OBJECTIVEThis study investigated the serum levels of interleukin-5 (IL-5), leukotriene B4 (LTB4) and C-reactive protein (CRP) in children with Henoch-Schonlein purpura (HSP) at different phases to explore the role of IL-5, LTB4 and CRP in the pathogenesis of HSP.

METHODSSerum levels of IL-5, LTB4 and CRP in 27 normal children and 31 children with HSP at the acute phase and the early recovery phase were detected using ELISA.

RESULTSThe serum levels of IL-5, LTB4 and CRP in children with HSP were 53.8 +/- 4.2 pg/mL, 95.3 +/- 12.0 pg/mL and 36.10 +/- 11.78 mg/L, respectively at the acute phase. The values were significantly decreased at the early recovery phase (37.8 +/- 3.9 pg/mL, 45.7 +/- 10.1 pg/mL, 18.35 +/- 6.43 mg/L; P < 0.01), but remained higher than those in normal controls (12.7 +/- 3.2 pg/mL, 17.6 +/- 5.7 pg/mL, 4.75 +/- 2.85 mg/L; P < 0.01). The serum levels of IL-5 and LTB4 positively correlated to the CRP level.

CONCLUSIONSThe serum levels of IL-5 and LTB4 in children with HSP increased during the acute phase and decreased at the early recovery phase, suggesting that IL-5 and LTB4 may be involved in the pathogenesis of HSP.

Adolescent ; C-Reactive Protein ; analysis ; Child ; Child, Preschool ; Female ; Humans ; Interleukin-5 ; blood ; Leukotriene B4 ; blood ; Male ; Purpura, Schoenlein-Henoch ; blood ; etiology

OBJECTIVETo summarize our experience on the diagnosis and treatment of pancreatic serous cystadenoma.

METHODData from 20 patients with pancreatic serous cystadenoma in Peking Union Medical College Hospital from 1994 to 2004 were analyzed retrospectively.

RESULTSUltrasound test was a good choice for primary diagnosis, while computed tomography scan and endoscopic retrograde cholangiopancreatography (ERCP) were better choice for the suspected cases. Most tumors (60%) were located in the body and tail of pancreas. The distal pancreatectomy was the commonest operation procedure. The main complications were pancreatic leakage (35%). The symptoms were resolved after surgical treatment.

CONCLUSIONSThe treatment of pancreatic serous cystadenoma depends on the accurate diagnosis. Ultrasound and computed tomography are useful diagnostic methods. Surgical operation is the treatment of choice. Long-term follow-up has shown satisfactory outcomes if the tumors are resected completely.

Adult ; Aged ; Aged, 80 and over ; Cystadenoma, Serous ; diagnosis ; diagnostic imaging ; surgery ; Female ; Humans ; Male ; Middle Aged ; Pancreatectomy ; Pancreatic Neoplasms ; diagnosis ; diagnostic imaging ; surgery ; Pancreaticoduodenectomy ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonography

OBJECTIVETo explore the effect of perioperative nutrition support on nutritional condition and complications of the patients with postoperative pancreatic head cancer.

METHODSThirty four patients received perioperative nutrition support, including enteral nutrition and parenteral nutrition (treatment group). Forty eight patients received routine postoperative parenteral nutrition (control group). According to the operative method, these two groups were further divided into two sub-groups: (1) pancreaticoduodenectomy (PD) subgroup, including 13 cases from treatment group, and 24 cases from control group; (2) palliative operation subgroup, including 21 cases from treatment group, and 24 cases from control group. Body weight, total protein (TP), serum albumin (ALB), and the complications after operation were compared.

RESULTSThe concentrations of ALB and TP in the treatment group were significantly higher than those in the control group (P< 0.05). Body weight and TP of the patients received PD in the treatment group were significantly better than those of the control group (P < 0.05).

CONCLUSIONPerioperative nutrition support can improve postoperative nutritional condition and reduce the postoperative complications in patients with pancreatic head cancer.

Adult ; Aged ; Combined Modality Therapy ; Enteral Nutrition ; Female ; Humans ; Male ; Middle Aged ; Nutritional Support ; methods ; Pancreatic Neoplasms ; surgery ; therapy ; Pancreaticoduodenectomy ; Parenteral Nutrition ; Postoperative Complications ; prevention & control

OBJECTIVETo investigate the value of the noninvasive examinations for localization of insulinoma.

METHODSThe clinical materials of 88 cases of insulinoma treated in Peking Union Medical College Hospital between January 2005 and November 2008 were analyzed retrospectively. There were 40 males and 48 females aged from 15 to 74 years old (averaged, 46.5 years old).

RESULTSThe positive rates for localization were 19.3% (17/88), 52.4% (11/21), 95.5% (64/67), 1/6, 30.0% (6/20), 83.9% (26/31), 8/8 and 5/5 respectively in transabdominal ultrasound, enhanced CT, multislice spiral CT pancreatic perfusion, MRI, somatostatin receptor scintigraphy, endoscopic ultrasound, laparoscopic ultrasound and intraoperative ultrasound. Thirty-one multiple tumors in 8 patients were resected. The positive rates of locating the multiple insulinomas of multislice spiral CT pancreatic perfusion and Intraoperative Ultrasound were 48.4% (15/31) and 100% (14/14) respectively.

CONCLUSIONSThe locating diagnosis of insulinoma has came to noninvasive examination era. Multislice spiral CT pancreatic perfusion is the first choice for localization. Intraoperative ultrasound might play an important role in locating tumors for patients with multiple insulinomas.

Adolescent ; Adult ; Aged ; Female ; Humans ; Insulinoma ; diagnosis ; Male ; Middle Aged ; Pancreatic Neoplasms ; diagnosis ; Retrospective Studies ; Young Adult

OBJECTIVETo explore the relationship between methylenetetrahydrofolate reductase (MTHFR) gene polymorphism and microsatellite instability (MSI) in patients with gastric cancer.

METHODSMTHFR gene C677T and A1298C polymorphism were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and MSI was examined with PCR.

RESULTSMTHFR gene C677T and A1298C polymorphisms were analyzed on 122 gastric cancers and 110 normal controls The genotype frequencies of MTHFR 677CC, 677CT and 677TT were 47.5%, 39.3% and 13.1% on patients with gastric cancer, and 48.5%, 42.6%, 8.9% in the controls respectively. There was no significant difference of genotype frequency between the two groups (P > 0.05). The individuals with 677CT genotype, 677TT genotype and 677CT + TT genotype exhibited significantly reduced risk (OR = 0.38,95% CI: 0.15-0.98; OR = 0.26,95% CI: 0.03-2.18 and OR = 0.36,95% CI: 0.07-0.98) of developing gastric cardia cancer compared with those harboring the wild-type(677CC). The individuals with 677TT genotype having a 3.03-fold (95% CI: 1.07-8.65) increased risk of developing gastric corpus cancer. The genotype frequency of MTHFR 1298AA, 1298AC and 1298CC were 59.8%, 36.1% and 4.1% in gastric cancer patients, and 57.4%, 7.6%, 5.0% in the controls, respectively. The distribution of MTHFR A1298C genotype was not significantly different between gastric cancer and controls (P > 0.05). The individuals with 1298CC genotype had a reduced risk of developing gastric antrum cancer (OR = 0.41- fold, 95% CI: 0.03-2.18, 0.05-3.72) when comparing with those having 1298AA genotype. Patients with MSI+ gastric cancer had an increased frequency of the MTHFR 677TT genotype when comparing with those suffering from MSI- gastric cancer (P = 0.009) and with controlled subjects (P = 0.008). There was no significant association found between MTHFR A1298C polymorphism and MSI (P>0.05).

CONCLUSIONPolymorphism of MTHFR C677T was associated with increased risk on gastric corpus cancer and reduced risk on gastric cardia cancer. The polymorphism of MTHFR A1298C was associated with reduced risk for gastric antrum cancer while MSI pathway was possibly involved in the development of gastric cancer with MTHFR 677TT genotype.

Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Methylenetetrahydrofolate Reductase (NADPH2) ; genetics ; Microsatellite Instability ; Middle Aged ; Polymorphism, Genetic ; Stomach Neoplasms ; genetics

OBJECTIVETo investigate the protective effects of 15-methyl-lipoxin A4 (LXA4) on mesangioproliferative nephritis in rats and the possible mechanisms.

METHODSMesangioproliferative nephritis was induced by a single intravenous injection of the mouse monoclonal anti-Thy1.1 antibodies (ER4) in 20 rats. Ten nephritic rats were injected with 15-methyl-LXA4 at 10 minutes before ER4 antibody injection and then 8-hourly until the rats were sacrificed on day 4 after nephritis induction. The nephritis was evidenced by presence of proteinuria, histologic examination with light microscopy, infiltrating leukocyte assessed by immunofluorescence microscopy, and mesangial cell proliferation assessed by proliferation scoring and by immunohistochemical staining of proliferating cell nuclear antigen (PCNA). Expressions of interleukin (IL)-1beta and IL-6 protein or mRNA in glomeruli were determined by radioimmunoassay or RT-PCR, respectively. Phosphorylated phosphoinositide 3-kinase (PI3-K), Akt1 and p27(kip1) in glomeruli were analyzed by Western Blot. Activities of nuclear factor-kappaB (NF-kappaB) and signal transducer and activator of transcription 3 (STAT3) in glomeruli were assessed by electrophoretic mobility shift assay (EMSA).

RESULTSThere were increases in glomerular infiltration of leukocyte, expressions of IL-1beta and IL-6 protein and mRNA, and activities of NF-kappaB in nephritic rats between days 1 and 4 after nephritis induction. The enhanced proteinuria, score of mesangial proliferation, glomerular PCNA positive cells, activities of phosphorylated PI3-K, Akt1 and STAT3, and reduced p27(kip1) expression were found on day 4 after nephritis induction. 15-Methyl-LXA4 treatment significantly reduced the proteinuria, glomerular infiltration of leukocyte, expressions of IL-1beta and IL-6 protein and mRNA, score of mesangial proliferation, glomerular PCNA positive cells, activities of phosphorylated PI3-K, Akt1, NF-kappaB and STAT3, and increased the p27(kip1) expression.

CONCLUSIONS15-Methyl-LXA4 can markedly inhibit the proteinuria, glomerular inflammation, and mesangial cell proliferation induced by anti-Thy1.1 antibodies. The inhibition effects are related to PI3-K/Akt1/p27(kip1)/cyclin pathway, STAT3 and NF-kappaB pathway-dependent signal transduction.

Animals ; DNA ; metabolism ; Female ; Glomerulonephritis, Membranoproliferative ; drug therapy ; Interleukin-1 ; genetics ; Interleukin-6 ; genetics ; Lipoxins ; therapeutic use ; NF-kappa B ; metabolism ; Phosphatidylinositol 3-Kinases ; physiology ; RNA, Messenger ; analysis ; Rats ; Rats, Inbred Lew ; STAT3 Transcription Factor ; metabolism ; Signal Transduction ; drug effects

the process of malignant transformation of esophageal epithelial cells, and jointly promoting the occurrence and development of EC.

Objective To investigate the feasibility of constructing an animal model for training of otoscopic anatomy and surgical operation using living guinea pigs.Methods Eight healthy adult guinea pigs were used as ex-perimental animals to construct a model of endoscopic operation by opening the upper tympanic cavity and abrading the upper wall of the external acoustic meatus to establish a space for endoscopic observation and operation.The an-atomical opening of the temporal bone and basic surgical steps were performed by the same resident on eight guinea pigs.The resident assessed the difficulty and completion of the endoscopic operation and measured various dimen-sions,including the anteroposterior and superior/inferior diameters of the mastoid process,the posterolateral wall of the upper tympanic cavity,and the upper wall of the external acoustic meatus,as well as the maximal depth of entry of the endoscope.Results The fine structures of guinea pig tympanic chamber were clearly displayed under otoen-doscopy.Except for the two steps of free preservation of the chorda tympani nerve and exposure of the stapes after removal of the ossicles,the other steps,such as separation of the tympanic membrane from the malleus,exposure of the malleus-anvil complex,removal of the cochlea shell to observe the cochlea axis,and exposure of the tympanic segment of the facial nerve under the endoscope,were all easily accomplished.The anterior and posterior diameters of the mastoid after opening were 3.56±0.21 and 3.89±0.16 mm,respectively,and the anterior and posterior di-ameters of the upper tympanic cavity and the upper wall of the external acoustic meatus after opening were 5.60±0.09 and 6.02±0.10 mm,respectively.The maximum depth of entry of the otoscopic endoscope was 15.14±0.24 mm.Conclusion Using guinea pig as an animal model for otoscopic surgery training can provide a more realis-tic surgical experience,which is helpful for beginners to be trained in the basic surgical skills of otoscopic surgery and otoscopic anatomy.

OBJECTIVETo summarize the experience of diagnosis and treatment in solid-pseudopapillary tumor of pancreas (SPT).

METHODRetrospectively analyzed 12 cases of SPT diagnosed between 2000 August and 2004 February in Peking Union Medical College Hospital.

RESULTSThe average age of these 12 cases was 29.1, including 11 women and 1 men. The tumors of 6 cases were located in the pancreatic head, one tumor was in the neck of pancreas and 5 tumors were in the body and tail of pancreas. There were no characteristic clinical manifestations. Solid and solid-cystic masses of low echo were found in pancreas in ultrasonic examinations. CT scan found masses of low density in pancreas, while irregular enhancement appeared in the circumference of all tumors in enhanced CT scan sequences. Tumor markers in patients' serum were all negative. Pancreaticoduodenectomy were performed in 2 cases. Resection of tumors and pancreaticojejunostomy were performed in 3 cases. Simple resection of tumor was performed in 1 case. Segmental pancreatectomy and pancreaticojejunostomy was performed in one patient. Five patients underwent distal pancreatectomy and spleen resection. Ten patients were followed up with the average time of 14.3 months. No evidence of relapses and metastasis in these cases was found.

CONCLUSIONSolid-pseudopapillary tumor of pancreas was one of rare pancreatic neoplasm with low malignant potential, affecting primarily young women. Complete resection resulted in long-term survival.

Adolescent ; Adult ; Carcinoma, Papillary ; diagnosis ; therapy ; Female ; Humans ; Male ; Middle Aged ; Pancreatectomy ; Pancreatic Neoplasms ; diagnosis ; therapy ; Pancreaticoduodenectomy ; Retrospective Studies ; Splenectomy ; Tomography, X-Ray Computed

OBJECTIVETo explore the clinical significance of improvement gastrostomy in pancreaticoduodenectomy.

METHODSClinical data of 82 patients who underwent pancreaticoduodenectomy and jejunostomy from November 2004 to December 2006 were collected, among which 36 patients received improvement gastrostomy (treatment group), 24 patients accepted traditionary gastrostomy (control group 1) and 22 patients without any gastrostomy (control group 2). Operative time, postoperative duration of gastrointestinal decompression tube, postoperative gastroparesis, pancreatic fistula, biliary fistula, and abdominal cavity infection were compared.

RESULTSThe incidence of postoperative gastroparesis in the treatment group and control group 2 were can significantly lower than that in the control group 1 (P < 0.05). The postoperative duration of gastrointestinal decompression tube of the treatment group was significant shorter than that of control group 2 (P < 0.01). There were no significant difference in other items.

CONCLUSIONSThe improvement gastrostomy in pancreaticoduodenectomy is simple and secure. It can significantly shorten the postoperative duration of gastrointestinal decompression tube and also obviously reduce the incidence of postoperative gastroparesis compared with traditionary gastrostomy.

Adult ; Aged ; Female ; Gastroparesis ; etiology ; prevention & control ; Gastrostomy ; methods ; Humans ; Male ; Middle Aged ; Pancreaticoduodenectomy ; adverse effects ; methods ; Postoperative Complications ; etiology ; prevention & control ; Treatment Outcome