[23-28] In the present study, rs-fcMRI was used to investigate whether CM, a disorder consisting of frequent headaches and aberrant affective responses to stimuli perceived as Venetoclax datasheet painful (eg, cutaneous stimulation, light, noise), is associated, interictally, with atypical rs-fc of affective pain-processing regions. Following institutional review

board approval, 20 CM subjects diagnosed using International Classification of Headache Disorders II (ICHD-II) criteria were enrolled.[29] Subjects were excluded if they met ICHD-II criteria for medication overuse, had contraindications to magnetic resonance imaging, neurologic disorders other than migraine, psychiatric disorders other than anxiety or depression, or pain disorders other than migraine. Use of medications considered migraine prophylactics was permitted as long as there were no changes in medications or dosages within 8 weeks of study participation. Extant data from healthy controls who were not taking medications and who were studied using the same imaging protocols were used for comparison. All subjects provided written informed consent for study participation.

Data collected from chronic migraineurs included: (1) number of years with migraine; (2) number of years with CM; (3) CDK inhibitor headache frequency; (4) current medications; (5) Migraine Disability Assessment Scale score; (6) Beck Depression Inventory (BDI) score; and Decitabine solubility dmso (7) State-Trait Anxiety Inventory (STAI) scores.[30-32] Migraineurs were studied when migraine free ≥48 hours and migraine abortive medication free ≥48 hours. Controls were in their usual

healthy state at the time of imaging. Images were obtained on Siemens MAGNETOM Trio 3T scanners (Siemens, Erlangen, Germany) with total imaging matrix technology using 12-channel head matrix coils. Structural anatomic scans included a high-resolution T1-weighted sagittal magnetization-prepared rapid gradient echo (MP-RAGE) series (repetition time [TR] = 2400 ms, echo time [TE] = 1.13 ms, 176 slices, 1.0 mm3 voxels) and a coarse T2-weighted turbo spin echo series (TR = 6150 ms, TE = 86.0 ms, 36 axial slices, 1 × 1 × 4 mm3 voxels). Functional imaging used a BOLD contrast-sensitive sequence (T2* evolution time = 25 ms, flip angle = 90°, resolution = 4 × 4 × 4 mm). Whole-brain echo planar imaging volumes (MRI frames) of 36 contiguous, 4 mm thick axial slices were obtained every 2.2 seconds. BOLD data were collected in two 6-minute runs during which subjects were instructed to relax with their eyes closed. All analyses were performed using in-house software (FIDL analysis package, www.nil.wustl.edu/labs/fidl) that has been utilized in numerous previously published studies.[33-35] fMRI BOLD data were preprocessed via standard methods used in our lab.

All values are means+/-SE (unpaired Student T-tests). Results: Patients with NASH (age 54.4+/-2.1 years; 69% male; BMI 34.2+/-1.0 kg/m2]

had significantly higher fasting serum glucose, insulin and HOMA-IR than healthy controls (age 33.1+/- 2.2 years; 60% male; BMI 26.7+/-1.0 kg/m2). NASH patients had significant hepatic and muscle insulin resistance compared to controls, as demonstrated by lower % suppression of hepatic glucose production rate (41+/-4.3 vs.70+/-9.5 %; p<0.05) and lower glucose selleck chemicals llc disposal (0.85+/-0.1 vs.1.76+/-0.39 mg/kg/min; P<0.05). NASH patients have significant adipose insulin resistance, as demonstrated by higher insulin concentration required to 1/2-maximaIIy suppress circulating free fatty acids

(227+/-35.2 vs.65.2+/-14.0 pmol/L; p<0.001). Furthermore, in patients with NASH, interstitial fluid glycerol release from subcutaneous adipose tissue in response to both low-dose (379+/-42.6 vs.143+/-18.1 AUC μmol/l. h; p<0.0001) and high-dose insulin (261+/-30.7 vs.65.8+/-13.6 AUC μmol/l. h; p<0.0001) was significantly higher. NASH patients had significantly higher fasting circulating leptin: adiponectin ratio (3.22+/-0.49 vs.1.27+/-0.35 ng/μg p=0.003), TNFα (4.89+/-0.60 vs.1.32+/-0.14 pg/ml P<0.0001), hs-CRP (4.31+/-0.89 vs.1.47+/-0.47 μg/ml p<0.05), IL-6 (4.44+/-0.56 vs.2.59+/-0.51 pg/ml; p<0.05) and CCL-2 (224+/-14.4 vs.170+/-14.5 pg/ml; p<0.05) than controls. Conclusions: NASH patients have profound insulin resistance in the liver, muscle and adipose tissues.

Ku-0059436 cell line This study represents the first in-vivo description of dysfunctional subcutaneous adipose tissue in patients with NASH. Disclosures: Matthew J. Armstrong – Grant/Research Support: Novo Nordisk Ltd Stephen Gough – Advisory Committees or Review Panels: Novo Nordisk, Eli Lilly, Sanofi Aventis, Takeda, GSK; Sitaxentan Grant/Research Support: Novo Nordisk, Eli Lilly, Takeda; Speaking and Teaching: Novo Nordisk, Eli Lilly, Sanofi Aventis, GSK Philip N. Newsome – Grant/Research Support: Novo Nordisk The following people have nothing to disclose: Jonathan M. Hazlehurst, Diana Hull, Sarah Borrows, Kathy Guo, Jinglei Yu, Darren Barton, Piers Gaunt, Jeremy W. Tomlinson Background: Cytokeratin 18 (CK18) is a major intermediate filament protein in liver cells. Serum/plasma CK18 levels have been investigated as potential biomarkers for steatohepatitis, in patients with non-alcoholic fatty liver disease (NAFLD) /nonalcoholic steatohepatitis (NASH). The current study was performed to determine the usefulness of serum CK18 levels for evaluating long-term prognosis in NASH patients. Methods: The M30 enzyme-linked immunosorbent assay kit (Peviva) was used for estimating serum CK18 levels in 147 patients with NAFLD/NASH diagnosed by liver biopsies. A second liver biopsy (4.3±2.6 y) was required in 71 patients.

“
“Wheat stripe rust caused by Puccinia striiformis f.sp. tritici (Pst) is one of the most important diseases of wheat worldwide. Detection of latent infection in leaves is critical for estimating the initial inoculum potential of epidemics.

A loop-mediated isothermal amplification (LAMP) assay was developed and evaluated for the detection of Pst DNA in spores and wheat seedlings with latent infections. LAMP assay could detect as low as 2 pg/μl template DNA and detect latent infections from leaves as RAD001 early as 24 h after inoculation. This provides a rapid and accurate method of estimating latent infection levels. “
“Pestalotia leaf spot, caused by the fungus Pestalotiopsis longisetula Guba, has become the major disease affecting strawberry production in Brazil. Strawberry seedlings with 4–5 leaves were inoculated with a conidial suspension of P. longisetula (2 × 105 conidia/ml),

and leaf samples were collected at 48, 72, 96 and 144 h after inoculation (hai) for observation in the scanning electron microscope. Conidia germinated within 48 hai. At 72 hai, conidia had formed very long germ tubes over the epidermal cells without any evidence of appressorial formation nor direct penetration. At 96 hai, fungal hyphae grew inter- and intracellularly in the lacunous parenchyma and also through tracheary elements. Pycnidia were first observed on the leaf surface at 96 hai. At 144 hai, conidia of P. longisetula were first liberated from the pycnidia. This study adds new information to better

understand of the infection process of P. longisetula that may help in developing Olaparib research buy more effective disease control strategies. Tacrolimus (FK506) “
“Symptoms suggestive of phytoplasma diseases were observed in infected sweet cherry trees growing in the central regions of Iran. Phytoplasmas were detected in symptomatic trees by the nested polymerase chain reaction (nested PCR) using phytoplasma universal primer pairs (P1/Tint, PA2F/R, R16F2/R2 and NPA2F/R). Restriction fragment length polymorphism analyses of 485 bp DNA fragments amplified in nested PCR revealed that different phytoplamas were associated with infected trees. Sequence analyses of phytoplasma 16S rRNA gene and 16S-23S intergenic spacer region indicated that the phytoplasmas related to ‘Ca. Phytoplasma asteris’ and peanut WB group infect sweet cherry trees in these regions. This is the first report of the presence of phytoplasmas related to ‘Ca. Phytoplasma asteris’ and peanut WB group in sweet cherry trees. “
“Transmission tests were conducted with field-collected Bunchy Top Symptoms (BTS) phytoplasma-infected specimens of Empoasca papayae. BTS developed in all eight inoculated papayas 3 months later. The BTS phytoplasma was identified in six of eight inoculated papayas, whose partial 16S rRNA sequence (GenBank Accession no. FJ6492000) was 99.9% identical with those from the collected papayas (GenBank Accession no FJ649198) and E.

“
“Wheat stripe rust caused by Puccinia striiformis f.sp. tritici (Pst) is one of the most important diseases of wheat worldwide. Detection of latent infection in leaves is critical for estimating the initial inoculum potential of epidemics.

A loop-mediated isothermal amplification (LAMP) assay was developed and evaluated for the detection of Pst DNA in spores and wheat seedlings with latent infections. LAMP assay could detect as low as 2 pg/μl template DNA and detect latent infections from leaves as GSK-3 beta phosphorylation early as 24 h after inoculation. This provides a rapid and accurate method of estimating latent infection levels. “
“Pestalotia leaf spot, caused by the fungus Pestalotiopsis longisetula Guba, has become the major disease affecting strawberry production in Brazil. Strawberry seedlings with 4–5 leaves were inoculated with a conidial suspension of P. longisetula (2 × 105 conidia/ml),

and leaf samples were collected at 48, 72, 96 and 144 h after inoculation (hai) for observation in the scanning electron microscope. Conidia germinated within 48 hai. At 72 hai, conidia had formed very long germ tubes over the epidermal cells without any evidence of appressorial formation nor direct penetration. At 96 hai, fungal hyphae grew inter- and intracellularly in the lacunous parenchyma and also through tracheary elements. Pycnidia were first observed on the leaf surface at 96 hai. At 144 hai, conidia of P. longisetula were first liberated from the pycnidia. This study adds new information to better

understand of the infection process of P. longisetula that may help in developing Sorafenib purchase more effective disease control strategies. Palbociclib price “
“Symptoms suggestive of phytoplasma diseases were observed in infected sweet cherry trees growing in the central regions of Iran. Phytoplasmas were detected in symptomatic trees by the nested polymerase chain reaction (nested PCR) using phytoplasma universal primer pairs (P1/Tint, PA2F/R, R16F2/R2 and NPA2F/R). Restriction fragment length polymorphism analyses of 485 bp DNA fragments amplified in nested PCR revealed that different phytoplamas were associated with infected trees. Sequence analyses of phytoplasma 16S rRNA gene and 16S-23S intergenic spacer region indicated that the phytoplasmas related to ‘Ca. Phytoplasma asteris’ and peanut WB group infect sweet cherry trees in these regions. This is the first report of the presence of phytoplasmas related to ‘Ca. Phytoplasma asteris’ and peanut WB group in sweet cherry trees. “
“Transmission tests were conducted with field-collected Bunchy Top Symptoms (BTS) phytoplasma-infected specimens of Empoasca papayae. BTS developed in all eight inoculated papayas 3 months later. The BTS phytoplasma was identified in six of eight inoculated papayas, whose partial 16S rRNA sequence (GenBank Accession no. FJ6492000) was 99.9% identical with those from the collected papayas (GenBank Accession no FJ649198) and E.

We conducted a systematic review and Meta analysis of all randomized controlled trials (RCT) to study if use of everolimus along Selleck Talazoparib with CNI minimization or withdrawal improves the renal function in LT recipients. Methods: We performed search of all major databases through May 2014. We included studies of primary adult LT recipients with GFR> 30ml/min with use of everolimus either with reduced dose or complete withdrawal of CNI. A random effect model was used to determine the pooled estimate of the change in renal function at 1 year and pooled estimate relative risk (RR) of adverse reactions associated with everolimus

based therapy. Results: Six RCT and 6 observational studies reported the results of everolimus use in LT recipients. Four randomized controlled trials met the inclusion criteria. There were total 883 patients (Everolimus n= 465, control n= 428) with baseline GFR > 50 ml/min in all patients. In 3 RCT everolimus was initiated early at 4 weeks after LT (2 CNI withdrawal and one CNI minimization), whereas in one study

mean time since transplantation was 3 years (CNI withdrawal). At 12 months everolimus use was associated with significant improvement in GFR 7.4 ml/min (095 % CI= 0.28-14.85). In subgroup analysis of three studies Ixazomib order with everolimus initiation at 4 weeks after LT improvement in GFR was 10.2 ml/min (95 % CI= 2.75-17.8). Everolimus use was not associated with increased risk of biopsy proven acute rejection relative risk (RR) =0.70 (95% CI 0.34-1.44)} or wound dehiscence (RR=1.22 T95% CI=0.93-1.61) or increased mortality (RR=1.54 95%CI-0.82-2.88). There was no increased risk of hepatic artery thrombosis (HAT). However, everolimus use was associated with increased risk of infections (RR 1.18, 95% CI 1.04-1.34). In conclusion in LT recipients’ everolimus use without CNI or with reduced dose CNI results in improved renal function at 12 months. Everolimus was not associated with increased risk of death or graft failure or wound dehiscence or hepatic artery thrombosis. Disclosures: The following people have nothing to disclose: Frahad Sahebjam, Sahil

Mittal, Gagan K. Sood Background: Portal vein thrombosis (PVT) PtdIns(3,4)P2 is present in an estimated 7.8% of patients undergoing liver transplantation (LT). The decision to anti-coagulate a LT candidate for PVT requires an understanding of the risk of LT with PVT. Aim: To analyze LT outcomes in patients with PVT. Methods: UNOS data (20022013) was used to identify 50,393 adult recipients undergoing first LT (excluding patients with split grafts, donation after cardiac death, live donor and multi-organ transplants). PVT was reported as present at LT in 3321 (6.6%), absent in 45,249 (89.8%) and data missing in 1823 (3.6%) patients. Demographic and clinical characteristics (% or mean± standard deviation) were compared in patients with and without PVT. Patient and graft survival were analyzed by the Kaplan-Meier method (log rank test).

1 for GC recurrence prediction (sensitivity = 66.67 and specificity = 83.3). When combining methylated genes and the clinical

stage, the AUC was 83.69, with a sensitivity of 76.19 and a specificity of 83.3. Conclusion: The status of promoter hypermethylation of SFRP-1 and DKK-3 in plasma may serve as a non-invasive diagnostic and prognostic biomarker for GC. Key Word(s): 1. gastric cancer; 2. SFRP1; 3. DKK-3; 4. Plasma; Presenting Author: FENGTING HUANG Additional Authors: SHINENG ZHANG, ZHIQIANG GU Corresponding Author: SHINENG ZHANG Affiliations: Sun Yat-sen Memorial Hospital, Sun Yat-sen University Objective: Colorectal cancer is one of the most common cancers of selleck screening library human and with the increasing morbidity in China recent years. The long intergenic non-coding RNAs (lincRNAs) are emerging as promising regulatory factors in various cancers. In this study, we investigated lincRNAs profiles in 4 pairs of human colorectal cancers (CRC) and the corresponding adjacent nontumorous tissues (NT) by microarray. Methods: The expression of lincRNAs and mRNAs in both CRC and NT was detected by microarray assays. The lincRNAs and mRNAs that were differentially expressed (>2 fold-change or <0.5 fold-change) in CRC compared to NT were screened out.

The potential target genes of Selleckchem FDA-approved Drug Library the differentially expressed lincRNAs were predicted via cis-regulatory effects. Bioinformatic analysis was performed through gene ontology (GO) analysis. The pathway analysis showed the target gene-related pathways. Results: With abundant probes accounting 42545 RNAs in our microarray, 124 lincRNAs were differentially expressed selleck kinase inhibitor (>2 fold-change or <0.5 fold-change) in CRC tissues compared with NT, and 1633 mRNAs were differentially expressed. 41 potential

target genes of differentially expressed lincRNAs were predicted. GO analysis displayed various functions of the predicted target genes. 17 signal pathways were considered to be associated with these predicted target genes. Conclusion: Our study reveals genome-wide lincRNAs expression patterns in CRC by microarray. The results imply that clusters of lincRNAs are aberrantly expressed in CRC compared with NT, which suggests that lincRNAs may play a novel role in the pathogenesis and progression of CRC through different mechanisms and pathways. Taken together, our study may provide a promising insight of CRC. Key Word(s): 1. lincRNAs; 2. colorectal cancer; 3. pathogenesis; 4. progression; Presenting Author: LEI LI Additional Authors: TIAN LUO, WEI JIANG Corresponding Author: LEI LI Affiliations: zhongshan hospital, Fudan university Objective: Colorectal cancer (CRC) is a major cause of morbidity and mortality throughout the world. However, the genetic alterations and molecular mechanism of the early onset CRCs are not fully investigated.

Conclusions.— The Pediatric Migraine Disability Assessment provides a simple tool to measure the impact of selleck inhibitor headaches in adolescents. Adolescents with migraine headaches suffered the greatest level of disability. Higher depression scores were associated with more severe headache-related disabilities in adolescents, independent of headache frequency and severity. “
“Migraine is a chronic, episodic, often disabling, neurological condition that affects more than 12% of the US population, 3 times more in women than men. It has widespread effects on cerebral function and appears to be inherited. There are many types of therapy including

behavioral, complementary, acute pharmacologic care, preventive pharmacologic care, and physical techniques. General treatment principles include

lifestyle changes and using rapidly acting Nutlin-3 order acute care medications alone or in combination early in the migraine attack. Migraine-specific medications such as triptans and non steroidal anti-inflammatory drugs should be used when possible. There are several promising medications and devices in the migraine pipeline. “
“Background.— One of the genome-wide linkage studies performed in migraine has yielded a significant linkage of migraine (with and without aura) with markers located at 6p12.2-21.1. This locus (named MIGR3) has not been replicated in the only genome-wide association Org 27569 scan

study performed to date or in previous genome-wide linkage studies. Objective.— Our objective had been to replicate the MIGR3 locus performing a family-based association study. Methods.— A sample of 594 subjects belonging to 134 migraine families of diverse complexity underwent genotyping for the markers previously published as linked at 6p12.2-21.1 migraine locus. Family-based association test, under different models of inheritance, and also the model-free TDT analysis were performed. Results.— The best result was obtained with the D6S1650 marker under the additive model (rank [S observed] = 265.0; permuted P = .0006), using family-based association test program (HBAT subprogram). Similar results were obtained with the model-free TDTPHASE algorithm (P < .0001, corrected). Nominal significant P values were obtained for D6S1630, D6S452, and D6S257. After correction for multiple testing with the stratified false-discovery rate, all markers showed significant association (P < .0001). Conclusion.— We corroborated that the MIGR3 locus at 6p12 is a genetic risk for migraine with and without aura. (Headache 2012;52:393-399) "
“This article describes a single case of migraine headaches misdiagnosed as idiopathic intracranial hypertension in a young woman. The implications of such a diagnosis are discussed. Literature regarding normal intracranial pressure is reviewed.

Conclusions.— The Pediatric Migraine Disability Assessment provides a simple tool to measure the impact of CDK inhibitor headaches in adolescents. Adolescents with migraine headaches suffered the greatest level of disability. Higher depression scores were associated with more severe headache-related disabilities in adolescents, independent of headache frequency and severity. “
“Migraine is a chronic, episodic, often disabling, neurological condition that affects more than 12% of the US population, 3 times more in women than men. It has widespread effects on cerebral function and appears to be inherited. There are many types of therapy including

behavioral, complementary, acute pharmacologic care, preventive pharmacologic care, and physical techniques. General treatment principles include

lifestyle changes and using rapidly acting Cilomilast acute care medications alone or in combination early in the migraine attack. Migraine-specific medications such as triptans and non steroidal anti-inflammatory drugs should be used when possible. There are several promising medications and devices in the migraine pipeline. “
“Background.— One of the genome-wide linkage studies performed in migraine has yielded a significant linkage of migraine (with and without aura) with markers located at 6p12.2-21.1. This locus (named MIGR3) has not been replicated in the only genome-wide association Morin Hydrate scan

study performed to date or in previous genome-wide linkage studies. Objective.— Our objective had been to replicate the MIGR3 locus performing a family-based association study. Methods.— A sample of 594 subjects belonging to 134 migraine families of diverse complexity underwent genotyping for the markers previously published as linked at 6p12.2-21.1 migraine locus. Family-based association test, under different models of inheritance, and also the model-free TDT analysis were performed. Results.— The best result was obtained with the D6S1650 marker under the additive model (rank [S observed] = 265.0; permuted P = .0006), using family-based association test program (HBAT subprogram). Similar results were obtained with the model-free TDTPHASE algorithm (P < .0001, corrected). Nominal significant P values were obtained for D6S1630, D6S452, and D6S257. After correction for multiple testing with the stratified false-discovery rate, all markers showed significant association (P < .0001). Conclusion.— We corroborated that the MIGR3 locus at 6p12 is a genetic risk for migraine with and without aura. (Headache 2012;52:393-399) "
“This article describes a single case of migraine headaches misdiagnosed as idiopathic intracranial hypertension in a young woman. The implications of such a diagnosis are discussed. Literature regarding normal intracranial pressure is reviewed.

“
“(Headache 2010;50:1153-1163) Objective.— To review potential and theoretical safety concerns of transcranial magnetic stimulation (TMS), as obtained from studies of single-pulse (sTMS) and repetitive TMS (rTMS) and to discuss safety concerns associated with sTMS in the context of its use as a migraine treatment. Methods.— The published literature was reviewed to identify adverse events that have been reported during the use of TMS; to assess its potential effects on brain tissue, the cardiovascular system, hormone levels, cognition

and psychomotor tests, and hearing; to identify the risk of seizures associated with TMS; and to identify safety issues associated with its use in patients with attached or implanted electronic equipment or during pregnancy. Results.— Two decades of clinical experience with sTMS have shown it to be a low risk technique with promise in the diagnosis, monitoring, and treatment of neurological and psychiatric Osimertinib price disease in adults. Tens of thousands of subjects have undergone TMS for diagnostic, investigative, and therapeutic intervention trial purposes with minimal adverse events or side effects. No discernable evidence exists to suggest that sTMS causes harm to humans. No changes in neurophysiological function have

been reported with FK866 order sTMS use. Conclusions.— The safety of sTMS in clinical practice, including as an acute migraine headache treatment, is supported by biological, empirical, and clinical trial evidence. Single-pulse TMS may offer a safe nonpharmacologic, nonbehavioral therapeutic approach to the currently prescribed drugs for patients who suffer from migraine. “
“Understanding the pathophysiology and pharmacology of migraine has been driven by astute clinical observations, elegant experimental medicine studies, and importantly by studying highly effective anti-migraine agents in the laboratory and the clinic. Significant progress has been made in the use of functional brain imaging to compliment observational studies of migraine phenotypes Osimertinib in vitro by

highlighting pathways within the brain that may be involved in predisposition to migraine, modulating migraine pain or that could be sensitive to pharmacological or behavioral therapeutic intervention (Fig. 1). In drug discovery, molecular imaging approaches compliment functional neuroimaging by visualizing migraine drug targets within the brain. Molecular imaging enables the selection and evaluation of drug candidates by confirming that they engage their targets sufficiently at well tolerated doses to test our therapeutic hypotheses. Migraine is a progressive disorder. Developing our knowledge of where drugs act in the brain and of how the brain is altered in both episodic migraine (interictal state and ictal state) and chronic migraine are important steps to understanding why there is such differential responsiveness to therapeutics among migraine patients and to improving how they are evaluated and treated.

Symptoms were assessed with Eckardt scores. The thickness of muscularis propria was measured endosonographically at 25 cm, 30 cm, 35 cm, and 40 cm from the incisors and at the gastroesophageal junction (GEJ). Of the 43 patients evaluated, 23 had spindle-type achalasia (Group A), 14 had flask-type (Group B), and 6 patients had sigmoid type (Group C). Results: The thickness of muscularis propria was significantly greater in Group C than A and

B when measured at 25 cm (P = 0.02) and 30 cm (P = 0.03) from the incisors. The thickness was greater in Group B than Group A and C when measured at 35 cm from the incisors (P = 0.01). There was no significant difference in the thickness of muscularis propria measured at the GEJ (P > 0.05) and 40 cm from the incisors

(P = 0.45) Angiogenesis inhibitor among the groups. There was very little correlation between the thickness and symptom scores (r = -0.2, P = 0.15), or the average pressure of the lower oesophageal sphincter (r = 0.3, P = 0.13). However, the duration of symptoms was negatively correlated with the thickness of muscularis propria (r = -0.5, P = 0.04). Conclusion: The appearance of muscularis propria thickening was common in patients with achalasia. EUS may be valuable in evaluating the severity of achalasia as we indicated an inverse relationship between the duration of symptoms and the thickness of the muscularis propria. Key Word(s): 1. POEM; 2. achalasia; Presenting Author: WEIXIANG MENG LDE225 clinical trial Additional Authors: GUOBAI XU, YAN LIU, LUOLUO YANG Corresponding Author: WEIXIANG MENG Affiliations: Jinlin University First Hospital; Jinlin University First Hospital Objective: Objective: To explore the sites, pathological type of the primary duodenal malignant tumors, especially differences in young and middle-aged and elderly patients and to find out inspection methods

in early. Methods: Methods: The statistics of 161 cases of diseased parts, the first symptoms, and the detection rate of the relevant Amisulpride checks, pathological features, and abnormal serum tumor markers of primary duodenal malignant tumors. To explore their respective characteristics and the value of early diagnosis of the disease. Results: Results: Young group and older group, with no specific clinical manifestations. The average duration from onset to diagnosis is 2.3 months. The tumors in young group patients mainly occur in the duodenal papilla. The tumors in elder group patients mainly occur in descending part (excluding nipple). There has no significant difference in the incidence of site between Two groups. The manly pathological type of the young group patients and older group patients are both adenocarcinoma. There has no significant difference in the in the pathological type between Two groups. The highest detectable rate of Auxiliary examination is duodenoscope, followed by ERCP. The highest detectable rate methods of serological detection are γ-GT and CA199. Conclusion: 1.