Objective To evaluate the safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) for the diagnosis and treatment of pancreas divisum(PD) associated with recurrent acute pancreatitis(RAP) in children and teenagers. Methods Data of patients with symptomatic PD associated with RAP under 18 years old who were diagnosed and treated with ERCP from January 2011 to January 2015 were retrospectively analyzed. Patients with complete pancreas divisum underwent endoscopic minor sphincterotomy combined with dorsal duct stenting ( ESCS ) , and those with incomplete pancreas divisum underwent bi?papilla endoscopic sphincterotomy combined with dorsal duct stenting ( Bi?ESCS ) . ERCP?related data, complications were recorded. Long?term follow?up was conducted for procedure related complications. Results Nine patients with symptomatic PD associated with RAP were firstly diagnosed. A total of 18 ERCP procedures were performed in these patients, with success rate of 100. 0% ( 18/18) in the minor papilla cannulation, and mild ERCP?related complication rate of 11. 1% ( 2/18) . One was acute mild pancreatitis and the other was hyperamylasemia. During follow?up from 3 to 60 months, all patients had pain relief, among whom 7 were asymptomatic, with no onset of acute pancreatitis. Dorsal ducts of all patients were not obviously dilated in MRCP or CT scan. All patients gained weight and presented normal physical and intelligence development. Conclusion Symptomatic PD associated with RAP can be completely diagnosed with ERCP . ESCS and Bi?ESCS are safe and effective endoscopic treatment techniques for pediatric cases.

Objective To explore the influence of icotinib in the apoptosis of the human salivary adenoid cystic carcinoma cells ACC-M, and to clarify the mechanism of icotinib for the treatment of salivary adenoid cystic carcinoma.Methods The ACC-M cells were randomly divided into control group,2,4,8μmo1·L-1 icotinib groups,p38-MAPK inhibitor SB203580 (20μmol· L-1 )group,SB203580 (20 μmol· L-1 )+4μmo1 · L-1 icotinib group;the cells were collected 4 h after treatment.The viability of ACC-M cells was measured by MTT assay.The apoptosis of ACC-M cells was assessed by caspase-3 activity kit. The expression of p-p38-MAPK protein was determined by Western blotting analysis.Results Compared with control group,the inhibitory rates of growth of the ACC-M cells in icotinib groups were significantly decreased (P<0.05 ), and the activities of caspase-3 were increased (P<0.05),and the expression levels of p-p38-MAPK were significantly increased (P<0.05).Compared with 4μmo1·L-1 icotinib group,the expression level of p-p38-MAPK in SB203580+icotinib group were decreased (P < 0.05 ), and the activity of caspase-3 was decreased dramatically (P < 0.05 ). Conclusion Icotinib may induce the apoptosis of ACC-M cells through the activation of p38-MAPK signaling pathway.

[ABSTRACT]AIM:ToinvestigatetherolesofthecanonicalWntpathwayinautism.METHODS:Usinganau-tistic model induced by prenatal exposure to valproic acid ( VPA) , we detected the expression of the signaling molecules of the canonical Wnt pathway in the prefrontal cortex (PFC) and hippocampus formation (HF) of autistic rats.The expres-sion levels of glycogen synthase kinase 3β( GSK-3β) , phosphorylated GSK-3β, β-catenin and phosphorylated β-catenin were observed by Western blotting .The mRNA expression of GSK-3β, β-catenin, c-Myc and cyclin D1 was assessed by semi-quantitative RT-PCR.RESULTS:The results of Western blotting showed that inactivated GSK-3β(Ser9) phospho-rylation was significantly increased , and inhibitory β-catenin ( Ser33/37/Thr41 ) phosphorylation was obviously decreased compared with control group .The results of RT-PCR showed that the mRNA levels of β-catenin, c-Myc and cyclin D1 in-creased, and GSK-3βwas significantly enhanced in VPA-exposed rats compared with the controls .CONCLUSION: In-creased activity of canonical Wnt pathway in the PFC and HF of autistic rats may contribute to the susceptibility to autism .

[ ABSTRACT] AIM:To investigate the effects of sulindac on oxidative stress in autism.METHODS:With an au-tistic model induced by prenatal exposure to valproic acid ( VPA) , we detected the expression of the signaling molecules of canonical Wnt pathway in the prefrontal cortex ( PFC) and hippocampus ( HC) of autistic rats treated with sulindac.The protein expression levels of glycogen synthase kinase 3β(GSK-3β), β-catenin and 4-hydroxynonenal (4-HNE) were ob-served by Western blotting.The mRNA expression of thioredoxin(Trx)1 and Trx2 was assessed by semi-quantitative RT-PCR.RESULTS:The protein level of GSK-3βand mRNA levels of Trx1 and Trx2 were lower, whereas the protein expres-sion levels ofβ-catenin and 4-HNE were higher in VPA group than those in control group.In contrast, the protein levels of GSK-3βwere significantly higher in the animals treated with both VPA and sulindac than those in VPA group, while the lev-els ofβ-catenin and 4-HNE were decreased.CONCLUSION:Sulindac attenuates oxidative stress in the pathogenesis of au-tism, suggesting the up-regulation of the Wnt/β-catenin signaling pathway disrupts oxidative homeostasis and further facili-tates susceptibility to autism.

Objective To evaluate the imaging features of benign fibrous histiocytoma (BFH).Methods Imaging data were retrospectively collected and reviewed in 11 patients with pathologically proved BFH.Of the 11 patients,X-ray was performed in all patients,MR scans in 6 patients,and CT scans in 4 patients.Results ALL lesions detected were a solitary lesion.The distribution of BFH was in the tibia (n =5 ),femur ( n =3),fibula ( n =1 ),sacrum ( n =1 ),and thoracic vertebrae ( n =1 ).X-ray features included eccentric osteolytic lesions in 7 patients and centric in 2 patients,with clear boundary and thinning of the cortex,and 7 patients with varying degrees of ossified border were found. CT scan shows bone destruction with density similar to soft tissue.The majority of lesions ( n =3 ) were observed in the expanding shell of bone,2 patients in the tibia and 1 patient in the thoracic lesions with cortical bone perforation.The thoracic lesion as soft tissue mass was detected. All of the lesions detected in CT showed no periosteal reaction.In patients with MR images,hypo to isointense signal intensity on T1WI and hyperintense signal intensity on T2WI was found. All lesions on post-contrast T1WI were detected with homogeneous or heterogeneous lesion with moderate or significant enhancement.Conclusion Imaging features were typical for MFH which is useful tool helping correct diagnosis of MFH.

Objective To report outcomes of patients with PSA ≥ 30 μg/L with initial negative transperineal template-guided saturation biopsy (TTSB). Methods From 2003 to 2010,a total of 1824 patients underwent transperineal saturation biopsies with the prostate template at the Peking Union Medical College Hospital.44 of them had initial negative biopsy with PSA ≥ 30 μg/L were reviewed in this study.The mean age was 68 years old (range,51 to 80).The mean biopsy cores were 28.7 (range,11 to 44).The median PSA level was 40 μg/L (range,30 to 128),and the median prostate volume was 73 ml (range,30 to 190).They were divided into four groups:TURP group,chronic prostatitis group,repeat biopsy group and miscellaneous group. Results Patients were followed up for a mean of 49 months (range,12 to 91).All patients of TURP group (15 cases) were identified as prostatic hyperplasia by postoperative pathology.2 of them had a second TTSB for PSA ＞ 10 μg/L after TURP,which were negative.5 patients of chronic prostatitis group had a declining PSA level after antibiotic therapy for 3 to 4 weeks.One patient took a second biopsy,which was identified as prostatitis.All patients of repeat biopsy group (18 cases) showed no significant decrease in PSA level during follow-up and undertook biopsies 2 to 4 times,6 of which were proved to be prostate cancer.All patients of the miscellaneous group (6 cases) had a declining PSA and didn't take a second biopsy. Conclusions Close follow-up and regular PSA testing for patients who had a high PSA level with initial negative biopsy would be help to avoid both false negative of prostate cancer and unnecessary biopsy.

Objective This study was to investigate the relationship between the activities of thymidine phosphorylase (TP) and dihydropyrimidine dehydrogenase (DPD) and clinicopathological parameters in human colorectal cancer,and the relationship between TP and/or DPD activity in tumor tissue and efficiency of chemotherapy. MethodsSixty-eight patients undergoing surgery for primary colorectal cancer were enrolled including 40 patients receiving postoperative adjuvant chemotherapy with 5-FU plus leucovorin(de Gramont regimen). The activities of TP and DPD both in tumor tissue and in normal tissue were determined by enzyme-linked immunosorbent assay(ELISA). Results The TP activity was significantly higher in tumor than in normal tissues(P

OBJECTIVES: To compare the features of patients with peptic ulcer between Han and Uyghur ethnicity from 2013 to 2018 in Xinjiang and to provide the evidence of prevention and treatment for the different ethnicity. METHODS: Data of 3 586 patients with peptic ulcer (3 293 Han and 293 Uyghur) in the Karamay Central Hospital of Xinjiang, including the detection rate of peptic ulcer, () detection rate of population, season, gender, lesion location and complication, were collected from January 2013 to December 2018 and compared between 2 nationalities. RESULTS: There were significant difference in the detection rate of peptic ulcer and population's between Han and Uyghur (<0.01). The detection rates for peptic ulcer of Han were sustainable declined from 15.20% to 10.23%, while Uyghur's detective rates for peptic ulcer were raised again from 17.49% to 8.38%. The detection rate of Uyghur's population was higher than that of Han (<0.01). There were significant difference in the season's detection rate for peptic ulcer between Han and Uyghur (<0.01). The detection rate for peptic ulcer of Han was the highest in the winter, while that of Uyghur was the highest in the spring. The detective rate of Uyghur's peptic ulcer was significant higher than that of Han in the spring (<0.01). The detection rates for peptic ulcer of 2 nationality were the highest at ≤25 age groups, the detection rate for Uyghur's peptic ulcer was higher than that of Han at ≤35 age groups (<0.05). There were more men than women in peptic ulcer in the 2 nationalities. The approximate proportion was 2꞉1. The rates of multiple gastric ulcer and compound duodenal ulcer of Han were more than those of Uyghur (<0.05), but the rate for pyloric obstruction of Uyghur patient was higher than that of Han (<0.05). CONCLUSIONS There are statistical difference in detection rate of PU, detection rate of population, morbidity season, age, complication and the rate of complex ulcer between Han and Uyghur, However, there aren't statistical difference in detection rate of peptic ulcer patient, the gender, lesion location between the 2 nationalities during last 6 years.
Child, Preschool ; Duodenal Ulcer ; Ethnic Groups ; Female ; Helicobacter Infections ; Helicobacter pylori ; Humans ; Male ; Stomach Ulcer

Objective To analyze the safety and efficacy of autogenous femoral lateral iliotibial fascia(autologous fascia lata) in the treatment of female stress incontinence.Methods The clinical data of 7 female patients with stress incontinence admitted from January 2016 to June 2017 were retrospectively analyzed.The mean age was 58.2 years (range 45-72 years).The mean disease duration was 10.7 years (range 5-21 years).The mean Body mass index (BMI) was 24.1 kg/m2 (range 20.3-31.4 kg/m2).7 patients had severe subjective scores according to clinical symptoms.The average score of urinary incontinence questionnaire-simple form (ICIQ-SF) of international urinary incontinence advisory committee was 14.3 ± 1.1,the score of incontinence-quality of life (I-QOL) was 24.3 ± 4.8,respectively.During general anesthesia,the patient was placed in a half-recumbent position with the right leg straight down and the left leg bent over.The position of patella as well as the iliotibial band of the lateral femoral muscles were marked on the body surface.The iliotibial fascia of the lateral femoral muscle was exposed through a transverse incision 4-6 cm perpendicular to the iliotibial fascia of the lateral femoral muscle.The fascia of the lateral iliac tibial fascia of the lateral vastus with a width of 1.5 to 2.0 cm and a length of 12 to 14 cm was cut.The fascia was immersed in physiological saline and sutured with two 2-0 CT1PDS absorbable sutures or 2-0 vascular sutures at both ends of the fascia for 3 consecutive needles to form a sling.Then the urethral catheter was placed in the position of lithotomy,and then urethral suprapubic suspension was performed using autologous fascia through bilateral paravaginal incisions.The duration of surgery,intraoperative blood loss,intraoperative complications,postoperative catheter indwelling time,the length of hospital stay and postoperative complications were recorded.The situation of urinary incontinence as well as life quality before and after surgery were compared respectively.Results The operation was successfully performed.The mean operative time was 117.6 min(range 95-140 min).The mean intraoperative blood loss was 70.3 ml (range 50-90 ml).No complication was observed during the operation.The mean postoperative indwelling catheterization was 5.8 days (range 5-7 days).The mean postoperative hospital stay was 6.3 days (range 5-8 days).All 7 patients were cured after surgery,2 patients experienced urinary retention after removal of the catheter.The mean follow-up time was 18.2 months(range 13-24 months).No urinary incontinence or complications was observed postoperatively in all cases.Patient ICIQ-SF urinary incontinence questionnaire summary score and quality of life score of I-QOL questionnaire of 1 year post operation were 0.6 ± 0.5 and 96.1 ± 4.3,which were significantly improved compared with that before surgery(P ＜ 0.01).Conclusion It is safe to use autologous femoral lateral muscle iliotibial fascia in the middle segment of urethra suspension for the treatment of female stress incontinence,and the curative effect is affirmative through one-year observation.

Objective: To investigate the prevalence, awareness, treatment and control of hypertension in adult residents in Jiangsu province and provide evidence for the prevention and control of hypertension. Methods: A population-based cardiovascular disease screening project was conducted during 2015-2018 in Jiangsu, a total of 95 348 community-dwelling adults aged 35-75 years from 6 project areas were included in the study. The prevalence rate of hypertension and rates of awareness, treatment and control of hypertension in the adults with different characteristics were analyzed. Multilevel model was applied to identify the influencing factors. Results: Among 95 348 adults surveyed, 54 407 were hypertensive, the standardized prevalence rate was 48.1%. The prevalence rate was significantly higher in males than in females (62.1% vs. 54.0%, P<0.05). Among the hypertension patients, the rates of awareness, treatment and control of hypertension were 56.6%, 45.3% and 12.0% (standardized rates: 52.2%, 41.0% and 11.2%), respectively, and all the rates were positively associated with age (all P<0.05). Multilevel model analysis showed that those who were males, at older age, lived in rural area, suffered from diabetes, had frequent alcohol drinking and those who were overweight/obese had higher risk for hypertension (all P<0.05). Among people with hypertension, those who had younger age, lower education level, lower household income level and those who had frequent alcohol drinking had lower awareness, treatment and control rates of hypertension (all P<0.05). Conclusions The prevalence rate of hypertension was high, but related awareness, treatment and control rates were low in adult residents in Jiangsu province. Comprehensive measures should be taken to improve awareness, treatment and control of hypertension in whole population, especially in young adults, and those with low education or income levels.