Objective To investigate the pathological and immunohistochemical characteristics of female bladder ectopic skene glands.Methods A female with bladder tumor was treated in our hospital in May 2013.Preoperative so(n)graphy revealed a 0.9 cm×0.6 cm round solid mass in the bottom of bladder wall.Mass was hypoechoic homogeneous with regular shape,blood flow within the mass was noted.The tumor was treated with transurethral resection.Routine pathological examination suggested bladder ectopic Skene glands.Immunohistochemical stains for prostate specific antigen (PSA),prostate spectific acid phosphatase (PSAP),androgen receptor (AR),estrogen receptor (ER),CD10,cytokeratin 14 (CK14),cytokeratin 18 (CK18),P63,high molecular weight cytokeratin (34βE12),α-methylacyl-CoA racemase (AMACR/p504s) were further performed.Results Routine pathological examination showed prostate glands composed of prostate gland epithelial cells and basal cells in a submucosal location.Immunohistochemical stains showed:PSA-,PSAP +,AR +,ER-,CD10+,CK18 +,CK14-,P63 +,34βE12 +,AMACR-.Conclusions Routine pathological examination combined with immunohistochemical stains such as PSA,PSAP,and others,can be used to diagnose ectopic Skene glands disease.Female bladder ectopic Skene glands is a benign lesion,and the prognosis is good.

Objective To assess the efficacy and safety of nimotuzumab in combination with radiochemotherapy in locoregionally advanced nasopharyngeal carcinoma (NPC).Methods 42 patients with locoregionally advanced NPC were retrospectively analyzed.They all received the treatment of nimotuzumab in combination with radiochemotherapy.Intensity modulated radiationtherapy (IMRT) was applied and the prescribed radiation dose administered to the primary tumor was between 70 to 79.2 Gy in 32-37 fractions and 41-49 days.The dose administered to lymph nodes was between 65 to 76 Gy in 32-37 fractions and 41-49 days.Nimotuzumab was given weekly during irradiation.All patients received chemotherapy.Results The main adverse events were mucositis,bone marrow suppression,dermatitis and xerostomia.Grade 1 or 2 oropharyngeal mucositis occurred in 29 (69.0 ％) patients,and grade 3 in 2 (4.8 ％).Grade 1 or 2,3 or 4 leucopemia occurred in 25 cases (59.5 ％),16 cases (38.1％),respectively,without occurrence of febrile neutropenia.There was no treatment related death.Complete response (CR) rate was 90.5 ％ (38/42),partial response (PR) rate was 9.5 ％ (4/42) and the total efficiency was 100 ％.After a median follow-up of 22.5 months,the 1-year local control rate was 100 ％.1-year distant metastasis-free survival rate was 92.7 ％.1-year overall survival rate was 95.2 ％.Conclusion Nimotuzumab combined with radiochemotherapy was efficient and safe for locoregionally advanced NPC.

Objective To evaluate the effect and feasibility of mini-flank approach for open partial nephrectomy (MI-OPN) in complex renal tumors with high Zhongshan Score (ZS Score ≥8).Methods Between January 2012 and December 2014, the data from 25 patients with renal tumors , including 18 male and 7 female patients, were retrospectively reviewed.The average age was 50.2 years(range 26-75 years) and the average body mass index was 24.5 kg/m2(range 21.3-30.1 kg/m2).The initial symptom included asymptom in 17 cases, hematuria in 6 cases and other presentation in 2 cases.Bilateral renal tumors were found in 4 cases.Fifteen cases suffered with contralateral urinary stone , renal cyst or hydronephrosis .The preoperative serum creatinine level was 76.9 μmol/L ( range 47 -132 μmol/L ) and the preoperative estimated glomerular filtration rate (eGFR) was 103.8 ml/(min· 1.73 m2)(range 36.5-173.9).The ZS Score was 8 in 11 cases, 9 in 3 cases, 10 in 5 cases, 11 in 2 cases, 12 in 2 cases, and 13 in 2 cases.Mean maximum tumor size was 4.9 cm ( range 2.5-8.1 cm) in CT scan.The average length of incision was 8.0 cm( 7.5 -10.0 cm ) .During the operation , the mass and around normal renal tissue were exposed after opening the Gerota fascia.Along the dorsal of kidney , the renal artery was dissected and clamped .Then, the mass was completely removed along margin of 0.5-1.0 cm normal renal tissue.The vascular end was closed by 3-0 absorbable suture.The entire wound of kidney was U shaped closed by 2-0 absorbable suture.The operative time, ischemia time, estimate blood loss, pathology parameters, operative and short-term (2 -3 months) postoperative complications were recorded .Renal function was recorded 2 -3 months after operation.Results MI-OPN was successfully performed in 23 cases.Radical nephrectomy was performed in 1 cases due to the tumor invasion into the renal pelvis and ureteropelvic junction .Another radical nephrectomy was performed for suspection of positive margin .Mean operative time was 100.2 min ( range 75-150 min) , mean warm ischemia time was 28.3 min( range 21-39 min) and mean estimated blood loss was 63.6 ml(range 10-400 ml).Only 1 case accepted blood transfusion.Mean postoperative hospital stay was 6.6 days (range 5-9 days).Postoperative complications were found in 1 patient, who was found the fluid in surgical region and relieved after the drainage . The pathological diagnosis included clear cell carcinoma in 21 cases, papillary carcinoma in 3 cases and chromophobe cell tumor in 1 case.The mean postoperative serum creatinine level was 88.9μmol/L( range 61-189μmol/L) and the mean postoperative eGFR was 86.3 ml/( min· 1.73 m2 ) ( range 34.0-149.6 ) .There was significant difference between pre and postoperative renal function ( P<0.01 ) .During the average follow-up period of 13.7 months ( range 6-24 months ) , no local recurrence or metastasis occurred .Conclusion MI-OPN is an innovation of traditional OPN and suitable for the complex renal tumors with high ZS score .

OBJECTIVESTo retrospectively review the results of closed reduction for developmental dysplasia of the hip (DDH), and analyze the causative for the unsatisfactory results of radiological.

METHODSFrom 1997 to 2005 the results of closed reduction for DDH in 60 children (77 hips) over 4.5 years period were retrospectively reviewed. Radiological final results of the patients were evaluated with Severin classification. The causative factors made from medical records and radiographs were used to make statistical analysis.

RESULTSSeventy-three percent of the patients (56/77) had satisfactory results according to Severin classification. Twenty-one hips classed as Severin III-V. Seventeen of the 21 hips had a reconstructive procedure. Avascular necrosis was observed in 29 hips (38%). The most important parameters affecting the result were age at reduction (P < 0.05) and avascular necrosis (P < 0.05).

CONCLUSIONSIn order to achieve better clinical and radiological results, the infants suffering from the DDH should be treated in the early stage. The postoperative avascular necrosis usually leads to poor prognosis.

Casts, Surgical ; Child, Preschool ; Female ; Follow-Up Studies ; Hip Dislocation ; surgery ; Humans ; Infant ; Male ; Retrospective Studies ; Treatment Outcome

Objective To Establish an evaluation system of the quality of life for Chinese liver and kidney transplant recipients,and develop a specialized scale to measure the quality of life (QOL)for such recipients preliminarily.Methods By combining subjective and objective methods,this study determined the evaluation system and created items of QOL scale based on literature analysis,Delphi method (expert consultation),interviews,and experience of researchers.Then,a nationwide clinical survey was conducted on 5 Level Ⅲ Class A hospitals.454 valid questionnaires were collected,including 153 from liver recipients,and 301 from kidney recipients.Subjective statistical methods such as critical Ratio method,correlation coefficient method,dispersion tendency method,and exploratory factor analysis were used for selection of questionnaire items.Results The study established an evaluation system of QOL for liver and kidney transplant recipients,including 4 primary indexes and 12 secondary indexes,and developed QOL scales that were appropriate for liver and kidney transplant recipients respectively.Conclusions The structure of QOL scale for liver and kidney transplant recipients was basically consistent with theoretical assumption.The QOL scale for patients showed good reliability and validity,therefore,it can fully reflect the quality of their life.

Objective To investigate the danger of iodine excess for people in the downstream area of Yellow River in Shandong Province by describing the distribution of iodine excess water and the gorer of children Methods Water samples were collected from 5 villages of every town of Yuncheng,Jiaxiang and Dongchangfu Counties to determine the iodine of the water using arsenic cerium oxidation reduction method.In the 5 towns having water iodine in the range of 150～300μg/L,200 students aged from 8～10 years received the paJpation of thyroid,half of them were also measured of urinary iodine with As3+-Ce4+ catalytic spectrophotometry using ammonium persulfate digestion method,and 50 of the 100 students further underwent thyroid B-ultrasound.Results Three counties all have high iodine towns.The medium of urinary iodine of 30 town8 in 56 towns was higher than 150μg/L Urinary iodine and sign detection were performed in 13 towns,where water iodine was between 150～ 300μg/L;the medium ofurinary iodine of 11 towns were higherthan 400μg/L,and 3 of the 11 towns were higher than 800μg/L.In all 13 towns,the goiter rate of the students aged 8 to 10 years exceeded 5%by palpation in 11 towns:exceeded 5% by B-ultrasound method in 9 towns.Conclusions There are areas of iodine excess in drinking water and iodine-excess endemic goiter prevails in downstream area of the Yellow River in Shandong Province.It indicates that iodine excess in drinking water has done severe harm in these areas. Active management should be taken to control this endemic disease.

OBJECTIVETo study the validity and accuracy of differing cutoff scores of the Ages and Stages Questionnaires-Chinese (ASQ-C) for screening infants and toddlers in comparison with the gold standard, Bayley Scale of Infant Development, Second Edition (BSID II).

METHODThe 269 samples were enrolled from the normative children, aged 3 - 31 months, of the ASQ-C in Shanghai. The age-appropriate ASQ-Cs were completed by parents/caregivers and the BSIDIIwas administered by professionals. The cutoff scores of -2 standard deviation (s), -1.5 s, and -s for the ASQ-C were examined against BSID II with the cutoff scores set at -2 s as the standard of developmental delay, -s as the standard of suspected developmental delay and developmental delay respectively. Agreement between the classifications of the ASQ-C (i.e., typical, suspected, delay) was compared with the classification of the BSID II (typical, suspected, delay), sensitivity, specificity, Youden Index and area under ROC curve of ASQ-C were examined. The statistical analysis was carried out using SPSS 13.0.

RESULTWhen the cutoff score for BSID II was -2 s, the -2 s cutoff score for ASQ-C exhibited the following properties: the highest agreement of 83.64%, the sensitivity and specificity both above 80% being respectively 88.46% and 83.13%, the highest Youden Index of 0.72 and the largest area of 0.86 under ROC curve. The -1.5 s cutoff score for ASQ-C showed the following properties: 71.75% agreement, 100% sensitivity, 68.72% specificity, Youden Index = 0.69, the area under ROC curve = 0.84. The -s cutoff score for ASQ-C showed the following properties: the lowest agreement of 55.02%, 100% sensitivity, the lowest specificity of 50.21%, the lowest Youden Index of 0.50, and the smallest area of 0.75 under ROC curve. When the cutoff score for BSID II was set at -s, the -2 s for ASQ-C showed the following properties: the highest agreement of 85.87%, the lowest sensitivity of 68.57%, the highest specificity of 91.96%, Youden Index = 0.61, the smallest area = 0.77 under ROC curve. The -1.5 s for ASQ-C showed the following properties: the agreement of 80.67%, the sensitivity and specificity both above 70% being respectively 85.71% and 78.89%, the highest Youden Index of 0.65, the largest area of 0.82 under ROC. The -s cutoff score for ASQ-C showed the following properties: the lowest agreement of 68.40%, the highest sensitivity of 94.29%, the lowest specificity of 59.30%, the lowest Youden Index of 0.54, and the area under ROC curve = 0.80. When the cutoff score for BSID II was -1 to 2 s, the identifying percentages of the -2 s, -1.5 s and -s for the ASQ-C were 56.82%, 77.27% and 90.91%, respectively.

CONCLUSIONFor developmental delay identification, the -2 s cutoff score for ASQ-C produces the most robust validity and highest accuracy; for the identification of suspected developmental delay and developmental delay, the -1.5 s cutoff score for ASQ-C has the highest screening accuracy with appropriate sensitivity and specificity; for identifying the suspected developmental delay, the -s cutoff score for ASQ-C has the highest percentage of the identification. It is necessary to add 1 - 2 s to the ASQ-C's cutoff scores as the standard for screening suspected developmental delays.

Child Development ; Child, Preschool ; Humans ; Infant ; Mass Screening ; Reference Standards ; Sensitivity and Specificity ; Surveys and Questionnaires ; standards

OBJECTIVETo assess the osseointegration capability of hydroxyapatite-coated porous titanium with bone morphogenetic protein-2 (BMP-2) and hyaluronic acid to repair defects in the distal femur metaphysis in rabbits.

METHODSPorous titanium implants were made by sintering titanium powder at high temperature, which were coated with hydroxyapatite by alkali and heat treatment and with BMP-2 combined with bone regeneration materials. And hyaluronic acid was further used as delivery system to prolong the effect of BMP-2. The implants were inserted into the metaphysis of the distal femur of rabbits. The animals were killed at 6, 12 and 24 weeks to accomplish histological and biomechanical analyses.

RESULTSAccording to the result of histological analysis, the osseointegration in BMP-2 group was better than that of the HA-coated porous titanium group. In push-out test, all the samples had bigger shear stress as time passed by. There was statistical difference between the two groups in 6 and 12 weeks but not in 24 weeks.

CONCLUSIONHydroxyapatite-coated porous titanium with BMP-2 and hyaluronic acid has a good effect in repairing defects of distal femur in rabbits, which is a fine biotechnology for future clinical application.

Animals ; Biomechanical Phenomena ; Bone Morphogenetic Protein 2 ; Bone Morphogenetic Proteins ; pharmacology ; Coated Materials, Biocompatible ; Durapatite ; Femur ; surgery ; Hyaluronic Acid ; pharmacology ; Osseointegration ; physiology ; Porosity ; Prostheses and Implants ; Rabbits ; Titanium ; Transforming Growth Factor beta ; pharmacology

Nonaqueous capillary electrophoresis is used for the determination of the contents of diosgenin and ruscogenin in Radix Ophiopogonis. The operating buffer was composed of 20 mmol x L(-1) Na2B4O7-HCl (pH 7.61) in 70% methanol. The applied voltage was 25 kV and detection potential was at +0.70 V. With these conditions, the components were successfully separated. The content of diosgenin in Radix Ophiopogonis was 0.018 mg x g(-1) and ruscogenin was 0.008 mg x g(-1). The average recoveries of diosgenin and ruscogenin were 102% and 99.2%, respectively. A new method of the quality control of diosgenin and ruscogenin in Radix Ophiopogonis is provided.
Diosgenin ; analysis ; Electrophoresis, Capillary ; methods ; Ophiopogon ; chemistry ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Quality Control ; Spirostans ; analysis

AIM: To establish an animal model of experimental autoimmune myocarditis (EAM) in BALB/c mice and to investigate the expression and significance of Toll-like receptor 3 in mouse EAM. METHODS: BALB/c mice were immunized with cardiac myosin extracted from porcine ventricular myocardium covered by complete freund's adjuvant (CFA) on 0 d and 7 d, then divided into immunized with CFA only. Serum and myocardium samples were collected at 14 d and 21 d after the first immunization. HE staining was used to identify the areas of inflammation. The myosin IgG antibody was examined by indirect ELISA assay. The changes of TLR3 protein and mRNA expression in myocardial tissue were measured by immunohistochemistry and real time-PCR. RESULTS: Compared to control group, immunohistochemistry results showed that there was positive expression of TLR3 in the myocardium of mice with EAM and the mRNA of TLR3 were more than 20 times (P<0.05). The expression of interferon beta mRNA in EAM group was more than 14 times as many as basal expression, that of tumor necrosis factor alpha was more than 18 times (P<0.05). CONCLUSION: The expression of Toll-like receptor 3 in myocardium is up-regulated in experimental autoimmune myocarditis. The inflammatory response to cardiac myosin may associate with the TLR3 signal transduction pathway.