Objective To increase the appreciation of manifestations in autoimmune pancreatitis (AIP) and to decrease misdiagnosis rate by investigating the clinical characteristics of AIP. Methods Clinical data were collected and laboratory ,imaging and histopathology were analyzed from the Chinese PLA General Hospital from 1995 to 2009. Patients with AIP were included in the study. Results Eight patients (male 6, female 2) aged 35-69 (52.4 ±9.4) years were diagnosed as AIP from 2006 to 2009. The main clinical manifestations include intermittent jaundice in 6 cases (6/8), abdominal pain in 5 cases (5/8),weight loss in 4 cases (4/8), and accompanied with other diseases of immune system in 4 cases (4/8).The imaging showed head of pancreas enlargement in 3 cases (3/8) and whole pancreas enlargement in 5 cases (5/8). There is a "banana-peel like" ring around the pancreas and irregular stenosis of pancreatic duct. Massive lymphocytes and plasma cells infiltration and parenchymal fibrosis were shown in pancreatic tissues, bile duct,salivary gland and liver in pathology. Clinical manifestations, laboratory examinations and images in 7 cases (7/8) were improved after treatment with prednisone. Twenty-two of them were misdiagnosed as pancreatic or biliary carcinoma and 21 were performed laparotomy in the period of 1995-2005 ( 23 cases). After 2006, however, the misdiagnosis rate significantly decreased from 95.7% ( 22/23 ) to 0. Conclusions AIP seems to be a systemic autoimmune disease rather than an isolated disorder,markedly overlapping with other autoimmune diseases. Definitive diagnosis can be improved by the detection of immune parameters and pathological examination.

Objective To investigate the expression and the roles of Angiopoietin 1(ang-1) and Angiopoietin 2(ang-2) in the endometrium of women with abnormal bleeding after medical abortion. Methods Analyzing endometrial pathological change of 1087 patients with abnormal bleeding after medical abortion in early pregnancy,and the endometrial specimens from 40 patients were randomly chosen for the study. The endometrial specimens from 20 women without abnormal bleeding after medical abortion were used as control group.Immunohistochemistry was used to detect the levels of Ang-1 and Ang-2 proteins in endometria. Results The percentage of patients with both the residul decidua and villus was 80.5%; positive immunoreactive signals of Ang-1 and Ang-2 were found in the endometrial glandular epithelium, stromal cells and the endothelial cells of vessels; the expression rate of Ang-1 and Ang-2 in the patients with abnormal bleeding were higher than that in the control group(P

Objective To investigate the expression of lung keratinocyte growth factor receptor (KGFR) in rats with acute spinal cord injury (ASCI) in different time points and its role in lung edema.Methods Thirty-two adult Wistar rats weighing 240 g to 260 g were assigned to experimental group (n =16) and control group (n =16) according to the random number table.Each group consisted of time points of 24 hours,3 days,1 week and 2 weeks after the modeling (4 rats per time point).A rat model of ASCI in experimental group was induced at C7 segment by dropping a weight of 10 g from the height of 2.5 cm (Allen' s method).In control group,laminas were removed only,leaving spinal cord at C7 intact.Rats were sacrificed at each time point for measurement of lung wet/dry weight ratio,Western blot analysis of expression of lung KGFR protein and RT-qPCR detection of lung KGFR mRNA expression.Results After ASCI in rats,the expressions of lung KGFR protein and mRNA began to drop at 24 hours (0.23 ±0.06,0,012 1 ±0.002 3),reached the trough at 3 days (0.17 ±0.04,0.008 5 ±0.001 7)and picked up at 1 week.Expression of lung KGFR mRNA in experiment group showed statistically significant difference from that in control group at 24 hours and 3 days (P ＜ 0.05),whereas in each time point the difference of KGFR protein expression between experiment and control groups was statistically significant(P ＜0.05).Variation trend of KGFR expression was in parallel with the severity degree of pulmonary edema.Conclusion Lung KGFR presents significant down-regulation in ASCI rats and this may be associated with the development of pulmonary edema after ASCI.

Objective To investigate incidence,diagnosis and treatment strategy of delayed esophageal complications after anterior cervical spine surgery.Methods The clinical data of 2316 patients who had undergone anterior cervical spine surgery from January 2001 to December 2011 were analyzed.The delayed esophageal complications were defined as esophageal perforation,esophago-tracheal fistula,esophago-cutaneous fistula,diverticulum of esophagus,esophagopleural fistula and esophageal stenosis that occurred 2 weeks after spine surgery.Results Delayed esophageal complications occurred in 4 patients,and the incidence was 0.17％.Esophageal perforation occurred in 2 patients; the incidence was 0.09％.Case 1 was a 31-year-old man who was found to have esophageal diverticulum and perforation 7 years after anterior cervical spine surgery.Then he underwent removal of implant,excision of diverticulum,and repair of esophagus with sternohyoid muscle flap and omohyoid muscle flap.Case 2 was a 46-year-old man who was found to have esophageal diverticulum 3 years after cervical spine surgery.He also underwent removal of implant,excision of diverticulum,and repair of esophagus with sternohyoid muscle flap and omohyoid muscle flap.Case 3 was a 58-year-old woman who was found to have esophageal diverticulum 5 years after cervical spine surgery.She underwent removal of implant,excision of diverticulum,and repair of esophagus with sternocleidomastoid muscle flap.Case 4 was a 56-year-old woman who was found to have esophageal perforation 3 years after cervical spine surgery.She underwent removal of implant and repair of esophagus with sternocleidomastoid muscle flap.All 4 patients recovered after operation.Conclusion The incidence of delayed esophageal complications after anterior cervical spine surgery is low,and the diagnosis is difficult.X-ray,digestive tract radiography,and gastrointestinal endoscopy are the main diagnostic tools.Surgical treatment is the main and effective management.

ObjectiveTo investigate the effects of astragalin on pulmonary edema after acute cervical spinal cord injury in rats.MethodsA total of 200 adult Wistar rats weighing 240-250 g were randomly divided into five groups:astragalin group,low concentration astragalin group,physiological saline group,blank group and sham group,with 40 rats in each group.The rats with cervical spinal cord injury were induced at C7 by modified Allen' s method,with the dropping weight of 10 × 2.5 g · cm.In the sham group,the laminas were removed only,leaving spinal cord at the C7 intact.Each group was further divided into four time points:24 hours,3 days,1 week and 2 weeks after the modeling,with 10 rats in each time point,according to the specimen collection time.Rats were sacrificed at different time points to observe the pathological change of the lung tissue using optical microscope,measure the lung wet/dry weight ratio (W/D) and protein concentrations of the serum and bronchoalveolar lavage fluid and calculate the lung W/D and lung permeability index (LPI).ResultsAt the same instant,the W/D and LPI in the astragalin group and low concentration astragalin group were lower than those in physiological saline group and blank group,with the lowest value in the astragalin group at day 3 after injury ( P ＜0.05 ).ConclusionsRats with acute cervical spinal cord injury may cause pulmonary edema,which can be efficiently alleviated through early use of astragalin.

This study aimed to investigate the anti-apoptotic effects of Tangnaikang (TNK) on islet β cells in Zucker diabetic fatty (ZDF) rats.Six male fa/+ ZDF rats were took as the control group,while other thirty male fa/fa ZDF rats were divided into five groups at random:the model group,the metformin group,the high-,mediumand low-dose TNK groups,depending on their body weight and random blood glucose.Prior to the administration,fasting blood glucose and fasting insulin were measured by drawing blood with inner canthusl.Materials were prepared when administered for six weeks.Fasting blood glucose and fasting insulin were detected again.When the sections of the rat pancreatic tissue were embedded,the morphological changes of the islet were observed via HE staining,and the apoptosis of islet β cell were observed using TUNEL.Positive expression of Caspase-3,the transduction enzyme of cell death signal,was tested by immunohistochemical method.It was found that the fasting blood glucose of the (fa/fa) ZDF rats in the high-,medium-and low-dose TNK group was significantly improved after administration (P ＜ 0.01).The serum insulin of rats in the high-,medium-and low-dose TNK group arised compared with the model group,while the high-and low-dose TNK group showed differences in a statistical sense.Compared with the model group,the HOMA-IR of all the treatment group decreased,while significant difference was presented between the high-dose TNK group and the metformin group.HE staining showed that the morphology of the islet β cell of the rats in all the treatment group was improved.The results of TUNEL showed significantly apoptotic changes on islet β cell of the fa/fa ZDF rats.Compared with the model group,the positive expression of TUNEL in the metformin group and the high-dose TNK group were significantly reduced (P ＜ 0.05).The result of immunohistochemistry method showed that the protein levels of Caspase-3 in the metformin group and the high-dose TNK group decreased (P ＜ 0.05).In conclusion,it was demonstrated that TNK effectively reduced the apoptosis of islet β cells in fa/fa ZDF rats,which presented a protective effect.

ObjectiveTo analyze the prenatal sonographic features of facial anomalies and evaluate the relationship between facial anomalies and increased nuchal translucency.MethodsPregnant women coming to Shenzhen Maternity and Child Healthcare Hospital afifliated to Nanfang Medical University between October 2008 and December 2012 for the 11th-13th+6 gestational week scanning were included in this study. Fetal facial region was evaluated by the technique of cross-sectional view of the fetal lateral ventricle with probe tilting. Comparative analysis was performed on autopsy and prenatal ultrasonograpgy. ResultsThe prenatal ultrasonic results of 10 518 fetus: 10 343 fetus (98.3%, 10 343/10 518) were conifrmed as facial normal with the technique of cross-sectional view of the fetal lateral ventricle with probe tilting at the ifrst trimester. Twenty-eight cases of facial malformation were conifrmed at the ifrst trimester (8 cases of cleft lip/plate, 14 cases of absence of nasal bone, 5 cases of holoprosencephaly facial feature and 1 cases of irregular facial cleft). Forty-nine cases of facial malformation were conifrmed by postnatal evaluation or autopsy (the incidence was 0.47%, 49/10 518 ). Twenty-one cases were misdiagnosed (11 cases of cleft lip/plate, 7 cases of ear deformity, 2 cases of micrognathia and 1 cases of irregular facial cleft). Ultrasonic soft marker: 34 cases were combined with abnormal soft marker (69.4%, 34/49), 22 cases of various kinds of facial malformation were combined with other structural deformity. Twenty-three cases were combined with increased nuchal translucency. Fourteen cases of absence of nasal bone were detected in the ifrst trimester, including twelve cases of increased nuchal translucency, six cases of structural deformity, two cases of chromosomal abnormalities (21-trisomy). Five cases of holoprosencephaly facial feature were detected in the first trimester, including three cases of increased nuchal translucency and structural deformity. Eight cases of cleft lip/plate were detected in the ifrst trimester, including ifve cases of increased nuchal translucency. One cases of irregular facial cleft were detected in the ifrst trimester, who was combined with structural deformity and increased nuchal translucency. Postpartum examination showed: there were 25 cases of simple facial anomaly, 22 cases were combined with structural deformity (9 cases of cardiac defect and 8 cases of holoprosencephaly), there were 2 cases of chromsomal abnormalities. The results showed that increased nuchal translucency had certain relationship with facial anomaly. The value of nuchal translucency of facial anomalies fetus was apparently higher than that of normal fetus and fetus with simply facial anomalies. There was no signiifcant difference between normal fetus and fetus with simply facial anomalies.ConclusionsFindings of holoprosencephaly and cardiac defects is a signiifcant clue for diagnosing facial anomalies. Fetuses with cleft palate/lip have an abnormal conifguration of the retronasal triangle. Cross-sectional view of the fetal lateral ventricle with probe tilting caudal slightly technique is an important method to screen fetal facial malformation in the ifrst trimester.

Objective To investigate facial-cervical index difference in undergraduates of different height or weight in Han nationality to provide an additional reference for plastic surgery of facialcervical region.Methods Subjects consisted of 200 college undergraduates of Han nationality,aged 20 to 24 years,with average 22.9 ± 1.7,of whom 100 were male and 100 were female.Their height,weight,bizygomatic breadth,facial height,cervical height,neck circumference,neck breadth,shoulder width,cervical-mandibular angle,thorax-cervical angle,shoulder-cervical angle,pulvinar-cervical angle and back-cervical angle were measured and calculated.Results The differences among the indices mentioned above were of statistical significance (P＜0.05);the indices of female subjects of different height were significantly different (P＜0.05);the differences in indices of male subjects of different weight were of statistical significance (P＜0.05);the indices of female subjects of different weight were also statistically different (P＜0.05).The facial-cervical indices in both male and female subjects of different height or weight were of no stistical difference (P＞0.05).Conclusions Male subjects of different height or weight have different cervical height,cervical-mandibular angle,neck height and facial height indices are different;hence,the indices are related to body height;female subjects of different body height have different neck height.Subjects of different weight have different neck circumference,neck breadth,should breadth,shoulder-cervical angle and pulvinar-cervical angle.

Objective To evaluate the protective effect of polysaccharide nucleic acid fraction of bacillus Calmette-Guerin (BCG-PSN) against atopic dermatitis (AD) in Nc/Nga mice,and to explore its possible mechanism.Methods Sixteen Nc/Nga mice were classified into normal control group (n =4),low-concentration BCG-PSN group (n=5) and high-concentration BCG-PSN group (n =7) to be subcutaneously injected with sodium chloride physiological solution,BCG-PSN of 0.1 mg/kg and 0.5 mg/kg respectively,at 1,8,15 and 22 days of age.Dinitrochlorobenzene (DNCB) was repeatedly and topically applied to these Nc/Nga mice to induce AD-like lesions at 49 days of age.The preventive effect of BCG-PSN against AD was evaluated by dermatitis scores,scratching frequency,histopathological manifestations and immunological parameters (including IgE,i nterleukin (IL)-4 and-12,and interferon (IFN)-γ).Results Repeated injection of BCG-PSN within 4 weeks after birth significantly decreased the severity of DNCB-induced AD-like lesions,dermatitis scores and scratching behavior in Nc/Nga mice.There was no statistical difference in scratching frequency between the high-and low-concentration BCG-PSN groups.BCG-PSN treatment reduced the plasma level of IgE in Nc/Nga mice in a dose-dependent manner.BCG-PSN at 0.5 mg/kg increased the number of cells secreting IFN-γ in skin lesions of mice.Both doses of BCG-PSN down-regulated IL-4 level,but up-regulated IL-12 level in the culture supernatant of spleen mononuclear cells from mice.Conclusion Early injection of BCG-PSN could protect Nc/Nga mice against dermatitis by promoting the proliferation of IFN-γ-secreting cells,increasing the synthesis of IL-12,and reducing the levels of IL-4 and IgE.

Objective To investigate the efficacy of the clinical pathway introduced in children with Mycoplasma pneu-moniae pneumonia (MMP). Methods Based on a retrospective study, the length of hospital stay, hospital expenses and curative rate were compared between 145 MMP patients managed according to clinical pathway and other 45 MMP patients. The causes of variation were analyzed in the clinical pathway group as well. Results The length of hospital stay in clinical pathway group [9 (6~10) days] was significantly shorter than that in the control group [10 (7-12.5) days] (P=0.003). The curative rate (93.8%) was significantly higher than that in the control group (84.4%) (P=0.043). The hospital expenses [4 696.5 (3 608.3-5 677.6) CNY] was significantly higher than that in the control group [3175.3 (2490.8-4585.0) CNY] (P<0.001). The variation rate of clinical pathway was 48.3%(70/145 cases) in clinical pathway group. Conclusions The curative rate is improved and the length of hospital stay is shortened after the clinical pathway is introduced in MMP children. However, there is a high variation rate in the clinical pathway. It is necessary to optimize the clinical pathway before it is adapted in clinic.