Objective To evaluate the effectiveness and safety of partial splenic embolization using polyvinyl alcohol versus gelfoam to treat hypersplenism in cirrhotic patients.Methods A literature search was performed in databases which included PubMed,Embase,Cochrane library,Sinomed,CNKI,Wangfang data and VIP for trials on partial splenic embolism using PVA or gelfoam to treat hypersplenism in cirrhotic patients.The study was censored in May 2016.After data extraction and assessment of quality,a meta-analysis was performed using the RevMan 5.3 software.Results Five studies which involved 197 patients were selected in this study.Included into the PVA group were 92 patients and the gelfoam group 105 patients.On Meta-analysis,the PVA group had a higher value of WBC a month after PSE (WMD =0.4,95％ CI:0.05 ～ 0.75,P ＜ 0.05),higher values of WBC (WMD =0.39,95％ CI:0.06 ～ 0.71,P ＜0.05) and PLT (WMD =8.08,95％ CI:1.65 ～ 14.51,P ＜ 0.05) on month 6 post-embolization.The degree of post-embolization pain was more severe (RR =1.32,95％ CI:1.14 ～ 1.54,P ＜ 0.05) and the length of painful time was longer (RR =2.01,95％ CI:1.36 ～ 2.66,P ＜0.05) in the PVA group.There were no significant differences in the values of PLT,fever and complications (all P ＞ 0.05).Conclusions PSE using PVA achieved better short-term and long-term results in hematological indicators than gelfoam.However,the degree and extent of duration of pain were significantly longer.

Objective To determine the capability of emergency physicians (EPs) after goaldirected training to make accurate judgement and assessment of left ventricular systolic function (LVSF) as they own manipulated the hand-held echocardiography.Methods Eighty-one patients with acute dyspneic symptom admitted into emergency department of Xinhua Hospital Affiliated to Shanghai qaotong University School of Medicine from November 2011 to February 2012 were enrolled for a prospective,observational study.Patients with a history of trauma or acute myocardial infarction diagnosed by electrocardiogram were excluded.Four EPs after a intensive course of goal-oriented training in a good command of trans-thoracic echocardiography (TTE) in 81 emergency patients using hand-held echocardiography.EPs attempted to obtain images at the parasternal (long and short axis),apical,and subcostal positions,and visually estimated left ventricular ejection fraction (LVEF) and categorized LVSF as normal function,mild or moderate or severely depressed function.The results of echocardiographic LVEF got by EPs were compared quntitatively with those measured by an professional echocardiographer.The kappa statistical test by using SPSS version 13.0 software was used to allow for comparison in agreement between EPs and the professional echocardiographer's interpretations of TTE findings.Results Using the results of TTE measured by the professional echocardiographer as agold standard,EPs correctly distinguished the normal LVSF from decreased LVSF in 89％ patients.The rate of positive predictive value for the EPs identifying any abnormality in LV function was 83％ and the rate of negative predictive value was 93％.The kappa coefficient for the agreement between EPs and the professional echocardiographer' s interpretations for any abnormality in LV function was 0.77 (95％ CI:0.70-0.84,P ＜ 0.01).EPs correctly placed LV function into one of three categories in 68 of 81 cases (84％),The kappa coefficient for the agreement was 0.71 (95％ CI:0.64-0.78,P ＜0.01).Conclusions Emergency physicians after a intensive course of training in mastering echocardiography can accurately determine the left ventricular systolic function.

OBJECTIVETo determine the exact location of the opening of the ejaculatory duct in men and provide some basic anatomical evidence for seminal vesiculoscopy and the treatment of ejaculatory duct obstruction.

METHODSWe performed ureterocystoscopy for 21 male patients aged 26 - 47 years with hematuria (n = 12), hematospermia (n = 2), glandular cystitis (n = 6), and anejaculation after radical resection of rectal carcinoma (n = 1), and meanwhile, with the consent of the patients, massaged the prostate and ejaculatory duct and observed the outlet of the expelled fluid. Under the microscope, we described the fluid samples with sperm as the expulsion from the ejaculatory duct.

RESULTSUreterocystoscopy showed that the exact anatomical sites of the expulsion of prostatic fluid and semen in the patients were the side and lower side of the prostatic utricle opening above the verumontanum and the ventral side of the verumontanum. Quantities of sperm were found in the expulsion fluid of 13 of the patients, and no expulsion, including semen, was seen from the prostatic utricle opening.

CONCLUSIONAnatomically, the ejaculatory duct openings of males are located at the two sides of the verumontanum adjacent to the opening of the prostatic utricle, rather than in the prostatic utricle above the verumontanum.

Adult ; Cystoscopes ; Ejaculation ; physiology ; Ejaculatory Ducts ; anatomy & histology ; physiology ; Endoscopy ; instrumentation ; methods ; Hematuria ; Hemospermia ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Prostate ; anatomy & histology ; physiology ; Rectal Neoplasms ; surgery ; Semen ; secretion ; Spermatozoa

Adolescent ; Anti-Glomerular Basement Membrane Disease ; pathology ; Diagnosis, Differential ; Granulomatosis with Polyangiitis ; pathology ; Humans ; Kidney ; pathology ; Lung ; pathology ; Lupus Erythematosus, Systemic ; pathology ; Male

Objective To evaluate the clinical characteristics and pathological features of Meckel's diverticulum(MD) in children.Methods 244 MD cases admitted between January 2010 and December 2014 were retropectively analyzed.Results In fifty patients,MD was an incidental finding at laparotomy or laparoscopy for unrelated entities.Among the remaining 194 symptomatic patients,there were 76 patients presenting GI bleeding,forty eight patients were identified with perforated Meckel's diverticulum,thirty six patients suffered from intestinal obstruction.34 patients had MD caused severe complications such as volvulus and intestinal necrosis,diverticular perforation and peritonitis.61 out of 76 GI bleeding patients underwent a 99mTc scan,and positive tracer was found in 42 patients.Among the 19 negative 99mTc scan patients,8 received capsule endoscopy and only 3 patients were suspected of diverticulum.242 patients underwent one stage resection of the diverticulum.Histology revealed ectopic gastric mucosa or ectopic pancreatic tissue in 128 patients.One patient died of volvulus and intestinal necrosis postoperatively,and two suffered from adhesive intestinal obstruction during one to five year's follow up.Conclusions It is necessary to maintain a high suspicion of MD in the pediatric age group with symptoms of abdominal pain,gastrointestinal hemorrhage or intestinal obstruction.Ectopic mucosa assumes the ultimate responsibility for major complications of MD.

This study examined the expressions of miR-22 and miR-135a in rats with acute edematous pancreatitis (AEP) and their target genes in order to shed light on the involvement of miR-22 and miR-135a in the pathogenesis of acute pancreatitis (AP). The in vivo model of AEP was established by introperitoneal injection of L-arginine (150 mg/kg) in rats. The miRNA microarray analysis was used to detect the differential expression of miRNAs in pancreatic tissue in AEP and normal rats. The in vitro AEP model was established by inducing the rat pancreatic acinar cell line (AR42J) with 50 ng/mL recombinant rat TNF-α. Real-time quantitative RT-PCR was employed to detect the expression of miR-22 and miR-135a in AR42J cells. Lentiviruses carrying the miRNA mimic and anti-miRNA oligonucleotide (AMO) of miR-22 and miR-135a were transfected into the AR42J cells. The AR42J cells transfected with vehicle served as control. Western blotting was used to measure the expression of activated caspase3 and flow cytometry analysis to detect the apoptosis of AR42J cells. Targets of miR-22 and miR-135a were predicted by using TargetScan, miRanda, and TarBase. Luciferase reporter assay and quantitative real-time RT-PCR were performed to confirm whether ErbB3 and Ptk2 were the target gene of miR-22 and miR-135a, respectively. The results showed that the expression levels of miR-22 and miR-135a were obviously increased in AEP group compared with the control group in in-vivo and in-vitro models. The expression levels of miR-22 and miR-135a were elevated conspicuously and the expression levels of their target genes were reduced significantly in AR42J cells transfected with lentiviruses carrying the miRNA mimic. The apoptosis rate was much higher in the TNF-α-induced cells than in non-treated cells. The AR42J cells transfected with miRNA AMOs expressed lower level of miR-22 and miR-135a and had lower apoptosis rate, but the expression levels of ErbB3 and Ptk2 were increased obviously. It was concluded that the expression levels of miR-22 and miR-135a were elevated in AEP. Up-regulating the expression of miR-22 and miR-135a may promote the apoptosis of pancreatic acinar cells by repressing ErbB3 and Ptk2 expression in AEP.

OBJECTIVETo summarize the experience in the treatment of erectile dysfunction (ED) with no successful intercourse at the baseline with tadalafil.

METHODSWe retrospectively analyzed 21 cases of ED with no successful intercourse at the baseline treated with tadalafil on alternate days combined with sex guidance.

RESULTSAfter 4 weeks of tadalafil treatment, 19 of the patients achieved successful sexual intercourse, and the IIEF-5 score was remarkably improved as compared with pre-medication (3.24 +/- 1.55 vs 18.95 +/- 3.02, P<0.0001). Mild adverse reactions were observed in 6 cases, including 2 cases of mild headache and 4 cases of facial blush.

CONCLUSIONTadalafil on alternate days combined with sex guidance can significantly improve ED with no successful intercourse at the baseline.

Adult ; Carbolines ; administration & dosage ; therapeutic use ; Coitus ; Erectile Dysfunction ; drug therapy ; physiopathology ; Humans ; Male ; Retrospective Studies ; Tadalafil ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the vasorelaxant effect of puerarin in rat aortic rings and the mechanism.

METHODThe isolated thoracic aortic rings of male Sprague-Dawley rats were mounted on the organ bath and the contractile responses of the vessel were recorded.

RESULTPuerarin completely relaxed the contractions induced by phenylephrine in a concentration-dependent manner in endothelium-intact and endothelium-denuded rat aorta, but it had no effect on those preconstricted by a high concentration of potassium chloride (KCl, 60 mmol x L(-1)). The relaxant effect of puerarin was significantly inhibited by pretreatment of endothelium-denuded aorta with potassium channel antagonists tetraethylammonium, 4-aminopyridine but not glibenclamide.

CONCLUSIONPuerarin induces an endothelium-independent relaxation in rat aortic rings. The mechanisms may involve the reduction in Ca2+ influx through the calcium channels operated by alpha-adrenergic receptor and the activation of the potassium channels (Kv and BKca, but not KATP).

4-Aminopyridine ; pharmacology ; Animals ; Aorta, Thoracic ; drug effects ; physiology ; Endothelium, Vascular ; physiology ; In Vitro Techniques ; Isoflavones ; isolation & purification ; pharmacology ; Male ; Phenylephrine ; antagonists & inhibitors ; Plants, Medicinal ; chemistry ; Potassium Channel Blockers ; pharmacology ; Potassium Channels ; drug effects ; Pueraria ; chemistry ; Rats ; Rats, Sprague-Dawley ; Tetraethylammonium ; pharmacology ; Vasoconstriction ; drug effects ; Vasodilation ; drug effects ; Vasodilator Agents ; pharmacology

Objective To investigate the expression of matrix metalloproteinase 7(MMP-7) mRNA in LOVO cells of colon cancer induced by TF/F Ⅶ a and its signal pathway.Methods We transfected LOVO cells stably with RNAi plasmid targeting to tissue factor to get TFRNAi LOVO cells and detected efficiency of interference in TFRNAi LOVO cells based on Western blot analysis;Expression of MMP-7 was evaluated in LOVO cells treated with 100 nmol/L FⅦa in 0 h、4 h、8 h、12 h、24 h based on RT-PCR and Northern blot.Expression of MMP-7mRNA was determined in quiescent LOVO cells treated with different doses of FⅦa(0 nmol/L、10nmol/L、50 nmol/L、100 nmol/L、200 nmol/L)for 8 h based on Northern blot.Quiescent LOVO cells were treated for 0 h、4 h、8 h、12 h、16 h、24 h with 100 nmol/L FⅦa to evaluate the expression of p-P38;The expression level of MMP-7mRNA induced by 100 nmol/L FⅦa for 8 h in LOVO cells blocked by 10retool SB203580 0.5 h previously and in TFRNAi LOVO cells were measured by Northern blot.Results Northern blot analysis revealed that FⅦa markedly increased the expression of MMP-7mRNA in a time-and dose-dependent manner.Western blot analysis confirmed that FⅦa stimulates p-P38 in a time-dependent manner.SB203580 block 59.2% expression of MMP-7mRNA in LOVO cells induced by TF/FⅦa.In TFRNAi LOVO cells,the expression of MMP-7mRNA induced by TF/FⅦa was 48% less than that in normal LOVO cells.Conclusions TF/FⅦa Complex induces the expression of MMP-7mRNA in LOVO cells in vitro,possibly through P38 pathway.

This study examined the expressions of miR-22 and miR-135a in rats with acute edematous pancreatitis (AEP) and their target genes in order to shed light on the involvement of miR-22 and miR-135a in the pathogenesis of acute pancreatitis (AP). The in vivo model of AEP was established by introperitoneal injection of L-arginine (150 mg/kg) in rats. The miRNA microarray analysis was used to detect the differential expression of miRNAs in pancreatic tissue in AEP and normal rats. The in vitro AEP model was established by inducing the rat pancreatic acinar cell line (AR42J) with 50 ng/mL recombinant rat TNF-α. Real-time quantitative RT-PCR was employed to detect the expression of miR-22 and miR-135a in AR42J cells. Lentiviruses carrying the miRNA mimic and anti-miRNA oligonucleotide (AMO) of miR-22 and miR-135a were transfected into the AR42J cells. The AR42J cells transfected with vehicle served as control. Western blotting was used to measure the expression of activated caspase3 and flow cytometry analysis to detect the apoptosis of AR42J cells. Targets of miR-22 and miR-135a were predicted by using TargetScan, miRanda, and TarBase. Luciferase reporter assay and quantitative real-time RT-PCR were performed to confirm whether ErbB3 and Ptk2 were the target gene of miR-22 and miR-135a, respectively. The results showed that the expression levels of miR-22 and miR-135a were obviously increased in AEP group compared with the control group in in-vivo and in-vitro models. The expression levels of miR-22 and miR-135a were elevated conspicuously and the expression levels of their target genes were reduced significantly in AR42J cells transfected with lentiviruses carrying the miRNA mimic. The apoptosis rate was much higher in the TNF-α-induced cells than in non-treated cells. The AR42J cells transfected with miRNA AMOs expressed lower level of miR-22 and miR-135a and had lower apoptosis rate, but the expression levels of ErbB3 and Ptk2 were increased obviously. It was concluded that the expression levels of miR-22 and miR-135a were elevated in AEP. Up-regulating the expression of miR-22 and miR-135a may promote the apoptosis of pancreatic acinar cells by repressing ErbB3 and Ptk2 expression in AEP.
Animals ; Apoptosis ; genetics ; Cell Proliferation ; Focal Adhesion Kinase 1 ; biosynthesis ; genetics ; Gene Expression Regulation ; Humans ; Male ; MicroRNAs ; biosynthesis ; genetics ; Pancreatitis ; genetics ; pathology ; Rats ; Receptor, ErbB-3 ; biosynthesis ; genetics ; Tumor Necrosis Factor-alpha ; genetics