Objective Gastrointestinal tract is commonly affected in amyloidosis.The deposition of amyloid protein may cause a variety of endoscopic changes in the gastrointestinal tract.The aim of this study was to investigate the endoscopic manifestations and evaluate the biopsy results in amyloidosis of the gastrointestinal tract.Methods The gastroscopy or colonoscopy records of ten patients with amyloidosis of gastrointestinal tract(five males,five females) were reviewed.The definitive diagnosis of amyloidosis was made by tissue biopsy.The endoscopic changes in the gastrointestinal tract were characterized. Results The frequent clinical symptoms related to amyloidosis of the gastrointestinal tract presented as:abdominal pain,hematochezia or melena,abdominal distension and chronic diarrhea.Five patients underwent gastroscopy and three of them were established the diagnosis.Gastroscopic examinations revealed ulcerations,granular appearance,mucosal denudations and scars except one patient in whom the mucosa appeared normal.Eight patients underwent colonoscopy or sigmoscopy and all of them got positive results.The endoscopy revealed polyps,ulcerations,mucosal denudations,granular appearance,mucosal hyperemia and edema.Two patients who suffered from abdominal pain and hematochezia were diagnosed as colonic ischemia clinically.The histopathological examination of one of the patients showed that there was amyloid deposits in the blood vessels.In another patient,amyloid was found in the stroma.This suggests that there are some relationship between amyloidosis and colonic ischemia. The amyloid deposition in the small vessels may decrease the blood flow of the colon,on the other hand,chronic ischemia may cause inflammation which may lead to amyloidosis.The relationship between amyloidosis and colonic ischemia needs to be further investigated.Conclusion Gastrointestinal tract is one of the predisposed organs in amyloidosis.Endoscopic examination may discover the lesion.Biopsy of gastrointestinal tract may greatly help the diagnosis of this disease.

ObjectiveTo observe the manifestations of depression at different stages after cerebral concussion. Methods77 cerebral concussion patients received Hamilton Depression Rating Scale (HAMD) examination at acute stage (in the 7 days after disease) and convalescence stage (at about 30 days after disease), and then compared with 48 health adults. ResultsThe scores of anxietas somatization, cognitive handicap, retardation, dyssomnia, feeling of despair conclude the total score in the cerebral concussion patients at acute stage were all significantly higher than that of the control (P<0.05). During the convalescence stage, the scores of anxietas somatization, the change of body weight, cognitive handicap, diurnal variation, retardation, dyssomnia, feeling of despair conclude the total score were all significantly higher than that of the control (P<0.05). The scores of almost all the item of HAMD were significantly higher than that of the control at both acute stage and convalescence stage, and the scores of athymia, suicide, difficulty falling asleep, early awake, agitate, somatization, constitutional symptom, hypochondriasis, loss of weight, insight, diurnal variation, feeling of despair, anosognosia, sense of inferiority and total HAMD scores at convalescence stage were all significantly higher than that at the acute stage, but the scores of blockage, psychoanxietas, derealization, symptom of over-absorption mind, compel symptom, sense of capability decrease at the acute stage were all significantly higher than that at the convalescence stage (P<0.05).ConclusionThe manifestations of depression in the cerebral concussion patients were not completely the same, so the mental intervention should be in direction.

OBJECTIVE: MRI-Ultrasound fusion guided targeted biopsy has revolutionized the diagnosis of prostatecancer through accurate identification, localization and characterization of prostatic lesions utilizingthe prostate imaging reporting and data system (PI-RADS) scoring system by multiparametric MRI(MPMRI). The fusion prostate biopsy system on the other hand, enables accurate targeting and easyaccess of the tumor. The study objective is to determine the detection rate of clinically-significantprostate cancer using fusion biopsy, and to establish the correlation between PI-RADS score andGleason's score. PATIENTS AND METHODS: A retrospective cohort study was conducted to determine the correlation betweenPI-RADS score and the presence of prostate cancer using MRI-Ultrasound fusion guided transperinealprostate biopsy. This was carried out from June 2017 to July 2018 in a single institution. One hundredthirty five (135) men were included in this study. They presented with an elevated PSA, abnormalDRE or a previous negative prostate biopsy, but with a persistent rise in PSA. A total of 220 prostatelesions were identified. The following characteristics were measured: patient age; the size, location,the PI-RADS score of each lesion, the maximum PI-RADS score for select patients; and the Gleasonscore of discovered tumors. RESULTS: Two hundred twenty PI-RADS 3, 4 and 5 lesions were detected in 135 patients by MPMRI.131 of the 220 lesions were scored as PI-RADS 3, 61 as PI-RADS 4 and 28 as PI-RADS 5. Theselesions were biopsied using the MRI-Ultrasound fusion guided transperineal prostate biopsy system.Thirty-three out of the 131 PI-RADS 3 lesions (25.2%), 44 out of the 61 PI-RADS 4 lesions (72.1%)and 24 out of the 28 PI-RADS 5 lesions (85.7%) respectively were positive for malignancy. Overall,there were 101 (45.9%) lesions classified as PI-RADS 3 to 5 that were positive for prostate carcinoma.Seventy four (74) of the 135 patients (54.8%) were diagnosed with prostate adenocarcinoma. Nineteenout of 65 patients with a maximum score of PI-RADS 3 (29.2%), 33 of 44 with a maximum of PI-RADS 4 (75%) and 22 of 26 with a maximum of PI-RADS 5 (84.6%) harbored malignancy. In termsof location, 45 of the 101 (44.6%) malignancies were in the peripheral sector, 31 (30.7%) in theanterior sector, and 25 (24.8%) in the central sector of the prostate. The mean Gleason grade of PI-RADS 3, 4 and 5 lesions were 6.61, 7.73, and 7.38, respectively. Using Spearman correlation, the rhocoefficient was 0.3153 (p-value =.00013) which denotes a significant positive relationship betweenGleason and PI-RADS score. CONCLUSION This is the first comprehensive Philippine study on Multiparametric MRI-Ultrasoundfusion-guided transperineal prostate biopsy. Present data validate the superiority of MPMRI in theidentification, localization and characterization of prostate cancers. The authors also verified thepositive correlation between PI-RADS score and Gleason score. Finally, they demonstrated theaccuracy of the MRI- ultrasound fusion-guided transperineal prostate biopsy system in targetingprostate lesions.

Aim To evaluate the bioequivalence of two preparations of gliclazide in healthy volunteers.Methods The concentration of gliclazide was measured by high performance liquid chromatography(HPLC) after a single or multiple dosage of gliclazide sustained released tablet in healthy volunteers.The pharmacokinetic parameters of the two preparations were calculated by 3P97 program.LnAUC0~∞,lnAUC0~72 and lnAUC0~? were used to evaluate the bioequivalence of the two preparations with analysis of variance and two one-side t-test.Results Both the gliclazide extended action tablet were best fitted to one-compartment model.The main parameters of the tested and reference gliclazide after a single dose were as follows:Cmax(2.07?0.61) and(2.26?0.61)mg?L-1;Tmax(5.10?0.55)h and(5.05?0.51)h;T12Ka(1.50?0.26)h and(1.52?0.27)h;T12Ke(8.89?1.56)h and(8.68?1.72)h;MRT(22.63?1.01)h and(22.38?0.93)h;AUC0~72(39.19?8.03)mg?h-1?L-1 and(39.26?8.37)mg?h-1?L-1;AUC0~∞:(45.80?9.51)mg?h-1?L-1 and(45.57?9.76)mg?h-1?L-1;F0~72 and F0~∞(100.19?6.22)% and(100.85?5.88)%,respectively.The main parameters of the tested and reference gliclazide after multiple dose were as follows:Cmax(4.83?0.86)mg?L-1 and(4.69?0.64)mg?L-1;Cmin(0.68?0.14) mg?L-1 and(0.66?0.12)mg?L-1;Tmax:(4.10?0.45) h and(4.10?0.55)h;T12Ka:(2.03?0.53)h and(2.04?0.40)h;T12Ke:(7.24?0.87)h and(7.09?1.14)h;MRT(9.17?0.30)h and(9.19?0.37)h;AUCSS:(41.62?6.48) mg?h-1?L-1 and(42.18?6.03)mg?h-1?L-1;Cav:(1.73?0.27)mg?L-1 and(1.76?0.25)mg?L-1;DF(240.85%?34.07)and(230.23%?24.80%) respectively.The relative bioavailability was(98.60?4.60)%.The AUC0~T,AUC0~∞ or AUCSS,Cmax and Tmax were bioequivalent between the two preparations.Conclusion The tested and reference gliclazide sustained released tablet are bioequivalent.

Aim To explore the anti-fibrotic effect of Oxymatrine(OM) on CCl4-induced liver fibrosis in rats and its modulation on the TGF-?1.Methods A hepatic fibrosis model was induced by CCl4.The levels of Alanine transaminase(ALT),aspartic transaminase(AST),type-Ⅰ collagen and TGF-?1 in plasma were detected by chemical Kit.The deposition of collagen was observed with H&E and Masson staining.Pathological changes were observed under light microscope in 8 randomly selected fields in each group.RT-PCR method was applied to detect the expression of TGF-?1 mRNA in hepatic tissue.Results The concentration of serum ALT,AST,type-Ⅰ collagen and TGF-?1 was significantly reduced in the middle and high dose treated groups compared with that of model group.A significant reduction of collagen deposition and rearrangement in OM-treated group was displayed in histopathological changes.The expression of TGF-?1 mRNA was considerably decreased in the treated animals.Conclusions Oxymatrine is effective in reducing the production and deposition of collagen in the liver tissue of experimental groups,and it has an obvious protective effect on model rats.It may be one of the therapeutic mechanisms to modulate the expression of TGF-?1 mRNA.

AIM:To investigate effect of hypoxia on the expression of proliferating cell nuclear antigen(PCNA) a nd phenotype of cardiac fibroblasts(CFs). METHODS: The purif ied cardiac fibro blasts were cultured and divided randomly into there groups :control group, mode rate hypoxia(MH) group and severe hypoxia(SH) group. After 72 h,MTT method was u s ed to investigate the proliferation of CFs, and the ultrastructure of fibroblast s were observed with transmission electron microscopy The expression of PCNA a n d ?-actin in cardiac fibroblasts were measured by the means of immunohistochemi s try and laser scanning confocal microscopy, respectively. RESULTS: MTT A 490 nm value of MH group was significantly higher than that of control group by (18 4?25 0)% ( P

Objective To explore the rehabilitation needs and its influential factors of adults with physical disability in Shanghai, and to provide evidence for decision-making of the precise rehabilitation service. Methods From November to December, 2016, the rehabilitation demands, utilization rate and its influential factors of 390 registered people with physical disability were investigated with a questionnaire. Results The service of occupational rehabilitation met 62.34%and educational rehabilitation met 52.00%of the needs of adults with physi-cal disability at the age of 18 to 40 years. The service of occupational rehabilitation met 38.71%and educational rehabilitation met 35.29%of the needs of adults with physical disability of grade two. The main obstacle to the service utilization wasDo not know(67.34%). As a part ofotherreason, the cumulative frequency oftemporarily not neededaccounted for 16.41%in all reasons. Conclusion The rehabili-tation service should focus unmet needs to complete the community rehabilitation and health governance, and optimize the service system.

Steatotic liver disease was suggested as an overarching term encompassing various etiologies of hepatic steatosis. Experts from multinational liver societies went through the Delphi process, including four rounds of surveys, and consented to adopt a new nomenclature and definition instead of the conventional nonalcoholic fatty liver disease (NAFLD). This was to improve the understanding of the patients and primary care physicians, with an explanation of the pathophysiology in the name of the disease. Also, it could minimize the stigmatization of patients by using the histological neutral term “steatosis” instead of “fatty”. Herein, we will discuss the changes and continuity between the two nomenclatures, metabolic dysfunction-associated steatotic liver disease (MASLD) and NAFLD, as well as the challenges to MASLD which need to be addressed in future.