Objective To evaluate the clinical efficacy of endoscopic esophageal variceal ligation (EVL) for esophageal variceal bleeding (EVB) in elderly patients with hepatic cirrhosis.Methods From July 2007 to July 2013,clinical data of 198 patients who had been diagnosed with liver cirrhosis presenting with EVB were retrospectively analyzed.Among them,167 patients who had received EVL were divided into the elderly EVL group (n=97,age≥60 years) and the non-elderly EVL group (n=70,aged ＜ 60 years).The other 31 cases (aged ≥ 60 years) had received propranolol therapy.Treatment effectiveness,adverse effects,complications and the one-year survival rate of each group were analyzed.Results The efficacy rates and variceal recurrences were 77.3％ (75/97) and 78.6％ (55/70) in the elderly EVL group and 19.6％ (19/97) and 18.6％ (13/70) in the non-elderly EVL group,respectively,with no significant difference between the two groups (each P＞0.05).The re-bleeding rate was higher in the propranolol treatment group than in the elderly and non-elderly EVL groups [58.1％ (18/31) vs.24.7％ (24/97) vs,22.9％ (16/70),x2 =14.76,P =0.00].One-year survival rates in the elderly group,the non-elderly EVL group and the propranolol treatment group were 86.6 (84/97),88.6％ (62/70),64.5％ (20/31),respectively,with statistically significant differences between the three groups (x2 =10.24,P=0.01).Conclusions EVL is effective for the treatment of hepatic cirrhosis with EVB and can be used as a secondary prophylaxis measure for EVB in elderly patients with hepatic cirrhosis.

Objective To investigate the protective effect of adenovirus mediated heat shock protein 70 (HSP70) on lungs in neonatal rats with hypoxic pulmonary hypertension (HPH).Methods One hundred and twenty-eight 7-10 d healthy Wistar neonatal rats were randomly divided into HPH model group and control group.HPH group was divided into saline group,empty virus group,and HSP70 group according to the transfection solution.HPH model was established in the hypoxia cabin of 80 mL/L nitrogen oxygen mixed gas after transfection.The mean pulmonary artery pressure(mPAP) was measured after 3,7,10 and 14 days of hypoxia in each group.The mRNA and protein expression of HSP70,hypoxia inducible factor-1 alpha(HIF-1 α),endothelin-1 (ET-1) and inducible nitric oxide synthase(iNOS) in the lung tissues of neonatal rats were detected by using reverse transcription-PCR and Western blot respectively.Results (1) The mPAP level was significantly higher in saline group (M,Q:12.00,2.50;15.00,2.00;18.00,1.75;20.00,2.25) than that in control group (M,Q:9.50,4.75;10.50,1.00;13.00,1.00;15.50,3.25),and the differences were significant (z =-3.28,-3.40,-3.34,-3.06,all P ＜ 0.01);and the differences were also significant between empty virus group (M,Q:13.50,2.00;15.50,1.75;18.00,1.00;22.00,4.25) and control group (z =-2.83,-3.42,-3.40,-2.97,all P ＜ 0.01) in 3,7,10,and 14 days;but there was no significant difference between HSP70 group (M,Q:8.50,4.00;10.50,1.00;13.00,1.00)and the control group in 3,7,and 10 days (z =-0.43-0.00,-3.06,all P ＞ 0.05).(2) The expressions of HSP70 mRNA among the groups were statistically significant(F =6.321,9.669,6.333,all P ＜ 0.01),and the expressions of HSP70 protein also had significant difference(F =16.463,3.637,17.749,all P ＜ 0.01).(3)The level of HIF-1α mRNA in saline group was significantly higher than that of the control group,and the differences were statistically significant (q =4.312,9.106,6.151,all P ＜ 0.01);and the level of HIF-1α mRNA in empty virus group was also significantly higher than that in the control group,and the differences were statistically significant (q =3.982,9.235,5.352,all P ＜ 0.01) in 3,7,and 10 days;hypoxia in HSP70 group was lower than that of the empty virus group in 3,7 days,and the differences were statistically significant (q =6.083,11.031,all P ＜ 0.05).The level of ET-1 mRNA in saline group was significantly higher than that in the control group(q =5.112,10.086,6.264,all P ＜ 0.01),in empty virus group was significantly higher than that in the control group,and the differences were statistically significant (q =4.182,12.238,5.864,all P＜0.01) in 3,7,and 10 days,but in HSP70 group it was lower than that in the empty virus group in 3,7,and 10 days,and the differences were statistically significant (q =6.912,10.235,7.021,all P ＜ 0.05).The level of iNOS mRNA in saline group was significantly higher than that of the control group,and the differences were statistically significant (q =4.998,8.056,5.369,all P ＜0.01),in empty virus group was significantly higher than that in the control group,and the differences were statistically significant (q =4.778,10.138,5.154,all P ＜0.01) in 3,7,and 10 days,but in HSP70 group it was lower than that in the empty virus group in 3,7,and 10 days,and the differences were statistically significant (q =7.819,9.838,6.156,all P ＜ 0.05).The level of HIF-1 α protein in saline group was significantly higher than that of the control group in 3,7,and 10 days,and the differences were statistically significant (q =3.146,3.012,4.106,all P ＜ 0.05),in empty virus group was significantly higher than that of the control group in 10 days,and the difference was statistically significant (q =3.468,P ＜ 0.05);but in HSP70 group it was lower than that in the empty virus group in 3,7,and 10 days,and the differences were statistically significant (q =3.876,4.108,4.021,all P＜ 0.05).The level of ET-1 protein of HSP70 group was lower than that of the saline group,the differences were statistically significant(q =3.367,2.983,3.246,all P ＜ 0.05),in HSP70 group was lower than that of the empty virus,and the differences were statistically significant (q =3.268,2.678,3.567,all P ＜0.05).The level of iNOS protein in saline group was significantly higher than that in the control group in 3,7,and 10 days,and the differences were statistically significant (q =3.360,3.567,3.567,all P ＜ 0.05),but in HSP70 group it was lower than that in the empty virus group,and the differences were statistically significant (q =3.126,3.908,3.087,all P ＜ 0.05).Conclusion Adenovirus mediated HSP70 can improve the HSP70 expression in HPH,down-regulate the expression of HIF-1 α,ET-1,iNOS,and reduce pulmonary arterial pressure.

To investigate a therapeutic method for post-herpes neuralgia,.Methods:Seventy-six cases of post-herpes neuralgia were equally divided into the treatment group treated with encircled needing and cotton moxibustion and control group treated with the routine acupuncture. Results:The total effective rate was 94.7% in the treatment group and 78.9% in control group. Conclusion:The encircled needing plus cotton moxibustion had the better therapeutic effect than routine acupuncture in treating post-herpes neuralgia.

Objective To evaluate the efficacy of endoscopic variceal ligation(EVL)in esophageal variceal bleeding (EVB)in elderly patients with hepatic cirrhosis,and the safety of endoscopic operation under anesthesia.Methods From July 2007 to July 2013,170 patients diagnosed as liver cirrhosis complicated with EVB were retrospectively analyzed.Among them,139 patients who received EVL were divided into elderly anesthesia group (n=52,age≥60 years),elderly non-anesthesia group (n=45 ,age≥60 years)and non-elderly anesthesia group (n=42,age<60 years);the other 31 cases (age≥60 years) received propranolol therapy.The degree of satisfaction of visual fields and esophageal peristalsis under the gastroscope,the effect,adverse effects and complications of EVL,the recurrence of EVB and mortality of each group were analyzed.Two-way analysis of variance and crosstabs chi square test were performed for statistical analysis.Results The satisfaction rate of visual fields and esophageal peristalsis under the gastroscope were 82.5 % (104/126)and 89.7% (113/126)in elderly anesthesia group;82.6% (71/86) and 89.5 % (77/86)in non-elderly anesthesia group;40.3% (29/72)and 44.4% (32/72)in elderly non-anesthesia group.The satisfaction rate of visual fields and esophageal peristalsis under the gastroscope in anesthesia group were better than those in non-anesthesia group (χ2 =47.46,64.28;both P <0.01 ). The efficacy rates of EVL in elderly anesthesia group,elderly non-anesthesia group and non-elderly anesthesia group were 84.6%(44/52 ),68.9%(31/45 )and 81 .0%(34/42 ),respectively.The variceal recurrence rates were 19.2% (10/52 ),20.0% (9/45 )and 19.0% (8/42 ),respectively.There was no significant difference among them (all P > 0.05). Rebleeding rate of medication treatment group was 58.1%(18/31),which was obviously higher than that of elderly anesthesia group (19.2%,10/52 ), elderly non-anesthesia group (31 .1 %,14/45 )and non-elderly anesthesia group (23.8%,10/42 ),and the difference was statistically significant (χ2 =15 .10,P <0.01 ).No case of hepatic encephalopathy was found in elderly anesthesia group or non-elderly anesthesia group after EVL.The incidence of pneumonia in elderly non-anesthesia group was 4.2%(3/72),which was higher than that of elderly anesthesia group and non-elderly anesthesia group,and the difference was statistically significant (χ2 =8.93,P =0.01). The mortality within a month after EVL in elderly anesthesia group,elderly non-anesthesia group and non-elderly anesthesia group was 0,8.9% (4/45 )and 0,and the difference was statistically significant (χ2 =9.27,P =0.01).Conclusion The efficacy of EVL under anesthesia in EVB in elderly patients with liver cirrhosis was good,with no induction or aggravation of hepatic encephalopathy or irreversible complications were found.

Aim To observe the fluctuation of uric acid in serum after replicating rat hyperuricemia model with hypoxanthine、uricase inhibitor combined,and to discuss the method of continuity hyperuricemia replication on rats. Method Hypoxanthine was administered via stomach or bait vessel,uricase inhibitor was injected subcutaneouslly,then the relative biochemical indicators of rats were inspected respectively at different periods of time after replicating the model. Results When hypoxanthine(50 g HX?kg-1bait vessel or 100 g HX?kg-1bait vessel) was administered via bait vessel,uricase inhibitor(200mg?kg-1) was injected subcutaneouslly,the uric acid in serum of different groups were much higher than control group(P

OBJECTIVE:To study the effect of basic medical insurance system(BMIS) on essential medicine system(EMS) . METHODS:By analyzing the relationship between BMIS and EMS,ideas on facilitating BMIS participate in every part of EMS were put forward. RESULTS&CONCLUSION:Basic medical insurance system ensure the accessibility of essential medicine system,supervise the implement and participate in every part of EMS,meet the demand of patients on essential drugs.

Objective To explore the hypoglycemic effects of Viola tianshanica Maxim.Methods Extraction conditions by orthogonal design research,in total flavonoids as index by reflux extraction for Viola tianshanica Maxim extracted.Established mouse model of diabetes with streptozotocin(STZ),reused Viola tianshanica Maxim extract for hypoglycemic experiment.The mice were divided into high dose group,middle dosage group,low dose group,blank control group,positive control group and normal mice group,15 mice in each group.The mice blood glucose and body weight of the different groups were observed.Results Viola tianshanica Maxim in a high concentration had significantly hypoglycemic effect in diabetic mice,average blood glucose level decreased from (18.4±5.8)mmol/L to (11.6±3.4)mmol/L,and the concentration of the extract could reduce the level of blood glucose in diabetic mice,average blood glucose level decreased from (24.8±5.6)mmol/L to (18.5±4.6)mmol/L,the differences were statistically significant(all P<0.05).Conclusion Viola tianshanica Maxim crude extract has a certain hypoglycemic effect.

Objective To improve the clinical blood level Through explore the feasibility of blood free surgery for congenital heart disease.Methods Collected 160 patients with congenital heart disease during January 2014 to December 2016 in our hospital,patients were divided into bloodless surgery experimental group (n =69) and blood transfusion treatment group (n=91) according to perioperative blood use.The basic data which including age,weight and GCS score,preoperative and postoperative hemoglobin(Hb),operation and postoperative pleural effusion drainage,intraoperative extracorporeal circulation time,mechanical ventilation time and blocking time,ICU stay,postoperative hospital stay,total hospital stay,reintubation and re-surgery of the two groups were compared.To investigate the effect of the implementation of bloodless surgical strategy for patients with congenital heart disease.Results 1) The difference between the two groups in age,body weight and GCS was not statistically significant (P＞0.05);2) The differences of Hb and intraoperative and postoperative pleural effusion drainage between two groups were not statistically significant (P＞0.05);3) The differences with cardiopulmonary bypass time,mechanical ventilation time,blocking time,re-intubation,re-surgery and ICU days of two groups were also not statistically significant (P ＞ 0.05);but bloodless surgery patients' postoperative hospitalization days and total hospitalization time was significantly lower than the control group (P＜0.05).Conclusion The implementation of bloodless surgery in congenital heart disease is safe and feasible.It can shorten the patient's hospitalization time.It is worth popularizing in clinical surgical treatment.

Objective: To investigate the role of JAK/STAT signal pathway in myocardial fibrosis (MF) of the chronic viral myocarditis (VMC) of mice and hypericin intervention study. Methods: Sixty healthy male Balb/c mice were used to establish the MF model by intermittent multiple ip injection of coxsackie B3, another 10 mice were used as normal control. Two months after the modeling, survival mice were randomly divided into four groups, model group, low- or high-dose hypericin group, and Captopril group. The mice were treated by Captopril or hypericin, respectively, ig administration, once a day. After 30 d, we took the myocardium of left ventricle to dye with Masson, to observe the cardiac histological changes. The serum type I collagen and type III collagen were detected by the means of ELISA, and the expression of JAK1 and STAT3 was observed with semi-quantitative RT-PCR and immunohistochemistry technique. Results: The model group, serum type I and type III collagen increased significantly, the expression level of JAK1/STAT3 was higher than that of the normal group, and the difference was significant (P < 0.05). While the hypericin and Captopril treatment could significantly reduce serum expression of type I and, type III collagen, and decrease JAK1/STAT3 expression. Histology showed the improvement of myocardial fibrosis degree, and a significant difference was observed when comparing with the model group (P < 0.05). Conclusion: In the process of chronic viral myocarditis, the activation of JAK1/STAT3 pathway may be one of pathological mechanisms of the MF-induced with type I and type III collagen increasing. Hypericin could inhibit the myocardial fibrosis by blocking JAK1/STAT3 pathway.

Calbindin-D28k (CB), calretinin (CR) and parvalbumin (PV) are the most common calcium-binding proteins (CaBPs). In the present study, FOS immunoreactivity was first induced in neurons of the medullary dorsal horn (MDH) of the rat by noxious orofacial stimulation; CaBPs (CB, CR and PV) in these neurons were then identified by imumunofluorescence histochemistry, and then, in addition, afferents to CaBPs/FOS double-labeled neurons were showed by immunofluorescence histochemical staining for the γ-aminobutyric acid (GABA) , glycine transporter 2 (GlyT2) , enkephalin (ENK) , serotonin (5-HT) or substance P (SP). Under the light microscope,we observed that: (1) neuronal cell bodies exhibiting FOS-immunoreactivity were present throughout all laminae of the MOH, with the highest concentration in lamina Ⅱ; (2) most CB-, CR- and PV-immunoreactive (IR) neurons were located in lamina Ⅱ , but some were also encountered in laminae Ⅰ and Ⅲ; (3) 5-HT-, GABA-, GlyT2-, ENK- and SP-IR fibers and terminals were also chiefly located in laminae Ⅰ and Ⅱ of the MDH; (4) some FOS-IR neurons showed CB-, CR-, or PV-immunoreactivity; (5) 5-HT-, GABA-, GlyT2- and ENK-IR terminals made close contacts with FOS/CB, FOS/CR or FOS/PV double-labeled neurons; (6) SP-IR terminals, as well as 5-HT-, GABA-, GlyT2- or ENK-IR terminals, closely contacted CB-, CR- or PV-containing neurons. Under the electron microscope, 5-HT-, GABA-, GlyT2- and ENK-IR terminals principally made symmetric (inhibitory) synaptic connections with CB-, CR- and PV-containing neurons were observed. These results suggest that 5-HT, GABA, glycine (Gly) and ENK may modulate transmission of orofacial noxious information by inhibiting nociceptive neurons that contain CaBPs in the rat MDH.