Clinical application of 18F-FDG PET/CT parameters in predicting tumor spread through air spaces in patients with lung adenocarcinomas at T1-2 stage / 中华核医学与分子影像杂志

Objective:To evaluate the clinical value of 18F-FDG PET/CT findings in patients with T1-2 lung adenocarcinoma spread through air spaces (STAS). Methods:From June 2018 to June 2020, a total of 80 patients (36 males, 44 females; age: 19-84 (59.9±11.8) years) with surgically and pathologically confirmed T1-2 lung adenocarcinomas in Jiangmen Central Hospital were enrolled retrospectively. All patients underwent 18F-FDG PET/CT examination preoperatively and were divided into STAS positive and negative groups according to the histopathological diagnosis. Independent-sample t test, Mann-Whitney U test, χ2 test and Fisher exact test were used to analyze differences of gender, age, tumor biomarker, SUV max, SUV mean, features showed on high resolution CT (HRCT; including diameter, lesion location, morphology, density, lobulated sharp, spiculated sign, vacuole sign, air bronchgram sign, pleural traction and para-emphysema), and pathologic findings (micropapillary pattern, lymphvascular inversion, pleural inversion and lymph node metastasis) between the two groups, and then multivariate logistic regression was performed. The ROC curve was employed to evaluate the predictive value of parameters for STAS of T1-2 lung adenocarcinomas. Results:Among the 80 patients with T1-2 lung adenocarcinomas, 12 (15.0%) were STAS positive and 68 (85.0%) were STAS negative. Significant differences were shown in SUV max, SUV mean, micropapillary pattern, lymphvascular inversion and lymph node metastasis between the two groups ( z values: -2.60, -2.17; χ2 values: 29.56, 9.28, 17.40, P<0.001 or P<0.05). SUV max (odds ratio ( OR): 1.348 (95% CI: 1.071-1.695), P=0.011), micropapillary pattern ( OR=47.444 (95% CI: 4.592-490.214), P=0.001) and lymph node metastasis ( OR=8.201 (95% CI: 1.129-59.576), P=0.038) were independent risk factors for STAS positive in multivariation logistic regression analysis. The optimum cut-off value for SUV max was 3.85 in the ROC analysis with the AUC of 0.737 (95% CI: 0.614-0.859), the sensitivity of 11/12, the specificity of 55.9%(38/68) and the accuracy of 61.2%(49/80). The AUC of the SUV max combined with micropapillary pattern and lymph node metastasis was 0.945 (95% CI: 0.892-0.999) with the sensitivity of 11/12, the specificity of 88.2%(60/68) and the accuracy of 88.7%(71/80). Conclusions:The PET/CT characteristics may be useful in differentiating STAS status among patients with T1-2 lung adenocarcinoma. SUV max >3.85, pathological papillary pattern and lymph node metastasis are independent risk factors to predict STAS.

Inhibitory effect of CLC-2 chloride channel targeted blocking on fibrosis of human conjunctival fibroblasts / 中华实验眼科杂志

Objective:To investigate the inhibitory effect of CLC-2 chloride channel targeted blocking on fibrosis of human conjunctival fibroblasts (HConF).Methods:HConF were divided into blank control group, lipofectamine 2000 (Lipo2000) group, nonsense small interfering RNA (siRNA) group, and CLC-2 siRNA transfected group.The HConF were cultured in medium containing the corresponding transfection reagents according to grouping.No intervention was given to blank control group.The expression level of CLC-2 mRNA of HConF was detected by real-time fluorescence quantitative PCR; absorbance ( A) value indicating the proliferative ability of HConF was determined by CCK-8 kit; the apoptosis ratio of HConF was tested by flow cytometry; the migration ability of HConF was identified by cell scratch test and Transwell migration assay; the contraction rate of HConF was assayed by collagen contraction test; the expression levels of collagenⅠ, collagen Ⅲ, PI3K, Akt, p-PI3K and p-Akt proteins were measured by Western blot. Results:Significant differences were found in relative expression levels of CLC-2 mRNA and A value among four groups ( F=90.110, 198.680; both at P<0.001). The relative expression level of CLC-2 mRNA and A value were significantly lower in CLC-2 siRNA transfected group than nonsense siRNA group, showing statistically significant differences (both at P<0.001). The proportion of apoptotic HConF in blank control group, Lipo2000 group, nonsense siRNA group, and CLC-2 siRNA transfected group was (4.78±1.10)%, (4.54±1.51)%, (4.82±0.88)% and (28.90±0.91)%, respectively, and a statistically significant difference was found ( F=363.260, P<0.001). The proportion of apoptotic HConF was significantly higher in CLC-2 siRNA transfected group than nonsense siRNA group, with a statistically significant difference ( P<0.001). Statistically significant differences were found in cell migration rate and the number of migrating cells among four groups ( F=74.493, 1 625.431; both at P<0.01). The cell migration rate of HConF in CLC-2 siRNA transfected group was significantly lower and the number of migrating cells was significantly smaller than those of nonsense siRNA group, with statistically significant differences (both at P<0.001). A statistically significant difference in contraction rate was found among four groups ( F=104.692, P<0.001). The contraction rate of HConF was significantly lower in CLC-2 siRNA transfected group than nonsense siRNA group, and the difference was statistically significant ( P<0.001). Statistically significant differences were found in relative expression levels of collagen Ⅰ and collagen Ⅲ proteins, p-PI3K/PI3K ratio, and p-Akt/Akt ratio among four groups ( F=112.073, 456.931, 340.889, 43.021; all at P<0.001). The relative expression levels of collagen Ⅰ and collagen Ⅲ proteins, p-PI3K/PI3K ratio and p-Akt/Akt ratio in CLC-2 siRNA transfected group were significantly lower than those of nonsense siRNA group, showing statistically significant differences (all at P<0.05). Conclusions:Targeted blocking of CLC-2 chloride channel gene expression can inhibit fibrosis of HConF by promoting apoptosis of HConF through PI3K/Akt signaling pathway and inhibit fibrotic processes such as cell migration, collagen synthesis and collagen contraction.

Influencing factors of rebleeding after gastroscopy in patients with liver cirrhosis and esophagogastric variceal bleeding / 临床肝胆病杂志

Objective To investigate the influencing factors for rebleeding after gastroscopy in patients with liver cirrhosis and esophagogastric variceal bleeding. Methods A retrospective analysis was performed for the clinical data of the patients with liver cirrhosis and esophagogastric variceal bleeding who were hospitalized in Tianjin Third Central Hospital from January 1, 2017 to December 31, 2018, and according to the presence or absence of rebleeding and bleeding time, the patients were divided into non-bleeding group ( n =148) and bleeding group ( n =119). The risk factors for rebleeding after gastroscopy were analyzed. The t -test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. The Cox regression model was used for univariate and multivariate analyses. The receiver operating characteristic (ROC) curve was used to evaluate the accuracy of Child-Turcotte-Pugh (CTP), fibrosis-4 (FIB-4), and albumin-bilirubin (ALBI) scores in predicting rebleeding after gastroscopy, and MedCalc was used to compare the area under the ROC curve (AUC). Results A total of 267 patients with liver cirrhosis and esophagogastric variceal bleeding were enrolled, among whom 53 (19.9%) had liver cancer. A total of 119 patients suffered from rebleeding, with an overall rebleeding rate of 44.6% and a median time to rebleeding of 11.0 (0-39.0) months. The univariate Cox regression analysis showed that liver cancer (hazard ratio [ HR ]=0.377, P 0.05). Conclusion Liver cancer, AST, PT, CTP score, FIB-4 score, and ALBI score are associated with rebleeding after gastroscopy in patients with liver cirrhosis and esophagogastric variceal bleeding, among which CTP, FIB-4, and ALBI scores have a good value in predicting rebleeding outcome, while there is no significant difference in predictive ability between them.

Advances in the application of laparoscopic bile duct detection of stone extraction / 中国医师杂志

With the continuous development of laparoscopic technology, the treatment of common bile duct stones has changed from the traditional open surgery to the current laparoscopic common bile duct exploration (LCBDE), which has the advantages of small trauma, fast recovery, less complications, short hospital stay and so on. LCBDE has two ways: through the common bile duct (LCD) and through the cystic duct (LTCBDE). LCD + T-tube drainage has a wide range of applications while the LCD + primary suture of bile duct eliminates T-tube and improves the quality of life of patients. LTCBDE has a certain range of applications, but has little trauma. The improvement of endoscopic technology and the application of new equipment also improve the efficiency and safety of operation. This article reviews the application progress of laparoscopic common bile duct exploration and lithotomy in the treatment of common bile duct stones.

Effect of phacoemulsification with different corneal micro-incision sizes on postoperative corneal healing / 中华实验眼科杂志

Objective:To investigate the effect of phacoemulsification using different corneal micro-incision sizes on the postoperative corneal healing.Methods:A non-random controlled study was performed.Seventy-six patients (76 eyes) with age-related cataract who underwent phacoemulsification and cataract extraction combined with intraocular lens (IOL) implantation in Yanbian University Hospital from May 2016 to May 2017 were enrolled.The subjects were divided into 2.2 mm incision group (37 eyes) and 1.8 mm incision group (39 eyes) according to corneal incision size.The intraoperative cumulative dissipated energy (CDE) and ultrasound time of the two groups were measured and compared.The corneal incision structure and corneal thickness of operative eyes were measured by anterior segment optical coherence tomography before surgery and at postoperative 1 day, 1 week and 1 month.The corneal endothelial cells count, the central corneal thickness (CCT), and the corneal volume in the central corneal diameters of 3.0 mm (CV3) and 10.0 mm (CV10) were measured by Pentacam.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the Yanbian University Hospital (No.2015153), and written informed consent was obtained from all subjects before surgery.Results:There were statistically significant differences in the corneal endothelial cells count, CCT, CV3, CV10, and corneal thickness at epithelial side of the incision between pre-operation and post-operation in each group ( Ftime=17.717, 67.356, 17.577, 13.559, 80.076; all at P<0.01).But there was no statistically significant difference in the indexes between the two groups ( Fgroup=0.788, 0.706, 3.692, 4.341, 4.182; all at P>0.05).The number of corneal endothelial cells in the two groups was gradually decreased after surgery, and was significantly reduced at one month after surgery in comparison with the pre-operation, and the differences were statistically significant (both at P<0.05).At 1 day after surgery, the CCT, CV3, CV10, and corneal thickness at epithelial side of the incision in the two groups were increased significantly in comparison with the pre-operation and the differences were statistically significant (all at P<0.05), and the differences were not statistically significant between preoperative and postoperative 1 week or 1 month (all at P>0.05).With time going by, the indexes were back to normal gradually.The incidence of endothelial gaping and dislocation at the corneal incision in the 1.8 mm incision group was 12.8% (5/39) and 5.1% (2/39), which were significantly higher than 0.0% (0/37) and 2.7% (1/37) in the 2.2 mm incision group, and the differences were statistically significant ( χ2=5.078, P=0.024; χ2=0.295, P=0.590).At 1 day after surgery, corneal thickness at the endothelial side in the 1.8 mm incision group was significantly thicker than that in the 2.2 mm incision group, and the difference was statistically significant ( P=0.042), and the corneal thickness at endothelial side of the incision was positively correlated with CDE in the two groups ( r=0.231, P=0.025; r=0.347, P=0.003). Conclusions:Compared with 2.2 mm incision, 1.8 mm corneal incision results in higher incidence of endothelial gaping and dislocation at the corneal incision, greater corneal thickness at endothelial side of the incision and slower recovery.

The effect and mechanisms of chloride channel blocker NPPB on TGF-β1 induced HConF fibrosis / 中华实验眼科杂志

Objective To study the effect and mechanisms of chloride channel blocker 5-Nitro-2-(3-phenylpropylamino) benzoic acid (NPPB) on thansforming growth factor β1 (TGF-β1) induced human conjunctival fibroblasts (HConF) fibrosis.Methods Cell counting kit (CCK-8) was used to screen out the optimal TGF-β1 treatment time and the optimal NPPB concentration.The cells were divided into control group,TGF-β1 treatment group and TGF-β1+NPPB group.Cell proliferation and cell cycle were detected by CCK-8 and flow cytometer,respectively.Cell migration ability were observed by scratch and transwell migration assays.Western blot and Real time-PCR were used to detect the expression of collagen Ⅰ (COL-Ⅰ),fibronectin (FN) and α-smooth muscle actin (α-SMA).The phosphorylation level of PI3K and Akt were measured by Western blot.Results TGF-β1 promotes cell proliferation in a time-dependent manner.There was no statistically significant difference in A values between 48 hours and 72 hours after TGF-β1 treatment (P =0.064).Forty-eight hours was selected as the most appropriate time for TGF-β1 treatment.NPPB inhibited HConF cell proliferation in a concentration-dependent manner.Compared with the control group,the proliferation A values of cells in the 50 mol/L and 100 mol/L NPPB groups were significantly reduced (P =0.020,0.000),and 100 mol/L was selected as the optimal concentration of NPPB.The cell proliferation A value,migration area and migration cell number of TGF-β1 +NPPB group were significantly lower than those of TGF-β1 treatment group (all at P＜0.05).Compared with the control group and TGF-β1 +NPPB group,the proportion of G1 phase cells in the TGF-β1 treatment group was reduced,and the proportion of cells in the S phase and G2/M phase were increased,with statistically significant differences between them (all at P ＜ 0.05).The protein and mRNA expression of α-SMA,COL-Ⅰ and FN in the TGF-β1 treatment group were higher than those in the control group and TGF-β1+NPPB group,with statistically significant differences between them(all at P＜0.05);the ratios of p-PI3K/PI3K and p-Akt/Akt in the TGF-β1 treatment group were significantly higher than those in the control group and TGF-β1 +NPPB group,with statistically significant differences between them (all at P＜0.05).Conclusions NPPB may inhibit TGF-β1 induced HConF fibrosis process by inhibiting phosphorylation of PI3K and Akt.

Clinical strategy and individualized treatment of cholecystolithiasis / 国际外科学杂志

Gallstone is a common and frequently-occurring disease in surgery,and its formation is a process of many factors,many links and many steps,often accompanied by a variety of metabolic diseases.The treatment of cholecystolithiasis,operation time and operation mode are influenced by many factors.Clinicians are often confused because of their different strategies in diagnosis and treatment.Based on the domestic and foreign research progress of diagnosis and treatment of gallbladder calculi,combined with clinical practice,this article discusses the existing problems in the diagnosis and treatment of gallstone problems,treatment principles,individualized treatment strategy to make a discussion,aimed at strengthening grassroots doctors and general practitioners awareness of gallstones,individual treatment protocol.Therefore we could avoid excessive and inadequate treatment,and make the treatment of "standardization"" individualization",the benefit of the "maximum".

Changes of chemokine receptors expression in the conjunctival epithelial cells and Th-17 cell number in tears of diabetic dry eye disease / 中华实验眼科杂志

Objective To explore the expression of chemokine receptor 6 (CCR6) and T helper cell 17 (Th-17) in the epithelial cells and tears in diabetic patients with dry eye disease.Methods Prespective study was performed.Ninety-one type 2 diabetic patients with dry eye disease and 102 normal subjects were involved from January to July in 2017 in Affiliated Hospital of Yanbian University.Ocular Surface Disease Index (OSDI)questionnaire survey score,Break-up time of tear film (BUT),Schirmer Ⅰ test (S Ⅰ t) and fluorescein corneal stainning (FLS) were performed on both groups.The conjunctival epithelial cells of both groups were obtained by impression cytology.The expression of the chemokine receptors (CCR) 4,CCR5 and CCR6 in conjunctival epithelial cells and the number of Th-17 cells in tears were detected by flow cytometry.This study was approved by the ethics committee of Affiliated Hospital of Yanbian University (2014053),and all the patients signed informed consent.Results The OSDI questionnaire scores,BUT,S Ⅰ t and FLS were significantly different between diabetic dry eye group and normal control group (all at P＜0.05).The ratio of CCR4+ CD4+ T cells,CCR5+ CD4+ T cells and CCR6+CD4 +Tcells was (1.1±0.9)％,(2.1±1.7)％ and (5.2±2.4)％ in the normal control group,(1.2±0.8)％,(9.5±5.3)％ and (19.2±5.7)％ in the diabetic dry eye group,respectively.The ratios of CCR5+CD4+ T cells and CCR6+CD4+ T cells in the diabetic dry eye group were significantly higher than those in the normal control group (both at P＜0.05).The proportion of Th-17 cell in tears of diabetic dry eye group was significantly higher than that in the normal control group (P＜0.001).Conclusions CCR5,CCR6 and Th-17 cells may play a key role in the pathogenesis of diabetic patients with dry eye.

Analyzing the Treatment of Stomachache of Menghe FEI's and MA's / 浙江中医药大学学报

[Objective]By analyzing the treatment of stomachache of the surnames FEI and MA from Menghe scholarly sect, exploring the experiences in treatment and formula regularity. [Method]The thesis gives standard of medicine names and processing technology based on Traditional Chinese Pharmacology;calculates the medication frequency and classifies medicines by frequency analysis.[Results]There are totally 40 medical cases included in the study, statistics analysis shows that the drug is mainly Qi regulating drugs,drugs for eliminating dampness, drugs of promoting blood circulation and hematinics drugs.Mr FEI took 13.22 drugs on average,high-frequency medicines include Angelica,Tribulus terrestris,Tangerine Peel,Green Tangerine Peel, Radix aucklandiae.Mr MA took 10.72 drugs on average,high-frequency medicines include Salvia miltiorrhiza,Poria cocos,Angelica,Radix Curcumae,Pinellia. [Conclusions]The surnames FEI and MA from Menghe scholar sect paid attention to the method of regulating qi-flowing for harmonizing stomach,the method of resolving phlegm and removing blood stasis,the method of pacifying the stomach through the treatment of the liver.The idea of prescribing is moderate, lightly and well-proportioned.The nuances state their personal characteristics.It's worth our reference in clinical treatment.

Role of Rouviere's sulcus in relation to posterior cystohepatic triangle in prevention of bile duct injury in laparoscopic cholecystectomy / 中华普通外科杂志

Objective To evaluate the function of Rouviere's sulcus with posterior cystohepatic triangle in prevention of bile duct injury in laparoscopic cholecystectomy.Methods The clinical data of 170 patients undergoing laparoscopic cholecystectomy through Rouviere's sulcus approach with posterior cystohepatic triangle from May 2016 to June 2017 in the Department of General Surgery,the Second People's Hospital of Wuhu were retrospectively analyzed.The incidences and types of Rouviere's sulcus were documented.Results The open type of Rouviere's sulcus was visualized in 108 patients(63.53％),the fused type in 44 patients(25.88％),and the deficient type in 18 patients (10.59％).Hence in a total of 152 (89.41％) patients had Rouviere's sulcus.All patients underwent laparoscopic cholecystectomy safely.There was no bile duct injury or mortality.Four patients (2.35％) were converted to open operation,all were deficient type of Rouviere's sulcus for chronic inflammation of the gallbladder triangle.Conclusion Rouviere's sulcus are present and visible in most patients.Guided by Rouviere's sulcus with posterior cystohepatic triangle it could be safely and effectively to expose the anatomical structure of Calot's triangle and prevent bile duct injury in laparoscopic cholecystectomy.

Application of 18F-FDG PET/CT in diagnosis of Adrenal Lymphoma / 中国医学影像学杂志

Purpose To explore the 18F-FDG PET/CT imaging features of adrenal lymphoma and to improve the diagnosis of this disease.Materials and Methods A total of 13 cases with pathology-proven adrenal lymphoma and PET/CT examinationfrom December 2012 to March 2016 were retrospectively reviewed,The contents including the extent,shape,size and density of the adrenal lymphoma as well as the SUVmax value and affected lymph gland were recorded.The region of interesting (ROI) was delineated with the SUVmax value being calculated,which was compared with pathological diagnosis.Results All 13 cases were non-Hodgkins lymphoma,12 of which were secondary lymphoma,with the other case being primary lymphoma.Nine cases were diffuse large B-cell lymphoma (DLBCL);2 cases were mantle cell lymphoma;2 cases were NK/T-cell lymphoma.In 10 cases there were bilateral adrenal involvement,and unilateral involvement in 3 casesincluding on 2 the left and 1 on the right.A total of 23 adrenal glands were involved,with soft masses in 13,soft nodules in 8 and adrenal thickening in 2.The lesions were well-defined in 10 cases.In 3 cases there were cystic changes or necrosis.No hemorrhage,calcification or fat was identified.Extra-adrenal involvement was discovered in 9 cases.Lymphadenopathy was seen in 10 cases involving the neck,mediastinum and retroperitoneum.Adrenal lesions showed intense FDG uptake on PET/CT with SUVmax ranging from 5.7 to 30.8 and mean SUVmax of 15.8±8.9.Conclusion Most of the adrenal lymphoma cases were diffuse large B-cell non-Hodgkin's lymphoma.The features of PET/CT include bilateral involvement,well-defined soft tissue mass with intense FDG uptake.PET/CT can differentiate primary and secondary adrenal lymphoma and help with treatment planning.

Relation between macroscopic type and cellular origin of intrahepatic cholangiocarcinoma / 国际外科学杂志

Intrahepatic cholangiocarcinoma,which occurrence and development involved kinds of cells and genes changes,is a vital part of the primary carcinoma of liver.The cellular origin may includes bile duct epithelial cells,hepatic stem cells and hepatic cells.The macroscopic type may includes:nass-forming types,periductal infiltrating types,intraductal growth types.The fact was revealed that different macroscopic type of intrahepatic cholangiocarcinoma has different clinical features,outcomes and prognosis.The author reviewed recently published studies covering various aspects of intrahepatic cholangiocarcinoma,focusing especially on the macroscopic subtypes and related cell features,to discover the relaticn between macroscopic type and cellular origin of intrahepatic cholangiocarcinoma and better understand the pathogenesis of intrahepatic cholangiocarcinoma.

Aberrant methylation reactions in tumor tissues / 国际外科学杂志

The threat of cancer to human being' s health is definite.In order to find more effective cures,experts has always taking the mechanism of tumorigenesis as a research foucus and hot spot.As everyone knows,the basic biological behaviors of malignant cells have changed a lot,such as cell proliferation,apoptosis,and so on,and the causes are related to the aberrant methylation reaction occurred in these cells.Researchers have found out that DNA methylation in tumor tissues were obviously different from that in normal tissues,with the charateristics of extensive hypomethylation and localized hypermethylation.To identify the effect of abnormal methylation reaction in the evolution and progression of tumor,this article is aiming to overview those previously researches about the abnormal methylation reaction in tumor cell and its effect on cell growth.

Effect of molecular subtype on chemosensitivity and survival in patients with breast cancer following neoadjuvant chemotherapy / 国际外科学杂志

Objective Pathologic complete response (pCR) has been suggested as a surrogate prognostic indicator in breast cancer patients treated with neoadjuvant chemotherapy.We assessed whether the likelihood of pCR and survival is associated with the immunohistochemistry-based molecular subtypes.Methods We retrospectively analyzed the records of l01 patients with breast cancer who received neoadjuvant chemotherapy between January 2007 and January 2010.Patients were dassified into four molecular subtypes based on the immunohistochemistry prnfiles of estrogen receptor,progesterone receptor,and HER2.Logistic regression was used to analyze variables associated with pCR.Results The pCR was achieved in 19 patients (18.8％).The triple negative subtype was an independent predictive factor for pCR (odds ratio,3.35,95％ confidence interval,1.25-9.79,P =0.012),and the Her-2 subtype showed a trend for higher pCR rates (odds ratio,3.11;95％ confidence interval,1.09-10.89,P =0.021) compared with the luminal A subtype.The pCR was significantly associated with prolonged disease-free survival (P =0.002).The triple negative subgroup had shorter disease-free survival (P =0.0006) and overall survival (P =0.008) than the other subgroups.Conclusions We demonstrated that the triple negative and Her-2 subtypes are more likely to obtain pCR when neoadjuvant chemotherapy is given,compared to the luminal A subtype.Despite the high pCR rate,the triple negative subtype showed worse survival outcomes,paradoxically,primarily due to patients who had residual disease.

A brief analysis of “the liver being an evil of Zang-organ” / 临床肝胆病杂志

The liver being an “evil” of Zang-organ has been mentioned repeatedly in ancient medical books and is thought-provoking. The author believes that the ”evil” nature of the liver lies in the diversity, complexity, and latency of diseases caused by liver disorders, which is closely related to the physiological characteristics and pathological changes of the liver. This article discusses the liver itself and its relationship with other organs, meridians and collaterals, and qi-blood and body fluid and elaborates on the three pathogenic characters of the liver being an “evil” of Zang-organ. A correct understanding of the ”evil” nature of the liver plays an important role in guiding clinical diagnosis and treatment.

Adult intratesticular rhabdomyosarcoma:clinicopathologic analyses and review of literatures / 临床与实验病理学杂志

Purpose To study the clinicopathologic features, differential diagnosis, immunophenotype and treatment and prognosis of adult intratesticular rhabdomyosarcoma ( ITRMS) . Methods One case of adult ITRMS was analyzed by histology and immunohisto-chemistry, the date of treatment and prognosis through electronic medical record. The published relevant literatures were reviewed. Re-sults A 19-years old male patient was admitted to the hospital with a history of 2-months testicular painless enlargement. Testis ultra-sound examination and scrotal and abdominal CT revealed a mass in right testis. Macroscopic observation of the testis showed that a grey-white tumor. The tunica albuginea, epididymis and spermatic cord hadn’ t been invaded by the tumor. Microscopically, medium-size oval or round cells were arranged in sheets, and spindle-shaped, strap-like, large-circle cells were also presented. Few large cells had abundant granular eosinophilic cytoplasm with crossstriations under oil immersion objective. Immunohistochemically, the tumor cells were positive for vimentin, HHF35, desmin, MyoD1, Myogenin and h-Caldesmon protein, more than 50% neoplasm cells were positive. The rate of Ki-67 was 75%. Conclusions Adult ITRMS is rare. Histologically, embryonal rhabdomyosarcoma ( ERMS) is the most common type. They have highly invasive and poor prognosis. The accurate diagnosis depends on the combination of the histo-logic and immunohistochemical examination.

Analysis on the implementation effect of nursing management intervention quality of care in critically ill patients with mechanical ventilation / 中国医学装备

Objective:To investigate the clinical application of and critically ill patients received comprehensive nursing interventions during mechanical ventilation effect value. Methods:Ninety eight patients were selected in 2012 July~2013 year in July in our hospital, were treated with mechanical ventilation, were randomly divided into observation group and control group, 49 cases in each group, the control group using ICU routine care, the observation group in the control group on the basis of comprehensive nursing intervention, observation and nursing effect of the two groups. Results:The group of patients with mechanical ventilation time, hospitalization time was shorter than the control group, comparing the data between the groups, the difference was statistically significant(t=8.3678, t=5.9103; P<0.05). The observation group patients with unplanned estuation, ventilator-associated pneumonia was lower than the control group, the mortality rate was lower than the control group, comparing the data between the groups, the difference was statistically significant (x2=5.0178, x2=10.2424, x2=5.9905;P<0.05). Conclusion:in critically ill patients were given comprehensive nursing intervention can shorten the duration of mechanical ventilation and hospitalization in patients with mechanical ventilation, to reduce the unplanned extubation and ventilator-associated pneumonia, reduce mortality, it is worth promoting in clinical use.

Family-based analysis of the adiponectin gene polymorphisms and polycystic ovary syndrome / 中华妇产科杂志

Objective To study the association between three single nucleotide polymorphisms (SNP; rs2241766,rs1501299 and rs12495941) variants of the adiponectin gene (ADIPOQ) and polycystic ovary syndrome (PCOS) in PCOS family trios.Methods A total of 224 unrelated PCOS probands,their biological parents were recruited.Anthropometric variables such as waist circumference (WC),hip circumference (HC),height and weight were measured in all subjects during the first visit to the outpatient department.Body mass index (BMI) and waist-hip ratio (WHR) were calculated.Serum fasting glucose (FBG),fasting insulin (FINS),total cholesterol (TC),triglycerides (TG),low-density lipoprotein and highdensity lipoprotein cholesterol (HDL) levels were measured.PCOS patients were divided into two groups based on BMh group A (BMI＜25 kg/m2) and group B (BMI≥25 kg/m2).Parents of PCOS patients were accordingly categorized into group C,D (fathers) and group E,F (mothers).The transmission disequilibrium test (TDT) was used to analyze the association between three SNP of ADIPOQ and PCOS.Results (1) A significant positive association was detected between SNP rs1501299 and PCOS (x2=7.093,P=0.008).However we failed to find significant overtransmission of the other two SNP rs2241766 and rs12495941 from parents to PCOS offsprings (x2=1.620,P=0.203; x2=0.713,P=0.398).(2) Linkage disequilibrium (LD) was analyzed in the subjects,rs1501299 and rs2241766 were in weak LD (r2=0.063,D'=0.621).(3) The levels of WC,HC,WHR,testosterone,TG,HDL and FINS were significantly differences between obese and lean PCOS patients (P＜0.05).While in fathers we only found WC,HC,TC levels being statistically different (P＜ 0.05).Mothers of obese PCOS patients had increased levels of FINS compared with mothers of lean PCOS patients (P＜0.05).The genotype frequencies of the three SNP were not different in obese and lean PCOS patients and their parents (P＞0.05).Conclusions TDT confirms that SNP rs1501299 in the ADIPOQ is significantly associated with the risk of PCOS in the Chinese Han population.The three SNP of the ADIPOQ were not associated with the obesity of PCOS.

Performance-based compensation management system at a public hospital in Wuhu / 中华医院管理杂志

Reasonable and effective compensation and incentive mechanism is key to maintaining and stimulating incentives of the staff.By means of defining the main problems and defects in the current hospital compensation system in China,performance management is used as the cornerstone for designing the public hospital compensation and incentive mechanism.Resource-based relative value scale(RBRVS) assessment system is called into play to build a compensation management system,which features workload as the basis,technical competency and risk assessment as the reference and balance scorecard as the means.This can build a fair,scientific and reasonable salary distribution system and performance evaluation system,which maximize incentives of the compensation system,and in the end maximize the economic and social benefits of the hospital.

Effect of MG132 on the expression of ERK1/2 and connective tissue growth factor in rat peritoneal mesothelial cells induced by high glucose / 中华肾脏病杂志

Objective To observe the effect of MG132 on the expression of extracellular regulated kinase 1/2 (ERK1/2) and connective tissue growth factor (CTGF) in rat peritoneal mesothelial cells (RPMCs) induced by high glucose.Methods RPMCs were isolated,cultured and passaged by trypsin,then identified.The second generation of cultured RPMCs were used in the experiment.RPMCs were divided into normal control group,high glucose (1.5％,2.5％,4.25％) for 24 hours,high glucose (2.5％) for 0,12,24,48 hours,incubated with MG132 (0.5,1,2 μmol/L) for half an hour and then with high glucose (2.5％) for 24 hours.ERK1/2 protein was detected by Western blotting,and CTGF protein in supernatant was detected by ELISA.Results Compared with the control group,the expression of p-ERK1/2 was significantly increased in the groups stimulated by high glucose (P ＜0.01),reached the peak at 24th hour (P ＜ 0.01),and then the expression decreased at 48th hour,but still was higher than that in the normal control group (P ＜ 0.01).CTGF protein expression of RPMCs induced by high glucose increased,in time-and dose-dependent manner (P ＜ 0.05).MG132 could significantly decrease the expression of ERK1/2 and CTGF induced by high glucose (P＜0.05).Conclusions MG132 can decrease the expression of p-ERK1/2 and CTGF in RPMCs induced by high glucose.The ubiquitin proteasome pathway participates in the development of peritoneal fibrosis,and blocking the way may contribute to the prevention of peritoneal fibrosis.