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.

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 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.

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.

1.6 kb ?4-desaturase gene(FAD4)was amplified by PCR using plasmid pGEM-TFAD4 as template.The fragment was subcloned into the HindⅢ/XbaⅠrestriction site of pYES2.0 vector.Recombinant plasmid pYFAD4 was transformed into Saccharomyces cerevisiae strain INVScl for expression.It was found to exhibit ?4-fatty acid desaturase activity in the recombinant S.cerevisiae YFAD4 in the presence of exogenous fatty acid substrate docosapentaenoic acid(100?mol/L)under introduction of GAL1.Expression of the FAD4 under appropriate media and temperature conditions led to the production of DHA and it reached 41.13% of the total yeast fatty acid by GC detection.It was suggested that the protein encoded by FAD4 could specifically catalyze DPA into DHA.

Objective To investigate the consumption status of iodized salt and iodine nutrition status of Tianjin residents,and to provide a scientific basis for iodine supplementation.Methods Sampling methods:① Salt iodine:According to The National Project of Surveillance on IDD,the iodine in salt samples from 18 Tianjin districts (counties) was tested between 2002 to 2011.②Iodine nutritional status of children:Investigation of iodine nutritional status of children was conducted four times in 2002,2005,2009 and 2011.In 2002 and 2005,two primary schools were selected in each district.By age,gender parity principle,40 subjects aged from 8 to 10 in each school were randomly selected to perform thyroid examination and 20 of them were selected to collect urine samples for determination of urinary iodine.In 2009,according to their sub-area positions in the north,the south,the east,the west and the center of each district,5 primary schools were selected in each town (if there were less than five towns in the district,all towns had been selected).Twenty subjects aged from 8 to 10 in each school were selected to collect urine samples for determination of urinary iodine.In 2011,probability sampling method (PPS) was used to select 30 primary schools,and then 40 children aged from 8 to 10 were randomly selected in each school to examine thyroids.At the same time,urine samples from 12 children of the 40 selected children were tested.③Iodine nutritional status of women of childbearing age:In 2007,2008 and 2010,150,50 and 60 women of childbearing age were selected in Hangu District,urine samples of them were collected for determination of urinary iodine.④Iodine nutritional status of pregnant and lactating women:In 2011,3 towns around each primary school were selected.Five pregnant and five lactating women were selected in each town,urine samples of them were collected for determination of urinary iodine.Test methods:①Salt iodine was tested by direct titration,while Sichuan salt and other reinforced edible salt by arbitration determination based on the General Test Method in Salt Industry-Determination of Iodide Ion (GB/T 13025.7-1999).②Thyroid was tested by B-type-ultrasound and judged according to Diagnostic Criterion of Endemic Goiter (WS 276-2007).③Urinary iodine was tested by the Method for Determination of Iodine in Urine by As3+-Ce4+ Catalytic Spectrophotometry (WS/T 107-2006).Results From 2002 to 2011,the consumption rate of qualified iodized salt,the rate of qualified iodized salt,the coverage rate of iodized salt,the rate of non-iodinated salt was 92.7％(43 489/46 926),97.4％(43 489/44 694),95.1％ (44 694/46 926) and 4.8％(2273/46 926),respectively.The median salt iodine was in the range of 29.2-36.7 mg/kg.Children's urinary iodine was monitored 4 times,the median urinary iodine was 228.0,221.5,191.8; and 194.7 μg/L,respectively.Children goiter rates were 2.1％(27/1258),1.6％(19/1186) and 2.1％(26/1219) of the 3 times monitored.The median urinary iodine in pregnant and lactating women was 145.2 and 136.0 μg/L.The median urinary iodine in women of childbearing age was 130.7,196.1 and 229.5 μg/L,which increased with the increase of coverage of iodized salt.Conclusions The iodine nutrition of Tianjin residents,women of childbearing age and lactating women are at appropriate level.The iodine nutrition of pregnant women is lower than appropriate level.Recommended salt iodine level in our city is 30 mg/kg,or 25 mg/kg for ordinary residents,and 30 mg/kg for pregnant women.

Objective To observe the effects of low-intensity(650 nm,5 mW)laser irradiation on the pathological changes associated with aortic atherosclerosis using a rabbit model.Methods Thirty-six male Zelanian rabbits were randomly divided into 4 equal groups:a control group,a laser irradiation group,a simvastatin treatment group and a laser plus simvastatin group,and were treated accordingly.After being fed the basic diet for a week,all the animals were fed a high fat diet during the experiment.Blood samples were taken for lipid assay at the 60th day. The animals were sacrificed at the 61st day and their aortas removed for gross and microscopic examination.Any pathological changes were graded as mild,intermediate or severe according to the indicators of atherosclerosis observed.Results There were no significant differences in blood fat levels among the four groups before the experi- ment,but significant differences in serum triglyceride prevailed after the treatments.Low-density lipoprotein(LDL)- C level in the control group was significantly higher than those in the laser irradiation,simvastatin treatment and laser plus simvastatin groups.There was also a very significant difference in high-density lipoprotein(HDL)-C levels among the laser irradiation group,the laser plus simvastatin group and the control group.The pathological changes observed were correlated with blood fat levels.Mild atherosclerosis was found in the treated groups,but severe or in- termediate atherosclerosis was more prevalent in the control group.Conclusion Low-intensity laser irradiation a- lone or combined with simvastatin can significantly decrease blood lipid levels and the severity of pathological changes associated with aortic atherosclerosis in this animal model.

AIM To study the effects of coadministration of berberine chloride(Ber) with cyclosporin (CsA) on liver microsomal cytochrome P450 isoenzyme and multi drug resistance gene in rats. METHODS The activities of liver microsomal erythromycin demethylase(ERD) and aminopyrence N demethylase(ADM) were determined. The levels of mRNA expression of CYP3A1, CYP1A1, CYP2E1, mdr1a and mdr1b were assayed with RT PCR. RESULTS After administration for 6 days, all treatment groups except Ber at 100 mg?kg -1 exhibited inhibitory action on ERD activity in rats. ERD activity markedly decreased in all drug treatment groups after taking drug for 12 days. After administration for 6 days, 45 mg?kg -1 CsA, 100 mg?kg -1 Ber coadministrated with 45 mg?kg -1 CsA and 200 mg?kg -1 Ber plus 45 mg?kg -1 CsA had significant inhibitory effects on ADM activity in rats. All groups except 100 mg?kg -1 Ber and 150 mg?kg -1 ketoconazole had the same effects on ADM activity after treatment for 12 days. Again, after 12 days, all drug treatment groups except 100 mg?kg -1 Ber group was found of remarkable inhibition of the mRNA expression of CYP3A1, CYP2E1, mdr1a and mdr1b. The CYP1A1 gene was not detected in all groups. CONCLUSION The mechanism of Ber to increase CsA concentration is that Ber decreases the expression of CYP3A, mdr1a and mdr1b thereby reduces the metabolism and elimination of CsA by liver.