Objective To investigate the relationship between bile amylase (BA) elevation and biliary tract disease in patients with normal pancreaticobiliary junction (NPBJ). Methods The bile juice was collected from bile duct in 202 consecutive cases who underwent therapeutic endoscopic retragrade cholangiopancreatography (ERCP) for biliary diseases ( biliary bile group), and from gallbladder (GB) in 73 consecutive cases who underwent percutaneous transbepatic cholecystoscopy for extraction of GB stone ( GB bile group). In biliary bile group, in addition to the measurement of BA, the level of lipnse (n =68), bacteria culture ( n = 149 ), manometry of Oddi's sphincter ( n = 27 ) and bile duct ( n = 38) were also performed. In GB bile group, additional GB biopsy was taken in 31 cases. No patient with pancreaticobiliary maljunction, history of cholangiojejunostomy or post-endoscopic sphincterotomy was included in the study. Results In biliary bile group, BA level was elevated in 95 patients (47. 0% ), in which there was no significant difference between neoplastic and non-neoplastic cases ( 56. 9% vs. 43.7%, P > 0. 05 ), although BA was elevated in most patients with hiler cholangiocarcinoma (7/9). The level of BA was correlated with bile lipase (r =0. 561 ), but not with pressure of Oddi's sphincter or bile duct. No significant difference in positive rate of bile bacteria culture was detected between patients with normal BA level and those with elevated level. In GB bile group, BA level was elevated in 25 patients (34. 3% ), in which the frequency of GB epithelium dysplasia is 87.5%, which was significantly higher than that from patients with normal BA level ( P < 0. 001 ). Conclusion The patients with biliary tract disease and NPBJ have high incidence of reflux of pancreatic juice into bile duct. In patients with elevated BA level, there was no significant difference between incidences of neoplastic or non-neoplastic disease, while the frequency of GB epithelium dysplasia and hilar cholangiocarcinoma were higher than those from patients with normal BA level.

Aged ; Angina Pectoris, Variant ; physiopathology ; Coronary Vasospasm ; physiopathology ; Coronary Vessels ; physiopathology ; Humans ; Male

Adult ; Aged ; Aged, 80 and over ; Bile Duct Diseases ; diagnosis ; Bile Duct Neoplasms ; diagnosis ; Cholangiopancreatography, Endoscopic Retrograde ; Cytodiagnosis ; Cytological Techniques ; methods ; Female ; Humans ; Male ; Middle Aged ; Pancreatic Diseases ; diagnosis ; Pancreatic Neoplasms ; diagnosis

Objective To identify the configuration of the fascial sheath of the sciatic nerve in the adult pelvis . Methods A total of 14 cadaveric pelvic specimens and 20 living subjects were used for cadaveric examination and magnetic resonance imaging ( MRI) observation , respectively .The cadaveric specimens were investigated by the local latex injection method ( n =10 ) sectional anatomy ( n=2 ) or histological staining methods ( n =2 ) .The MR images were collected and analyzed from twenty patients without pelvic disorders .Results The injected latex did not diffuse along the pelvic segment of the sciatic nerve .Sectional anatomical and histological data showed that the architecture of the fascial sheath of the sciatic nerve varied at different levels .An intact circular sheath around the nerve was rarely observed .There was no fascia barrier between the obturator and sciatic nerves .Appearance on MRI was consistent with the cadaveric observation.Conclusion No intact fascial sheath exists along the pelvic segment of the sciatic nerve , thus sciatic anesthesia may block the obturator nerve .

OBJECTIVETo express and purify the protein coded by the TRAF-type zinc finger domain of myasthenia gravis (MG)-related gene P9 (P9-ZFD) and to prepare P9-ZFD antiserum for detecting expression and subcellular distribution of P9-ZFD protein in the skeletal muscles of patient with MG.

METHODSThe cDNA encoding P9-ZFD was amplified by RT-PCR. The cloned P9-ZFD cDNA was ligated into pET24a, and the P9-ZFD recombinant protein was induced via E. coli. BL21 (DE3) and purified by histidine affinity chromatography. P9-ZFD antiserum was prepared and its titer and specificity were determined by ELISA and Western blot. Expression and subcellular distribution of P9-ZFD protein in the skeletal muscles of MG and control were studied.

RESULTSThe molecular weight of purified P9-ZFD protein was about 30 kD. Its purity was more than 95%. Antiserum specific for P9-ZFD was excellent. P9-ZFD protein is fully confined to the cytoplasm membrane of skeletal muscle cell of MG, obvious immunostaining was absent in the A, I, and Z bands of cytoplasm and no immunoreactivity was observed in the skeletal muscle cell of control.

CONCLUSIONP9-ZFD protein is expressed as a cytoplasm membrane-bound protein and has obvious distribution difference in the skeletal muscle cells of patient with MG and normal control.

Adult ; Cell Membrane ; metabolism ; Escherichia coli ; metabolism ; Female ; Humans ; Muscle Proteins ; biosynthesis ; genetics ; Muscle, Skeletal ; metabolism ; pathology ; Myasthenia Gravis ; metabolism ; Peptide Fragments ; biosynthesis ; genetics ; Recombinant Proteins ; biosynthesis ; genetics ; Transfection ; Zinc Fingers

Objective To investigate the effects of blockade of OX40/OX40L costimulation pathway on mice islet allograft tolerance in CD40/CD154 costimulation pathway blockade mice.Methods C57BL/6 mice were induced into diabetes mellitus as recipients,and were transplanted with DBA/2 mice islets.The recipients were divided into four groups,(1) treated with IgG as controls,(2) anti-OX40L mAb,(3) anti-CD154,(4) combined treatment of anti-OX40L mAb and anti CD154mAb.The mean survival time (MST) of islet allograft was observed.The expression of OX40 in activated T cells of CD154 deficient mice was detected.Effector T cells were obtained from the spleen of CD154 deficient mice cultured with or without anti-OX40L mAb for 3 days.The proliferation of T cells was assayed.Results The MST in the control group,anti-OX40L mAb group,anti-CD154 mAb group and anti OX40L mAb + anti-CD154 mAb group was 19,22,48,and ＞150 days respectively (P ＜0.05).The OX40 expression was readily induced in the 66％ activated T effector cells.CD154 deficient T effector cells proliferation was inhibited by the addition of anti-OX40L mAb in the culture in a dose-dependent fashion.Conclusion The blockade of OX40/OX40L costimulation pathway can promote islet allograft tolerance in CD40/CD154 costimulation pathway blockade mice by inhibiting the proliferation of T cells.

OBJECTIVETo explore the effect of Dandi Tablet (DDT), a TCM preparation for tonifying Shen and activating blood circulation, on blood lipids and sex hormones in women of postmenopausal stage.

METHODSSeventy-three women were randomly divided into two groups. The 46 subjects in the DDT group were treated with DDT (consisted of prepared Rehmannia Root 24 g, Dogwood Fruit 9 g, Poria 9 g, Water-plantain 9 g, Tuber Peony bark 9 g, Chinese Yam 12 g and Red Sage 15 g, etc.) twice a day, 4 tablets each time. The 27 subjects in the control group were treated with nylestriol (each tablet contains 2.5 mg of 17 alpha-ethynylestriol-3-cyclopentyl ether) 5 mg every month, for 3 successive months. Levels of blood lipids, including total cholesterol (TC), triglyceride (TG), high and low density lipoprotein cholesterol (HDL-C, LDL-C), apoprotein A and B (apoA, apoB) and sex hormones, including follicular stimulating hormone (FSH) and estradiol (E2) were determined before and after treatment.

RESULTSCompared with pre-treatment, after treatment, levels of TC/HDL-C and FSH significantly lowered, HDL-C and E2 increased in both groups (P < 0.05 or P < 0.01), levels of TG lowered and apoA increased significantly in the DDT group (P < 0.05).

CONCLUSIONDDT has the effect of elevating levels of estrogen and improving blood lipid metabolism, therefore shows a coronary heart disease preventive effect in women of postmenopausal stage.

Adult ; Aged ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; Coronary Disease ; prevention & control ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Estradiol ; blood ; Female ; Follicle Stimulating Hormone ; blood ; Humans ; Middle Aged ; Phytotherapy ; Postmenopause ; Tablets ; Triglycerides ; blood

BACKGROUND:Recent years, fiber posts and resin cores have been widely used in repairing the endodonticaly treated teeth with satisfactory effect. Erbium:yttrium aluminum garnet (Er:YAG) laser is a new type of water power laser system, which can be used for surface treatment of fiber posts. But studies on the effect of Er:YAG laser surface treatment on the bond strength of fiber posts are rarely reported. OBJECTIVE: To evaluate the effect of surface treatment utilizing Er:YAG laser irradiation with different parameters on the bond strength of fiber posts to root canal dentin. METHODS: Fifty human maxilary central incisors that had similar dimensions were used. After endodontic treatment, removal of the crown and canal preparation, ParaPost FIBER LUX glass fiber posts were cemented into the root canals. According to the method of surface treatment, 50 teeth were randomly divided into: no surface treatment as control group; four groups undergoing surface preparation with Er:YAG laser with four different power settings (150, 250, 350 and 450 mJ at 10 Hz for 60 s at 100-μs pulse duration), named 1.5, 2.5, 3.5, and 4.5 W Er:YAG laser irradiation groups, respectively. RESULTS AND CONCLUSION: The mean bond strength values reduced from the cervical to the apical root canal, and the bond strength of the dental cervix was significantly different from that of middle and apical thirds (P < 0.05), but there was no difference between the middle and apical thirds (P> 0.05). Regardless of the different part of the root slices, the bond strength was highest in the 4.5 W Er:YAG laser irradiation group, showing significant difference from other groups (P < 0.05). These findings indicate that 4.5 W Er:YAG laser irradiation significantly increases the bond strength of the fiber posts to root canal dentin.

Objective To evaluate the value of intra-cavitary contrast-enhanced ultrasound (IC-CEUS) via abdomen in fistulas difficult to diagnose before operation.Methods Clinical data of 12 patients with preoperative clinical suspicion of Crohn's Disease (CD) complications of fistula were enrolled in the study.Colonoscopy,cystoscope,or CT/MR has not confirmed the diagnosis of intra abdominal fistulas.IC-CEUS were performed by locally-injection of contrast agent in abdominal abscess,observing fistula and the relationship with the adjacent organs in CEUS mode.Diagnostic criteria were surgical findings.Results Fistulas in 10 patients were detected by IC-CEUS,including 7 cases of Ileo-mesenteric fistuls,2 cases of il eo-vesical fistulas,and 1 case of colo-vesical fistula.The accuracy rate of IC-CEUS in diagnosis of fistulas difficult to diagnose before operation in Crohn's disease was 83.3％ (10/12).No severe adverse events occurred during and after IC-CEUS procedure.Conclusions Our preliminary study shows that IC-CEUS is feasible in detecting abdominal fistula with high accuracy.It might be used as the alternative imaging tech nique for detecting fistulas when CT and MR are insufficient.

BACKGROUND:Deep vein thrombosis after total knee arthroplasty has attracted increasing attention in recent years,but how to detect deep vein thrombosis in the early time in clinical practice remains unclear.Whether it is necessary to perform type-B ultrasonic or other invasive examination in lower limbs has become a hot issue.OBJECTIVE:To explore the significance of D-Dimer and fibrin degradation products in the prediction of deep vein thrombosis after total knee arthroplasty.METHODS:56 patients received total knee arthroplasty were colected from Department of Orthopedics,The 306th Hospital of Chinese PLA,between December 2012 and February 2014.The D-Dimer and fibrin degradation products were dynamicaly monitored before operation and at 1,3,5,7,10 days post-operation.Al the patients received type-B ultrasonic examination in double lower limbs at 10 days post-operation,and divided into thrombus group and non-thrombus group.The D-Dimer and fibrin degradation products in the two groups were compared.RESULTS AND CONCLUSION:Deep vein thrombosis was found in 13 cases by ultrasonic-B postoperation,D-Dimer and fibrin degradation products showed no significant difference between the two groups at 1 week after operation (P＞0.05),but the difference was significant at 10 days (P＜0.01).D-Dimer and fibrin degradation products index should be monitored dynamicaly for at least 10 days after operation,which is helpful for the earlydiagnosis of thrombosis.