Barrett’s esophagus is associated with esophageal adenocarcinoma and cardia cancer,although it has no significant influence on individual’s expectation of life and the canceration rate is comparatively low. However,Barrett’s esophagus has big burden on the psychology and economy of patients. At present,there are still some debates about the diagnosis and management of Barrett ’s esophagus. American Gastroenterological Association, British Society of Gastroenterology and Chinese Society of Gastroenterology have updated their guidelines on Barrett’s esophagus. In this review,we introduced the updated progress in diagnosis and management of Barrett’s esophagus according to these three new guidelines,and compared the similarities and differences between these guidelines.

In the acute phase of traumatic brain injury or cerebrovascular disease,disorders of hypothalamic-pituitary-cortical axis,hypothalamic-pituitary-thyroid axis and hypothalamic-pituitary-gonad axis may exist.The main cause is primary or secondary impairment of hypothalamus as well as pituitary after brain injury.Most of the variations of endocrine after acute brain injuries may be temporary and reversible,but some patients will accompany with hypopituitarism or neuroendocrine deficiency.It is important to set a guideline to decide who and when to test.Hormone replacement therapy should also be verified if it can improve the outcome of patients with brain injuries.

AIM: To explore the anatomical changes of the optic nerve head in cats after radial optic neurotomy (RON).METHODS: The normal anatomic data were obtained from 12 healthy cats. A total of 18 healthy cats were used in the experiment, which were divided into four groups: each operative group was executed at the :Lst, 15th, 30th, 90th day after undergoing RON unilaterally.(six in 1st group). The enucleated eyes of each operative group were cut section routinely and embedded in paraffin, the cross sections were stained by special staining.RESULTS: At the 1st day after operation, the incision came into being and connected with cerebral subarachnoid space of orbital optic nerve. At 15th day, incision was fusiform and hyperplastic neuroglial cells and fibroblasts aggregated at the incision. At 30th day, there was obvious proliferation of type fibril at the neurotomy. The aligned texture of collagen fibril of the lamina cribrosa near the incision was moved close to each other. At the 90th day, a discrete scar was noted at the site which reached the cribriform and sclera.CONCLUSION: RON can cut scleral ring and piamater of optic nerve sharply. The incision of RON connects with subarachnoid space of orbital optic nerve and becomes broaden gradually at the site of scleral ring. The potential role of incision of RON is relevant to the subject.

ObjectiveTo investigate the effect of age on long-term prognosis of patients with traumatic brain injury (TBI).Methods102 inpatients with TBI were evaluated by following-up, using Glasgow Outcome Scale (GOS), Functioning Item of Disability Rating Scale (DRS-F) , Employability Item of Disability Rating Scale (DRS-E) and Quality of Life Index (QLI).ResultsThe average age of 102 cases was 29.7±12.5. There were no significant differences among different groups in GOS and DRS-F (P>0.05), but the level of DRS-E or QLI showed much higher in <27 years old group than those in >45 years old group (P<0.01).ConclusionThe factor of age may affect the long-term prognosis of TBI, quality of life and employability of young patients are better than elder patients.

In order to investigate the lesion' s extention and the infiltrated deepth and the metastasis of the tumors preoperatively ,endoscopic ultrasonography (EUS) was performed in 28 patients with ampullary carcinoma and 18 patients with extrahepatic bile duct carcinoma. forty six patients underwent surgical ex- plorations. A radical resection with detailed pathological study was done for 22 resectable cases of ampullary carcinoma and all the 18 cases of extrahepatic bile duct carcinoma. Carcinoma of ampulla of Vater and ex- trahepatic bile duct were assessed and staged preoperatively according to the TNM staging system. The re- sults of EUS were compared with surgical explorations and pathological findings for evaluating the accuracy of preoperative staging of EUS. The accurate rate of EUS in assessing the extent of cancer invasion was 8l.8% for ampullary carcinoma, 72. 2% for extrahepatic bile duct carcinoma. The accuracy of EUS in pre- dicting regional lymph node metastasis was 59% for ampullary carcinoma , and 61.6% for extrahepatic bile duct carcionoma. invasion of portal vein was correctly predicted by EUS in 2 out of 3 patients of ampullary carcinoma. All the 3 cases of liver metastasis were not detected by EUS. EUS is a more accurate diagnostic method in judgement of invasive extent of ampullory carcinoma and extrahepatic bile duct carcinoma preop- eratively , but less accurate for metastasis of the tumors.

Objective To study on the effectiveness of endoscopic ultrasonography (EUS) in diagnosing common bile duct (CBD) stones. Methods Accuracies for the diagnosis of choledocholithiasis by abdominal ultrasonography ( B-US) and computed tomography (CT) are compared with those by EUS in 45 patients. Final diagnosis is determined by endoscopic retrograde cholangiography ( ERC) with or without sphincterotomy ( EST) or operative exploration. Results Forty-three out of 45 patients with choledtx-holithia sis were diagnosed by EUS, of them 2 patients with slight dilation of common bile duct in which stones were confirmed in the proximal part of common bile duct by EST. In 2 out of 43 patients EST and operation diagnosed cholecystolithiasis instead of choledocholilhiasis. The sensitivity and the positive predictive value are both 95%. With 41 patients choledocholithiasis were confirmed by EUS, the sizes of stone were diameter ≥ 10mm in 5 patients, 6-9 mm in 10 patients and ≤5mm in 26 patients. Four out of 45 patients were suspected to have CBD stones and 2 patients had tumor in periampullar area by B-US. Three patients were diagnosed to have CBD stone and 1 patient was suspected to have tumor in peri-ampullar area by CT. Conclusions EUS appears to be the best diagnostic tool for the diagnosis of choledocholithiasis compared with other noninvasive procedures such as B-US and CT. EUS is at least as sensitive as ERC especially in diagnosis of small CBD stones.

Idiopathic pulmonary fibrosis (IPF) is a specific form of chronic, progressive, fibrosing interstitial pneumonia of unknown etiology , a median survival time of which is 2 to 3 years.The diagnosis and treatment are important for IPF in time.Krebs von den lungen-6(KL-6), Surfactant protein-A(SP-A) and Surfactant protein-D(SP-D) are acceptable biomarkers in clinical for idiopathic pulmonary fibrosis in Japan,which have shown good sensitivity at diagnosis IPF and predict the prognoses for patients with IPF . However , the differential diagnosis of IPF from other interstitial lung diseases is still challenging .Other biomarkers are being developed , one of which would have the best specificity and sensitivity at diagnosis IPF.Those biomarkers about pathogenesis of IPF includes alveolar epithelial cell dysfunction , fibrogenesis and immune dysregulation are shown .They are potential to account for underlying disease mechanisms , accelerated drug development and advance clinical management.

OBJECTIVE To investigate the effect of root saponins of Panax notoginseng(RPNS) on different voltage-dependent calcium and potassium ion channels. METHODS By using the two-elec?trode voltage clamp (TEVC), the effect of RPNS 0.01, 0.06, 0.1, 0.6, 1 and 4 g · L- 1 was investigated on Cav1.2,and the effect of RPNS 1 g · L-1 was evaluated on Cav2.1,Cav2.2,Cav3.1, KCNH2,KCNQ1,KCNQ1/KCNE1 and BK channel. All the ion channels examined were expressed in Xenopus laevis oocytes. RESULTS TEVC suggested that the effect of RPNS on Cav1.2 exhibited the concentration-response relationship and its EC50 was 0.048 g · L-1. Compared with cell control,TEVC also showed that RPNS 1 g·L-1 had obviously inhibitory effect on Cav1.2,Cav2.2 and Cav3.1,and the inhibitory rate of RPNS 1 g · L-1 on the peak current of Cav1.2,Cav2.2 and Cav3.1 was(57.1 ± 8.6)%, (17.2 ± 0.7)% and(50.2 ± 7.7)%(P<0.01),respectively. RPNS 1 g · L-1 had obviously activated effect on BK channel,and the activated rate of RPNS 1 g·L-1 on the peak current of BK channel was(37.9± 2.7)%(P<0.01). RPNS 1 g·L-1 showed no significant effect on Cav2.1,KCNH2,KCNQ1 and KCNQ1/KCNE1. CONCLUSION RPNS may effectively inhibit Cav1.2 and Cav3.1,activate BK channel,but have little effect on Cav2.1,Cav2.2,KCNH2,KCNQ1 and KCNQ1/KCNE1.

Objective To investigate the effect of Icariin ( ICA) experimental IgA nephropathy in rats and to explore related mechanisms .Methods Experimental IgA nephropathy rat model was established and then model rat were treated with or without different doses of ICA .Then, urine RBC, Urine protein and urine NAG were analyzed; IgA precipitation was detected with immunofluorescence staining;the protein level of NF-κBp65 and MCP-1 were examined by immunohistochemical staining;the mRNA level of IL-4, IL-10 and IL-13 were determined by quantitative PCR .Results The concentrations of urine RBC, Urine protein and urine NAG were reduced after ICA treatment , as companied by a decrease of IgA precipitation .Moreover, ICA treatment also decreased the protein level of NF-κBp65 and MCP-1, and the mRNA level of IL-4, IL-10 and IL-13.Conclusions ICA exerts a certain degree of efficacy on the treatment of experimental IgA nephropathy through regulating NF-κBp65 and MCP-1 expression and the immunoregulation mechanism .

Objective To observe the effects of isoflurane on ocular hemodynamics .Methods Fifteen patients without eye diseases undergoing non-head and non-neck surgical procedures ,were enrolled in this study. Anesthesia was induced with intravenous propofol and atracuronium, followed by laryngeal mask insertion, and was maintained with isoflurane. Peak systolic velocity(PSV),end diastolic velocity(EDV),Tmax and resistant index(RI) of double ophthalmic arteries, central retinal artery and posterior ciliary arteries were determined by coloured Doppler imaging before anesthesia, 30 min following inhalation of isoflurane 1.0MAC or 1.5MAC respectively . Blood pressure, heart rate and SpO 2 were also measured at above time points.Results As compared with those before anesthesia ,no significant changes were found in all above parameters of double ocular arteries in all time points; PSV and EDV of central retinal artery decreased significantly with increase of isoflurane level(P005); all above parameters of posterior ciliary artery decreased significantly ,with increase of isoflurane level(P005). The diastolic pressure was positively correlated with PSV and EDV of central retinal artery and posterior ciliary arteries ,and negatively with RI , but no correlation to all above parameters of double ophthalmic arteries.Conclusions It may be dangerous for the patients with potential ischemia of eyes undergoing isoflurane anesthesia. Decreasing its concentration and improving blood pressure can increase ocular blood supply to prevent ophthalmic ischemic complications from occurrence.