Objective To study whether Clonorchis sinensis eggs were involved in the pathogen esis of gallbladder stones.Method From March to August 2011,the gallbladder stones from 183 patients were studied using microscopic examination and FTIR spectroscopy.Twenty egg-positive and 20egg-negative gallbladder stones found under microscopic examination were chosen randomly and analyzed through real-time fluorescent PCR and scanning electron microscopy.Results Eggs were detected in 118 of 183 gallbladder stones.The eggs were preliminarily diagnosed as Clonorchis sinensis eggs using the morphologic characteristics under light microscope.The results of real-time fluorescent PCR showed eggs in the gallbladder stones were Clonorchis sinensis eggs.The 118 egg-positive gallbladder stones were composed of 97 pigment stones,21 mixed stones and no cholesterol stones.The detection rate of Clonorchis sinensis eggs in pigment stones were the highest among the three types of gallbladder stones (P＜0.001).The 20 egg-positive stones were observed by scanning electronic microscopy:dozens or even hundreds of Clonorchis sinensis eggs were visible under 400 times magnification; and a dozen or even dozens of Clonorchis sinensis eggs and the surrounding particles were adherent to or parceled with each other under 1000 times magnification.While under 3000 times magnification,uneven texture was seen on the surface of eggs with pieces being shed from some eggs.Some eggs were hollow or without cover.Most of them were adherent to or wrapped with amorphous particles or mucoid matter.Conclusions A large amount of Clonorchis sinensis eggs were detected in gallbladder stones.Clonorchis sinensis eggs were associated with the formation of gallbladder stones,especially with pig ment stones.

Forms and Records Control ; methods ; Humans ; Pathology, Clinical ; methods

Objective A systematic study to classify mixed gallbladder stones to determine their relationship with Clonorchis sinensis infection.Methods 349 consecutive patients with mixed gallbladder stones were enrolled into this study and their gallstones were studied.The material composition of gallbladder stones was analyzed using Fourier Transform Infrared spectroscopy,and the distribution and microstructure of the material components were studied using Scanning Electron Microscopy.The composition and distribution of the elements were analyzed by an X-ray energy spectrometer.Gallbladder stones were classified accordingly,and the stones were then grinded for microscopic examination.The stones were divided into two groups based on the results of detection of clonorchis sinensis eggs.Patients were also divided into two groups according to the patients' region (high-incidence and low-incidence regions of Clonorchis sinensis infection).The diversity of the subtypes of mixed gallbladder stones was compared.Results 14 subtypes were found,including Bilirubinate-calcium carbonate mixed stones (n =134),Cholesterol-bilirubinate mixed stones (n =87),Bilirubinate-phosphate mixed stones (n =39),Cholesterol-calcium carbonate mixed stones (n =30),Cholesterol-bilirubinate-calcium carbonate mixed stones (n =15),etc.Bilirubinate-calcium carbonate mixed stones were the main subtype of egg-positive mixed gallbladder stones and the patients were from high-incidence regions.Cholesterol-bilirubinate mixed stones were the main subtype of egg-negative mixed gallbladder stones and patients were from low-incidence regions.The differences of the subtypes constituent between the high-incidence and low-incidence regions groups were significant (P ＜ 0.05),and between the egg-positive and egg-negative groups were also significant (P ＜ 0.05).Conclusions The most common subtypes of mixed gallbladder stones were bilirubinate-calcium carbonate mixed stones,while the second was cholesterol-bilirubinate mixed stones.Clonorchis sinensis infection was mainly associated with Bilirubinatecalcium carbonate mixed stones.

Objective To explore the relationship between the expression of Ki67 and mitosis karyorrhexis index（MKI）in ganglioneuroblastoma（GNB）.Methods Clinical materials and histology slides from 28 patients with GNB were reviewed.MKI was counted under microscope and the expression of Ki67 protein in GNB was evaluated by immuohistochemical technique.The follow-up data were also collected and statistically analyzed.Results There were 15 patients with favourite prognosis（favourite subgroup,FS） and 13 patients with poor prognosis（unfavourite subgroup,US）.The survival time of GNB patient in FS was significantly longer than that in US（P 0.05）.The survival time is related to pathology classification（P 0.05）.MKI was correlated with advanced clinical stage,pathology classification and survival time（P 0.001）.No significant difference in Ki67 expression was found between low and high MKI patients.Conclusion MKI might be a reliable prognostic parameter for making diagnosis and evaluating prognosis of GNB.Detection of Ki67 expression might be not useful for evaluating the prognosis of GNB.

Objective To confirm the association between the“Tip-Apex Distance (TAD)”and cut-out of the lag screw from the femoral head.and to analyze other factors leading to the cut-out.Methods The complete radiographic and clinical data of 106 patients with femoral intertrochanteric fractures were available for this study. They were 65 men and 41 women,with an average age of 52.4 years (range,20 to 83 years).According to Evans classification.19 cases belonged to typeⅡ.25 to typeⅢ,32 to typeⅣ,29 to typeⅤ,and one to type R.The bone quality was classified by Singh rating system:44 cases were rated as typeⅥ.34 as typeⅤ,23 as typeⅣand five as typeⅢ.They were treated with open reduction and fixation with 135?dynamic hip screw (DHS).According to the finding of Baumgaertner that“TAD”beyond 25 mm would grcatly increase the risk of cut-out,the patients could be divided into two groups:59 cases with“TAD”less than 25 mm and 47 greater than 25 mm.Results The mean duration of follow-ups was 14.45 months (range,4.5 to 28.0 months).Of the 15 cases whose“TAD”was more than 30 mm,one had the cut-out.Of the seven cases whose“TAD”was more than 40 mm,two had the cut-out (P=0.000). The average age of the three patients was 78.7 years (range:75 to 83 years) and 27.1 years older than that of the 103 patients whose fracture healed (P=0.000).They belonged to the unstable intertrochanteric fracture of the femur (two to Evans type V and one to type R).The reduction was assessed as excellent in 43 cases,good in 47 cases,fair in nine cases (of whom one had the cut-out),poor in seven cases (of whom two had the cut-out). Conclusions The cut-out of the lag screw from the femoral head can be caused by age,fracture type and stability of reduction and“TAD”.The greater the“TAD”value,the greater possibility of cut-out.

0.05).After treatment,in neuromus- cular electric stimulation therapy group and ice-massage therapy group,SSA scores and degrade of SaO_2 were improved. There was significant difference between before and after treatment(P

ObjectiveTo investigate the relationship between intramural gallstones and intraluminal gallstones. MethodsIn this present study, the control study was applied to analysis on the gallstones from 116 cholecystolithiasis patients with intramural gallstones as well as intraluminal gallstones. All the patients were from the general surgery department and accepted gallbladder-preserving cholecystolithotomy during 2009.02-2009.08. Meanwhile, 171 patients with intraluminal gallstones were investigated the clinical traits; and gallstones from them were analyzed with FT-IR and microsopic examination. ResultsThe results showed the coincidence rate of stone type was 97.4％, and it was mainly pigment gallstones and mixed gallstones in 116 cases; the coincident detection rate of clonorchis sinensis eggs was 98.3 ％, and it was much higher in the pigment gallstones and mixed gallstones than that in the cholesterol gallstones. The ratio of pigment gallstones from the 116 patients group was higher than the 171 patients group, and the detection rate of C. sinensis eggs of the two groups had no statistical difference (P＞0.05). ConclusionsThe stone type of intramural gallstones was mainly pigment gallstones and mixed gallstones. Intramural gallstones and intraluminal gallstones were homologous.

Objective To discuss the clinical and electrophysiological characteristics of sleep related rhythmic movement disorder ( SRMD).Methods We studied the clinical and electrophysiological characteristics of 3 patients diagnosed as SRMD in the Electroencephalography Monitoring Center of Xijing Hospital, Xi′an, China.The 3 patients accorded with diagnostic criteria of SRMD that international classification of sleep disorders-3 edition recommended and were followed up for more than 1 year.Results These 3 male patients were ranging from 6 to 27 years old.The onset age of the patient 1 was 13 years,and the others were 1 year old.The patient 2 became symptom-free at the age of 7.The patient 3 relieved at 2-year-old, but recurred at the age of 21. There was no epileptic seizure discharge in video-electroencephalography of the 3 patients, but synchronous electromyography changes during the attack were mistaken for slow wave.Video-polysomnography showed that numbers of awakenings and arousals index were high.Two patients were treated with clonazepam.One had an obvious curative effect, the other had marked efficacy until added trazodone.Conclusions SRMD can occur not only in infants, but also in adolescents and adults.Patients who have the problems of the sleep quality should be treated.Clonazepam can obviously relieve symptoms and improve sleep quality.Patients who do not have a good effect with clonazepam can try to add trazodone.Video-electroencephalography monitoring and interpreting it correctly are important to the diagnosis of paroxysmal disease.

Objective To evaluate the lung V/Q imaging in the diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH).Methods Seventy-six patients (46 males,30 females,age 27-84 y) with clinically suspected CTEPH who had undergone lung V/Q imaging,CT pulmonary angiography (CTPA),pulmonary angiography (PA) and right heart cardiac catheterization were studied.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of lung V/Q imaging in detecting CTEPH were calculated and compared with those of CTPA.The x2 test was used for statistical analysis with SPSS 11.5.The distribution of involvement of segments in 47 patients with CTEPH was analyzed.Results Forty-seven patients had a final diagnosis of CTEPH and 29 had non-CTEPH etiology.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of lung V/Q imaging were 97.9％ (46/47),86.2％ (25/29),93.4％ (71/76),92.0％ (46/50) and 96.2％ (25/26),while those of CTPA were 78.7％ (37/47),93.1％ (27/29),84.2％ (64/76),94.9％ (37/39) and 73.0％ (27/37),respectively.The sensitivity (x2 =5.818,P=0.012) and negative predictive value (x2 =5.693,P =0.017) for lung V/Q imaging were significantly higher than those of CTPA.V/Q imaging could identify patients with CTEPH from those with idiopathic PAH and familial PAH based on the almost normal ventilation imaging.The lung perfusion SPECT imaging detected 585 (62.2％) of involved segments among 940 segments in 47 patients with CTEPH,with an average of 12.4 involved segments in each patient.The number of involved segments in the right lung was significantly higher than that in the left lung (36.2％ (340/940) vs 26.1％ (245/940) ; x2 =40.85,P＜0.01).Conclusions Lung V/Q imaging plays an important role in diagnosis of CTEPH and in identification of CTEPH from other types of PAH.A normal V/Q imaging can effectively exclude CTEPH.In addition,V/Q imaging can provide more diagnostic information in patients with a clinical suspicion of CTEPH who had negative results by CTPA and PA.

Objective To develop a classification of gallbladder stones,to analyze the clinical characteristics of each type of stone and to provide a theoretical basis for the formation of different types of gallbladder stones.Method 925 consecutive patients with gallbladder stones were enrolled and their gallstones were studied.The material composition of the gallbladder stones was analyzed using fourier transform infrared spectroscopy and the distribution and microstructure of the material components were observed using scanning electron microscopy.The composition and distribution of the elements were analyzed by an X-ray energy spectrometer.Gallbladder stones were classified accordingly.Results The gallbladder stones were classified into 8 types and more than ten subtypes,including cholesterol stones (n =334),pigment stones (n =246),calcium carbonate stones (n =167),phosphate stones (n =14),calcium stearate stones (n =11),protein stones (n =3),cystine stones (n =1) and mixed stones (n =149).Mixed stones were those stones with two or more than two kinds of material components and the content of each component was similar.A total of 11 subtypes of mixed stones were found in this study.Conclusion The systematic classification of gallbladder stones indicated that different types of stones had different characteristics in terms of infrared spectrogram,microstructure,elemental composition and distribution,thus providing an important basis for the mechanistic study of gallbladder stones.