Objective To investigate the function of acid pocket in reflux esophagitis. Methods The 15 healthy controls and 24 reflux esophagitis patients were identified by reflux disease questionnaire (RDQ) and gastric endoscopy. The location of subjects' lower esophageal sphincter (LES) was determined by 4 channel esophageal manometry system. Then a single-channel pH electrode was positioned 1 cm below the distal border of the LES to monitor fasting pH for half an hour. After a standard meal, the pH was continuously measured for two hours. Then the electrode was moved to 5 cm above the proximal border of the LES to monitor the dynamic pH for 24 h.Results Acid pocket was found in 16 cases of reflux esophagitis patients(66.67%) and 10 cases of healthy individuals (10/15). Acid pocket occurred earlier in reflux esophagitis group than healthy controls [11.00(4.25-17.00) min vs 30.00(15.50-54.25) min, P＜0.05], and the average pH value was lower [1.84(1.59-2. 19) vs 2.32 (1.96-2.71), P＜0.05]. There was no statistic difference in mean pH value of gastroesophageal junction and the duration of acid pocket before the meal.Conclusion There is abnormal acid reflux in reflux esophagitis patients, and acid pocket with earlier occurrence and lower pH value may relevant to esophageal mucosal impairment.

Objective:To investigate the possible role of miR-181d in regulating the multidrug resistance (MDR) of small cell lung cancer (SCLC) and its clinical significance. Methods: Quantitative reverse transcriptase-polymerase chain reaction (QRT-PCR) and Western blot were used to investigate the differential expression of miR-181d and BCL2 from mRNA and protein levels in the chemo-sensitivity cell H69 and the chemo-resistance cell H69AR. The miR-181d expression in H69AR was then upregulated. More-over, CCK8 assay was employed to detect the sensitivities of the cells to chemotherapy drugs, such as ADM, DDP, and VP-16. Mean-while, the expression of miR-181d in the specimens of 87 cases with SCLC were detected using QRT-PCR. All patients received the chemotherapeutic regimen of EP (etoposide+cisplatin). Correlation of the miR-181d expression with clinicopathological features, prog-nosis, and survival time of the patients was studied. Results:miR-181d was downregulated in the SCLC multidrug-resistant cell line H69AR and chemo-resistant patients. Moreover, miR-181d was concurrent with the upregulation of BCL2 protein compared with the parental H69 cell line and chemo-sensitive patients (P<0.001). miR-181d expression in H69 cells resistant to chemotherapy drugs (ADM, DDP, and VP-16) was inhibited (P<0.01). Enforced miR-181d expression reduced the BCL2 protein level and sensitized H69AR cells to chemotherapy drugs (P<0.01). miR-181d expression was associated with tumor stage, sensitivity of chemotherapy, and survival time (all P<0.001). Patients with high miR-181d expression had longer overall survival and progress-free survival time com-pared with those with low miR-181d expression (P<0.001). Conclusion: miR-181d may play a role in the development of MDR in SCLC and may be a potential predictive factor for treatment efficacy.

Objective To investigate the dose-effect effects of th ree relating bone growth factors, dexamethasone, recombinant human basic fibro blastic growth factor (rhFGF) and recombinant human bone morphogenetic protein- 2 (rhBMP-2), on proliferation and differentiation of periosteal cells so as to provide experimental basis for their further application in bone tissue engineer ing. Methods Periosteal cells were isolated and cultured in vitro and then exposed to dexamethasone (10 -8 mol/L, 10 -7 mol/L and 10 -6 mol/L), rhFGF (50 ng/ml, 200 ng/ml and 500 ng/ml) and rhBMP-2 (50 n g/ml, 500 ng/ml and 1 000 ng/ml) respectively. At the 4th and 7th days respectiv ely, the culture stopped and the total protein and alkaline phosphatase (ALP) ac tivities were measured. ResultsDexamethasone at concentratio n of 10 -6 mol/L significantly inhibited protein synthesis without obvious effects on ALP expression. The rhFGF at various concentrations significantly pro moted cell proliferation but inhibited ALP activity. The rhBMP-2 at various con centrations exerted insignificant effect on cell proliferation. In comparison, A LP expression was significantly enhanced by treatment of rhBMP-2 at concentrati on of 500 ng/ml and 1 000 ng/ml ( P

ObjectiveTo analyze the transitional shifts between with different sets of cone-beam computed tomography (CBCT) and the planning CT for liver cancer patients,and calculate the margins from clinical target volume (CTV) to the planning target volume (PTV)with and without image guided radiotherapy (IGRT).MethodsFive liver cancer patients received radiotherapy after transcatheter arterial chemoembolization (TACE).The first CBCT images (CBCT1) were obtained with Elekta CBCT plus active breathing control (ABC) system before treatment.The second CBCT images (CBCT2 ) were obtained after correcting the set-up errors and the third CBCT images ( CBCT3 ) were obtained after treatment.The CBCT images were registered and matched with the planning CT images using lipiodol as a direct surrogate for target localization.The PTV margins were calculated by comparing the shift between planning CT and CBCT according to formula M =2.5 ( Σ doctor2 + Σ set-up2 + Σ transter2 )1/2.Paired t-test was used to compare the differences between the results from CBCT1,CBCT2 and CBCT3. Results The average transition shifts in the left-right ( LR),superior-inferior (SI) and anterior-posterior (AP) directions were 0.254,-0.612,0.314 cm between planning CT and CBCT1 ;were 0.020,0.014,-0.064 cm between planning CT and CBCT2 ;and they were -0.004,0.042,-0.040 cm between planning CT and CBCT3.The PTV margins were LR 0.96 cm,SI 0.96 cm and AP 0.83 cm without IGRT,and LR 0.67 cm,SI 0.68 cm and AP 0.58 cm with IGRT.ConclusionsThe PTV margins can be reduced by 3 mm with IGRT for liver cancer using lipiodol as a direct surrogate for target localization.

A HPLC method was established to determine the contents of the five anthraquinones and rhaponticin in the different varieties of Rhei Radix et Rhizoma. The difference existed in different varieties. The results showed that rhein and rhaponticin were marker substances which could be used to distinguish palm leaf groups rhubarb and wave leaf groups rhubarb. Authentic rhubarb didn't contain rhaponticin. Falsify rhubarb contains trace amounts of rhein. Rheum tanguticum contains abundant rhein. The ratio value of the content of rhein to chrysophanol could be used to distinguish R. tanguticum from the other two authentic varieties (R. palmatum and R. officinale). The content of rhaponticin varied largely in different varieties of wave leaf groups rhubarb.
Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; analysis ; Quality Control ; Rheum ; chemistry ; classification ; Rhizome ; chemistry ; classification

Objective To investigate the combination effect of tramadol and low dose propofol on emergence agitation in children receiving sevoflurane for adenotonsillectomy procedure. Methods Ninety patients receiving sevoflurane for adenotonsillectomy procedure were randomly divided into control group (administration of 0.1 mL/kg normal saline 30 min before the end of operation), tramadol group (administration of 1 mg/kg tramadol 30 min before the end of operation) and tramadol + propofol group (administration of 1 mg/kg tramadol 30 min before the end of operation and 1 mg/kg propofol at the end of operation). Time of extubation and time stayed in postanesthetic care unit (PACU) after operation were recorded, scores of Pediatric Anesthesia Emergence Delirium ( PAED) Scale, modified Aldrete scores and pain scores were obtained immediately after entrance into PACU, and the prevalences of post-operative nausea and vomiting were observed. Results There was no significant difference in time of extubation, time stayed in PACU and modified Aldrete Scores among groups (P >0.05). There were significant differences in scores of PAED Scale immediately after entrance into PACU, with control group > tramadol group > tramadol + propofol group (P < 0.05). The pain scores of tramadol group and tramadol + propofol group were significantly lower than that of control group (P < 0.05). The prevalence of nausea and vomiting was the highest in tramadol group, and the prevalence in tramadol + propofol group was significantly lower than that in tramadol group ( P < 0.05). Conclusion The combination use of tramadol and low dose propofol can decrease the severity of emergence agitation in children receiving sevoflurane for adenotonsillectomy procedure, and reduce the prevalence of nausea and vomiting.

OBJECTIVETo observe therapeutic effect of Shaoshanhuo needling method on periarthritis of shoulder.

METHODSOne hundred and twenty cases were randomly divided into two groups: a treatment group of 57 cases and a control group of 63 cases. The treatment group were treated with Shaoshanhuo needling method and massage combined with functional exercise of shoulder joint, and the control group were treated with warming acupuncture and moxibustion combined with massage and functional exercise of shoulder joint. Their therapeutic effects were evaluated after 2 courses.

RESULTSThe effective rate and the cured rate were 96.5% and 70.2% in the treatment group, and 88.9% and 50.8% in the control group respectively, with no significant difference between the two groups in the effective rate (P>0.05), but with a significant difference between the two groups in the cured rate (P<0.05), the treatment group being higher than the control group.

CONCLUSIONShaoshanhuo needling method has a better therapeutic effect on periarthritis of shoulder.

Objective To evaluate the precision of image guided radiotherapy (IGRT) for vertebra metastasis.Methods Cone-beam computed tomography (CBCT, ELEKTA SynergyTM) scanning was performed to 15 patients with vertebra metastasis treated with three dimensional conformal radiation therapy (3DCRT) or intensity modulated radiation therapy (IMRT).CBCT images were then compared with corresponding planning images to calculate the position errors.The isocenter was adjusted based on the errors calculated , CBCT scanning was re - performed , and the new - errors were then calculated .Results Compared to the firstly collected CBCT images, the average errors of 4 cases of cervical bone metastases in x (left-right), y (cervical-caudal), and z (anterior-posterior) directions were 1.8 mm, 0 mm and 3.6 mm respectively.After adjusting the isocenter, the new-errors were reduced to 0.1 mm, 0.4 mm and 0.3 mm.For 11 cases of thoracic and lumbar bone metastases, the average errors in x, y, and z directions were 1.9 mm, 0.1 mm, and -2.1 mm, respectively.While the new-errors were reduced to 0.9 mm, 0.5 mm and -0.3 mm.Conclusions IGRT can improve the precision of radiotherapy for vertebra metastasis to less than 2 mm, which provides a possibility of dose escalation in GTV while reduce the dose in the spinal cord.

Objective To investigate whether physical training can activate the PI3K/Akt (phosphatidyli-nositol 3-kinase/Protein Kinase B) signal transduction pathway after focal brain isehemia, leading to the reduction ofendothelial cell apoptosis. Methods Twenty-four male adult Sprague-Dawley rats (2 ～ 3 month old, n = 24) weresubjected to 60-min right middle cerebral artery occlusion (MCAO). All rats were randomly assigned to one of thethree groups: physical training group, control group and sham operation group. 24 hours after MCAO ,physical train-ing group underwent 30 min treadmill training per day for 2 weeks. Results After two weeks, the phosphorylationlevel of PI3K/Akt in the physical training group was significantly higher when compared with that in the control group(P <0.05), while the expression level of Bax in physical training group was lower when compared with that in thecontrol group( P < 0.05 ). Conclusion Physical training can activate PI3K/Akt signal transduction pathway,which may be associated with the neurological recovery.

BACKGROUND: Mesenchymal stem cells (MSCs), with low immunogenicity, can regulate cellular immunity and mitigate graft rejection, which has a good prospect in tissue engineering. However, it is rarely present in bone marrow. OBJECTIVE: To explore an isolation and culture method of the rabbit bone marrow-derived MSCs, to observe the biological characteristics and differentiation potential of bone marrow-derived MSCs.METHODS: MSCs were isolated from rabbit tibia bone marrow by combination of gradient centrifugation and different adherent method, then proliferation in vitro. Morphology was examined by phase contrast microscopy, and the growth curve of cultured MSCs was drawn via MTT results. MSCs were treated with osteogenetic inductor (L-DMEM/F12, 10% fetal bovine serum, 0.1 μmol/L dexamethasone, 200 μmol/L vitamin C, 10 mmol/L β-phosphoglycerol), adipose inductor (L-DMEM/F12, 10% FBS, 1 μmol/L dexamethasone, 200 μmol/L antifani, 0.5 mmol/L IBMX, 10 μg/mL insulin), and chondrocytes inductor (L-DMEM/F12, 10% FBS, 10 μg/L TGF-β1, 0.1 μmol/L dexamethasone, 50 μmol/L vitamin C, 6.25 mg/L insulin) to differentiated into osteoblast, dipocytes and chondrocytes. And the differentiated cells were identified by alkaline phosphatase staining, oil red O staining, and toluidine blue staining, respectively.RESULTS AND CONCLUSION: Bone marrow-derived MSCs can be isolated and cultured by the combination of gradient centrifugation and different adherent method in vitro, which have the better potentiality of proliferation and multi-directional differentiation. Mostly of the primary and passaged cells were spindle-shaped. After osteogenetic induction, cells were positive to alkaline phosphatase staining. Oil red O staining showed that red lipid droplet existed in adipose cells, and toluidine blue staining showed that toluidine blue was positive after chondrocytes induction.