Postpolypectomy syndrome without abdominal pain led to sepsis/septic shock and gastrointestinal bleeding: A case report

BACKGROUND

Postpolypectomy syndrome (PPS) is a rare postoperative complication of colonic polypectomy. It presents with abdominal pain and fever accompanied by coagulopathy and elevated inflammatory markers. Its prognosis is usually good, and it only requires outpatient treatment or observation in a general ward. However, it can be life-threatening.

CASE SUMMARY

The patient was a 58-year-old man who underwent two colonic polypectomies, each resulting in life-threatening sepsis, septic shock, and coagulopathy. Each of the notable manifestations was a rapid drop in blood pressure, an increase in heart rate, loss of consciousness, and heavy sweating, accompanied by shortness of breath and decreased oxygen in the finger pulse. Based on the criteria of organ dysfunction due to infection, we diagnosed him with sepsis. The patient also experienced severe gastrointestinal bleeding after the second operation. Curiously, he did not complain of any abdominal pain throughout the course of the illness. He had significantly elevated concentrations of inflammatory markers and coagulopathy. Except for the absence of abdominal pain, his fever, significant coagulopathy, and elevated inflammatory marker concentrations were all consistent with PPS. Abdominal computed tomography and superior mesenteric artery computed tomography angiography showed no free air or vascular damage. Thus, the diagnosis of colon perforation was not considered. The final blood culture results indicated Moraxella osloensis. The patient was transferred to the intensive care unit and quickly improved after fluid resuscitation, antibiotic treatment, oxygen therapy, and blood transfusion.

CONCLUSION

PPS may induce dysregulation of the systemic inflammatory response, which can lead to sepsis or septic shock, even in the absence of abdominal pain.

Knockdown of USP8 inhibits prostate cancer cell growth, proliferation, and metastasis and promotes docetaxel’s activity by suppressing the NF-kB signaling pathway

Ubiquitin-specific protease 8 (USP8) has been recently reported to be involved in tumorigenesis. Prostate cancer (PCa) is the most diagnosed malignancy among men, but USP8’s role in PCa is not yet investigated comprehensively. Therefore, the PCa cell lines DU145 and PC3 were transfected with USP8 siRNA or overexpressing vector together with or without docetaxel. The silencing USP8 and docetaxel treatment reduced cell viability and migration and promoted apoptosis. In contrast, USP8 knockdown was found to enhance docetaxel antitumor activity. In contrast, increased cell viability and migration were noticed upon USP8 overexpression, thereby decreasing apoptosis and suppressing docetaxel antitumor activity. Notably, although EGFR, PI3K, and NF-kB were found to be increased in both USP8 overexpression and docetaxel treatment, it significantly attenuated the effects in USP8 silencing followed by with or without docetaxel. Although EGFR silencing decreased PI3K and NF-kB activation, overexpression of USP8 was shown to counteract SiEGFR’s effects on NF-kB signaling by increasing PI3K expression. Our findings revealed that USP8 plays an oncogenic role in PCa and can suppress docetaxel activity. Additionally, as EGFR/PI3K/NF-kB was previously reported to develop docetaxel resistance, the combination treatment of USP8 knockdown with docetaxel might be a potential PCa therapeutic.

Breakdown of the Stokes-Einstein relationship and rapid structural ordering in CuZrAl metallic glass-forming liquids

The results of a combined structural and dynamical study of Cu-Zr-Al metallic glass forming liquids are presented. Containerless high-energy x-ray scattering experiments made using electrostatic levitation are combined with molecular dynamics simulations to probe the onset of rapid structural ordering as well as the temperature-dependent diffusivity and viscosity in three liquids: Cu₄₉Zr₄₅Al₆, Cu₄₇Zr₄₅Al₈, and Cu₄₃Zr₄₅Al₁₂. These compositions were chosen because they are reported to have dramatically different glass forming-ability. Experimental data show that the first peak in the x-ray static structure factor displays evidence for a Curie-Weiss type behavior, but also a peak in the effective Curie temperature. The evidence provided here for the onset of cooperativity, marked by a crossover temperature, T_A (which is usually above the liquidus temperature), is accompanied by the onset of development of more spatially extended structural order in the liquids. Based on the molecular dynamics simulations, each of the liquids exhibits a clear breakdown of the Stokes-Einstein relation at a temperature near, but below, the crossover temperature, T_A. The breakdown is manifest as a rapid reduction in the relative diffusion coefficients between Cu, Zr, and Al.

Resveratrol induces depletion of TRAF6 and suppresses prostate cancer cell proliferation and migration

Although the early diagnosis of prostate cancer (PCa) enhances life expectancy with a 5-year survival rate of 100 %, metastasized-PCa is the fundamental reason for death by PCa, hence requires an advanced and target-directed treatment strategy. Metastasis is considered to be initiated with the epithelial-mesenchymal transition (EMT) event in which tumor cells change their epithelial characteristics into mesenchymal form and exacerbates the cancer progression. Herein, we investigated the effect and mechanism of resveratrol function in PCa cell proliferation and migration and reported that TNF-receptor associated factor 6 (TRAF6), an unconventional E3 ligase, is a key mediator of resveratrol function to inhibit PCa cell growth and proliferation and targeted for lysosomal degradation by resveratrol. MTT and cell counting demonstrated that resveratrol inhibited the viability and proliferation in DU145 and PC3 cells. Resveratrol (50 μM) mediated the degradation of TRAF6 which in turn facilitated repression of the NF-κB pathway. Also, wound healing and transwell migration assays and level of EMT-related proteins showed that resveratrol used TRAF6, at least in part to inhibit cell migration. Overexpression of TRAF6 augmented EMT in PCa by upregulating the expression of transcription factor SLUG. Moreover, TRAF6 overexpression was closely associated with EMT process through the NF-κB pathway. Our exploration exhibited that resveratrol may inhibit EMT through the TRAF6/NF-κB/SLUG axis. Altogether, this study represents that TRAF6 acts as an intermediary of resveratrol action to suppress PCa cell proliferation and migration, and concerns future attention to obtain as a therapeutic target for the treatment of PCa.

[Health literacy level and influence factors of occupational population in one province]

Objective: To understand health literacy (HL) status of occupational population in work place and provide the basis of developing for HL standards and specific intervention strategies. Methods: Being selected by stratified cluster sampling, 3507 employees in 13 companies wthin Hebei Province were investigated by questionnaire. Results: The survey was conducted with 3507 questionnaires, the valid rate was about 97.83%. There were a total of 2629 men (76.62%) and 802 women (23.38%) . The overall level of HL was 32.24%. Health literacy level (HLL) of three aspects are: basic knowledge and concepts 52.03%, healthy life-style and behavior 26.00%, and health related skills 40.25%, the HL rate of six health issues as scientific view of health, prevention of communicable diseases, prevention of chronic diseases, safety and first aid, basic medical care and health information are 61.59%, 28.62%, 21.95%, 75.20%, 32.99% and 49.17% respectively. The group aged 25-34 had the highest HLL (43.95%) ; the higher culture degree, the higher the level of health literacy (P<0.05) . The HLL of the occupational population in Hebei province was 32.24%, which was close to the HLL of the national occupational population, but higher than that of general population in Hebei province and in the whole country. Conclusions: The HLL of the occupational population in Hebei province which was close to the HLL of the national occupational population. HLL of basic knowledge and concepts is higher than that of healthy life-style and behavior and health related skills, the health literacy rate of prevention of communicable diseases and chronic diseases were low. Age, culture degree and type of industry are important influence factors.

Targeting ubiquitin specific protease 7 in cancer: A deubiquitinase with great prospects

Deubiquitinase (DUB)-mediated cleavage of ubiquitin chain balances ubiquitination and deubiquitination for determining protein fate. USP7 is one of the best characterized DUBs and functionally important. Numerous proteins have been identified as potential substrates and binding partners of USP7; those play crucial roles in diverse array of cellular and biological processes including tumour suppression, cell cycle, DNA repair, chromatin remodelling, and epigenetic regulation. This review aims at summarizing the current knowledge of this wide association of USP7 with many cellular processes that enlightens the possibility of abnormal USP7 activity in promoting oncogenesis and the importance of identification of specific inhibitors.

[The clinical impact of artery-first approach combined with vascular resection and reconstruction in the treatment of pancreatic head carcinoma]

Objective: To evaluate the application of artery first, combined vascular resection and reconstruction in the treatment of pancreatic head carcinoma. Methods: The clinical data of 13 patients with pancreatic head cancer were retrospectively analyzed from February 2014 to March 2016 in the Affiliated Hospital of Xiamen University. Preoperative computed tomography of high resolution layer or magnetic resonance imaging examination demonstrated pancreatic head carcinoma, as well as close adhesion, stenosis, compression or displacement of superior mesenteric vein or portal vein wall. In the operation, the artery first approach was used and the whole arterial blood supply in the head of the pancreas was fully exposed and interdicted. Finally, en block resection and vascular resection and reconstruction was adopted. Results: 12 of 13 patients had pancreatoduodenectomy synchronously with vascular resection and reconstruction; the other patient had these two surgery sequentially. Four patients received blood vessel wedge resection, five had segmental resection combined with end to end suture, and four had segmental resection combined with artificial vascular graft reconstruction. Operation time was (327.2±65.5) minutes, and the amount of blood loss was (472.6±226.4) millilitres. One patient suffered from delayed gastric emptying, and two patients had pancreatic fistula. All patients recovered from postoperative complications by conservative treatment. No patients developed biliary fistula, gastrointestinal fistula, abdominal infection, pulmonary infection, diarrhea, hypoglycemia or other complications, and none died in perioperative period. Postoperative pathological findings confirmed the diagnosis of pancreatic ductal adenocarcinoma. Mean tumor diameter was (4.2±1.5)cm, and (3.8±1.5) metastasis were found in (13.6±2.5) resected lymph nodes. In 11 cases, the tumor cells were found in the outer membrane of blood vessels, 2 cases were found to have tumor invasion in the inner membrane, and all the resection margins were negative. All patients were followed up, and 2 patients died of liver metastasis 11 months and 18 months after operation, respectively. One patient survived with local recurrence of tumor 13 months after surgery. Other patients had no tumor recurrence and metastasis. Conclusions: The artery first approch combined vascular resection and reconstruction is safe effective and feasible in the treatment of pancreatic head carcinoma. It can improve the ablation rate of pancreatoduodenectomy.

ISG15 inhibits cancer cell growth and promotes apoptosis

Cervical cancer is one of the most common causes of cancer-related mortality in women in developing countries. Interferon (IFN)-α has been widely used in the treatment of various types of cancer, including cervical cancer, and IFN-stimulated gene 15 (ISG15), an ubiquitin-like protein, is upregulated by IFN-α treatment. The anti-virus and antitumor effects of ISG15 have been reported; however, its mechanism of action have not yet been fully elucidated. In this study, HeLa cells were used as a model system to investigate the roles of ISG15 in IFN-α-mediated cancer cell growth inhibition and induction of apoptosis. The results revealed that both p53 and p21 were upregulated in HeLa cells treated with IFN-α or in the HeLa cells overexpressing ISG15. In addition, the expression levels of ubiquitin-like modifier-activating enzyme 7 (UBA7, also known as UBE1L; ISG15 E1-activating enzyme), UBCH8 (ISG15 E2-conjugating enzyme) and HERC5 (ISG15 E3-ligase) were elevated in the HeLa cells treated with IFN-α. The levels of p53 in the HeLa cells were attenuated by transient transfection with small interfering RNA (siRNA) targeting ISG15 (ISG15-siRNA). Cell viability was inhibited by both IFN-α treatment and ISG15 overexpression. However, these effects were significantly diminished when p53 was knocked down, suggesting that the effects of inhibitory effects of ISG15 on HeLa cell growth and the induction of apoptosis were p53-dependent. Taken together, these results suggest the existence of the IFN-α/ISG15/p53 axis in cervical cancer cells and any strategies manipulating the levels of ISG15 may thus prove to be effective in the treatment of cervical cancer.

[Application of benchmark dose on renal injury in people chronically exposed to lead]

Objective: To screen sensitive indicators of renal injury in lead workers using benchmark dose method. Methods: Of the 486 subjects,116 did not occupationally contact to lead as a control. The blood lead was considered as exposure biomarker, while Uβ₂-MG and UNAG as effect biomarkers for renal injury. The BMD and BMDL of blood lead were estimated at the 10% benchmark response using BMDS Version 2.6. Results: There was statistical rise in blood lead between the lead group and control group (P<0.05) ; and the blood lead level was divided into four groups by quarterback spacing method, among which UNAG was statistically different (P<0.05) . There was an increased prevalence of abnormal rates of Uβ₂-MG and UNAG with increasing blood lead concentration (P<0.05) , after trend chi-square test. BMD and BMDL of UNAG and Uβ₂-MG were 602.784/431.838 μg/L and 130.398/100.981 μg/L caculated by Log-Probit model, respectively. Conclusions: Occupational lead exposure may cause kidney damage, and UNAG could be as a more sensitive marker for monitoring early renal injury than Uβ₂-MG.

Metabolic syndrome and risk for ED: a meta-analysis

There are many recent observational studies on metabolic syndrome (MS) and the risk for ED, and it is still inconclusive whether MS increases the risk for ED. This meta-analysis aims to detect a relationship between MS and ED. We identified eligible studies by searching PubMed, Embase and the Cochrane Library for articles published before August 2013. Adjusted relative risks (RR) with 95% confidence interval (CI) were calculated using random-effects or fixed-effects models. A total of 10 studies involving 4092 participants were included in the meta-analysis. MS was associated with an increased incidence of ED (RR=1.60, 95% CI=1.27-2.02, P<0.001), with significant evidence of heterogeneity among these studies (P for heterogeneity <0.001, I(2)=92.9%). The subgroup and sensitivity analyses confirmed the stability of the results and no publication bias was detected. The present meta-analysis suggests that MS is significantly associated with the risk for ED. Large-scale and well-designed prospective studies are required to further investigate the association between MS and risk for ED.

Characteristics of unrecognised bipolar disorder in patients treated for major depressive disorder in China: general versus psychiatric hospitals

OBJECTIVES

Bipolar disorder is often misdiagnosed as major depressive disorder. Such misdiagnosis partly depends on the type of treatment setting. This study compared general hospital psychiatric units with psychiatric hospitals in China with respect to basic demographic and clinical characteristics of patients with unrecognised bipolar disorder who are treated for major depressive disorder.

METHODS

Patients treated for major depressive disorder were consecutively examined in 13 health centres (6 general hospital psychiatric units and 7 psychiatric hospitals) in China. Their socio-demographic and clinical features were recorded using a standardised protocol and data collection procedure. The DSM-IV diagnoses were established using the Mini-International Neuropsychiatric Interview.

RESULTS

Of the 1487 patients included in the study, 309 (20.8%) were diagnosed with bipolar disorder. There was no significant difference between general hospital psychiatric units and psychiatric hospitals in the ratio of all types of unrecognised bipolar disorders (χ2 = 0.008, degrees of freedom = 1, p = 0.9) and bipolar II disorders (χ2 = 3.1, degrees of freedom = 1, p = 0.08). The proportions of unrecognised bipolar I disorders (χ2 = 4.1, degrees of freedom = 1, p = 0.04) differed significantly between the 2 types of study site. Multivariate analyses showed that patients with bipolar I disorders with more seasonal depressive episodes were more likely to receive treatment in general hospital psychiatric units (odds ratio = 3.3, 95% confidence interval = 1.1-9.8).

CONCLUSION

Patients with bipolar I disorders receiving treatment in general hospital psychiatric units had different clinical characteristics compared to their counterparts treated in psychiatric hospitals in China.

Ubiquitin-proteasome pathway and prostate cancer

Prostate cancer is one of the most common cancers in men. Various signaling pathways and proteins are involved in prostate carcinogenesis. Ubiquitination and deubiquitination of the related proteins contribute to the development of prostate cancer in various ways. The ubiquitin-proteasome (UPS) system is a common cellular process for protein degradation in eukaryotes. In this article we review recent advances related to the involvement of the UPS pathway in prostate cancer. The UPS pathway plays an important role in the regulation of cellular proteins with respect to cell cycle control, transcription, apoptosis, cell adhesion, angiogenesis, and tumor growth. It is involved in prostate cancer in various ways by modulating prostate cancer-related genes/proteins such as androgen receptor, cyclin-dependent kinase inhibitor P27, cyclin D1, and PTEN. Some ubiquitin-like modifier proteins have also been found to be associated with prostate cancer. The UPS pathway represents a potential therapeutic target for prostate cancer, and proteasome inhibitors represent a class of chemotherapeutic agents that inhibit tumor growth. The UPS pathway is related to prostate cancer in different ways. More research on that link is needed, as targeting the UPS pathway has led to some success in prostate cancer treatment.

Effects of rosiglitazone on the growth and lymphangiogenesis of human gastric cancer transplanted in nude mice

Gastric cancer mainly metastasizes via lymphatic vessels. Thus, it is critical to identify efficacious chemopreventive agents for lymphangiogenesis. The present study was undertaken to explore the effects of rosiglitazone (ROSI) on the growth and lymphangiogenesis of human gastric cancer. We established a model of gastric cancer by subcutaneously inoculating the human gastric cancer cell line SGC-7901 into nude mice. Mice were randomly divided into 4 groups and each group received a different agent by oral gavage. The control group received normal saline and treatment groups received different doses of ROSI once every 2 days. The growth of the tumor in vivo was assessed by measuring tumor volume. After 42 days, the mice were sacrificed and the tumors were removed. H&E staining was used to observe the histomorphological features; immunohistochemistry staining for lymphatic vessel density (LVD) was used to evaluate tumor lymphangiogenesis, RT-PCR was performed to determine the mRNA expression of vascular endothelial growth factor C (VEGF-C) and VEGF receptor-3 (VEGFR-3), and western blotting was used to detect the protein expression of VEGF-C and VEGFR-3. Compared with the control group, all treatment groups had smaller tumor volume and higher tumor growth inhibitory rate every day. The number of typical tumor cells in the control group was higher compared to that in the treatment groups, and the highest level of LVD was found in the control group. Furthermore, both the expression of VEGF-C and VEGFR-3 mRNA and proteins in the control group were significantly higher compared to those in the treatment groups. Markedly, these changes were correlated in a dose-dependent manner with ROSI. These results demonstrated that, through simultaneously blocking the expression of VEGF-C and VEGFR-3, ROSI suppresses lymphangiogenesis. This may represent a powerful therapeutic approach for controlling gastric cancer cell growth and metastasis.

A new cell culture system for infection with hepatitis B virus that fuses HepG2 cells with primary human hepatocytes

Hepatitis B virus (HBV) infection exhibits a very narrow host range and shows a strong tropism for liver parenchymal cells, however none of the previously established experimental models can reproduce the natural process of HBV infection. In the present study, primary human hepatocytes were fused with HepG2 cells to establish the hybrid HepCHLine-4 cell line with high susceptibility to HBV. The HepCHLine-4 cells expressed HBV-specific antigen when co-incubated with HBV-positive serum from a hepatitis B patient. Post-infection, HBV relaxed circular DNA and covalently closed circular DNA were detected in HepCHLine-4 cells using a nested polymerase chain reaction, and HBV-specific particles were visualized by electron microscopy of the culture media of HepCHLine-4 cells. HepG2 cells were not susceptible to HBV infection under the same conditions. The HepCHLine-4 cells can be sub-cultured for > 12 months while maintaining susceptibility to HBV and may, therefore, be useful for studying HBV infection and the viral life cycle in human hepatocytes.

[Chemical constituents from the fruit of Rosa bella Rehd. et Wils]

OBJECTIVE

To investigate the chemical constituents from the fruit of Rosa bella and its bioactivity.

METHOD

The compounds were isolated from the methanol extract by column chromatography, then identified by 1H, 13C NMR and by comparison with authentic samples. The unorganized hoptoad heart was used for testing the contracting force of cardiac muscle and enzymology for measuring the bloody lipid of serum in rats.

RESULT

Seven compounds were isolated and identified as pomolic acid, tiliroside, euscaphic acid, daucosterol, quercetin, oleanolic acid and beta-sitosterol, respectively. In the concentration of 0.4-1.0 mg.ml-1, the methanol extract had obvious cardiotonic effect. While at 400 mg.kg-1, there are no obvious effect to the TC, HDL-ac and TG of serum in rats.

CONCLUSION

The isolated compounds may be the active components of this plant.

A non-invasive method for evaluating cirrhotic portal hypertension by administration of 99mTc-MIBI per rectum

A study was performed to evaluate radio-isotopic imaging using technetium-99m hexakis 2-methoxyisobutyl isonitrile administered per rectum to assess portal collateral circulation. The heart-liver ratios (H/L; mean +/- standard deviation) in 15 controls, 13 cases of histologically confirmed viral hepatitis and 57 cirrhosis patients were 0.27 +/- 0.11, 0.43 +/- 0.14 and 1.00 +/- 0.28, respectively (P < 0.001). Among the cirrhosis patients those with the Child-Pugh classification A, B and C had H/L of 0.56 +/- 0.14, 1.00 +/- 0.20 and 1.19 +/- 0.26, respectively (P < 0.001). A high value of H/L was associated with a high risk of hepatic encephalopathy (1.25 +/- 0.17, P < 0.01) and oesophageal varices (1.02 +/- 0.20, P < 0.01). There were associations between H/L and serum bilirubin (P < 0.01), albumin (P < 0.05) and prothrombin time (P < 0.05). The results also showed a good correlation between H/L and portal vein pressure measured during operation in 13 patients (P < 0.001, r = 0.87). The regression equation: y = 6.77 + 32.5 H/L, allowed portal vein pressure to be estimated. The prognostic value of the test was supported by the fact that good correlations were observed between the H/L ratio and widely accepted prognostic classification (Child-Pugh). It is suggested that this new method could be a reliable non-invasive way to give an indication of the degree of portasystemic shunting to evaluate the prognosis and to follow up the effects of medications for reducing portal hypertension in patients with cirrhotic portal hypertension.

Anastomotic false aneurysm following abdominal aortic aneurysmectomy and prosthetic grafting

Anastomotic false aneurysm (AFA) of the aorta is a potentially lethal complication after prosthetic grafting. Nineteen aneurysms were encountered in 18 patients within a 30-year period (1960-1991). There were 10 men and 8 women, aged 27-80 years (mean 58 years). In 14 patients, the prostheses were made of silk, in 2 were PTFE, and in 1 each Dacron or silk-Dacron cross-weaved. Patients with an intact AFA had a pulsatile abdominal mass, abdominal pain, an occluded graft and peripheral emboli. Five patients were asymptomatic. Clinical onset of AFA varied from 2 weeks to 12 years (mean 5 years). The accurate rate of diagnosis of single plane angiography was 75% (3 of 4), and computed tomography 100% (ten of ten). Ultrasound was used only once and suggested an AFA. Four AFAs were less than 5cm in diameter. Five patients refused operation and died in 2 years from rupture. Operative mortality was 11% (1 of 9). Treatment was resection of AFA and replacement with a new graft. Life-long follow-up is required for patients with an aortic aneurysm. All ratroperitoneal AFAs should be resected, since the outcome of rupture is poor.

[Diagnostic value of heart-liver nuclein ratio in cirrhotic portal hypertension]

A new method for evaluating portal systemic collaterals with administering 99mTc-MIBI per rectum was described in 80 cases. The heart to liver uptake ratio (H/L) in 15 healthy subjects was 0.267 +/- 0.1, slightly increased (0.455 +/- 0.13) in 8 patients with viral hepatitis and significantly increased in 68 cirrhotics. There was a good correlation between H/L ratio and the Child-Pugh classification with the ratio in Child A group of 0.57 +/- 0.12, in Child B group of 1.0 +/- 0.19, and in Child C group of 1.19 +/- 0.25 respectively (P < 0.01). For the diagnosis of portal hypertension, tentatively taking the ratio of > or = 0.62 as positive the sensitivity was 96%, specificity 89%, and accuracy 94%. The authors believe that 99mTc-MIBI imaging is a noninvasive method very useful in evaluating porta-systemic shunts.

Surgical treatment of atherosclerotic infrarenal abdominal aortic aneurysms. A review of 30 years' experience

During the 30 years from 1960 to 1989, 100 sequential patients with atherosclerotic infrarenal abdominal aortic aneurysm (AAA) were admitted to Zhongshan Hospital. Twenty-eight were not treated surgically and 72 underwent resection of the AAA with prosthesis replacement. Nineteen non-surgical patient were followed up, and 8 died from ruptures with a five-year survival rate of 41.3 +/- 13%. In 72 surgically treated patients, the operative mortality was 2.8%. The five-year survival rate is 77.5 +/- 6.2%, which is higher in comparison with the non-surgical group (P < 0.01). The data show that the operation for AAA is safe and the postoperative long-term results are satisfactory.

Role of aorto-angioplasty in hypertension caused by Takayasu's arteritis

Sixteen patients with Takayasu's arteritis and a long-stenotic segment of the descending thoracic aorta and/or proximal and middle portion of the abdominal aorta, with or without renal artery stenosis, were treated by percutaneous transluminal aorto-angioplasty (PTAA). These patients might be subdivided into three groups: A. with normal renal artery, B. with severe renal artery stenosis or occlusion without treatment or with failure of dilatation, and C. with renal artery stenosis but relieved by percutaneous transluminal renal angioplasty (PTRA). It was found that the hypertension may be caused by the suprarenal aortic stenosis itself. PTAA has an excellent effect to normalize the blood pressure in Group A. The elevated blood pressure may also be decreased in various extent in the patient with severe renal artery stenosis after PTAA, but not to normal. An additional PTRA or other renal vesel reconstruction procedure is necessary in this group. No recurrence of the aorta stenosis was found by non-invasive examinations or aortography during the long-term follow-up. PTAA may be considered as the first choice for the aortic stenosis caused by Takayasu's arteritis.

[Diagnosis and management of visceral artery aneurysms: report of 24 cases]

During the past 30 years 24 patients were treated for visceral artery aneurysms in our hospital. There were 12 hepatic, 7 gastroduodenopancreatic, 3 splenic, and 2 superior mesenteric artery aneurysms. Perilous ruptures occurred in 20 patients, among them 13 ruptured into the biliary tract, 4 into the upper gastrointestinal tract, and 3 into the abdominal cavity. Correct preoperative diagnosis was often difficult. Selective celiac and superior mesenteric angiography was most valuable, and 14 patients were correctly diagnosed preoperatively by the procedure. Nineteen underwent emergent surgery and 8 died. Prognosis depended on the anatomic location of the aneurysms and the general condition of the patients.

Evaluation of non-invasive diagnostic tests in detecting cancer of the pancreas

Monoclonal antibody defined antigen (CA19-9), carcinoembryonic antigen (CEA), ultrasonography (US) and computerized tomography (CT) were carried out as the tests in 113 patients suspected to have pancreatic cancer. Of 98 patients who underwent operation, 55 were found to have pancreatic cancer, 25 benign pancreatic disease, and 18 cancer of the biliary tract. Follow-up study was carried out for more than 1 year in 15 other patients suffering from pancreatitis without surgical intervention. The accuracy of CA19-9, US, CEA and CT was 87%, 69%, 61% and 56% respectively. The sensitivity of each test was CA19-9, 98%; US, 89%; CT, 80%; and CEA, 38%. The sensitivity of parallel test combined with CA19-9 and CEA was 100%. It may be regarded as the first step to detect pancreatic cancer in suspected population. The specificity of each test was CEA, 82%; CA19-9, 76%; US, 50% and CT, 40%. And the specificity of serial tests combined with CA19-9 and US was 90%. When these two tests were both positive, pancreatic cancer was highly suspected.

Influence of medicinal herbs decocted with different utensils on colony formation of gastric carcinoma cells

In order to elucidate the different results obtained in cancer patients with similar condition and symptoms treated by the same medicinal herbs, an investigation of the utensils used for making decoctions was carried out. It was found that the decoction made by means of glassware, enamel and earthenware pots had the best effect of inhibiting the colony formation of human gastric carcinoma cells, the next were the decoctions made by means of unrefined iron pots, stainless steel pots and copper pots, and the worst was that made with aluminium pots. It was also found that there was no difference between the water contained in those utensils and normal saline in the influence on the colony formation of human gastric carcinoma cells. Therefore, it is believed that the difference in effect of the decoctions made by means of different kinds of utensils is not due to the trace dissolution of the utensil materials, but is most likely due to the occurrence of some chemical reactions while making the decoction. That the decoctions made by means of different utensils had different peak values in the absorption spectrum also supports this proposition.