BACKGROUND: Hepatic myelopathy results from liver disease, which lacks of effective cure method. Liver transplantation has attempted to cure this disease; however, the long-term therapeutic effect is rarely reported. OBJECTIVE: To explore the long-term therapeutic effect of liver transplantation in patients with hepatic myelopathy. METHODS: The clinical data of 2 patients with hepatic myelopathy, who underwent orthotopic liver transplantation, in August 2002 and November 2004, at the 309 Hospital of Chinese PLA, were analyzed retrospectively. The time of follow-up was 18 and 43 months, respectively. The muscle strength of double lower limbs in 2 patients was assessed prior to and after operation. RESULTS AND CONCLUSION: Two patients recovered well at 4 weeks after transplantation, the clinical symptom and physical signs of patients were improved obviously, the blood routine examination and other biochemical index were normal,and the function of transplanted kidney was normal. Two patients discharged at 6 weeks after transplantation. Patient 1 could stand for a long time at months 6 after transplantation, walked slowly with the supporter after 12 months and without the supporter at 43 months. The muscular strength of two lower limbs was grade 4. And the liver function was normal. Patients 2 could move his lower limbs in bed at months 6 after transplantation, walked with the supporter at 18 months. The muscular strength of two lower limbs was grade 3. The liver function was normal. It demonstrated that liver transplantation is beneficial to control hepatic myelopathy and recover muscular strength of two lower limbs. It is a newly developed, effective curing method for treating hepatic myelopathy. However, the numbers were small with short time observation, thus, the long-term therapeutic effect still need to be explored.

Background:As a new concept of treatment for gastroesophageal reflux disease(GERD),local electrical stimulation on lower esophageal sphincter(LES)is still in a preliminary stage. Aims:To explore the ideal local electrical stimulation parameters for LES contraction and the local neural reflex path that inhibits LES contraction. Methods: Anti-gastroesophageal reflux model with electrical stimulation in vivo was established. The changes of gastroesophageal reflux were observed to explore the ideal electrical stimulation parameters for LES contraction. Effects of different drugs on gastroesophageal reflux in condition with ideal electrical stimulation parameters were observed. Results:When frequency was 10 Hz and pulse was 0. 4 ms,gastroesophageal reflux in voltage 10 V or 15 V groups was significantly decreased(P <0. 001). When voltage was 10 V and pulse was 0. 4 ms,gastroesophageal reflux in frequency 10 Hz group was significantly decreased(P < 0. 001). When voltage was 10 V and frequency was 10 Hz,gastroesophageal reflux in pulse 0. 4 ms group was significantly decreased(P < 0. 001). Local infiltration of tubocurarine or capsaicin on LES could significantly increase gastroesophageal reflux(P < 0. 05). The administration of NK1 receptor blocker L-732,138 or NO synthase inhibitor L-NAME could significantly decrease gastroesophageal reflux(P < 0. 05). Conclusions:In view of the injury of electrical energy on tissue,the ideal electrical stimulation parameters are voltage of 10 V,frequency of 10 Hz and pulse of 0. 4 ms. Local neural reflex path consisted of primary TRPV-1-positive tachykininergic neurons and nitrergic neurons in the muscle layer of esophagus could inhibit LES contraction evoked by electrical stimulation.

Objective To study the mechanisms of extrarenal arterial blood supply of renal malignancy for its interventional therapy.Methods Routine abdominal aortography and selective questionable feeding arteriography were performed in 141 patients with renal malignancy.The characteristics and formation mechanisms of extrarenal arterial blood supply for renal malignancy were analyzed.Results Of the 141 patients,extrarenal arterial blood supply of renal malignancy were found in 51 patients and there were 87 branchs.The breakthrough of renal capsule with malignancy were found in those 51 patients.No extrarena]arterial blood supply of renal malignancy was found in 90 patients,including 50 patients with and 40 patients without the renal capsule breakthrough with malignancy.The emerge of extrarenal arterial blood supply of renal malignancy were significantly different(x~2 = 31.64,P

Objective To explore the effect of the rational-emotive-behavior therapy (REBT) on mood, cognition and activities of dailyliving (ADL) of patients with poststroke depression (PSD). Methods 80 PSD patients were divided into control group (n=40) and observationgroup (n=40). Both groups were given Prozac (20 mg/d) for 8 weeks, and the observation group received REBT (3 times per week, 20min every time) additionally. Hamilton Rating Scale for Depression (HAMD), Mini Mental State Examination (MMSE) and Barthel Index(BI) were evaluated before and after treatment. Results After 8-week treatment, the scores of HAMD in two groups reduced significantly(P<0.01), and the scores of MMSE and BI increased significantly (P<0.01). The scores of HAMD were lower in the observation group thanin the control group (P<0.05), and the scores of MMSE and BI were higher in the observation group than in the control group (P<0.05). TheBI score was related with sleeping disorder in control group (P<0.05). The BI score was both related with sleeping disorder and somatizationin the observation group (P<0.05). There was no significant difference in the extent of effectiveness on depression between two groups(P>0.05), but there was the trend that the efficacy of the observation group was better than the control group. Conclusion REBT combinedwith antidepressant drugs can better relieve the symptoms of depression and improve cognitive function and ADL of PSD patients. The improvementof somatization and sleep disorders by REBT has a relationship with the enhancement of ADL.

OBJECTIVETo investigate the effects of free and pedicled thoracodorsal artery perforator (TDAP) flaps for repairing skin and soft tissue defects in limbs, neck, axillary and shoulder.

METHODSFrom October 2009 to Auguest 2011, 16 TDAP flaps were used to repair skin and tissue defects. Among them, five ipsilateral pedicled flaps were used to repair wounds in neck, axillary and shoulder. 11 free TDAP flaps were used to repair the wounds with bone or tendon exposure. In 12 cases, the flaps were pedicled with thoracodorsal artery and vein-lateral branches-perforators, in 4 cases, pedicled with thoracodorsal artery and vein-serratus anterior muscular branches-perforators. The deep fascia, the latissimus dorsi and thoracodorsal nerve were not included in all flaps. The flaps size ranged from 10 cm x 5 cm to 26 cm x 10 cm.

RESULTSAll 16 flaps survived completely with primary healing both at donor site and recipent area. After a follow-up of 3 to 24 months, all flaps gained good texture and appearance. Only linear scar was left at donor area. The shoulder could move freely.

CONCLUSIONSTDAP flap has good texture, long vascular pedicle,and reliable blood supply, leaving less morbidity at donor site. The latissimus dorsi and thoracodorsal nerve are also preserved. The pedicled TDAP flap is an ideal flap for repairing the ipsilateral skin and soft tissue defects of the neck, shoulder, axillary. The free TDAP flap is suited for repairing skin and soft tissue defects of the extremities.

Arteries ; Axilla ; Humans ; Muscle, Skeletal ; Perforator Flap ; transplantation ; Surgical Flaps ; blood supply ; transplantation ; Thoracic Wall ; Wound Healing ; Wounds and Injuries ; surgery

OBJECTIVETo evaluate the efficacy and safety of three different spinal rotation manipulations for the treatment of lumbar disc herniation.

METHODSFrom September 2011 to April 2013,180 patients diagnosed as lumbar disc herniation were randomly divided into seat fixed rotation group (A), lateral position rotation group (B) and supine position rotation group (C) by using a digital table. Finally 10 patients were excluded and dropped, 170 patients were included in the study. There were 57 patients in group A, 57 patients in group B and 56 patients in group C. Baseline demographic characteristics of patients, clinical findings and indexes of health status had no statistically differences among three groups (P > 0.05). The manipulation was performed every other day, and the treatment duration for all patients was 3 weeks. Body pain (BP), Physical function (PF) in SF-36, Oswestry Disability Index (ODI) and adverse reactions were observed statistically 6 weeks, 3 months, 6 months, one year and two years after finishing treatment.

RESULTSBP, PF scores in 3 groups were significantly improved and ODI scores were significantly lower than those before treatment and the differences were statistically significant (P < 0.05); However, there was no significant difference among three groups in the BP, PF and ODI scores (P > 0.05). There were no obvious and serious adverse reactions among these groups.

CONCLUSIONBased on the theory of dislocation of bone joints in TCM, three kinds of spinal rotation manipulations can be used safely for the treatment of lumbar disc herniation, and the efficacy was similar.

Adolescent ; Adult ; Case-Control Studies ; Female ; Humans ; Intervertebral Disc Displacement ; physiopathology ; therapy ; Male ; Manipulation, Spinal ; methods ; Middle Aged ; Rotation ; Treatment Outcome ; Young Adult

OBJECTIVETo observe the clinical efficacy of modified Wuhua Decoction (WHD) on corticosteroid addictive dermatitis (CsAD) and in improving patients' facial skin barrier function.

METHODSSeventy-five patients were randomly assigned to two groups, the 38 in the treated group treated with WHD together with oral administration of levocetirizine tablet, while the 37 in the control group treated with levocetirizine tablet alone in the same way, 30 days as a course. Skin erythema dose (ED) and transepidermal water loss (TEWL) of patients were measured before and after treatment.

RESULTSFive cases in the treated group and 7 cases in the control group were dropped out. The total effective rate was 69.7% (23/33 cases) in the treated group and 10.0% (3/30 cases) in the control group respectively, with the score of objective symptoms reduced from 5.48 +/- 1.60 before treatment to 1.24 +/- 1.62 after treatment and the score of subjective symptoms reduced from 7.06 +/- 1.54 to 1.55 +/- 1.72 in the treated group, while in the control group, the two indexes reduced from 5.57 +/- 1.25 to 3.27 +/- 1.55 and from 6.77 +/- 1.36 to 3.07 +/- 1.36 respectively, showing significant difference between the two groups and the efficacy in the treated group was better than that in the control group (P <0.01). Skin ED decreased significantly in the treated group after treatment, and insignificantly in the control group. TEWL began to decrease on the 15th day in the treated group, while it was unchanged in the control group; on the 30th day, although a decrease was shown in both groups, its reduction was lower in the treated group (P <0.05).

CONCLUSIONWHD has significant clinical efficacy on CsAD, it could reduce the skin ED and quickly recover the injured facial skin barrier function.

Adrenal Cortex Hormones ; adverse effects ; Dermatitis, Contact ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Face ; Humans ; Skin Physiological Phenomena ; drug effects ; Substance-Related Disorders ; complications

OBJECTIVE To explore the effects and underlying mechanism of Jieyu Anshen granule (JY) in chronic unpredictable mild stress (CUMS)-treated rats after ischemic stroke. METHODS A rat model of post-stroke depression(PSD)was developed by additional CUMS procedures after middle cere-bral artery occlusion(MCAO).Sprague-Dawley rats were given 1 g·kg-1and 3 g·kg-1of JY by gastrogavage for 4 weeks.Escitalopram(10 mg·kg-1)served as a reference drug.Behavioral tests including sucrose preference test, forced swim test and open-field test were performed to evaluate the antidepressant effects. Levels of norepinephrine (NE), dopamine (DA) and 5-hydroxytryptamine (5-HT) in rat brain were assayed. The anti-inflammatory activity was evaluated by measuring TNF-α and IL-1β in brain. Serum adrenocorticotropic hormone (ACTH) and corticosterone (CORT) were estimated as indices of hypothalamic-pituitary-adrenal (HPA) axis activity. Western blot analysis was used to evaluate hippo-campal expression of the 5-HT1A receptor (5-HT1AR) and brain-derived neurotrophic factor (BDNF). RESULTS PSD rats exhibited decreased sucrose consumption and motor activity, increased immobility time (P<0.01). JY treatment reversed the depressive behaviors in PSD rats (P<0.05, P<0.01). Treat-ment with JY resulted in significantly increased levels of NE, DA and 5-HT in the hippocampus and prefrontal cortex (P<0.05, P<0.01), and increased expression of 5- HT1AR and BDNF in the hippocampus(P<0.01). JY treatment significantly down-regulated the levels of TNF-α and IL-1β in hippocampus andprefrontal cortex (P<0.05). Treatment with JY also resulted in significantly decreased ACTH and CORTin serum which had been increased (P<0.05). CONCLUSION These findings suggest that JY treat-ment could ameliorate PSD, and the effects are likely ascribed to inhibiting HPA axis hyperfunction andinflammatory, up-regulating the levels of neurotransmitters (NE, DA and 5-HT), and the expression ofhippocampal 5-HT1AR and BDNF.

AIM: To determine the effect of hydrogen peroxide(H_2O_2) on voltage-gated potassium channel currents(IKv) in pulmonary vascular smooth muscle cells(PASMCs).METHODS: Using whole cell patch-clamp technique,IKv was recorded in freshly isolated rat PASMCs with acute enzymatic digestion method.The effect of hydrogen peroxide on IKv in PASMCs was investigated in normoxia.RESULTS: IKv in PASMCs was increased significantly by H_2O_2 and the increase depended on the concentration in normoxia.Current-voltage relationship curve shifted to the left.CONCLUSION: Hydrogen peroxide is an important K~+ channel opener.

Background and purpose:Ionizing radiation(IR) activates the early growth response- I(Egr1) promoter through specific cis-acting sequences termed CArG elements by production of radical oxygen intermediates(ROls).Egr-EG,an expression vector pCIneo containing CArG elements cloned upstream of the cDNA for human recombinant GM-CSF,was used to treat hematopoietic damage due to chemotherapy.Commonly used chemotherapeutic agents can cause tumor cell death by producing DNA damage and generating ROIs.We therefore hypothesized that clinically employed chemotherapeutic agents that increase ROIs could also be employed to activate Egr-EG in a chemoinducible gene therapy strategy.This study was done to explore the chemo-protective effect of the expression of hematopoietic growth factors regulated by Egr-1 promoter on chemotherapy induced damage. Methods:The human GM-CSF cDNA and EGFP cDNA were linked together with internal ribosome entry site(IRES) and then inserted into the eukaryotic expression vector pCI-neo with the Egr-1 promoter(Egr-EG),and was further transduced into human bone marrow stromai cell lines HFCL(HFCL/EG).The HFCL/EG cells were transplanted i.v.into BI6 melanoma in C.B-17 combined immunodeficient(SCID) mice.5-FU was given i.p.on day 3 and 4.The white blood cell amount in peripheral blood,the expression of EGFP and GM-CSF in human stromal cell engrafted in recipient mice were detected by flow cytometry,RT-PCR,Western blot and colony-forming units for granulocytes and macrophages(CFU-GM),respectively.Results:In contrast to the two control groups,HFCL/EG(the Egr-regulatory element-derived expression of GM-CSF gene therapy) resulted in a proportional increase in the number of the white blood cell after chemotherapy,no significant diifferences were found for CFU-GM in bone marrow cells and the inhibition ratio on tumor in recipient mice.Chemotherapy could markedly increase the expression of EGFP and GM- CSF mRNA/protein as compared with that of non-chemotherapy control groups and HFCL group.Conclusion: Chemoinducible GM-CSF gene therapy regulated by Egr-1 promoter can ameliorate the toxic effect on 5-FU chemotherapy-inducible hematopoietic damage.