Objective To explore the correlation between the change of CT value of osteolytic bone metastasis after the treatment of zoledronic acid and bone metabolism before treatment in breast cancer patients.Methods Twenty breast cancer patients with osteolytic bone metastases were diagnosed by 99m Tc-MDP bone scintigraphy and 99m Tc-MDP SPECT/CT ( contain 16-slice spiral CT) for the first time entered this study.After treatment of zoledronic acid for 3-12 months with the same method, 99m Tc-MDP bone scintigraphy and 99mTc-MDP SPECT/CT were peformed in the 20 breast cancer patients again with the same CT scan parameters(voltages:120kV, tube currents:80mA, pitches:3.75mm).With using regions of interesting (ROI)technique, the T/NT value of osteolytic bone metastases in the first 99m Tc-MDP bone scintigraphy were measured.The CT value of same ROI before and after zoledronic acid therapy were measured (CT1 and CT2), and the change of CT value (△CT,△CT=CT2-CT1) were calculated.The correlation between them were analyzed. SPSS 16.0 was applied for variance and linear correlation analyses.Results (1)A total of 30 lesions of osteolytic bone metastases were detected in the 20 breast cancer patients by the first 99m Tc-MDP bone scintigraphy and 99m Tc-MDP SPECT/CT.The CT value before therapy was significantly higher than that after therapy(425 ±152HU vs 120 ±73HU, t=9.95, P<0.01).(2)The change of CT value after therapy was positively correlated with and the T/NT value of osteolytic bone metastasis(r=0.907, P<0.01).(3)The change of CT value of positive lesions after therapy was significantly higher than that of negative lesions by 99mTc-MDP bone scan(W=15,P=0.001). Conclusion 99m Tc-MDP bone scintigraphy provides an effective method to predict the efficacy of zoledronic acid for breast cancer pa-tients with osteolytic bone metastases.The breast cancer patients with high bone metabolism should be recommended zoledronic acid thera-py, conversely should not be recommended.

A total of 100 patients with subacute thyroiditis hospitalized from January 2011 to October 2012 were recruited.Each received glucocorticoid treatment for 8 weeks and there was a 2-month follow-up period after drug withdrawal.After treatment,the short-term recurrence rate was 34％ (34/100).If thyroid ultrasound was abnormal,the recurrence rate was 52％ (30/58).And it was significantly higher than 10％ recurrence rate for those with normal thyroid ultrasound (4/42,x2 =9.67,P ＜ 0.01).The recurrence rate of different erythrocyte sedimentation rate groups of 40-100 mm/1 h and ＞ 100 mm/1 h was 37％ (22/60) and 30％ (12/40) respectively (P ＞ 0.05).

Objective To study the clinical rescue for basicranial fracture complicated with massive hemorrhage.Methods The therapies for 20 patients of basicranial fracture complicated with massive hemorrhage treated in our hospital within 3 years were analyzed retrospectively.Results Among 20 patients,16 cases were male,4 cases were female.7 cases were simple anterior basicranial fracture with massive hemorrhage,1 case was the delayed massive hemorrhage in cavernous fistula caused by anterior basicranial fracture,12 cases were anterior and mid basicranial fracture complicated with massive hemorrhage.In consequence,6 cases were secondary cerebrospinal leak,8 cases recovered,8 cases died.Conclusion The basicranial fracture complicated with massive hemorrhage is a very dangerous symptom with high death rate and high disability rate.The patients should be rescued actively.

Objective To explore the effects of parent-adolescent conflict and cohesion on relational aggression among junior students.Methods Parent-adolescent Conflict Questionnaires,Parent-adolescent Cohesion Questionnaires,and the Relational Aggression Questionnaires were used in investigating 392 junior students.Results The level of relational aggression of junior students was low (22.52±5.15).There was no differences between relational aggression of male students (22.93± 5.43) and female students (22.00± 4.73) (P＞ 0.05),and of grade 1 students(22.72±5.14)and grade 2 students(22.64±5.67),grade 3 students(21.93±4.22) (P＞0.05).The students' relational aggression showed a significantly positive correlation with frequency and intensity of parent-adolescent conflict(r=0.269,r=0.307,r=0.268,r=0.271,P＜0.01),and negative correlation with father-adolescent cohesion(r=-0.171,P＜0.01).Parent-adolescent cohesion was negative predictor of relational aggression(β=-0.123,P＜0.05),and the intensity of parent-adolescent conflict was positive predictor(β=0.301,P＜0.01).Conclusion Parent-adolescent conflict and cohesion have significant effect on relational aggression among junior students.

Objective To investigate the association of endothelial nitric oxide synthase (eNOS) polymorphisms and avascular necrosis of femoral head (ANFH),to explore possible relationship between the ANFH incidence and 27-bp repeat polymorphism in intron 4 and G894T polymorphism in exon 7.Methods Totally 125 atraumatic ANFH patients and 126 healthy controls without hip trauma history were enrolled.Gene polymorphisms in 27-bp repeat polymorphism in intron 4 and G894T polymorphism in exon 7 were determined.Medical history was collected for etiology analysis.Results In between-group comparison,the frequency of b/a genotype intron 4 in ANFH group was significantly higher than that in healthy control group [19/125 (15.2％) vs 6/126 (4.8％),P =0.0001,OR =4.501],and the result of G/T genotype exon 7 in the ANFH group also indicated a statistical significance with the healthy control group [30/125 (24.0％) vs 17/126 (13.5％),P =0.0094,OR =3.804].In subgroup analysis,genotype b/a and G/T were especially higher in the idiopathic group than that in the healthy control group.Conclusions eNOS gene polymorphisms might be a risk factor of ANFH,there is underlying relevance of eNOS and the disease.Both 27-bp repeat polymorphism in intron 4 and G894T polymorphism in exon 7 are associated with ANFH incidence.

Purpose To investigate the clinicopathlogical characteristics, diagnosis and differential diagnosis of ovarian small cell car-cinoma hypercalcemic type ( OSCCHT) associated with acute renal dysfunction. Methods A case of OSCCHT associated with acute renal dysfunction was reported. The clinical and pathologic data, treatment and pathological examinations were analyzed and the related literatures were reviewed. Results A 29-year-olds women was presented to hospital with inappetence and significant weight loss for 2 months. The laboratory examination showed abnormal renal function, and pelvic cavity mass, possibly coming from adnexa of the uterus was seen by radiography. Serum levels showed significantly increased serum calcium with acute renal dysfunction. An emergency opera-tion was performed just after renal function partially recovered by 2 times hemodialysis. During surgery, right ovary tumor with a size of 12 cm × 10 cm × 10 cm was inspected. Microscopically, the tumor cells were arranged in a diffuse solid pattern, mutiple nodules were separated by fibrous tissue. some small folliculars and pseudoglandular cavities with acidophilia secretion within nodules could been ob-served. Tumor cells were medium to large with eosinophilic cytoplasm, round or oval vesicular nucleus, increased karyoplasmic ratio and pathologic mitosis. Immunohistochemistry revealed that the tumor cells expressed EMA, CKpan, C-erbB-2 ( +) , CA125 ( focal+) and Ki-67 proliferation index was about 60%, while ER, PR, Syn, CgA, PTH, Inhibin, CD99, AFP, PLAP, CD30 and CD20 were not expressed. Conclusion Ovarian small cell carcinoma hypercalcemic type with acute renal dysfunction is a very rare with a rapidly progressive and highly malignant tumor. The final diagnosis mainly lies on clinical information ( hypercalcaemia) , morphology and immunohistochemistry, combined with electron microscopy and molecular biological detection when necessary.

Objective To establish reference methods for the measurement of catalytic activity concentrations of enzymes at 37℃ which have been published by IFCC and evaluate accuracy of reference methods.Methods Six reference methods for the measurement of catalytic activity of enzymes were established with two sets of apparatus systems of PE and Agilent according to International Federation of Clinical Chemistry(IFCC)37℃ reference procedures in two reference labs respectively.The commercial Roche calibrator c.f.a.s was used to monitor the precision of two reference labs as quality control material.Certified Reference Materials(CRMs)represented an efficient tool to assess the analytic performance for the verification of trueness and in two labs.The measurement accuracy of the assays for catalytic activity concentrations of 6 enzymes [alanine aminotransferase(ALT),aspartate aminotransferase(AST),lactate dehydrogenase(LDH),creatine kinase(CK),gamma-glutamyhransferase(GGT),amylase(AMY)]was further verified and validated by international ring trial program.Results The within-laboratory variations of 6 enzymes in both of the reference lab were ranged from 0.5%-1.9%.Their results showed fully agreement with deviation less than 2.1%.The value of CRM was in the tolerant limit and analytic accuracy was verified.The results of four enzymes(ALT,AST,GGT,AMY)lay within (x)±s.However,the result of CK and LDH lay within (x)±2s.Except sample A for the LDH testing,we did not find any deviation variable in the detection of other enzymes.Conclusions The reference methods for the measurement of catalytic activity of enzymes(ALT,AST,LDH,CK,GGT,AMY)at 37℃ in the two labs by use of two sets of apparatus systems of PE and Agilent have been established and these methods showed excellent stability and accuracy.

Under the guidance of meridian theory, the acupoints heat-sensitive moxibustion is a treatment method which applies moxa stick to perform mild moxibustion at heat-sensitive acupoints, which can arouse the meridian sensation transmission and promote the movement of meridian qi; consequently, the qi can be extended to the diseases. For its many advantages, such as no direct contact on skin, no injuries, no pains, fewer side effects, easy operating and moderate cost, the acupoints heat-sensitive moxibustion is widely accepted in dermatology, male urology disease, rectum and anus diseases and breast diseases. The application and research status of the acupoints heat-sensitive moxibustion in traditional Chinese surgery in recent years is reviewed, and several problems and suggestions in its clinical application and research are proposed, aiming to provide clinical basis for its further development and clinical application in traditional Chinese surgery.
Acupuncture Points ; Clinical Trials as Topic ; General Surgery ; Humans ; Moxibustion ; Sensation

Abstract Formaldehyde has been widely employed to immobilize clinical tissue specimens, inactivate toxins and viruses in biomedical fields. Formaldehyde can react with active groups in bio-molecules such as proteins, resulting in protein cross-linking, inactivation, and immobilization. By using several standard peptides and tryptic peptides from matrix protein of influenza virus as experimental models, we studied the chemical modifications of peptides and proteins with formaldehyde by matrix-assisted laser desorption ionization time-of-flight mass spectrometry and nano-electrospray quadruple time-of-flight tandem mass spectrometry. The reaction between formaldehyde and peptides was performed under the same conditions as those during inactivation of virus (4℃, 0. 025% Formalin (V/V), 37% formaldehyde solution (w/w), and 72 h). The results indicated that under above conditions, formaldehyde could react with amino group of N-terminus of standard peptide to generate a methylol adduct, which was further condensed into an imine to generate+12 Da product. Besides, formaldehyde could react with side chain of two amino acids such as arginine and lysine, yielding +12 Da product respectively. The analysis of the reaction between formaldehyde and tryptic peptides from matrix protein of influenza virus showed that +24 Da products could be detected in most peptides due to combinational contribution from N-terminus of peptide (+12 Da ) and side chain of C-terminal arginine or lysine (+12 Da) . Moreover, a +36 Da product was detected for a peptide with miss-cut site. The results indicated that low-concentration formaldehyde primarily reacted with amino group on N-termini of peptides and proteins, as well as the side chains of arginine and lysine residues. The present study suggested an effective mass spectrometry-based method for analyzing the reaction between low-concentration formaldehyde and peptides and proteins, thus provided strategies for interpretation for the mass spectra of reaction products.

Objective Cervical lymph node enlargement may be attributed to inflammation or tumors .This study was to analyze the pitfalls in fine-needle aspiration cytology ( FNAC) of cervical lymph nodes and the measures for avoiding misdiagnosis of cervical lymph node lesions . Methods We retrospectively analyzed the data about 435 cases of FNAC in comparison with the results of corre-sponding tissue biopsies in cervical lymph nodes . Results Among the 435 cases, 7 showed disagreement between the results of cytolog-ic and histologic diagnoses, which included 5 males and 2 females, at the age of 41 to 71 (58.4 ±8.9) years.Six of the cases presented with local lymph node enlargement and 1 with generalized lymphadenopathy, all with enlarged lymph nodes palpable 1-4 cm in diameter . Based on the results of FNAC, 1 case of malignant lymphoma was misdiagnosed as lowly differentiated adenocarcinoma, 1 case of lympho-ma misdiagnosed as poorly differentiated metastatic carcinoma, 2 cases of lymphoma diagnosed as lymphoproliferation and recommended for biopsy, 1 case suggestive of malignant tumor without further classification, and 2 cases microscopically characterized and recommended for lymph node biopsy.Compared with the results of the biopsy, FNAC achieved a 99.3%coincidence rate of qualitative diagnosis (432/425), with a misdiagnosis rate of 1.6%(7/435). Conclusion FNAC plays a very important role in the initial identification of the nature of lymph node lesions and the type of tumors.Practiced puncture skills and intimate knowledge about the histopathological features, diagnostic criteria, and differential diagnosis of the lymphatic system disorders are essential for improving the diagnostic accuracy of FNAC .