Objective To assess the safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) for pancreaticobiliary diseases in children. Methods Data of 9 patients younger than 14 years who underwent ERCP at between November 2004 and May 2010 were indentified through a computer database search. Therapeutic methods, success rate and procedure-related complications were evaluated.Results A total of 9 patients underwent 17 ERCP procedures under anesthesia, including 16 therapeutic and 1 diagnostic procedure. The success rate was 94. 1% (16/17) and the complication rate was 11.8%(2/17), including 1 mild pancreatitis and 1 peri-pancreatic infection. Conclusion ERCP is an important tool with high safety and efficacy for diagnosis and treatment of pancreaticobiliary diseases in children.

Objective To investigate epidemiological and clinical features of patients with clonorchiasis sinensis infection. Methods The epidemiological, clinical, laboratory and treatment data of clonorchiasis patients in Department of Infectious Diseases, Second Affiliated Hospital, Harbin Medical University from 2002 to 2004 were retrospectively analyzed. Results Sixty-eight point two percent patients had a history of eating raw freshwater fish and shrimp. Patients with occupations as cook, fish stock man, fishing man and fishmonger accounted for 22.6%. The transmission route was not clear in 9.1% of patients. The common clinical manifestations were abdominal pain (60.3%), fatigue (52.3%), diarrhea (33.0%), anorexia (69.3%), jaundice (23.9%), hepatomegaly (59.1%), splenomegaly (8.0%), dizziness (20.9%), fever (5.7%) and biliary colic (14.8%). Twenty-eight point four percent were asymptomatic. Other findings included liver dysfunction (70.4 %) and eosinophile granulocyteosis(69.3 %). Negative rate of stool egg of clonorchis sinensis after treatment with praziquantel or albendazole was 91.9% or 86.5%, respectively. There was no significant difference between the two groups ( χ2 = 0.561, P = 0.454). Conclusions Clinical manifestations of patients with clonorchiasis sinensis are complicated and often accompanied with liver dysfunction. Clonorchiasis sinensis is often misdiagnosed and should be paid much attention.

Objective To study the effect of fosinopril on the expression of NADPH oxidase subunit p22phox mRNA and the extracellular matrix (ECM) accumulation in the kidneys of rats with diabetes mellitus . Methods Diabetic rats induced by streptozotocin were randomly divided into control group(DM group) and fosinopril group (fosinopril 10 mg'kg-1·d-1) (DM+Fosin group) and treated for 12 weeks . Expression of p22phox mRNA of NADPH oxidase in kidneys was measured by RT-PCR . The expression of fibroneetin was studied by immunohistochemistry and matrix metalloproteinases 9 activity was detected by Zymography . Meanwhile, the kidney hypertrophy index, serum creatinine level and 24-hour urinary protein excretion were evaluated . Results The expression level of p22phox mRNA in the kidneys of DM+Fosin group rats was decreased by 45% than that of DM group at week 4 (P＜0 .05) . At week 8 fosinopril significantly decreased the expression of glomerular and tubulointerstitial fibronectin by 52,5% and 42 .9% respectively (P＜0 .05), while increased MMP-9 activity by 29 .6% (P＜0 .05) compared with DM group . Fosinopril significantly decreased 24-hour urinary protein excretion of diabetic rats from week 8 . Serum creatinine level, 24-hour urinary protein excretion and kidney hypertrophy index were significantly decreased by 35 .9%, 50 .2% and 17 .2% in rats of DM+Fosin group than those of DM group at week 12 (P＜0 .05) . Fosinopril did not affect blood sugar significantly . Conclusion Fosinopril has beneficial effect on diabetic nephropathy partly through inhibiting the expression of NADPH oxidase p22 phox mRNA .

Objective To investigate the value of dynamic contrast-enhanced magnetic resonance imaging ( DCE-MRI) in differentiating serological negative early stage rheumatoid arthritis (RA) from osteoarthritis (OA)in hand. Methods Plain MRI, enhanced MRI of whole hand and DCE-MRI of single slice were performed in 53 patients suspected of RA or OA and 18 healthy volunteers. Twenty-three of them were diagnosed as RA,including 18 cases of serological negative RA and 18 of them were diagnosed as OA after 3 to 6 months follow-up. The contrast rate,slope, thickening of synovial membrane were measured on DCE-MRI in three groups and the MRI findings were also were detected in both RA and OA groups. The contrast rate and slope of synovial membrane were compared among three groups using rank sum test. The thickening of synovial membrane were compared among three groups using variance analysis. MRI signs of RA and OA group were evaluated with rank sum test Results The dynamic contrast rate of synovial membrane in RA group,OA group and control group was(100.78±61.96)%,(40.44±15.43)% and (23.56±9.14)%,respectively.Individually,RA group to OA group,u=3.101,P=0.002;RA group to control group,u=4.669,P=0.000;OA group to control group,u=3.482,P=0.000.The slope of contrast curve of synodal membrane of RA group,OA group and control group was 72.50°±13.34°,45.39°±9.94°,14.56°±5.75°,respectively.Individually,RA group to OA group,u=8.002,P=0.000;RA group to control group,u=17.102,P=0.000;OA group to control group,u=9.100,P=0.000.The synovial membrane thickening of RA group,OA group and control group was(3.3±0.5),(2.8±0.7)and (1.4±0.6)mm,respectively.Individually,RA group to OA group,q=2.622,P=0.011;RA group to control group,q=9.583,P=0.000;OA group to control group,q=6.961,P=0.000.Conclusion The quantitative index of DCE-MRI,including contrast rate and synovial membrane thickening may provide useful information for differentiating OA from semlogical negative early stage RA.The contrast rate and thickening of synovial membrane in RA group are higher than those in OA group.Many signs of MRI Can help differentiate OA from RA.

OBJECTIVETo investigate the apoptosis and proliferation effect of matrine on human medulloblastoma cell line D341 in vitro and the effect of the expression of the related caspase 3 and caspase 9 proteins.

METHODSThe D341 cells were cultivated successfully in vitro. Then the cells were divided into 5 groups according to the concentration of matrine (0.5 mg/mI group, 1.0 mg/ml group, 1.5 mg/ml group, 2.0 mg/ml group and the control group was 0 mg/ml). All the experiments were repeated three times. The cell morphologic and structure change was observed with the optical microscope and the transmission electron microscope. The proliferation of D341 cell was analyzed using Cell Counting Kit-8 assay. Apoptosis was detected by Annexin V-FITC/PI double staining. The expression of Caspase3 and Caspase9 was detected by Western blot.

RESULTSWith the effect of matrine, the proliferation inhibition rate gradually increased with drug concentrations increasing, and there was a significant difference (P < 0.01). The inhibitory effect of matrine on cell proliferation was different with the different treatment time, there was a significant difference between the 24 h to 72 h groups (P < 0.01). The apoptotic rate increased with matrine concentrations increasing. There were significant differences between the group of 0.5 mg/mI or 1.0 mg/mI to the group of 1.5 mg/mI or 2.0 mg/mI (P < 0.05). The apoptotic rate increased with the prolonged treatment time. There were significant differences between the group of 24 h or 48 h to the group of 72 h ( P < 0.05). With the increase of matrine concentration, the expression of Caspase 3 and Caspase 9 increased (P < 0.01).

CONCLUSIONMatrine induces the apoptosis, and inhibits the proliferation of human medulloblastoma D341 cells in vitro by up-regulation of the expression level of Caspase3, Caspase9.

Alkaloids ; pharmacology ; Apoptosis ; Caspase 3 ; metabolism ; Caspase 9 ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; Cerebellar Neoplasms ; metabolism ; pathology ; Humans ; Medulloblastoma ; metabolism ; pathology ; Quinolizines ; pharmacology ; Up-Regulation

Objective To study the mechanism of serum thyroxin and insulin change after hemihepatectomy. Methods The hemihepatectomy was performed in rabbits, the fasting peripheral blood samples were drawn on the day prior to surgery, and 24 hour, 48 hour, the first week, one month after operation respectively for monitoring the serum thyroxin and insulin.Results The level of TT 3 was (1.93?0.47) nmol/L, TT 4 (53.56?8.4) nmol/L preoperatively. The levels of TT 3 and TT 4 significantly decreased at 24 hour postoperatively, and gradually rose at 48 hour and up to normal levels in the first month postoperatively. The level of insulin rapidly rose immediately after operation, and began to decrease in the first week, and returned to the preoperative level in one month after operation. Conclusions The syndrome of normal thyroid disease and the syndrome of non thyroid disease can occur after hemihepatectomy; and hyperinsulinemia also can occur after hemihepatectomy.

Objective To explore the role of computer-based simulators in upper gastrointestinal endoscopy training.Methods Forty-one graduate students,residents and GI fellows for further cducation with no experience in endoscopy were randomly assigned to two groups and underwent one-month training with or without a 10-hour computer-based simulator.Each trainee performed upper endoscopy in 20 patients.Comparison was made between the two groups in terms of these performance parameters:esophageal intubation,retroflexion,pyloric intubation,intubation of the descending part of the duodenum and procedure time.Resuits There Was no significant difference in esophageal intubation(P=0.699)and intubation of the second part of the duodenum(P=0.141)between two groups.While the differences were significant in retroflexion (P<0.001),pyloric intubation(P<0.001)and procedure time(P=0.032),i.e.,the simulator group was much better in performance than the other group.Conclusion The computer-bascd simulator is effective in providing trainees with the skills needed for upper gastrointestinal endoscopy,shortening the teaching hours and lessening patients'pain.

Objective To evaluate the efficacy and safety of fluoroscopy guided frequency-doubled double-pulsed laser lithotripsy for removing difficult bile duct stones. Methods From March 2008 to December 2009, patients with difficult bile duct stones were divided into cholangioscopy guided group ( n = 21 )and fluoroscopy guided group ( n = 19) to receive corresponding treatments. The success rate of complete stone removal and the complication rate related to the procedure were compared between the two groups.Results There are no significant differences between 2 groups in regarding of either success rate of complete stone removal ( 19/21, 90. 5% in cholangioscopy guided group vs. 17/19, 89. 5% in fluoroscopy guided group, P ＞0. 05 ) or rate of procedure related complication (4/21, 19. 0% in cholangioscopy guided group vs. 3/19, 15. 8% in fluoroscopic guided group, P = 0. 559 ). Conclusion Frequency-doubled doublepulsed laser lithotripsy guided by cholangioscopy or fluoroscopy are both safe and effective.

Objective To study the expression of NKx2.5 on the heart of offspring during the development of embryo,whose mother is deficient of folic acid.Methods 1.Control group involving 18 rats and study group involving 18 rats were chosen from the total 36 adult female SD rats randomly copulate with the male normal rats after feeding different fodder for 2 weeks.The heart of the 13.5 days,17.5 days embryos and the newborns were obtained;2.the expression of NKx2.5mRNA by RT-PCR was observed;3.the expression of NKx2.5 protein by Western-blotting was investigated.Results 1.The expression of NKx2.5 mRNA of study group was weaker than control group in heart of the 13.5 days,17.5 days embryos and the newborns(P

Objectiye To evaluate the therapeutic efficacy and safety of (endoscopic sphincterotomy, EST) plus balloon dilation for difficult bile duct stones. Methods Patients with difficult common bile duct stones on endoscopic retrograde cholangiopancreatography (ERCP) from March 2008 to December 2009 were randomly divided into 2 groups to receive EST or EST plus balloon dilation ( EST + EPBD), respectively. The success rate of complete stone removal, number of endoscopic sessions, the rate of using mechanical lithotripsy and the complication rate related to the procedure were compared between the 2 groups. Results Compared with EST alone, EST plus balloon dilation resulted in similar outcomes in terms of overall successful stone removal rate (2/62 vs. 2/61 ) and early complication rate (4/62 vs. 6/61, P ＞0. 05). However,EST group needed more sessions ( EST 15/46 vs. EST + EPBD 5/57, P ＜0. 05) and use of mechanical lithotripsy to achieve complete removal of stones ( EST 12/61 vs. EST + EPBD 4/61, P ＜0. 05 ). Conclusion EST plus balloon dilation is as safe and effective as, but more convenient than EST, for endoscopic removal of common bile duct stones.