Objective To study the relationship between plasma lipids and gallbladder stones(GD).Methods The plasma lipids levels were determined and GD was diagnosed by ultrasonic instrument in 5 982 subjects,then the occurrence of GD was compared between hyperlipemia and no-hyperlipemia.Results The detectable rate of GD of the hyperlipemia was 9.86% and that of the no-hyperlipemia was 7.00%,the difference was significant(P0.05,OR=1.223,95%CI:1.127-2.748).Conclusion The prevalence rate of GD in hyperlipemia patients is higher than that in normal plasma lipids subjects.The sick risk of GD in patients with hypercholesterolemia is much higher than that in persons with normal total cholesterol levels.Sex has no influence on the formation of GD in hyperlipemia patients.

Objective This study analyzes the expression and clinical significance of Gli1 and Gli3 proteins in hepatocellular carcinoma.Methods 36 patients with hepatocellular carcinoma were studied.The expressions of Gli1 and Gli3 in the carcinoma and adjacent non-tumor tissues were detected with immunohistochemical assay,and their correlations with clinicopathological factors were statistically analyzed.Results Expression rates of Gli1 in hepatocellular carcinoma and adjacent nontumor tissues were 75 ％ and 36.1％,respectively.Expression rates of Gli3 in hepatocellular carcinoma and adjacent non-tumor tissues were 58.3％ and 30.6％,respectively.Expression rates of Gli1 and Gli3 in hepatocellular carcinoma were significantly higher than in adjacent non-tumor tissues (P＜0.05),and a positive correlation was found between the expression of Gli1 and Gli3 (r=0.423,P＜0.05).There was no association between the expression of Gli3 and clinicopathological factors such as age,tumor size,tumor differentiation and lymphatic metastasis.The expression of Gll1 was not related witha patient's age and tumor size,hut there were significant associations with tumor differentiation and lymphatic metastasis.Conclusions Therefore,the expression rate of Gli1 was positively correlated with tumor malignancy,which makes the detection of Gli1 and Gli3 valuable for the diagnosis and prognosis of hepatocellular carcinoma.

OBJECTIVETo study the biomechanical change of the craniovertebral junction in conditions of atlas assimilation.

METHODSMimics software was used to process CT data of the craniovertebral junction in a health adult to obtain the three-dimensional reconstruction and the cloudy points of C1, C2 and part of the occipital bone. Then the cloudy points were imported into the Abaqus 6. 8 software to establish the occipito-atlantoaxial finite element model in normal structure. According to the established model in normal structure, the model in conditions of atlas assimilation was set by changing the model parameters. Both models of normal structure and atlas assimilation were loaded with 1. 5 N . m static moment to simulate four motions of flexion, extension, lateral bending and axial rotation respectively. The movement characteristics,joint stress force and ligament deformation was analyzed.

RESULTSUnder 1. 5 N . m moment, in model of atlas assimilation the C1-C2 range of movement decreased from 13. 55° to 11.88° in flexion,increased from 13. 22° to 15. 24° in extension and from 4. 05° to 4. 23° in lateral bending and remained unchanged in axial rotation when compared with the normal model. In flexion movement, the contact force of the atlanto-dental joint increased from 1. 59 MPa to 3. 28 MPa and the deflection of apical ligament, tectorial membrane and alar ligament increased 129. 1%, 157. 6% and 75. 1% respectively when compared with the normal model.

CONCLUSIONSThe normal C1-C2 motion mode is destructed in conditions of atlas assimilation, leading to the changes of the range of movement,joint stress force and the ligament deformation at C1 C2 junction. The atlantoaxial instability will likely occur in flexion motion.

Atlanto-Axial Joint ; physiology ; Biomechanical Phenomena ; Cervical Atlas ; physiology ; Cervical Vertebrae ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; Joint Instability ; Ligaments, Articular ; Occipital Bone ; Range of Motion, Articular ; Rotation

Background and purpose:Postoperative recurrence of esophageal cancer is one of the main factors that affect the patients’ prognosis and quality of life. This study mainly investigated the clinical features of thoracic stomach cancer (TSC) after surgical treatment for esophageal carcinoma. Methods:We retrospectively reviewed 51 cases of postoperative TSC in our hospital. Results:10.97% of the cases with TSC were diagnosed by endoscopy. There were 13 cases who also had anastomotic recurrence. The locations of 46 cases (90.2%) in 51 patients were same as the primary cancer. 48 cases of them were squamous cell carcinoma and 3 cases were adenocarcinoma at the time of esophagectomy for esophageal carcinoma. Endoscopic manifestations were puffiness-infiltrating type 39.2%(20/51), massive type 15.7%(8/51), ulcerative type 7.8%(4/51) and ulcer-infiltrating type 33.3%(17/51) and diffuse infiltrating type 3.9(2/51). Conclusion:The incidence of TSC after surgical treatment for esophageal carcinoma was high. The main cause was that the local residual cancer invaded the gastric wall. The gastroscopic features of TSC were different from gastric cancer. The follow up with endoscopy for the postoperative patients with esophageal carcinoma is a primary way to diagnose TSC.

Background:Gastric cancer(GC)is the fourth commonly seen cancer in the world. The role of Notch signaling pathway in the pathogenesis of tumors has become a focus in related studies,however,the underlying mechanism of Notch1 in GC has not yet been fully understood. Aims:To investigate the expression and significance of Notch1 in human GC tissue. Methods:A total of 115 patients with GC admitted at Jiaxing First Hospital from October 2011 to July 2014 were enrolled. Expression of Notch1 in cancerous tissue and para-cancer noncancerous tissue was determined by immunohistochemistry. The correlation between expression of Notch1 and clinicopathological characteristics of GC was analyzed. Results:Expression rate of Notch1 in cancerous tissue was significantly higher than that in para-cancer noncancerous tissue(73. 9% vs. 3. 5% ,P < 0. 001). Notch1 expression in cancerous tissue was significantly correlated with depth of vascular involvement,lymph node metastasis and TNM stage of GC(P < 0. 05). Conclusions:Notch1 as a cancer-promoting gene is involved in the pathogenesis of GC,and has a close association with tumor invasion and metastasis.

Objective To explore the clinical features, diagnosis and treatment of ectopic thyroid gland and to improve the management of ectopic thyroid. Methods The clinical data of 15 cases of ectopic thyroid in our hospital and the literatures were analyzed. The clinical features of ectopic thyroid gland, its diagnosis and the treatment were summarized. Results Of the 15 cases, 13 cases underwent operation. Among them, 9 cases showed symptom relief and their thyroid gland function resumed normal with no reoccurrence, 3 cases were complicated by temporary hypothyroidism and 1 case was misdiagnosed and mistreated, resulting in permanent hypothyroidism and lifetime thyroid hormone replacement. Conclusions Ectopic thyroid gland is a rare disease which was frequently misdiagnosed and mistreated. Improvement of related examination is essential in reducing misdiagnosis and mistreatment.

Objective:To investigate the syndromes distribution in patients with dysfunctional uterine bleeding(DUB) related to kidney deficiency, and to provide the basis for standardizing the DUB syndrome differentiation of kidney deficiency. Methods: DUB Patients with kidney deficiency were chosen and accepted epidemical survey through the questionnaire, then the frequency and constituent ratio of each syndrome were calculated. Results: In 612 cases of DUB patients with kidney deficiency, there were 102 patients with simple syndromes covered 16.67%, and 510 patients with compound syndromes covered 83.33%. In patients with simple syndromes, the common syndromes were kidney-yin deficiency(45,44.12%) and kidney-qi deficiency(45,41.18%). And the syndromes of kidney-qi deficiency and kidney-yin deficiency were often respctively complicated with liver stagnation(68,11.09%; 113,18.43%), blood defi ciency(57,9.30%; 99,16.15%) and blood stasis(57,9.30%; 99,16.15%), the syndrome of kidney-yang deficiency usually complicated with spleen-qi deficiency(75,12.23%). The syndrome of kidney-qi deficiency(186,57.23%) was commonly-seen in the patients with ovular DUB, while the syndromes of kidney-qi(146,50.69%) and kidney-yin deficiency(111,38.54%) were frequently-seen in the patients with anovular DUB. Conclusion: In clinic, the compound syndromes were commonly seen in patients with DUB due to kidney deficiency, the complicated syndromes of kidney deficiency were liver stagnation, spleen-qi deficiency, blood deficiency and blood stasis..

Objective To describe the clinical features, radiological and pathological characteristic and the treatment of the cerebral arteriovenous malformations (AVM) which were appeared diffuse on angiography. Methods The related clinical information of 8 cases with AVM which were diagnosed by cerebral angiogram were reviewed and analyzed. Results 8 cases were found to be diffuse AVM. They were mostly presented with intracerebral hemorrhage. On angiography, the AVM included multiple small arterial feeders, a diffuse, wedge-shaped and puddling appearance of the contrast dye, without an identifiable compact nidus. Multiple draining veins were noted. 4 cases were underwent craniotomy, the AVM were completely removed in 2 cases, 1 case who was pretreated with embolization had residual nidus after operation, and the nidus of the other one case was not removed completely because the nidus located in the eloquent area of the brain. On histological examination, normal brain tissue were found in the abnormal AVM vessels. In the rest 4 cases, 2 patients died of repeated intracerebral hemorrhage, and the other 2 cases received no special treatment. Conclusion The diffuse cerebral AVM is different from the typical AVM on angiography and histopathology. Because of its' diffuse character, it should be treated individually. If the lesion locates in the silent areas of the brain, craniotomy should be taken, but it is difficult to remove the nidus completely.

OBJECTIVETo investigate the role of R-Spondinl in the activation of hepatic stellate cells (HSCs).

METHODSTwenty-four healthy male Kunming mice were randomly divided into the following two groups:fibrosis model group (n=16) and control group (n=8). Hepatic fibrosis was induced by subcutaneous injections of CC14 (20% in olive oil) at a dose of 5 ml/kg twice per week. After 10 weeks, the animals were sacrificed by CO(2) over-exposure and liver tissues were harvested.The protein and mRNA levels of R-Spondin1, alphat-SMA,and collagen I were examined by Western blot assay and real-time PCR respectively. Additionally,HSCs were isolated from the mice liver tissues to examine the time-series expression changes of R-Spondinl, alpha-SMA, and nuclear beta-catenin.TCF activity was analyzed by luciferase reporter assay.Moreover,HSCs were cocultured with recombinant R-Spondin1 and DKK1 to evaluate dose-response.

RESULTSR-Spondinl expression was significantly higher in the fibrosis model group than in the control group (protein level:3.16 ± 0.18 vs. 0.99 ± 0.16, t =13.31, P < 0.01; mRNA level:4.36 ± 0.26 vs. 0.98 ± 0.12, t =21.46, P < 0.01).The culture-activated mouse HSCs showed up-regulated TCF activity (5.33 ± 0.34 vs. non-activated: 1.03 ± 0.09, t =20.93, P < 0.01), nuclear beta-catenin expression (4.47 ± 0.21 vs. 0.97 ± 0.14, t =25.25, P < 0.01), and R-Spondin1 expression (protein level: 4.54 ± 0.18 vs. 1.04 ± 0.12, t =31.17, P < 0.01; mRNA level:5.13 ± 0.15 vs. 1.01 ± 0.16, t=38.06, P < 0.01). Exogenous stimulation of freshly isolated mouse HSCs with recombinant R-Spondin1 induced a dose-dependent increase in both TCF activity and the expression of nuclear beta-catenin and alphat-SMA. DKK1 down-regulated activities of factors in the WNT signaling pathway and repressed activation of HSCs. Conclusion R-Spondin1 may promote HSC activation by enhancing the canonical WNT signaling pathway.

Animals ; Down-Regulation ; Extracellular Matrix Proteins ; Hepatic Stellate Cells ; Liver Cirrhosis ; Male ; Mice ; RNA, Messenger ; Wnt Signaling Pathway ; beta Catenin