OBJECTIVETo observe the histological changes of gastric mucosa in patients with active gastric ulcer before and after treatment by Qifang Weitong Powder combined with omeprazole (QWP-Op).

METHODSSixty patients were equally randomized into the treated group and the control group. They were all treated in the 1st week by the Helicobacter pylori eradication triad regimen. From the 2nd to 6th week, the study group re-ceived QWP-Op therapy, and the control group was given Omeprazole alone.Biopsy specimens were obtained around ulcer area before and after treatment for histological observation on changes of gastric mucosa membrane.

RESULTSThe improvement of mucosal thickness and glandular morphology was better in the treated group than that in the control group (P <0.05).

CONCLUSIONQWP-Op therapy can improve the histological quality of ulcer healing and restore the morphological structure of gastric mucosa in patients with active gastric ulcer.

Adult ; Anti-Ulcer Agents ; therapeutic use ; Biopsy, Needle ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Gastric Mucosa ; pathology ; Humans ; Male ; Middle Aged ; Omeprazole ; therapeutic use ; Phytotherapy ; Powders ; Stomach Ulcer ; drug therapy ; pathology ; Treatment Outcome ; Young Adult

AIM AND METHODSBy hydrogen gas clearance technique to measure gastric mucosal blood flow (GMBF) and a high dose of capsaicin to ablate the capsaicin-sensitive afferent fibers, the roles of capsaicin-sensitive afferent fibers and endogenous NO in the gastric acid secretion and hyperemic response to intragastric distention were studied in rats.

RESULTS(1) There was an increase in acid secretion associated with the increase in GMBF to intragastric distention. (2) Pretreatment with a high dose of capsaicin to ablate afferent fibers completely abolished the GMBF and partially inhibited the acid secretion during the intragastric distention. (3) The increase in GMBF to intragastric distention was completely blocked by pretreatment with L-NAME, whereas the acid secretion was significantly attenuated.

CONCLUSIONCapsaicin-sensitive afferent fibers and endogenous NO are involved in the increases of gastric acid secretion and GMBF.

Animals ; Capsaicin ; pharmacology ; Gastric Acid ; secretion ; Gastric Dilatation ; metabolism ; Gastric Juice ; secretion ; Gastric Mucosa ; blood supply ; Male ; NG-Nitroarginine Methyl Ester ; Neurons, Afferent ; drug effects ; Nitric Oxide ; physiology ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo study the changes of body composition in females patients with human immunodeficiency virus (HIV)-related lipodystrophy (LD) syndrome (HIV-LD).

METHODSTotally 25 female patients who were treated in our hospital from January 2002 to December 2009 were divided into LD group and non-LD group based on the existence of LD. All these patients were receiving highly active antiretroviral therapy (HAART). In addition, 12 healthy women were set as the controls. Total and regional body composition were measured by dual X-ray absorptiometry in all three groups.

RESULTSThe fat mass (FM) was correlated negatively with the duration of HAART (r=-0.431, P=0.029). Multiple linear regression analysis showed that FM had positive correlation with weight and negative correlation with lean mass (LM) (r = - 0. 973, P =0. 000). Total, trunk and leg FM were significantly lower in LD patients than that in controls (P <0.05).Meanwhile, total, trunk and leg bone mineral contents were statistically lower in LD patients than that in controls (P <0. 05). Lumbar bone mineral density of LD patients was lower than that of non-LD patients and controls, and there was significant difference between LD patients and controls (P = 0. 001). LM of LD patients was higher than that of non-LD patients but without statistical difference (P > 0. 05).

CONCLUSIONSThe peripheral and central FM and bone mineral contents remarkably decrease in female patients with HIV-LD. How-ever, HIV-LD patients tend to have higher LM than non-LD patients. .

Adipose Tissue ; metabolism ; Adult ; Body Composition ; physiology ; Bone Density ; physiology ; Female ; HIV-Associated Lipodystrophy Syndrome ; metabolism ; Humans ; Middle Aged ; Young Adult

OBJECTIVETo investigate the relationship between alterations of p16INK4a and p14ARF genes and gastric carcinogenesis.

METHODSTumors and gastric tissues neighboring carcinoma from 48 patients with gastric cancer were studied. Homozygous deletion, mutation, methylation of the CpG islands, mRNA expression of p16INK4a and p14ARF genes were assessed by polymerase chain reaction (PCR), PCR-single strand conformation polymorphism (SSCP), PCR based methylation assay, and reverse transcription (RT)-PCR.

RESULTS(1) The overall homozygous deletion rate of p16INK4a and p14ARF was 35.4% (17/48), and no homozygous deletion was examined in all the gastric tissues neighboring tumor. (2) There was no point mutation of p16INK4a and p14ARF in 31 gastric cancers without homozygous deletion and in the matched gastric tissues adjacent to tumor. (3) Methylation of the CpG islands of p16INK4a and p14ARF was detected in 47.9% (23/48) of gastric cancers, while methylation was observed only in 2 of 48 gastric tissues neighboring cancers with a significant difference (P <0.01). (4) The rate of p16INK4a mRNA loss was 47.9% (23/48) in gastric cancer, and the cases of combined methylation of exons 1alpha and 2 had a higher loss rate (100%, 6/6) of p16INK4a mRNA than those of methylation form the other exons (11.8%, 2/17) (P <0.01). The loss rate of p14ARF mRNA was 45.8% (22/48) in gastric cancer, and patients with combined methylation of exons 1beta and 2 had a higher loss rate (100%, 3/3) of p14ARF mRNA than those of the methylation from the other exons (15%, 3/20) (P < 0.05). (5) The combined loss of p16INK4a and p14ARF mRNAs was examined in 1 (5.6%) of 18 cases of well and moderately-differentiated carcinomas, and 11 (36.7%) of 30 cases of poorly and not-differentiated carcinomas with significant difference (P <0.05).

CONCLUSIONp16INK4a and p14ARF genes were frequently inactivated by homozygous deletion and methylation of the 5' CpG islands in gastric cancer, which might have played an important role in the development of gastric cancer.

Adenocarcinoma ; genetics ; Adolescent ; Adult ; Aged ; Cyclin-Dependent Kinase Inhibitor p16 ; genetics ; DNA Methylation ; Female ; Gene Deletion ; Genes, p16 ; Humans ; Male ; Middle Aged ; RNA, Messenger ; analysis ; Stomach Neoplasms ; genetics ; Tumor Suppressor Protein p14ARF ; genetics

OBJECTIVESTo explore the clinical features of traumatic atlantoaxial instability combined with subaxial cervical spinal cord injury (CSCI), and to analyze the feasibility, indication and therapeutic effects of anterior-posterior approach in such cases.

METHODSFrom March 2004 to September 2009, 16 cases with this trauma were admitted and surgically treated in our department. Before surgery, skull traction was performed. Posterior atlantoaxial pedicle screw internal fixation and bone graft fusion were conducted to manage traumatic atlantoaxial instability. As for subaxial CSCI, anterior cervical corpectomy or discectomy decompression, bone grafting and internal fixation with steel plates were applied.

RESULTSAll operations were successful. The average operation time was 3 hours and operative blood loss 400 ml. Satisfactory reduction of both the upper and lower cervical spine and complete decompression were achieved. All patients were followed up for 12 to 36 months. Their clinical symptoms were improved by various levels. The Japanese Orthopaedic Association (JOA) scores ranged from 10 to 16 one year postoperatively, 13.95+/-2.06 on average(improvement rate equal to 70.10%). X-rays, spiral CT and MRI confirmed normal cervical alignments, complete decompression and fine implants'position. There was no breakage or loosening of screws, nor exodus of titanium mesh or implanted bone blocks. The grafted bone achieved fusion 3-6 months postoperatively and no atlantoaxial instability was observed.

CONCLUSIONSTraumatic atlantoaxial instability may combine with subaxial CSCI, misdiagnosis of which should be especially alerted and avoided. For severe cases, one stage anterior-posterior approach to decompress the upper and lower cervical spine, together with reposition, bone grafting and fusion, as well as internal fixation can immediately restore the normal alignments and stability of the cervical spine and effectively improve the spinal nervous function, thus being an ideal approach.

Aged ; Atlanto-Axial Joint ; injuries ; surgery ; Female ; Humans ; Joint Instability ; diagnosis ; surgery ; Male ; Middle Aged ; Spinal Cord Injuries ; diagnosis ; surgery

OBJECTIVETo study the expression of NFkappaB p65 and its target genes in intestinal metaplasia (IM), dysplasia (Dys), gastric cancer (GC) infected with Helicobacter pylori (Hp) and explore the mechanism of infection by cytotoxin-associated antigen A expressing Hp (CagA(+)Hp) in the development of gastric cancer.

METHODSCagA antibody in blood sample of 289 patients was determined by ELISA. Hp was detected by rapid urease test and Warthin starry staining. Expression of NFkappaB p65 and its target genes in IM, Dys and GC was examined by immunohistochemistry.

RESULTSIn IMI approximately II, IMIII, DysI, DysII approximately III and GC, the expression of NFkappaB p65 was significantly higher in patients with CagA(+)Hp infection than those without CagA Hp infection. In IMIII and DysII approximately III, the expression of NFkappaB p65, c-myc, CyclinD(1) and bcl-xl was significantly higher in patients with CagA Hp infection than those without CagA Hp infection. In gastric cancer infected with CagA(+)Hp, the expression of NFkappaB p65, c-myc, CyclinD(1) and bcl-xl was significantly higher in intestinal type than in diffuse type.

CONCLUSIONThere are different mechanisms in intestinal type and diffuse type in the development of gastric cancer. The occurrence of intestinal type gastric cancer is associated with CagA(+)Hp infection which by NFkappaB p65 upregulating the expression of c-myc, CyclinD(1),bcl-xl in patients with IMIII, DysII approximately III. It may be an effective method to prevent gastric cancer by inhibiting NFkappaB p65.

Adult ; Aged ; Antigens, Bacterial ; analysis ; Bacterial Proteins ; analysis ; Cyclin D1 ; metabolism ; Female ; Helicobacter Infections ; complications ; metabolism ; microbiology ; Helicobacter pylori ; Humans ; Male ; Middle Aged ; Precancerous Conditions ; metabolism ; microbiology ; pathology ; Proto-Oncogene Proteins c-myc ; metabolism ; Stomach Neoplasms ; metabolism ; microbiology ; pathology ; Transcription Factor RelA ; genetics ; metabolism ; bcl-X Protein ; metabolism

To study the dynamic change law of bioactive constituents from Polygonum multiflorum, and to explore the optimal harvest period of P. multiflorum. Determination of stilhene glucoside, anthraquinones and catechin from P. multiflorum in different harvest times by MEKC-DAD, and principal component analysis (PCA) was used to comprehensive evaluation for bioactive constituents. There are obvious differences among the contents of active ingredients in various collecting periods samples, the content of stilbene glucoside was the highest in November, the total content of combined anthraquinone was the highest in November and December, the content of catechin was the highest in September. The comprehensive evaluation index obtained with principal component analysis showed that the sample collected in November is significantly higher than those with other samples. The optimal harvest period of P. multiflorum is November.
Electrophoresis ; Fallopia multiflora ; chemistry ; growth & development ; metabolism ; Time Factors

Adolescent ; Adult ; Female ; Hepatitis ; therapy ; Humans ; Liver, Artificial ; Male ; Middle Aged ; Plasma Exchange

OBJECTIVETo explore the perioperative features of surgical treatment in valvular patients with small left ventricle, and investigate the postoperative early structural changes of left ventricle and its correlation with cardiac function.

METHODSA total of 51 patients with small left ventricle underwent mitral valve replacement from January 2003 to August 2008. There were 7 males and 44 females with mean age of (48 +/- 5) years old. The mean pathologic course was (18 +/- 9) years old. The concomitant procedures included aortic valve replacement in 6 cases, coronary artery bypass grafting in 1 case, tricuspid valvular plasty in 48 cases, left atrial thrombi scavenging in 36 cases, and left atrium folding in 42 cases.

RESULTSThe perioperative mortality was 3.9% (2/51). Fourteen patients (27.5%) suffered from severe low-output syndrome in the earlier period postoperatively. Among them, 5 patients needed secondary cardiopulmonary bypass (CPB) to assist circulation, with the result of 1 patient died of weaning off CPB unsuccessfully, 1 patient revived with intra-aortic balloon pump assisted for another 2 d after termination of CPB and another 1 patient died of multiple organ failure (MOF) 10 d later. Eleven cases complicated with MOF. Five patients complicated with ventricular arrhythmia. The echocardiographic examinations showed that the left ventricular dimensions didn't expand significantly postoperatively at 7 to 14 d postoperatively. Left ventricular end-diastolic diameter (LVEDD) was (36.5 +/- 3.2) mm preoperatively and (38.6 +/- 5.3) mm postoperatively (P > 0.05). Preoperative LVEDD index (LVEDDI) was (45.9 +/- 3.8) ml/m(2) and postoperative LVEDDI was (48.2 +/- 7.4) ml/m(2) (P > 0.05). The contract function of left ventricle was improved postoperatively but with no statistical significance. Ejection fraction was 48.6% +/- 6.7% preoperatively and 52.8% +/- 8.3% postoperatively. Left ventricular fraction shortness was 25.5% +/- 3.3% preoperatively and 27.1% +/- 1.3% postoperatively.

CONCLUSIONSFor the patients with small left ventricle usually, the postoperative emphases should be put on the management of low output syndrome. The decreased dimension of left ventricle doesn't expand in the early period after valvular operation.

Adult ; Aged ; Female ; Heart ; physiopathology ; Heart Valve Prosthesis Implantation ; Heart Ventricles ; abnormalities ; Humans ; Male ; Middle Aged ; Myocardium ; pathology ; Postoperative Period ; Retrospective Studies

OBJECTIVETo explore the effects of the combined method of abdominal axial flap transposition and penile elongation for the treatment of the remnant penis.

METHODSFifty-two cases of the remnant penis treated with the combined method from 1984 April to February 2004 were analyzed retrospectively. Follow-up ranged from 0.5 to 20 years postoperatively.

RESULTSThe lengths (both in normal and erectile conditions) and the circumferences of the penis gained after operation were (5.6 +/- 1.4) cm, (6.8 +/- 2.5 cm and (6.9 +/- 2.3) cm respectively. The recovery rates of the sensory function were 94.2% and 100% in the glans (immediately and 3 months after operation) and 32.7%, 51.9% and 75% in the flap area (3, 6 and 12 months postoperatively). The two-point distinguishing sense in the glans and the flap area was (5.1 +/- 0.9) mm and(7.9 +/- 1.3) mm 5 years after operation. Early complications included distant flap necrosis (3 cases), disruption of the wound (2 cases), part necrosis of the skin graft in the abdominal wall (2 cases) and poor contours occurred in 4 cases in the later period because of the thickness of the flaps. All of them were corrected with satisfactory results.

CONCLUSIONThe combined method of abdominal axial flap transposition and penile elongation was recommendable for the treatment of the remnant penis because of its positive effects and less complications.

Adolescent ; Adult ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Penis ; injuries ; surgery ; Reconstructive Surgical Procedures ; Retrospective Studies ; Surgical Flaps