Dieulafoy lesion are usually located in the stomach but can also occur in the small or large intestines. It is an uncommon but significant source of massive upper gastrointestinal hemorrhage. A female patient with Dieulafoy lesion was admitted to the Tenth People's Hospital of Tongji University on June 2, 2009. The site of the lesion was diagnosed at the anterior wall of stomach with a bleeding vessel in the center. The size of the lesion was about 1.0 cm×1.0 cm. Partial gastric resection was successfully performed using laparoscopy and endoscopy. The lesion was demarcated by gastroscope, and then it was hung up and removed by laparoseope. Bowel movement recovered at the second day, and the patient was discharged 6 days after surgery. The patient was followed up for 1 month, and no recurrent hemorrhage or other complications were observed. The combined approach of laparoscopy and endoscopy not only resects the lesion completely and widens the scope of minimally invasive surgery but also decreases the risk of operation.

I sopropylmine vanillinate (IV) given iv 5 , 10 mg/kg in anesthe tized rats produced a dose-dependent decrease in mean arterial pressure and a concomitant decrease in heart rate.In pithed rats IV was unable to shift the phenylephrine doserespon-se curve to the right, but prazosine caused 53-fold shift.No direct effect of vasodilation was shown by IV on rabbit aorta strips .The concentration-response curve of isoprenaline in isolated rat right atrium was competitively inhibited by IV and propranolol. pA2 value was 4.0 for IV and 8.2 for propranolol. In addition, 'IV depressed contractility & heart rate of isolated rat atria.These results suggest that the hypotensive action of IV may be related to the decrease of HR, inhibition of contractility and slight blocking of B-adrenergic receptor. However the mechanism underlying the hypotensive effect of IV is to be further studied.

IQ86034 (5.3).In addition, the blocking action of 4 isoquinoline derivatives on ?1 and ?2 adrenoceptors was similar to that of benzoquinolizine derivatives.

Objective To explore the role of PI3K/AKT signaling pathway in total hepatic ischemia-reperfusion(I/R)-induced lung injury in rats.Methods This study was divided into 2 sub-projects.(1)36 rats were killed respectively at preischemia and after reperfusion,the lung tissue was then sampled.(2)12 rats were randomly divided into Wortmannin group and model control group. AKT,p-AKT protein expression,apoptotic cells and PCNA protein expression were tested respectively by Western blot,TUNEL and immunohistochemistry analysis.Results(1)Compared with that in preiscemia group,after I/R the apoptotic index (AI)was increased,the p-AKT/AKT ratio and PCNA-positive index showed bidirectional changes,and the histological changes were well identified.(2)p-AKT/AKT ratio showed a positive correlation with PCNA-positive index and a negative correlation with AI.(3)Compared with control group,the p-AKT/AKT ratio and PCNA-positive index were lower,histological changes was more significant and AI was higher in Wortmannin group. Conclusion PI3K/AKT signaling pathway had protective effect on lung injury induced by hepatic I/R,which was potentially mediated by anti-apoptosis and promoting proliferation.

Objective To design and formulate a electronic preoperative preparation checklist for applying in the preoperative preparation,to reduce missing rate in preoperative preparation and transfer,to improve patient satisfaction,to avoid operation delay and medical accident caused by inappropriate preparation.Methods A total of 145 patients with surgery from March 2013 to February 2013 were as experimental group,and 158 patients with surgery from March 2012 to February 2012 were as control group.The experimental group was used electronic preoperative preparation checklist for preoperative preparation and transition,and the control group was used conventional methods.The incidence of mistake for preoperative preparation and transfer and both surgeon's and patient's satisfactory were compared between two groups.Results After applying the electronic preoperative preparation checklist,the incidence of mistake for preoperative preparation and transfer in experimental group reduced significandy to 1.37％(2/145) and 4.83％ (7/145),compared with the incidence of control group 6.33％(10/158),11.39％(18/158),and the differences between two groups were statistically different (x2=4.870,4.305,P ＜ 0.05).Both surgeon's and patient's satisfactory were improved dramatically,the satisfactory in experimental group improved to 100.00％(50/50)and 97.93％(142/145),compared with the satisfactory of control group 90.00％(45/50) and 90.51％(143/158),and the differences between two groups were statistically different(x2=5.263,7.459,P ＜ 0.05).Conclusions Implementing the electronic preoperative preparation checklist can reduce the incidence of mistake before operation and ensure patient operation schedule.Therefore,it could improve nursing care quality and efficiency.

Objective Stress effect plays an important role in the development of some myocardial diseases. We hypothesized it was important nosogenesis to myocardial damage and cardiac allograft vasculopathy. Methods The transplanted hearts from Lewis to Wister rats served as allografts and from Lewis to Lewis rats as isografts based Ono's model. The differential proteins in the transplanted hearts were separated by comparative proteome, and then identified by matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS) and searched by Matrix Science software system.Results All transplanted hearts were characterized by lumen loss [(total vessel area-luminal area)/total vessel area] in the coronary artery 2 weeks after the operation [(2.07%±0.93%) vs. (27.58%±11.14%), P＜0.01], but more predominant after 8 weeks [(2.34%±1.06%) vs. (72.29%±20.57%), P＜0.01]. All samples of the left ventricle were analyzed by proteomic techniques and 37 distinct proteins involving their respective isoforms and subunits were identified. Nine proteins were correlated to endoplasmic reticulum stress effect and myocardial damage, and 2 proteins were verified by Western blot.Conclusion Stress plays an important role in cardiac allograft damage and the development of rat cardiac allograft vasculopathy.

AIM　To investigate the effect of 4-aminopyridine (4-AP) on ion channels of myocytes. METHODS　L-type calcium channel and sodium channel currents were recorded in guinea pig single ventricular myocyte using whole-cell patch-clamp techniques. RESULTS　4-AP, 0.1, 0.5 and 1.0 mmol*L-1 were shown to inhibit L-type calcium channel currents (ICa,L) and sodium channel currents (INa) concentration-dependently. The percentage of inhibition were (11.6±1.7)%, (37.5±8.3)% and (54.5±6.9)% (P<0.01) respectively for ICa,L, and (22.1±14.3)% (P<0.05), (39.4±8.8)% and (62.3±6.8)% (P<0.01) respectively for INa. 4-AP 0.5 mmol*L-1 shifted the I-V curves of ICa,L and INa upwardly. CONCLUSION　4-AP blocked L-type calcium channel and sodium channels in guinea-pig ventricular myocytes concentration-dependently.

Objective To investigate the effects of transcatheter arterial chemoembolization (TACE) using low doses of oxaliplatin in elderly patients with hepatocellular carcinoma.Methods A retrospective study was conducted in the Department of Interventional Radiology,Changhai Hospital from September 2009 to September 2011.Fifty-eight patients were divided into two groups according to the doses of oxaliplatin used in TACE as group 1 (40 mg/m2) and group 2 (80 mg/m2).The clinical data were collected and analyzed using SPSS 19.Results When compared with group 2,patiems in group 1 showed less postoperative nausea and vomiting (22.6％ vs.66.7％;x2 =11.43;P ＜0.05),lower pain scores (29.3％ vs.77.8％;x2 =13.73;P ＜ 0.05),and less decrease in leukocyte numbers (7.98 ± 1.04 × 199/L vs.3.98 ±1.66 × 199/L;t =8.27;P ＜ 0.05),and better liver function as measured by ALT [(44.1 ± 23.8) U/L vs.(79.4 ±24.7)U/L;t =-5.54;P ＜0.05].The two groups showed no significant differences at one year and three years on follow up with overall survival rates of 67.7％ vs.63.0％,30.7％ vs.22.2％,respectively,P ＞ 0.05.Conclusion Elderly HCC patients treated with TACE using low doses of oxaliplatin had milder side effects of chemotherapy and better overall survival.

Objective To assess the effect of ultrasound-guided percutaneous 125I seed implantation for the treatment of osteolytic metastases. Methods From February 2011 to December 2013, a total of 18 patients with advanced cancer complicated by osteolytic metastases received ultrasound-guided percutaneous implantation of 125I seeds. According to visual analog score (VAS) the pain was estimated before and 3 days as well as one month after the treatment. One month after the treatment follow-up CT scan was performed in all patients to check the tumor size and the distribution of 125I seeds, and the therapy was repeated if necessary. The efficacy was evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST). Results A total of 33 times of procedure were carried out in the 18 patients. Three days after the treatment, local pain was obviously relieved in all cases. Compared with preoperative VAS, the postoperative VAS was significantly improved (P=0.000). The pain was well controlled even one month after the treatment (P=0.000). One month after the last treatment the complete remission (CR) rate was 0% (n=0), partial remission (PR) rate 61.1% (n=11), stable disease (SD) 33.3% (n=6) and progress disease (PD) 5.6% (n=1), and local control rate (CR+PR) was 61.1%. No severe brachytheray-related complications occurred. Conclusion Ultrasound-guided percutaneous 125I seed implantation brachytherapy is technically simple and repeatable, it can safely and effectively guide the performance of percutaneous 125I seed implantation for the treatment of osteolytic metastases. Even in the circumstance of not using TPS, this technique can also obtain satisfactory local control rate and significant pain relief.

Objective To discuss the effect and safety of modified XELOX regimen for the treatment of colorectal cancer with he-patic metastases.Methods A retrospective analysis on the clinical data in 18 patients with colorectal cancer with hepatic metastases was performed in our hospital.The diagnosis in all patients was confirmed by biopsy and colonoscopy,and the primary lesion was not resected but with at least 2 courses treatment with modified XELOX regimen (intravenous infusion of oxaliplatin changed into ar-terial perfusion and 1-hour slow perfusion with indwelling catheter).The intrahepatic metastases were detected by CT and/or MRI and the primary focus was examined by enteroscopy every 2 months.A follow-up on survival time was performed and the objective response was evaluated in accordance with RECIST criteria.SPSS 1 9.0 was used for an analysis by Kaplan-Meier method.Results (1)Curative effect was evaluated in all 18 patients and TACE has been used for 1 1 5 times.The median OS was 14.0 months with 95% CI (9.6,18.4),and the median PFS was 8.0 months with 95% CI (5.2,10.8)including CR in 2,PR in 7,SD in 4 and PD in 5.The efficiency rate (RP)was 50.0% and the clinical benefit rate (CBR)was 72.2%;(2)The post-treatment adverse reactions mainly included fever,nausea,emesis,pain,impaired liver function,myelosuppression and peripheral sensory neuropathy,most of which were at Level Ⅰ-Ⅱ without treatment-related death.Fever with different degrees occurred in all patients,and nausea and emesis in 13.Pain and abnormal liver function occurred within 3-5 days after TACE with less than Level 2.Conclusion Modified XELOX regimen is practically effective in treating colorectal cancer with hepatic metastases.With a high objective response rate,it can improve patients'living quality and increase excision rate with tolerable adverse reactions.