Carcinoma ; classification ; pathology ; Consensus ; Humans ; Thymoma ; classification ; pathology ; Thymus Neoplasms ; classification ; pathology ; World Health Organization

Objective To explore the risk factors analysis of infection after total hip replacement and its early diagnosis .Methods 86 patients with total hip replacement were selected ,the clinical data and surgical process were obtained retrospective ,to analysis the risk factors analysis of infection after total hip replacement .Results The age of infected patients with total hip replacement was significantly higher than non-infected patients (P< 0 .05) .The surgery time and postoperative drainage time in infected patients were significantly longer than non-infected patients(P<0 .05) .The risk of infection of patients who had long-term application of hormone ,complicated with diabetes mellitus ,history of hip surgery and lower serum albumin content were significantly higher (P<0 .05) .Intraoperative blood loss ,sex ,patient bone cement application and antimicrobial drug use had no obvious relation with post-operative infection(P>0 .05) .After the early diagnosis and treatment ,the joints function of infected patients were recovery good , and without serious effects .Conclusion The infection after total hip replacement is associated with a variety of factors ,it should give positive prevention in the clinical work .For suspected patients should be early diagnosis ,and should choose suitable treatment according to the patient′s specific situation .

This paper reviews the long-term care policy in Japan and discusses successes and challenges in order to provide policy guidelines for China. All Japanese adults aged 65 or over are covered by the long-term care in-surance ( LTCI) program and are eligible for both in-home and institutional-care services following a thorough, sys-tematic care certification process. The program is financed by a mix of general tax revenues from the three levels of gov-ernment , income-tested premiums, and standardized co-payments. A key success of the policy is its universal and compre-hensive coverage. Notwithstanding this success, increasing costs remain a challenge as Japan’s population ages and the number of LTCI users increases. Learning from the experience of Japan, China should establish a long-term care system, which covers all the aged population, mainly focuses on in-home care, and qualifies social funding to invest.

Objective To explore the potential risk of category Ⅱ fetal heart rate(FHR) tracing according to the latest electron-ic fetal monitoring tracings .Methods The prenatal fetal heart rate tracings in 400 parturients with hospitalized delivery in this hos-pital from November 2011 to October 2012 were classified by category .Among them ,the pregnancy outcomes were compared be-tween the category Ⅰ FHR tracings(control group) and category Ⅱ FHR tracings(observation group) .Results The case number of meconium-staining amniotic fluid ,cesarean rate ,hypamniony and umbilical cord abnormality was significantly higher than that of the control group with statistical difference between the two groups (P<0 .05);the case number of neonatal asphyxia ,aging of pla-centa and neonatal death had no statistical difference between the two groups (P>0 .05);among the groups with various fetal heart monitoring abnormalities ,the rate of meconium-staining amniotic fluid in the decreased variation group was significantly higher than that in the fetal tachycardia group ,the difference showing statistical significance (P<0 .05);the rate of meconium-staining amniotic fluid in the fetal tachycardia group was significantly higher than that in the prolonged acceleration and ineffective acceleration group with statistical difference (P< 0 .05);the pregnant outcomes had no statistical differences among the other groups .Conclusion Compared with the category Ⅰ FHR tracings ,the category Ⅱ FHR tracings indicate a potential risk to the fetus ,which need to strengthen the prenatal and intrapartum fetal monitoring .

Small molecule antibodies are naturally existed and well functioned but not structurally related to the conventional antibodies. They are only composed of heavy protein chains or light chains, much smaller than common antibody. The first small molecule antibody, called Nanobody was engineered from heavy-chain antibodies found in camelids. Cartilaginous fishes also have heavy-chain antibodies (IgNAR, "immunoglobulin new antigen receptor"), from which single-domain antibodies called Vnar fragments can be obtained. In addition, free light chain (FLC) antibodies in human bodies are being developed as therapeutic and diagnostic agents. Comparing to intact antibodies, common advantages of small molecule antibodies are with better solubility, tissue penetration, stability towards heat and enzymes, and comparatively low production costs. This article reviews the structural characteristics and mechanism of action of the Nanobody, IgNAR and FLC.

Objective To investigate the causes and influencing factors of dead on arrival (DOA) in children.Methods The clinic data from 66 children with DOA admitted in the emergency department of Hunan Children's Hospital from Jan 2010 to Apr 2012 were analyzed retrospectively.Results All of the 66 cases had cardiac respiratory arrest when admission.Fourteen cases had arrest for 10 minutes,12 cases for 30 minutes to an hour,40 cases had no details.Forty-four (68.2％) cases were carried by parents,22(31.8％)cases were transferred by medical professionals.The main causes of DOA were severe pneumonia with respiratory failure and (or) heart failure,intracranial infection,neonatal diseases.All cases were taken to resuscitation room by triage immediately.Tracheal intubations were completed in 48 cases and intravenous access with injection of epinephrine and other resuscitative drugs were established in all cases,but all cases were dead due to breathing and heartbeat stopped for a long time.Conclusion DOA is one of the important reasons for pediatric high-risk.The key of reduction of DOA incidence and improvement of survival rate is to improve pediatric emergency medical service system,strengthen the health education for the parents,to carry out training and establish homogenization service in emergency ICU.

Objective To describe the clinicopathologic features of two cases of mucoepidermoid carcinoma of the skin.Methods Two cases of mucoepidermoid carcinoma of the skin were analyzed histopathologically using hematoxylin and eosin (HE) staining,alcian blue-periodic acid Schiff (AB-PAS) staining and immunohistochemical staining.Relavant literature was reviewed.Results Histopathological examination showed that the tumor was subcutaneously located in both cases,with epidermoid cells and intermediate cells arranged in sheets or nests,as well as different sizes of glandular structures lined by mucinous columnar epithelium in some areas.Both tumors had a relatively clear boundary with peripheral invasive growth and no obvious capsules.Immunohistochemical examination showed positive staining for carcinoembryonic antigen (CEA),high and low molecular weight cytokeratin (CK(H) and CK(L)).The cytoplasm of mucous cells was stained blue with,and mucus was visualized after,AB-PAS staining.Conclusions Primary mucoepidermoid carcinoma of the skin is a kind of malignant tumor arising from skin appendages,whose diagnosis depends on histological and immunohistochemical examination.

Objective To develop an immunohistochemical assay for the diagnosis of cutaneous malignant melanoma (CMM) micrometastasis via blood and lymphatic vessels,and to evaluate its clinical significance.Methods Fifty-three patients (32 males and 21 females) histopathologically diagnosed as CMM were enrolled in this study.The patients were aged (61.2 ± 8.4) years (range,52-72 years).Tissue specimens were obtained from the central area of tumor in each case,and also from removed lymph nodes in some cases.The average duration of follow-up was (65.00 ± 5.68) months.During the follow-up,17 patients died of the recurrence or metastasis of CMM,and 6 patients were lost to follow-up.The expressions of D2-40,S100 and CD34 antigens in 53 tissue specimens were examined by immunohistochemical staining with three individual monoclonal antibodies,or by an immunohistochemical method using 2 two-antibody cocktails (D2-40/S 100 and CD34/S100) and double-color chromogens in single tissue sections.Results Of the 53 patients,30.19％ (16/53) were positive for hematoxylin-eosin (HE) staining combined with immunohistochemical staining with individual monoclonal antibodies,and 49.06％ (26/53) for the immunohistochemical method using two-antibody cocktails and double-color chromogens.Statistical differences were found in the positive rate between the two methods (x2 =3.94,P＜ 0.05).Compared with patients without blood/lymph vessel tumor emboli,those with blood/lymph vessel tumor emboli showed higher lymph node metastasis rate (80.77％ (21/26) vs.37.04％ (10/27),x2 =10.43,P ＜ 0.001),but lower five-year survival rate (42.31％ (11/26) vs.70.37％ (19/27),x2 =4.25,P ＜ 0.05).Conclusions The immunohistochemical method with two-antibody cocktails is superior to HE staining combined with immunohistochemical staining with individual monoclonal antibodies in the detection of blood/lymph vessel tumor emboli.And blood/lymph vessel tumor emboli may be an important prognostic factor in patients with CMM.

Objective To analyze the effect of clomipramine combine sleep deprivation on depression rat behavior and hippocampal CA3 neuron apoptosis.Methods Chronic unpredictable mild stimulation was used to establish 40 depression model rats.They were randomly divided into depression group,clomipramine group (5 mg/kg orally),sleep deprivation group (36 h continuous full sleep deprivation),chlorpromazine combination of sleep deprivation group,and then selected 10 rats as control group.Open-field test and water maze test were used to test rats' behavioral change after 28 days intervention.RT-PCR,Western blot were used to detect the GDNF and Bcl-2 expression of hippocampal CA3 neurons.TUNEL assay was performed to test hippocampal CA3 neuron apoptosis ratios in each group.Results Open-field test level score,vertical score and latency of combination group were (75.6±7.3),(26.4±4.3),(1.1±0.2),and showed no significant difference with those of control group((79.4 ±6.8),(28.6±5.7),(1.0±0.4)) after 28 d intervention (P＞0.05),while the level score,vertical score were significantly higher than those in other three groups(P＜0.05),and the latency period was significantly lower than that in other three groups (P＜0.05).The combined group showed a trend of gradually shortened in water maze escape latency.GDNF,Bcl-2 expression of control group and combined group was significantly higher than those in other three groups (P＜0.05),while the difference between the two groups was not statistically significant (P＞0.05).Sleep deprivation group' apoptotic rate was the highest (55±6)％,significantly higher than the control group and the combination group ((14±3) ％ and (19±4)％).Conclusion Clomipramine combined sleep deprivation can improve the ability of rat model of depression and suppression of acts of hippocampal CA3 neuron apoptosis,and its effect may be related to increased hippocampal CA3 GDNF,Bcl-2 level.

Aiming at the technical characteristics and transforming difficulties for patents in medical health industry,this paper makes proposition on establishing a service system for patent transformation in healthcare system and accelerating the transformation and clinical application of medical technologies through the enhancement of technical service platform construction,strengthening of professional staff capabilities,and the improvement of patent values assessment.