Objective To investigate the value of prostate-bladder angle (PBA) measured by MRI in the diagnosis of benign prostate obstruction (BPO). Methods A retrospective analysis was carried out on 87 benign prostatic hyperplasia (BPH) patients referred for lower urinary tract symptoms (LUTS) between March 2009 and November 2009. PBA was measured by MRI and urodynamic parameter Qmax was measured as well. With the diagnostic criteria of BPO as Qmax＜10 ml/s, the patients were divided into two groups: obstruction group and non-obstruction group. PBA was compared between these two groups. The sensitivity and the specificity of PBA in diagnosing BPO were also analyzed. Results The age range of the patients was 57-90 years with a median age 73 years; Qmax was 2.325.4 ml/s with median Qmax 7.9 ml/s; PBA was 4°-52° with median PBA 27°. There were 25 patients in the non-obstruction group with PBA between 4°- 21°(13°); in the obstruction group,there were 62 patients with PBA between 15°- 52°(34°). PBA was found statistically different between the obstruction and non-obstruction group (P＜0.01). With the cutoff at PBA≥20°for the diagnosis of BPO, the sensitivity and specificity of the diagnosis were 90. 3 % (56/62)and 96.0% (24/25), respectively. Conclusion PBA measured by MRI is valuable and can be used as a new non-invasive parameter in the diagnosis of BPO.

Objective To investigate the biological effects of exosomes secreted by KYSE410 cells on migration and invasion of KYSE410,KYSE510,YES2 cells and the possible mechanisms underlying the phenotype change.Methods The exosomes were isolated from the conditional supernatant of esophageal cancer cell line KYSE410 by ultracentrifugation.The morphology of exosomes was observed by transmission electron microscopy (TEM).Western blotting was used to detect the protein markers of exosomes.The uptaken of fluorescence-labeled KYSE410 exosomes by KYSE410,KYSE510 and YES2 was also recorded under confocal microscopy.Migration and invasion ability of the three esophageal carcinoma cell lines and the effects of exosomes from KYSE410 on migration and invasion of KYSE410,KYSE510 and YES2 cells were analyzed by Transwell chamber,respectively.The alteration of Wnt/β-catenin and PI3K/Akt pathway-related proteins were detected by Western blotting.Results The membrane structure of KYSE410 derived exosomes could be observed with its diameter ranged between 30-100nm.The invasion and migration ability of three esophageal cancer cells are KYSE410＞ KYSE510＞ YES2.KYSE410 exosomes promoted the migration and invasion of KYSE410,KYSE510 and YES2 cells.Conclusions Concentrated exosomes derived from the highly migratory and invasive esophageal cancer cell line KYSE410 promoted the migration and invasion potentials of itself and esophageal cancer cell lines KYSE510 and YES2,which possibly exerted the effects by activating Wnt/β-catenin and PI3K/Akt signaling pathways.

Objective To evaluate the applicability and security of transpancreatic precut sphincterotomy vs double guidewire technique for cannulation in difficult bile duct cannulation in endoscopic retrograde eholangiopancreatography (ERCP). Methods Retrospective analysis of 158 cases difficult bile duct cannulation in ERCP from January 2012 to January 2014, according to the intubation tube method, we divided all the cases into 3 groups, transpancreatic precut sphincterotomy group (group A); double guide wire technique group (group B); single guide wire technique group (group C). Then compare the intubation success rate and the incidence of complications among the 3 groups. Results 54 of 58 patients in group A intubation successful, the success rate is 93.1%, 50 of 56 patients in group B intubation successful, the success rate is 89.3%, 26 of 44 patients in group C intubation successful, the success rate is 59.1%, there was no significant difference between group A and B(P > 0.05), group A and group C, group B and C have significant difference (P < 0.05). In group A, 4 cases were complicated with acute pancreatitis, hemorrhage in 6 cases, infection in 2 cases, the complication rate is 20.7%; In group B, 5 cases were complicated with postoperative pancreatitis, 4 cases of infection, incidence of complications is 16.1%; 7 patients were complicated with pancreatitis in group C, hemorrhage in 2 cases, infection in 4 cases, complication rates is 29.5%, 3 groups were no perforation occurred.The complication rate of group B is lower than in group A, but no significant difference (P > 0.05), group A and group C, B and C complication rates had significant difference (P < 0.05). Conclusions When selective bile duct intubation is difficulty and guide wire thread into the pancreatic duct, continue to single guide wire have low intubation success rate and higher incidence of complications,transpancreatic precut sphincterotomy and double guide wire technique can effectively improve the success rate of intubation, and complication rates are relatively low, no significant difference between the two.

Objective To investigate the therapeutic effect and safety of the clip with the flossmethod during endoscopic submucosal dissection for early gastric angle cancer. Methods A total of 27 gastric angle lesions diagnosed as early gastric cancer were treated by ESD. They were randomized to two groups, routine ESD group and clip with the flossgroup. The procedure time, complication events, en-block resection rate and complete resection rate were compared between the two groups. Also,the learning time was divided to two stages and the learning curve was studied according to the resected specimen areas per minute. Results The en block rate was 85. 7%(12/14) in the routine ESD group and 100. 0%(13/13) in the clip with the floss group. The procedure time in the clip with the flossgroup was significantly less than that in the routine ESD group (the median time 30 min VS 40 min, P =0. 011) . Perforation and the post operative bleeding did not occur in either group. The ESD learning curving during the first learning period and the mean resected specimen (area/min) in theclip with the floss group were larger than routine ESD group(30±6 mm2/min VS 20±5 mm2/min,P=0. 01). However, no difference presented during the second learning period between the two groups. Conclusion Clip with the flossmethod during endoscopic submucosal dissection for early gastric angle cancer as a novel procedure is safe, efficacious and worthy to recommend to beginning learners.

Background and purpose:Head and neck cancer is common worldwide. This article aimed to describe the patterns of incidence of head and neck cancer and their changes in Shanghai from 2003 to 2012, in order to provide reference for prevention programs, research and control strategies on cancer.Methods:The data of lip, oral cavity and pharynx cancer cases were collected by the Shanghai Cancer Registry. The distributions of Shanghai lip, oral cavity and pharynx cancer incidences from 2003 to 2012 were described. The patterns were described according to gender, age, basis of diagnosis, histological type, diagnostic stage in detail. We compared incidences of recent 5 years (from 2008 to 2012) with those of previous 5 years (from 2003 to 2007).Results:On average from 2003 to 2012, 1105 new cases of head and neck cancer were diagnosed in Shanghai each year, with 2.08% among the total cancer cases. The crude rate was 8.01 per 100000 and the age-standardized rate was 4.45 per 100000. Nasopharyngeal cancer was the major subtype of the head and neck cancer, with 50.81% among the total head and neck cases. The crude and age-standardized rates among males were higher than those among females. The histologically verified percentage was 85.77%. The squamous carcinoma was the major histological type, with 57.58% among the total cases. The age-stan-dardized rate of nasopharyngeal cancer was in decline.Conclusion:The incidence of head and neck cancer was low in Shanghai during the past 10 years. Male cases were more than female cases. The major histological type was squamous carcinoma. Half of new cases were nasopharyngeal cancer which appeared to affect patients at a relatively young age. Patients with nasopharyngeal cancer were diagnosed at relatively advanced stages.