Objective To analyze the CT features of large adrenal adenoma and to compare the pathological features of large adenoma and small adenoma in order to improve the diagnosis of large adenoma.Methods The unenhanced and enhanced CT images of 14 patients with large adrenal adenoma,proven surgically and pathologically and pathological features of small adrenal adenomas in 30 cases were retrospectively reviewed.The pathological features were evaluated in the cell composition,the incidence of cystic degeneration and hemorrhage of large adenoma and small adenoma.Results 14 large adenomas were unilateral and single,3 had distinct margin and 11 had indistinct margin,14 showed regular contour of round or ellipse,the size of tumors were 5 cm?5.5 cm～18 cm?20 cm.14 large adenomas presened heterogenous density in unenhanced CT study with CT value of-36～51 HU,and 3 showed calcification and 6 showed cystic degeneration.Most of the 14 adenomas presented heterogenenous enhancement after contrast administration.Pathologic examination indicated that the clear cells were predominant in the cell composition of small adenoma,while in the case of large adenoma,the proportion of compact cell predominance was equivalent to that of the clear cell and compact cell concomitance.3 small adenomas and 6 large adenomas had cystic degeneration,5 small adenomas and 4 large adenomas had hemorrhage respectively.Statistical analysis suggested that large adenoma had higher incidence of degeneration than that in small adenoma,while no difference was found in the cell composition and incidence of hemorrhage between large adenoma and small adenoma.Conclusion The large adrenal adenomas have higher incidence of degeneration than that in small adenoma,while no difference is found in cell composition and incidence of hemorrhage between large adenoma and small adenoma.

OBJECTIVE:To detect and analyze the drug resistance of the AmpC and the extended-spectrum ?-lactamases(ESBLs)in Escherichia coli(E coli)from urinary infections.METHODS:ESBLs was detected by Phenotypic Confirmatory Test and AmpC was detected by improved three dimensional test.RESULTS:The isolating rates of ESBLs(45 strains),AmpC(8 strains)and AmpC+ESBLs in E.coli(5 strains)were 34.6%,6.2% and 3.8%,respectively.The drug resistance rates of ESBLs and AmpC-producing E.coli was higher than those of the strains without producing ESBLs or AmpC.CONCLUSION:Production of AmpC and ESBLs in ?-lactam antibiotics was the main resistance mechanism against E.coli.Carbopenems should be regarded as the first choice in clinical empirical medication for enzyme-producing strains.

Adult ; Female ; Foreign Bodies ; surgery ; Humans ; Neck ; Oropharynx ; surgery

In the past, the ways to amblyopia neural mechanism research are given priority to visual electrophysiology and so on, which express the result use two -dimensional form, these ways mainly research the functions of the state before the lateral geniculate body. For the study of optic center, animal models are used to research it. But these kinds of methods are unable to accurately detect amblyopia neural mechanisms of human beings. Vulnerable to a variety of factors, it is difficult to finish the amblyopia treatment effect evaluation. Functional magnetic resonance imaging ( fMRI ) can reflect the three-dimensional visual cortex neuron activity noninvasively and accurately, and give rise to amblyopia neural mechanism and therapeutic effect evaluation. Therefore, in this paper, the amblyopia neural mechanisms and visual center after treatment effect evaluation of fMRI research progress are summarized.

Objective:To observe the effect on the apoptosis of breast cancer cell MCF-7 with acupunctural and moxibustional therapy.Methods:Zusanli and Sanyinjiao neiguan in both sides of female Wistar mice were acupunctured and moxibusted.MCF-7 cell was cultirated with the serum.To detecte the cytoxicity with MTT,and detecte the apoptosic rate and Fas expression rate with flow cytometry after 72 hours.Results:The Fas expression was obviously increased upto 57.70% after 72h.The proliferation of MCF-7 was inhibited remarkably.The inhibition rate were 17.55%,24.71% and 31.85% after 12h,24h and 72h.The apoptosic rate were 8.72% and 10.18% after 72h,remarkably higher than the control group(P

Objective To investigate the effect of three kinds of low molecular weight heparin combined with methylprednisolone on the high coagulation state and renal function in patients with refractory nephrotic syndrome.Methods 140 cases of refractory nephrotic syndrome were divided into four groups, 35 cases in each group.The control group were treated with methylprednisolone.Small, medium, and large dose group in the control group on the basis of the treatment, were given low molecular weight heparin on once every other day, once daily, twice daily treatment, 3075 AxaIU per times.The improvement of renal function and high coagulation state were compared between the four groups before and after treatment.In the course of treatment, the occurrence of adverse reactions was recorded.Results Remission rate in large, medium and small dose group remission rate was higher than the control group(χ2 =4.375,P<0.05); there was no significant difference in remission rate of three different dose groups.The 24h urine protein and ALB of the four groups after treatment were significantly increased, BUN and SCr were significantly lower(P<0.05).The 24h urine protein, ALB, BUN, SCr of improvement of large, medium and small dose group were significantly better than the control group( P<0.05).The 24 h urine protein, ALB, BUN, SCr in large dose group improved significantly better than those in small dose group(P<0.05).The APTT, PT in large, medium and small dose groups after treatment increased significantly, FIB decreased significantly(P<0.05).The improvement of FIB, APTT, PT in large, medium and small dose group were significantly better than the control group after treatment ( P <0.05 ).The FIB, APTT, PT in large dose group improved significantly better than those in medium and small dose group ( P <0.05 ) .Conclusion The low molecular weight heparin combined with methylprednisolone can significantly improve hypercoagulable state and renal function in the patients with refractory nephrotic syndrome, and the large dose of low molecular weight heparin effect is the best, and no significant adverse reactions occurred.

To summarize the etiological factor and to assess the therapeutic effect for neovascular glaucoma(NVG).Methods A retrospective study of 28 cases (29 eyes) with NVG was performed. The mean age, proportion of sex and primary ocular disease, incidence of symptom, sign and postoperative complication were analyzed. Results 78 6% of the patients were over 40 years old. 62% of the patients were secondary to the ocular ischemic disease such as central retina vein occlusion and proliferative diabetic retinopathy. The clinical characters included intraocular pressure (IOP) increasing, pain, mixed conjunctival congestion and rubeosis iridis. The mean IOP reduction was 19.5 mmHg in 29 eyes after antiglaucomatous drags treatment and 19.13mmHg in 23 eyes after Hunan aqueous humor drainage (HAD) implantation. The common postoperative complications were flat anterior chamber and choroidal detachment. The success rate of HAD implantation was 87%.Conclusions NVG was commonly secondary to ocular ischemic disease. Although prevention was the principal, reducing IOP and ameliorating ischemic situation were as the same important.

The paper first analyzes the current status of and existing problems with the management personnel in domestic third-tier hospitals and expounds from such angles as work motives, knowledge structure and personality the necessary qualities that hospital management personnel should possess. Then it argues on the basis of analyses from such perspectives as methodology, disciplinary system development and macro policy environment that only through appropriate training in hospital management can the current status of the management personnel in domestic hospitals be changed, the professional advancement of the management personnel in the third-tier hospitals be genuinely realized, and the support and impetus for maintaining the competitiveness of domestic third-tier hospitals in the medical market be provided.

Gastrectomy ; methods ; Humans ; Laparoscopy ; Stomach Neoplasms ; surgery

Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; chemistry ; pathology ; Female ; Head and Neck Neoplasms ; chemistry ; pathology ; Humans ; Immunohistochemistry