Objective To study the clinical characteristics and imaging features of alien hand syndrome (AHS). Methods We retrospectively analyzed the clinical data of 3 typical cases in our hospital,in comparison with case reports and reviews of domestic and foreign during the past decade. Result All 3 patients showed corpus callosum lesions from CT or MRI detections. The symptoms of the patients included alien hand sign , abnormal involuntary movements, intermanual conflict of upper limbs, and so on. And the patients accompanied with emotional and cognitive changes. Two of them were improved in different degrees after treatment. Conclusion AHS was a complex disease. The diagnosis of this syndrome was based on the advanced neuroimaging. There was still no well established treatment for AHS.

AIM: To establish the quality standard for Compound Songluo Granule (Rhizoma Corydalis, Radix Angelicae Sinensis, Lichen Usneae). METHODS:Rhizoma Corydalis, Radix Angelicae Sinensis were identified by TLC. Usnic acid in Lichen Usneae was determined by TLCS. RESULTS: Rhizoma Corydalis, Radix Angelicae Sinensis could be detected by TLC. Usnic acid showed a good linear relationship at the range of 0. 50～2.50 ?g, r=~0.999 9. The average recovery was 97.5% and RSD was 2.61%, respectively. CONCLUSION:The method is available with a good reproducibility and can be used for the quality control of Compound Songluo Granule.

Thyroid-stimulating hormone receptor(TSHR)is an important autoantigen whose cleavage and shedding can induce autoimmunity.The TSHR is the main functional receptor of the thyroid.The shedding of the ? subunit plays an important role in the forming of TSAb and balancing between TSAb and TBAb.Research on the cleavage and shedding of the TSHR extracellualar domain helps to gain a deep insight into the structure and function of TSHR,illuminate the pathogenesis of autoimmune thyroid disease and find out a new therapy.The structure of TSHR,the mechanism and the significance of its cleavage and shedding are reviewed in this article.

Angioplasty, Balloon, Coronary ; Coronary Restenosis ; prevention & control ; Endothelial Cells ; cytology ; Endothelium ; cytology ; Humans ; Stem Cells ; cytology ; Stents

BACKGROUND:Ankylosing spondylitis is an autoimmune disease involved in chronic systemic inflammation. Tumor necrosis factor and interleukin-6 levels increased in patients with ankylosing spondylitis. Inflammatory factors such as tumor necrosis factor and interleukin-6 can suppress CD36 expression in monocytes. OBJECTIVE: To analyze the correlation between CD36 expression in monocytes and ankylosing spondylitis. METHODS:A total of 84 newly diagnosed ankylosing spondylitis patients and 111 healthy individuals were included in this study. CD36 expressions in monocytes in ankylosing spondylitis patients and healthy individuals were tested using flow cytometer; meanwhile, biochemistry, immunology, routine blood examination and related inflammatory markers were determined between the two groups. RESULTS AND CONCLUSION:Results of baseline data in both groups demonstrated that CD36 fluorescence intensity in monocytes was significantly lower in patients with ankylosing spondylitis compared with healthy controls (P < 0.01). CD36 fluorescence intensity in monocytes was negatively correlated with C-reactive protein, erythrocyte sedimentation, interleukin-6 and tumor necrosis factor. In addition, CD36 fluorescence intensity in monocytes was negatively correlated with BASDAI score. Logistic regression analysis showed that erythrocyte sedimentation, interleukin-6, tumor necrosis factor and CD36 fluorescence intensity in monocytes were associated with ankylosing spondylitis, and risk factors for ankylosing spondylitis (P < 0.05). These findings confirm that inflammatory cytokine in patients with ankylosing spondylitis weakened the expression of CD36 in monocytes. There was a remarkable association between low expression of CD36 expression in monocytes and ankylosing spondylitis. CD36 expression of monocytes clinicaly may be considered to be an effective indicator to evaluate inflammation and disease activity in patients with ankylosing spondylitis.

Objective To evaluate the long-term clinical outcome of percutaneous coronary intervention ( PCI) with drug-eluting stents ( DES) for distal unprotected left main coronary artery (ULMCA) lesions. Methods Between Jan 2005 and Dec 2009, 111 patients with distal ULMCA disease who underwent drug-eluting stents implantation were enrolled in this retrospective study. The primary end points were major adverse cardiac and cerebrovascular event (MACCE) at follow-up, including death, non-fatal myocardial infarction, cerebrovascular event and target lesion revascularization ( TLR) . Results Patients were 65. 6 ± 10 years old. 21. 6% were diabetic. 31. 5% of the left main bifurcations were classed as Medina 1, 1, 1. Provisional T stent technique was performed for 79. 3% of the population. 30. 6% of cases underwent angiography follow-up. The median follow-up time was 2. 3 years, the MACCE-free survival was 87. 4% and the estimated freedom from TLR was 94. 6% . Diabetes mellitus was identified as the predictor of TLR. Conclusions PCI with DES for distal ULMCA disease was safe and effective when the strategy was made based on the case-by-case assessment.

Objective To explore the feasibility and reliability of laparoscopic fundoplication in the treatment of severe gastro-esophageal refulx disease. Methods Five cases of laparoscopic fundoplication were reviewed retrospectively from June 2001 to October 2001. Results Laparoscopic Nissen Fundoplication was performed in 3 cases, Laparoscopic Toupet Fundoplication in 2 cases. Preoperative symptoms were completely relieved. The postoperative esophageal manometry increased from (7 32?1 34)mmHg to (18 20?3 43)mmHg( t =12 23, P

Objective To evaluate the efficacy of laparoscopic and open operation combined with endoscopic nasobiliary drainage(ENBD) in the management of choledocholith. Methods 44 cases treated by laparoscopic common bile duct exploration (LCBDE) and 34 ones by open common bile duct exploration(OCBDE) combined with ENBD and primary suture of common bile duct were retrospectively analyzed from January 1997 to July 2001. Results All cases were operated on successfully. The clearance rate of stones was 100%(78/78). No postoperative complications such as bile leakage, hemobilia, cholangitis, etc occurred. Postoperative hospital stay was (6 2?1 3)days in group LCBDE and (7 4?2 1)days in group OCBDE. 57 cases had been followed up for (1～4 5)years with an average of 2 6 years, and ultrasoundgraphy showed no bile duct stricture and recurrent stones. Conclusions LCBDE or OCBDE combined with ENBD and primary suture of common bile duct is safe and reliable.

Objective To study the causes of conversions to open surgery during laparoscopic cholecystectomy (LC). Methods The study was based on a retrospective review of 156 cases of conversions to laparotomy out of 12672 cases of LC from December 1991 to October 2001 in this hospital. Results Ninety-two (58.97%) cases of conversions were due to complicated clinical condition and preoperative misdiagnosis, 47 (30.13%) cases of conversions due to technological complications, and 17 (10 90%) cases underwent delayed laparotomy. The total conversion rate was 1.23% and the rate of bile duct injuries was 0.2% (26/12672). Conclusions Inadequate preparation, deficiency of experience, complicated clinical situation, and anatomical variation of bile ducts are the leading causes to conversions.

Objective To discuss clinical effects of combined use of duodenoscopy and laparoscopy in the treatment of acute billiary pancreatitis (ABP), and to establish a systematic protocol of minimally invasive treatment for ABP. Methods According to the patients’ biliary tract conditions, severity of disease and treatment methods, a total of 696 patients with ABP were given laparoscopic cholecystectomy (LC) alone, or endoscopic retrograde cholangiopancreatography (ERCP) and LC, or ERCP and laparoscopic common bile duct exploration (LCBDE), or ERCP and endoscopic sphincterotomy (EST), or individualized treatment for severe acute pancreatitis (SAP). Clinical effects were observed. Results Among the 696 patients, 330 patients (47.4%) received EST and biliary stones were successfully removed under endoscope in 267 patients (38.4%). ERCP, LC and LCBDE were conducted in 411 (59.1%), 513 (73.7%) and 85 (12.2%) patients, respectively, and successfully accomplished in 409 (99.5%), 511 (99.6%) and 82 (96.5%) patients, respectively. Out of 36 patients with SAP, 34 patients survived (94.4%). The total cure rate was 99.7% (694/696). Conclusions Combined use of duodenoscopy and laparoscopy is significantly effective for acute billiary pancreatitis and benefits the improvement and standardization of the protocol of minimally invasive treatment for acute billiary pancreatitis.