Objective To investigate magnetic resonance imaging(MRI) characteristics of autoimmune pancreatitis(AIP) in middle-aged and elderly patients. Methods MRI were performed in 17 middle-aged and elderly patients with AlP proved histopathologically or clinically. All clinical and MRI data were reviewed. Results Of 17 cases, MRI showed diffuse enlargement of the pancreas in 13 cases, and focal lesions in 4 cases. Swelled pancreas was hypointense on T1-weighted images, mildly hyperintense on T2-weighted images, decreased enhancement on artery phase of dynamic imaging, and moderate enhancement on delayed phase images. Capsule-like enhanced rim was found around swelled pancreas in 13 patients. Stricture of distal common bile duct was present in 15 patients, and diffuse irregular narrowing of the main pancreatic duct was showed in 5 cases. The mean apparent diffusion coefficient(ADC) value of AIP was 1.64×10~(-3) mm~2/s in 13 cases. Conclusions AIP occurs more often in middle-aged and elderly people. AIP shows some characterized MRI findings including swelled pancreas looking like banana or sausage, delayed enhanced capsule-like rim around the lesion and diffuse irregular narrowing of pancreatic duct. MRI will play an important role not only in the diagnosis of AIP, but also in evaluating curative effect of AIP.

Death ; Hematoma, Subdural/etiology* ; Humans ; Syphilis, Congenital/complications*

OBJECTIVETo evaluate the clinical effects of iliolumbar fixation for the sacrum fractures of Denis type II.

METHODSThe clinical data of 86 patients with sacrum fracture of Denis type II treated by iliolumbar fixation from January 2008 to January 2012 were retrospectively analyzed. There were 55 males and 31 females, aged from 17 to 55 years old with an average of 39.1 years. Among them, 73 cases complicated with pelvis fracture and 13 cases with acetabular fracture; 37 cases with sacral neurological symptoms and 49 cases without sacral neurological symptoms. Fracture healing time, nerve function, clinical function and complications were observed in the patients.

RESULTSIn 86 cases, 6 cases were out of followed-up and 80 cases were followed up from 24 to 71 months with an average of 36 months. The mean fracture healing time was 13 weeks (ranged, 10 to 38 weeks). According to Gibbons scoring to evaluate the neurological function, preoperative nerve rehabilitation, lower limbs feeling, lower limbs activity,bladder and rectum function,total score respectively were 0.62 +/- 0.04, 1.54 +/- 0.35, 1.12 +/- 0.18, 0.23 +/- 0.01, 3.46 +/- 0.47 and postoperative respectively were 0.82 +/- 0.12, 0.36 +/- 0.04, 0.05 +/- 0.01, 0.03 +/- 0.01, 1.25 +/- 0.22, there were statistically significant differences between preoperative and postoperative (P < 0.05). According to Majeed scoring to evaluate the clinical function, postoperative pain, standing, sitting, sexual life, work ability, total score respectively were 22.54 +/- 4.02, 27.93 +/- 5.46, 8.47 +/- 3.61, 2.54 +/- 1.33, 16.46 +/- 4.34, 81.32 +/- 8.73, 60 cases got excellent results, 17 good, 3 fair. The main complications including fracture nonunion of 5 cases,deep incision infection of 1 case, and screw prominence resulting uncomfortable of 8 cases.

CONCLUSIONIliolumbar fixation has the advantages of stable fixation, satisfactory functional rehabilitation, less complications, and is a good method in treating sacrum fracture of Denis type II.

Adolescent ; Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Sacrum ; injuries ; surgery ; Spinal Fractures ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the pathological diagnostic features and the differential diagnosis of radial sclerosing lesions of the breast.

METHODSMorphological observation and immunohistochemistry were applied to forty-four cases of radial sclerosing lesions of the breast.

RESULTSAll forty-four patients were females, the mean age was 40.3 years (range 17 to 54 years). In the 31 consultation cases, 13 were misdiagnosed as carcinoma. The lesions had a radiating outline, and a central scar area where squeezed or pressed irregular shaped tubules were frequently seen. Dilated tubules and proliferated ducts or lobules were seen radically arranged at the periphery accompanied sometimes with the apocrine glands or columnar cell metaplasia and hyperplasia. Aside, there were 14 cases displaying necroses and 8 cases showing atypical ductal hyperplasia. Immunostaining showed myoepithelial cells around the pseudo-infiltrating tubules, and the florid proliferating epithelial cells were positive for CK5/6.

CONCLUSIONSRadial sclerosing lesions of the breast possess characteristic histological features, and may be misdiagnosed as carcinoma. The lesions should be differentiated from ductal carcinoma in situ, lobular neoplasia, tubular carcinoma and invasive ductal carcinoma.

Adenocarcinoma ; pathology ; Adolescent ; Adult ; Breast ; pathology ; Breast Diseases ; metabolism ; pathology ; Breast Neoplasms ; pathology ; Carcinoma in Situ ; pathology ; Carcinoma, Ductal, Breast ; pathology ; Carcinoma, Lobular ; pathology ; Diagnosis, Differential ; Diagnostic Errors ; Female ; Humans ; Hyperplasia ; Keratin-14 ; metabolism ; Keratin-5 ; metabolism ; Keratins ; metabolism ; Middle Aged ; Sclerosis ; metabolism ; pathology ; Young Adult

Objective To investigate the imaging characteristics of autoimmune pancreatitis (AIP).Methods MR imaging was performed in 12 patients with AIP proved histopathologically or clinically,of them CT was scanned in 10 patients and endoscopic retrograde cholangiopancreatography (ERCP)in 3.All imaging data were reviewed retrospectively.Results All 12 patients had enlargement of the pancreas either diffusely(n=9)or focally(n=3).The swollen pancreas was hypointense on T_1-weighted images and mildly hyperintense on T_2-weighted images.It also demonstrated decreased enhancement on artery phase of dynamic imaging and moderate enhancement on delayed phase images. Capsule-like enhanced rim was found around the swollen pancreas in 11 patients.Stricture of the distal common bile duct was found in 9 patients,and ERCP showed diffuse and irregular narrowing of the main pancreatic duct in 3 cases.At follow-up,pancreatic abnormalities and common bile duct stricture resolved after steroid therapy in 7 patients.Conclusion AIP showed some characteristic imaging findings,and imaging examinations will play an important role in the diagnosis of AIP.

ncreatic enlargement, MRI is comparable to CT.

OBJECTIVETo explore the quality of life and related social support among people living with HIV/AIDS with related factors.

METHODS331 people living with HIV/AIDS and 148 of their family members were selected using a typical sampling method. Questionnaires on general conditions, tables on history of infection, generic quality of life inventory-74 (GQOLI-74) and social support scale (SSS) were used.

RESULTSData from one-way analysis suggested that people living with HIV/AIDS and their family members with the different sexs, different villages and different cultural backgrounds had differences in GQOLI-74 scores (P < 0.05) while people living with HIV/AIDS with the different villages had differences in SSS scores (P < 0.05). Results from Multiple linear regression analysis revealed that being elderly and negative life events were negatively associated with social support (P < 0.05), while factors as more advanced educational background, harmonious neighborhood relationship and having bother pouring nature were the predictive factors (P < 0.05).

CONCLUSIONMany factors might affect dimensions of quality of life among people living with HIV/AIDS and their family members in rural areas of northern Anhui. Community care and social support of HIV/AIDS should still be greatly enhanced in the countryside of China. A community care mode based on family and neighborhood was expected to be developed.

Acquired Immunodeficiency Syndrome ; complications ; ethnology ; psychology ; China ; Cultural Characteristics ; Family Relations ; Female ; Humans ; Male ; Quality of Life ; Social Support

OBJECTIVETo investigate the clinicopathologic features, clinical progress and prognosis of the basal-like subtype of invasive lobular carcinoma (ILC) of the breast.

METHODSFour cases of ILC were analyzed by detailed histopathologic observation and immunohistochemical staining for E-cadherin, p120 catenin, ER, PR, HER2, CK5/6, EGFR, p63, p53, Ki-67 using MaxVision method. The follow-up and clinical data were analyzed.

RESULTSMorphologically, one case was mixed ILC and three cases were pleomorphic ILC. The tumor cells were negative for E-cadherin except one case with focal membrane positivity, and all showed p120 catenin cytoplasmic positivity except one case with focal membrane positivity. All cases were negative for ER, PR and HER2 (triple negative), and positive for EGFR and CK5/6. Two cases were positive for p63. The cases were partly and weakly positive for p53, and the Ki-67 positive rate was between 30% and 75%. Follow-up data showed that two cases developed chest wall metastases, and in one case, there was progression to liver and abdominal metastases.

CONCLUSIONSILC of the breast are ER, PR and HER2 "triple negative", CK5/6 and EGFR positive, indicative of basal-like characteristics. Basal-like subtype of ILC are peculiarly prone to metastasis and poor response to chemotherapy, suggesting that it is associated with poor prognosis.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Biomarkers, Tumor ; metabolism ; Breast Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; Cadherins ; metabolism ; Carcinoma, Lobular ; drug therapy ; metabolism ; pathology ; secondary ; surgery ; Catenins ; metabolism ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Keratin-5 ; metabolism ; Keratin-6 ; metabolism ; Ki-67 Antigen ; metabolism ; Liver Neoplasms ; secondary ; Lymphatic Metastasis ; Mastectomy, Modified Radical ; Middle Aged ; Receptor, Epidermal Growth Factor ; metabolism ; Receptor, ErbB-2 ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Thoracic Neoplasms ; secondary ; Thoracic Wall ; Tumor Suppressor Protein p53 ; metabolism

Purpose :To investigate the relationship of peripheral blood T-lymphocyte subsets with the acuterejection or severe CMV infection in transplanted patients. Methods :T-lymphocytes subsets of peripheral bloodwere consecutively detected by using mice-verse-human T-lymphocytes subsets monoclonal antibody-OKT serialsand flow cytometer. Results:The difference of CD4/CD8 ratios between the no acute rejection group and the acuterejection group, or between the acute rejection remission group and the resistant acute rejection group was signif-icant ( P ＜0.05); In patients with intensive CMV infection, the CD4/CD8 ratios were converse to the acute re-jection group. Conclusions:These results indicated that monitoring of peripheral blood T-lymphocyte subsets wasof much benefit to early diagnosis and differential diagnosis of acute rejection of intensive CMV infection and rea-sonable treatment.

Objective To analyze the safety and effectiveness of photoselective green-light laser vaporization of the prostate(PVP)in treatment of large prostate with volume more than 80 ml. Methods Retrospective analysis was performed in 25 benign prostatic hypertrophy patients undergoing the PVP treatment,whose prostate volume was more than 80 ml.Results Twenty-five patients with prostate mean volume of 151.8(84.0-270.0)ml were treated by PVP and 23 cases were finished successfully.One operation was suspended because of bleeding and the other because of damaging orifice.No blood transfusion was needed and no“transurethral resection(TUR)syndrome”happened.Five cases had acute retention and 2 of them needed second PVP.In a mean of 7.9(3.0- 12.0)months follow-up,maximal urinary flow rate(Qmax),international prostate symptom score (IPSS),quality of life score(QOL),and prostate-specific antigen(PSA)level were improved significantly.The volume of prostate reduced after PVP than before PVP but no significant difference was found.Conclusions PVP is feasible in treating large prostate even the volume is more than 80 ml,although it needs better skill.Catheterization for some time is helpful in reducing the incidence of early postoperative acute urinary retention.