Objective To explore the significance of serum cytokine interferon-gamma (IFN-γ) ,interleukin-4(IL ) ,transforming growth factor-beta 1 (TGF-β1) ,interleukin-9 (IL-9) ,interleukin-17 (IL-17) in detection of youth first-episode depression .Methods Ninety cases of youth first-episode depression as the experimental group were equally divided into 3 groups according to different disease courses(<6 months ,6 months to 2 years ,>2 years)and other 30 normal persons served as the control group .The levels of serum cytokines were measured by ELISA .The level of each cytokine and Hamilton Depression Scale (HAMD) score were per-formed the Spearman correlation analysis .Results The IL-9 level in the 6 months to 2 years group and > 2 years group was high-er than that in the control group (P< 0 .05);the IFN-γlevel was negatively correlated with psychic anxiety (P<0 .05);the IL-9 level was positively correlated with the somatic anxiety and systemic symptoms (P<0 .05);the IL-17 level was positively correla-ted with the depressive mood and suicide (P<0 .05);the IFN-γlevel was positively correlated with difficulty falling asleep ,early a-wakening ,work and interest in the 6 months to 2 years group ,while positively correlated with somatic anxiety (P<0 .05);the IFN-γ level was positively correlated with depressive mood and block in the >2 years group(P<0 .05);the IL-4 level was positively correlated with the depressive mood (P<0 .05) .Conclusion Different cytokines play different roles in youth first-episode depres-sion ,cytokines may involve in the occurrence and development of depression .

Objective To evaluate the clinical value of magnetic resonance cholangiopancreatography (MRCP) in diagnosis of extrahepatic bile duct obstruction. Methods MRCP images of 42 patients presented clinically with obstructive jaundice were retrospectively reviewed to assess the lumen morphological abnormalities of benign versus malignant bile duct obstructions, with clinical pathological correlation. Results The bile duct of the 30 cases of benign biliary obstruction presented regular and symmetric dilation, gradual tapering,regular thickening and had a “beak like” tip. The accuracy of MRCP for evaluating the site and the etiology of the benign biliary obstruction were 100%(30/30) and 97%(29/30) respectively. The bile duct of the 12 cases of malignant biliary obstruction presented irregular and asymmetric dilation,abrupt narrowing or iterruption,irregular thickening and had “dual duct sign”. The accuracy of MRCP for evaluating the site and the etiology of the malignant biliary obstruction were 100%(12/12) and 92%(11/12) respectively. Conclusion MRCP is the noninvasive technique of choice with excellent accuracy for the evaluation of obstructive biliary pathology.

Objective To explore the diagnosis and treatment of tumor associated gastrocolic fistula (GCF).Methods The records of the 4 patients with GCF between August 2008 to February 2014 were retrospectively analyzed.Three female and one male patients,those whose average age were 61 years,have been pathologically diagnosed postoperatively as gastrocolic fistula caused by malignant diseases.The main clinical symptoms were diarrhea (3 cases),fecal vomitus (3 cases),weight loss (4 cases),and abdominal pain (4 cases).Positive diagnostic tests for GCF included gastroscope (3 cases),colonoscope (1 case),barium enema (1 case),upper gastrointestinal contrast (2 cases).Results En-bloc resection of the involved gastrocolic region have been performed for all,2 patients underwent radical gastrectomy and colon resection and 2 patients were taken on palliative procedure.Pathology indicated adenocarcinoma all,Immunohistochemical detection for CK20,CDX-2 were applied for identifying the originations of tumors.Delayed gastric emptying and DIC occurred in one patient who died in 3 months after the operation,anastomotic leakages were found in 2 cases.The survival patients were all discharged and taken capecitabine combined with Oxaliplatin for chemotherapy.Conclusions Endaoscopy and gastrointestinal imaging are main evidences for diagnosis of GCF.En-bloc resection of the involved gastrocolic region were recommended,enterostomy was safer than entero-anastomosis in one stage procedure.The originations of tumors may be identifying according to the pathological characteristic and CDX-2,CK20 staining.Adjuvant chemotherapy should be applied.

OBJECTIVE: To summarize clinical experience of application of argon knife under electronic bronchoscope in the management of pediatric glottic and subglottic diseases. METHOD: Reports in the literature were reviewed. Outcome and prognosis of 4 cases with pediatric glottic and subglottic diseases managed with argon beam coagulator technique in Shanghai children's Medical Center since 2011 were retrospectively analyzed. RESULT: Granulation tissue hyperplasia in 3 cases with subglottic lesions did not recur after surgery. Scarring or stenosis were not found in the airway. Intubation of the trachea and tube of tracheotomy was pulled out successfully in all cases, restoring normal breathing. No lesion recurrence was found in 1 case with squamous cell moderate atypical hyperplasia one month after the surgery. CONCLUSION Electronic bronchoscope has advantages of clear image, fine and soft lens body, optional bending, angle conversion, accurate positioning. And the argon knife with small head diameter can pass the pediatric supraglottic. It can be manipulated precisely with short operation time and no damage to surrounding normal tissues. Its worth in popularization and application of management for with glottic and subglottie disease in pediatric patients.
Adolescent ; Argon ; therapeutic use ; Bronchoscopes ; Child ; China ; Cicatrix ; Humans ; Hyperplasia ; Intubation, Intratracheal ; methods ; Laryngeal Diseases ; surgery ; Lasers, Gas ; therapeutic use ; Neoplasm Recurrence, Local ; Prognosis ; Retrospective Studies ; Tracheotomy ; instrumentation

Objective To analyze the related rules and prognosis analysis for lymphatic metastasis in patients for Siewert Ⅱ and Ⅲ adenocarcinoma of the gastroesophageal junction.Methods This study retrospectively reviewed 65 patients who underwent radical surgery for Siewert Ⅱ and Ⅲ adenocarcinoma of the gastroesophageal junction in Beijing Friendship Hospital between July 2013 and March 2017.The primary indicators were sex,age,tumor site,tumor size,macroscopic type,histological type,depth of invasion,operation,tumor emboli and carcinoma nodes.The clinical characteristics and pathological features were analyzed by using Logistic regression and Kaplan-Meier survival analysis.Follow-tup using outpatient examination and telephone interview was performed to detect patients' diseases and postoperative survival up to April 2017.Results Lymph node metastasis was observed in 41 of 65 patients (63.1％).Lymph node metastasis frequency was found in No.1,No.2,No.3,No.7,No.11 and No.110 lymph nodes.The incidences of those lymph node metastasis were 45.3％,32.5％,28.8％,22.5％,19.4％ and 8.2％.The metastasis rate of the tumors with diameter over 2 cm was higher than the tumors which were less than 2 cm (71.9％ vs 0;P =0.000);The observed rate of lymph node metastasis was 0,12.5％,69％,95.2％ in early cancer (T1) and advanced cancer (T2-T4) (P=0.000) respectively.The metastasis rate of highly differentiated Siewert Ⅱ and Ⅲ adenocarcinoma of the gastroesophageal junction was 45.2％ lower than poorly differentiated tumors 79.4％ (P =0.009).Thirty-three cases were found with lymphatic embolus,28 of them (84.8％) were found to be combined with lymph node metastasis among them (P =0.001).All the differences were statistically significant (P ＜ 0.05).The results of multivariable analyzed by binary logistic regression analysis revealed that neoplasms histologic type and lymphatic embolus were independent risk factors for lymph node metastasis of Siewert Ⅱ and Ⅲ adenocarcinoma of the gastroesophageal junction.Sixty-five patients were followed up for 1-45 months,with a median time of 18.81 months.Although there was no statistically significant difference,3 years-overall survival rate showed tumor without lymph node metastasis has better prognosis than with lymph node metastasis and early stage tumor also has better prognosis than advanced tumor.Conclusions Lymph node metastasis of Siewert Ⅱ and Ⅲ adenocarcinoma of the gastroesophageal junction is related with histological type of tumor and lymphatic embolus.For Siewert Ⅱ and Ⅲ adenocarcinoma of the gastroesophageal junction,the incidence of lymphatic metastasis were higher appear in abdominal cavity,which included No.1,No.2,No.3,No.7 and No.11;Meanwhile,the metastasis of mediastinal lymph node is given priority to No.110 lymph node.Therefore,radical total gastrectomy combined with standard D2 lymphadenectomy and No.110 lymphadenectomy are performed in order to improving the prognosis.For patients with lymph node metastasis and tumor in advanced stage,long-term prognosis remains to be further study.

Hepatoid adenocarcinoma of the stomach (HAS) is defined as a special type of gastric cancer characterized by low incidence rates and high degree of malignance with an extremely poor prognosis.As it is characterized by morphological similarities to general alimentary cannal symptoms with unclear etiology and pathogenesis,diagnostic errors can always be made.The alpha-fetoprotein (AFP) and carcino-embryonic antigen (CEA) are helpful with diagnosis.However,histopathological examination is the gold standard for diagnosing HAS.So far,radical operation,adjuvant chemotherapy,interventional therapy with immune-biological treatment are the main approaches for HAS treatment.

Objective To evaluate the feasibility of model-based iterative reconstruction (MBIR) in low-dose chest CT (80 kV) examination in children.Methods Forty-four children who had post-operation scoliosis and received low dose chest CT scans were included.The fix tube voltage was 80 kV,fix current was 50 mA.Images were reconstructed with MBIR (observation group).The pre-operation scan were used 120 kV and 50 mA for acquisition,and images were reconstructed with filtered back-projection (FBP) mehed (control group).The subjective quality of the images was independently evaluated by two radiologists.Objective noises in the muscle and lung field were measured,the SNR,CNR were calculated,and the CTDIvol was record.Results The subjective noise score in the observation group was significantly higher than that in the control group (P＜0.05).Objective noise reduced about 40.36％,SNR increased 72.37％,CNR increased 78.69％,CTDIvol decreased by 66.52％,all of which had statistical difference between both groups (all P＜0.001).Conclusion Low-dose chest CT (80 kV) examination in children can meet the requirements of diagnosis for children.

MicroRNAs (miRNAs) , a species of small noncoding RNA, could regulate gene expression bv binding to the 3'-untranslated region of target mR NA at post-transcription level.MicroRNAs play important roles in various human biological processes such as differentiation, cell proliferation, and apoptoMs.Abnormal expression of miRNAs is implicated in carcinogenesis and progression of various cancers, indicating that miRNAs could be served as molecular biomarkers for diagnosis and treatment of cancer.In this resiew, the author summarize the most common altered miRNAs expression profiles and their possible roles in promoting cell proliferation, tumor metastasis,and chemotherapeutic resistance in gastric cancer.

Tongluo Xingnao effervescent tablet (TLXNET) is a patented prescription, which comes from modified Xionggui decoction and can improve cognitive function. However, its effect on the urine metabolites and anti-dementia mechanism in the dementia model rats induced by hippocampal injection with Aβ25-35 remains unclear. The experiment focused on the changes in trajectory and inter-relationship among the urinary metabolite of rats in the blank group, Aβ25-35 hippocampal injection dementia model group and the TLXNET intervention group, in order to determine theirs characteristic metabolic markers and explain the anti-dementia effect of TLX-NET base on the change of metabolic trajectory of these bio-markers. According to the experimental results, 5, 6-indolequinone, 4-hydroxyphenyl pyruvic acid (4-HPPA), cortisol and 3-thiosulfate lactic were preliminarily identified as the characteristic metabolic markers. They mainly participate in dopamine system, glucocorticoids and energy metabolic pathways. TLXNET can apparently downregulate the disturbances of metabolic trajectory of the four bio-markers. The experiment indicates that the dementia model induced by injecting Aβ25-3 into hippocampus has its characteristic endogenous metabolic markers in urine, and ELXNET can ameliorate dementia by down-regulating the disturbances of metabolic trajectory.
Amyloid beta-Peptides ; metabolism ; toxicity ; Animals ; Biomarkers ; urine ; Dementia ; drug therapy ; urine ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Hippocampus ; drug effects ; metabolism ; Humans ; Male ; Metabolomics ; Peptide Fragments ; metabolism ; toxicity ; Rats ; Rats, Sprague-Dawley ; Tablets ; administration & dosage ; Urine ; chemistry

OBJECTIVETo explore the best acupoints for the treatment of herpes zoster.

METHODSTwo hundred cases were randomized into an observation group and a control group, 100 cases in each one. In observation group, meridian-collateral electric information diagnosis and treatment instrument was used to detect meridian and collateral so as to find out the relevant "sick meridian open" for electric stimulation, bloodletting and cupping. In control group, Acyclovir was administered orally.

RESULTSIn observation group, it had been dectcted that "sick meridian open" were mostly localized in Ashi point (Extra), Zhangmen (LR 13), Daimai (GB 26), Qimen (LR 14), Dabao (SP 15), etc. The totally effective rate in observation group was 100.0% (100/100) that was superior to 60.0% (60/100) in control group (P < 0.000 1). Additionally, the time for pain relief, blister relief and scarring in observation group was shorter obviously than that in control group (P < 0.000 1). There was no case of post-herpetic neuralgia in observation group, but the incidence of it in control group was 26.0% (26/100).

CONCLUSIONMeridian-collateral diagnosis and treatment instrument detects "sick meridian open" for electric stimulation and bloodletting and cupping in the treatment of herpes zoster, which can effectively relieve pain and prevent from post-herpetic neuralgia promptly.

Adult ; Aged ; Aged, 80 and over ; Electric Stimulation Therapy ; Female ; Herpes Zoster ; therapy ; Humans ; Male ; Medicine, Chinese Traditional ; Meridians ; Middle Aged ; Neuralgia ; therapy ; Punctures