Objective To study the methods for diagnosis and treatment of insulinoma.Methods The clinical data of 120 patients with insulinoma who had been admitted to our hospital in the last 40 years were retrospectively reviewed.Results Fasting blood glucose values were less than 2.75 mmol/L in all the patients.Fasting serum insulin values in 75 patients were higher than 25 ?U/mL,and the average was (65 ?6.0)?U/mL.Before operation,tumor was detected in 2 of 60 patients by ultrasound scan,and in 10 of 50 by CT. Among 18 patients who had intra-operative B-ultrasound examination, 16 positive cases were verified by intraoperative exploration; and one case the tumor was not palpable but was found by intraoperative B-ultrasound examination.The operations included enucleation of insulinoma(70 patients),insulinoma resection and distal resection of the pancreas(44),distal resection of the pancreas(4),and biopsy(2).The low blood glucose symptoms disappeared after the first operation in 111 of the 112 patients who had benign tumor.One case with benign tumor was cured by a second operation.Twenty patients developed pancreatic fistula after tumor enacleation, of them,14 healed uneventfully after drainage,5 were cured by operation,and 1 died of peritoneal infection.Conclusions Preoperative localization of insulinomas is difficult. Intraoperative exploration and ultrasound scan are the chief methods for the localization of insulinoma.Enucleation of insulinoma should be selected for benign tumor. Resections of the pancreatic body and tail is required for large,deep or multiple tumors.

ObjectiveTo analyze the epidemiological characteristics and incidence trend of influenza-like illness in Xuhui District from 2010 to 2019， in order to understand the patterns of influenza epidemic of Xuhui District，and to provide evidence for the prevention and control of influenza in the future. MethodsSurveillance data of influenza-like illness （ILI） in Xuhui District from 2010 to 2019 were collected from the National Influenza Surveillance System for statistical description and trend analysis. ResultsFrom 2010 to 2019， the overall proportion of influenza-like illness was 0.54%. The annual proportions of ILI were between 0.35%~1.14%．The majority of cases were reported in age group of 25~59， accounted for 54.50% of the total ILI. A total of 9 053 throat swab specimens from ILI patients were collected and tested， from which 2 137 specimens were positive， with a positive rate of 23.61%. The most frequent subtype of influenza virus detected was influenza A virus （accounting for 67.62%）. The proportion of ILI and the positive rate of influenza virus nucleic acid detection reached the peak in summer and winter over time. There was a positive correlation between the proportion of ILI and the positive rate of influenza （r=0.666， P<0.01）. From 2010 to 2019， both ILI% and nucleic acid positive rate of influenza virus showed a downward trend. ConclusionThe incidence of influenza shows a downward trend in Xuhui District， with two peaks in summer and winter. The most susceptible individuals are in 25~59 age group. The dominant strains of influenza virus alternate regularly， influenza A（H3N2） dominate the summer epidemic peak while the epidemic peak in winter is dominated by influenza A（H1N1） and influenza B.

AIM:To investigate the inhibitory effect of small interfering RNA ( siRNA) on the expression of protein kinase Cε( PKCε) in human hepatoma SK-Hep-1 cells, and the biological behaviors of the transduced cells , inclu-ding proliferation and invasion , were investigated.METHODS:The cultured SK-Hep-1 cells were divided into 3 groups, including PKCε-siRNA group , negative control ( NC)-siRNA group and control group .MTT assay was used to analyze the proliferation of the SK-Hep-1 cells in the respective groups , while invasion potency was determined by Transwell assay .The protein levels of functional biomarkers such as Ki 67 and matrix metalloproteinase 9 ( MMP-9 ) were measured by Western blotting .The Luciferase reporter gene assay was used to explore the activity of the NF-κB pathway .RESULTS:PKCεex-pression in SK-Hep-1 cells transfected with PKCε-siRNA was significantly down-regulated at both mRNA and protein levels compared with that in the normal SK-Hep-1 cells (P<0.01), with the decreases in the protein levels of Ki67 and MMP-9. The invasion and proliferation of SK-Hep-1 cells were obviously inhibited in PKCε-siRNA group compared with control group (P<0.01).Furthermore, the transcriptional activity of NF-κB was down-regulated when PKCε was effectively in-hibited by PKCε-siRNA (P<0.01).CONCLUSION:Down-regulation of PKCεinhibits the proliferation and invasion of hepatic carcinoma cells , which might be mediated via the NF-κB signaling pathway .

Objective To observe the influence of Huiyang Shengji Ointment and its modified formulae on interleukin-1 (IL-1α) and thromboxane B2 (TXB2) in diabetic rats with chronic skin ulcers, and explore the mechanism for promoting the healing of ulcer.Methods Six out of 160 rats were randomly selected as a blank group, without any further processing. The remaining rats were made diabetic model and randomly divided into five groups after 2 weeks:1 d, 3 d, 5 d, 7 d and 14 d groups. Then, these groups were further divided into normal group (Vaseline ointments), model group (Vaseline ointments), Huiyang Shengji Ointment group (whole formula Ointment), Wenyang Yiqi group (Yiqi group, modified Wenyang Yiqi formula ointments) and Huoxue Shengji group (Huoxue group, modified Huoxue Shengji formula ointments). Normal group and model group were given Vaseline ointments;whole formula group, Yiqi group and Huoxue group were given corresponding ointment. Normal group used the method of skin excision, while other groups used STZ injection-hydrocortisone interference-skin excision-foreign body embedded preparation of composite factors for chronic skin ulcer model. After the appropriate treatment period, the rats were executed and tested for the contents of IL-1α and TXB2 in serum by enzyme-linked immunosorbent assay of five time points.Results In treatment 3 d, the contents of IL-1α in Yiqi group were significantly higher than the blank group, model group, whole formula group and Huoxue group (P<0.05). In treatment 5 d, the contents of IL-1α in whole formula group were significantly higher than the blank group and model group (P<0.05). In treatment 7 d, the contents of IL-1α in each treatment group were significantly higher than blank group and model group (P<0.05), and the whole formula group was higher than the Yiqi group and Huoxue group. In treatment 14 d, the contents of IL-1α in model group and Huoxue group were lower than the blank group (P<0.05). In treatment 3 d, the contents of TXB2 in normal group and the whole formula group were higher than the blank group (P<0.05). In treatment 5 d, the contents of TXB2 in whole formula group were higher than the blank group and the normal group (P<0.05). In treatment 7 d, the contents of TXB2 in Yiqi group were higher than the blank, the model, the whole formula and Huoxue groups (P<0.05). In treatment 14 d, the contents of TXB2 in Huoxue group were higher than the blank and model group (P<0.05), and the contents of TXB2 in the blank group and normal group was lower than those treatment groups (P<0.05).Conclusion Huiyang Shengji Ointment and its modified formulae could promote inflammation, stimulate secretion of inflammatory cytokines, while Yiqi Wenyang ointments played a more active role in promoting inflammation of the early phase of wound surface.

Objective To understand the relationship between the dietary patterns and metabolic syndrome among elderly people in Zhejiang province,in order to provide scientific basis and reference for nutrition interventions.Methods Data were obtained from the 2010-2012 Chinese National Nutrition and Health Survey,and factor analysis was used to obtain food patterns among elderly people in Zhejiang province.The Logistic regression was used to explore the association of the food patterns with metabolic syndrome and its components.Results The intakes of bean products,nuts,fruits,eggs,and milk in elderly people were generally low,and the intakes of livestock and poultry meat,cooking oil and salt were relatively high.5 dietary patterns were derived by factor analysis:high-quality protein diet,mediterranean diet,condiments diet,traditional dietary pattern and western dietary pattern.The medical test results in 780 elderly people showed that the standardized prevalence of metabolic syndrome in the elderly was 28.8％,standardized central obesity rate was 41.2％,standardized hypertension rate was 50.3％ and standardized hyperglycemia rate was 39.5％.Logistic regression analysis showed that different dietary patterns had different effects on the metabolic syndrome and its components.Conclusions The prevalence rate of metabolic syndrome and the abnormal rates of its components are high in the elderly in Zhejiang.The intakes of fruits and milk are generally low,and intakes of livestock and poultry meat,cooking oil and salt are relatively high.The relationship between dietary patterns and MS or its components is complicated,so it is necessary to guide the elderly people to adopt reasonable diet by referring to the Diet Pagoda in order to reduce the risk of MS or its components.

Aged ; Bone Marrow ; metabolism ; Cytokines ; metabolism ; Female ; Humans ; Karyotype ; Male ; Mesenchymal Stromal Cells ; Middle Aged ; Myelodysplastic Syndromes ; genetics ; metabolism

OBJECTIVE: To investigate the rule of lymphatic formation and the relationship between lymphatic formation and clinical pathological factors in supraglottic carcinoma. METHOD: Immunohistochemistry method and automatic image analysis technique were applied to observe the lymphatic quantity and state in central carcinoma tissue, join tissue and normal larynx mucosa of supraglottic carcinoma. Analyze the rule and the correlation between lymphatic formation and T stage, differentiation, lymph metastasis. RESULT: The lumen-lymphatic formation was not seen in central carcinoma tissue. There are little lymphatic in normal larynx mucosa whereas many lymphatic formation in join area. The lymphatic density in join tissue is correlated with T stage, differentiation and lymph metastasis: T(1-2) lower than T(3-4) and the difference is significant (P<0.01); The difference between high and middle differentiation is insignificant (P=0.212); High-middle differentiation lower than low differentiation and the difference is significant; No lower than N+ and the difference is significant (P<0.01). CONCLUSION In join area, there are lymphatic formation both in carcinoma area and para-tumor area. Tumor cell can go to lymph nodes via this pathway. This conclusion provides theoretical basis for clinical utility of the anti-tumor medicines which inhibitable lymphatic formation. It can help surgeons forecast prognosis and select more effective treatment method to observe join lymphatic vessel quantity.
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; pathology ; Female ; Humans ; Laryngeal Neoplasms ; pathology ; Lymph Nodes ; pathology ; Lymphangiogenesis ; Lymphatic Metastasis ; Lymphatic Vessels ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis

The nasal deformity secondary to cleft lip of 1 0 patients was repaired with lateral segment of partial costal cartilage harvested by a self-made special knife.6 to 30-month follow-up showed that nasal alar morphology of all patients was improved.No any complications happened at donor site.

Objective To evaluate the diagnostic accuracy of coronary artery stenosis caused by calcified coronary artery plaques with 64-detector row CT under different conditions. Methods Totally 165 patients with coronary artery calcification accompanied by one or more branches stenosis more than 50% detected with computed tomography coronary angiography (CTCA) were collected. The Agatston calcium score (ACS) and stenosis rate were calculated based on per-patient, per-vessel, per-segment, various stenosis degree and different morphology of calcification as the analysis object, respectively. The measurement results of coronary angiography (CAG) were taken as the gold standard. The diagnostic accuracy was evaluated with receiver operating characteristic (ROC) curves which were created to assess the diagnostic value and to determine the diagnostic cutoff level (threshold). Results When per-patient analyzed, the greatest diagnostic accuracy rate was obtained with ACS threshold of 113.5, and the area under curve (AUC) value of ROC was 0.791. With the analysis object of per-vessel, the greatest diagnostic accuracy rate was found in right coronary artery and its sub-branches, and the AUC value was 0.897. Per-segment analyzed, the highest accuracy rate was obtained in RCA1 segment, and the AUC value was 0.894. When the analysis object was the morphology of calcification, the range of AUC value was merely 0.601-0.667, while the diagnostic value was rather low. The highest accuracy of CTCA was obtained in stenosis less than 50%, and the AUC value was 0.856. Conclusion Coronary artery calcification has different influence on the diagnostic accuracy rate of coronary artery stenosis with CTCA in various situations. Moreover, the morphology of the calcification may not be the main impact factors of the diagnostic accuracy.