OBJECTIVE: To investigate the clinical features of chronic tracheoesophageal fistula (TEF), provided disease-related treatment experience and lessons for clinicians. METHOD: To successfully repair one case of chronic tracheoesophageal fistula with surgery, and to analyze the clinical treatment process, combined with relevant literature, the author reported the experiene of diagnosis and treatment in TEF. RESULT: After the gastrointestinal ostomy and Stent implantation, the fistula persisted, nine months later ,we took the surgery to repair the fistule, ten days postoperation, the fistule healed and esophageal iodine water examination didn't prompt obvious abnormalities, the patient was discharged without any postoperative complications 12 days postoperation. CONCLUSION If conservative treatment failed with TEF, the surgical repair should be carried timely, By double sutured with fistula in surgery, and reinforced with the approaching muscle tissue, It can achieve good results.
Humans ; Postoperative Complications ; Postoperative Period ; Tracheoesophageal Fistula ; pathology ; surgery ; Wound Healing

Objective To evaluate the role of hippocampal histone acetylation in isoflurane-induced amnestic effect in mice.Methods Fifty-four male C57BL/6J mice,aged 8 weeks,weighing 18-22 g,were randomly divided into 3 groups (n =18 each) using a random number table:control group (group C),isoflurane group (group ISO) and histone deacetylase inhibitor sodium butyrate group (group SB).Group C inhaled 35％ oxygen for 30 ain,and ISO and SB groups inhaled the mixture of 35 ％ oxygen and 0.4％ isoflurane for 30 min,and then the animals underwent contextual fear conditioning training.After the end of training,normal saline 6 ml/kg was intraperitoneally injected in C and ISO groups,while in group SB,sodium butyrate 1.2 g/kg was intraperitoneally injected.One hour after the end of training,3 mice were sacrificed randomly in each group and their hippocampi were immediately removed for determination of the expression of acetylated histone-H3 (Ac-H3) and Ac-H4 by Western blot.Twenty-four hours after the end of training,contextual fear conditioning test and open field test were conducted.The freezing time,total distance and time of staying at the central zone were recorded.Results Compared with group C,Ac-H3 and Ac-H4 expression was significantly down-regulated,and the percentage of freezing time during testing was decreased in group ISO (P ＜ 0.05).Compared with group ISO,Ac-H3 and Ac-H4 expression was significantly up-regulated,and the percentage of freezing time during testing was increased in group SB (P ＜ 0.05).There was no significant difference in the percentage of freezing time during training,total distance and time of staying in the central zone among the 3 groups (P ＞ 0.05).Conclusion Hippocampal histone acetylation is involved in the regulation of isoflurane-induced amnestic effect in mice.

Objective To investigate the in vitro effects of acitretin on the apoptosis and expressions of insulin-like growth factor binding protein 7 (IGFBP7) and vascular endothelial growth factor (VEGF) in HaCaT cells.Methods Cultured HaCaT cells were treated with various concentrations (10-5,10-64,10-7,10-8 mol/L) of acitretin for various durations,with those cultured in acitretin-free medium serving as the control group.Then,CCK-8 assay was performed to evaluate the proliferation of cells after 24-,48-and 72-hour treatment,flow cytometry to detect the apoptosis of HaCaT cells,and Western blot and reverse transcription-PCR to quantify the protein and mRNA expressions of IGFBP7 and VEGF in HaCaT cells,respectively,after 48-hour treatment.Statistical analysis was carried out by one-way analysis of variance and Pearson correlation analysis.Results The proliferation of HaCaT cells was inhibited by the treatment with acitretin,and the inhibitory effect increased with the elevation of concentration and prolongation of treatment duration of acitretin.A significant decrease was observed in the proliferative activity of HaCaT cells treated with acitretin of 10-8 mol/L for 48 hours,and when the concentration of acitretin was 10-5 mol/L,the proliferation of HaCaT cells was inhibited by 39.94％ ± 2.27％ and 49.77％ ± 1.87％ at 48 and 72 hours respectively,compared with the control cells.The HaCaT cells treated with acitretin of 10-5 mol/L for 48 hours showed a significant elevation in apoptosis rate (7.617％ ± 0.767％ vs.1.803％ ± 0.313％,P ＜ 0.05),IGFBP7 protein and mRNA expressions (0.939 ± 0.040 vs.0.436 ± 0.013,0.872 ± 0.079 vs.0.190 ± 0.056,both P ＜ 0.05),but a significant reduction in VEGF protein and mRNA expressions (0.213 ± 0.032 vs.0.798 ± 0.036,0.274 ± 0.041 vs.0.933 ± 0.054,both P ＜ 0.05) in comparison to the control cells.Conclusions Acitretin can induce the apoptosis of HaCaT cells,and up-regulate IGFBP7 but down-regulate VEGF expressions in HaCaT cells at protein and mRNA levels.

BACKGROUND:Because of convenient source, multi-lineage differentiation and low immunogenicity, bone marrow mesenchymal stem cels are the ideal cel type to serve as vectors of transgenic cels in pain management. However, the replicative senescence and smal amount of cels obtained from the bone marrow restrict the application of bone marrow mesenchymal stem cels in pain research. OBJECTIVE:To construct human telomerase reverse transcriptase (hTERT)-immortalized rat bone marrow mesenchymal stem cels as transgenic celular vectors for pain therapy. METHODS:Bone marrow mesenchymal stem cels were obtained from whole rat bone marrow, and then transfected with a lentivirus containing the hTERT (pLV-Puro-EF1α-hTERT) folowed by puromycin selection. hTERT expression and telomerase activity in these transfected cels were determined by RT-PCR and TRAP. Morphological changes, capacity of cel growth and multi-lineage differentiation, chromosome karyotype and tumorigenicity were observed in vitro. Moreover, the expression of cel surface molecule, Nestin, MHC-I and MHC-II in transfected cels were also detected by flow cytometry and immunocytochemistry. RESULTS AND CONCLUSION: The bone marrow mesenchymal stem cels geneticaly modified by hTERT could be cultured and passaged through 30 generations in vitro. Compared to the primary and negative transfected cels, the hTERT-modified bone marrow mesenchymal stem cels showed higher expression of hTERT mRNA, telomerase activity and cel proliferation. Most of transfected cels stayed at G2/M and S stages. The proliferation index of the transfected cels were increased dramaticaly. The positive rates of CD29, CD44 and CD90 were over 70%, but the positive rates of CD34 and CD45 were less than 5%. Transfected cels were positive for Nestin in the cytoplasm, but negative for MHC-1 and MHC-11. In addition, this cel line continued to exhibit the characteristics of fibroblastic bone marrow mesenchymal stem cels, including phenotype, differentiation into osteoblasts, adipocytes and neuron-like cels. No chromosome abnormality and tumor formation were observed in this experiment. Taken together, these data suggests that the rat bone marrow mesenchymal stem cels immortalized by hTERT gene are constructed successfuly and stil maintain major stem cels characteristics, which provide safe and stable cel vectors as research base for pain therapy.

Objective To investigate the prevalence of adult osteofluomsis in the endemic fluomsis areas in Tianjin and to provide scientific foundation for endemic fluorosis.Methods Stratified sampling in 55 villages were selected in 3 areas with slight,moderate and severe fluorosis regions in Tianjin from April to June in 2008.Water fluorine were tested and clinical osteofluorosis examinations were conducted to the population aging 16 and above in the villages.Tweenty villages were selected randomly in the slight,moderate and severe fluorosis regions.X-ray osteofluorosis examination were conducted to patients and suspected patients in these 20 villages.Results The geometric mean fluoride content in the water for the 3 areas were 1.35 mg/L,3.44 mg/L,5.49 mg/L,respectively.The prevalence of osteofluorosis were 36.7%(44/120),20.6%(33/160),39.4%(43/109),respectively.The prevalence of osteofluorosis Was increased gradually(r=0.534,P<0.01)and the symptoms and signs of the disease were more serious(H=84.813,P<0.01).The prevalence of X-ray diagnosis Was increased gradually(r=0.990,P<0.01)and signs of the disease were more severe(H=25.169,P<0.01)with an increase in age.There was no statistical significance of prevalence rate of osteofluorosis between males and females,regardless if it Was a clinical diagnosis(X2=0.343,P>0.05)or an X-ray diagnosis(X2=3.532,P>0.05).Conclusions Adult osteofluorosis to a certain extent is still prevalent in the fluorosis areas in Tianjin.Endemic fluorosis is still rampant.Improving water in fulorosis areas should be mandatory.

Objective To explore the feasibility of extending liver blood perfusion cessation by ultrasound combining microbubbles.Methods The livers of 9 healthy rabbits were treated with a pulsed therapeutic ultrasound device,in presence of microbubbles.For quantification of liver perfusion,contrastenhanced ultrasonography was performed on 6 rabbits before treatment and at different time points of 0 min,30 min,60 min and 48 hours after treatment.Pathological examination of the treated livers was performed immediately after treatment on the other 3 rabbits.Results The liver blood perfusion almost vanished immediately after treatment,remained at a low perfusion level from 30 to 60 min,and completely recovered 48 hours later.The peak intensity dropped from ( - 51.88 ± 4.26)dB to ( - 62.53 ± 4.83)dB after treatment and rose up to ( - 52.00 ± 4.60) dB 48 hours later.The peak intensities before treatment and 48 hours after treatment were significantly higher than those of 0 min,30 min and 60 min time points after treatment( P ＜0.05).Pathological examination showed significant swelling of hepatocytes and hemorrhage around portal veins.Conclusions Microbubbles enhanced ultrasound can induce liver blood perfusion cessation for up to 1 hours.The mechanism could be swelling of hepatocytes and hemorrhage of portal track.

The chromatographic fingerprint was established by eluting with the mobile phase consisted of acetonitrile and 0.2% formic acid water on an Agilent TC-C18 (2) column (4.6 mm x 250 mm, 5 microm). Six chromatographic peaks were identified by HPLC-MS/MS method. Ten batches of Glycyrrhizea Radix et Rhizoma Praeparata Cum Melle were determined, and the similarity was arranged from 0.72 to 0.99. Good precision, stability and repeatability were obtained, and this study provides a reference for the quality control of Glycyrrhizea Radix et Rhizoma Praeparata Cum Melle.
China ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; chemistry ; Glycyrrhiza uralensis ; chemistry ; Mass Spectrometry ; Quality Control ; Rhizome ; chemistry

Objective To examine the occupational stability,training needs and capacity building requirements of the general practitioners purposely trained to work in rural communities,for improvement of policies regarding their training and issues related. Methods There counties were selected by stratified random sampling, where general practitioners graduated from such training completed an anonymous questionnaire. Focus group interviews were made to officials of the local Health and Family Planning Commission,those of primary healthcare institutions,and general practitioners themselves. Results The of the 190 valid questionnaires recovered, male accounted for 34. 2% and female 65. 8%. These general practitioners were mostly satisfied with their working environment, social status, work stress and job achievement,yet with lower satisfaction with their salary and availability of medical devices. Consideration of resignation was reported by only 5. 3% of them,with more males than females. As high as 63. 2% of them prefer to work in hospitals of county level. 91. 1% of them held it as necessary to participate in standard resident training,and 98. 4% held it as necessary to have on-job training. 94. 7% of them have participated in further education to gain a bachelor degree in medicine. Conclusions These doctors were found with high stability to work in rural communities and low turnover intention. Further studies are required to encourage these general practitioners to serve rural communities in a long term, and to improve the standard resident training mechanism,and their career development.

Objective To evaluate endovascular therapy and open surgery for subclavian artery occlusion disease. Methods In this study, 69 patients received endovascular therapy (44 patients)or open surgery(25 patients)from January 2002 to July 2007.Balloon dilatation was carried out in 3 cases and 43 stents was placed in 41 cases. Results All procedures were successful. In endovascular therapy group, the ratio of healthy/dieased side of mean blood pressure was improved from 0.66±0.14 to 0.96±0.13(t=9.532,P＜0.001＝;in surgery group, the ratio improved from 0.63±0.16 to 0.95±0.18(t=8.236,P＜0.001＝.Sixty-one discharged patients were followed up for 2～49 months(mean 16.7 months),in endovascular group, restenosis occurred in 1 patient 1 year after the therapy, in surgery group, all prothesis remained patent and there was no complication related to prothesis. Conclusions Both endovascular therapy and surgery were the effective methods for subclavian artery occlusion, and endovascular therapy is preferred for less invasiveness.

Objective To observe and compare the association of serum levels of of complement component 3(C3)and high-sensitive C-reactive protein(hs-CRP)with insulin resistance in non-diabetic subjects. Methods 587non-diabetic Chinese were recruited. Weight, height, blood pressure, waist circumference, fasting plasma glucose,fasting serum insulin, blood lipids, C3 and hs-CRP were measured. HOMA index(HOMA2-IR)was calculated.Insulin resistance was defined as the upper quartile of HOMA2-IR. Results C3 and hs-CRP were significantly higher in subjects with insulin resistance compared with subjects without insulin resistance. After controlling for age, gender,body mass index, and waist circumference, C3 was positively and significantly correlated with HOMA2-IR(r = 0.19,P＜0.01). As C3 increased, subjects were 3.78(OR= 3.78, P＜0.05)times more likely to suffer from insulin resistance, after adjustment for age, gender, systolic blood pressure, diastolic blood pressure, total cholesterol,triglycerides,high-density lipoprotein cholesterol, and waist circumference. However, hs-CRP was not significantly correlated with insulin resistance. Conclusions Serum complement component 3 has a more marked association with insulin resistance than hs-CRP in non-diabetic Chinese.