Objective To observe the therapeutic effect of modified Danshen Yin on primary achalasia. Methods The 42 achalasia patients were randomized into two groups. The treatment group, 24 cases, was treated by modified Danshen Yin and the control group, 18 cases, by Nifedipine, for one week. The symptom scores of dysphagia, retrosternal pain and food regurgitation and the improvement of X-ray image were taken to evaluate the therapeutic effect. Results After treatment, both groups had improvement in the symptom scores, but the improvement of treatment group in dysphagia and food regurgitation was more significant. There was a significant difference of both groups in retrosternal pain before and after treatment (P

Objective To explore the application value of gastrointestinal reconstruction by continuous jejunum interposition after total gastrectomy.Methods A retrospective analysis in March 2006 to March 2012 was performed in 60 patients with gastric underwent continuous jejunal interposition after total gastrectomy.Results There were no operation death and anastomotic fistula.Follow-up for 12-24 months,some patients had mild reflux esophagitis,generation of gastric capacity of more than 300 ml,emptying time of 30-100 min.The quality of life was improved after operation.Conclusions Continuous jejunal interposition pouch is safe and reliable,with satisfactory effect of digestive tract reconstruction.

Objective To observe the regulation of ?-7 neuronal nicotinic acetylcholine receptors(?-7-nAChRs) by nicotine in the ventral tegmental area(VTA),the substantia nigra(SN) and the cortex of the rat. Methods Nicotine exposed animal models were established.The changes of ?-7-nAChRs proteins and mRNA were observed by immunohistochemistry and in situ hybridization in VTA,SN and cortex,and the expression of ?-7-nAChRs proteins by Western blotting in PC12 cells. Results The expression of ?-7-nAChRs proteins in cortex and mRNA in VTA and SN were upregulated by nicotine.The expressions of ?-7-nAChRs in PC12 cells were in proportion to and dependent on the time for nicotine to function and the dose.Conclusion Both ?-7-nAChRs mRNA in VTA and SN in transcriptional mechanism and ?-7-nAChRs protein in the cortex at the translation level were upregulated.

OBJECTIVE: To reduce medication errors by using bar code technology.METHODS: By searching the relevant literature about the bar code technology in preventing medication errors,this article systematically introduced the concepts of bar code technology,the FDA's bar code rules and the effect of it in reducing medication errors,as well as the current use of it by providing the relative data,examples and cases.RESULTS & CONCLUSIONS: Bar code technology can effectively reduce the incidence of medication errors.

地震造成大规模人群的复杂创伤,病情进一步发展,常导致多脏器功能障碍(MODS)。本文总结了地震伤后MODS的发病机制、预防、早期诊断以及治疗措施。

Objective The prestin,a motor protein responsible for outer hair cell(OHC)electromotility,is expressed on the OHC surface.Previous experiments revealed that OHC electromotility and its associated nonlinear capacitance was mainly located at the OHC lateral wall and was absent at the apical cuticular plate and the basal nucleus pole.Immunofluorescent staining for prestin failed to demonstrate the prestin expression at the OHC basal ends in whole-mount preparation of the organ of Corti.The aim of this study is to investigate the distribution of prestin at OHC.Methods In this experiment,the localization of prestin protein in single dissociated OHCs from cochlea of normal mouse,rat and guinea pig,were examined by immunofluorescent staining and confocal microscopy.Results We found that prestin was uniformly expressed on the OHC basolateral surface,including its basal pole.No staining was observed on the cuticular plate and stereocilia.The OHC lateral wall had a trilaminate organization and was composed of the plasma membrane,cortical lattice,and subsurface cisternae.By with co-staining with a membrane marker di-8-ANEPPS,prestin-labeling was found locating at the outer layer of the OHC lateral wall.Further separating the plasma membrane from the underlying subsurface cisternae,using a hypotonic extracellular solution,prestin-labeling was shown locating at the plasma membrane instead of the subsurface cisternae.Conclusion The data revealed that prestin is expressed in the plasma membrane on the whole OHC basolateral surface.

Objective To investigate the expression of serum microRNA-210 (miR-210) in patients with acute cerebral infarction(ACI),and to evaluate its clinical significance. Methods A retrospective study was conducted. Eighty patients with ACI admitted to Tianjin Hospital from January 2011 to March 2014 within 48 hours of onset were enrolled,and 30 healthy volunteers served as controls. The peripheral blood was collected,and the expression of serum miR-210 was determined by reverse transcription-polymerase chain reaction(RT-PCR). The receiver operating characteristic curve(ROC)was drawn to analyze the role of miR-210 in the diagnosis of ACI. According to the pathological and physiological characteristics of patients receiving treatment,the relationship between miR-210 and clinical physiology index was analyzed. Results The expression of miR-210 in serum of patients with ACI was significantly lower than that of the healthy control group(2-ΔΔCt:1.349±0.043 vs. 1.923±0.107,t=6.567, P<0.000). ROC analysis results showed that the sensitivity of miR-210 in the diagnosis of ACI was 90.4%,the specificity was 76.2%,and the area under the ROC(AUC)was 0.804〔95%confidence interval(95%CI)=0.700-0.908〕. No difference in expression of miR-210(2-ΔΔCt)in serum was found in patients of different gender,age, and infarction area(male and female:1.33±0.13 and 1.31±0.06,t=3.562,P=0.473;≤60 years and>60 years:1.32±0.12 and 1.31±0.09,t=2.351,P=0.264;large infarction,small infarction,lacunar infarction:respectively 1.31±0.02, 1.33±0.11, 1.31±0.06, F=1.236, P=0.087), or with the severity of cerebral infarction,and there was a tendency in lowering of expression of miR-210(2-ΔΔCt,light,medium,severe:1.53±0.11, 1.33±0.11,1.08±0.04,F=5.394,P=0.014).Conclusion The serum level of miR-210 in ACI was significantly lower than that in normal healthy persons,and it may be an important new serological marker in screening and diagnosis of ACI.

Objective To research the electrocardiogram (ECG) manifestations of common electrolyte disturbance and to discuss the accuracy of ECG diagnosis. Methods One hundred and sixty-nine hospitalized patients with hyperkalemia and 170 patients with hypokalemia were selected and the results of ECG were analyzed. Results In mild hyperkalemia patients (serum potassium concentration 5.5- 6.5 mmol/L), the ECG abnormal rate was 91.4% (64/70). In mild hypokalemia patients (serum potassium concentration 3.0-3.5 mmol/L), the ECG abnormal rate was 56.9% (41/72). There was significant difference (P < 0.05). The greater the deviation of serum potassium concentration, the more obvious the characteristic changes of ECG. Conclusions In addition to the blood biochemical test, ECG is also a kind of check tool that can help to diagnose abnormal blood potassium.

Objective To investigate the safety and feasibility of femoral vein thrombectomy for patients with acute deep vein thrombosis in the lower limbs.Methods During June 2003 to August 2006,a succession of 43 patients with acute deep vein thrombosis in the lower extremities received femoral vein thrombectomy in our hospital.An inferior vena cava filter was employed before the operation.Anticoagulation and regional thrombolysis were taken postoperatively.Analyse the data of operation procedure,curative effect and complications.Results The operation time ranged from 55 to 115 minutes with a mean of 92.6 minutes.Four of the patients received blood transfusion during the operation.The mean blood loss was 384.6 ml (100 to 1000 ml).Five patients showed transient fluctuation of blood pressure during the surgery.None of the patients had pulmonary embolism during and after the operation. Five patients developed lymph leakage from the incision at the inguinal area,and was cured in 1 week.One aged patient suffered from postoperative postatic pneumonia and was cured before being discharged;no other complications were found in this series.The thrombectomy achieved good outcomes in our patients.The edema and pain in the lower limbs were relieved quickly after the operation, the difference between the circumferences of the two legs decreaed from a median of 5.5 cm (thigh) and 4.0 cm (crus) to 1.5 cm and 1.0 cm (Z=-5.345,P=0.000 and Z=-5.461,P=0.000),respectively,32 of the patients received re-examination 6 months postoperation,none of them showed recurrent thrombosis.Conclusions Femoral vein thrombectomy is feasible and safe for serious acute deep vein thrombosis in the iliac and femoral veins.Patients can recover quickly after the operation.

Objective To evaluate the feasibility and efficacy of laparoscopic tubal anastomosis after tubal sterilization.Methods A total of 27 cases of fallopian tube anastomosis with tubal anastomosis were performed under laparoscopy.After removing the sterilized scar in the tubes the hydrotubation was carried out using Methylene Blue to detect whether the tube was patent.By using 6/0 absorbable thread,we sutured the mesosalpinx with 2 or 3 stitches to close the both ends of the fallopian tube.And then,isthmus-isthmus(1 whole-layer stitch at the 12 o'clock,and then 1-stitch sutures at the serous layer of the 8 and 4 o'clock respectively)ampulla-ampulla(1 whole-layer stitch at the 12 o'clock,and then 1-stitch sutures at the whole layers of the 9,7,5,and 3 o'clock respectively),or isthmus-ampulla(same method as the ampulla-ampulla anastomosis but more closed sutures)was performed.The patients received hydrotubation at the first day after the operation and then 3 to 5 days after the first menstruation.They were followed up for every 6 months till pregnancy.Results In the 27 patients(54 tubes),the rate of patency was 88.9%(48/54).The patent rate in the patients received isthmus-isthmus or ampulla-ampulla anastomosis was 86.5%(32/37)and 100%(15/15)respectively.In the 2 cases of isthmus-ampulla anastomosis,one was patent after the operation,and in the other,the Methylene Blue test showed anastomotic leakage.The hydrotubation performed at the first day after the treatment showed a rate of patent in 25 cases(2.6%,25/27),only two patient showed obstruction of the tube(7.4%,2/27).Follow-up was available in 26 of the patients up to over 6 months,19 of them had intrauterine pregnancy(73.1%,19/26)in 24 months after the procedure,among which 89.5%(17/19)occurred in 12 months;one(3.8%,1/26)patient developed ectopic pregnancy.Conclusions Laparoscopic tubal anastomosis is safe and effective for patients who desire reversal after sterilization.