Objective To explore whether the presence of juxtapapillary duodenal diverticula (JPDD) risks biliary stone disease and recurrence.Methods 829 patients undergoing ERCP in our hospital from Aug 2008 to Dec 2012 were divided into four groups:biliary stone disease (n =609) non-stone biliary abnormality (n =124) common bile duct malformation with cholelithiasis (n =38) and normal control group (n =58).There were 206 patients with JPDD and 623 patients without JPDD.Biliary stoneformation,post-ERCP pancreatitis,cannulation failure,and stone recurrence were compared between those with JPDD and those without.Results The incidence of JPDD in biliary stone disease group (27.8％) was significantly higher than in non-stone biliary anatomical abnormality group (18.5 ％) (x2 =4.512,P ＜ 0.05).In biliary stone disease group,rates of post-ERCP pancreatitis were significantly higher in JPDD cases (33.7％) compared to those without JPDD (13.8％) (x2 =30.841,P ＜ 0.05).The cannulation failure rate was also higher in patients with JPDD (15.4％) compared to JPDD negative (6.8％) (x2 =0.731,P ＜0.05).Recurrence rates in biliary stone disease were significantly higher in patients with JPDD (19.5％) when compared to JPDD-lacking individuals (9.3％) (x2 =14.51,P ＜ 0.05).Conclusions JPDD is a risk factor for biliary stone formation.JPDD also is associated with post-ERCP pancreatitis,cannulation failure and biliary stone recurrence.

Objective: To investigate the alterations of bcl-2 gene family in the rat brain and the molecular mechanism of neuronal apoptosis follow ing traumatic brain injury (TBI). Methods: Male Sprague-Dawley rats were subjected to lateral fluid percussion brain injury(FPBI) of moderate severity. bax and bcl-xL mRNA and protein expression was detected by RT-PCR an d immunohistochemistry. In addition to morphological evidence of apoptosis, TUNE L histochemistry was used to identify DNA fragmentation in situ under both l ight and electron microscope, whereas characteristic internucleosomal DN A fragm entation of apoptosis was demonstrated by DNA gel electrophoresis. Resul ts: bcl-xL mRNA and protein decreased in the ipsilateral hemisphere t o the impact site as early as 6 h post-injury［(67.42±7.54)% and (85.85±5.72)% r espectively］. The decrease in bcl-xL mRNA and protein preceded apoptosis was observed 12 h post-injury. And this was the main cause of up-regulation of the ratio of bax to bcl-xL in the acute period(minutes-hours) followin g FPBI. bax mRNA and protein were observed to rise slowly, doubled 3 d post- injury, returned to sham level slowly. The delayed cell death (days-weeks) migh t associated with the up-regulation of pro-apoptotic gene bax. Conclusio n: The expression of bcl-xL and bax coincide with apoptosis following TBI. The reg ulation of bax and bcl-xL by TBI occur before transcription. The balance of bax/bcl-xL ratio determines the neurocytes to survive or die following FPBI.

BACKGROUNDThe decrease of glomerular filtration rate has been theoretically supposed to be the result of low perfusion in renal artery stenosis (RAS). But the gap between artery stenosis and the glomerular filtration ability is still unclear.

METHODSPatients with selective renal artery angiogram were divided by the degree of renal artery narrowing, level of estimated glomerular filtration rate (eGFR), respectively. The different levels of eGFR, renal microcirculation markers, and RAS severity were compared with each other, to determine the relationships among them.

RESULTSA total of 215 consecutive patients were enrolled in the prospective cohort study. Concentrations of microcirculation markers had no significant difference between RAS group (RAS ≥ 50%) and no RAS group (RAS < 50%) or did not change correspondingly to RAS severity. The value of eGFR in RAS group was lower than that in the no RAS group, but it did not decline parallel to the progressive severity of RAS. The microcirculation markers presented integral difference if grouped by different eGFR level with negative tendency, especially that plasma cystatin C (cysC) and urinary microalbumin to creatinine ratio (mACR) increased with the deterioration of eGFR, with strong (r = -0.713, P < 0.001) and moderate (r = -0.580, P < 0.001) correlations. In the subgroup analysis of severe RAS (RAS ≥ 80%), the levels of plasma cysC and urinary mACR demonstrated stronger negative associations with eGFR, (r = -0.827, P < 0.001) and (r = -0.672, P < 0.001) correlations, respectively.

CONCLUSIONSSeverity of RAS could not accurately predict the value of eGFR, whereas microcirculation impairment may substantially contribute to the glomerular filtration loss in patients with RAS.

Aged ; Female ; Glomerular Filtration Rate ; physiology ; Humans ; Male ; Microcirculation ; physiology ; Middle Aged ; Prospective Studies ; Renal Artery Obstruction ; physiopathology ; Retrospective Studies

INTRODUCTIONThe objective of this study was to evaluate the accuracy of using intravesical prostatic protrusion (IPP) as a parameter for the diagnosis of prostate adenoma (PA), as well as to determine the relationship between the site of PA and bladder outlet obstruction. IPP was determined with the use of transabdominal ultrasonography (TAUS).

METHODSA total of 77 consecutive adult men aged 30-85 years with haematuria or undergoing checkup for bladder tumour were enrolled. International Prostate Symptom Score (IPSS), and the results of uroflowmetry, TAUS and cystourethroscopy were assessed. All cases of IPP were classified into grades 0 (no IPP), 1 (1-5 mm), 2 (6-10 mm) or 3 (> 10 mm). PA diagnosis was confirmed using flexible cystourethroscopy. The sites of PA were classified as U0 (no adenoma), U1 (lateral lobes), U2 (middle lobe) or U3 (lateral and middle lobes).

RESULTSOf the 77 patients, 11 (14.3%) had no IPP. PA was confirmed using cystourethroscopy for all patients with IPP and for 7 of the 11 patients without IPP. Of the 37 patients with prostate volume < 20 g, 29 (78.4%) had IPP. Sensitivity, specificity, as well as positive and negative predictive values for diagnosing PA using only IPP were 90.4%, 100.0%, 100.0% and 36.4%, respectively. Higher sensitivity (95.9%) and negative predictive value (50.0%) were obtained when PA was used together with peak urinary flow rate (Qmax) < 20.0 mL/s. The mean Qmax of patients classified as U1 (n = 39) was 16.0 mL/s, while the mean Qmax in those classified as U2 (n = 12) and U3 (n = 22) was 11.9 mL/s and 8.9 mL/s, respectively.

CONCLUSIONAll patients with IPP had PA, and PA in the middle lobe was more obstructive than those in lateral lobes. Patients without IPP may still have PA.

Adult ; Aged ; Aged, 80 and over ; Biopsy ; Cystoscopy ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prospective Studies ; Prostate ; diagnostic imaging ; pathology ; Prostatic Hyperplasia ; complications ; diagnosis ; Ultrasonography ; Urinary Bladder Neck Obstruction ; diagnosis ; etiology

OBJECTIVETo study the relationship between estrogen and the development of hemangioma.

METHODSThe expression of EST and ER in samples from the thirty-eight cases of hemangioma and six cases of normal control group was examined with the immunohistochemical steptavidin peroxidase conjugated method (SP method).

RESULTSThe EST in capillary hemangioma expressed significantly higher than in the cavernous hemangioma, the racemose hemangioma or the control group. Although the EST in cavernous hemangioma and racemose hemangioma also expressed higher than in the control, there are no statistical differences among them. The ER only expressed in some cases in the capillary hemangioma group. No sexual difference was shown in the expressions of the EST and the ER.

CONCLUSIONThis study shows that there may be a relationship existed between the estrogen and the capillary hemangioma. It may indicate that some capillary hemangioma may be possibly treated by the drugs.

Case-Control Studies ; Estrogens ; metabolism ; Female ; Hemangioma, Capillary ; metabolism ; Hemangioma, Cavernous ; metabolism ; Humans ; Male ; Receptors, Estrogen ; metabolism

OBJECTIVETo investigate the technique and therapeutic effect of laparoscopy-insisted vaginoplasty with peritoneum in patients with androgen insensitivity syndrome.

METHODSFrom May. in the Fifth People' s Hospital of Shenzhen. The therapeutic effect was retrospectively analyzed.

RESULTSLaparoscopy-insisted vaginoplasty was successfully completely with peritoneum in patients with androgen in 4 cases. Ileumtivity segyndroment was used instead of peritoneum in one case. Open operation was not adopted in any cases. The ectopic testicles were removed during operation in 4 cases. The average operation time and bleeding volume was 60 min and 20 ml, respectively. Rectum, bladder and urethra were not injured in any case. The average vaginal length was 9 cm (range 8-10 cm) 21-28 days after operation. 6 months after operation, the surface of reconstructed vagina was smooth, ruddy and flexible, with satisfactory anatomical and functional results. Normal sexual activity was achieved in 2 cases.

CONCLUSIONSLaparoscopy-insisted vaginoplasty with peritoneum could be used for female patients with androgen insensitivity syndrome. The ectopic testicles should be removed. Estrogen supplement and psychological guide after operation are also important.

Adult ; Androgen-Insensitivity Syndrome ; surgery ; Female ; Humans ; Laparoscopy ; methods ; Male ; Peritoneum ; surgery ; Reconstructive Surgical Procedures ; methods ; Vagina ; surgery ; Young Adult

OBJECTIVETo study the role of proximal nerve stimulation at Erb point in the early diagnosis of Guillain-Barré syndrome (GBS) in children.

METHODSThirty-two children who were diagnosed with GBS between October 2013 and December 2014 received neurophysiological examination. Thirty healthy children were used as controls. Compound muscle action potentials and distal motor latency of the median and ulnar nerves were determined and analyzed after nerve stimulation at the wrist, elbow, and Erb point in the two groups. Moreover, F-wave latency of the median nerve and H-reflex latency of the tibial nerve were measured and analyzed in the two groups.

RESULTSThe F-wave and H-reflex latencies were significantly longer in the patient group than in the control group (P<0.05). In thirty-two patients, the numbers of patients with abnormal amplitude, abnormal latency, and conduction block at Erb's point were 24 (75%), 22 (69%), and 20 (62%), respectively. The patient group had significantly lower amplitudes but significantly longer latencies of the ulnar and median nerves at Erb point than the control group (P<0.05). There were no significant differences in the amplitudes and latencies at the wrist and elbow between the two groups (P>0.05).

CONCLUSIONSThe nerve stimulation at Erb point holds promise as a routine examination for the early diagnosis of GBS.

Adolescent ; Child ; Early Diagnosis ; Electrodiagnosis ; methods ; Female ; Guillain-Barre Syndrome ; diagnosis ; physiopathology ; H-Reflex ; Humans ; Male ; Neural Conduction ; physiology ; Reaction Time

OBJECTIVETo explore the effective therapeutic method in the treatment of idiopathic sudden hearing loss (ISHL).

METHODSOne hundred and eighty-eight cases of ISHL were randomized into a warming-promoting needling group (74 cases), a conventional acupuncture group (56 cases) and a medication group (58 cases). In the conventional acupuncture group, the conventional needling technique was applied to Baihui (GV 20), Fengchi (GB 20), Yifeng (TE 17), Tinggong (SI 19), Touqiaoyin (GB 11) and Zhigou (TE 6) on the affected side. The treatment was given 5 times each week. Totally, the treatment of 6 weeks was required. In the warming-promoting needling group, on the basic treatment as the conventional acupuncture group, the warming-promoting needling technique was applied to Fengchi (GB 20). In the medication group, the intravenous drop with salvia injectio and mecobalamin was prescribed, once per day, for 10 days totally. Meanwhile, Erlong Zuoci Wan was prescribed for oral administration, 8 pills each time, three times a day for 30 days continuously.

RESULTSAll of the three therapeutic methods achieved the effect on ISHL. The total effective rate was 89.2% (66/74) in the warming-promoting needling group, which was better than 62.5% (35/56) in the conventional acupuncture group and 53.4% (31/58) in the medication group (both P<0.01).

CONCLUSIONThe warming-promoting needling techinque achieves the significant efficacy on ISHL. The hearing improvement is superior to that treated with either the conventional needling technique or medication.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; Adult ; Female ; Hearing Loss, Sudden ; therapy ; Humans ; Male ; Middle Aged ; Needles ; Treatment Outcome

OBJECTIVETo investigate the effect of bufalin on nucleus-mitochondria localization of human telomerase reverse transcriptase(hTERT) by exploring its effect on proliferation and apoptosis in human esophageal squamous carcinoma EC9706 cells.

METHODSEC9706 cells were treated with bufalin at various concentrations, and then the cell growth inhibition of EC9706 cells was examined by CCK-8 assay and the 50% inhibitory concentration (IC(50)) was calculated.Cell cycle analysis was performed by flow cytometry with PI staining, and nucleus morphology of apoptosis were observed by fluorescence microscopy with Hoechst 33342 staining. The apoptotic index was measured by flow cytometry with Annexin V-FITC/PI double staining. hTERT subcellular localization and protein expression were determined by Western blotting and multiple immunofluorescence labling combined with laser confocal scanning microscopy.

RESULTSThe proliferation of EC 9706 cells was significantly inhibited by bufalin along with the increase of processing time and concentrations (p<0.01). After the EC9706 cells were exposed to 100 nmol/L bufalin,the number of cells gradually decreased in G(1) phase and increased in S and G(2)/M phases(p<0.05). The typical nucleus morphological changes of apoptosis were observed and the apoptotic index was increased(p<0.01). The expression of hTERT decreased in nucleus but increased in mitochondria(p<0.05).

CONCLUSIONSBufalin can inhibit the proliferation of human esophageal squamous carcinoma EC9706 cells in a time- and dose-dependent manner. It can arrest cell cycle in S and G(2)/M phases and induce the apoptosis of EC 9706 cells. hTERT is localized in both nucleus and mitochondria,and can be partially translocated from nucleus to mitochondria during the bufalin-induced apoptosis.

Apoptosis ; drug effects ; Bufanolides ; pharmacology ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Esophageal Neoplasms ; metabolism ; pathology ; Humans ; Telomerase ; metabolism

AIMTo investigate the effects of 323-A and 323-B, two isomers extracted from the metabolites of cultured marine fungus, Halorosellinia oceanicum 323, on the contraction of isolated guinea pig ileum (GPI).

METHODSThe GPI contractions were recorded with a two-channel-physiological recorder with tension transducers. Cumulative dose-response curves of contractions of isolated GPI induced by histamine (Hist), acetylcholine (ACh) and potassium chloride (KCl) were constructed, then the influences of 323-A and 323-B on each curve were observed. Furthermore, possible mechanisms underlying effects of the two compounds were explored by analyzing their influences on the biphasic contractile response to ACh, with comparison of a calcium antagonist, verapamil (Ver).

RESULTSThe data indicated that both 323-A and 323-B inhibited the contractile actions of GPI triggered by Hist, ACh and KCl in a concentration-dependent manner, with pD2' values of 5.13, 4.97, 5.36 and 5.51, 5.56, 5.62, respectively. The initial phase component of the ACh-elicited contractions, in the absence of external Ca2+, was significantly reduced by 323-A, 323-B, as well as Ver, whereas the subsequent sustained tonic contractions induced by adding Ca2+ to the bath solution were almost unaffected.

CONCLUSIONThese results suggest that 323-A and 323-B have calcium antagonistic effects similar to that of Ver in mechanisms, and they might have potential to be developed as calcium antagonists.

Acetylcholine ; antagonists & inhibitors ; Animals ; Calcium ; antagonists & inhibitors ; Calcium Channel Blockers ; isolation & purification ; pharmacology ; Female ; Fungi ; chemistry ; Guinea Pigs ; Histamine Antagonists ; pharmacology ; Ileum ; drug effects ; physiology ; Male ; Muscle Contraction ; drug effects ; Muscle, Smooth ; drug effects ; Potassium Chloride ; antagonists & inhibitors