Objective To investigate the diagnosis,differential diagnosis,treatment and prognosis of solitary plasmacytoma (SP) and summarize its clinical features for pathological and clinical application.Methods Reviewed the data of 18 patients diagnosed with SP from January 2005 to August 2013.The clinical features,diagnosis,treatment and prognosis were analyzed retrospectively.Results All 18 cases were pathologically confirmed with SP and met the diagnostic criteria of SP.In 18 patients,12 patients were male and 6 patients were female.Four cases of lesion were located at lumbar,each 2 cases of lesion were located at mandible and ribs,each 1 case of lesion was located at sacrum and occipital bone,3 cases of lesion were located at nasal cavity and maxillary sinus,2 cases of lesion was located at pars nasalis pharyngis,each 1 case of lesion was located at parotid,parasternal and peritoneal cavity.All patients were followed up for 54 months,2 patients were died,3 patients were local recurrence,2 patients were transformed to multiple myeloma,others were survival with no tumor.Conclusions As early as possible to diagnose is the key to treat SP.The final diagnosis of SP is based on the histopathological findings and the optimal treatment for patients with SP is surgery combined with moderate dose radiotherapy.

AIM: To investigate the clinical effect of small incision lenticule extraction (SMILE) for super high myopia.METHODS: Totally 64 cases (128 eyes) patients with super high myopia, were randomly divided into observation group and control group, 32 cases (64 eyes) in each group.The two groups were separately treated with SMILE or femtosecond laser LASIK (FS-LASIK).We calculated the effectiveness index and safety index by contrastive observation of clinical effects in all patients included uncorrected visual acuity, best corrected visual acuity and postoperative spherical equivalent at preoperative and postoperative 1d, 1wk, 1, 3 and 6mo.RESULTS: The safety index: the observation group and the control group at 6mo after operation were respectively 1.10±0.10 and 1.08±0.12, the difference between the two groups was not statistically significant (P>0.05).The validity index: the observation group and the control group at 6mo after operation were respectively 1.08±0.12 and 1.06±0.14 and there was no significant difference between the two groups (P>0.05).Postoperative spherical equivalent at 6mo in the observation group was 0.09±0.36D, that in the control group was 0.36±0.46D.After 6mo, the count of spherical equivalent refraction within ±0.50D were 58 eyes (90.1%) in observation group and 49 eyes (76.6%) in the control group, within±1.0D were 64 eyes (100%) and 60 eyes(93.8%).CONCLUSION: SMILE is safe and effective in the treatment for super high myopia.The postoperative visual acuity and diopter can be stabilized earlier by comparing with FS-LASIK.

ObjectiveTo investigate the common pathogenic bacteria and antimicrobial resistance status in neonatal ward to provide guidance for rational clinical medication. MethodsData of 2306 cases in neonatal ward from July 2008 to June 2010 whose body fluid were cultured with positive results of common bacteria were collected. The change of the bacteria and drug resistance was analyzed. Results Among 10 017 body fluid samples, 80 species consisted of 2306 strains of bacteria were found. Enterobacteria accounted for about 53.8％ (1241/2306), Klebsiella pneumoniae subsp. pneumoniae (430/1241, 34.6％) and Escherichia coli (341/1241, 27.5％) were the most common ones,and among which 68.1％(293/430)strains of Klebsiella pneumoniaesubsp.pneumoniae and 59.5 ％ (203/341 ) strains of Escherichia coli were extended-spectrum β-lactamases (ESBLs) producing strains, which were significantly lower than those[78.1％ (118/151) and 82.6％(76/92) respectively]during 2003 to 2005 (U=-2.32 and -4.11, P＜0.05 respectively).Methicillin-resistant Staphylococcus aureus(MRSA)detectionrate was 8. 5％(23/272)in Staphylococcus, which was lower than that (17.7％, 15/85) in year 2004 to 2006 (U= -2.4, P＜0. 05). Methicillin-resistant coagulase-negative Staphulococcus (MRCNS) detection rate was 63.5％(157/247), which was higher than that (32.6％, 97/298) in year 2004 to 2006(U=7.54,P＜0.05).The common pathogens of nosocomial infection were Klebsiella pneumoniae subsp.pneumoniae,Escherichia coli , Acinetobacter baumannii and Pseudomonas aeruginosa ; while common pathogens of community infection were Staphylococcus aureus, Klebsiella pneumoniae subsp.pneumoniae and Escherichia coli. Multiple drug-resistant infections in hospital were significantly higher than those in community. Drug susceptibility results showed that the resistance of Staphylococcus haemolyticus,Acinetobacter baumannii and Klebsiella pneumoniae subsp.pneumoniae were especially severe.ConclusionsOpportunistic infections and drug resistant strains increased. The increasing of MRCNS and drug-resistant of Acinetobacter baumanniishouldbepaidmore attention.Comprehensive measures might reduce the production of ESBLs bacteria. The choice of antibiotics should be based on drug susceptibility test.

Competition of teaching skills is regarded as an effective means to develop teacher's ability in teaching.This article briefly described a teaching competition at a medical school from participant identification,requirement clarification,training before competition,evaluation index screening and interviewer selection.Meanwhile the article further analyzed and analyzed the problems arising from the competition and proposed measures to promote teachers' awareness and ability of teaching.

Objective To investigate the effect of Yiqi Huoxue prescriptions on prevention of neointima hyperplasia after carotid artery vascular injury in rats.Methods Ninty male SD rats were randomly divided into 6 groups:the model group,the aspirin group,the low-dose Yiqi Huoxue group,the mid-dose Yiqi Huoxue group and the high-dose Yiqi Huoxue group.All of the rats were fed with hypercholesterolemic diet for 30 days,then the 2.0F balloon catheter injury was perfomed through the right femoral artery into the left common carotid artery of rats,the balloon was inflated and deflated 3 times.The rats was given drugs from 1 d before injury and to 5 d,14 d,28 d after injury.Around 6 rats from each group were euthanized by exsanguination at appropriate time point.The injuried left common carotid arteries were carefully removed and harvested for HE staining.Results The neointima hyperplasia was faint at 5 d after the operation.Morphological analysis demonstrated that there were markedly differences in the area of neointima hyperplasia at 14 d or 28 d,the average thickness of neointima hyperplasia,the surplus area of lumen/the total area of lumen between the high-dose Yiqi Huoxue group and the model group(P

Objective To study the expression of protein kinase B (Akt/PKB) isoforms in the gastrocnemius muscle of rats at different ages. Methods The expression levels of mRNA and protein of three Akt isoforms in the gastrocnemius muscle of 30-month-old and 6-month-old rats were detected respectively by RT-PCR and Western blotting. Data were analyzed statistically. Results (1) The levels of Akt1 and Akt2 mRNA in the 30-month-old rats was significantly higher than those in the 6-month-old rats (t=7.124, P=0.000; t=2.598, P=0.021), however, no significant difference was found in the level of Akt3 mRNA between the two groups (t=0.460, P=0.653) . (2) The level of Akt-Thr308 phosphorylation in the 30-month-old rats was significantly lower than that in the 6-month-old rats (t=-9.861, P=0.000), while the level of Akt2 protein in the 30-month group was significantly higher than that in the younger rats (t=7.522, P=0.000). No significant differences were detected in the levels of Akt1 and Akt3 proteins between the two groups (t=0.469, P=0.646; t=0.058, P=0.955). Conclusion The expression levels of three Akt isoforms in the gastrocnemius muscle of rats change with age, suggesting that the three isoforms of Akt have different functions in the gastrocnemius muscle metabolism of rats at different ages.

Objective To arthroscopically re-observe the remodeling and maturity process following anterior cruciate ligament(ACL) reconstruction with a hamstring tendon autograft.Methods Thirty-three patients who had undergone a previous arthroscopic ACL reconstruction with a homolateral hamstring autograft were given a second observation under arthroscope.The interval from initial reconstruction to second-look arthroscopy ranged 2~36 months(mean,11.9 months).According to different intervals,the patients were grouped as 1~,4~,7~,10~,13~,18~,and 25~ months.The shape,color,tension,covering synovial tissue,and vascularity of the grafts were evaluated.Results As the interval increased,the hamstring grafts tended to progress to normal ACL morphologically.Under arthroscopic observation,the tendon grafts were characterized as grayish-white thick ligamentous tissues without synovial membrane and blood vessels after 7 months following initial reconstruction,which corresponded with the maturation period of autogenous grafts and simulated normal ACL.Conclusions Remodeling and maturation of the hamstring autografts progresses with time,which is comparable to patellar tendon autografts.

Objective To analyze the causes of misdiagnosis of uterine sarcomas and to explore the measures to reduce these errors. Methods A retrospective study of 40 cases of uterine sarcomas admitted between January 1980 and June 2002 to our hospital was performed. Results Uterine sarcomas were easily misdiagnosed as leiomyomas. A correct diagnosis of uterine sarcoma was made at primary operation in 15 cases (37.5%). A wrong diagnosis was made in 25 cases (62.5%), and among them re-operation was done in 15 cases. In 7 patients, three operations were performed. Recurrence rate was as high as 64.0%. The rate of hematogenous dissemination was also high. The patients in whom a misdiagnosis was made at their primary operation were younger in age than the patients in whom a correct diagnosis was made (43 years vs 50 years). The amounts of bleeding and transfusion during operations were increased in patients with misdiagnosis. Conclusions Atypical manifestations and lack of knowledge about the diseases were the main causes for misdiagnosis of uterine sarcomas. Misdiagnosis might be avoided by a comprehensive analysis of all clinical information. Radical resection of the primary tumor was the most significant means to ensure a better prognosis.

Objective To evaluate the impact of different anatomical landmarks on registration in imaging-guided radiation (IGRT) for lung cancer. Methods For 20 patients with non-small cell lung cancer receiving stereotactic body radiotherapy (SBRT) in Fudan University Cancer Hospital, 100 frames of kilo-voltage cone-beam computed tomography scanning were evaluated in this study. The spine, carina and tumor were selected as landmarks for registration, respectively. Results of registration using different landmarks were documented and compared. Results The average set-up errors in the left-right, superiorinferior and anterior-posterior directions were -0. 08 cm ±0. 32 cm, -0. 16 cm ±0. 45 cm and 0. 06 cm ±0. 23 cm with the spine for registration;0. 06 cm ±0. 34 cm, -0. 13 cm ±0. 45 cm and -0. 02 cm±0.23 cm with the carina;and -0. 17 cm ±0.25 cm, 0.03 cm ±0.47 cm and 0. 15 cm ±0.38 cm with tumor. The registration results between using the carina and tumor as landmarks were statistically significant different (q=4.61, P=0. 002 ;q = 2. 23 , P=0. 118;q=3.44, P=0. 017). The registration results were equal when using the spine and tumor as landmarks ( q = 1.85, P = 0. 195; q = 2. 54, P = 0. 075; q = 1.89,P=0. 185), as well as using the carina and tumor as landmarks (q=2.76, P=0. 054;q=0.31, P=0. 826 ;q = 1.55, P = 0. 276). Conclusions For early stage lung cancer, the spine and tumor can be used equally as registration landmarks in imaging-guided SBRT. The carina is not suggested for its poor reproducible position.