Humans ; Ion Channels ; Myocytes, Smooth Muscle ; metabolism ; physiology ; Pulmonary Artery ; metabolism ; physiology

Objective To observe the effects and benefits of the gastroscopy-assisted thoracoscopic modified Heller operation for the treatment of achalasia of cardia. Methods Retrospective analysis was conducted on the clin﹣ical data of 33 cases in our hospital. The surgical approach was gastroscopy-assisted thoracoscopic modified Heller operation. The intraoperative and postoperative effect and complications were observed. All patients were followed up for six months. Results After operation 33 achalasia patients' symptom of obstruction is alleviated. 1 case changed to open operation because of severe adhesion; 4 cases esophageal mucosal were injured and need to be repair assisted by thoracoscope. 1 case had esophagopleural fistula after operation and was cured by conservative treatment in one month. 1 case had gastroesophageal reflux symptoms after operation and relief symptoms after conservative treatment. All patients were follow-up more than six months, only 1 patient recured eating obstruction in 3 months after opera﹣tion, and was cured by gastroscopic expanding treatment. Conclusions The results of gastroscopy-assisted thoraco﹣scopic modified Heller operation to patients with Achalasia is significant. The operation is easy to perform and the complications is less, it can be promoted and applied in clinical practice.

BackgroundDiabetic retinopathy (DR) is a progressive vision-threatening complication of diabetes mellitus,but its pathogenic mechanism is still unclear. Recent studies showed that it may be associated with the inflammation response of retinal capillary. Cytokines can cause induction of proinflammatory and adhesion molecules and thereby increase monocyte endothelial cell adhesion, which is now accepted as the early key event in the development of DR. ObjectiveThe present study was to determine the relationship between the stages of DR and the levels of serum vascular endothelial growth factor (VEGF) , interleukin-2 ( IL-2 ), tumor necrosis factor-alpha (TNF-α) in diabetic patients. Methods This was a pilot case-controlled study. Ninety patients with type 2 diabetes mellitus were included in this clinical trial and 30 healthy individuals were enrolled as controls. The patients were grouped into the non-diabetic retinopathy(NDR) group,background DR group and proliferative DR(PDR) group according to the results from ophthalmoscopic examination and fundus fluorescein angiography(FFA) ,with 30 patients for each group. The levels of serum VEGF,IL-2,TNF-α were assayed by ELISA and compared among the 4 groups.Written informed consent was obtained from each subject before received any related medical examination to this study. ResultsThe mean serum VEGF levels were(217.35±27. 87)ng/L,(298.31±49.26)ng/L,and(341.23±40. 18)ng/L, respectively, and mean serum IL-2 levels were( 12. 12± 1. 57 )ng/L, (16.43 ±2. 26 )ng/L, and (21.36±0. 86) ng/L,respectively and mean serum TNF-α levels were( 11.63±0. 94) ng/L, ( 17. 52±0. 65) ng/L,and(22. 01±0. 87 ) ng/L respectively in the patients with NDR ,background DR and PDR, showing significant differences from healthy controls with( 193.46±37. 39 ) ng/L for serum VEGF, ( 8. 99 ±0. 57 ) ng/L for serum IL-2 and ( 7.31 ±0. 52 ) ng/L for serum TNF-α ( F =126. 38, P＜0. 0 1 ;F =120. 37, P＜0. 01 ;F =99. 84, P＜0. 01 ). The levels of serum VEGF, IL-2, and TNF-α in the patients with the NDR,background DR and PDR were increased significantly. The level of serum VEGF showed the positively significant correlation with serum IL-2 level and TNF-α level ( r =0. 749, P ＜ 0.01 ; r =0. 631,P＜0. 01 ). The serum levels of VEGF, IL-2 and TNF-α showed a significantly positive correlation with the prolongation and severity of DR(r=0. 791 ,P＜0. 01 ;r=0. 665 ,P＜0. 01 ;r=0. 632,P＜0. 01 ). ConclusionsVEGF, IL-2 and TNF-α play active roles in the generation and development of diabetic retinopathy, and the level of serum VEGF is closely associated with the levels of serum IL-2 and TNF-α. during the development of DR.

Objective To explore the features of clinical manifestations and electrophysiology of spinal muscular atrophy(SMA) in children.Methods The clinical features and laboratory data were analyzed in 32 children with SMA,electromyography tests were carried out in 28 patients and the muscle biopsy were performed in 24 cases.Results The 32 cases were subdivided into 3 clinical groups,15 cases were SMAⅠ,12 cases were SMAⅡ,5 cases were SMAⅢ.They were all characterized by progressive muscle weakness associated with hyptonia and atrophy.The clinical distinction between SMAⅠto SMAⅢ reflected different age of onset and disease severity.All cases of SMAⅠhad symptoms of respiratory disability,only 1 case of SMAⅡ had paradoxical breathing and none of SMAⅢ had similarly symptoms.Electromyographic studies showed a pattern of denervation with no sensory involvement.The rate of spontaneous potential was 87%,with gentle strain,the duration of motor unit was extended(30%-150%) and the amplitude of it was increased(90%-450%),the motor nerve conduction velocity was reduced slightly in 28% patients.The muscle biopsy provided evidence of skeletal muscle denervation with groups of atrophy.Conclusions The clinical features,the changes of electromyography and the muscle biopsy are valuable for diagnosis of SMA.Respiratory management will prolong survival and improve the quality of life for these patients.

Objective To compare the effect of postoperative intercostal nerves cryoanalgesia and patient controlled epidural analgesia (PCEA) in patients undergoing thoracic surgery. Methods From April 2006 to May 2008,89 patients undergoing thoracic surgery were randomly divided into intercostal nerves cryoanalgesia group (group A,47 cases) and PCEA group (group B,42 cases). The scores of pain, use of pain medication and time of out-of-bed activity after the operation were used to evaluate the effect of pain between two groups. Results The scores of pain in group A and group B were (1.49 ± 0.80) and (2.43 ± 1.21) scores respectively. There were significant differences in the scores of pain. The use of pain medication [(1.28 ± 0.62) times vs (2.02 ± 1.05) times]and time of out-of-bed activity after the operation [(43.15 ± 12.22) h vs (64.10 ± 14.25) hi were significant difference between the two groups(P< 0.05). Conclusions For reducing the post- thoracotomy pain,intercostal nerves cryoanalgesia is superior to PCEA. Intercostal nerves cryoanalgesia can provide satisfactory analgesia after thoracic surgery.

Humans ; Occupational Diseases ; diagnosis ; Occupational Health ; Occupational Health Services ; United Kingdom

Administration, Oral ; Administration, Topical ; Adult ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Female ; Humans ; Interleukin-10 ; blood ; Interleukin-18 ; blood ; Male ; Middle Aged ; Phytotherapy ; Warts ; blood ; drug therapy ; Young Adult

Diverticulum ; diagnosis ; diagnostic imaging ; Heart Defects, Congenital ; diagnosis ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed

Purpose To explore the expression of Aurora kinase A (Aurora-A), minichromosome maintenance protein 7 (MCM7) and human papillomavirus type 16 E7 protein (HPV 16 E7) in uterine cervical squamous cell carcinoma (CSCC) and to investigate their relationship with clinicopathological factors. Methods Immunohistochemical method was employed on 20 cases of low-grade cervical intraepithelial neoplasia (CIN1) , 30 cases of high-grade cervical intraepithelial neoplasia (CIN2+3), 40 cases of CSCC, and 20 ca-ses of chronic cervicitis. Results (1) Aurora-A localized in the cytoplasm and nucleus. MCM7 protein positive staining localized in the nucleus. In the nucleus, and (or) the cytoplasm appeared brown particles positive for HPV 16 E7. (2) The expression of Aurora-A, MCM7 and HPV 16 E7 were higher in the group of CIN2+3 and CSCC than that in the group of chronic cervicitis or CIN1 ( P<0. 0083). (3) In cervical cancer, the expression of Aurora-A, HPV 16 E7 showed positive correlation (P<0. 001, rs =0. 657). The expression of MCM7, HPV 16 E7 showed positive correlation (P<0. 001, rs =0. 616). The expression of Aurora-A, MCM7 showed positive correlation (P<0. 001, rs =0. 597). (4) Aurora-A expression levels was associated with tumor cell differentiation, clinical stage and lymph node metastasis (P<0. 05). MCM7 expression levels was associated with tumor cell differentiation and clinical stage (P<0. 05). HPV 16 E7 expression had no correlation with patient age, tumor size, tumor differentiation, clinical stage and lymph node metastasis (P>0. 05). Conclusion Aurora-A, MCM7 and HPV 16 E7 expression are gradually increased with disease progres-sion, and closely related to the occurrence and development of cervical cancer, they are expected to be early diagnosis, early treatment of biological indicators of cervical cancer.

Objective:To investigate the theraputic effect of STAT3 Decoy-ODN combined with chemotherapy drugs for HCC commonly used in clinical,include doxorubicin (DOX),5-fluorouracil (5-Fu) and cisplatin;and,analyzing the impact of combination therapy on the immune system.Methods:MTT assay was used to detect cell proliferation,and Annexin-V /7AAD double staining assay was used to detect the apoptosis of Decoy ODN transfected-hepatoma cells treated with chemotherapy drugs.The tumor growth and survival rate of H22 tumor-bearing mice treated with DOX combined with STAT3 Decoy-ODN or not were observed.FACS was applied to analyze the subpopulation and activation of PBMCs from tumor-bearing mice treated as above,and to evaluate the influence of DOX or DOX-treated tumor cells on spleen lymphocyte activation.Results: DOX-induced the suppression and the apoptosis of H22 were significantly increased by Decoy ODN transfection.The combination treatment of Decoy ODN and DOX significantly reduced H22 tumor growth and extended the survival of tumor-bearing mice.Low-dose DOX could increase the proportion of T cells and CD69+T cells in PBMCs,as well as the expression of CD107a and IFN-γin NK cells.DOXt-reated H 22 cells increased the proportion of T cells.Conclusion:Targeted blocking STAT3 could enhance the sensitivity of liver cancer cells to doxorubicin.So,combination therapy may improve DOX therapeutic effect and reduce DOX-mediated side effects.Furthermore,low dose of DOX can promote the activation of host immune system by acting on tumor cells.