ObjectiveThis system review for the medicine of children gastroesophageal reflux disease(GERD) will provide the latest evidence based medicine evidence for pediatric clinical medication.MethodsThe documents of randomized controlled clinical trials of children GERD,which had been published in domestic and foreign journals from the year 2000 to 2010,had been retrieved and screened by the study inclusion criteria.According to the Jadad evaluation questionaire,the documents' quality had been evaluated.The efficiency rates of treatment were calculated respectively by the merger of same medicines,and the meta-analysis of different drugs had been done for evaluating the effect of different pharmacological therapeutic agents.In addition,the adverse events occurred during treatment were analyzed.ResultsThere were 31 documents fitting inclusion criteria.2 015 cases of children ( 1039 cases in treatment groups and 976 cases in control groups) had been included in these randomized controlled clinical trials.In these documents the agents included:cisapride ( 18 articles ),erythromycin ( 8 articles ),motilium ( 5 articles ).The merger efficiency rates of these medicines were cisapride (93.43％ ),erythromycin (92.86％ ),motilium (93.06％) respectively.There were no significant difference in the efficiencies of the three drugs in the treatment of GERD ( P＞0.05 ).In addition,the results of meta-analysis about treatment inefficiency,used with the postures therapy and support therapy as controls,were cisapride OR=0.15 ( OR 95％ CI0.11～0.20),erythromycin OR =0.08 ( OR 95％ CI 0.04～0.14 ),motilium OR=0.03 ( OR 95％ CI 0.01～0.07).Furthermore,their adverse effect rates were cisapride 0.72％ ( diarrhea 0.58％,somnolence 0.14％ ),erythromycin 0.96％ ( drug rashes 0.48％,slight increase of GOT 0.48％ ),motilium 1.50％ (diarrhea 1.50％ ).ConclusionThe efficiencies of smaller doses of erythromycin were better than cisapride,and not better than motilium;but the adverse effect rates were better than cisapride,and not better than motilium.In summary,smaller doses of erythromycin is better currently in the treatment of GERD.Attention should be paid in the use of erythromycin,since it accounted for slight increases in GOT or drug rashes approximately.

Objectives:To examine the effect of chloride blocker (NPPB and tamoxifen)on volume sensitive chloride channels in mouse cardiac ventricular myocytes. Methods:Isolated mouse cardiac ventricular myocytes were subjected to whole cell patch clamp to record the hypotonicity activated chloride currents. Results:When the myocytes were exposed to hypotonic solution, an obvious whole cell currents were activated. The currents were inhibited by extracellular NPPB reversibly and significantly. The specific blocker for volume sensitive chloride channel , tamoxifen (50 ?mol/L), could apparently block the activity of this channel in a voltage dependent manner. Conclusions:Mouse cardiac ventricular myocytes process volume sensitive chloride channel which is sensitive to NPPB and tamoxifen.

Medical whole-body positron emission tomography (PET), one of the most successful molecular imaging technologies, has been widely used in the fields of cancer diagnosis, cardiovascular disease diagnosis and cranial nerve study. But, on the other hand, the sensitivity, spatial resolution and signal-noise-ratio of the commercial medical whole-body PET systems still have some shortcomings and a great room for improvement. The sensitivity, spatial resolution and signal-noise-ratio of PET system are largely affected by the performances of the scintillators and the photo detectors. The design of a PET system is usually a trade-off in cost and performance. A better image quality can be achieved by optimizing and balancing the key components which affect the system performance the most without dramatically increases in cost. With the development of the scintillator, photo-detector and high speed electronic system, the performance of medical whole-body PET system would be dramatically improved. In this paper, we report current progresses and discuss future directions of the developments of technologies in medical whole-body PET system.
Humans ; Positron-Emission Tomography ; trends

Objective To explore the ideal choice of feeding artery which is used for regional arterial infusion (RAI) in severe acute pancreatitis. Methods Forty-five patients with SAP were treated with RAI. The ideal feeding artery was that can supply entire pancreas according to arteriography and can maximize concentration of drug at pancreatic tissue. The pancreatic arteriography was considered as the final objective evidence for choice. Results (1)Gastroduodenal artery was chosen as feeding artery in forty-four cases, and superior mesenterlc artery was chosen in only one case because of vascular abnormity. (2)According to splenic arteriography, blood of splenic artery was supplied to spleen chiefly, and only partial tail of pancreas was applied by splenic artery. (3)According to celiac trunk arteriography, blood of celiac trunk could be supplied to entire pancreas, but a considerable proportion of the total blood was supplied to spleen through splenic artery and liver through hepatic artery proper.Therefore, the drug utilization index was lower. (4)According to gastroduodenal arteriography, blood of gastroduodenal artery could be supplied to entire pancrea, and almost all of the blood that contains drug flowed into pancreas. Therefore, the drug utilization index was higher. Conclusions Gastroduodenal artery is the ideal choice of artery which is used for regional intra-arterial infusion in sever acute pancreatitis. Pancreatic arteriography should be applied routinely when yever acute pancreatitis was treated with RAI.

OBJECTIVETo discuss the methods for urethral external meatus and glanuloplasty after correction of hypospadias.

METHODSThe V shape flap on the dorsal side of glan, combined with the bilateral glan flaps were moved to the ventral side. The flap at the ventral side of urethral external meatus was turned over. Then the urethral external meatus was repositioned to the top end of glan with the ventral defects covered by the dorsal flaps. Then the coniform glan was reconstructed.

RESULTSFrom January 2008 to December 2013, 28 cases were treated, including glandular hypospadias, postoperative retraction of external urethral meatus and meatal stenosis. 21 patients were followed up for 1 -12 months (average, 1 month) with marked improvement of glan appearance and retraction of external meatus. No meatal stenosis happened.

CONCLUSIONSPostoperative retraction of urethral external meatus and meatal stenosis can be corrected by V shape flap on the dorsal side of glan combined with the bilateral glan flaps. The flat appearance of glan can be improved. It is an ideal method for glandular hypospadias.

Humans ; Hypospadias ; surgery ; Male ; Penis ; surgery ; Postoperative Complications ; surgery ; Postoperative Period ; Surgical Flaps ; Urethra ; surgery ; Urethral Stricture ; etiology ; surgery

Objective To study the effects of decoy strategy targeted to NF-?B on IL-6 in rat's liver after traumatic inflammatin. Methods Ninty six Wistar rats were randomly divided into 4 groups: control group,traumatic inflammation group, decoy ODN group, and mutant decoy ODN group. Rats were killed on 3 , 6, 12, 24, 48 , and 72 h respectively, for the determination of plasma ALT. Hepatocytes were isolated and nuclear protein was extracted, DNA binding activity of NF-?B was measured by EMSA. Decoy ODN's competition inhibition effect was assayed by EMSA. IL-6 gene expression in liver tissue was assessed by RT-PCR and IL-6 protein level was determined by ELISA. Results After traumatic inflammation, DNA binding activity of NF-?B in the liver increased. IL-6 mRNA and protein level also significantly increased and was in positive correlation with the activity of NF-?B. Decoy ODN effectively inhibited the activity of NF-?B ex vivo. After using decoy ODN, IL-6 mRNA and protein levels of liver tissue significantly decreased, plasma ALT levels were also significantly decreased. Conclusions Decoy strategy targeted to NF-?B could effectively inhibit rat's liver IL-6 release by inhibiting specifically the activity of NF-?B.

OBJECTIVETo investigate the impact of hepatic steatosis on virologic response to treatment with pegylated interferon-alpha-2a (PEG-IFNα-2a) in chronic hepatitis B (CHB) patients.

METHODSWe retrospectively analyzed 50 biopsy-proven cases of CHB in patients who had been administered a 48-week course of PEG-IFNα-2a in our hospital between 2005 and 2009. The patients were stratified according to presence of steatosis confirmed by pathological findings, with 28 in the non-steatosis group and 22 in the steatosis grouP(21 with mild steatosis,and 1 with moderate steatosis).

RESULTSfrom blood routine test,hepatic and renal function tests, fasting blood glucose test, thyroid function test and blood lipid test were collected for analysis, as were results from hepatitis B viral load test and detection of hepatitis B virus (HBV) markers and autoantibodies. The efficacy of antiviral treatment and side effects were compared between the stratified groups by statistically comparing the results from before and after the 48 weeks of treatment.

RESULTSAt the end of treatment, the non-steatosis group had 42.9% of patients with undetectable HBV-DNA ( less than 500 copies/ml), a hepatitis B e antigen (HBeAg) seroconversion rate of 31.6% and a complete response rate of 39.3%. The steatosis group had a lower rate of patients with undetectable HBV-DNA (40.9%) and higher rates of HBeAg seroconversion (33.3%) and complete response (40.9%), but none of the differences reached the threshold for statistical significance (x2=0.012, 0.019, 0.014 and P=0.560,0.600,0.568 respectively). Both groups showed significant increases in triglyceride levels after treatment (steatosis group:t =-2.164, P=0.040; non-steatosis group:t =-2.863, P=0.009), and there was a significant difference between the two groups (t=2.41, P=0.020).

CONCLUSIONOur study did not show that mild hepatic steatosis affected the efficiency of a 48-week course of PEG-IFNα-2a treatment for patients with CHB.

Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; Fatty Liver ; pathology ; Hepatitis B e Antigens ; blood ; Hepatitis B virus ; Hepatitis B, Chronic ; drug therapy ; pathology ; Humans ; Interferon-alpha ; therapeutic use ; Polyethylene Glycols ; therapeutic use ; Recombinant Proteins ; therapeutic use ; Retrospective Studies

Objecive: To assess the clinical outcomes of patients who received modified penile augmentation by free dermal-fat grafting. Methods: From April 2012 to December 2014, a total of 15 male adults (18-24 years of age) after hypospadias repairs were included. They underwent modified penile augmentation, including girth enhancement using free dermal-fat grafting, and penile elongation (suprapubic skin advancement-ligamentolysis). Penile measurements were performed using ruler before operation and 6 months after operation. The outcome was evaluated by patients, based on the Male Genital Image Scale. SPSS 22.0 was used to analyze the data. In-paired t-test and Wilcoxon test were applied. Results: In 6-84 months of follow-up, all patients achieved excellent cosmetic results, and satisfied with the appearance and diameter. In weak state, the penile length increased from (5.03±0.47) cm to (6.69±0.49) cm. The increased value was (1.67±0.24) cm (t=8.6, P<0.001). Under traction, the penile length increased from (7.29±0.74) cm to (9.21±0.73) cm. The increased value was (1.93±0.21) cm (t=7.8, P<0.001). In weak state, the diameter of the middle part of penis increased from (7.16±0.25) cm to (8.69±0.44) cm, with the increased value of (1.53±0.23) cm (t=8.2, P<0.001). The MGIS score grew from 31.73±4.86 to 40.20±4.54(Z=3.2, P=0.001). Conclusions This modified technique is safe and effective in enlarging penile size for patients who had underwent hypospadias repair. It is confirmed that physical dimensional enhancement does contribute to improving their self-estimation of penile size.

Objective: To evaluate the histological integration process of the buccal mucosa onlay graft applied on the dorsal corpora cavernosa for urethroplasty in an experimental study in rabbits, as well as to preliminarily investigate potential mechanism of the survival of the buccal mucosa and the impact of the tunica and corpus cavernos. Methods: Six New Zealand rabbits were fed with finasteride powder(10 mg/kg, 7 d)from 19th days of gestation, and the rabbit model of congenital hypospadias was established.At the age of 4 months, after releasing the chordee of the dorsal corpora cavernosa, the urethral defect was created by applying buccal mucosa onlay graft for the penile urethral reconstruction. The animals were sacrificed at 1, 2, 4, 12, 24 and 36 weeks post surgery and their genitals were subjected to morphological observation and histological assessment with hematoxyiin-eosin (HE), Masson and Stirus staining. Results: A total of 23 male rabbits were obtained from natural childbirth, 1 of them were normal rabbits, and the other 22 were hypospadias(1 glandular hypospadias, 15 penile hypospadias and 6 scrotal-perineal type). The buccal mucosa graft showed complete uptake in all animals the location of the graft was macroscopically identifiable, demonstrating its good integration. The typical squamous epithelium of buccal mucosa was observed. One week post operation, the tunica albuginea layer and the submucosa were blurred, with inflammatory cells infiltration. Two weeks after surgery, the epithelial layer was getting thick, few neovascularity and young fibroblasts were observed in the subepithelial layer. Gradual arrangement of epithelial layer was visible, the young fibroblasts were increasing and areas of mature collagen could be seen four weeks post operation. The typical squamous epithelium of buccal mucosa and minimal inflammatory cell infiltration in the subepithelial tissues were observed at the grafted mucosa twelve weeks after surgery. It was distinguishable to identify the cell level of subepithelial layer and the tunica of corpus cavernos. Twenty-four weeks after surgery, the epithelial layer was well integrated with adjacent urethral mucosa. Accentuated fibrosis was noticed with extensive mature collagen and without signs of inflammation and scar proliferation of the grafts. Conclusions The animal model of congenital hypospadias in rabbits could be established using Finasteride. It was feasible to use the animal model to carry out the experimental study of buccal mucosa grafts. The minimal inflammatory cell infiltrations in the subepithelial tissues were observed at the grafted mucosa twelve weeks after surgery. It was distinguishable to identify the cell level of subepithelial layer and the tunica albuginea of corpus cavernos. Buccal mucosa grafting had no obvious limitation effect on the tunica albuginea and the corpus cavernos development.

Objective:To explore the cleansing effect of Nitric Oxide (NO) sustained-release silica nanoparticles (short for NO sustained-release agent) on endoscopic biofilm and its clinical application.Methods:A total of 160 clinical endoscopes were randomly divided into two groups: the cleansing agent group (80 pieces, disinfected with cleansing agents), NO group (80 pieces, disinfected with NO sustained-release agent). A biofilm model of Pseudomonas aeruginosa was constructed and used as the control for phosphate buffered solution (PBS) treatment. A biofilm model of Pseudomonas aeruginosa on the surface of endoscopic lumen was built first in vitro. Scanning electron microscopy was then used to observe the microstructure of biofilm after treatment with NO sustained-release agent. Viable counting method was used to evaluate the cleansing effect of NO sustained-release agent on biofilm. Finally, at the clinical level, the actual disinfection effect of NO sustained-release agent on clinical endoscopy was evaluated by detecting the protein residues, viable counting and adenosine triphosphate (ATP) biofluorescence detection. Results:The scanning electron microscopy showed that the biofilm was intact in the model group, but scattered bacteria were observed on the biofilm surface in the NO group and the detergent group. Compared with the model group [(4.86±2.67)×10 6(colony-forming units, CFU)/mL], the standard CFUs of the NO group [(1.37±0.61)×10 4CFU/mL] and the detergent group [(1.31±0.21)×10 5CFU/mL] were significantly lower (detergent group VS model group, P=0.009; NO group VS model group, P=0.008), and there was significant difference between the detergent group and the model group ( t=9.53, P=0.000 6). The levels of residual proteins in the endoscopic lumens before and after the treatment were 8.03±1.47 mg/mL and 0.50±0.37 mg/mL in the NO group, 8.01±1.51 mg/mL and 0.91±0.52 mg/mL in the detergent group with significant difference ( P<0.01), and the reduction effect of the NO group was more significant. The disinfection of NO group and cleaning agent group was within the qualifying range, but the ATP bioluminescence value, protein residue and colony count of NO group (78.56±42.59 RLU, 0.50±0.37 mg/mL, 7.55±4.56 CFU) were significantly lower than those of detergent agent group (120.80±54.00 RLU,0.91±0.52 mg/mL,11.50±4.75 CFU, P<0.01). Conclusion:NO sustained-release agent can effectively clear endoscopic biofilm and further improve the disinfection effect on endoscopes, which may be of great significance for improving the effects on treatment and prognosis of patients.