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To investigate the effectiveness and safety of diverticular peroral endoscopic myotomy (D-POEM) for mid-esophageal diverticulum. Data of consecutive patients in the prospective database with mid-esophageal diverticulum who received D-POEM in West China Hospital, Sichuan University between April 2014 to September 2019 were collected. The modified Eckardt scoring system for mid-esophageal diverticulum was used to evaluate the severity of diverticular symptoms. The effectiveness and safety of D-POEM were evaluated in terms of clinical success, technical success, complications and recurrence. A total of 7 patients with mid-esophageal diverticulum were included. Clinical and technical success was achieved in all patients with operation time of 16-70 minutes. No serious complications (2 cases with minor complications) or recurrence occurred. The follow-up time was 2-16 months. The median modified Eckardt score decreased from 3 points before operation to 0 points after operation. It is preliminarily believed that D-POEM ensures a complete septotomy between normal esophageal lumen and esophageal diverticulum. It is a safe and effective technique for mid-esophageal diverticulum. The modified Eckardt scoring system is suitable for symptom evaluation before and after treatment of mid-esophageal diverticulum.
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Objective To observe the effect ofGuanxin-Shutongcapsule in the treatment of arterial elasticity on patients with hypertension.Methods The hypertension patients who met the inclusion criteria were divided into treatment group (50 cases) and control group (52 cases). The control group was treated with antihypertensive drugs to control blood pressure within the normal range. The treatment group was treated withGuanxin-Shutongcapsule on the basis of the control group. All were given 8 weeks treatment. The main artery elastic parameters were meansured by the carotid-femoral pulse wave velocity (C-FPWV) and cervical-dorsal arterial pulse wave velocity (C-DPWV). The immune turbidimetric method was employed to enhance for the determination of high sensitive C reactive protein (hs-CRP); and radioimmunoassay was used to assess the serum IL-6, TNF-a, triglyceride (TG) and total cholesterol (TC). The blood pressure was monitored during the treatment.Results After the treatment, the level of hs-CRP (2.83 ± 1.35 mg/Lvs. 3.65 ± 1.38 mg/L,t=6.357), TNF-α (0.16 ± 0.08 mg/Lvs. 0.28 ± 0.07 mg/L,t=18.213), C-FPWV (13.85 ± 1.86 m/svs. 15.34 ± 1.78 m/s,t=6.524), C-DPWV (11.98 ± 1.45 m/svs. 12.87 ± 1.48 m/s,t=7.152) in treatment group was significantly lower than those in the control group (P<0.01).ConclusionGuanxin-Shutong capsule by inhibiting systemic inflammation, reducing and reversing atherosclerosis, and improving the arterial elasticity and blood pressure.
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Objective To explore a better method to repair cervical cicatricle contracture deformity.Methods The cervicai cicatrical contraction deformity was repaird by the cervico-shoulder island skin flap with blood supply crossing and abundant anastomotic branches of the neck-shoulder blood vessels. After removing the cervical scar, the flaps were designed according to the size of the wound to be repaired, and the clinical anatomy of crossing and abundant anastomotic branches of the neck-shoulder blood vessels. The secondary wound of donor site was closed directly if the donor region was small, or closed by skin graft. Results Sixteen patients in this clinic were operated with this method, and venous return dysfunction occurred in 1 case, but blood circulation was improved after treatment. All the flaps survived with good appearance and texture. The extensive flap was created and transferred to the anterior neck by one stage without pre-expansion which met some patients'requirement of repairing cervical cicatricle contracture deformity. Conclusion The cervico-shoulder island skin flap, with abundant blood supply, is a new method to repair cervical cicatricle contracture deformity.
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In this study, the effects of overvitamin D on cardiac lesions and the protective effects of zinc on them were studied. The results showed that cardiac MDA and calcium were significantly increased and cardiac lesions were characterized by nonspecial focal necrosis, accompaning with myofib-eral and interstitial calcification. Zinc could remarkably decrease cardiac MDA and calcium and the cardiac lesions were also much milder. It suggested that cardiac lesions induced by overvitamin D related to both cardiac lipid peroxide and calcium overload. It might be concluded that zinc could protect heart from overvitamin D intoxication.
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This article reported the results of eight series of animal experiments. In each series, the rats were divided into two groups: the experimental group was fed on corns and vegetables from endemic districts; the control group, from non-endemic districts. The composition of the foodstuffs was the same in the two groups. 375 albino rats were used in the experimental group, and 315 rats in the control group. The observation period was 8-13 weeks.The results showed that the incidence of myocardionecrosis had increased, the heart weight was comparatively larger, the mortality rate was higher, growth was stunted and the weights of the thymus and brown fat were lower than those of controls. The differences between experimental and control groups were stastistically singnificant. Such difference was not due to the composition of foodstuffs, but was closely related to the districts, from where the corns and vegetables were obtained. The results of these eight series of experiments were similar, and with very good reproducibility. It seemed that there were some myocardiac necroti-zing and growth inhibition factors in the corns and vegetables from the Keshan disease endemic districts.
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According to the level of selenium (Se) and methionine (Met) in diet, Wistar rats were randomly divided into 3 groups, group A (normal Se and normal Met); group B (Low Se and normal Met); group C (low Se and low Met). The animals were sacrificed after 8-week feeding. The results showed that the alteration of myocardial ultrastructure was slight in group B. Decreased activities of cytochrome oxidase and succinate dehydrogcnase of myocardial mitochonria and decreased activities of GSH-Px in the blood, heart and liver in group B were observed, as compared with those in group A. But the level of TBA was higher than that of group A.The above mentioned changes in group C were extremely apparent than group A or B, indicating both Se and Met deficiency in diet may concern the etiology of Keshan disease.