Sphincter of Oddi dysfunction (SOD)is a functional gastrointestinal disorder manifesting with the main symptoms of abdominal pain,abnormal liver function and recurrent idiopathic acute pancreatitis,which involved the abnormal contraction of sphincter of Oddi. The incidence of SOD has been increasing in recent years. More attention should be paid on SOD for decreasing the misdiagnosis in clinical practice. This article reviewed the recent advances in diagnosis and treatment of SOD.

Objective　To gain a better understanding of the regulatory mechanism and kinetic behaviour of granulocyte colony-stimulating factor (G-CSF). Methods　An enzyme-linked immunosorbent assay (ELISA) method was used to detect serum G-CSF in 61 patients with chronic renal failure±long-term hemodialysis and 30 normal controls. Results　Serum G-CSF levels in CRF patients were significantly higher than in normal controls. Eighty percent of patients had detectable G-CSF and serum G-CSF levels were 566.40±207.98?ng/L in non-hemodialyzed (non-HD) patients. The detectable percentage in hemodialyzed patients was 93.33%, serum G-CSF levels in pre-HD and post-HD patients were 1255.36±611.25?ng/L and 1151.61±599.47?ng/L respectively. Serum G-CSF levels in HD patients were slightly higher than in non-HD patients, but no significant difference was found between the two groups. No difference was found between the G-CSF values obtained in pre-HD and post-HD patients. There was no relationship between G-CSF levels and WBC, BUN or Scr (P>0.05). Conclusion　The high value of G-CSF in patients with CRF may be caused by a decrease in G-CSF clearance and/or an increase in G-CSF release.

Objective:To investigate the effect of instantaneous flow rate on the consistency of diagnostic accuracy of severe degenerative mitral regurgitation (DMR) using proximal isovelocity surface area (PISA).Methods:From June 2019 to June 2021, 75 patients with DMR who underwent echocardiography in Department of Echocardiography of Zhongshan Hospital, Fudan University were prospectively enrolled. The instantaneous flow rate of DMR during the systolic phase was calculated using M-mode PISA(PISA M-mode), and a time-integrated curve was plotted. Regurgitant volume (RVol) and effective regurgitant orifice area (EROA) were calculated by traditional PISA (PISA max), pair PISA (PISA pair), and PISA M-mode, respectively. RVol acquired from cardiac magnetic resonance (CMR) volumetric method in 22 patients of the enrolled patients. The correlation and consistency of RVol acquired between the three PISA methods and CMR were compared. Agreement of diagnostic accuracy of severe mitral regurgitation (sMR) acquired between the three PISA methods and multi-parameter algorithm by American Society of Echocardiography (ASE) was analyzed using Cohen′s Kappa analysis. Results:The curve of instantaneous flow rate of DMR showed unimodal pattern with the peak at mid-late systolic phase. The correlation of RVol acquired between PISA methods and CMR was moderate for PISA max and PISA pair ( r=0.77, 0.80, both P<0.001), whereas PISA M-mode presented strong correlation with CMR ( r=0.87, P<0.001). RVol acquired from PISA max was larger than that of CMR[(69.1±37.1) ml vs (49.0±29.0)ml, P=0.002]. Both PISA max and PISA pair were shown moderate agreement of diagnostic accuracy of sMR with ASE multi-parameters algorithm (RVol: κ=0.496, 0.525, both P<0.001; EROA: κ=0.570, 0.578, both P<0.001), while PISA M-mode presented strong agreement (RVol: κ=0.867 and EROA: κ=0.802, both P<0.001). Conclusions:Based on the unimodal pattern of instantaneous flow rate in patients with DMR, PISA max may significantly overestimate RVol, exposing a significant proportion of patients with DMR to unnecessary MR surgery. PISA M-mode presents better correlation and consistency with CMR on the quantification of RVol compared with PISA max and PISA pair, and may improve the diagnostic accuracy of quantification of sMR using PISA.