Objective To probe the differences and similarities of clinical feature between alcoholic and biliary chronic pancreatitis (CP) and their therapy. Methods Retrospective analysis of the clinical features was made in 110 cases of CP in Peking Union Medical College Hospital from 1991 to 2000. Results ① In 110 cases of CP, the clinical manifestations were abdominal pain (85.4%), diarrhea (22.7%), calcification of pancreas (13.6%), and pseudocyst of pancreas (28.2%); 3 cases (2.7%) complicated with pancreatic carcinoma. ② The frequency of the different kind of clinical manifestations in alcoholic CP was higher than in biliary CP.③The frequency of diarrhea (29.1%),diabetes mellitus (41.9%) and calcification of pancreas (22.6%) in alcoholic CP was also higher than in those caused by bile duct system diseases (16.7%, 19.1% and 9.5%).④The response rate of medical treatment was 81.2%. Conclusions The clinical features and complications are more typical and occur earlier in alcoholic CP than those in biliary CP. With regard to management, medical treatment is less used than surgical therapy.

Objective To explore the clinical features and possible carcinogenesis mechanism of the ulcerative colitis (UC)-associated colorectal cancer. Methods From 1984 to 2008, 6 clinical cases of UC-associated colorectal cancer were collected at Peking Union Medical College Hospital. The characters of morbidity, clinical features, pathology type, treatment and prognosis were analyzed.Immunohistochemistry(IHC) was performed to study the protein expression of adenomatous polyposis coli protein(APC), β-catenin, P53 and Wnt-1 in the specimens. Results The canceration of UC was 1.1 %, higher in female cases (5/6), the average duration was 14.3 years. All cases presented typical UC manifestation, most involved total colon (5/6) and none of them complicated with primary sclerosing cholangitis (PSC). There were 4 rectal cancers and 2 descending colon caners the UC cases collected. The major pathology type was adenocarcinoma with poor prognosis. The positive protein expression ratio of APC, β-catenin, P53 and Wnt-1 were 6/6, 6/6, 5/6 and 6/6 respectively.Conclusion The rectal cancer should be monitored and prevented in UC patients with total colon involved and long disease duration. Multi-pathway may possibly be involved in the carcinogenesis.

Objective To evaluate the clinical value of the three-category classification of severe acute pancreatitis (SAP).Methods Clinical data of 337 traditional SAP patients,who were admitted to Peking Union Medical College Hospital (PUMCH)from January 2001 to December 2012,were retrospectively studied.These patients were classified into moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP) according to the latest 2013 Atlanta Classification.SAP patients were further categorized as critical acute pancreatitis (CAP) and non-CAP.Disease severity,therapy and prognosis among three groups were compared.Results Among the total 337 traditional SAP patients,253 were classified as MSAP and 84 as SAP.In the group of SAP,40 patients were categorized as CAP and 44 as non-CAP.Compared with non-CAP patients,CAP patients had significantly higher mortality rate which was 70％ (28/40).Other results were all significantly higher in CAP group rather than non-CAP group,including ICU admission rate 77.5％(31/40),length of ICU stay (15.5 ± 20.6) days,Ranson,APACHE Ⅱ,BISAP,MCTSI,modified Marshall scores 4.6 ± 1.4,16.8 ± 5.8,3.0 ± 1.0,8.6 ± 1.7,and 7.4 ± 2.9,respectively (P ＜ 0.01 in each endpoint).These parameters of SAP group were also significantly higher than those of MSAP group (P ＜0.01).Conclusions Using the new three-category classification to distinguish traditional severe acute pancreatitis,namely MSAP,SAP,and CAP,can better reflect the severity of disease,predict outcome and guide clinical management.

Objective To investigate the value of plasma chromogranin A (CgA) in the diagnosis of neuroendocrine tumors (NETs), and to evaluate the diagnostic efficacy of plasma CgA in different gastrointestinal pancreatic neuroendocrine tumors (GEP NETs). To investigate the role of monitoring plasma CgA in the progress of GEP NETs. Methods ELISA kits were used to measure the CgA plasma level in 56cases of GEP NETs, 52 cases of pheochromocytoma, and 7 cases of small cell lung cancer (SCLC) and 52cases of normal controls respectively. The sensitivity and specificity of plasma CgA in diagnosis of gastrointestinal pancreatic endocrine tumor; pheochromocytomas and SCLC were calculated. The group of GEP NETs included 13 cases of gastrointestinal carcinoid tumors, 13 cases of gastrinomas, 12 cases of islet cell tumors and 18 cases of other type tumors of GEP NETs. The differences of plasma CgA levels and various sensitivities were compared in different types tumors of GEP NETs. Meanwhile the value of plasma CgA in the diagnosis of metastatic and nonmetastatic tumors in GEP NETs was determined. Results The median CgA levels and quartile of the groups of GEP NETs, pheochromocytomas and SCLCs were 84. 5U/L and 38. 3-175.5 U/L, 154.0 U/L and 53. 3-243.8 U/L, and 55.0 U/L and 19.0-79.0 U/Lrespectively, which were significantly higher than that of ( 18. 5 U/L and 12. 3-25. 8 U/L) normal controls (P＜0. 001 ). The sensitivities of CgA in diagnosis of GEP NETs, pheochromocytomas and SCLCs were 82. 1%, 88.5% and 57. 1% respectively, and the specificities were all 96.2%. In the group of GEP NETs, the CgA level of gastrinoma was significant higher than the groups of carcinoid, islet cell tumor, and other type tumors of GEP NETs. The sensitivities of CgA in diagnosis of gastrinoma, carcinoid tumors, and islet cell tumors were 92. 3%, 84. 6% and 50. 0% respectively. In the group of GEP NETs, it showed significant differences in CgA levels in patients with metastatic and non-metastatic tumors. Conclusion The plasma CgA levels were elevated significantly in the GEP NETs, and showed a high sensitivity and specificity particularly in the diagnosis of gastrinoma. CgA also can be used as a marker in monitoring tumor development and evaluating prognosis during the clinical application.

Objective To investigate the diagnostic value of capsule endoscopy (CE), CT enterography (CTE), ileocolonoscopy and small bowel follow through (SBFT) for small bowel Crohn's disease (CD). Methods Fifty-seven consecutive patients with CD underwent ileocolonoscopy, CTE, CE, and SBFT. It included the presence of the following symptoms and signs: abdominal pain, weight loss,diarrhea, fever and positive fecal occult blood test. The location and the characteristics of intestinal and extra-intestinal lesions detected by four techniquks were compared. The proportions of patients with positive findings using each examination were compared. Results Of the 57 patients, 50 underwent ileocolonoscopy, terminal ileum lesion was found in 33 patients (66. 00% ), the remaining 17 (34.0%)were normal; among 34 patients who had CTE, 29 of small bowel lesion were found (85. 29% ); CE were performed in 27 patients, due to prolonged gastric transit one time, the capsule did not reach the cecum in one patient during battery lifetime. CE showed small bowel lesion in 26 patients (96.30% ); SBF was performed in 39 patients and 26 of small bowel lesion were detected (66. 67% ). CE had the highest diagnostic yield for CD and ileocolonoscopy had the lowest, and there were statistically significant difference among the 4 examinations (P = 0. 006 ). The combinded positive rates of two methods were: CE + CTE 92. 86% (13/14), SBFT + CTE 90. 91% (20/22), CE + ileocolonoscopy 95. 65% (22/23), CE + SBFT100% (17/17), ileocolonoscopy + CTE 89. 66% ( 26/29 ), ileocolonoscopy + SBFT 77.78% ( 28/36 ), but there were no significant differences between each two examinations. Conclusion CE, CTE have a higher yield in depicting mild to moderate finding of CD than SBFT. CE is better for assessing early mucosal disease,whereas CTE is better for detecting transmural and extraluminal abnormalities. Most important, CE plus CTE may depict nonobstructive CD of the small bowel when conventional techniques such as ileocolonoscopy or SBFF have negative or inconclusive finding. CE provides us explanations for the symptoms of patients, decision to follow up or therapy.

H1 gene inactivation.Demethylation agent inhibits human pancreatic cancer cell line growth in association with ARH1 re-expression and reduced p-stat3 expression.

Objective To analyze the effect of dental anxiety on tooth extractionin patients with cardiovascular disease,provide guidance for clinical work. Methods A total of 157 cases were selected from patients with cardiovascular disease who underwent tooth extraction by electrocardiograph monitoring in stomatology department. The Modified Dental Anxiety Scale (MDAS) and Wong-Baker Facial Scale was used to assess preoperative anxiety, pain degree of operation. The heart rate and blood pressure were recorded by biological measurements, and the length of operation was recorded.Whether or not could hemostasis after the operation.According to the MDAS scoring standard, patients who scored more than or equal to 13 points were classified as anxiety. Results The age of the patient was (74.73±8.98) years,the anxiety score was (9.95±3.35) points, there was a negative correlation between age of patients and anxiety score (r=-0.383, P<0.05). There was a positive correlation between anxiety score and the degree of pain in the patient, the length of the operation (r=0.340-0.445, P<0.05). Forty-nine cases of anxiety patients and 108 cases of non anxiety patients. The diastolic blood pressure after anesthesia for 5 minutes was (80.24± 8.10) mmHg(1 mmHg=0.133 kPa) in the patients with dental anxiety, the diastolic blood pressure afteranesthesia for 5 minutes was (77.04 ± 9.15) mmHg in the patients without dental anxiety,there were statistic differences in diastolic blood pressure after anesthesia for 5 minutes between the patients of two groups (t=2.11, P<0.05). The effective hemostasis rate of the patients with dental anxiety was 77.551％(38/49) and the patients without dental anxiety was 92.592％(100/108), there were statistical differences in hemostatic effect after the operation between the two groups of patients (χ2=7.169, P<0.05).Conclusions Medical staff can assess dental anxiety condition in patients with cardiovascular diseases who underwent tooth extraction and analysis its effecton surgery, implement targeted and personalized health education, eliminate the negative emotions of patients, reduce the incidence of anxiety, thereby reduce the adverse effects of anxiety on surgery, and guarantee safety during operation.

OBJECTIVETo detect the expression of SCUBE3 in human osteosarcoma cell lines and surgical specimens of osteosarcomas and investigate its association with the patients' prognosis.

METHODSThe expression of SCUBE3 protein was detected in 5 osteosarcoma cell lines using Western blotting. CCK8 assay was used to assess the effect of SCUBE3 suppression mediated by two specific small interfering RNAs (siRNAs) on the proliferation of U2OS osteosarcoma cells, and the cell cycle changes were detected using flow cytometry. Immunohistochemistry was performed to detect the expression of SCUBE3 in 60 osteosarcoma tissues, and Kaplan-Meier method was performed for survival analysis of the patients.

RESULTSCompared with osteoblast hFOB1.19 cells, the osteosarcoma cell lines all showed significantly higher expressions of SCUBE3. In U2OS cells, suppression of SCUBE3 expression by siRNA significantly inhibited the cell proliferation (P<0.05). Kaplan-Meier survival analysis indicated that patients with high SCUBE3 expression had worse prognosis than those with low SCUBE3 expression (P=0.036).

CONCLUSIONSCUBE3 is up-regulated in the 5 osteosarcoma cell lines and in primary osteosarcoma tissues to promote the proliferation of osteosarcoma cells. A high SCUBE3 expression in osteosarcoma tissues is associated with a poor prognosis of the patients, suggesting that SCUBE3 can serve as a potential therapeutic target for osteosarcoma.

Bone Neoplasms ; metabolism ; pathology ; Calcium-Binding Proteins ; metabolism ; Cell Cycle ; Cell Line, Tumor ; Cell Proliferation ; Flow Cytometry ; Humans ; Immunohistochemistry ; Kaplan-Meier Estimate ; Osteosarcoma ; metabolism ; pathology ; Prognosis ; RNA, Small Interfering ; Up-Regulation

OBJECTIVETo detect the expression of CXCL14 in human osteosarcoma cell lines and tissues and investigate its association with the prognosis of the patients.

METHODSRT-PCR, enzyme-linked immunosorbent assay (ELISA) and real-time PCR were used to detect the expression of CXCL14 in 4 osteosarcoma cell lines and in 40 pairs of osteosarcoma tissues and adjacent muscular tissues. CCK8 assay and colony formation assay was used to assess the effect of CXCL14 suppression mediated by two specific siRNAs on the proliferation of U2OS osteosarcoma cells. Immunohistochemistry was performed to detect the expression of CXCL14 in 58 osteosarcoma tissues, and Kaplan-Meier method and log-rank test were performed for survival analysis of the patients.

RESULTSSignificant up-regulation of CXCL14 expression was found in the osteosarcoma cell lines and in osteosarcoma tissues compared with the adjacent muscles (P<0.01). In U2OS cell, suppression of CXCL14 expression by siRNA significantly inhibited the cell proliferation (P<0.01) and colony formation rate (P<0.05). Kaplan-Meier survival analysis indicated that patients with high CXCL14 expression had worse prognosis than those with low CXCL14 expression (P=0.02).

CONCLUSIONCXCL14 is up-regulated in both osteosarcoma cell lines and primary osteosarcoma tissues to promote the proliferation of osteosarcoma cells. A high CXCL14 expression in osteosarcoma tissues is associated with a poor prognosis, suggesting the that CXCL14 serve as a potential therapeutic target for osteosarcoma.

Bone Neoplasms ; metabolism ; pathology ; Cell Line, Tumor ; Cell Proliferation ; Chemokines, CXC ; metabolism ; Humans ; Osteosarcoma ; metabolism ; pathology ; Prognosis

Objective: To evaluate efficacy of the BiRd regimen, a combination of clarithromycin, lenalidomide, and dexamethasone, in the treatment of patients with relapsed/refractory multiple myeloma (RRMM) . Methods: Patients with RRMM treated with BiRd between September 11, 2013 and August 1, 2016 at six centers were included to evaluate overall survival rate (ORR) , clinical benefit rate (CBR) , progression-free survival (PFS) , overall survival (OS) , as well as adverse events. Results: Of 30 patients with RRMM, 27 patients were evaluable, and ORR and CBR were 51.9% (14/27) and 66.7% (18/27) respectively, including 1 sCR (3.7%) , 3 CR (11.1%) , 3 VGPR (11.1%) , and 7 PR (25.6%) . In 13 patients with prior Rd, ORR and CBR were 38.5% (5/13) and 61.5% (8/13) respectively, of which 5 patients with ≥MR carried high-risk cytogenetic[ (e.g.17p- or t (4;14) ] together with at least one of other adverse-prognostic cytogenetic (e.g.13q- and/or 1q21+) . In 24 patients with prior bortezomib-based therapy, ORR and CBR were 45.8 and 62.5%, respectively. With a median follow-up time of 14.9 (range 1.0-33.8) months, the median PFS and OS were 12.0 (95%CI 11.6-12.4) and 27.6 (95%CI 15.1-40.1) months, respectively. The BiRd regimen was well tolerated. Conclusion The BiRd regimen is an effective and safety protocol for RRMM, including those carrying high-risk cytogenetic markers.