Wolffian Adnexal Tumor:Report of One Case / 中国医学科学院学报

This article reports a patient who suffered from Wolffian adnexal tumor.We also briefly elucidate the pathogenesis,clinicopathological features,diagnosis,differentiation,and treatment of Wolffian adnexal tumor,with an attempt to increase the awareness of the disease and reduce misdiagnosis.

Value of endoscopic ultrasonography in diagnosis of pancreatic space-occupying diseases / 临床肝胆病杂志

ObjectiveTo investigate the value of endoscopic ultrasonography (EUS) in the diagnosis of pancreatic space-occupying diseases. MethodsA total of 85 patients with suspected pancreatic space-occupying diseases who were treated in The Second Affiliated Hospital of Jiaxing College from January 2015 to January 2017 were enrolled. Surgical pathological results or follow-up results were used as the gold standard for evaluating the value of EUS and EUS-guided fine needle aspiration (EUS-FNA) in the diagnosis of pancreatic space-occupying diseases. The chi-square test was used for comparison of categorical data between groups. ResultsEUS had an imaging detection rate of 96.7% (59/61), a specificity of 100% (24/24), and an accuracy rate of 97.6% (83/85) in the diagnosis of pancreatic space-occupying diseases; EUS had significantly higher detection rate and accuracy rate than abdominal ultrasound, computed tomography, and magnetic resonance imaging (detection rate: χ2=4.344, 3.873, and 15.445, all P＜0.05; accuracy rate: χ2=6.675, 8.685, and 17389, all P＜0.05). EUS-FNA had a detection rate of 81.8% (45/55) and an accuracy rate of 81.0% (47/58). Among the patients who underwent surgery to have pathological results, the overall coincidence rate of preoperative EUS-FNA was 84.2% (16/19). ConclusionCompared with conventional imaging examinations, EUS has a higher diagnostic accuracy for pancreatic space-occupying diseases, and EUS-FNA can further clarify the nature and pathological type of space-occupying lesions. EUS may help with the early diagnosis and treatment of pancreatic tumors.

Diffusion kurtosis imaging in diagnosis of prostate carcinoma in peripheral zone / 局解手术学杂志

Objective To evaluate the application value of 3 main parameters of diffusion kurtosis imaging(DKI) in diagnosis of prostatic carcinoma in the peripheral zone.Methods Conventional MRI and DKI were performed in 40 patients with histological confirmed as prostatic carcinoma in the peripheral zone.The values of ADC,FA and MK were calculated in the patients' tumor center and normal areas of the peripheral zone,and compared by two samples t-test.ROC curve were carried out to analyze the ability of ADC,MK and FA in differentiating prostate carcinoma from normal tissue in the peripheral zone.Results The mean values of MK and FA were significantly higher in tumor center than those in normal areas of the peripheral zone,and the ADC values were lower in tumor center,the differences were signicant(P<0.01).ROC curve analysis showed that the AUC of the ADC,FA and MK values were 0.966,0.871 and 0.998,respectively.Conclusion The 3 parameters of DKI could be a potential tool in diagnosing prostate carcinoma in the peripheral zone.The MK value has the highest sensitivity and specificity.

Diagnosis and treatment for pancreatic neuroendocrine neoplasms / 中华胰腺病杂志

Objective To summarize the experience of diagnosis and treatment for pancreatic neuroendocrine neoplasms (pNENs).Methods Forty-seven patients with pNENs who were treated at Anhui Province Hospital during January 2002 to December 2013 were retrospectively analyzed.They were followed by telephone or clinic interview,and the deadline date was January 31st,2014.Survival was analyzed with the Kaplan-Meier method,and the prognostic factors for survival were identified.Results Among the47 patients,there were 13 males and 34 females,aged from 16 to 74 years old,with a median age of 45 years,There were 17 cases of non-functioning pNENs,30 cases of functioning pNENs.The detection rate of B ultrasound,CT,MRI was 71.8％ (28/39),92.7％ (38/41),75.6％ (6/8).Forty-six patients underwent radical surgery,and 1 patient underwent palliative surgery.The pathologic type included 41 cases of pancreatic neuroendocrine neoplasms,6 cases of neuroendocrine cancer.There were 22,19,6 cases of grade G1,G2,G3 lesions,respectively.There were 32,11,4 cases of TNM staging Ⅰ,Ⅱ,Ⅲ,respectively.Vascular structure was invaded in 15 cases,and nerve was invaded in 18 cases.Lymph node was examined in 15 cases,and 5 were found to have metastatic lesion.After surgery,pancreatic fistula occurred in 9 patients,ascites in 4 patients,wound infection in 4.The follow-up period ranged from 2 to 144 months.The overall 1,3,5-year survival rates were 94.9％,88.4％,and 84.4％.The 5-year survival rates of patients with grade G1,G2,G3 were 100％,73.3％,60％;and the 5-year survival rates of patients with TNM staging Ⅰ,Ⅱ,Ⅲ were 100％,70.0％,33.3％.It was showed that TNM staging system,WHO classification,lymph node metastasis,vascular and neural invasion were associated with the prognosis.Conclusions CT is the imaging test of choice for pNENs,while surgery is the first choice for treatment.Surgical resection of pNENs results in long-term survival.TNM staging,WHO classification,lymphatic metastasis,vascular and neural invasion are closely related to the prognosis of pNENs.

As possibilidades de enfrentamento da violência infantil na consulta de enfermagem sistematizada / Possibilities for addressing child abuse in systematized nursing consultations / Posibilidades de enfrentamiento de la violencia infantil en la consulta de enfermería sistematizada

A violência infantil vem crescendo e aos serviços de saúde compete lidar com este fenômeno. A CIPESC® é uma ferramenta sistematizadora do cuidado e pode visibilizar a violência infantil nas consultas de enfermagem. Este estudo buscou identificar os limites e potencialidades da CIPESC® na consulta de enfermagem com crianças vítimas de violência doméstica. Estudo descritivo, qualitativo, tipo estudo de caso, analisou 15 relatos por web-questionário de enfermeiros da atenção básica, da Secretaria Municipal de Curitiba, Paraná, sobre a ocorrência de violência. Embora a CIPESC® tenha mostrado potencialidades, os diagnósticos e intervenções existentes da nomenclatura não foram plenamente acionados pelos pesquisados. Apresentou limites preocupantes no que tange ao reconhecimento das necessidades e vulnerabilidades que envolvem o fenômeno da violência. Conclui-se que é preciso agregar à nomenclatura os atributos referentes à liberdade e autonomia, essenciais para o enfrentamento da violência, além de maneiras de intervir baseadas em evidências.

Child abuse has been increasing, and addressing this phenomenon is within the responsibilities of health services. The International Classification of Nursing Practice in Public Health (Classificação Internacional das Práticas de Enfermagem em Saúde Coletiva - CIPESC®) is a tool that systematizes care and identifies child abuse during nursing consultations. The present study aimed to identify the limitations and potential of CIPESC® in nursing consultations with children that were victims of domestic violence. The present qualitative descriptive case study examined 15 web-based reports on violence completed by primary care nurses from the Curitiba City Council (Secretaria Municipal de Curitiba) in the state of Paraná. Although CIPESC® has shown potential, the diagnoses and interventions presented in the classifications were not fully utilized by the respondents. The reports showed worrisome limits regarding the recognition of needs and vulnerabilities involving the phenomenon of violence. In conclusion, it is necessary to contribute to the nomenclature the attributes concerning freedom and autonomy, which are essential for addressing violence, in addition to methods for evidence-based interventions.

La violencia infantil está en crecimiento, compete a los servicios de salud enfrentar el fenómeno. La CIPESC®, herramienta de sistematización del cuidado, puede visibilizar la violencia infantil en las consultas de enfermería. Se buscó identificar límites y posibilidades de la CIPESC® en consulta de enfermería con niños víctimas de violencia doméstica. Estudio descriptivo, cualitativo, tipo estudio de caso; analizando 15 testimonios por cuestionario-web de enfermeros de atención primaria de la Secretaría Municipal de Curitiba-PA, sobre ocurrencia de violencia. Aunque la CIPESC® haya expresado potencialidades, los diagnósticos e intervenciones existentes en la nomenclatura no fueron plenamente accionados por los entrevistados. Presentó límites preocupantes en lo atinente al reconocimiento de necesidades y vulnerabilidades que envuelven al fenómeno de la violencia. Se concluye en que es necesario agregar a la nomenclatura los atributos referentes a la libertad y autonomía, esenciales para enfrentar la violencia, además de modos de intervención basados en evidencias.

Investigation of association of the galectins family and gynecological malignancy / 肿瘤研究与临床

Galetins is a family of endogenus lectins with highly affinity for polysaccharide containing β-galactosides residues.It is involved in cell growth and differentiation,cell adhesion,cell signal transduction and apoptosis.In recent years,many studies have shown that galectin plays an important role in the development and occurrence of gynecological malignancy.It has been an important evidence for diagnosis of progress of malignancy.

Clinicopathological characteristic analysis of three cases of colonic muco-submucosal elongated polyp / 中华消化杂志

Objective To explore the clinicopathological features,diagnosis and differential diagnosis of colonic muco-submucosal elongated polyp (CMSEP).Methods The clinical manifestations,endoscopic and histological features of three cases of CMSEP were analyzed.The literature was reviewed with regard to the diagnostic criteria and differential diagnosis.Results Three patients were male,and aged 25,45 and 75 years old.Two polyps were at transverse colon and one at rectum.Under colonoscope,all three cases showed the long pedunculated polyps.The surfaces of two polyps were smooth and the colors were similar to colonic mucosa while one polyp appeared mucosal erosion and congestion on the top.Under optical microscope,three cases had similar lesions.The axis of the lesions was expanded submucosa and the surface was the layer of colonic mucosa.The expanded and thick walled blood vessels were seen paralleled to the long axis in the submucosa of the axis of lesions.One polyp with mucosal erosion on the top presented with adenocarcinomal changes.Conclusions CMSEP is a kind of specific polypoid lesion,with characteristic colonoscopic and pathological features.Most are benign changes,however malignant changes occur in a few cases.In histology,CMSEP should be identified with mucosal prolapse syndrome associated inflammatory polyp.

Clinical Manifestations and Diagnosis of Psoriatic Arthritis / 대한내과학회지

Psoriatic arthritis (PsA) is an autoimmune arthritis related to psoriasis and one of seronegative spondyloarthropathies. PsA provokes joint pain and morning stiffness more than 30 minutes, which is relieved by exercise. PsA usually affects distal small joints and exhibits asymmetry, which is one of the typical characteristics of PsA and gives clues to make a differential diagnosis between PsA and rheumatoid arthritis. Thirty to forty patients with PsA experience arthritis in one large joint or asymmetric multiple joints. Arthritis in distal joints and arthritis mutilans often develop concurrently and patterns of PsA change along with disease progression. Spondylitis is observed in 20-30% of PsA patients. In contrast to ankylosing spondylitis, spondylitis in PsA present with mild clinical symptoms despite radiological progression, inflammation limited to one spinal tract, cervical spine dominance, non-marginal syndesmophytosis. Enthesitis is also one of the typical characteristics of PsA and it frequently affects Achilles tendon, plantar fascia and tendons inserting pelvic bones. Tenosynovitis can develop accompanied by enthesitis. Typical dactylitis (sausage digit), pitting edema and nail lesions, including nail pits, onycholysis, hyperkeratosis and splinter hemorrhage, also contribute to a differential diagnosis of PsA. Anterior uveitis, SAPHO syndrome, amyloidosis and IgA nephropathy are well-known extra-articular manifestation of PsA. In 2006, a new classification-criterion for PsA was suggested by the CASPAR study. The CASPAR criteria included 5 categories with a certain number of points; 1) skin psoriasis, 2) nail lesions, 3) dactylitis, 4) negative RF and 5) bone formation around joints. The CASPAR criteria should be applied to PsA patients having at least one of three (peripheral arthritis, spondylitis and enthesitis).

Food poisoning

This article aims to help physicians to make a differential diagnosis of food poisoning by introducing the incubation period, clinical symptoms of each causative agent according to the mode of manifestation. Etiologic agents for food poisoning are classified as bacterial, viral, natural toxin, and chemical toxin. Bacterial food poisoning is classified as infectious type, toxin type and other type according to the pathogenesis. Natural toxin food poisoning are classified as plant and animal food poisoning according to causative food. Many of the diagnoses are made clinically, without confirmative laboratory tests. However, some of food poisonings require the confirmative etiologic diagnoses, because they have rapid life-threatening courses and need proper speedy therapies. When incubation period is 1-6 hours, natural toxin type food poisoning should be suspected such as Staphylococcus aureus, Bacillus cereus vomiting type. When it is 7 to 12 hours, Clostridium perfringens and Bacillus cereus diarrheal type should be suspected. When it is 12 to 72 hours, Enterotoxigenic Echerichia coli, Salmonella spp., Vibrio parahemolyticus and Norovirus should be suspected. Before the result of confirmative laboratory test, a probable diagnosis for the etiology of food poisoning should be based upon the combination of their clinical manifestations, food histories, and pathogenic mechanisms.

Clinical analysis of gastrointestinal stormal tumor:areport of 38 cases / 中国基层医药

Objective To investigate the clinical and immunohistochemical features,diagnosis and treatment of gastrointestinal stromal tumor(GIST). Methods Clinic and pathological datas of 38 cases with GIST were retrospectively analyzed. Results The most common clinal maifestions were abdominal pain,distention or discomfort in 24 cases(50%), abdominal mass in 10,melena and liematemesis in 8 cases. The tumor was located in the stomach in 20 cases, the small infestine in 14,the colorectum in 4.All the cases underwent operation. Conclusion Endoscopy and imaging examination are main methods to detect GIST. Surgical resection is the main mothod of pathologic diagnosis and treatment.

Cincial analysis of primary retropertoneal tumor-A report of 23 cases / 临床外科杂志

Objective To explore the diagnosin and management of primary retropeitoneal tumor.Methods The clinical data of 23 cases of primary retroperonneal tumor were reviewed and analyzed from 1996 to 2003.Restults The Fibroma(tosis) of malignant primary retroperitoneal tumor were most popular types.of the 21 cases receiving surgical operation,5 underwent complete resection of tumor(54.7%).Among the 16 cases malingnant tumor.Complete excision 8 cases.Complete excision rate was 50%.Among the 5 cases benige tumor.All complete excison.Conclusions surgical resection was the most effective treament for primary retroperitoneal tumor.Re-operation was the first choice forecturrent prmary retroperitoneal tumor.B-ultrasonic and CT examination was a common way for the diagnosis of primary retroperitoneal tumor.

Early Diagnosis aed Treatment of Duodenal Trauma: A Report of 36 Cases / 中国医师杂志

Objective To explore the early diagnosis and operative treatment of duodenal injury. Methods The clinic data of 36 patients with duodenal trauma were retrospectively analyzed. Results Among 36 cases of duodenal injury, 4 cases (4/36,10.3%) were located in the first section of duodenum, 26 cases (26/36,72.2%) were between the second and third sections of duodenum, 6 cases (6/36,16.7%) were located in the fourth section of duodenum, and 14 cases were accompanied by other organ injury. The frequency of the postoperative complications was 13.9%, the curative rate was 94.4%, and the mortality was 2.8%. Conclusion Familiarizing with charateristics of duodenum injury, early diagnosing, mastering surgical exploration indication, selecting suitable operative approach, effective duodenal decompression, sufficient drainage and anti-infection treatment can improve the curative rate of duodenal injury.

THE EARLY STAGE DIGNOSIS OF PRIMARY GALLBLADDER CARCINOMA:ANALYSIS OF 679 CASES / 中国现代普通外科进展

Objective:In order to enhance the early dignosis level and strengthen the understanding of pathogeny、pathology by stage and prognosis of primary gallbladder car-cinoma(PGC). Methods : The results of 679 patients of PGC from 1956 to 1998 in first affiliated hospital of Xi'an medical university were retrospectively analyzed. Results: Most of the patients belong to advanced stage when dignosised. The PGC were usually found among the old women patients. The sex ratio(female/male) was 3:1. There is a intimate relatioship between gallstone and PGC. About sixty percents of PGC might be found gallstone.The dignostic accordance rate was low between preoperation and postopera-tion.Most patients with PGC were found unexpectedly in operation due to gallstone or a-cute cholecystitis. To worse more, many of patiens with PGC were missed the opportunities of dignosis and treatment because of only paying attention to gallstone. Most of the pathological types were adenocarcinoma. The development of imaging examination is hoped to find early stage cases and improve its prognosis. Conclusion : It is a basic way for early dignosis and improving prognosis to strengthen the understanding of pathogeny, pathology by stage and prognosis and rationalize application of all kinds of exzamination means in PGC.