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Objective To analyze the clinical characteristics of pheochromocytoma crisis (PCC). Meth-ods Data of 123 cases of pheochromocytoma and paraganglioma (PPGL) admitted from Apr. 2011 to Feb. 2017 were retrospectively analyzed and they were divided into crisis group and noncrisis group according to the pa-tients with or without haemodynamic instability and end-organ damage. The differences of demographics charac-teristics, presentations, laboratory tests, imaging findings, perioperative clinical conditions and pathological fea-tures were compared between the two groups. Results ①16 cases were enrolled into crisis group, among whom 5 were misdiagnosed, while 107 cases were enrolled into noncrisis group. ②Compared with noncrisis group, the incidence of headache, palpitation, sweating, the classic triad, other presentations of PPGL, severe hypertension and hypotension were higher, and more patients had paroxysmal hypertension and admitted to our hospital for paroxysmal presentations in crisis group (P<0.05). ③Leukocyte, fasting blood glucose, liver transaminases, tro-ponin and D-dimmer were higher, while estimated glomerular filtration rate(eGFR) was lower, more tumors locat-ed in the left of adrenal in crisis group(P<0.05). ④ Patients in crisis group had higher plasma free metanephrines (MNs), larger maximal tumor diameter, higher enhanced CT value in each period, more benign tumors and hem-orrhage or necrosis in the tumors, but all the differences were not significant when compared with the noncrisis group. ⑤Patients in crisis group were more likely to undergo elective surgery. However, there was no difference in the preoperative time of α-blockade, type of surgery, intraoperative and postoperative complications, mortality a-mong the two groups. Conclusions PCC is a rare endocrinological emergency with a highly variable manifesta-tions, which commonly presents with typical triad, with higher incidence of hemodynamic instability and end-organ damage. Although biochemical and imaging examinations are relatively effective in the diagnosis of PCC, the mis-diagnosis remains inappropriate high. Once the diagnosis is established, clinicians should timely start drug prepa-ration while surgical resection is the key to the treatment of PCC.
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Objective@#To analyze the clinical characteristics of pheochromocytoma crisis (PCC) .@*Methods@#Data of 123 cases of pheochromocytoma and paraganglioma (PPGL) admitted from Apr. 2011 to Feb. 2017 were retrospectively analyzed and they were divided into crisis group and noncrisis group according to the patients with or without haemodynamic instability and end-organ damage. The differences of demographics characteristics, presentations, laboratory tests, imaging findings, perioperative clinical conditions and pathological features were compared between the two groups.@*Results@#①16 cases were enrolled into crisis group, among whom 5 were misdiagnosed, while 107 cases were enrolled into noncrisis group. ②Compared with noncrisis group, the incidence of headache, palpitation, sweating, the classic triad, other presentations of PPGL, severe hypertension and hypotension were higher, and more patients had paroxysmal hypertension and admitted to our hospital for paroxysmal presentations in crisis group (P<0.05) . ③Leukocyte, fasting blood glucose, liver transaminases, troponin and D-dimmer were higher, while estimated glomerular filtration rate (eGFR) was lower, more tumors located in the left of adrenal in crisis group (P<0.05) . ④ Patients in crisis group had higher plasma free metanephrines (MNs) , larger maximal tumor diameter, higher enhanced CT value in each period, more benign tumors and hemorrhage or necrosis in the tumors, but all the differences were not significant when compared with the noncrisis group. ⑤Patients in crisis group were more likely to undergo elective surgery. However, there was no difference in the preoperative time of α-blockade, type of surgery, intraoperative and postoperative complications, mortality among the two groups.@*Conclusions@#PCC is a rare endocrinological emergency with a highly variable manifestations, which commonly presents with typical triad, with higher incidence of hemodynamic instability and end-organ damage. Although biochemical and imaging examinations are relatively effective in the diagnosis of PCC, the misdiagnosis remains inappropriate high. Once the diagnosis is established, clinicians should timely start drug preparation while surgical resection is the key to the treatment of PCC.
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Objective@#To investigate the incidence of occult cervical lymph node metastasis and the common neck level of metastases in cN0 laryngocarcinoma, and the relationship between the clinicopathologic features of laryngocarcinoma and cervical lymph node metastasis.@*Methods@#A total of 506 cases with cN0 laryngocarcinoma treated at the First Affiliated Hospital of Chongqing Medical University between March 2011 and March 2018 were enrolled, and their medical records and follow-up data were retrospectively analyzed. Of them, 211 cases of were glottic carcinoma in stage T1 without neck dissection and they were observed by clinical follow-up; other 295 cases, including glottic carcinoma, supraglottic carcinoma and hypopharyngeal carcinoma in stage T2-T4 were treated with surgical resection of the primary lesions and selective neck dissection. SPSS 22.0 software was used to analyze the data.@*Results@#The total incidence of cervical lymph node metastasis was 10.87%(55/506), with a lower incidence in T1 stage glottic carcinoma(6/211,2.84%) than that in other cases(49/295,16.61%). The incidence of cervical lymph node metastasis in glottic carcinoma (29/426, 6.81%) was lower than those in supraglottic carcinoma (22/71,30.99%) and subglottic carcinoma (4/9) (χ2=35.810,P<0.01).The pN+ rates of glottic carcinoma at T1, T2, T3 were 2.84%(6/211), 5.31%(6/113), 16.05%(13/81), and 19.05%(4/21), respectively (χ2=18.572, P<0.01). The pN+ rates of supraglottic carcinoma at T2, T3 and T4 were 3/13, 32.50%(13/40) and 6/13, respectively (χ2=3.649,P>0.05). The incidence of cervical lymph node metastasis in poorly differentiated carcinoma (17/42, 40.48%) was higher than those in moderately differentiated carcinoma (26/205, 12.68%) and high differentiated carcinoma(12/246, 4.88%)(χ2=36.356, P<0.01). Moreover, 85 pN+ lymph nodes were obtained by selective neck dissection, respectively 43(50.59%) in level Ⅱa, 30(35.29%) in level Ⅲ, 1(1.18%) in level Ⅳ and 11(12.94%) in level Ⅵ.@*Conclusions@#The occult cervical lymph node metastasis was frequently found in cN0 laryngocarcinoma. Selective neck dissection should be performed with surgery for the primary lesions in T3-T4 glottic laryngeal cancer, T2-T4 supraglottic laryngeal cancer and subglottic carcinoma, and the neck dissection for level Ⅱa and Ⅲ is appropriate. It is required to detect pre-laryngeal and pre-tracheal lymph nodes in patients with subglottic laryngeal carcinoma.
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Objective To observe the levels of interferon gamma-induced protein 10(IP-10)in children with acute viral and bacterial infection.Methods There were three groups:acute viral infection group(51 ca-ses),acute bacterial infection group(52 cases),and healthy control group(51 cases).Serum IP-10 levels were detected by enzyme linked immunosorbent assay(ELISA),and serum C reactive protein(CRP)were deter-mined with BNⅡ automatic protein analyzer.Results The level of serum IP-10 and CRP were significantly different in different groups(P<0.05).Compared with control group,the level of IP-10 and CRP were higher in acute viral infection group or in acute bacterial infection group(P<0.05).The level of IP-10 was higher in acute viral infection group than that in acute bacterial infection group(P>0.05).The level of CRP was higher in bacterial infection group than that in acute viral infection group(P<0.05).The IP-10 levels in viral Infec-tion patients were not correlated with the CRP levels.The area under curve(AUC),sensitivity and specificity of IP-10 and CRP were 0.688 and 0.873,35.0% and 79.6%,96.1% and 98.0%.When cut-off value of predic-tive probability was 0.713,sensitivity and specificity were increased to 82.5% and 100.0%.Conclusion Ser-um IP-10,CRP and predictive probability are valuable in the diagnosis of acute pathogen infection in children.
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Objective To investigate the value of serum IgG4 level for the diagnosis of IgG4-related hepatobiliary diseases and the differentiation from other hepatobiliary diseases.Methods A total of 270 patients with hepatobiliary diseases in the People's Hospital of Hunan Province from August 2015 to April 2017 were enrolled in this study,and 20 healthy subjects were selected as controls.The 270patients were divided into eight groups:liver cirrhosis group (n =17),acute pancreatitis group (n =52),chronic pancreatitis group (n =33),cholecystitis and gallstone group (n =27),bile duct carcinoma group (n =30),cholangitis and biliary calculi group (n =41),pancreatic cancer group (n =47),IgG4-related hepatobiliary disease group (n =23).The levels of serum IgG4 were measured by rate nephelometery assay.The sensitivity and specificity of IgG4 levels for distinguishing IgG4-associated hepatobiliary diseases were evaluated by receiver operating characteristic curve.Results The levels of IgG4 of the cirrhosis group and the IgG4 related hepatobiliary disease group were significantly higher than those of the control group (P ＜ 0.05).The IgG4 level in the hepatobiliary disease group was significantly higher than those of the other seven groups (Z =-5.267,-6.802,-5.921,-6.005,-6.173,-6.513,-6.014,P all ＜ 0.01).The area under curve (AUC) for IgG4 level in distinguishing IgG4 associated hepatobiliary diseases and other hepatobiliary diseases was 0.982.When 4.13 g/L was used as the cut off value of diagnosis,the sensitivity and specificity of IgG4for diagnosis were 95.7％ and 96.0％ respectively.The IgG4 levels in twelve patients with IgG-associated hepatobiliary diseases after 2 months of glucocorticoid therapy were significantly lower than those before glucocorticoid therapy (Z =-2.021,P =0.043).Conclusion The elevated serum IgG4 level may not be specific just for IgG4-related hepatobiliary diseases.The cut off value of 4.13 g/L should be very useful for diagnosing IgG4-related hepatobiliary diseases,differentiating from other hepatobiliary diseases and evaluating the therapeutic effect of glucocorticoid therapy.The further detailed verification for these findings should be necessary in clinical practice by increasing the sample size.
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Objective To explore the cause constituents of neonatal severe hyperbilirubinemia and the clinical efficacy and safety of blood exchange transfusion treatment .Methods 142 neonates with severe hyperbilirubinemia conducted the blood exchange transfusion therapy .The levels of serum total bilirubin ,indirect bilirubin and direct bilirubin and the change of blood routine indica-tors were analyzed before and after blood exchange transfusion .Results The main causes leading to neonatal severe hyperbilirubi-nemia were bacterial infection(28 .20% ) ,glucose-6-phosphate dehydrogenase(G6PD) deficiency(27 .50% ) and pregnant women with ABO blood group incompatibility (16 .20% ) .The levels of serum total bilirubin ,indirect bilirubin ,direct bilirubin and blood routine indicators after operation in neonates with severe hyperbilirubinemia were significantly lower than those before operation , the differences were statistically significant (P<0 .05) .The total bilirubin swap exchange was (54 .40 ± 9 .90)% .The intraoperative adverse reactions rate was 3 .50% .The postoperative thrombocytopenia occurrence rate was 72 .00% .Conclusion The blood ex-change transfusion for treating neonatal severe hyperbilirubinemia possesses has clinical significance ,but the hematology and bio-chemical indicators monitoring should be strengthened for avoiding adverse reactions occurrence .
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Objective:To study the effect of alum on immune response in mice induced by HBoV1 VP2 VLPs.Methods:BABL/c mice were randomly divided into VLPs experimental group, alum adjuvant experimental group, PBS control group and alum adjuvant control group,the experimental group mice were intramuscular immunization with HBoV1 VP2 VLPs and HBoV1 VP2 VLPs added alum,control group mice were immunization with alum or PBS buffer,then to study the effect of alum on immune response in mice induced by HBoV1 VP2 VLPs by cellular and humoral immune strength.Results: Alum adjuvant decreased cellular immune response induced by HBoV1 VP2 VLPs(P<0.001),enhance the HBoV1 VP2 VLPs immuned serum IgG titer(P<0.05)and IgG activity(P<0.01).Conclusion:Alum adjuvant can enhance humoral immune response induced by HBoV1 VP2 VLPs,but weaken cellular immune response induced by HBoV1 VP2 VLPs,when HBoV1 VP2 VLPs used as a prophylactic vaccine it should add alum adjuvant,when used as a therapeutic vaccine,it should not add alum adjuvant.
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Objective By comparing the biological characteristics among Lewis lung cancer cells ( LLC) , LLC or-thotopic transplantation derivative cells ( R1-LLC) and R1-LLC orthotopic transplantation derivative cells ( R2-LLC) , we e-valuate their invasion and metastatic abilities in orthotopic transplantation models.Methods In vitro, we applied CCK8, clonogenic assay, and Transwell invasion assay to detect the proliferation ability, invasion ability and morphologic structures of LLC,R1-LLC, R2-LLC cells respectively, meanwhile observing morphologic structures by transmission electron microsco-py.In vivo, we constructed LLC, R1-LLC and R2-LLC orthotopic transplantation models.Herein, we observed their tumor growth and metastasis.The tumor formation rate and tumor-forming time were recorded for statistic analysis.Results In vitro:LLC, R1-LLC and R2-LLC cells showed no significant difference in proliferation ability ( P>0.05 ) , but significant differ-ences in invasion ability:R2-LLC>R1-LLC>LLC(P<0.05).In vivo:In the orthotopic group, the tumor formation rates of LLC, R1-LLC and R2-LLC cells were 66.67%、80%、93.33%(P <0.05).Conclusions In orthotopic implantation mouse models, R2-LLC cells present higher invasion and metastatic ability than R2-LLC and LLC cells.
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Test is an important way for getting feedback from students about teaching. The traditional examination is not suitable for the requirements of modernization teaching.Web-Based Course Examination of practice pathology simplifies the process of traditional examination greatly. It is one of the important means in modernization teaching.
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A well Web-based teaching supplementary system is beneficial for saving teaching resources,arousing students’enthusiasm for study.but there is no the emotion exchange between teachers and students which exists in traditional class.Web-based supplementary teaching is an important supplementary method for medical morphology courses,but it can not replace the traditional teaching method.Combining them each other is needed for raising teaching quality.
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Objective:To investigate the expression of vascular endothelial growth factor-C(VEGF-C) and vascular endothelial growth factor receptor 3(VEGFR-3)and the correlation with the lymph node metastasis in esophagus squamous cell carcinoma.Methods:72 esophagus squamous cell carcinoma cases with complete clinical,pathological and following-up data were included in this study.Immunohistological method SABC was used to detect the expression of VEGF-C and VEGFR-3.Results:(1)The VEGF-C positive rate in esophagus squamous cell carcinomas is 59.72%(43/72).The mean number of VEGFR-3 vessel in VEGF-C positive group is 5.02?2.24 per high power field(HPF),while is 2.82?0.16 per HPF in VEGF-C negative group.The former is significantly higher than the later ( P
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Objective To explore the effect of xanthine oxidase inhibitor allopurinol on cardiomyocyte apoptosis in rats after myocardial infarction(MI).Methods MI model was established by the ligation of anterior descending coronary artery.The survivors were randomly divided into 3 groups: sham operation group(n=5),MI group(n=16) and allopurinol group(n=15,receiving allopurinol 50 mg?kg-1? d-1).After 28 days,the infarct size was measured.In non-infarcted zone(NIZ),cardiomyocyte apoptosis was detected by TUNEL;the expression of Fas was detected by immunohistochemistry;the expressions of xanthine oxidase(XO) and caspase 3 were detected by Western blot.In addition,the activities of XO and ?O-2,?OH-scavenging in NIZ were detected by colorimetry.Results Compared with sham operation group,the apoptosis index and expressions of Fas,XO,caspase 3 in NIZ were significantly increased in MI group.The activity of XO was increased but the activities of ?O-2 and ?OH-scavenging were decreased(P0.05).Conclusion Allopurinol could inhibit the cardiomyocyte apoptosis in NIZ in rats.The protective mechanism of allopurinol involves the reduction of reactive oxygen species and depression of the expressions of Fas and caspase 3.
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Objective To investigate the expressions of COX-2 and VEGF-C in breast carcinoma and their correlation with lymphangiogenesis and lymph node metastasis. Methods The expressions of COX-2 and VEGF-C and D2-40 were evaluated in 46 cases of breast carcinoma by immunohistochemical staining SP methods. The lymphatic vessels density (LVD) in tumor was counted through the special marker D2-40. Results The positive rate of COX-2 and of VEGF-C was 73.91% (34/46) and 71.74% (33/46) respectively in breast carcinoma tissues. The positive rate of COX-2 and VEGF-C was 86.48% (32/37) and 81.08% (30/37), and LVD was (13.350?3.097)/?200 in the lymph node metastasis group, while that in non-lymph-node metastasis group was 22.22% (2/9), 33.33% (3/9) and (9.560?2.031)/?200 respectively, with significant difference between the two groups (P
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Objective To investigate the protective effect of Calcitonin Gene-related Peptide(CGRP)on ET-1 mediated injury of human hepatocyte.Methods Human liver tissues obtained from patients undergoing partial hepatectomies were randomly divided into five groups:control group,liver perfused with D-Hank's solution group;liver perfused with ET-1 group and three liver perfased with ET plus CGRP(10-6M,10-7M,10-8M)treated groups.Collagenase digestion method was used to isolate human hepatocytes,then hepatocytes were cultured,and the level of MDA and TNF-?,the viability and proliferation of hepatocyte,and the hepatocyte function(ALT,Alb,Urea and LDH)were determined.Results As compared with control group,in ET-1 group,the viability and proliferation of hepatocytes,the level of Alb and Urea declined significantly(P