Objective To explore the effect of surgical treatment of bronchioloalveolar carcinoma (BAC). Methods Data were collected from 94 patients with BAC (including 67 cases with pure bronchioloalveolar carcinoma, 16 cases with BAC by local infiltration and 11 cases with adenocarcinoma having BAC character). All patients were proved pathologically bronchioloalveolar carcinoma from January 1989 to December 2003. Clinical features, characteristics of radiology, methods of treatment and survival status were studied retrospectively. Surgical treatment and efficacy approaches according to different TNM stages and clinical patterns were also analyzed. Results Ninety-eight patients underwent complete resection and 4 underwent palliative operation and 2 underwent exploratory thoractomy. The 1-, 3-, 5-year survival rates were 75.5 %, 53.2 %, 41.5 %. According to international staging system of lung cancer, there were marked difference in stage Ⅰ group, stage Ⅱ group and stage Ⅲ group (P <0.01). According to pathological classification, there were marked difference in pure bronchioloalveolar carcinoma, BAC with local infiltration and adenocarcinoma having BAC character (P <0.01). Conclusion Bronchioalveoar carcinoma is a special form of lung cancer. It has its own characteristics on biology,radiology,clinic or pathology. Lobectomy is performed commonly in patients with bronchioloalveolar carcinoma. It may be concluded that the early diagnosis, early therapy are the key points for improving the survival rate of BAC.

BACKGROUND:The type B synoviocytes induced by transforming growth factor β1(TGF-β1) have the potential to differentiate into chondrocyte,which can remain the phenotype in vitro. However,whether the transfected cell combined with scaffold can form cartilage tissues need further research. OBJECTIVE:Rabbit type B synoviocytes was transfected by liposome method in vitro,combined the cells with Pluronic-F127,and then implanted into nude mouse to construct tissue engineering cartilage. Additionally,to explore the feasibility of synoviocytes differentiate into chondrocytes.DESIGN,TIME AND SETTING:The randomized animal experiment of cytology observation. The experiment was performed at the Medical Research Center,the Second Affiliated Hospital of Sun Yat-sen University between April 2007 and May 2008.MATERIALS:Healthy New Zealand white rabbits,aged 3 months,and 12 BALB/c nude mice,aged 4 weeks,weighted 20 g.METHODS:The synovial membrane tissues were taken out from the rabbit knee,isolated by enzyme digestion,and then transfected. The positive cloning was screened by G418,and the expression of TGF-β1 and collagen Ⅱ was detected. The Pluronic-F127 was dissolved at 4℃ and prepared fluid with concentration of 30%. The fluid was mixed with cells. At the same time,there were 2 groups as the control group:chondrocytes with Pluronic-F127,and synoviocytes transfeced by pcDNA3.1(+)and Pluronic-F127. The cell density was 5x1010/L. Each compound (0.2 mL) was injected into the subcutaneous of the nude mouse back. Rats were sacrificed at weeks 4,6 and 8 to harvest samples.MAIN OUTCOME MEASURES:Cell growth curve;phenotype change of the cells after transfection;histological observation of the tissue in the subcutaneous of the nude mouse back. RESULTS:Cell growth curve demonstrated that the living activity of the transfected cells was temporary decreased,which returned into normal level at days 6,7 after transfection. At day 4 after transfection,TGF β1 were positive expressed,and at day 7,the collagen Ⅱ staining were positive. The compounds in the subcutaneous of the nude mouse back formed immature chondroid tissues at week 4,which turned to mature chondroid tissue at week 8,and the collagen Ⅱ staining were positive.CONCLUSION:The transfected synoviocytes can express the phenotype of chondrocytes in vitro,and form chondrocyte-likecells. The transfected synoviocytes with Pluronic-F127 can form chondroid tissues in nude mice.

Blindness ; epidemiology ; etiology ; prevention & control ; China ; epidemiology ; Humans ; Vision, Low ; epidemiology ; etiology ; prevention & control

As the integration of human parasitology and medical microbiology curriculum, pathogen biology, although constructed and developed about 20-years, didn't realize the true integration of the two disciplines. Beyond that, it was also faced with numerous difficulties such severe compression of human par-asitology class, lack of teaching materials to achieve the true meaning of integration, difficulty to cultivate teachers and so on. The organ-system based learning (OBL) curriculum model may provide new strategies for the dilemma, to be resolved through the following channels: Rearranging the curriculum and teaching materials based on the classification of pathogenic organism parasitic or invasive organs; Corresponding training in microbiology and parasitology teaching by teachers continuous realization, while highlighting the professional teaching level of highly qualified teachers in both courses.

Objective To assess the differential diagnosis and characteristics of renal benign and malignant tumors with three-dimensional contrast-enhanced ultrasound (3D-CEUS). Methods Totally 68 patients with renal tumors were examined by conventional ultrasound and two-dimensional contrastenhanced ultrasound(2D-CEUS). 3D imaging was reconstructed from 2D imaging, the differential diagnosis of renal tumors with 3D-CEUS was analyzed by comparing with 2D-CEUS. All patients with renal tumors were proved by operational pathology. Results Eighteen patients with renal benign tumors mostly displayed equal or low enhancement, showed "slowly in and slowly out" with 2D-CEUS, while displayed regular peripheral and internal vessels with 3D-CEUS. Fifty patients with renal malignant tumors mostly displayed high enhancement, showed "rapidly in and rapidly out" with 2D-CEUS,displayed winding peripheral vessels and disordered internal vessels with 3D-CEUS. 3D-CEUS may display the vascular characteristics of tumors and showed superior imaging quality to 2D-CEUS ( P ＜ 0.05). Conclusions 3D-CEUS can display the vascular characteristics of tumors and their spatial positions, it plays an important role in differential diagnosis between renal benign and malignant tumors.

To introduce the methods and experience of arthroscopy treating different types of sports traumatic ankle arthritis.Methods The study involved 25 patents with spots traumatic ankle arthritis treated under ankle arthroscopy from January 2008 to October 2010.American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scoring system was applied to make functional evaluation before and after operation.Also,anterior drawer stress radiographs were used to assess the stability of joint.All patients had arthroscopic examination and received corresponding treatments,including synovial scar tissue resection,cartilage surface trimming,and microfracture management.Five patients underwent stage Ⅰ extramalleolus ligament repair.Results Arthroscopy showed simple synovitis in four patients,impingement syndrome developed from synovitis with fibrous scar tissue formation in 10,tibial or talus cartilage lesions in 11 and congestion of fresh injury of fibular end in four.A total of 23 cases were followed up for average 13.5 months (range,6-24 months).The ankle-hindfoot score was increased from preoperative (54.3 ± 6.2) points to (81.5 ± 7.9) points at 1 month,(82.9 ± 2.5) points at 3 months,( 83.1 + 2.1 ) points at 6 months and ( 83.5 ± 3.9 ) points at 12 months,with statistical differences ( t =13.01,20.58,21.10,19.11 respectively,P＜0.05).The anterior drawer stress radiographs showed that the anterior translation of talus improved from preoperative ( 15.2 ± 2.5 ) mm to postoperative (3.5 ± 0.2 ) mm,with statistical difference ( t =9.33,P ＜ 0.05 ).The anterior drawer test and talus tilt test were both negative for all patients.Concluslons Ankle arthroscopy is characterized by micro trauma and fast recovery.Symptomatic treatment under arthroscopy can obviously relieve the uncomfortable symptoms following sports traumatic ankle arthritis.

Objective To evaluate the mid-term results of arthroscopic anterior cruciate ligament (ACL) reconstruction using Transfix technique.Methods From August 2002 to December 2003,38 patients (24 left knees and 14 right knees) with ACL ruptures underwent arthroscopic ACL reconstruction with hamstring tendon using Transfix femoral fixation and interference screws tibial fixation.There were 21 males and 17 females,aged from 19 to 48 years (average,28.4 years).The causes of injury included sports injury in 27 cases,traffic injury in 2 cases and fall injury in 2 cases,and 7 patients had no significant injury.There were 6 cases of acute injury and 32 cases of old injury.Anterior drawer test was positive in 35 cases,weak positive in 1 case and negative in 2 cases.Lachman test was positive in 37 cases,and weak positive in 1 case.The Lysholm score was used to evaluate the results.Moreover,X-rays and MRIs were used to observe the conditions of graft and bone tunnel.Results Thirty-six patients were followed up for 6.3 to 7.6 years (average,6.8 years).All patients had normal joint range of motion.The Lysholm score improved from preoperative 64.4±4.52 to postoperative 85.6±4.60,and the difference was statistically significant (P ＜ 0.05).The X-rays and MRIs showed femoral and tibial tunnel enlargement in 3 cases,femoral tunnel enlargement in 5 cases and tibial tunnel enlargement in 3 cases.No joint space narrowing was found in all patients.One patient underwent arthroscopic revision ACL reconstruction with allograft tendon using bioabsorbable interference screws fixation on both tibial and femoral sides for re-rupture of ACL 4 years after operation due to trauma.Conclusion Arthroscopic ACL reconstruction with hamstring tendon using Transfix femoral fixation and interference screws tibial fixation is an effective method,which can provide satisfactory joint range of motion and stability.

Objective To investigate the experimental methods of transferring the synoviocytes with the reconstructed pcDNA3.1-TGF-β1 gene by the liposomes and study the feasibility of self-induction of synoviocytes to the chondrocytes in vitro so as to provide a scientific and experimental basis for the further gene enhanced tissue engineering research in articular cartilage repair.Methods Synoviocytes were cultivate in vitro and purified to construct the eucaryotic expression plasmid carrying the recombinant rabbit TGF-β1 gene.By means of Lipofectamine 2000,the synoviocytes were transfected with pcDNA3.1-TGF-β1 (experimental group) and with pcDNA3.1 ( + ) blank plasmid (control group).The synoviocytes free from transfection was set as blank group.After 48 hours of transfection,the cells were screened by G418.Representative sections from among the positive clones were used for RT-PCR assay of instant expression of TGF-β1.The other sections were used for immunohistochemical analysis with antibodies to TGF β1.Screening of cells by G418 was continued for 12 days of cell counting and drawing the growth curve.The antigens of TGF-β1 and collagen Ⅱ were examined every week three weeks after transfection.All images were processed by using analysis instrument (Image-Pro Plus V6.0).Statistical analysis was conducted with SPSS 13.0 software package.The difference between groups was tested by using variance ( ANOVA) analysis.Results The transfection efficiency in experimental group was 18% ,with temporary decreased living activity of the transfected cells shown by growth curve.The cell population decreased to 3.6 × 104/ml four days after transfection.After 72 hours of transfection,the positive fragment of TGF-β1 was detected by RT-PCR assay,and immunohistochemical staining of antibiotics to TGF-β1 showed positive particles only in the experimental group.After three weeks of tranfection,the immunohistochemical analysis with antibodies to TGF-β1 and type Ⅱ collagen showed that there were positive particles in the transfected cells in the experimental group,with no positive particle in the control and blank groups.According to the results of Image-Pro Plus V6.0,PU value of anti-TGF-β1 was (19.04±1.26) seven days after transfection,while that of control and blank groups were (4.07 ± 0.65)and (3.23 ±0.56) respectively,with statistical difference (P<0.05).PU value of anti-type Ⅱ collagen in experimental group,control group and blank group was (13.74 ± 1.27),(4.62 ±0.56) and (3.93 ± 0.38) 14 days after transfection,with statistical difference ( P < 0.05).Conclusions Transfection of the rabbit articular synoviocytes with the reconstructed pcDNA3.1-TGF-β1 gene can be successfully accomplished by using Lipofectamine 2000 method.The transfected synoviocytes can express TGF-β1 and excrete type Ⅱ collagen,have chondrogenic potential when transfected by pcDNA3.1-TGF-β1 gene and can be used as candidate cells for repair of articular cartilage.

Objective To investigate the situation of urine albumin measurement of clinical laboratory in Tianjin.Methods Control materials from patient mixed urine samples were made to validate precision in the clinical laboratories in Tianjin.Reference Material ERM-DA470K was prepared as the first external quality assessment ( EQA) sample, and the bias between laboratories was calculated.Then we give some advice about the methods of routine maintenance, calibration, standardized operation, internal quality assessment and so on to the laboratories which were not qualified in the first EQA.Then the second EQA was carried out and CV and bias were culculated.Results 52 clinical laboratories has 12 series of instruments and 17 series of reagents.The precision research showed that most laboratories ( 93.55%) had good precision for urine albumin measurement, while CV of inter-laboratory was great:the range of low level of control sample was 8.91 -43.95 mg/L, 34.46% for CV; and the high level was 36.32 -281 mg/L, 28.51% for CV.Only 36.5% laboratories were qualified in the first EQA. The qualified rate for nephelometry and turbidimetry was higher (55.6%, 42.9%).The qualified rate of trueness verification was 58.6%in the second EQA, and the CV between laboratories was significantly decreased, Inter-laboratory CV of the five samples were:19.83%, 13.57%, 13.41%, 13.08%, 11.37%. The qudified rate for nephelomety and turbidimetry was 71.4% and 56.3%.Conclusions There are a mide variety of measurement systems of urine albumin in Tianjin, and the CV between these systems is great.Clinical laboratory should strengthen the laboratory standardization operation and upgrade calibration testing to improve the testing consistency.

Objective To evaluate the diagnostic value of MSCT in Solitary Pulmonary Nodules (SPN) with different pathologic types .Methods Four-five SPN with pathological findings including 16 benign cases and 29 malignant cases were retrospectively an-alyzed ,and performed with MSCT scanning .Observation of the distribution ,morphology and internal characteristics of SPN by post-processing technique were done ,and the results were compared with pathological findings .Results Among 45 SPN ,the benign nodules included 6 cases of inflammatory pseudotumor ,4 cases of tuberculoma ,3 cases of hamartoma ,2 cases of cryptococcus and 1 case of hemangioendothelioma ,and the malignant nodules included 21 cases of adenocarcinoma ,3 cases of squamous carcinoma ,2 ca-ses of small cell carcinoma and 3 cases of alveolar cell carcinoma .Average diameter of benign nodules was 2 .1 cm ,and 2 .6 cm for the malignant nodules .All SPN ,including 5 cases in the inner zone ,12 in the medial zone and 28 in the lateral zone ,the percentages with malignant signs at the corresponding parts were 40% (2/5) ,50% (6/12) ,75% (21/28) ,there was significant difference be-tween distributions(P<0 .05) .The distributions of malignant nodules in the upper and lower lung lobe had no significant difference (P>0 .05);the incidences of leaf sign ,burr sign ,pleural indentation sign ,cavitas and bronchial air sign ,blood vessels cluster sign of malignant nodules were higher than that of the benign nodules(P<0 .05) ,and the inflammatory pseudotumor and adenocarcinoma owned similar characteristics ;the incidence of calcification in tuberculoma and hamartoma was high ,while cavitas in tuberculosis and lung cancer were high .Conclusion MSCT can sufficiently display the distribution ,morphology and internal characteristics of SPN , and can help make qualitative diagnosis of benign and malignant SPN ,providing great practical value in clinical treatment .