Background and Purpose:The objective of this study was to assess the value of tumor markers and clinical characteristics in making a differential diagnosis between mature cystic teratoma(MCT) and its malignant transformation(MT).Methods:176 patients with mature cystic teratoma of the ovary diagnosed by postoperative pathology were treated in our hospital between 1997 and December 2004,the authors studied their clinicopathologic data and tested several serum tumor markers.Results:170 were MCT,the mean age was 35.8,the mean tumor size was 8.8cm,153 were tested for CA125,the mean serum CA125 level was 33u/ml,37 with serum CA125 level over 35u/ml;140 for tested CA19-9,the mean serum CA19-9 level was 217u/ml,77 with serum CA19-9 level over 37u/ml;112 tested for SCC,the mean serum SCC level was 1.82ng/ml,29 with serum SCC level over 1.5ng/ml;115 tested for CEA,the mean serum CEA level was 1.42ng/ml,8 with serum CEA level over 5ng/ml;6 cases were malignant transformation,the mean age was 47,the mean tumor size was 17.6cm,the mean serum CA125 level was 500u/ml,5 with serum CA125 level over 35u/ml,the mean serum CA19-9 level was 609.8u/ml,5 with serum CA19-9 level over 37u/ml,the mean serum SCC level was 23.4ng/ml,5 with serum SCC level over 1.5ng/ml,the mean serum CEA level was 22.8ng/ml,4 with serum CEA level over 5ng/ml.There were significant differences in age,tumor size and levels of the serum tumor markers between MCT and MT.(P

Objective To evaluate Tornwaldt′s cyst using MR imaging. Methods 1 452 cases with head MR imaging were reviewed. The signal intensity, shape, and size of the lesions were observed. Results Tornwaldt′s cyst were found in 18 of 1 452 cases (1 24%), all of the 18 cases were isointense to CSF on T 2WI and hyperintense to muscle on T 1WI.Tornwaldt′s cyst were round ( n =13)and ovoid ( n =5). The size of lesions were from 2 mm to 15 mm. There were 15 cases with adenoid hyperplasia. Conclusions Tornwaldt′s cysts occupied 1 24% in routine head MR imaging and were hyperintense to muscle on T 1WI and isointense to CSF ON T 2WI.

Objective To evaluate MR imaging diagnosis in acute suppurative osteomyelitis at early stage. Methods The axis, sagittal and coronal planes were performed with Philips 0.5 T superconduct MR scanner on 12 cases of acute suppurative osteomyelitis in lower extremity proved by clinical data 2 to 14 days after onset. Results Abnormal signals in marrow were displayed in all 11 cases 3 to 14 days after onset. No abnormality was found in 1 case 2 days after onset. The interface between normal and abnormal marrow became clear as time going on. The lesion presented as patchy low intensity on T 1WI and high signal on T 2WI. The signal changes were marked especially on STIR. Conclusion MRI was superior to other imaging methods in diagnosis of acute suppurative osteomyelitis.

Objectives To investigate the effects of orthotopic liver transplantation (OLT) plus non-biologic artificial liver support system (NBALSS) on fulminant liver failure(FLF), and efficiency of NBALSS on the preoperative preparation of OLT. Methods Seven FLF patients received OLT after 2 to 20 sessions of NBALSS therapy while waiting donor liver.Results Decreased serum bilirubin, improved hepatic encephalopathy and ascites was achieved in all 7 cases after NBALSS. Five of 7 patients have survived for 3 to 20 months after OLT, of whom 3 have had excellent quality of life for more than 18 months. Two patients died of hepatorenal syndrome or of hepatorenal syndrome and serious pancreatitis. Conclusions OLT plus NBALSS is one of the most effective therapies for FLF, NBALSS can be used to tide the FLF patients over until a donor liver is available.

BACKGROUND:In order to avoid distal arterial embolism fol owing mechanical thrombectomy, micro-bal oon catheter temporary isolation is applied to prevent thrombus shedding.
OBJECTIVE:To investigate the safety and feasibility of adopting the micro-bal oon catheter technique in treatment of the hyperacute cerebral infarction. The micro-bal oon catheter technique can temporarily block the artery blood flow and isolate the embolism location fol owing mechanical thrombectomy and aspiration combined with thrombolysis.
METHODS:Ten beagle dogs were included in this study. Under general anesthesia, the micro-bal oon catheter was delivered to the dominant vertebral artery through the femoral artery in al the dogs and it was fil ed and temporarily blocked the blood flow. Then the autologous thrombus was injected through the micro-catheter into proximal vertebral artery to make a thrombosis model. Al the dogs were equal y divided into two groups according to the embolectomy method:control group (receiving pure stent embolectomy, n=5) and experimental group (n=5). The experiment group was disrupted and aspirated thrombus combined with the drug thrombolysis after temporarily blocking out the blood flow and isolating the target artery by micro-bal oon catheter technique. After treatment, two groups underwent digital subtraction angiography to review the vertebral artery recanalization after different embolectomy methods. The hemodynamic status was evaluated through the thrombolysis in cerebral ischemia grade. Al the dogs were scanned with magnetic resonance diffusion weighted imaging before modeling and at 12 hours after the thrombectomy. The animals were kil ed to perform pathological examination after magnetic resonance diffusion weighted imaging (12 hours after the thrombectomy). The vessel recanalization rates and complications were calculated in the two groups.
RESULTS AND CONCLUSION:The thromboembolism model was successful y established in the dominant vertebral artery of al the 10 beagle dogs. In the control group, the vertebral arteries were completely successful recanalized in two dogs and were partly recanalized in three dogs, while the vertebral-basilar and intracranial arteries in one dog showed multiple smal punctate fil ing defects with poor intracranial arterial development and contrast agent reflux. At 12 hours after embolectomy, the magnetic resonance diffusion weighted imaging showed slightly high signal intensity at the left temporoparietal lobe and the pathologic examination suggested thrombosis in the cerebral artery lumen of the left temporal lobe. In the experimental group, the vertebral arteries in five dogs were completely recanalized without infarction. The revascularization rate in the experimental group was significantly higher than that in the control group (P<0.05). Experimental findings indicate that, the application of disruption and aspiration thrombus combined with the drug thrombolysis after temporarily blocking the blood flow and isolating the target artery by micro-bal oon catheter technique in treatment of hyperacute cerebral infarction, can effectively prevent the smal embolus exfoliating, which can cause distal embolization. Thus, the micro-bal oon catheter technique is a safe, effective and relatively inexpensive interventional embolectomy.

Objective To identify and classify six isolates of swine-originated Trichinella from China. Methods Five specific pairs of primers were synthesized based on DNA sequence of expansion segment V region and internal tran-scribed spacers (ITS1 and ITS2) of ribosomal DNA repeat from Trichinella. International reference strains of five Trich-inella species [Trichinella spiralis (T1), T. nativa (T2), T. britovi (T3), T. pseudospiralis (T4) and T. nelsoni(T7)] were used as control. Six swine Trichienlla isolates from Henan, Yunnan, Harbin, Tongjiang of Heilongjiang, Hubei and Tianjin were identified by multiplex PCR and its effecting factors of PCR amplification were observed. Results Electrophoresis results of multiplex PCR products of Trichinella larvae showed that the band (173 bp) of the six isolates was the same as T. spiralis(T1). The specific band (173 bp) was detected by multiplex PCR through amplification from issues of single T. spiralis larva, the larvae conserved in 80% ethanol for 6 months, the larvae stored in 10% formaldehyde, in 0.05% formaldehyde, 0.2% sodium azide or 0.05% merthiotate for 2 weeks,or fresh mouse muscle with larvae. Conclusion All the six swine Trichinella isolates are identified as T. spiralis (T1) by multiplex PCR.

Objective To observe the therapeutic effects of the drugs alternation multiple stages and long term therapy in elderly patients with recurrent urinary tract infection.Methods The patients were divided into elderly group (age≥65 years,n=30) and non-elderly group (n=48).The multiple effective antibiotics were selected for alternate use.The treatment included four periods as follows:(1)Treatment period:the regular dose of antibiotic was maintained until the urine routine test result became normal;(2)Consolidation period:the dosage of antibiotic was reduced;(3)Maintenance period:the dosage of antibiotic was reduced to once every night and the treatment should be kept for three months;(4)Observation period:the patients were observed for six months after withdrawal of antibiotics.During the treatment,if the urine routine test became abnormal repeatedly,the patient should return to the previous treatment period.During the treatment and consolidation period,each medication should be applied for one week alternatively.Results Among 78 patients,69 cases (88.5%) were cured,7 cases (8.9%) were effective,and two cases (2.56%) were invalid.There were 28 cured cases,1 effective case and 1 invalid case in elderly group.The corresponding data were 41,6 and 1 in non-elderly group,respectively.There was no difference in cure rate between the two groups (F= 0.469).Compared with non-elderly group,the overall treatment time [(54.8± 16.2)weeks vs.(44.5± 13.7) weeks,t= 2.8467,P＜0.01],treatment period [( 34.3± 15.2) weeks vs.(26.2±14.8) weeks,t=2.2081,P＜0.05] and consolidation period [(5.7±2.6) weeks vs.(4.1±0.2) weeks,t=3.9369,P＜0.01] were all prolonged in elderly group.But there was no difference in maintenance period [(14.8±4.6) weeks vs.(14.2±3.1) weeks,t=0.6480,P＞0.05].There were no markedly changes in blood routine,liver and kidney function during the course of treatment.Conclusions For the elderly patients with recurrent urinary tract infection,the drugs alternation,multiple stages and long-term treatment has a high cure rate and no adverse effect on blood routine,liver and renal function.

AIM:To observe the expression of Toll like receptor 4 (TLR4) in the left ventricle of Goldblatt rats and to explore the role and mechanism of TLR4 in left ventricular remodeling of hypertension.METHODS:Goldblatt model of Two-kidney,one-clip (2K1 C) renovascular hypertension was induced in twenty-five rats(H group),and twenty rats served the sham-operated group(sham group).The tail cuff blood pressure was detected every week and echocardiogram was observed every other week.After eight weeks of operation,the rats were killed and the samples of the left ventricle were collected.The concentration of Ang Ⅱ in left ventricle was assessed by tadioimmunoassay.Western blotting and RT-PCR were used to exam the mRNA and protein expression of TLR4 in the left ventricle.Immunohistochemistry was adopted to exam the location of TLR4 in the myocardium.RESULTS:TLR4 mRNA and protein expression were consistently upregulated in the left ventricle of H group compared with sham group.In H group, predominantly sarcolemmal staining was observed,especially focal areas of intense TLR4 staining were found in juxtaposed regions of two or more adjacent myocytes;However,in sham group,TLR4 expression was diffuse and presumably cytoplasmic.Considerable correlation was found between blood pressure,MESS,LVMI,RWT,the concentration of Ang Ⅱ in left ventricle and the protein expression of TLR4 in myoeytes.CONCLUSION:During the development of left ventricular remodeling of Goldblatt rats,expression of TLR4 increases significantly.Enhanced expression of TLR4 locates in the sarcolemma,especially in juxtaposed regions of two or more adjacent myocytes.These indicate that TLR4 transmembrane receptor which is closely relative with inflammation and immunity probably contributes to the development of ventricular remodeling.[KEY WORDS]Hypertension;Ventricular remodeling;Receptors,Toll-like;Goldblatt rats

Objective To investigate the effects of hypertension on left atrial myocardial properties by strain and strain rate(SR)imaging.Methods A total of 56 consecutive patients with hypertension were divided into 2 groups:33 with normal LVMI and 23 with left ventricular hypertrophy.These patients and 20 controls underwent transthoracic echocardiography,strain and SR imaging examination.Atrial strain and SR values of hypertensive patients were compared with those of controls.Results When compared with the controls,early diastolic SR(ESR)was significantly decreased in hypertensive patients(P＜0.01-0.001),with time to peak late diastolic SR corrected for heart rate(TASRe)significantly increased in normal LVMI subgroup(P＜0.05).Moreover,late diastolic SR(ASR)were significantly decreased(P＜0.05)in hypertensive patients with left ventricular hypertrophy as compared with normal LVMI.Conclusions Enlargement of left atrium leads to increased reservoir function in hypertensive patients,which compensates for the deterioration of conduit function.The duration of atrial systole may be prolonged to meet the need of ventricular filling in consequence of lower left atrial booster pump function.Noninvasive quantification of left atrial function by SR imaging enables evaluation of left atrial dysfunction due to hypertension.

Objective To assess isehemic myocardial regional function of different coronary atherosclerosis using velocity vector imaging(VVI).Methods Two-dimensional images of apical four-，two-chamber and long-axis view were obtained in 50 patients with coronary artery disease.All segments of the left ventricle were divided into 5 groups：group 0 with no coronary artery stenosis，group 1 with stenosis＜50%，group 2 with stenosis 50%to 74%，group 3 with stenosis 75%to 99%and group 4 with a completely occluded coronary artery.The segmental myocardial systolic peak strain(ε)，systolic strain rate(SRs)，early diastolic strain rate(SRe)，late diastolic strain rate(SRa)and their ratio(SRe/SRa)were analyzed with VVI offline software.Results①Compared with group 0，SRe and SRe/SRa of group 1，SRs，SRe，SRe/SRa of group 2～4，εof group 2 and group 4 decreased significantly(P＜0.05).②In the comparison of four ischemic groups，ε，SRe，SRa of group 3 were markedly higher than those of group 2，while ε，SRs，SRa of group 2 were lower than those of group 1(P＜0.05)；for group 4，ε，SRs，SRe were lower than those of group 1，SRe was lower than that of group 2，and ε，SRs，SRe were lower than those of group 3(P＜0.05).ConclusionsIn the process of coronary atherosclerosis，myocardial diastolic and systolic dysfunction occurred early and orderly，and has a bidirectional change：decreased firstly，then increased and decreased at last.