Objective To explore whether the presence of juxtapapillary duodenal diverticula (JPDD) risks biliary stone disease and recurrence.Methods 829 patients undergoing ERCP in our hospital from Aug 2008 to Dec 2012 were divided into four groups:biliary stone disease (n =609) non-stone biliary abnormality (n =124) common bile duct malformation with cholelithiasis (n =38) and normal control group (n =58).There were 206 patients with JPDD and 623 patients without JPDD.Biliary stoneformation,post-ERCP pancreatitis,cannulation failure,and stone recurrence were compared between those with JPDD and those without.Results The incidence of JPDD in biliary stone disease group (27.8％) was significantly higher than in non-stone biliary anatomical abnormality group (18.5 ％) (x2 =4.512,P ＜ 0.05).In biliary stone disease group,rates of post-ERCP pancreatitis were significantly higher in JPDD cases (33.7％) compared to those without JPDD (13.8％) (x2 =30.841,P ＜ 0.05).The cannulation failure rate was also higher in patients with JPDD (15.4％) compared to JPDD negative (6.8％) (x2 =0.731,P ＜0.05).Recurrence rates in biliary stone disease were significantly higher in patients with JPDD (19.5％) when compared to JPDD-lacking individuals (9.3％) (x2 =14.51,P ＜ 0.05).Conclusions JPDD is a risk factor for biliary stone formation.JPDD also is associated with post-ERCP pancreatitis,cannulation failure and biliary stone recurrence.

Adrenergic receptors are members of the G-protein coupled receptor superfamily. Recent studies revealed that these adrenergic receptors are playing an important role in the growth and metastasis of prostate cancer cells. The expression of adrenergic receptors rises significantly in prostate cancer cells and tissues. Agonists of these receptors promote the growth and mobility of prostate cancer cells, while antagonists may suppress their proliferation, trigger their apoptosis, and inhibit their metastasis. Clinically, receptor antagonists can significantly reduce the risk of prostate cancer and improve its prognosis after androgen depravation therapy. This article presents an overview on the roles of adrenergic receptors in prostate cancer.
Adrenergic Agonists ; pharmacology ; Adrenergic Antagonists ; pharmacology ; Apoptosis ; Humans ; Male ; Prostatic Neoplasms ; metabolism ; pathology ; Receptors, Adrenergic ; drug effects ; physiology

Objective To analyze the characteristics of bone scintigraphy in 117 cases with primary hyperparathyroidism (PHPT).Methods Of these 117 cases (50 males and 67 females),there were 116 parathyroid adenomas and 1 parathyroid cancer.Mean age was 61.1(12-86) years old.All had ~(99)Tc~m-methylene diphosphonate (MDP) bone scintigraphy.The bone images could be classified into 4 categories.Category Ⅰ:normal;category Ⅱ:localized abnormal,which could be subcategorized as Ⅱ A with skull and mandible involvement,and Ⅱ B with Ⅱ A characteristics plus metabolic derangement;category Ⅲ:systemic,whole-body incmased tracer uptake;category Ⅳ:systemic plus localized metabolic derangement.Data were analyzed statistically with X~2 and t-test (isolated samples).Results According to the scintigraphic findings,there were 47 cases(40.17%)of category Ⅰ,35 cases(29.91%) category Ⅱ (21/35cases Ⅱ A and 14/35 cases Ⅱ B),30 cases (25.64%) category Ⅲ,and 5 cases (4.27%) category Ⅳ.Combining categories Ⅱ、Ⅲ and Ⅳ together,there were 70 abnormal cases.These patients had history of abnormal bone images such as bone fracture (39 cases,55.71%),calculus (8 cases,11.43%),bone fracture plus calculus(7 cases,10.00%),osteoporosis (51 cases,72.86%) or ostalgia(26 cases,37.14%);however,in the 47 cases of category Ⅰ,only 1 (2.13%),0,0,10(21.28%)and 10 cases (21.28%),respectively,were found.Therefore.these case history characteristics were statistically significant (X~2=11.152,P=0.01).The tumor size,parathyroid hormone (PTH),blood calcium,blood phosphorus in the patients of abnormal PHPT categories Ⅱ to Ⅲ were(14.52±13.72)cm~3,(731.67±618.40)ng/L,(3.05±0.29) mmol/L and (0.71±0.14) mmol/L,respectively.with statistically significant difference compared to category Ⅰ:(0.78±1.33) cm~3,(112.04±62.98)ng/L,(2.56±0.42) mmol/L and (1.03±0.36)mmol/L(t=-5.724,-5.741,-7.274 and -6.451;all P＜0.01).Conclusions (1)Bone scintigraphy was normal in 40% of PHPT patients.(2)The bone images of PHPT could be classified into 4 categories and each could reflect the duration and severity of the disease status on bone.(3)The bone imaging characteristic could be useful for differential diagnostic purposes.

Objective To investigate the correlation between serum interleukin-8 (IL-8 )and immunoglobulin/complement 3A (IgA/C3)and immune imbalance in Henoch-Schonlein Purpura(HSP)in children,and provide evidence and guidance for clinical therapy of HSP.Methods Serum IL-8 was measured by Enzyme-linked immunosorbent assay(ELISA),and IgA and C3 were de-tected by automatic biochemistry analyzer,and calculate the ratio of IgA/C3.Results Serum IL-8 levels were (389±5 1.68)ng/L, significantly higher than that in healthy children (P < 0.05 ).Serum IgA levels were(306.2 ± 32.21 )mg/L,significantly higher (P <0.05).Serum C3 levels were (1 14.5 ±20.7)mg/L,of no statistical difference.IgA/C3 were (3.041 ±0.508 5),significantly higher(P <0.05).There was a positive correlation between IL-8 and IgA/C3 (r =0.534,P <0.05 ).Conclusion The children of HSP has cytokine and immunoglobulin disturbance,and presents a hyperreactivity in both humoral immunity and cellular immunity. Positive correlation between IL-8 and IgA/C3 was observed.

Objective To detect the mutations of GJB2 and GJB6 genes in the first Chinese case of keratitis, ichthyosis and deafness (KID) syndrome. Methods Genomic DNA was extracted from the patient with KID syndrome and his family members. All encoding exons and adjacent splice sites of the GJB2 and GJB6 genes were amplified by PCR. Mutation scanning was carried out by direct bidirectional DNA sequencing. Results No mutation was found in GJB6. A G148A mutation was found at exon2 of GJB2 in the patient, which caused a change from aspartic acid to asparagine at codon 50(D50N). Conclusion This case of KID syndrome may be caused by the mutation in GJB2.

Objective To investigate the effect of acitretin on the histopathology and ultrastructure of lesions from patients with bullous ichthyosiform erythrodermia (BIE), and to explore mechanisms underlying the modulation of keratinization process by acitretin. Methods Lesional tissue was obtained from the back of 4 patients with BIE before and after the treatment with acitretin. Light microscopy and transmission electron microscopy were performed to observe histopathological and ultrastructural changes in these lesions. Results After treatment, the improvement in clinical manifestations was more than 75% in all the 4 patients, and reached 90% in 1 of the 4 patients. As histopathology and ultrastructural study showed, there was an obvious improvement in hyperkeratosis and continuity of extra cellular lamellar membrane, and a decrease in keratin deposition in prickle and granular layer, but no remarkable changes were observed for the proliferation of prickle cells or acantholysis. Conclusions Acitretin shows a favorable efficacy in clinical treatment of BIE,with histopathological and ultrastructural improvement mainly located in the stratum corneum. The modulation of keratinization process in keratinocytes by acitretin appears more apparent in granular and corneum layers.

ObjectiveTo study the value of strain ratio from longitudinal section and cross section in differential diagnosis of benign and malignant thyroid nodules using ultrasonic elastography.MethodsA total of 118 patients with 153 thyroid nodules underwent examinations with real-time ultrasonic elastography to obtain the strain ratio from longitudinal section and cross section. Receiver operating characteristic (ROC) curves were used to evaluate the value of elastography. The nodules are divided into two groups, group one included nodules which were near the isthmus and group two included other nodules. Diagnostic results were compared with pathological results.ResultsThe area under the ROC curve (AUC) of the strain ratios for differentiating benign and malignant thyroid nodules were 0.906 and 0.844. There was no statistical difference (Z=1.542,P>0.05). The best diagnostic cut-off points of the strain ratios were 3.65 and 3.58. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of the strain ratio from longitudinal section for differentiating benign and malignant thyroid nodules were 81.2%, 80.8%, 81.0%, 87.2% and 71.2% and those of strain ratio from cross section were 77.2%, 76.9%, 77.1%, 84.4% and 63.4%. In group one, the AUC were 0.903 and 0.830. There was no statistical difference (Z=1.125,P>0.05). The best diagnostic cut-off points were 3.30 and 3.28. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of the strain ratio from longitudinal section for differentiating benign and malignant thyroid nodules were 86.2%, 68.8%, 80.0%, 83.3% and 73.3% and those of strain ratio from cross section were 78.6%, 58.8%, 71.1%, 75.9% and 62.5%. In group two, the AUC were 0.906 and 0.852. There was no statistical difference (Z=0.936,P>0.05). The best diagnostic cut-off points were 3.33 and 3.71. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of the strain ratio from longitudinal section for differentiating benign and malignant thyroid nodules were 90.1%, 75.7%, 85.2%, 87.7% and 80.0% and those of strain ratio from cross section were 84.7%, 70.3%, 80.6%, 83.6% and 72.2%. ConclusionReal-time ultrasonic elastography is helpful to the differential diagnosis of thyroid nodules, but there is no statistical difference between the strain ratio from longitudinal section and cross section.

Objective To evaluate the correlation between impaired fasting glucose and the extent and severity of angiographic coronary artery disease( CAD ) in patients who underwent coronary angiography.Methods A total of 630 consecutivc patients who underwent coronary angiography were selected in the stndy.The extent and severity of angiographic CAD were diagnosed based on the followings:whether or not with CAD diagnosis by angiography,the number of diseased vessels,the CAD Gensini cumulative index.According to fasting plasma glucose ( FPG),all patients were divided into three group,group 1 ( FPG ＜5.6 mmol/L),group 2 ( 5.6 mmol/L ≤ FPC ＜ 6.1 mmol/L) and group 3 ( 6.1 mmol/L ≤ FPG ＜ 7.0mmol/L).The CHD risk factors and the lesion degree of coronary arteries were compared among three groups.The relation of FPG and CAD were analyzed by univariate and multivariate analyses.Results The incidence of CH and,the CAD Gensini cumulative index and the incidence of mult-vessel lesions were significantly different among the three subgroups ( all P ＜ 0.05 ).After adjusting other inffluencing factors,there were significantly positive correlation between the number of diseased vessels and the CAD Gensini cumulative index and FPG( P ＜0.05).The FPG had significant correlation with the diagnosis or not of CAD by angiography( OR =3.042,95％ CI:2.589 -6.275,P ＜0.01).Conclusions In prediabetic period,the extent and severity of angiographic coronary artery disease have significant correlations with the impaired fasting glucose,and the extent and severity can increase along with the increasing FPG.

ObjectiveTo evaluate the value of microsurgery for acoustic neuromas.MethodsThe author performed a retrospective study of 63 consecutive patients after vestibular schwannomas (VSs) microsurgery with the retrosigoid approaches. The tumor was debulked firstly and dissected from surrounding neural and vascular structures by gripping the tumor capsule,and then drilled of the IAC.Intraoperative electrophysiological monitoring of facial nerve function during operation.Results Total tumor resection was achieved in 52 cases, subtotal resection was achieved in 11 cases. The anatomic preservation of facial nerve was achieved in 58 cases,the acoustic nerve was preserved anatomically in 29 cases.Fifty-eight cases received a follow-up, the mean follow-up time was 7.2 years. Two recurrent patients were found and there were no operative deaths. A long term facial nerve status:twenty-three cases were in grade Ⅰ, twenty-nine cases in grade Ⅱ ,five cases in grade Ⅲ , one cases in grade Ⅳ.Hearing level had an improvement in 9 cases and remained unchanged in 8 cases.ConclusionMicrosurgery treatment is the main choice of the treatment of VSs, could achieve better result in control of tumor and facial and acoustic nerve function restoration.

Objective To analyze the risk factors of voiding dysfunction after mid-urethral sling surgery for stress urinary incontinence.Methods Clinical data of 573 consecutive patients undergoing midurethral sling surgery from January 2003 to December 2010 were collected and analyzed retrospectively.All relative risk factors were evaluated by univariate and multivariate Logistic analysis to identify risk factors of voiding dysfunction.Results Voiding dysfunction occurred in 28 patients,with an incidence of 4.9％ (28/573).Univariate analysis showed that age,previous pelvic surgery,pre-operative postvoid residuals,maximum flow rate,average urine flow rate,Valsalva leak point pressure,concomitant anterior pelvic repair and operator performing＜50 procedures were the relative risk factors (P＜0.05) for voiding dysfunction.Multivariate logistic regression analysis revealed that the maximum flow rate (Qmax) ≤ 15 ml/s (OR=3.782,P=0.003) was an independent risk factor for voiding dysfunction and surgery experience was its protection factors (OR=0.295,P=0.016).Conclusions Qmax ≤ 15 ml/s on preoperative urodynamic study is an independent risk factor for voiding dysfunction after mid-urethral sling procedure.Improving skill of surgery and strengthening technical training will help to reduce the incidence of this complication.