In order to investigate the lesion' s extention and the infiltrated deepth and the metastasis of the tumors preoperatively ,endoscopic ultrasonography (EUS) was performed in 28 patients with ampullary carcinoma and 18 patients with extrahepatic bile duct carcinoma. forty six patients underwent surgical ex- plorations. A radical resection with detailed pathological study was done for 22 resectable cases of ampullary carcinoma and all the 18 cases of extrahepatic bile duct carcinoma. Carcinoma of ampulla of Vater and ex- trahepatic bile duct were assessed and staged preoperatively according to the TNM staging system. The re- sults of EUS were compared with surgical explorations and pathological findings for evaluating the accuracy of preoperative staging of EUS. The accurate rate of EUS in assessing the extent of cancer invasion was 8l.8% for ampullary carcinoma, 72. 2% for extrahepatic bile duct carcinoma. The accuracy of EUS in pre- dicting regional lymph node metastasis was 59% for ampullary carcinoma , and 61.6% for extrahepatic bile duct carcionoma. invasion of portal vein was correctly predicted by EUS in 2 out of 3 patients of ampullary carcinoma. All the 3 cases of liver metastasis were not detected by EUS. EUS is a more accurate diagnostic method in judgement of invasive extent of ampullory carcinoma and extrahepatic bile duct carcinoma preop- eratively , but less accurate for metastasis of the tumors.

Objective To explore the effect of medical cooperation health education after conservative surgery placed Mirena treatment with uterine gland myopathy.Methods 30 patients were collected and divided into general group and cooperation group by random number table method,with each group including 15 cases.General group accepted regular health education,while cooperation group received medical cooperation health education.6 months of home visits and telephone follow-up of two groups,statistical comparisons of menstruation,menstrual days,life satisfaction,adverse symptoms and satisfaction of diseases,Mirena,nursing methods between the two groups before and after the treatment.Results Patients' satisfaction and disease knowledge,Mirena knowledge,nursing knowledge the cooperation group scored higher than the conventional group (x2=2.184-6.184,P ＜0.05 or 0.01);the number of higher anxiety level was lower than the conventional group (x2=13.258,P ＜ 0.05);after treatment,dysmenorrhea severity score,menstrual flow,menstrual days,the quality of life the cooperation group were (0.35±0.08) points,(14.20±16.54) ml,(4.21±1.14) d,(9.01±1.36) points while the conventional group were (1.37±0.34) points,(39.64±8.62) ml,(6.74±1.07) d,(7.81±1.30) points,and the difference was statistically significant (t =2.47-11.31,P ＜0.01).the number of adverse symptoms of cooperation group was lower than that of the conventional group (x2=13.594,P ＜ 0.01).Conclusions Compared with single health education,cooperative medical health education has more advantage after conservative surgery placed Mirena treatment uterine gland myopathy which should be promoted in clinic.

Objective To investigate the clinical characteristics and surgical treatment of retroperitoneal Castleman′s disease (CD) with paraneoplastic pemphigus (PNP).Methods The clinical symptoms, laboratory, histopathologic, CT findings and results of surgery in 7 patients were evaluated.Results All of 7 patients presented with PNP.Retroperitoneal tumors were found by CT examination and surgically removed.Castleman disease was confirmed by histopathology.Reoperation was performed to resect the recurrent tumor in one patient.The signs of PNP were dissolved completely or partially after operation.Conclusion Retroperitoneum CD with PNP are characteristic of distinctive clinical features.Surgical excision improves the mucocutanous manifestation of PNP.

Objective To evaluate the relationship between endoscopic rectal aberrant crypt foci (ACF) and colon neoplasm, including lesions with high risk of aggressive progression (adenoma with diameter ≥ 1cm, villus adenoma, tubular-villus adenoma, adenoma of high grade dysplasia, or cancer). Methods The rectum of 212 patients who underwent colonoscopy was stained by 0. 4% indigo armine, and the patient was classified into different grade according to the number of rectal ACF, namely Grade 0 as no ACF, Grade Ⅰ as 1-4, Grade Ⅱ as 5-9 and Grade Ⅲ as more than 10. The correlation between rectal ACF grade and colon lesions was analyzed. Results Of 212 patients, 72 were classified as Grade 0, 48 as Grade Ⅰ , 41 as Grade Ⅱ, and 51 as Grade Ⅲ. The detection rate of colon neoplasm and lesions with high risk of aggressive progression in patients with rectal ACF were significantly higher than that in patients without rectal ACF (OR at 95% CI was 22. 352 (6. 716 -74. 395) and 7. 982 ( 1. 838-34. 672), respcetively). Conclusion Rectal ACF may predict the detection of colon lesions, including those with high risk of aggressive progression.

Objective: To compare the survival rates difference between diabetic kidney disease (DKD) and non-DKD maintenance hemodialysis patients. Methods: The eligible patients who started hemodialysis treatment in Dalian Municipal Central Hospital from January 1, 2010 to December 31, 2016 were enrolled. The endpoint was all-cause death. Patients were divided into two groups according to the primary disease: DKD group and non-DKD group. Survival between two groups was compared by Kaplan-Meier plots and log-rank test. Survival was timed from the start of dialysis until the date of death and was censored for the date of end of the study period (December 31, 2016). SPSS 13.0 software was used for statistical analysis. Univariate COX regression analysis was used for risk assessment. Independent analysis was performed by multivariate COX regression. P < 0.05 indicated that the difference was statistically significant. Results: A total of 769 patients were enrolled, including 305 patients with DKD (39.7%) and 464 patients with non-DKD (60.3%). There were 465 males, accounting for 60.5%, and 304 females, accounting for 39.5%. The mean age of starting dialysis was (56.2 ± 14.9) years. The median follow-up time was 21 months. One hundred and seventy patients died due to all causes, accounting for 21.7%. The 1-, 2-, 3-, 4-, 5-, 6- and 7-year survival rates in the diabetic kidney disease group were 94%, 77%, 68%, 56%, 44%, 31% and 26%. The 1-, 2-, 3-, 4-, 5-, 6- and 7-year survival rates in the non-diabetic kidney disease group were 94%, 87%, 81%, 77%, 69%, 65% and 60%. The survival rate of DKD group was significantly lower than that of non-DKD group (χ²=23.656, P < 0.01). Multivariate Cox regression analysis showed that age of onset of dialysis, primary disease, low density lipoprotein, serum potassium, ejection fraction (EF), coronary heart disease and stroke were independent risk factors of mortality (P < 0.05). Conclusions The survival rate of patients with diabetic kidney disease is significantly lower than that of patients with non-diabetic kidney disease in the maintenance hemodialysis patients in our center. Age, primary disease, low density lipoprotein, EF, coronary heart disease, and stroke are independent predictors of death.

Objective To obtain a better understaning of the clinical features of Castleman tumor associated paraneoplastic pemphigus. Methods The clinical features and therapy of 10 cases of this disease, diagnosed in the Department of Dermatology of Peking University First Hospital were analyzed. Results Castleman tumor was shown to be the most common neoplasm associated with paraneoplastic pemphigus in China. The clinical presentations, histopathologic characteristics, CT scan findings, and immunologic features were all unique. The early diagnosis and removal of the Castleman tumor are crucial for the treatment of this tumor-associated autoimmune disease. Conclusions Because Castleman tumor is directly related to the induction of autoimmunity, early diagnosis and prompt removal of the tumor are essential to the management of this disease.

Maintaining the stemness of the transplanted stem cell spheroids in an inflammatory microenvironment is challenging but important in regenerative medicine. Direct delivery of stem cells to repair periodontal defects may yield suboptimal effects due to the complexity of the periodontal inflammatory environment. Herein, stem cell spheroid is encapsulated by interfacial assembly of metal-phenolic network (MPN) nanofilm to form a stem cell microsphere capsule. Specifically, periodontal ligament stem cells (PDLSCs) spheroid was coated with Fe^III/tannic acid coordination network to obtain spheroid@[Fe^III-TA] microcapsules. The formed biodegradable MPN biointerface acted as a cytoprotective barrier and exhibited antioxidative, antibacterial and anti-inflammatory activities, effectively remodeling the inflammatory microenvironment and maintaining the stemness of PDLSCs. The stem cell microencapsulation proposed in this study can be applied to multiple stem cells with various functional metal ion/polyphenol coordination, providing a simple yet efficient delivery strategy for stem cell stemness maintenance in an inflammatory environment toward a better therapeutic outcome.
Anti-Bacterial Agents/pharmacology* ; Capsules/pharmacology* ; Cell Differentiation ; Cell Encapsulation ; Cells, Cultured ; Ferric Compounds/pharmacology* ; Osteogenesis/physiology* ; Periodontal Ligament ; Polyphenols/pharmacology* ; Stem Cells ; Tannins/pharmacology*