Purpose To study the diagnostic value of imprint cytology and to improve the accuracy of the rapid diagnosis of sentinel lymph node (SLN) during the operation of breast cancer.Methods 169 SLNs during 67 operations of breast cancer were detected by both frozen section and imprint cytology, and the results were compared with the histopathological diagnosis of permanent sections.Results Of 169 SLNs, 163 cases were diagnosed correctly with frozen section (163/169, 96.45%); 162 cases were diagnosed correctly with imprint cytology (162/169,95.86%);and 166 cases were diagnosed correctly by combination of imprint cytology and frozen section (166/169,98.22%).Conclusions Combination of imprint cytology and frozen section could increase the accuracy of the rapid diagnosis of SLN in breast cancinoma operation.

Traumatic pseudoaneurysms (TPA) were surgically produced in the right common carotid artery of 24 rabbits. Three to four weeks later the survived rabbits 16 were randomly divided into 3 groups: (1)control group; (2)treatment group with TPAs embolized with microcoils(MC); (3)treatment group with occlusion of the by parent artery with MC. Three months after embolizaton, the TPAs were examined by digital subtraction angiography (DSA). The results showed that the TPAs embolized with MC were proved to be completely occluded, and the parent artery remained patent. Histopathological examination showed that TPAs were replaced by a mass of scar tissues. In the rabbits with occlusion of the parent artery embolization with MC, the TPA also disappeared. However, all the untreated rabbits died of rupture of TPAs. Statistic analysis showed that both methods of treatment were effective in the treatment of TPA.

Purpose To study the cytopathologic features of CT-guided percutaneous lung biopsy samples and to evaluate the role of cytopathology in the diagnosis and staging of lung carcinomas, as compared to histopathology. Methods Four-hundred twenty-five specimens were collected by CT-guided percutaneous lung biopsy which were also confirmed by histological diagnosis. Direct smears were performed for each case. Cytological and histological examination was carried out. Results The sensitivity, specificity, false positive rate, false negative rate and accuracy of cytopathology in diagnosing lung carcinomas by CT-guided percutaneous lung biopsy was 86. 6% (264/305), 100% (120/120), 0 (0/120), 13. 4% (41/305), 90. 4% (384/425), respectively. Overall 51. 1%(135/264) of the cases were precisely typed, including 77. 6% (83/107) of adenocarcinoma, 76. 9% (40/52) of squamous cell car-cinoma and 75. 0% (9/12) of small cell carcinoma. Conclusions Cytopathology of CT-guided percutaneous lung biopsy specimens is sensitive and accurate for diagnosing pulmonary carcinomas. In some cases, the lung carcinoma can be precisely typed. Therefore, it is useful for diagnosing and staging lung carcinomas.

Pregnant women with subacute thyroiditis (SAT) are rare.One case was reported and the clinical features and management principles of SAT during pregnancy were reviewed.In pregnant women with SAT,the illness is usually not serious.If subclinical or clinical hypothyroidism develops,L-T4 must be given and thyroid function be monitored routinely,and the medication be adjusted carefully to ensure the maternal-fetal safety.

A sandwich ELISA for the measurement of urokinase(UK)antigen was developed based on anti—UK monoclonal antibodies(McAbs)against two non—overlapping epitopes.The lower limit of sensitivity of the assay was 0.15ng/ml.Coefficients of variation of the assay at physilogi-cal levels of UK were 4.3 percent within assaysw and 8.7 percent between assays.The recovery of added UK was about 98 percent.Culture media of some human malignant cell lines contains more UK than that of normal cell lines measured by our assay.The ELISA was used to measurethe concentration of UK in plasma from 82 healthy donors.The mean value for the healthy donors was 1.31?60.6ng/ml of UK in plasma.

Objective To investigate the prevalence of the genotypes of extended spectrum ? lactamses (ESBLs) in klebsiella pneumoniae and eschrichia coli, which were isolated in Hangzhou City from 2000 to 2001. Methods Total of 198 isolates of E. coil and K. pneumoniae were isolated from five hospitals in Hangzhou. ESBLs-producing isolates were detected by inhibitor-potentiated disc diffusion test, Agar dilution method was used to determine the minimum inhibitory concentrations (MIC) of cefotaxime and ceftazidime.ESBLs genes were analysed by isoelectric focusing (IEF) assay and PCR initially,genotypes were determined by sequencing. Results 51 isolates (25.76%) from 198 E. coil and K. pneumoniae strains were obtained. In ESBLs producers, the ESBLs types of SHV, TEM, CTX-M were 17.65%,84.31% and 80.39% respectively. genotypes were: SHV 11,12;TEM 1;CTX M 3and CTX M 3 like, CTX M 13,14. respectively. Conclusions CTX M type were the major genotypes of ESBLs in klebsiella pneumoniae and eschrichia coli isolated in Hangzhou city.

Objective To detect the clinical effect of posterior reduction combined with H-shaped bone grafting and spinous process replantation for reconstruction of spinal structures in treatment of thoracolumbar fracture.Methods Forty-three patients with thoracolumbar burst fracture treated surgically from February 2008 to June 2012 were reviewed retrospectively.There were 30 male and 13 female patients aged 23 to 55 years (mean,38 years).Fracture resulted from high falls in 21 patients,traffic accidents in 16 patients,and a crush by heavy objects in 6 patients.Denis system was used for classification of fracture and Frankel rating for assessing the degree of nerve damage and recovery.After posterior reduction combined with H-shaped bone grafting and spinous process replantation for all patients,visual analogue scale (VAS) was utilized to assess symptom improvement and Cobb' s angle and sagittal spinal canal diameter were measured to help assess the treatment outcome.Results Pain was apparently eased at a 24-month follow-up (range,12-46 months).Cobb' s angle improved from preoperative 43.56° to postoperative 8.23° (t =1.33,P ＜ 0.01).CT findings showed mean spinal canal stenosis rate was 56.3％ before surgery and that mean sagittal canal diameter of the injured spine was larger than that of adjacent segments at follow-up,with the mean ratio of 116.3％ (range,111.3％-120.3％).Rate of spinal canal stenosis was negative for all patients and posterior canal with bone grafts healed.Spinal cord injury improved at least one Frankel grade.Conclusion Posterior reduction combined with H-shaped bone grafting and spinous process replantation is worthy of clinical application,for the procedure can restore the fractured thoracolumbar spine and posterior canal structure,but also effectively avoid the iatrogenic spinal stenosis.

Objective:To investigate the role of bone morphogenetic protein 2/7 heterodimer (BMP-2/7)in the osteogenesis of human adipose-derived stem cells (hASCs).Methods:hASCs were exposed to three different treatments in vitro:osteogenic medium with 1 50 μg/L BMP-2/7 (experimental group), osteogenic medium alone (OM group)and proliferation medium (PM group).After 1 ,4 and 7 days of osteogenic induction,the amount of cellular DNA was measured to investigate the cytotoxicity.After 7 and 1 4 days,alkaline phosphatase (ALP)staining and quantification were performed to test the activity of ALP.After 21 and 28 days,the calcification deposition was determined by Alizarin Red S (ARS)stai-ning and quantification.The expressions of the osteoblast-related genes were tested on days 1 ,4,7 and 1 4.In the in vivo study,6 nude mice were used and 4 groups were set and implanted subcutaneously into the back of nude mice:(1 )β-TCP scaffold only (scaffold control group );(2 )β-TCP scaffold with hASCs cultured by PMin vitro for 1 week (PMcontrol group);(3)β-TCP scaffold with hASCs cultured by OM in vitro for 1 week (OM control group);(4)β-TCP scaffold with hASCs cultured by OM with 1 50 μg/L BMP-2/7 in vitro for 1 week (test group).After 4 weeks of implantation,histological staining was performed to evaluate the in vivo osteogenesis of hASCs.Results:After induction for 1 day,there was no significant difference between the experimental group and the PM group on the cellular DNA con-tent (P>0.05 ).After 4 days,the cellular DNA content increased under the stimulation of BMP-2/7 (P<0.05).On day 7,there was no significant difference among the three groups (P>0.05).ALP ac-tivity was higher by the induction of BMP-2/7 than in OMalone and PM(P<0.05).More mineraliza-tion deposition and more expressions of osteoblast-related genes such as Runx2,ALP,COL-1 A1 and OC were determined in the experimental group at different time points (P<0.05).HE staining showed that, in the test group and OM control group,the extracellular matrix (ECM)with eosinophilic staining were observed around hASCs,and newly-formed bone-like tissues could be found in ECM around the scaffold materials.Moreover,compared with the OM control group,more bone-like tissues could be observed in ECMwith typical structure of bone tissue in the test group.Masson’s trichrome staining showed that more expression of collagen could be observed in ECM in the test group compared with the other groups.There was small amount of expression of collagen in the OM and PM control groups.No obvious positive results were found in the scaffold group.Conclusion:BMP-2/7 heterodimer plays a significant role in the osteo-genesis of hASCs and is able to enhance the osteogenic differentiation of hASCs in vitro and in vivo.

Objective:To construct a novel biomimetic calcium phosphate (BioCaP) scaffold loaded with bone morphogenetic protein-2 (BMP-2),and to investigate its role in the osteogenesis of human adipose-derived stem cells (hASCs) in vitro and in vivo.Methods:The BioCaP scaffold coprecipitated with BMP-2 (BMP-2-BioCaP) was constructed in this study.Field emission scanning electron microscopy (SEM) was used to analyze the morphology of the surfaces.The release kinetics was measured to evaluate the slow-release characteristics in vitro.BMP-2-BioCaP was immersed in proliferation medium (PM) or osteogenic medium (OM),respectively.The supernatants were collected and used to culture hASCs in vitro.Cell numbers were determined using the cell-counting kit-8 (CCK-8) to assess the cell proliferation.After 7 and 14 days,alkaline phosphatase (ALP) staining and quantification were performed to test the activity of ALP.After 14 and 21 days,the calcification deposition was determined by alizarin red S (ARS) staining and quantification.The expressions of the osteoblast-related genes were tested on day 4 and day 14.In the in vivo study,6 nude mice were used and implanted subcutaneously into the back of the nude mice for 4 groups:(1) BioCaP scaffold only,(2) BioCaP scaffold + hASCs,(3) BMP-2-BioCaP scaffold,(4) BMP-2-BioCaP scaffold + hASCs (test group).After 4 weeks of implantation,hematoxylin-eosin (HE) staining was performed to evaluate the in vivo osteogenesis of hASCs.Results:SEM observations showed that BioCaP and BMP-2-BioCaP scaffold were entirely composed of straight,plate-like and sharp-edged crystal units,and the length of the crystal units varied between 5 and 10 μm.Release kinetics analysis demonstrated that BMP-2 incorporated with BioCaP could be released at certain concentration and last for more than 21 days,and the accumulative protein release could reach 20％.CCK-8 assays showed that cell proliferation was not significantly affected by BMP-2BioCaP.ALP activity was higher by the induction of OM + BMP-2-BioCaP than of the other groups (P ＜0.01).More mineralization deposition and more expressions of osteoblast-related genes such as Runt-related transcription factor 2 (RUNX2),ALP,osteopontin (OPN) and osteocalcin (OC) were determined in the OM + BMP-2-BioCaP group at different time points (P ＜0.01).HE staining showed that,in the test group and BMP-2-BioCaP scaffold group,the extracellular matrix (ECM) with eosinophilic staining were observed around hASCs,and newly-formed bone-like tissues could be found in ECM around the scaffold materials.Moreover,compared with the BMP-2-BioCaP scaffold group,more bone-like tissues could be observed in ECM with typical structure of bone tissue in the test groups.No obvious positive results were found in the other groups.Conclusion:BMP-2-BioCaP scaffold could achieve slow-release of BMP-2 and promote the osteogenic differentiation of hASCs in vitro and in vivo.The novel tissue-engineered bone composed of hASCs and BMP-2-BioCaPis promising for the repair of bone defect.

OBJECTIVE To study the mechanism of drug-resistance of multi-resistant Pseudomonas aeruginosa,and provide the guideline for treatment and control of P.aeruginosa infection in hospital.METHODS Fifty strains of multi-resistant P.aeruginosa were selected with K-B susceptibility method.The three-dimensional method was taken to differentiate the various beta-lactamases.The relative drug-resistance gene was detected by polymerase chain reaction(PCR).RESULTS Among 50 strains of multi-resistant P.aeruginosa,there were 2 strains(4%)producing ESBLs,20 strains(40%)producing AmpC beta-lactamases,and 11 strains(22%) producing ESBLs and AmpC beta-lactamases at the same time.There were 8 positive genes in the detected drug-resistance gene,the most common sources of gene were CTX(56%),OprD(60%) and aac(6′)-Ⅱ(60%),respectively.CONCLUSIONS The main beta-lactamases are AmpC beta-lactamases and the main genotype is CTX in the multi-resistant P.aeruginosa cultured in our area.The main course of imipenem-resistance was deletion of outer membrane proteins,and the aminoglycoside modifying enzyme gene and disinfectant-resistance gene in multi-resistant P.aeruginosa are acquired.In order to reduce the drug-resistance strains and control the infection of P.aeruginosa,antibiotics should be used reasonably according to drug susceptibility testing clinically.