Objective To evaluate the long-term efficacy and safety of endoscopic mucosal resection (EMR) for lesions at gastroesophageal junction (GEJ). Methods A total of 51 lesions located at GEJ from 51 patients, with an average size of 10. 9±4. 0 mm (3-28 mm), were treated with EMR between November 2005 and March 2009, among which 39 were diagnosed as low grade dysplasia and 12 as high grade dysplasia pathologically after EMR. The histopathologic results were compared between biopsies and EMR samples. All patients were followed up endoscopically. Results Complete resection was achieved in 44 ( 86. 3% ). The histopathologic diagnosis of 25 cases (49. 9% ) was inconsistent between biopsy and EMR samples, with 24 exhibited higher grade dysplasia after EMR. Main complication during EMR was bleeding in 17 patients ( 33. 3% ), all of which were successfully managed. No perforation or postoperative stenesis occurred. Endoscopic follow-up was carried out in 8 patients for more than 3 years, in 17 for 2-3 years, in 12 for 1-2 years and in 14 for less than 1 year. No death occurred during follow-up. Conclusion EMR can be adquately adopted as an effective treatment for pre-cuncerous lesions at GEJ, which is important in blocking malignant progression of dysplastic lesions.

Animals ; Aorta ; pathology ; Apolipoproteins E ; deficiency ; Atherosclerosis ; metabolism ; pathology ; Female ; Glycosides ; isolation & purification ; pharmacology ; Intercellular Adhesion Molecule-1 ; metabolism ; Mice ; Plants, Medicinal ; chemistry ; Polygonum ; chemistry ; Vascular Cell Adhesion Molecule-1 ; metabolism

This study was purposed to establish the method of quantifying RhD antigen on red blood cells (RBC) by flow cytometry (FCM) and to explore the expression of D antigen on RBC of different RhD serotype. RhD(+) RBCs and RhD(-) RBCs were mixed in 1:1 ratio. Cells were stained by the indirect method (IgG anti-D as the first antibody, FITC-anti-IgG F(ab')2 as the second antibody), and the ratio of RhD(+) on RBCs was quantified by FCM. The optimal dosage of IgG anti-D was defined. Expression of RhD antigen on RBC of RhD(+), weak D, RhDel and RhD(-) type were detected by FCM. The results showed that optimal dilution of IgG anti-D monoclonal antibody was 1:4, 1x10(6) cells/50 microl. The percentage of D(+) RBC of RhD(+), weak D, RhDel and RhD(-) type were 96.8+/-2.97%, 79.5+/-9.88%, 47.8+/-11.43%, 3.7+/-2.96%, respectively. The mean fluorescence intensity (MFI) of RhD antigen expression of RhD(+), weak D, RhDel and RhD(-) type were 33.3+/-6.21 Dal, 18.6+/-5.39 Dal, 7.10+/-1.17 Dal, 0.79+/-0.55 Dal, respectively. In conclusion, there are significant differences of RhD antigen expressions among RBC of different RhD serotypes. The level of antigen on RhD(+) RBC is the highest and then weak D the next, while the level of antigen on RhDel RBC is the lowest level.
Blood Donors ; Erythrocytes ; immunology ; metabolism ; Flow Cytometry ; methods ; Humans ; Rh-Hr Blood-Group System ; immunology ; metabolism

OBJECTIVESTo study the effectiveness of the lidocaine test in evaluating the liver reserve of rats with experimental liver injury in different phases.

METHODS40 healthy male Wistar rats were divided randomly into experimental and control groups. Rats of the experimental group received subcutaneous CCl4 in oil injection, and rats of the control group received saline injections. Monoethylglycinexylidide (MEGX) test, common hepatic function tests and histological examination of the livers were performed on all the rats.

RESULTSWith the development of the severity in liver injury, the concentrations of the serum MEGX in lidocaine test decreased gradually, which were consistent with liver histological changes. However, the results from the common liver function tests were all abnormal in the experimental group and were not consistent with the liver histological changes.

CONCLUSIONThe results obtained from the MEGX test are more agreeable to liver histological changes than those from common liver function tests. The results from the MEGX test can represent liver histological changes concisely.

Animals ; Carbon Tetrachloride ; Carbon Tetrachloride Poisoning ; Lidocaine ; analogs & derivatives ; Liver ; pathology ; physiopathology ; Liver Cirrhosis, Experimental ; chemically induced ; pathology ; physiopathology ; Liver Function Tests ; Male ; Random Allocation ; Rats ; Rats, Wistar

A simulated moving bed (SMB), equipped with eight silica-gel columns, was used to separate phosphatidylcholine (PC) from soybean phospholipids. The effects of flow rate in Sections 2 (Q(2)) and 3 (Q(3)), switching time, feed flow rate and feed concentration on the operating performance parameters: purity, recovery, productivity and desorbent consumption were studied. Operating conditions leading to more than 90% purity in both outlet streams have been identified, together with those achieving optimal performance. Regions leading to complete separation are observed and explained theoretically. As the mass-transfer effect was not considered, the triangle theory only gives initial guesses for the optimal operating conditions.
Chemical Fractionation ; methods ; Chromatography, High Pressure Liquid ; methods ; Computer Simulation ; Models, Chemical ; Phosphatidylcholines ; isolation & purification ; Phospholipids ; chemistry ; Plant Extracts ; isolation & purification ; Soybeans ; chemistry

OBJECTIVETo study the pathological changes of the liver tissues of patients with HIV infection.

METHODS14 biopsy and 12 autopsy liver tissues were examined histologically. HIV-1 related antigen of outer membrane protein gp120 and capsid protein p24 were examined with their corresponding monoclonal antibodies by immunohistochemistry.

RESULTSIn the biopsy group, cytomegalic virus (CMV) infection was found in one (1/14) case, outer membrane protein gp120 and/or capsid protein p24 antigen were detected in Kupffer cells and in some of the lymphocytes in 11 cases. All the hepatocytes were negative for outer membrane protein gp120 and capsid protein p24 antigens. In the autopsy group, there were 5 (5/12) cases of liver tissues with CMV infection and 5 cases each with mycobacterium and Toxoplasma gondii infection. Capsid protein p24 was detected in liver tissues in 3 cases.

CONCLUSIONThere is HIV infection in liver tissue of patients with HIV. The rate of opportunistic infections in liver biopsy samples was lower than that in the autopsy liver tissues of patients with HIV.

Adult ; Female ; HIV Core Protein p24 ; biosynthesis ; genetics ; HIV Envelope Protein gp120 ; biosynthesis ; genetics ; HIV Infections ; pathology ; Humans ; Liver ; pathology ; Male ; Middle Aged

OBJECTIVETo explore an effective and reasonable surgical strategy for active spinal tuberculosis with severe kyphotic deformity (kyphotic angle >or= 45 degrees).

METHODSFrom January 2004 to January 2008, 30 consecutive patients of active spinal tuberculosis complicated with significant angulation were enrolled in this study, including 8 male and 22 female. The average age was 35 years (range, 7 - 60 years), with average angle of kyphosis of 58 degrees (range, 45 degrees - 70 degrees). There were 28 patients complicated with intraspinal abscess, of which 10 patients presented with incomplete paraplegia. According to the Frankel's scoring system, there were 2 patients with Frankel Grade B, 6 with Grade C, 2 with Grade D. After antituberculous chemotherapy (HREZ) for at least 2 weeks, all patients underwent posterior multiple-level pedicle screw instrumentation and kyphotic correction, and then received anterior debridement, decompression and supportive bone grafting, all of which were completed in the same day. The postoperative standardized chemotherapy was 6HREZ/6-12HRE. The angle of kyphosis, curve correction after surgery, and recovery of paraplegia were analyzed. Fusion status and erythrocyte sedimentation rate were recorded to determine the presence of active disease.

RESULTSOperative time was 4 to 6 hours (average 5.2 h), blood loss was 600 to 900 ml (average 760 ml). No perioperative severe complications occurred. The kyphotic angle was corrected to 0 degrees - 10 degrees, and the maximum corrected angle was 65 degrees . The average follow-up duration was 18 months (range, 12 - 48 m). All patients showed evidence of solid fusion and healing of the active disease at 6 months follow-up. Neurologic deficits were improved: 2 patients from B to D, 6 patients from C to E, 2 patients from D to E. No recurrence of the tuberculosis infection or instrumentation failure happened at final follow-up.

CONCLUSIONCombined posterior instrumentation and anterior debridement, fusion surgery in one stage is proved to be successful in treating spinal tuberculosis, correcting the kyphosis, and providing solid fusion.

Adolescent ; Adult ; Child ; Female ; Follow-Up Studies ; Humans ; Kyphosis ; complications ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Spinal Fusion ; methods ; Thoracic Vertebrae ; surgery ; Tuberculosis, Spinal ; complications ; surgery ; Young Adult

BACKGROUNDLiver transplantation is the most effective treatment for end-stage liver diseases; however, infections after transplantation can seriously affect the patient's health. The aim of this research was to investigate the diagnosis and treatment of fungal infection following liver transplantation.

METHODSClinical data for 232 liver transplant patients at risk of fungal infection were examined for the presence of fungus in the blood, fluid, sputum, urine and stools of patients and by chest or abdominal CT scans. Patients diagnosed with a fungal infection were treated with Fluconazole or, if this was not effective, Voriconazole or Amphotericin B. Immunosuppressive therapy was also reviewed.

RESULTSThirty-seven of 232 (15.9%) patients were diagnosed with a fungal infection, which occurred 4 to 34 days post-transplantation. Candida infections were diagnosed in 23 cases (62.2%) and Aspergillus infections in 12 cases (32.4%). Twenty-one cases were effectively treated with Fluconazole, 11 cases with Voriconazole, and two cases with Amphotericin B; however, three cases were not effectively treated with any of the antifungal agents. Overall, treatment was effective in 91.9% of patients.

CONCLUSIONSFungal infection has a significant influence on survival rate after liver transplantation. Imaging studies, and pathogenic and biopsy examinations can diagnose fungal infections, which can be effectively treated with antifungal agents such as Fluconazole, Voriconazole or Amphotericin B.

Adult ; Amphotericin B ; therapeutic use ; Antifungal Agents ; therapeutic use ; Female ; Fluconazole ; therapeutic use ; Humans ; Liver Transplantation ; adverse effects ; Male ; Mycoses ; diagnosis ; drug therapy ; etiology ; Pyrimidines ; therapeutic use ; Triazoles ; therapeutic use ; Voriconazole

OBJECTIVETo evaluate the therapeutic effect of comprehensive therapeutic protocol of electroacupuncture combined with active-blood-and-dissolve-stasis herbs and rehabilitation training for cerebral infarction.

METHODSA multi-center randomized controlled trial was done, three hundred and twenty cases were divided into four groups: electroacupuncture combined with active-blood and dissolve-stasis herbs and rehabilitation training group (group A), electroacupuncture combined with rehabilitation training group (group B), herbs combined with rehabilitation training group (group C) and rehabilitation training group (group D), 80 cases in each group. The following two groups of acupoints were used alternatively in electroacupuncture treatment: the first group including Vasomotor Area, Jianyu (LI 15), Biguan (ST 31), Hegu (LI 4) and Taichong (LR 3); the second group including Motor Area, Quchi (LI 11), Yanglingquan (GB 34) and Shenshu (BL 23). 20 mL Xiangdan injection and 250 mL 5% glucose injection or 250 mL 0.9% sodium chloride injection were used by intravenous drip in herbs treatment once a day. The rehabilitation training was performed by the professional physical therapist. Each group was treated with corresponding treatment protocol. The therapeutic effect was evaluated by index of the mortality or disability rate 3 months after the onset of disease. The intention to treat analysis (ITT) was used in data.

RESULTSThe mortality or handicap rate 3 months after the onset of disease of four groups were 17.5% (14/80) in group A, 22.5% (18/80) in group B, 40. 0% (32/80) in group C, and 31.3% (25/80) in group D, respectively. The group A has a best therapeutic effect (vs group C, group D, both P<0.05), and there was no adverse event.

CONCLUSIONThe combined application of electroacupuncture, active-blood and dissolve-stasis herbs and rehabilitation training is a better treatment for cerebral infarction in clinic.

Adult ; Aged ; Cerebral Infarction ; drug therapy ; rehabilitation ; therapy ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged

OBJECTIVEto summarize the complications of posterior vertebral column resection (pVCR) and pedicle screw fixation for the treatment of rigid thoracic and lumber spinal deformity.

METHODSfifty four patients from a single center from February 2000 to February 2009 were included in this study. There were 23 males and 31 females with an average age of 28.3 years (range, 16-58 years). Patients were divided into 4 diagnostic categories: severe scoliosis (n = 9, mean Cobb angle, 91.7°), kyphoscoliosis (n = 22, mean scoliosis, 101.5°, and mean kyphosis, 69.4°), angular kyphosis (n = 21, mean kyphosis, 72.2°), global kyphosis (n = 2, mean kyphosis, 93.6°). All of the patients received one stage pVCR combined correction with pedicle screws and circumferential fusion. Radiographs and hospital charts were reviewed to analyze the outcomes of correction.

RESULTSa mean of 1.4 vertebral levels were resected, the mean operative time was 470 min, and the mean blood loss was 4180 ml. All the patients were followed-up for an average time of 26 months (range, 12 - 66 months). At the latest follow-up, the major curve correction averaged: severe scoliosis 61.4° (67%), kyphoscoliosis 59.7° (56%)/kyphosis 42.3° (59%), angular kyphosis 48.5° (71%), global kyphosis 62.7° (67%). A total of 21 complications (38.9%) occurred in 17 patients, including 5 (9.3%) neurological complications happened in early stage and one case of delayed complete paraplegic. There were 11 (20.4%) non-neurological complications happened in early stage and 5 (9.3%) cases in late stage.

CONCLUSIONSone stage posterior-only vertebral column resection can achieve satisfactory correction of severe deformities with limited flexibility. Given its technically demanding and exhausting features, its potential risk of significant complications should be paid more attention.

Adolescent ; Adult ; Bone Screws ; Female ; Follow-Up Studies ; Humans ; Kyphosis ; surgery ; Male ; Middle Aged ; Osteotomy ; adverse effects ; methods ; Postoperative Complications ; Scoliosis ; surgery ; Spine ; surgery ; Treatment Outcome ; Young Adult