A total of 62 cases with autogenous arteriovenous fistulas were examined bv color Doppler ultrasonography.Venous thrombotic manifestations (n =13) and large local hematoma (n =3) were detected.The diameter ranges were around (1.8 ± 0.7) cm for arteriovenous fistula and (2.0 ± 0.8) cm for local hematoma.And there was no statistical significance (t =1.63,P ＞ 0.05).According to edge shape,presence or absence of flow signal and fistula searching,it could be used to identify venous thrombosis and local hematoma of arteriovenous fistula.Color Doppler ultrasound is helpful for the differential diagnosis and the mass properties of arteriovenous fistula so that it provides useful diagnostic information for the clinicians.

Objective To improve the capability of diagnosing and treating renal chromophobe cell carcinoma (RCCC) and the recognition of this subtype of renal cell carcinoma (RCC). Methods The clinical data of 15 cases of RCCC (10 men and 5 women) were analyzed.Their age ranged from 47 to 74 years,with a mean of 57 years. Radical nephrectomy was performed in all these cases. Results Postoperative pathological findings confirmed the diagnosis of RCCC.The pathologic TNM stage of RCCC was as follows:pT 1N 0M 0 in 6 cases,pT 2N 0M 0 in 5,pT 3bN 0M 0 in 2,pT 1N 2M 0 in 1 and pT 2N 2M 0 in 1.The pathologic grade of RCCC was G 2 in 10 cases and G 3 in 5.Eleven cases were followed up.During the follow-up of 2 to 31 months (mean, 19 months),1 died of heart attack,1 had local recurrence and 9 were surviving tumor free. Conclusions RCCC is a morphologically distinctive uncommon subtype of RCC.Radical nephrectomy is the first choice for the treatment of RCCC.Compared with other types of RCC at the same stage and of the same grade,RCCC has a better prognosis.

Objective To introduce and evaluate the procedure of suprapubic tensionless Sparc TM sling system in treating female stress urinary incontinence (SUI). Methods A total of 42 patients (mean age,54 years) diagnosed with SUI (a mean course of 12 years) were treated by Sparc TM sling method.Of them 4 cases had detrusor instability.Under local anesthesia,this procedure took about a mean of 20 min.The urinary catheters were removed the next morning after the procedure.The patients were counseled on abstaining from heavy lifting,exercises and intercourse for 4 weeks. Results After removal of catheters,all the 42 patients successfully voided without incontinence.Detrusor instability to various degrees developed in 7 patients and was relieved by expectant treatment.All the patients were followed up for 3 to 12 months (mean,6 months).Neither recurrence of SUI nor lower urinary tract obstruction was found.No implant related complications such as local irritation,extrusion,erosion through the urethra,migration from the desired location,fistula formation and inflammation occurred. Conclusions Sparc TM sling system is a simple,safe and efficacious method of treating SUI under local anesthesia.

Objective To investigate the role of Keratin 13 gene in laryngeal carcinogenesis. Methods To detect the deletion frequency of keratin 13 sequence indirectly by LOH analysis at DNA level using 5 STR primers within and near keratin 13 gene in 100 cases. Results LOH was found in all of the microsatellite loci, and the LOH frequencies were 30.48%, 26.02%, 21.62%, 37.66% and 21.51% at D17S1964E, D17S2092, D17S791, D17S1665, and D17S808 positions respectively. The frequencies of LOH were not related to the type of laryngeal carcinoma. Conclusion Keratin 13 gene might play an important role in the laryngeal carcinogenesis,and further research is necessary to confirm it.

Objective To study the variables of behavioral function and TUNEL (terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling) figure in Bcl-2 transgenic (TG) mice and control mice after spinal cord injury (SCI), thus to find new ideas and ways for diagnosing and treating SCI. Method The genesis of Bcl-2 overexpression transgenic (TG) mice were produced by injection of Bcl-2 plasmid into the fertilized ova of mice.Nine Bcl-2 TG mice and nine control mice were subjected to SCI of moderate severity at T10, with the use of weight dropping (WD) method (impact force 2.5～3.0 g·cm). Up to 1 day , 7 days, and 14 days after SCI,functional deficits were evaluated with BBB scales, and the apoptosis of neurons was investigated by using TUNEL method. Another three mice of control group were only treated with laminectomy without SCI for comparison. Results The mean functional scores in the control mice were lower than those in the Bcl-2 TG mice, although the unpaired T -test revealed no significant differences. On the other hand, the number of TUNEL positive neurons and IOD(Integrated Optical Density)score in the Bcl-2 TG mice were both significantly lower than those in the control mice. Conclusions This experiment suggests that overexpression of Bcl-2 may suppress neuronal apoptosis after SCI. The Bcl-2 may be an important factor in relieving the damage within CNS after trauma.

BACKGROUND:Insulin-like growth factor-1 (IGF-1) is an important mitogen and an indispensable regulator during normal hair cell development. Extracellular signal regulated kinase 1/2 (ERK1/2) is also expressed in mammalian vestibular organs.OBJECTIVE: To investigate the changes of the expression and the distribution of IGF-1, IGF-1 receptor (IGF-1R) and ERK1/2 in guinea pig's vestibular epithelium following gentamycin injury.DESIGN: A randomly controlled study.SETTING: Department of Otorhinolaryngology, General Hospital of Chengdu Military Area Command of Chinese PLA.MATERIALS: Twenty healthy and adult guinea pigs, weighing 300 to 350 g, provided by the Experimental Animal Center,Fourth Military Medical University of Chinese PLA, were randomly divided into four experimental groups and a control group with 4 in each group.METHODS: The experiment was performed at Department of Otorhinolaryngology Research Laboratory of Xijing Hospital,Fourth Military Medical University of Chinese PLA from January 2002 to May 2002. In the experimental groups,gentamycin was intraperitoneally administered daily (80 mg/kg) for 10 consecutive days. For the control group, 1 mL of 0.9% sterile saline was administered in the same way. The guinea pigs, in which unsteady gait or nystagmus appeared,could be involved in the further experiments. Before being sacrificed, the animals' gait, nystagmus and the amount of food-intake were observed every day. The animals were anesthetized deeply with 50 mg/kg pentobarbital 1, 7, 14 or 21days after the last gentamycin administration and then decapitated. Bilateral otic vesicles were harvested and immersed in 4% paraformaldehyde. Then the specimens were decalcified in 10% ethylenediamine tetraacetic acid (EDTA),thereafter embedded in OCT gel and serially sectioned at a thickness of 10 μm in the cryostat. The behavioral changes of guinea pigs were observed. The morphological changes of vestibular epithelium were examined by hematoxylin and eosin (HE) staining. The expression and distribution changes of IGF-1/1R and ERK1/2 were investigated immunohistochemically. MAIN OUTCOME MEASURES: The behavioral, morphological, expression and distribution changes of IGF-1/1R and ERK1/2 of guinea pigs in each group.RESULTS: Twenty involved guinea pigs entered the stage of final analysis. ① All the guinea pigs' vestibular functions were impaired after gentamycin treatment, then partially restored without any pharmaceutical treatment. ②Morphological injury was obvious after gentamycin treatment, and improved 1 week later. ③The expression of IGF-1/1R was low in the control group, and in the 1-day group it increased significantly to its maximum. After that, its expression decreased gradually, but was still higher in the 21-day group than that in the control group. There were significant differences in the expression of IGF-1/1R among different groups (F =51.8,45.7,P ＜ 0.05). The expression changes of IGF-1 and its receptor were similar. ④The expression of ERK1/2 was low in the control group, and increased gradually after gentamycin toxicity. In the 7-day group, the immunoreactivity reached its maximum. Then the levels of ERK1/2 decreased gradually, but were still higher in the 21-day group than that in the control group. There were significant differences in the expression of ERK1/2 among different groups (F =103.7,106.4, P ＜ 0.01), but no significant differences existed in the expression between ERK1 and ERK2 among different groups (P ＞ 0.05).CONCLUSION: The expression of IGF-1/1R and ERK1/2 in vestibular epithelium increased after gentamycin treatment,and IGF-1 may play an important role as an endogenous mitogen through a paracrine or autocrine manner in the early stage of hair cell self-repair of guinea pigs. ERK1/2 may play an important role in signal transduction during vestibular hair cell self-repair after gentamycin toxicity in guinea pigs.

Objective To study the diagnosis and treatment of retroperitoneal schwannoma.Methods Clinical data of 11 cases of primary retroperitoneal schwannomas were analyzed retrospectively from February 1990 to September 2014.There were 6 males and 5 females,with a median age of 46 years,and the median tumor size was 9.6 cm (4.5-12.3 cm).Seven cases were revealled due to physical examination,3 cases were revealled due to ipsilateral lower back pain or discomfort,and 1 case was revealled due to right lower extremity numbness.There were no clinical manifestations of hypertension or appearance shape change,and there were no abnormal findings in routine laboratory and endocrine examinations.Radiological examination showed a retroperitoneal mass.There were 3 cases in the left adrenal gland,1 case in the right adrenal gland,3 cases in the lower pole of left kidney and 4 cases in the lower pole of right kidney.Four patients were initially diagnosed as adrenal tumors,and 7 patients were diagnosed as kidney tumors.Results All the 11 cases underwent surgical resection,with 7 cases of complete resection,1 case of capsule resection,2 cases of partial resection and 1 case of biopsy.The pathology of immunohistochemical staining showed S-100 positive in 10 cases of benign retroperitoneal schwannomas.During the follow-up period for 1.5-24 years (median 14 years),no recurrence and malignance was observed.One case of malignant retroperitoneal schwannoma died of multiple metastases in 17 months after opreation.Conclusions Primary retroperitoneal schwannoma is rare and preoperative diagnosis is difficult.Clinical manifestations and radiological findings are usually nondiagnostic,and histopathology is the only way for final diagnosis.Complete surgical resection is proved to be the best choice.

Objective To study the ultrasonographic characteristics and significance of color Doppler ultrasound in the diagnose of soft tissue haematoma in the elderly.Methods Totally 45 elderly patients with soft tissue hematoma were retrospectively analyzed.Hematoma were divided into 3 types:traumatic hematoma,iatrogenic hematoma and spontaneous hematoma.The ultrasonographic features of hematoma including location,size,shape,internal echo,boundary and relationship with around muscles were detected by color Doppler ultrasound.Results The ultrasonographic diagnostic rate of soft tissue haematoma was 98.0％ (44/45) in this study.The haematomas in patients were found in the soft tissues of many body parts and the types were mainly iatrogenic and spontaneous haematomas (42.0％ and 40.0％ respectviely).The traumatic hematomas and iatrogenic hematomas could be found in the early stage by ultrasound due to the trauma history,and the sonograms were mainly equal and low echo (75.0％ and 80.0％ respectively).Traumatic hematoma was found between the disorder muscles,and partial ruptured muscle fibers could be detected within or around the hematoma.Iatrogenic hematoma was mainly located around the vessels,which were compressed to the deep part as compared with the vessel in contralateral.Spontaneous haematoma was not almost found in the early stage and could be easily ignored and misdiagnosed.Spontaneous hematoma was mainly located within muscle fibers or fatty layers,presented anechoic area with irregular hypoechoic between the muscles and had well-defined hyperechoic boundary with compressed muscles around it.Conclusions Color Doppler ultrasound has a reliable diagnosis of soft tissue haematoma with quick,noninvasive,convenient for follow-up advantages in the elderly.

OBJECTIVETo observe the effect of using polytetraflouroethylene (e-PTFE) tube with self-Schwann cells implanted to repair facial nerve defect.

METHODSEnzymatic digest method was used to get pure Schwann cells in short time. The e-PTFE membrane tube was used to bridge the 1.0 cm defect of facial nerve and pure self-Schwann cells were injected into the tube. As control group, the e-PTFE tube without self-Schwann cells was used in the same way. Electric physiological and histological examinations were taken in different times.

RESULTSThe effect of nerve regeneration of the experimental group was better than control group at any time. The nerve conduction velocity of the experimental group was 29.70 m/s in the 16th week, while the control groups was 23.00 m/s respectively at the same time.

CONCLUSIONIt is possible to obtain sufficient active Schwann cells by enzymatic digest method. Using e-PTFE tube to bridge the defect of facial nerve with self-Schwann cells implanted can get effect of nerve regeneration.

Aged ; Cardiac Pacing, Artificial ; adverse effects ; Echocardiography ; methods ; Heart Failure ; diagnostic imaging ; etiology ; Humans ; Male