Objective:To observe clinical and pathological features of pancreatic solid-pseudopapillary tumor ( SPPT) , and to find some useful immunohistochemical methods for its differential diagnosis.Methods: The clinical features of 14 SPPT patients were obtained. Each case underwent microscopic observation and immunohistochemical staining. The primary antibodies were CgA, Syn, E-cadherin, β-catenin and Cyclin Dl. These results were compared with 5 pancreatic well-differentiated tumors and well-differentiated carcinomas ( WET/WEC). Results: SPPT mainly involved young women, and the head of pancreas was the commonest location. Tumors were always in solid and cystic gross appearance.Although the tumor' s borderlines seemed clear, focal infiltrations could often be identified. The histological features of SPPT were similar in some aspects to those of WET/WEC, especially the solid pattern of WET/WEC. Both of them could express CgA and Syn. But all SPPTs lost E-cadherin membranous signals, and even had some nuclear signals (5/14) , while all WET/WECs remained the same staining pattern with normal pancreas cells, β-catenin positive signals in SPPTs were located both in nuclei and plas mas. WET/WECs' positive signals were all in membranes and plasmas, but negative ones in nuclei. Perinuclear dot-like signals could also be seen in the majority cells, which were similar to normal islet cells' staining pattern. SPPTs' nuclear positive rates of Cyclin Dl were usually more than 70% (12/14). WET/WECs' rates were all lower than 30%. Conclusion: Comprehensive analysis of patients'clinical, pathological features and immunohistoehemistry results, including E-cadherin, β-catenin and Cyclin Dl, was helpful to the diagnosis of SPPT and its differential diagnosis of WET/WEC.

OBJECTIVE To investigate the distribution and the drug resistance of pathogens in cerebral stroke patients with hospital infction and to provide a foundation for reasonabie application of antibacterials.METHODS Pathogenic bacteria were isolated from inpatients of burn department from 2003 to 2008,instruments assay or K-B disk diffusion method was taken to carry out the sensitive test.The drug resistance rate of the pathogenic bacteria was analyzed.RESULTS Totally 222 strains were isolated,among which 122 strains were Gram-negative bacteria,58 strains were Gram-positive ones,and 42 strains were fungi.The percentage of these three groups was 54.95%,26.13% and 18.92%,respectively.The main strains of Gram-negative bacteria were Pseudomonas aeruginosa,Escherichia coli,and Enterobacter cloacae,and that of the Gram-positive bacteria were Staphylococcus aureus,Enterococcus and S.epidermidis.The major strain of fungi was Candida albicans.The pathogenic bacteria tested showed high drug resistance.The detection rate of the meticillin-resistant S.aureus(MRSA)was 73.68%.The detection rate of the ESBLs from the K.pneumoniae and the E.coli was 60.00% and 33.33 %.CONCLUSIONS The pathogenic bacteria are multidrug-resistant.Inspecting pathogens and strengthening susceptibility tests are very important in reducing drug abuse,decreasing the resistance rate and raising the cure rate in hospital.

Objective To investigate the probable risk factors for type 2 diabetic patients complicated nonalcoholic fatty liver disease (NFLD)in elderly, through comparing the body composition, serum lipid profile, incidences of abdominal obesity and metabolic syndrome (MS) between elderly type 2 diabetic patients with and without NFLD. Methods The enrolled elderly type 2 diabetic patients were divided into NFLD group (n=83) and non-NFLD group (n=85). Their clinical data including body composition, serum lipid profile, incidences of abdominal obesity and MS were analyzed retrospectively and compared. Results Compared with non-NFLD group, the BMI [(26.9±2.5) kg/m~2 vs. (24.1±2.5) kg/m~2, P=0.000], waist-hip ratios (WHR) ((0.92±0.07) vs. (0.87±0.06), P=0.000], total body fat percentage [(29.6%±6.6%) vs. (25.3%±5.5%),P=0.000], abdominal fat [(11.0±2.5) kg vs. (8.7±2.3) kg, P=0.000], visceral fat [(3.0±0.7) kg vs. (2.3±0.6)kg, P=0.000], visceral fat area [(97.6±22.2) cm~2 vs. (75.5±21.1) cm~2,P=0. 000], serum triglyceride [(1.98±0.94) mmol/L vs. (1.22±0.61) mmol/L, P=0.000]were all increased, while serum HDL [(1.23±0.32) mmol/L vs. (1.40±0.37) mmol/L, P=0.002]was decreased in NFLD group. The incidences of over-body fat (68.7% vs. 36.5%, P=0. 000),dyslipidemia (47.0% vs. 21.2%, P=0. 000), abdominal obesity (69.9% vs. 43.5%, P=0.001) and MS (49.4% vs. 9.6%, P=0.000) were obviously increased. But there were no statistical differences in serum TC [(4.93±0.94) mmol/L vs. (4. 73±1.07) mmol/L, P=0.219]and LDL [(3.23±0.80) mmol/L vs. (3. 07±0.89) mmol/L, P=0. 229]between the two groups. Logistic regression showed that high BMI (β=1.268, P=0.000, OR=3.56), over-total body fat percentage (β=0.902, P=0.023, OR=2.47)and the existence of MS (β=1. 664, P=0. 000, OR=5.28) were related to elderly type 2 diabetic patients complicated NFLD. Conclusions The high BMI, over-total body fat percentage are related to elderly type 2 diabetic patients complicated NFLD, and NFLD is probably one of components of metabolic syndrome.

OBJECTIVE To investigate the status of the management of nosocomial infection in Anhui Province so as to help to improve it.METHODS Twenty-four hospitals were on-the-spot investigated in a way of questioning and sampling using uniform questionnaire by trained investigators.RESULTS 95.83% Of all involved hospitals have built independent department of nosocomial infection management.These departments from 70.83% hospitals play an important role in infection management and 45.83% of them have suitable structure of staff.There are some problems in the key regions of nosocomial infection control such as operating room,blood dialyzing center and sterilization supply department: small work area,old equipment,irrational arrangement,sterilizing inadequately and so on.CONCLUSIONS The work of administration of nosocomial infections needs to be strengthened.

Objective To observe the expression of peroxisome proliferator-activated receptor γ (PPARγ) in hippocampus neurons in rats after different time of neuron oxygen deprivation/oxygen supply, and to investigate the role of PPARγ in neuron ischemia reperfusion injury.Methods One day old newborn SD rats were chosen. Primary cultured hippocampus neurons were used to establish neuron ischemic reperfusion model in vitro by oxygen and glucose depriving 15 minutes and supplying again, and then the neuron structure was observed by transmission electron microscope of JEM-200EX.The expression of PPARγ mRNA and protein were detected by RT-PCR and Western blot, respectively.Results Neuron structure was damaged after neuron oxygen deprivation/oxygen supply. There was no significant difference between 0 h oxygen supply group and the control group.The expression of PPARγ was decreased both at mRNA and protein level after 6 h of oxygen supply. The difference between 6 h oxygen supply group and the control group was significant(P<0.01), which decreased with the length of reperfusion and the lowest was at 48 h after the reperfusion. The difference among the different reperfusion groups and the control group was significant(P<0.01). Conclusion PPARγ may participate in the pathological damage course of neuron ischemical reperfusion injury, and may become a new intervention target of treatment for ischemic cerebrovascular disease.

OBJECTIVETo study clinical effects of unilateral pedicle screw-rod system fixation combined with the single the cage of interbody fusion in the treatment of lumbar degenerative instability via paraspinal intermuscular approach under MAST Quadrant retractor.

METHODSFrom February 2010 to December 2011, 39 patients with lumbar degenerative instability after invalid conservative treatment were treated with unilateral fixation combined with interbody fusion via the paraspinal intermuscular approach under MAST Quadrant retractor. The indexes such as the operative time, blood loss, complications, VAS pain scores, JOA (subjective symptoms of low back pain,lower limb pain and numbness, sensory disturbance, movement disorders) scores, modified Macnab criteria for curative effect evaluation were observed before treatment, at the 1st month after treatment and the latest follow-up. The intervertebral fusion was studied on the X-ray at the latest follow-up.

RESULTSAll the patients were followed up, and the mean during was (22.3 +/- 8.6) months. The operation time was (138 +/- 46) min, and the amount of bleeding was (335 +/- 152) ml. There were no complications such as cerebrospinal fluid leakage and spinal nerve injury during operation, and no incision infection after operation. The VAS pain score was reduced from preoperative 7.93 +/- 1.27 to 2.05 +/- 1.18 on the 1st month after operation and 1.89 +/- 0.42 at the latest follow-up. The JOA total score was improved from preoperative 1.59 +/- 0.42 to 8.86 +/- 0.37 on the 1st month and 9.02 +/- 0.29 at the latest follow-up. According to modified Macnab criteria, there were 17 cases got an excellent result, 19 good, 3 case fair. Thirty-five patients got intervertebral bony fusion at the latest follow-up.

CONCLUSIONUnilateral pedicle screw-rod system fixation combined with single cage interbody fusion in the treatment of lumbar degenerative instability via paraspinal intermuscular approach under MAST Quadrant retractor is a safe, minimally invasive, satisfactorily effective methods to treat lumbar degenerative instability.

Adult ; Aged ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; Humans ; Intervertebral Disc Degeneration ; surgery ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Pedicle Screws ; Reconstructive Surgical Procedures ; Spinal Fusion ; Treatment Outcome

Background and purpose: Extraskeletal myxoid chondrosarcoma (EMC) is a malignancy of uncertain differentiation tumor characterized by a multinodular structure and abundant myxoid matrix. Its preferred sites were the deep soft tissues of the extremities. The aim of this study was to investigate the clinicopathologic characteristics, diagnosis and differential diagnosis of EMC. Methods: Seven cases of EMC were analyzed for clinicopathological and immunohistochemical features with review of the related literature. Results: It occurred predominantly in females (male/female=2︰5). Five cases were located in low extremities and two in upper limb girdles, more commonly near the joint. Grossly, the masses showed as grey, lobular and somewhat transparent with a relatively well-deifned margin. Microscopically, the small ovary or plump spindle-shaped cells arranged in strand and cord patterns and lobular architecture which separated by delicate fibrous networks with an abundant myxoid but hypovascular background. And the tumors were immunoreactive for vimentin, and partly for S-100 and EMA, meanwhile, negative for CK. Conclusion:EMC is a rare soft tissue sarcoma with distinctive histopathological features. It should be distinguished from some mimics especially those tumors with a myxoid stroma or chondroid differentiation, such as chordoma and chondrosarcoma.

Objective To investigate if down regulation of MTDH could inhibit proliferation and induce apoptosis in breast cancer SK-BR-3 cells.Methods RNA interference was employed to reduce MTDH expression in human breast cancer SK-BR-3 cells.Western blot assay was applied to measure the down regulation of MTDH.MTT assay was performed to assess the proliferation of SK-BR-3 cell.Flow cytometry was employed to detect cell cycle and apoptosis.Western blot assay was applied to detect the molecular alterations that was associated with cell proliferation,cell cycle and apoptosis.Results MTDH down regulation significantly inhibited cell proliferation.48 hours and 72 hours after trasnfection,the absorbance value(A value)in blank control,negative control and treatment group was (2.0 ± 0.1) vs (1.9 ± 0.3) vs (0.9 ± 0.1) (P =0.02) and (2.7 ± 0.2) vs (2.5 ± 0.4) vs (1.3 ± 0.2) (P =0.008).MTDH down regulation resulted in accumulation of the G0/G1 phase cells and reduction of S and G2/M phase cells.Moreover,MTDH down regulation significantly induced cell apoptosis.The cell apoptosis rate in blank control,negative control and trial group was (1.3 ± 0.2) ％,(1.4 ± 0.3) ％ and (19.6 ± 2.7) ％ (P =0.012).MTDH down regulation resulted in a decreased expression of cyclinD1 and Bcl-2,an increased expression of P21 and the activation of caspase-3.Conclusions Reduced MTDH expression in SKBR-3 cells can inhibit proliferation and induce apoptosis,which may be associated with decreased expression of cyclinD1 and Bcl-2,an increased expression of P21 and the activation of caspase-3.

Objective:To investigate and evaluate the safety of intravitreal injection of recombinant human endostatin (rh-endostatin) with different concentrations in rabbit eyes.Methods:Thirty healthy adult New Zealand white rabbits were enrolled with the right eyes selected as experimental eyes, and were randomly divided into five groups by random distribution of computer numbers, with 6 eyes in each group.The rabbits in the normal control group were given no treatment, and the rabbits in the normal saline group, 0.125 mg rh-endostatin group, 0.250 mg rh-endostatin group and 0.500 mg rh-endostatin group were treated with 100 μl of normal saline, 0.125 mg/100 μl, 0.250 mg/100 μl and 0.500 mg/100 μl rh-endostatin according to grouping, respectively.The anterior segment and fundus of the experimental eyes were examined using slit lamp biomicroscope and indirect ophthalmoscope, and the intraocular pressure (IOP) of the experimental eyes were measured with iCARE handheld tonometer before injection and 1 day, 3, 7, 14, 30 and 60 days after injection.Optical coherence tomography (OCT) examination was performed before the intravitreal injection and 7, 30, and 60 days after injection, respectively.Flash electroretinogram was performed before intravitreal injection and 14 days and 60 days after injection.The rabbits were sacrificed by euthanasia at 60th day after injection.Three experimental eyes of each group were dissected and made into paraffin section, and histopathological staining was used to detect the retinal structural changes.The retinal tissue was separated from the other three study eyes in each group, and the transmission electron microscope was employed to observe the ultrastructural changes of the retina.All animal experiments were performed in adherence to the Regulations of the State and the Animal Center of Yangzhou University Medical College for the Use of Animals in Research.Results:After intravitreal injection, no obvious anterior or posterior chamber change was observed by slit lamp microscopy in all groups at any time point.Flocculent seepage was observed in one eye of the 0.125 mg and 0.500 mg rh-endostatin group, respectively, which was then absorbed completely on the 7th and 14th day.OCT examination showed no abnormal light reflection or morphological changes in fundus of day after injection in all the groups.There was no significant difference in IOP, a-wave and b-wave amplitude among all the groups at different time points ( Fgroup=0.134, 0.101, 0.476; Ftime=1.709, 2.479, 1.706; all at P>0.05). Neither light nor electron microscopy showed any retinal damage in any group. Conclusions:Intravitreal injection of rh-endostatin is safe at the dosage of 0.125-0.500 mg in rabbits.

[Abatract] In order to improve the result of clinical practice for undergraduate students of clinical medicine, combined with the professional characteristics of hematology and teaching syllabus, Hematology Department in the First Affiliated Hospital of Dalian Medical University developed practi-cal teaching content and tried using a variety of teaching methods and teaching means such as multi-media aided teaching, case teaching and simulation teaching method and so on. Besides, multiple station examination was established; teaching feedback and supervision were strengthened. The prac-tice proved that the reform measures were conducive to the cultivation of medical students' practical skills and clinical thinking, which helped to speed up the transformation from the students to the role of doctors.