Objective To evaluate the improvement of diagnosis and treatment of hypercatecholaminism. Methods A total of 95 cases of hypercatecholaminism were reviewed.Of them 74 cases were of pheochromocytoma and 21 cases were of adrenal medullary hyperplasia (AMH).In pheochromocytoma group,67 cases (90.5%) had symptom of hypertension.Increase in 24 h urinary VMA occurred in 62 cases (83.8%) and elevated urinary catecholamine level in 67(90.5%).All thses had positive findings of ultrasound,CT scan and MRI.In AMH group,all the patients were hypertensive and their 24 h urinary VMA was increased.Most of them (15/16) had higher urinary catecholamine level than normal;14 out of the 21 cases had positive findings of B-ultrasound examination. Results Surgical operations were performed in the 74 patients with pheochromocytoma including 9 cases of extra-drenal pheochromocytoma.Of them 5 cases were confirmed as malignant pheochromocytoma.In the 21 cases of AMH,18 undewent surgical operation.Of them 12 received unilateral resection and 6 received bilateral resection of adrenal gland.The pathological examination confirmed the diagnosis of AMH. Conclusions The diagnosis of pheochromocytoma should be focused on endocrinological examination,ie,qualitative examination,whereas it is diffucult to localize the lesion in AMH compared with pheochromocytoma.The establishment of notion of AMH as an isolated clinicopathological entity broadens and perfects the theory of hypercatecholaminism.

Epigenetics refers to steady phenotypic changes in gene expression without modifications in the genetic nucleotide sequence.Disorder of epigenetic mechanisms plays an important role in the occurrence and development of human malignant tumors including hepatocellular carcinoma.A large number of gene targets and pathways related to epigenetics were discovered.For instance,DNA methylation,histone modification and RNA regulator gene silencing were associated with the development of hepatocellular carcinoma.Exploring the abnormal epigenetics is of great significance for prevention and treatment of hepatocellular carcinoma.

The miR-17-92 cluster,consisting of six individual microRNAs,including miR-17,miR-20a,miR-18a,miR-19a,miR-19b and miR-92a-1,is a kind of typical oncogenic polycistron microRNA.MiR-19 (containing miR-19a and miR-19b),as the key oncogenic component in miR-17-92 cluster,is overexpressed in human cancers including lymphomas,leukaemia,lung cancer,breast cancer and multiple myeloma,and has been one of research focus in recent years.It is found that miR-19 promotes tumor growth,invasion and metastasis through negative regulation of target genes such as PTEN,PP2A,Bim,SOCS1,and is correlated strongly with PI3K-AKT-mTOR pathway.MiR-19 plays an important role in tumor genesis and development.

Objective To investigate age-related changes of serum prolactin(PRL) and testosterone (T) in aging males and to study the correlation between PRL and prostatic hyperplasia. Methods 84 aged males were divided into four groups, the fifties, the sixties, the seventies and the eigh- ties . Serum PRL and T were measured using radioimmunoassay. The volume of prostate was evaluated by ultrasound in 38 and it's correlation with PRL studied. Results Serum T level of the 4 age groups from fifties to eighties was (25.92?2.54),(21.00?1.92),(18.37?2.49) and (14.75? 2.38 ) nmol/L respectively and PRL concentration (1.11?0.16), (0.96?0.20), (0.99?0.18) and (0.91?0.29) nmol/L. Analysis of variance showed that serum T concentration significantly decreased with age ( F =3.44, P 0.05). No association between PRL and volume of prostate has been observed. Conclusions PRL play a physiological role in the development and growth of prostate via androgen. But such effect of androgeno-dependence on prostate is greatly diminished because of the decrease of androgen hormone with age especially in the aged.

[Objective] To retrospectively analyze the treatment of tailor's bunion with minimal incision osteotomy,and to investigate the indications and effects of this procedure.[Method]Thirty-seven patients(69 feet)underwent the procedure from July 2002 to August 2007.The axial and lateral films of all feet with loading were taken before and after operation.AOFAS were recorded and analyzed preoperatively and postoperatively.[Result]The forth intermetatarsal angle was 14.36??7.32? before operation and 9.36??2.92?after operation.The unguis aduncus angle of digitus quintus pedis was 20.44??7.36? before operation and 4.36??1.35?after operation.The forth reforming intermetatarsal angle was 10.36??.2.81? before operation and 7.83??2.37?after operation.The exstrophy angle of the fifth metatarsal was 5.46??1.70? before operation and 2.13??0.38?after operation.The score of AOFAS was 45.7?5.6 before operation and 85.3?5.1 after operation.[Conclusion]The treatment of tailor's bunion with minimal incision osteotomy is easy to operate and its therapeutic effect is convincing.

ObjectiveTo evaluate the value of CT in diagnosis and discrimination of acute focal bacterial nephritis(AFBN). Methods 6 cases of AFBN were reported which were all performed with ultrasound and CT scan.4 of 6 cases were observed by delay contrast enhanced CT examination. ResultsCT scan showed wedge-shaped masses with thickened Gerota fascia.The delayed contrast enhanced CT revealed more clear shapes and verges of the lesions than immediate contrast enhanced CT. ConclusionCT scan is of significant value in diagnosis and discrimination of AFBN with overall review of documents and statistic analysis.

Objective To investigate the effects of hedysarum polybotys saccharide (HPS) on lipid metabolism and the expression of stearoyl-CoA desaturase-1(SCD-1) gene in rats with non-alcoholic fatty liver disease (NAFLD). To discuss the interfering effects of HPS on NAFLD. Methods The SD rats were randomly divided into the blank control group and the experiment group. Rats in the experiment group were fed with lipid rich food for 8 weeks to establish model and were randomly divided into model group, drug positive group and HPS group. After 8 weeks of drug intervention, the level of ALT, AST, TC, TG, HDL-c and LDL-c were measured with automatic chemistry analyzer, and expression of SCD-1 gene was measured by semi-quantitative polymerase chain reaction.Results Compared with blank control group, serum ALT, AST and TC, TG, LDL-c of model group were higher (P<0.05,P<0.01), the level of HDL-c of model group and the expression of SCD-1 gene were lower (P<0.01). Compared with model group, HPS was useful to decrease serum ALT, AST, LDL-c, TC and TG (P<0.05,P<0.01), and increase the level of HDL-c (P<0.01) and the expression of SCD-1 gene (P<0.01).ConclusionHPS had a positive effect on regulating lipid metabolic disturbance of NAFLD rats and promoting the expression of regulatory gene SCD-1.

With the combined interruption of the superior mesenteric vein, the splenic artery and vein and the portal vein, we successfully separated the adhesion between the collum pancreatis and the portal vein which is difficult to separate in 8 cases During the separation, the portal vein was damaged in 2～5 parts, and the size of wounds of vein were of 2～6mm in length, but the amount of bleeding was small and the bleeding speed was slow All the wounds were easily repaired under direct vision We consider that the mothod of the combined interruption is safe and effective for the separation of the adhesion between the collum pancreatis and the portal vein, and is helpful to increasing the success rate of removing carcinoma of the head of pancreases The interruption is safe for 20～25 minutes under normothermia

ObjectiveTo study the role of laparoscopic splenectomy (LS) using the anterior approach with sequential layered dissection. MethodsFrom December 2007 to July 2009, we performed 27 LS using the anterior approach with sequential layered dissection. The clinical data were retrospectively analyzed. ResultsThe range of splenic length was 8-20 cm. Accessory spleen was found in 6 patients (22.2%). The mean operative time was 125 mins. The mean intraoperative blood loss was 90 ml, and the mean postoperative stay was 5.5 days. ConclusionsLaparoscopic splenectomy using the anterior approach with sequential layered dissection could be carried out smoothly and rapidly. It reduced accidental injuries and shortened the operative time.

Objective To explore the electrophysiological features of triggering atrial premature contraction(APC) in patients with hypertension combined paroxysmal atrial fibrillation (PAf).Metbods The originating sites and prematurity index (PI) of triggering APC were analyzed in 46 PAf patients with hypertension (hypertension group)and in 35 PAf patients without hypertension( non-hypertension group)from April,2008 to March,2011 in Shanghai Punan Hospital of Pudong New District.Results Triggering APCs in 46 cases with hypertension combined PAf in the hypertension group originated mainly in the left atrium( 81.6％ ).The coupling interval (CI)of triggering APC in hypertension group was significantly shorter than that in non-triggering APC ( [ 374.1 ± 31.5 ] ms versus [ 443.6 ± 32.6 ] ms,t =23.361,P ＜ 0.001 ) and that in triggering APC in nonhypertensive group ( [374.1 ±31.5]ms versus [395.7 ±38.2]ms,t =5.549,P ＜0.001 ).PI in triggering APC was lower than that in non-triggering APC in hypertension group(0.50 +0.05 versus 0.63 ±0.06,t =22.544,P ＜ 0.001 ) and that in triggering APC in non-hypertension group (0.50 + 0.05 versus 0.55 ± 0.08,t =5.849,P ＜ 0.001 ).Conclusion The triggering APC in patients with hypertension combined PAf mainly originates in the left atrium,the PI of triggering APC is significantly lower than that in non-hypertension patients with PAf and PAf occurs more easily in patients with hypertension.Prompt measures should be taken for hypertension patients with lower prematurity index to prevent the occurrence of PAf.