Forty-eight patients with subclinical Cushing's syndrome(SCS)were evaluated.Eleven of them underwent adrenalectomy(Group 1)and the other 37 cases did not(Group 2).Serum and urine corticosol, plasma ACTH and parameters related to metabolic syndrome(such as waist circumference,blood pressure,blood lipids and fasting plasma glucose)were measured.The data at diagnosis were compared with those during the survey.The results indicated that patients with SCS had a significantly high prevalence of metabolic syndrome.The symptoms and signs of metabolic syndrome could be improved after removing the tumor.Otherwise there is no improvement,some patients will even develop into overt Cushing's syndrome.

The present of atlanto-axial pedicle screw fixation through posterior approach provide a new remedy for treating instability of pillow and cervical. A lot of researches have reported feasibility of atlanto-axial pedicle screw fixation, the results showed that it had advantages of easily exposure, less blood loss, shorter operative time, especially in treating as remedy fixation for atlanto-axial joint screw, atlas lateral mass screws and pedicle screw caused by injuries of tumor,inflammation and trauma. If not done properly, it can cause serious complications, such as iatrogenic fracture,injuries of vertebral artery and cervical spinal cord. Therefore,the safty and effectiveness of atlanto-axial pedicle screw fixation may be focus of research.
Atlanto-Axial Joint ; surgery ; Bone Screws ; utilization ; Cervical Atlas ; surgery ; Fracture Fixation, Internal ; instrumentation ; methods ; trends ; Humans ; Spinal Fractures ; surgery

The diagnosis and treatment of prostate cancer are being improved due to the popularized screening of prostate specific antigen. Advanced prostate cancer, in spite of its response to androgen deprivation therapy, may finally develop into castration-resistant prostate cancer (CRPC) and shorten the overall survival of the patients. Many efforts have been made by worldwide researchers for new approaches to the management of CRPC, including new hormonal therapy, cytotoxic chemotherapy, immunotherapy, and bone metastasis-targeted therapy. This paper reviews the emerging agents undergoing clinical evaluation and drugs that have received approval for the treatment of CRPC in order to provide doctors and patients with more treatment options for CRPC and improve the overall survival rate and quality of life of the patients.
Androgen Antagonists ; Bone Neoplasms ; prevention & control ; Humans ; Immunotherapy ; Male ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms, Castration-Resistant ; therapy ; Quality of Life

Objective To learn the change trend of live newborn birth condition from 1987 to 2011 in Hongjiang people′s hospi-tal .Methods Cluster sampling was adopted and altogether 2 711 singleton live newborns in 1987 ,1995 ,2005 ,2011 year were retro-spectively analyzed .Results From 1987 to 2011 ,the birth weight changes of live newborn overall showed an increasing trend .The sex ratio of birth appeared rising after 1995 ,especially apparent in parous wowen and rural areas .Incidence of macrosomia showed an increasing trend ,the post-term infant delivery rate decreased after 1995 .Low birth weight infant and premature infant birth rate trend was not obvious .Conclusion 25 years in Hongjiang people`s hospital ,the overall trend of live newborn birth outcomes is good which prompts that the quality of perinatal care in the hospital is improved .In the future ,the perinatal health care should focuse on taking effective comprehensive measures to control the growth of the birth sex ratio and the incidence of macrosomia .

Objective To investigate the efficacies of laparoscopic sleeve gastrectomy + duodenojejunal bypass (DJB) and laparoscopic gastric bypass in the treatment of patients with non-obese type 2 diabetes mellitus (T2DM).Methods The clinical data of 42 patients with type 2 diabetes mellitus and body mass index (BMI) ＜ 30 kg/m2 received surgical treatment at the First Affiliated Hospital of Nanjing Medical University from January 2012 to June 2013 were retrospectively analyzed.Fifteen patients received laparoscopic sleeve gastrectomy + DJB (Sleeve + DJB group),and 27 received Roux-en-Y gastric bypass (RYGB group).The follow-up time for all the patients was more than 6 months.The decrease of BMI,complete remission of T2DM,decrease of fasting glycemia and glycosylated hemoglobin (HbAlc),postoperative nutritional condition and the incidence of complications of the 2 groups were compared.The measurement data were analyzed using the t test and the repeated measurement chi-square test.Results The operation time of the Sleeve + DJB group and the RYGB group were (137 ± 61)minutes and (89 ± 43) minutes,with significant difference between the 2 groups (t =6.158,P ＜ 0.05).No mortality and hemorrhage,bowel obstruction and anastomotic stenosis were detected.One patient was complicated with bile leakage in the Sleeve + DJB group,and was cured by conservative treatment 5 days later.The levels of fasting glucose before operation and at postoperative month 1,3,6 were (8.9 ± 0.7) mmol/L,(5.8 ± 1.3) mmoL/L,(5.6 ±1.8) mmol/L and (5.7 ± 0.3) mmol/L in the Sleeve + DJB group,and (9.9 ± 1.2) mmol/L,(6.9 ± 0.8) mmol/L,(6.6 ± 2.2) mmol/L and (5.6 ± 0.8) mmol/L,with no significant difference between the 2 groups (F =1.670,2.932,0.444,0.158,P ＞ 0.05).The levels of HbAle before operation and at postoperative months 1,3,6 were 7.4％± 1.4％,6.5％ ±0.6％,5.7％±0.5％,5.9％ ±0.6％ in the Sleeve + DJB group,and 7.7％± 2.0％,6.8％ ± 1.3％,5.7％±0.8％,5.6％ ± 1.1％ in the RYGB group,with no significant difference between the 2 groups (F =0.055,0.125,0.005,0.286,P ＞ 0.05).The remission rates of T2DM of the Sleeve + DJB group and the RYGB group were 14/15 and 74.1％ (20/27) at postoperative month 6,with no significant difference between the 2 groups (x2 =2.320,P ＞ 0.05).The decrease rate of BMI of the Sleeve + DJB group and the RYGB group were 18.2％±9.5％ and 21.2％ ± 4.9％,with no significant difference between the 2 groups (t =0.982,P ＞0.05).The numbers of patients with postoperative anaemia,avitaminosis and diarrhea were 0,0,2 in the Sleeve + DJB group and 3,2,6 in the RYGB group,with no significant difference between the 2 groups (x2=1.795,1.167,0.908,P ＞0.05).The BMIs of all the patients were above 19 kg/m2.Conclusion The effects and incidence of postoperative complications of Sleeve + DJB for the treatment of T2DM are comparable to those of RYGB.Sleeve + DJB has less interference on the nutritional condition of patients compared with RYGB.

Objective To clone human asparagine synthetase(ASNS)gene,express the MS2- ASNS fusion protein through gene engineering and use the purified target protein to immune BALB/C mice, prepare and identify the monoclonal antibody(McAb),which forms the base for studying mechanism of L- asparaginase used as salvage regimen in midline NK/T cell lymphoma nasal type.Methods ASNS gene fragment was amplified by RT-PCR from HepG2 cell line and constructed into prokaryocytic expression vector.Fusion-protein of MS2-ASNS was expressed and used for immunizing BALB/C mice to prepare McAbs against ASNS.Identified the McAb and detected the expression of ASNS in tumor.Results Part of the ASNS reading frame(NCBI,M27396:179-1 420 bp)was cloned and product length of RT-PCR was 1 263 bp.Molecular weight of MS2-ASNS was about 54 700 Da.Two strains of hybridoma secreting ASNS McAbs were obtained.The subtype of the ASNS McAb was IgG2a.Western-blot showed that the McAbs could specifically react with MS2-ASNS fusion protein and ASNS protein in tumor cell lines.ASNS expression was detected by immunocytochemistry and Immunohistochemisrry.Conclusion We have cloned human ASNS gene,obtained the anti-ASNS McAb and examined the expression of ASNS in tumor.

OBJECTIVE: To investigate the clinical features of chronic tracheoesophageal fistula (TEF), provided disease-related treatment experience and lessons for clinicians. METHOD: To successfully repair one case of chronic tracheoesophageal fistula with surgery, and to analyze the clinical treatment process, combined with relevant literature, the author reported the experiene of diagnosis and treatment in TEF. RESULT: After the gastrointestinal ostomy and Stent implantation, the fistula persisted, nine months later ,we took the surgery to repair the fistule, ten days postoperation, the fistule healed and esophageal iodine water examination didn't prompt obvious abnormalities, the patient was discharged without any postoperative complications 12 days postoperation. CONCLUSION If conservative treatment failed with TEF, the surgical repair should be carried timely, By double sutured with fistula in surgery, and reinforced with the approaching muscle tissue, It can achieve good results.
Humans ; Postoperative Complications ; Postoperative Period ; Tracheoesophageal Fistula ; pathology ; surgery ; Wound Healing

Adolescent ; Adult ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Parotid Neoplasms ; surgery ; Salivary Glands ; surgery ; Young Adult

OBJECTIVETo observe the effect of Fructus Aurantii Immaturus (FAI) on the electro-activity of small intestines in rats, and evaluate the interrelations between the FAI regulating effect and choecystokinin (CCK) and somatostatin (SS).

METHODSMigrating myoelectric complex (MMC) cyclic period, the ratio of the active time to the cyclic period, and the number of the fast wave within the active time per minute were observed between FAI and the normal saline group by external alimentary canal electrodes; the CCK contents in dorsomedial hypothalamic nucleus (DMH), ventromedia hypothalamic nucleus (VMH), lateral hypothalamus area (LHA) and SS in VMH, LHA, paraventricular nucleus (PVN) by using immuno-chemistry technique and micro-image pattern quantitative analysis and scanning system.

RESULTSThe MMC cyclic period shortened, the ratio of the active time to the cyclic period increased and the number of the fast wave within the active time per minute increased in the FAI group, which showed significant difference from the normal saline group; CCK positive neurons were reduced in the areas of DMH, VMH and LHA, SS positive neurons were increased in the areas of VMH, LHA and PVN in the FAI gioup,which showed significant difference compared with the normal saline and the blank control group.

CONCLUSIONFAI can stimulate the electro-reactivity of small intestines. The stimulative effect of FAI might be related to CCK and SS in hypothamus.

Animals ; Central Nervous System Stimulants ; pharmacology ; Cholecystokinin ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Hypothalamus ; drug effects ; metabolism ; Intestine, Small ; drug effects ; physiology ; Myoelectric Complex, Migrating ; drug effects ; Rats ; Somatostatin ; metabolism

Objective To discuss the surgical outcome and operative technique of the modified trans-petrosal presigmoid approach in treating cases with facial nerve palsy after petral bone fracture trea- ted with facial nerve canal decompression method.Methods A total of 15 cases with facial nerve pal- sy were treated with traumatic facial nerve canal decompression technique with the trans-petrosal presig- mold approach combined with high-dose hormone therapy,whereas 12 cases were treated with traditional Chinese medicine.The clinical data were analysed and compared retrospectively according to House- Brackmann facial nerve grading scale.Results At acute stage,eight(53.3%)out of 15 cases recov- ered to levelⅠ(P＜0.05),with no significant postoperative complications such as CSF leakage. Conclusions This approach is simple and safe and can expose extensively the facial nerve bone canal and effectively alleviate the edemous facial nerve aided by high-dose hormone therapy.Therefore,it is suitable for surgical treatment of acute facial nerve palsy after petral bone fractures.