Objective To identify endoscopic and the endoscopic ultrasonography (EUS) features of esophageal tuberculosis.Methods We retrospectively analyzed the data of 39 cases (mean age 50.7) of esophageal tuberculosis diagnosed by endoscopy and EUS in past 6 years.Results A total of 29 lesions were found in the middle part of esophagus,and 5 in upper and lower part,respectively.The lesions under endoscope demonstrated as protrusion in 30 and ulceration in 9.EUS found esophageal wall thickness in 9 cases,intra-wall occupying lesion in 17,mediastinum occupying lesions involving esophagus in 13,and calcified lymph nodes in mediastinum which was integrated with esophageal outer wall in 28 cases.Conclusion The esophageal tuberculosis occurs mainly in the middle part of the esophagus,and appears as protrusion and ulceration under endoscopy.EUS can find occupying lesions intra-or out of the esophageal wall,and full layer thickness,which can accompany calcified lymph nodes in meidastinum,and can be the basis of diagnosis.

Objective To analyze clinical features and sum up experience for the treatment of ischemic bowel disease. Methods Clinical data of 73 patients with the diagnosis of ischemic bowel disease were retrospectively analyzed. ResultsTwenty-eight patients were male and 45 patients were female. The median of age was 65 years (range of 38 to 89 years). Forty-eight patients were associated with hypertension, 23%(17/73) patients had a history of coronary disease and 15% (11/73) had diabetes. Seventy patients presented symptom of abdominal pain and 93% (68/73) had hematochezia. Symptoms relieved by conservative treatment in 96% (63/66) patients. Nine patients underwent a surgery. One patient died of sepsis postoperatively. One suffered from colostomy necrosis and leakage of the rectum segment. Conclusion 1. Elder patients presenting symptoms of abdominal pain and hematochezia, especially with a history of cardio-cerebrovascular disease and diabetes should be considered for the possibility of ischemic bowel disease. 2. Most patients with ischemic bowel disease could be successfully treated by conservative therapy. 3. Surgery for patients with chronic relapsing and nonresponsible symptoms was difficult and patients often suffer from high postoperative complications.

ObjectiveTo assess the protective effect of ischemic postconditioning in different ways after rabbit's testis completely torsion and detorsion and to assess the value of contrast-enhanced ultrasonography(CEUS) in it.MethodsForty male white rabbits were divided into 5 groups randomly:a control group,directly perfusion group (R),ischemic postconditioning groups (IP1,IP2 and IP3),with 8 in each.The acute testicular hemodynamic disorder models were established in R,IP1,IP2,IP3 groups by completely blocking the left testicular blood flow for 4 hours,then group R was directly subjected to perfusion,group IP1 was subjected to 15 s release and 15 s occlusion (15 s/15 s),IP2 was subjected to 30 s/ 30 s,IP3 was subjected to 45 s/45 s,each group was taken 3 cycles.All the groups underwent CEUS before operation and after 3 days,examined for the contents of malonaldehyde(MDA),superoxide dismutase(SOD) and histology,and observed for the pathobgieal changes of the testicular tissue.ResultsThe CEUS parameters of bilateral testes showed no significantly difference in all group before operation( P ＞0.05),3 days after reperfusion.The half of declining time of intensity was extended significantly in all operation groups comparing with control group (P ＜ 0.05),but the difference of peak and base intensity were increased in group IP1 and IP2,comparing with control group( P ＜0.05).The contents of MDA and SOD were remarkable differences in group IP1,IP2 comparing with group R and IP3 ( P ＜ 0.05).Johnsen' s score,apoptosis index showed significantly differences in group IP1,IP2 comparing with group R and IP3 (P ＜ 0.05).ConclusionsMicrocirculation of the complete torsion testicular was significantly improved by ischemic postconditioning after reperfusion,and the effects of ischemic postconditioning could be evaluated by CEUS.

Objective To investigate the differences of histopathological diagnosis between the endoscopic mucosal resection (EMR) specimens and the biopsy specimens,and to evaluate the value and the limitation of EMR in diagnosis of early esophageal cancers and its precursor lesions.Methods A retrospective analysis on 217 lesions with early esophageal cancers or the precursor lesions treated by EMR was performed.The differences between pathological diagnoses of biopsy and EMR were compared.Results Compared with pathologic diagnosis after EMR,the yield of biopsy consisted of 41.9％ (91/217) as under-diagnosed,15.7％ (34/217) as over-diagnosed,and 42.4％ (92/217) as consistent.EMR diagnosis also explicated the differentiation,the grade,the invasive depth and the lympho-vascular infiltration of the lesions.Conclusion The endoscopic biopsy diagnosis is limited for the pathological diagnosis of early esophageal cancer and precancerous lesions,while the EMR sample can provide objective diagnosis and provide the guideline for the further treatment.

Objective To investigate the value of predicting testicular viability following unilateral testicular torsion by color-Doppler ultrasound (CDU). Methods The clinical manifestations, intraoperative findings and scrotol CDU appearances before and after operation of 42 cases with testicular torsion were compared. According to a bleeding test intraoperatively, testicular viability was divided into A-D level. Testis of level A-C would be saved .while the level D removed. Testicular viability assessed by follow-up CDU was then classed into Ⅰ-Ⅲ level. In Ⅰ-Ⅱ level, the salvaged testis were recovery ultimatelybut atrophy in level Ⅲ. Results Seventeen cases of the 42 underwent orchidopexy and the remaining 25 cases underwent orchidectomy. As followed up, however, testis in only 7 cases were recovered, including 2 cases in level A,3 cases in level B and 2 cases in level C. respectively. The preoperative scrotal CDU appearances of the recovered testis were mainly as follows: ① Homogeneous parenchyma with decreased or disappeared blood perfusion. ②Sheet or radial hypoechoic in the local testis but with preserved blood perfusion in most area else. Testis in the remaining 10 patients, including 8 cases in level C and 2 cases in level D, respectively, were atrophy finally. And large radial hypoechoic or diffuse inhomogeneous echo with none or a small amount of blood supply on the edge parenchyma were found during their preoperative CDU (similar CDU performance was present in the orchidectomy group. The CDU appearances of contralateral testes both in orchidopexy and orchidectomy group were not obviously abnormal during follow-up. Conclusions The scrotal CDU examination is competent to predict testicular viability after detorsion. In addition, timely operation would be a key to CDU evaluation.

Chinese medicine (CM) is a discipline with its own distinct methodologies and philosophical principles. The main method of treatment in CM is to use herbal prescriptions. Typically, a number of herbs are combined to form a formula and different formulae are prescribed for different patients. Regularities in the mixture of herbs in the prescriptions are important for both clinical treatment and novel patent medicine development. In this study, we analyze CM formula data using latent tree (LT) models. Interesting regularities are discovered. Those regularities are of interest to students of CM as well as pharmaceutical companies that manufacture medicine using Chinese herbs.
Chemistry, Pharmaceutical ; standards ; Drug Compounding ; standards ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Models, Biological ; Prescription Drugs ; therapeutic use

Objective To investigate the association between genetic polymorphisms of ERCCl-C8092A and susceptibility to liver cancer, as well as the gene-environmental interaction on the etiology of liver cancer in Fuzhou. Methods A case-control study was conducted to collect the information on environmental exposure while genetic polymorphism of ERCC1 was analyzed by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. General relative risk regression models were further applied to fit the interaction between genetic polymorphisms of ERCC1-C8092A and the environmental factors of liver cancer. Results ERCC1-C8092A variant genotypes were associated with significant increasing risk of liver cancer adjusted odds ratio (OR= 3.789,95%CI:2.792-5.142 ), compared to the wild-type homozygote. Data from the analysis of interaction showed that genetic polymorphism of ERCC1-8092A appeared superadditive interaction with drinking pond-ditch or with hepatitis B, and super-multiplicative interaction with eating moldy food. Conclusion The point mutation in ERCC1-8092A was possibly susceptible to liver cancer, and related synergistically with other risk factors in hepatocelluar carcinogenesis in Fuzhou.

OBJECTIVETo establish a method of iduronate-2-sulfatase (IDS) activity assay and mutation analysis of IDS gene for the prenatal diagnosis of mucopolysaccharidosis type II (MPSII).

METHODSPrenatal diagnosis of two cases was performed using cultured fetal amniotic fluid cells. Enzyme activity of IDS in cultured fetal amniotic fluid cells extracted from the two pregnant women at high risk of MPS II was measured. Meanwhile, genomic DNA was extracted for fetal gender testing and mutation analysis of the IDS gene.

RESULTSEnzyme activity assay showed that IDS activity in amniotic fluid cells was significantly decreased. IDS gene sequencing showed that the male fetus was hemizygous mutant, and the female fetus was carrier of heterozygous mutation. Therefore the male fetus was an MPS II patient and the female fetus was a mutation carrier.

CONCLUSIONDetermination of IDS activity in fetal amniotic fluid cells together with IDS gene mutation analysis is a rapid, sensitive and accurate method of prenatal diagnosis of MPS II. Using this method, prenatal diagnosis for pregnant women at high risk of MPSII can be achieved.

Base Sequence ; Child ; Child, Preschool ; Exons ; Female ; Glycoproteins ; genetics ; metabolism ; Humans ; Male ; Mucopolysaccharidosis II ; diagnosis ; genetics ; metabolism ; Mutation ; genetics ; Pregnancy ; Prenatal Diagnosis

BACKGROUND:Autologous platelet rich plasma and bone marrow mesenchymal stem cells have certain effects on bone repair,but there are rare reports on the clinical treatment of long shaft fracture bone nonunion using autologous platelet rich plasma combined with bone marrow mesenchymal stem cell transplantation.OBJECTIVE:To investigate the therapeutic effect of autologous platelet rich plasma combined with bone marrow mesenchymal stem cell transplantation on long shaft fracture bone nonunion.METHODS:Forty-seven patients with long shaft fracture bone nonunion were randomly divided into two groups:monotherapy group (n=22) and combination group (n=25).In the monotherapy group,autologous bone marrow mesenchymal stem cell transplantation was performed in the bone nonunion site.In the combination group,autologous platelet rich plasma combined with bone marrow mesenchymal stem cell transplantation was implemented in the bone nonunion site.Callus score,clinical healing time,local complications and limb function grade were recorded and compared between the two groups.RESULTS AND CONCLUSION:The healing properties and limb function in the combination group were significantly superior to those in the monotherapy group [healing time:(4.2±1.5) vs.(5.6±1.1) months,P ＜ 0.05;healing rate:92％ vs.86％,P ＜ 0.05;callus score:2.74±0.36 vs.2.32±0.53,P ＜ 0.05;limb function recovery rate:77％ vs.84％,P ＜ 0.05].Complications like local skin redness or infection were not found in the two groups.In conclusion,both of the two methods can promote bone healing,but autologous platelet rich plasma combined with bone marrow mesenchymal stem cell transplantation has a better clinical effect on bone healing.

Objective To assess the clinical value of endoscopic uhrasonography(EUS)combined with the mini-probe endoscopic uhrasonography(MPUS)in determing tumor invasion depth and lymph node metastases of early superficial esophageal cancer.Methods One hundred and twenty-four superficial esophageal cancer lesions of 121 patients were staged by EUS combined with MPUS,and the results were finally compared with pathological findings of surgical specimens or samples obtained by mucosal resection.Results The diagnostic accuracy of EUS in T staging of superficial esophageal cancer was 82.3%(102/124).The total ratio of lymph node metastases was 5.0%(6/121),with no node metastases in carcinoma in situ,1.3%(1/28)in mucosal carcinoma,11.6%(5/43)in submucosal carcinoma.Conclusion EUS combined with MPUS is accurate in staging of the superficial carcinoma,which can help the choice of therapeutic strategies.