OBJECTIVE:  We aimed to determine the prevalence of eosinophilic esophagitis (EoE) and define its clinical and endoscopic characteristics in Chinese patients. METHODS:  Esophageal specimens obtained from January 2006 to December 2010 in the First Affiliated Hospital of Sun Yat‐sen University were reviewed, and the data on clinical characteristics and endoscopic findings of patients were obtained. Patients with eosinophils ≥15 per high power field (HPF) were identified as having EoE. RESULTS:  A total of 12 patients met the criteria for EoE, establishing a prevalence of 0.34%. These patients presented with dysphagia (4/12, 33.3%), gastroesophageal reflux disease (GERD)‐like symptoms (3/12, 25.0%), abdominal pain (3/12, 25.0%) and others (2/12, 16.7%). The most common endoscopic finding was plaques (5/12, 41.7%), and other findings were irregular Z‐line (2/12, 16.7%), erosive esophagitis (2/12, 16.7%), white exudates (1/12, 8.3%), linear furrows (1/12, 8.3%), Schatzki ring (1/12, 8.3%), ulcers (1/12, 8.3%) and erythema (1/12, 8.3%). CONCLUSIONS:  The prevalence of EoE was 0.34% in our patients. Clinicians should pay attention to patients manifested with dysphagia and GERD‐like symptomes with endosopic findings of white exudates, plaques, Schatzki ring and linear furrows.

PurposeAcupuncture therapy is effective for relieving postoperative pain. Our previous study showed that electroacupuncture (EA) at Futu (LI18) and Hegu (LI4)–Neiguan (PC6) could alleviate incisional neck pain, which was related with its effect in upregulating γ-aminobutyric acid (GABA) expression in cervical (C3–6) dorsal root ganglions (DRGs); but whether its receptor subsets GABAAα2R and GABABR1 in C3–6 DRGs are involved in EA analgesia or not, it remains unknown.Materials and methodsSeventy-five male Sprague Dawley rats were randomized to normal control, model, LI18, LI4–PC6, and Zusanli (ST36)–Yanglingquan (GB34) groups. The incisional neck pain model was established by making a longitudinal incision along the midline of the rats’ neck, followed by repeated mechanical stimulation. EA was applied to bilateral LI18, LI4–PC6, or ST36–GB34 for 30 minutes at 4, 24, and 48 hours after operation. The thermal pain threshold of the neck was detected by a tail-flick unit, and the C3–6 DRGs were removed for assaying the immunoactivity of substance P (SP), GABAAα2R, glial fibrillary acidic protein (GFAP; a marker of satellite glial cells [SGCs]), and GABABR1 and the expression of GABAAα2R and GABABR1 mRNA and proteins using immunofluorescence, real-time PCR, and Western blotting, respectively.ResultsThe cervical thermal pain threshold was significantly lower in the model group than the normal group (P<0.001), indicating hyperalgesia after neck incision, and was considerably increased in both EA-LI18 and LI4–PC6 groups (P<0.001), but not in ST36–GB34 group compared with model group (P>0.05). Immunofluorescence staining showed that GABAAα2 R expressed on SP+ neurons, and GABABR1 on SGCs. EA of LI18 and LI4–PC6 markedly suppressed the modeling-induced upregulation of the immunoactivity of SP (P<0.001 and P<0.01, respectively) and GFAP (P<0.01 and P<0.001, respectively) and significantly reversed neck incision–induced downregulation of the expression of GABAAα2R and GABABR1 mRNAs and proteins (P<0.05).ConclusionEA of LI18 and LI4–PC6 has an analgesic effect in incisional neck pain rats, which is related to its effects in upregulating GABAergic inhibitory modulation on nociceptive peptidergic neurons and SGCs in cervical DRGs.

Approximately 40% to 50% of gastrointestinal stromal tumor (GIST) patients will have recurrence or metastases after resection of the primary lesion, and the most common affected sites will be liver and peritoneum. Imatinib has been considered as the first-line therapy of metastatic GIST. Surgery for metastases is proposed when possible. Furthermore, there are controversies concerning hepatic resection and systemic tyrosin kinase inhibitors (TKIs). The therapeutic conditions and long-term outcome of GIST patients with liver metastases in northern China remain unknown.The clinical, pathological, and follow-up data of 144 GIST patients, who had liver metastases between June 1996 and June 2014 from 3 tertiary cancer centers in northern China, were reviewed.Thirty-two cases (22.2%) had hepatectomy with 23 (23/32, 71.9%) R0 resections and 9 (9/32, 28.1%) R1/R2 resections, respectively. Twenty-three patients were given imatinib postoperatively. Furthermore, 98 (68.1%) patients were given TKIs only to control disease progression, and sunitinib was considered after imatinib failure in 12 patients. The 1-, 3- and 5-year survival rate was 82%, 51%, and 24%, with a median overall survival of 48 months for all patients. Patients who had hepatic resection combined with TKIs had a tendency of improved outcome, and the median survival time was 89 months. This was in contrast to patients who received TKIs only, in which median survival time was 53 months. Patients who received imatinib plus sunitinib had a tendency of longer survival time, compared with patients who received imatinib only (not reached vs 50 months).TKIs combined with hepatic resection had a role in improving the outcome of GIST patients with liver metastases.

The SSI rate of paediatric patients after open tibia fracture fixation is significantly lower than that of adults, and the prognosis of the former is superior. The results indicate a superior ability of soft tissue recovery and infection resistance after open tibia fracture fixation among children.

Reduction ascending aortoplasty shows good early results in patients with aortic valve disease and dilatation of the ascending aorta. Redilatation tends to happen in patients with BAV, and long-term follow-up is necessary.