Congresses as Topic ; Humans ; Multiple Myeloma ; United States

Objective To evaluate the diagnostic value of intraductal ulstrasonography(IDUS)in non-opaque bile duct stones.Methods Between January 2009 and August 2010 in the Department of Gastroenterology at Shanghai 10th People's Hospital,a total of 183 patients(male:102 cases,mean age 69 years； female:81 cases,mean age 71 years)were enrolled,who were suspected of bile duct stones or stenosis which could not be diagnosed by abdominal CT,MRI,and abdominal B-mode ultrasound.All the patients underwent endoscopic retrograde cholangiopancreatography(ERCP)first,and then patients with non-opaque bile duct stones followed by IDUS.Results A total of 134 cases (73.2％)of bile duct stones were diagnosed by ERCP,49 cases(26.8％)were negative.And then the 49 patients underwent IDUS,of whom 24 patients with sand-like stones,11 patients with lowdensity stones,6 patients with ampullary cancer,2 patients with pancreatic cancer,6 patients with sclerosing cholangitis.The diagnostic accuracy of IDUS in the position and quality of bile duct stones was 100％,higher than that of ERCP,which was 80％.After ERCP,pancreatitis occurred in 3 patients and improved after conservative treatment,there was no complications like perforation and bleeding.Conclusion The diagnostic accuracy of IDUS in the position and quality of bile duct stones is high,which can make up for the misdiagnosis by ERCP without increasing the complications.IDUS can provide reliable basis for the diagnosis of clinical bile duct stones.

Objective To examine the impact of C-reactive protein (CRP) on the expression of interleukin-6 (IL-6), inflammatory cytokine, in cultured human pulmonary artery smooth muscle cells (hPASMCs) in order to find out the cause of pulmonary artery hypertension (PAH). Method The hPASMCs were cultured and stimulated by different concerntrations of CRP (5 - 200 μg/ml) for different lengths of time. The activity of nuclear factor-κB (NF-κB) was evaluated by electrophoretic gel mobility shift assay (EMSA). The expression of IL-6 mRNA and the level of IL-6 protein were measured by using real-time PCR and ELISA, respectively. Results CRP increased IL-6 production in hPASMCs in a dose-dependent manner. The increase in IL-6 at concerntration of 200 μg/mL in the CRP group was as high as 2.8times that in the control group. CRP also significantly induced the activation of NF-κB in hPASMCs. The effect of CRP on the inflammatory cytokine, IL-6, was inhibited by the specific FcγⅡa receptor antibody.Conclusions In vitro, CRP increases the production of IL-6 in hPASMCs mediated by FcγⅡa receptor and NF-κB translocation. These data offer important insights into the role of CRP in the pathogenesis of PAH.

Objective To investigate the efficacy of medical therapy after conservative operation for endometriosis.(Methods)Endometriosis was confirmed in 89 patients by laparoscopic inspection,and conservative operations were performed to remove the adhesion,excise or destroy all the endometriotic tissues,including single excision of endo-(metriotic) masses or plus unilateral salpingoophorectomy,and to restore pelvic anatomy to the best possible condition.All the patients were divided into two groups randomly: treatment group(n=44),three months drug therapy of go-(nadotropin-)releasing hormone analogs(GnRHa) after operation;control group(n=45),no drug therapy after operation.Clinical symptoms,concentrations of CA-125,manual and ultrasonic pelvic check-up,as well as pregnancy rate to those who had a desire for future fertility(n=28)were followed up. Results All the patients experienced alleviation of clinical symptoms after the operation.The recurring rates: 0% in treatment group vs 4% in control group six months later;2% in treatment group vs 4% in control group 12 months later(P

Objective:To determine the content of notoginsenoside R1 , ginsenoside Rg1 and Rb1 in Shuxuening capsules. Meth-ods:The three constituents were determined on a Hypersil ODS-2 C18 column (250 mm × 4. 6 mm, 5 μm) with gradient elution using acetonitrile (A) -aqueous solution (B) (0-8 min, 20%A→20%A, 8-40 min, 20%A→30%A, 40-60 min, 30%A→45%A) at the detection wavelength of 203 nm with a flow rate of 1. 0 ml·min-1 . The column temperature was 25℃ and the injection volume was 20μl. Results:The calibration curve showed good linearity within the concentration range of 0. 05-0. 50 mg·ml-1 for notogisenoside R1 , and 0.20-2.00 mg·ml-1 for ginsenoside Rg1 and Rb1(r =0.999 9). The average relative recovery was 98.79%, 98.42% and 98. 89% for each constituent(RSD=0. 85%, 0. 97% and 0. 74%, respectively, n=6). The intra-day RSD was 0. 49%, 0. 20% and 0. 39%, and the inter-day RSD was 0. 75%, 0. 56% and 0. 51%, respectively. The RSDs of stability test and repeatability test were less than 1%. Conclusion:The method is simple with good accuracy and repeatability, which can be used for the determination of no-toginsenoside R1 , ginsenoside Rg1 and Rb1 in Shuxuening capsules.

0.05). CONCLUSION: There are no significant differences in cell characteristics and transplantation outcome using OB-OEC and OM-OEC transplantation for repairing neurological function.

Objective To study the feasibility of defining the internal gross tumor volume (IGTV) of hepatocellular carcinoma applying the enhanced four-dimensional computed tomography (4DCT) images with deformable registration technology.Methods Ten HCC patients who accepted radiation therapy were selected in this study.The 4DCT in free breathing,non-enhanced 3DCT and arterial phase enhanced 3DCT in end inspiration breath holding associated with active breathing coordinator were acquired sequentially.4DCT were sorted into ten series CT images according to breath phase,and named CT00,CT10..…CT90.Gross tumor volume (GTV) were contoured on different CT series and the IGTV1 was merged by ten phases GTVs of 4DCT.The GTV of enhanced 3DCT was registered to different CT series of 4DCT and the IGTVDR was obtained by merging the GTVs after deformable registration.The target volumes differences were compared by paired t-test.Results The edge of tumor was difficult to define on 4DCT and non-enhanced 3DCT images.The enhanced 3DCT image showed clearer tumor edge,and the GTV increased by mean 37.99％ compared to GTV on 4DCT different series images and non-enhanced 3DCT image (P =0.002).The GTV after deformable registration on 4DCT different phase images increased by mean 36.34％ (P =0.011),which were similar to GTV on enhanced 3DCT image (P =0.632).The IGTVDR increased by 19.91％ (P =0.017),compared to IGTV1.Conclusions The contrast-enhanced 4DCT image which was obtained by combining enhanced 3DCT and 4DCT images with deformable registration technology could raise the position precision of the HCC IGTV effectively.

Objective To explore the expression of nestin and Ki-67 in malignant peripheral nerve sheath tumors (MPNST) and its significance in the differential diagnosis. Methods Immunohistochemical technique (SP) was used to detect the expression of nestin and Ki-67 in 42 cases of MPNST and 24 cases of benign peripheral nerve tumor.Results Total expression of nestin was found in 95.2 ％(40/42) of MPNST.Strong expression of nestin was detected more frequent in MPNST compared to benign peripheral nerve tumors [40.5 ％(17/42) versus 4.2 ％(1/24),x2 =8.403,P =0.004].Ki-67 labeling index in MPNST varied from 1％-70 ％.However,greater than 3 ％ labeling index of Ki-67 staining was observed in 64.3 ％(27 / 42) of MPNST while none of the 24 benign tumors had nuclear staining exceeding 3 ％. The higher Ki-67 labeling index showed significant differences between the two groups (x2 =23.518,P =0.000).Conclusion Nestin and Ki-67 are useful markers in distinguishing MPNST from benign tumors.

Objective To investigate the relationship between serum or urine tissue inhibitor of metalloproteinases-1 (TIMP-1)levels and the stages of chronic kidney disease (CKD).Methods Serum and urine level of TIMP-1 were measured by enzyme-linked immunoadsorbent assay (ELISA) in 122 CKD patients and 40 healthy controls.Serum cystatin-C (CystC),parathyroid hormone (PTH),low-density lipoprotein (LDL)and other markers were determined simultaneously.Correlationanalysis between TIMP-1 level and degree of renal function were performed.Results Serum and urine TIMP-1 of the patients in CKD group was significantly higher than that in control group (P

Objectives To summarize the characteristics,differential diagnosis and management of incomplete 17 alpha-hydroxylase/17,20-1yase deficiency(17 OHD)of Chinese patients.Methods Six cases of incomplete 17 OHD from Peking Union Medical College Hospital were studied retrospectively through analyzing their clinical data,and the molecular pathogenic mechanism was discussed after literature review.Results Four cases of 46,XX incomplete 17 OHD were reported.The clinical characteristics included female phenotype,various degrees of breast development and absent or sparse axillary/pubic hair, oligomenorrhea or secondary amenorrhea,recurrent luteinized ovarian cysts,hypogonadism with persistent hyperprogesteronemia or high serum 17 alpha-hydroxyprogesterone level,with or without hypokalemic hypertension.There were also 2 cases of 46,XY incomplete 17 OHD,in which ambiguous genitalia were present besides hypokalemic hypertension.Conclusions Incomplete 17 OHD is a very rare form of congenital enzymatic deficiencies of steroid synthesis,which should be included in the differential diagnosis when there are menstrual disorders,sexual infantilism,recurrent ovarian cysts or ambiguous genitalia.Under such circumstances,hyperprogesteronemia offers a valuable clue for further investigation.