Child, Preschool ; Chronic Disease ; Humans ; Male ; Tuberculosis, Miliary

Objective To summarize the management of scrotal gangrene.Methods Totally,14 male patients (mean age,48 years;age range,27-74 years) with scrotal gangrene were treated from August 2003 to June 2005.Among these patients,scrotal gangrene was complicated by perianal and penile gangrene in 2 cases;by perianal,penile and inguinal gangrene in 10 cases;by perianal,penile,inguinal gangrene and abdominal subcutaneous gangrene in 2 cases.Three cases had concomitantly necrosis of the penis;and 5 ca- ses,orchitis.Bacterial cultures were performed in all 14 cases with the positive results.All patients underwent surgical treatment,including PhaseⅠincisions,aggressive debridement,drainage,irrigation,and scrotoplas- ty.After operation they received antibiotic therapy and supporting treatment.Three cases of penile necrosis underwent complete penis amputation and transplanting the urethra before the anus.Five cases of orchitis un- derwent unilateral orchiectomy.Two cases of abdominal gangrene underwent surgical subcutaneous treatment, including incision,aggressive debridement,drainage,and irrigation.Results Twelve cases undergoing scrotoplasty achieved PhaseⅠhealing.Two cases undergoing urethral fistulation recovered well.Ten cases of penile skin gangrene received penile dermatoplasty 1 month later,and then recovered.Two cases who had al- ready had AIDS died 2 or 3 d after operation.Conclusions The management of scrotal gangrene primarily consists of early and aggressive debridement,antibiotic therapy and supporting treatment.The PhaseⅠde- bridement and scrotoplasty as well as drainage are effective for the treatment of scrotal gangrene.

OBJECTIVETo investigate the clinicopathological features of multiple mucosal neuromas without multiple endocrine neoplasia type IIB (non-MEN-IIB MMN).

METHODSThree cases of non-MEN-IIB MMNs were analyzed for the clinical manifestations and histopathological characteristics.

RESULTSAll the 3 cases were females, age ranging from 30 to 45 years. Two cases of them involved in the laryngopharyngeal mucosa and another one located in the left margin of the tongue. Clinically, non-MEN-IIB MMNs presented with uncertain foreign body sensation, itching, vomiting and causalgia in the laryngopharyngeal areas. Mucosal papular lesions were treated by laser ablation or local surgical excision. The cases were respectively followed up for 6 to 20 months and found nothing. Histological examination showed the lesions were not encapsulated and contained irregular tortuous nerve bundles with undefined perineurium in the lamina propria. There were no nuclear palisade. Immunophenotype showed tumor cells strongly positive for vimentin, S-100, myelin specific enolase, CD56, neurofilament and neuron specific enolase, uniformly negative to CD34, CD117 and epithelial membrane antigen.

CONCLUSIONSNon-MEN-IIB MMN is a very rare disease and the possibility of MEN-IIB should be excluded before making diagnosis. The lesions located in the mucosal tissue with polyp-like or papular appearance, so they should be differentiated from other neoplasms or non-neoplastic lesions.

Adult ; Female ; Humans ; Middle Aged ; Multiple Endocrine Neoplasia Type 2b ; pathology ; Neuroma ; pathology

OBJECTIVETo investigate the medium-term curative effects of locking proximal humerus plate for the treatment of comminuted fractures of proximal humerus, and provide evidences for the clinical practice.

METHODSFrom August 2005 and April 2008, 23 patients with comminuted fractures of proximal humerus were treated with locking plates, including 12 males and 11 females, aged 27 to 76 years old (averaged 51.5 years old). There were 18 cases of traffic accident injuries, 4 cases of falls injuries, and 1 case injured after heavy pressure. According to Neer classification, 11 cases were three-part fractures, and 12 cases were four-part fractures. Outcomes were assessed with radiography and the Constant-Murley (C-M) shoulder evaluation.

RESULTSAll the patients got primary healing of incisions. Twenty-three patients were followed up, and the duration ranged from 17 to 49 months, with an average of 35.25 months. Twenty patients had fracture healing during 4 to 7 months after operation. There was no significant differences among 3, 6 and 12 months after operation in C-M scoring. The average C-M score was (79.85 +/- 17.23) points (38 to 100 points) at the 12th month after operation, 8 cases got an excellent result, 8 good, 5 fair, and 2 poor. In the LPHP plus bone graft group 6 cases got an excellent result, 4 good, 3 fair, and 1 poor; in LPHP fixation group 2 excellent, 4 good, 2 fair,and 1 poor.

CONCLUSIONThe medium-term curative effect of the locking proximal humerus plate in the treatment of proximal humeral fractures is significant. For the comminuted fractures of proximal humerus combined with osteoporosis and bone defects, bone graft should be performed routinely.

Adult ; Aged ; Bone Plates ; Bone Transplantation ; Female ; Fracture Fixation, Internal ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Shoulder Fractures ; surgery

OBJECTIVETo study the clinicopathologic features of follicular dendritic cell sarcoma (FDCS) and its differential diagnosis.

METHODSTen cases of FDCS were studied by light microscopy, immunohistochemistry and in-situ hybridization. The clinical features and follow-up information were analyzed.

RESULTSAmongst the 10 cases of FDCS studied, the male-to-female ratio was 1:1. The mean age of the patients was 42 years. Six of them were located in cervical and peritoneal lymph nodes and four in extranodal sites (including tonsil, pelvic cavity, tail of pancreas and spleen). Histologically, the tumor cells had whorled, storiform or diffuse growth patterns. They were spindle in shape and contained syncytial eosinophilic cytoplasm, with round or oval nuclei, vesicular chromatin, distinct nucleoli and a variable number of mitotic figures. Multinucleated tumor giant cells and intranuclear pseudoinclusions were occasionally seen. There was a sprinkling of small lymphocytes and neutrophils within the tumor as well as in the perivascular region. Immunohistochemical study showed that the tumor cells were diffusely or focally positive for CD21, CD23, CD35 and D2-40, but negative for LCA, CD20, CD3, CD1a, HMB45 and CK. Some of them showed EMA, CD68 and S-100 reactivity. In-situ hybridization for Epstein-Barr virus-encoded RNA (EBER) showed positive signals in only one case (which was diagnosed as inflammatory pseudotumor-like FDCS). Of the 7 patients with follow-up information available (duration: 2 months to 39 months; mean: 14 months), 2 cases with paraneoplastic pemphigus died of pulmonary infection at 5 and 7 months respectively. The remaining 5 patients were alive and disease-free after surgical excision (+/- chemotherapy and radiotherapy).

CONCLUSIONSFDCS is a rare low to intermediate-grade malignant tumor. Appropriate application of FDC markers, such as CD21, CD35 and D2-40, would be helpful for arriving at a correct diagnosis. Most cases are associated with good prognosis after surgical treatment, with or without chemotherapy and radiotherapy. Patients with paraneoplastic pemphigus carry a less favorable prognosis.

Adult ; Antibodies, Monoclonal, Murine-Derived ; metabolism ; Dendritic Cell Sarcoma, Follicular ; complications ; metabolism ; pathology ; surgery ; Dendritic Cell Sarcoma, Interdigitating ; pathology ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; surgery ; Male ; Meningioma ; pathology ; Middle Aged ; Nasopharyngeal Neoplasms ; pathology ; Paraneoplastic Syndromes ; complications ; Pemphigus ; complications ; Receptors, Complement 3b ; metabolism ; Receptors, Complement 3d ; metabolism ; Receptors, IgE ; metabolism ; Tonsillar Neoplasms ; metabolism ; pathology ; surgery ; Young Adult

OBJECTIVETo analyze the therapeutic effect and the influencing factors of event-free survival (EFS) of childhood acute lymphoblastic leukemia (ALL) in Xiangya Hospital of Central South University and the First Affiliated Hospital of Guangxi Medical University.

METHODSAll the patients adopted chemotherapy according to therapeutic guideline revised by the Subspecialty Group of Hematology, The Society of Pediatrics, Chinese Medical Association for the second-time in 1998 (the Rongcheng ALL-98 Protocol). Kaplan-Meier method was used to estimate the survival rates of 188 patients who received therapy with good compliance. The differences of EFS between groups were assessed by Log-rank test. The independent influencing factors on EFS were analyzed by the Cox proportional hazards regression model.

RESULTSAfter receiving inductive treatment, 354 of 374 (93.6%) patients demonstrated a complete remission; 188 patients who received complete courses of treatment with good compliance showed (68.1 +/- 5.6)% five-year EFS. Meanwhile, the five-year EFS in standard-risk (SR) group and high-risk (HR) group were (75.2 +/- 6.0)% and (47.6 +/- 11.6)%, respectively. The total relapse rate was 10.6% and the median time to relapse was 13 months. Twenty-nine of 188 patients (15.4%) were dead, and 13 patients (7.0%) died from treatment-related complications. Independent adverse prognostic factors included risk grouping, t (9; 22)/bcr-abl gene and leukocyte count.

CONCLUSIONSThe total EFS of childhood ALL patients treated with Rongcheng ALL-98 Protocol in two hospitals was close to 70%. Therefore, it is necessary to evaluate risk factors and consider the grouping in more detail to reduce the treatment-related mortality and to increase the compliance of treatment which can ultimately improve the EFS.

Adolescent ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Child ; Child, Preschool ; China ; epidemiology ; Disease-Free Survival ; Female ; Humans ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; epidemiology ; mortality ; Prognosis ; Survival Rate ; Treatment Outcome

To study four A(3) subgroup samples identified by serologic tests, among which two belong to a family, three were A(3) subgroup, one was A(3)B subgroup. All four samples were genotyped by PCR-SSP method, and the nucleotide sequences of Exon 6, Exon 7 and part introns at the ABO locus for these samples were detected by ABI Prism 3100 DNA sequencer. Comparison with the consensus of A101 was performed. The results showed that haplotypes of two A(3) subgroups were common A102 allele and O1-2 allele, and haplotypes of one A(3) subgroup were common A102 allele and rare O(1v)-4 allele. Unexpectedly, a synonymous substitution 838C-->T had been found in A allele of the A(3)B subgroup sample, which predict a Leu280Phe alteration. The results suggested that molecular genetic background of the A(3) phenotypes is polymorphic. Possibly, the missense mutation 838C-->T is the molecular genetic basis of A(3)B subgroup that lead to low activity of the glycosyltransferases.
ABO Blood-Group System ; genetics ; Alleles ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; China ; DNA Mutational Analysis ; Exons ; Genotype ; Humans ; Introns ; Mutation ; Phenotype ; Polymerase Chain Reaction

OBJECTIVETo study the relationship between nasal carriage and Staphylococcus aureus (S. aureus) infection in hospitalized children.

METHODSFifty-six hospitalized children infected with S. aureus were recruited in this study. Nasal swabs were collected and cultured, and the nasal carriage rate of S. aureus was examined. PVL virulence gene and mecA resistance gene were both detected in clinical strains and nasal carriage strains by PCR.

RESULTSTwenty-two (39%) of the 56 children had nasal carriage of S. aureus, and most of them (18 cases) were younger than one year. Among these 22 children, 11 (50%) had previous hospitalization over the past year. In the infected strains, the rate of methicillin-resistant S. aureus (MRSA) was 29% (16/56), while it was 32% (7/22) in carriage strains. The mecA positive results in clinical strains were consistent with the results in nasal carriage strains. Among 5 PVL-positive nasal carriage strains, 4 (90%) could be matched with their clinical strains, all of which were MRSA.

CONCLUSIONSNasal carriage is a potential risk factor for S. aureus infection. Nosocomial transmission may lead to nasal carriage, which can cause S. aureus infection. The isolation rate of MRSA is high in hospitalized children infected with S. aureus, which implies that more attention is needed for this situation. The isolates from noses may be clonally identical to the isolates from clinical secretions, and the homology between them needs to be confirmed by multi-locus sequence typing.

Bacterial Proteins ; genetics ; Carrier State ; microbiology ; Child ; Child, Hospitalized ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Methicillin-Resistant Staphylococcus aureus ; isolation & purification ; Nose ; microbiology ; Penicillin-Binding Proteins ; Staphylococcal Infections ; microbiology ; Staphylococcus aureus ; isolation & purification

OBJECTIVETo study the clinical outcomes of stage I testis teratoma, including pure teratoma, and to provide information on the treatment options for this disease.

METHODSWe retrospectively analyzed 27 cases of orchiectomy for stage I testis teratoma, excluding epidermoid cyst, and investigated its recurrence associated with treatment methods and clinicopathological factors.

RESULTSFour of the 27 cases relapsed, all in the orchiectomy group and confined to the retroperitoneal region, 3 with and the other 1 without risk factors, but with no death. No recurrence was found in those treated by orchiectomy followed by chemotherapy with bleomycin, etoposide and platinum (BEP). The total rate of recurrence was 15.8%. No severe side effects were observed in the 9 patients undergoing adjuvant BEP chemotherapy.

CONCLUSIONRisk factors may increase the recurrence rate of stage I testis teratoma, while postoperative adjuvant chemotherapy can reduce it, including that of pure teratoma, though surveillance policy remains the most popular option after orchiectomy.

Adolescent ; Adult ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; pathology ; Neoplasm Staging ; Retrospective Studies ; Teratoma ; pathology ; therapy ; Testicular Neoplasms ; pathology ; therapy ; Young Adult

OBJECTIVETo study the ABO allele molecular characteristics of Ael blood subgroup.

METHODSFive individuals of diagnosed as Ael blood subgroup were subjected to PCR amplify ABO alleles using four pairs of sequence-specific primers. Exon 6 and exon 7 at ABO locus of all samples were sequenced. An individual with AelB phenotype was chosen for further analysis of transcript structure of ABO gene.

RESULTSSequence analysis indicated one Ael phenotype sample with reported Ael01 allele, one Ael phenotype sample with an Ael05 allele, and two AelB and one Ael individuals did not contain referred A allele, but contain O01 or O02 allele with 261G deletion.

CONCLUSIONMolecular bases for the Ael have highly polymorphism. The mechanism responsible for the express weak A antigen of O allele with 261G deletion awaits to be elucidated.

ABO Blood-Group System ; genetics ; Alleles ; Base Sequence ; Cloning, Molecular ; DNA ; analysis ; Female ; Humans ; Male ; Molecular Sequence Data ; Polymerase Chain Reaction ; Polymorphism, Genetic