Objective To compare the value of biphasicmulti-detector row helical computed tomogrpahy(MDCT),digital subtraction angiography(DSA)and lipiodol computed tomography(CT)in hypervascular hepatocellular carcinoma(HCC).Methods 80 cases with liver cancer were underwent MDCT、DSA、iodized oil CT scan,then compared detection rates of three methods.Results In detecting hepatic nodules(＞2cm),these three imaging techniques had the same sensitivity;for 1～2cm hepatic nodules,the detecting rate had no significant difference;The MDCT scan＜1cm detected 47 nodules(94.0%),iodized oil CT detected 27 nodules(54.0%),both statistically significant difference in detection rate(χ~2=3.11,P＜0.01),DSA is only detected 16 nodules(32.0%)compared with enhanced dual-phase MDCT scan and iodized oil CT detection rate the differences were statistically significant(χ~2=9.09,9.03,all P＜0.01).Conclusion MDCT is able to better show feeding arteries of hepatocellular carcinoma,The imaging examination of liver cancer before treatment can be used as a comprehensive evaluation.

OBJECTIVE: To analyze the clinical and molecular biological characteristics of a neonate with myeloid proliferation related to Down syndrome (DS). METHODS: The neonate, who was suspected for Down syndrome, was analyzed in terms of clinical feature, peripheral blood cell morphology, fluorescence in situ hybridization (FISH), immunological classification and other laboratory tests. On hundred and fourteen leukemia-related genes were subjected to next-generation sequencing (NGS). RESULTS: Laboratory test revealed obvious abnormal liver function and coagulation function, anemia, and extreme leukocytosis. Cell smear indicated significantly increased progenitor cells, which conformed to proliferation of megakaryocytes. FISH showed trisomy 21. By NGS, c.220+dupT, a novel mutation, was identified in exon 2 of the GATA1 gene, which encodes a N-terminal activation domain and has a frequency of 95.8%. No mutation was identified among the remaining 113 genes. CONCLUSION The neonate had DS and GATA1 gene mutation. High percentage of circulating blasts should be considered as transient myelodysplasia but not congenital leukemia.
Down Syndrome ; genetics ; GATA1 Transcription Factor ; genetics ; Humans ; In Situ Hybridization, Fluorescence ; Infant, Newborn ; Mutation ; Trisomy

ObjectiveTo investigate the expression of CXCR4 and CD133mRNA in primary lesion of primary gastric adenocarcinoma and the relation with clinicopathological features,and to explore the correlation of CXCR4 and CD133.MethodsThe primary lesion of primary gastric adenocarcinoma and normal tissues adjacent to gastric cancer were obtained from 50 patients.The diction of CXCR4 and CD133 protein expression was detected by the immunohistochemical staining,and the relative gray scale values of CXCR4 and CD133mRNA by semi-quantitative RT-PCR (Fisher' s exact probability method).Their relationship with clinicopathological features was also investigated ( Spearman relation analysis).ResultsThe positive rates of CXCR4 and CD133 protein in gastric cancers were 76.0％ and 66.0％ respectively,which were significantly higher than that in normal tissues adjacent to gastric cancer ( 16.0％ and 10％ ; P =0.000,P =0.000).The increment of relative gray scale values of CXCR4mRNA was associated with the larger tumor diameter,the later TNM stage and the occurrence of lymphatic metastasis( P ＜ 0.05 ).And the larger diameter of tumor,the later TNM stage were associated with the higher relative gray scale values of CD133mRNA (P ＜0.05).The levels of the relative gray scale values of CXCR4 mRNA and CD133mRNA were positively related(r =0.453,P ＜ 0.01 ).ConclusionsThe higher expression of CXCR4 and CD133mRNA correlateswith tumour diameter,TNM stage and lymphatic vessel invasion. The relative gray scale values of CD133mRNA increase with the increment of the relative gray scale values of CXCR4.

Objective: To analyze three events of severe fever with thrombocytopenia syndrome （SFTS） among family members by exposure risk matrix, so as to provide reference for SFTS prevention and control. Methods : The field investigation and clinical data of seven confirmed cases with SFTS reported in Linhai from 2014 to 2016 were collected. Exposure risk matrix was used to list the risk of exposure two weeks before the onset, such as the environment, duration of activity and protection, and evaluate the possible routes of transmission. Results: The first event involved three sisters. Two of them had plucked tea together on a hill, and the possibility of infection through tick bites were 60% and 75%, respectively. Another sister was more likely to be infected by ticks in her residence after visiting her sister （no physical contact with the sick sister）, with a possibility of 74%. The second event involved two cases （mother and son）. They were more likely to be infected by ticks in the current residential area, and the possibility were 100% and 80%, respectively. The third event involved two cases （husband and wife）. The wife had 60% possibility of being infected by the ticks on the hill she picked arbutus, and 40% by the ticks in her residence. The husband was most likely to be infected through contacting with body fluids or blood of his wife （44%）, then through the ticks on the hill he picked arbutus （33%）. Conclusion Among seven cases with SFTS reported in Linhai from 2014 to 2016, six cases have more than 50% possibility of being infected by tick bites; one case has higher possibility of being infected by contacting with body fluids or blood of a patient, but tick bites could not be ruled out.

Fever ; Humans ; Plasma Cells ; pathology ; Thrombocytopenia ; diagnosis ; pathology

Objective: To explore the clinical effect of reduction and reconstruction of the removed bony structure after one-stage posterior resection of high cervical tumors. Methods: From October 2009 to March 2018, 17 patients including 10 males and 7 females of high cervical tumors who underwent one-stage posterior resection with an average age of 57 years (26~84 years) were reviewed. There were 11 shwannomas, 3 meningiomas and 3 concurrent shwannoma and meningioma arising in the same level, respectively. Reduction with (14 cases) or without internal fixation (3 cases) were performed for the removed C1 posterior arch or C2 laminar and spinous process. The clinical effects were compared with Visual analogue score (VAS), Japanese Orthopaedic Association scores (JOA) and American Spinal Injury Association (ASIA) grade. The cervical lordosis and range of motion were measured with the X-ray before the operation and at the last follow-up. Results: There were no vertebral artery injury or massive hemorrhage during the surgeries. The operation time was 184±43 min, blood loss was 203±223 ml, and mean follow-up period was 29.1±28.2 months. No recurrence was found during the follow-up, and the motor and sensory were significant recovered in all patients after surgery. VAS score and JOA score were significantly improved at the last follow-up. ASIA grade was C for 1 case, D for 11 cases and E for 5 cases before surgery. After surgeries, C improved to D, 8 cases of D improved to E and 3 cases of D failed improved to E. Although the cervical lordosis and range of motion was decreased significantly in the last follow-up in X-ray, no patients complained stiffness and discomfort in rotation or flexion and extension of the neck. Cardiac arrest during operation was occurred in 1 case, and heartbeat recovered after stopping the manipulation. CSF leakage was found in 9 cases and no surgical site infection was occurred. Conclusion Resection of high cervical dumbbell-shape tumors is a demanding surgery with high incidence of complications. The reduction and reconstruction of removed bony structure without fusion could rebuild the stability of high cervical spine and preserve the cervical range of motion as much as possible which improves clinical effect.

Adult ; Animals ; Fasciolidae ; Hepatitis B ; complications ; surgery ; Humans ; Liver Cirrhosis ; etiology ; surgery ; Liver Transplantation ; Living Donors ; Male ; Trematode Infections ; drug therapy

OBJECTIVETo investigate the diagnosis and differential diagnosis of extranodal Rosai-Dorfman disease.

METHODSTwo cases of extranodal Rosai-Dorfman disease were studied using hematoxylin-eosin, and immunohistochemical staining, along with a literature review.

RESULTSThe lesions of RDD were characterized by the presence of large histiocytes with emperipolesis, accompanied by infiltration of lymphocytes, plasma cells and other inflammatory cells. The large histiocytes had an abundant cytoplasm, pale to eosinophilic in appearance, positive for S-100 protein staining, with a vesicular nucleus and a small basophilic nucleolus in each cell.

CONCLUSIONSExtranodal Rosai-Dorfman disease is known as an idiopathic proliferative disease of histiocytes with a distinct morphologic feature and is very rare. Differential diagnosis from other types of fibrohistiocytic proliferation lesions is recommended.

Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Brain ; pathology ; surgery ; Brain Diseases ; metabolism ; pathology ; surgery ; Dermatologic Surgical Procedures ; Diagnosis, Differential ; Histiocytosis, Sinus ; metabolism ; pathology ; surgery ; Humans ; Male ; Middle Aged ; S100 Proteins ; metabolism ; Skin ; pathology ; Skin Diseases ; metabolism ; pathology ; surgery

OBJECTIVETo assess the value of fluorescence in situ hybridization (FISH) combined with chromosomal analysis for the detection of Robertsonian translocation type trisomy 21 in amniotic fluid cells.

METHODSAmniotic fluid samples from pregnant women requesting prenatal diagnosis were cultivated. Metaphase cells were prepared for G-banding karyotype analysis. For the 5 Robertsonian translocation type trisomy 21, interphase nuclei from amniotic fluid and parental peripheral blood cells were prepared for FISH analysis.

RESULTSIn 2 cases, analysis of parental peripheral blood cells showed normal karyotypes. FISH analysis of amniotic fluid cells indicated that one sample had two copies of chromosome 21, which has a 46, XY, rob(21;21)(q10;q10) karyotype, whilst another had trisomy 21 by FISH, which has a 46, XY, rob(14;21)(q10;q10) karyotype. For the remaining three samples, analysis of parental peripheral blood cells indicated that their karyotypes were 45, XX, rob(14;21)(q10;q10), 45, XX, rob(15;21)(q10;q10) and 45, XX, rob(21;22)(q10;q10), whilst the karyotypes of amniotic fluid cells were 46, XX, rob(14;21)(q10;q10), 46, XY, rob(15;21)(q10;q10) and 46, XX, rob(21;22)(q10;q10), respectively.

CONCLUSIONCombined FISH and chromosomal analysis is an efficient method for detecting non-homologous Robertsonian translocation type trisomy 21. However, FISH has limited ability to detect homologous Robertsonian translocation type trisomy 21.

Adult ; Down Syndrome ; diagnosis ; Female ; Humans ; In Situ Hybridization, Fluorescence ; methods ; Karyotyping ; Pregnancy ; Prenatal Diagnosis ; Translocation, Genetic

OBJECTIVETo investigate the expression of CD123 and its significance in lymphocytic leukemia.

METHODSCD123 expression in 139 lymphocytic leukemia patients and in lymphocytes from 10 normal bone marrows (BM) was analyzed by multi-parameter flow cytometry. Cytogenetic and minimal residual disease (MRD) analysis were performed in acute B-lymphocytic leukemia (B-ALL) patients.

RESULTSCD123 expression was absent in B lymphoid lineage stem-progenitor cells, mature B and T lymphocytes from 10 normal BM. Among 139 lymphocytic leukemia patients, CD123 was negative in 5 T-ALL and 23 B-CLL patients. However, among 111 B-ALL patients, CD123 was expressed in 106 (12 pro B-ALL, 57 common B-ALL and 37 Pre B-ALL) (95.49%) but not in 5 mature B-ALL patients. There was a positive correlation between CD123 and p-Akt expression, and CD123 expression was much higher in hyperdiploid than in non-hyperdiploid B-ALL patients. A statistically significant difference in relapse rate within 12 months (MRD positive group: 63.04% vs MRD negative group 21.56%)and in disease free survival (DFS) time was found beween patients with MRD\[(36.06 +/- 2.62)%\] or not \[(48.23 +/- 1.82)%\] (P < 0.01). Moreover, stable CD123 expression could be observed in B-ALL patients in relapse.

CONCLUSIONSCD123 was predominantly expressed in B-ALL patients and remained in patients in relapsec, indicating that it may be an useful MRD marker in B-ALL patients.

Flow Cytometry ; Humans ; Leukemia, Lymphocytic, Chronic, B-Cell ; Neoplasm, Residual ; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma ; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma