Achalasia is an esophageal motility disorder with impaired relaxation of lower esophageal sphincter.Its clinical manifestations are progressive dysphagia, retrosternal pain, regurgitation of undigested food, weight loss.Medication, endoscopic treatment and surgery are the main treatments of achalasia.Peroral endoscopic myotomy (POEM) is an endoscopic mini-invasive technique which has smaller surgical injury, remarkable curative effect, lower cost, and lower recurrence rate when compared with the traditional treatment of achalasia.This article reviewed the advances and prospects of POEM in treatment of achalasia.

OBJECTIVE:To discuss the management targets of hospital drug sto rehouse.METHODS:Theory of physical distribution management was applied in combination with the actual situation of hospitals,the professional characteristic of hospital pharmacy,the functional characteristic of pharmaceutical legislation and the commercial characteristic of drug distri?bution were analyzed.RESULTS&CONCLUSION:The management targets of hospital drug storehouse must accord with the mission of hospital and embody its social effects as well as the economic returns.

AIM: To optimize the extraction process for Banxiaxiexin Decoction (Rhizoma pinelliae, Radix Scutellariae, Rhizoma coptidis, Radix Ginsenp, Rhizoma zinpiberis, Fruents Jujubae, and Radix Glycyrrhizae). METHODS: The content of berberine、baicalin and total solid in extract liquor were determined by orthogonal design and single factor experiment in combination with glycyrrhizic acid content and identification of Rhizoma zingiberis, Radix Ginseng and Rhizoma Pinelliae. RESULTS: The extracting was arrived at in the condition of adding eighteen times of 70% alcohol as much as crude drug and refluxing 2 times, 2h and 1h, respectively. CONCLUSION: The extraction is stable and feasible.

Objective Dipole source analysis was employed to investigate the transient changes in brain mechanisms at earlier latencies.Methods Fourteen healthy volunteers were recruited in this research and evoked event-related potentials (ERPs) of unimodal and bimodal visual auditory stimuli were recorded by 64-electrodes electroencephalograph (EEG) recording system.All these earlier phases of the stimuli were divided into several subphases by specific time window for source analysis.Results The results showed that ERPs sources were mainly generated from visual and audio cortex,and there were changes in the location and strength of the dipole sources in each sub-phase.Conclusions The result of this study implies a serial processing of sensory information in human cortices in early phase of visual and auditory stimuli.

BACKGROUND:Nano-hydroxyapatite/bacterial celulose (nHA/BC) composite scaffolds prepared by nano-bionics method exhibit a structure and performance similar to natural bone. OBJECTIVE:To study the cytotoxicity and biocompatibility of nHA/BC composite scaffolds. METHODS:(1) Acute systemic toxicity test: nHA/BC leach liquor and normal saline were respectively injected intraperitonealy into Kunming mice. After 24, 48, 72 hours, the body mass of mice was recorded. (2) Sensitization test: nHA/BC leach liquor and normal saline were respectively injected subcutaneously into the back of Japanese white rabbits. With 72 hours of injection, edema and erythema were observed, and the experiment was done again at an interval of 14 days. (3) Pyrogen test: nHA/BC leach liquor and normal saline were respectively injected into the ear vein of Japanese white rabbits, and after injection, the body temperature of rabbits were determined. (4) Hemolysis test: Diluted rabbit anti-coagulant was added into nHA/BC leach liquor, normal saline and distiled water, respectively. (5) Passage 3 bone marrow mesenchymal stem cels from rabbits were co-cultured with nHA/BC materials, and then, cel proliferation, growth and adhesion on the material surface were observed. RESULTS AND CONCLUSION: nHA/BC composite scaffold was of no acute systemic toxicity, non-alergenic, no pyrogenic and hemolytic reactions; nHA/BC had a three-dimensional porous structure that was better for growth, proliferation and adhesion of rabbit bone marrow mesenchymal stem cels. These findings indicate that the nHA/BC composite scaffold has good biocompatibility and cytocompatibility.

Objective To compare and analyze the clinical efficacy of locking plates versus artificial joint replacement for proximal humeral complicated fractures.Methods The retrospective data of 200 cases with locking plate or artificial joint replacement for the treatment of comminuted proximal humeral fractures were collected from February 2013 to July in our hospital.Patients were divided into locking plate group (n =114) and artificial joint replacement group (n =86) according to the treatment.The pain,functional recovery,activity,anatomical position,complications and Neer score after treatment were compared between the two groups.Results In artificial joint replacement group,Neer score was excellent in 34 cases,good in 23 cases,fair in 25 cases,poor in 4 cases,and the excellent and good rate was 66.3％ (57/86).In locking plate group,Neer score was excellent in 53 cases,good in 47 cases,fair in 10 cases,poor in 4 cases,and the excellent and good rate was 87.7％ (100/114).The excellent and good rate was higher in locking plate group than in artificial joint replacement group (x2 =13.35,P＜0.001).The scores of pain,functional recovery,activity and anatomical position were (26.9 ± 8.5),(22.4 ± 7.1),(19.8 ± 5.5) and (8.0 ± 1.8) respectively in locking plate group,and (24.8±10.2),(20.2±6.7),(18.1±6.6) and (7.9±2.1) respectively in artificial joint replacement group.There were significant differences in scores of functional recovery and activity between groups (t＝ 2.22 and 1.99,P =0.014 and 0.024),while no significant differences were found in scores of pain and anatomical position (t=1.59 and 0.36,P＝0.057 and 0.359).There were 2 cases with ankylosis,1 case with malunion and 1 case with humeral head necrosis in locking plate group,and 1 case with ankylosis,1 case with wound infection,1 case with refracture and 1 case with humeral head necrosis in artificial joint replacement group after treatment.There were no significant differences in complications between groups (x2 =0.17,P=0.683).Conclusions The locking plate and artificial joint replacement are effective in the treatment of comminuted proximal humeral fractures.Compared with artificial joint replacement,the locking plate can improve the functional recovery,activity and Neer score evaluation with a low technical requirement,which is an ideal method for comminuted proximal humeral fractures.

Aim To illustrate the actions and molecular mechanisms of interventions taken to convert the metabolism pathways of cellular apoptosis caused by hypoxia and hypoxia-reperfusion in hypertrophic cardiomyocytes.Methods Angiotensin Ⅱ(0.1 ?mol?L-1)was applied to induce the hypertrophy of mice cardiomyocytes.The cardiomyocytes received the treatment of hypoxia-reperfusion in a tri-gas incubator to simulate the conditions of hypoxia-reperfusion.Before hypoxia/reperfusion,no drug intervention and pre-treatments of DCA(1 mmol?L-1),TMZ(5 ?mol?L-1),LC(50 ?mol?L-1)and AA(10 ?mol?L-1)were given respectively.The glucose and fatty acid oxidative metabolism rates were measured with radioactive counting methods.RT-PCR and Western blot methods were employed respectively to measure the mRNA and protein expression levels of cytochrome C and apoptosis inducers.The spectrophotometry method was used to measure the activity of Caspase-3 and Hoechst 33258 staining to quantify the percentage of cellular apoptosis.Results At post-hypoxia 12 h and post-reperfusion 4 h,the glucose oxidative metabolism rates in hypertrophic cardiomyocytes all decreased while the fatty acid oxidative metabolism rates increased.DCA,TMZ and LC all could inhibit both the reduction of glucose oxidative metabolism after hypoxia-reperfusion and the elevation of fatty acid oxidative metabolism after hypoxia-reperfusion.AA drove the reduction of glucose oxidative metabolism rate even lower and the fatty acid oxidative metabolism rate even higher in hypertrophic cardiomyocytes after ischemia/reperfusion.At the same time,DCA,TMZ and LC could inhibit the expression levels of mitochondrial cytochrome C and AIF mRNA and proteins,the nuclear translocation of cytochrome c and AIF proteins and the activity of caspase-3.And with the opposing actions to AA,DCA,TMZ and LC could inhibit the apoptotic rate of hypertrophic cardiomyocytes after hypoxia-reperfusion.And AA had the opposite effect.Conclusion Intervening in the metabolism pathway of hypertrophic cardiomyocytes was an effective way to prevent and control their programmed death through inhibiting the expression of mitochondrial apoptotic proteins.

Objective To evaluate the efficiency of PCR-restriction fragment length polymorphism (PCR-RFLP)aiming at the structure gene g6341,versus PCR fingerprinting analysis in the genotyping of Cryptococcus neoformans MethodsEight reference strains and 68 clinical and environmental isolates of C.neoformans were genotyped by PCR-RFLP and PCR fingerprinfing.In PCR fingerprinting,the minisatel lite-specific core sequence of wild-type phage M13 was used as a single primer.The structure gene g6341 was selected for PCR-RFLP analysis by sequence alignments of multiple genes,a pair of pnmers were developed based on the conserved region of g6341 gene.PCR products were digested with the appropriate restriction endonucleases,and RFLP profiles were analyzed.Partial sequence analysis of g6341 gene was performed for different genotypes of C.Neoformans.Phylogenetic analysis was done to study the relatedness between these genotypes.Results As sequence homology analysis showed,g6341 gene was suitable for RFLP analysis.In the case of enotyping of 76 C. Neoformans strains,the results obtained from PCR-RFLP were consistent with those from PCR fingerprinting.Sequence analysis of g6341 gene revealed a homology of 84%-97%among the eight genotypes as well as a consistency of 99%-100%within a same genotype.In the phylogenetic tree,genotypes VNⅠ,VNⅡ,VNⅢand VNⅣ belonged to one cluster,and genotypes VGⅠ,VGⅡ,VGⅢ and VGⅣ to another cluster.Conclusions PCR-RFLP analysis aiming at the structure gene g6341 is a useful tool to genotype C.neoformans.Sequence analysis of g6341 gene can disclose the relatedness among different molecular types of C.neoformans.

Objective To evaluate the role of the complement 1 q (C1 q) in hepatic ischemia-reperfusion (I/R) injury in rats.Methods Sixty healthy male Sprague-Dawley rats,aged 3-4 months,weighing 180-200 g,were randomized into 2 groups:sham operation group (S group,n =12) and hepatic I/R group (I/R group,n =48).Hepatic specimens were obtained at 1,3,6 and 24 h of reperfusion and were then cut and stained with haematoxylin and eosin for examination of histological changes of the liver (with light microscope) and for determination of superoxide dismutase (SOD) activity and malondialdehyde (MDA) content (by colorimetric method),expression of Clq mRNA (using real-time PCR) and expression of Clq (by using Western blot).Results Compared with S group,the activity of SOD was gradually decreased,the content of MDA was gradually increased,and the expression of Clq and Clq mRNA was gradually up-regulated and peaked at 3 h of reperfusion with the prolongation of reperfusion time in I/R group (P ＜ 0.05).The pathological changes of the liver were aggravated with the prolongation of reperfusion time in I/R group.Conclusion Activation of C1 q is involved in hepatic I/R injury in rats.

Objective To assess the subgenotypes of pathogenic Cryptococcus gattii isolates from China and to elucidate the epidemiological links between these domestic isolates and those from other parts of the world. Methods DNA was extracted from 9 clinical isolates of Ctyptococcus gattii from China. The partially variable regions of the three unlinked loci, namely IGS1, PLB1 and GEF1, were amplified and sequenced, and the bioinformation at these loci was obtained from GenBank for multi-locus sequences alignment and phylogenetic analysis. Results Of these 9 clinical isolates, 8 were genotype VG Ⅰ and mating type α with the same sequences at the tested regions as the reference strain WM276, which was a representative isolate of an independent subgenotype; 1 was of genotype VG Ⅱ and mating type α, which was the first report in China, with the tested sequences consistent with those of the referrence strain R272. Sequencing and phylogenetic analysis of GEF1 gene, which was located at mating type locus, successfully identified the genotypes and mating types of all the Cryptococcus gattii isolates involved here. Conclusions Multi-locus sequence analysis shows that causative Cryptococcus gattii isolates of genotype VG Ⅰ in China carry similar sequences at the tested loci in IGS1, PLB1 and GEF1 genes, to a widely distributed subgenotype in the world, and the sequences of the first VG Ⅱ genotype isolate from China resemble the less virulent subgenotype VG Ⅱ b found in Vancouver islands.