Research progress on the application of artificial intelligence in the screening and treatment of retinopathy of prematurity / 中华眼底病杂志

Retinopathy of prematurity (ROP) is a major cause of vision loss and blindness among premature infants. Timely screening, diagnosis, and intervention can effectively prevent the deterioration of ROP. However, there are several challenges in ROP diagnosis globally, including high subjectivity, low screening efficiency, regional disparities in screening coverage, and severe shortage of pediatric ophthalmologists. The application of artificial intelligence (AI) as an assistive tool for diagnosis or an automated method for ROP diagnosis can improve the efficiency and objectivity of ROP diagnosis, expand screening coverage, and enable automated screening and quantified diagnostic results. In the global environment that emphasizes the development and application of medical imaging AI, developing more accurate diagnostic networks, exploring more effective AI-assisted diagnosis methods, and enhancing the interpretability of AI-assisted diagnosis, can accelerate the improvement of AI policies of ROP and the implementation of AI products, promoting the development of ROP diagnosis and treatment.

Membrane pools of phosphatidylinositol-4-phosphate regulate KCNQ1/KCNE1 membrane expression.

Plasma membrane phosphatidylinositol 4-phosphate (PI4P) is a precursor of PI(4,5)P2, an important regulator of a large number of ion channels. Although the role of the phospholipid PI(4,5)P2 in stabilizing ion channel function is well established, little is known about the role of phospholipids in channel membrane localization and specifically the role of PI4P in channel function and localization. The phosphatidylinositol 4-kinases (PI4Ks) synthesize PI4P. Our data show that inhibition of PI4K and prolonged decrease of levels of plasma membrane PI4P lead to a decrease in the KCNQ1/KCNE1 channel membrane localization and function. In addition, we show that mutations linked to Long QT syndrome that affect channel interactions with phospholipids lead to a decrease in membrane expression. We show that expression of a LQT1-associated C-terminal deletion mutant abolishes PI4Kinase-mediated decrease in membrane expression and rescues membrane expression for phospholipid-targeting mutations. Our results indicate a novel role for PI4P on ion channel regulation. Our data suggest that decreased membrane PI4P availability to the channel, either due to inhibition of PI4K or as consequence of mutations, dramatically inhibits KCNQ1/KCNE1 channel membrane localization and current. Our results may have implications to regulation of other PI4P binding channels.

PKCßII specifically regulates KCNQ1/KCNE1 channel membrane localization.

The slow voltage-gated potassium channel (IKs) is composed of the KCNQ1 and KCNE1 subunits and is one of the major repolarizing currents in the heart. Activation of protein kinase C (PKC) has been linked to cardiac arrhythmias. Although PKC has been shown to be a regulator of a number of cardiac channels, including IKs, little is known about regulation of the channel by specific isoforms of PKC. Here we studied the role of different PKC isoforms on IKs channel membrane localization and function. Our studies focused on PKC isoforms that translocate to the plasma membrane in response to Gq-coupled receptor (GqPCR) stimulation: PKCα, PKCßI, PKCßII and PKCε. Prolonged stimulation of GqPCRs has been shown to decrease IKs membrane expression, but the specific role of each PKC isoform is unclear. Here we show that stimulation of calcium-dependent isoforms of PKC (cPKC) but not PKCε mimic receptor activation. In addition, we show that general PKCß (LY-333531) and PKCßII inhibitors but not PKCα or PKCßI inhibitors blocked the effect of cPKC on the KCNQ1/KCNE1 channel. PKCß inhibitors also blocked GqPCR-mediated decrease in channel membrane expression in cardiomyocytes. Direct activation of PKCßII using constitutively active PKCßII construct mimicked agonist-induced decrease in membrane expression and channel function, while dominant negative PKCßII showed no effect. This suggests that the KCNQ1/KCNE1 channel was not regulated by basal levels of PKCßII activity. Our results indicate that PKCßII is a specific regulator of IKs membrane localization. PKCßII expression and activation are strongly increased in many disease states, including heart disease and diabetes. Thus, our results suggest that PKCßII inhibition may protect against acquired QT prolongation associated with heart disease.

Statin-specific inhibition of Rab-GTPase regulates cPKC-mediated IKs internalization.

Statins are prescribed for prevention and treatment of coronary artery disease. Statins have different cholesterol lowering abilities, with rosuvastatin and atorvastatin being the most effective, while statins like simvastatin and fluvastatin having lower effectiveness. Statins, in addition to their cholesterol lowering effects, can prevent isoprenylation of Rab-GTPase proteins, a protein family important for the regulation of membrane-bound protein trafficking. Here we show that endosomal localization of Rab-GTPases (Rab5, Rab7 and Rab11) was inhibited in a statin-specific manner, with stronger effects by fluvastatin, followed by simvastatin and atorvastatin, and with a limited effect by rosuvastatin. Fluvastatin inhibition of Rab5 has been shown to mediate cPKC-dependent trafficking regulation of the cardiac delayed rectifier KCNQ1/KCNE1 channels. We observed statin-specific inhibition of channel regulation consistent with statin-specific Rab-GTPase inhibition both in heterologous systems and cardiomyocytes. Our results uncover a non-cholesterol-reducing statin-specific effect of statins. Because Rab-GTPases are important regulators of membrane trafficking they may underlie statin specific pleiotropic effects. Therefore, statin-specificity may allow better treatment tailoring.

Fluvastatin inhibits Rab5-mediated IKs internalization caused by chronic Ca2+-dependent PKC activation.

Statins, in addition to their cholesterol lowering effects, can prevent isoprenylation of Rab GTPase proteins, a key protein family for the regulation of protein trafficking. Rab-GTPases have been shown to be involved in the control of membrane expression level of ion channels, including one of the major cardiac repolarizing channels, IKs. Decreased IKs function has been observed in a number of disease states and associated with increased propensity for arrhythmias, but the mechanism underlying IKs decrease remains elusive. Ca2+-dependent PKC isoforms (cPKC) are chronically activated in variety of human diseases and have been suggested to acutely regulate IKs function. We hypothesize that chronic cPKC stimulation leads to Rab-mediated decrease in IKs membrane expression, and that can be prevented by statins. In this study we show that chronic cPKC stimulation caused a dramatic Rab5 GTPase-dependent decrease in plasma membrane localization of the IKs pore forming subunit KCNQ1, reducing IKs function. Our data indicates fluvastatin inhibition of Rab5 restores channel localization and function after cPKC-mediated channel internalization. Our results indicate a novel statin anti-arrhythmic effect that would be expected to inhibit pathological electrical remodeling in a number of disease states associated with high cPKC activation. Because Rab-GTPases are important regulators of membrane trafficking they may underlie other statin pleiotropic effects.

Confirming a Role for α9nAChRs and SK Potassium Channels in Type II Hair Cells of the Turtle Posterior Crista.

In turtle posterior cristae, cholinergic vestibular efferent neurons (VENs) synapse on type II hair cells, bouton afferents innervating type II hair cells, and afferent calyces innervating type I hair cells. Electrical stimulation of VENs releases acetylcholine (ACh) at these synapses to exert diverse effects on afferent background discharge including rapid inhibition of bouton afferents and excitation of calyx-bearing afferents. Efferent-mediated inhibition is most pronounced in bouton afferents innervating type II hair cells near the torus, but becomes progressively smaller and briefer when moving longitudinally through the crista toward afferents innervating the planum. Sharp-electrode recordings have inferred that efferent-mediated inhibition of bouton afferents requires the sequential activation of alpha9-containing nicotinic ACh receptors (α9*nAChRs) and small-conductance, calcium-dependent potassium channels (SK) in type II hair cells. Gradations in the strength of efferent-mediated inhibition across the crista likely reflect variations in α9*nAChRs and/or SK activation in type II hair cells from those different regions. However, in turtle cristae, neither inference has been confirmed with direct recordings from type II hair cells. To address these gaps, we performed whole-cell, patch-clamp recordings from type II hair cells within a split-epithelial preparation of the turtle posterior crista. Here, we can easily visualize and record hair cells while maintaining their native location within the neuroepithelium. Consistent with α9*nAChR/SK activation, ACh-sensitive currents in type II hair cells were inward at hyperpolarizing potentials but reversed near -90 mV to produce outward currents that typically peaked around -20 mV. ACh-sensitive currents were largest in torus hair cells but absent from hair cells near the planum. In current clamp recordings under zero-current conditions, ACh robustly hyperpolarized type II hair cells. ACh-sensitive responses were reversibly blocked by the α9nAChR antagonists ICS, strychnine, and methyllycaconitine as well as the SK antagonists apamin and UCL1684. Intact efferent terminals in the split-epithelial preparation spontaneously released ACh that also activated α9*nAChRs/SK in type II hair cells. These release events were accelerated with high-potassium external solution and all events were blocked by strychnine, ICS, methyllycaconitine, and apamin. These findings provide direct evidence that activation of α9*nAChR/SK in turtle type II hair cells underlies efferent-mediated inhibition of bouton afferents.

Impact of Different Atorvastatin Doses on Platelet Reactivity in Patients With Acute ST-elevation Myocardial Infarction / 中国循环杂志

Objective: To explore the impact of different atorvastatin doses on platelet function and highreactivity in patients with acute ST-elevation myocardial infarction (STEMI) after emergent percutaneouscoronary intervention (PCI) therapy. Methods:A total of 120 STEMI patients with emergent PCI therapy were randomly divided into 2 groups:Standard group, the patients received atorvastatin 20 mg/day and Intensive group, the patientsreceived atorvastatin 40 mg/day, all patients were treated for 7 days. n=60 in each group. Blood lipids and biochemistry were examined before PCI and 7 days after atorvastatin treatment respectively;platelet fibrin clot strength induced by ADP (MAADP), AA and ADP induced platelet inhibition rate were measured by thrombelastography (TEG) test. Results: With 7 days treatment, compared with Standard group, Intensive group showed decreased MAADP (38.40±17.40) mm vs (45.70±14.50) mm, P0.05. The patients were followed-up for 3 months and the end point events including unstable angina, non-fatal MI, in-stent restenosis, in-stent thrombosis, and cardiovascular death or target vessel revascularization were similar between 2 groups, P>0.05. Conclusion: Early stage and short term administration of high dose atorvastatin could obviously inhibit platelet activity in STEMI patients after emergent PCI;such intensive atorvastatin treatment had no reduction on end point events in 3 months follow-up period.

The first phantom study on the diagnostic accuracy of quantitative ultrasound elastography / 中华超声影像学杂志

Objective To evaluate the effects of the range and the frequency of the compression load on the accuracy for discerning target stiffness differences in ultrasound elastography.Methods Quantitative ultrasound elastography was achieved by integrating two compression force sensors,a laptop computer and a clinical ultrasound elastographic system.The force sensors and the ultrasound probe were assembled in a 3D printed mounting bracket for continuous monitoring of compression loads during ultrasound elastography. Both the force measurements and the elastographic maps were acquired and displayed on the laptop computer in real time.Four targets of the same diameter(10.4 mm),the same depth (3 cm) and different stiffness levels (8,14,45 and 80 kPa) were examined by a HITACHI preirus,L74M linear-array transducer.Each target was evaluated 45 times with two different method(i.e.,freehand elastography and quantitative elastography),yielding 1 80 evaluations.The data were divided into the following three groups:group Ⅰ(80 kPa vs 45,14 and 8 kPa),group Ⅱ(80,45kPa vs 14,8 kPa)and group Ⅲ(80,45 and 14 kPa vs 8 kPa).Area under ROC curves(AUC)were calculated for different stiffness levels.Results In group Ⅲ, quantitative elastography yielded an greater AUC level than that of freehand elastography(P =0.0379).In group Ⅰ and group Ⅱ,two methods yielded the similar AUC levels (P = 1 .000).However,quantitative elastography was able to discern 8 kPa and 14 kPa targets (P <0.001),while freehand elastography was hard to differentiate them(P =0.258).Conclusions In comparison with freehand elastography,quantitative ultrasound elastography is able to improve the accuracy for discerning different target stiffnesses.

The impact of different doses of atorvastatin on plasma endothelin and platelet function in acute ST-segment elevation myocardial infarction after emergency percutaneous coronary intervention / 中华内科杂志

Objective To investigate the effects of different doses of atorvastatin on plasma endothelin and platelet function in acute ST-segment elevation myocardial infarction (STEMI) patients after emergency percutaneous coronary intervention (PCI).Methods A total of 120 patients with acute STEMI treated with emergency PCI were enrolled and randomly divided into 20 mg of atorvastatin treatment group (standard group,n =60),and 40 mg of atorvastatin treatment group (intensive group,n =60).The blood C reactive protein (CRP),blood lipid profiles,plasma endothelin (ET) were measured before atorvastatin treatment and after 7 days of treatment,respectively.The platelet fibrin clot strength induced by ADP (MAADP) was determined by thrombelastography (TEG).Results Seven days after of atorvastatin treatment,the level of plasma ET in intensive group was significantly lower than that in standard group [(0.49 ± 0.21) pmol/L vs (0.63 ± 0.58) pmol/L,P ＜ 0.05].Moreover,the MAADP in intensive group was significantly decreased compared with the standard group [(38.4 ± 17.4) mm vs (45.7 ± 14.5) mm,P ＜ 0.05].There was a positive correlation between the ET level and MAADP in intensive group after treatment (r =0.378,P ＜ 0.05).However,no significantly differences could be viewed in the CRP and LDL-C levels between the two groups (P ＞ 0.05).Conclusion In patients with acute STEMI,early administration of 40 mg atorvastatin after emergency PCI could significantly reduce the vascular endothelial injury,improve endothelial function,and reduce the residual platelet activity.

Impaired IKs channel activation by Ca(2+)-dependent PKC shows correlation with emotion/arousal-triggered events in LQT1.

BACKGROUND: The most common inherited cardiac arrhythmia, LQT1, is due to IKs potassium channel mutations and is linked to high risk of adrenergic-triggered cardiac events. We recently showed that although exercise-triggered events are very well treated by ß-blockers for these patients, acute arousal-triggered event rate were not significantly reduced after beta-blocker treatment, suggesting that the mechanisms underlying arousal-triggered arrhythmias may be different from those during exercise. IKs is strongly regulated by ß-adrenergic receptor (ß-AR) signaling, but little is known about the role of α1-AR-mediated regulation. METHODS AND RESULTS: Here we show, using a combination of cellular electrophysiology and computational modeling, that IKs phosphorylation and α1-AR regulation via activation of calcium-dependent PKC isoforms (cPKC) may be a key mechanism to control channel voltage-dependent activation and consequently action potential duration (APD) in response to adrenergic-stimulus. We show that simulated mutation-specific combined adrenergic effects (ß+α) on APD were strongly correlated to acute stress-triggered cardiac event rate for patients while ß-AR effects alone were not. CONCLUSION: We were able to show that calcium-dependent PKC signaling is key to normal QT shortening during acute arousal and when impaired, correlates with increased rate of sudden arousal-triggered cardiac events. Our study suggests that the acute α1-AR-cPKC regulation of IKs is important for QT shortening in "fight-or-flight" response and is linked to decreased risk of sudden emotion/arousal-triggered cardiac events in LQT1 patients.

Molecular biology research of recombinant human endostatin targeted therapy of non-small-cell lung cancer / 中国生化药物杂志

Objective To investigate the relationship between molecular biological markers and recombinant human endostatin targeted therapy in non-small-cell lung cancer(NSCLC).Methods 68 cases patients with non-small-cell lung cancer to meet the requirements were randomly divided into group A (n=34)and group B (n=34).Group A received docetaxel and cisplatin(DP)and gefitinib;group B received recombinant human endostatin on the base of group A.The biological markers species,such as,EGFR,KRAS,VEGF,BRCA1,EML4-ALK,ERCC1,β-tubulin and CD3 were detected by immunohistochemical.The types of population for different programs were summarized according to the expression of biological markers and progression free survival (PFS)of the two groups. Results Group B median PFS was significantly longer than that in group A;no matter low or high expression of VEGF and BRCA1,group B median PFS was significantly longer than that in group A(P<0.05);high expression of ERCC1,KRAS,EML4-ALK andβ-tubulin,group B median PFS was significantly longer than that in group A(P<0.05);low expression of EGFR and CD3,group B median PFS was significantly longer than that in group A (P<0.05 ).Conclusion No matter low or high expression of VEGF and BRCA1 ,low expression of KRAS, ERCC1,EML4-ALK and β-tubulin and high expression of EGFR and CD3 in patients with non-small cell lung cancer may be more sensitive to the treatment of DP and gefitinib combined with recombinant human endostatin.

A review of synaptic mechanisms of vestibular efferent signaling in turtles: extrapolation to efferent actions in mammals.

The vestibular labyrinth of nearly every vertebrate class receives a prominent efferent innervation that originates in the brainstem and ends as bouton terminals on vestibular hair cells and afferents in each end organ. Although the functional significance of this centrifugal pathway is not well understood, it is clear that efferent neurons, when electrically stimulated under experimental conditions, profoundly impact vestibular afferent discharge. Effects range from chiefly excitation in fish and mammalian vestibular afferents to a more heterogeneous mixture of inhibition and/or excitation in amphibians, reptiles, and birds. What accounts for these diverse response properties? Recent cellular and pharmacological characterization of efferent synaptic mechanisms in turtle offers some insight. In the turtle posterior crista, vestibular efferent neurons are predominantly cholinergic and the effects of efferent stimulation on vestibular afferent discharge can be ascribed to three distinct signaling pathways: (1) Hyperpolarization of type II hair cells mediated by α9/α10-nAChRs and SK-potassium channels; (2) Depolarization of bouton and calyx afferents via α4ß2*-containing nAChRs; and (3) A slow excitation of calyx afferents attributed to muscarinic AChRs. In this review, we discuss the evidence for these pathways in turtle and speculate on their role in mammalian vestibular efferent actions where synaptic mechanisms are largely unknown.

Changes of soluble fas and soluble fas ligand in serum and peritoneal fluid of infertile patients with endometriosis / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the relationship between levels of soluble Fas (sFas) and soluble Fas ligand (sFasL) in serum and peritoneal fluid of endometriosis-associated infertility.</p><p><b>METHODS</b>The soluble Fas ligand and soluble Fas levels in serum and peritoneal fluid of 20 infertile patients with endometriosis were assessed with enzyme-linked immunosorbent assay, and were compared with 14 infertile patients due to chronic pelvic infectious disease and 16 fertile controls.</p><p><b>RESULTS</b>The sFasL levels were significantly higher in infertile patients with endometriosis (175.09 +/- 80.55 pg/mL in serum and 284.50 +/- 152.38 pg/mL in peritoneal fluid) than those of infertile controls (88.47 +/- 43.55 pg/mL in serum and 17.30 +/- 9.62 pg/mL in peritoneal fluid) and fertile controls (16.13 +/- 11.75 pg/mL in serum and 8.84 +/- 2.31 pg/mL in peritoneal fluid). In contrast, as for the sFas levels, infertile patients with endometriosis (828.60 +/- 429.65 pg/mL in serum and 349.61 +/- 288.89 pg/mL in peritoneal fluid) did not show any significant difference compared with those in infertile patients resulting from pelvic infectious disease (868.75 +/- 570.48 pg/mL in serum and 181.76 +/- 157.78 pg/mL in peritoneal fluid) and fertile control (822.26 +/- 129.12 pg/mL in serum and 318.42 +/- 145.16 pg/mL in peritoneal fluid).</p><p><b>CONCLUSIONS</b>Based upon these results, high level of sFasL in serum and peritoneal fluid and thus apoptosis mediated by it may be implicated in the mechanism involved in endometriosis-related infertility.</p>

Effect of esophageal mucosal acid exposure on visceral sensation of patients with non-erosive gastroesophageal reflux disease / 第三军医大学学报

Objective To investigate the effect of esophageal mucosal acid exposure on visceral sensation of patients with non-erosive gastroesophageal reflux disease (NERD) and to evaluate the role of visceral hypersensitivity in NERD pathogenesis. Methods We recruited 21 NERD patients and 10 normal healthy volunteers. Mechanical distentions stimulation and acid perfusion through esophagus were performed using the balloon-affixed and polyvinyl multilumen catheter. Esophageal visceral perception thresholds were examined before and after acid perfusion with esophageal balloon distention by means of a computer-controlled barostat. Results As compared with healthy subjects, NERD patients demonstrated significantly lower initial perception threshold and maximally tolerated pain threshold (P

Thin barium meal examination of papilla function after endoscopic sphincterotomy / 中华消化内镜杂志

Objective To assess short term results of papilla functional status after endoscopic sphincterotomy (EST) with thin-barium meal examination.Methods From August, 2001 to December, 2003, eighty-nine patients were included for endoscopic sphincterotomy. Size of EST was (0.5～1.5) cm. Patients were prospectively followed on the short term-period (7 days, 6 months and 1 year) by clinical and thin-barium(100/100 V/W) meal examination which would be observed biliary gas and barium reflux from duodenal papilla.Results The patient number of gas reflux shows: 19 of 89 cases(21.3%) in one week, 5 of 36 cases(13.9%) in six months, 13 of 23 cases (13.0%)in one year; barium reflux with thin-barium meal examination shows: 11 of 89 cases(12.4%) in one week, 3 of 36 cases(8.3%) in six months, 2 of 23 cases(8.7%) in one year. In the size of EST more than 1.1 cm, these were nine patients (47.4%) with gas reflux, and seven patients (36.8%) with barium reflux, and five patients with gas-barium mix reflux. 6 month and 1 year after sphincterotomy, includes EST size 1.2 cm,2 cases and 1.5 cm,3 cases.Conclusion Thin-barium meal examination of papilla function after endoscopic sphincterotomy is an efficient procedure. Incidence rate of gas reflux and thin barium reflux were closely related to the size of EST.

Study of peripheral and central mechanism of visceral hypersensitivity in non-erosive reflux disease patients / 中国实用内科杂志

Objective The aim of this study was to evaluate and to characterize the visceral hypersensitivity in non-erosive reflux disease(NERD)through the detection of esophageal distension-cerebral evoked potentials(ED-CEP)and calcitonin gene related peptide(CGRP)and substance P(SP)levels in esophageal mucosa.Methods NERD patients(N 26)and 12 controls were enrolled in this study from Oct.2004 to Mar.2005.Mechanical distention stimulation was performed using the balloon-affixed and polyvinyl multilumen catheter.The ED- CEP was recorded with a muti-channel international 10~20 system of electroencephalograph.The esophageal specimens were immune-histologically evaluated for CGRP/SP-stain positive contents.Results Esophageal distention may evoke recognizable and reproducible muti-peak CEP.CEP morphology of NERD patients was characterized by randomly distributed patterns,and the peak latencies for N1,P1,and N2 were significantly shorter compared with control group(P

Clinical analysis of primary biliary cirrhosis: a report of 31 cases / 中华消化杂志

Objective Clinical features of primary biliary cirrhrosis(PBC) were reviewed in order to improve its diagnosis and treatment. Method The general conditions, clinical manifestations, biochemical and immunological changes, and pathological findings were assessed in 31 patients. Result Twenty five cases were females, the mean age at definite diagnosis was (49.2?10.7)years. Jaundice(74.2%) was the most frequent symptoms, pruritus (51.6%) and fatigues (32.3%)were the second and thrid, respectively. Three patients (9.7%)were complicated by ascites. Serum alkline phosphatase (ALP) , glutamyl transpeptidase (? GT) and bilirubin levels were markedly elevated ((388.9?277.5)U/L, (381.6?213.2)U/L and( 176.4 ?176.1)?mol/ L, respectively).ALT and AST levels were mildly or moderately elevated ((79.7?46.3) U/L and(119.8?61.2)U/L, respectively),mean level of IgM was also elevated to (3.0?1.9)g/L. 92% (23/25) of patients had positive anti mitochondrial antibody(AMA). Ursodeoxycholic acid (UDSA) was efficitive in 61.3% of patients. Conclusions PBC most frequently affects middle aged women. The elevated level of ALP, ? GT and IgM and AMA positive may be crucial to diagnosis of PBC. Liver biopsy can help to identify the diagnosis and carry on pathological staging.

Cerebral evoked potentials response to esophageal mucosal acid exposure and distention in patients with non-erosive gastro-oesophageal reflux disease / 中华消化杂志

Objective To investigate characteristics and alternation of cerebral evoked potentials (CEP) response to esophageal mucosal acid exposure and distention in patients with non-erosive gastro-oesoph- ageal reflux disease (NERD) and in healthy subjects,and to study the mechanism of visceral hypersensitivity in NERD.Methods Twenty-one NERD patients and 10 volunteers were recruited.Mechanical distention stimulation and acid perfusion of the esophagus were performed using the balloon-affixed and polyvinyl multi- lumen catheter.First,maximally tolerated pain thresholds of all subjects were recorded,then esophageal mechanical stimulation with a 75% of maximal tolerated intensity and a frequency of 0.2 Hz was performed altogether 64 times by means of a computer-controlled barostat.The alternation of esophageal CEP was recorded before and after acid perfusion with a multichannel international 10-20 system of electroencephalography. Experimental data was analyzed by student's t-test and one way analysis of variance.Results Esophageal mu- cosal distention may evoke recognizable and reproducible and multi-peak CEP.The latencies for N1,P1 and N2 in volunteers were (246?77),(388?84)and (502?78) ms,CEP morphology of NERD patients was charac- terized by randomly distributed patterns,and the latencies for N1 ,P1 and N2 were (192?46),(293?76) and (440?79)ms,significantly shorter for mechanical stimulation compared with those of control group respectively (all P value

A clinical study of short-segment Barrett's esophagus / 中华消化杂志

Objective To investigate the clinical features, management, surveillance and possible pathophysiology of short segment Barrett's esophagus (SSBE).Methods Fifty two cases of SSBE identified by endoscopy and pathology were enrolled in this retrospective study. The endoscopic manifestations, pathological changes, esophageal motor function, management and follow up results were assessed.Results The island pattern was most prominent type accounting for 86.5%, and specialized intestinal metaplasia (SIM) was found in 15.4% of patients with routing H E stain. Abnormal motor function were showed in 8 of 11 cases(72.7%) who received 24 hs esophageal pH and bilirubin monitoring and esophageal manomery. Argon plasma coagulation therapy was carried out in 21 cases and SSBE ablation was achieved in 15 cases based on shor term follow up result. No esophageal adenocarcinoma was found in 49 patients revisited.Conclusions SSBE is associated with abnormal gastroesophageal acid and bile reflux. Island pattern is the most common endoscopic appearance. Specialized intestinal metaplasia and dysplasia may be less frequent in patients with SSBE.

Clinical characteristics of reflux esophagitis in Chinese population / 中华消化内镜杂志

Objective To investigate clinical characteristics of reflux esophagitis ( RE) in Chinese population according to the retrospective analysis of RE in the past 14 years. Methods 3851 cases of RE were diagnosised in our department according to the Los Angeles grading system, and the general status, clinical symptoms, endoscopic findings and values of esophageal manometry,24-hour esophageal pH and biliru-bin monitoring were assessed. Results RE accounted for 2. 95% of the total endoscopy numbers, but the present of RE during 2000 - 2004 y was significantly elevated to 4. 25%. The gender ratio (male: female) was 3.4-1. In the recent 4 years mean age of the patients with original RE was (53. 9 ?14. 5) years. Grade A and B RE comprised of 85. 8% and grade C and D only 14. 2%. The index values such as percent of time with pH 0. 14 and total reflux times were abnormal in RE group, and significant difference existed between the mild and severe RE (P