Objective:To discuss the application value of MSCT in atypical benign and malignant gastric stromal tumor diagnosis. Methods:Twenty three patients that had definite pathological diagnosis of gastric stromal tumors image data were chosen in our hospital from January 2009 to January 2013, and patients were divided into highly malignant group (12 cases) and low malignant group (11cases) according to patient’s pathological dianosis. Tumor location, growth pattern, size, shape, boundaries, arterial phase enhancement level, ulceration, necrosis, cystic degeneration, calcification were recorded and the results were analyzed using SPSS17.0 for data processing. Results:Twenty three patients were all atypical gastrointestinal stromal tumors, and there were three cases of pedunculated walk, 8 cases od completely cystic, 7 cases of junction, 5 cases of irregular. There were statistically significant differencesin the tumor diameter, central liquefaction necrosis, the degree of enhancement, tumor morphology, tumor border(x2=15.683,x2=10.145, x2=16.130,x2=19.326,x2=9.224;P<0.05). Conclusion:Application of spiral CT is not typical GIST, according to the image characteristics of benign and malignant tumors of the qualitative analysis and diagnosis, worthy of clinical application.

Objective To investigate application value of dual energy CT nonlinear fusion technology in diagnosis of liver diseases.Methods 86 patients with liver disease screening from 2013 January to 2014 December in our hospital were selected as the research objects.All patients underwent dual energy CT nonlinear fusion and linear fusion imaging,image quality was compared between the two groups of image results,and compared the hepatic lesion area and normal hepatic tissue,change analysis of portal vein of hepatic lesions.Results Nonlinear fusion image CT value difference of (59.71 ±7.64)Hu higher than the value difference linear fusion images of CT (31.35 ± 10.53)Hu,the difference was statistically significant(t =4.361,P <0.05);nonlinear fusion image contrast to noise ratio of liver lesion,hepatic signal -to -noise ratio was (2.94 ±1.06),(5.62 ±1.53),which was higher than that of linear image fusion(4.84 ±2.36),(8.35 ±1.09),the differences were statistically significant(t =1.914,2.059, all P <0.05).Conclusion The use of dual energy CT nonlinear fusion technology can significantly improve the ima-ging quality of CT for liver parenchyma and portal vein without increasing the scanning phase conditions,and nonlinear fusion image for lesions of imaging is linear fusion image clearer,especially small lesions,help to improve the clinical liver lesion detection rate,clinical value.

Posterior vitreous detachment (PVD), retinal breaks, and lattice degeneration are common problems in ophthalmic clinical practice, which not only cause disturbance to patients' life-quality, but also increase the risk of retinal detachment and vitreoretinal traction.In September 2019, the American Academy of Ophthalmology published Posterior Vitreous Detachment, Retinal Breaks, and Lattice Degeneration Preferred Practice Pattern (PPP). Based on clinical evidence, this PPP provides authoritative guidance for the definition, epidemiological background, diagnosis and treatment of these diseases.This PPP also gives definite solution for treatment and follow-up of different sub-types.This article provides introduction and interpretation of this PPP.

Objective To study the mechanism of interferon-γ(IFN-γ)on the intervention of renal carcinoma cell proliferation.Methods Using concentration of 1 000,2 000,3 000 U/mL IFN-γtreatment of renal cell carcinoma 786-0 cell line,in 24 hours,48 hours,72 hours after treatment,the inhibition rate of cell proliferation was determined with CCK-8 method,using flow cytometric analysis of cell cycle,using RT-PCR for detection of hepaCAM mRNA,and using the Western boltting method for detection of MAD1 protein expression.Results Different concentrations of IFN-γhad the inhibitory effects on renal cell carcinoma cell proliferation,the concentration of the inhibitory rate of 72 hoursand 48 hours more than 24 hours,the difference was statistically significant (P<0.05);at the same time,a higher IFN-γconcentration,the inhibition rate was greater,the difference was statistically significant (P<0.05 );the cell cycle distribution results showed,the experimental group of renal carcinoma cells proliferation in the treatment of abnormal G0/G1 phase after 48 hours;and the control group (39.89 )compared with the experimental group,the proliferation index (25.65 )decreased significantly,the difference was statistically significant (P<0.05 );results showed that,the experimental group in renal cell carcinoma cells after 48 h of treatment,compared with control group,hepaCNM mRNA,MAD1 protein expression increased obviously,the difference was statistically significant (P<0.05 ).Conclusion IFN-γcould increase the expression of MAD1 by promoting hepaCAM expression,inhibits renal carcinoma cell proliferation.

Objective To study the education of medical mycology for undergraduates of medical laboratory specialty and provide a basis for teaching reformation.Method Setting of mycology related courses of medical mycology for undergraduates in 5 medical schools and 85 inspection and technical personnel's detection of fungi in 81 hospitals were investigated through consultation and questionnaire survey.Results More than 140 class hours for medical mycology were arranged in 5 schools,but as to medical mycology,22 class hours in 1 school and less than 10 class hours in 4 schools,the minimum class hours were 5.Although various numbers of Candida and filamentous fungi could be isolated in hospitals investigated,more than half laboratory workers could not identify penicillium,thermally dimorphic fungi,Zygomycetes and Dematiaceous fungi.Conclusion Education on medical mycology for medical laboratory specialty undergraduates is insufficient and the corresponding teaching lacks such content as medically important pathogenic fungi detection methods and identification characteristics.The hospital technical personnel's fungal identification ability cannot meet the situation of increasing fungal infection involved in clinical medicine,so it is necessary to carry out teaching reformation of medical mycology for undergraduates in laboratory medicine,including adding class hours,increasing course contents and so on.

Background and purpose:P38 mitogen-activated protein kinase (P38MAPK) signal transduction pathway is involved in occurrence, development and transfer process in a wide variety of tumors. Urokinase-type plasminogen activator (uPA) plays an important role in tumor invasion and metastasis. This study aimed to explore the clinical signiifcance of the P38MAPK signaling pathway and the expression of uPA in ovarian cancer.Methods:The expressions of uPA, P38MAPK, ERK and AKT were detected in 49 cases of cervical adenocarcinoma by immunohistochemistry. The expressions of uPA and P38MAPK were detected by Western blot in ovarian cancer cell lines HO8910, HO-8910PM, SKOV3 and CAOV3. The changes of uPA and P38MAPK were detected by SB203580, a speciifc inhibitor of P38MAPK signal transduction pathway.Results:The result of immunohistochemical method showed that positive expression rates for uPA, P38MAPK, ERK and AKT were 61.22%, 57.14%, 53.06% and 55.10%, respectively. The expression of the uPA was positively correlated with the P38MAPK (r=0.865,P=0.001), and related with clinicopathologic stage, differentiated degree, lymph node metastasis, but not related with age and histologic type (P>0.05). The expressions of AKT and ERK were related with the lymph node metastasis and greater omentum metastasis(P<0.05), but not related with age and histologic type (P>0.05). The expression of uPA in HO-8910PM was higher than that in ovarian cancer cell lines HO8910, SKOV3 and CAOV3, and the expression of uPA reduced when the P38MAPK signal transduction pathway was cut off by the SB203580. The expressions of P38MAPK and uPA were negatively correlated with the prognosis of ovarian cancer (Log-rank=3.897 and 11.044,P=0.048 and 0.001). Conclusion:The P38MAPK signal transduction pathway was activated in ovarian cancer. The activated P38MAPK signal transduction pathway can raise the expression of uPA, which may contribute to the development of ovarian cancer. The result indicates that the P38MAPK signal transduction pathway and uPA might play an important role in the invasion and metastasis of ovarian cancer. P38MAPK and uPA might be useful markers for evaluating prognosis of ovarian cancer.

OBJECTIVE:To observe the effects of dexmedetomidine hydrochloride on extubation stress response in elderly pa-tients during general anesthesia recovery period. METHODS:80 patients underwent general anesthesia of abdominal surgery were randomly divided into observation group and control group,with 40 cases in each group. Both groups received routine anesthesia before surgery and during surgery. 10 min before the end of surgery,observation group was given intravenous pump of dexmedeto-midine hydrochloride diluted to 10 ml 0.5 μg/kg,and control group was given constant volume of 10 ml 0.9% Sodium chloride so-lution. HR,MAP and SaO2 levels of 2 groups were compared before the induction of anesthesia (T0),at the moment of intrave-nous injection of dexmedetomidine hydrochloride or 0.9%Sodium chloride solution(T1),at the moment immediately before extuba-tion(T2),at the moment of extubation(T3),1 min after extubation(T4),5 min after extubation(T5)and 10 min after extubation (T6). Ramsay sedation score of 2 groups were compared at T0,T2,T4,T5 and T6;cough score,restlessness score,awake time(t1) and extubation time(t2)were also compared between 2 groups. RESULTS:Compared with at T0,the fluctuation of HR and MAR in 2 groups decreased significantly and became stable gradually at T4,T5 and T6,and HR and MAP of observation group at T1-T6 were significartly lower than those of control group,with statistical significance(P<0.05);but there was no statistical significance in SaO2 (P>0.05). There was statistical significance in Ramsay sedation score between 2 groups at T2,T4,T5 and T6 (P<0.05). The cough score and restlessness score of observation group were significantly lower than those of control group,and t1 and t2 were significantly shorter than those of control group,with statistical significance(P<0.05). CONCLUSIONS:Dexmedetomidine hydro-chloride can relieve extubation stress reaction in elderly patients during general anesthesia recovery period with good safety.

Objective To explore the clinical features,neuroimaging and histopathological findings in patients with idiopathic hypertrophic cranial pachymeningitis (IHCP) with a nodular space occupying effect.Methods Four IHCP cases with a nodular space occupying effect diagnosed in our hospital were retrospectively studied.Results All the 4 patients were men with a mean onset age of 40.25 (33 ～ 50) years old.They all had long disease duration and relapses.The common symptoms of IHCP were chronic headache,multiple cranial nerve palsies and epileptic seizures.CT and MRI of the brain revealed prominent dural partial thickening,which indicated a mass or nodular space occupying effect that mimicked intracranial tumour-like meningioma.The histopathological findings of dura in 2 cases revealed connective tissue proliferation,scattered neutrophile granulocytes and plasmacytes infiltration.Combination therapy of corticosteroid or/and immunosuppressive drugs was effective for the IHCP patients.Conclusions IHCP patients with a nodular space occupying effect usually onset with chronic headache and are often recurrent.The combination therapy of corticosteroid or/and immunosuppressive drugs is effective.The image of the brain presents prominent dural partial thickening,indicating a mass or nodular space occupying effect,which often lead to confusion with intracranial tumours or granulomatosis.

Objective To analyze the clinical features of differentiated thyroid cancer diagnosed during pregnancy or one year after delivery.MethodsA total of 234 women with differentiated thyroid cancer were treated from January 2001 to January 2011.Cases were divided into three groups according to the time of tumor diagnosis( group 1,no pregnancy history; group 2,during pregnancy or in the first year after delivery;group 3,longer than 1 year after the delivery).ResultsThe thyroid nodule was asymptomatic and discovered on routine examination more often in group 2(78.7％ ) than other two groups (P =0.02).There were no significant difference among three groups in age,hospitalization time,operation time,operation method,tumor type,primary tumor stage and mortality. But more patients in group 2 were suffering from extrathyroid invasion ( P =0.024 ),multi-focal cancer ( P =0.023 ),larger cervical lymph node ( P =0.021 ),later regional lymph node stage (P =0.020 ) and higher local recurrence (P =0.001 ).By stepwise logistic regression analysis,pregnancy is one of the factors impacting on local recurrence rate ( P =0.045 ).ConclusionsPregnancy does not affect the mortality of the differentiated thyroid cancer,but the incidence of extrathyroid invasion,multi-focal cancer,cervical lymph node metastasis,local recurrence is higher in patients with differentiated thyroid cancer diagnosed during pregnancy.

ObjectiveTo study the clinicopathological features of endometrial cancer patients diagnosed during or after tamoxifen (TAM)treatment for breast cancer and to evaluate the relevance between the clinicopathological features and the cessation time of TAM treatment. Methods42 TAM-related endometrial cancers patients in the Affiliated Hospital of Medical Collage of Qingdao University were divided into 2 groups according to the cessation time of TAM.Group B were 20 past TAM users who were diagnosed as endometrial cancer 12 or more months since the cessation of TAM.Group A included the rest 22 patients.The clinicopathological features of the 2 groups were analyzed retrospectively.ResultsThe age of patients was ranging from 32 to 85 years when they were diagnosed endometrial cancer.There was no significant difference in terms of the age at which breast cancer was diagnosed, BMI, HRT, single dose of TAM, duration and cumulative dose between the 2 groups.However, the difference of the age at which endometrial cancer was diagnosed, menopausal status, the interval between diagnostic date of the 2 cancers, histological types, pathological stage, myometrial invasion, and cervical invasion had statistical significance between the 2 groups ( P ＜ 0.05 ). Conclusion Compared with group A, group B have a higher pathological stage and more invasive histological features, which may be because group B include more elderly and postmenopausal patients.