Objective To investigate the diagnosis and treatment of hepatolithiasis complicated by bronchobiliary fistula.Method The data of 35 patients with hepatolithiasis and bronchobiliary fistula treated in our department in the last 10 years were retrospectively studied.Results The operations were:-repair of fistula in the diaphragm (n=35),hepatic segmentectomy (n=22) biliary stricturoplasty (n=13),T-tube drainage of common bile duct (n=19),hepaticojejunostomy (n=3) and bilateral hepatojejunostomy with a Roux-en-Y loop of jejunum (n=13).Residual stones were left in 4 patients.There was no recurrence of the bronchobiliary fistula on follow-up.Conclusions Expectoration of bitter and purulent yellow sputum was an important clinical feature of bronchobiliary fistula.The key steps in a successful operation were reliefing the obstructed bile duct and re-establishment of adequate biliary drainage.

OBJECTIVETo investigate the expressions of sphingosine-1-phosphate receptors 1-3 (S1P1- 3) in the corpus cavernosum of castrated male rats and its relationship with the NOS/NO/cGMP and RhoA/Rho kinase signaling pathways.

METHODSWe equally randomized 18 eight-week-old healthy male SD rats into a sham-operation control, a castration, and a testosterone replacement (TR) group and harvested the bilateral testes and epididymides from the rats in the latter two groups, followed by 4 weeks of subcutaneous injection of testosterone propionate at 3 mg per kilogram of the body weight per day for those in the TR group and that of plant oil for those in the control and castration groups. At the age of 12 weeks, we measured the serum testosterone (T) level and maximum intracavernous pressure/mean arterial pressure (ICPmax/MAP) of the animals and determined the expressions of SlP1-3, eNOS, P-eNOS, ROCK1, and ROCK2 in the corpus cavernosum by Western blot and immunohistochemistry.

RESULTSThe serum T level was significantly decreased in the rats of the castration group as compared with those of the control and TR groups ([0.41 ± 0.04] vs [16.01 ± 1.02] and [15.84 ± 1.32] nmol/L, P < 0.01), with no statistically significant difference between the latter two groups. The ICPmax/MAP at 0 V, 3 V, and 5 V electric stimulation was remarkably lower in the rats of the castration group (0.088 ± 0.014, 0.323 ± 0.014, and 0.432 ± 0.012) than in those of the control group (0.155 ± 0.011, 0.711 ± 0. 010, and 0.819 ± 0.024) and TR group (0.153 ± 0.012, 0.696 ± 0.017, and 0.763 ± 0.027) (P < 0.01), with no significant difference between the latter two groups. With GAPDH as internal control, the animals of the castration group showed markedly reduced expressions of S1P1 ([49.99 ± 3.39]%), eNOS ([46.82 ± 3.81]%) , and P-eNOS ([45.42 ± 4.35]%) in comparison with those in the control group ([72.57 ± 3.06], [89.76 ± 3.98], and [82.53 ± 8.92] and TR group ([71.77 ± 4.43], [87.19 ± 4.23], and [79.82 ± 7.38]%) (P < 0.01) , while the expressions of S1P2, S1P3, ROCK1, and ROCK2 were significantly upregulated in the castration group ([82.35 ± 4.13], [61.03 ± 5.14], [74.50 ± 4.02], and [69.83 ± 5.75]%) as compared with those in the control group ([41.67 ± 1.68], [31.66 ± 2.67], [35.69 ± 5.56], and [39.85 ± 7.17]%) and TR group ([42.80 ± 3.87], [32.25 ± 4.22], 38.06 ± 5.21], and [42.36 ± 4.44]%) (P < 0.01).

CONCLUSIONAndrogen deficiency induces significant reduction of ICPmax/ MAP in male rats, which is possibly associated with the decline of S1P1 in the corpus cavernosum, inhibition of the eNOS/NO/cGMP signaling pathway, increased expressions of S1P2 and S1P3, and activation of the RhoA/Rho kinase signaling pathway.

Animals ; Male ; Nitric Oxide Synthase Type III ; metabolism ; Orchiectomy ; Penis ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Receptors, Lysosphingolipid ; metabolism ; Testosterone ; blood ; pharmacology ; rho-Associated Kinases ; metabolism

Objective To identify the role of survivin and VEGF in angiogenesis of colorectal tumor by investigating tissue expression of survivin, VEGF and CD34 in human colorectal tumors. Methods Immunohistochemical staining for the paraffin sections by using the polyclonal antibodies of survivin, monoclonal antibodies of VEGF and CD34, was performed by the standard avidin-biotin-peroxidase technique. The percentage of positive cell and quantitative analysis were made by image analysis system, which also helped to calculate the amount of MVD. Results The immunoreactivity of survivin significantly increased in the transition from adenoma with low dysplasia to adenoma with high dysplasia (P <0.01). Similar changes in protein expression were observed for VEGF and MVD. The expression of survivin was closely related with that of VEGF. Both were positively correlated with MVD. Conclusion Survivin promotes angiogenesis of colorectal tumor together with VEGF. VEGF may be the potential causes of reexpression of survivin during colorectal tumorigenesis.

Background Pterygium is a relatively common eye disease,but its aetiology and pathogenesis remain uncertain.At present,the study on pterygia focuses on understanding its underlying mechanism.Objective This study was to detect the expression of 8-hydroxy-2'-deoxyguaine (8-OHdG),a marker of oxidative damage of DNA,and bcl-2,a gene related with apoptosis,on the pterygium tissue.Methods Thirty pterygium tissue specimens were obtained during the surgery with the primary pterygium 24 cases and recurrent pterygium 6 cases.In addition,20 normal conjunctival specimens from retinal detachment surgery and strabismus surgery were collected.The expressions of 8-OHdG and bcl-2 in pterygium tissue were detected using immunochemistry and compared with the normal conjunctival tissue.The difference in the expressions of 8-OHdG and bcl-2 among different specimens was compared by x2test,and the relationship between 8-OHdG expression and bcl-2 expression was evaluated by Kappa test.Results The positive expressing rate of 8-OHdG in the pterygium tissue was 62.5％ and 83.3％ in the primary and recrudescence pterygium tissue,respectively,but the expression of 8-OHdG was absent in the normal conjunctiva tissue.No significant difference was found in the positive expressing rate of 8-OHdG between primary and recrudescence pterygium tissue(x2 =0.938,P＞0.05).The bcl-2 expressing rate was 90.0％ and 87.5％ in the primary and recrudescence pterygium tissue,respectively.However,that in the normal conjunctival tissue was absent.No significant difference was seen in the bcl-2 expression rate between primary and recrudescence pterygium tissue (x2=0.833,P ＞ 0.05).Of the 27 pterygium tissue with bcl-2 positive expression,8-OHdG showed the positive expression in 20 specimens,and 3 specimens with the bcl-2 negative response were absent reactive to 8-OHdG,showing insignificant difference between them (P＞0.05).The relationship between 8-OHdG expression and bcl-2 expression was concord in a certein extent (Kappa =0.464).Conclusions The upregulation of 8-OHdG in the pterygium tissue indicates that oxidative damage of DNA plays a role in the development of pterygium.Oxidative damage of DNA caused by ultraviolet may be an upriver factor,which induces raising up of expression of bcl-2 and inhibits the apoptosis of normal cells and further proliferation of the conjunctiva tissue,resulting in the genesis and development of pterysium.

The introduction of highly active antiretroviral therapy (HAART) has greatly changed the pattern and natural history of ocular diseases of HIV-infected patients, resulting from the immune recovery and reduction of opportunistic infections. However, ophthalmic complica-tion continues to be concern in AIDS even in the HAART era, especially in developing areas, where absolute majority of HIV-positive patients live. Lack of test facilities and experience, poor conditions of hygiene, different microbiological environment, absence of effective treatment etc., characterize the ophthalmic manifestation of HIV-infected patients in developing countries from that in developed regions and thus pose a great challenge to the ophthalmic treatment in developing area. Not only varied from region to region, ocular complications are distinctive between adults and children. At the same time, the side effects due to the application of HAART pose their own risks of ocular complication and should, therefore, be given more research attention.

Objective To investigate the clinical features of patients with recurrent epithelial ovarian cancer (EOC),and explore the factors that can prolong the disease-free interval(DFI) after primary treatment.Methods We retrospectively reviewed the medical records of 54 patients with recurrent EOC and analyzed the clinical stage,histological subtypes,primary treatments,DFI,recurrent site,secondary treatment,and the response after secondary treatment.By Mann-Whitney test and T test,factors influent the DFI were analyzed,the relationship between DFI and the response after secondary treatment were analyzed also.Results The mean DFI for all 54 patients was 19.07 months.The DFI of patients received optimal cytoreductive surgery was longer than those received non-optimal cytoreductive surgery [(32 ± 19.10) months vs (18.77 ± 7.80) months,P ＜ 0.01];The DFI of patients with serous,mucous and clear cell tumor was [(20.16 ± 14.63) months,(14.00 ± 4.73) months and (16.67 ± 13.03) months,respectively],suggesting patients with mucous tumor might have shorter DFI.The DFI of patients with low tumor grade was longer than those with high tumor grade [(28.18 ± 16.97) months vs (16.52 ±9.46) months,respectively];The DFI of patients with stage Ⅰ and Ⅱ disease was [(19.60 ± 12.89)months],was compared to the DFI of patients with stage Ⅲ,stage Ⅳ disease,which was [(19.22 ± 12.38) months] and [(11.67 ±5.39) months],respectively.When disease recurred,the most frequent recurrent site was pelvic (50％,n =27),with upper abdominal (29.6％) and lymph node(29.6％) followed.When recurrence was found in lymph node,the most frequent site was pelvic and para-arotic lymph node.In our study,when disease recurred,response of the tumor after the secondary treatment has no relationship with the DFI.Conclusions Patients received optimal cytoreductive surgery,patients with low tumor grade and early stage have longer DFI.Retroperitoneal lymphadenectomy might be chosen during the primary cytoreductive surgery in some selected patients.

Objective: To explore the relationship between mental symptoms and functional dyspepsia (FD), and the effect of Xiaoyu decoction (XYD) plus psychotherapy on FD. Methods: SCL-90 scale and FD symptom scale were used to estimate the condition of 56 healthy subjects and 56 patients of FD before and after 4 weeks treatment with XYD plus psychotherapy. Results: There was significant difference in SCL-90 scales between the healthy subjects and the FD patients before treatment (P<0.01). After treatment, the mental symptoms and the symptom of FD in the patients were markedly improved, as compared with those before treatment, the difference was significant (P<0.01). Conclusion: Mental symptoms, such as depression and anxiety existed commonly in FD patients, were closely related to FD. XYD plus psychotherapy could cure it effectively.

Background and purpose: Lysine specific demethylase 1(LSD1) is an important chromatin modifier. It epigenetically regulates gene expression pattern through chromatin modification and participates in maintenance of tumor malignant properties, such as oncogenesis, development, invasion, migration and metabolic transformation. SIRT3 (sirtuin 3) is a mitochondria localized tumor suppressor and regulates tumor metabolic transformation and oxidative stress. The correlation between LSD1 and SIRT3 has never been reported before. This study aimed to elucidate the correlation between LSD1 and SIRT3 with gene transcriptional regulation methods. Methods: RNA interference technique, co-immunoprecipitation assay(CoIP), chromatin immune-precipitation assay(ChIP) and ifrelfy luciferase activity assay were employed to elucidate the correlation between LSD1 and SIRT3 in pancreatic cancer. Results:mRNA and protein levels of SIRT3 were signiifcantly elevated in LSD1 knock-down PANC-1 cells. LSD1 interacts with PGC-1α, an important regulator of SIRT3 gene expression. LSD1 and PGC-1αoccupied the same region in SIRT3 promoter region through ChIP analysis. Luciferase activity assay validated LSD1 as a negative regulator of PGC-1αin SIRT3 gene transcriptional regulation. Conclusion:LSD1, as an important tumor promoter, negatively regulates the expression of tumor suppressor gene SIRT3, these results provide important clues for the role that LSD1 plays in aberrant metabolism and oxidative stress.

Objective To ascertain the utility and difference of sonography with echo-tracking (ET) technique and pulse-Doppler to assess vascular stiffness in rats with hypercholesterolemia and atherosclerosis.Methods Sonography associated with ET technique and pulse-Doppler were used to measure stiffness parameter (β),arterial compliance (AC),distensibility coefficient (DC),one-point pulse wave velocity (PWVβ),resistence index(RI),peak systolic velocity(PSV),end-diastolic velocity(EDV) and EDV/PSV of the aorta in cholesterol-fed SD rats (group T1,n =10,for 4 weeks;group T2,n =10,for 12 weeks) and normal control rats(group C1,n =10;group C2,n =10).All parameters and blood biochemical markers[total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-CH) and highdensity lipoprotein cholesterol (HDL-CH)] among groups were analyzed with ANOVE factor analysis.Correlation was analyzed with Pearson analysis.Light microscopic evaluation were used to demonstrate atherosclerotic changes in the aorta.Results The PWVβ value and PSV of the aorta between group T1 and T2 were significantly different (P =0.001,P ＜0.05).The β,PWVβ values of the aorta in group T1 and T2 were significantly higher than those of group C1 and C2 (P ＜0.05).AC and DC values of the aorta in group T1 and T2 were significantly lower than those of group C1 and C2 (P ＜0.05).Correlation analysis showsed that RI was positively correlated with systolic pressure(P ＜0.05).All parameters had correlated with each other among β,PWVβ,AC,DC,TG,TC,systolic pressure and diastolic pressure.DC and AC were negatively correlated with β and PWVβ,also DC was negatively correlated with TG.Light microscopy confirmed morphologic typical changes of aortic atherosclerosis in group T1 and T2.Conclusions Sonography with the ET method compared with pulse-Doppler is much more sensitive and it can be used to evaluate tissue elastic changes in arterial walls associated with atherosclerosis and hypercholesterolemia.PSV can reflect atherosclerosis of rat's abdominal aorta well,but pulse-Doppler is limited in the diagnosis of earlier atherosclerosis period.

Objective To investigate the safety and short-term effect of anatomical hepatectomy for the treatment of hepatolithiasis with the caudate lobe as the sole remnant liver.Methods The clinical data of 1 patient with hepatolithiasis combined with liver atrophy-hypertrophy syndrome who was admitted to the Hunan Provincial People's Hospital in April 2014 were retrospectively analyzed.The stones were located in the left and right liver, the involved liver became fibroatrophy, and the hepatic caudate lobe not containing stones became hypertrophy.The body surface area of the patient was 1.65 m2 , standard total liver volume was 1 167.63 mL.According to the result of CT, expected residual liver volume after hepatectomy was 706.12 mL, and the ratio of residual liver volume over the standard total liver was 60.47％.The radio of residual liver volume over the body mass index was 1.21％.The patient received the second exploration of common bile ducts, hepatectomy with the caudate lobe as the sole remnant liver and T tube drainage.The follow-up including recurrence of calculus was performed by outpatient examination and telephone interview up to April 2015.Results The patient underwent caudate lobe as the sole remnant liver following anatomical hepatectomy successfully without blood transfusion.The operation time and volume of intraoperative blood loss were 380 minutes and 350 mL.The peritoneal drainage tube was removed at postoperative day 2 and the patient was discharged at postoperative day 8 with a good recovery of liver function.The postoperative pathological examination showed that there were focal biliary epithelial papillary hyperplasia combined with light-medium atypical hyperplasia and no canceration.The T tube cholangiography two month later showed that there were unobstructed lower bile duct and no residual intra-and extra-hepatic stones.The liver function was normal.Then T tube was removed and patient resumed normal life.During the 1-year follow-up, no chills and fever, jaundice and abdominal pain occurred, no calculus was detected by B-ultrasonography, and computed tomography reexamination showed that remnant liver volume was increased and no intra-and extra-hepatic bile duct stones were detected.Conclusion Anatomical hepatectomy for the treatment of hepatolithiasis with the caudate lobe as the sole remnant liver is safe and feasible, with a good curative effect.