Objective To explore the histopathological features of renal lesions in patients with prima- ry Sjgren's syndrome(pSS)and the correlation between the findings with clinical manifestations.Methods Kidney and labial salivary gland biopsies from 16 patients with pSS were studied by a semiquantitative assess- ment approach.Results Among these pSS patients,light microscopy showed acute or chronic interstitial nephritis(IN,8/16),diffuse mesangial proliferative glomerulonephritis(MePGN,3/16),mild mesangial prolifer- ative glomerulonephritis(3/16),focal segmental glomerulosclerosis(FSGS,2/16),membranoproliferative glomeru- lonephritis(MPGN,1/16)and membranous nephropathy(MN,2/16).There were 11/16(68.8%)cases had renal tubular acidosis(RTA),8 cases of them presented with IN.In two chronic renal failure cases,one showed MN and another showed IN accompanied with FSGS.Immunofluorescent examination revealed deposition of IgG, IgA,IgM,C3,Clq on the glomerular basement membrane or tubular basement membrane,mesangium focally.It was noted that the interstitial inflammation was focal in 85% of the patients and was always combined with dif- fusely distributed cellular infiltrates.The percentage of obsolescent glomeruli was found correlated with the level of vessel wall thickening(r=0.77,P=0.001)but not with the grade of tubular atrophy and interstitial fi- brosis.Creatinine clearance was correlated with the adjusted chronic tubulointerstitial nephritis(CTIN)score (r=-0.52,P=0.04)and the percentage of obsolescent glomeruli(r=-0.53,P=0.04).No association could be found between the labial salivary gland and the renal focus scores(r=0.28,P=0.30).Conclusions The renal tubular acidosis and IN are the most common findings in pSS patients with renal involvement.Glomerular dam- age is not uncommon,althought mild and is not merely secondary.Timely renal biopsy can help to estimate prognosis and guide therapy.

OBJECTIVETo compare the sensitivity, the specificity and the anti-jamming of several excrement occult blood experimental techniques. To evaluate the effect of transferrin (Tf) in the excrement in the digestive tract hemorrhage detection rate.

METHODSFor 600 patients of clinical suspicious digestive tract hemorrhage, take their excrement specimen, using the chemical process (pyramidon semi-quantitative examination law) to detect hemoglobin (Hb), and using monoclonal antibody colloidal gold method to detect Hb and Tf.

RESULTSFinally the hemoglobin chemical process (hereafter refers to as chemical process) to detect upper gastrointestinal hemorrhage with the positive rate 57.3%, and the detection of hemorrhage of lower digestive tract's positive rate is 44.8%; Hemoglobin monoclonal antibody colloidal gold method (hereafter refers to as colloid gold law) to examine upper gastrointestinal hemorrhage with a positive rate 60.4%, under examination hemorrhage with positive rate 77.6%; transferrin monoclonal antibody colloidal gold method (hereafter refer to as transferrin law) to examine upper gastrointestinal hemorrhage with a positive rate 82.3%, examination hemorrhage of lower digestive tract with a positive rate 66.4%; The union examination law (hemoglobin and transferrin to be detected twice, once positive that is positive) examines upper gastrointestinal hemorrhage the positive rate is 90.8%, hemorrhage of lower digestive tract's positive rate is 97.6%.

CONCLUSIONExcrement transferrin has the high detection rate in the upper gastrointestinal hemorrhage; Hb and the Tf combined examination may obviously raise the digestive tract hemorrhagic disease's positive detection rate.

Feces ; chemistry ; Gastrointestinal Hemorrhage ; diagnosis ; Gold Colloid ; Humans ; Occult Blood ; Transferrin ; analysis

Objective To analyze the clinical factors predicting long-term survival after curative resection of pancreatic head carcinoma. Methods The clinical data of 58 patients with ductal adenocarcinoma of pancreatic head who underwent curative resection of carcinoma of pancreatic head from 1996 to 2004 were collected and were analyzed by SPSS 10.0 with Cox Proportional Hazards Model. Results 58 patients, including 30 male and 28 female patients, were involved in this study. Pancreaticoduodenectomy were performed in 14 cases and extended resections were performed in 44 cases. The overall 1, 3, 5 year survival rates was 46.6%, 29.3% and 8.6%, respeclively. The 1,3, 5 year survival rates of pancreatoduodenectomy with extended regional lymphadenectomy was 43.1%, 22.7% and 6.8%, respectively. UICC staging, peri-pancreatic nerve invasion and blood infusion had significant effects on the prognosis after curative resection. Conclusions The long-term prognosis after curative resection of pancreatoduodenectomy was still dismal. Much importance should be paid to early diagnosis and comprehensive management for pancreatic head cancer.

Objective To investigate the role of hMSH2 in the pathogenesis of sporadic insulinomas and to determine whether the expression of hMSH2 could be used to differentiate benign sporadic insulinomas from malignant ones. Methods Fifty-five sporadic insulinomas (40 benign and 15 malignant tumors) resected from 50 patients were obtained. Expression of hMSH2 was detected by immunohistochemistry staining. DNA was obtained from micradissected tissue. Loss of heterozygnsity (LOH) of hMSH2 gene was detected by PCR-LOH. 6 microsatellite markers were selected on 3 chromosomes, and microsatellite instability (MSI) status of tumor tissue were detected by PCR. The findings were analyzed in relation to the clinicopathological characteristics. Results Down-regulation of hMSH2 expression was found in 13% of 55 sporadic insulinomas. LOH of the hMSH2 gene was not present in 55 insulinomas. High frequency MSI (MSI-H, MSI occurred in at least 2 out of 6 sites) was present in 36% (20/55) of all the insulinomas. Down-regulation of hMSH2 expression was found in 33% of the 15 malignant tumors, while it was 5% in benign tumors (P < 0. 05). Conclusions Down-regulation of mismatch repair gene hMSH2 may be correlated with the degree of tumor malignancy. The expression of hMSH2 could be used as a potential marker for distinguishing benign insulinoma from malignant ones.

Objective To find the relevant factors that can influence the results of Ritleng lacrimal duct intubafion surgery, apply effective nursing intervention measures, and cooperate with the success conduct of operation and perioperation. Methods 102 patients who underwent Ritleng lacrimal duct intubation were analyzed in our study. The relevant factors were found out, then various corresponding nursing intervention measures before and after the surgery were used in 293 patients that underwent the same operation from May 2007 to February 2008. Results After applying the effective nursing intervention measures, the cure rate of these 293 patients was 95.9%. Silicone tube was never broken in the operation. Conclusions Applying various corresponding nursing intervention measures before and after Ritleng lacrimal duct intubation can improve the success rate of surgery and reduce the complications.

Objective To evaluate the effect of protecting parathyroid glands in situ in the operation of total thyroidectomy by detecting parathyroid hormone after the operation.Methods In the surgical team, 1019 consecutive patients with thyroid diseases were treated with total thyroidectomy.During the operation, parathyroid glands were protected in situ with correctly identifying the parathyroid glands, precisely dissecting its envelope and protecting its blood supply.Serum calcium level and parathyroid hormone were measured before and 24 hours after operation. The patients who had symptomatic hypocalcemia or hypoparathyroidism were given supportive treatment and followed-up. Results At least one of the parathyroid glands was preserved and remained in situ in all cases.Eighty-nine cases (8.7%) had decreased parathyroid hormone levels and 42 cases (4.1%) had complicated symptomatic hypocalcemia.The symptoms of hypocalcemia in all these cases could be controlled by supportive treatment, and serum calcium level and parathyroid hormone had all recovered 1 - 6 months later.If 3 and 4 parathyroid were conserved in situ, the postoperative complication rate was significantly lower than those with 1 and 2 parathyroid conserved(decreased PTH 69/999 vs 20/20, symptoms of hypocalcemia 25/999 vs 17/20, all P <0.01).Conclusion The techniques to protect parathyroid glands in situ are effective measure to prevent the postoperative hypoparathyroidism in total thyroidectomy.