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Zhao Y.-X.,PUMC Hospital | Lu H.,PUMC Hospital
Acta Academiae Medicinae Sinicae | Year: 2016

Autoimmune pancreatitis (AIP), a special type of chronic pancreatitis, is autoimmune-mediated and can be accompanied by swelling of the pancreas and irregular stenosis of the pancreatic duct. The main pathological features are fibrosis of pancreatic duct with IgG4-positive lymphoplasmacytic infiltration. Different typing methods of AIP can have differerent disease conditions. This paper reviews the history, clinical presentation, diagnostic criteria, and treatment of different AIP types to provide a new basis for the diagnosis and treatment.


Zhou Y.,PUMC Hospital | Zhao W.-G.,PUMC Hospital
Acta Academiae Medicinae Sinicae | Year: 2016

Total pancreatectomy has been mainly used to treat malignant diseases of the pancreas, diffuse ductal involvement, and severe chronic pancreatitis. Patients may develop pancreatic diabetes after the surgery, in whom the glucose levels fluctuate widely and are hard to control, which increases the incidence of recurrent hypoglycemia. Postoperative complications are closely associated with the glucose levels. Thus, tighter glycemic management is essential for increasing the survival of these patients. Few cases have been discribed in China. In this article, we reviewed the blood glucose features, peri- and post-operative complications, and clinical treatment for patients undergoing total pancreatectomy.


Duan M.H.,PUMC Hospital
Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi | Year: 2013

To analyze efficacy of radiotherapy for adult patients with Langerhans cell histiocytosis (LCH). Clinical features and efficacy of radiotherapy for biopsy-proven adult patient with LCH from January 2000 to October 2012 in our hospital were retrospectively analyzed. Seventeen (11 male and 6 female) adult LCH patients with a mean age of 31 (18-56) years old were treated by irradiation, all patients presented as single-system disease. The mean duration from diagnosis to irradiation was 8.3 (0-108) months. Although 12 of 17 patients (70.6%) had short-term response to radiotherapy, all patients but one (94.1%) progressed during long-term follow-up, the mean progression-free survival (PFS) was 14 (0-131) months. Of the progressed patients, one relapsed in situ, the remaining 15 patients progressed outside the irradiated region. Thirteen patients (76.5%) eventually progressed to multisystem disease. Though radiotherapy for LCH in adults produced a high short-term response up to 70.6%, most of patients eventually progressed in situ or outside the irradiation region during long-term follow-up.


To observe the expressions of the collagen , matrix metalloproteases-2 (MMP-2), and tissue inhibitor of matrix metalloproteinase-2 (TIMP-2) in the posterior sclera of newborn guinea pigs with negative lens-defocused myopia. Newborn guinea pigs were monocularly defocused by -10D lens. After 4 weeks of defocus, the eyes were removed to provide posterior scleral samples for detection. Expression of collagen was detected by immunohistochemistry on frozen sections of guinea pig sclera, and the protein levels of MMP-2 and TIMP-2 were evaluated by Western blot. Immunohistochemical analysis indicated that the expressions of collagen and TIMP-2 were significantly lower and the expression of MMP-2 was significantly higher in the posterior sclera in the defocused eyes than in the contralateral eyes (all P < 0.01). However, all these indicators were not significantly different between the contralateral eyes and normal control eyes (all P > 0.05). In the defocused animals, the refraction of defocused eyes was positively correlated with the expression levels of collagen (r = 0.79, P < 0.01) and TIMP-2 (r = 0.74, P < 0.05) and was negatively correlated with the expression level of MMP-2 (r = -0.78, P < 0.01) in posterior sclera. Alteration of extracellular matrix in the posterior sclera, probably participated by MMP-2, may exist during the development of defocus-induced myopia.


Yu J.-C.,PUMC Hospital
Acta Academiae Medicinae Sinicae | Year: 2011

Bariatric surgery is one of the most effective treatment options for obesity. Compared with laparoscopic adjustable gastric banding (LAGB), laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery has demonstrated more benefits and surgical risks. Bariatric surgery can result in the decreases in multiple gastrointestinal hormone levels, which can partially explain the mechanisms behind weight loss and resolution of diabetes after bariatric surgery. The management after bariatric surgery should be multidisciplinary and comprehensive, including dietary adjustment, physical exercise, behavioral intervention, and drug therapy.


Deng J.-H.,PUMC Hospital | Li H.-Z.,PUMC Hospital
Acta Academiae Medicinae Sinicae | Year: 2011

Renal cell carcinoma is one of the most common malignant tumors of urinary system. The annual incidence rate is approximately 17.9/100 000 populations, and there is a continually rising trend in number of new diagnosis. Metastatic and high-risk renal cell cancer is associated with a poor prognosis and is resistant to traditional chemotherapy and/or radiotherapy. Although cytokine-based therapied (interferon and interleukin-2 ) have been widely used, their effectiveness remained unsatisfactory due to their low response rates and short survival. Drugs targeting anti-angiogenesis pathways have shown benefits in relapse-free survival. In this review, we introduce the recent advances in the treatment of renal cancer, especially the application of vasculogenic mimicry and mosaic vessels. Although targeted therapies with anti-angiogenic properties have proposed new treatment criteria for advanced renal cell carcinoma, new drugs or new combinations are needed to improve the clinical efficacy and minimize adverse effects.


This article outlines the clinical values and limitations of body mass index and waist circumference for nutritional assessment among obese individuals and emphasizes the importance of combining these two parameters for diagnosis of obesity.


Li J.-J.,PUMC Hospital | Liu X.-Y.,PUMC Hospital
Acta Academiae Medicinae Sinicae | Year: 2014

Cesarean scar pregnancy is an uncommon ectopic gestation. Without timely and proper management, it may cause major bleeding, uterine rupture, and other life-threatening complications. The causes of this condition remain unclear, and no standardized management has been available, although some medical and surgical treatment modalities have been suggested. The main treatment objectives include preventing massive blood loss, preserving the uterus function, and maintain the women's health and quality of life. Current data do not support expectant management After early diagnosis, single or combined medical and surgical treatment options should be provided to avoid uterine rupture and haemorrhage, so as to preserve the uterus and thus the fertility.


Yu J.C.,PUMC Hospital
Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery | Year: 2012

Nutritional risk and malnutrition was significantly higher in patients undergoing gastrointestinal surgery as compared to patients in other surgical departments, especially in elder patients, which would directly impact on the efficacy, cost and prognosis. Nutritional screening and assessment should be performed within 24-48 hours after admission. Patients at high risk of malnutrition should be planned with early nutrition support. The best nutrition route should be determined to improve the outcomes of surgery and nutritional support, reduce the complications, length of hospital stay and healthcare costs, and improve the quality of life in patients.


Li Z.,PUMC Hospital | Li J.-R.,PUMC Hospital | Gao J.-M.,PUMC Hospital
Acta Academiae Medicinae Sinicae | Year: 2014

Objective: To summarize the clinical features of bronchiectasis. Methods: We retrospectively analyzed the clinical data of 136 patients who had been admitted to Peking Union Medical College Hospital from January 2010 to December 2012 due to bronchiectasis, which was confirmed by high-resolution computed tomography. Results: The average age of these 136 patients (61 men and 75 women) was (57.7 ± 16.3) years. The average clinical history was (17.2 ± 15.8) years. The exact etiology was unidentified in 77.2% (105/136) of the patients. The most commonly identified cause was previous infections (14.7%, 20/136), particularly tuberculosis. The main symptoms of bronchiectasis were cough and sputum production. The types of bronchiectasis were cylindrical in 37.7% (37/98), varicose in 40.8% (40/98), cystic in 21.4% (21/98) of these patients. Multilober involvement was most common (77.2%, 105/136). The most commonly involved lobes were left lower lobe (76.5%, 104/136). Of 77 patients who had undergone pulmonary fuction test, 47 (61.0%) showed obstructive. For each bronchiectasis type, the values (percentages of predicted) of forced expiratory volume in one second (FEV1) (P = 0.918), forced vital capacity (FVC) (P = 0.982), and FEV1/FVC(P = 0.211) showed no statistical significance. The most commonly identified pathogen in sputum culture was Pseudomonas aeruginosa, which was sensitive to most broad-spectrum antibiotics. Current infections were most common in patients with cystic bronchiectasis, among whom rales were frequently heard. Conclusions: Most bronchiectasis patients are old women. The main etiology is previous infection, especially tuberculosis. The main symptom of bronchiectasis is productive cough. Many patients can have obstructive pulmonary function. The distribution of lesions is diffuse, and the lesions are often seen in both lungs, particularly in the left lower lobe. Cystic bronchiectasis may be a more severe type, and should be carefully managed once identified by radiology.

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