Objective To investigate the mechanism of anireflux procedures in treating sliding hiatal hernia and the effectiveness of the method of cardia position by clock to evaluate the outcome of antireflux procedures. Methods From 1992 to 2008, 136 patients with sliding hiatal hernia underwent transabdominal antireflux surgery: 27 patients received Nissen procedure and 109 recieved floppy Nissen operation. Results There is no postoperative death. Within one month after operation, in the Nissen group, 2 patients developed severe dysphagia and 1 had regurgitation; in the floppy Nissen group, 9 patients had regurgitation, and 3 had dysphagia. During the over-2-year follow-up period, 2 patients developed severe dysphagia,1 had nausea and 2 had significant reflux in the Nissen group. While 3 patients recturred, 2 had dysphagia and 7 had significant reflux in the floppy Nissen group. The effective rates of the Nissen group and the floppy Nissen group were 81.5% and 88.1%, respectively. There was no significant difference in postoperative tests between two groups ( P ＞ 0.05 ). Tests of cardia position by o'clock showed that cardia positions of 80. 1% patients before surgery were located at sites between 10 and 11 o'clock and those of 91.7% after surgery being at 9 o' clock or less. Conclusions The Niseen and the floppy Nissen fundoplication can reach good long-term results in treatment of sliding hiatus hernia. Mechanism of these antireflux procedures include, by fundoplication, increasing esophageal sphincter pressure, prolonging the sphincter length, deepening His angle and prolonging abdominal esophagus, etc. Among them, the last one, descending the cardia position to 9 o'clock or less is vital to antireflux.The test of cardia position by o'clock is practically important to reach the successful result.

AIM: To investigate the possible impact of conductive keratoplasty(CK)on intraocular pressure( IOP ).METHODS: 36 eyes of 20 patients with hyperopia underwent IOP measurement with non-contact tonometer (NCT), Goldmann applanation tonometer (GAT) and Schiotz tonometer before and after CK.RESULTS: After CK, a significant decrease was observed by NCT, GAT and Schiotz measurements. The change in IOP readings was not correlated with age, sex,keratometric readings, or attempted correction.CONCLUSION: The applanation tonometer atend to underestimate the true IOP after CK.

Histone deacetylase 3 (HDAC3) is an epigenetic modification enzyme that plays a crucial role in the development and progression of diabetes and its complications. Studies have reported that increased HDAC3 activity is associated with pancreatic β-cell dysfunction in type 1 diabetes, while in type 2 diabetes, HDAC3 affects insulin resistance and signaling by regulating the metabolism of the liver, adipose tissue, and muscle. Additionally, HDAC3 plays a key role in diabetic complications such as cardiomyopathy, retinopathy, and nephropathy. Selective inhibition of HDAC3 has the potential to improve insulin sensitivity, reduce chronic inflammation, and enhance pancreatic cell function, offering a promising new therapeutic strategy for diabetes and its complications.

Objective To observe and analyze the reasons of intra-abdominal hypertension,and to discuss the influence of intra-abdominal hypertension (IAH) on recipients' respiratory function and its changes after disposition.Method During January to June in 2012,50 patients who had performed orthotopic liver transplantation were involved in this study.Intra-abdominal pressure was measured by AbViser Intra-Abdominal Pressure Monitoring Kit.According to the value of intra-abdominal pressure,the patients were divided into two groups (IAH group and control group).The reasons of IAH were observed and analyzed.Respiratory rate,oxygenation index,and the arterial partial pressure of carbon dioxide between IAH and control groups were compared.IAH was dealt with restricting oral input,inserting nasogastric tube,administering enema,inserting ilues tube or placing percutaneous catheter drainage according to reasons.Intra-abdominal pressure,respiratory rate,oxygenation index,and arterial partial pressure of carbon dioxide were also observed after disposition.Result The incidence of IAH was 44％ (22/50).The respiratory rate of patients in IAH group was quicker than that in control group.The oxygenation index in IAH group was lower than that in control group.The arterial partial pressure of carbon dioxide in IAH grade I group was not higher than in control group.However,the arterial partial pressure of carbon dioxide in IAH grade Ⅱ and Ⅲ groups was higher than in control group.After disposition,the intra-abdominal pressure,respiratory rate and arterial partial pressure of carbon dioxide in IAH groups were decreased from 16.4 ± 3.1 mmHg,33.0 ± 5.2 L/min and 47.6 ± 9.4 mmHg to 10.5 ± 1.8 mrnHg,19.7 ± 4.1 L/min and 39.9 ± 2.9 mmHg respectively,while the oxygenation index was increased from 202.7 ± 72.9 mmHg to 350.5 ± 98.5 mmHg.Conclusion The incidence of IAH after orthotopic liver transplantation was high.The influence of IAH on patients' respiratory function was serious.After timely and proper disposition,the respiratory function of patients with IAH could be improved.

Objective To observe the clinical efficacy of electroacupuncture in treating herpes zoster.Method Ninety patients with herpes zoster were randomized into treatment group 1, treatment group 2, and a control group, 30 cases in each group. Treatment group 1 was intervened by surround needling at Ashi points (deep needling, by 33 mm) plus electroacupuncture; treatment group 2 was by surround needling at Ashi points (superficial needling by 16 mm) plus electroacupuncture; the control group was by oral administration of Valacyclovir Hydrochloride tablets plus Vitamin B1. After 10-day treatment, the blister-breaking time, crust-forming time, and the time of falling-off of the crust, and Visual Analogue Scale (VAS) were observed, and the clinical efficacies were compared.Result The recovery rate and total effective rate were respectively 73.3% and 93.3% in treatment group 1, versus 46.7% and 86.7% in treatment group 2, and 33.3% and 63.3% in the control group. The recovery rate of treatment group 1 was significantly different from that of treatment group 2 and the control group (P<0.01,P<0.05). The total effective rates of treatment group 1 and 2 were both significantly different from that of the control group (P<0.01,P<0.05). The blister-breaking time, crust-forming time, and crust falling-off time of treatment group 1 were significantly different from that of treatment group 2 and the control group (P<0.01,P<0.05). The crust-forming time and falling-off time of treatment group 2 were significantly different from that of the control group (P<0.05). The VAS scores were markedly changed after the intervention in the three groups (P<0.01). After the treatment, the VAS scores of treatment group 1 and 2 were significantly different from that of the control group (P<0.01). The VAS score of treatment group 1 was markedly different from that of treatment group 2 after the treatment (P<0.05).Conclusion Electroacupuncture is an effective method in treating herpes zoster, while deep surround needling at Ashi points plus electroacupuncture can effectively inhibit the development of blisters, promote crust-forming, release the neural pain, and reduce the incidence of postherpetic neuralgia.

Objective To study the mechanism of arecoline on damage to DNA through the bone marrow cell experiment in vivo. Methods Laser Confocal Microscope was adopted to measure DNA and RNA of the bone marrow cells marked by AO probe. Influences of arecoline on cell cycle were observed by the Flow Cytometer. Results Injection of arecoline to 20, 10, and 5 mg/kg posologic group, the fluorescence pixel ratio apparently higher than that in blank control group of the bone marrow cell inside RNA/DAN, the difference was significant (P

Education to medical postgraduates is relatively special. Their study and research work have something to do with their clinical practice. Based on their technical training for thoracic surgery,postgraduates were demanded to follow up and instruct their patients on postoperative recovery from surgery. In this way,these postgraduates were trained not only in clinical practice but also in other aspects,such as communication techniques,how to take care of patients,professional moral education. Instruction to outpatients is helpful to cultivate post-graduates and promote their abilities in self-thinking,self-acknowledging,initiative,creation,and so on. Instruction to outpatients is an important way to bring up excellent medical postgraduates.

Adolescent ; Adult ; CD36 Antigens ; blood ; Diagnosis, Differential ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Platelet Activation ; Psoriasis ; blood ; diagnosis ; Thrombin ; metabolism ; Thrombospondins ; blood

[Objective]To analyze the biodegradation properties and active osteogenesis features of implanted composites of gelatin microspheres(GMs) impregnated with calcium phosphate cement(CPC) and recombinant human bone morphogenetic protein-2(rhBMP-2) in bone defect.[Method]rhBMP-2 loaded gelatin microspheres was incorporated in rhBMP-2/CPC during setting.Thirty rabbits were divided into groups A,B and C(10 each).The rhBMP-2/GMs /CPC,GMs/cpc and rhBMP-2/cpc was implanted into the rabbits of group A,B and C,respectively.The biodegradation properties and active osteogenesis features of implanted composites bone substitute was evaluated by radiography,histology,bone mineral density(BMD)after the composites were implanted into the bone defects at rabbit radius for 6,12 weeks respectively.[Result]Significant implant resorption and bone ingrowth were observed in all rhBMP-2/GM/CPC treated defects while the defects treated with rhBMP-2/CPC implants showed slight resorption of CPC and the defects treated with GM/CPC implants showed slight formation of new bone.[Conclusion]The result of this study suggested that the rhBMP-2/GMs/CPC composite could be used as material for bone graft substitute.

Objective To investigate the effect of ischemic preconditioning (IPC) on coronary microcirculation function in short-term hibernating myocardium(SHM) animal model.Methods Twelve little domestic Chinese pigs were established as the model of SHM by interventional method (closed-chest) and divided into 2 groups at random: the control group (CON group, n =6) and ischemic preconditioning group (IPC group, n =6).IPC was elicited by 2 cycle of 5 min of ischemia followed by 5 min of reperfusion before the establishment of model.Intracoronary Doppler guidewire was used to measure average peak velocity (APV),diastolic systolic velocity ratio(DSVR) and coronary flow reserve(CFR) of the distal to the stenosis at the baseline and 10 min,30 min,60 min,120 min after the establishment of model.Results APV,DSVR and CFR all decreased significantly in SHM model in both groups( P 0.05 ),at 60 min CFR of the CON group decreased significantly than before( 0.96 ? 0.27 vs 1.74 ? 0.49 , P 0.05 ).Conclusions The coronary microcirculation dysfunction happened at the time point of 60 min after coronary stenosis in SHM model,IPC can protect the coronary microcirculation function in SHM model.