BACKGROUND:The implantable artificial pacemaker that needs long-term wear is in direct contact with human body tissue, and thus, biocompatibility of the materials is very important. OBJECTIVE:To investigate the material progress and material-related complications of implantable artificial pacemakers. METHODS:Articles related to implantable artificial pacemaker materials and related complications were searched in Wanfang database and PubMed database from 2000 to 2015. The keywords were pacemaker; materials; pacemaker leads; pacemaker electrode; complication in Chinese and English, respectively. Finaly, 27 articles were included and summarized. RESULTS AND CONCLUSION: The implantable artificial pacemakers are in direct contact with the body tissues through the titanium alloy shell covering the pulser, the electrode wire covering the silicone, polyurethane, epoxy resin, and the electrode materials (including carbon, platinum-iridium alloy, Elgilog alloy). These materials have good physical and chemical properties as well as good cytocompatibility, electrophysiological compatibility and blood compatibility with the human body that have been confirmed in the past decades. However, material-related complications often occur, such as contact dermatitis, wire breakage, dislocation, cardiac perforation, venous thrombosis and tricuspid regurgitation along the wire, capsular infection and hematoma when placing the pulser. With the rapid development of today's microelectronic technology, research on the modification of pacemaker materials and the pacing system has been ongoing and has made considerable progress. Moreover, wireless pacemaker development and clinical application may be the future direction of development.

Objective To explore the corrective role of lived combined Bacillus subtilis and Enterococcus faecium enteric-coated capsules on the bacteria overgrowth in small intestinal (SIBO)and assess the efficacy and possible mechanism of it in the treatment of diarrhea predominant irritable bowel syndrome (IBS-D).Methods From May to August 2013,IBS-D patients were collected.Screened by lactulose hydrogen breath test (LHBT),and a total of 60 SIBO positive patients were enrolled in the study and divided into experimental group and control group.Live combined Bacillus subtilis and Enterococcus faecium enteric were given to the experimental group and starch given to the control group,both were capsules,each 250 mg,three times per day,two capsules each time,and the treatment course was four weeks.Before and after administration a questionnaire was conducted in the study objects,including basic information (age,gender,disease type,family history and accompanied diseases) and the severe degree of the symptoms (abdominal pain,bloating,abdominal discomfort,increased frequency of defecation,defecation urgency,defecation endless,defecation hard,bowel and exhaust).Fasting peripheral venous blood was taken from the study individuals before and after administration.The level of interleukin (IL)-1β,IL-6,IL-10,IL-12 and tumor necrosis fator-α(TNF-α) in serum were detected by enzyme linked immunosorbent assay(ELISA).t-test was performed for measurement data comparison between two groups,and chi-square test was for count data comparison.Results Among 60 SIBO positive IBS-D patients,30 patients were in experimental group and 30 in control group.The SIBO negative conversion rate of experimental group and control group was 63.3 ％(19/30) and 30.0％ (9/30),the difference was statistically significant (x2 =6.696,P＜0.05).Before and after administration,in control group there were no significant differences in severe degree scoring of abdominal pain,bloating,abdominal discomfort,increased frequency of defecation,defecation urgency,defecation endless,defecation hard,bowel and exhaust or the level of TNF-α,IL-1β,IL-6,IL-10 and IL-12 (all P＞0.05).In experimental group,before and after administration there were statistically significant differences in severe degree scoring of abdominal floating (2.97 ± 1.45 vs 2.61±1.28),level of IL 1β ((1390.81±103.95) ng/L vs (1209.76±113.26) ng/L)and IL-10/IL-12 (4.94±0.74 vs 5.30±0.43),the differences were statistically significant (t=2.052,5.279 and 2.282,all P＜0.05).There were no signinficant differences in other items (all P＞0.05).Conclusions Lived combined Bacillus subtilis and Enterococcus faecium enteric coated capsules could alleviate the symptoms of abdominal floating.The possible mechanism may related with correcting SIBO,inhibiting low degree of inflammation reaction and regulating the inflammatory cytokines.

Objective To evaluate the possibility of slow and rapid liquid nutrient loading test (LNLT) in the proximal gastric function assessment according to the results of gastric barostat testing.Methods From April to August in 2013,20 healthy volunteer were selected.The sensitivity of gastric,basic abdominal pressure,gastric sensing threshold,gastric discomfort and pain thresholds were examined by barostat.The average gastric volume after fasting was tested by barostat,which reflected gastric accommodation.And then 200 mL liquild meal was taken in five minutes by the volunteers.The difference value between the maximum gastric volume in 60 minutes after taking the meal minus the average gastric volume after fasting was used to evaluate the proximal gastric adapted diastolic function.In LNLT,volunteers drank 100 mL/min and 15 mL/min (rapid and slow) liquid meal.The threshold value of drinking volume,satiety drinking volume and maximum drinking volume were determined.Pearson correlation analyses were performed in the results of fast and slow LNLT,correlation between LNLT and sensitivity of gastric,gastric adapted diastolic function tested by barostat.Results The basic abdominal pressure,gastric sensing threshold,gastric discomfort and pain thresholds,gastric volume after fasting,maximum gastric volume and adapted diastolic volume was (6.8±1.2) mmHg (1 mmHg=0.133 kPa),(2.7±1.9) mmHg,(5.2±2.0) mmHg,(7.3-±-2.1) mmHg,(188.7-±-80.0) mL,(505.2±133.7) mL and (316.5±87.7) mL,respectively.The maximum gastric volume after the meal was at (9.8±3.3) min after meal.In rapid LNLT,the threshold value of drinking volume,satiety drinking volume and maximum drinking volume of volunteers was (209-±-96),(501±148) and (674±199) mL,respectively,and that in slow LNLT was (107 ± 43),(340 ± 134) and (524 ± 213) mL,respectively,there was correlation between rapid and slow LNLT (r=0.768,0.825 and 0.856,all P＜0.01).The maximum drinking volume of rapid and slow LNLT was at (8.6± 1.2) and (34.9±6.4) minutes after meal.Threshold value of drinking volume in the slow drinking test was positively correlated with the gastric sensing threshold (r=0.714,P＜0.01).Satiety drinking volume in the slow drinking test was correlated with gastric sensing threshold,gastric discomfort and pain thresholds (r=0.599,0.650 and 0.622,all P＜0.01).The proximal gastric adapted diastolic volume was related with slow satiety drinking volume,rapid satiety drinking volume,slow maximum drinking volume and rapid drinking volume (r＝0.543,0.636,0.527 and 0.493,all P＜0.05).Conclusions Threshold value of drinking volume and satiety drinking volume in the slow LNLT is more suitable for evaluating the sensitivity of stomach.Satiety drinking volume in the rapid LNLT is more suitable for the evaluating of gastric adapted diastolic function.

Objective To evaluate the clinic application effects of laparoscopy in the diagnosis and treatment of abdominal difficult and complicated diseases.Methods The clinical data of 64 cases of agnogenic abdominal diseases underwent laparoscopic exploration and biopsies were retrospectively analyzed.All the patients were difficult cases to diagnose,who have one or more clinical situations,such as abdominal pain,ascites of unknown origin,abdominal mass and intestinal obstruction,and obscure hemorrhage of small intestine.Results Definite diagnosis was made in 62 patients after laparoscopy (96.9％).In patients with ascites,abdominal mass,intestinal obstruction and hemorrhage of small intestine,the definite diagnostic rate were 93.3％,100.0％,100.0％ and 6/6,respectively.The complication rate of laparoscopic exploration was 1.6％ (1/64).Underwent laparoscopic exploration,14 of 64 cases (22％) were treated by operation.Among them,8 cases (8/14) were treated by therapeutic laparoscopy,and other 6 cases (6/14) were treated by abdominal surgery without any comliactions.Conclusion Laparoscopic exploration is safe and effective in diagnosis and treatment of abdominal difficult and complicated diseases.

Objective:To evaluate visceral sensitivity,gut barrier function and autonomic nerve function (ANF) in patients with diarrhea-predominant irritable bowel syndrome (IBS-D),and to explore their roles in IBS-D pathophysiology.Methods:A total of 46 IBS-D patients (IBS-D group) were selected from the Department of Gastroenterology of China-Japan Friendship Hospital from October 2015 to March 2016,and 20 healthy volunteer were served as a control group (HC group).Clinical and psychological symptoms were evaluated by questionnaire,and visceral sensitivity to rectal balloon distention,gut barrier function and autonomic nerve function (ANF) were examined.The difference in the abovementioned indexes were compared between the 2 groups,and the correlations in the parameters were analyzed in the IBS-D group.Results:The scores of IBS symptom severity scale (IBS-SSS),Hamilton anxiety scale (HAMA),Hamilton depression scale (HAMD) and visceral sensitivity index (VSI) were significantly higher in the IBS-D group than those in the HC group (P＜0.01).In the visceral sensitivity test,maximum tolerable threshold in the IBS-D group was significantly decreased compared to that in the HC group (P＜0.01);there was no significant difference in first sensation threshold and defecating sensation threshold between the two groups (P＞0.05).As gut barrier function markers,the serum diamine oxidase (DAO) and d-lactate were significantly increased in the IBS-D group (P＜0.05).In ANF test,the total score and parasympathetic score as well as the proportion of abnormal scores in the IBS-D group were significantly higher than those in the HC group (P＜0.05).In IBS-D group,the HAMA,VSI and serum DAO were positively correlated with IBS-SSS (r=0.528,0.575,0.507;P＜0.01),while the 3 visceral sensitivity thresholds were negatively correlated with IBS-SSS (r=-0.636,-0.476,-0.697;P＜0.01);in addition to the IBS-SSS,the HAMA,HAMD,VSI and serum DAO were also significant negatively correlated with the visceral sensitivity thresholds (all P＜0.05);no significant correlations were found between the ANF and the other parameters.Conclusion:IBS-D patients show psychological symptoms,visceral hypersensitivity,impaired gut barrier function and abnormal ANF characterized by parasympathetic dysfunction;the former 3 factors are all associated with disease severity,and thus may play vital roles in IBS-D pathophysiology.

Objective To observe the effect of acute retrograde gastric electrical stimulation (RGES) on gastric accommodation,emptying and gastrointestinal hormones releasing in obese patients. Methods Sixteen obese patients were examined. On the first day,a pair of mucosal gastric electrodes was placed under endoscope. The liquid meal load test and the standard solid meal gastric emptying test were carried out on the second day. RGES was performed starting at 30 minutes before each test and through the whole testing process. The serum leptin,ghrelin,resistin and peptide YY were examined before and after the standard solid meal gastric emptying test. On the third day,sham stimulation was given. The effect of acute RGES on related index was compared by self-control.Results BMI of the 16 patients was (32. 90±2. 99) kg/m2. Acute RGES significantly reduced the liquid meal volume of fullness [(460±148) ml and (630±219) ml,t=-7. 200,P＜0. 01] and the maximal tolerable meal volume [(699±215) ml and (926±295) ml,t=- 5. 390,P＜0. 01]. The effects of RGES and sham RGES on half-emptying time of standard solid meal was (109±26) min and (103±31) min (t=1. 009,P= 0. 329);on the retention rate of standard solid meal at one hour and two hour was (63. 37±9. 75)% and (59. 73±12.87)% (t=1. 834,P= 0. 087),(42.22±13.97)%and (38. 33±16. 87)% (t= 1.780,P= 0. 095),respectively. The ratio of gastrointestinal hormones after and before the stimulation also of the sham stimulation,leptin was 1. 03±0. 34 and 1. 08±0. 38(t=-0.386,P=0. 705),ghrelin was 0. 99±0. 11 and 0. 98±0. 12 (t= 0. 413,P=0.685),resistin was 1. 11±0. 25 and 0. 99±0. 24 (t= 1. 753,P= 0. 100),and peptide YY was 1. 56±0. 71 and 1. 33±0. 61 (t=1. 402,P= 0. 181). Conclusions In obese patients,acute RGES significantly reduce the liquid meal volume by lower gastric accommodation,to certain extent which will delay gastric emptying. There is no significant influence on gastrointestinal hormones releasing.

Objective To investigate the effects of propofol on neuronal apoptosis in anterior horn of spinal cord in rabbits with spinal cord ischemia-reperfusion (IR) injury. Methods Sixty New Zealand white rabbits aged 4-6 months weighing 2.0-2.5 kg were randomized to receive normal saline (group C), 10% intralipid (group F) and propofol 30 mg/kg (group P1 ), 40 mg/kg (group P2), 50 mg/kg (group P3) and60 mg/kg (group P4 ). 10% intralipid was added to propofol solution to make the fluid infused equal in volume between the 6 groups ( n = 10 each). Spinal cord ischemia was induced by occlusion of abdominal aorta distal to the left renal arteries combined with simultaneous occlusion of bilateral common iliac arteries for 30 min. A catheter was inserted into abdominal aorta close to the site of occlusion via left femoral artery. Normal saline, 10% intralipid or different doses of propofol was infused through the catheter as soon as aorta was clamped at the rate of 12 ml·kg-1·h-1 for 30 min. The aorta and bilateral iliac arteries were then declamped. The L4-6 of spinal cord was removed at 48 h of reperfusion for microscopic examination and the total number of normal motor neurons in the anterior horn of spinal cord was counted. The total number of neurons and apoptosis neurons in the anterior horn of spinal cord was counted by TUNEL and the apoptosis index of neurons was calculated. The expression of caspase-3 in the anterior horn of spinal cord was determined by immunohistochemical technique. Results The number of normal motor neurons was significantly higher, and the apoptosis index and expression of caspase-3 were significantly lower in group P1-4 than in group C and F ( P < 0.05). Compared with group P1, the number of normal motor neurons was significantly increased and the apoptosis index was significantly decreased in group P2-4 and the expression of caspase-3 was down-regulated in group P3 and P4 ( P < 0.05). Compared with group P2, the number of normal motor neurons was significantly increased in group P3 while decreased in group P4, and the apoptosis index was significantly decreased and the expression of caspase-3 was down-regulated in group P3 and P4 ( P < 0.05). Compared with group P3, the number of normal motor neurons was significantly decreased and the apoptosis index was significantly increased and the expression of easpnse-3 was up-regulated in group P4 ( P < 0.05) . Conclusion Propofol 30-60 mg/kg infused through aorta during occlusion can inhibit the neuronal apoptosis and attenuate IR injury to spinal cord dose-dependently in rabbits. The underlying mechanism may be related to the down-regulation of caspase-3 expression.

Objective To observe the clinical effect of Qushi Hua yu Tongluo Formu la (Prescriptions for dissolving damp, removing stasis, and eliminating obstruct ion of meridians) on hyperuricemia complicated with diabetes. Methods Totally 60 patients were randomized into a treatment group and a control gr oup with 30 in each. The control group was administered Gliquidone 30mg, three t imes a day, while the treatment group was added Qushi Huayu Tongluo F ormula, one dosage per day. Both groups were treated for 90 days. The clinical e ffect and the changes in serum uric acid, renal functions, blood lipid, and gly cosylated hemoglobin of both groups were observed. Results The total effective rate of the treatment groups and control groups was 93.34% and 23.33% respectiv ely, the difference was significant (P

OBJECTIVE: To investigate the clinical features and therapeutic effects of sudden deafness after radiotherapy combined with chemotherapy in nasopharyngeal carcinoma patients. METHOD: Clinical data of 42 nasopharyngeal carcinoma patients suffered from sudden deafness after radiotherapy combined with chemotherapy were analyzed retrospectively. Among the 42 patients, 2 showed moderate deafness, 4 presented excessive deafness, 30 suffered from severe deafness, and 6 exhibited profound deafness. The audiogram pattern of 33 patients met with the type of high tone frequencies hearing loss, and that of the rest 9 cases showed hearing loss at all frequencies. All patients received medical therapy combined with hyperbaric oxygen therapy. RESULT: Of all the cases with hearing loss, 2 were cured, 2 showed excellent recovery, 9 came out partial recovery, and 29 showed no response to the treatment. The total effective rate was 30.95%. For the accompanied symptoms, none of the 30 cases of tinnitus were relieved, 3 out of 10 cases of aural fullness were cured, and the 5 cases of dizziness or vertigo were all improved. CONCLUSION The sudden deafness after radiotherapy combined with chemotherapy in patients with nasopharyngeal carcinoma is closely related to radiotherapy. The hearing loss is serious, and the therapeutic effects are not satisfactory.
Antineoplastic Agents ; adverse effects ; Carcinoma ; Dizziness ; etiology ; therapy ; Hearing Loss, High-Frequency ; etiology ; therapy ; Hearing Loss, Sudden ; etiology ; therapy ; Hearing Tests ; Humans ; Hyperbaric Oxygenation ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; drug therapy ; radiotherapy ; Radiotherapy ; adverse effects ; Retrospective Studies ; Tinnitus ; etiology ; therapy ; Vertigo ; etiology ; therapy

Objective To evaluate the relationship between dynamic index of proximal stomach and symptoms of functional dyspepsia (FD).Methods The dynamic indexes of proximal stomach, such as compliance, initial volume and pressure, maximal tolerable volume and pressure were measured in 22(14) functional dyspeptics and 8 healthy volunteers.Results In comparison of FD group with control group the compliance and maximal tolerance volumes were (49 9?13 8) (66 7?7 7) and (646 60?145 10) ml(768 75?47 04) ml respectively, with significant differences. ( P