Ovarian neoplasms,composed predominantly or exclusively of small round cells with scant cytoplasm,is relatively rare.However,there is a wide range of differentiation,and pathologists often struggle to make a correct diagnosis because of its overlapping histological features.Perhaps the best known neoplasm of this kind is ovarian small cell carcinoma of the hypercalcemic type,which may be confused with a wide range of neoplasm from sex cord-stromal tumor to neoplasm in the family of small round blue cell tumor to various undifferentiated malignancies.Small cell carcinoma of the pulmonary type may also arise from the ovary,and this may be a component of a typical ovarian surface epithelial-stromal tumor.Other small cell neoplasm that may arise within the ovary or involve the ovary includes intra-abdominal desmoplastic small round cell tumor,metastatic small cell carcinoma,peripheral primitive neuroectodermal tumor,and endometrial stromal sarcoma.In this review,the morphologic features of some of these neoplasms are described,as well the value of immunohistochemistry and other ancillary techniques in establishing a diagnosis.

Objective To investigate the protective effects of simvastatin on cobalt choride ( CoCl2 ) -induced hypoxia and reoxygenation injury on alveolar type Ⅱ cells and the underlying mechanisms.Methods CoCl2 was used to establish the hypoxia and reoxygenation injury model on AT Ⅱ cells.Blank,control and variant doses simvastatin-treated groups ( 5,10,20,30,50,100 μ mol/L) were designed in the present study.The proliferation of AT Ⅱ cells was evaluated by Cell Counting Kit-8 ( CCK-8 ) assay.The percentage of apoptotic cells was assessed by flow cytometry AV/PI double-staining.The protein levels of surfactant protein-C (SP-C) and proliferating cell nuclear antigen (PCNA) in AT Ⅱ cells was determined by Western blot.Results As compared with the control group,pretreatment with low dose (5 - 20 μmol/L),but not high dose simvastatin (50 - 100 μmol/L) markedly reduced A549 cells apoptosis,and increased their proliferation and the protein levels of SPC and PCNAin vitro.The protective effect could be reversed in vitro by L-mevalonate,a simvastatin competitive inhibitor,which indicated that the inhibition of mevalorate pathway was involved in the simvastatin induced AT Ⅱ cells function restoration.Condusion Low doses simvastatin reversed CoCl2-induced hypoxia and reoxygenation injury of AT Ⅱ cells.The inhibition of mevalonate pathway contributed to simvastatin induced AT Ⅱ cells function restoration.

OBJECTIVE:To establish a method for the simultaneous determination of paeoniflorin and paeonol in Dirda pill, and provide reference for improving its quality control standard. METHODS:HPLC was performed on the column of ZORBAX C18 with mobile phase of acetonitrile-0.1% phosphoric acid (gradient elutio) at a flow rate of 0.8 ml/min,detection wavelength was 230 nm(paeoniflorin),274 nm(paeonol),columne temperature was 35 ℃,injection volume was 20 μl. RESULTS:The linear range was 0.514 8-1.544 5μg for paeoniflorin(r=0.999 2)and 0.643 2-1.960 4μg for paeonol(r=0.999 8);the limits of quantifi-cation were 0.135 6,0.126 4 μg,limits of detection were 0.067 8,0.063 2 μg;RSDs of precision,stability and reproducibility tests were lower than 2%;recoveries were 95.78%-97.27%(RSD=0.62%,n=6) and 97.38%-98.38%(RSD=0.42%,n=6). CONCLUSIONS:The method is simple with good reprosucibility and high sensibility,and can be used for the simultaneous deter-mination of paeoniflorin and paeonol in Dirda pill.

Objective To evaluate initial results of Ivor Lewis minimally invasive esophagectomy (MIE) for esophageal carcinoma using a diamond-shaped anastomosis with 45 mm linear-stapler.Methods Clinical data of 12 patients diagnosed middle to distal esophageal carcinoma and undergoing Ivor Lewis minimally invasive esophagetomy using a diamond-shaped anastomosis technique during Dec.2015 and Nov.2016 in Peking Union Medical College Hospital were collected and analyzed retrospectively.Results The mean operation time was (378 ± 56) min,the mean blood loss was (280 ± 120) ml,and the mean postoperative hospital stay was (12.2 ± 2.0) days.No positive margin,no peri-operative death occurred.Postoperative complication included atelectasis and pulmonary infection in 1 patient,paresis of left recurrent laryngeal nerve in 1 patient.No anastomotic leak or constriction occurred.Median follow up was 7 months,11 patients had no evidence of disease progress,1 patient had subcutanecous metastasis and was reoperated.Conclusion The diamond anastomosis technique utilizing in Ivor Lewis MIE for esophageal carcinoma is feasible,easy to manipulate,safe and reliable.

Dentin ; Dentin-Bonding Agents ; Plant Extracts

Objective To develop a scale of the executive functional status for adolescents.Methods Regarding to the structure and the conception of executive function and the results of interviews to several adolescents,a preliminary inventory including 37 items was developed.The investigation sample consisted of 1722 students from 2 provinces in China by stratified sampling,and the the internal consistency,conduct validity and criterion validity were assessed by exploratory factor analysis.Results The revised scale including 21 items was consisted of three factors:inhibition control,cognitive flexibility,working memory,which explained 45.39％ of the total variance.The factor loading ranged from 0.499 to 0.727.The Cronbach alpha ranged from 0.786-0.897 for the scale and its three factors.Factor structure fitted actual data and its fit indices were x2=530.44,df=186,RESMA =0.053,GFI =0.93,AGFI =0.91,NFI =0.96,CFI =0.97.Conclusion It shows that the reliability and validity of the scale meet the standard of the psychometrics,and it can be suitable for evaluating the functional status of execution of Chinese adolescent.

Objective:To determine the effect of ketamine on the apoptosis of human uroepithelial cells (SV-HUC-1) and the pathogenesis of ketamine-associated cystitis. Methods:SV-HUC-1 cells were cultured under various concentrations of ketamine and different time. Flow cytometry was used to analyze the rate of cell apoptosis. hTe protein levels of Bax, Bcl-2, pro-caspase-3, and cleaved caspase-3 were detected by Western blot. Results:Compared with the control group, the apoptotic rate of ketamine cultured SV-HUC-1 cells increased. hTe expression of Bax increased, Bcl-2 expression decreased, and Bax/Bcl-2 in the ketamine cultured SV-HUC-1 cells was signiifcantly higher. hTe protein level of pro-caspase-3 was signiifcantly lower, and that of cleaved caspase-3 was signiifcantly higher than that in the control group (P<0.05), positively correlated with the dose of ketamine and time of culture (P<0.05). Conclusion:Ketamine can induce the apoptosis of SV-HUC-1 cells in a dose and time dependent manner.

Objective: To determine the therapeutic effect of regular urethral dilatation on patients with postoperative urethral stricture. Methods: A total of 142 patients underwent urethral stricture. The unimproved patients after the surgery were divided into a reoperation group and a regular urethral dilatation group. All the patients were followed up for 1-3 months, and the curative effect was compared. Results: Of the 142 patients, 42 had no improvement and 27 of them had reoperation, and symptoms in 21 were improved. Another 15 patients received regular urethral dilatation, and 5 improved. hTere was signiifcant difference between the 2 groups (P<0.01). Conclusion: Regular urethral dilatation has some effect on postoperative patients, but no obvious effect on patients with dissatisifed operation for urethral stricture or restenosis.

Objective:To determine the diagnosis, treatment, and pathogenesis of ketamine-associated cystitis.
Methods:Clinical data from 3 patients with ketamine-associated cystitis were analyzed retrospectively and discussed in light of relevant literature.
Results:In the 3 cases, 2 presented severe lower urinary tract symptoms, including frequency, urgency, dysuria, urge incontinence, and painful haematuria. Urinalysis and urine culture were negative. Imaging examination demonstrated thickening of the bladder wall and a small capacity. Inflammatory changes in the bladder mucosa were observed by cystoscopy and biopsies. After cessation of ketamine use, with the addition of steroids or hydrodistension, the symptoms in the 3 patients improved. The symptoms recurred in 2 patients, as 1 was exposed to ketamine again and 1 had severe bladder contraction after for 3-4 month follow-up.
Conclusion:Ketamine-associated cystitis is a new urinary system inlfammatory damage. Its etiology and treatment methods are not clear. early abstinence from ketamine use and early treatment are crucial for patients with ketamine-associated cystitis to avoid irreversible damage.

ObjectiveWe evaluate our experience of previously blocking both pulmonary artery and veins in true video assisted thoracic surgery (VATS) for the treatment of non-small-cell lung carcinoma ( NSCLC ).MethodsSix patients undergoing lobectomy with previously blocking both pulmonary artery and veins in the VATS in our institution between December 2007 and June 2011 were reviewed.ResultsIn our series,six patients required previously blocking both pulmonary artery and veins in the VATS,The mean occlusion time of PA and PV was (42.0 ± 8.6 ) min and ( 39.3 ± 8.2 ) min,respectively.Four patients required partial PA reconstruction.The mean repair time of the PA was (21.25 ±9.91 ) min.No complications attributable to the technique or mortality were seen.There were no local recurrences on the pulmonary artery.ConclusionIt is feasible and safe that the technology of previously blocking of the pulmonary artery and veins was applied in VATS.This technique can reduce the risk of intraoperative bleeding and the chance of converting to open thoracotomy,and extend the inclusion criteria of VATS lobectomy.