Glutathione ; metabolism ; Humans ; Lipoxygenase ; metabolism ; Oxidation-Reduction ; Xenobiotics ; metabolism

Objective To explore the diagnostic value of EUS-guided aspiration biopsy for wall-thickened gastric lesions. Methods A retrospective study was performed in 45 patients who were diagnosed as having thickened gastric wall by EUS examination.Pathological and follow-up results of routine endoscopy and EUS-guided aspiration biopsy were analyzed,with the surgical results and follow-up outcome as the golden standard.The positive rate of routine endoscopy and EUS-guided aspiration biopsy were compared. Results In routine biopsy,gastric cancer was confirmed in 6,lymphoma in 3,dysplasia in 6,Menetrier′s disease in 2 and inflammatory changes in 28.EUS-guided aspiration biopsy was conducted in 45 patients,and gastric cancer was confirmed in 18,lymphoma in 5,dysplasia in 4,Menetrier′s disease in 2 and inflammatory changes in 16.The final pathological and follow-up results confirmed 21 gastric cancer,6 lymphoma,2 dys-plasia,2 Menetrier′s disease,other tumors in 4 and inflammatory changes in 10. The accuracy rate of routine biopsy and EUS-guided aspiration biopsy was 51. 11%( 23/ 45 ) and 82. 22%( 37/ 45 )respectively. Conclusion EUS-guided aspiration biopsy can yield a higher positive rate than endoscopic biopsy.

Objective To report on the experiences related to diagnosing and managing the bile duct injury in laparoscopic cholecystectomy. Methods To analyse retrospectively the diagnostic and treating experience in 23 cases of bile duct injury. Results Twelve cases of the common bile duct injury, 6 cases of transection of common bile duct, 2 cases of transection injury of common hepatic duct, one case of transec-tion of right hepatic duct, one case of transverse clip block of common bile duct, perforation in each of common bile duct and common hepatic duct. Eleven cases of accessory hepatic duct injury, including one case of aberrant bile duct injury, 7 cases of tiny accessory hepatic duct injury and 3 cases of thick accessory hepatic duct injury. All cases in this group were cured. Conclusion Comparing with LC and open cholecystectomy, occult bile duct injury is more readily to happen in LC with more difficulty in repairment and poor prognosis. Therefore we should strictly select the appropriate operative manual according to patient' s situation.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Panic Disorder ; psychology ; therapy ; Treatment Outcome

BACKGROUND: Changes of physiological structure, changes of phenotype and first basic excision are all the changes of gene expression. The technique of DNA microarray is a new method to filtrate target genes fleetly and largely by using the theory of base-partnershin, which can holistically and magnificently study the expression and function of organics genes. OBJECTIVE: To study early differential expression genes of rats with cerebral hemorrhage with DNA microarray and establish academic foundation for exploring mechanism of cerebral hemorrhage.DESIGN: Randomized controlled research.SETTING: Department of Neurology, Affiliated Hospital of North Sichuan Medical College. MATERIALS: The experiment was conducted at the Affiliated Hospital of North Sichuan Medical College from October 2002 to December 2003. Twenty Wistar rats, of either gender, with body mass of 220-260 g, without special pathogen, provided by Experimental Animal Center of Chongqing University of Medical Sciences, were selected and randomly divided into control group and cerebral hemorrhage group, with 10 in each group. METHODS: Animal models with cute cerebral hemorrhage of rats were established with type Ⅶ collagenase tridimensional localization method,and 4 hours later tissues around hematom and normal cerebral tissue at the same part were detected with gene chip. Fluorescent signal was scanned with scanning apparatus and analyzed with computer. Result of genic expressive pattern was researched with reverse transcriptase-polymerase chain reaction (RT-PCR). MAIN OUTCOME MEASURES: Result of gene chip in cerebral tissue of rats and result of RT-PCR.RESULTS: Four hours after acute cerebral hemorrhage, 129 differential expression genes were screened out, in which there were 114 up-regnlation genes and 15 down-regulation genes. Those genes were mostly related to the following aspects: stress, immunological response, apoptosis, energy metabolism and signal transmitting. Genes related with inflammatory impairment were mostly obvious. The result of RT-PCR suggested that the level of genic expression was as the same as the result of Cdna chip, which indicated that genic expressive pattern based on gene chip had great reliability.CONCLUSION: Early cerebral hemorrhage has many differential expression genes, which can play an important role in hemorrhagic brain damage.

Objective To investigate clinical characteristics and outcome of patients with liver cirrhosis complicated with diabetes,and to explore the differences of clinical characteristics and prognosis between hepatogenous diabetes (HD) and type 2 diabetes mellitus (T2DM).Methods From November 2010 to April 2012,246 patients with liver cirrhosis were collected and divided into liver cirrhosis complicated with diabetes (LC-DM) group (n=72) and liver cirrhosis without diabetes (LC) group (n=174).LC-DM group was then sub-divided into HD group (n=33) and T2DM group (n =39).All the patients were followed up until death or the study endpoint.The clinical characteristics,prognosis and indicators of glucose metabolism were compared and analyzed.Oral glucose tolerance test and insulin C-peptide release test were conducted in part of patients in LC-DM group.Student t test was performed for mean comparison between two groups.Chi-square test was used for count data and rate comparison between two groups.The death related factors of liver cirrhosis were analyzed by Logistic regression analysis.Results The percentage of alcoholic liver cirrhosis of LC-DM group was 18.1 ％ (13/72),which was higher than that of LC group (6.9％,12/ 174) and the difference was statistically significant (x2=6.946,P=0.008).In HD group,the percentage of patients with diabetes family history was 9.1％ (3/33),which was lower than that of T2DM group (30.8％,12/39),the percentage of alcoholic liver cirrhosis was 30.3％ (10/33),which was higher than that of T2DM group (7.7％,3/39),the total bilirubin level ((43.4±57.7) μmol/L) was higher than that of T2DM group ((22.6 ± 13.3) μmol/L),the total cholesterol level ((3.3 ±1.2) mmol/L) was lower than that of T2DM group ((4.0±1.6) mmol/L),and the differences were statistically significant (x2=5.093 and 6.177,t=2.178 and 2.014,P=0.024,0.013,0.033 and 0.048).The duration of hospitalization,Chiid-Pugh score,the incidence of upper gastrointestinal bleeding,the incidence of hepatic encephalopathy,electrolyte disturbances and mortality of LC-DM group were all higher than those of LC group and the differences were statistically significant(t=2.389 and 2.270,x2 =6.496,5.572,5.194,19.646,all P＜0.05),and there was no significant difference between HD group and T2DM group(all P＞0.05).The blood glucose levels of HD group at different time point (0,30,60,120,180 min) were all lower than those of T2DM group and the differences were statistically significant (t=3.175,2.345,3.444,3.090,3.542,all P＜0.05).The fasting insulin level of HD group was close to that of T2DM group,the insulin levels of HD group at other time point (30,60,120,180 min) were all higher than those of T2DM group and the differences were statistically significant (t =3.084,2.881,3.648,2.840,all P＜ 0.05).There was obvious hyperinsulinemia in HD group.At 0,30,60,120,180 min,C-peptide level of HD group was at normal levels,and which of T2DM group was lower than normal.Child-Pugh grade C was an independent predictor factor of death in patients with liver cirrhosis (OR =3.056,95 ％ CI:1.268 ～ 7.346,P=0.013).Conclusions Compared with liver cirrhosis patients without diabetes,the liver function of patients complicated with diabetes was worse,and the incidence of complication and mortality was higher.However there was no significant difference between HD group and T2DM group.

Objective To investigate the role of temporary placement of fully covered self-expandable metal stent (cSEMS) for treatment of uncontrolled bleeding after endoscopic sphincterotomy (EST).Methods From January 2000 to present,a total of 3460 cases of EST were performed,and bleeding after the procedure was complicated in 29 (0.84％) of them,in which 4 could not to be stopped by conventional managements.Covered SEMSs were placed across the major papilla in these 4 patients.Results The stents were successfully placed and hemostasis was achieved in all patients.The stent was removed in 1 patient 1 week later,and spontaneous stent dislodgment occurred in 1 patient within 4 weeks.The other 2 patients rejected to remove the stents,and the patency maintained for more than 6 and 12 months respectively.No complication was observed in procedures of placing and removing stents.Conclusion Covered SEMS placement is a safe,effective and simple method for patients with uncontrolled bleeding after EST.

lnsulin-like growth factor (IGF) system has multiple bioactivities,such as regulating cell proliferation and differentiation,and inhibiting apoptosis and so on.In vivo and in vitro experiments have confirmed that IGF system takes part in the malignant transformation of cells and is related to the growth,invasion and metastasis of toumor.IGF system will be applied to early screening and target therapy for colorectal cancer.

Objective To analyze the clinical features and evaluate outcomes of active pulmonary tuberculosis(TB)patients in floating population.Methods Retrospectively analyzed the clinical data of 68 active pulmonary TB patients in floating population,in comparison with 123 cases of TB patients of local which was treated as control group.Evaluated the outcomes by analyzing the composition of sex and age,tuberculosis type,positive phlegm germ.males and 33 females;so the male to female ratio was 2.73:1,the difference between two groups was statistically significant(x2=3.37,P＜0.05).The age in study group ranged from 18 to 62,the average was(30.23±18.52),and it ranged from 18 to 70 in control group,the average was(46.46±31.50),the difference between two groups was statistically significant(t=25.14,P＜0.05).Among those aged 21 to 30,the incidence in study group was 44.11%(30/68),and in control group it was 24.39%(30/123),the difference between two groups had statistical significance(x2=9.91,P＜0.05).In study group,there were 68 sputum smears,47 of them were positive,and the proportion was 69.11%;In control group,there were 123 sputum smears,70 of them were positive,and the proportion was 56.91%.The difference between two groups had statisticall significance.In study group.there were 22 patients who stopped by themselves accepting treatment,accounting for 34.92%;At same time,in control group,there were 23 patients who stopped by themselves accepting treatment,accounting for 18.67%.The difference of treatment compliance between two groups had statistical significance(x2=6.890,P＜0.05).After 6 months treatment,41 cases were treated in study group,of them 37 cases sputum bacterium turns negative,accounting for 90.24%;the same time 100 cases were treated in control group,of them 92 cases sputum bacterium turns negative,accounting for 92.00%.The difference of sputum bacterium conversion rate in two groups had no statistical significance(x2=0.1 10,P＞0.05).Conclusion The incidence rate of tuberculosis was high in floating population of Pinghu City.The TB patients in floating population could receive the same treatment as those in local population through DOTS treatment.

Objective: To study the effects ot intravenous 1％ procaine on cortex. Method: Ten patients,aged 29-59 years,for elective surgical operations,were observed the changes of spectral edge frequency(SEF), medium power frequency (MPF)and ? rate(?R)on power spectral analysis and bispectral index(Bl)on bispectral analysis during intravenous propofol 4 mg?kg~(-1)? h~(-1) purely for 15 min,intravenous combination of 1％ procaine 1mg?kg~(-1)?min~(-1) and propofol for 30 min, then intravenous propofol 4mg?kg~(-1)?h~(-1)purely for 15min. Result: SEF,MPF and BI values during combination stage were lower significantly (15.46?1.87Hz, 7.21?2.01Hz, 68.77?7.99 respectively)than the values during other two stages(stage 1 and stage 2 were 21.36?2.79Hz,11.55?2.62Hz,85.6?8.84 and 20.59?3.10Hz, 9.5?3.44Hz, 84.97?8.71 respectively, P