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.

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.

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.

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.

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 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.

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.

Objective Aspirin is a non steroidal anti-inflammatory drugs, whether or not which does harm to renal function in the course of using, there is a big debate at home and abroad.In this paper, The aim of this study was to observe the effects of different doses of aspirin on renal function in elderly patients with cardiovascular disease at different ages.MethodsWe Selected a total of 288 patients with cardiovascular disease from January 2014 to March 2016 in Zhejiang Rongjun hospital.There were 288 cases of cardiovascular disease, including 144 cases of normal uric acid, 144 cases with hyperuricemia (including gout).The two groups according to the age of 60 to 70 years, 71 to 80 years old, over 80 years old respectively into three subgroups, each subgroup of 48 cases;Each subgroup was randomly selected without the use of aspirin (0mg/d) and the use of different doses of aspirin (50mg/d, 100mg/d, 150mg/d) for a total of four groups, each which is 12 patients.We detect patients routine blood tests, liver and kidney function, blood urea nitrogen (BUN), blood creatinine (SCR) levels and glomerular filtration rate (GFR) (MDRD) and blood and urine beta 2-microglobulin used aspirin before and used after 6 months and 12 months.ResultsBefore treatment, there were no significant differences in body mass index (BMI), blood pressure, hemoglobin, serum albumin and platelet count between various groups of the same age group.After treatment for 6 and 12 months,Uric acid normal patients and high uric acid patients with 0mg/d, 50mg/d, 100mg/d or 150mg/d dose of aspirin has no statistical difference in BUN, Scr and eGFR, 2-microglobulin Ccr, blood, urine beta 2-microglobulin.ConclusionRegardless of uric acid, different doses of aspirin had no significant effect on renal function in elderly patients with cardiovascular disease, and can be safely used.

Objective:To study the long-term stability of 6MV photon beam on TrueBeam, which is a new linear accelerator introduced by Varian Medical System. Methods:QA BeamChecker Plus (QABC+, Standard Imaging Inc., Middleton, USA) was used to measure 6MV X-ray on TrueBeam linac as daily quality assurance (Daily QA). Dosimetric parameter, including output Constancy, flatness and symmetry, were employed to evaluate the dose delivery stability of TrueBeam linac. Results: Daily QA results of 18 months showed the dose output delta was (0.0%±0.7%), only once out of tolerance of 2%. The constancy of Flatness was excellent with the delta of (0.1%±0.1%). The symmetric of axial and transverse varied within 1%. Conclusion:The output constancy of TrueBeam with 6MV is very stable, as well as flatness and symmetry. It’s stable and reliable to implement Truebeam linear accelerator in clinical.

Currently,the worldwide frequency of catastrophic e-vents has made post-traumatic stress disorder (PTSD)a major public health problem.As a stress-related psychiatric disorder, PTSD is considered as the result of interaction between gene and environments (especially early life adversity).The epigenetics plays an important role in PTSD pathogenesis.Due to the core role of hypothalamic-pituitary-adrenal (HPA)axis,the research on the relationship between HPA axis epigenetics and PTSD pathogenesis in recent years was reviewed in the paper so as to provide references and thinking of the prevention and therapy for PTSD in the future.