Background and Purpose:The objective of this study was to assess the value of tumor markers and clinical characteristics in making a differential diagnosis between mature cystic teratoma(MCT) and its malignant transformation(MT).Methods:176 patients with mature cystic teratoma of the ovary diagnosed by postoperative pathology were treated in our hospital between 1997 and December 2004,the authors studied their clinicopathologic data and tested several serum tumor markers.Results:170 were MCT,the mean age was 35.8,the mean tumor size was 8.8cm,153 were tested for CA125,the mean serum CA125 level was 33u/ml,37 with serum CA125 level over 35u/ml;140 for tested CA19-9,the mean serum CA19-9 level was 217u/ml,77 with serum CA19-9 level over 37u/ml;112 tested for SCC,the mean serum SCC level was 1.82ng/ml,29 with serum SCC level over 1.5ng/ml;115 tested for CEA,the mean serum CEA level was 1.42ng/ml,8 with serum CEA level over 5ng/ml;6 cases were malignant transformation,the mean age was 47,the mean tumor size was 17.6cm,the mean serum CA125 level was 500u/ml,5 with serum CA125 level over 35u/ml,the mean serum CA19-9 level was 609.8u/ml,5 with serum CA19-9 level over 37u/ml,the mean serum SCC level was 23.4ng/ml,5 with serum SCC level over 1.5ng/ml,the mean serum CEA level was 22.8ng/ml,4 with serum CEA level over 5ng/ml.There were significant differences in age,tumor size and levels of the serum tumor markers between MCT and MT.(P

Objectives To investigate the effects of orthotopic liver transplantation (OLT) plus non-biologic artificial liver support system (NBALSS) on fulminant liver failure(FLF), and efficiency of NBALSS on the preoperative preparation of OLT. Methods Seven FLF patients received OLT after 2 to 20 sessions of NBALSS therapy while waiting donor liver.Results Decreased serum bilirubin, improved hepatic encephalopathy and ascites was achieved in all 7 cases after NBALSS. Five of 7 patients have survived for 3 to 20 months after OLT, of whom 3 have had excellent quality of life for more than 18 months. Two patients died of hepatorenal syndrome or of hepatorenal syndrome and serious pancreatitis. Conclusions OLT plus NBALSS is one of the most effective therapies for FLF, NBALSS can be used to tide the FLF patients over until a donor liver is available.

Objective To evaluate Tornwaldt′s cyst using MR imaging. Methods 1 452 cases with head MR imaging were reviewed. The signal intensity, shape, and size of the lesions were observed. Results Tornwaldt′s cyst were found in 18 of 1 452 cases (1 24%), all of the 18 cases were isointense to CSF on T 2WI and hyperintense to muscle on T 1WI.Tornwaldt′s cyst were round ( n =13)and ovoid ( n =5). The size of lesions were from 2 mm to 15 mm. There were 15 cases with adenoid hyperplasia. Conclusions Tornwaldt′s cysts occupied 1 24% in routine head MR imaging and were hyperintense to muscle on T 1WI and isointense to CSF ON T 2WI.

Objective To evaluate MR imaging diagnosis in acute suppurative osteomyelitis at early stage. Methods The axis, sagittal and coronal planes were performed with Philips 0.5 T superconduct MR scanner on 12 cases of acute suppurative osteomyelitis in lower extremity proved by clinical data 2 to 14 days after onset. Results Abnormal signals in marrow were displayed in all 11 cases 3 to 14 days after onset. No abnormality was found in 1 case 2 days after onset. The interface between normal and abnormal marrow became clear as time going on. The lesion presented as patchy low intensity on T 1WI and high signal on T 2WI. The signal changes were marked especially on STIR. Conclusion MRI was superior to other imaging methods in diagnosis of acute suppurative osteomyelitis.

Objective To identify and classify six isolates of swine-originated Trichinella from China. Methods Five specific pairs of primers were synthesized based on DNA sequence of expansion segment V region and internal tran-scribed spacers (ITS1 and ITS2) of ribosomal DNA repeat from Trichinella. International reference strains of five Trich-inella species [Trichinella spiralis (T1), T. nativa (T2), T. britovi (T3), T. pseudospiralis (T4) and T. nelsoni(T7)] were used as control. Six swine Trichienlla isolates from Henan, Yunnan, Harbin, Tongjiang of Heilongjiang, Hubei and Tianjin were identified by multiplex PCR and its effecting factors of PCR amplification were observed. Results Electrophoresis results of multiplex PCR products of Trichinella larvae showed that the band (173 bp) of the six isolates was the same as T. spiralis(T1). The specific band (173 bp) was detected by multiplex PCR through amplification from issues of single T. spiralis larva, the larvae conserved in 80% ethanol for 6 months, the larvae stored in 10% formaldehyde, in 0.05% formaldehyde, 0.2% sodium azide or 0.05% merthiotate for 2 weeks,or fresh mouse muscle with larvae. Conclusion All the six swine Trichinella isolates are identified as T. spiralis (T1) by multiplex PCR.

Objective To evaluate the valuations of the intracranial vertebrobasilar arteries using CT angiography (CTA) in order to improve the understanding of various variants in intracranial vertebrobasilar arteries.Methods The CTA images of 435 subjects were analyzed retrospectively.The data were collected by a 16-slice CT scanner.All the CTA images were processed technically by the maximum intensity projection and volume rendering.The intracranial vertebrobasilar arteries were measured and analyzed.Results Among the 435 subjects,bilateral intracranial vertebral arteries (V4) showed symmetry in 183 (42.07％) and dissymmetry in 252 (57.93％).Hypoplasia were found in 27 subjects (6.21％) on the left V4 segments and 36 (8.28％) on the right V4 segments,and a total of 21 (4.83％) were directly continued as the ipsilateral posterior inferior cerebellar arteries on the unilateral V4 segments.There were 2 subjects (0.46％) with vertebrobasilar dolichoectasia.There were 32 subjects (7.36％) had fenestration variation,3 of them (0.69％) were on the V4 segments,10 (2.30％) at the junctions,and 19 (4.37％) in the basilar arteries.Two subjects (0.46％) had persistent trigeminal arteries.Conclusions The variations of intracranial vertebrobasilar arteries mainly include angiodysplasia,vertebrobasilar dolichoectasia,fenestration variation,and persistent trigeminal artery.As a noninvasive vascular imaging method,CTA may accurately and visually assess the anatomic variation of intracranial vertebrobasilar artery,and provide imaging guidance for the preoperative evaluation of posterior fossa surgery.

Objective To investigate the impact of overweight and obesity on left atrial (LA) function in healthy subjects with excess body weight.Methods Conventional echocardiography and tissue Doppler imaging were performed in 30 obese subjects (BMI≥28 kg/m2),30 overweight subjects (BMI,24to 28 kg/m2) and 30 age-matched normal subjects (BMI＜24kg/m2).Strain (S),peak systolic strain rate (SSR),peak early diastolic strain rate (ESR) and peak late diastolic strain rate (ASR) values were used to evaluating LA function.Results Compared with controls,mean S,SSR and ESR were decreased in obese subjects,while mean SSR,ESR and ASR were decreased in overweight subjects.Compared with overweight subjects,mean ESR was decreased in obese subjects.Conclusions An impaired LA function is found in overweight and obese subjects who has no other clinically appreciable cause of heart disease by using strain and SR imaging.

Objective To observe the therapeutic effects of the drugs alternation multiple stages and long term therapy in elderly patients with recurrent urinary tract infection.Methods The patients were divided into elderly group (age≥65 years,n=30) and non-elderly group (n=48).The multiple effective antibiotics were selected for alternate use.The treatment included four periods as follows:(1)Treatment period:the regular dose of antibiotic was maintained until the urine routine test result became normal;(2)Consolidation period:the dosage of antibiotic was reduced;(3)Maintenance period:the dosage of antibiotic was reduced to once every night and the treatment should be kept for three months;(4)Observation period:the patients were observed for six months after withdrawal of antibiotics.During the treatment,if the urine routine test became abnormal repeatedly,the patient should return to the previous treatment period.During the treatment and consolidation period,each medication should be applied for one week alternatively.Results Among 78 patients,69 cases (88.5%) were cured,7 cases (8.9%) were effective,and two cases (2.56%) were invalid.There were 28 cured cases,1 effective case and 1 invalid case in elderly group.The corresponding data were 41,6 and 1 in non-elderly group,respectively.There was no difference in cure rate between the two groups (F= 0.469).Compared with non-elderly group,the overall treatment time [(54.8± 16.2)weeks vs.(44.5± 13.7) weeks,t= 2.8467,P＜0.01],treatment period [( 34.3± 15.2) weeks vs.(26.2±14.8) weeks,t=2.2081,P＜0.05] and consolidation period [(5.7±2.6) weeks vs.(4.1±0.2) weeks,t=3.9369,P＜0.01] were all prolonged in elderly group.But there was no difference in maintenance period [(14.8±4.6) weeks vs.(14.2±3.1) weeks,t=0.6480,P＞0.05].There were no markedly changes in blood routine,liver and kidney function during the course of treatment.Conclusions For the elderly patients with recurrent urinary tract infection,the drugs alternation,multiple stages and long-term treatment has a high cure rate and no adverse effect on blood routine,liver and renal function.

AIM:To observe the expression of Toll like receptor 4 (TLR4) in the left ventricle of Goldblatt rats and to explore the role and mechanism of TLR4 in left ventricular remodeling of hypertension.METHODS:Goldblatt model of Two-kidney,one-clip (2K1 C) renovascular hypertension was induced in twenty-five rats(H group),and twenty rats served the sham-operated group(sham group).The tail cuff blood pressure was detected every week and echocardiogram was observed every other week.After eight weeks of operation,the rats were killed and the samples of the left ventricle were collected.The concentration of Ang Ⅱ in left ventricle was assessed by tadioimmunoassay.Western blotting and RT-PCR were used to exam the mRNA and protein expression of TLR4 in the left ventricle.Immunohistochemistry was adopted to exam the location of TLR4 in the myocardium.RESULTS:TLR4 mRNA and protein expression were consistently upregulated in the left ventricle of H group compared with sham group.In H group, predominantly sarcolemmal staining was observed,especially focal areas of intense TLR4 staining were found in juxtaposed regions of two or more adjacent myocytes;However,in sham group,TLR4 expression was diffuse and presumably cytoplasmic.Considerable correlation was found between blood pressure,MESS,LVMI,RWT,the concentration of Ang Ⅱ in left ventricle and the protein expression of TLR4 in myoeytes.CONCLUSION:During the development of left ventricular remodeling of Goldblatt rats,expression of TLR4 increases significantly.Enhanced expression of TLR4 locates in the sarcolemma,especially in juxtaposed regions of two or more adjacent myocytes.These indicate that TLR4 transmembrane receptor which is closely relative with inflammation and immunity probably contributes to the development of ventricular remodeling.[KEY WORDS]Hypertension;Ventricular remodeling;Receptors,Toll-like;Goldblatt rats

Objective To assess isehemic myocardial regional function of different coronary atherosclerosis using velocity vector imaging(VVI).Methods Two-dimensional images of apical four-，two-chamber and long-axis view were obtained in 50 patients with coronary artery disease.All segments of the left ventricle were divided into 5 groups：group 0 with no coronary artery stenosis，group 1 with stenosis＜50%，group 2 with stenosis 50%to 74%，group 3 with stenosis 75%to 99%and group 4 with a completely occluded coronary artery.The segmental myocardial systolic peak strain(ε)，systolic strain rate(SRs)，early diastolic strain rate(SRe)，late diastolic strain rate(SRa)and their ratio(SRe/SRa)were analyzed with VVI offline software.Results①Compared with group 0，SRe and SRe/SRa of group 1，SRs，SRe，SRe/SRa of group 2～4，εof group 2 and group 4 decreased significantly(P＜0.05).②In the comparison of four ischemic groups，ε，SRe，SRa of group 3 were markedly higher than those of group 2，while ε，SRs，SRa of group 2 were lower than those of group 1(P＜0.05)；for group 4，ε，SRs，SRe were lower than those of group 1，SRe was lower than that of group 2，and ε，SRs，SRe were lower than those of group 3(P＜0.05).ConclusionsIn the process of coronary atherosclerosis，myocardial diastolic and systolic dysfunction occurred early and orderly，and has a bidirectional change：decreased firstly，then increased and decreased at last.