[Summary] Limb numbness is a common symptom of diabetic peripheral neuropathy(DPN),which is similar to lumbar vertebra disease and spinal cord tumor compression syndrome. Diabetes mellitus (DM) combined with lumbar spondylosis and spinal cord tumor compression is rarely occurred and is difficult to distinguish from DPN . Here we reported a case of DM combined with spinal neurilemoma that was misdiagnosed as DPN for half a year.

Angiolymphoid Hyperplasia with Eosinophilia ; pathology ; Child, Preschool ; Humans ; Male

Objective To investigate the application of quantitative parameters associated with iodine concentration derived from iodine overlay image by dual-source dual-energy computed tomographic (CT) in differentiating benign and malignant thyroid nodules. Methods Seventy-eight patients (total 112 nodules, including 64 benign and 48 malignant nodules) with thyroid nodules who underwent plain scan (PS), arterial phase (AP) and venous phase (VP) enhanced scan by DSCT (80 kVp/ Sn140 kVp) were analyzed retrospectively. Iodine overlay images were obtained by the dual energy post-processing software. The mean iodine concentrations in the normal thyroid parenchyma (ICThy), the lesion (ICLes), and the carotid artery(ICCar) of PS, AP and VP were measured from iodine overlay images. The iodine concentration difference (ICD), the iodine concentration difference-to-normal parenchyma ratio (ICDNR) and the normalized iodine concentration ratio (NIC) were calculated. The two-sample t test was performed to compare quantitative parameters between the benign and malignant nodules. ROC curve with quantitative parameters of three phases was used to analyze the diagnostic efficiency of ICD, ICDNR, NIC and ICles. Results During
PS, mean ICDNR, ICD and ICLes of malignant nodules were respectively 1.04 ± 0.95, (2.20 ± 1.82) mg/ml, (-0.04 ± 1.65) mg/ml, ICDNR, ICD and ICLes of benign nodules were respectively 0.04 ± 0.41, (0.35 ± 0.97) mg/ml, (2.19 ± 0.55) mg/ml. ICDNR and ICD of malignant nodules were higher than benign nodules (t'=6.63, 6.39, P<0.05), while ICles of malignant nodules were lower than benign nodules (t=10.13, P<0.05). During AP , mean ICDNR, ICD, ICLes of malignant nodules were 0.39 ± 0.29, (2.23 ± 1.77) mg/ml, (3.81 ± 1.50) mg/ml, and benign nodules were 0.49 ± 0.22, (2.97 ± 1.91) mg/ml, (3.17 ± 1.64) mg/ml, respectively. ICDNR, ICD of malignant nodules were lower than benign nodules (t'=2.08, t=2.12;P<0.05),while ICles of malignant nodules were higher than benign nodules (t=2.12, P< 0.05). During VP, mean NIC of the malignant and benign nodules were 0.45 ± 0.21, 0.58 ± 0.37, respectively. NIC of malignant nodules were lower than benign nodules (t'=2.35, P< 0.05). AUC of ICDNR during PS was 0.892, the sensitivity was 83.3% and the specificity were 90.5%. Conclusion Quantitative parameters associated with iodine concentration by dual-source dual-energy CT may increase the efficiency and accuracy in differentiating benign and malignant thyroid nodules.

ObjectiveTo examine the effects of temsirolimus, an inhibitor of mammalian target of rapamycin, on bladder cancer cell lines T24 and BIU-87 in vitro and in vivo for purpose of evaluating the probability of mTOR targeted therapy for bladder cancer.MethodsAfter being treated by a different concentration of temsirolimus, T24 and BIU-87 cells were tested by MTT assay for cell proliferation activity.Cell cycle and apoptosis analysis were performed with flow cytometer. Wound scratch assay was used for cell migration activity and transwell motility assay. Western blot analysis was used to test the mTOR phosphorylation. Subcutaneous inoculation of 6-week-old nude mice was performed using 1 × 106 T24 cells in 50％ matrigel for both control (n = 10) and temsirolimus (n = 10) groups. The volume of tumors was examined and then the expression of Ki-67 was detected by immunohistochemistry.ResultsTemsirolimus significantly inhibited proliferation of T24 and BIU-87 cells in a dose- and time-dependent manner. After administration of temsirolimus on T24 and BIU-87 cell lines for 24 h, the rate of wound healing in 0 nmol/L groups were (88.9 ± 14. 1 ) ％ and ( 83.6 ± 16.3)％ , which were higher than in the 5 nmol/L groups, which were (42.7 ± 11.6) ％ and ( 36.9 ± 9.7 ) ％ ( P ＜ 0.05 ). In the transwell motility assay, the number of cells in the 0 nmol/L group was 26.5 ± 5.8 and 28.2 ± 4.6, which was higher than in the 5 nmol/L group ( 19.0 ±3. 8 and 21.3 ± 5.1, respectively) (P ＜ 0. 05). When temsirolimus was administered on T24 and BIU-87 cell lines for 48 h the percentages of cells delayed in phase G0/G1 in 5 nmol/L group were ( 77.46 ±6.11)％ and (73. 39 ± 4. 94)％ respectively, and higher than in the 0 nmol/L group, which were (65.99 ±5.01 )％ 、(60.15 ±3.98)％ (P ＜0.05). There was no statistically significant difference in the apoptosis rate between the two groups (P ＞ 0.05 ). In Western blot analysis, the ratios of p-mTOR/β-actin were 0.92 ±0.09 and 1.01 ± 0.08 in 0 nmol/L group, and higher than in the 5 nmol/L group (0.47 ±0.05、0.04 ±0. 01 ) (P ＜ 0.05 ). After administration of temsirolimus for 21 days, the tumor volume in nude mice in the control group were 351.1 ± 139.9 mm3 , which was larger than 351.1 ± 139.9 mm3 in the temsirolimus group ( P ＜ 0.05 ). The positive rate of Ki-67 expression was ( 67.3 ± 8.4 ) ％ in the control group, which was higher than in the temsirolimus group ( 35.5 ± 6.7 ) ％ ( P ＜ 0.05 ).ConclusionsThis study provides in vitro and in vivo evidence that temsirolimus may inhibit the viability of bladder cancer cells and temsirolimus could be exploited as a potential therapeutic strategy in bladder cancer.

Objective To explore the treatment of thromboangitis obliterans (TAO) of lower extremities.Methods From March 1994 to February 2009,24 cases (26 limbs) affected by chronic ischemia were diagnosed as TAO by Doppler ultrasound and DSA,CTA or MRA.According to the different levels of the extensive and diffuse arterial occlusion,the revascularization was performed in the ways:19 cases (21 limbs) underwent venous arterialization,3 cases (3 limbs) underwent endovascular therapy,and 2 cases (2 limbs) underwent thrombectomy.ResultsAfter the venous arterialization,19 cases (21 limbs) were followed up for 1 to 14.5 years.Apart from the 5 limbs amputation (23.8%),the postoperative results of the most limbs were satisfactory (61.9%).The ABI before therapy (0.38?0.11) was significantly lower than that 6 months after therapy (0.79?0.08),P

Objective To investigate the significance of helper T cell 1(Th1)/Th2 cytokines unbalance in children with hepatitis B virus-associated glomerulonephritis(HBV-GN).Methods The serum levels of interferon-gamma(IFN-?),interleukin-2(IL-2) and IL-4 were determined in 22 children with HBV-GN and 18 children with HBV by enzyme-linked immunosorbent assay(ELISA),respectively,and the difference of Th1/Th2 cytokines in the 2 groups.Results Serum levels of IL-2 and IFN-? in children with HBV-GN were decreased(P

Objective To understand the subjective perception and influential factors of critical care training in rescue nurses. Methods The same self-designed questionnaire with a total of 49 closing entries were used before and after training course to investigate the ability of critical care and prevention ability of infectious diseases in rescue nurses. Results The ability of emergency response nursing improved remarkably after rescue nurse training (t=-7.071--3.693,P<0.01). But there were several weaknesses still in existence including specialty knowledge, first aid techniques, and clinical application of biochemical indicators, psychological trauma assessment, epidemics and ECG recognition, critical
thinking, the differences were statistically significant (t=-6.736--3.286,P<0.01). Conclusions Rescue nurses training can improve the ability to take care of critical illness under emergency situations, which can ease the insufficiency of human resource for short-term.

0.05),but urine levels of MIF in children HSPN increased significantly than those in normal controls(P

Objective To study prevention and treatment for patients during the intermittent period of maintaining hemodialysis complicated by acute left heart failure. Methods The treating process of 126 examples suffered from acute left heart failure during the intermittent period of 14 225 person-time maintaining hemodialysis in 143 patients were retrospectively analyzed. Results In this case group, 0.89% suffered from acute left heart failure during the intermittent period of hemodialysis and the successful rescuing rate was 88.9%. Conclusions Applying the treatment of emergency hemodialysis, quickly filtering body fluid, the curative effect is reliable and rapid. It is one of the best ways to cure patients suffered from acute left heart failure during the intermittent period of maintaining hemodialysis. Combined with other treatments, it will be able to improve the successful rate, and ensure the sufficiency of hemodialysis. United with other steps of reducing blood pressure, such as using angiotensin converting enzyme inhibitors, angiotensin II receptor blocker, and ? receptor blocker, it is an effective countermeasure to prevent patients suffering from acute left heart failure during the intermittent period of maintaining hemodialysis, and effectively reduces its appearance as well.

Objective To explore the therapeutic effect and medication safety of low-dose erythromycin treatment on intractable allergic rhinitis(AR) associated with bronchus asthma.Methods Totally 173 cases of children received outpatient treatment because of AR associated with asthma,their ages ranging from 3 to 14 years.Among them,78 cases developed intractable AR with symptoms of asthma having been controlled or satisfactorily controlled after 2 courses of conventional treatment.Seventy-six children with intractable AR received full follow-up and were randomly divided into observation group and control group.The control group was given different second-generation antihistamines,when necessary,supplemented by nasal glucocorticoids.In the observation group,the same treatment as it was done in control group was continued,plus oral treatment with erythromycin enteric-coated capsules(10 mg?kg-1?d-1,which were taken 3 times a day for 1 month) to the observation group.Both observation group and control group were in accordance with the norms of the treatment of asthma.Results The improvement rate,inefficiency and the total efficiency were different between observation group and control group,and the diffe-rence was statistically significant(?2=12.629,8.412,8.412,Pa0.05).Their liver function was also monitored and was found normal before treatment and after the replacement of drugs for 1 month,including alanine ami-notransferase,aspartate aminotransferase,albumin,globulin,and were found normal.Conclusions On the basis of conventional treatment,low-dose erythromycin treatment of intractable AR is effective and safe.However,the treatment must be limited to the refractory cases,and the appropriate indications must be strictly observed.