Currently,the diagnosis of malignant pheochromocytoma still faces a big challenge.Neither biochemical nor histological features can be reliably used to distinguish malignancy from benign tumors.Numerous efforts have been applied to identify novel molecular markers to predict malignancy.

Recent studies have indicated that miRNA is an important element that regulates gene expression at the post transcriptional level.MiRNAs play important roles in development and progression of chronic disorders of many organs.This review summarizes the recent researches on the association of miRNA with chronic liver diseases.

Objectives This study was to describe the prevalence of depressive and/or anxiety symptom and disorder in outpatients with irritable bowel syndrome (IBS) or functional dyspepsia (FD) in the comprehensive hospitals in big cities, China. Methods This was a hospital-based cross-sectional study conducted in three main cities in China in 2004. Six hundred and eight eligible subjects with IBS or FD were recruited consecutively from the outpatient departments within 3 months. Face-to-face interview was used in data collection together with the self-completed HAD scale for depressive and/or anxiety symptom screening. Subjects getting a HAD score of 9 and above were further assessed for depressive and/or anxiety disorders with HAMA scales and HAMD scales by the licensed psychologists or psychiatrists. Results The prevalence of depressive and/or anxiety symptoms was 24. 8% and 23. 6% respectively in outpatients with IBS or FD. And among detected depressive and/or anxiety symptoms, the prevalence of depressive and/or anxiety disorder was 69. 6% and 68. 7% respectively; Less than 12% of subjects had obtained a diagnosis of depressive disorders and been treated, and less than 8% of subjects had obtained a diagnosis of anxiety disorders and been treated prior to the investigation. The prevalence of anxiety symptom in female patients with IBS was significantly higher than male patients (17. 0% vs. 8. 7%; X2=4. 432,P = 0. 035); among detected depressive and/or anxiety symptoms, the prevalence of depressive disorder, anxiety disorder, depressive and anxiety disorder and depressive and/or anxiety dis order in female patients with IBS were higher than those in male patients (52. 6%vs. 25. 0% ,X2 = 4. 612, P=0. 032; 79. 5% vs. 53. 8%,X2=4. 815, P = 0. 028; 51. 4% vs. 21. 7%,X2=5. 112,P = 0. 024; 78. 6% vs. 55. 6%,X2=4. 112,P = 0. 043). Conclusions It is important for healthcare providers and health policy makers to note that the prevalence of depressive and/or anxiety symptoms and depressive and/or anxiety disorders are high and the percentages of previous diagnosis and treatment in outpatients with somatic diseases in general hospitals of urban China are rather low.

Objective To explore the etiological factors of primary pathological duodenogastric reflux (DGR) through investigating the relationship between severity of bile refulx,the changes of surface gastric electric rhythm and gastric emptying movement in primary pathological DGR patients.Methods From January 2007 to April 2008 in Qingdao Municipal Hospital,58 cases of outpatients diagnosed as primary pathological DGR and 21 healthy individuals (control group) were collected and underwent 24-hour gastric bilirubin monitoring,gastric endoscopy,gastric electric rhythm,and gastric emptying test.The relationship between gastric electric parameters and gastric emptying,bilirubin reflux,Hp infection was analyzed.Results 1.The main frequency in fasting and postprandial of primary pathological DGR patients [(1.94±0.04) cpm vs (2.93±0.07) cpm; (2.12±0.03) cpm vs (3.35 ±0.05) cpm],the percentage of normal gastric slow wave in fasting and postprandial (74.46± 0.56 vs 85.55 ± 1.06 ; 63.97 ± 0.64 vs 86.13 ± 1.49),and fasting/postprandial power ratio (PR) (1.68±0.02 vs 2.75±0.09) were all lower than those of control group (P＜0.05).The percentage of bradygastria in fasting and postprandial of DGR patients (18.04±0.36 vs 7.76±0.78;23.73±0.91 vs 8.47±0.55),the percentage of tachygastria in fasting and postprandial (8.93±0.26 vs 5.75±0.66;13.02±0.40 vs 7.66±0.27) were higher than that of control group (P＜0.05).2.The main frequency of severe reflux patients in fasting and postprandial [( 1.68 ± 0.07) cpm vs (2.13 ± 0.07)cpm; (2.18±0.09) cpm vs (2.76±0.06) cpm],the percentage of normal gastric slow wave in fasting and postprandial (69.71±0.43 vs 80.35±0.68; 56.36 ±0.85 vs 72.34±0.80),fasting /postprandial PR (1.47±0.04 vs 2.02±0.04) were lower than those of mild-reflux group (P＜0.05).The percentage of bradygastria in fasting and postprandial of severe reflux patients (22.94 ± 0.68 vs 13.47 ± 0.61; 29.61 ± 1.14 vs 17.55 ± 0.51) and the percentage of tachygastria in fasting and postprandial (9.94 ± 0.54 vs 7.02 ± 0.42 ; 17.04 ± 0.70 vs 10.71 ± 0.20) were higher than that of mild-reflux group (P＜0.05).3.There was no significant difference of gastric electrical parameters in fasting and postprandial between Hp-positive and Hp-negative groups (P＞0.05).4.The ratio of gastric emptying in DGR group was significantly lower than that of control group (37.9％ vs 90.5 ％,P＜0.05).The gastric emptying delay in DGR group significantly increased compared with control group (60.3％ vs 9.5％,P＜0.05).There was no significant difference in gastric emptying delay between severe-reflux group and light-reflux group (69.0％ vs 51.7％,P ＞ 0.05).Conclusions There is dysfuntion of gastric myoelectrical activity and gastric motility in primary pathological DGR patients,which may be an important mechanism in pathological DGR.

Objective To compare the characteristics of post-stroke depression in patients with and without aphasia.Methods Seventy patients on the first infarction with aphasia and 70 stroke patients without aphasia were recruited.The aphasia deficits in patients were evaluated by using the Aphasia Battery of Chinese ( Aphasia Battery of Chinese, ABC) .The Stroke Aphasic Depression Questionnaire Hospital Version ( Stroke Aphasic Depression Questionnaire Hospital Version, SADQ-H) was applied to analyze the depression in the two groups.Results The sore in SADQ-H of the aphasia group was significantly higher than the control group( (22.03 ±9.55 )vs ( 16.81 ± 10.47 ), P ＜ 0.01 ) .Loss interest, anhedonia, social avoidance, irritability, depression, decreased attention were more serious in patients with aphasia after stroke than that without aphasia.Compared with control group ,the incidence of depression in aphasia group was higher(64.28% vs 50.00% ).The incidence in different types of aphasia: the complete aphasia ( 78.26% ), transcortical mixed aphasia ( 62.50% ), Broca ( 61.53% ),Werincke (62.50%).There was significantly correlation between the incidence of depression and the severity of aphasia.Conclusion The incidence of depression in stroke patients with aphasia is high,especially who have complete aphasia, transcortical mixed aphasia, Broca and Werincke, and it closely relate to the severity of aphasia.

Objective To preliminarily investigate the cutoff value of Stroke Aphasic Depression Questionnaire Hospital Version (SADQ-H) in the diagnosis of post-stroke depression. Methods Using receiver operating characteristic (ROC) curves, the total scores of 17-item Hamilton Depression Rating Scale (HAMD-17) greater than 7 points and Beck Depression Inventory (BDI-13) greater than 4 points were taken as the cutoff values for the assessment of depression. SADQ-H for the assessment of the depression classification standard in patients with post-stroke aphasia was investigated preliminarily by HAMD-17 (8-17 were mild depression; 18-24 were moderate depression, and＞24 was severe depression). Results When HAMD-17 was used as a standard, ROC area under curve (AUC) was 0. 909 (95% confidence interval [CI] 0.814-1.005). When 19.50 was used as a cutoff value, the sensitivity, specificity, positive predictive value, negative predictive value, and κ coefficient of SADQ-H were 82. 6%,91.7%, 87. 0%, 83.3%, and 0. 77, respectively. When BDI-13 was used as a standard, ROC AUC was 0. 916 (95% CI 0. 824-1. 008). When choosing 18.50 as a cutoff value of diagnosis,the sensitivity, specificity, positive predictive value, negative predictive value, and κ coefficient of SADQ-H were 80. 0%, 90. 0%, 84. 0%, 90. 0%, and 0. 68, respectively. The classification standards of SADQ-H for the assessment of depression in patients with post-stroke aphasia were 19, 22 and 26 points. Conclusions When the cutoff value of SADQ-H was 19 points, it had higher sensitivity, specificity, positive predictive value and negative predictive value for the assessment of depression; 19, 22 and 26 points could be used as the classification diagnostic standard of SADQ-H in the assessment of depression in patients with post-stroke aphasia.

OBJECTIVE To study the causes of recurrence and treatment methods in patients with recurrent sinonasal melanoma. METHODS From 1993 to 2003, a retrospective analysis of consecutive 11 cases with recurrent sinonasal melanoma was conducted. RESULTS Four out of the 11 cases with recurrent sinonasal melanoma were caused by misdiagnosis, while the other 7 cases recurred after operation with pathological diagnosis. Among the 7 cases, 5 were found recurrences after operation alone, and the other 2 after the operation and radiation therapy. The recurrence lesions located in nasal and paranasal sinus in 7 cases, in orbit, skull base, soft and hard palate in 1 case, in parotid gland and skin in 1 case. In face, orbit and extended skull base in 1 case. Cervical lymph node recurrence developed in 1 patient. The time of first relapse was 10 months after therapy. The 1-, 2-and 3-year survival rates after reoperation were 72.7 %, 18.2 % and 9.1 % respectively. CONCLUSION The reasonable treatment and decrease the misdignosis are the main measures to improve the cure rate of recurrent sinonasal melanoma.

Objective To investigate the characteristics and clinical significance of ocular vestibular evoked myogenic potential (oVEMP) and caloric test in Meniere disease (MD) at different hearing stages.Methods Fifty-five patients(52.8±15.8 years old) with MD were divided into stage 1(9 cases,48.8±13.8 years old), stage 2(9 cases,46.0±16.3 years old), stage 3(23 cases,50.3±13.5 years old) and stage 4(cases 14, 53.5±16.2 years) respectively according to the pure tone audiometry.They were evaluated by oVEMP and caloric test.Results The abnormal rates of oVEMP were 55.6%, 66.7%, 78.3%, 78.6%,and caloric tests were 22.2%, 33.3%, 78.3%,and 85.7% respectively in stage 1, 2, 3, and 4 MD patients.The amplitudes of oVEMP in stage of 1, 2, 3, and 4 MD patients were 4.3±4.0 μV,3.5±2.3 μV,2.5±2.4 μV,and 1.3±0.5 μV,respectively.Conclusion The abnormal rates of oVEMP and caloric tests in MD patients increased with the degree of hearing impairment and the amplitudes of oVEMP were decreased, suggesting that utricle and horizontal semicircular canal injuries were aggravated.

Objective To study the diagnostic value of porphobilin staining of gastric mucus for primary pathologic duodenogastric reflux (DGR). Methods A total of 58 DGR patients diagnosed from January, 2007 to April, 2008 were recruited to the study as DGR group, and 21 healthy volunteers as control.All subjects underwent 24-hour intragastric bilirubin monitor and gastroscopy. Bilirubin absorption value of 0. 25 and median reflux time of 23.60% were taken as thresholds to differentiate low reflux group ( reflux time ＜ 23.60% ) and high reflux group (reflux time ≥23.60% ). Porphobilin staining of gastric mucosa was quantitatively analyzed. Results Deposition of porphobilin in mucosa of gastric antrum, gastric angle and gastric body in primary pathologi DGR group was significantly higher than those in healthy group (P ＜0. 05 ). The occurrence of atrophic and intestinal metaplasia of gastric antrum in high reflux group was significantly higher than that of low reflux group (P ＜ 0. 05). Deposition of porphobilin in mucosa of gastric antrum, gastric angle and gastric body in high reflux group was significantly higher than that of low reflux group (P ＜ 0. 05 ). The New Sydney system pathological scores of gastric antrum and angle of high reflux group was higher than that of low reflux group ( P ＜ 0. 05 ). The deposition of porphobilin in mucosa of gastric antrum and gastric angle was positively correlated with New Sydney system pathological scores in primary pathological DGR group (r=0.59, P=0.041 andr=0.73, P=0.038). Conclusion Porphobilin staining of mucosa in gastric antrum can reflect the severity of bile reflux, and is positively correlated with the extent of gastric mucosal lesion, which may be helpful in diagnosis of primary pathological DGR.

Objective To evaluate the clinical efficacy of nerve-related acupoints electrical stimulation in preventing urinary retention after hemorrhoid surgery. Method Ninety-seven patients were randomized into two groups: the treatment group received nerve-related acupoints electrical stimulation 1 h after Milligan-Morgan hemorrhoidectomy for mixed hemorrhoids, while the control group was taken as a blank control. The incidence of postoperative urinary retention, residual urine volume after the first urination, general urinary condition score, and satisfaction evaluation were compared between the two groups. Result The incidence of postoperative urinary retention and residual urine volume after the first urinary were lower, and the general urination condition and satisfaction evaluation were higher in the treatment group compared to those in the control group. Conclusion Nerve-related acupoints electrical stimulation can prevent and reduce the adverse reactions such as urinary retention after hemorrhoidectomy, and it can effectively protect the bladder function and improve the prognosis.