Objective To investigate clinical and imaging features of malignant transformation in monostotic fibrous dysplasia (FD).Methods Radiography (n=12),computed tomography (CT)(n=7)and magnetic resonance imaging (MRI)(n=5)data of 12 monostotic FD cases proved by surgery and pathology were retrospectively reviewed.Results Among 12 cases,6 cases underwent surgery.Their images showed osteolytic lesions in the operative area with direct signs of aggressiveness (poorly defined margin,cor-tical destruction and soft tissue mass).For the 6 cases without surgery,radiography and CT showed poorly margin,osteolytic le-sions within or near the area of ground-glass opacity.MRI showed lesions with heterogeneous signal intensity and pronounced con-trast-enhancement.Histopathologically,9 cases were osteosarcomas,2 cases were fibrosarcomas,and 1 case was malignant fibrous histiocytoma (MFH).Conclusion The imaging information of malignant transformation of FD can provide evidence of possible ma-lignancy.

Books ; Language ; Linguistics ; Medicine, Chinese Traditional ; Translations

Purpose To investigate the expression of Dkk3 and Cyclin D1 protein in human hepatocellular carcinoma (HCC) and clinical significance.Methods Immunohistochemistry was used to detect Dkk-3 and Cyclin D1 protein expression level in 80 cases of hepatocellular carcinoma and corresponding para-cancer tissue.Results The expression of Dkk-3 in hepatocellular carcinoma was significantly lower than those in corresponding para-cancer tissue (P ＜ 0.05) and the expression of Cyclin D1 in hepatocellular carcinoma was significantly higher than those in CoTesponding para-cancer tissue (P ＜ 0.05).The up-regulation of Cyclin D1 and the down-regulation of Dkk-3 proteins were correlated with pathologic differentiation degree (P ＜0.05).There was a significant inverse correlation between Dkk3 and Cyclin D1 expression (P =0.044,rs =-0.226).Conclusion The abnormal expression of Dkk-3 and Cyclin D1 gene in human hepatocellular carcinoma suggest that Dkk-3 and Cyclin D1 gene may play an important role in the development and progression of the cancer.The combination deteetion of the two biomarkers may provide valuable data for diagnosis and prognosis estimation of HCC.

Objective To measure hepatic ultrasonic integrated backscatter (IBS) in healthy rabbits as a non-invasive quantitative diagnostic means for hepatic steatosis, hepatic fibrosis, and liver cirrhosis; to determine the factors that may influence the IBS measurement. Methods Thirty-five healthy New Zealand white rabbits with normal liver function tests and normal liver biopsies were used in this study. HP Sonos 5500 image system with quantitative analysis function was used for IBS measurement. With the machine setting fixed, and optimal image obtained, left and right liver were divided into near, medial and far areas according to the depth. Further the measurements of IBS in different depth were performed respectively. Meanwhile, in the same liver the IBS image was collected and the change of IBS intensity was measured in various setting of machine index (MI), time gain compensation (TGC) and lateral gain compensation (LGC). Results Average image intensity (AII) of left liver (from near to far areas) was ( 25.38? 2.36)dB, ( 26.32? 2.38)dB, and ( 26.45? 2.28)dB, respectively. The AII of the right liver (from near to far areas) was ( 24.99? 2.23)dB, ( 24.92? 2.59)dB, and ( 25.38? 2.36)dB, respectively. The average standardized AII of image in left livers was significantly higher than that of the right (P

Objective To explore the clinical presentation,etiology of sepsis,common positions of in-fection and anti-infectious treatment of pediatric acute leukemia with septicemia resistance to carbapenem. Meth-ods A retrospective chart review of all pediatric acute leukemia with septicemia cases of Beijing Children 's Hospital from December 2011 to September 2015 were analyzed. All cases were selected based on the clinical presentation,at least one Gram-negative bacteria positive result of blood culture and were resistant to carbapen-em. The basic clinical characteristics and the results of blood culture and antimicrobial susceptibilities were ana-lyzed. Results All 45 cases with fever,among them 8 cases under went continued fever,The other 37 cases fe-ver days were ( 6. 1 ± 5. 2 ) d. Twenty-six cases had agranulocytosis. Agranulocytosis time from 2 to 79 days, mean days(15. 2 ± 16. 2)d. Significant difference of fever time between agranulocytosis team and non-agranulo-cytosis team was significant(P=0. 011). Twenty-three cases had infection positions among 45 cases. Lung,di-gestive tract,mouth and crissum were the common positions of infection. The quantum of blood culture samples were 711 parts. There were 162 parts resistant to carbapenems. The primary pathogens were pseudomonas aerugi-nosa,klebsiella pneumoniae, enterobacter cloacae and Escherichia coli. Among those 45 cases, 36 cases were cured,9 cases were ineffective treatment. Conclusion Pseudomonas aeruginosa, klebsiella pneumoniae, enter-robacter cloacae and Escherichia coli accounted for the most of G-bacteria infections resistant to carbapenem in our center. The incidence of septicemia was related to the level of granulocyte and duration of agranulocytosis.

Objective To investigate the epidemiology of fungemia and provide evidence for clinical therapy.Methods A retrospective survey was conducted with 42 cases of fungemia in our hospital from Jan 2002 to Jan 2011.Results Forty cases candida fungemia accounted for 95.2％ in 42 fugemia.The main pathogen agent was non-Candida albicans in candida fungemia,which were candida albicans(14.3％),candida parapsilosis (38.1％),candida glabrata (35.7 ％),candida tropicalis (2.4％).Eleven uneffecfive cases accounted for 26.2％.Multiple-factor analysis showed that neutropenia time ＞ 7 days,antibiotic using time ＞ 7 days and fungal infection history correlated with bad prognosis.Our study also showed that chemotherapy regiments including hormone、combining with other organs fungal infection and non-Candida albicans were risk factors of bad prognosis.Conclusion The main pathogen agent of fungimia is candida,especially non-Candida albicans.Neutropenia time ＞ 7 days,antibiotic using time ＞ 7 days and fungal infection history correlate with poor prognosis.

Objective To investigate the epidemiology of fungemia and provide evidence for clinical therapy.Methods A retrospective survey was done with the 42 cases of fungemia in our hospital.Results 42 cases of fungemia include 35 cases acute lymphoid leukemia,6 acute myloid leukemia.95.2％ of the fungemia pathogen agent was monilia.8 cases combined with bacterial septicemia,accounting for 19.0％.Drug sensitivity test showed that 2 cases were intermediary to Fluconazole,1 patient was resisdence to Amphotericin B but sensitive to Voriconazole,Itraconazole and fluorocytosine.The main risk factors of fungimia included using wide-spectrum antibiotic,neutophil less than 0.5 × 109/L,central venous indwelling catheter,age and the time of in hospital more than 15 days.Conclusion The effective measure to reduce fungemia morbitity is controlling risk factors.Timely and effectively antifungal therapy is also needed.

· AlM:To investigate the effect of compound anisodine on fundus blood circulation after vitrectomy with face-down position.
· METHODS: Sixty patients ( 60 eyes ) with rhegmatogenous retinal detachment received vitrectomy with silicone oil tamponade operation, who were randomized divided into treatment group ( 30 eyes ) and control group ( 30 eyes ) .The patients in the treatment group received the subcutaneously injection of compound anisodine hydrobromide by the superficial temporal artery once daily for 14d since postoperative first day.Retinal microcirculation blood flow parameters were recorded with Heidelberg retinal flowmeter postoperative 1d, 1 and 2wk, and were compared between two groups.
·RESULTS: The blood flow parameters ( Vol, Flw, Vel) of control group postoperative 1 and 2wk were significantly less than those postoperative 1d.Otherwise the parameters of treatment postoperative 1 and 2wk were significantly more than those postoperative 1d. The parameters between two groups were significant different ( P<0.01) .
· CONCLUSlON: Facing down after vitrectomy with
silicone oil tamponade may reduce retinal blood supply, consequently lead to retinal ischemia; compound anisodine can effectively improve the retinal and choroidal microcirculation after vitrectomy with face-down posture, reduce retinal ischemia, and enhance the visual function.

Deep venous thrombosis (DVT) is initiated intraoperatively and may display symptoms postopera- tively following total hip or total knee arthroplasties. Pulmonary embolism (PE) and DVT cause morbidity and mortality. It has been established that patients who undergo a major lower-extremity joint replacement should receive prophylaxis due to the increased risk of DVT. Despite use of thrombo-prophylaxis, elective replacement surgery carries a high risk of venous thromboembolic complications. The early detection of DVT and treatment with systemic anticoagulation to pre- vent DVT are essential in the management of patients undergoing total joint arthroplasty. Extended medical throm- bo-prophylaxis is indicated for some high-risk patients. Routine postoperative duplex surveillance for DVT may be clinically useful. In the early post-operative phase, combined prophylaxis such as low-molecular-weight heparins and mechanical methods may be more effective than single intervention measures. However, the efficacy and safety of an- ticoagulation therapy, using various medicines administered after total arthroplasty of large joints are still undetermined and controversial.We should also be alert to the frequency and extent of postoperative hematomas. There are still many uncertainties in treatments to prevent DVT in terms of safety and cost-effectiveness. Therefore, prospective, ran- domised, controlled and multicenter studies may be necessary to obtain valuable information according to evidence based medicine.