ABSTRACT
Objective To explore the experience in the diagnosis and treatment of elastofibroma dorsi.Methods Clinical data of 19 cases of pathologically confirmed elastofibroma from October 2001 to October 2011 were reviewed.The clinical features,the specific radiological characteristics,the typical pathological alterations and the short-term and long-term effects were analyzed.Results All the lesions were located within the muscles in the subscapular region.There were 3 cases with bilateral lesions and 16 cases with unilateral lesions.Seven patients complained of local pain and feeling of foreign body when activated the upper limb,while 12 were asymptomatic.Except for the early 6 cases,accurate diagnosis was made in all the other 13 cases before the histological exams solely based on the physical examination and imaging findings.Marginal excision was done for all the cases:the diameters of the masses were between 3 centimeters to 10 centimeters.Fluid accumulation complications was found in 1 case and resolved by repeated paracentesis;errhysis complication,was found in 1 case and resolved by compression,applying hemostatics and blood transfusion.No recurrence was found during the follow-up period(6 months to 48 months).Conclusion Elastofibroma dorsi is usually found in the subscapular region in elderly women.The diagnosis can be made on the basis of unique imaging characteristics and physical examination before histological examine.Surgical marginal excision can achieve good short-term and long-term effects.
ABSTRACT
Objective To study the clinical significance of peripheral blood PD-1 (CD279) and its ligands(CD274 and CD273)between patients with anti-HBe positive chronic hepatitis B (CHB) or anti-HBs positive group of normal glutamic acid alanine aminotransferase (ALT).Methods A total of 70 subjects of normal ALT,including 23 patients with anti-HBe positive,22 anti-HBs positive and 25 normal controls,were enrolled.The expression level of CD279,CD274 and CD273 in peripheral lymphocyte were detected by flow cytometry.Compare the group differences by multivariate analysis of variance.Results The expression level of CD279 in control group,anti-HBe positive group and anti-HBs positive group was (33.3±5.4)％,(48.0±9.1) ％,(42.8±9.0) ％,respectively.The expression level of CD274 in control group,anti-HBe positive group and anti-HBs positive group was (59.4 ±4.4) ％,(71.3± 10.3) ％ and (62.9 ± 10.2) ％,respectively.The expression level of CD273 in control group,anti-HBe positive group and anti-HBs positive group was (5.3±2.2)％,(15.6±5.3)％ and (5.1±1.0)％,respectively.The expression level of CD279 and CD274 decreased gradually from anti-HBe positive group to anti-HBs positive group and then to normal control group.Three dependent variables in the overall difference was statistically significant (Pillai trace =0.988,F=3090.105,P=0.000),η partial square was 0.458.The difference for CD273 expression level of anti-HBs positive group compared with control group was not statistically significant (P =0.082) ; for other groups pairwise comparisons were statistically significant(P＜0.01).Conclusion Monitoring the alteration of PD-1 and its ligands of the HBeAg seroconversion CHB patients and the anti-HBs positive population can better understand the changes in course of HBV infection,thereby improving the prognosis of patients.with HBV infection.