Objective To discuss the diagnosis and management of adrenal cortical carcinoma. Methods 12 cases of adrenal cortical carcinoma were evaluated with regard to clinical,pathologic characteristics and prognosis.Of the 12 patients,6 were male and 6 were female with an average age of 37.The tumor was functional in 4 and nonfunctional in 8.The tumor was on the right side in 10 and on the left in 2.The diameter of the tumor was 3～30 cm.3 cases were Sullivan stage Ⅰ,3 stage Ⅱ,2 stage Ⅲ and 4 stage Ⅳ. Results Tolal ablation of the tumor has been conducted in 11 and biopsy only in 1.Estrogen receptor expression was positive in 5 out of 7 as deteted by immunohistochemistry assay.Five patient died within 1.5 years after operation whereas the other 7 are still surviving including 5 administered with tamoxifen. Conclusions Adrenal cortical carcinoma may be an estrogen-dependant tumor,so tamoxifen is an effective adjuvant drug in the treatment.Tumor size and stage appear to be strongly correlated with prognosis,larger size and higher stage are associated with a poor prognosis.

ObjectiveTo study the diagnosis and trea tm ent of bilateral renal angiomyolipomas.MethodsThe clin ic data of 13 cases of bilateral renal angiomyolipoms were reviewed.There were 2 male and 11 female patients with an average age of 42.Preoperative ultrasonogra phy and CT scanning have been undertaken in all.Renal angiomyolipoma was diagnos ed in 11 and cancer nodules could not be ruled out in the other 2.Unilateral and bilateral renal sparing surgerys were carried out in 5 and 8 cases respectively .ResultsAll cases were examined with rapid frozen sect ion analysis at operations.The renal function of all the patients except 1 was n ormal after operation except 1 with a temporary rise in Scr (350 ?mol/L).The pa tients have been followed up 1 to 4 years after discharging from hospital and th e renal function became normal in all.No recurrence was found.Conc lusionsUltrasonography and CT are important methods to diagnose ang iomyolipoma with specific manifestations.Rapid frozen section analysis at operat ions is helpful to diagnose and to choose the correct surgical technique.Attenti on should be paid to reserve the renal tissues as much as possible and renal fun ction should be protected properly.

Objective To study the changes of the semen quality and the spermatogoa ultrastructure in uremic patients before and after renal transplantation. Methods The semen was analyzed and spermatogoa were investigated under scanning electron microscopy (SEM) in 8 patients before and after renal transplantation and 5 normal volunteers. Results In uremic patients, there was significant decreases in sperm motility, survival rate and sperm density. Under SEM, the deletion of the acrosome, distinct vacuoligation in the nucleus, deficiency of the postacromal and postnuclear ring and ~absence of the middle segment of mitochondrial sheath were found. After renal transplantation, the semen main parameters were significantly improved (P

ObjectiveTo present 4 cases of primary c ar cinoid tumor of urinary bladder and to discuss the characteristics,diagnosis,tre atment and prognosis.MethodsA retrospective study of p athological and clinical data of 4 cases of primary bladder carcinoid tumor was made.Three were male patients and 1 female with an average age of 58.Two cases w ere considered as benign carcinoid tumor whereas the other 2 carcinoid of high malignancy.All of them presented macroscopic or microscopic hematuria but with no carcinoid syndrome noted.ResultsOne case of maligna nt carcinoid tumor with deep muscle invasion underwent radical cystoprostatectom y and adjurvent chemotherapy,but the prognosis was poor (died 5 months after the operation).Transurethral resection were performed for 2 cases of benign carcino id tumor and 1 case of focal malignant carcinoid with good prognosis.ConclusionsThe primary carcinoid tumor of urinary bladder has no specific symptoms,and should be diagnosised on histopathologic studies.Surgical intervention is the mainstay to treat the disease but the prognosis is hard to b e predicted.

0.05).Compared with electrocautery resection group, more cases in HoLRBT group obtained accurate tumor stages, less cases needed bladder perfusion and had bladder perforation ( P

Objective:To investigate the relationship between the structure of TMJ and the craniofacial pattern,occlusion in ClassⅡ1mandibular retrusion children. Methods:TMJ MRI,lateral cephalometric were taken respectively from 30 ClassⅡ1 patients (14 boys and 16 girls,the average age was 10.8?1.1 years). The condyle position and disc position were measured. The correlation of condyle and disc position with craniofacial pattern and occlusion were analyzed metrically and compared with pearson test.Results:There were low positive correlation between MP-SN angle and anterial space. No correlation between posterior-anterior ratio and other data were found. The posterior facial height and Dp-Cc/Cs-Cc angle had low positive correlation. The anterior facial height and Dp-Cc/Cs-Cc、Ca-Ca'、Ca-Cp showed low negative correlation,and little correlation was found between condyle position and overbite and overjet. Overbite had no correlation with disc-condyle-fossa relationship. However,The positive correlation was found between the overjet. and Ca-Dm and Dp-Cc/Cs-Cc,and Pearson coefficient is 0.420 and 0.460.Conclusion:Vertical craniofacial patter has relation to forward displacement of condyle and backward displacement of disc. A deeper overjet is related with a higher risk of abnormal disc-condyle-fossa relationship.

BACKGROUND: It has been verified in relevant clinical and epidemiological researches in recent years that a part of stomatopathy is associated to psychological stress factors.OBJECTIVE: To analyze the relationship between the changes in salivary secretory IgA and cortisol and psychological stress states.DESIGN: cross-sectional investigation was designed.SETTING: Department of Stomatology, Zhejiang University.PARTICIPANTS: The investigated participants were 60 students in the 2nd grade of Fuzhou №.2 Senior School selected from May to November 2003. Fifty-seven of them accomplished the investigation, of male; aged varied from 17 to 19 years, of healthy, no stomatopathy and family history of disorders in immune system and without indulgence in smoke and alcohol. All of them had participated in the 3-day terminal exam.METHODS: Before the exam, evaluation with symptom checklist (there are 90 questions, including about 10 factors, such as somatization, compulsive state, sensitive interpersonal relationships, melancholy, anxiety, hostility, fear, paranoid state, psychotic state and others. The total average score results by divided total score with 90. ) was applied. Fifty-seven students that had accomplished the investigation were divided in low-symptom group (the total score of symptom checklist ＜ 2.0) and high-symptom group (the total score ≥ 2.0). 5 weeks before the exam, the students were called together to fill up investigation form of general situation. Four weeks before the exam and at 7: 30 am on the day of exam, the first and second saliva specimens were collected respectively to determine salivary secretory IgA and cortisol before and after exam stress. The students were called together again 3 days after exam to fill up questionnaire on psychological health to evaluate their psychological health state.stress.RESULTS: Intention management analysis was adopted, in which 57 stulist with Chinese norm: after exam, the scores of 4 factors, named compulsive state, anxiety, hostility and paranoid state, were higher than Chinese norm [(1.98±0.72, 1.69±0.61) scores; (1.79±0.31, 1.42±0.43) scores; (1.77±0.68,1.50±0.57)scores; (2.00±0.71, 1.52±0.60)scores, P ＜ 0.01] and there was parison of salivary secretory IgA content after stress: that before exam in low symptom group was remarkably higher than that in high symptom group [(236.6±82.29),(194.55±66.29) mg/L, P ＜ 0.05], that after exam in low symptom group was higher than that in high symptom group [(182.21±55.92,tration after stress: that after exam in low symptom group was remarkably higher than that in high symptom group [(5.96±2.46, 3.68±2.26) μg/L, P secretory IgA and cortisol in two groups: the decrease rate of secretory IgA (0.012±0.197) and increase rate of cortisol (0.199±0.654) were relevant to compulsive state and paranoid state.CONCLUSION: In evaluation with symptom checklist after exam, the scores of anxiety, compulsive state, hostility and paranoid state were higher than Chinese norm, indicating that exam stress induces increased anxiety level and variation of psychological behavior of students. The difference presented in decrease rate of salivary secretory IgA before and after exam stress between high and low symptom groups, explaining that the students with more psychological symptoms are weak to endure exam stress.

Objective To observe the effect of Jisheng injection(JI)in preserving isolated heart of mice.Methods Langendorff' s isolated -perfused mouse heart mod el was established.The isolated hearts were preserved in modified Eu-ro -Collins solution(MECS)and MECS with JI added for 3h,7.5h and8.5h respectively.Cardiac functio n,coronary flow and myocardial water -volume (MWV)were observed after 3h ,7.5h and 8.5h of preservation,heart reactivatio n(HR)rate,coronary flow,MWV and time for HR were also observed.Results After 3h of preservation and 20min,30min or 40min of reperfusion,cardiac function and coronary flow in three M ECS +JI groups and especially in that of large dose were improved as compared with t hose in MECS group;MWV in large -dose and moderate -dose groups was obvi-ously lower than that in MECS group(P

BACKGROUND: Previous studies demonstrated that construction of eoexpression plasmid containing multiple genes on the same vector could improve transfection and expression rates.OBJECTIVE: To construct eukaryotic expression plasmid pcDNA3.1 (+)-MUC1 -GM-CSF by human polymorphic epithclial mucin (MUC 1) and granulocyte macrophage colony stimulating factor.(GM-CSF) and to observe expression of recombinant plasmid in COS-7 cells.DESIGN,TIME AND SETTING: Gene recombination design,which was carried out in the Animal Central Laboratory,the Fourth Military University of Chinese PLA from September 2005 to December 2006.MATERIALS: Eukaryotic expression vector pcDNA3.1 (+) was presented by Pro.Taylor-Papadimitriou;pGEM-3zf()-GM-CSF plasmid,COS-7 cells,pUCI 8 vector,and E.coli DH5α were made in the center; female BALB/c mice were provided by Experimental Animal Center of the Fourth Military University of Chinese PLA.METHODS: Signal peptide was synthesized with encoded MUCI gene sections to obtain repeated sequence coneatemer after renaturation.Next,the accepted concatemer was cloned with GM-CSF following enzyme identification and sequencing analysis,and then they were put in eukaryotic expression vector pcDNA3.1(+) to construct eukaryotic coexpression plasmid pcDNA3.1 (+)-MUCI -GM-CSF in order to transform COS-7 cells.MAIN OUTCOME MEASURES: Gene expression was detected by indirect immunofluorescence and enzyme linked immunosorbent assay (ELISA).RESULTS: Enzyme identification and sequencing analysis showed that recombinant plasmid contained a fusion gene encompassing human MUC1 repeated sequence concatemer and GM-CSF; moreover,MUC1 expression was detected in COS-7 cells,while recombinant plasmid could induce the production of anti-GM-CSF antibody.CONCLUSION: The recombination between human MUC1 repeated sequence concatemer and GM-CSF gene successfully constructs eukaryotic coexpression plasmid.

Objective To investigate the clinical value of amplitude integrated electroencephalogram on early diagnosis and prognosis evaluation of brain injury caused by neonatal asphyxia.Methods A total of 34 full-term asphyxiated neonates(asphyxia group)hospitalized in NICU of our hospital from January 2015 to September 2015 were selected;meanwhile,34 full-term healthy infants(control group)of the same term were selected.All cases were monitored for the activities of aEEG background,sleep-awakening cycle(SWC)and epileptic activity(SA)within 6 hours after birth.Meanwhile,the relationships between various indexes and asphyxia degree and brain injury were analyzed.Results The electroencephalogram of the asphyxia group was 52.9％and the rate of SWC was 58.8％,which were lower than those of the control group,and the difference had statistic significance(P<0.05).Meanwhile,neonates with epileptic activity in asphyxia group accounted for 11.8％,which was higher than that of control group significantly(P<0.05).Conclusion The AEEG changes of neonates at early period after birth are closely related to perinatal asphyxia and brain injury after asphyxia.The application of amplitude integrated electroencephalogram has an important significance on early diagnosis of neonatal asphyxia.