[Analysis on the secondary attack rates of SARS-CoV-2 Omicron variant and the associated factors].

Objective: To evaluate the secondary attack rates of the SARS-CoV-2 Omicron variant and the associated factors. Methods: A total of 328 primary cases and 40 146 close contacts of the SARS-CoV-2 Omicron variant routinely detected in local areas of Jiangsu Province from February to April 2022 were selected in this study, and those with positive nucleic acid test results during 7 days of centralized isolation medical observation were defined as secondary cases. The demographic information and clinical characteristics were collected, and the secondary attack rate (SAR) and the associated factors were analyzed by using a multivariate logistic regression model. Results: A total of 1 285 secondary cases of close contacts were reported from 328 primary cases, with a SAR of 3.2% (95%CI: 3.0%-3.4%). Among the 328 primary cases, males accounted for 61.9% (203 cases), with the median age (Q1, Q3) of 38.5 (27, 51) years old. Among the 1 285 secondary cases, males accounted for 59.1% (759 cases), with the median age (Q1, Q3) of 34 (17, 52) years old. The multivariate logistic regression model showed that the higher SAR was observed in the primary male cases (OR=1.632, 95%CI: 1.418-1.877), younger than 20 years old (OR=1.766, 95%CI: 1.506-2.072),≥60 years old (OR=1.869, 95%CI: 1.476-2.365), infected with the BA.2 strain branch (OR=2.906, 95%CI: 2.388-3.537), the confirmed common cases (OR=2.572, 95%CI: 2.036-3.249), and confirmed mild cases (OR=1.717, 95%CI: 1.486-1.985). Meanwhile, the higher SAR was observed in the close contacts younger than 20 years old (OR=2.604, 95%CI: 2.250-3.015),≥60 years old (OR=1.287, 95%CI: 1.052-1.573) and exposure for co-residence (OR=27.854, 95%CI: 23.470-33.057). Conclusion: The sex and age of the primary case of the Omicron variant, the branch of the infected strain, case severity of the primary case, as well as the age and contact mode of close contacts are the associated factors of SAR.

[A case of left pulmonary artery sling combined with congenital tracheal stenosis in an adult].

Pulmonary artery sling in adults is a rare congenital vascular malformation usually accompanied by tracheal and bronchial stenosis. Due to its high mortality risk and relatively poor prognosis, it has rarely been reported in adults. We reported a middle-aged patient who presented with shortness of breath, predominantly after activity, since childhood. He was diagnosed with "tracheal stenosis" in another hospital and received symptomatic treatment. The diagnosis of left pulmonary artery sling with congenital tracheal stenosis was confirmed by multi-slice spiral CT (MSCT), airway examination with flexible bronchoscope and 3D image post-processing system. Data from this case and the related literatures have been summarized and analyzed. This will help clinicians to improve their level of diagnosis and treatment.

Focused electric field (FEF) ablation in a left ventricular and infrared thermal imaging model: a proof-of-concept study.

BACKGROUND: Currently, RF ablation is limited in its ability to deliver deep lesions, as most of the energy delivered to the tissue is dissipated in the first few millimeters from the catheter tip. Focused electric field (FEF) is a novel technology with the potential to ablate deeper than currently available RF catheters. This work is the first proof of concept of FEF technology. OBJECTIVE: To introduce FEF technology and demonstrate its feasibility as an ablation tool. METHODS: We constructed a FEF catheter with a truncated dome-shaped tip, creating a toroidal ablating surface. We performed ablation ex vivo in porcine hearts and examined ablation characteristics using both tissue sectioning and real-time thermal imaging. RESULTS: RF lesions were 9.1 ± 1.0 mm wide by 6.1 ± 1.1 mm deep with ablation using a conventional irrigated tip catheter (Thermocool SF). In contrast, lesions created using FEF ablation were 12.8 ± 1.6 mm wide and 14.0 ± 1.6 mm deep. Steam pops were less frequent in the FEF group. Thermal imaging demonstrated that in contrast to an irrigated tip RF catheter, the FEF catheter generated a uniform temperature profile down to a maximum depth exceeding 15 mm. CONCLUSION: This study is the first proof of concept of FEF technology. Using a novel toroidal catheter tip design, the electric field remains confined to a narrow tissue region, thus avoiding the rapid fall off in energy delivery from the tissue surface inherent to current RF catheter designs. FEF ablation may allow delivery of deeper ablations lesions with potentially lower risk of tissue hyperthermia than conventional catheters. Future studies are needed.

[Efficacy of selective bronchial occlusion in the treatment of biliary bronchial fistula].

Objective: To analyze the effect of selective bronchial occlusion (SBO) in the treatment of biliary bronchial fistula (BBF). Methods: Eight patients with BBF that without biliary obstruction admitted to the Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Naval Medical University from January 1, 2015 to December 31, 2021 were included in this study. Bronchial silicone plug (6 cases) and autologous blood+thrombin (2 cases) were used as sealing materials for SBO treatment for the first time. Among the 7 patients who underwent subsequent closure treatment, 5 cases were blocked by bronchial silicone plug, 1 case was blocked by "bronchial silicone plug+bullet-covered stent" and 1 case was blocked by "bronchial silicone plug+bronchial one-way valve". The clinical data related to SBO treatment were collected and patients were followed up, and the therapeutic effect of SBO on BBF was analyzed. Results: The age of BBF onset was (58±9) years old, including 6 males. Among the 6 patients who used bronchial silicone plug as plugging material in the first SBO treatment, 1 case was successfully plugged, 2 cases did not achieve symptoms relief after plugging, 2 cases coughed up the plugging device immediately after surgery, and 1 case developed a new fistula. Autologous blood and thrombin were used as sealing materials in 2 patients, and both failed. Among the 7 patients who received subsequent closure treatment, bronchial silicone plug+bullet-covered stent (1 case) and bronchial silicone plug+bronchial unidirectional valve (1 case) were successful. After 2-6 times of bronchial silicone plug (5 cases), fistula were successfully blocked in 3 cases, and the frequency and volume of bile-like sputum decreased by 50% or more in 2 cases. The main postoperative complications were fever and cough (expectoration) in 7 and 6 cases, respectively. During the follow-up period, 2 patients were lost to follow-up, and the remaining 6 patients were followed up for 2-31 months. During the follow-up period, the effect of closure treatment was basically stable, and there was no death case. Conclusion: SBO therapy provides a safe and feasible palliative treatment for BBF.

LncRNA RP11-567G11.1 accelerates the proliferation and invasion of renal cell carcinoma through activating the Notch pathway.

OBJECTIVE: In recent years, the death number of renal cell carcinoma (RCC) has been enhanced annually. The crucial function of long non-coding RNA (lncRNA) in the occurrence and progression of cancer is of great significance. However, the specific role of lncRNAs in the pathogenesis and prognosis of RCC has not been fully elucidated. Therefore, the aim of this study was to uncover the role of lncRNA RP11-567G11.1 in regulating the progression of RCC. PATIENTS AND METHODS: Relative expression level of RP11-567G11.1 in RCC tissues and cells was determined by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). The influences of RP11-567G11.1 on proliferative and invasive abilities of RCC cells were assessed. Subsequently, regulatory effects of RP11-567G11.1 on the viability and apoptosis of DDP-induced RCC cells were examined. Furthermore, the mRNA and protein levels of Notch pathway-related genes Jagged1/HES5/HEY1 in RCC were detected by qRT-PCR and Western blot, respectively. RESULTS: RP11-567G11.1 expression was significantly up-regulated in RCC tissues and cells. Meanwhile, RP11-567G11.1 was highly expressed in RCC patients with advanced stage. Knockdown of RP11-567G11.1 significantly attenuated proliferative and invasive abilities of 786-O and 769-P cells. Silence of RP11-567G11.1 attenuated viability, while it induced apoptosis in DDP-induced RCC cells. In addition, knockdown of RP11-567G11.1 remarkably down-regulated both mRNA and protein levels of Jagged1, HES5, and HEY1 in RCC. CONCLUSIONS: RP11-567G11.1 accelerates the proliferative and invasive abilities of RCC through activating the Notch pathway. Our findings suggest that it may be a new therapeutic target for RCC.

Prevalence of pollen-induced allergic rhinitis with high pollen exposure in grasslands of northern China.

BACKGROUND: The aim of this study was to investigate the prevalence of epidemiologic and physician-diagnosed pollen-induced AR (PiAR) in the grasslands of northern China and to study the impact of the intensity and time of pollen exposure on PiAR prevalence. METHODS: A multistage, clustered and proportionately stratified random sampling with a field interviewer-administered survey study was performed together with skin prick tests (SPT) and measurements of the daily pollen count. RESULTS: A total of 6043 subjects completed the study, with a proportion of 32.4% epidemiologic AR and 18.5% PiAR. The prevalence was higher in males than females (19.6% vs 17.4%, P = .024), but no difference between the two major residential and ethnic groups (Han and Mongolian) was observed. Subjects from urban areas showed higher prevalence of PiAR than rural areas (23.1% vs 14.0%, P < .001). Most PiAR patients were sensitized to two or more pollens (79.4%) with artemisia, chenopodium, and humulus scandens being the most common pollen types, which were similarly found as the top three sensitizing pollen allergens by SPT. There were significant regional differences in the prevalence of epidemiologic AR (from 18.6% to 52.9%) and PiAR (from 10.5% to 31.4%) among the six areas investigated. PiAR symptoms were positively associated with pollen counts, temperature, and precipitation (P < .05), but negatively with wind speed and pressure P < .05). CONCLUSION: Pollen-induced AR (PiAR) prevalence in the investigated region is extremely high due to high seasonal pollen exposure, which was influenced by local environmental and climate conditions.

The use of susceptibility-weighted imaging to detect cerebral microbleeds after lacunar infarction.

OBJECTIVE: To study the value of susceptibility-weighted imaging (SWI) technology to detect cerebral microbleeds (CMBs) in senile cerebral lacunar infarction patients; and to evaluate the complicated cerebral hemorrhage risk after patients with CMBs took aspirin, an antiplatelet medication or received anticoagulant therapy. PATIENTS AND METHODS: MRI scanning, using GRE-T2*WI, SWI and FSE sequences (T1WI, T2WI, and T2FLAIR), was performed on the three groups: (1) a cerebral lacunar infarction group; (2) cerebral lacunar infarction with cerebral microbleeds (CMBs) group; and (3) a healthy elderly group. A total of 60 cases were in each group (180 total patients). In addition, the lacunar infarction group and lacunar infarction with CMBs groups were both treated with formal antiplatelet or anticoagulant therapy, according to medical guidelines. Patients were followed for 12 months, during which time their cerebral hemorrhages and post-event effects were observed. The relativity of CMBs, antiplatelet therapy, anticoagulant therapy and cerebral hemorrhage transformation was analyzed and defined. The two groups of research patients with lacunar infarctions were scanned with relevant sequences. RESULTS: The SWI scanning sequence showed the highest positive rate of CMBs, followed by GRE-T2*WI and other conventional scanning sequences. T1WI, T2WI and T2FLAIR showed a relatively lower positive rate of CMBs. In the cerebral lacunar infarction group and healthy elderly group, 34 cases in the SWI sequence showed 84 positive sites; 18 cases in the GRE-T2*WI sequence showed 40 positive sites; 2 cases in the T1WI sequence showed 4 positive sites; and 6 cases in the T2WI sequence showed 11 positive sites. After a chi-squared test, the differences between the sequences were statistically significant (p < 0.05). In the lacunar infarction group, 26 cases (43.33%) exhibited microbleeding lesions, while the normal control group represented 8 cases (13.33%). The lacunar infarction group exhibited mild, moderate and severe cases, the three types of CMBs. The normal control group only showed mild hemorrhaging. The degree of lacunar infarction was significantly related to the severity of CMBs (p < 0.05). After patients with CMBs had received formal antiplatelet therapy and anticoagulation therapy, one case in the lacunar infarction with microbleeds group showed cerebral hemorrhaging, but this had no statistical significance (p > 0.05). CONCLUSIONS: The SWI scanning sequence is more sensitive than the GRE-T2*WI sequence. The GRE-T2*WI sequence is more sensitive than the conventional FSE sequence. SWI is highly sensitive and specific to the diagnosis of CMBs. It is an accurate and effective method for the analysis and diagnosis of CMBs. If patients with CMBs caused by lacunar infarction are treated with antiplatelet and anticoagulant therapy, the risk of cerebral hemorrhagic transformation is relatively smaller within 12 months. However, this needs to be observed further to define possible long-term risks.

[Clinical analysis of therapeutic bronchoscopy for tracheal neoplasm].

Objective: To analyze the clinical features in adults with tracheal neoplasm and to evaluate the efficacy of interventional bronchoscopic treatment. Methods: We retrospectively analyzed the clinical features of 43 adults undergoing therapeutic bronchoscopy for tracheal neoplasm diagnosed in Changhai Hospital affiliated to the Second Military Medical University from January 2004 to July 2014.The degree of stenosis, the grade of dyspnea, and Karnofsky performance status scale were evaluated before and after the last procedure. All cases were followed up for 2 years. Results: The 43 cases took (4.6±3.9) months on average to be diagnosed since initial symptom. The initial misdiagnosis rate was 41.9%(18/43), and 11 cases were mistaken for asthma (11/43). Malignant tumors were more common than benign tumors for tracheal neoplasm in adults. Squamous cell carcinoma and adenoid cystic carcinoma were the top 2 histological types. Central airway obstruction was completely or partially alleviated with significant relief of dyspnea after the procedures, and all 6 cases of tracheal benign tumors got complete alleviation (the overall response rate was 100%). The grade of dyspnea was 3.2±0.7 before and 1.5±0.8 after the procedures(t=6.63, P<0.05). The value of KPS was 63±12 before and 83±11 after the procedures(t=5.78, P<0.05). The 2-year survival rate of 6 cases of tracheal benign tumors was 100.0%, and 1 case of papillomatosis had a relapse. The 1-year survival rate and 2-year survival rate of 37 cases of tracheal malignant tumors were 59.5% and 43.2% respectively with a median survival of 13.6 months. Conclusion: Therapeutic bronchoscopic interventions provide significantly alleviation of central airway obstruction and result in improvement in shortness of breath and quality of life for tracheal neoplasm.

[The effects and related risk factors on cataract surgery in Shandong province].

Objective: To explore the efficacy and related risk factors on cataract surgery in Shandong province. Methods: A total of 108 190 cataract surgeries which were reported from 17 cities of Shandong province during January 2013 to December were reviewed. The demographic information, preoperative examination, surgery related information (including date of surgery, surgical methods, and intraoperative complications), and postoperative situations (naked eye visual acuity, curative efficacy after three days, and postoperative complications) were reviewed. Wilcoxon signed-ranks, univariate and orderly multivariate Logistic regression analysis were used according to nature of the data. Results: There were 64 852 female patients (59.9 %) and 43 338 male patients (40.1%) in all 108 190 cases. About 36.5% patients (39 496 cases), the highest proportion, were 71 to 80 years of age, 31.26% patients (33 711 cases) were 61 to 70 years old and 13.6% patients (14 720 cases) were over 81 years old. Visual acuity increased significantly after surgery (Z=165.24, P<0.01). Simple factor Logistic regression analysis showed that preoperative corrected visual acuity less than 0.1 (OR=2.30 95%CI: 0.59 to 1.07), complications (OR=8.50,95% CI: 1.34 to 2.94), congenital cataract (OR=1.69, 95%CI: 0.22 to 0.83), extracapsular cataract extraction (OR=1.99, 95% CI:0.57 to 0.81), postoperative complications in three days (OR=7.46, 95% CI:1.77 to 2.25) were predictors of worse outcome after cataract surgery. Multivariate logistic regression analysis showed that the efficacy of cataract surgery were influenced by history of diabetes (OR=1.79, 95% CI: 0.46 to 0.71), history of hypertension (OR=3.49, 95% CI: 1.07-1.43), postoperative complications in three days (OR=3.91, 95% CI: 1.53 to 1.20) and extracapsular cataract extraction (OR=1.54, 95% CI: 0.20 to 0.66). Young male patients (OR=0.82, 95% CI:-0.28 to -0.12), normal preoperative intraocular pressure (OR=0.79, 95%CI: -0.38 to -0.10) and pupil (OR=0.42, 95% CI:-1.17 to -0.57) were predictors of better outcome. Conclusions: Visual acuity improved significantly after cataract surgery in Shandong province. The efficacy of cataract surgery was influenced by many factors. It is important to control systemic diseases and to choose modern operation method. (Chin J Ophthalmol, 2016, 52: 929-935).

Biochemical characterization and functional analysis of UDP-glucose dehydrogenase, in the synthesis of biopolymer Ss from Sphingomonas sanxanigenens NX02.

Biopolymer Ss of Sphingomonas sanxanigenens strain NX02 is an sphingan that can be extracted using a small quantity of acid, which is a low cost extraction process. A UDP-glucose dehydrogenase gene (ugdG), related to Ss biosynthesis, was cloned from S. sanxanigenens NX02 and expressed in Escherichia coli. It encoded a 454-residue protein of 48.2 kDa. The deduced amino acid sequence had 77% identity with UDP-glucose dehydrogenase (UgdG) from Sphingomonas sp. KC8, and 73% identity with UgdG from Sphingomonas elodea ATCC31461. Purified recombinant UgdG had maximum activity at 35°C and pH 8.0, with Km values of 0.47 and 0.38 mM for UDP-glucose and NAD+, respectively. Overexpression of the ugdG gene in S. sanxanigenens resulted in increased (14.9 ± 0.5)% Ss production and higher fermentation broth viscosity. Furthermore, the weight-average molecular weight of polymer Ss from the recombinant strain was (5.3 ± 0.16)% higher and the viscosity was (74 ± 0.15)% higher than those from the WT strain at a shear rate of 1 rev/min.

COL11A1 promotes tumor progression and predicts poor clinical outcome in ovarian cancer.

Biomarkers that predict disease progression might assist the development of better therapeutic strategies for aggressive cancers, such as ovarian cancer. Here, we investigated the role of collagen type XI alpha 1 (COL11A1) in cell invasiveness and tumor formation and the prognostic impact of COL11A1 expression in ovarian cancer. Microarray analysis suggested that COL11A1 is a disease progression-associated gene that is linked to ovarian cancer recurrence and poor survival. Small interference RNA-mediated specific reduction in COL11A1 protein levels suppressed the invasive ability and oncogenic potential of ovarian cancer cells and decreased tumor formation and lung colonization in mouse xenografts. A combination of experimental approaches, including real-time RT-PCR, casein zymography and chromatin immunoprecipitation (ChIP) assays, showed that COL11A1 knockdown attenuated MMP3 expression and suppressed binding of Ets-1 to its putative MMP3 promoter-binding site, suggesting that the Ets-1-MMP3 axis is upregulated by COL11A1. Transforming growth factor (TGF)-beta (TGF-ß1) treatment triggers the activation of smad2 signaling cascades, leading to activation of COL11A1 and MMP3. Pharmacological inhibition of MMP3 abrogated the TGF-ß1-triggered, COL11A1-dependent cell invasiveness. Furthermore, the NF-YA-binding site on the COL11A1 promoter was identified as the major determinant of TGF-ß1-dependent COL11A1 activation. Analysis of 88 ovarian cancer patients indicated that high COL11A1 mRNA levels are associated with advanced disease stage. The 5-year recurrence-free and overall survival rates were significantly lower (P=0.006 and P=0.018, respectively) among patients with high expression levels of tissue COL11A1 mRNA compared with those with low expression. We conclude that COL11A1 may promote tumor aggressiveness via the TGF-ß1-MMP3 axis and that COL11A1 expression can predict clinical outcome in ovarian cancer patients.

Isolated invasive Aspergillus tracheobronchitis: a clinical study of 19 cases.

Isolated invasive Aspergillus tracheobronchitis (iIATB) is an uncommon clinical form of invasive Aspergillosis in which Aspergillus infection is limited entirely or predominantly to the tracheobronchial tree. In the present study, we retrospectively analyzed the medical records of 19 patients who had histological documented iIATB in the Department of Respiratory Medicine of Changhai Hospital between October 2000 and February 2008. Malignancy was the most common underlying disease, which existed in 14 patients (73.7%) in our series. Most patients had impaired airway structures or defence functions, whereas the systemic immune status was relatively normal. Only three patients (15.8%) had neutropenia. The clinical manifestations and chest radiograph were nonspecific. We classified iIATB into four different forms according to the bronchoscopic features of intraluminal lesions: superficial infiltration type (Type I, n = 4), full-layer involvement type (Type II, n = 2), occlusion type (Type III, n = 6) and mixed type (Type IV, n = 7). Type IV was the largest group in our study, followed by Type III. All patients with iIATB of Type IV had definite airway occlusion. Fourteen patients (73.7%) had a good response to antifungal treatments and five (26.3%) died as a result of the progression of Aspergillosis, all of whom had full-layer invasion of the involved bronchi. In conclusion, we found that iIATB could occur in moderately or non-immunocompromised patients with impaired airway structures or defence functions and may be an early period of invasive pulmonary Aspergillosis. Most of the iIATB patients had a favourable prognosis with early diagnosis and effective antifungal treatment. The morphological features of intraluminal lesions might be of prognostic value.

Database of repetitive elements in complete genomes and data mining using transcription factor binding sites.

Approximately 43% of the human genome is occupied by repetitive elements. Even more, around 51% of the rice genome is occupied by repetitive elements. The analysis presented here indicates that repetitive elements in complete genomes may have been very important in the evolutionary genomics. In this study, a database, called the Repeat Sequence Database, is first designed and implemented to store complete and comprehensive repetitive sequences. See http://rsdb.csie.ncu.edu.tw for more information. The database contains direct, inverted and palindromic repetitive sequences, and each repetitive sequence has a variable length ranging from seven to many hundred nucleotides. The repetitive sequences in the database are explored using a mathematical algorithm to mine rules on how combinations of individual binding sites are distributed among repetitive sequences in the database. Combinations of transcription factor binding sites in the repetitive sequences are obtained and then data mining techniques are applied to mine association rules from these combinations. The discovered associations are further pruned to remove insignificant associations and obtain a set of associations. The mined association rules facilitate efforts to identify gene classes regulated by similar mechanisms and accurately predict regulatory elements. Experiments are performed on several genomes including C. elegans, human chromosome 22, and yeast.

Effects of dexamethasone on intracellular Ca2+ in its sensitive cells from neonatal mouse hippocampus and cultured cortical neurogliocytes.

AIM: To investigate the effects of dexamethasone (Dex) on intracellular free calcium ([Ca2+]i) in the single neuron or neurogliocyte. METHODS: Neonatal mouse hippocampal cells (NMHC) and cultured cortical neurogliocytes (CCN) were loaded with Fura 2-AM. The [Ca2+]i was measured with AR-CM-MIC-cation measurement system. RESULTS: Most of freshly isolated NMHC exhibited a rapid and concentration-dependent [Ca2+]i increase after administration of Dex 40-200 mumol.L-1. Only 10% of NMHC showed their [Ca2+]i decreases in total 96 tested cells. Dex-triggered [Ca2+]i rise was prevented by incubating the cells with Mg(2+)-free solution and reduced by adding LaCl3. Suspended NMHC in Ca(2+)-free solution or pretreated cells with mifepristone or tetrodotoxin prevented the initial [Ca2+]i increases caused by Dex 40-90 mumol.L-1, but only diminished the later [Ca2+]i rises by Dex 200 mumol.L-1. About 50% of tested single CCN showed a rapid and concentration-related [Ca2+]i increase due to Dex 90-270 mumol.L-1 exposure. This effect was partially inhibited under extracellular Ca(2+)- or Mg(2+)-free and mifepristone pretreatment conditions. CONCLUSION: Dex produces the rapid [Ca2+]i changes in both neurons and glia cells. Reactions among most cells include a Mg(2+)-dependent and glucocorticoid receptor-related extracellular Ca2+ influx and a high concentration of Dex-mediated intracellular Ca2+ release.

S100 protein-positive dendritic cells and the significance of their density in gastric precancerous lesions.

Quantitative analysis of dendritic cells (DC's) was carried out in tissue specimens of normal gastric mucosa (n = 15), gastric ulcer (n = 19), chronic atrophic gastritis (n = 28), and gastric carcinoma (n = 65) by ABC immunostaining with S100 protein antibody. Significant increases in DC number were observed in chronic atrophic gastritis with type III intestinal metaplasia and/or grade II, III dysplasia. The result suggests that DC's are potentially capable of presenting neoantigens associated with malignant transformation at the precancerous stage when malignant morphological changes have not yet taken place. Combined with routine diagnostic methods, the serial monitoring of DC density in gastric mucosa may be useful in the follow-up of premalignant lesions in the stomach and the diagnosis of early gastric carcinoma.

[Duodenal ulcer and the insulin releasing level].

Indirect pieces of evidences indicate the correlation between insulin level and pathogenesis of peptic ulcer. In the present study, serum insulin releasing level after glucose loading was determined in 16 patients with duodenal ulcer (DU) using radioimmunoassay, and was compared with that of normal controls. The peak insulin level (PIL) in DU patients was significantly higher than that of normal individuals (P less than 0.05), the measurements of gastric acidity, insulin level and the gastroscopic examination were carried out both before and after the treatment. The rebound phenomenon of gastric acidity (BAO) was correlated to that of PIL (r = 0.85). The possible relationship between insulin level and DU was discussed.