Abstract： Objective To investigate the influence of vasoactive intestinal peptide （VIP) on the sling fibers and the clasp fibers of the lower esophageal sphincter （LES） and the difference， and explore whether VIP belongs to a nonadrenergic and noncholinergic （NANC） neurotransmitter. Methods Thirty LES specimens were obtained from 30 patients with high-position carcinoma of the middle thoracic esophagus who underwent esophagectomy from March to August 2010 in Fourth Affiliated Hospital of Hebei Medical University. There were 14 male patients and 16 female patients with their average age of 58.0±6.1 years. The clasp fibers and sling fibers were isolated and suspended in perfusion. Exogenous VIP was added to the two kinds of strips to draw a concentration-effect curve. Electric field stimulation （EFS） or exogenous VIP was applied to clasp fibers and sling fibers， and the influence of VIP （10-28） on LES was compared. Results ExogenousVIP in different concentration caused concentration-dependent relaxation of the sling fibers and clasp fibers of LES in vitro. There was statistical difference in relaxation between the sling fibers and clasp fibers under same VIP concentration （P＜0.05）， and the relaxation of sling fibers was more significant than that of clasp fibers. VIP （10-28） transiently inhibited the relaxationof the sling fibers and clasp fibers caused by exogenous VIP. VIP （10-28） also transiently inhibited the relaxation of the sling fibers and clasp fibers after the activation of EFS. Conclusion The relaxation of sling fibers and clasp fibers induced by EFS is related to VIP. VIP is a kind of NANC neurotransmitter in human LES.
Objective To investigate the effect on motility function of remnant esophagus and intrathoracic stomach after esophagectomy for esophageal and cardiac carcinoma. Methods Thirty nine patients with esophageal and cardiac carcinoma were divided into two groups according to surgical procedure. Group of anastomosis above aortic arch （n = 21）： esophagogastrostomy was performed above the aortic arch in patients with esophageal carcinoma of the middle third; group of anastomosis below aortic arch（n= 18）： esophagogastrostomy was performed below the aortic arch in patients with esophageal carcinoma of the low third and cardiac carcinoma. Six health volunteers without gastroesophageal reflux were recruited as control group. Esophageal manometry and upper alimentary tract roentgenography were performed in all patients. Results There was a high pressure zone at the anastomotic orifice in parts of patients of both anastomosis groups. The resting pressure of remnant esophagus was higher than that in control group （P〈0. 05）, and similar to the resting pressure of intrathoracic stomach （P〉0. 05）. There was no significant difference in resting pressure of remnant esophagus and intrathoracic stomach between two anastomosis groups （P〉0.05）. The amplitude and number of primary peristalsis in remnant esophagus of group of anastomosis above aortic arch were significantly reduced in comparison with control group. The number of primary peristalsis in remnant esophagus of group of anastomosis above aortic arch was significantly lower than that of group of anastomosis below aortic arch （P〈0. 05）. The motility in the body of intrathoracic stomach was not observed. Weak motor activity of the gastric antrum was observed with upper alimentary tract roentgenography after surgery and evidently recovered 1 year after surgery. Conclusions The resting pressure of remnant esophagus and intrathoracic stomach is not influenced by the site of anastomosis. Esophagogastric anastomosis at the upper thorax is likely to result in poor motility of remnant esophagus. The motor activity of intrathoracic stomach becomes weak after esophagectomy and then recovers gradually over time, hut still fail to return to normal level.
ObjectiveTo evaluate the clinical effect of early and deferred intravesical instillation in the treatment of cystitis glandularis after transurethral resection (TUR). MethodsWe retrospectively analyzed the clinical data of 95 patients with cystitis glandularis during February 2007 to April 2012. Among them, 37 patients underwent the first intravesical instillation within 24 hours after transurethral resection (group A), while the others underwent the same treatment within a week (group B). Then, intravesical instillation in all patients were carried out once every week for 8 weeks, and after that, it was carried out once every month for 5 to 10 months. All the patients were followed up for 12 to 16 months. The cure rate, improvement rate, total effective rate, recurrence rate and incidence of adverse events associated with therapy were observed. ResultsRecovery rate, improvement rate, side effects were observed in group A and B respectively, and there was no significant difference between the two groups (P>0.05). But there was significant difference in the total effective rate and recurrence rate (P<0.05). ConclusionThe first intravesical instillation within 24 hours after transurethral resection in the treatment of cystitis glandularis can improve curative effect and lower recurrence rate, without the increase of side effects.
Objective To compare the effectiveness and safety of transurethral plasma kinetic enucleation of the prostate (TPKEP) and transurethral resection of the plasma (TURP) in patients with benign prostate hyperplasia (BPH) on the basis of bipolar plasma kinetic technology. Methods Eighty BPH patients who met the included criteria were assigned to two groups according to block balanced randomization, of which, 40 received TPKEP and the others received PKRP. We conducted statistical analysis after recording the clinical outcomes including international prostate symptom score (IPSS), quality of life (QOL), maximum flow (Qmax), post void residual urine volume (PVR), rates of prostate coated perforation, blood loss in the operation, duration of operation, time of bladder irrigation, duration of indwelling catheter, post-operative adverse effects, etc. Results The two groups were consistent at baseline before operation. The results of the analysis of clinical outcomes showed that, the TPKEP group was superior to the TURP group in prostate coated perforation (2 cases vs. 8 cases), hemoglobin in flushing fluid (index of blood loss, 10.95±5.02 g vs. 15.8±5.86 g), duration of operation (45.13±11.22 min vs. 53.33±8.69 min), time of bladder irrigation (12.58±2.77 h vs. 22.1±2.33 h), duration of indwelling catheter (65.13±10.67 h vs. 84.5±5.67 h), post-operative irritation sign of the bladder and urethra (5 cases vs. 12 cases), and the event of indwelling catheter after removal (0 cases vs. 4 cases), with significant differences; however, the TPKEP group was higher than the TURP group in the incidence of transient uracratia (10 cases vs. 3 cases), with a significant difference. The results of a 6-month follow-up showed that, no significant difference was found between the two groups in IPSS (2.78±1.03 vs. 2.40±1.13), QOL (1.28±0.45 vs. 1.45±0.51), Qmax (21.10±2.68 vs. 20.58±2.57), and PVR (2.82±2.90 vs. 2.18±2.27), respectively (Pgt;0.05). Long-term uracratia, urethrostenosis and secondary bleeding were not observed after operation in both groups. Conclusions TPKEP and TURP were alike in the short-term effectiveness of operation. TPKEP is safer than the TURP, which is regarded as a fairly ideal method for treating symptomatic BPH. However, the long-term effectiveness of TPKEP is yet to be further proved by large-scale randomized controlled trials with long-term follow-up.
ObjectiveTo investigate the effect of overexpressing the Indianhedgehog (IHH) gene on the chondrogenic differentiation of rabbit bone marrow mesenchymal stem cells (BMSCs) in a simulated microgravity environment. MethodsThe 2nd generation BMSCs from rabbit were divided into 2 groups: the rotary cell culture system (RCCS) group and conventional group. Each group was further divided into the IHH gene transfection group (RCCS 1 group and conventional 1 group), green fluorescent protein transfection group (RCCS 2 group and conventional 2 group), and blank control group (RCCS 3 group and conventional 3 group). RCCS group cells were induced to differentiate into chondrocytes under simulated microgravity environment; the conventional group cells were given routine culture and chondrogenic induction in 6 well plates. During differentiation induction, the ELISA method was used to detect IHH protein expression and alkaline phosphatase (ALP) activity, and quantitative real-time PCR to detect cartilage and cartilage hypertrophy related gene expressions, and Western blot to detect collagen typeⅡ, agreecan (ANCN) protein expression; and methylene blue staining and Annexin V-cy3 immunofluorescence staining were used to observe cell slide. ResultsAfter transfection, obvious green fluorescence was observed in BMSCs under fluorescence microscopy in RCCS groups 1 and 2, the transfection efficiency was about 95%. The IHH protein levels of RCCS 1 group and conventional 1 group were significantly higher than those of RCCS 2, 3 groups and conventional 2, 3 groups (P < 0.05); at each time point, ALP activity of conventional 1 group was significantly higher than that of conventional 2, 3 groups (P < 0.05); ALP activity of RCCS 1 group was significantly higher than that of RCCS 2 and 3 groups only at 3 and 7 days (P < 0.05). Conventional 1 group expressed high levels of cartilage-related genes, such as collagen typeⅡand ANCN at the early stage of differentiation induction, and expressed high levels of cartilage hypertrophy-related genes, such as collagen type X, ALP, and Annexin V at the late stage (P < 0.05). RCCS 1 group expressed high levels of cartilage-related genes and low levels of cartilage hypertrophy-related genes at all stages. The expression of collagen typeⅡprotein in conventional 1 group was significantly lower than that of conventional 2 and 3 groups at 21 days after induction (P < 0.05); RCCS 1 group expressed high levels of collagen typeⅡand ANCN proteins at all stages (P < 0.05). Methylene blue staining indicated conventional 1 group was stained lighter than conventional 2 and 3 groups at 21 days after induction; while at each time point RCCS 1 group was significantly deeper than RCCS 2 and 3 groups. Annexin V-cy3 immunofluorescence staining indicated the red fluorescence of conventional 1 group was stronger than that of conventional 2 and 3 groups at each time point. The expression of red fluorescence in each RCCS subgroup was weak and there was no significant difference between the subgroups. ConclusionUnder the simulated microgravity environment, transfection of IHH gene into BMSCs can effectively promote the generation of cartilage and inhibit cartilage aging and osteogenesis. Therefore, this technique is suitable for cartilage tissue engineering.