots of Euphorbia hylonoma Hand-Mazz,which were hexadecyl-3-methoxy-4-hydroxybenzeneacrylate Ⅰ,ethyl brevifolincarboxylate Ⅱ and(+) 3′-angeloyl-4′-isovalerylcis-khellactone peuformosin Ⅲ. Conclusion The above compounds were isolated from Euphorbia hylonoma Hand-Mazz for the first time,and the compound Ⅲ was the first obtained from the Euphorbiaceae.

Objective To explore the influence of candesartan (an angiotensin II receptor 1 antagonist,AT1R) in radioresistance of human nasopharyngeal carcinoma CNE1 cells.Methods Cell growth of CNE1 with or without candesartan treatment was measured in vitro by MTT method;radiosensitivity of CNE1 with or without candesartan treatment was tested under normoxic or hypoxic conditions by clone formation assay.The expression of hypoxia-induced factor 1α(HIF-1α)in CNE1 cells was analysed by western blotting.Results Candesartan did not significantly inhibit the growth of CNE 1 cells in both normoxic and hypoxic conditions.Candesartan also did not influence the radiosensitivity of CNE1 cells in normoxic condition;however,it significantly increased the radiosensitivity of CNE1 cells in hypoxic condition.The expression of hypoxia-induced factor 1 α (HIF-1 α)in hypoxic CNE1 cells was significantly inhibited by candesartan treatment.Conclusion Candesartan does not significantly influence the proliferation of CNE1 cells in both normoxic and bypoxic conditions but significantly enhances the radiosensitivity of hypoxic CNE1 cells,in which the mechanisn may be involved in its inhibiting HIF1α expression in hypoxic CNE1 cells.

OBJECTIVETo explore the effect of Shengjiang Xiexin Decoction (SXD) on the intestinal mucosal and functional cells of rats after irinotecan (CPT-11) chemotherapy.

METHODSTotally 24 healthy Sprague-Dawley (SD) male rats were divided into three groups, the normal control group, the CPT-11 group, the SXD combined CPT-11 group according to random digit table, 8 in each group. CPT-11 was injected at the daily dose of 150 mg/kg to rats in the CPT-11 group and the SXD combined CPT-11 group from the caudal vein on the 4th day, once daily for 2 successive days to duplicate delayed diarrhea model. Equal volume of normal saline was injected to rats in the normal control group from the caudal vein. SXD at 2 g/mL (10 g/kg body weight) was administered to rats in the SXD combined CPT-11 group by gastrogavage for 9 successive days. Deionized water was administered to rats in the CPT-11 group and the normal control group. Diarrhea was observed at 48, 60, 72, 84, 96, and 108 h to calculate the incidence rate of diarrhea. Meanwhile, scoring for diarrhea was performed by referring methods of Akinobu Kurita. Rats were killed on day 10, ileum, cecum, and colon tissues were collected and fixed in 10% formalin solution. HE staining was performed. Intestinal mucosa injuries were graded under light microscope according to the criterion of Chiu's score. The expressions of goblet cells and Paneth cells were observed by PAS stain. Enteroendocrine cells were observed by immunohistochemical CgA staining. Positive cells were counted and cumulative optical density (IOD) analyzed by Image-Pro-Plus 6.0.

RESULTSNo diarrhea occurred in rats of the normal control group at each time point. The incidence rate of diarrhea was 75.0% (6/8) at 48 h, 100.0% (8/8) at 60 h, 100.0% (8/8) at 72 h, 87.5% (7/8) at 84 h, 75.0% (6/8) at 96 h, and 75.0% (6/8) at 108 h in the CPT-11 group. The incidence rate of diarrhea was 25.0% (2/8) at 48 h, 50.0% (4/8) at 60 h, 12.5% (1/8) at 72 h, 0.0% (0/8) at 84 h in the SXD combined CPT-11 group. Compared with the same group at 60 h, scores for diarrhea at 48, 84, 96, and 108 h obviously decreased in the CPT-11 group, and scores for diarrhea at 48, 72, 84, 96, and 108 h obviously decreased in the SXD combined CPT-11 group (P < 0.05, P < 0.01). Compared with the same group at 72 h, scores for diarrhea at 84, 96, and 108 h obviously decreased in the CPT-11 group (P < 0.05, P < 0.01). Compared with the normal control group, scores for diarrhea increased in the CPT-11 group at each time point (P < 0.01); grading of ileum, cecum, and colon mucosal tissues increased (P < 0.05, P < 0.01); expressions of ileum and cecum mucosal epithelial goblet cells obviously decreased (P < 0.05); the number and expressions of ileum and cecum mucosal epithelial Paneth cells increased (P < 0.01). Expressions of ilium endocrine cells increased, while those of cecum and colon endocrine cells decreased in the CPT-11 group (P < 0.01). Compared with the CPT-11 group, scores for diarrhea were obviously lowered (P < 0.05, P < 0.01), grading of ileum, and cecum mucosal tissues decreased (P < 0.05, P < 0.01); expressions of ileum, cecum, and colon mucosal epithelial goblet cells obviously increased (P < 0.05, P < 0.01); the number and expressions of ileum cecum mucosal epithelial Paneth cells increased (P < 0.05); expressions of cecum and colon endocrine cells increased (P < 0.05, P < 0.01) in the SXD combined CPT-11 group.

CONCLUSIONSXD played roles in preventing and treating CPT-11 induced delayed diarrhea by improving CPT-11 chemotherapy induced apoptosis and necrosis of intestinal mucosal and functional cells.

Animals ; Apoptosis ; Camptothecin ; adverse effects ; analogs & derivatives ; Colon ; Diarrhea ; Drug Therapy ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Ileum ; Intestinal Mucosa ; drug effects ; Male ; Rats ; Rats, Sprague-Dawley ; Wound Healing ; drug effects

Objective To evaluate protective effects of hypothermic pulmonary protective solution with uli-nastatin on lung function during cardiopulmouary bypass (CPB) in the patients with congenital heart disease(CHD) and pulmonary hypertenion. Method Fifty-four children,who had CHD of left-to-fight shunts with moderate-se-rious pulmonary hypertension, were enrolled. They had been performed with the radical operation under CPB from September 2005 to December 2006 in the Department of Cardiovascular Surgery, Children' s Hospital of Zhejiang University. Moderate-serious pulmonary hypertension was defined as pulmonary-to-systolic pressure ratio > 0.45(Pp/Ps > 0.45). Fifty-four children were randomly divided into three groups. Patients in group A (n = 18)didn't receive pulmonary protective solution, and scrved as control; patients in group B (n = 18) were adminis-tered with pulmonary protective solution without ulinastatin;patients in group C (n = 18) were administered with pulmonary protective solution with ulinastatin. The serum concentrations of MDA and MPO were measured at five different time points:pre-operation, 0 h, 3 h, 6 h and 24 h in the intensive care unit (ICU) (T1～5). Patients'lung functions were monitored at T1 - T4. The time of mechanical ventilation was recorded. Results No one died in this study. The mean time of mechanical ventilation was shorter in the group B and group C than that in the group A. The MDA and MPO levels were lower in group B compared with group A at T4. The MDA level at T3-T5 and the MPO level at T4 was lower in group C than those in group A. There were no significant in MDA and MPO levels between group B and group C at five time point.A-aDO2 was lower in groups B and C than those in group A at T3 and T4, whereas at T4, A-aDO2 was lower in group C than that in group B. Cdyn was higher in group B at T3and group C at T3 - T4 than those in group A. Cdyn was lower in groups C than that in group B at T4.Condusions Lung perfusion with hypothermic protective solution during CPB can all lung injury and promote recovery after operation, especialy with ulinastatin.

Objective To compare the effects on blood lipid level by immunosuppressive drugs in renal transplantation recipients. Methods Two hundred and eighty-three renal allograft recipients with tacrolimus(FK506), cyclosporine A(CsA) and rapamycin (SRL) immunosuppressive regimen were reviewed in this study. The variation of whose total cholesterol(TC) and triglyceride(TG) concentration in serum were compared before and after three immunosuppressive regimen. Results There was no significant difference in TC and TG before and after oral FK506 for 93 patients[(4.9± 1. 1) and (1. 4±0. 8)mmol/L vs (4. 9±1.1) and (1.4±1.0)mmol/L, respectively, P>0. 05]. The concentration of TC and TG from 106 patients with CsA[(4. 8±1. 0) and (1. 6±0. 8)mmol/L vs (6. 6±1. 7) and (3. 2±1. 0)mmol/L, respectively] and 29 patients with SRL was higher than those before taking drugs, P<0. 05. The concentration was increased after 12 to 24 weeks generally. The concentration of TC and TG of CsA from FK506 to tacrolimus for 51 patients[(6. 7±1. 1) and (2. 8± 1. 0)mmol/L vs (4. 7±1. 7) and (1. 5±1. l)mmol/L, respectively] were decreased after 12 weeks (P<0. 01). Conclusions Primary factor of dyslipidemia was that CsA and SRL were used for patients post-renal transplantation, which should be regarded. The FK506-based immunosuppressive regimen should be recomended in renal transplantation patients who have a hyperlipidmia.

Adult ; Heart Atria ; Heart Neoplasms ; complications ; Humans ; Intracranial Aneurysm ; etiology ; Magnetic Resonance Imaging ; Male ; Myxoma ; complications

Objective To evaluate the values of prenatal surveillances of ultrasonography in twin pregnancies with amniotic fluid discordance. Methods Two hundred and seventy cases of diamniotic twins were included. Both postnatal outcomes and prenatal amniotic fluid discordant variations were analyzed,and the incidences of amniotic fluid discordance were compared between the monochorionic-diamniotic(MCDA)and dichorionic-diamniotic (DCDA) gruop. Results Twenty four cases of twins with amniotic fluid discordance were found in the study. The incidence of amniotic fluid discordance in MCDA group was much higher than that in DCDA group (28.9% vs 5.6%, P ＜0. 001 ) ,and 24 cases of twin-to-twin transfusion syndrome (TTTS) were diagnosed in the former group and none were found in the latter group. Downward tendency of amniotic fluid discordance was shown in non-TTTS cases of MCDA group. Compared with TTTS cases, the postnatal outcomes of non-TTTS cases with amniotic fluid discordance were much better in MCDA group ( P ＜0.001 ). Conclusions TTTS and MCDA twins with amniotic fluid discordance may overlap each other in the early stage. Serial surveillances of ultrasonography are necessary for prenatal differentiating twin pregnancies complicated by amniotic fluid discordance,and providing strong support to clinical treament.

Objective: To investigate the effect of different doses of perindopril on peripheral endothelial progenitor cells (EPCs) and vascular endothelial function in patients with coronary artery disease (CAD) .
Methods: A total of 84 CAD patients with coronary angiography confirmed diagnosis were divided into 3 groups: Control group, the patients received routine medication, n=27. Low-dose group, the patients received routine medication with perindopril for 4mg, n=29. High-dose group, the patients received routine medication with perindopril for 8mg, n=28. All patients were treated for 12 weeks. The EPCs level was detected by flow cytometry assay, flow-mediated-dilation (FMD) function in brachial artery was measured by ultrasound and plasma levels of high sensitivity C-reactive protein (hs-CRP), angiotensin II (AngII) were examined in all groups.
Results: ① After12 weeks of treatment, the EPCs level and FMD function had certain improvement, hs-CRP level decreased in various degrees in all 3 groups, P<0.05, and AngII level decreased in both perindopril groups, P<0.05.②After treatment, compared with Control group, both perindopril groups had the increased EPCs level and FMD function, while decreased levels of hs-CRP and AngII, P<0.01.③Compared with Low-dose group, High-dose
group showed increased EPCs level and FMD function, decreased levels of hs-CRP and AgnII, P<0.05.
Conclusion: Perindopril may mobilize peripheral EPCs at certain point, and therefore improve endothelial function, the higher dose of perindopril may have better effect.