Objective To explore the clinical characteristics and prognostic factors of patients with hepatolithiasis associated with intrahepatic cholangiocarcinoma. Methods The clinical data of 39 patients with hepatolithiasis associated with intrahepatic cholangiocarcinoma in the First Affiliated Hospital of Chongqing Medical University from Jan 2006 to Jun 2013 was retrospectively analyzed. Results The main clinical manifestations of hepatolithiasis associated with intrahepatic cholangiocarcinoma included recurrent fever, abdominal pain, jaundice and hepatic percussion pain. Among the 39 cases, the patients older than 60 years accounted for 69.2 % (27/39), and the duration of hepatolithiasis more than 10 years accounted for 76.9 % (30/39). Remarkable differences were found in serum CA19-9 and surgery methods (both P< 0.05). Conclusions Recurrent fever, abdominal pain, jaundice and hepatic percussion pain are the main clinical manifestations for the patients who are diagnosed with hepatolithiasis associated with intrahepatic cholangiocarcinoma. Advanced age and longer duration of the disease may be the high risk factors. Serum CA19-9 levels and surgical methods are the important prognostic factors.

Objective To discuss MRI appearance of the cerebral schistosomiasis and its clinical value through analyzing the MRI features and post surgery pathological findings. Methods MRI features of the cerebral schistosomiasis in 16,pathologically ( n =6) or clinically( n =10) proved cases were analyzed etrospectively,and compared with the post surgery pathological findings in 6 cases. Results Single masses were found in 11 cases (11/16),and multiple masses in 5 cases(5/16), amounting to 23 masses . fifteen masse(15/23) were located in right cerebral hemisphere,including frontal lobe ( n =2),frontoparietal lobe ( n =5) ,and occipitoparietal lobe ( n =8), while 8 masses (8/23) in left cerebral hemisphere,including frontal lobe ( n =1),frontoparietal lobe ( n =3), and occipitoparietal lobe ( n =4).The nodular masses were isointense with the gray mass like "island", and 12 cases (12/16) show the "gigantic hand" form of edma around them. After IV administration of Gd DTPA,15cases (15/16) revealed multiple closely spaced,intensely enhancing nodules,1 3 mm in diameter,distributed throughout the mass. Seven cases misdiagnosed by CT were revised by MRI. Conclusion The MRI appearance of the cerebral schistosomiasis is characteristic,and MRI is the most valuable tool to diagnose it without injury.

Objective To investigate the serum copeptin level in patients with acute pancreatitis and explore its clinical significance. Methods Sixty-three patients with acute pancreatitis were enrolled , 35 of which were diagnosed as mild acute pancreatitis (MAP), and the other 28 patients were diagnosed as severe acute pancreatitis (SAP). Serum copeptin levels of all patients were determined on admission , on the second day and the third day after admission, respectively. Thirty healthy subjects were enrolled as the control group. Results Serum copeptin level was obviously higher in patients with SAP than the healthy individuals (P < 0.05), and was also significantly higher in the SAP patients than in the MAP patients (P < 0.05). Moreover, the serum copeptin level in SAP patients was highly associated with mortality and local complication (P < 0.01). Conclusion Serum copeptin level was increased at the early stage of acute pancreatitis and was associated with disease severity, which made it a potential diagnostic and prognostic marker for acute pancreatitis.

Objective To evaluate the risk factors of urethral recurrences following radical cystectomy for transitional cell carcinoma of the bladder and to discuss the treatment options. Methods Clinical data of 278 patients who underwent radical cystectomy for bladder cancer were analyzed retrospectively. Urethral recurrences were observed in 24 patients. Risk factors of recurrence were evaluated by Cox's multifactor regression model. Results None of the 6 patients undergoing selective prophylactic urethrectomy died;10 of the 24 patients with urethral recurrence died of tumor metastasis.Multiple factor analysis suggested that prostate involvement,bladder neck involvement,trigone tumor,multiple tumor and carcinoma in situ were the high risk factors,and their relative risk coefficients were 1.573,1.532,1.360, 1.337 and 1.213,respectively. Conclusions Simultaneous urethrectomy following radical cystectomy should be performed for patients with high risk factors (prostate involvement, bladder neck involvement, trigone tumor,multiple tumor and carcinoma in situ) of urethral recurrence,while patients without risk factors are eligible candidates for reconstruction of the urinary tract after cystectomy by an orthotopic neobladder.

We investigated the effects of γ-interferon and exogenous indole on the growth of domestic dominant standard strains and clinical straìns of Chlamydia trachomatis E-UW-5/Cx,and compared with the dominant strains of D-UW-5/Cx abroad.We used DMEM-10,DMEM-10 containing 5 ng/mL recombinant human interferon gamma (referred to as DMEM-10+IFN) and DMEM-10 containing 5 ng/mL recombinant human interferon gamma and 50 μM exogenous indole (referred to as DMEM-10+IFN+IND) to culture C.trachomatis,and then we fixed it with methanol to count inclusions after 48 hours,observing the influence of r-interferon and exogenous indole on the growth of C.trachomatis standard strains(E,D) and clinical strains.Results showed that the count of Chlamydia inclusion bodies in DMEM-10+IFN group was significantly lower than others (P＜0.05);no significant difference was found (P＞0.05) between the count of DMEM-10 group between DMEM-10+IFN+IND group.There were no significant difference between the E and D standard or clinical strains (P＞0.05).Under the effect of IFN-γ,the growth of domestic dominant strain E-UW-5/Cx C.trachomatis was significantly inhibited.After adding exogenous indole,C.trachomatis can escape the scavenging activity of IFN-γγto restore the infection vitality.

ObjectiveTo analyze the association of HLA-DQA1 gene polymorphism with persistent Chlamydia trachomatis genital infection.Methods Blood samples were collected from 80 patients with persistent genital Chlamydial infection,80 patients with common genital Chlamydial infection(who tested negative for Chlamydia trachomatis after one course of standard systemic treatment) and 80 normal human controls.HLA-DQA1 alleles were genotyped by PCR followed by gene sequencing.ResultsThe frequency of HLA-DQA1*0102 allele and HLA-DQA1*0501 allele was 22.5％ and 5.0％ respectively in patients with persistent genital Chlamydial infection,5％ and 20％ respectively in those with common genital Chlamydial infection,2.5％ and 17.5％ respectively in normal human controls.Compared with the patients with common genital Chlamydial infection and controls,the patients with persistent genital Chlamydial infection had a higher frequency of HLA-DQA1*0102(x2 =14.6286,P ＜ 0.001 ),but a lower frequency of DQA1*0501 (x2 =6.2598,P ＜ 0.05).ConclusionsHLA-DQA1*0102 allele may be a susceptible gene or closely linked with the susceptible genes of persistent genital Chlamydial infection.HLA-DQA1*0501 allele may have protective effects against persistent genital Chlamydial infection.

Objective To investigate the relationship between polymorphism of arylamine N-acetyltransferase 2 (NAT2) and hair dye dermatitis in a Chinese population. Methods Polymorphism chain-restriction fragment length polymorphism (PCR-RFLP) was used and the wild-type allele (NAT2 * 4) and three mutant alleles (NAT2 * 5A, 6B and 7A) were determined in 60 patients with hair dye dermatitis and 73 age-matched control subjects in Tianjin region. Results In hair dye dermatitis cases, the frequency of NAT2 * 4, NAT2 * 5A, NAT2 * 6B, NAT2 * 7A was 52. 5 % , 5. 0 % ,26.7 % and 15. 8 %, respectively, and no statistically significant difference of the frequencies was found between the hair dye dermatitis patients and controls (P>0. 05). The frequency of rapid genotype, intermediate genotype and slow genotype was 26. 7 % , 51. 7 % and 21. 7 % in hair dye dermatitis cases, 30. 1 %, 50. 7 % and 19. 2 % in control subjects, respectively, and no statistically significant difference of the frequencies between the two groups (P>0. 05). Conclusions Our study suggests that there might be no relationship between polymorphism of NAT2 and genetic susceptibility to hair dye dermatitis in a Chinese population.

Objecfive To detect serum antibodies to Pmp in patients with urogenital Chlamydia trachomatis infection and to assess the relationship between Pmp and urogenital C.traehomatis infection.Methods Twenty healthy adults and 77 patients with urogenital C. trachomatis infection were recruited into this study.A 3-month foilow-up was carried out in 43 patients,who were classified into persistent infection group(n=19)and negative-conversion group(n=24).Western-blot was performed to detect serum antibodies to Pmp in all subjects.Results The positivity rate of anti-Pmp antibodies was 90.20% (71/77) in patients,significantly higher than that in the normal controls[20% (4/20),P<0.05].All the 9 types of anti-Pmp antibodies were detected in patients with a varying positivity rates,which were 61.04% (47/77),88.31% (68/77),63.63% (49/77),28.57% (22,77),63.63% (49/77),75.32% (58/77),62.34% (48/77),77.92% (60/77)and 70.13% (54/77) for antibodies against PmpA,PmpB,PmpC,PmpD,PmpE,PmpF,PmpG,PmpH and PmpI respectivelyThe prevalence was highest for anti-Pmp B antibodies and lowest for anti-Pmp D antibodies.There was no significant difference in the positivity rate of anti-Pmp antibodies between persistent infection group and negativeconversion group.Conclusions Anti-Pmp antibodies could be generated in patients infected with C. trachomatis.The immunogenicity of different Pmps is different,and the immunoprotective activity of Pmps is rather weak.Individual differences exist in serum anti-Pmp antibodies among patients.Nine types of Pmps are expressed in patients with urogenital C. trachomatis infection.

ObjectiveTo study the effect of a recombinant plasmid encoding mouse interleukin 2 (mlL-2) on the immunogenicity of DNA vaccine against Chlamydia trachomatis(Ct) serovar E.Methods BALB/c mice were divided into 4 groups to be intramuscularly inoculated with blank plasmid(negative control group),DNA vaccine against Ct serovar E(DNA vaccine group),DNA vaccine against Ct serovar E and a recombinant plasmid containing mIL-2(combination group),and inactivated Ct serovar E elementary bodies (positive control group),respectively.The immunological effects were evaluated by posterior foot pad thickness,proliferation level of spleen lymphocytes,serum level of IL-4 and interferon (IFN)-γ in mice,and the capability to clear Ct genital tract infection.ResultsThe proliferation index of spleen lymphocytes in the combination group and positive control group was similar(3.64 ± 0.41 vs.3.77 ± 0.34),but was significantly different from that in the blank control group and DNA vaccine group (1.37 ± 0.21 and 2.52 ± 0.30).The serum level of IL-4 was(38.49 ± 12.24) pg/ml in the positive control group,significantly higher than in the negative control group,DNA vaccine group and combination group ((25.37 ± 18.93),(24.75 ± 8.49),(21.74 ± 6.43) pg/ml,respectively).With respect to the serum level of IFN-γ,the combination group and positive control group were similar ((1923.3 ± 518.1) pg/ml vs.(2712.5 ± 887.2) pg/ml),but were significantly different from the negative control group and vaccine group((310.8 ± 160.7) pg/ml and(601.3 ± 357.9) pg/ml).Six days after Ct challenge,the exfoliated cells from genital tract were positive for Ct culture in the negative control group,but negative in the other 3 groups.ConclusionIL-2 genetic adjuvant can enhance the immune response,especially Th1 type response,induced by the DNA vaccine against Ct serovar E.

Retmperitoneal ganglioneuroma is a rare neurogenic benign tumor.The prognosis of patients was good when the tumor was completely resected,while the surgical procedure is complicated.In March of 2013,a male patient with complex retroperitoneal ganglioneuroma was treated at the First Affiliated Hospital of Chongqing Medical University.A hypoechoic solid lesion (size,6.5 cm ×4.5 cm) adjacent to the head of the pancreas was detected by color Doppler ultra-sonography 9 months ago,and no any other clinical symptoms were detected.Perioperative abdominal computed tomography and the surgery confirmed that the tumor (size,8.5 cm × 7.5 cm × 4.5 cm) was located beneath the pancreas,encompassing thc ccliac artery,hepatic artery,splenic artery and superior mesenteric artery,surrounding the head and uncinate process of the pancreas,making it impossible to be separated.The tumor was closely connected with the portal vein,superior mesenteric vein,splenic vein and left renal vein.The tumor was separated from the major blood vessels,the body and tail of the pancreas,while the tumor could not be resected from the pancreatic head,and thus tumor resection and pancreaticoduodenectomy were performed.The surgery was extremely diffcult,but the complete removal of tumor was successfully achieved without excision of the major blood vessels and the patient recovered well.