Sphincter of Oddi dysfunction (SOD) refers to a series of clinical syndromes that occurs because of structural or functional disorders involving the biliary and/or pancreatic sphincters.It remains controversial whether endoscopic sphincter manometry (SOM) or sphincterotomy is needed in patients with type Ⅲ SOD.An important problem is that ERCP (with or without SOM) carries significant risks, especially the post-ERCP pancreatitis.The EPISOD trial has updated our knowledge on type Ⅲ SOD.The latest Rome Ⅳ consensus suggested that the classification term type Ⅲ biliary SOD should be abandoned and a new classification of biliary SOD was proposed;also, manometry and sphincterotomy were not recommended for patients with this type of SOD.The goal of this paper is to review recent literatures and elucidate the selected important questions regarding type Ⅲ SOD.

OBJECTIVE:To establish a HPLC method for the quantitative determination of loratadine(Lor),paracetamol(Par)and pseudoephedrine sulfate(Pse)in loratadine paracetamol pseudoephedrine sulfate sustained-release tablets(LPPST). METHODS:The HPLC method was carried out on Kromasil-C 18 column(250mm?4.6mm,5?m).The mobile phase consisted of a mixture of methanol-sodium acetate(0.82g in1000ml)(2000∶1000)for paracetamol with detection at243nm.The mo?bile phase consisted of a mixture of acetic acid-methanol-1%(V/V)sodium lauryl sulfate(0.1∶70∶30)for loratadine and pseudoephedrine sulfate with detection at257nm.RESULTS:The calibration curve was linear in the range of13.79～55.18?g/ml for paracetamol(r=0.9999),0.013～0.105mg/ml for loratadine(r=0.9999),0.30～2.37mg/ml for pseudoephedrine sul?fate(r=0.9999).The average recoveries were99.89%(RSD=0.43%),99.69%(RSD=0.20%)and99.57%(RSD=0.10%)for three above-mentioned components respectively(n=6).CONCLUSION:This method is accurate and reliable for the quality control of this compound preparation.

Objective To explore the value of MRI T2*quantification of visceral iron deposition in patients with β-thalassemia major. Methods A total of one hundred and two patients with β-thalassemia major were retrospectively analyzed. They underwent genetic testing and the cardiac and (or) abdominal MRI scanning. Among them, 47 patients underwent splenectomy operation, 95 patients underwent cardiac MRI scanning, 102 underwent abdominal MRI scanning for their livers, pancreases and kidneys, and 55 underwent splenic MRI scanning. The T2* values of the hearts, livers, pancreases and kidneys were measured, meanwhile the liver iron concentrations (LIC) were measured. The levels of serum ferritin (SF) patients were measured in 81 patients. The Spearman rank correlation was employed to analyze the relationship between SF, LIC, age and each organs T2* values. Independent sample t test (normal distribution) or the Mann- Whitney U test (non-normal distribution) were used to compare the hepatic, cardiac, renal and splenic T2* values differences between patients with splenectomy and those without. Results Serum ferritin were highly positively correlated with LIC, moderately correlatied with age, moderately negatively correlated with hepatic and pancreatic T2* values, with r values of 0.833, 0.537,-0.623 and -0.403, respectively (P<0.05). There was significantly negative correlation between hepatic T2*value and LIC (r=-0.925, P<0.01). There were moderately correlations between hepatic and splenic T2*values (r=0.634, P<0.01), hepatic and pancreatic T2*values (r=0.530, P<0.01). However, those T2*values of other organs had no correlation (P>0.05). The hepatic and pancreatic T2*values were reduced (P<0.05), the renal T2* value was increased (P<0.05) in the patients with splenectomy. The cardiac T2* value was not statistically different (P>0.05). Conclusions The patients with β-thalassemia major have prone to suffer from excessive iron deposition in the heart and abdominal organs. The technology of MRI quantification of T2*values could reflect the body iron overload.

Objective To investigate the mechanism of malignant transformation in human bronchial epithelial cell line BEP2D exposed to α-particles.Methods The levels of intracellular ROS and malonaldehyde (MDA) in BEP2D,RH22 (passage 22 of α-particle-irradiated BEP2D cells) and BERP35T-1 cells (derived from nude mice bearing malignant transformed cells generated from the passage 35 of α-particle-irradiated BEP2D cells) were assayed with DCFH-DA and MDA kit,respectively.The expressions of 8-OH-dG and γ-H2AX in BEP2D,RH23 (passage 23 of α-particle-irradiated BEP2D cells)and BERP35T-1 cells were also measured with immunocytochemistry and immunofluorescence staining.Results Compared to BEP2D cells,the levels of ROS ( t =4.30 and 3.94,P ＜ 0.05 ) and MDA ( t =4.89 and 15.10,P ＜0.05) increased in RH22 and BERP35T-1 cells.The expressions of 8-OH-dG (t =3.80 and 2.92,P ＜ 0.05 ) and γ-H2AX ( t =7.61 and 12.67,P ＜ 0.05 ) in RH23 and BERP35T-1 cells were also higher than those in BEP2D cells.Conclusions Oxidative stress induces lipid peroxidation and DNA damage leading to genomic instability,which could contribute to cellular malignant transforming process in the human bronchial epithelial cell line BEP2D with α-particle exposure.

Objective To analyze the etiology and clinical features of isolated gastric varices.Methods A retrospectives analysis was carried out in 31 patients with isolated gastric varices between January 2003 and January 2008.The patients records including data of etiology,clinical presentation,imaging studies and therapeutic modalities were reviewed.Results Those who had isolated gastric varices were accounted for 7.38 0A (31/420)of all patients with gastroesophageal varices.The etiologies were left-sided portal hypertension(14 cases,45.2%),liver cirrhosis(8 cases,25.8%),unknown origin(6 eases,19.4%),hepatocellular carcinoma(2 cases,6.5%),portal cavernous transformation(1 case,3.2%).Twenty-one patients(67.7%)had variceal hemorrhage.Splenomegaly was present in 21 cases(67.7%),among which 10 cases(32.3%)had concomitant hypersplenism.Venous involvement was identified in 18 patients(splenic vein obstruction in 9 cases and portal vein involvement in 9 cases).Surgical therapy was performed in 8 cases,selerotherapy in 3 cases,and medical therapy in 20 cases.Conclusions Left-side portal hypertension is responsible for most of the isolated gastric varices,and some of which are also caused by liver cirrhosis.Surgery is the appropriate procedure of choice in management of hemorrhage and recurrence.

Objective To explore the relationship among the sense of coherence,empowerment and self-efficacy in peritoneal dialysis patients.Methods General information,the Sense of Coherence Scale,the Peritoneal Dialysis Empowerent Scale-Short Form and the Self-Efficacy for Managing Chronic Disease Scale were used to investigate a total of 160 peritoneal dialysis patients in a third-class hospital in Tianjin from March to June,2015.Results The mean score of the sense of coherence,empowerment,self-efficacy were (62.01±11.94) points,(4.09±0.68) points and (6.08±2.19) points.Both the sense of coherence and empowerment could positively influence the self-efficacy of peritoneal dialysis patients directly (r=0.429-0.571,P ＜ 0.01),and the sense of coherence could also indirectly influence the self-efficacy through the mediation of empowerment (β decreased from 0.429 to 0.172,P ＜ 0.01),the mediation effect accounted for 60.1％ of the total effect.Conclusions Medical staff should take different actions to improve the sense of coherence and empowerment to improve the self-efficacy of peritoneal dialysis patients.

Objective To investigate the relationship of interleukin-9 (IL-9) and the transcription factor PU.1 with chronic urticaria.Methods Thirty patients with chronic urticaria (patient group) and 30 healthy volunteers (control group) were included in this study.Venous blood samples were collected from these subjects.Enzyme-linked immunosorbent assay (ELISA) was performed to detect serum levels of IgE,flow cytometry (FCM) to determine the percentage of CD4+IL-9+ T cells,real-time fluorescence-based quantitative PCR (RTFQ-PCR) to measure the mRNA expressions of IL-9 and PU.1 in peripheral blood mononuclear cells (PBMCs).Measurement data were compared between the two groups by independent-samples t test,and relationship among these parameters was assessed by Pearson correlation analysis.Results The expressions of IL-9 and PU.1 mRNAs in patients with chronic urticaria were significantly higher than those in healthy controls (4.44 ± 1.90 vs.3.20 ± 1.78,t =2.60,P＜ 0.05; 3.26 ± 1.59 vs.2.34 ± 1.47,t =2.34,P ＜ 0.05).Compared with the control group,the patient group showed increased percentage of CD4+IL-9+ T cells in peripheral blood (0.63％ ± 0.44％ vs.0.22％ ± 0.12％,t =5.04,P ＜ 0.01) and serum IgE levels ((82.04 ± 31.72) vs.(60.74 ± 28.26) IU/ml,t =2.75,P ＜ 0.01).The percentage of CD4+IL-9+ T cells and levels of IL-9 and PU.1 mRNAs in peripheral blood were all positively correlated with serum levels of IgE in these patients (r =0.596,0.767,0.746,respectively,all P ＜ 0.01).Conclusion T helper type 9 (Th9) cells and IL-9 may take part in the occurrence of chronic urticaria.

Objective To investigate the effect of scalp acupuncture plus MOTOmed virtual scene training on gross motor function and ADL in patients with spastic cerebral palsy. Methods Thirty patients with spastic cerebral palsy meeting the inclusion criteria were randomly allocated to a treatment group of 12 cases and a control group of 18 cases. The control group received routine rehabilitation therapy and the treatment group, scalp acupuncture plus MOTOmed virtual scene training in addition. Adductor, gastrocnemius and hamstring muscle tensions were determined using the Modified Ashworth Scale (MAS), gross motor function was measured using the Gross Motor Scale and the activities of daily living were assessed using the ADL in the two groups of patients before and after treatment. Results There were statistically significant pre-/post-treatment differences in adductor, gastrocnemius and hamstring muscle tensions in the treatment group (P<0.05). There was a statistically significant pre-/post-treatment difference in adductor muscle tension in the control group (P<0.05). There were statistically significant post-treatment differences in gastrocnemius and hamstring muscle tensions between the treatment and control groups (P<0.05). There were statistically significant pre-/post-treatment differences in the foot dorsiflexion angle and popliteal fossa angle in the treatment group (P<0.05). There was a statistically significant pre-/post-treatment difference in the posterior femoral angle in the control group (P<0.05). There were statistically significant post-treatment differences in the foot dorsiflexion angle and popliteal fossa angle between the treatment and control groups (P<0.05). There were statistically significant pre-/post-treatment differences in the GMFM score and the ADL score in the two groups (P<0.05). There were statistically significant post-treatment differences in the GMFM score and the ADL score between the treatment and control groups (P<0.05). Conclusions Scalp acupuncture plus MOTOmed virtual scene training is an effective way to treat spastic cerebral palsy. It can improve gross motor function and the ADL score in the patients.

ObjectiveTo investigate the clinicopathologic features,therapy,and prognosis of primary small cell carcinoma of the pancreas.MethodsDatabases including Chinese Journal Full-text Database,VIP Database for Chinese Technical Periodicals,Medline/Pubmed,and OVID were searched electronically up to April 2012.A systematic review was performed together with one case in our hospital.ResultsTwenty-eight articles fulfilling the criteria consisting of 46 patients with pathologically confirmed diagnosis of primary small cell carcinoma of the pancreas were studied,together with 1 patient in our Drum Tower Hospital,finally 47patients were included.The results of this systematic review showed:( 1 ) Primary small cell carcinoma of the pancreas was more common in men with a median age of 62.The most common clinical presentations were abdominal pain,jaundice and weight loss.Para-neoplastic syndrome was rarely observed.(2)Most cases were found to have abnormally elevated serum levels of neuron-specific enolase.CT displayed heterogeneous,and marked enhancing masses in most cases.The conclusive diagnosis depended on histological confirmation.(3)63.8％ of the cases were found to be associated with metastasis at the time of diagnosis.The overall median survival time was 28 weeks.(4) There was no consensus on the treatment of primary small cell carcinoma of the pancreas. Chemotherapy was currently considered as the treatment of choice among the systematic management for these patients.ConclusionsPrimary small cell carcinoma of the pancreas was a rare and aggressive neuroendocrine tumor with a poor prognosis.

Aim To study effects of metfomin(MF) on calmodulin(CaM) mRNA exprssion of the pitutary-gonad axis in rats.Methods The CaM mRNA expression of the pitutary-gonad axis in rats was measured with the real time quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) technique. Results MF (270 mg?kg-1?d-1,ig,21 d) significantly inhibited the CaM mRNA expression in testes (P