Repeated superovulation induction after failure in previous IVF-ET cycles with the ultra-long protocol: Analysis of outcomes of clinical pregnancy / 中华男科学杂志

Objective@#To analyze the clinical outcomes of repeated superovulation induction in patients with adenomyosis or moderate to severe pelvic endometriosis after failure in previous IVF-ET cycles with the ultra-long protocol.@*METHODS@#We retrospectively analyzed the clinical data about 37 patients with adenomyosis or moderate to severe pelvic endometriosis in our center from 2009 to 2013, who underwent repeated IVF-ET after failure in the previous cycles with the ultra-long protocol, namely by injection of 2－6 ampoules of 3.75 mg gonadotropin-releasing hormone agonist (GnRH-a). All the patients met the following requirements: hCG-negative at 14 days after transfer, within 3－7 days after menstruation, and properly down-regulated serum follicle stimulating hormone (FSH) (<10 mIU/ml), luteinizing hormone (LH) (<10 mIU/ml), estradiol (E2) (<30 pg/ml), follicle diameter (<10 mm) and endometrial thickness, and received GnRH (Gonal-F, Serono) for ovulation induction. We compared the clinical and laboratory data and pregnancy outcomes between the first and repeated cycles before and after ovulation induction.@*RESULTS@#The repeated cycles, as compared with previous ones, showed significant increases in the antral follicle count (AFC) on the first day of stimulation (7.55 ± 1.86 vs 6.45 ± 2.5, P<0.05), number of follicles =≥14 mm in diameter on the hCG trigger day (7.81 ± 3.6 vs 5.56 ± 3.68, P<0.05), level of E2 (［2 362.15 ± 1 210.49］ vs ［1 749.22 ± 1 139.44］ pg/ml, P<0.05), and numbers of oocytes retrieved (7.51 ± 3.23 vs 4.78 ± 3.41, P<0.05) and embryos transferred (2.00 ± 0.33 vs 1.50 ± 0.67, P<0.05), exhibited a remarkably reduction in the dose of GnRH (［1 791.65 ± 1 889.41］ vs ［3 439.56 ± 1 836.53］ IU, P<0.05), and achieved a clinical pregnancy rate of 62.16%.@*CONCLUSIONS@#With proper reduction of the FSH, LH and E2 levels and follicle diameter, repeated superovulation induction for IVF-ET can improve the ovarian response and pregnancy outcomes of the patients with adenomyosis or moderate to severe pelvic endometriosis after failure in the previous IVF-ET cycles with the ultra-long protocol.

Epidemic analysis on AIDS,gonorrhea and syphilis from 1990 to 2013 in Huangpu District,Shanghai / 上海预防医学

Objective To analyze the epidemic characteristics of AIDS, gonorrhea and syphilis from 1990 to 2013 in Huangpu District, Shanghai, and to evaluate the effects of prevention and control in this re-gard. Methods Ecology research method was used to analyze epidemic characteristics of sexually trans-mitted disease. Results From 1990 to 2013, the incidence of gonorrhea increased first and then de-creased in recent years, while that of syphilis had been increasing since 1994, among which latent syphilis was the most.AIDS cases occurred each year from 2006.The young male adults of 25-39 years old were the main population who had these three kinds of sexually transmitted diseases.The cases of AIDS and syphilis were mainly found in those engaged in housekeeping, housework and the unemployed, and gonor-rhea was mostly with workers. Conclusion The incidence of gonorrhea in Huangpu District has been de-creasing, while the prevention and control of AIDS and syphilis still needs to be strengthened.The inci-dence is influenced by the change of people’ s awareness and behavior.In future, we should focus on key groups like young males, housekeeping, unemployed and recurrent population.

Epidemic situation analysis on tuberculosis from 1990 to 2013 in Huangpu District of Shanghai / 上海预防医学

[Objective] To investigate epidemic characteristics of tuberculosis (TB) in Huangpu District of Shanghai, and evaluate the effects of its prevention and control. [ Methods] Ecology research method was used to analyze epidemic characteristics of TB from 1990 to 2013 in Huangpu District. [Results] In 1990-2013, the average incidence rate of TB was 37.37/105, showing a trend of gradual decline as a whole and the average death rate was 0.47/105 .The incidence rate in elderly males aged over 65 was the highest.Those with the highest morbidity were accordingly retirees, workers, housekeeping and the unemployed. [ Conclusion] The overall effect of control of TB was obvious in Huangpu District from 1990 to 2013.While public's lack of knowledge and awareness, non-standard cure, high rate of drug resistance and large numbers of floating population posed challenge for prevention and control.TB cure and control still need to be improved.

Application of Gail model for assessment on breast cancer risk / 上海预防医学

To discuss the application value of the Gail model in evaluation of breast cancer risk in Huangpu District , Shanghai. [Methods] Case-control study was adopted for 156 cases of breast cancer and 198 age-matched controls .From the subjects were collected information of age , history of breast disease , family history , age at menarche , age at first birth , breast biopsy and race .Gail model was used to evaluate the risk of breast cancer for these women 5 years before. [Results] A total of 72 cases and 11 controls had high risk of breast cancer within 5 years.As the evaluation results of the diagnos-tic test, the sensitivity of the Gail model was 50.3 percent and the specificity 92.0 percent.The positive predictive value was 86.7 percent and the negative predictive value 64.0 percent (The Chi square was 60. 09 and P value 0.000, The McNemar Chi square was 43.90 and P value 0.000).The Youden's index was 0.423.The total agreement was 70.7 percent. [ Conclusion] The Gail model did not achieve the de-sired results for assessment of population with high risk of breast cancer .The tool needs to be further studied as a tool for screening population with high risk of breast cancer .

Effects of resuscitation with different kinds of colloids on pulmonary edema in swine in shock stage of severe burn injury / 中华烧伤杂志

<p><b>OBJECTIVE</b>To observe and compare the effects of natural colloid and artificial colloid on pulmonary edema of swine during shock stage of severe burn injury.</p><p><b>METHODS</b>Twelve Guangxi Bama miniature swine were inflicted with 40% TBSA full-thickness burn on the back, and then they were divided into natural colloid group (N) and artificial colloid group (A) according to the random number table, with six swine in each group. At post injury hour (PIH) 2, fluid resuscitation was begun. The main part of electrolyte was lactic acid Ringer's solution. The colloids included swine plasma and hydroxyethyl starch 130/0.4. Before injury and at every hour within PIH 48, heart rate, blood pressure, urine volume, central venous pressure (CVP), and pulmonary arterial wedge pressure (PAWP) were recorded. The mean heart rate, blood pressure, urine volume per hour per kg of body weight, CVP, PAWP, resuscitation liquid volume, and the ratio of fluid intake to output during the first and second PIH 24 were calculated. At PIH 48, lung tissue was harvested for histopathological observation and calculation of lung water ratio. Data were processed with one-way analysis of variance, analysis of variance of repeated measurement, LSD test and independent sample t test.</p><p><b>RESULTS</b>(1) There were no statistically significant differences between two groups in heart rate, blood pressure, and urine volume before injury and during the first and second PIH 24 (P values all above 0.05); during the first PIH 24, the CVP and PAWP of group A were significantly higher than those of group N (P values all below 0.05). Compared with those before injury, the heart rate, CVP and PAWP of two groups during the first and second PIH 24 were significantly higher (P < 0.05 or P < 0.01); the urine volume of group N was decreased during the first PIH 24 (P < 0.05), while there was no significant change in group A (P > 0.05); the urine volumes of two groups during the second PIH 24 were increased, while no statistically significant differences were observed (P values all above 0.05). There were no statistically significant differences in blood pressure of two groups between the first, second PIH 24 and before injury (P values all above 0.05). (2) There were no statistically significant differences in the resuscitation liquid volume and fluid intake to output ratio between two groups during the first and second PIH 24 (P values all above 0.05). (3) The alveolar septum was found widened in varying degrees, and there were edema fluid accumulating and inflammatory cell infiltrating within the pulmonary interstitial of lung tissue sections in both two groups. (4) The lung water ratio of group N [(71 ± 10)%] was not statistically significant different from that of group A [(79 ± 4)%, t = -1.753, P > 0.05].</p><p><b>CONCLUSIONS</b>The natural colloid or artificial colloid (hydroxyethyl starch 130/0.4) applied during shock stage had similar effects on pulmonary edema in swine with severe burn.</p>

Bedside chest radiography of novel influenza A (H7N9) virus infections and follow-up findings after short-time treatment / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Influenza A (H7N9) virus infections were first observed in China in March 2013. This type virus can cause severe illness and deaths, the situation raises many urgent questions and global public health concerns. Our purpose was to investigate bedside chest radiography findings for patients with novel influenza A (H7N9) virus infections and the followup appearances after short-time treatment.</p><p><b>METHODS</b>Eight hospitalized patients infected with the novel influenza A (H7N9) virus were included in our study. All of the patients underwent bedside chest radiography after admission, and all had follow-up bedside chest radiography during their first ten days, using AXIOM Aristos MX and/or AMX-IV portable X-ray units. The exposure dose was generally 90 kV and 5 mAs, and was slightly adjusted according to the weight of the patients. The initial radiography data were evaluated for radiological patterns (ground glass opacity, consolidation, and reticulation), distribution type (focal, multifocal, and diffuse), lung zones involved, and appearance at follow-up while the patients underwent therapy.</p><p><b>RESULTS</b>All patients presented with bilateral multiple lung involvement. Two patients had bilateral diffuse lesions, three patients had unilateral diffuse lesions of the right lobe with multifocal lesions of the left lobe, and the remaining three had bilateral multifocal lung lesions. The lesions were present throughout bilateral lung zones in three patients, the whole right lung zone in three patients with additional involvement in the left middle and/or lower lung zone(s), both lower and middle lung zones in one patient, and the right middle and lower in combination with the left lower lung zones in one patient. The most common abnormal radiographic patterns were ground glass opacity (8/8), and consolidation (8/8). In three cases examined by CT we also found the pattern of reticulation in combination with CT images. Four patients had bilateral and four had unilateral pleural effusion. After a short period of treatment the pneumonia in one patient had significantly improved and three cases demonstrated disease progression. In four cases the severity of the pneumonia fluctuated.</p><p><b>CONCLUSIONS</b>In patients with influenza A (H7N9) virus infection, the distribution of the lung lesions are extensive, and the disease usually involves both lung zones. The most common imaging findings are a mixture of ground glass opacity and consolidation. Pleural effusion is common. Most cases have a poor short-time treatment response, and seem to have either rapid progressive radiographic deterioration or fluctuating radiographic changes. Chest radiography is helpful for evaluating patients with severe clinical symptoms and for follow-up evaluation.</p>

Effect of artificial colloids on blood coagulation during shock stage of severe burn injury / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>There are controversies about the use of artificial colloids. This research was aimed to determine the effect of various artificial colloids on blood coagulation in the shock stage of severe burn injury.</p><p><b>METHODS</b>Totally, 18 female Ba-Ma mini-pigs were subjected to a 40% total body surface third-degree flame burn under anesthesia. Resuscitation therapy was applied 2 hours after the injury, using the burn shock fluid resuscitation formula commonly accepted in the surgical treatment of burns. The Ba-Ma mini-pigs were randomly assigned to three groups (six pigs in each group): succinylated gelatin group (the artificial colloid used was succinylated gelatin Injection), hydroxyethyl starch group (the artificial colloid used was hydroxyethyl starch (130/0.4)), and allogeneic plasma group (the colloid used was allogeneic plasma). Blood samples were collected from the animals prior to the burn injury and again at intervals of 4, 8, 24 and 48 hours post-injury. The platelet count (PLT), prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), and fibrinogen (Fib) were measured, followed by a statistical analysis of all results.</p><p><b>RESULTS</b>The PLT of succinylated gelatin group and hydroxyethyl starch group at intervals of 24 and 48 hours were (124.3 ± 52.7), (78.8 ± 16.4) × 10(9)/L and (159.0 ± 62.8), (87.3 ± 32.0)× 10(9)/L respectively. But in the allogeneic plasma group at intervals of 8, 24, and 48 hours were (234.3 ± 52.6), (136.0 ± 47.4), (75.8 ± 31.0) × 10(9)/L. The decrease were all statistically significant (P < 0.05, P < 0.01) when compared to pre-burn ((383.3 ± 77.9), (382.7 ± 65.7), (381.0 ± 49.4)× 10(9)/L). The PLT among the three groups, at all the time points, had no statistical difference (P > 0.05). Compared to pre-burn ((10.8 ± 0.9), (11.4 ± 0.8), (10.6 ± 0.7) seconds), the PT of succinylated gelatin group and hydroxyethyl starch group at 24 hours were (14.5 ± 1.5) and (16.2 ± 1.3) seconds, whereas in the allogeneic plasma group at 8 and 24 hours the PT were (13.0 ± 0.9) and (14.5 ± 1.5) seconds, i.e., an increase in the statistical significance (P > 0.01). Statistical significance was observed at 8 and 48 hours between the succinylated gelatin group and hydroxyethyl starch group, and at 48 hours between the hydroxyethyl starch and allogeneic plasma group (P < 0.05). The INR at 24 hours were (1.26 ± 0.13) in the succinylated gelatin group, (1.40 ± 0.11) in the hydroxyethyl starch group, and (1.13 ± 0.07) and (1.26 ± 0.13) at 8 and 24 hours in the allogeneic plasma group. When compared with pre-burn ((0.94 ± 0.08), (0.99 ± 0.07), and (0.92 ± 0.06) seconds), the other groups have increased significantly (P > 0.01). The comparison at 8 and 48 hours between the succinylated gelatin group and the hydroxyethyl starch group, at 48 hours between hydroxyethyl starch group and allogeneic plasma group showed statistical difference (P < 0.01). The APTT of succinylated gelatin group and hydroxyethyl starch group at 24 hours were (13.1 ± 1.1) and (14.6 ± 2.9) seconds. The APTT of the allogeneic plasma group at 4, 8 and 24 hours were (10.9 ± 1.4), (11.8 ± 1.1), and (13.7 ± 1.5) seconds. Compared to pre-burn ((11.5 ± 4.2), (11.2 ± 3.3), (10.1 ± 1.4) seconds), they were statistically significant (P < 0.05). There was no statistical difference in the APTT between the three groups, at all the time points. The Fib of the succinylated gelatin group at 24 and 48 hours were (4.3 ± 0.3) and (4.7 ± 0.2) g/L, (4.1 ± 0.3), and (5.0 ± 0.1) g/L in allogeneic plasma group, and at 8, 24, and 48 hours the Fib for the hydroxyethyl starch group was (2.9 ± 0.4), (4.0 ± 0.5), and (4.6 ± 0.6) g/L. Compared to pre-burn ((2.4 ± 0.2), (2.5 ± 0.3), (2.6 ± 0.5) g/L), they were all statistically significant (P < 0.01). There was no statistical difference in APTT between the three groups, at all time points.</p><p><b>CONCLUSION</b>The changes of the indices in blood coagulation during the shock phase of a severe burn injury correlate with the stress response to the burn, rather than to the application of HES (130/0.4) and succinylated gelatin.</p>

Comparison among several foam dressings in the properties of water-absorption, water-locking and air permeability / 中华烧伤杂志

<p><b>OBJECTIVE</b>To compare the properties of water-absorption, water-locking, and air permeability among several foam dressings, and to provide references for clinician in choosing dressings for different types of wounds.</p><p><b>METHODS</b>The comparison was made among Allevyn foam dressing, Mepilex foam dressing, and Biatain foam dressing that were commonly used in clinic. NaCl and CaCl2·H2O respectively in the weight of 8.3 g and 0.367 g were diluted with distilled water to the volume of 1 L to simulate wound exudation. The simulated wound exudation was used to test the water-absorbing rate of dressings at post immersion hour (PIH) 24, water-absorbing speed of dressings at post immersion minute (PIM) 1, 5, 10, and 20, the diffusion diameter of exudation dripped on the surface of dressings for 5 min to reflect the water-locking capacity of dressings, and the water evaporation capacity of exudation after being sealed up by dressings for 24 h to reflect the air permeability of dressings. Five samples of each dressing were used for each index. Data were processed with one-way analysis of variance and analysis of variance of repeated measurement, and LSD method was applied in paired comparison.</p><p><b>RESULTS</b>(1) The water-absorbing rate at PIH 24 of Allevyn foam dressing, Mepilex foam dressing, and Biatain foam dressing were respectively (646 ± 18)%, (616 ± 19)%, and (499 ± 11)% (F = 423.854, P < 0.01). The differences between each two dressings in water-absorbing rate were statistically significant (with P values all below 0.01). (2) The water-absorbing speed of Allevyn foam dressing at PIM 1, 5, 10, and 20 were (35.20 ± 2.31), (12.48 ± 0.37), (6.63 ± 0.23), and (3.39 ± 0.08) g×s(-1)×m(-2), which were obviously lower than those of Mepilex foam dressing [(119.68 ± 2.59), (24.39 ± 0.62), (12.33 ± 0.29), and (6.18 ± 0.13) g×s(-1)×m(-2)] and Biatain foam dressing [(121.09 ± 3.41), (24.73 ± 0.52), (12.37 ± 0.25), (6.18 ± 0.13) g×s(-1)×m(-2)], with P values all below 0.01. The water-absorbing speed of each dressing showed the trend of declination among three dressings with prolongation of time. The differences between two adjacent time points within each dressing in water-absorbing speed were statistically significant (with P values below 0.01). (3) Diffusion diameters of exudation dripped on the surface of Allevyn foam dressing, Mepilex foam dressing, and Biatain foam dressing were respectively (5.66 ± 0.15), (4.84 ± 0.15), (3.94 ± 0.21) cm (F = 124.742, P < 0.01). The differences between each two of the three dressings in diffusion diameter were statistically significant (with P values all below 0.01). (4) The water evaporation capacity of exudation after being sealed up by each dressing for 24 h decreased in succession for Allevyn foam dressing, Mepilex foam dressing, and Biatain foam dressing, which were respectively (31.2 ± 3.1), (29.7 ± 8.7), (5.6 ± 2.8) g×h(-1)×m(-2) (F = 24.324, P < 0.01). The water evaporation capacity of exudation sealed with Biatain foam dressing was significantly lower than that of exudation sealed with Allevyn foam dressing and Mepilex foam dressing (with P values below 0.01).</p><p><b>CONCLUSIONS</b>Among the three kinds of foam dressings, Allevyn performs best in water-absorbing rate, water-locking capacity, and air permeability, while Mepilex and Biatain perform best in water-absorbing speed. For selecting foam dressing in clinic, the properties of foam dressings and wound characteristics should be considered at the same time.</p>

Dynamic contrast-enhanced MSCT findings of intraductal papillary neoplasm of the bile ducts / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the findings of contrast-enhanced multislice computed tomography (MSCT) that characterize intraductal papillary neoplasms of bile ducts (IPNB).</p><p><b>METHODS</b>The MSCT findings and clinical data of 16 cases of IPNB proven by surgical pathology were reviewed retrospectively.</p><p><b>RESULTS</b>Among the 16 cases, nine were adenoma (multi-lesions, n = 5; single lesions, n = 4) and seven were adenocarcinoma (multi-lesions, n = 4; single lesions, n = 3). Among the nine adenoma cases, seven showed nodules or masses in the expanding intrahepatic bile ducts with asymmetrical low density on plain scan, and two showed obvious expansion of biliary ducts and the inner wall of bile ducts was rough. All seven of the adenocarcinoma cases showed nodules or masses in the expanding intrahepatic bile ducts with asymmetrical low density-like adenoma. When contrast enhancement was applied, the nine adenoma cases manifested slight-to-moderate degrees of asymmetrical enhancement. For the seven adenocarcinoma cases, two showed asymmetrical enhancement similar to that of the adenoma cases and five showed continued enhancement; one case showed malignant infiltration of the bile duct and evident damage in the adjacent hepatic tissue. The CT plain scan findings for the two groups (adenoma and adenocarcinoma) were not significantly different (t = -1.17, P = 0.2632). Significantly different findings were obtained with the MSCT imaging analysis for the arterial phase (t = 6.53, P less than 0.01) and the portal vein phase (t = 5.63, P less than 0.01). All cases showed asymmetrical expansion of intrahepatic biliary ducts, diffuse or local, and four cases showed moderate expansion of the common bile duct. One adenocarcinoma case showed intumescence in the celiac lymph node by moderate asymmetrical enhancement.</p><p><b>CONCLUSION</b>MSCT is helpful for the differential diagnosis of IPNB from other hepatic lesions.</p>

Evaluation of the clinical curative effect of applying vacuum sealing drainage therapy in treating deep partial-thickness burn wound at the initial stage / 中华烧伤杂志

<p><b>OBJECTIVE</b>To evaluate the clinical curative effect of applying vacuum sealing drainage (VSD) therapy in treating deep partial-thickness burn wound at the initial stage prospectively, and to provide the basis for its clinical application.</p><p><b>METHODS</b>Twenty-two patients with about 10% TBSA burn of the lower limbs, and in which partial-thickness wound exceeded 1% TBSA in each limb, were admitted to our hospital within 3 hours after burn from May 2009 to March 2010. Wounds in each patient were divided into VSD treatment group (treated with VSD therapy) and control group (treated with 10 g/L silver sulfadiazine cream) based on the principles of symmetry of location, identical deepness, and similarity in size etc. The amount of water evaporation, the swelling intensity, the status of bacterial colonization, the degree of pain, the healing time, and the quality of healing of wounds in 2 groups were observed and compared. Data were processed with t test and rank-sum test.</p><p><b>RESULTS</b>The observation was completed in 21 patients. All of the wounds were treated within 4 hours post burn (PBH). The amount of water evaporation of the normal skin and burn wounds before dressing coverage in VSD treatment group was respectively close to that in control group (with t value respectively 1.310, -0.911, P values all above 0.05); the amount of water evaporation on the surface of dressing in VSD treatment group [(44.3+/-3.9) mLxh(-1)xm(-2)] was less than that in control group [(66.1+/-6.4) mLxh(-1)xm(-2), t=-11.39, P<0.01]. In VSD treatment group, the circumference of proximal thigh increased (3.48+/-0.35) and (2.51+/-0.21) cm on post burn day (PBD) 3, 7 as compared with that on PBH 5, which was respectively smaller than that [(8.02+/-0.41), (3.99+/-0.32) cm] in control group (with t value respectively 4.110, 3.569, P values all below 0.01). Positive bacteria' culture rate on PBD 10 of each group was respectively lower than that at admission (with Z value respectively -3.220, -3.870, P values all below 0.01), and there was no significant statistical difference between 2 groups at admission or on PBD 10 (with Z value respectively -0.894, 0.000, P values all above 0.05). The wound surface in VSD treatment group was weak acidic (pH value 7.12+/-0.06) on PBD 10, and it was neutral (pH value 7.41+/-0.13) in control group. The wound pain degree in control group on PBD 1, 3, 7 was respectively higher than that in VSD treatment group (with t value respectively -16.132, -21.230, -16.453, P values all below 0.01). There was no significant statistical difference between 2 groups in healing time of wounds (t=1.186, P>0.05). The healing quality of wounds in VSD treatment group (100.00%, 100.00%) 2 or 3 months after burn was better than that in control group (19.05%, 85.71%) (with Z value respectively -11.638, -3.870, P values all below 0.01).</p><p><b>CONCLUSIONS</b>Early application of VSD therapy cannot expedite the healing process of deep partial-thickness burn wounds, but it can improve the healing quality. It is one of the effective methods to deal with deep partial-thickness burn wounds, which is worthy of clinical attention and further research.</p>

Study on the feasibility of a cell-culture inoculation test in the detection and isolation of street rabies virus / 中华流行病学杂志

Objective Feasibility of using MNA cell-culture inoculation test to detect and isolate the street rabies virus. Methods Using MNA cell-culture inoculation test, fluorescent antibody test (FAT) and sandwich ELISA with double-antibodies to detect 33 specimens of street rabies virus, 20 specimens of negative canine brains and 4 specimens of healthy mice brains. Results 33 specimens of street rabies virus were positive to the cell-culture inoculation test but the others were negative. The concordances of MNA cell-cultured inoculation test with FAT and sandwich ELISA with double-antibodies were both 100%. Conclusion MNA cell-culture inoculation test appeared to be both highly sensitive and specific in detecting the street rabies virus, and could be used in detection and isolation of the virus.

CT and MRI imaging features of peripheral primitive neuroectodermal tumors / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the CT and MRI features of peripheral primitive neuroectodermal tumors (pPNETs) and evaluate its diagnostic value.</p><p><b>METHODS</b>The clinicopathological data of 9 surgically treated patients with peripheral primitive neuroectodermal tumors confirmed by pathology were collected, spiral CT (4/9) and MRI (6/9) plain scanning and dynamic enhancement scanning were performed preoperatively. Both CT and MRI scannings were performed in 1 case. Those CT and MR images were retrospectively reviewed and analyzed together with clinicopathological findings.</p><p><b>RESULTS</b>The 9 lesions were located in skeletal muscles (n = 6), pelvic cavity (n = 2) and thoracic cavity (n = 1). The tumor size was 7.4-18.3 cm in diameter with a mean diameter of 11.6 cm. The shape of those lesions was round or ellipse (4 lesions) and irregular (5 lesions). The tumor usually presented as ill-defined masses, with homogeneous (n = 2) or inhomogeneous density (n = 7). Seven cases, including the 3 lesions located in the chest and pelvis, showed obvious necrosis and multilocular cyst formation. The tumors showed iso-density as that of the adjacent muscles on CT plain scans and moderate heterogeneous enhancement after intravenous injection of contrast agents. The features of the tumors on the MRI including slightly low signal intensity on SE T1-weighted imaging, iso-signal intensity or slightly high signal intensity on FSE T2-weighted imaging and heterogeneous dynamic delayed contrast-enhancement with obvious necrosis in most of them. Six cases had a lesion in the skeletal muscles, presented as a giant ill-defined masse surrounding bone and extended along neural route with bone destruction to varying degrees.</p><p><b>CONCLUSION</b>Primitive neuroectodermal tumor is a kind of malignant tumor with proliferation of small, undifferentiated neuroectodermal cells, usually occurring in children or adolescent and frequently located in the extremities, chest cavity, pelvic cavity and chest wall. It typically presents as a large, ill-defined masse extending along neural route with heterogeneous and obvious enhancement after intravenous injection of contrast agents. The tumors located in the chest and pelvic cavities and some in the extremities show obvious necrosis and multilocular cyst formation, while some of the tumors in the extremities appear as homogeneous solid masses.</p>

Immunophenotypic characteristics of uterinenatural killer cells and helper T cell 1/ helper T cell 2 immunity in the third trimester decidua of preeclampsia patients / 中华妇产科杂志

Objective To investigate immunophenotypic characteristics of uterine natural killer (uNK)cells and helper T cell 1/helper T cell 2(Th1/Th2)immunity in third trimester decidua in preeclampsia.Methods The proportions of uNK cell subsets,expression of CD_(69)and CD_(94)on uNK cells and Th1/Th2 immunity in decidua were determined in 20 cases of preeclampsia patients and 11 cases of normal term pregnancies by flow cytometric analysis.Results The percentage of CD_(56)~(bright)CD_(16)~-uNK cell subset in preeclampsia patients and the controls was(17.3?11.1)% vs(17.9?16.8)%,that of CD_(56)~(dim) CD_(16)~+uNK cell subset was(16.3?8.7)% vs(16.2?8.8)%;that of CD_(56)~+CD_(69)~+uNK cells was(37.9 ?18.9)% vs(36.8?19.7)%,that of CD_(56)~+CD_(94)~+uNK cells was(34.9?15.2)% vs(32.7?16.2)% and the ratio of CD_(56)~+CD_(69)~+/CD_(56)~+CD_(94)~+was 1.1?0.2,1.2?0.6.No statistical difference was shown in the above values between the preeclampsia patients and controls.The percentage of cytoto xic T cell(Tc)2 cells was significantly lower in the decidua of preeclampsia patients [(3.0?1.0)% vs(4.3?0.9)%,P= 0.001 ],and the ratio of Tc1/Tc2 in preeclampsia patients was significantly higher than that of normal term pregnancies(17.8?3.4 vs 11.8?4.6;P=0.001);the ratio of Th1/Th2 was increased(15.1?2.4 vs 13.2?3.1;P=0.06).Conclusions The immunophenotypie characteristics of uNK cells do not present any significant change in preeclampsia patients.Owing to Tc2 cell decrease,the Th1/Th2 immunity shifts to Th1 type immunity in the decidua,which might contribute to the pathogenesis of preeclampsia.

The comparative study of the imaging features of chromophobe cell renal carcinoma with pathologic findings / 中华放射学杂志

Objective To analyze and compare the imaging features of chromophobe cell renal carcinoma(CCRC)with pathologic findings in order to improve the diagnostic accuracy.Methods The data of CT and MRI of 12 patients with CCRC were reviewed retrospectively.Ten patients underwent CT examination,including precontrast scan,the contrast eortieomedullary phase scan and the parenchymal phase scan(one patient without corticomedullary phase scan).Two patients underwent MR examination including precontrast T_1WI,T_2WI and enhanced T_1WI of the corticomedullary phase and the parenchymal phase.Results Four lesions located in left kidney and eight in right kidney.Maximum diameter of lesions ranged from 24 mm to 125 mm,average 56.7 ram.Homogenous density was observed in six lesions of ten on unenhanced CT scan and five lesions had homogenous enhancement on enhanced CT scan,which was due to the less incidence of necrosis,liquefaction and hemorrhage on pathologic findings.Nine Lesions showed hyperdense compared with renal medulla but the density was lower than renal cortex on the corticomedullary phase.The enhanced degree was positively correlated with microvessel density(MVD).All ten lesions became hypodense compared with renal medulla on the parenchymal phase scan.Central stellate scar was found in two big lesions and psudocapsula were observed in four lesions confirmed by pathology.Two patients underwent MRI examination.Compared with medulla,the two lesions showed hyperintense on unenhanced T_1WI and obviously hypointense on unenhaneed T_2WI.The enhancement pattern of them was similar to CT. Conclusion The imaging features of CCRC,such as homogeneity,special enhancement pattern and distinct hypointensity on T_2WI,help to differentiate CCRC from other renal tumors.

CT diagnostic value of adrenal ganglioneuroma / 中华放射学杂志

Objective To explore the dynamic spiral CT findings of adrenal ganglioneuromas and to evaluate its clinical value.Methods All 7 cases patients with adrenal ganglioneuromas confirmed by surgical pathology underwent spiral CT plain scanning and two phases dynamic enhancement scanning before operation.The CT images were reviewed and analysed retrospectively in comparison with surgical and pathological results.Results Six of 7 lesions were located in the right adrenal gland,1 in the left.The diameter of the tumors was 3.7—7.5cm,with a mean diameter of 4.6cm.The CT value of the plain scans, AP phases and PVP phases was 16.2—31.7 HU(with a mean value of 24.3 HU),20.9—36.6 HU(with a mean value of 30.2 HU),and 27.4—45.5 HU(with a mean value of 36.0 HU),respectively.The masses were well defined and showed a tendency of wedging into the space between the adjacent organs and structures and encasing the large vessels such as IV,but didn't compress or occlude them.Conclusion The dynamic SCT features of adrenal ganglioneuromas were obvious,dynamic SCT scans could suggest the diagnose.

CT findings of primary adrenocortical carcinoma / 中华放射学杂志

Objective To explore the imaging features and dynamic CT findings of primary adrenocortical carcinoma and evaluating its clinical value.Methods All 11 cases patients with primary adrenocortical carcinoma confirmed by surgical pathology underwent spiral CT plain scanning and two phases dynamic enhancement scanning before operation.Contrast injection was done by using nonionic Omnipaque at a flow rate of 3 ml/s with a power injector.The CT images were reviewed and analysed retrospectively in comparison with surgical and pathological results.Results Five of 11 lesions were located in the right adrenal gland,6 in the left.The diameter of the tumors was 4.1—16.0cm with 2 cases10.0cm.The attenuation of the plain scans,two phases contrast scans was 21.9—46.7 HU(with a mean value of 35.3 HU),30.5—65.8 HU(mean value 47.1 HU),and 52.6— 97.0 HU(mean value 74.2 HU),respectively.Four were in the shape of capsule,6 reticular,1 slightly inhomogeneous masses.The irregular tumor vessels of 6 reticular masses were seen in the artery phase. Conclusion The dynamic CT features of primary adrenocortical carcinoma were obvious,dynamic SCT scans could suggest the diagnose.