Objective To explore the clinical characteristics and prognostic factors of patients with hepatolithiasis associated with intrahepatic cholangiocarcinoma. Methods The clinical data of 39 patients with hepatolithiasis associated with intrahepatic cholangiocarcinoma in the First Affiliated Hospital of Chongqing Medical University from Jan 2006 to Jun 2013 was retrospectively analyzed. Results The main clinical manifestations of hepatolithiasis associated with intrahepatic cholangiocarcinoma included recurrent fever, abdominal pain, jaundice and hepatic percussion pain. Among the 39 cases, the patients older than 60 years accounted for 69.2 % (27/39), and the duration of hepatolithiasis more than 10 years accounted for 76.9 % (30/39). Remarkable differences were found in serum CA19-9 and surgery methods (both P< 0.05). Conclusions Recurrent fever, abdominal pain, jaundice and hepatic percussion pain are the main clinical manifestations for the patients who are diagnosed with hepatolithiasis associated with intrahepatic cholangiocarcinoma. Advanced age and longer duration of the disease may be the high risk factors. Serum CA19-9 levels and surgical methods are the important prognostic factors.

Objective To study the effect of arsenic trioxide(As_2O_3) on reactive oxygen species(ROS) of human hepatocellular carcinoma cell(HCC) line.Methods The MTT method was used to evaluate the influence of As_2O_3 on proliferation of HCC.ROS was detected by flow cytometry.Results As_2O_3 could obviously decrease the proliferation rate of HCC cell line in dose-dependent and time-dependent manner.The analysis of flow cytometry showed As_2O_3 could obviously increase ROS in dose-dependent and time-dependent manner as well.Conclusion As_2O_3 can inhibit the proliferation of hepatic cell carcinoma SMMC-7721 cell line significantly,and the anti-tumours mechanism of arsenic trioxide may be that it could induce SMMC-7721 cell apoptosis by increasing ROS level.

Acupuncture ; history ; Acupuncture Points ; China ; History, Ancient ; Humans ; Medicine in Literature ; Terminology as Topic

Retmperitoneal ganglioneuroma is a rare neurogenic benign tumor.The prognosis of patients was good when the tumor was completely resected,while the surgical procedure is complicated.In March of 2013,a male patient with complex retroperitoneal ganglioneuroma was treated at the First Affiliated Hospital of Chongqing Medical University.A hypoechoic solid lesion (size,6.5 cm ×4.5 cm) adjacent to the head of the pancreas was detected by color Doppler ultra-sonography 9 months ago,and no any other clinical symptoms were detected.Perioperative abdominal computed tomography and the surgery confirmed that the tumor (size,8.5 cm × 7.5 cm × 4.5 cm) was located beneath the pancreas,encompassing thc ccliac artery,hepatic artery,splenic artery and superior mesenteric artery,surrounding the head and uncinate process of the pancreas,making it impossible to be separated.The tumor was closely connected with the portal vein,superior mesenteric vein,splenic vein and left renal vein.The tumor was separated from the major blood vessels,the body and tail of the pancreas,while the tumor could not be resected from the pancreatic head,and thus tumor resection and pancreaticoduodenectomy were performed.The surgery was extremely diffcult,but the complete removal of tumor was successfully achieved without excision of the major blood vessels and the patient recovered well.

Objective To investigate the prevalence of BPPV in patients with Meniere’s Disease(MD),and to investigate the diagnostic and predictive values of VEMP in patients with MD and BPPV.Methods A total of 1 1 6 patients previously diagnosed MD were followed up through telephone about their BPPV-like attacks.We recorded the detailed history of BPPV-like attacks,and provided them with complete Dix-Hallpike and roll tests if patients were on their BPPV-like attacks.Results In all,4 patients'histories supported BPPV,and 4 patients were found with BPPV.The prevalence of BPPV in patients with MD was 3 .4%(4/1 1 6 ).Meniere's symptoms preceded the on-set of BPPV in 8 patients.In 4 confirmed BPPV patients with Meniere's disease,BPPV was limited to the same ear as the MD in 2 cases,and 1 had contralateral BPPV,and 1 was uncertain.Six histories supported or confirmed BP-PVpatients with high abnormal oVEMP rates (5/6).Four in this 5 (80%)had abnormal oVEMP of the same MD ear.The single repositioning procedures can improve vertigo and eliminated positional nystagmus in cases of BPPV associated with MD.Conclusion In the present study,the prevalence of BPPV in patients with MD was 3 .45%.De-tailed medical histories combined with Dix-Hallpike and roll tests and VEMP tests can identify BPPV in patients with MD.

OBJECTIVE: To explore the roles of otolith organs in the occurrence and recurrence of primary benign paroxysmal positional vertigo (BPPV) by vestibular evoked myogenic potential (VEMP) test. METHOD: We enrolled 17 recurrent primary BPPV patients and 42 non-recurrent primary BPPV patients between September 2014 and November 2014. All patients underwent VEMP tests, including cervical vestibular evoked myogenic potential (cVEMP and ocular vestibular evoked myogenic potential (oVEMP) tests. The abnormal case was defined as non-elicitation or asymmetry rate between bilateral sides is larger than 29%. RESULT: Significant difference was found in abnormal rate between cVEMP and oVEMP (P < 0.05 ) in BPPV patients. The abnormal rate of oVEMP was higher than that of cVEMP. Significant difference was found in abnormal rate in oVEMP test between recurrent and non-recurrent groups (P < 0.01) but not in cVEMP( P > 0.05). No significant difference was found in sex and age between recurrent and non-recurrent groups (P > 0.05). CONCLUSION The impairment of otolith organs, especially the utricle, is related to primary BPPV. Dysfunction of utricle may play a role in recurrence of BPPV. Recurrence of BPPV is not correlated with sex and age.
Benign Paroxysmal Positional Vertigo ; physiopathology ; Humans ; Otolithic Membrane ; physiopathology ; Recurrence ; Saccule and Utricle ; physiopathology ; Vestibular Evoked Myogenic Potentials

OBJECTIVE: To analyze the abnormal conditions of the affected ear and the contralateral ear of patients with unilateral Meniere's disease and the prevalence of bilateral abnormalities among these unilateral Meniere disease population, providing reference for the clinical treatment strategies for Meniére disease. METHOD: A retrospective analysis of 106 Meni6re disease cases was performed, the abnormal incidence of the affected ears, the contralateral ears and the bilateral abnormalities were calculated, and the disease characteristics were analyzed. RESULT: The bilateral ears abnormal incidence of unilateral Meniére disease was 35. 85% (38/106); the cochlear symptoms of the contralateral ears often occurred 2. 25 years later of the symptoms of Meni6re disease; contralateral cochlear symptoms included at least two symptoms of tinnitus, deafness and ear fullness; 39. 47%(15/38) patients with bilateral abnormalities would appear binaural hearing impairment. CONCLUSION This study showed that about one-third of unilateral Meniére diseases have binaural symptoms, among which about one-third would occur bilateral hearing loss. Therefore, it is necessary to consider the course of disease and the symptoms of the contralateral ear before taking damage or destructive method for treating Meniére's disease clinically.
Cochlea ; physiopathology ; Deafness ; Ear ; abnormalities ; Hearing Loss, Bilateral ; epidemiology ; Humans ; Incidence ; Meniere Disease ; epidemiology ; Prevalence ; Retrospective Studies ; Tinnitus

Objective To investigate the expression of complement regulatory proteins on placentas of pregnant C57BL/6 mice infected with Toxoplasma gondii in order to explore the molecular immunological mechanism for abnormal pregnancy induced by T. gondii infection. Methods Twenty-four pregnant C57BL/6 mice were randomly divided into two groups equally. The infection group was intraperitoneally injected with 200 of living T, gondii RH strain tachyzoites on the 8th day of gestation, and the normal group of mice was injected with physiological saline. All mice were killed on day 14 after gestation and placentas were collected. The expression levels of Crry, GPI-DAF and CD59a mRNA were analyzed by real-time quantitative PCR, and the positive rates of Crry and GPI-DAF were measured with flow cytometry. Results The died fetus rates of infected group and control were 80. 95% and 4. 41% , respectively. The infected group was significantly higher than of that the control group (P＜0.01). The expression levels of Crry, GPT-DAF and CD59a mRNA in the infected and control group were 0.786 ±0. 199, 0.594 ±0.096, 0.880 ±0. 179 and 0.550 ±0.077, 0.221 ±0.074, 0.591 ± 0.075 , respectively, and the difference of three kind of complement regulation proteins between two groups was all significant (P＜0.01). The positive percentages of Crry and GPI-DAF cells of infected and control group were (10. 03 ± 2. 11) % , (2.95 ±1.04)% and (3. 15 ± 1. 32) % , (0. 66 ±0. 26) % , respectively, and the difference of the two kind complement regulation proteins between two groups was also significant ( P ＜ 0. 01). Conclusion The expression level of mouse placental complement regulatory proteins was increased after infection with T. gondii, and then immunological microenvironment at the fetomaternal interface was destroyed. It may be one of important immunological mechanism for abnormal pregnancy induced by T. gondii infection.

Objective:Observed activity of adjuvant arthritis ( AA) rats Hedgehog signaling pathway and explore the effect of Cyclopamine on rat arthritis and kidney injury.Methods:40 rats were randomly divided into control group,Cyclopamine group,AA+Cyclopamine group and AA model group.We used Freund′s complete adjuvant rat model with Cyclopamine intraperitoneal injection.By measuring paw swelling, systemic inflammation and arthritis semi-quantitative assessment methods of rats to evaluate the model.HE staining was used to detect the renal pathological changes of rats.Western blot was used to detect kidney Gli1 protein expression levels of the rats.Immunohistochemical staining was used to detect the rat kidney TNF-α,IFN-γ,IL-6 expression.Results:After using Cyclo-pamine,the AA rat paw swelling reduced and arthritis refers relieved significantly.Compared with the control group,Cr,BUN and organ coefficient increased significantly in AA model group, and the difference was statistically significant.Meanwhile renal TEM detection appeared obvious pathological changes in rats of AA model group.After using cyclopamine,the content of Cr,BUN and organ coefficient change reduced significantly, so did the pathological.Western blot detected kidney tissue Gli1 protein in each group.Compared to control group,there was no significant difference in Cyclopamine group.AA model group and AA+Cyclopamine group Gli1 protein expression was significantly higher compared with Cyclopamine Gli1 protein group,the difference was statistically significant.AA model group and AA Cyclopamine group Gli1 protein expression was significantly higher,the difference was statistically significant.Compared to the AA model group,AA+Cyclopamine group Gli1 protein levels have decreased significantly,the difference was statistically signifi-cant.Immunohistochemical assay detection found that kidney tissue proinflammatory cytokines TNF-α,IFN-γ,IL-6 expression and semi-quantitative score changed.Compared with the control group, TNF-α, IFN-γexpression of AA model group were significantly increased.After using Cyclopamine,the expression of TNF-α,IFN-γin kidney of AA model reduced significantly.IL-6 expression in AA model group was significantly higher than the control group.Conclusion:Cyclopamine AA can relieve arthritis and kidney injury in rats with arthritis AA,the Hh pathway was on activity state in the process,may altered expression of inflammatory factors.

Objective To evaluate the feasibility and clinical efficacy of amputation in situ secondary braches of splenic pedicle for laparoscopic splenectomy(LS)in patients of idiopathic thrombocytopenic purpura(ITP).Methods LS was performed in 41 ITP patients hospitalized in our department from January 2007 to November 2008 by dissecting secondary braches of splenic pedicle.The serosa on the spleen pedicle was opened by using a harmonic scalpel.Then secondary structures of the splenic arteries and veins,one by one,were disconnected from downward to upward,and then double ligated with the Hem-O-lok clips.The ligated section was cut off with the harmonic scalpe1,and then the spleen was resected.Results LS was successfully completed with no conversion to open surgery in all the 41 cases.The operative time was 75 to 180 min,and the estimated intra-operative blood loss was 50 to 800 ml.There were 3 cases of vice spleen and the vice spleen removed.Two cases were converted to traditional LS with Endo-GIA.The period of hospitalization was 4 to 9 d after operation.There was no severe postoperative complication.Platelet counts began to increase significantly after operation,reached to the peak in 5 to 7 d after operation.During the follow-up of 3 to 20 months to all 41 ITP patients,the total effective rate was 85.4%(35/41,including 22 cases of complete response and 13 cases of partial response).Conclusion LS with amputation in situ secondary braches of splenic pedicle is a safe,effective,minimally invasive and low complication in treatment of ITP.It is worth be recommended because of its lower costs in comparison with common LS.