Small intestinal obstruction is a common complication of primary gastrointestinal cancer or metastatic cancers.Patients with this condition are often poor candidates for surgical bypasses,and placement of self-expanding metal stent (SEMS) can be technically challenging.In this study,we examined the feasibility of combined application of single-balloon enteroscope (SBE) and colonoscope for SEMS placement in patients with malignant small intestinal obstruction.Thirty-four patients were enrolled in this study,among which 22 patients received SEMS placement by using SBE and colonoscope,while the other 12 patients received conservative medical treatment.The patients were followed up for one year.Stent placernent was technically feasible in 95.5％ (21/22).Clinical improvement was achieved in 86.4％ (19/22).For the 19 clinical success cases,the average time of benefits from a gastric outlet obstruction scoring system (GOOSS) increase ≥1 was 111.9±89.5 days.For the 12 patients receiving conservative medical treatment,no significant improvement in GOOSS score was observed.Moreover,a significant increase of Short-Form-36 health survey score was observed in the 19 patients at time of 30 days after stent placement.By Kaplan-Meier analysis,a significant survival improvement was observed in patients with successful SEMS placement,compared with patients receiving conservative medical treatment.Taken together,combined use of SBE and colonoscope makes endoscopic stent placement feasible in patients with malignant small intestinal obstruction,and patients can benefit from it in terms of prolonged survival and improved quality of life.

The study is aimed to ensure the quality and safety of medicinal plants by using ITS2 DNA barcode technology to identify Corydalis boweri, Meconopsis horridula and their close related species. The DNA of 13 herb samples including C. boweri and M. horridula from Lhasa of Tibet was extracted, ITS PCR were amplified and sequenced. Both assembled and web downloaded 71 ITS2 sequences were removed of 5. 8S and 28S. Multiple sequence alignment was completed and the intraspecific and interspecific genetic distances were calculated by MEGA 5.0, while the neighbor-joining phylogenetic trees were constructed. We also predicted the ITS2 secondary structure of C. boweri, M. horridula and their close related species. The results showed that ITS2 as DNA barcode was able to identify C. boweri, M. horridula as well as well as their close related species effectively. The established based on ITS2 barcode method provides the regular and safe detection technology for identification of C. boweri, M. horridula and their close related species, adulterants and counterfeits, in order to ensure their quality control, safe medication, reasonable development and utilization.
Base Sequence ; China ; Corydalis ; chemistry ; classification ; genetics ; DNA Barcoding, Taxonomic ; methods ; DNA, Plant ; chemistry ; genetics ; DNA, Ribosomal Spacer ; chemistry ; genetics ; Molecular Sequence Data ; Nucleic Acid Conformation ; Papaveraceae ; chemistry ; classification ; genetics ; Phylogeny ; Plants, Medicinal ; chemistry ; classification ; genetics

Objectlve To detect the KChIP2 mRNA level in rheumatic heart disease patients with or without atrial fibrillation (AF) by real-time PCR.Methods Right atrial appendage samples from rheumatic heart disease patients with (n=17) or without AF (n=13) were obtained during cardiac surgery.Total RNA was extracted from the atrial tissues.and the KChIP2 and Kv4.3 mRNA were detected by SYBR Green I real-time PCR with the GAPDH as the house keeping gene.Result The ratio of KChIP2/GAPDH(0.1468 ±0.0452 VS.0.2200±0.0388,P＜0.01)and the ratio of Kv4.3/GAPDH(0.3946±0.1826 vs.0.5257±0.1427.P＜0.05)were significantly lower in AF patients compared to non-AF patients.Conclusion Down-regulated atrial KChIP2 and Kv4.3 mRNA expressions in rheumatic heart disease patients with chronic AF might be one of the molecular bases responsible for the down-regulation of the Ito current density of AF.

Translational biomedical informatics is a new discipline integrating bioinformatics,medical informatics with translational medicine.The paper discusses the rise and ecology of the discipline,pointing out that full sharing of data is the foundation,complete genotype-clinical phenotype is the core and precise prediction that solves complicated diseases is the key,and analyzing the connotation of the discipline and development trend against the big data background profoundly.

Hemangioendothelioma, Epithelioid ; Humans ; Liver Neoplasms ; Male ; Middle Aged

BACKGROUND: Numerous studies focus on animal models of intervertebral disc degeneration (IDD), but criteria for establishing the animal models of IDD have not been confirmed, and there is a lack of systematic comparison among models. OBJECTIVE: To compare the rat models of IDD established by puncturing at annulus, endplate injection and their combination, thus providing reference for IDD model selection. METHODS: Eighty Sprague-Dawley rats were equivalently randomized into four groups: puncturing group (puncturing at the annulus), endplate injection group (endplate injected with ethyl alcohol), combination group (puncturing at the L5-6annulus and endplate injection at the same segment) and sham operation group. Three rats in each group were taken at postoperative 4, 8, and 12 weeks for X-ray examination to measure the disc height; and the discs were removed for histological observation and immunohistochemical staining. RESULTS AND CONCLUSION: The results of X-ray examination, hematoxylin-eosin staining and immunohistochemical staining all showed that the IDD degree was gradually aggravated in all groups except the sham operation group. At postoperative 4 weeks, compared with the sham operation group, in the endplate injection and combination groups, the percent disc height was significantly decreased, the pathological scores were significantly increased and the average gray value of collagen type I was significantly reduced (P ＜ 0.05). At postoperative 8 and 12 weeks, compared with the sham operation group, the percent disc height in the other three groups were all significantly decreased, the pathological score was significantly increased, and the average gray value of collagen type I was significantly decreased (P ＜ 0.05). Compared with the puncturing and endplate injection group, in the combination group, the percent disc height at postoperative 8 weeks was significantly decreased, and the average gray value of collagen type I at postoperative 12 weeks was significantly decreased (P ＜ 0.05). These results suggest that the rat IDD model can be successfully constructed by above three methods. Puncturing at the annulus is easy to operate and control IDD progression, which can be used to study different stages of IDD. Endplate injection is suitable for the etiological study of IDD, and induces IDD earlier than puncturing, but the final results are similar. The combination method can significantly accelerate IDD aggravation, and thus is not time consuming.

Objective: To investigate the characteristics of oral lesions in HIV infected patients aged 50 years or older in Yunnan.Methods: 315 HIV infected patients aged 50 years and older from January 2013 to December 2016 were included in a cross-sectional survey at the Third People's Hospital of Kunming. The characteristics of oral mucosal lesions and the relationship between the oral lesions and CD4 count level were analyzed. Results: 13 kinds of oral mucosal lesion in 185 out of the 315 cases (58. 73％) were observed. 122 cases were with candidiasis (38. 73％), including 68 (21. 59％) of pseudomembranous type, 52 (16. 51％) of erythema and 18 (5. 71％) of stomatitis; 25 (7. 94％) were with Hairy leukoplakia, 20 (6. 35％) with recurrent oral ulcer, 17 (5. 40％) with fissured tongue, 11 (3. 49％) with herpes simplex. 2 and 3 lesions were detected in 41 cases (13. 02％) and 1 case (0. 32％), respectively. The rate of simultaneous detection of more than 2 lesions and the detection rate of oral candidiasis were related to the CD4 count level. Conclusion: Oral mucosal lesions are common in elderly patients with HIV infection, and oral candidiasis is the main type.

BACKGROUNDThe blood vessels of a transplanted organ are the interface between donor and recipient. The endothelium in the blood vessels is thought to be the major target for graft rejection. Endothelial cells of a transplanted organ can be of recipient origin after transplantation. In this study, we tested whether endothelial chimerism correlated with the graft rejection and cold ischemia.

METHODSWe studied the biopsy samples from 34 renal transplants of female recipients who received the kidney from a male donor for the presence of endothelial cells of recipient origin. We examined the tissue sections of renal biopsy samples by fluorescence in situ hybridization (FISH) for the presence of endothelial cells containing two X chromosomes using a biotinylated Y chromosome probe and digoxigenin labelled X chromosome probe, and then analyzed the relationship between the endothelial cell chimerism and the rejection and cold ischemia.

RESULTSEndothelial chimerism was common and irrespective of rejections (P > 0.05). The cold ischemic time of chimerism group was longer than no chimerism group ((14.83 +/- 4.03) hours vs (11.27 +/- 3.87) hours, P < 0.05).

CONCLUSIONSThere is no correlation between the percentage of recipient endothelial cells in vascular endothelial cells and the type of graft rejection. The endothelium damaged by ischemic injury might be repaired by the endothelial cells from the recipient.

Animals ; Biopsy ; Endothelial Cells ; pathology ; Female ; Graft Rejection ; Humans ; In Situ Hybridization, Fluorescence ; Kidney ; pathology ; Kidney Transplantation ; Male ; Mice ; Time Factors ; Transplantation Chimera ; Transplantation, Homologous

In order to verify the hypothesis that left ventricular epicardial (LV-Epi) pacing and biventricular (BiV) pacing unavoidably influence the myocardial electrophysiological characters and may result in high risk of malignant ventricular arrhythmia, we calculated, in both normal mongrel dogs and dog models with rapid-right-ventricular-pacing induced dilated cardiomyopathy congestive heart failure (DCM-CHF), the monophasic action potential duration (MAPD) and the transmural dispersion of repolarization (TDR) in intracardiac electrogram together with the QT interval and T(peak)-T(end) (T(p(-T(e)) interval in surface electrocardiogram (ECG) during LV-Epi and BiV pacing, compared with those during right ventricular endocardial (RV-Endo) pacing. To prepare the DCM-CHF dog model, rapid right ventricular pacing (250 bpm) was performed for 23.6+/-2.57 days to the dog. All the normal and DCM-CHF dogs were given radio frequency catheter ablation (RFCA) to His bundle with the guide of X-ray fluoroscopy. After the RFCA procedures, the animals were under the situation of complete atrioventricular block so that the canine heart rates could be voluntarily controlled in the following experiments. After a thoracotomy, ECG and monophasic action potentials (MAP) of subendocardial, subepicardial and mid-layer myocardium were recorded synchronously in 8 normal and 5 DCM-CHF dogs during pacing from endocardium of RV apex (RV-Endo), epicardium of LV anterior wall (LV-Epi) and simultaneously both of the above (biventricular, BiV), the later was similar to the ventricular resynchronization therapy to congestive heart failure patients in clinic. The Tp-Te) meant the interval from the peak to the end of T wave, which was a representative index of TDR in surface ECG. The TDR was defined as the difference between the longest and the shortest MAPD of subendocardial, subepicardial and mid-layer myocardium. Our results showed that in normal dogs, pacing participating of LV (LV-Epi, BiV) prolonged MAPD of all the three layers of the myocardium (P<0.05) with the character that mid-layer MAPD was the longest and subepicardial MAPD was the shortest following subendocardial MAPD. At the same time, TDR prolonged from 26.75 ms at RV-Endo pacing to 37.54 ms at BiV pacing and to 47.16 ms at LV-Epi pacing (P<0.001). Meanwhile in surface ECG, BiV and LV-Epi pacing resulted in a longer Tp-Te) interval compared with RV-Endo pacing (P<0.01), without parallel QT interval prolongation. Furthermore, all the DCM-CHF model dogs showed manifestations of congestive heart failure and enlargement of left ventricles. Based on the lengthening of mid-layer MAPD from 257.35 ms to 276.30 ms (P<0.0001) and increase of TDR from 27.58 ms to 33.80 ms (P equals;0.002) in DCM-CHF model due to the structural disorders of myocardium compared with the normal dog, LV-Epi and BiV pacing also led to the effect of prolonging MAPD of three layers of the myocardium and enlarging TDR. From these results we make the conclusions that prolongation of MAPD of subendocardial, subepicardial and mid-layer myocardium and increase in TDR during pacing participating of LV (LV-Epi, BiV) may contribute to the formation of unidirectional block and reentry, which play roles or at least are the high risk factors in the development of malignant ventricular arrhythmia, especially in case of structural disorders of myocardium. These findings must be considered seriously when ventricular resynchronization therapy is performed to congestive heart failure patients.
Action Potentials ; Animals ; Bundle-Branch Block ; complications ; physiopathology ; Cardiomyopathy, Dilated ; complications ; physiopathology ; Dogs ; Female ; Heart Conduction System ; physiopathology ; Heart Failure ; etiology ; physiopathology ; Heart Ventricles ; physiopathology ; Male ; Torsades de Pointes ; physiopathology ; Ventricular Dysfunction, Left ; physiopathology ; Ventricular Function, Left

Objective:To assess the usage of β-blocker in patients with acute myocardial infarction (AMI) in early hospitalization period (admission within 24 hours) in Liaoning Province from 2001 to 2011.Methods:By convenience sampling, patients from 10 hospitals in 3 study years (2001, 2006, and 2011) were randomly selected and clinical data were extracted, the usage frequency, types and dosage of β-blocker were analyzed.Results:A total of 1 365 AMI patients from ten hospitals were included in this analysis, and about 296 cases (21.68%) were considered as ideal patients for early β-blocker use (53.10% cases in 2001, 68.70% cases in 2006, and 78% cases in 2011, P<0.001).Logistic regression analysis showed that the heart rate was related to the early usage of β-blocker.The most frequently used β-blocker was metoprolol (90.73%) within 3 years, only 1.46% had the dosage above 50 mg.Conclusions:During the past decade, the utilization rate of βB among the appropriate patients with AMI during the early-phase hospitalization in Liaoning Province present the increasing trend.However, there is a distinct gap between the utilization status and guideline.Although the early application can reduce the occurrence of cardiovascular event, the heart rate of patients and so on are the main causes that influence its application.Therefore, regarding the early application, it is necessary to comply with the evidence-based medical science and combine it with the individualization principle.