Adolescent ; Adult ; Cholecystitis ; complications ; drug therapy ; surgery ; Cholecystolithiasis ; complications ; drug therapy ; surgery ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Pancreatitis ; drug therapy ; etiology ; surgery ; Phytotherapy ; Postoperative Period ; Sphincterotomy, Endoscopic

Dust ; Humans ; Lung ; pathology ; Mining ; Occupational Exposure ; adverse effects ; Tin ; adverse effects

Objective: To investigate the prevalence and influencing factors of dyslipidemia among adult residents in Hefei City, so as to provide the evidence for formulating the dyslipidemia control strategy. Methods: A total of 10 812 permanent residents at ages of 18 years were randomly sampled from 5 counties (districts) in Hefei City using a multi-stage stratified cluster random sampling method. Participants' demographic features, dietary behaviors and development of chronic diseases were collected using questionnaire surveys, and the height, body weight, waist circumference and blood lipids were measured. The prevalence of dyslipidemia was analyzed, and the factors affecting the development of dyslipidemia were identified using a multivariable logistic regression model. Results: Totally 10 812 valid questionnaires were recovered, with an effective recovery rate of 92.02%. The participants had a male to female ratio of 0.85∶1, a mean age of (51.89±12.56) years. The prevalence of dyslipidemia was 25.20%, and hypertriglyceridemia and low high-density lipoprotein cholesterol (HDL-C) were predominant types of dyslipidemia, with prevalence of 12.70% and 10.20%, respectively. Multivariable logistic regression analysis showed that urban areas (OR=1.340, 95%CI: 1.219-1.474), age of 40 years and older (40 to 59 years, OR=1.181, 95%CI: 1.047-1.333; 60 to 88 years, OR=1.321, 95%CI: 1.154-1.513), alcohol consumption (OR=1.205, 95%CI: 1.093-1.329), insufficient physical activity (OR=1.217, 95%CI: 1.111-1.332), static behavior duration of 3 h/d and longer (OR=1.126, 95%CI: 1.027-1.234), overweight (OR=1.162, 95%CI: 1.045-1.291), obesity (OR=1.310, 95%CI: 1.097-1.564), central pre-obesity (OR=1.236, 95%CI: 1.102-1.387), central obesity (OR=1.414, 95%CI: 1.247-1.603), hypertension (OR=1.279, 95%CI: 1.107-1.477), diabetes (OR=2.192, 95%CI: 1.820-2.640), medical insurance (OR=0.594, 95%CI: 0.395-0.893) and self-rated “very good/good” oral health (OR=0.731, 95%CI: 0.576-0.927) were factors affecting the development of dyslipidemia. Conclusion The risk of dyslipidemia is high among adult residents living in urban areas, middle-aged and elderly residents, residents with alcohol consumption, insufficient physical activity, overweight, obesity, central pre-obesity, central obesity, hypertension and diabetes.

Objective To investigate the expressions of microRNA-21 in cholangiocarcinoma tissues and the relationship between epithelial-mesenchymal transition (EMT) and the prognosis of patients.Methods Forty-one samples of cholangiocarcinoma and 10 samples of adjacent tissues from 10 patients who received radical resection of cholangiocarcinoma at the Provincial Hospital of Anhui Medical University from January 2005 to January 2010 were collected.The expressions of microRNA-21,E-cadherin and N-cadherin were detected by in situ hybridization and immunohistochemistry,and effect of their expressions on the prognosis was analyzed.Enumeration data were analyzed using chi-square test.The correlation between microRNA-21 and EMT markers was analyzed using the Spearman correlation coefficient.The survival curve was drawn by Kaplan-Meier method,and the survival rate was analyzed using the Log-rank test.Results The expression rate of microRNA-21 in the cholangiocarcinoma tissues was 63％,which was significantly higher than 30％ of that in the adjacent tissues (x2 =0.324,P ＜ 0.05).The expression of microRNA-21 was closely related with the tumor differentiation degree,lymph node metastasis,perineural invasion (x2 =6.365,0.552,11.896,P ＜ 0.05),but not with gender,age,tunor location and tumor type (x2 =0.322,0.588,0.510,0.256,P ＞ 0.05).The expressions of E-cadherin and N-cadherin were related with lymph node metastasis and perineural invasion (x2 =4.630,5.512;6.600,7.152,P ＜0.05),but not with gender,age,tumor location,tumor differentiation degree and tumor type (x2 =0.266,0.013,0.067,0.666,0.003; 1.036,0.997,1.808,2.997,0.812,P ＞0.05).A positive correlation between the expression of microRNA-21 and EMT related markers E-cadherin and N-cadherin was detected (r =0.373,0.614,P ＜0.05).The results of survival analysis showed that the overall survival rate and tumor-free survival rate of patients with low expression of microRNA-21 were significantly higher than those of high expression of microRNA-21 (x2 =3.999,4.376,P ＜ 0.05).Conclusion Over expression of microRNA-21 in cholangiocarcinoma and metastatic lymph nodes may accelerate the invasion and metastasis of cholangiocarcinoma through inducing EMT,microRNA-21 might predict the prognosis of patients.

Objective To investigate the bone metabolism of children with leukemia and its relationship to tumor necrosis factor-?(TNF-?)pre-and post-treatment.Methods Serum bone gla protein(BGP),the excretion rate of urianry deoxypyridinoline(DPD)and TNF-? were measured in 35 children with leucocythemia pre-and post-treatment and 30 normal children(control group).Results The results showed that BGP,the excretion rate of DPD and TNF-? in children with leucocythemia before treatment were significantly higher than those in control group.However,the excretion rate of DPD decreased after chemotherapy but still significantly higher than that of control group(P0.05).Conclusions In children with leukemia,there are bone absorption and bone dissolution before chemotherapy,while there is osteogenesis dysfunction and bone absorption after chemotherapy.TNF-? can be used as a parametre for evaluating treatment effect and monitoring relapse.

Objective To observe the changes of lung parameters,the ratios of B and T lymphocyte attenuator(BTLA) and serum cytokines in patients with knee osteoarthritis (KOA),and explore possible molecular mechanism of them.Methods Forty-seven cases of knee osteoarthritis from the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from 2011 October to 2012 July were analyzed in this study.Pulmonary parameters were detected by spirometer; B and T lymphocyte attenuator(BTLA) was detected by flow cytometry ; Interleukin (IL)-1β,IL-10,matrix metalloproteinase-9 (MMP-9),tissue inhibitor of matrix metalloprotease-1 (TIMP-1) were detected by ELISA;ESR was determined by Westergren method ; hs-CRP was determined by the automatic biochemistry analyzer.Results (1) Compared with NC group,levels of FVC,FEV1,FEV1/FVC,PEF,MEF25.75,MEF50,MEF25,CD3 + BTLA+ T cell,CD4+ BTLA+ Tcell,IL-10,TIMP1 were significantly decreased,IL-1 β,MMP9 were significantly increased.(2)Correlation analysis showed FVC was negatively correlated to Lequesne MG,symptom classify quantization scores,course,MMP9,while positively related to CD3+ BTLA+T cell,IL-10,TIMP1 ;FEV1 was positively correlated to CD3 + BTLA+T cell,CD4+ BTLA+T cell,TIMP1,while negatively correlated to course ; MEF50 was positively related to CD3+BTLA+T cell,CD4+ BTLA+T cell.Conclusion While articular cartilage lesions occurred in KOA patients,the lung function was also declined.The mechanism may be associated with the declination of expression of BTLA,which can cause up-regulating of IL-1 β,MMP9 and down-regulating of IL-10,TIMP1,thus leading to immune dysfunction and abnormal immune response.Those may induce airway injuries and result in lung function decline finally.

BACKGROUND: Traditional anterior release followed by posterior correction and fusion is frequently used to treat severe and rigid adolescent idiopathic scoliosis, which is considered as Cobb angle of the major curve > 65° and flexibility < 34.5%; however, there are a great majority of complications. Whether isolated posterior correction using pedicle screw fixation combining with bone grafting and fusion may provide better effects on severe and rigid adolescent idiopathic scoliosis needs to be further studied.OBJECTIVE: To evaluate isolated posterior correction using pedicle screw fixation combining with bone grafting and fusion for the treatment of severe and rigid adolescent idiopathic scoliosis. DESIGN: Case analysis.SETTING: Department of Orthopaedics, Renji Hospital, Medical College of Shanghai Jiao Tong University.PARTICIPANTS: Twenty patients with severe and rigid adolescent idiopathic scoliosis, including 8 males and 12 females, were selected from Department of Orthopaedics, Renji Hospital, Medical College of Shanghai Jiaotong University from June 1999 to August 2005. They were 12-18 years old, and the mean age was 14.6 years. All patients were finally diagnosed as X-ray of whole spine. According to King-Moe criteria, patients were classified into type Ⅰ(n =4), type Ⅱ(n =6), type Ⅲ (n =5), type Ⅳ(n =3) and type Ⅴ(n =2). Before surgery, mean Cobb angle of the major curve was 82° (75°-92°), mean flexibility was 30% (20%-40%), and mean shoulder height difference was 15 mm (5-35 mm). Moreover, according to Risser syndrome, patients were classified into degree 1 (n =3), degree 2 (n =5), degree 3 (n =6), degree 4 (n =5) and degree 5 (n =1). All patients and their relatives provided the informed consents, and the experiment was approved by the local ethical committee. Artificial bone was Osteoset provided by Wright Company, USA.METHODS: Patients underwent isolated posterior correction using pedicle screw fixation combining with bone grafting and fusion, and spinous process, lamina of vertebra, zygapophysial joints and transverse process were exposed in a preconcerted fusion area. Pedicle screw was inserted into strategy vertebra using free hand technique according to the anatomic landmark of entry point. Six patients underwent fixation with TSRH system, and the other patients with CDH M8 system. Operative time and blood loss were evaluated after surgery. At 7 days after operation, Cobb angle was measured with X-ray, and correction rate of major curve was calculated. While shoulder height difference and admission duration were evaluated simultaneously. Complications and recovery states were followed up in the next 4 years.MAIN OUTCOME MEASURES: ① Operative time and blood loss; ② Cobb angle and correction rate of major curve; ③ shoulder height difference and admission duration; ④ follow-up results.RESULTS: All 20 patients were included in the final analysis. ① Operative time and blood loss: Operative time lasted from 3.2 to 4.3 hours, and the mean time was 3.5 hours. Blood loss ranged from 660 to 1 070 mL, and the mean loss was 865 mL. ② Cobb angle and correction rate of major curve: Cobb angle of the major curve ranged from 82° (75°-92°) before surgery to 31° (22°-37°) after surgery, and the mean correction rate was 62%. ③ Shoulder height difference and admission duration: Mean should height difference before surgery was 15 mm (5-35 mm). Postoperative lateral film of spine indicated that thoracic and lumbar vertebra generally suffered from normal posterior and anterior convexity, and mean shoulder height difference after surgery was 7.5 mm (0-11 mm). The admission duration lasted from 8 to 11 days, and the mean duration was 9 days. ④ Follow-up results: All patients were followed up in the next 4 years after surgery. The cobb angle correction of major curve remained unchanged, and the instrumented segments were completely fused without instrumentation failure.CONCLUSION: Isolated posterior correction using pedicle screw fixation combining with bone grafting and fusion may effectively cure severe and rigid adolescent idiopathic scoliosis, which is considered as Cobb angle of the major curve between 75° and 92° and flexibility ≥ 20%.

This study was aimed to explore the mechanism of Xin-Feng capsule (XFC) on pulmonary function of Sjogren's syndrome (SS) rat model based on the TGF-β1-ERK1 signal pathway. A total of 50 SD rats were ran-domly divided into the normal control (NC) group, model control (MC) group, hydroxychloroquine sulfate (HCQ) group, radix paeoniae alba (total glucosides of paeony capsules, TGP) group, and the XFC treatment group, with 10 rats in each group. Except the NC group, the complete Freund's adjuvant (CFA) and the same rat sub-mandibular gland antigen induced method were applied to each rat after metatarsus injection on two feet and CFA after sufficient emulsification of 0.2 mL submandibular gland protein mixed antigen induced SS. The water drink-ing quantity, body weight change, pulmonary function, ERK1, TGF-β1 protein expression and serum cell factor (IL-17, IL-4) changes were detected in each group. The results showed that compared with the NC group, the body quality and serum IL-4 of MC rats were obviously decreased, and the water drinking quantity, submandibu-lar gland / lung index, submandibular gland pathological score, ERK1, TGF-β1 integral and IL-17 were increased (P < 0.01 or P < 0.05), and the pulmonary function parameter was decreased (P < 0.01 or P < 0.05). Compared with the MC group, the body quality, pulmonary function parameters FEF50 and MMF of the XFC group were in-creased, the IL-4 expression was increased, the water drinking quantity, submandibular gland / lung index, sub-mandibular gland pathological score, serum IL-17 expression, ERK1 and TGF-β1 integral were decreased (P <0.01 or P < 0.05). Compared with the HCQ group, the body quality and IL-17 were significantly decreased in the XFC group (P < 0.01), FEF25, FEF75 and MMF were increased (P < 0.01 or P < 0.05). Compared with the TGP group, the lung index and IL-17 were decreased in the XFC group (P < 0.01 or P < 0.05). It was conclud-ed that the lung function of SS rats was declined, which is closely related to the activation of TGF-β1-ERK1 sig-nal pathway. Traditional Chinese medicine of XFC is able to downregulate the TGF-β1 expression and to restrain epithelium-mesenchymal cell transformation, in order to inhibit ERK1 phosphorylation activation and proliferation, decrease immune inflammation, in order to improve SS and lung function.

Objective To explore the sensitivity of contrast-enhanced ultrasound (CEUS) and ultrasonic elastography(UE) in detecting different sizes of thyroid papillary carcinoma.Methods 64 cases of thyroid papillary carcinoma were divided into two groups according to the diameter size(group 1,≤1 cm;group 2,＞ 1 cm) and examined by the contrast-enhanced ultrasound and elastography,then the features were analyzed and the sensitivity for detecting of the two methods in different groups were compared.Results The sensitivity for detecting in CEUS was higher than in UE,which had significant difference between two methods.CEUS and UE were valuable for detecting and they had no difference in sensitivity for detecting in group 1.There was a significant difference in sensitivity for detecting between two methods in group 2.Conclusions Both CEUS and UE were valuable in diagnosis of thyroid papillary carcinoma and the sensitivity for detecting in CEUS is higher than in UE in group 2.

Objective To explore imaging features of the lateral atlanto-dental interval (LADI) of atlanto-axial joint and its value in the diagnosis of atlanto-axial joint dislocation/subluxation. Methods Two hurdred and forty healthy volunteers without atlanto-axial joint dysfunction and 32 patients with torticollis and/or functional impairment at atlanto-axial joint were enrolled into this study. All subjects were examined with multi-slice CT in both neutral and max rotation positions to the left/right. Clinical endpoints including VBLADI, variance range of the VBLADI and asymmetric conditions were evaluated. x2 test is used to evaluate the variance of incidence of bilateral LADI asymmetry in different age groups, Pearson-test(2-tailed) is used to evaluate the correlation between VBLADI and rotary function of atlanto-axial joint,precise test of fourfold table is used to compare normal group with patient groups. Results ( 1 ) In the normal control group: asymmetry of bilateral LADI were observed in 204 among 240 (85.00%) healthy volunteers including 60 youngsters( ＜ 15 years) and 180 adults( ≥ 15 years). The median and P95% of |VBLADI| were 0.850 mm,2.450 mm in the young ( ＜ 15 years) and 0.700 mm,2.051 mm in the adult(≥15 years),there were 2 and 10 volunteers whose |VBLADI| ≥P95% in the young and in the adult respectively. There was no correlation between VBLADI( -2.146 to 2.114 mm,Median 0.000 mm) and LA(22.949° to 44.649°, Median 34.500°), RA (25.284° to 45.334°, Median 35.300° ), VLRA ( - 11.643°to 8.623 °, median 0.000 ° ) respectively in normal people ( r = - 0.030, - 0.005,0.026, P ＞ 0.05 ). ( 2 ) In the study with 32 patients including 25 youngsters( ＜ 15 years) and 7 adults( ≥ 15 years). Seventeen of 32 had atlanto-axial lateral subdislocation (AALSD),in 16 youngsters( ＜ 15 years), the median of the |VBLADI| was 3.350 mm and 14 cases |VBLADI| ≥2.450 mm;1 adult patient(≥ 15 years) had |VBLADI| ≥ 2.051 mm; 7 of 32 patients had atlanto-axial rotatory dislocation (AARD) including 4 youngsters |VBLADI| ＜2.450 mm,median 1.200 mm,3 adults |VBLADI| ＜2.051 mm,all of the 7 patients with AARD had unilateral parasol LADI in neutral position;8 of 32 patients had atlanto-axial complicated dislocation(AACD) including 5 youngsters |VBLADI| ≥2.450 mm,3 adults |VBLADI| ≥2.051 mm. There are more cases whose |VBLADI| ≥P95% in group AALSD and group AACD than in abnormal group( P<0.01 ), but there is no difference between group AARD and normal group( P = 0.738 ).Conclusion The imaging finding of "asymmetry of bilateral LADI" may be either a physiological variation or a pathological condition, clinical manifestations and other imaging findings should be evaluated to make a diagnosis.