To study the nodal distribution in endometrial carcinoma and to evaluate its effect on recurrence and survival, 230 patients with endometrial carcinoma were reviewed and analyzed. 32(20 25%)cases were found to have lymph node metastasis. Stage Ⅲc disease was defined by positive PLN alone in 22 cases, positive PLN and PALN in 4 cases, and positive PALN alone in 6 cases. Positive peritoneal cytology and adnexal metastasis were present in 10 patients. Only 2/10 of these patients had isolated positive PLN whereas 8/10 had positive PALN ( P 0 05). These findings indicate that PALN involvement is common in patients with FIGO Stage Ⅲc endometrial cancer, and suggest that PLN sampling alone may result in underdiagnosis of disease, and dissection of PALN may have a significant therapeutic role.

To study the clinicopothologic diagnosis and treatment of small cell neuroendocrine carcinoma of the cervix(SCNCC)in relion to its outcome. Eight cases of SCNCC treated within 10 years in our hospital were reviewed and andlyzed retrospectively and followed up in our clinic. The clinical and pathologic classifications were correct, namely:Ⅰa 1,Ⅰb 2,Ⅱa 2, Ⅱb 1; Ⅲa 1 and Ⅲb 1 case. Three early cases had total hysterectomy with all pelvic lymph nodes removed and 5 late cases had radio therapy only.Of them 5 cases died 13～38 months after treatment,averaging 19 months, 3 liviny,for 3,4 and 5 months,respectively,one case, however,with metastasis to kidney.SCNCC is a rare tumor of high malignancy with early metastasis and poor prognosis.It should be recognized early and treated with Wertheim's operation and total removal of pelvic lymph nodes with postoperative radio or chemotherapy. Late cases might be benefited by radio or chemotherapy.

Objective This research approaches the methods of intensifying the medical clinical skills training to develop students’medical abilities in clinical practice.Methods We chose 129 seven-year medical students.They were devided into two groups in random.The con-trol group entered the clinical practice directly,while the experimental group accepted the clini-cal skill training before they entered the clinical practice.Results The examination record and qualification number of experimental group were higher than the control group obviously.After the clinical skill training,the examination record became higher than before.Conclusion The experiment shows that receiving clinical skill training before entering clinical practice is the ef-fective method of elevating medical students’clinical abilities and practical skill level.

Objective To explore the volume size of mastoid pneumatization in normal adults and the relation‐ship with a history of recurrent otitis media in childhood .Methods A total of in 40 adults (80 ears) ,based on with or without otitis media in childhood ,were divided into the study group (n= 20) and the control group (n=20) . The volume sizes of mastoid pneumatization were measured by temporal bone CT scanning of three-dimensional re‐construction ,and the relationship with the history of childhood ear infections was studied .Results The average vol‐ume of pneumatization in all 80 temporal bones was 10 .4 ± 1 .8 ml .The average volume of pneumatization in sub‐jects without otitis media history (48 ears) and subjects with a history of otitis media (32 ears) were 9 .7 ± 2 .2 ml and 6 .3 ± 1 .7 ml ,respectively .The difference was statistically significant (P<0 .05) .For the subjects with single ear disease in the study group ,the average volume of pneumatization in subjects without otitis media history(8 ears) and subjects with a history of otitis media(8 ears) were 9 .2 ± 1 .3 ml and 5 .8 ± 3 .6 ml ,respectively ,and there were statistically significant differences(P<0 .05) .The average volume of pneumatization in the control group (40 ears) was 10 .1 ± 4 .4 ml .Comparing with the subjects with out otitis media history(8 ears) in the study group ,there was no statistically significant difference (P>0 .05) .Conclusion The volumes of mastoid pneumatization in normal ears have a wide range .The subjects with a history of recurrent otitis media in childhood may be the cause of the volume decrease of mastoid pneumatization in adulthood .

Bone Marrow Cells ; metabolism ; DNA-Activated Protein Kinase ; genetics ; metabolism ; Humans ; Leukemia ; genetics ; Nuclear Proteins ; genetics ; metabolism ; PTEN Phosphohydrolase ; genetics ; metabolism ; RNA, Messenger ; Telomerase ; genetics ; metabolism

We have developed and characterised a mouse model of Japanese encephalitis virus (JEV) infection via footpad inoculation in order to better mimic viral transmission by mosquito bites. Two-week-old and 5-week-old mice consistently developed signs of infection such as ruffled fur, weight loss, hunchback posture, tremors, mask-like facies and occasionally, hindlimb paralysis at 4 days post infection (dpi) and 11-13 dpi, respectively. Most of the animals died within 24 to 48 hours following the onset of signs of infection, with mortalities of 100% and 33.3% in 2-week-old and 5-week-old mice, respectively. Mild meningitis and variable parenchymal inflammation with formation of microglial nodules, focal necrosis and neuronophagia, and perivascular cuffing by inflammatory cells were observed in the caudate nucleus, putamen, thalamus, cerebral cortex, brainstem, and spinal cord. Viral antigens/RNA were demonstrated by immunohistochemisty and in situ hybridization, respectively, in most of these areas as well as in the hippocampus and cerebellum, albeit more focally. The pathological findings in this mouse model were generally similar to human Japanese encephalitis (JE) and other established JE models but perhaps, compared to other JEV mouse models, it demonstrates lethal encephalitic infection more consistently. We believe that our mouse model should be useful to study the pathogenesis of JE, and for testing anti-viral drugs and vaccines

We have developed and characterised a mouse model of Japanese encephalitis virus (JEV) infection via footpad inoculation in order to better mimic viral transmission by mosquito bites. Two-week-old and 5-week-old mice consistently developed signs of infection such as ruffled fur, weight loss, hunchback posture, tremors, mask-like facies and occasionally, hindlimb paralysis at 4 days post infection (dpi) and 11-13 dpi, respectively. Most of the animals died within 24 to 48 hours following the onset of signs of infection, with mortalities of 100% and 33.3% in 2-week-old and 5-week-old mice, respectively. Mild meningitis and variable parenchymal inflammation with formation of microglial nodules, focal necrosis and neuronophagia, and perivascular cuffing by inflammatory cells were observed in the caudate nucleus, putamen, thalamus, cerebral cortex, brainstem, and spinal cord. Viral antigens/RNA were demonstrated by immunohistochemisty and in situ hybridization, respectively, in most of these areas as well as in the hippocampus and cerebellum, albeit more focally. The pathological findings in this mouse model were generally similar to human Japanese encephalitis (JE) and other established JE models but perhaps, compared to other JEV mouse models, it demonstrates lethal encephalitic infection more consistently. We believe that our mouse model should be useful to study the pathogenesis of JE, and for testing anti-viral drugs and vaccines
Encephalitis, Japanese ; Virus Diseases

Purpose Papillary thyroid microcarcinoma (PTMC) is difficult to diagnose its nature before surgery, thus results in misdiagnosis. This paper aims to determine the best diagnostic cutoff value using anteroposterior and transverse diameter ratio (A/L) and longitudinal and transverse diameter ration (L/T) in PTMC. Materials and Methods The CT data of 154 pathology proven benign and malignant thyroid nodules ≤ 1.0 cm in diameter in 78 cases were reviewed, including 75 PTMC in 47 patients and 79 benign nodule in 31 patients. The anteroposterior and transverse diameter ratio (A/T) on axial view, A/L on sagittal view, and L/T on coronal view were measured and calculated. A non-parametric method was used to draw the receiver operating curve of A/T, A/L and L/T. The mean and standard deviation of CT diameters in benign and malignant nodules were calculated. The area under the curve, sensitivity, specificity and diagnostic accuracy, positive predictive value and negative predictive value were determined. CT manifestations of small benign and malignant thyroid nodules were also analyzed. Results The A/T and A/L ratio were significantly larger for PTMC than benign nodules (P<0.01), while L/T diameters were significantly smaller than the benign nodules (P<0.01). The area under ROC was 0.8841, 0.7676 and 0.4052 for A/T, A/L and L/T respectively. The best diagnostic cutoff value of A/T and A/L were 1.05 and 1.0. With A/T ≥ 1.05, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 88.00%, 84.81%, 86.36%, 84.62% and 88.12%, respectively. With A/L ≥ 1.0, the sensitivity, specificity, accuracy, positive predictive value and negative predictive values were 66.67%, 82.28%, 74.68%, 78.13% and 72.22%, respectively. CT characteristics of PTMC included superficial location, oval low density, blurry boundary, microcalcification and progressive enhancement with accuracy of 71.43%, 50.00%, 79.22%, 68.83% and 90.91%, respectively. Conclusion The cutoff values of A/T ≥ 1.05 and A/L ≥ 1.0 can be used to diagnose PTMC with high accuracy.

ObjectiveTo assess the diagnostic value of dual-energy dual-source CT in detecting the enhancement ofhepatocellularcancer( HCC )aftertransarterialchemoembolization( TACE )treatment.Methods Twenty-seven patients with HCC underwent dual-energy dual-source CT including nonenhanced,arterial,portal,and delayed phases scanning after TACE treatment.Arterial phases were acquired with the dual-energy mode for reconstruction of virtual nonenhanced images and color overlay images.DSAs were performed in all these patients.Two blinded and independent readers evaluated the data in 2 reading sessions:standard nonenhanced,arterial phase,portal phase,and delayed phase images were read in session A,and virtual nonenhanced,arterial phase,portal phase,and delayed phase images in session B.Sensitivity and specificity were calculated,with the DSA data set as the reference standard.The sensitivity and specificity were compared with Chi-square test.Results DSA revealed 63 lesions in 27 patients,and 39 of them had blood supply.Overall sensitivity and specificity were 74.4％ (29/39) and 83.3％ (20/24) for session A,and 94.9％ (37/39),95.8％ (23/24) for session B,respectively.The sensitivity of the two reading sessions was significantly different (x2 =6.303,P ＜ 0.05 ),while the specificity was insignificantly different ( x2 =2.009,P ＞ 0.05 ).Conclusion Compared with standard dynamic protocols,an arterial dual-energy dual-source CT scan with reconstruction of virtual nonenhanced and color overlay images enables detection of relapse and intrahepatic metastasis of HCC after TACE treatment with higher accuracy.

Objective To investigate the epidemiological characteristics of gonorrhea,and to analyze its temporal-spatial clustering in Zhejiang province.Methods Data on the incidence and demographic characteristics of gonorrhea in Zhejiang province from January 2004 to December 2012 were obtained from the China Information System for Disease Control and Prevention.The population,time and space distributions of gonorrhea were described.Epidemic curve and incidence maps were drawn.A space-time permutation scan statistic was used to detect space-time clusters,and spatial autocorrelation analysis was performed to calculate the Moran's I value and draw Local Indicators of Spatial Association (LISA) cluster maps.Results In Zhejiang province,a total of 199 956 cases of gonorrhea were reported with a decreasing trend in incidence rate from 2004 to 2012.The male to female ratio was 3.51:1 (155 634/44 331).People aged between 25 and 60 years accounted for 75.21％ of these patients,whereas the constituent ratio of people aged 0-1 years and ＞ 60 years increased with time.The incidence rate of gonorrhea was significantly higher in middle and north parts than in the south part of Zhejiang province,and higher in summer than in winter and spring with the peak incidence observed in August.Thirteen temporal-spatial clusters were detected,with the large clusters in Hangzhou,Huzhou,Ningbo,Shaoxing and their neighbor counties/cities/ districts,as well as some counties/cities/districts in Jinhua.All of the above clusters lasted 4.5 years.LISA maps showed an increasing trend in high-high aggregation counties/cities/districts which spread from the north to south part of Zhejiang province.Conclusion There is a temporal-spatial aggregation of gonorrhea in Zhejiang province with young and middle-aged men as the main affected population.