Objective To explore the characteristics of clinic and epidemiology of neonatal respiratory syncytial virus(RSV) pneumonia in newborn infants.Methods Three hundred and nine neonates(male 196,female 113) who were admitted to children's hospital of Fudan University and identified as having RSV pneumonia from Jan.2004 to Dec.2008 were enrolled.RSV antigen was detected in exfoliated respiratory cells by direct immunofluorescence.All the clinical data were collected and subjects and they were divided into different groups based on path of infection,gestational age and RSV status.Results From case notes over the 5 years,309 eligible neonates with RSV infection were identified.Male term neonates were more likely to acquire infection,as compared to female,1.71.0.The incidence of RSV infection peaked in winter and spring.Compared with community acquired infection group,hospital acquired infection group had more premature infants(23.2% vs 8.7%,P=0.002),lower birth weight[(3 010.8?852.8) g vs(3 153.2?943.4) g,P=0.026],much longer mean length of hospital stay[(19.0?8.0) d vs(12.2?4.5) d,P=0],more expensive cost[(5 646.4?3632.2) RMB vs(4 175.8?2 879.2) RMB,P=0] and later occurrence day[(21.3?8.6) d vs(15.8?6.0) d,P=0].Compared with simple RSV infection group,mixed infection group had more expensive cost[(6 063.1?3 085.4) RMB vs(4 513.2?3 860.8) RMB,P=0.047] and more oxygen use(40.0% vs 25.7%,P=0.006).The clinical characteristics of patients with RSV pneumonia varied.Preterm group compared with term group more frequently exhibited apnea and cyanosis(20.0% vs 0.7%,42.9% vs 22.7%),respectively.Forty-two percent of them had bacterial infection,while 13.3% of them had infection of other part of body.The prognosis of most RSV(99.0%) infections was good.Conclusions RSV was an important cause of respiratory tract infections during the last five years.Clinical characteristics of RSV infections were atypical.Hospital acquired RSV infection was more severe than the community acquired infection in neonates.There are no specific,effective interventions for treating RSV infections,so preventive measures are most important.

Objective To investigate the survival rate, voiding, sexual function after nerve-sparing surgery with extended systematic extraperitoneal lateral lymphadenectomy in lower rectal cancer. Methods Three hundreds and ninety-two cases with advanced lower rectal cancer who underwent nerve-sparing surgery with radical dissection from 1996 to 2000 were reviewed. Among them,173 cases only cleared in abdominal cavity,219 cases coupled with extraperitoneal lateral lymphadenectomy. Results The metastatic rate of lateral lymph node was 17.8%(39/219),the rate of non-modal foci of metastatic disease in lateral out of the abdominal cavity was 5.9%(13/219).Local recurrence rate, the abdominal cavity group was 16.2%(28/173); the coupled group was 9.6%(21/219), P

Adult ; Ear Neoplasms ; Eustachian Tube ; pathology ; Humans ; Male ; Teratoma

Bibliometrics ; China ; Occupational Exposure ; Poisoning

Objective To explore the value of Toll-like receptor 2(TLR2) on the diagnosis of neonatal septicemia especially for the early diagnosis.Methods Twenty-two newborns with septicemia were divided into 2 groups according to the time of onset:early-onset group(n=12) and late-onset group(n=10).Another 14 non-infectious newborns were collected as control group.The TLR2 mRNA in peripheral blood was detected by real-time polymerase chain reaction,and mononuclear cells were isolated by the density gradient centrifuga-tion;the C reaction protein(CRP) was detected,and the co-relationship of the indexes was analyzed by Pearson correlation analysis.Results 1.The level of CRP in early-onset group were(157.89?32.96) ng?L-1,and(89.78?16.24) ng?L-1 in late-onset group,and there was significant difference between both groups(P=0.001);(6.91?1.20) ng?L-1 in control group,which was significantly lower than that in early-onset group and late-onset group(P=0.000,0.001).2.The expression of TLR2 mRNA in early-onset group and late-onset group was(57.38?10.72)?1012 copies?L-1and(32.74?4.65) ?1012 copies?L-1,which was significantly higher than that in control group[(4.12?0.68) ?1012 copies?L-1].3.CRP is positively correlated with TLR2 mRNA(C=0.972,P=0.000).Conclusions TLR2 expression is proven to be related to both the level of CRP and the stage of onset and may play a key role in the pathogenesis of neonatal septicemia.Detection for TLR2 may assist the earlier diagnose of atypical neonatal septicemia.

Objective To study the clinicopathoiogic features of four cases of extranodal follicular dendritic cell sarcoma(FDCS). Methods Four cases of FDCS were examined by histological and immunohistochemistry and in situ hybridization for Epstein-Barr virus (EBV)-encoded RNA, and the related literatures were reviewed. Results Microscopically, the neoplastic cells were spindle-shaped or ovoid with pale-stained cytoplasm, indistinct cell borders, granular chromatin, distinct small nucleoli. There were varied growth patterns in the tumour, such as fascicular, circular whorls and storiform, and abundant with intermixed small lymphocytes. There scattered multinucleated giant cells and perivascular cuffing phenomenon. There were rare mitoses. The neoplastic cells were positive for one or more of the follicular dendritic markers such as CD21, CD23 and CD35. It was variably positive for CD68, Vimentin, LCA and S-100. Staining for CD20, CD3 and CD1α were negative. Ki-67 labeling ranged from 10 %-20 %. The neoplastic cells were negative for Epstein-Barrvirus (EBV)-encoded RNA. Conclusion FDCS is a rare low-grade malignant tumor with varied growth pattern. The diagnosis should be confirmed by immunohistochemical staining. It is important to recognize its morphological characteristics to avoid confusion with other similar lesions, such as gastrointestinal stromal tumour, inflammatory pseudotumor, interdigitaing dendtritic cell sarcoma, malignant histiocytoma, lymphoepithelial carcinoma, diffuse large B-cell lymphoma, and malignant melanoma.

Objective To analyse the factors that have effects on patients' procalcitonin (PCT)level after gastic surgery and to evaluate PCT as a parameter for detection of infectious complications.Methods A total of 153 patients undergoing gastric surgery were included in the study between Jul 2011 and Jan 2013.Temperature and routine blood samples for determining PCT level,neutrophil ratio,white blood cell count were obtained on postoperative days (POD) 1,3,7.Predictive values for each of the markers were examined.Results Postoperative complication,preoperative infection and surgery type affected the PCT level of patients on POD 1.Meanwhile,the independent factor that had influence on PCT level on POD 3 and 7 was postoperative complication.After excluding those patients with preoperative infection,patients with infectious complication exhibited significantly higher PCT levels (t =2.92,P ＜0.01,t =5.34,P ＜0.01,t =4.03,P ＜0.05) on POD 1,3,7 respectively),neutrophil ratio (on POD 3 and 7) and WBC count (on POD 3) than did those without complication.According to receiver operating characteristic analysis,PCT showed the highest AUC on POD 1,7 (AUC =0.89 and 0.87 respectively).In the patients without complication,the mean PCT value was (0.47 ± 0.97),(0.36 ± 0.50),(0.23 ± 0.24) ng/ml on POD 1,3,7 respectively.The PCT level declined 55％ from POD 1 to POD 3 and from POD 3 to POD 7.Conclusions The serum PCT level of patients without any complication showed a decreasing trend while PCT level of those with infectious complications increased significantly.Continuous monitoring PCT level could serve as a diagnostic tool for the early identification of infectious complication after gastric surgery.

Objective To investigate the clinical value of contrast-enhanced ultrasound(CEUS) in the diagnosis of postnatal placenta increta. Methods Twenty-six patients with postnatal placenta increta were examined by gray-scale and color Doppler ultrasound and CEUS. Then microvascular perfusion and enhanced features of lesions, myometrium and serous layer were observed. Arriving time (AT), time to peak intensity (TTP) and the lasting time of enhancement (LTE) were recorded. AT,TTP and LTE of enhanced lesions were compared with those of normal myometrium. Results Serous layer, lesions and adjcent myometrium,normal myometrium enhanced in turn. There was no obvious boundary between the lesions enhanced and adjcent myometrium. AT and TTP of the lesions enhanced were both less than those of normal myometrium ( P ＜0. 05). LTE of the part of lesions enhanced was more than that of normal myometrium ( P ＜0.05).Part of lesions never enhanced during the whole process. The serous layer of uterine was smooth and uninterrupted in 24 patients. These 24 patients all recovered after conservative treatment. The local serous layer adjcent lesions was not smooth, but no contrast agent leakage occurred in another 2 patients, and uterine lobectomy were performed in emergency because of massive hemorrhage during conservative treatment. Conclusions Microvascular perfusion and enhanced features of lesions,myometrium and serous layer could be showed clearly through CEUS.

Objective To analyze the clinical features of rectal and perianal inflammatory myofibroblastic tumor and evaluate its diagnosis and treatment.Method Clinicopathological data of 3 cases diagnosed as inflammatory myofibroblastic tumor from January,2005 to June,2011 were retrospectively reviewed.Results Inflammatory myofibroblastic tumor presents as infiltrative growth mass with rich vascularization on CT or MRI,and is difficult to distinguish from hemangioma and other rectal tumors.Preoperative biopsy usually fails to ascertain the entity of mass,and pathological examination of the whole resected specimen with immunohistochemical staining is needed to make final diagnosis.All 3 cases underwent sphincter preserving surgery.One case received a second radical operation 16 months after primary resection because of local recurrence.All patients are followed up to now,with a survival time of 67 months,55 months,and 35 months respectively.Conclusions Rectal and perianal inflammatory myofibroblastic tumor is difficult to diagnose on preoperative imaging examinations or biopsy.Immunohistochemical staining is needed to make final diagnosis.Sphincter preserving surgery with complete tumor removal could achieve long term survival.