Cholangitis, Sclerosing ; complications ; Histiocytosis, Langerhans-Cell ; etiology ; Humans

Crohn Disease ; pathology ; Humans ; Infant ; Male

Objective To preliminarily proved that the cerebellar hypothalamic pathways regulate inflammatory cytokines involved in post?stroke depression(post?stroke depression,PSD). Methods 160 male(Sprague?Dawley,SD)rats were randomly divided into sham operation group,the stroke group,PSD group,kainic acid(kainic acid,KA)damage of cerebellar fastigial nucleus group,electrical damaged decussation of superior cer?ebellar peduncle(superior cerebellar peduncle,xSCP)group. The behavioral observation were observed and expression of IL?1βand TNF?αin hip?pocampus by immunohistochemistry. Results Compared with the sham operation group and stroke group,PSD group,TNF?α,IL?1βcontent signif?icantly increased;and the factor of rats with KA group and xSCP group expression consistent with PSD group,there was no significant difference among the three groups. Conclusion The cerebellar fastigial nuclear may through the cerebellar hypothalamic pathways regulate inflammatory cyto?kines and participate in post stroke depression.

Objective To determine the dietary nutritional status of rural residents in Midwestern Shandong Province,in order to improve the dietary pattern and health status of them.Method 11 987 residents,from 10 273 households,were included in this study by multi-stage randomized cluster sampling in 8 counties located in Midwestern Shandong Province.Questionnaire of Food Frequency (QFF) was applied to collect the information about the amount and frequency of food consumed by the subjects in the past year.Results The average intake of cereal,vegetable,fruit,meat,egg,milk,bean,oil and salt per reference man per day was 553.9 g,310.6 g,58.2 g, 36.3 g,50.1 g,16.7 g,34.4 g,44.8 g and 12.3 g,respectively.The average intake of energy,carbohydrate,protein,fat and dietary fiber per reference man per day was 12 095.6 kJ,451.8 g,85.6 g,78.8 g and 18.7 g as well Cereal food provides 66.1% of total energy; however,the meat provides only 6.6% of that.Carbohydrate,protein and fat amount to around 63.2%,12.0% and 24.8% of total energy, respectively.24.0% of fat intake was from animal food,while 76% of that was from vegetable food.Conclusions The intake of energy, protein,fat was sufficient for these subjects;however,the intake of vegetable,fruit,bean and meat was lower than the dietary reference intake.Moreover,oil and salt intake in these subjects was much higher than Chinese Recommended Nutrient Intakes.Thus,the amelioration of dietary pattern in rural residents will be an important task for nutrition workers in rural area of Midwestern part of Shandong Province in the future.

Objective To investigate clinical phenotype and the characteristics of gene mutation of patients with spinocercbellar ataxia type 2 and type 3.Methods The trinucleotide repeat mutations were detected by polymerase chain reaction (PCR),fluorescence-PCR and capillary electrophoresis in 9 patients and 43 members from 4 spinocerebellar ataxia families,1 sporadic patients,and 60 normal controls without family history.Results Six patients from 3 families and one sporadic patient had SCA3/MJD (CAG) n expansion mutation(n=68-75) ;Three patients from 1 family had SCA2 allele expansion for 37-41 times. Some of clinical menifestations were same among patients with type 2 or 3,while they showed significant difference in age of onset ,disease devetopment and nervous system injury.Conclusion The difference of clinical feature helps to distinguish SCA3/MJD and SCA2,however genotype analysis is the only method of definite diagnosis.

Adult ; Humans ; Male ; Patellar Dislocation ; congenital ; diagnosis ; therapy

Objective To evaluate the application of percutaneous nephroscopy in the treatment of upper urinary tract transitional cell carcinoma, particularly renal pelvic carcinoma. Methods From June 2006 to June 2010, eight cases (with 10 sides) of renal pelvic carcinoma received percutaneous nephroscopy tumor resection. There were six males (with 7 sides) and two females (with 3 sides) in the study group. There were six cases with solitary kidney and two cases with bilateral renal pelvic tumors. There were four cases with high-grade tumors and six cases with low-grade tumors. The age of patients ranged from 52 to 72 yrs (average 61.2 yrs). Tumor sizes ranged from 0.5 to 3.5 cm (average 2.6 cm). Patients were treated with laser or electrocautery through percutaneous nephroscopy. A ureteral stent was placed in the patients after the procedure. Chemotherapy was administered postoperatively through the nephrostomy tube. Results All the operations were successfully completed uneventfully. The operative time was 45-95 min (average 73 min), estimated blood loss was 20-300 ml (average 50 ml). No remarkable differences were found in serum creatinine levels before and after operation. After 10 to 36 mon. follow-up by CT, MRI, and ureteroscopy, one patient died of tumor metastasis and two patients had local tumor recurrence. The remaining patients had no local recurrence. Conclusions Percutaneous nephroscopy in treating renal pelvic tumor is safe and feasible. This is a better choice for the renal pelvic carcinoma patients who are unsuitable for ureteronephrectomy.

Objective To discuss the technique of laparoscopie radical cystectomy with Studer orthotopic ileal neobladder. Methods Eight men with bladder cancer who were indicated for radical surgery underwent laparoscopic cysteetomy with Studer orthotopic ileal neobladder. The ages were be-tween 51 and 69 with the mean age was 57 years. Seven cases were transitional cell carcinoma and 1 case was adenocarcinoma. A 5-port approach was employed. The first step was the bilateral pevic lymphadenectomiy including obturator lymph nodes, internal and external iliac lymph nodes. Then ventral surface of the bladder was mobilized and the bilateral endopelvic fascia was incised. Next step included the stich of dorsal vein complex and dissection of both the vas deferens and seminal vesicles. Denonvillier's fascia was incised to develop the plane between the rectum and the prostate. The urethra located in the prostatic apex was divided and transected thereby completely separating the specimen. Then the specimen was placed in a packet. Finally, a 6-8 cm lower median abdominal incision was performed, through which the specimen was extracted. Construction of the Studer pouch. A portion of terminal ileum about 45cm long was isolated approximately 20cm proximal to the ileocecal valve. The ends of the isolated ileal segment were closed to restore the bowel continuity. The distal 40 cm segment of ileum was placed in a U shape and opened along the antimesenteric border. The two medial borders were then oversewn and the bottom was folded over to form a neobladder. The ureters were anastomosed to the nonineised 5 cm portion of ileum. Finally, the neobladder was put into the abdomi-nal cavity and the anastomosis between the neck of the neobladder and the end of the remaining ure-theral was performed with interrupted suture. Results All the procedures were successful. The time of the operation was 6-8 h with the mean estimated blood loss 420(200-800)ml. Complication included 1 case of right ureteral indigitation in neobladder. The postoperative histopathology revealed 7 cases of pT2 and 1 cases of pT3. No positive margin was found. The follow-up (3 - 12 months) showed no recurrence. Conclusions The technique of laparoseopic radical cystectomy is feasible with the advantages of smaller incision and less blood loss. Studer orthotopic ileal neobladder has the ad-vantages of simple skill, antireflux, better postoperative urination.

Objective To investigate the MRI features of the brain in patients with neuromyelitis optica (NMO), and to evaluate the correlation between the brain abnormalities and related risk factors.Methods Fifty-four patients with definite NMO according to 2006 Wingerchuk diagnosis criteria were enrolled in this study. MRI scanning of the brain was performed in these patients. Distribution and signalfeatures of all the lesions were analyzed. A Logistic regression analysis was used to evaluate the risk factors of brain abnormalities. Results Twenty-four NMO patients (44. 4%) showed unremarkable findings and thirty (55.6%) showed abnormalities on brain MRI. Multiple and non-specific small lesions in the subcortical white matter and grey-white matter junction were the most frequent abnormalities on brain MRI (13/30, 43. 3%). Typical lesion locations included corpus callosum, subependyma of ventricles,hypothalamus and brain stem. The lesions showed punctate, patchy and linear abnormal signals. Postcontrast MRI showed no abnormal enhancement in 16 cases. Logistic regression analysis showed that coexisting anto-immune disease or infection history had correlations with abnormalities of the brain on MRI (OR=3.519,P ＜0.05). Conclusions There was a high incidence of brain abnormalities in NMO.Subependymal white matter, corpus callosum, hypothalamus and brain stem were often involved in NMO.NMO patients with coexisting anto-immune disease and infection history had higher risk of brain abnormalities.

Objective To investigate the relationship between coagulation function and the tumor size, clinical stage and metastasis status in renal cell carcinoma (RCC) patients. Methods A total of 290 RCC patients from 2004 to 2009 were included in present study. There were 181 male patients and 109 female patients. The average ages was (56.3± 13. 5) years. There were 252 cases of clear cell carcinoma, 19 cases of papillary carcinoma, 5 cases of chromophobe cell carcinoma, 3 cases of cystic RCC, and 11 cases of other types. TNM classification: stage Ⅰ 202 patients, stage Ⅱ32 patients , stage Ⅲ 32 cases, stage Ⅳ 24 cases. There were N0 264 patients, N1 11 patients and N2 15 cases. There were M0 273 cases, M1 17 cases. One hundred and eighty-six cases of benign renal tumors were set as the control group. Fibrinogen (Fib), prothrombin time (PT), activated partial thromboplastin time (APTT) and international normalized ratio (INR) were detected. Results The preoperative serum Fib of RCC patients was (39. 6±15.6) g/L, the control group was (32. 8±8. 2)g/L. There was significant difference between them (P<0. 05). The values of preoperative APTT,INR, and PT were (31.7±5.2)s, (1.0±0. 1), (11.2±1.3)s in RCC group and (32. 4±4.2)s,(1.0±0. 1), (11.1±1.3)s in the control group. There were no significant differences between them (P＜0.05). The values of Fib in stage Ⅰa, Ⅰb, Ⅱ, Ⅲ, Ⅳ groups were (32. 6±6. 6), (36. 1±8. 7),(48.8±21.6), (49.9± 17.8) and (59.7± 19.2)g/L, respectively. There was no significant difference between stage Ⅰ, and the control group. But the other stages showed significant difference with the control group (P<0.01). Hyperfibrinogenemia (Fib>44.0 g/L) in the RCC group accounted for 74 cases (25.5%). If the value of Fib ≤44. 0 g/L, 92.1% of patients can be excluded from the probability of metastasis. Conclusions Preoperative plasma Fib levels could be elevated in RCC patients with distant metastasis or lymph node metastasis. Increased preoperative plasma Fib levels, especially hyperfibrinogenemia may be a predictor of metastasis.