BACKGROUNDXanthogranulomatous cholecystitis (XGC) is a rare type of gallbladder inflammation. Unlike other cholecystitis, it can be easily misdiagnosed as gallbladder cancer based on radiological images. In response to misdiagnosis, extended surgical treatments are inappropriately given to patients, which is not beneficial to their health and/or recovery. In this study, we set out to determine whether tumor biomarkers can help to avoid misdiagnosis in patients with XGC.

METHODSBetween January 2005 and January 2012, a total of 37 preoperative patients at Sir Run Run Shaw Hospital were suspicious of having gallbladder cancer and was pathologically confirmed to be XGC after surgical operations. Before operations, all patients received a tumor biomarker test to verify diagnosis, which included serum CA 19-9, carcinoembryonic antigen (CEA), and CA 12-5.

RESULTSA measured amount (54.05%) of cases (20 in 37) had at least one elevation over the thresholds of CA 19-9 (37 IU/L), CEA (5 ng/ml), and CA 12-5 (35 IU/L), which increased the suspicion of malignancy and consequently enhanced the difficulty to make right diagnosis of XGC as benign. 45.95% of cases (17 in 37) had an elevation in CA 19-9. 2.70% of cases (one in 37) had an elevation in CEA and 24.32% of cases (nine in 37) had an elevation in CA 12-5. Analysis with Fisher's exact test discovered that the presence of common bile duct stone was a contributor to elevations of CA19-9 in patients with XGC. However, even in cases without common bile duct stones, 42.86% of patients (nine in 21) had elevations of at least one tumor biomarker. Among them, 26.09% of patients (six in 21) had elevations of CA 19-9, with the maximum of 536.29 IU/L.

CONCLUSIONSThe elevations of tumor biomarkers in XGC were frequent, suggesting their inabilities to clarify the disease's nature, especially when there was a suspicion of gallbladder cancer. Intraoperative frozen pathology of gallbladder might be a possible solution. However, it is against the en bloc surgical principle and has the potential to cause tumor cell spreading. More research should be conducted, such as the discovery of a novel biomarker, so that XGC can less likely be misdiagnosed as malignancy until the final pathological judgment.

Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; blood ; CA-125 Antigen ; blood ; CA-19-9 Antigen ; blood ; Carcinoembryonic Antigen ; blood ; Cholecystitis ; blood ; diagnosis ; Female ; Granuloma ; blood ; diagnosis ; Humans ; Male ; Middle Aged ; Xanthomatosis ; blood ; diagnosis

Cholangiopancreatography, Endoscopic Retrograde ; Duodenum ; surgery ; Humans ; Retrospective Studies

Objective To investigate the effect and current situation of the standardized construction of laboratories of schis?tosomiasis control institutions in Hubei Province,so as to provide the evidence for establishing and improving the quality control system of diagnosis of schistosomiasis after the transmission of schistosomiasis was under control. Methods According to the procedures of self?examination,field operation,and laboratory on?site,five laboratories were assessed,and all the results were analyzed comparatively. Results The average number of staffs were(7.00 ± 1.58)persons,and the staffs of the laboratories of the schistosomiasis control institutions with senior professional titles in the city level were more than that in the county level(t=5.563,P<0.05). The average space was(3.20±1.64)rooms,and the average area was(117.00±88.29)m2. The average score of field operation was(96.40 ± 4.49)points. The average score of laboratory on?site assessment was(106.6 ± 6.15)points. The highest and lowest of the laboratory on?site assessment scores were environment and facilities(19.60 ± 0.55)points and manage?ment system of laboratory quality control(15.70 ± 2.39)points(F=2.869,P<0.05),respectively. Conclusion The cultiva?tion of laboratory staff should be strengthened,and the diagnostic capacity should be maintained and improved. The laboratory quality control system should be paid more attention to,and the construction and management of schistosomiasis laboratories should be standardized.

Objective To analyze the construction and operation status of management system of laboratories of schistosomi?asis control institutions in Hubei Province,so as to provide the reference for the standardized detection and management of schis?tosomiasis laboratories. Methods According to the laboratory standard of schistosomiasis at provincial,municipal and county levels,the management system construction and operation status of 60 schistosomiasis control institutions was assessed by the acceptance examination method from 2013 to 2015. Results The management system was already occupied over all the labora?tories of schistosomiasis control institutions and was officially running. There were 588 non?conformities and the inconsistency rate was 19.60%. The non?conformity rate of the management system of laboratory quality control was 38.10%(224 cases)and the non?conformity rate of requirements of instrument and equipment was 23.81%(140 cases). Conclusion The management system has played an important role in the standardized management of schistosomiasis laboratories.

OBJECTIVETo investigate the expression of suppressor of cytokine signaling(SOCS)-3 and caspase-3 and their correlative significance in endometriosis.

METHODSImmunohistochemical EnVision method was used to detect the SOCS-3 and caspase-3 protein expression in ectopic and eutopic endometrium (n = 32) of patients with endometriosis, as well as normal endometrium (n = 30) of women without endometriosis.

RESULTSSOCS-3 and caspase-3 proteins were expressed in all three groups and not affected by the menstrual cycles. The expression of SOCS-3 in ectopic endometrium (5.54 ± 2.12) was significantly lower than that in eutopic (7.39 ± 1.09, P = 0.001) and control group (7.48 ± 1.26, P < 0.01), but without difference between the eutopic and control group (P = 0.756). SOCS-3 expression in ectopic and eutopic endometrium was significantly lower in III/IV stages than that in I/II stages of endometriosis (P < 0.05). Significantly lower expression of caspase-3 protein was found in ectopic (3.20 ± 1.24) and eutopic endometrium (3.88 ± 1.93) as compared with the control group (6.49 ± 1.85, P < 0.01), however ectopic and eutopic endometrium showed no significant difference (t = 1.66, P = 0.10). There was no significant difference of the expression of caspase-3 in ectopic and eutopic endometrium at different disease stages (P > 0.05). Positive correlation was found between the expression of SOCS-3 and caspase-3 proteins in ectopic endometrium (r = 0.655, P < 0.01).

CONCLUSIONSOCS-3 may be involved in the development of endometriosis through inhibition of apoptosis of ectopic endometrial cells.

Adult ; Caspase 3 ; metabolism ; Endometriosis ; metabolism ; pathology ; Endometrium ; metabolism ; pathology ; Female ; Humans ; Immunohistochemistry ; Menstrual Cycle ; Middle Aged ; Suppressor of Cytokine Signaling 3 Protein ; Suppressor of Cytokine Signaling Proteins ; metabolism ; Uterine Diseases ; metabolism ; pathology ; Young Adult

Adult ; Aged ; Aged, 80 and over ; Fascia Lata ; surgery ; Female ; Humans ; Male ; Middle Aged ; Synovial Cyst ; surgery

Objective To investigate the effect of warfarin on coagulation and hemorheology in patients with atrial fibrillation.Methods 106 cases of admitted in our hospital from October 2014 to October 2016 were randomly divided into observation group(53 cases)and control group(53 cases).The control group re-ceived routine treatment,the observation group received routine and warfarin treatment.The two groups were treated for 4 weeks.The therapeutic effects were compared between the two groups.Before and after treat-ment,indicators of heart function,blood coagulation and hemorheology were observed.Results The total effi-ciency of observation group(92.45%)was higher than that of the control group(73.58%,P<0.05).After treatment,the TT and APTT of the two groups both increased(P<0.05);The TT and APTT of the observa-tion group were higher than that of the control group(P<0.05);The plasma viscosity,erythrocyte aggrega-tion index,and fibrinogen of the two groups decreased(P<0.05);The plasma viscosity,erythrocyte aggrega-tion index,fibrinogen of the observation group were lower than that of the control group(P<0.05).Conclu-sion Warfarin has obvious curative effect on patients with atrial fibrillation,and can improve the function of blood coagulation and hemorheology.

OBJECTIVETo explore the risk factors of children with high dmft.

METHODSIn suburban of Guangzhou, oral health of 401 3 - 4-year-old children were examined and structured questionnaire were completed by their parents. 120 children with highest number of dmft (dmft > or = 5) and 118 caries-free children were chosen for case-control analysis.

RESULTSThe results of logistic regression analysis showed that the factors associated with high dmft were developmental defect of enamel, visible plaque index, frequency of toothbrushing, frequency of sugar consumption, and income.

CONCLUSIONSAdvocating brushing teeth at least twice daily, controlling the frequency of sugar consuming, reducing the developmental defect of enamel and paying more attention to the oral health of lower income population may effectively reduce dental caries of the children.

Child, Preschool ; Dental Caries ; epidemiology ; etiology ; Health Behavior ; Humans ; Logistic Models ; Oral Health ; Oral Hygiene ; Risk Factors ; Surveys and Questionnaires ; Tooth, Deciduous

Objective To evaluate the effect for stroke(cerebral infarction)at acute stage intervened by traditional Chinese medicine(TCM) clinical pathway. Methods A retrospective analysis was carried out in the patients before and after intervention by TCM clinical pathway during the year of 2013-2016. The outcomes included the entrance rate,completion percentage,aberration rate,severity,hospitalization time,and hospitalization fee as well as functional prognosis 30 d after discharge. Results A total of 792 cases was included,241 cases admitted in the year of 2013, 191 in the year of 2014, 135 in the year of 2015, and 225 in the year of 2016. In the year of 2014-2016,the entrance rate,completion percentage,hospitalization time,hospitalization fee,critical case percentage,and gender constituent ratio were steadily(P > 0.05). Modified Rankin Scale(mRS)for short-term functional prognosis mRS 0 ~ 2 percentage and aberration rate in the year of 2016 were superior to those in the year of 2014 and 2015(P < 0.05). Functional improvement on discharge day 30 in the year of 2014-2016 was superior to that in the year of 2013(P < 0.05). The hospitalization time and hospitalization fee in the year of 2014-2016 were a liffle higher than those in the year of 2013(P < 0.05), showing no obvious increase. Conclusion The application of TCM clinical pathway can make the diagnosis and treatment procedure of stroke at acute stage standardized,enhance the therapeutic effect,achieve or even exceed the goal of manage scheme.

Objective:To analyze survival in patients with advanced oral cancer from prospective clinical trials. Methods:From 2008 to 2010, 256 patients with oral cancer at clinical stage III/IVA were randomly categorized into two groups. Patients in the experi-mental group received neo-adjuvant chemotherapy, surgery, and post-operative radiation, and patients in the control group underwent surgery and post-operative radiation. All patients were routinely followed-up after treatments. Survival was analyzed using Kaplan–Meier method and log-rank test, and differences were considered statistically significant at P value lower than 0.05. Results: Each group was composed of 128 patients. With the median follow-up period of 60 months, the 5-year overall survival rate was 61.7%and the disease-free survival rate was 53.9%. The overall survival rate (P=0.350) and the disease-free survival rate (P=0.160) were not sig-nificantly different between the experimental and control groups. Patients with positive pathological response to neo-adjuvant chemo-therapy exhibited significantly improved overall survival (P＜0.05). Conclusion:Radical surgery should be emphasized to improve the prognosis of oral cancer. Functional reconstruction could also improve the quality of life and survival of patients. Despite that neo-adju-vant chemotherapy could not improve the survival of patients with advanced oral cancer in entirety, it could benefit patients exhibiting positive treatment responses.