Objective To discuss effect on prevention of postpartum hemorrhage of caesarean section by us- ing calcium gluconate combined with oxytocin and misoprostol.Methods 385 cases of caesarean section were select- ed and randomized into O(Oxytocin) group and OM(Oxytocin+ Misoprostol) group and COM (Calcium gluconate+ Oxytocin+Misoprostol)group.Results The mean operative blood loss in O group and OM group and COM group were (300?50.24)ml,(220?30.83) ml,(150?45.52) ml.The amount of the mean operative blood loss of COM group was significantly lower than those of O group and OM group(P＜0.05).The amount of bleeding of 2 hours after delivery in O group and OM group and COM group were (400?45.52)ml,(260?60.43)mi and(210?50.54) ml.The amount of bleeding of COM group was significantly lower than those of O group and OM group (P＜0.05).Conclusion The prevention by used calcium gluconate combined with oxytocin and misoprostol is efficient in reducing the amount of postpartum hemorrhage of caesarean section.The operation of medicine is easy and safe and economic.

Objective To evaluate the clinical significance of serum levels of ProGRP, TPS and NSE in diagnosis and therapy monitoring in small cell lung cancer patients. Methods The levels of serum ProGRP, TPS and NSE in 51 SCLC patients (SCLC group), 60 benign pulmonary disease patients (benign disease group ) and 60 healthy people (healthy group ) were determined using chemiluminescent immunoassay, ELISA and electrochemiluminescent immunoassay respectively. Blood samples were collected and detected prior to therapy, before the second course of chemotherapy and the third course of chemotherapy consecutively in all the 51 SCLC patients. Results The serum ProGRP, TPS and NSE concentrations prior to chemotherapy in limited stage SCLC (LSCLC) were 136. 9(22.8-631.7)ng/L, 78. 2(56.4-114.6) U/L and 28.1(20.9-46.1)μg/L, respectively; And in extensive stage SCLC patients (ESCLC) were 1 106.6(41.2-2161.1) ng/L, 230. 9( 143.5-259.0) U/L and 81.1 (34.3-140.0)μg/L, respectively. The serum concentrations of the 3 markers in benign disease group were 19. 7 ( 9. 5-29. 1 )ng/L, 48. 7 ( 17.9-95.4) U/L and 12. 1(1.2-13.9) μg/L; and in healthy group were 20.3(10.7-30.6) ng/L, 50.3(19.5-70.7) U/L and 11.7 (1.1-13.4)μg/L, respectively. The Kruskal-Wallis test showed significantly statistical difference in different groups of the 3 tumor markers, Chi-Square were 51. 368,36. 532 and 81. 645( P ＜0. 01 ). Significant statistically differences showed when the concentrations of the 3 marks of the 2 control group were compared with that of the LSCLC group ( U =491, 827, 609 and 476, 831, 585,respectively, P ＜ 0. 05 ). Differences were also statistically significant when the 2 control group compared with that of the ESCLC group ( U = 314,532,456 and 302,553,430, respectively, P ＜ 0. 01 ). The AUC of ProGRP was 0.832 +0.029(95% CI:0.774-0.890). When cutoff value of ProGRP set as 37.7 ng/L, the diagnostic sensitivity, specificity, positive predictive value, negative predictive value and Youden's index were 71% (36/51), 97% (116/120), 90% (36/40), 89% ( 116/131 ) and 67%, respectively; show good detection performance. The sensitivity increased to 92%, 86%, 92% and 88%, when combination detection of ProGRP + TPS + NSE, ProGRP + TPS, ProGRP + NSE and TPS + NSE were used, and the specificities were 77%, 77% , 92% and 77% accordingly. The Fridman test showed significantly statistical difference in the 3 tumor markers at different stages of treatment, x2 were 49. 120, 10. 614 and 44. 392, P ＜0. 01. After the first chemotherapy course, all the tumor marker levels except TPS decreased significantly in comparison with the pretreatment concentrations. However, only ProGRP levels showed a progressive drop during the two consecutive courses of therapy, and the median concentrations were 68.0 ( 18. 6-158.4 ) and 21.0( 14. 9-63.5) ng/L (compared to the level before therapy,Z=-4. 889 and -5. 594, P ＜0. 01 ). The median of serum TPS increased slightly to 105.2 (54. 1-181.2 ) U/L after the first chemotherapy course (Z=-1.248, P＞0.05), and decreased significantly to 79.0(48.7-155.3) U/L after the second chemotherapy course (Z=-2.484, P＜0. 05 ). As to the NSE, the median concentration decreased to 11.8(8.0-16.0)μg/L after the first chemotherapy course ( Z= - 5. 568, P ＜ 0. 01 ). However, the median was 10. 6(9.0-12.7)μg/L, which showed no significant decrease after the second chemotherapy course (Z=-1.851, P＞0.05).Forty-six SCLC patients evaluated as clinical remission ( 3 CR and 43 PR) after the second chemotherapy course, among them there were 38 patients (83%) with normal serum ProGRP, TPS and NSE level ( 19 patients) or with only 1 abnormal tumor level ( 19 patients). There were only 2 patients with all abnormal serum ProGRP, TPS and NSE level, and both patients were evaluated as clinical PD. Two patients with 2 abnormal tumors results were classified as SD, the only 1 patient without therapy evaluation also had 2 abnormal tumor marker results. Conclusions The serum ProGRP, TPS and NSE are valuable tumor markers for diagnosis and treat monitoring of SCLC, particularly the ProGRP + NSE shows the highest clinical value. Combing detection of the 3 tumor markers are valuable for therapy monitoring and prognosis in SCLC patients.

Objective To explore the differences in clinical and laboratory parameters between elderly and non-elderly patients with acute lymphoblastic leukemia (ALL).Poor prognostic factors in elderly patients were explored to guide the individualized treatment.Methods Two hundred and seventy-nine ALL patients were divided into two groups:elderly group with their age more than 60 years (60-79 years) and nonelderly group with their age less than 60 years (14-59 years).The differences in clinical and laboratory parameters,abnormal molecular genetics on related genes,including IKZF1,PAX5,NOTCH1,PHF6,SH2B3,LEF1,and JAK1,as well as the correlations with treatment response and clinical outcome were compared between the two groups.Results Males accounted for a smaller part in elderly group [42.9 ％ (21/49) vs.61.7 ％ (142/230),P =0.015].The percentage of B cell lineage ALL (B-ALL),Philadelphia chromosome positive (Ph+) and CD33 positive rate were higher in elderly group compared with those in non-elderly group [87.8 ％ (43/49) vs.70.4 ％ (162/230),P=0.009;47.8 ％ (22/49) vs.27.4 ％ (58/230),P=0.007;56.8 ％ (21/49) vs.39.0 ％ (64/230),P =0.049,respectively].While both lymphodenopathy and total complete remission (CR) rate gained the upper hand in non-elderly group [38.9 ％ (81/230) vs.20.0 ％ (9/49),P=0.016;91.3 ％ (178/195) vs.68.3 ％ (28/41),P＜ 0.001,respectively].Moreover,elderly group had lower 3-month,6-month,12-month and 24-month overall survival (OS) rates (64.6 ％ vs.84.4 ％,P=0.001;50.0 ％ vs.73.8 ％,P=0.001;29.2 ％ vs.52.4 ％,P=0.003;6.2 ％ vs.26.2 ％,P=0.003,respectively) than those of non-elderly group.No significant differences in mutation rates of PAX5,NOTCH1,PHF6,SH2B3,LEF1 and JAK1 were found (all P ＞ 0.05).Conclusions Compared with non-elderly ALL patients,elderly ones harbor their intrinsic characteristics which might give rise to inferior outcomes.As a consequence,more attention should be poured into treating this particular group of ALL patients to improve their prognosis.

Purpose Intravoxel incoherent motion (IVIM) MR is a method developed in recent years which can quantitatively evaluate the diffusion and perfusion characteristics of microenvironment.The aim of this study was to investigate the application value of IVIM in assessing relapsing-remitting multiple sclerosis (RRMS).Materials and Methods A retrospective analysis of the clinical data of 27 patients with RRMS confirmed clinically at the First Affiliated Hospital of Chongqing Medical University from Jun.2015 to Jan.2016 was carried out in the study.All the patients underwent the conventional MRI and IVIM MRI based on multi-b-factor (b values of 10,20,30,40,50,100,150,200,350,500,650,800,1000 s/mm2) with 3.0T MR scanner.The apparent diffusion coefficient (ADC),ADCslow,ADCfast and f values were evaluated since they could reflect the diffusion and perfusion status of RRMS lesions and normal-appearing white matter (NAWM) regions.Results The ADC,ADCslow,ADCfast and f values of the non-enhancing (NE) lesions were significantly higher than those in the NAWM regions both near and far from NE lesions (P＜0.05).However,the ADC,ADCslow,ADCfast and f values in the NAWM regions close to the NE lesions had no significant differences with those in the NAWM regions far from the lesions (P＞0.05).Conclusion The IVIM MRI can measure the diffusion and perfusion status of the lesions and NAWM in RRMS patients,which,therefore,is helpful in speculation of the pathological changes of RRMS lesions and in its injury classification and identification.

Objective To assess the damage of limbic system pathways in relapsing-remitting multiple sclerosis (RRMS) by diffusion tensor imaging (DTI) tractography.Methods DTI tractography was used to acquire fiber numbers,fractional anisotropy (FA),mean diffusivity (MD) of cingulum,fornix,and uncinate fasciculus (UF) in 20 RRMS patients (MS group) and 20 healthy volunteers (control group),and statistical analysis was performed.Results Compared with control group,lower FA value (P＜0.01) and higher MD value (P＜0.05) were found in cingulum,fornix and UF of MS group,and the fiber numbers of fornix decreased in MS group (P＜0.001).There were significant differences between the left and the right UF in fiber numbers and FA value of control group and the fiber numbers of MS group.Negative correlations were found between FA value of cingulum and UF and EDSS scores in MS group (r=-0.572,-0.665,both P＜0.05),and positive correlations were found between MD value and EDSS scores (r=0.627,0.603,both P＜0.05).Conclusion DTI tractography is valuable in assessing MS associated limbic system damage and in monitoring the clinical progression of the disease.

Objcetives To sparch for the change of cerebrospinal fluid ferritin (CSF-Ft) content and its clinical significance.Methods The 42 patients with acute lymphatic leukemia(ALL)diagnosed by bone marrow biopsy were divided into 3 groups. There were 14 cases in Ⅰ group [introduced therapy stage without central nervous system leukemia(CNSL)7, 24 cases in Ⅱgroup (complete remission stage without CNSL) and 18 cases in Ⅲ grotip (with CNSL). There were 17 patients with viral encephalitis in viral encephalitis group and 15 patients without central nervous system oisease in control group. The CSF-Ft and SFt were determined by radioimmunoassay.Results The CSF-Ft contents of Ⅰ、Ⅱ、Ⅲ 、viral encepbalitis and control groups are 7.03 ?2.21 ?g/L,6.75 ?1.94?g/L, 31.06 ? 8.85?g/L, 7.26?1.83?g/L and 6.52 ?1.57?g/L. The CSF-Ft content in Ⅲ group are bigher than that in the other group (P

Objective To explore an algorithm to define the threshold value for tumor contouring on 18F-fluorodexyglucose (FDG) PET imaging. Methods A National Electrical Manufacturing Association (NEMA)NU 2 1994 PET phantom with 5 spheres of different diameters were filled with 18F-FDG. Seven different sphere-to-background ratios were obtained and the phantom was scanned by Discovery LS 4. For each sphere-to-background ratio, the maximum standardized uptake value ( SUVmax ) of each sphere, the SUV of the border of each sphere ( SUVborder ), the mean SUV of a 1 cm region of background (SUVbg) and the diameter (D) of each sphere were measured. SPSS 13.0 software was used for curve fitting and regression analysis to obtain the threshold algorithm. The calculated thresholds were applied to delineate 29 pathologically confirmed lung cancer lesions on PET images and the obtained volumes were compared with the volumes contoured on CT images in lung window. Results The algorithm for defining contour threshold is TH% = 33.1% + 46.8% SUVbg/SUVmax + 13.9%/D ( r = 0.994) by phantom studies. For 29 lung cancer lesions, the average gross tumor volumes ( GTV ) delineated on PET and CT are ( 7.36 ± 1.62 ) ml and (8.31 ±2.05) ml, respectively (t = -1.26, P＞0.05). Conclusion The proposed threshold algorithm for tumor contouring on PET image could provide comparable GTV with CT.

OBJECTIVETo identify the anatomical variability of the left spermatic vein (LSV) and determine its effect on the induction of experimental left varicocele (ELV) in adolescent rats.

METHODSWe equally randomized 30 adolescent male SD rats to groups A (LSV collaterals fully ligated and the left renal vein constricted), B (only the left renal vein constricted), and C (sham operation), observed the courses of the LSVs and measured their diameters. At 30 days after operation, we analyzed the changes in the left kidneys and the diameters of the LSVs.

RESULTSIrregular collaterals were observed in 90% of the LSVs and no abnormal changes were found in the left kidneys after surgery. The postoperative LSV diameter was remarkably increased in group A as compared with the baseline ([1.47 +/- 0.15 ] vs [0.16 +/- 0.08] mm, P < 0.01), but showed no significant difference in group B ([0.31 +/- 0.49] vs [0.15 +/- 0.07] mm, P > 0.05) and C ([0.17 +/- 0.07] vs [0.16 +/- 0.06] mm, P > 0.05), and it was significantly longer in A than in B (P < 0.01). The success rate of ELV induction was 100% in group A and 10% in group B, but no varicocele was observed in group C.

CONCLUSIONCorrect identification of the anatomical course of the LSV and ligation of its irregular collaterals are essential for the establishment of a stable and consistent ELV model.

Animals ; Disease Models, Animal ; Kidney ; pathology ; Ligation ; Male ; Rats ; Rats, Sprague-Dawley ; Spermatic Cord ; blood supply ; Varicocele ; Veins ; abnormalities

OBJECTIVETo investigate the expression of Tenascin-C mRNA in keloids and hypertrophic Total RNA was isolated from normal adult skin. A cDNA fragment (base 5941-6481bp) of the scars.

METHODSfull-length human Tenascin-C cDNA was synthesized by polymerase chain reaction and subcloned in pGEM-T-easy. Dioxygen-labeled anti-sense and sense probes were synthesized by using a Sp6/T7 RNA synthesis kit in the present of Dig-UTP in vitro. The samples were taken from keloids in 10, hypertrophic scars in 10 and normal adult skin in 5. The hybridization was performed with 4% paraformaldehyde-fixed and wax-embedded sections to detect the Tenascin-C mRNA.

RESULTSThe Tenascin-C mRNA was negative in the normal adult epidermis and weakly located in the fibroblasts of the papillary dermis and the epidermal adnexa. In all of the 10 keloid specimens, the Tenascin-C mRNA was positive throughout the epidermis and widely distributed in the dermis included in the fibroblasts, endothelial cells and epidermal adnexa. In the specimens of the 3 hypertrophic scars,the Tenascin-C mRNA was also positive in the epidermis, but in the other 7 cases, it became negative. In the dermis of the hypertrophic scar,the Tenascin-C mRNA was weaker than that in the keloid, but stronger than that in the normal skin.

CONCLUSIONSThe expression of Tenascin-C mRNA is markedly enhanced in the keloids.

Cicatrix, Hypertrophic ; genetics ; metabolism ; pathology ; Female ; Humans ; Keloid ; genetics ; metabolism ; pathology ; Male ; RNA, Messenger ; metabolism ; Tenascin ; genetics ; metabolism

Objective To evaluate the efficacy of computed tomography ( CT ) and diffusion?weighted magnetic resonance imaging ( DWMRI ) in the diagnosis of regional lymph node metastasis in thoracic carcinoma, and to figure out the methods and thresholds for delineation of lymph nodes with higher reasonability and accuracy. Methods A total of 43 patients with thoracic carcinoma, including 35 patients with esophageal cancer and 8 patients with non?small cell lung cancer, were enrolled as subjects from 2012 to 2013. All patients received abdominal CT scan and DWMRI examination one week before surgery, and regional lymph node metastasis was diagnosed based on the images of CT scan or DWMRI. With the postoperative pathology as the gold standard, the diagnostic efficacy was evaluated and compared between the two methods. The two sets of obtained images were analyzed using the χ2?test. Results The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and Youden’ s index of CT versus DWMRI in the diagnosis of regional lymph node metastasis were 57?1% vs. 60?0%, 96?3% vs. 98?9%, 93?8% vs. 96?5%, 50?0% vs. 77?8%, 97?2% vs. 97?4%, and 53?4% vs. 58?9%, respectively;the specificity, accuracy, and positive predictive value of DWMRI were significantly superior to those of CT ( P=0?005,0?038,0?022) . Twenty out of forty lymph nodes diagnosed by CT scan were false positive, and 15( 75%) of them could be corrected by DWMRI. Fifteen out of forty lymph nodes diagnosed by CT scan were false negative, and 3 ( 20%) of them could be recognized by DWMRI. In all 35 metastatic lymph nodes, 5 lymph nodes had no apparent swelling on images, and 13(43?3%) out of the other 30 lymph nodes had a short diameter less than 1?0 cm. Conclusions CT scan has apparent limitation in the diagnosis of regional lymph node metastasis. Many metastatic lymph nodes would be missed if a short diameter not less than 1? 0 cm is the only standard for target volume delineation . With superior specificity , accuracy , and positive predictive value to CT in the diagnosis of regional lymph node metastasis, DWMRI can effectively rule out non?cancerous intumescent lymph nodes and recognize some of small metastatic lymph nodes.