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Objective:To evaluate the effect of noninvasive prenatal testing (NIPT) as first-line screening in fetal chromosome aneuploidy screening practice, and to provide evidence for the prevention and control strategy of birth defects.Methods:Since July 2019, Hebei province had carried out the NIPT project providing first-line screening for eligible pregnant women in the area (except for those who were not applicable). Pregnant women with high risk received genetic counseling, prenatal diagnosis and intervention guidance. Low risk and false-positive ones received continuous detection and moved to prenatal diagnosis center for counseling and diagnosis if abnormities were discovered. All pregnant women were followed up to learn about pregnancy outcomes and newborn health status. Detection results and clinical data of pregnant women participating the NIPT project from July 2019 to July 2020 were collected. The detection results and effect of NIPT were analyzed.Results:(1) Basic information of the screened population: A total of 424 330 pregnant women were screened, and 423 596 were successfully detected, with a success rate of 99.83% (423 596/424 330). The age of pregnant women was (28.8±4.5) years old; the gestational age of screening was (16.6±2.3) weeks; the proportion of advanced-age pregnant women (≥35 years old) was 10.18% (43 132/423 596); in vitro fertilization-embryo transfer (IVF-ET) rate was 1.58% (6 713/423 596); the twin rate was 1.38% (5 849/423 596); the proportion of primipara was 34.23% (144 977/423 596). (2) Screening results and detection performance: totally, 325, 73 and 20 pregnant women were diagnosed with trisomy 21, 18 and 13; the sensitivity were 99.39%, 100.00% and 100.00%; the specificity were 99.98%, 99.99% and 99.98%; the positive predictive value were 75.76%, 68.87% and 21.51%, respectively. Besides, 249 190 pregnant women were received supplementary reports as well, and 255, 10 and 9 were confirmed for sex chromosome aneuploidy, other autosomal aneuploidy and deletion/duplication syndrome; the positive predictive value were 37.78%, 6.06% and 32.14%, respectively. The sensitivity of NIPT for target trisomy (trisomy 21, 18 and 13) screening in advanced-age, IVF-ET and twin pregnant women were 99.29%, 100.00% and 90.00%, respectively; the specificity were 99.93% for all; the positive predictive value were 82.25%, 61.54% and 69.23%, respectively.Conclusions:NIPT has a significant effect and good performance in the first-line screening of fetal chromosome aneuploidy in the whole population, which might provide reference for the improvement of birth defect prevention and control strategy.
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Objective:To explore surgical treatment strategies and prognosis of early-stage nail apparatus melanoma.Methods:A total of 115 patients with early-stage nail apparatus melanoma receiving surgical treatment were collected from Department of Dermatology, Xijing Hospital, the Fourth Military Medical University from July 2011 to December 2019, and surgical treatment strategies and outcomes were analyzed retrospectively.Results:According to the modified ABCDEF criteria and clinical manifestations (such as deformation of the nail plate, ulcers, nodules) , 73 patients with early-stage nail apparatus melanoma received extended surgical resection based on the resection principles of melanoma in situ, 22 based on the resection principles of stage I and II melanoma, 20 based on the resection principles of stage I and II melanoma with invasion risks. During the follow-up period of 6 months to 9 years, there was no recurrence of the primary tumors in any patients; no abnormalities were observed by the ultrasound examination of lymph nodes in 101 patients; metastases occurred in 2 patients receiving finger amputation, 1 of whom died; 12 patients were lost to follow-up. Conclusion:To select extended surgical resection strategies for early-stage nail apparatus melanoma based on clinical manifestations, can ensure adequate treatment and preserve the normal function of the extremities to the greatest extent without recurrence of the primary tumors.
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Objective:To analyze clinicopathological characteristics of trauma-related melanoma and their relationship with the prognosis of patients.Methods:Clinical data were collected from 87 cases of trauma-related melanomas in Department of Dermatology, Xijing Hospital, the Fourth Military Medical University from 2009 to 2020, and their clinicopathological characteristics were retrospectively analyzed. Mann-Whitney test was used to analyze the difference in Breslow thickness of tumors between patients of different ages or genders; Spearman rank correlation analysis was used to analyze the correlation between the time from trauma to the notice of melanoma and Breslow thickness, Kaplan-Meier survival analysis and Log-Rank test were employed to analyze the relationship between clinicopathological characteristics of melanoma and the prognosis of patients; Cox regression model was used to analyze risk factors for survival duration of patients with trauma-related melanoma.Results:Among the 87 patients with trauma-related melanoma, 47 (54.02%) were males and 40 (45.98%) were females. Among them, melanoma occurred in 50 (57.47%) cases after sharp injuries, and in 37 (42.53%) after blunt injuries. In addition, 31 (35.63%) cases presented with primary lesions on the hands, and 48 (55.17%) on the feet. The Breslow thickness of the primary tumors was significantly higher in the group aged > 55 years than in the group aged ≤ 55 years ( U= 623.500, P= 0.010) , but there was no significant difference between patients of different genders ( P= 0.138) . The time from trauma to the notice of melanoma was negatively correlated with the Breslow thickness of tumors ( r=-0.203, P= 0.037) . The age of patients, Breslow thickness of tumors, Ki67 proliferation index and genetic background of tumor significantly affect the survival duration of patients with trauma-related melanoma ( P= 0.011, 0.031, 0.002 and 0.031, respectively) ; the gender, type of trauma and ulceration of tumor mass did not significantly affect the survival duration of patients ( P= 0.618, 0.114 and 0.379, respectively) . Cox regression model analysis showed that the Ki67 proliferation index and Breslow thickness were independent risk factors affecting the prognosis of trauma-related melanoma (risk ratio [ RR] and 95% confidence interval [ CI] were 1.946 (1.234, 4.217) and 1.839 (1.014, 3.332) , P= 0.039 and 0.045, respectively) . Conclusion:The Breslow thickness of trauma-related melanoma is related to the age of patients and time from trauma to the notice of melanoma; the age, Breslow thickness of tumors, Ki67 proliferation index and genetic background of tumor all affect the survival duration of patients with melanoma, and Ki67 proliferation index and Breslow thickness are independent risk factors affecting prognosis.
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Objective:To explore the values of electroencephalogram (EEG) combined with glial fibrillary acidic protein (GFAP) in the early diagnosis and prognosis evaluation of viral encephalitis (VE).Methods:A total of 63 patients with VE admitted to the Hangzhou Seventh People′s Hospital from January 2016 to December 2019 were selected as the observation group. In addition, 80 healthy people suspected of central nervous system disease in the same period were selected as the control group. The data of gender, age, body mass and body mass index (BMI) were recorded, the Niolet V32 digital EEG instrument of American Nigolli Company was used for EEG inspection, and the level of serum GFAP was detected by enzyme-linked immunosorbent assay (ELISA). The general data, abnormal EEG results and the level of serum GFAP of the control group and the observation group were compared. The diagnostic values of EEG and its combination with serum GFAP in VE were analyzed by four grid table; and the diagnostic value of serum GFAP for VE was evaluated by drawing receiver operating characteristic (ROC) curve.Results:There was no significant difference in sex, age, body mass and BMI between the two groups ( P>0.05). The results of EEG diagnosis for VE showed that 11 of 63 cases were missed and 10 of 80 cases in the control group were misdiagnosed, and the sensitivity, specificity and accuracy of EEG diagnosis for VE were 82.54%, 87.50% and 85.31%, respectively. Compared with that of the control group, the level of serum GFAP of the observation group was higher: (460.19 ± 126.53) ng/L vs. (217.36 ± 53.17) ng/L, t =15.525, P<0.05. ROC curve showed that area under curve (AUC) of serum GFAP for VE diagnosis was 0.907 and cutoff value was 238.37 ng/L. The sensitivity, specificity and accuracy of EEG combined with serum GFAP in diagnosing VE were 93.65%, 83.75% and 88.11%, respectively, and the sensitivity and accuracy of EEG combined with serum GFAP were higher than those of EEG and GFAP alone. The results of 12-month follow-up showed that 20 of 63 VE patients had sequel (poor prognosis group), 43 patients had good prognosis (good prognosis group), and the incidence of adverse prognosis was 31.75%(20/63). There were significant differences in EEG and GFAP between the good prognosis group and poor prognosis group ( P<0.05). Conclusions:The sensitivity and accuracy of EEG combined with serum GFAP in the diagnosis of VE are good, which may be used for the early diagnosis and prognosis evaluation of VE.
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Objective@#To investigate the genetic characteristics of human norovirus (NoV) among infants under 5 years of age with diarrhea in Chaoyang District, Beijing from 2011 to 2017.@*Methods@#NoV-positive stool samples were collected from 2011 to 2017 in this region. The partial RdRp and VP1 genes were amplified and sequenced. Multi-sequence alignment was performed and phylogenetic tree was constructed using Mega software.@*Results@#A total of 151 samples were sequenced and analyzed. The ratio of male and female was 2.28∶1 with mean age of 1.72 years. Fourteen NoV subtypes were detected, including GII.Pe/GII.4 (47.68%), GII.P12/GII.3 (20.53%), GII.P4/GII.4 (17.22%), GII.P16/GII.2 (3.31%), GII.P12/GII.12 (1.99%), GII.P17/GII.17 (1.99%), GII.P16/GII.13 (1.32%), GII.P7/GII.7 (1.32%), GII.P7/GII.6 (1.32%), GII.P2/GII.2 (0.66%), GII.P21/GII.21 (0.66%), GII.Pg/GII.12 (0.66%), GI.Pa/GI.3 (0.66%) and GI.P6/GI.6 (0.66%).@*Conclusions@#NoV genetic diversity was found among infants under 5 with diarrhea in Chaoyang district, Beijing. The subtypes from surveillance and those from epidemics occurred in chronological order. The surveillance should be strengthened for early detection of new subtype for monitoring the epidemic and vaccine design.
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Objective@#To investigate the genetic characteristics of human adenovirus (AdV) among infants with diarrhea in Chaoyang district, Beijing from 2011 to 2017.@*Methods@#Adenovirus positive stool samples were collected from 2011 to 2017 in Chaoyang District of Beijing. The hexon region genes of human adenovirus were sequenced. Multi-sequence alignments were performed and phylogenetic tree was constructed by Mega software.@*Results@#A total of 64 samples were sequenced and analyzed. The ratio of male to female was 11∶5. The mean age was 1.56 years. Among them, AdV41 accounted for 70.31%, followed by AdV31 (26.25%), AdV40 (4.69%), AdV1 (3.13%), AdV5 (3.13%), AdV6 (3.13%), AdV7 (3.13%), AdV2 (1.56%), AdV3 (1.56%), AdV4 (1.56%) and AdV61 (1.56%).@*Conclusions@#Human adenovirus may play an important role in viral diarrhea in Chaoyang district from 2011 to 2017. The current adenovirus epidemic is complex and AdV41 was the dominant strain in this region.
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Multimodality optical imaging probes have emerged as powerful tools that improve detection sensitivity and accuracy, important in disease diagnosis and treatment. In this review, we focus on recent developments of optical fluorescence imaging (OFI) probe integration with other imaging modalities such as X-ray computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), single-photon emission computed tomography (SPECT), and photoacoustic imaging (PAI). The imaging technologies are briefly described in order to introduce the strengths and limitations of each techniques and the need for further multimodality optical imaging probe development. The emphasis of this account is placed on how design strategies are currently implemented to afford physicochemically and biologically compatible multimodality optical fluorescence imaging probes. We also present studies that overcame intrinsic disadvantages of each imaging technique by multimodality approach with improved detection sensitivity and accuracy.
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As a rapid, accurate and high throughput bacterial identification technique, matrix-assisted laser desorption ionization time of flight mass spectrometry(MALDI-TOF MS)has been gradually applied to clinical microbiological laboratories.However, the application of MALDI-TOF MS is far beyond the identification of bacteria.It also has broad application prospect in bacterial typing.The MALDI-TOF MS based typing method is simple, rapid, low-cost and high throughput, which can play an important role in nosocomial infections surveillance.
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Objective: To investigate the clinicopathological features, morphological characteristics, immunophenotypes of littoral cell angioma (LCA) in spleen, and to provide new evidence for making diagnosis and avoiding misdiagnosis.Methods: Clinicopathological data, histological characteristics of 13 cases of LCA were retrospectively studied and immunohistochemical staining was imposed on the paraffi-nembedded specimens, and 5 cases of cavernous hemangioma, 4 cases of normal littoral cells of spleens were used as control groups, simultaneously.Results: All the 13 LCA patients included 7 males and 6 females, aged from 39 to 70 years with an average of 54.2 years and a median age of 55 years.Among these tumor patients, 6 cases were accompanied by malignances, benign tumors or inflammation states at abdominal cavities, and 7 cases were accidentally discovered by physical examinations.Grossly, spleens contained solitary or multiple gray red nodules ,which ranged from 0.5 to 6.2 cm in diameter.Histologically, tumors were composed by anastomosing vascular spaces which were lining by plump, rounded to cuboidal littoral cells that extended into vascular lumens.Usually, papillary frameworks that were covered by these cells were also seen extending into the lumens in some areas.Other types of histiocytoid cells were identified in lumens and the sizes were larger than the littoral cells.Both types of cells absented cytologic atypia.Immunohistochemical study demonstrated that the littoral cells in all cases were positive for vascular endothelial and histiocyte markers, such as CD21, CD31, CD68, polyclone FⅧRAg and ERG, while these cells were negative for CD8, CD34, and WT-1.These findings manifested that immunophenotype of littoral cell in LCA distinctive from that in controls.Conclusion: LCA is a benign lesion, which frequently occurs in the elderly.Its etiology remains confusion, however, immune dysregulation may associate with it because of the concomitance with other tumor or inflammation in some cases.The littoral cells in LCA show a hybrid endothelial-histiocytic phenotype on immunohistochemistry, therefore these cells may have features that intermediate between those of endotheliocytes and histiocytes.Emphasizing the histological findings and immunophenotypes is significant for diagnosis and differential diagnosis.
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Objective The purpose of this study was to analyze the susceptibility profile of Acinetobacter baumannii to antimicrobial agents,and validate the results of different antimicrobial susceptibility testing methods,for improving the quality of antibiotic resistance monitoring data.Methods The susceptibility data of Hebei Provincial Antimicrobial Resistant Investigation Net were analyzed retrospectively and 126 strains ofA.baumannii were collected.The susceptibility ofA.baumannii to piperacillintazobactam,amikacin,gentamicin,ciprofloxacin,levofloxacin,ceftazidime,imipenem,and meropenem was tested by E-test,KirbyBauer method and VITEK system.Results The susceptibility results of the 126 A.baumannii strains showed that the susceptibility to piperacillin-tazobactam,amikacin,gentamicin,levofloxacin and ceftazidime was significantly different between the three methods (P＜0.05).The categorical agreement,major error,minor error,and very major error of Kirby-Bauer method were within acceptable range.There were evident difference in classification consistency for piperacillin-tazobactam,amikacin,levofloxacin between Kirby-Bauer method and VITEK (P＜0.05).Conclusions Different antimicrobial susceptibility testing methods may lead to different results of resistance monitoring data.Bias may be generated in antibiotic resistance surveillance if different methods are used.The susceptibility results of piperacillin-tazobactam,amikacin,levofloxacin derived from VITEK system should be validated by Kirby-Bauer or E-test method.
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Objective To investigate the antimicrobial resistance of Streptococcus pneumoniae strains isolated from multiple medical institutions across Hebei Province in 2015.Methods The bacterial data were collected from 53 member hospitals of Hebei Antimicrobial Resistance Investigation Net (HEBARIN) according to the unified surveillance program in Hebei province.WHONET 5.6 was used to review,analyze and summarize the surveillance data.The results were interpreted according to CLSI guideline 2014.Results A total of 2 408 strains of S.pneumoniae were included in this analysis.S.pneumoniae was the third most frequently isolated gram positive bacteria.More than 95％ of these S.pneumoniae strains were susceptible to vancomycin and moxifloxacin.However,96.4％,89.3％ and 67.4％ of these strains were resistant to erythromycin,clindamycin,and trimethoprim-sulfamethoxazole,respectively.The antimicrobial susceptibility profile was similar between the strains isolated from adults and those isolates from children.Conclusions The antimicrobial resistance profile ofS.pneumoniae isolates in Hebei Province is generally consistent with the nation-wide data,except higher resistance level to a few antimicrobial agents.We should be alert to and control the emergence of resistant S.pneumoniae.
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Objective To evaluate the value of spectral CT in risk classification of gastrointestinal stromal tumor (GIST).Methods Forty-one patients with GIST were collected,including 1 3 in high risk,1 2 in medium risk,1 1 in low risk and 5 in very low risk. All of the patients underwent plain and triple phases contrast enhanced CT with spectral CT scanning mode.CT value of 70 keV monochromatic images,the slope of spectral curve and normalized iodine concentration (NIC)were measured and calculated.Then, data was correlated with the risk of GIST.Results ①The CT value of 70 keV monochromatic images was negative correlation in the arterial phase (r=-0.173),positive correlation in delayed phase (r=0.552),and no correlation in venous phase with the risk of GIST.②The slopes of spectral curves in delayed phase were significantly different in GISTs with the different risk (χ2= 6.641,P= 0.036).③The NIC values of GISTs with different risk were significantly different in the triple phases (F=3.646,χ2=6.046,F=57.233,P=0.035, P=0.049,P<0.001),and correlated with the risk of GIST (r=-0.564)in the delayed phase.Conclusion Quantitative paremeters of spectral CT imaging such as the CT value of 70 keV,the slopes of spectral curves and iodine concentration are valuable for the risk classification of GIST,and can be used as a preoperative reference.
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Objective To explore the safety and feasibility of guiding catheter passing through spasmodic vessels in patients undergoing percutaneous coronary intervention (PCI) via radial artery access by the aid of PCI guiding wire and balloon .Methods The clinical data of 33 coronary artery disease (CAD) patients undergoing PCI via radial artery access with radial artery or (and) brachial artery spasm ( group A ) were retrospectively analyzed .Among all these patients , guiding catheters were delivered through the spasmodic vessels successfully by the aid of PCI guiding wires and balloons .The clinical data of other 38 CAD patients having PCI during the same period performed by other operators via radial artery or ( and ) brachial artery approach and experienced vessel spasm were anlysed as the control ( group B ) .All patients in group B received conventional anti-spasm management during PCI .All vessel spasm was identified by angiography.For patients in group A , a diameter of 0.014 inch guiding wire was chosen to pass through the spasmodic vessel segment carefully and gently .The diameter of balloon should be chosen according to the diameter of guiding catheter .A balloon diameter of 2.0 mm and 2.5 mm was corresponded to 6F and 7F guiding catheter respectively .The balloon was advanced to the tip of guiding catheter , keeping a half in catheter and a half in vessel followed by inflating the balloon with a pressure of 8 atm.The balloon was kept inflated the guiding catheter was pushed in vitro carefully and slowly until the catheter passed through the spasmodic vessel segment .Then the balloon was deflated and pulled out together with PCI guiding wire . Exchanged a diameter of 0.035 inch wire and completed the positioning of guiding catheter .After finishing the PCI, radial or ( and) brachial angiography was performed again to observe if spasm disappeared and to determine if there any contrast medium exudation .For patients in group B , routine approach was applied including administration of nitroglycerine , diltiazem or nitroprusside etc . to relieve vessel spasm. Results The location of vessel spasm was similar in group A and group B ( P=0.150 ) , and the incidence rate of spasm in brachial artery was higher than that in radial artery in both groups .The chance of guiding catheter crossing the spasmodic vessel segment was significantly higher in group A than in group B ( 100%vs.39.5%, P=0.00).In patients whose guiding catheter could pass through the spasmodic vessel segment successfully , time spent in group A was shorter than in group B ( P=0.000 ) .The patient number which time spent was less than five minutes , five to 15 minutes and more than 15 minutes was 30 and 2 ( 90.1%vs.13.3%) , 3 and 7 ( 9.9% vs.46.7%) and 0 and 6 ( 0% vs.40.0%) in group A and in group B respectively.The incidence of forearm hematoma was lower in group A than in group B without statistical difference [6.1%(2/33) vs.18.4%(7/38), P =0.113].Conclusions It is safe and feasible for passing guiding catheter through spasmodic vessels during PCI via radial artery access by the aid of PCI guiding wire and balloon .
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ObjectiveTo explore the feasibility and efficacy of percutaneous transhepatic approach in the treatment of intrahepatic and extrahepatic bile duct stones. MethodsNineteen patients with bile duct stones who were treated in our hospital from January 2000 to October 2014 were enrolled as subjects. In the treatment of bile duct stones, all patients received percutaneous transhepatic approach combined with the application of cholangioscopy and lithotripsy equipment. ResultsIn the 19 patients, 12 had the stones successfully removed in a single session, 5 had the stones completely removed through the liver sinus in three sessions, and 2 had residual stones in intrahepatic tertiary bile ducts. The success rate of lithotomy reached 89.47%(17/19). ConclusionThe percutaneous transhepatic approach achieves minor surgical invasion and slight pain in the treatment of bile duct stones, which can be selectively used based on patients′ condition.
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ObjectiveTo explore the feasibility and efficacy of percutaneous transhepatic approach in the treatment of intrahepatic and extrahepatic bile duct stones. MethodsNineteen patients with bile duct stones who were treated in our hospital from January 2000 to October 2014 were enrolled as subjects. In the treatment of bile duct stones, all patients received percutaneous transhepatic approach combined with the application of cholangioscopy and lithotripsy equipment. ResultsIn the 19 patients, 12 had the stones successfully removed in a single session, 5 had the stones completely removed through the liver sinus in three sessions, and 2 had residual stones in intrahepatic tertiary bile ducts. The success rate of lithotomy reached 89.47%(17/19). ConclusionThe percutaneous transhepatic approach achieves minor surgical invasion and slight pain in the treatment of bile duct stones, which can be selectively used based on patients′ condition.
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Objective To explore the factors influencing the intra-laboratory turnaround time ( ILTAT) and establish a COX regression model.Methods Data of 5 weeks with a total of 904 cases from the samples of blood routine examinations from January 2014 to June 2014 in The Third Hospital of Xingtai were randomly collected.The records of the samples included test dates , times of arrival , times of test , sample statuses, time consumption, time duration, operators, project portfolios, delay, PLT counts, results of 30-minute treatment and test weeks.Based on SPSS 17.0, the above indicators were analyzed by COX single factor analysis and then COX mutiple-factor regression analysis.Results Within the prescribed time , 421 cases were sent taking up 46.6%of the total samples.The ratios of sent cases in 10, 20, 30, 40 and 50 minutes are 10.4%, 24.7%, 46.6%, 58.7% and 82.1% respectively.The results of COX single factor analysis showed that times of arrival , sample statuses, times of examination, operators, project portfolios and delay had statistical significance for ILTAT ( P0.05).Conclusions Times of arrival, times of test, operators, project portfolios and delay were the independent risk factors leading to the delay in ILTAT.Other laboratories could determine the variable number of proportional hazards models based on their sample transport , test procedures and principal influence factors , and carry out quantitative evaluation on the factors in sample processing for improvement.Thus, significant decrease on ILTAT would be achieved.
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Objective To investigate antimicrobial resistance and pathogen in hebei antibacterial resistance investigation net in 2012.Methods Antimicrobial susceptibility test was detected by Kirby-Bauer method or broth dilution test.Results were analyzed according to CLSI 2010 breakpoints.WHONET 5.5 software was used to analyze the data.Results A total of 10 504 clinical isolates were collected in 2012,of which gram negative bacilli and gram positive cocci accounted for 76.2%, 23.8%,respectively.The most common pathogen in gram-negative rod was E.coli,K.pneumoniae,P.aeruginosa, A.baumanii and E.cloacae respectively.The most common pathogen in gram-positive cocci was S.aureus,E.facium,E-.faecalis,S.pneumoniae and S.epidermidis.ESBL rate of E.coli and K.pneumoniae was 66.5 and 46.7%.The resistant rate of E.coli,K.pneumoniae,E.cloacae to imipenem was 0.1%,0.5%,8.9% and to meropenem was 0.1%,0.6%,4.2%, respectively.P.aeruginosa was resistant to imipenem and meropenem were 38.9% and 32.3%.A.baumanii was resistant to imipenem and meropenem were 5 6.5% and 5 9.7%.Methicillin-resistant strains accounted for an average of 5 7.5% in S.aureus and 87.3% in coagulase negative staphylococcus.Staphylococcus was still susceptible to minocycline and chloram-phenicol.No staphylococcal strains were found resistant to vancomycin,linezolid.But a few coagulase negative staphylococcal strains were resistant to teicoplanin.Conclusion Surveillance of antimicrobial agents played an important role in controlling hospital infection.
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Objective To explore the MRI features of germ cell tumors in sellar regions for better developing clinical treatment plans.Methods The imaging and pathologic findings of 44 sellar germ cell tumors were retrospectively analyzed.Results There were 1 9 germinoma,most of which had clear boundaries,different extents of cystic necrosis and mild peritumoral edema.Lesions were significantly enhanced in contrast-enhanced MRI (CE-MRI).There were 8 cases with mature teratoma,most showed cystic-solid changes,presenting mixed-intensities on T1-weighted images and T2-weighted images.There were 1 1 malignant teratoma(im-mature teratoma and teratoma malformation ),however,there were more parenchymatous tissue in malignant teratoma than mature teratoma.Two yolk sac tumors showed uniform signals on T1-weighted images and T2-weighted images,significant enhancement on CE-MRI,and visibly higher AFP in serum.Two embryonal carcinomas had clear boundary,inhomogeneous intensities,visibly cyst-ic necrosis,median to servere peritumoral edema,the parenchyma showed significant enhancement in CE-MRI.The signals of two mixed germ cell tumors were not typical,which depended on the components within tumors.Conclusion The MRI features of germ cell tumors in sellar region are characteristic.
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BACKGROUND:Serious patel ar comminuted fractures can be treated by a number of methods such as cerclage with tension band steel wire or steel wire, or fixation with the nickel titanium patel a concentrator and absorption lines, or cerclage with 10# double-loop wire plus fixation with split-type patel a claws or with the memory al oy patel a concentrator. But it is difficult to achieve strongly fixed effect on patel a fractures by these methods. OBJECTIVE:To investigate the clinical effects of suture with polyester braided wire and cerclage with belt lock cable on serious comminuted patel ar fractures. METHODS:A retrospective analysis was performed on the clinical data of 57 patients with serious comminuted patel ar fractures who received suture with polyester braided wire and cerclage with belt lock cable from January 2007 to October 2012. According to AO classification of fractures, there were nine cases of type B3, 22 cases of type C2 and 26 cases of type C3. After satisfactory reduction of comminuted patel ar fractures during the operation, firstly we sewed up both sides of the expansion region of quadriceps muscle and stitched on periosteum and prepatel ar tissue with thick polyester braided wire fol owed by patel ar cerclage with belt lock cable. According to the stability of fracture blocks, tension band fixation with polyester braided wire was partial y added. After the operation, the clinical effects were assessed based on the Bostman score system. RESULTS AND CONCLUSION:Total y 46 out of 57 cases were fol owed up with an average of 8 months (4-18 months). Al patients obtained bone union within 3-5 months. Wounds healed in the first stage without any infections, and fractures in al patients healed without complications such as implant loosening and skin irritation. According to the Bostman score system, 33 cases were scored excellent, 10 good and three fair. The excellent and good rate was 93.5%. It suggests that treatment of serious patel ar comminuted fracture by the combination of polyester braided wire and belt lock cable leads to closely contact fracture sites and reliably fix bone fragments. It can facilitate early postoperative range of motion exercises.
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BACKGROUND:The etiological factor for rheumatoid arthritis remains unclear, but the effects of nuclear factor-κB on the onset of rheumatoid arthritis have been gradual y paid great attention by rheumatologists. OBJECTIVE:By using the RNA interference (RNAi) technique to block the signal pathway of nuclear factor-κB mRNA of human rheumatoid arthritis synovial cells, this study explored its application prospect in the treatment of rheumatoid arthritis. METHODS:The synovial cells were isolated, digested, and cultured for further use. In accordance with the design principle of smal interfering RNA (siRNA), target sequences of siRNA of nuclear factor-κB were identified, and siRNA expression vector of nuclear factor-κB was synthesized and constructed. The four pGenesil-1/nuclear factor-κB siRNA expression vectors were transfected into the first passage of synovial cells that wel grew. Blank and negative control groups were set. cells at 12, 24, 48, 72 hours, 5 and 7 days after transfection were col ected, and RNA was extracted. Intracellular nuclear factor-κB mRNA expression levels were measured, and siRNA plasmid vector that could effectively inhibit nuclear factor-κB mRNA expression was screened out. RESULTS AND CONCLUSION:Nuclear factor-κB highly expressed in synovial cells after human rheumatoid arthritis. 3#pGenesil-1/nuclear factor-κB apparently suppressed nuclear factor-κB mRNA expression in synovial cells with human rheumatoid arthritis. RNAi technique blocked nuclear factor-κB mRNA expression. Therefore, the block of nuclear factor-κB signal pathway might be a good target for rheumatoid arthritis gene therapy.