Objective:To investigate the clinical characteristics and therapy of laryngeal neuroendocrine carcinoma(LNEC).Method:Ten cases of LNEC treated in our department were retrospectively analyzed.Result:Eight out of 10 cases were were atypical carcinoid:1 case treated as supraglottic horizontal partial laryngectomy died 22 months after operation; 1 case was lost;the other 6 cases were followed up for more than 2 years. Two cases were small cell type,one received supra-cricoid partial laryngectomy-cricohyoidopexy (SCPL-CHP) ,neck dissection,and radiotherapy,but died after 14 months;the other was receiving radiotherapy.Conclusion:LNEC is a rare malignant tumor and the diagnosis relies on clinical characteristics, histopathological and immunohistochemistry examination. The different types of LNEC should give different treatment protocols.

[Objective] The aim of our study was to seek the mutations in MODY1～5 genes in Chinese population by direct sequencing in probands from families with early-onset type 2 diabetes.[Methods] Variants screening in MODY 1-5 genes were performed by PCR and direct sequencing in 19 probands from early-onset type 2 diabetes families.[Results] We found no mutation but many polymorphisms.There were 6,5,15,1,and 1 variants in MODY 1-5 genes respectively.[Conclusion] Our negative results in MODY genes suggest the genetic heterogeneity of different populations.Mutations in MODY 1-5 genes might not be the cause of diabetes in those 19 families.

Objective To investigate the patients′cell morphology characteristics in peripheral blood and bone marrow with the reduce of leukocyte,hemoglobin and platelet in peripheral blood,and analyze the common cause.Methods From June 2005 to Feb-ruary 2011,222 patients with pancytopenia treated in the hospital were enrolled in the study,whose peripheral blood and bone mar-row smears were stained by Wright,combined with histochemical staining and the clinical data of patients,the disease types were analyzed.Results In the 222 patients with pancytopenia,patients with hematopoietic system disease accounted for 84.65% (188/222),non-hematopoietic system disease accounted for 15.35%(34/222),the difference was statistically significant(P <0.05 ).In 150 patients whose peripheral blood smears were obseved,58% patients obtained positive results.Conclusion The diseases of hem-atopoietic system are the common cause of pancytopenia,but can not ignore the non-hematopoietic system diseases.Peripheral blood smear has a high value in the diagnosis of these diseases.

ovel GCK-E339K mutation might be linked to this MODY2 pedigree.

Objective To explore the value of practicing PBL which was guided by MDT in teaching diagnoses and treatments of war wound and trauma caused by compound agents.Methods An emulational war wound case caused by compound factors was designed and a multi-disciplinary team been organized,then totally 45 interns who would graduate in 2017 were divide into two groups randomly,experimental group which had 23 cases received PBL model combined with MDT followed six step procedure which included case preparation by teachers,independent analysis and group discussion by interns,problem extraction by teachers and division of solution by interns before class,then answering and debating problems by interns in class,conclusion and reporting after class in the end,while the control group which had 22 cases received traditional teaching model in accordance with common case discussion in class including characteristics of patient,diagnosis and diagnostic basis,examinations needed to carry out,first aid measures and professional treatments.The effect of new teaching model was evaluated by assessment in class and questionnaire after class.The data was analyzed through Chi-square test by SPSS 22.0.Results Class assessment showed 18 (78.3％) interns in experimental group displayed good abilities of proposing,analyzing and resolving medical problem,as well as good presentation and speech skills.Questionnaire survey showed that not only clinical teaching of war wound and trauma could meet the demands of talent training in battle-field rescue,but also displayed new model,which could help interns to enhance abilities of first-aid and treatment of war wound on future war field,reinforce the consciousness of military medical support and service.In addition,it could clear confusion more professionally and strengthen teamwork and overall importance.Conclusion Applying PBL combined with MDT in teaching diagnoses and treatments of war wound and trauma can not only help interns to review and retain important knowledge of related subjects,but also improve the abilities of interns in clinical diagnoses and treatments,and moreover,it merges the medical knowledge and war wound cure together organically.In short,the new model is well worth applying in clinical teaching and military medical education because of its excellent effects.

OBJECTIVETo improve the clinician's ability for emergency treatment of priapism.

METHODSBoth cases received 2 mg to 8 mg of metaraminol injection at the root of cavernous body, and perfusion of heparinized saline at glans and root of cavernous body of the penis by contrecoup, but they had not good response to the above therapy. At last surgery was performed.

RESULTSTotal penectomy was performed for both cases. One case was diagnosed of penile sarcoma, and another was metastatic transitional cell carcinoma.

CONCLUSIONPriapism due to neoplasma is infrequent, it should not be misdiagnosed in case of emergency.

Erectile Dysfunction ; diagnosis ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Penile Neoplasms ; complications ; surgery

OBJECTIVETo improve the diagnosis of the testicular tumor.

METHODSFifty-seven cases, including their signs and symptoms, imaging studies, tumor markers and histologic diagnoses, were reviewed.

RESULTS31.3% of the patients failed to go to hospital in time. B mode ultrasound and CDFI had sensitivity of 93.5% and 96.4% respectively. Compared with final diagnoses, 23 from 26 cases (88.5%) were correspondingly diagnosed by intraoperative frozen section examination (FSE), which, however, had no definitive influence on the surgical management. Histologic examination showed 22 patients with seminoma, 9 with embryonal carcinoma, 7 with teratoma, 3 with yolk sac tumor, 9 with combined patterns, 4 with lymphoma, and 3 with other histologic types of tumor.

CONCLUSIONSFor earlier diagnosis, patients testicular self-examination counts for much, and ultrasound and CT should be used before possible histologic examination, while all patients with testicular tumors should have intraoperative FSE, which is very practical in identifying malignant and benign masses, and in choosing between enucleation of the tumor and radical orchiectomy.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Frozen Sections ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Sensitivity and Specificity ; Testicular Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Ultrasonography, Doppler, Color

OBJECTIVETo explore the clinical features, treatment and prognosis of the C5 palsy after surgery of cervical spondylosis.

METHODSTwo hundred and twenty-three cases treated from March 1994 to October 2003 were retrospectively reviewed.

RESULTSSeven of the 223 cases developed the complication of C5 palsy, manifesting the paresis of the deltoid muscle as well as the sensory deficits and (or) intractable pain in shoulder. The incidence was 3.1%. In this study, 2 cases occurred in the anterior subcorpectomy, 5 cases developed in the laminoplasty with 1 case on the opened side, 3 cases on the hinged side and 1 case on both sides. All the 7 cases with the C5 palsy recovered within 2 weeks to 6 months.

CONCLUSIONThe C5 palsy can develop either anterior decompression or posterior open-door laminoplasty of cervical spondylosis. Generally speaking, patients with postoperative C5 palsy can be cured by conservative measures. And prognosis is good.

Adult ; Aged ; Bone Transplantation ; adverse effects ; Cervical Vertebrae ; surgery ; Decompression, Surgical ; adverse effects ; Female ; Humans ; Laminectomy ; adverse effects ; Male ; Middle Aged ; Postoperative Complications ; diagnosis ; etiology ; prevention & control ; Radiculopathy ; diagnosis ; etiology ; prevention & control ; Retrospective Studies ; Spinal Nerve Roots ; Spinal Osteophytosis ; surgery

OBJECTIVETo explore the diagnosis, treatment, and prognosis of prostatic malignant mesenchymal tumors (PMMT).

METHODSWe retrospectively analyzed the clinical and follow-up data about 20 cases of PMMT and reviewed the literature relevant to the diagnosis, treatment, and prognosis of the disease.

RESULTSBased on the results of pathology and immunohistochemistry, the 20 PMMT cases included leiomyosarcoma (n = 7), rhabdomyosarcoma (n = 5), prostatic stromal sarcoma (n = 3), chondrosarcoma (n = 1), and undifferentiated PMMT (n = 4). Twelve of the patients were treated by radical prostatectomy (3 concurrently by sigmoid colostomy and 1 by cystostomy), 2 by pelvic tumor resection following arterial embolization, 1 by total pelvic exenteration, 1 by colostomy with pelvic lymph node biopsy, and 4 by conservative therapy because of metastasis to the lung, pelvis and bone. Of the 20 patients, 9 died of systemic metastasis within 3 months after treatment, 3 died at 6, 7, and 14 months, respectively, 3 survived with tumor for 5, 11, and 12 months, respectively, 2 survived without tumor for 12 and 24 months so far, all subjected to periodic chemotherapy postoperatively, and 3 lost to follow-up.

CONCLUSIONPMMT is a tumor of high malignancy and rapid progression, for which transrectal ultrasound-guided biopsy remains the main diagnostic method. The clinical stage of the tumor is an important factor influencing its prognosis and the survival rate of the patients can be improved by early diagnosis and combined therapy dominated by radical prostatectomy.

Combined Modality Therapy ; methods ; Humans ; Immunohistochemistry ; Male ; Mesenchymoma ; mortality ; pathology ; therapy ; Prognosis ; Prostatectomy ; Prostatic Neoplasms ; mortality ; pathology ; therapy ; Retrospective Studies

BACKGROUNDMono-(2-ethylhexyl) phthalate (MEHP), the metabolite of di-(2-ethylhexyl) phthalate (DEHP), was suspected to be toxic to human embryos. This study contributes to investigating its toxic effects by an embryonic stem cell test (EST) based on two human embryonic stem cell (hESCs) lines.

METHODSCH1 established in our own lab and H1, a federally registered cell line were two human embryonic stem cell lines used in this test. Four endpoint measurements were performed consisting of cell viability, proliferation ability, apoptosis as well as changes of gene expression patterns after spontaneous differentiation were determined. For measuring effects on the first three endpoints, the cells were treated with various concentrations of MEHP dissolved in dimethyl sulfoxide (DMSO) and only with DMSO which served as control and harvested after 5 days. For measuring effects during spontaneous differentiation, the RNA of embryoid bodies (EBs) formed after 8 days' MEHP exposure was collected and changes in differentiation specific gene expression patterns were analyzed by quantitative real time RT-PCR.

RESULTSAs a result the viability and proliferation ability of both cell lines decreased significantly at 1000 µmol/L MEHP, while there was no effect on apoptosis or cell morphology. In addition MEHP also changed the gene expression pattern in the EBs of both cell lines.

CONCLUSIONMEHP in a high dose was cytotoxic and affected the development of hESCs, which indicates its embryo toxicity in human embryos.

Apoptosis ; drug effects ; Cell Differentiation ; drug effects ; Cell Proliferation ; drug effects ; Cell Survival ; drug effects ; Cells, Cultured ; Diethylhexyl Phthalate ; analogs & derivatives ; toxicity ; Dose-Response Relationship, Drug ; Embryonic Stem Cells ; drug effects ; pathology ; Humans