Adenocarcinoma, Mucinous ; metabolism ; pathology ; Calbindin 2 ; Carcinoma, Endometrioid ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; methods ; Inhibins ; metabolism ; Keratin-7 ; metabolism ; Mucin-1 ; metabolism ; Ovarian Neoplasms ; metabolism ; pathology ; S100 Calcium Binding Protein G ; metabolism ; Sex Cord-Gonadal Stromal Tumors ; metabolism ; pathology

Objective To evaluate the features of solid-pseudopapiHary tumors of pancreas (SPTP),and to compare with the clinical and pathological findings in order to improve the diagnostic accura-cy.Methods The CT appearances were analyzed retrospectively in 5 patients with pathologically proven SPTP.There were 4 women and 1 man,with the mean age of(16.20±7.49)years.Plain CT and contrasted CT were performed in all 5 cases.Results The tumors of 4 caseswerelocatedinthe head and neck of pan-creats and 1 case was in the body and tail of pancreas.Clear tumor margins were seen in all cases.The mean diameter of these tumors was 5.2 cm(3.0-9.0 cm).Two cases were predominantly composed of cystic por-tions,2 cases were mainly composed of solid portions,and 1 case was composed of similar proportions of solid and cystic portions.Inhomogeneous enhancement Was rewealed in contrasted CT scan,but Was lower in both phase than normal pancreas.Tumor border discontinuous ring-shape calcification was seen in 1 case,dilata-tion of the main pancreatic duct Was demonstrated in 1 case and no metastasis were seen.Conclusions Certain CT features may suggest the diagnosis of SPTP.CT combined with the clinical feature is helpful to the diagnosis.

Objective To investigate the etiopathogenesis of exertional heat stroke(EHS)induced by military training of those patients admitted in military hospitals,and analyze the influence of EHS as a predisposing factor on prognosis.Methods Eighteen patients with EHS were admitted in 6 military hospitals from Sep.1995 to Aug.2007,their clinical data were retrospectively analyzed.All cases were evaluated according to Minard's EHS predisposing factors including the individual's physiologic limitations,environmental conditions and the organizational predisposing factors.According to the final treatment outcome,18 cases of EHS were divided into fatal group(Group F)and survival group(Group S).The significance of deviation on the predisposing factors,and of the differences on the accumulated predisposing factors between the two groups,was analyzed.Results All the 18 cases of EHS occurred after military training,and complicated with multiple organ dysfunction syndrome(MODS).Hyposthenia,excessive physical efficiency training,incorrect disease classification to the patients,and inappropriate diagnosis and treatment were found to be the strong predictors to a grave prognosis.The effect of accumulated predisposing factors of EHS in group F was significantly higher than that in group S(10.0?1.41 vs 5.64?1.96,P

Recent years,progress has been made on the basic researches and clinical applications of ocular surface reconstruction with autologous or allogeneic limbal stem cells,oral mucosa epithelium and ex vivo cultured limbal stem cells.However,there are several issues,including the successful treatment for severe ocular damage,longterm follow-up and evaluation of clinical outcome,and the in vivo tracking of donor stem cells,remained to have definitive conclusions.Future studies should address the questions and challenges based on the basic research of limbal stem cell deficiency and standardized evaluation of clinical outcome.

Objective To study the experience of laparoscopic repair in gastric and duodenum perforation. Methods 35 patients with gastric and duodenum perforation were performed laparoscopic repair.Results 34 pati- ets with gastric and duodenum perforation were safely operated.1 case with perforation of gastric carcinoma was con- verted to open for radial gastrectomy.The mean time of hospitalization was 7.5 days.There was no intraoperative and postoperative complications.Pathological examination showed 4 patients with perforation of gastric ulcer and one with perforation of gastric carcinoma.Conclusion Laparoseopic repair was one of the safe,quick recovery and little suffering treatment for duodenum perforation.

Child ; Humans ; Hypertension, Pulmonary

Objective To investigate the correlation between deep vein thrombosis(DVT) and clinical laboratory tests in the regulation of hemostasis. Methods Endothelin-1 (ET-1), thrombomodulin (TM), P-selectin, prothrombin fragment _ 1+2 (F_ 1+2 ), thrombin-antithrombin complex (TAT), thrombus precursor protein (TpP) and D-Dimer (D-D) were measured in DVT patients (n=72) and normal individuals (n=20) with ELISA method. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and accuracy were evaluated for each of the items, and the area of the underlying receiver operating characteristic curve (AUC ROC ) was used to appraise diagnostic efficiency. Results Except ET-1, there were significant differences between the DVT group and normal control group in the other items. The AUC ROC of P-selectin, F_ 1+2 , TpP and D-D was bigger than that of ET-1, TM and TAT (P0.05). The TpP had the highest sensitivity, NPV and accuracy, and the D-D had the highest specificity and PPV. Conclusion The increase of D-D and TpP could reflect the occurrence of continuous coagulation and fibrolysis respectively. Thus the combination of measuring TpP and D-D could provide better laboratory evidence for the diagnosis of patients with DVT.

Objective To prove that valve sparing aortic root reconstruction may have an impact on the outcome and longevity of the repair for patients with acute type A aortic dissection.Methods Clinical data of 98 consecutive AAAD patients undergoing the valve sparing aortic root reconstruction were analyzed.The postoperative follow-up and the clinical effect of the procedure were retrospectively analyzed.Results Pre-operative grade of aortic insufficiency was(2.3 ± 0.5), CPB-time was (217.8 ± 43.1)min, aortic cross clamp time was(142.7 ± 37.4)min and stay on ICU (11.1 ± 5.7) days, while hospitalisation was(14.3 ± 3.2) days.8 patients(8.2％) died peri-operatively.None of the early deaths were valve-related.Rethoracotomy rate was 3.1％.All patients followed up(19.3 ± 7.6) (6-68) months.Survival at 1 year was 90.8％.Freedom from valvular reoperation was 97.9％ at 3 years.At last investigation, mean grade of aortic insufficiency for AADA was 0.5 ± 0.3 (0-3).Conclusion Regardless of the underlying indication, the aortic valve preserving reimplantation technique can be performed with favourable functional results.

Cardiac surgery carried out on cardiopulmonary bypass(CPB) in a pregnant woman is associated with poor neonatal outcomes although maternal outcomes are similar to cardiac surgery in non-pregnant women.Most adverse maternal and fetal outcomes from cardiac surgery during pregnancy are attributed to effects of CPB.The CPB is associated with utero-placental hypoperfusion due to a number of factors,which may translate into low fetal cardiac output,hypoxia and even death.Better maternal and fetal outcomes may be achieved by early pre-operative optimization of maternal cardiovascular status,use of perioperative fetal monitoring,optimization of CPB,delivery of a viable fetus before the operation and scheduling cardiac surgery on an elective basis during the second trimester.

Objetcive To analyze the contrast-enhanced ultrasound (CEUS)features in clear cell renal cell carcinoma (CCRCC) of different size and to discuss the diagnostic value of CEUS in CCRCCs. Methods The contrast-enhanced and conventional US features of 80 CCRCCs confirmed pathologically were retrospectively analyzed. Samples were divided into three groups by diameters: small CCRCCs (≤30 mm), medium CCRCCs(＞30 mm) and large CCRCCs(＞50 mm). The tumoral vascularity, lesion homogeneity and presence of an anechoic rim were observed on conventional US. The enhancement of echogenicity, homogeneity and pseudocapsule were evaluated on CEUS. Results Among the 80 renal masses, 32 were small CCRCCs, 28 were medium CCRCCs while the large CCRCCs were 20. On conventional US, 18.8%(6/32) of small CCRCCs, 71.4%(20/28) of medium CCRCCs and 95%(19/20) of large CCRCCs demonstrated as heterogeneous and the differences were highly statistically significant, whereas there were no differences in the tumoral vascularity and the presence of pseudocapsule sign among the three groups. On CEUS, 28.1%(9/32) of small CCRCCs, 85.7%(24/28) of medium CCRCCs and 100%(20/20) of large CCRCCs showed a homogeneous enhancement. The incidence of pseudocapsule sign in medium tumors was higher than small and large groups(71.4%,50% and 25%,respectively). There were statistically significant differences among the three groups in the enhanced homogeneity and the presence of pseudocapsule sign. However, all the three groups revealed mainly isoechoic and hyperechoic and there were no differences among them. Compared with conventional US, CEUS depicted significantly the increased tumoral vascularity (51.3% vs. 87.5%) and pseudocapsule sign(22.5% vs. 51.3%). Eight lesions demonstrated heterogeneous contrast enhancement on CEUS while homogeneous on conventional US, but there were no differences in lesion homogeneity between conventional US and CEUS findings. Conclusions Different sizes of CCRCC showed distinct CEUS features in the enhanced homogeneity and the presence of pseudocapsule sign. CEUS is more effective on improving the sonographic characteristics of tumoral visualization and may provide important information of US findings for the diagnosis of renal cell carcinoma.