Objective To evaluate the safety and efficacy of carbon dioxide (CO2) used as an alternative to air in the gastric endoscopic submucosal dissection (ESD). Methods 80 cases underwent ESD treatment were randomly as-signed to two groups, 40 cases in CO2 group and 40 in air group. Arterial blood CO2 partial pressure was measured preoperative, intraoperative and postoperative respectively. Visual analog scale (VAS) was used to record patients the degree of abdominal pain and distention at 1 h, 6 h and 24 h after operation in each group. The incidence of com-plications were evaluated. Regular follow up were scheduled in all the patients. Results There was no significant dif-ference in degree of abdominal pain score and the CO2 partial pressure between the two groups. The abdominal dis-tension scores of CO2 group were significant lower than air group at 1 h, 6 h after the ESD procedure. There were no statistically significant difference in the incidence rate of complications. Conclusion The utilization of CO2 in gas in-sufflation during gastric ESD is safe. CO2 insufflation can significant reduce the postoperative abdominal distension and improve the quality of postoperative recovery.

Objective To explore the clinical effects of aortic valvuloplasty in treatment of ventricular septal defect(VSD)with moderate or severe aortic valve insufficiency(AI)in children.Methods Thirteen children less than 14 years old underwent open heart surgery as well as aortic valvuloplasty for VSD with moderate or severe AI.There were 9 cases of subpulmonary VSD,perimenbranous VSD in 4 cases.AI was mo-derate in 4 cases,severe in 9 cases.Results There was no hospital death.Post-operative echocardiogram and X-ray revealed that both cardiothoracic ratio and left ventricular end diastolic diameter decreased markedly(P

OBJECTIVETo compare the manifestations of peripheral lung squamous cell carcinoma by CT dynamic enhancement with that of adenocarcinoma, and evaluate the difference of CT dynamic enhancement to distinguish peripheral lung squamous cell carcinomas from adenocarcinoma.

METHODSThirty peripheral lung squamous cell carcinomas and 40 adenocarcinomas were examined with dynamic contrasted CT, enhancement at various phases recorded, based on which the time-intensity curves were produced. The enhancement patterns were compared and analyzed.

RESULTSThere was no statistically significant difference in the enhancement degree and peak time between peripheral lung squamous cell carcinoma and adenocarcinoma (P > 0.05). The difference in enhancement pattern between these two different types of carcinoma was not statistically significant when the lesion was larger than 3 cm in diameter (P > 0.05), whereas it became statistically significant when the lesion is less than 3 cm (P < 0.05). Most of the squamous cell carcinoma showed heterogeneous enhancement or peripheral enhancement in the tumor zone, however, most of the adenocarcinomas had homogenous enhancement.

CONCLUSIONThe maximum enhancement and the peak time are not helpful in differentiating peripheral lung squamous cell carcinoma from adenocarcinoma. When the lesion is less than 3 cm in diameter, the enhancement pattern of peripheral squamous cell carcinomas is different from that of adenocarcinoma.

Adenocarcinoma ; diagnostic imaging ; pathology ; Adult ; Aged ; Carcinoma, Squamous Cell ; diagnostic imaging ; pathology ; Female ; Humans ; Lung Neoplasms ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Radiographic Image Enhancement ; Tomography, Spiral Computed ; methods

Objective To promote comprehension of pulmonary sequestration by investigating the diagnosis and surgical treatment methods of this disease.Methods A retrospective analysis of the clinical records of 27 patients with pulmonary sequestration was made,15 male patients and 12 female patients,with the age ranging from 4 to 56 years old.The patients were examined by chest radiography,computerized tomography (CT),computerized tomography angiography (CTA),magnetic resonance imaging (MRI) before the surgery.Eleven patients were confirmed preoperatively as pulmonary sequestration by the contrast enhanced CT and 64slice spiral CT examinations.Sequestrectomy was performed on patients with extralobar sequest ration (ELS) and lobectomy was performed on patients with intralobar sequestration (ILS).There were 21 cases of left lower lobectomy,5 cases of right lowerlobectomy,and 1 case of right sequestrectomy.Results All recovered uneventfully.No significant complications occurred in the perioperative period.All patients were cured and discharged from hospital.No relapse was reported during follow up period.Conclusion Diagnosis mainly depended on the chest radiography,CT,MRI and CTA.Surgical operation should be the best choice of treatment.

AIM AND METHODSWhole-cell recording technique was used to observe the changes of voltage-dependent ion channels and NMDA receptor currents of rat hippocampal neurons during primary culture.

RESULTSThere was no significant difference of voltage-dependent Na+ current (I(Na)) at 7 d, 14 d and 21 d in culture. It's the same for delayed rectifier K+ current (Ik). However, voltage-dependent Ca2+ current (I(Ca)) and its density were continuously and markedly increased. Further studies showed that the increase of I(Ca) was resulted from the increase of L-type voltage-dependent Ca2+ channels (L-VDCC). NMDA receptor current was also significantly increased with time of culture.

CONCLUSIONCa2+ influx through VDCC and NMIDA receptor is the fatal factor in the aging and death of hippocampal neurons.

Animals ; Animals, Newborn ; Calcium ; metabolism ; Calcium Channels, L-Type ; metabolism ; Cell Membrane ; metabolism ; Cells, Cultured ; Cellular Senescence ; Hippocampus ; cytology ; Ion Channels ; metabolism ; Neurons ; metabolism ; Patch-Clamp Techniques ; Rats ; Rats, Wistar ; Receptors, N-Methyl-D-Aspartate ; metabolism ; Time Factors

Objective To summarize the clinical experience in the replacement of the damaged sec- ond metacarpophalangeal joint with the second metatarsophalangeal joint with a pedicle of dorsal pedis artery and great saphcnous vein.Methods The damaged second metacarpophalangeal joint,distal part of the sec- ond metacarpal and proximal part of the proximal phalanx were dissected.The metatarsophalangeal joint was transferred to the region of metacarpophalangeal joint of hand.The dorsal pedis artery was anastomosed to the radial artery,and the great saphenous vein was anastomosed to the cephalic vein at anatomical snuff-box.The dissected bones of the hand removed of the cartilage of joint and soft tissue were grafted back to the donor site of the foot.Results A 5～30 month follow-up study in 8 out of 11 cases showed that satisfactory functional recovery was achieved in clinical practice.The movement of second metacarpophalangeal joint was excellent. Conclusion The function of the second metacarpophalangeal joint can be effectively recovered by the trans- fer of the vascularized second metatarsophalangeal joint.

AIMTo build a three dimensional structure model that correlates the biological activities and the structures of a series of 1-(8-chloro-6,11-dihydro-5H-benzo[5,6]cyclohepta-[1,2-]pyridin-11-yl) piperazines farnesyl protein transferase (FPTase) inhibitors.

METHODS AND RESULTSMutation in the ras oncogene takes place in many human cancers, involving 30%-50% of colon and 90% of pancreatic cancer. Ras proteins function as central switches for signals given by growth factors that direct cell growth and cell differentiation. The dependence of the transforming activity of Ras on the farnesylation has led to intense search for FPTase inhibitors that may have therapeutic pontetial as anticancer agents. This paper is to build a three dimensional structural model that correlates the biological activities and the structures of a series of FPTase inhibitors. The investigated sixty-nine inhibitors contain six types of structures, the optimal conformations of which were studied using system search. A three dimensional quantitative structure-activity relationship (3D-QSAR) model was constructed using the method of comparative molecular field analysis (CoMFA). The resulting cross-validation R2 is 0.581, non-cross-validation R2 0.968, SE 0.148, F 198.7. The predicted activities of 10 inhibitors using this 3D-QSAR model are comparable to the experimental activities, indicating that the 3D-QSAR model has ability to predict activities of new inhibitors and offers an approach to design new FPTase inhibitors.

CONCLUSIONThe information of CoMFA model offers an approach to designing new FPTase inhibitors.

Alkyl and Aryl Transferases ; antagonists & inhibitors ; Enzyme Inhibitors ; chemistry ; pharmacology ; Humans ; Molecular Conformation ; Molecular Structure ; Pyridines ; chemistry ; pharmacology ; Quantitative Structure-Activity Relationship

Animals ; Dynorphins ; metabolism ; Parkinson Disease ; drug therapy ; metabolism ; Peptides ; pharmacology ; Rats ; Scorpion Venoms ; pharmacology

OBJECTIVETo identify the SEDL gene mutation in a Chinese family with X-linked spondyloepiphyseal dysplasia tarda (SEDL) and to establish a genotyping assay for rapid diagnosis of this X-linked recessive disorder.

METHODSClinical diagnoses were made based on physical examination, radiological examination and pedigree analysis for this family. Four primer pairs flanking the SEDL exons 3-6 including their exon/intron boundaries were designed. A rapid genotyping assay based on denaturing high performance liquid chromatography (DHPLC) was established to screen the point mutations of the SEDL gene. Genomic DNA was extracted by standard methods from 18 members in the three generations of the pedigree and subjected to PCR-denaturing high performance liquid chromatography (PCR-DHPLC) assay followed by direct DNA sequencing.

RESULTSA c.218C>T mutation in exon 4 of the SEDL gene, which resulted in a substitution of serine 218 with leucine, was identified in this family. Among the 18 members, 3 patients, 5 obligate female carriers and 2 unmarried young females were found to have the missense mutation, and other 8 healthy individuals were not detected to carry the mutation, in which genotype-phenotype correlations were well established in each member investigated in this family.

CONCLUSIONA c.218C>T missense mutation in the SEDL gene was firstly reported in Chinese population and the results of this study expand the spectrum of SEDL mutations. The PCR-DHPLC assay is a useful tool to rapidly detect the SEDL mutation in clinical and prenatal diagnosis.

Adolescent ; Adult ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; Child ; Chromatography, High Pressure Liquid ; DNA Mutational Analysis ; Exons ; genetics ; Family ; Female ; Genes, X-Linked ; genetics ; Genotype ; Humans ; Male ; Membrane Transport Proteins ; genetics ; Mutation, Missense ; Osteochondrodysplasias ; diagnosis ; genetics ; Pedigree ; Polymerase Chain Reaction ; Transcription Factors ; genetics

Objective To assess the clinical application of contrast-enhanced MR angiography using three-dimensional(3D)time-resolved imaging of contrast kinetics(CE-MRA 3D-TRICKS).Methods TRICKS is a high temporal resolution(2—6s)MR angiographic technique using a short TR(2.8— 4.0 ms)and TE(0.9—1.3 ms),partial echo sampling and the central part of the k-space being updated more frequently than the peripheral part of the k-space.Pre-contrast mask 3D images are first acquired and 15--20 sequential 3D images following bolus injection of Gd-DTPA are then acquired.Results Thirty patients underwent contrast-enhanced MR angiography using TRICKS.Twelve vertebral arteries were well displayed on TRICKS.Seven of them showed normal,bilateral vertebral artery stenosis was shown in 1 case, and unilateral vertebral artery stenosis was shown in 4 wth aecompaning ipsilateral carotid artery bifurcation stenosis in one case.Bilateral renal artery showed normal in 4 cases,and the artery in transplanted kidney showed normal in one case and stenosis in another case.The cerebral artery showed normal in 2 cases, sagittal sinus thrombosis was detected in one case and intracranial arteriovenous malformation in one case. Pulmonary artery displayed normal in 3 cases,pulmonary artery thrombosis was seen in one case and pulmonary sequestration's abnormal feeding artery and draining vein was revealed in one case.The feeding artery in left lower limb fibrolipoma was showed in one case.The radial-ulnar artery artificial fistula stenosis was seen in one case,and left antebrachium hemangioma was showed in one case.Conclusion TRICKS can clearly delineate the whole body vascular system and can reveal any vascular abnormality.It is convenient and with high successful rate,which make it the first method of choice in displaying vascular abnormality.