There are also many unanswered questions on the duodenogastroesophageal reflux(DGER),though it has been studied for more than 100 years.Based on the references and our studies,we reviewed the bile' injury on esophageal mucosal epithelial cells,the diagnosis and treatment of bile reflux into esophagus.The relationships of the biles with Barrett's esophagus and esophageal adenocarcinoma were elucidated especially.

Objective　To study the relation between myocardia l changes and left ventricular function in preoperative patients with combined m itral diseases provide theoretical basis for clinical therapy and evaluate the effects of treatment. Methods　A total of patients with combined mitral lesions were selected randomly for study. The cases were divided into tw o groups according to the degree of ultrastructural damage of the myocardium bef ore aortic occlusion in mitral valve replacement (Flameny cla ssification). The preoperative pulmonary artery catheterization(Swan-Ganz cathe ter), color Doppler echocardiography, roentgenologic measurement of heart size, preoperative clinical data and postoperative follow-up data were collected for analysis. Results　The results showed that myocardial lesion in mitral disease had intimate correlation with the cardiac enlargement, especial c orrelated with left ventricular enlargement and cardiac pumping. Conclus ion　Results suggest that the myocardial lesions in mitral valvular dise ases mainly involved the process of rheumatism and reflected in the disturbance of left ventricular function. Operation should be performed before the appeare nce of non-reversible myocardium injury in patients with rheumatic mitral va lvul ar diseases.

Humans ; Noise, Occupational ; adverse effects ; Occupational Exposure ; standards

Oblective To observe the effect of bile reflux on the intragastric pH. Methods We used ambulatory intragastric pH monitoring along with simultaneous Bilitec 2000 to measure the pH and absorbance of the mixed gastric juice diluted with bile with increasing bilirubin concentration in vitro and the yellow and clear gastric juice aspirated under endoscopy. In vivo,we studied 20 functional dispepsia patients for 24 h with simultaneous intragastric pH and bilirubin monitoring. Results In vitro dilutions,the absorbance value reached to 0. 900 while the concentration was only 20% ,but when the pH of the solution was more than 4,it′s concentration was already up to 60％. The mean absorbance of the yellow gastric juice(0. 348± 0. 131) was significantly higher than that of the clear juice (0. 008 ± 0. 003)(P＜0.05). The pH of 80％ yellow gastric juice was less than 4, the percentage was not significantly different from the clear samples (81％) (P＞0. 05). The pH showed no correlation with the absorbance in the yellow and clear groungs. Eight of the 12 patients with the spontaneous nocturnal episcodes of alkalinization had simultaneous increase of absorbance,4 of the 8 subjects with no aikalinization had increase of absorbance. Gonclusion In some concentration,bile reflux affect little on the intragastric pH.

Objective To investigate the mechanism of presynaptic protein (Munc18) antibody in inducing epilepsy on rat. Methods Munc18 antibody was continuously micro-injected into CA1 area of hippocampus in Sprague-Dawley (SD) rat (the injection times were nine). The potential epileptic seizure was evaluated according to both electroencephalogram (EEG) and behaviors. HE, Nissle and TUNEL staining were applied on rat brain sections as to detecting the cell damage and apoptosis after tenth week. Results Ten of twelve rats produced epileptic EEG, five cases among these ten rats maintained abnormal EEG after the sixth week since injections. Nine of the above twelve rats had epileptic seizure according to Racine grade one to four, four cases among these nine rats kept seizure after the sixth week since injections. The number of neurons decreased (155?20,P

Objective To investigate the changes of circulating endothelial progenitor cells (EPCs) in patients with acute cerebral infarction or chronic cerebral ischemia and discuss the related clinical significance.Methods Circulating EPCs were isolated using staining markers of CD34,CD133,and kinase insert domain receptor (KDR).Peripheral venous blood was collected from patients with acute cerebral infarction within 24 hours of onset (infarction group,n =30),with chronic cerebral ischemia (ischemia group,n =20),and without cerebral ischemia (control group,n =10) to quantify circulating level of EPCs using flow cytometry and measure parameters of systolic pressure,glycosylated hemoglobin (HbAlc),total cholesterol (TC),and triglyceride (TG),and low density lipoprotein-cholesterol (LDL-C),and high density lipoprotein-cholesterol (HDL-C).Results CD34-,CD34/CD133-,and CD34/KDR-positive cells counted (14.2 ± 8.1)‰,(7.1 ± 4.1)‰ and (5.0 ± 3.7)‰ in infarction group,(28.5 ± 9.9)‰,(15.2 ± 3.7)‰ and (6.8 ± 2.0)‰ in ischemia group,and (44.8 ± 9.5) ‰,(22.1 ± 6.6) ‰ and (16.7 ± 6.9) ‰ in control group.Taken together,circulating level of EPCs lowered substantially in infarction and ischemia groups compared to control group (P ＜ 0.05) and a far lower level was observed in infarction group (P ＜ 0.05).Circulating level of EPCs in infarction group was in a moderate negative correlation with systolic pressure,TC,TG,and LDL-C (P ＜ 0.05).Conclusions Decreased circulating level of EPCs may be a risk factor to the development of cerebral ischemia in acute cerebral infarction patients.Therefore,level of EPCs is vital for prediction,prevention and treatment of acute cerebral infarction.

Objective　To study the relation between myocardia l changes and left ventricular function in preoperative patients with combined m itral diseases provide theoretical basis for clinical therapy and evaluate the effects of treatment. Methods　A total of patients with combined mitral lesions were selected randomly for study. The cases were divided into tw o groups according to the degree of ultrastructural damage of the myocardium bef ore aortic occlusion in mitral valve replacement (Flameny cla ssification). The preoperative pulmonary artery catheterization(Swan-Ganz cathe ter), color Doppler echocardiography, roentgenologic measurement of heart size, preoperative clinical data and postoperative follow-up data were collected for analysis. Results　The results showed that myocardial lesion in mitral disease had intimate correlation with the cardiac enlargement, especial c orrelated with left ventricular enlargement and cardiac pumping. Conclus ion　Results suggest that the myocardial lesions in mitral valvular dise ases mainly involved the process of rheumatism and reflected in the disturbance of left ventricular function. Operation should be performed before the appeare nce of non-reversible myocardium injury in patients with rheumatic mitral va lvul ar diseases.

AIM:To explore whether YAP protein is important in induced pluripotent stem cell ( iPSC)-induced cardiovascular progenitor cell and/or vascular smooth muscle differentiation .METHODS:Using episomal vector based reprogramming , we generated human iPSCs from donor fibroblasts .We used both this iPSCs and human H 1 embryonic stem cells to differentiate into vascular smooth muscle cells (VSMCs) through cardiovascular progenitor cells (CVPC).Western blotting, qPCR and immunofluorescence microscopy were used to check the expression of YAP and related genes during this differentiation process .RESULTS:The results showed that iPSCs expressed pluripotent stem cell markers, such as Oct4, Nanog, Sox2, TRA-1-60 and SSEA3, and could form teratoma in SCID mice.YAP was highly expressed in pluripotent stem cells , but dramatically decreased when CVPC differentiation started .YAP gradually increased dur-ing CVPC three-day differentiation.The TAZ and YAP binding partner TEAD1, but not TEAD2 and TEAD4, have similar expression pattern in CVPC differentiation .Immunofluorescence result confirmed that YAP was activated and accumulated in nucleus .Interesting-ly, both YAP and phosphorylated YAP expression decreased to very low level after CVPC differentiated into VSMCs in 7 days.TEAD4 and TAZ also decreased, while TEAD1, TEAD2 and TEAD3 expression did not change during VSMC differentiation .CONCLU-SION:YAP and TEAD1 expression increased during CVPC differentiation , while YAP and TEAD4 expression decreased from CVPC to VSMCs differentiation , which suggested YAP might have different function during diverse cell differentiation .

OBJECTIVETo explore the clinical efficacy and action mechanism of acupuncture for premature ovarian failure (POF).

METHODSAccording to prospective cohort study design, 30 cases were included. Based on theory of regulating Chong and Conception Vessels as well as soothing the liver and calming the nerves, acupuncture at Guanyuan (CV 4), Dahe (KI 12), Taixi (KI 3), Taichong (LR 3), Baihui (GV 20) was applied, three times per week and 3 months were considered as one session. Totally two sessions were performed. The menstruation condition, estradiol (E2), follicle-stimulating hormone (FSH) and scores of the clinical perimenopausal symptoms were taken as treatment outcomes.

RESULTSThe total effective rate was 86.7% (26/30) and the cured rate was 16.7% (5/30). The recovery rate of menstruation was 16.7% (5/30) and the regain rate of menstruation was 56.7% (17/30). After the treatment, the level of E2 was significantly increased from (45.41 +/- 18. 09) pmol/L to (59.07 +/- 24.21) pmol/L (P < 0.05), and the score of perimenopausal symptoms was obviously reduced from 14.28 +/- 8. 30 to 4.04 +/- 3.28 (P < 0.01). However, no statistical differences could be seen in FSH before and after treatment (P > 0.05).

CONCLUSIONAcupuncture has certain effect on improving menstruation and perimenopausal symptoms in POF patients, which is likely to he related with increasing the level of E2.

Acupuncture Therapy ; Adolescent ; Estradiol ; metabolism ; Female ; Humans ; Luteinizing Hormone ; metabolism ; Primary Ovarian Insufficiency ; metabolism ; therapy ; Prospective Studies ; Young Adult

Cardiovascular Diseases ; metabolism ; pathology ; Humans ; Smad Proteins ; metabolism ; Trans-Activators ; metabolism