Diagnostic accuracy of magnetically guided capsule endoscopy with a detachable string for detecting oesophagogastric varices in adults with cirrhosis: prospective multicentre study

OBJECTIVE

To evaluate the diagnostic accuracy and safety of using magnetically guided capsule endoscopy with a detachable string (ds-MCE) for detecting and grading oesophagogastric varices in adults with cirrhosis.

DESIGN

Prospective multicentre diagnostic accuracy study.

SETTING

14 medical centres in China.

PARTICIPANTS

607 adults (>18 years) with cirrhosis recruited between 7 January 2021 and 25 August 2022. Participants underwent ds-MCE (index test), followed by oesophagogastroduodenoscopy (OGD, reference test) within 48 hours. The participants were divided into development and validation cohorts in a ratio of 2:1.

MAIN OUTCOME MEASURES

The primary outcomes were the sensitivity and specificity of ds-MCE in detecting oesophagogastric varices compared with OGD. Secondary outcomes included the sensitivity and specificity of ds-MCE for detecting high risk oesophageal varices and the diagnostic accuracy of ds-MCE for detecting high risk oesophagogastric varices, oesophageal varices, and gastric varices.

RESULTS

ds-MCE and OGD examinations were completed in 582 (95.9%) of the 607 participants. Using OGD as the reference standard, ds-MCE had a sensitivity of 97.5% (95% confidence interval 95.5% to 98.7%) and specificity of 97.8% (94.4% to 99.1%) for detecting oesophagogastric varices (both P<0.001 compared with a prespecified 85% threshold). When using the optimal 18% threshold for luminal circumference of the oesophagus derived from the development cohort (n=393), the sensitivity and specificity of ds-MCE for detecting high risk oesophageal varices in the validation cohort (n=189) were 95.8% (89.7% to 98.4%) and 94.7% (88.2% to 97.7%), respectively. The diagnostic accuracy of ds-MCE for detecting high risk oesophagogastric varices, oesophageal varices, and gastric varices was 96.3% (92.6% to 98.2%), 96.9% (95.2% to 98.0%), and 96.7% (95.0% to 97.9%), respectively. Two serious adverse events occurred with OGD but none with ds-MCE.

CONCLUSION

The findings of this study suggest that ds-MCE is a highly accurate and safe diagnostic tool for detecting and grading oesophagogastric varices and is a promising alternative to OGD for screening and surveillance of oesophagogastric varices in patients with cirrhosis.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03748563.

Hoffa’s fracture in an adolescent treated with an innovative surgical procedure: A case report

BACKGROUND

Hoffa fracture is rare, especially in adolescents, and has a high rate of complications such as avascular necrosis and osteoarthritis; moreover, there are no definitive guidelines for its treatment. This report could provide a new potential treatment for Hoffa fracture.

CASE SUMMARY

A 16-year-old girl presented to the orthopedic emergency department of No. 2 People’s Hospital of Yibin City with persistent pain following a right knee injury sustained during a sprint race. Her knee was swollen and tender, and the range of motion was restricted by the pain. X-ray and computed tomography revealed a Hoffa fracture in the right knee. After consultation, surgical treatment was performed, and the fracture was fixed with three 3.5-mm cannulated cancellous screws; osteochondral plugs that were harvested from the screw insertion site were re-implanted to cover the screw head. The patient’s fracture and osteochondral plug healed 6 mo postoperatively, and she presented a knee range of motion of 0–135 without pain, and was walking without support with a normal gait.

CONCLUSION

Here, we describe an innovative surgical procedure for Hoffa fracture that could provide a new possibility for the treatment of similar fractures, and further improve their management.

Features of capsule endoscopy in COVID-19 patients with a six-month follow-up: A prospective observational study

Recently, the coronavirus disease 2019 (COVID‐19) has caused a global pandemic. Several studies indicate that the digestive system can also be affected by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). Therefore, patients with digestive symptoms should have a capsule endoscopy (CE). COVID‐19 patients with gastrointestinal (GI) symptoms who underwent CE were recruited from March 2020 to April 2020. We collected patients’ data and performed a prospective follow‐up study for 6 months. All 11 COVID‐19 cases with GI symptoms who underwent CE presented gastritis. Eight cases (72.7%) had intestinal mucosa inflammation. Among them, two cases showed intestinal ulcers or erosions. Moreover, two cases displayed colonic mucositis. One case was lost during follow‐up. At 3–6 months after hospital discharge, five patients underwent CE again, presenting gastrointestinal lesions. Five of the 10 cases had GI symptoms, such as abdominal pain, diarrhea, constipation, and others. Among these five cases, the GI symptoms of three patients disappeared at the last follow‐up and two patients still presented diarrhea symptoms. Overall, we observed damaged digestive tract mucosa that could be caused by SARS‐CoV‐2. Moreover, after discharge, some patients still presented intestinal lesions and GI symptoms.

The clinical effect and safety of the treatment of tibia intercondylar eminence fracture with cannulated screw and suture fixation under arthroscope: Protocol for a systematic review and meta-analysis of randomized controlled trials

BACKGROUND

The clinical effects and safety over the treatment of tibia intercondylar eminence fracture (TIEF) with cannulated screw and suture fixation were evaluated under arthroscope systematically, providing evidence-based medical support for the selection of surgical methods in terms of minimally invasive arthroscopic treatment for TIEF.

METHODS

The English databases of PubMed, EMBASE, Cochrane Library, CNKI, SinoMed, VIP, and Wanfang databases were searched by computer. The randomized controlled trials were conducted to compare the clinical effects of TIEF with cannulated screw and suture fixation under arthroscope. The retrieval period is from the beginning of database building to January 2020. There is no language restriction. Chinese databases are searched by keywords, while English databases are searched by the combination of subject words and free words. According to the retrieval strategy, the two evaluators will lead the conforming documents into Note Express for repeated literature screening, and the two evaluators will extract and cross-check the conforming documents according to the pre-designed data extraction table. Two researchers adopted the modified Jadad scale independently to evaluate the quality of the literature. The RevMan 5.3 version software provided by the Cochrane Collaboration Network was adopted for statistical analysis.

RESULTS

The study will strictly review and extract the data included in the literature, and scientifically make statistical analysis for the pre-set outcome indicators. All the research processes will be conducted in strict accordance with the guidance of system evaluation. In this study, the differences between cannulated screw fixation and suture fixation under arthroscopy will be evaluated by comparing the relevant outcome indicators. All the results of this study will be published openly in a highly influential professional academic journal.

CONCLUSION

The paper adopted Cochrane system evaluation method to collect and sort out the published literature about the treatment of tibial eminence fracture between cannulated screw fixation and suture fixation under arthroscopy, and to compare the clinical efficacy and safety of the two fixation methods utilizing meta-analysis and comparison of related outcome indicators. Through this study, we will draw a positive conclusion, which will provide a basis for the better treatment of tibial eminence fracture.

PROSPERO REGISTRATION NUMBER

PROSPERO CRD42020168433.

Acid sphingomyelinase/ceramide mediates structural remodeling of cerebral artery and small mesenteric artery in simulated weightless rats

AIMS

Weightlessness exposure conduces to substantial vascular remodeling, mechanisms behind which remain unclear. Acid sphingomyelinase (ASM) catalyzed ceramide (Cer) generation accounts for multiple vascular disorders, so the role of it in adjustment of cerebral artery (CA) and small mesenteric artery (MA) was investigated in simulated weightless rats.

MAIN METHODS

Rats were hindlimb unloaded tail suspended (HU) to simulate the effect of weightlessness. Arterial morphology was examined by hematoxylin-eosin staining. Cer abundance was measured by immunohistochemistry. Western blotting was used to detect protein content. Apoptosis was detected by transferase-mediated dUTP nick end labeling.

KEY FINDINGS

During 4 weeks of tail suspension, intima-media thickness (IMT) and media cross section area (CSA) were increased gradually in CA but decreased gradually in MA (P < 0.05). Correspondingly, the apoptosis and proliferation of vascular smooth muscle cells were reduced and enhanced respectively in CA (P < 0.05), while promoted and restrained in MA (P < 0.05). As compared to control, both ASM protein expression and Cer content were lowered in CA and elevated in MA of HU rats (P < 0.05). Permeable Cer incubation reversed the change of apoptosis and proliferation in CA of HU rats, while ASM inhibition recapitulated it in control rats. On the contrary, ASM inhibitors restored the alteration of apoptosis and proliferation in MA of HU.

SIGNIFICANCE

The results suggest that by controlling the balance between apoptosis and proliferation, ASM/Cer exerts an important role in structural adaptation of CA and MA to simulated weightlessness.

CiteSpace-based Document Information Visualization of Literature Published by Journal of Forensic Medicine from 1985 to 2018

Abstract

Objective To analyze a knowledge web of the literature published by Journal of Forensic Medicine from its founding in 1985 to 2018, describe the evolving process of forensic science research and explore the research hotspots and frontiers at present. Methods The literature that was published by Journal of Forensic Medicine from 1985 to 2018 was collected and analyzed in terms of elements, such as emerging research hotspots, high frequency keywords, authors, dispatching units, location of institution and funding, by CiteSpace5.3 information visualization analysis software. Results All disciplines of forensic medicine were continually developing and maturing, and the publication volume of the literature on forensic pathology had the highest weight; in research hotspots, the two categories, research and identification each had their own emphasis; as the main source of contributions to the journal, research institutes accounted for 38.99% of the total number of publications; Shanghai ranked first among all regions with 1 046 articles published. The number of funded articles was generally on the rise, with the number of funded articles published largest in 2015. Conclusion As an authoritative academic journal in the field of forensic science in China, Journal of Forensic Medicine carries the development of forensic science and witnesses the institutional reform of universities and colleges, and offers a wide range of communication and cooperation in terms of technicality and application. Many scholars and scientific research institutions have gained progress continually in various research directions in the form of teamwork; and emerging research hotspots will continue to play a huge role in future practical applications.

[The efficacy and safety of testa triticum tricum purif in treatment of functional constipation in the late middle-aged and elderly patients: a multicenter randomized controlled clinical trial]

Objective: To evaluate the efficacy and safety of testa triticum tricum purif for the treatment of functional constipation(FC) in the late middle-aged and elderly patients. Methods: This study was designed as a multicenter randomized controlled trial. Patients who met Rome Ⅲ diagnostic criteria of FC were enrolled, with age between 55-85 years old. Those with organic diseases were excluded. The patients were randomly allocated to receive testa triticum tricum purif (3.5 g bid) or polyethylene glycol 4000 powder (PEG4000, 10g bid) for 8 weeks, followed by single dose of maintenance therapy for 4 weeks. Follow-up visits were at 4 and 12 weeks after treatment discontinuation. The independent investigators in each center evaluated the constipation symptoms scores. The primary endpoints included rates of significant improvement, improvement and overall improvement at the end of 2, 4 and 8 weeks of therapy, which were calculated by the reduction of symptom scores ≥75%, 50%-74%, ≥25% respectively. Results: A total of 127 FC subjects were enrolled from 3 centers, and 122 cases valid for final analysis. The mean age was (69.4±6.9) years old, including 62 cases in testa triticum tricum purif group and 60 cases in PEG4000 group. The demographic data, constipated symptoms scores and proportion of FC subtypes at baseline were comparable. The rates of significant improvement, improvement and overall improvement in testa triticum tricum purif and PEG4000 groups at the end of 2, 4 and 8 weeks were 37.70% (23/61) vs 59.32% (35/59) (P=0.018), 57.38% (35/61) vs 74.14% (43/58) (P=0.054), and 64.41% (38/59) vs 79.31% (46/58) (P=0.073) respectively. Testa triticum tricum purif therapy significantly improved the proportion of spontaneous bowel movement(SBM) ≥3 times/week from 43.55% (27/62) to 80.33% (49/61), 83.61% (51/61) and 93.22% (55/59) at 2, 4, and 8 weeks respectively (all P<0.01), which were comparable with PEG4000 group (all P>0.05). The proportion of normalized stool forms in study group was significant higher than that of control group at the end of 8 weeks [86.44% (51/59) vs 67.24% (39/58), P=0.014]. Only one patient complained mild abdominal distension during testa triticum tricum purif therapy. Conclusions: The efficacy of testa triticum tricum purif for the treatment of FC in late middle-aged and older patients is comparable with osmotic laxatives PEG4000, which has significant effect on normalization of fecal forms and reliable safety.

[One case of multiple primary carcinoma: laryngeal neuroendocrine carcinoma complicated with splenic mantle cell lymphoma]

To report a rare case of multiple primary carcinoma：laryngeal neuroendocrine carcinoma complicated with splenic mantle cell lymphoma to improve the understanding of multiple primary carcinoma. The incidence rate of multiple primary carcinoma was low. Laryngeal neuroendocrine carcinoma with mantle cell lymphoma has not been reported yet. Early diagnosis and antidiastole is very important for MPC. Pathological examination and immunohistochemistry plays an important role in the diagnosis of multiple primary carcinoma, laryngeal neuroendocrine carcinoma and mantle cell lymphoma.

Comparison of amlodipine versus other calcium channel blockers on blood pressure variability in hypertensive patients in China: a retrospective propensity score-matched analysis

Aim: Reducing the fluctuation of blood pressure has recently been recognized as a potential target for improving management of hypertension to prevent cardiovascular events, particularly for strokes. Some randomized controlled trials demonstrated that amlodipine can effectively reduce blood pressure as a well-established, long-acting calcium channel blocker (CCB). However, few data are available for amlodipine on blood pressure variability (BPV) in China in a real-world setting. This study aimed to assess the effect of amlodipine versus other CCB antihypertensive agents on BPV. Materials & methods: A retrospective propensity score-matched analysis was conducted, which retrieved the encounter data from 5582 hypertensive inpatients (with a median age of 69, female percentage of 48%, diastolic blood pressure ≥40 and <150 mmHg; systolic blood pressure (SBP) ≥70 mmHg and <260 mmHg), who had taken at least one antihypertensive agent and completed at least three SBP measurements during the visit. International Classification of Diseases was used to identify the hypertensive patients. BPV was calculated with standard deviation (SD) and coefficient of variation (CV) of SBP during a single inpatient visit. The Propensity Score Matching was used to balance the cohort of patients prescribed amlodipine or other CCBs. A series of appropriate statistical tests were applied to the propensity score-matched samples to examine the different effects on BPV. Additionally, the hypertensive patients with comorbidity such as coronary artery disease, diabetes mellitus, myocardial infarction, heart failure and chronic kidney disease were analyzed. Results: For the hypertensive patients (n = 1756, for each cohort), patients prescribed amlodipine showed lower BPV than patients prescribed other CCBs (12.90 vs 13.76 mmHg, p < 0.05 [SD] and 9.47 vs 10.06, p < 0.05 [CV]). For the hypertensive patients with comorbidity (n = 1080, for each cohort), patients prescribed amlodipine had lower BPV than patients prescribed other CCBs as well (13.24 vs 14.23 mmHg, p < 0.05 [SD] and 9.66 vs 10.28, p < 0.05 [CV]). Conclusion: amlodipine was associated with lower BPV than other CCBs for both hypertensive patients and hypertensive patients with comorbidity.

Doxepin Mitigates Noise-induced Neuronal Damage in Primary Auditory Cortex of Mice via Suppression of Acid Sphingomyelinase/Ceramide Pathway

Neuronal damage in primary auditory cortex (A1) underlies complex manifestations of noise exposure, prevention of which is critical for health maintenance. Acid sphingomyelinase (ASM) catalyzes generation of ceramide (Cer) which if over-activated mediates neuronal disorders in various diseases. Tricyclic antidepressants (TCAs), by restraining ASM/Cer, benefits multiple neuronal anomalies, so we aimed to elucidate the effect of TCA on noise induced hearing loss and auditory cortex derangement, unraveling mechanism involved. The mice were exposed to noise with frequencies of 20-20 KHz and intensity of 95 dB. Doxepin hydrochloride (DOX), a kind of TCAs, was given intragastrically by 5 mg kg^-1  days^-1 . Morphology of neurons was examined using hematoxylin-eosin (HE) and Nissl staining. Apoptosis was assayed through transferase-mediated dUTP nick end labeling (TUNEL). The content of ASM, Cer or acid ceramidase (AC) was detected by western blot and immunohistochemistry analysis. We demonstrated intense, broad band noise caused upward shift of auditory brainstem response (ABR) threshold to sound over frequencies 4-32 KHz, with prominent morphologic changes and enhanced apoptosis in neurons of primary auditory cortex (A1) (P < 0.05). DOX partly restored noise-caused hearing loss alleviating morphologic changes or apoptosis remarkably (P < 0.05). Both ASM and Cer abundance were elevated significantly by noise which was reversed upon DOX treatment (P < 0.05), but neither noise nor DOX altered AC content. DOX had no influence on hearing, neuronal morphology or ASM/Cer in control mice. Our result suggests DOX palliates noise induced hearing loss and neuronal damage in auditory cortex by correcting over-activation of ASM/Cer without hampering intrinsic behavior of it. Anat Rec, 300:2220-2232, 2017. © 2017 Wiley Periodicals, Inc.

Acid sphingomyelinase/ceramide regulates carotid intima-media thickness in simulated weightless rats

Structural adaptation of arteries to weightlessness might lower the working ability or even threaten the physical health of astronauts, but the underlying mechanism is unclear. Acid sphingomyelinase (ASM) catalyzes ceramide (Cer) generation controlling arterial remodeling through multiple signaling pathways. In the present study, we aimed to investigate the contribution of ASM/Cer to the changes of common carotid artery intima-media thickness (CIMT) induced by simulated weightlessness. Hindlimb-unloaded tail-suspended (HU) rats were used to simulate the effect of weightlessness. Morphology of the carotid artery (CA) was examined by hematoxylin-eosin staining. Protein content of ASM or proliferating cell nuclear antigen (PCNA) was detected by Western blot. Cer level was measured by immunohistochemistry analysis. Apoptosis events were observed by transferase-mediated dUTP nick end labeling (TUNEL) staining. During 4 weeks of tail suspension, CIMT was increased gradually in HU but not in their synchronous control rats (P < 0.05). Correspondingly, the CA of HU rats had a lower apoptosis and higher proliferation of vascular smooth muscle cells (VSMCs). As compared to the control, both ASM protein expression and Cer content were reduced significantly in CA of HU rats (P < 0.05), incubation of which with permeable Cer reversed the changes in apoptosis and proliferation substantially. Furthermore, when the ASM protein content as well as Cer level in CA of control rats was diminished by using an ASM inhibitor, an increase of CIMT along with reduced apoptosis and enhanced proliferation of VSMCs was found. Our results suggest that by controlling the balance between apoptosis and proliferation, ASM/Cer plays an important role in the regulation of CIMT during simulated weightlessness.

Effects of hyperbaric oxygen on hippocampal neuronal apoptosis in rats with acute carbon monoxide poisoning

INTRODUCTION

Acute carbon monoxide (CO) poisoning causes serious health problems such as neuropsychological sequelae. This study aimed to investigate neuronal apoptosis and the effects of hyperbaric oxygen (HBO₂) on different regions of the rat hippocampus after CO poisoning.

METHODS

90 mature male Sprague Dawley rats were randomly divided into three groups: the normal control group (NC group), the acute carbon monoxide-poisoned group (CO group) and the hyperbaric oxygen treatment group (HBO₂ group). CO exposure included 0, 1, 3, 7, 14 and 21 treatment days, one exposure on the first day, and sacrifice on each of the following days. HBO₂ exposure included treatment for 0, 1, 3, 7, 14 and 21 days, daily treatment after CO exposure, and sacrifice after the last HBO₂ treatment on each of those days. Hematoxylin-eosin staining, immunohistochemical staining, immunofluorescence staining, and western blot analysis were performed to detect apoptosis in brain tissue samples.

RESULTS

MMP-9 and caspase-3 were prominently increased by CO exposure and inhibited by HBO₂ in the CA3 region in the hippocampus at one, three and seven days (immunohistochemical staining [IHC]: P ⟨ 0.05). Neu N and the ratio of Bcl-2/ BAX were prominently decreased by CO exposure and rescued by HBO₂ in the CA3 region after seven days of treatment (IHC: P ⟨ 0.05).

CONCLUSION

These findings indicated that neuronal apoptosis in the rat hippocampus could be induced by acute CO exposure, especially in the CA3 region. HBO₂ could effectively inhibit neuronal apoptosis, especially in the CA3 region after seven days of treatment. The application of HBO₂ to inhibit MMP-9 and apoptosis may contribute to brain recovery after acute CO poisoning.

Disaster nursing experiences of Chinese nurses responding to the Sichuan Ya'an earthquake

AIM

The aim of this study was to investigate the disaster experiences of nurses called to assist survivors one month after the 2013 Ya'an earthquake.

BACKGROUND

China has experienced an increasing number of earthquake disasters in the past four decades. Although a health and disaster management system was initiated after the 2008 Wenchuan earthquake, nurses' roles and experiences in a disaster have been overlooked.

METHODS

The researchers used qualitative descriptive design that included 16 participants. Data were collected using semi-structured interviews and observation notes, after which a qualitative content analysis was conducted.

FINDINGS

Three major themes emerged: the process of being dispatched from hospitals to the disaster zone, the effort involved in getting to and working in the affected site and reflecting on the challenges they encountered.

DISCUSSION

About half of the participants had received disaster nursing training before deploying to the disaster site, but they consistently expressed a lack of physical and psychological preparedness regarding the process of being dispatched from their hospitals to the disaster zone.

LIMITATIONS

This was a single-incident experience. Caution should be taken when trying to extend the findings to other parts of China.

CONCLUSION

These findings highlighted the need for disaster in-service training as well as for having disaster plans in place.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Hospital and nursing leaders should provide disaster training opportunities that included topics such as compiling resource inventories, formulating disaster drills and simulations, managing emergencies, and using emergency communication methods. Health policy-makers should be required to prioritize capacity-building training for front-line nurses as well as to develop and implement disaster management plans to better prepare nurses for future disasters.

Accuracy of Magnetically Controlled Capsule Endoscopy, Compared With Conventional Gastroscopy, in Detection of Gastric Diseases

BACKGROUND & AIMS

Diseases of the stomach, including gastric cancer and peptic ulcer, are the most common digestive diseases. It is impossible to visualize the entire stomach with the passive capsule currently used in practice because of the large size of the gastric cavity. A magnetically controlled capsule endoscopy (MCE) system has been designed to explore the stomach. We performed a prospective study to compare the accuracy of detection of gastric focal lesions by MCE vs conventional gastroscopy (the standard method).

METHODS

We performed a multicenter blinded study comparing MCE with conventional gastroscopy in 350 patients (mean age, 46.6 y), with upper abdominal complaints scheduled to undergo gastroscopy at a tertiary center in China from August 2014 through December 2014. All patients underwent MCE, followed by conventional gastroscopy 2 hours later, without sedation. We calculated the sensitivity, specificity, positive predictive value, and negative predictive value of detection of gastric focal lesions by MCE, using gastroscopy as the standard.

RESULTS

MCE detected gastric focal lesions in the whole stomach with 90.4% sensitivity (95% confidence interval [CI], 84.7%-96.1%), 94.7% specificity (95% CI, 91.9%-97.5%), a positive predictive value of 87.9% (95% CI, 81.7%-94.0%), a negative predictive value of 95.9% (95% CI, 93.4%-98.4%), and 93.4% accuracy (95% CI, 90.83%-96.02%). MCE detected focal lesions in the upper stomach (cardia, fundus, and body) with 90.2% sensitivity (95% CI, 82.0%-98.4%) and 96.7% specificity (95% CI, 94.4%-98.9%). MCE detected focal lesions in the lower stomach (angulus, antrum, and pylorus) with 90.6% sensitivity (95% CI, 82.7%-98.4%) and 97.9% specificity (95% CI, 96.1%-99.7%). MCE detected 1 advanced gastric carcinoma, 2 malignant lymphomas, and 1 early stage gastric tumor. MCE did not miss any lesions of significance (including tumors or large ulcers). Among the 350 patients, 5 reported 9 adverse events (1.4%) and 335 preferred MCE over gastroscopy (95.7%).

CONCLUSIONS

MCE detects focal lesions in the upper and lower stomach with comparable accuracy with conventional gastroscopy. MCE is preferred by almost all patients, compared with gastroscopy, and can be used to screen gastric diseases without sedation. Clinicaltrials.gov number: NCT02219529.

[Effect of hyperbaric oxygen therapy on antioxidant capacity in brains of rats after acute carbon monoxide poisoning]

OBJECTIVE

This study was designed to observe the antioxidant effects of hyperbaric oxygen (HBO) on brains of rats after acute carbon monoxide (CO) poisoning.

METHODS

Sixty-six Sprague-Dawley (SD) male rats were divided into three groups including control group, CO group and HBO group.Morris water maze experiments were used for monitoring cognitive function.Antioxidant capacities were evaluated by detecting T-AOC, GSH-PX, GR and CAT activities in the brain.

RESULTS

Compared with the control group (45±17, 43±14, 35±12, 34±11, 29±13) s and the HBO group (40±10, 39±6, 35±9, 31±11, 21±10) s, the CO group (57±5, 54±8, 52±8, 52±10, 46±8) s had the longer escape latency (P<0.05). Compared with the control group (51±6) s and the HBO group(40±10) s, the CO group (8±5) s had the shorter swimming time in I quadrant (P<0.05). Compared with the control group (1.25±0.40) U/mg and the HBO group(0.97±0.31, 0.97±0.39, 1.45±0.15, 1.40±0.25, 1.20±0.20) U/mg, the CO group (0.68±0.09, 0.45±0.17, 0.71±0.18, 0.69±0.29, 0.48±0.29) U/mg had the lower T-AOC activity of brain tissue.The GSH-PX activity (42±13, 106±46, 197±49, 173±42, 429±58) U/mg in the CO group decreased compared with the control group (182±53) U/mg and the HBO group (203±63, 325±86, 389±29, 385±100, 453±32) U/mg.GR activity (4.3±0.7, 2.6±0.5, 3.0±1.2, 1.8±0.8, 3.2±1.9) U/mg in the CO group decreased compared with the control group(14.5±3.0) U/mg and the HBO group (13.9±3.3, 4.3±1.0, 3.9±0.7, 4.8±0.9, 4.6±0.9) U/mg.CAT activity (1.6±0.8, 4.3±1.6, 3.9±1.0, 8.5±2.6, 5.4±1.7) U/mg in the CO group decreased compared with the control group(5.2±1.3) U/mg and the HBO group (5.2±2.2, 8.8±2.8, 5.3±1.0, 9.2±2.1, 14.1±3.8) U/mg.

CONCLUSIONS

HBO can improve the behavior of rats after acute CO poisoning.The antioxidant capacity in rat brain tissue after acute CO poisoning decreases, while after the HBO therapy, the antioxidant capacity in rat brain tissue can increase.

[A comparison of clinical characteristics between non-erosive reflux disease and reflux esophagitis]

OBJECTIVE

To summarize the clinical symptoms of patients with non-erosive reflux disease(NERD) and reflux esophagitis(RE), which is helpful to the differential diagnosis.

METHODS

Out-patients who met the criteria of NERD or RE according to the Montreal definition in Gastroenterology Department Wuhan Union Hospital from 2010-2014 were enrolled in our study. Clinical data were comprehensively collected. Incidence of disease, severity, frequency of esophageal and extraesophageal symptoms, and the rates of overlapping with functional dyspepsia (FD) or irritable bowel syndrome (IBS) were all studied.

RESULTS

Totally 446 subjects were recruited, including 225 patients with NERD and 221 patients with RE. The occurrence rates of esophageal symptoms including heartburn [76.0%(171/225) vs 52.0%(115/221), P<0.01] and acid regurgitation [74.7%(168/225) vs 54.3%(120/221), P<0.05] in NERD group were significantly higher than those in RE patients, with more severe and frequent (P<0.05). Despite the rates of food regurgitation were similar, NERD patients behaved more severely and frequently (P<0.05). Extraesophageal symptoms including throat burning and foreign body sensation in NERD group [40.9%(92/225) vs 27.6%(61/221), 42.2%(95/225) vs 31.7%(70/221), all P<0.05] were also higher than those in RE group, the degree of which was more severe too (P<0.05). RE patients claimed a higher proportion of chronic cough. The incidences of overlapping with IBS in two groups were similar. But there were more patients with FD in NERD group [72.0%(162/225) vs 62.9%(139/221), P<0.05] than in RE group.

CONCLUSIONS

The menifestations and degree of esophageal and extraesophageal symptoms in patients with NERD or RE are different, as well as comorbidities such as FD and IBS. These results suggest that NERD and RE are independent diseases.

Segmental Duodenectomy in Surgical Therapy of Tumor of the Third and Fourth Portions of Duodenum

BACKGROUND/AIMS

To analyze our experience of segmental duodenectomy for tumors located at the third and fourth portion of the duodenum and attempt to explore the security and feasibility of this surgical procedure.

METHODOLOGY

A retrospective cohort study of five patients who underwent segmental duodenectomy in our hospital, medical records were analyzed in this study.

RESULTS

The initial symptoms in five patients are not specific. Five were surgically treated by segmental resection. All patients without postoperative anastomotic leakage, the gastroparesis and anastomotic stenosis each appeared in a case and all recovered after supportive care. Pathological examination showed: 3 cases of stromal tumor, 1 :ases of lymphangioma, diffuse large B-cell lymphoma. Postoperative gastrointestinal bleeding does not appear in the lymphangioma,two cases of high risk group of stromal tumor patients received targeting therapy with Imatinib Mesylate for 2 years after resection, the patient with lymphoma administer postoperative adjuvant chemotherapy. All patients are still alive and the lymphoma patient developed postoperative local recurrence after approximately six months.

CONCLUSIONS

Segmental duodenectomy is a reliable and curative option for most duodenal benign tumor and stromal tumor located at the third and fourth portion. It is also applicable to some malignant tumor.

Highly stable wideband microwave extraction by synchronizing widely tunable optoelectronic oscillator with optical frequency comb

Optical frequency combs (OFCs), based on mode-locked lasers (MLLs), have attracted considerable attention in many fields over recent years. Among the applications of OFCs, one of the most challenging works is the extraction of a highly stable microwave with low phase noise. Many synchronisation schemes have been exploited to synchronise an electronic oscillator with the pulse train from a MLL, helping to extract an ultra-stable microwave. Here, we demonstrate novel wideband microwave extraction from a stable OFC by synchronising a single widely tunable optoelectronic oscillator (OEO) with an OFC at different harmonic frequencies, using an optical phase detection technique. The tunable range of the proposed microwave extraction extends from 2 GHz to 4 GHz, and in a long-term synchronisation experiment over 12 hours, the proposed synchronisation scheme provided a rms timing drift of 18 fs and frequency instabilities at 1.2 × 10⁻¹⁵/1 s and 2.2 × 10⁻¹⁸/10000 s.

[Surveillance of endemic situation of schistosomiasis in a national surveillance site in Jiangling County from 2005 to 2011]

OBJECTIVE

To understand the dynamics of schistosomiasis japonica in a national surveillance site in Jiangling County, Hubei Province, China, so as to provide the evidence for formulating the intervention strategy of schistosomiasis control in the whole county.

METHODS

The surveillance was performed in the surveillance village according to The National Surveillance Scheme of Schistosomiasis japonica, and the results were analyzed statistically from 2005 to 2011.

RESULTS

The schistosome infection rates in residents and cattle decreased from 1.83% and 11.67% in 2005 to 0.91% and 0 in 2011, respectively. The density of living Oncomelania hupensis snails, the density of infected snails, and the infection rate of snails decreased from 4.02/0.1 m2, 0.014 5/0.1 m2, and 0.36% in 2005 to 0.70/0.1 m2, 0.000 3/0.1 m2, and 0.04% in 2011, respectively.

CONCLUSIONS

The transmission of schistosomiasis in the surveillance site shows a gradually decreasing trend year by year, but the prevalence is still not stable. Therefore, the comprehensive interventions with the main effort for the infectious source control still need to be strengthened.

Activation of BK(Ca) channels in zoledronic acid-induced apoptosis of MDA-MB-231 breast cancer cells

BACKGROUND

Zoledronic acid, one of the most potent nitrogen-containing biphosphonates, has been demonstrated to have direct anti-tumor and anti-metastatic properties in breast cancer in vitro and in vivo. In particular, tumor-cell apoptosis has been recognized to play an important role in the treatment of metastatic breast cancer with zoledronic acid. However, the precise mechanisms remain less clear. In the present study, we investigated the specific role of large conductance Ca(2+)-activated potassium (BK(Ca)) channel in zoledronic acid-induced apoptosis of estrogen receptor (ER)-negative MDA-MB-231 breast cancer cells.

METHODOLOGY/PRINCIPAL FINDINGS

The action of zoledronic acid on BK(Ca) channel was investigated by whole-cell and cell-attached patch clamp techniques. Cell apoptosis was assessed with immunocytochemistry, analysis of fragmented DNA by agarose gel electrophoresis, and flow cytometry assays. Cell proliferation was investigated by MTT test and immunocytochemistry. In addition, such findings were further confirmed with human embryonic kidney 293 (HEK293) cells which were transfected with functional BK(Ca) α-subunit (hSloα). Our results clearly indicated that zoledronic acid directly increased the activities of BK(Ca) channels, and then activation of BK(Ca) channel by zoledronic acid contributed to induce apoptosis in MDA-MB-231 cells. The possible mechanisms were associated with the elevated level of intracellular Ca(2+) and a concomitant depolarization of mitochondrial membrane potential (Δψm) in MDA-MB-231 cells.

CONCLUSIONS

Activation of BK(Ca) channel was here shown to be a novel molecular pathway involved in zoledronic acid-induced apoptosis of MDA-MB-231 cells in vitro.

[Speciation analysis of trace elements Cu, Fe and Zn in serum by flame atomic absorption spectrophotometry]

Since biological functions of the elements are generally different, depending on their chemical forms, chemical speciation analysis is really important in metallomics research. Thus, multielement analysis and chemical speciation of the elements in serum were carried out in the present work. A hyphenated technique was developed for high-throughput speciation analysis of the copper, iron and zinc in serum by molecular biology technology and flame atomic absorption spectrophotometry (AAS). Here, Cu, Fe and Zn in serum were classifyied as the forms of combination and non-combination. The serum protein was precipitated by 60% concentration of ethanol under hypothermy. The forms of combination of Cu, Fe and Zn in serum which combined with proteins were in precipitations, and the forms of non-combination of Cu, Fe and Zn in serum, which were free ions, were in supernatant. The total amount of Cu, Fe and Zn in serum and the amount of the forms of non-combination of Cu, Fe and Zn were analyzed by AAS. The amount of the forms of combination of Cu, Fe and Zn was obtained by calculation. The detection limit of Cu in serum by the method is around and 9.84 x 10(-3) microg x mL(-1). For Fe and Zn, the detection limit is about 2.76 x 10(-2) microg x mL(-1) and 1.06 x 10(-3) microg x mL(-1), respectively. The percentage recovery of trace elements Cu, Fe and Zn by the proposed procedure is in the range 95.0%-101.0%, 95.0%-102.0% and 95.0%-103.0%, respectively. The relative standard deviation (RSD) of trace elements Cu, Fe and Zn in the serum is in the range 1.88%-2.26%, 0.56%-1.59% and 0.34%-1.36%, respectively. Speciation of trace elements Cu, Fe and Zn in the serum of SD rat were analyzed by the method.

Monolithic 160 Gbit/s optical time-division multiplexer

We present the design and experimental characterization of a monolithic optical time-division multiplexer (MUX) for 160 Gbit/s operation based on periodically poled lithium niobate (PPLN) waveguides. Its key figures of merit agree well with theoretical predictions and meet or exceed those of a previously demonstrated PPLN-planar-light-wave-circuit hybrid MUX. The monolithic design has a simpler layout and higher efficiency while keeping the cross talk low.

Amplitude modulation and apodization of quasiphase-matched interactions

We propose several techniques to modulate the local amplitude of quasi-phase-matched (QPM) interactions in periodically poled lithium niobate waveguides and demonstrate apodization by using each of these techniques. When the hard edges are removed in the spatial profile of the nonlinear coupling, the sidelobes of the frequency tuning curves are suppressed by 13 dB or more, compared with a uniform grating, consistent with theoretical predictions. The sidelobe-suppressed gratings are useful for frequency conversion devices in optical communication systems to minimize interchannel cross talk, while the amplitude modulation techniques in general have potential uses in applications that require altering the tuning curve shapes.

Odd waveguide mode quasi-phase matching with angled and staggered gratings

Angled and staggered gratings are used for quasi-phase matching of antisymmetric TM(10) modes in periodically poled lithium niobate waveguides with high efficiency. Control of the symmetry of the nonlinear coefficient d adds a new degree of freedom in the choice of which waveguide modes will interact in a quasi-phase-matched device.

[Comparative study of the late results between two types of operations in the treatment of old derangement of distal radio-ulnar joint]

OBJECTIVE

To evaluate the clinical results of Darrach's procedure and Sauve-Kapandji's procedure in the treatment of old derangement of distal radioulnar joint.

METHODS

Twenty-three patients with old derangement of distal radioular joint were divided into two groups, in which 11 patients received resection of distal end of ulna by Darrach's procedure and 12 patients received pseudoarthrosis operation of the distal ulna by Sauve-Kapandji's procedure.

RESULTS

Fifty-six months after Darrach's procedure, complete relief of pain was obtained in 6 cases (P < 0.01), the flexion-extension movement improved from 104 degrees to 125 degrees (P < 0.01), rotation movement of the forearm improved from 106 degrees to 128 degrees (P < 0.01) and grippig strength improved from 17 kg to 28 kg (P < 0.01). Fifty-five months after Sauve-Kapandji's procedure, complete relief of pain was obtained in 9 cases (P < 0.01), the movement flexion-extension improved from 108 degrees to 126 degrees (P < 0.01), rotation movement of the forearm improved from 101 degrees to 135 degrees (P < 0.01) and grippig strength improved from 17 kg to 35 kg (P < 0.01).

CONCLUSION

1. The two operation showed no difference in relief of the wrist pain, improvement of the movement of the wrist and that of the forearm; 2. Sauve-Kapandji's procedure was superior to Darrach's procedure in increasing gripping strength; and 3. So the Sauve-Kapandji's procedure was superior to Darrach's procedure, especially in the long-term result, in the treatment of old derangement of the distal radioulnar joint.

[An electrophysiological analysis of pathways from lateral septum to hippocampal CA1 area in rat]

Upon stimulating the lateral septal region, a population spike could be recorded in the stratum pyramidale of hippocampal CA1 together with a recordable EPSP in the apical dendrites (stratum radiatum). After destruction of hippocampal CA3, CA4 pyramidal cells by intraventricular microinjection of kainic acid, electrical stimulation of the lateral septum could no longer evoke EPSP in the apical dendrites. This experiment suggests that the neural connection of the lateral septo-CA1 apical dendrites is mediated by the collaterals of the ipsilateral CA3 pyramidal cells. But after the destruction of CA3, CA4, electric stimulation of lateral septum could still evoke EPSP in the basal dendrites (stratum oriends). The neural connection mediating the response of the lateral septo-CA1 basal dendrites was not reported before, but the neural pathway remains to be investigated.

[A microcomputer processing system of evoked potentials of brain slices and applied examples]

Processing the evoked potentials of neurons with a computer can greatly increase the efficiency of data processing and obtain much more information from the data. Besides, it renders possibility of large quantities and prolonged observation. In this system, DMA mode is used for data transfer from A/D card to the computer, so total processing program including sampling subroutine was made in BASIC language. This article introduces the functions of this program in processing data and the technique in making this program.

Inhibition of long-term potentiation of the hippocampal CA1 EPSP by a negative cooperativity

Tetanization of commissural-CA1 input to the apical dendrites of the dorsal hippocampal CA1 area was found to produce a marked long-term potentiation of the field EPSP. Whereas by concurrent tetanization of the commissural pathway and medial septo-CA1 input, this potentiation was significantly reduced. Thus a negative cooperativity in LTP induction was revealed.