Objective To explore the diagnostic and therapeutic value of endoscopic retrograde cholangiopancreatography ( ERCP) in teenagers with chronic pancreatitis. Methods Thirteen teenagers with chronic pancreatitis diagnosed and treated by consecutive ERCP procedures in our hospital from Feb 1997 to Feb 2002 were studied retrospectively. Results Of the 13 patients 12 had abdominal pain and 10 had history of acute/chronic pancreatitis. The ERCP findings were as follows: pancreatic duct stricture and/ or dilation 12, pancreatic duct stones 7, pancreatic pseudocysts 2, pancreas divisum 3, and cholecystolithia-sis 1. Therapeutic interventions included EST 7 , basket stone extraction 6, placement of pancreatic duct stent 5 , pancreatic duct stricture bougie or balloon dilation 4, accessory papillotomy 2 and endoscopic papillary dilation 1. In the 6 - 68 months follow - up, 11 (84. 6% ) never had recurrence of pancreatitis or abdominal pain ,2 patients had no abdominal pain after the second ERCP procedure. There were procedure -related complications of hyperamylasemia in 4 cases(30. 8% ) and pancreatitis in 3 cases(23. 1% ). Conclusion ERCP has significant value in diagnosing and treating chronic pancreatitis in teenagers, but has a rather high rate of complication . It suggested that the restrict selection of indication and safe application of the procedures in pediatric patients may be expected to decrease the adverse events of ERCP.

Objective To explore the imaging diagnostic value of primary ureter carcinoma.Methods Intravenous or retrograde pyelography was performed in 21 cases.Ultrasound(US)examination was performed in 25 cases.CT scan was performed in 14 cases.Results The manifestations of the intravenous and retrograde pyelography of the ureter carcinoma were irregular filling defect. The US revealed the various sized, irregular solid node , the tumor protruding into the bladder cavity. The CT displayed as various sized , different density , irregular soft mass . Conclusion The intravenous and retrograde pyelography combine with US , CT , the diagnostic level of ureter carcinoma can be increased .

Objective To estimate the current quality of the reporting of randomized controlled trials (RCTs) related to digestive diseases in China. Methods All the papers related to RCTs published in Chinese Journal of Digestion from 1999 to 2008 were hand-searched by professional staff then evaluated and analyzed them according to the international reference standard. ResultsIn the 3298 issues of the recent ten years, there were 92 research papers of RCTs which was accounting for 2.8%. The sample size ranged from 18 to 5241. Sixty-one (66.0%) trials included the exact standard of internalize and exclusion. Sixteen (17.4%) trails told the specific method of random allocation and 22(23.9%) were double-blinded. Fifty-eight (63.0%) trials compared the baseline condition of each groups. Seventy-three(79.3%) trails showed the specific approach of statistic. In the end, only 7(5.7%) trails were identified as the strictly-designed RCTs. Conclusions The quantity and quality of the clinical RCTs can not satisfy the demand of clinical practice. Strictly-scientific designed, multicentered, large sample prospective clinical RCT should be advocated.

Objective To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD)in treatment of patients with early gastric cancer(EGC).Methods A total of 4 3 consecutive patients with EGC were treated with ESD at Changhai Hospital from July 2007 to July 2008.The data referred to one-piece resection,histologically complete resection,operation time,complications,the post-ESD ulcer-healing and local recurrance were retrospectively analyzed.ResultsEn bloc resection was achieved in 97.7 0A(4 2/43)lesions in one-piece resection.The histologically complete resection rate was 95.3%(41/43).Only one patient had acute minor bleeding during the ESD procedure(2.3%,1/43)and one patient had delayed bleeding(2.3%,1/43).Post-ESD epigastric pain was found in 2 2 patients(51.2%).There was no complications such as acute major bleeding,perforation,requiring surgical treatment and death.The median operation time was 60.4 miutes.The post-ESD ulcer-healing was achieved in 100%(42/42)8 weeks after esomeprazole treatment.During follow-uP of 10.3 months(ranged from 8 to 1 8 months),no residual or local recurrence of EGC was seen.Conclusion ESD has the advantages of increasing one-piece resection and histologically curative resection rates.It is a safe and effective procedure in treatment of EGC.

Objective To study the morphological characteristics of eyes of female Uygur youth for providing the relevant data for eye aesthetic plastic surgery.Methods Compared with 150 cases of Han youth in the same school,the somatological survey was carried out in 150 female Uighur college students with the morphological characteristics of the eyes and good facial harmony.SPSS 17.0 was used for statistical analysis of the measured data in groups divided according to different race.Results 59.3％ (89/150) of the Uighur young women had prominent brow ridges tall nose and superior orbit cave,18.7％ (28/150) of them were similar to the Han type of eye,and 22.0％ (33/150) in between.The rate of epicanthus in Uighur women was 28.0％ (42/150),which was significantly lower than the Han nationality women 62.7％ (94/150).Double eyelid incidence was 96.7％ (145/150),which was significantly higher than that of Chinese Han women 67.3％ (101/150).There was a no statistically significant difference between them in palpebral fissure length inner canthic diameter and outer canthic diameter (P＞0.05),but a statistically significant difference was found in the height of palpebral fissure,the width of double eyelid and the distance between the eyebrow eyelid (P＜0.05).Conclusions The Uighur women's eye morphology has dual characteristics of Caucasoid and Mongoloid.The data have great significance and value in guiding the eye's cosmetic plastic surgery.

AIM: To investigate the role of p38 mitogen-activated protein kinase (p38MAPK) signaling pathway in the Kupffer cells (KCs) production of pro-inflammatory cytokines, tumor necrosis factor-?(TNF-?) and interleukin-1?(IL-1?), in severe acute pancreatitis (SAP) rats. METHODS: Sprague-Dwaley rats were randomized into three groups: ①sham operation rats, ②SAP rats, ③SAP rats given the p38 MAPK inhibitor CNI-1493(10 mg/kg, iv). The SAP model was induced by the bili-pancreatic duct infusion with 5% sterile soduim taurocholate solution. Rats from each group were killed at 12 h after sham operation or SAP and Kupffer cells (KCs) were isolated. The mRNA expressions of TNF-? and IL-1? (by quantitative real-time RT-PCR) and p38 MAPK activity (by Western blot analysis) in KCs were examined. The levels of TNF-? and IL-1? in plasma were determined by ELISA. RESULTS: There was a significant acvitation of p38 MAPK in KCs harvested from SAP rats than those from sham operation rats. SAP also promoted the mRNA expressions of TNF-? and IL-1? in KCs and the plasma levels of TNF-? and IL-1?. These events were significantly inhibited by treatment with CNI-1493.CONCLUSIONS: p38 MAPK activation is one important aspect of the signaling events that may mediate the KCs production of pro-inflammatory cytokines, TNF-? and IL-1?, in SAP rats. The inhibition of the p38 MAPK may be a potential target in the prevention and treatment of SAP.

Objective:To explore the risk factors influencing the prognosis for patients with hepatocellular carcinoma (HCC) recurrence after liver transplantation and summarize the relevant diagnostic and therapeutic experiences.Methods:The clinicopathological features with diagnosis and treatment plan of 102 recurrent HCC patients fulfilling the Fudan Criteria were compared for survival rate (univariate analysis) and independent prognostic indicators were obtained by Cox multivariate analysis.Results:The 1/3/5-year overall survival rates were 92.2%, 48.6% and 34.6% and the 1/3/5-year survival rates with tumor were 63.2%, 31.0% and 16.7% respectively. Cox regression analysis indicated that patient age, whether tumor can be surgically resected or not and personalized diagnostic & therapeutic plan based upon targeted therapy were independent prognostic factors affecting the overall survival rates and survival rates with tumor.Conclusions:Although HCC recurrence and metastasis after liver transplantation seriously influence patient prognosis, satisfactory outcomes may be obtained for some patients through active, effective and precise managements.

Objective To determine the efficacy of therapeutic endoscopic retrograde cholangio-pan-creatography (ERCP) in treatment of pain of chronic pancreatitis (CP). Methods The data of CP patients accompanying with pain, who received therapeutic ERCP from 1997 to 2006, were retrospectively analyzed.The diagnosis of CP was made based on the criteria from 2002 Asia-Pacific Consensus, and the effect of ther-apy was evaluated. Results Of 253 patients who received therapeutic ERCP, follow-up data were obtained from 214 patients ( 144 males and 70 females, ages ranging from 6.5 to 78.0 years, mean age 40. 5 years).The mean follow-up period was 41.9 months (12～131 months). Twenty-eight patients (13. 1% ) under-went surgery after ERCP. Relief rates of pain in patients who underwent ERCP with or without operation were 71.4% and 83.9% (P >0. 05 ) respectively. The overall relief rate of ERCP was 73%. The incidence of major complications related to the procedure was 14.9% (71/476) in terms of ERCP sessions, including post-ERCP pancreatitis in 12. 6%, mild cholangitis in 2. 1% and hemorrhage in 0. 2%. All complications sub-sided with conservative medical managements in 2 to 20 days. No perforation or death related to the procedure occurred. Conclusion Therapeutic ERCP is a mean of effective management of pain in patients with CP.

To investigate the changes of endocrine, cyclic nucleotide and immune systems in subjects of yang deficiency constitution, and to explore the relationship among characteristics and causes of yang deficiency constitution, the physiological and biochemical parameters.

Objective:To investigate whether ferroptosis of nerve cells exists in a rat model of neuropathic pain (NP), and to explore the mechanism of O 3 treatment of NP. Methods:Sixty male SD rats were randomly divided into three groups: neuropathic pain model group (NP group), sham operation group (Sham group) and ozone group (O 3 group). The partial sciatic nerve ligation was used in the NP and O 3 groups to construct a neuropathic pain model. The Sham group was subjected to sham surgery. In the O 3 group, 15 μl of O 3 (40 μg/ml) was injected locally at the injury site, and the NP and Sham were injected with the same amount of air, once per day. The mechanical contraction response threshold (MWT) and thermal contraction latency (TWL) of the rats were measured 1 day before the surgery (T0) and 1, 3, 7, 14 days after the surgery (T1 to T4). The spinal cord segments of rats were collected. The expression levels of glutathione peroxidase 4 (GPX4) and long chain fatty acid coenzyme A synthetase 4 (ACSL4) at T1 to T4 was detected using Western Blot. The number of NeuN+ neuron cells in the spinal dorsal horn at T4 was detected using immunofluorescence technology. The specific changes of ferroptosis at T4 was observed by a transmission electron microscopy. Iron deposition in the spinal dorsal horn at T1 to T4 was measured using ferroptosis kits. Results:Compared with the Sham group, rats in the NP group and O 3 group showed decreasing of MWT decreased and shortening of TWL at T2 to T4, decreasing of NeuN+ neurons in spinal dorsal horn at T4, specific changes of ferroptosis in mitochondria at T4, and increasing of iron content in nerve tissue at T2 to T4. Compared with the Sham group, rats in NP group showed decreasing of GPX4 level and increasing of ACSL4 level. Compared with the NP group, rats in the O 3 group showed increasing of MWT and prolonging of TWL at T2 to T4, increasing of the GPX4 level and decreasing of ACSL4 level at T2 to T4, increasing of the number of NeuN+ neuron cells in the spinal dorsal horn, improving of the mitochondrial atrophy of nerve cells, and decreasing of the iron content in nerve tissue at T2 to T4. The above results are statistically significant (all P<0.05). Conclusions:The mechanism of O 3 in treating neuropathic pain may be through inhibition of iron death.