Objectives To investigate the pathophysiologic mechanisms and the clinical character- istics and variations of nutcracker esophagus(NE).Methods Clinical data obtained from 22 patients with NE were retrospectively analyzed.Seven followed-up patients had esophageal motility,multi-channel electrogastrography(MEGG),the autonomic nervous system(ANS) and psychology tests and were com- pared to 10 healthy subjects(HS).Results①In NE group,12 patients had reflux symptom(55%),7 patients had chest pain(32%)and 3 patients had dysphagia(13%).There was no statistical difference in mean contraction amplitude(MCA) between patients with reflux symptom and chest pain.②Eight out of the 13 patients with NE who received 24 h pH monitoring were positive reflux,and 4 out of 17 patients had reflux esophagitis in endoscopic examinations.The symptoms were improved in 58%patients(7/12) by regular acid-suppression therapies.③There was no statistical difference beween NE and HS groups in dominant frequency and power of MEGG.However,the percentages of normal rhythm in preprandial and slow wave coupling in pre and postprandial of NE patients were significantly decreased than those in HS.④The ANS function in NE group had no statistical difference compared to those in HS.⑤In follow- up group,no difference was found before and after nitroglycerin sublingually.Four patients had depres- sion.Conclusions The clinical presentations of NE are vary.The symptoms of NE were poorly correla- ted with MCA,but partially correlated with GER,which may represent a special subtype of GERD. Gastric dysmotility and psychological factors might contribute to the pathogenesis of NE.

Aged ; Humans ; Male ; Neoplasms, Muscle Tissue ; Skull Neoplasms ; Temporal Bone ; pathology

Animals ; Brain Injuries ; blood ; cerebrospinal fluid ; chemically induced ; Endotoxins ; toxicity ; Female ; Male ; Natriuretic Peptide, C-Type ; analysis ; Neurotensin ; analysis ; Rabbits

Objective To investigate the application value of interleukin-27 (IL-27) in the patients with acute coronary syndrome (ACS).Methods A total of 208 ACS patients were enrolled in the study,including 76 acute myocardial infarction (AMI) patients with ST elevation (STEMI),58 AMI patients with non-ST elevation (NSTEMI) and 74 unstable angina pectoris (UAP) patients.These patients were divided into single-vessel lesions,double-vessel lesions and three-vessel lesions groups,and 62 patients with chest pain syndrome (CPS) were selected as a control group.The plasma IL-27 levels of all patients were determined by enzyme linked immunosorbent assay (ELISA) and analyzed.Results The levels of plasma IL-27 (median[P25,P75]) in STEMI (308.64 [245.17,359.26] pg/mL),NSTEMI (256.88 [181.52,332.51] pg/mL) and UAP (218.12 [165.33,312.46] pg/mL) patients were significantly higher than that in CPS patients (100.66[68.98,228.86] pg/mL,P ＜ 0.01).The levels of plasma IL-27 in STEMI patients were significantly higher than that in NSTEMI and UAP patients (P ＜ 0.05).The positive rate of IL-27 in ACS patients with negative TnI was 54.24％ (32/59).The sensitivity and specificity of IL-27 in predicting ACS from chest pain patients were 80.29％and 58.06％,respectively.The levels of plasma IL-27 in the patients with three-vessel lesions were significantly higher than that with single-vessel lesions (P ＜ 0.05).Conclusion Plasma IL-27 levels in ACS patients increase obviously,which may be involved in the pathogenesis of ACS.IL-27 may be helpful for the diagnosis of ACS patients with negative TnI and the prediction of ACS state.

As an important immune organ,spleen also plays a crucial role in stabilizing hematologic system.Previous reports support that splenectomy must be performed after the ligation of spleen vessels.At recent time,with the deep knowledge of the anatomy and function of spleen,the surgeons have tried to preserve this organ after the ligation of the vessels.From March 2012 to April 2016,five patients in our hospital have undergone the distal pancreatectomy with spleen preservation after the ligation of splenic vessels,and all the patients' outcomes were satisfactory in the follow-up.This essay aims to discuss the safety and feasibility of preserving spleen after the ligation of the vessels by reporting our own experience and reviewing related literatures on this topic.

Objective To investigate the accuracy and availability of three‐dimensional ultrasonography ( 3DUS ) in the Bismuth‐Corlette classification of hilar cholangiocarcinoma ( HCCA ) . Methods Forty‐eight patients who underwent surgery and obtained pathologic diagnosis of HCCA were retrospectively analyzed . All patients underwent 3DUS and magnetic resonance cholangiopancreatography (MRCP) before surgery . With surgical outcomes as the gold standard ,the diagnostic efficacy of two examinations in classification of HCCA were compared . Results Forty‐eight cases of HCCA were divided into 5 types according to surgical results ,including type Ⅰ (8 cases) ,type Ⅱ(13 cases) ,Ⅲa(8 cases) ,Ⅲb (11 cases) and type Ⅳ(8 cases) respectively . Among them ,39 cases accepted radical resection and the rest of 9 cases received palliative resection . The accuracy of the Bismuth classification confirmed by 3DUS was 85 .4% (41/48) . The percentage of underestimated and overestimated classification confirmed by 3DUS were 10 .4% (5/48) and 4 .2% (2/48) respectively . The accuracy of the classification confirmed by MRCP was 87 .4% (42/48) .Both of the percentage of underestimated and overestimated classification confirmed by MRCP were samely 6 .3% (3/48) .The difference between the 3DUS and MRCP was not statistically significant(χ2 =0 .597 ,P=0 .440) . Both the percentage of underestimated and overestimated classification between 3DUS and MRCP were samely not statistically significant ( P =0 .714 , P =1 .000 ,respectively) . Conclusions As a new diagnostic technique ,3DUS was feasible and had significant value in evaluating HCCA classification comparable to MRCP .

Objective To investigate the intermediary and regulating effect of self?esteem on per?ceived stress and training burnout among accelerated plateau soldiers. Methods A total of 700 accelerated plateau soldiers were investigated which were chosen by a random cluster sampling method,and assessed by the Perceived Stress Scale, Self?esteem Scale and Self?compiled Soldiers' Training Burnout Questionnaire. Results ( 1) The total score of training burnout,the score of physical and mental exhaustion and the score of training alienated among soldiers who had a history of training injury (27.85±5.80,14.89±3.46 and 6.89± 2.26,respectively) were significantly higher than those of soldiers who didn't have a history of training injury (25.05±5.12,12.68±3.25 and 6.16±2.78,respectively),and the differences were significant ( t= 4.321, 5.764,2.825,all P<0.01). The total score of training burnout,the score of physical and mental exhaustion and the score of training alienated among soldiers who had a high training expectation were higher than those of soldiers who didn't have a high training expectation,and the differences were significant (P<0.01). (2) Among accelerated plateau soldiers,training burnout showed significantly positive correlation with perceived stress ( r=0.323, P<0.01),and significantly negative correlation with self?esteem ( r=-0.409, P<0.01). (3) The intermediary role of self?esteem between perceived stress and training burnout was remarkable (P<0.01) ,which accounted for 33.8% of the total effect,and self?esteem also had a regulating effect (P<0.05) . Conclusion Radical plateau soldiers have remarkable differences due to the history of training injury or training expectations,and self?esteem has partial intermediary and regulating effect between perceived stress and training burnout.

Objective To investigate the function of transferrin-DNA complex,transported by transferrin(Tf)and trans-arterial injection via interventional approach be the duel-target-orientated delivery and the transferring into malignant cells to get more effective therapy.Methods p53-LipofectAMINE ligand with different concentrations of Tf(0,10,25,50,100?g)transfected the 4 strains including LM6、Hep3B、YY and L02 in vitro to evaluate the gene transfeetion efficiency through western blot.Then,after setting up the VX2 hepatocarcinoma models,we delivered the Tf-p53-LipofeetAMINE complex into the hepatic arteries via interventional techniques to analyse the transfection efficiency in vivo.Results Tf,within the range of 10 100?g,could increase gene transfection efficiency mediated by liposome,and the efficiency increases with the raise of Tf concentration.Combination with interventional technique to inject Tf-DNA complex into tumor arteries,gene transfeetion efficiency was enhanced in rabbit models.Conclusion Tf can enhance gene- liposome transfection efficiency,furthermore with combination of interventional catheter technique,there would be a potential duel-target-orientated gene therapy method.(J Intervent Radiol,2007,16:99-103)

Objective Using polysulfon fibers, a new bioartificial liver was developed. This study was to evaluate the efficacy of this bioartificial liver in the support of a disfunctioned liver. Methods Hepatocytes were procured from swine using Seglen′s methods. The bioartificial liver was constructed based on polysulfon bioreactor with a procurement of 10 10 hepatocytes, and was applied in 12 acute liver failure patients for 14 sessions. Each BAL treatment lasted 6 hours. The general conditions of the patients and the biochemical parameters were evaluated. Results After treatment with bioartificial liver, ammonia, prothrombin time and total bilirubin level significantly decreased (all P

Objective: To explore the association of hypertriglyceridemic waist phenotype ( HTGW ) with impaired fasting glucose ( IFG ) and diabetes, so as to provide reference for the early prevention and control of diabetes. Methods: The survey was conducted among 35 to 75-year-old residents in 8 project sites in Jiangsu Province from 2015 to 2019. The information about demography and lifestyle was collected by the general information questionnaire and the primary screening questionnaire from the National Center for Cardiovascular Diseases; waist circumference, height, weight, triglyceride, high-density lipoprotein cholesterol, total cholesterol and fasting plasma glucose were measured. The multinomial logistic regression model was employed to analyze the association of HTGW with IFG and diabetes. Results: A total of 118 383 subjects were included, among whom 21 851 cases of HTGW, 27 245 cases of IFG and 22 899 cases of diabetes were identified, with the prevalence of 18.46%, 23.01% and 19.34%. The multinomial logistic regression analysis showed HTGW was statistically associated with IFG ( OR=1.414, 95%CI: 1.343-1.489 ) and diabetes ( OR=2.216, 95%CI: 2.098-2.341 ). Conclusion HTGW is associated with IFG and diabetes, which make it possible to be an indicator for screening and assessment of glucose abnormality in middle-aged and elderly population.