Objective To evaluate the application of chromogranin A (CgA) as a marker in the diagnosis of prostate cancer. Methods Serum chromogranin A were detected by means of ELISA technique in 35 cases of prostate carcinoma,10 cases of benign prostate hyperplasia and 30 cases of healthy subjects. Results Serum CgA [(162?12.5)ng/ml] of patients with prostatic carcinoma was significantly higher than those of healthy subjects and of BPH( P

Objective To investigate the diagnostic value and feasibility of PTC diagnosis on pancreaticobiliary maljunction (IBM), and to summarize the PTC radiological characteristics of PBM. Methods Clinical findings and cholangiopancreatographic results were analyzed retrospectively for a group of consecutive 363 patients with obstructive jaundice receiving the PTCD therapy. Meanwhile the standard selected for cases and diagnostic conditions were established. The length and diameter of pancreaticobiliary common duct, the diameter of pancreatic duct and common bile duct and the confluence angle were measured respectively. The t test and rank sum test were used to analyze the result statistically. Results Thirty-eight cases were radiologicaUy diagnosed as PBM owing to the reference standard and the detection rate was 10.5% (38/363). The length of common duct was (12.6±7.9)mm. The significant difference existed between it and normal value (6ram) (t=5.15 , P <0.05). The site of duodenal papilla had influence on the length of common duct. The diameter of common bile duct, pancreatic duct and common duct near the confluence are (3.7±1.9 ) mm, (2.4±1.3) mm, (3.3±1.4 ) mm, respectively. There was no statistical difference between them and the normal value (t=1.79,2.85,5.72, P>0.05). Fifteen patients' duodenal papilla located the middle of descending duodenum. The length of common duct was (10.6±9.1)mm , the confluence angle was 51.1°±28.0°, the number of the duodenal papilla locating in the inferior 1/3 of descending duodenum, juncture , horizontal part of duodenum was 10, 8,5, respectively. The length of common duet were (9.9±3.7), ( 18.6±8.9), ( 13.9±3.5 ) mm, respectively. The confluence angle were 54.0°±18.6°、48.7°±12.6°、74.4°±18.5°, respectively . The site of duodenal papilla had significant influence on the length of common duct(X2=14.51, P <0.05). Conclusion PTC is a safe, feasible, method to diagnose PBM, and it demonstrates the characteristic findings of PBM.

A number of biosimilars will be soon marketing due to the expiration of patent protection of their originators.Unlike classical chemical drugs,biotherapeutics are proteins with large and complex molecules produced by biological high-tech with sophisticated manufactural procedures.This leads to the difficulties of the copy of biosimilars from their originators,and the almost inevitable distinctions between the two products.Thus biosimilars are only similar but not identical to their reference drugs in terms of stracture,action,and safety.It is important for physicians to understand these differences before using biosimilars.Optimal management by a national regulatory authority with rigorous standards is very important in all aspects of authorization of the development,production,marketing,and postmarketing surveillances for biosimilars.

Resident doctor standardization training program is the necessary and important part of medical education after graduation.The Hainan branch of PLA General Hospital combines scientific and practical medical conditions and discipline characteristics of Hainan to scientifically plan the standardized treatment of cancer pain in training.This model combines lecture-based learning (LBL) teaching method and virtual demonstration for theoretical training.In practical training,we conduct problem-based learning (PBL) teaching method,situational teaching and standardized examination to systemically improve resident doctors' skill for cancer pain management.This combined teaching strategy can help resident doctors to establish correct and standard concept in future clinical practice,and enable them to establish a correct concept of treatment,and adopt two-way evaluation to continuously improve teaching quality before the end of training.

Objective To compare the sensitivity between forceps biopsy and brushing, and to explore a feasible approach to pathological diagnosis of the obstructive jaundice.Methods 92 consecutive patients with obstructive jaundice underwent transluminal foreceps biopsy and brushing during percutaneous transhepatic cholangiography and percutaneous transhepatic cholangiodrainage. The technique was performed through an preexisting percutaneous transhepatic tract with multiple specimens obtained after passing the forceps biopsy or brush into a 8-French sheath. Finally the specimens were fixed with formalin for pathologic or cytologic diagnosis. Results The histopathologic diagnosis was acquired in 81 out of 92 patients with forceps biopsy reaching the successful rate of 97.83%. Sensitivity of forceps biopsy in 92 patients was higher than that of brush in 84 patients(88.04% vs 76.19%,? 2=4.251,P=

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula (BSF). Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types (A and B) of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7(87.5%) of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple,safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. (J Intervent Radiol, 2007, 16: 253-257)[ Key words ] Fistula, pulmonary; Bronchialpleural fistula; Stents and prostheses; Computed tomography

Objective:To study the clinical efficacy of levosimendan combined with naoxintong capsule in the treatment of acute heart failure and effects on the serum amino terminal B type natriuretic peptide precursor (NT-proBNP),Galectin-3,endothelin 1 (ET-1),Cystatin C levels.Methods:90 patients with acute heart failure from March 2015 to June 2016 in our hospital were selected and divided into observation group (n=45) and control group (n=45) by lottery method.Patients in the control group were treated by levosimendan alone.Patients in the observation group were treated by Naoxintong capsule combined with levosimendan.The clinical effect,changes of serum NT-proBNP,galectin-3,ET-1,cystatin C levels before and after treatment and the incidence of adverse reactions were compared between two groups.Results:After treatment,the total effective rate was 93.33％ in the observation group,which was higher than that in the control group (77.78％) (P＜0.05);the left ventricular fractional shortening,left ventricular ejection fraction,stroke volume of both groups were higher than those before treatment,the blood pressure,heart rate and serum NT-proBNP,galectin-3,ET-1,cystatin C levels were lower than before treatment,and LVFS,LVEF,SV levels of the patients in the observation group were significantly higer than those of the control group (P＜0.05),the blood pressure,heart rate and serum NT-proBNP,galectin-3,ET-1,cystatin C levels were lower than those of the control group (P＜0.05).Conclusion:Levosimendan combined with Naoxintong Capsule could improve the therapeutic effect of acute heart failure with higher safety and reduce the levels of serum NT-proBNP,Galectin-3,ET-1 and Cystatin C.

Objective To improve the diagnosis and treatment of testicular masses associated with congenital adrenal hyperplasia(CAH).Methods A 25-year-old man presented with bilateral testicular nodules.Physical examination revealed palpable multiple nodules in the bilateral testes and epididymides as well as enlarged and hard right testis with uneven surface.Biochemical examination showed testosterone(T) of 18.7 nmol/L,17?-(OH)P＞20.0 ng/ml,positive results of rapid ACTH stimulation test and dexametha- sone suppression test.B-ultrasound demonstrated diffuse testicular lesions with nodules in parts of the bilater- al testes.Bilateral testicular nodules were biopsied,and pathological diagnosis was interstitial cell hyperplasi- a.Positive staining for?-inhibin was observed immunohistochemically.The clinical characteristics of testicular masses associated with CAH were reviewed in combination with the literature.Results Based on medical history,imaging,laboratory and pathologic examinations,the patient was diagnosed with testicular masses as- sociated with CAH.He received oral cortisol at dose of 40 mg daily for 2 weeks,and then at dose of 30 mg daily as maintenance therapy.After treatment of 8 months,B-ultrasound showed complete regression of the testicular tumors.Follow-up of 24 months showed no recurrence of the tumor.Conclusions For patient with bilateral testicular masses,endocrinological evaluation and clinical history taking are indicated to exclude testicular interstitial cell hyperplasia associated with CAH.By oral steroid replacement therapy,hormone-sen- sitive testicular masses can regress.

Ear, Middle ; surgery ; Humans ; Otologic Surgical Procedures