Humans ; Intestinal Obstruction ; diagnosis ; etiology ; therapy ; Neoplasms ; complications ; Palliative Care ; methods ; Quality of Life

Objective To evaluate the diagnostic value of intraductal ulstrasonography(IDUS)in non-opaque bile duct stones.Methods Between January 2009 and August 2010 in the Department of Gastroenterology at Shanghai 10th People's Hospital,a total of 183 patients(male:102 cases,mean age 69 years； female:81 cases,mean age 71 years)were enrolled,who were suspected of bile duct stones or stenosis which could not be diagnosed by abdominal CT,MRI,and abdominal B-mode ultrasound.All the patients underwent endoscopic retrograde cholangiopancreatography(ERCP)first,and then patients with non-opaque bile duct stones followed by IDUS.Results A total of 134 cases (73.2％)of bile duct stones were diagnosed by ERCP,49 cases(26.8％)were negative.And then the 49 patients underwent IDUS,of whom 24 patients with sand-like stones,11 patients with lowdensity stones,6 patients with ampullary cancer,2 patients with pancreatic cancer,6 patients with sclerosing cholangitis.The diagnostic accuracy of IDUS in the position and quality of bile duct stones was 100％,higher than that of ERCP,which was 80％.After ERCP,pancreatitis occurred in 3 patients and improved after conservative treatment,there was no complications like perforation and bleeding.Conclusion The diagnostic accuracy of IDUS in the position and quality of bile duct stones is high,which can make up for the misdiagnosis by ERCP without increasing the complications.IDUS can provide reliable basis for the diagnosis of clinical bile duct stones.

OBJECTIVE:To extract and purify organic acids with macroporous resins from Folium Isatidis.METHODS:Folium Isatidis was extracted with 70% aqueous ethanol(pH=2)by Soxhlet extraction.The process was optimized by employing orthogonal test design with the content of anthranilic acid as the index.RESULTS:The resin HPD100 had much better adsorption capacity and desorption ratio by using 3 BV 60% aqueous ethanol to extract organic acids in Folium Isatidis than other resins.The results showed that HPD100 possessed the better ecomic under the concentration of sample 0.18mg?mL-1,the condition of pH 3.5,and flowing rate of 2BV?h-1.CONCLUSION:Macroporous resin HPD100 may be value of isolating and purifying the organic acids from Folium Isatidis.

Objective To investigate the role of pancreatic β cell on pancreatic regeneration following experimental acute pancreatitis.Methods Eighty-seven SD male rats were randomly divided into four groups:control group ( n =15 ),STZ group ( n =24),L-Arg group ( n =24 ),STZ + Arg group ( n =24).60 mg/kg of STZ was administrated by intraperitoneal injection to induce the diabetes model.2.5 g/kg body weight of LArg was administrated by intraperitoneal injection to induce the acute pancreatitis model.The rats were sacrificed 1,3,5,7 d later and the serum levels of amylase and glucose were measured.Relative pancreatic weight (pancreatic weight/body weight) were measured.Pancreatic tissue underwent routine pathologic examination,and the percentage of area of necrosis and tissue transformation was calculated.The expression of Reg4 and insulin was performed by immunofluorescence.Results Serum level of glucose significantly increased after STZ injection.After L-Arg injection,serum level of amylase significantly increased,and there was pancreatic tissue edema,necrosis,infiltration of inflammatory cells,which suggested the successful model induction.The percentage of area of necrosis in STZ + L-Arg group was (71.6 ± 6.0) ％ at the 3rd day,which were significantly higher than (42.3 ± 4.0 ) ％ in L-Arg group; the percentage of area of transformation was (45.6 ± 5.4) ％,which were significantly lower than (78.5 ± 6.4) ％ in L-Arg group.Expression of Reg4 in pancreatic islets of STZ + L-Arg group was significantly lower than those in L-Arg group.Conclusions STZ impairs pancreatic β cells,aggravates pancreatic damage following L-arginine induced pancreatitis and inhibits pancreatic regeneration.

The gene types of breast cancer can be classified into three types according to its molecules: Luminal type A, Luminal type B, HER-2-positive type, triple negative type. Authors combined pathological characteristics of breast cancer, biological characteristics, and comprehensive treatment, used syndrome typing based medication, and explored treatment meticulous ideas and methods of "treating the same disease with different methods" as well as "different treatment methods in accordance with patients individually".
Biomarkers, Tumor ; genetics ; Breast Neoplasms ; classification ; genetics ; therapy ; Female ; Humans ; Receptor, ErbB-2 ; genetics

AIM:To investigate the expression of visfatin in the placenta of patients with preeclampsia and its significance.METHODS:The pregnant women (n=100) were divided into normal pregnancy group , mild preeclampsia group and severe preeclampsia group according to the severity of the disease .The pathological changes of the placenta were observed by hematoxylin-eosin staining .The expression of visfatin at mRNA and protein levels in the placenta was detected by real-time PCR and immunohistochemistry respectively .RESULTS:Compared with normal pregnancy group , the patho-logical changes of the placenta in preeclampsia groups was significant , showing that the structure and the form were disor-dered and incompleted in both cytotrophoblasts and syncytiotrophoblasts .The proliferation of cytotrophoblasts and the num-bers of the placental villi with syncytial knots were observed .The vascular numbers of villi were decreased and congested . The results of immunohistochemistry and real-time PCR showed that the visfatin protein was observed in the cytoplasm of cy-totrophoblasts and syncytiotrophoblasts among 3 groups.The expression of visfatin at mRNA and protein levels was in-creased with the severity of the preeclampsia .CONCLUSION:The injury and dysfunction of vascular endothelial cells in the villi exist in the patients with preeclampsia .High expression of visfatin at mRNA and protein levels in placenta of the patients with preeclampsia indicates that visfatin is closely related to preeclampsia .

Background The clinical effectiveness of soft corneal contact lens for correction of myopia has been confirmed.Theoretically,aspherical soft hydrophilic corneal contact lens has better visual qualify for myopic eyes,and the lenses have been applied widely.But abnormal tear film,even many cornea and conjuctiva diseases caused by soft contact lens have been reported,so the effectiveness and safety of aspherical soft hydrophilic corneal contact lens are worth concerning.Objective This clinical trail was to compare the effectiveness and safety between aspherical and NUV soft hydrophilic contact lens for myopic eyes.Methods A randomized,double-blind and controlled clinical study was performed under the approval of Ethic Committee of Qingdao Municipal Hospital and informed consent of each patient.One hundred and forty eyes of 70 myopic patients were enrolled in QingdaoMunicipal Hospital from July to October,2012.The subjects were randomized into the trial group and control group using random number table.Aspherical soft hydrophilic contact lenses were worn in the trial group and NUV soft hydrophilic contact lenses were worn in the control group.The characteristics of the lens surface,outcomes and the eye number in different scores of ocular signs and symptoms were assessed before and 15 minutes,1 week,2 weeks and 1 month after wearing lenses.Results The sores of humidity of anterior surface,the sediment in anterior and posterior surface are 0 in both lenses in various time points after wearing.The corrected visual acuity of all the subjects were ≥ 1.0.The eye number of 2-3 scores in various ocular signs was 0 in both groups,but the eye number of 1 score in palpebral conjunctival congestion and limbus congestion were more in the trail group than those in the control group in different time points (all at P＜0.05).There were significant differences in corneal fluorescine staining between the groups in different time points (all at P＞0.05).There was no eye for 2-3 scores of eye symptoms in both groups.The eye number for 1 score in foreign body sensation increased in the target-trail group compared to the control group at various time points (P =0.002,0.006,0.005,0.005).However,there was no statistically significant differences in the eye number for 1 score in visual clearness and stability between the two groups at the follow-up duration (all at P＞ 0.05).Conclusions Aspherical soft hydrophilic corneal contact lens has good outcomes in corrected visual acuity for myopia like NUV soft hydrophilic contact lens,but the wearing of aspherical soft hydrophilic corneal contact lens induces more ocular discomfortableness.

ostic sensitivity and specificity of EUS are high in distinguishing benign and malignant character of upper digestive tract GIMTs. EUS plays an important role in guiding the clinical management of upper digestive tract GIMTs.

ObjectiveTo study the using of cerrobase as the compensation material in the intensitymodulated radiation therapy (IMRT) implementation and impact factors.MethodsWith therapy planning system (TPS) exported the radiation field intensity file (Dicom RT),through measuring the attenuation coefficient of cerrobase,to calculate the processing depth of AUTIMO 3D CNC corresponding for Dicom RT files at each pixel,then using the processed foam casting of Cerrobase,produced the required IMRT compensator.Through the MATRIXX testing the IMRT compensator in clinical implementation.At the same time we compared the MU of using multi-leaf collimator (MLC) and Cerrobase IMRT compensator for 10patients.ResultsWith cerrobase compensation IMRT can get similar dose or dose distribution to dose produced by TPS for point or plane dose,error is within 5％.To comparison with MLC,using cerrobase compensator has fewer treatment times ( (4.44±0.39) min:(5.71±0.57) min (t =10.82,P =0.000) )and fewer MU (462.5 ± 65.8) MU:(524.5±99.6) MU(t=3.14,P=0.012) ).Conclusions Comparison with MLC IMRT,the cerrobase compensation technique has an important application value with its unique advantages.This research provides an implemented method of IMRT radiotherapy for the primaryhospital.

ObjectiveTore-identifyfifteenclinical Pseudallescheriaboydii/Scedosporium apiospermum isolates by the sequence difference of ITS rDNA and partial β-tubulin gene (TUB) and thus understand thepathogenicstrain typesfor guiding theclinicaltreatment.MethodsMorphological appearances,D-ribose assimilation and sequencing of ITS and TUB were used to re-identify the fifteen clinical strains of Pseudallescheria boydii/Scedosporium apiospermum.The sequences of ITS and TUB were analyzed with Clustal X and MEGA 4 software.Results No difference of morphological appearances was found in the fifteen strains.Cleistothecium was observed in one isolate.All the strains were D-ribose assimilation positive.The clinical strains were re-identified as P.boydii species complex by the CBS database (http://www.cbs.knaw.nl).ElevenstrainswereP.boydiiandfourstrainswereS.apiospermum respectively.Conclusions P.boydii and S.apiospermum cannot be identified correcdy by the time-consuming conventional morphological method and biochemical characteristics.The study recommend that the clinical isolates of P.boydii and S.apiospermum should be identified utilizing a combination of traditional phenotype method and molecular biotechnology.