Objective To analyse CT appearances of malignant neurilemoma in the thorax and abdomen,in order to improve the diagnostic accuracy of this disorder. Methods There were 9 cases(5 cases in thorax and 4 cases in abdomen) with malignant neurilemoma proved by pathology (7 cases by surgery and 2 cases by CT guided percutaneous puncture biopsy). CT both plain and enhanced scans were performed in all cases. Results Tumors were located in the mediastinum in 5, in abdominal wall and retroperitoneum in 2 respectively .7 cases were isolated masses,2cases were disseminated masses,in company with pleuritic fluid was in 4 and with osteogenic metastasis of vertabral body in one case.The isolated masses appeared as round or ellipse with low density in the centre,the CT value was 5~20 HU,6 cases had complete capsule.The disseminated masses in 2 cases appeared as homogeneous density.On contrast-enhanced scan,the solid parts of masses were enhanced in different degree. Conclusion The isolated thoracic and abdominal malignant neurilemoma is of certain CT characteristics, but the disseminated one is not.

Objective To monitor the antibiotic resistance in Neisseria gonorrhoeae, determine the prevalence of penicillinase-producing Neisseria gonorrhoeae (PPNG) and plasmid-mediated tetracycline-resistant Neisseria gonorrhoeae (TRNG) in Xi'an region, and to analyse the trends in antibiotic resistance in Neisseria gonorrhoeae. Methods In total, 647 strains of Neisseria gonorrhoeae were isolated from patients with gonorrhea in sexually transmitted disease (STD) clinic settings from 2002 to 2009. Agar dilution method was used to detect TRNG and determine the minimal inhibitory concentration (MIC) of antibiotics, and paper acidometric method to detect PPNG. Results Of these 647 strains, 216 (33.4%) were TRNG, 290 (44.8%)were PPNG. The prevalence of TRNG strains remained between 28.3% and 49.2% in 2002-2009, except for 17.3% in 2005; the prevalence of PPNG strains increased from 37.1% in 2002 to 64% in 2005, but declined from 2006 to 2009 (32.3%). The prevalence of resistance to spectinomycin maintained at a low level (0 to 2.8%) over these years, while that to ciprofloxacin remained higher than 80% from 2002 to 2009, and accounted for 100% in 2005, with the exception of 51% in 2006. Ceftriaxone resistance was observed in none of these strains except 4 isolates in 2003, but the susceptibility to ceftriaxone decreased yearly. Conclusions Neisseria gonorrhoeae is highly sensitive to spectinomycin, which should serve as the first treatment choice for gonorrhea.Full dose is necessary for the application of ceftriaxone in the treatment of gonorrhea. Ciprofloxacin should not be used to treat gonorrhea.

Objective To investigate the in vivo effect of silenced actin-associated protein Transgelin on the growth of human pancreatic carcinoma xenograft in nude mice.Methods Human pancreatic cancer cell line BxPC3 were transfected with small hairpin RNA (shRNA) eukaryotic expression vector targeting Transgelin gene.RT-PCR and Western blot were used to analyze Transgelin expression after transfection.24 animal models were randomly divided into three groups with 8 in each:Experimental group (transplanted BxPC3/Transgelin shRNA),negative control group (transplanted BxPC3/Neo) and untreated group (transplanted BxPC3).Tumor size was measured weekly.All mice were sacrificed after 28 days.Tumor volume was calculated,inhibitory effect was analyzed.Immunohistochemical staining of paraffin sections for Transgelin and proliferating cell nuclear antigen (PCNA) proteins were performed.Results Tumors varied in sizes among 3 groups (all P ＜ 0.05).On day 21 and 28 tumor was significantly smaller in experimental group than those in control groups.Tumor weighed(0.74 ±0.21) g in experimental group,lower than that in negative control group(1.42 ± 0.28) g and untreated group(1.59 ± 0.24) g (all P ＜ 0.05).The inhibitory effect was 53.5％ in experimental group.The PCNA index was significantly lower in experimental group than those in control groups (all P ＜ 0.05).Conclusions Deletion of Transgelin gene can significantly inhibit the proliferation and tumor growth of BxPC3 cells in nude mice.

Objective To explore the clinicopathologic characteristics,to screen risk factors of metastasis and to analyze the diagnosis,treatment and prognosis of gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN).Methods From January 2010 to November 2015,the clinical data of 405 patients with GEP-NEN were retrospectively analyzed.GEP-NEN tumors were classified as neuroendocrine tumor (NET,G1 and G2 grade),neuroendocrine carcinoma (NEC,G3 grade) and mixed adenoendocrine carcinoma (MANEC,G3 grade).The clinicopathologic characteristics were summarized.The staining characteristics of synaptophysin (Syn),chromogranin A (CgA) and CD56 of tumor tissues were analyzed by immunohistochemistry.x2 and t test were performed to analyze differences in pathologic characteristics between groups.Logistics regression method was used to analyze the risk factors of metastasis.KaplanMeier method and Log-rank test were used for survival analysis.Results The mean age of patients with GEP-NEN was (54.7± 13.3) years.Gastric NEN was the most common GEP-NEN (98 cases,24.2％),followed by 95 cases (23.5％) with NEN in rectum,86 cases (21.2％) in pancreas and 50 cases (12.3％)in esophagus.Among them,47 cases (11.6％) were functional GEP NEN and 358 cases (88.4％) were non-functional GEP-NEN.According to pathologic diagnosis,227 cases (56.0％) were NET,125 cases (30.9％) were NEC and 16 cases (4.0％) were MANEC.According to tumor classification,120 cases (29.6％) were grade G1,108 cases (26.7％) were grade G2 and 177 cases (43.7％) were grade G3.Immunohistochemistry staining positive ratesof Syn,CgA and CD56 were 97.4 ％ (381/391),44.0 ％ (121/275) and 83.9％(291/347),respectively.The median (lower quartile,upper quartile) diameter of grade G1,G2 and G3 tumors were 1.0 cm (0.6 cm,1.5 cm),1.5 cm (1.0 cm,2.5 cm),4.0 cm(2.5 cm,6.0 cm),respectively,and the difference was statistically significant (Z =99.171,P ＜ 0.01).The positive rate of CgA of grade G3 tumor was lower than that of grade G1 and G2(x2 =7.078 and 11.391,both P＜ 0.01).The results of Logistic regression analysis revealed that tumor size and pathologic classification were the important predictors of metastasis.The median survival time of metastasis group and non-metastasis group of grade G3 was 12.0 months and 41.5 months,and there was a significant difference between the two groups by Log-rank test (x2 =37.075,P＜0.01).Conclusions GEP-NEN may occur at any part of the digestive system.There are differences in tumor size positive rate of,immunohistochemistry staining and the primary site of tumors with different pathological grading.The tumor diameter and pathologic classification are the important predictors of metastasis.The prognosis of metastasis group is worse than that of non-metastasis group.

380 mmHg) while the PaCO2 increased slightly at T5 and decreased gradually. The PCWP decreased slightly at T2, T3 , T4 and increased quickly at T5 , T6, levelling with T0 at T9. PVRI was on gradual increase beginning ahepatic stage and falling to the level of T0 at T7. The changes of PAP were similar with PCWP, the value at T6 being higher than that at T3, T4 significantly. Conclusion DO2 -directed hemodynamic management protects pulmonary function from damage during LTx.

Objective To predict clinical chemotherapy sensitivity of primary ovarian cancer by jointing adenosine triphosphate(ATP) - tumor chemo-sensitivity assay(TCA) method in vitro and detection of drug resistance genes, provide reference for clinical treatment. Methods Forty-seven primary epithelial ovarian tumor samples were collected from the patients who received cytoreductive surgery. Viable ovarian cancer cells obtained from malignant tissue were tested for their sensitivity to carboplatin (CBP), cisplatin (DDP), paclitaxel(PTX) and CBP + PTX using ATP-TCA method in vitro; at same time, real-time quantitative PCR was used to analysis BRCA1 and ERCC1 mRNA relative expression in forty-six specimens (1 frozen tumor samples mRNA were not detected due to serious degradation). The relationship between ATP-TCA test results, clinical indicators, and the effectiveness of the joint prediction on clinical chemosensitivity by combining these two methods were statistically analyzed using chi-square test. Results (1)The results showns that three programs of DDP,CBP and PTX + CBP were significantly related with clinical results(P<0.05) in vitro, in which the compliance rate in PTX + CBP program was the highest 83%(39/47) ,and the predictive sensitivity, predictive specificity, positive predictive value, negative predictive value and predictive accurate rate were 90%,71%,84% and 80% ,respectively.PTX + CBP combined in vitro test results was also related with residual tumor size and neoadjuvant chemotherapy, which was more prone to drug resistance with residual tumor larger than 2 cm (P = 0. 023) and with neoadjuvant chemotherapy (P = 0.011). (2) BRCA1 mRNA expression levels in the clinical-resistant group and the clinical-sensitive group was 0.673 ± 2.143 and - 1.436 ± 2.594 (P=0.008), ERCC1 mRNA expression levels in the clinical-resistant group and the clinical-sensitive group was -0.529 ± 1.982 and - 3.188 ±2.601 (P =0.001). There were also significant correlation among the expression levels of BRCA1 ,ERCC1 mRNA and clinical efficacy (P<0.01). (3)ATP-TCA and detection of drug resistance genes combined to predict the clinical application of PTX + CBP resistance may occur in 8/9 cases. Conclusions ATP-TCA may be an ideal method of in vitro drug sensitivity testing method, which could effectively predict clinical chemotherapy sensitivity. Combination of the drug-resistant associated genes detection method and the ATP-TCA method can increase the predictive effectiveness of ovarian cancer chemosensitivity and guide individual chemotherapy of ovarian cancer.

Objective Toinvestigatetheconsistencyofultrasoundand MSCTindiagnosing microvascularinvasion (MVI)in hepatocellularcarcinoma,andtocomparethediagnosticefficiencyofbothtwomethods.Methods TheultrasoundandMSCTdataof 82patientswithhepatocellularcarcinomawerecollected.Accordingtothepostoperativepathologicalresults,theconsistencyanddiagnostic efficiencyofultrasoundandMSCTindiagnosingMVIinhepatocellularcarcinomawerecompared.Results Accordingtothepostoperative pathologicalfindingsof82patients,30caseswerepositiveofMVI,while52caseswerenegative.ThepreoperativeMSCTandultrasound examinations had a strong consistency (Cohen’s Kappa＝0.829 ,P＜0.001 ).The sensitivity ,specificity and accuracy of preoperative ultrasoundinpredictingtheMVIinhepatocellularcarcinomawere76.67% (23/30),67.31% (35/52)and70.73% (58/82),respectively. Thesensitivity,specificityandaccuracyofpreoperativeMSCTinpredictinghepatocellularcarcinomaMVIwere83.33% (25/30),73.08%(38/52)and75.61% (63/82),respectively.Conclusion Preoperativeultrasoundand MSCThavegoodconsistencyandhighdiagnostic efficiencyindiagnosing MVIinhepatocellularcarcinoma.

With the rapid development of the nuclear industry, the uranium-exposed population is rapidly expanding. Kidney injury is a major health concern for uranium-exposed population because uranium is initially retained in the kidneys and induces chemical toxicity. However, the commonly used clinical markers of kidney injury usually show significant changes in the late stages of such damage, making it difficult to monitor the occupational health of uranium-exposed population. In recent years, a number of biomarkers that can reflect early kidney injury caused by uranium have been identified and investigated by enzyme-linked immunosorbent assay and protein blotting. This article will review the studies in this area, with the aim of providing a basis for the diagnosis and understanding the development and prognosis of uranium-induced kidney injury.

Objective To observe the outcomes of seizure control by three different surgical approaches,hippocampal transection,anterior temporal lobectomy and selective amygdalo-hippocampectomy,for the treatment of intractable medial temporal epilepsy,and explore their influences in the impairments of cognitive and memorial functions.Methods Twenty-nine patients with intractable medial temporal epilepsy,admitted to our hospital from January 2012 to October 2015,were chosen in our study;8 patients accepted hippocampal transection,10 accepted anterior temporal lobectomy and 11 accepted selective amygdalo-hippocampectomy.Seizure controls after treatment with these 3 approaches were compared and results of neuropsychological examinations (verbal intelligence quotient [VIQ],performance intelligence quotient [PIQ],full intelligence quotient [FIQ] and memory quotient [MQ]) were compared before and after operation.Results The effective rates of seizure controls were all higher than 80％ and seizure free rate was about 60％ in the 3 groups;Engel grading showed no significant differences among the three groups (P＞0.05).Results of all the neuropsychological examinations in the hippocampal transection group before and after operation had no significant differences (P＞0.05);however,all results in the anterior temporal lobectomy group after operation were significantly declined as compared with those before operation (P＜0.05);and PIQ,FIQ and MQ scores in the selective amygdalo-hippocampectomy group after operation were significantly lower as compared with those before operation (P＜0.05).Conclusions Hippocampal transection will not cause significant damage in intelligence and memory functions.As compared with both anterior temporal lobectomy and selective amygdalo-hippocampectomy,hippocampal transection can have good seizure control and preserve memory function.

With the development of nuclear energy technology and the use of depleted uranium weapons, the uranium exposed population is gradually expanding and the health effects of uranium exposure are of increasing concern. The toxicity of uranium to kidney, a sensitive organ for uranium to enter the body to produce effects, cannot be ignored. As of now, the effects of uranium exposure on the kidney are still not well understood, the threshold of uranium-induced kidney injury has been controversial, and there is a lack of sensitive and specific biomarkers for the diagnosis of early kindey damage, especially in the context of chronic uranium exposure. For these reasons, this paper reviewed the results of research on dose-effect relationships and biomarkers of uranium-induced kidney injury and provided an outlook on future research directions, with the aim of providing a basis for subsequent study on animal experiments and population health effects related to uranium exposure.