Clinical and Magnetic Resonance Imaging Features of Solid Pseudopapillary Tumor of the Pancreas in Male Patients.

Objective To analyze the clinical and magnetic resonance imaging(MRI)findings of solid pseudopapillary tumor(SPT)of the pancreas in male patients. Methods Clinical and MRI features of 51 patients with pathologically-proved SPT were retrospectively analyzed.The following MRI features of the lesions were analyzed:location,maximal diameter,shape,margin,capsule,solid and cystic components,signal intensity characteristics,and enhancement patterns.Results The average maximal diameter of the SPT in male patients was significantly smaller [(3.9±1.6)cm vs.(6.3±3.9)cm,P=0.035]than that of SPT in female patients.Pure solid tumors were signiciantly more common in male patients(8/14)than in female patients(9/37)(P=0.037).T1-weighted images of SPT showed mainly homogenous hypo-intensity in male patients(11/14)and heterogeneous hypo-intensity in female patients(23/37)(P=0.001).Hemorrhage was more prevalent in female patients(22/37)than in male patients(2/14)(P=0.005).There were no significant differences between male and female patients regarding clinical features and other magnetic resonance features(P>0.05).Conclusions On MRI,SPT in male patients is small and shows mainly pure solid component with rare hemorrhage.The clinical and other MRI features of SPT are not different between males and females.

Incidents and adverse events of endoscopic ultrasound-guided fine-needle aspiration for pancreatic cystic lesions.

AIM: To evaluate the diagnostic value and safety mainly regarding incidents of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for pancreatic cystic lesions (PCLs). METHODS: A total of 150 consecutive patients with suspected PCLs were prospectively enrolled from April 2015 to November 2016. We finally enrolled 140 patients undergoing EUS-FNA. We compared the diagnostic accuracy of EUS-FNA and pathological diagnosis, which is regarded as the gold standard, for PCLs. Patients undergoing EUS-FNA at least 1 wk preoperatively were monitored for incidents and adverse events to evaluate its safety. RESULTS: There were 88 (62.9%) women and 52 (37.1%) men among 140 patients, with a mean age of 50.1 (± 15.4) years. There were 67 cysts located in the head/uncinate of the pancreas and 67 in the body/tail, and 6 patients had at least 1 cyst in the pancreas. There were 75 patients undergoing surgery and 55 undergoing EUS-FNA with interval at least 1 wk before other operations, with 3 patients undergoing the procedure twice. The accuracy of EUS-FNA in differentiating benign and malignant lesions was 97.3% (73/75), while the accuracy of characterizing PCL subtype was 84.0% (63/75). The incident rate was 37.9% (22/58), whereas only 1 AE was observed in 58 cases. CONCLUSION: EUS-FNA is effective and safe for diagnosis of PCLs, however procedure-related incidents are common. Caution should be taken in patients undergoing EUS-FNA.

Establishing a predictive model for aspirin resistance in elderly Chinese patients with chronic cardiovascular disease.

BACKGROUND: Resistance to anti-platelet therapy is detrimental to patients. Our aim was to establish a predictive model for aspirin resistance to identify high-risk patients and to propose appropriate intervention. METHODS: Elderly patients (n = 1130) with stable chronic coronary heart disease who were taking aspirin (75 mg) for > 2 months were included. Details of their basic characteristics, laboratory test results, and medications were collected. Logistic regression analysis was performed to establish a predictive model for aspirin resistance. Risk score was finally established according to coefficient B and type of variables in logistic regression. The Hosmer-Lemeshow (HL) test and receiver operating characteristic curves were performed to respectively test the calibration and discrimination of the model. RESULTS: Seven risk factors were included in our risk score. They were serum creatinine (> 110 µmol/L, score of 1); fasting blood glucose (> 7.0 mmol/L, score of 1); hyperlipidemia (score of 1); number of coronary arteries (2 branches, score of 2; ≥ 3 branches, score of 4); body mass index (20-25 kg/m(2), score of 2; > 25 kg/m(2), score of 4); percutaneous coronary intervention (score of 2); and smoking (score of 3). The HL test showed P ≥ 0.05 and area under the receiver operating characteristic curve ≥ 0.70. CONCLUSIONS: We explored and quantified the risk factors for aspirin resistance. Our predictive model showed good calibration and discriminative power and therefore a good foundation for the further study of patients undergoing anti-platelet therapy.

[The experimental study of simvastatin on improving aspirin resistance in diabetic rats].

OBJECTIVE: The purpose of the present study was to investigate the effects of the combination of aspirin, simvastatin in diabetic rat on platelet function. METHODS: Eight-week-old male Wistar rats were selected and randomly divided into diabetic group (n=48) and normal control group (n=48). Diabetic rats were injected with 1% STZ (65mg/kg, dissolved in 0.l mmol/L, pH 4.5 citrate buffer) to induce diabetic model and the rats in normal control group were injected with the same dose of citrate buffer. A rat with blood glucose greater than 16.8 mmol/L and along with diabetic symptoms of polydipsia, polyuria and weight loss was considered the successful model of diabetes. Diabetic rats and normal Wistar rats were randomly divided into 4 groups and given aspirin(10 mg/kg), simvastatin(2 mg/kg), combination of aspirin(10mg/kg) and simvastatin(2 mg/kg), PBS for 8 weeks, respectively. The platelet function and the expression of CD62P were evaluated. The levels of nitric oxide (NO), endothelin (ET), thromboxane B2(TXB2), prostacyclin (PGI2), adiponectin (APN), TXB2 were detected in the serum. The expressions of heme oxygenase-1(HO-1), HO-2, endothelial nitric oxide synthase(e-NOS), p-eNOS, B-cell lymphoma-2(Bcl-2), cyclooxygenase-2(COX-2) in thoracic aorta were evaluated by Western blot. RESULTS: Compared with control rats, diabetic rats had high platelet aggregation and activation (P<0.05), which treated aspirin also showed lower aspirin sensitivity (P<0.05). The combination of drugs upregulated the expression of HO-1, eNOS, p-eNOS, BCL-2, APN levels and decreased the expression of COX-2, and had a greater inhibitory effect on platelet aggregation and activation. The combination of drugs improved endothelial function, adjusted TXA2/PGI2 levels and increased NO levels, which resulted in a great potential antiplatelet effect. CONCLUSIONS: These results suggest that simvastatin may improvethe effect of aspirin on anti-platelet function in diabetic rats.

[Correlation of coronary heart disease with multiple genes, gene polymorphisms and multiple risk factors in old Chinese Han patients].

OBJECTIVE: To explore the related risk factors and genetic susceptibility of coronary heart disease (CHD) in old Chinese Han patients. METHODS: In a case-control study, we enrolled 246 patients with CHD for cases, 185 cases without CHD for control. Correlation of CHD with 15 risk factors, including sex, age, smoking, drinking, hypertension, diabetes mellitus, hyperlipidemia, homocysteine (HCY), N-terminal pro-brain natriuretic peptide (NT-pro-BNP), high-sensitivity C-reactive protein (Hs-CRP), antithrombin III (ATII), cholesterol (CHOL), triglycerides (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) were analyzed by a logistic regression analysis. Meanwhile, facilitated by USA Sequenom high-throughput single nucleotide polymorphisms (SNP) genotyping systems, 10-Plex Genes, 11 SNPs were investigated. RESULTS: Aging, hypertension, lower ATIII were major risk factors for CHD (P < 0.05). Platelet glycoprotein GP1BA rs2243093 (-5T/C), angiotensin-converting enzyme ACE rs4332 (547C/T) and ATIII rs2227589 (893C/T) were associated with CHD in old Han Chinese patients. Mutant genotype CC of rs2243093 (-5T/C) compared with T + AT, P was 0.029 (OR = 3.41, CI: 1.19-9.75). Heterozygous TC of rs4332 (547C/T) was compared with CC + TT, P is 0.003 (OR = 0.56, CI: 0.38-0.82). T-allele carrier CT + CT of rs2227589 (893C/T) was compared with wild genotype CC, P = 0.003 (OR = 1.79, CI: 1.22-2.63). CONCLUSION: Our study demonstrated that aging, hypertension, lower ATIII were the major risk factors of CHD. Three mechanisms associated with platelets, anti-coagulation system, the renin-angiotensin system were involved in coronary heart disease in the elderly.

[A cross-sectional survey of crab intolerance positive rate and its determinants in healthy medical examination population in Beijing].

OBJECTIVE: To explore the positive rate of crab intolerance and its related factors in a healthy physical examination population in Beijing, China. METHODS: A cross-sectional survey was carried out from August 1, 2008 to July 30, 2009. It recruited a total of 12 765 adults with crab intolerance at Health Sciences Center, Chinese PLA General Hospital. The epidemiological data were entered into computer by two persons and organized by Epidata3.0. Non-conditional Logistic regression model was used to calculate the values of odd ratio (OR) and 95%CI. Statistic analysis was performed by SPSS 13.0. RESULTS: The incidence rate of crab intolerance was 24.5% (3128/12 765) and increased with age. Grades of crab intolerance were associated with age and gender and there was a linear correlation tendency (P < 0.05). Incidence rate of crab intolerance in females (27.5%, 1077/3912) was higher than that of males (23.2%, 2051/8853). Multiple regression analysis showed that crab intolerance was correlated with age, gender, body mass index and helicobacter infections(all P < 0.05). In comparison with age group < 40 years old, the values of OR (95%CI) of age groups 41 - 50, 51 - 60 and > 60 years old were 1.224 (1.095 - 1.368), 1.616 (1.431 - 1.827) and 2.177 (1.799 - 2.634) respectively. In comparison with males, the OR (95%CI) of females was 1.286 (1.174 - 1.408). The OR (95%CI) of Helicobacter pylori infections was 1.303(1.201 - 1.413). In comparison with normal weighters, the OR (95%CI) of obese subjects was 1.154 (1.026 - 1.298). CONCLUSIONS: Crab intolerance may be correlated with age, gender, Helicobacter pylori infections and body mass index. Health education should be targeted at its characteristics.

Prognostic value of ultra-sensitive pregnancy associated plasma protein-A in patients with acute coronary syndrome.

OBJECTIVE: To investigate the prognostic value of ultra-sensitive pregnancy associated plasma protein-A (PAPP-A) level in the early phase of acute coronary syndrome (ACS) attack. METHODS: Patients diagnosed as ACS were enrolled and the level of circulatory PAPP-A was measured within 12 hours after ACS attack. The patients were followed at the time of 1st, 6th, and 12th months post-ACS attack in order to observe the incidence of the cardiovascular adverse events. According to the highest quintile, the patients were divided into 2 groups: high level (≥26.08 µg/L) group and low level (<26.08 µg/L) group, to evaluate the association between the level of PAPP-A and the incidence of the cardiovascular events. RESULTS: Compared with the low level group, the incidence of the composite outcome is significantly increased in the high level group, and the values of OR are 4.76, 4.38, 3.75 for 1st, 6th, 12th months respectively (P=0.000). For myocardial infarction (MI) + cardiac death (CD) the values of OR were 9.81, 6.08, 4.12 (P<0.01). Multivariate logistic regression analysis demonstrates that PAPP-A was an independent risk factor for the cardiovascular adverse events in the early, median, and late phase of ACS (P<0.05). CONCLUSION: In the early phase of ACS attack, the elevation of PAPP-A is an independent risk factor for the occurrence of cardiovascular adverse events.

[A cross sectional survey on the relationship between intolerance to eggs and body mass index in Beijing, China].

OBJECTIVE: To explore the prevalence of intolerance to eggs and its relationship with body mass index in Beijing, China. METHODS: A cross sectional survey which included 12 766 adults from health sciences center of general hospital of the Chinese People's Liberation Army from August, 2008 to July, 2009 was carried out. Data was entered computer and organized by EpiData 3.0 software for epidemiological analysis. Nonconditional logistic regression model was used for odd ratio (OR) and 95%CI calculation, and statistics analysis was carried out by SPSS 13.0 software. RESULTS: Positive rate of intolerance to eggs in the cohort was 28.5%. Grades of intolerance to eggs were associated with sex (P < 0.05). Positive rate of intolerance to eggs in females (36.5%) was higher than those in males (24.9%). Data from multiple regression analysis showed that intolerance to eggs was associated with sex and body mass index. Compared with males, the OR (95%CI) of female was 1.732 (1.590 - 1.887). Compared with normal weights, the OR (95%CI) of low weights was 1.443 (1.018 - 2.045). CONCLUSION: Sex and body mass index mignt be associated with intolerance to eggs.

[Hairy cell leukemia: report on one case with survival for 10 years].

One case of hairy cell leukemia with survival for 10 years was reported. The patient received Interferon-alpha(2b) treatment continuously for more than 9 years and intravenous administration of fludarabine for 2 courses of treatment in the later period, and died due to complication of severer infection in thd end. The manifestation, diagnosis and treatment of hairy cell leukemia were discussed.