[Clinical analysis of 182 cases esophageal foreign bodies and treatment for special cases].

OBJECTIVE: To provide clinical reference by summarizing and analyzing characteristics, therapeutic principles and methods for special cases of esophageal foreign bodies. METHOD: Statistical analysis 182 cases with esophageal foreign bodies, including 41 special cases. Surgery 165 cases, 17 cases without surgery. RESULT: One hundred and seventy-five cases were cured, 7 cases improved. Hospitalization time 0.5-50 d (average 4.5 d). CONCLUSION: It is important to learn about characteristics of esophageal foreign bodies, therapeutic principles and methods for special cases, and it's a key point to diagnosis early and remove the foreign bodies as soon as possible, and comprehensive treatment measures are really effective to process special cases.

[Diagnosis and treatment of esophagus perforation caused by esophageal foreign bodies].

OBJECTIVE: Summarize the treatment skills of esophagus perforation caused by esophageal foreign bodies. METHOD: Retrospectively analyze the seven cases of esophagus foreign body perforation with various complications in our department. RESULT: Six cases recovered in 3 to 18 days after operation, on average 14.2 day, while one case recovered in 49 days by conservative method. CONCLUSION: Foreign bodies removing, fistulae repairing, abscess incising, effusion rinsing, effective antibiotics administrating and support treatment are effective to treat esophagus perforation caused by esophageal foreign bodies. It will take a relative long time to be treated only by conservative way.

Revaluation of clopidogrel: let the data speak for themselves.

Clopidogrel was believed to be superior to aspirin by the well-known CAPRIE trial. However, no other large clinical trials demonstrated the same results, but all focused on the combination use of clopidogrel with aspirin, and combination therapy in CREDO was called the "Emperor's New Clothes". However, no one overturned the results of these clinical trials by quantitatively analyzing them. We reviewed ten large-scale clinical trials about clopidogrel. On the basis of results of CAPRIE, CREDO and CHARISMA trials, we re-estimated their minimal sample sizes and their powers by three well-established statistical methodologies. From the results of CAPRIE, we inferred that the minimal sample size should be 85 086 or 84 968 but its power was only 30.70%. A huge gap existed. The same was also true of CREDO and CHARISMA trials. Moreover, in CAPRIE trial, 0 was included in the 95% confidence interval and 1 was included in the 95% confidence interval for the relative risk. There were some paradoxical data in CAPRIE trial. We are led to conclude that the results in CAPRIE, CREDO, and from the subgroup analysis in CHARISMA trials were questionable. These results failed to demonstrate that clopidogrel was superior to aspirin or that clopidogrel used in combination with aspirin was better than aspirin alone. The cost-effectiveness analyses by some previous studies were not reliable.

Revaluation of Clopidogrel: Let the Data Speak for Themselves / 华中科技大学学报（医学）（英德文版）

Clopidogrel was believed to be superior to aspirin by the well-known CAPRIE trial. However, no other large clinical trials demonstrated the same results, but all focused on the combina-tion use of clopidogrel with aspirin, and combination therapy in CREDO was called the "Emperor's New Clothes". However, no one overturned the results of these clinical trials by quantitatively ana-lyzing them. We reviewed ten large-scale clinical trials about clopidogrel. On the basis of results of CAPRIE, CREDO and CHARISMA trials, we re-estimated their minimal sample sizes and their powers by three well-established statistical methodologies. From the results of CAPRIE, we inferred that the minimal sample size should be 85 086 or 84 968 but its power was only 30.70%. A huge gap existed. The same was also true of CREDO and CHARISMA trials. Moreover, in CAPRIE trial, 0 was included in the 95% confidence interval and 1 was included in the 95% confidence interval for the relative risk. There were some paradoxical data in CAPRIE trial. We are led to conclude that the results in CAPRIE, CREDO, and from the subgroup analysis in CHARISMA trials were questionable. These results failed to demonstrate that clopidogrel was superior to aspirin or that clopidogrel used in combination with aspirin was better than aspirin alone. The cost-effectiveness analyses by some pre-vious studies were not reliable.

[Modulation of gamma-aminobutyric acid receptor on medial vestibular nucleus neurons in vivo].

OBJECTIVE: To investigate modulation of gamma-aminobutyric acid (GABA) and its receptors on medial vestibular nucleus neurons in vivo. METHODS: Twenty-six male Wistar rats were used. gamma-aminobutyric acid, bicuculline (BIC, gamma-aminobutyric acid A receptor antagonist) and 2-hydroxysaclofen (SAC, gamma-aminobutyric acid B receptor antagonist) were microiontophoresed on medial vestibular nucleus (MVN) neurons to determine the effects of gamma-aminobutyric acid and its antagonists on the neuronal firing rates of medial vestibular nucleus in rats in vivo. RESULTS: Microiontophoretic application of y-aminobutyric acid at 10, 30, 50 nA electric current produced inhibitory responses on 42 MVN neurons, these responses were dose-dependent decreases, firing rates (x +/- s) of MVN neurons decreased form (14.8 +/- 5.6) times/s to (8.7 +/- 3.4) times/s, (4.1 +/- 1.6) times/s and (2.2 +/- 1.1) times/s respectively; microiontophoretic application of bicuculline in 37 MVN neurons, 86.5% (32/37) neurons produced excitatory responses, 13.5% (5/37) neurons didn't response, firing rates of MVN neurons increased form (15.3 +/- 6.3) times/s to (16.8 +/- 7.1) times/s, (25.9 +/- 10.1) times/s and (32.7 +/- 11.3) times/s respectively at 10, 30, 50 nA electric current, which were dose-dependent increases, and the inhibitory responses of gamma-aminobutyric acid on MVN neurons were blocked by bicuculline completely; however, microiontophoretic application of 2-hydroxysaclofen didn't produced responses as bicuculline did. CONCLUSIONS: Modulation of gamma-aminobutyric acid on medial vestibular nucleus neurons was mediated by y-aminobutyric acid A receptor in vivo.

Firing properties and classification of MVN neurons in rats.

In order to know the effects of caloric stimulation on neuronal firing in medial vestibular nuclei (MVN) by middle ear irrigation, the middle ear was irrigated with ice (4 degrees C), hot (44 degrees C), and warm (37 degrees C) water, and the firing rate of MVN neuron was extracellularly recorded. The results showed that the firing rate of MVN neuron was changed by caloric stimulation, and the majority of MVN neurons showed excitation by irrigation with hot water and inhibition by ice water (type A). The neuronal firing was recovered immediately after the cessation of the stimulation. I It was concluded that the neuronal firing rate in MVN was changed by caloric stimulation in middle ear cavity. The response was different in various neurons.

Influence of evoked HSP70 expression on hearing function of the cochlea in guinea pigs.

OBJECTIVE: To investigate the effect of evoked heat shock protein 70 (HSP70) expression on the hearing function of the cochlea in guinea pigs. METHODS: Guinea pigs were divided into pre-exposure group (pre-treated with white noise exposure at 100 dB SPL for 45 min) and none pre-exposure group. Auditory brainstem response (ABR) thresholds were recorded at 12, 60 and 108 h after the animals in both groups were exposed to loud white noise (125 dB SPL, 90 min). RESULTS: HSP70 expression was evoked by pre-treatment with white noise (100 dB SPL, 45 min). There was no significant difference of ABR thresholds between the 2 groups (P>0.05) at 12 h after exposure to loud noise, while ABR thresholds became lower in pre-exposure group than in none pre-exposure group (P<0.01) at both 60 and 108 h. In the pre-exposure group, ABR thresholds at 108 h were significantly lower than that measured at 60 h (P<0.05), but which was not the case in none pre-exposure group. CONCLUSION: HSP70 expression induced by pre-exposure to noise protects the hearing function of the cochlea in guinea pigs.