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.

Inflammatory bowel disease( IBD)is a group of chronic nonspecific intestinal diseases characterized by a clinical relapsing-remitting behavior. The evaluation of disease activity is concerned by clinicians all the time. With the evolving in recognition of the pathogenesis of IBD,many novel biomarkers are emerging in recent years. This article reviewed advances in the accepted and ongoing research fecal markers of IBD.

This paper reviews the research progress in relations between indoor air pollution and human health for the last 20 years,and focuses on: the studies on environmental risk assessment methods; the major health effects caused by indoor air pollution; the minor and limited health effects caused by indoor air pollution; other key issues concerned.

Objective To explore the therapeutic effect of loop electrosurgical excision procedure (LEEP)in the treatment of patients with cervical intraepithelial neoplasia (CIN) and its influence on pregnancy outcome.Methods 62 women with CIN who underwent LEEP were selected as treatment group,and 63 women with CIN who did not undergo LEEP in the same period were selected as control group.Then the curative effect and the pregnancy outcome were observed.Results The total effective rate was 93.65％ in the treatment group and 76.19％ in the control group,the difference was significant (x2 =7.034,P ＜ 0.01).The operation blood loss,operation time and the day of colporrhagia after operation in the treatment group were less than those in the control group(all P ＜ 0.05).There were no significant differences in the gestational age,incidence rates of abortion and cesarean section between the two groups (all P ＞ 0.05),while there were significant difference in the incidences of preterm delivery,premature rupture of membrane and low birth weight infant (all P ＜ 0.05).Conclusion LEEP is an effective treatment for patients with CIN,which can increase the incidence rates of preterm delivery,premature rupture of membrane and low birth weight infant,but not increase the gestational age,incidence rates of abortion and cesarean section.

Objective To observe the expression of IGF-1 in the peri-hematomal brain region of Intracerebral Hemorrhage(ICH) patients,and to investigate the relationship among IGF-1,excessive and depletion syndrome of stroke.Methods 28 patients were evenly and randomly recruited into 3groups:Yin excessive group,Yang excessive group and depletion group.Additional 6 persons of normal death within 3 hours were taken their brain tissue.The IGF-1 expression was detected with Western blotting method.The correlation among the expression of IGF-1,excessive and depletion syndromes were observed.Results The expression of IGF-1 in the peri-hematomal brain region of ICH patients significantly increased in comparison with the normal control group (P=0.00).The expression of IGF-1 was significantly different among Yang excessive,Yin excessive and the depletion syndromes [ (0.696±0.111)、(1.151 ±0.185)、(1.697±0.108),P＜0.01],with the expression of IGF-1 of depletion syndrome ranked the highest,followed by Yin excessive and Yang excessive syndrome.Conclusion The expression of IGF-1 could reflect the degree of brain impairment.

Autophagy is a vital phenomena which widely exists in eukaryotic cells.It runs through the cellular normal growth,development,and physiological pathology processes.Studies in recent years have shown that autophagy involves in the pathological process after stroke,and affects the survival and death of nerve cells,This article reviews the classification,formation process,molecular mechanism and detection of autophagy as well as its relation with stroke.Our purpose is to provide a new direction for clinical treatment of stroke.

The peak of the brain edema after intracerebral hemorrhage usually begins after 3 to 4 days.A large quantity of hemoglobin releases and degrades during this process,and its degradation products iron ion,bilirubin and carbon monoxide,etc play important roles in the process of cerebral edema.They all involve in the formation Of delayed brain edema after intracerebral hemorrhage.The research of hemoglobin and its degradation products is expected to find out a new way for the treatment of intracerebral hemorrhage.

Objective To evaluate the role of spinal extracellular signal-regulated kinase (ERK) signaling pathway in reduction of remifentanil-induced hyperalgesia by electro-acupuncture (EA) at Zusanli in rats with incisional pain.Methods Fifty male adult Sprague-Dawley rats, weighing 250-280 g, in which the intrathecal catheter was successfully placed without complications, were randomly divided into 5 groups (n=10 each) using a random number table: control group (group C), remifentanil + incisional pain group (group RI), EA at acupoint group (group E) , EA at non-acupoint group (group NE), and 1/2 ERK inhibitor U0126 + EA at acupoint group (group UE).Normal saline 0.1 ml · kg-1 · min-1 was infused intravenously for 60 min in group C.In RI, E, NE and UE groups, after the model of incisional pain was established, remifentanil 1.0 μg · kg-1 · min-1 was infused for 60 min, and in addition, EA (intensity 10 mA, frequency 4 Hz) of Zusanli lasting for 60 min was performed at the same time in E and UE groups, and EA was performed at the points 5 mm lateral to the acupoints of Zusanli on the operated side simultaneously in group NE.ERK1/2 inhibitor U0126 5 μg (in 5％ dimethyl sulfoxide 10 μl) was injected intrathecally in group UE, and 5％ dimethyl sulfoxide 10 μl was injected intrathecally in the other groups.The mechanical paw withdrawal threshold (MWT) was measured before remifentanil or normal saline infusion (T1) , and at 2 h, 1, and 2 days after the end of infusion (T2-4).After MWT was measured at T4, the expression of ERK1/2 and phosphorylated ERK1/2 (p-ERK1/2) in spinal cord dorsal horns was measured by Western blot.Results Compared with group C, the MWT was significantly decreased at T2-4 in RI, E, NE and UE groups, and the expression of p-ERK1/2 was up-regulated in RI, E and NE groups (P＜0.05).Compared with group RI, the MWT was significantly increased at T2-4 , and the expression of p-ERK1/2 was down-regulated in E and UE groups (P＜0.05);and no significant change was found in the parameters mentioned above in group NE (P＞0.05).Compared with group E, the MWT was significantly increased at T2-4, and the expression of p-ERK 1/2 was down-regulated in group UE (P＜0.05).Conclusion The mechaism by which EA at Zusanli reduces hyperalgesia induced by remifentanil in rats with incisional pain is related to inhibited activation of ERK signaling pathway in the spinal cord.

BACKGROUND:There are more ways of internal fixation in treatment of elderly intertrochanteric fracture;however, how to choose a fixed way is the key issue of ensuring the efficacy. OBJECTIVE:To compare the therapeutic effect of proximal femoral anti-rotation intramedul ary nail and proximal femoral locking plate in the treatment of elderly femoral intertrochanteric fractures. METHODS:Total y 100 patients with femoral intertrochanteric fractures who received the treatment at Qionghai City People’s Hospital from December 2009 to December 2013 were randomly divided into locking plate and anti-rotation intramedul ary nail groups. Patients in the anti-rotation intramedul ary nail group underwent internal fixation using proximal femoral anti-rotation intramedul ary nail. Patients in the locking plate group underwent internal fixation using proximal femoral locking plate. RESULTS AND CONCLUSION:Compared with the locking plate group, the amount of bleeding, operation time, postoperative bed activity time and hospital stay in the anti-rotation intramedul ary nail group significantly reduced, the excel ent rate of Harris scores was significantly increased after 1 year of internal fixation and the incidence of complications and adverse reactions was significantly decreased. There was no host response to the material in these two groups.

Objective To diagnose retinal detachment with International Classification of Diseases10 (ICD-10) and to analyze the surgical modalities of vitrectomy for the disease.Methods The clinical data of 1 648 hospitalized patients with retinal detachment undergoing vitrectomy in our hospital in 2013 were retrospectively analyzed.Results The ICD etiological classification showed that primary retinal detachment accounted for 50.18％ (827/1 648),tractional retinal detachment accounted for 32.52％ (536/1 648),exudative retinal detachment accounted for 0.61％ (10/1 648)and other types accounted for 16.69％ (275/ 1 648).The top 5 common etiological diagnoses were simple rhegrnatogenous retinal detachment (25.73％,424/1 648),diabetic tractional retinal detachment (12.62％,208/1 648),traumatic retinal detachment (12.08％,199/1 648),other primary retinal detachment (11.23％,185/1 648) and retinal detachment after intraocular surgery (10.62％,175/1 648).The top 4 modalities of vitrectomy were combined silicone oil implanting surgery (54.73％,902/1 648),basic vitrectomy (21.97％,362/1 648),combined silicone oil and lenticular surgery (14.38％,237/1 648) and combined lenticular surgery (5.58％,92/1 648).Conclusions Modern vitrectomy is used mainly for the treatment of primary retinal detachment and the treatment of retinal detachment related to diabetes,ocular trauma and intraocular surgeries.The complexity of various retinal detachment diseases requires different surgical modalities of vitrectomy for treatment.