Objective To improve the diagnosis and treatment of benign renal tumor so as to avoid overtreatment.Methods The clinical data of 9 cases with benign renal tumor misdiagnosed as renal cell carcinoma treated from May 1999 to May 2011 were retrospectively analyzed.All cases were misdiagnosed as renal cell carcinoma with ultrasound or computed tomographic imaging before operation.Results All cases underwent surgical operation.For 1 case,frozen pathological test suggested a benign outcome.The tumor was enucleate accordingly.For another 7 cases,radical nephrectomy were performed.For the last 1 case,simple nephrectomy was performed.All cases were confirmed as benign by postoperative pathologic test,including 6 cases of renal angiomyolipoma,2 cases of renal oncocytoma,1 case of metanephric adeoma.Follow-up assessment lasted for (1-5) years without recurrence or metastasis.Conclusions It must be paid special attention to unique features which benign renal tumor shows in medical imaging.When the diagnosis is inconclusive,nephrectomy can be avoided by further intraoperative frozen pathological test to avoid overtreatment.

Objective To explore the clinical meanings of serum CA19-9 levd in hepatocirrhosis patients. Methods 61 hepatitis B and hepatocirrhosis patients were as treatment group, and 35 normal were as control group. The content of serum CA19-9 was measured by dectrochemistry lighting and the liver function was determined too. According to Child-Pugh liver function integral method,the treatment group was divided into 27 cases of A grade,20 cases of B grade and 14 cases of C grade. Results The serum CA19-9 level in hepatocirrhosis patients was higher than that of normal group significantly(P< 0. 005 ). The serum CA19-9 level decreaed obviously through the treat- ment,thereinto A and B grade fell evidendy in the Child-Pugh liver function integral method( P < 0. 005). C grade was not significantly different(P<0.05 ). The serum CA19-9 levd was positivdy associated with TBiL, ALT and AST of liver function integral method. Conclusion The serum CA19-9 levd of hepatocirrhosis patients is improved in different degrees. And it can be a prognostic target and used to estimate the degree of damage of liver function of hepatocirrhosis patients.

ABSTRACT:Objective To investigate the role of PAR2 in the visceral sensitivity of IBS patients by observing the expression of rectal PAR2 in patients with irritable bowel syndrome and the effect of exogenous PAR2 on visceral sensitivity.Methods Based on Rome III criteria,16 patients with constipation predominant IBS (IBS-C),18 patients with diarrhea predominant IBS (IBS-D ),and 1 8 controls were selected from our hospital inpatient and outpatient departments. All the patients received colonoscopic examination and rectal mucosa biopsies. The expression of rectal mucosa PAR2 was observed by immunohistochemistry and Real-time fluorescence quantitative PCR.We studied the abdominal reactions by administering the PAR2 agonist in the rectal mucosa of rats to explore whether PAR2 is involved in visceral sensitivity.Results The results of PAR2 immunohistochemistry showed that PAR2 was mainly expressed in intestinal epithelial cells,especially in the villi;in addition,endothelial cells were also found positive.While the integral optical density (IA)of PAR2 expression did not significantly differ between IBS-D or IBS-C patients and controls according to the IPP image analysis.The PAR2 mRNA level in IBS-D or IBS-C patients was not significantly different from that of the control group by Real-time PCR analysis.There was no significant difference between the IBS-D and IBS-C groups.The EMG activity significantly increased in a volume-dependent manner during the rectal balloon expansion in the PAR2 agonist group.However,there was little EMG activity when the balloon was not dilated.The area under the curve in the PAR2 agonist group with 0 mL,0.4 mL and 0.6 mL of distension volume did not differ compared with that of the vehicle group.When the balloon volume increased to 0.8 mL,1.0 mL and 1.2 mL,the EMG activity was statistically significant (P<0.01)in the PAR2 agonist group compared with the control group.Conclusion PAR2 is highly expressed in the rectal mucosa of IBS patients.Administration of exogenous PAR2 agonist increases visceral sensitivity,suggesting that PAR2 is involved in visceral sensitivity.

Objective:To study the anatomic basis of superior trapezius myocutaneous and spina scapulae osteomyocutaneous flaps pedicled with transverse cervical vessel.Methods:The blood vessels,the size of the superior trapezius muscle and the spina scapulae were dissected and examined in 32 adult corpses.Results:The superior trapezius muscle was in the shape of trapezium.The border length (mm) of A,B,C and D was 174.63,157.18,86.98 and 80.95 in average respectively.The area of the muscle was 126.78 cm2 on the average.The spina scapulae was 131.21 mm in average length.The length (mm) of transverse cervical artery trunk, superficial cervical artery trunk and its ascending artery,spina scapulae branch artery was 42.50,27.80,43.12,28.75 in average,their external diameter(mm) was 2.71,2.39,1.96 and 0.50 respectively.Entering the muscle,the ascending artery had 3～6 branches with the external diameter of 0.5 mm or more.The venous vessels were following the copartner artery.Conclusion:The superior trapezius muscle and the spina scapulae may be made for the myocutaneous and osteomyocutaneous flaps pedicled with transverse cervical artery used in oral and maxillofacial reconstruction.

Objective To explore the psychological status of patients after hand tenolysis and the pertinent nursing countermeasures. Methods 47 patients after hand tenolyais were selected and investigated their psychological status and relevant influencing factors with serf-designed questionnaire and symptom checklist-90(SCL-90). Besides, corresponding psychological nursing were applied. The SCL-90 results of Chinese Norm were adopted to undergo comparison with them and t test was chosen. Results On the first day after operation, the score of the investigation objectives was significantly different compared with that of the Chinese norm. After pertinent mental nursing, their symptoms alleviated, and no significant difference was seen between them. Conclusions There are obvious psychological obstacles in patients after hand tenolysis. The pertinent mental nursing has important effect on rehabilitation training and functional rehabilitation after hand tenolysis.

Objective: To investigate the effects of nerve growth factor(NGF) on the differentiation of goat bone marrow mesenchymal stem cells (BMSCs) into osteoblasts. Methods: The goat BMSCs were cultured in vitro and the marker proteins on the BMSCs surface were identified by flow cytometry. The third passage of BMSCs were randomly divided into blank control group, osteoblasts control group, NGF group and experimental group. The activities of alkaline phosphatase (ALP) and osteocalcin (0C) were examined and the of von Kossa staining method was used to observe the osteogenic differentiation. Results: CD90 and CD105 were strong positive while the CD34 and CD45 were negatively expressed in BMSCs. The activities of ALP and OC was significantly higher in the experimental group than that in the other three groups(P<0.05). The staining of von Kossa was positive and the black calcium nodules were appeared in the the osteoblasts control group. The number and the area of the calcium nodules were greater in the experimental group. But there were no significant differences of each index between the NGF group and the blank control group. Conclusion: NGF can′t induce goats BMSCs to osteoblasts, but can clearly promote the differentiation of goats BMSCs.

Objective:To compare of the effects of laparoscopic and open radical hysterectomy on the serum Interleukin-4(IL-4),interleukin-10 (IL-10),tumor Necrosis Factor-α (TNF-α) and Interferon-γ (IFN-γ) levels of Patients with Cervical Cancer.Methods:64 patients of cervical cancer who were treated from March 2014 to September 2016 in our hospital were selected as research objects.The patients were randomly divided into the abdominal cavity group and open group.The operative time,blood loss,postoperative ventilation time and the levels of IL-4,IL-10,TNF-a and IFN-γin serum before and after treatment were compared between the two groups.Results:The intraoperative blood loss and postoperative ventilation time were significantly lower or shorter in the abdominal cavity group than in the open group (P＜0.05).There was no statistically significant difference in the operation time between the two groups (P＞0.05).There were no significant differences in the levels of serum IL-4,IL-10,TNF-α and IFN-γ between the two groups before operation(P＞0.05);The serum IL-4 level was significantly lower than that of the open group during the operation (P＜0.05).There was no significant difference in the other three index between the other three groups and the laparotomy group (P＞0.05).The serum levels of IL-4,IL-10,TNF-α and IFN-γ in the abdominal cavity group were significantly lower than those of the laparotomy group on the 1 st and 7th day after operation(P＜0.05).Conclusion:Laparoscopic radical mastectomy in cervical intraoperative less blood loss and more secure.The effect of IL-4,IL-10,TNF-α and IFN-γin the postoperative patients was more obvious.Conducive to the recovery of patients after surgery.

Objective To investigate the epidemiological feature of respiratory viruses in children with respiratory tract infection and to provide evidences for diagnosis and rational use of drugs .Methods Nasopharyngeal secretion were collected from 399 chil‐dren with acute respiratory tract infection ,and 7 respiratory viruses ,including respiratory syncytial virus (RSV) ,adenovirus(ADV) , influenza virus A (FA ) ,influenza virus B (FB) ,parainfluenza virus Ⅰ(PIVⅠ) ,parainfluenza virus Ⅱ (PIVⅡ )and parainfluenza vi‐rus Ⅲ(PIVⅢ) ,were detected by using direct immunofluorescence assay .The clinical epidemiological characteristics were analyzed by age group ,virus distribution and seasons .Results Among 399 children ,142 cases were positive for 7 viruses ,which included 40 cases of RSV infection(28 .2% ) ,26 cases of ADV infection (18 .3% ) ,43 cases of FA infection (30 .3% ) ,15 cases of FB infection (10 .6% ) ,5 cases of PIVⅠ infection(3 .5% ) ,4 cases of PIVⅡ infection(2 .8% ) and 9 cases of PIVⅢ infection(6 .3% ) .The total positive rate was 35 .6% .The number of infected infants of <1 year group were 40 cases(36 .0% ) ,the number of infected infants of 1 to 3 year group were 48 cases(32 .0% ) and the number of infected infants of >3 year group were 54 cases(39 .1 .0% ) .In 4 seasons ,the positive rates were 32 .1% (spring) ,26 .9% (summer) ,29 .3% (autumn) ,45 .0% (winter)respectively .The positive rate in winter was the highest .Conclusion FA and RSV is the major virus in children with respiratory tract infection .FA infection rate in infants(>3 years old )is the highest ,and FA is most prevalent in winter .RSV infection rate in infants (< 1 years old )is the highest ,and RSV is most prevalent in spring .

Objective To investigate the effects of apoptosis and related gene p21WAF1 and Bcl-2 in the tumorigenesis of primary gallbladder neoplasms. Methods p21WAF1 and Bcl-2 were detected by immunohistochemistry and apoptotic cells were stained in situ by terminal deoxynucleotidyl transferase mediated-dUTP nick end labeling(TUNAL) in 46 cases of primary gallbladder neoplasms with different histological grades. Results Apoptotic index and p21WAF1 were decreased,but the expression of Bcl-2 was increased with the increasing of the histological grades in primary gallbladder neoplasms (P

Objective To explore the clinical characteristics and prognosis of the patients of acute myocardial infarction complicated with heart failure by analyzing the prognostic factors of these patients.Methods This was a single-center prospective study of 349 patients with acute heart failure and ECG documented acute ST elevated myocardial infarction.All patients were treated with primary PCI.After PCI,clinical,angiographic and ECG characteristics,and prognosis of those with preserved (≥50％) or reduced (＜ 50％) left ventricular ejection fraction (LVEF) were assessed.Heart failure patients were divided into two groups:124 with reduced EF (HFREF) and 225 with preserved EF (HFPEF).After 367 days of average follow-up,the primary outcome and number of death were recorded.Results Of them,4 (1.8％) patients in the HFPEF group vs.6 (4.8％) in the HFREF group died.The difference in rate of death between two groups was not significant (P =0.314).There were significant difference in main adverse cardiac and cerebra vascular events (MACCE) occurred during follow-up period between the two groups (P =0.022).The Killip Classification of heart failure (HR =1.092,95％ CI 1.040 ～ 1.149,P ＜0.01) was significantly related to the death rate during follow-up.Conclusions The independent factors affecting prognosis in patients with acute heart failure after coronary revascularization were closely consistent with the stratums of the Killip Classification.Patients with HFPEF had a similar prognosis as those with HFREF after primary stenting.