Transforming growth factor-?(TGF-?) plays a significant role in promoting chondrocyte anabolism in vitro and in vivo.Induction of the expression of TGF-? in vivo and the gene transfer may provide a new approach for treatment of osteoarthritis.

Objective To explore the effects of lower esophageal leiomyoma on esophageal dynamics.Methods A total of 25 patients with lower esophageal leiomyoma,31 patients with gastroesophageal reflux disease (GERD) and 16 healthy controls were selected.The differences of high resolution esophageal manometry results were compared among the groups.The t-test or one way analysis of variance was performed for normally distributed measurement data comparison.Rank sum test was used for non-normally distributed measurement data comparison.Results Among 25 patients with lower esophageal leiomyoma,14 patients accompanied with acid reflux,heartburn,chest pain or other GERD symptoms.In the group of patients with lower esophageal leiomyoma,the lower esophageal sphincter pressure (LESP),the lower esophageal sphincter relaxation rate (LESRR),low esophageal body pressure and peristaltic contraction percentage were (9.00 ± 6.30) mmHg (1 mmHg =0.133 kPa),53.0 ％ (0,334.0％),(34.66±18.33) mmHg and 55.6％ (0,100.0％),respectively,which were lower than those of the healthy control group ((16.25 ± 3.71) mmHg,86.5％ (49.0％,103.0％),(57.75 ± 22.49) mmHg,100.0％ (80.0％,100.0％)),and the differences were statistically significant (t=-4.150,Z=-2.353,t=-3.601,Z=-3.798; all P＜0.05).However there were no significant differences in esophageal dynamics indexes between patients with lower esophageal leiomyoma accompanied GERD symptoms and without GERD symptoms (all P＞0.05).There were no significant differences in esophageal dynamics indexes between the GERD patients and patients with lower esophageal leiomyoma accompanied GERD symptoms (all P＞0.05).LESRR level of patients with lower esophageal leiomyoma (71.4％(45.5％,150.0％)) increased after endoscopic submcosal dissection (Z=-2.194,P=0.028).Conclusions Lower esophageal leiomyoma may affect esophageal motor function,which contributed to anti-reflux esophageal function decline.Lower esophageal leiomyoma combined with gastroesophageal reflux symptoms are not uncommon.

To study the transport mechanisms of drugs for transplacental treatment of fetal tachyarrhythmia, MDCKII-BCRP and MDCKII cell models was used. MDCKII-BCRP and MDCKII cell monolayer model was used to investigate the bi-direction transport of sotalol, propranolol, propafenone, procainamide and flecainide. Drug concentrations were measured by HPLC-UV or chemiluminescence. The apparent permeability coefficient (P(app)), efflux rate (R(E)) and net efflux rate (R(net)) were calculated. Drugs with R(net) greater than 1.5 were further investigated using cellular accumulation experiments with or without a BCRP inhibitor. The R(net) of sotalol, propranolol, propafenone and procainamide were less than 1.5, while R(net) of flecainide with concentrations of 20 and 5 μmol x L(-1) were 1.6 and 1.9, respectively. The results showed that the transport of flecainide on MDCKII-BCRP cell monolayer could be mediated by BCRP; and the affinity increased when the concentration of flecainide decreased. Cellular accumulation experiments further suggested that accumulation of flecainide in MDCKII-BCRP cells was significantly lower than that in MDCKII cells in a concentration-dependent manner. BCRP inhibitor quercetin (50 μmol x L(-1)) significantly increased the accumulation of flecainide in MDCKII-BCRP cells (P < 0.05). Our preliminary data showed that flecainide but not sotalol, propranolol, propafenone or procainamide can be a substrate of BCRP. Thus the effect of flecainide may be affected by the BCRP in the maternal placental trophoblast membrane layer when treating fetal tachyarrhythmia.

Coronary Disease ; complications ; Erdheim-Chester Disease ; complications ; Humans ; Male ; Middle Aged

Adrenal Gland Neoplasms ; Adult ; Humans ; Male ; Pheochromocytoma ; Rupture, Spontaneous

Objective To analyze postoperative effect of a new rectopexy technique with Douglas pouch elevation for complete rectal prolapse (CRP) in adults.Methods From January 2010 to May 2011, 52 CRP cases were treated by rectopexy with Douglas pouch elevation.In terms of different surgical techniques, patients were divided into two groups : Group A (n =28) received laparoscopic rectopexy with Douglas pouch elevation;and Group B (n =24) received laparoscopic rectopexy with Douglas pouch elevation combined with procedure for prolapse and hemorrhoids (PPH).Rectal prolapse, constipation, and fecal incontinence in the two groups were assessed respectively before surgery, and on the 6th, 12th, and 24th month after surgery, postoperative complications were evaluated with severe grading of surgical complications.Results Symptoms of rectal prolapse disappeared at half a year after surgery in all patients, and relapsed to different extent afterwards.However, two years after operation, the status of rectal prolapse in Group B tended to be stable.The trend of constipation after surgery was consistent with that of rectal prolapse.In addition, fecal continence improved gradually on half a year after surgery in the two groups and recovered to the optimal status in the first postoperative year.However, in the second year, the results of fecal incontinence reduced slightly in Groups A, and Group B became stable.Two years after surgery, four cases in Groups A relapsed while there was no recurrence in Group B.Difference of Grade I to Grade Ⅲ complications among the two groups was statistically insignificant (x2 =0.05, P ＞ 0.05).Conclusions The clinical effect of laparoscopic rectopexy with Douglas pouch elevation associated with the procedure for prolapse and hemorrhoids (PPH) is better than that without PPH for female and male CRP patients with severe symptoms.

Objective To evaluate the incidence and imaging features of tibial plateau fracture combined with dislocation.Methods A total of 298 patients with intact imaging data treated for tibial plateau fracture from December 2012 to June 2014 were analyzed retrospcctively.Tilt angle of medial fragment fracture line,ratio of width of medial fragment to total plateau,surface area percentage,fragment height,and major displacement were measured on CT images using picture archiving and communication system (PACS).Results Eighteen patients (6.0％) had tibial plateau fractures combined with dislocation,with tilt angle of medial or posteromedial fragment fracture line of (62.1 ± 14.1)°.Eleven patients (61％) had split of the medial tibial plateau with surface area percentage of (46.3 ± 2.5) ％,fragment height of (43.9 ± 6.2) mm,and major displacement of (5.3 ± 2.1) mm.Seven patients (39％) had posteromedial fragment fracture with surface area percentage of (25.1 ± 5.7) ％,fragment height of (40.0 ± 10.1) mm,and major displacement of (4.8 ± 6.45) mm.Conclusions Fracture line of fracture-dislocation tibial plateau fracture is much often through the eminence or located at the lateral eminence with large medial or posteromedial fragments.Surgical approaches and directions of nailing should be considered properly according to the morphological characteristics.

Objective To investigate the effect of penehyclidine hydrochloride ( PHC) pretreat?ment on nuclear factor erythroid 2?related factor 2∕heme oxygenase?1 ( Nrf2∕HO?1) signaling pathway in re?nal tissues of rats with rhabdomyolysis?induced acute kidney injury ( AKI) . Methods Thirty?six pathogen?free male Sprague?Dawley rats, weighing 200-220 g, were assigned into 3 groups ( n=12 each) using a random number table: control group (group C), group AKI and PHC pretreatment group (group PHC). Rhabdomyolysis was induced by intramuscular injection of 50% glycerol 10 ml∕kg in bilateral hindlimbs. PHC 0?2 mg∕kg was injected intraperitoneally at 30 min before glycerol was injected intramuscularly in group PHC. At 1 and 6 h after glycerol injection, serum was collected for determination of blood urea nitro?gen ( BUN) and creatinine ( Cr) concentrations, and bilateral kidneys were harvested for pathological ex?amination and for determination of HO?1 activity and expression of Nrf2 mRNA and HO?1 mRNA ( by quan?titative real?time polymerase chain reaction) , Nrf2 in nucleoprotein and total protein and HO?1 in total pro?tein in renal tissues ( by Western blot) . The damage to the renal tubules was scored. Results Compared with group C, the BUN and Cr concentrations in serum and renal tubular damage scores were significantly increased, the expression of Nrf2 in nucleoprotein and total protein and HO?1 in total protein was signifi?cantly up?regulated, and HO?1 activity was significantly increased in AKI and PHC groups, the expression of HO?1 mRNA was significantly up?regulated in group AKI, and the expression of Nrf2 mRNA and HO?1 mRNA was significantly up?regulated in group PHC (P<0?01 or 0?05). Compared with group AKI, the BUN and Cr concentrations in serum and renal tubular damage scores were significantly decreased, the ex?pression of Nrf2 in nucleoprotein and total protein and HO?1 in total protein was significantly up?regulated, and HO?1 activity was significantly increased in group PHC ( P<0?01 or 0?05) . Conclusion The mecha?nism by which PHC pretreatment attenuates rhabdomyolysis?induced AKI may be related to activation of Nrf2∕HO?1 signaling pathway in renal tissues of rats.

This paper discusses the current prevalence of hospital preparations backward quality standard test methods, quality standards for lack of a serious problem , and analyses the reasons from four aspects , proposed to strengthen the construction of a pharmaceutical ethics; examination and approval departments shall strictly agents registration review technical requirements;rectify and improve the quality of all preparation standards;Introduction and training of strengthen pharmacy personnel , and actively improve the quality standard revision work;hospital in-creasing hardware and software construction , support quality standards revision suggestions for the improvement of work, provide reference standard for quality improvement of hospital preparations .