Objective To study the long term results of condylar reconstruction using pedicled patella in the treatment of giant cell tumor of lower femur. Methods From August 1964 to December 1996, 6 patients with giant cell tumor in the lateral condyle of femur were treated with unicondylar resection curettage and reconstruction with pedicled patella autograft. There were 3 males and 3 females. The average age of the pateints was 30.5 years. The operative indications were as the following: tumor was located in one condyle, complicated with pathological fracture or the tumor had invaded underneath cartilage which was difficult for curettage. Surgical procedure included: Lateral condyle resection according to X ray or CT image, curettage of the possible remaining tumor tissues in the medial condyle. A muscle pedicle of 2.5 cm wide from the quadriceps was raised with the patella, then the articular surface of patella was used to reconstruct the articular surface of femoral condyle, ilium graft(sometimes allograft) was used to fill the defect proximal to the patella. The grafts was fixed by screws and(or) plates. Anterior cross ligament was fixed to the patella. Results 6 patients were followed up for a mean period of 136 months. There were no infection, recurrence, metastasis and instability. All patients could walk for a long distance. The range of motion of the involved knees was between 80? and 120?. There was no varus deformity under stress test, but about 5 degrees valgus deformity under stress test could be found in some, muscle strenth was 5 grade. Conclusion Pedicled patella autograft is a good method for the treatment of giant cell tumor that invades unilateral condyle of lower femur, it is specially suitable to the patients with pathological fracture or severe destruction underneath the cartilage. Thorough resection and curretage of the tumor, preserving the blood supply of patella, refixing the cross ligament, and lower placement of patella are the key points to obtain the satisfactory results.

Objective To research the clinical outcome of atypical glandular cell (AGC)according to various subtypes of HPV infection and histological pathology results.Methods The data of the liquid-bases cytology (LBP),HPV infection and histology in 102 cases of AGC at the gynecology outpatient department of our hospital from January 1 ,2009 to February 28,2014 were collected and performed the analysis on their clinical outcomes.Results Among 67 218 cases of LBP detection,102 cases were AGC with the total incidence rate of 0.15%.In the cases of AGC-NOS,67 cases were normal or benign lesions,11 cases were precancerous lesion and malignant lesions;in the cases of AGC treading to tumor,the benign,precancerous and malignant lesions were in 7,14 and 3 ca-ses respectively.At the same time in the cases of AGC-NOS,HPV infection was in 64 cases,in which 57 cases were high risk infec-tion(type 16,52,45)and 7 cases were low risk infection(type 6,11 ).The single infection,double infection and multiple infection were in 54,6 cases respectively;in the cases of AGC trends to neoplasm,HPV infection was in 19 cases,in which 18 cases were high risk infection(type 52,16,18)and 1 case was low risk infection(type 6),single infection and double infection were in 15 cases and 4 cases respectively.Conclusion AGC may play an important role for the forecast of cervical malignant lesions.The results of differ-ent HPV subtypes infection in AGC related tumors also play a certain role in the prediction of cervical neoplasia.Their combined a-nalysis is the important signal for judging the occurrence of gynecological cervical precancerous lesion and malignant tumor,i.e., AGC combining with the corresponding HPV subtype infection not only can make a judgement for the cervical lesions,but also pro-vides the basis for predicting the high risk existence of gynecological malignant tumor and provides constructive suggestions for Chi-na regional cervical carcinoma vaccine manufacturing and promotion.

Objective To report the result of analysis of 72 cases of facial cutaneous sporotrichosis. Methods Seventy-two patients were included in this study. They were diagnosed as facial cutaneous sporotrichosis according to clinical mainfestations and fungal culture. Histopathological examinations were done in some atypical cases. The patients were treated with combined antifungal agents. Results The lesion forms were varied, in which lymphangitic cutaneous form accounted for 9.72% and fixed cutaneous form accounted for 90.28% respectively. Nineteen cases (26.4%) had a history of skin trauma before the cutaneous lesions. All of the patients were successfully treated with potassium iodide and/or itraconazole, terbinafine for 6-8 weeks. Conclusions The skin lesions and mycological examination are the important evidences for the diagnosis of sporotrichosis. The main form of the facial cutaneous sporotrichosis is the fixed cutaneous form. The misdiagnosis rate is 16% in primary level clinics. Potassium iodide is an effective and inexpensive medicine in the treatment of cutaneous sporotrichosis.

objective Using iodimetric analysis of dual-energy CT,to explore the dual perfusion amount and proportion of hepatic artery and portal vein in different hepatic lobes on normal living bodies.Methods A total of 77 patients without hepatic diseases underwent contrast-enhanced upper abdomen dual-energy CT scanning.The raw data were transferred to the workstation for postprocessing.ROI were selected,then the iodine content in arterial phase,portal phase and delay phase were calculated automatically.The differences of these measures (iodine content and hepatic artery to portal vein perfusion ratio of the left hepatic lobe,right hepatic lobe and caudate lobe) in the left,fight and caudate lobe of liver were detected by using ANOVA test.Results The iodine concentration in the caudate lobe was(851 ± 35)μg/L from hepatic artery and (2912 ± 78) μg/L from portal vein.The iodine concentration in the left hepatic lobe was (445 ± 34) μg/L from hepatic artery and (2373 ± 77) μg/L from portal vein.The iodine concentration in the right hepatic lobe was(504 ± 30)μg/L from hepatic artery and(2515 ± 78) μg/L from portal vein.The perfusion condition (amount of blood supply) of caudate lobe showed a significant statistic difference from the left and right hepatic lobe (P ＜ 0.05),and the amount of blood supply from both sources were more than those of the left and fight hepatic lobes.There was no significant statistic difference in the amount of hepatic artery and portal vein blood supply between the right and left hepatic lobe(P ＞ 0.05).The proportions of blood supply from hepatic artery and portal vein (hepatic artery/portal vein) were different among the three hepatic lobes,which was (28.41 ± 3.42) ％ in left lobe,(35.76-± 5.80) ％ in fight lobe and (49.92 ±4.63)％ in caudate lobe,respectively(F =5.36,P ＜0.01).Conclusion Dual-energy CT can be used to study the dual-perfusion condition of the liver.On normal living bodies,the hepatic artery and portal vein perfusion in caudate lobe are different from those in left and right lobes.

Objective To investigate the causes of hypothermia in severe trauma patients as well as the effects of warming nursing.Methods Toally 100 severe trauma patients with hypothermia were engaged in the study during January to December 2014.Their temperature was monitored and recorded,the causes analyzed so that the warming nursing measures were done to them.Results Among the 100 patients,59 contracted hypothermia,with the rate of 59.0％ before operation,28 contracted hypothermia during operation,with the incidence rate of 28.0％.The causes of hypothermia included injury,anaesthesia,exposure and fluid resuscitation.The nursing measures included pre-treatment before anaesthesia,avoidance of more exposure and intraoperative warming.Conclusions For the patients with severe trauma,the hypothermia during the operation can be caused by injury,anaesthesia,exposure and fluid resuscitation.The warming nursing can reduce the incidence of hypothermia so as to increase their survival rate.

Spectrophotometry and single factor test were used in the investigation of effects on extraction results of total flavonoids from the fruit ofVernonia esculenta Hemsl. from aspects of ethanol concentration, frequency of extraction, length of extraction time, and the solid-liquid ratio. The extraction conditions were optimized by orthogonal test. The results showed that the optimum extraction conditions were ethanol concentration of 70%, extracted for 4 times, 1 h for each time, and the solid-liquid ratio of 1:20. Under these extraction conditions, the content of total flavonoids in the fruit ofVernonia esculenta Hemsl. was 103.55 mg·g-1.

ObjectiveTo investigate the therapeutic effectiveness of low-power laser on myofascial pain syndrome. Methods73 self-controlled patients with myofascial pain syndrome were irradiated on myofascial trigger points with Nd:YAG laser in wavelength 830nm, power 500mW, 20 minutes per day for 5 times. At pre-and post-treatment,pain intensity and pressure pain of myofascial trigger points were checked. ResultsAfter treatment, score of pain intensity was reduced signficantly from (7.24±2.41) to (2.21±1.22) (P<0.001). The pressure pain of myofascial trigger points were improved . Conclusions Low-power laser can reduce the pain intensity and increase the pressure pain threshold of myoficial trigger points.

Objective To identify risk factors of perforation in acute appendicitis. Methods Patients with acute appendicitis who underwent surgical treatment from 2016 January to 2017 December were retrospectively reviewed. According to clinical and pathological records, patients were divided into perforation group (including 150 patients) and non-perforation group (including 157 patients). The progress of disease, duration from occurrence to surgery, preoperative highest temperature and pulse rate, and a series of indicators including WBC, NCP, LCP, HCT, CRP, TP through blood routine or biochemical assays. Logistic regression analysis was adopted to analyze the risk factors of perforation were compared. Results Preoperative highest temperature, pulse rate, WBC, NCP, LCP and CRP in perforation and non-perforation group were (37.98 ± 0.54) ℃ vs. (37.58 ± 0.52) ℃, (94.94 ± 20.74) times/min vs. (87.41 ± 15.35) times/min, (15.25 ± 4.71)×109/L vs. (11.04 ± 4.29)×109/L, (83.06 ± 9.84)% vs. (75.27 ± 13.71)%, (11.76 ± 3.73)% vs. (18.23 ± 5.72)%, (89.35 ± 23.10) mg/L vs. (52.16 ± 18.46) mg/L, respectively. There existed significant differences between the two groups (P＜0.05). Logistic regression analysis showed that WBC ( OR＝1.185, 95% CI 1.090-1.280), CRP( OR＝2.043, 95% CI 1.243-2.843), the preoperative highest temperature ( OR＝2.007, 95% CI 1.114-3.616), and pulse rate ( OR＝1.160, 95% CI 1.124-1.196) were risk factors of perforation in patients with acute appendicitis (P＜0.05). The Hosmer-Lemeshow test proved that the predictive accuracy rate of the Logistic model was up to 79.1%. Conclusions WBC, CRP, the preoperative highest temperature and pulse rate are risk factors, which contributes to predict the risk of perforation in patients with acute appendicitis.

OBJECTIVETo assess the platelet and plasma concentrations of fibronectin (Fn) and fibrinogen (Fg) in congenital fibrinogenopenic (FgP) patients and explore their role in inducing platelet adhesion and aggregation.

METHODSA FgP family was selected as study group and the platelets isolated and purified to assess concentrations of Fn and Fg in platelets, alpha-granules and plasma with Western blotting, immuofluoresence staining and flow cytometry (FACS), respectively, the expression of platelets GP II b/III a by FACS.

RESULTSThe concentration of platelets Fn in FgP patients is higher than that in controls, and is higher in homozygote than in heterozygote. In contrast, plasma Fn levels were identical in all samples. The amount of platelet Fg from FgP patients is lower than that from the controls and positively correlated with the concentration of their plasma Fg. No difference in the expression of platelet GP II b/III a had been found.

CONCLUSIONIt suggested that increased platelet Fn could partially compensate the lack of Fg and lead the platelet adhesion and aggregation.

Afibrinogenemia ; congenital ; metabolism ; pathology ; Blood Platelets ; metabolism ; pathology ; Cell Adhesion ; physiology ; Female ; Fibrinogen ; genetics ; metabolism ; Fibronectins ; blood ; genetics ; metabolism ; Heterozygote ; Homozygote ; Humans ; Male ; Pedigree ; Platelet Aggregation ; physiology ; Platelet Membrane Glycoproteins ; metabolism

BACKGROUND AND OBJECTIVEHuman achaete-scute homolog 1 (hASH1) gene plays a critical role in development of the central nervous system, automatic nervous system, adrenal medullary chromaffin cells, thyroid C cells and pulmonary neuroendocrine cells. The aim of this study is to determine hASH1 gene expression in the normal lung tissue and various types of lung tumors, to analyze whether its expression correlated with pulmonary neuroendocrine markers, and to explore the possibility of hASH1 as clinical pathological markers in the neuroendocrine tumors compared with previous neuroendocrine tumor markers.

METHODShASH1, Chromogranin A, Synaptophysin and CD56 expression were examined in lung tumor specimens (lung inflammatory pseudotumor, squamous cell carcinoma, adenocarcinomas, large cell carcinoma, typical carcinoids, atypical carcinoids, large cell neuroendocrine carcinomas and small cell lung carcinoma and corresponding normal lung specimens) using immunohistochemistry (S-P method). Western blot and reverse transcription polymerase chain reaction (RT-PCR) assay were applied to detect the expressions of hASH1 protein and mRNA in lung cancer tissues.

RESULTShASH1 expression was positive in 2/16 (12.5%) typical carcinoids, 15/20 (75%) atypical carcinoids, 6/10 (60%) large cell neuroendocrine carcinomas and 31/40 (77.5%) small cell lung carcinoma, respectively, but not in any normal lung tissue (0/10), lung inflammatory pseudotumor (0/49), squamous cell carcinoma (0/30), adenocarcinomas (0/30) or large cell carcinoma (0/20). There was a significant difference in hASH1 expression between typical carcinoids and atypical carcinoids (P < 0.01), but not in large cell neuroendocrine carcinomas and small cell lung carcinoma (P > 0.05). hASH1 expression highly closely correlated with Chromogranin A, Synaptophysin and CD56 expression (P < 0.05).

CONCLUSIONhASH1 is a new kind of highly specific markers of pulmonary neuroendocrine tumours, and may be applied to clinical pathology diagnosis of the pulmonary neuroendocrine tumors.

Adenocarcinoma ; genetics ; metabolism ; pathology ; Basic Helix-Loop-Helix Transcription Factors ; genetics ; metabolism ; Carcinoma, Large Cell ; genetics ; metabolism ; pathology ; Carcinoma, Neuroendocrine ; genetics ; metabolism ; pathology ; Carcinoma, Squamous Cell ; genetics ; metabolism ; pathology ; Gene Expression Regulation, Neoplastic ; genetics ; physiology ; Humans ; Immunohistochemistry ; Lung Neoplasms ; genetics ; metabolism ; pathology ; Neuroendocrine Tumors ; genetics ; metabolism ; pathology ; Reverse Transcriptase Polymerase Chain Reaction ; Small Cell Lung Carcinoma ; genetics ; metabolism ; pathology