Objective To investigate the effect of Octreotide on pancreatic head carcinoma patients with obstructive jaundice who underwent endoscopic retrograde cholangiopancreatography (ERCP) with pancreatic stent placement.Methods Niney-nine patients hospitalized in Department of Gastroenterology of Wuhan Central Hospital from Jan 2006 to Dec 2011 were included in this study.All the patients were diagnosed as pancreatic head carcinoma with obstructive jaundice.The patients were randomly divided into the Octreotide treatment group and the control group.Both groups underwent ERCP with pancreatic duct stent placement for malignant biliary obstruction.The patients in Octreotide treatment group were injected with subcutaneous Octreotide at a dose of 0.1 mg twice per day for more than 90 day till death.The changes of serum total bilirubin before and after treatment were compared.The improvement of symptoms of nausea,vomiting,abdominal pain,diarrhea and anorexia was compared.The complication rates and survival were also determined.Results Postoperative recurrence of jaundice was observed in six patients in control group,and the cause may be stent occlusion,and 3 of the 6 patients underwent a second ERCP and stent placement,then jaundice was relieved,the other 3 patients did not receive a second ERCP.The serum bilirubin level in the remaining 45 patients returned to basically normal value (below 2 times of the normal value).The prevalence of nausea,vomiting,abdominal pain,diarrhea and anorexia in the 2 groups was not statistically different before treatment,and after treatment the prevalence of symptoms in the 2 groups was significantly decreased except for diarrhea.The decrease in Octreotide treatment group was more obvious than that in control group,and the difference between the two groups was statistically significant (P ＜ 0.01).In the control group,post-ERCP pancreatitis occurred in three patients,and all were cured after treatment.There was no post-ERCP pancreatitis occurred in the Octreotide treatment group.Minor pain at the injection site was noted in three patients in the Octreotide treatment group.Pain was relieved after changing the injection site.The survival was significantly longer in the Octreotide group than that in control group [(14.4 ± 8.7) months vs (7.3 ± 5.3) months,P ＜ 0.05),and the difference between the two groups was statistically significant (P ＜ 0.05).Conclusions Octreotide can improve the quality of life and increase the survival of patients with pancreatic head carcinoma who undergo ERCP with pancreatic duct stent placement.

Objective:To study the combined use of endoscopic balloon dilation with endoscopic biliary brushings in diagnosis of bile duct strictures.Methods:A prospective single center study was conducted at the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology. All patients with suspected malignant bile duct strictures shown on CT or MRI imaging from January 2018 to January 2020 were reviewed. All patients gave informed consent to the endascopic retrograde cholangiopancreatography procedures. Their clinical and follow-up data were analyzed. All patients underwent endoscopic balloon dilation of bile duct strictures. Before and after balloon dilation, biliary brush cytology was performed, and the results were used to classify the patients into the control group and the experimental group. Pathological examination of the brush cytology samples was carried out by a single chief pathologist. Presence of cancer cells or significant heterogeneous cells indicated a positive brush cytology test. Negative patients who still highly consider cholangiocarcinoma and agree to surgery and whose gross specimen is confirmed to be malignant after surgery should be considered as false negative by brush examination; it is difficult to judge that patients with cholangiocarcinoma have progress after 2 months of follow-up should be considered as false negative by brush examination. Any progression of disease indicated that the brush test was wrong and the test was again classified as false negative. Only when there was no progression of strictures was the possibility of a benign biliary stricture being considered. The advantage test (McNemar test) was used to analyze the difference between the two diagnostic methods.Results:Of 39 patients who were included in this study, there were 26 males and 13 females, with an age of (68.0 ± 5.2) years. Cholangiocarcinoma was diagnosed by histopathology, surgery or at 2 months follow-up in 35 patients. In the control group, 17 patients had a positive brush test (sensitivity rate was 48.6%, 17/35). In the experimental group, 26 patients had a positive brush test (sensitivity rate was 74.2%, 26/35). In addition, 2 patients in the control group had a positive brush test, while in the experimental group, a negative brush test. A total of 28 patients were positive in the two groups. The sensitivity rate of the brush test was 80.0% (28/35). There were significant differences between the two groups ( P<0.05). Conclusion:Endoscopic balloon dilation combined with endoscopic biliary brushings improved the sensitivity of pathological diagnosis of cholangiocarcinoma, and endoscopic biliary brushings before and after balloon dilation improved the sensitivity of diagnosis.

Objective To analyze the clinical characteristics of hypertrophic cranial pachymeningitis (HCP). Methods The clinical data of 10 HCP patients receiving comprehensive therapies in Xuanwu Hospital between 2004 and 2007 were retrospectively analyzed. Results All the 10 patients showed symptomatic improvements after the administration of effective treatment, including 8 with complete recovery, 1 with mild insufficiency in left eye abduction, and 1 with frequent mild headache after the treatments. During the follow-up for 6 months to two years, 2 patients experienced a single rclapsc and 1 had 3 relapses, who all responded favorably to therapy with corticosteroid hormones. Conclusion Early definite diagnosis of HCP can bc derived based on the clinical characteristics and results of laboratory examinations. Timely use of corticosteroid hormones and antibiotics can be essential to prevent the occurrence of irreversible nervous system impairment in these patients, and surgical removal of the lesions can be performed when necessary.

Objective To evaluate the MRI features of central neurocytoma (CNC). Methods Thirteen patients with CNC (7 males and 6 females, aged 18-28), admitted to our hospital fiom January 2007 to January 2010, were chosen; preoperative plain and contrast enhanced MRI scans were performed on these 13 patients and 1 also received CT scan. The clinical and imaging data and pathological features of these patients were retrospectively analyzed. Results The largest tumor enjoyed its maximum diameter of 3.2-8.5 cm; the CNC in 12 patients located at the lateral ventricle and that in 1 patient at the parenchyma of the left frontal and temporal lobes. Lobulated solid tumors were noted in these lesions,showing T1 isointense and T2 hyperintense in MRI; some multiple, scattered cystic lesions showed stronger T1 and T2 signal than the former ones; vascular "flow void" signal was shown in 6 patients in T2WI, and slightly weak T1 signal was shown in 8. All the tumors demonstrated inhomogeneous enhancement and the tumor vessels in 6 patients were noted under contrast MRI. Focal calcification was found. Conclusion CNC in the lateral ventricle enjoys typical location; considering the age of patients, non-contrast and contrast MRI findings, correct diagnosis of CNC can be made; however, CNC outside the lateral ventricle is hard to diagnose.

Objective To evaluate the value of 3.0T susceptibility-weighted magnetic resonance imaging (SWI) in the diagnosis of cerebrovascular malformations. Methods Forty-six patients with cerebrovascular malformations, admitted to our hospital fiom May 2008 to December 2010, were examined with a 3.0T MR scanner. All patients were examined with MRI conventional sequences T1WI,T2WI, 3DTOF, and their results were compared with SWI sequence so as to evaluate the value of SWI in the diagnosis of cerebrovascular malformations.Results Twenty-five patients had arteriovenous malformation (AVM), 10 with cavernous hemangioma, 8 with venous malformations, and 3 with telangiectasis in the 46 patients with cerebrovascular malformations. SWI could delineate all the cerebrovascular malformation lesions, especially small lesions, but could not display all supplying artery in AVM. 3DTOF was a better technique in delineating large AVM lesions. Conclusion SWI is much more sensitive in showing small cerebrovascular malformations; and combined with other MR sequences,clear diagnosis of cerebral vascular malformations can be made by SWI.

OBJECTIVETo study the chemical constituents of Eriophyton wallichii.

METHODCompounds were separated and purified by column chromatographic methods, and their structures were elucidated by spectroscopic methods.

RESULTEight phenylpropanoids were isolated and identified as martynoside (1), leucosceptoside A (2), citrusin B (3), (+)-dehydrodiconiferyl alcohol-4, 9-beta-D-glucopyranoside (4), liriodendrin (5), velutinoside 11[ (6), jionoside B, (7), stachysoside D (8), respectively.

CONCLUSIONThe eight compounds were firstly isolated from E. wallichii.

Arecaceae ; chemistry ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Furans ; chemistry ; isolation & purification ; Glucosides ; chemistry ; isolation & purification ; Glycosides ; chemistry ; isolation & purification ; Phenylpropionates ; chemistry ; isolation & purification

OBJECTIVETo evaluate the characteristics of MR imaging of hepatic lesions using measurement of apparent diffusion coefficient (ADC) value of hepatic lesions on diffusion weighted imaging.

METHODSMR diffusion weighted images were obtained in patients with 97 hepatic lesions (22 hepatocellular carcinomas, 21 metastatic tumors, 28 hemangiomas, 26 cysts). ADC values were evaluated with different sequences. The ADC ratio of lesion/liver was estimated.

RESULTSAverage ADC values of hepatic lesions were as follows: carcinomas (0.91 +/- 0.07) x 10(-3) mm(2)/s, metastatic tumors (1.13 +/- 0.27) x 10(-3) mm(2)/s, cavernous hemangiomas (1.94 +/- 0.37) x 10(-3) mm(2)/s, cysts (3.26 +/- 0.30) x 10(-3) mm(2)/s. The ADC ratio of lesion/liver was significantly different between primary carcinomas and metastatic tumors (P < 0.05).

CONCLUSIONQuantitative study in hepatic lesions using ADC values and the ADC ratio of lesion/liver, would improve the accuracy in diagnosing hepatic lesions.

Cysts ; diagnosis ; Diagnosis, Differential ; Diffusion ; Hemangioma, Cavernous ; diagnosis ; Humans ; Liver ; pathology ; Liver Neoplasms ; diagnosis ; secondary ; Magnetic Resonance Imaging

Objective To investigate the clinical value of diffusion tensor imaging (DTI) in the evaluation of cerebral infraction. Methods Sixty-nine patients with cerebral infraction confirmed by clinical manifestation and routine MRI and/or CT were analyzed for the signal intensity changes on DTI. The isotropic apparent diffusion coefficient (ADCiso) and fractional anisotropy (FA) of the infracted area were measured and compared with those of the unaffected side. Results Four types of signal intensity changes on DTI were identified. Type Ⅰ changes were found in 8 infraction lesions, where the ADCiso decreased and FA increased, and the infraction lesions showed hypointensity on ADCiso map and hyperintensity on FA map. Type Ⅱ changes, found in 23 lesions, were characterized by decreased ADCiso and FA values, but ADCiso in the peripheral of the lesions decreased and FA increased, and the lesions were shown as isointensity or hypointensity on ADCiso and FA maps with hyperintensity on the peripheral. Type Ⅲ changes (7 lesions) were manifested by decreased ADCiso and FA values and hypointensity on ADCiso and FA maps. Type Ⅳ changes were found in 31 infraction lesions, showing increased ADCiso and decreased FA with corresponding hyperintensity on ADCiso map and hypointensity on FA map. Significant differences were found in the DTI parameters between the infraction lesions and unaffected side (P<0.05). Conclusion DTI for qualitative and quantitative analysis of cerebral infraction better reveals the pathophysiology of the infraction, allows more precise imaging-based staging of the lesion, and provides evidences for more objective diagnosis, treatment, monitoring and prognostic evaluation of the condition.

OBJECTIVETo study the socio-demographic characteristics, acquired immune deficiency syndrome (AIDS) related behaviors of male clients of female sex workers and their determinants.

METHODSContacting subjects through 5 ways including volunteers of female sex workers (FSWs), sexually transmitted disease (STD) clinics, long-distance bus stations, long-distance cargo station while adopting methods as snowballing, employing an anonymous questionnaire. Data was analyzed by logistic regression analysis.

RESULTS(1) The majority of clients were 25-45 years old, married and of junior high school or above educational levels; (2) Among male clients of FSWs, numbers of having had commercial sexual intercourse was between 1 to 240, averaged 24 in the previous year. It significantly related to their occupation and the experience of their friends or colleagues who ever visited female sex workers; (3) 27.98% of them used condom every time during commercial sexual intercourse, which significantly related to the score of knowledge on AIDS, concourse of sex intercourse and inhabitation; (4) 28.36% of them had ever contracted STD, which significantly related to the frequency of commercial sexual intercourse in the previous year, risk awareness of being infected with human immunodeficiency virus, and frequency of condom use during commercial sexual intercourse.

CONCLUSIONThe proportion of always using condom was low among male clients of FSWs, and had had STDs. And it's necessary for active and specific intervention programs to them.

Acquired Immunodeficiency Syndrome ; prevention & control ; Adult ; China ; Condoms ; Humans ; Male ; Middle Aged ; Risk-Taking ; Sex Work ; Sexual Behavior ; Unsafe Sex ; statistics & numerical data

OBJECTIVETo investigate the safety of autologous bone marrow mononuclear cell (BM-MNCs) transplantation by intracoronary infusion in patients with acute myocardial infarction (AMI).

METHODSOne hundred and eighty-four patients with AMI treated with percutaneous coronary intervention (PCI) were randomized in a 1:1 way to either intracoronary transplantation of autologous BM-MNCs (n = 92) right after PCI or to sodium chloride concluding heparin (controlled, n = 92) via a micro infusion catheter. In the process of the intracoronary infusion of BM-MNCs, the complications should be recorded, which were aberration reflect (including of pale, syncope, nausea, hypotension and shock), deterioration of angina or heart failure, arrhythmias (including of bradycardia, sinus arrest or atrial ventricular block or ventricular fibrillation), embolism etc. Body temperature, blood pressure and heart rates should be monitored during the first week after transplantation. Holter, coronary angiography and ultrasonic cardiography were performed at the designed time points. Main heart accidents, restenosis and tumor were recorded during 2-years follow up.

RESULTSDuring the period of bone marrow puncture and intracoronary infusion of BM-MNCs, few patients occurred pale, dizziness, bradycardia and hypotension, which were transient and due to vagus reflect. No stem cell-related arrhythmias, deterioration of angina were noted. In BM-MNCs group one patient developed in-stent reocclusion in one week after transplantation, five developed in-stent restenosis during further follow-up 30 months, which were similar with control group. There were no deaths, major adverse cardiac events, tumor and other late adverse events during follow-up period in both groups.

CONCLUSIONIntracoronary transplantation of autologous BM-MNCs in the acute phase after AMI is feasible and seems safe in the 30 months of follow-up.

Adult ; Aged ; Bone Marrow Transplantation ; methods ; Coronary Vessels ; Female ; Follow-Up Studies ; Humans ; Male ; Mesenchymal Stem Cell Transplantation ; methods ; Middle Aged ; Myocardial Infarction ; surgery ; Transplantation, Autologous