Objective To evaluate the value of real-time enhanced-ultrasonography (EUS) in the diagnosis of hepatic tumor. Methods Twenty-nine patients with 34 hepatic solid lesions were examined by real-time EUS,including 16 primary liver malignant tumors,4 metastatic liver tumors,5 focal nodular hyperplasias (FNH),and 9 hemangiomas. All the cases were confirmed by histopathology. The ultrasound unit (Esaote Megas) with real-time EUS technique was used. The contrast agent used was SonoVue (Bracco,Italy). Results After injection of SonoVue,all the lesions were variously enhanced on real-time ultrasonogram. A holistic inhomogeneous enhanced pattern with quick disappearing was mostly detected by real-time EUS in hepatic malignant tumors,a peripheral and centripetal enhanced pattern was mostly shown in hamangiomas,and a radial centrifugal enhanced pattern with homogeneity and quickly was observed in FNHs. If the lesions with enhancement in arterial phase and disappearing in portal phase after injection of SonoVue were regarded as a sign for malignant liver tumor,the sensitivity,specificity and accuracy in the diagnosis of liver cancer with real-time EUS were respectively 95%(19/20),100%(14/14) and 97% (33/34). Conclusions The dynamic enhanced fashions and various enhanced features in various hepatic tumors will be reflected by real time EUS,which improves the accuracy of ultrasonography in the diagnosis of liver tumors.

Objective:To observe the clinical effect of tuina plus Baixiao moxibustion in the treatment of temporomandibular joint dysfunction syndrome (TJDS). Methods: A total of 70 TJDS patients who met the inclusion criteria were randomized into an observation group and a control group by flipping a coin, with 35 cases in each group. Patients in the observation group were treated with tuina plus Baixiao moxibustion, while patients in the control group received oral intake of diclofenac potassium (75 mg/pill), 1 pill after every dinner. Both tuina and Baixiao moxibustion were done once a day during treatment. The therapeutic evaluation was evaluated after 10 treatments in both groups. The maximum mouth opening distance and visual analog scale (VAS) were observed before and after treatment, and the therapeutic efficacy was also compared. Results: After treatment, the maximum mouth opening distance and VAS improved in both groups (all P＜0.05); both items in the observation group were superior to those in the control group (both P＜00.05). The total effective rate was 91.4% in the observation group, versus 74.3% in the control group, and the between-group comparison of the total effective rate showed statistical significance (P＜0.05). Conclusion: Tuina plus Baixiao moxibustion can effectively improve TJDS patient’s temporomandibular joint function and alleviate pain, with better efficacy than oral intake of diclofenac potassium.

Objective:To consolidate ten years of clinical experience on the application of breast fiberoptic ductoscopy (FDS) in breast intra-ductal lesion. Methods:The clinical data of 1 368 cases of patients with nipple discharge were retrospectively collected and analyzed. Results:Significant differences were observed in the FDS diagnoses of patients with nipple discharge. The rates of tumor de-tection by FDS diagnosis were significantly higher when bloody and serous nipple discharge was used rather than milky and watery nip-ple discharge. For non-tumor nipple discharge, local drug perfusion via FDS was an effective treatment. A total of 303 patients had tu-mor resection or segmentectomy under localization via FDS, and 44 had segmentectomy after breast duct infusion of methylene blue. The diagnostic rate of localization via FDS (97.0%) was higher than that of breast duct infusion of methylene blue (86.4%). Conclu-sion:FDS is an accurate method for diagnosing patients with nipple discharge. In addition, it is also a good local drug perfusion method for patients with breast inflammatory nipple discharge ductoscopy. For patients with tumorous nipple discharge, localization via FDS can help improve the detection of the lesions, which can be removed by surgery.

Objective To study the (-)-epigallocatechin-3-gallate (EGCG) function on the proliferation of T cells derived from the peripheral blood and synovial fluid of rheumatoid arthritis (RA) and RA-related cytokine levels and the role of EGCG on RA synovial fibroblasts (FLS) proliferation was investigated. Methods ① Mononuclear cells from RA peripheral blood (30 cases) and synovial fluid (23 cases)were isolated. Blank group, negative control group, positive control methotrexate (MTX) group and therapeutic group with three different concentrations of EGCG were set up. Incorporated isotope 3H was used to test T cell proliferation from RA-PBMC and SFMC. ELISA assay was used to test cytokine (TNF-α, IFN-γ, IL-1, IL-6 and IL-17A) levels. ② MTT assay was used to test FLS proliferation from RA synovial tissue (8 cases).Results ① The CPM value of the high-dose group of EGCG in the peripheral blood and synovial fluid of RA patients was [ ( 15 136±2910), ( 11 587±3135 ) ], which was declined significantly than the control group (42856±2127) (P＜0.01). The levels of TNF-α, IFN-γ, IL-1, IL-6 and IL-17A in the high-dose group of EGCG in the peripheral blood were [(321±13), (298±20), (132±12), (197±7), (59±8) pg/ml], which were decreased significantly than those of the control group [ (458±28), (505±26), (346±28), (405±25),(109±13) pg/ml ] (P＜0.05 or P＜0.01 ). The levels of TNF-o, IFN-γ, IL-1, IL-6 and IL-17A in the highdose group of EGCG in the synovial fluid were [(41.4±2.9), (182±16), (56.3±11.0), (34.2±1.9), (44±8)pg/ml ], which was decre-ased significantly than the control group [ ( 388.3± 19.3 ), (469±20), ( 104.2±17.8 ),( 114.5±4.8), ( 104±11 ) pg/ml] (P＜0.05 or P＜0.01 ). ② The level (A) of the high-dose group of EGCG in the FLS was (0.08±0.02), which was declined significantly than the blank group (0.27±0.04) (P＜0.05).Conclusion ① In vitro EGCG can inhibit T cell proliferation from peripheral blood and synovial fluid of RA patients and the TNF-α, IFN-γ, IL-1, IL-6 and IL-17A secretion are decreased. ② In vitro EGCG can inhibit the proliferation of RA FLS.

Animals ; Animals, Newborn ; Cell Hypoxia ; Cell Lineage ; Cell Proliferation ; Cells, Cultured ; Oligodendroglia ; cytology ; Rats ; Rats, Sprague-Dawley

Objective To compare enhancement features of hepatic tumors on SonoVue-enhanced real-time gray-scale ultrasonography and contrast-enhanced helical CT.Methods SonoVue-enhanced real-time gray-scale ultrasonography and contrast-enhanced helical CT were performed on 49 patients with 54 focal liver lesions,including 29 primary liver carcinomas,4 metastatic liver tumors,11 hepatic carvernous hemangiomas,7 focal nodular hyperplasias,2 focal fatty sparing,1 cirrhotic.Results Contrast-enhanced ultrasonography and helical CT showed consistent results in demonstrating hemodynamics of hepatic tumors.In the differentiating of malignant tumors and benign tumors,the sensitivity,specificity and accuracy of contrast-enhanced ultrasonography were(90.9)%(30/33),(90.5)%(19/21) and(90.7)%((49/54)),respectively.Those of contrast-enhanced CT were(90.9)%(30/33),(95.2)%(20/21) and(92.6)%((50/54)),respectively.Conclusions Both of the two imaging methods are valuable for differential diagnosis of liver tumors.

Objective To study the clinicopathologic features,immunophenotype,diagnosis and differential diagnosis,prognosis and treatment of solid papillary carcinoma(SPC)of breast.Methods A retrospective study was performed to analyse the clinicalpathologic features and immunophenotype of 52 case of SPC,with or without invasion. The cytokeratins(CK),myoepithelial markers,neuroendocrine markers,proliferation marker Ki -67,estrogen receptor (ER),progesterone receptor(PR),HER2,ect were detected by immunohistochemical staining,and HER2 was detected by FISH.All patients were followed up.Results All the patients were females with a mean age of (66.76 ±10.19)years. The incidence of SPC among all the breast cancers in this department was 0.99%.The presenting symptoms was a painless mass with or without nipple discharge in the central of breast.All of them accepted surgical resection,13 cases were administrated with chemotherapy after surgery,6 cases were radiotherapy.Metastasis was observed four in 34 cases who had undergone axillar lymph node dissection.General observation tumor was substantive and nodular lesions,may be accompanied by cyst formation,microscopy tumor for swelling,substantive nodules within only fine fiber vascular axis,and lacked obvious nipples and screen structure.The cells were lack of atypia,adhesive in cells nest,35 patients were accompanied with mucus secretion.Immunohistochemical study show that the tumor cells experssed CK8 /18,ER and PR,but not basal cell cytokertin CK5 /6 and 34βE12.Positivity for CK5 /6,34βE12 and P63 were 5.78%, 9.62% and 7.69% in the myoepithelial layers of axis of papillary,and were 21.15%,38.46% and 19.23% in cell nests and tumor peripheral myoepithelial,respectively.Positivity for CgA,Syn,NSE,CD56 were 82.69%,88.46%, 94.23% and 90.38%,respectively.The staining of HER2 oncoprotein was most negative,and 23 cases of FISH detection were all negative.The average positive index of Ki -67 was 4.28%.47 cases received follow -up of patients(90.38%),only 1 case death,1 case recurrence the rest were no tumor recurrence or metastasis,disease -free survival.Conclusion SPC of breast,a rare pathologic type,usually occurs in old females.The diagnosis depends on pathological characteristics and its unique immune phenotypic characteristics,is closely associated with mucinous carcinoma and neuroendocrine carcinoma,and the treatment is given priority tosurgery with a relatively inert biological behaviour.

Objective To study the clinicopathologic features,immunophenotype,diagnosis and differential diagnosis of solid papillary carcinoma (SPC) of breast.Methods A retrospective study was performed to analyse the clinicopathologic features and immunophenotype of 31 cases of SPC with or without invasion.The cytokeratins (CK),myoepithelial markers,neuroendocrine markers,proliferation marker Ki-67,estrogen receptor (ER),progesterone receptor (PR),HER2,ect were detected by immunohistochemical staining,and HER2 was detected by FISH.All patients were followed up.Results All the patients were females with a mean age of (67.0±12.5) years.The presenting symptom was a painless mass with or without nipple discharge.In 19 cases who had undergone axillar lymph node dissection,only one metastasis was observed.General observation showed that tumors had substantive and nodular lesions,accompanied by cyst formation.Microscopy examination showed that tumors had swell and substantive nodules with only fine fiber vascular axis,and lacked obvious nipples and screen structure.The cells were lack of atypia,adhesive in cells nest.20 patients were accompanied by mucus secretion.Immunohistochemical study showed that the tumor cells expressed CK8/18,ER,PR,but didn' t express basal cell CK5/6,34β12.The positive rates of CK5/6,34β12,p63 were 3.23 ％ (1/31),9.68 ％ (3/31),6.45 ％ (2/31) in the myoepithelial layers of axis of papillary,and were 19.25 ％ (6/31),38.71％ (12/31),16.13 ％ (5/31) in peripheral cell nests and tumors,respectively.The positive rates of CgA,Syn,NSE,Cd56 were 83.87 ％ (26/31),87.10 ％ (27/31),93.55 ％ (29/31),90.32 ％ (28/31),respectively.The staining of HER2 oncoprotein was negative mostly,and the FISH detection outcome of 15 cases were all negative.The average positive index of Ki-67 was 4.12 ％.28 cases (90.23 ％) received follow-up,only 1 patient died,and the rest patients were without tumor recurrence or metastasis.Conclusions SPC of breast,a rare pathologic type,usually occurs in old females.The diagnosis depends on pathological characteristics and its unique immune phenotypic characteristics.SPC of breast has close relationship with mucinous carcinoma and neuroendocrine carcinoma,with a relatively inert biological behavior.

Objective To investigate the effect of Qingjing Capsule (QC) in treating advance menorrhea (AM) and to evaluate its safety. Methods Double- blind, double- imitating, parallel- controlled and randomized trial was performed in 63 cases of AM with deficiency- heat syndrome.Thirty- two cases was in QC group(Group A) and other 31 in Gujing pill group(Group B).The menstrual cycle, clinical symptoms and signs, basal body temperature (BBT), serum levels of estradiol (E2) and progesterone and endometrium biopsy were observed to evaluate the effects of QC. Results The short- term markedly- effective rate was 90.63% and 77.42% and the short- term effective rate was 96.88% and 93.55% in Group A and Group B respectively. The long- term markedly- effective rate was 83.87% and 67.74% and the long- term effective rate was 93.55% and 80.65% in Group A and Group B respectively. The long- term markedly- effective rate in QC group is superior to that in Gujing pill group, the differences being significant(P

Objective To determinate whether the first post-operative day serum parathyroid hormone (PTH) is more effective than serum calcium in predicting hypocalcemia after total thyroidectomy.Methods According to PTH level on the first post-operative day,104 patients after total thyroidectomy were divided into different groups.Patient's serum calcium was measured,the number of patients who developed hypocalcemia and the time for calcium supplement were recored.Results Serum PTH was more accurate in predicting hypocalcemia than serum calcium.There were 26 patients whose PTH value was ＜ 5 pg/ml,among whom 7 patients had transient hypocalcemia and symptoms,while 5 of them developed hypocalcemia for long time and needed long-term calcium supplement.The positive predictive value of group PTH value ＜ 5 pg/ml was 28％,and the accurate rate was 46％,higher than other groups.Besides,the positive predictive value and the accurate rate of PTH value ＜ 5 pg/ml was higher than serum calcium.Conclusion Serum PTH is more effective in determining hypocalcemia after total thyroidectomy than serum calcium,and PTH value ＜ 5 pg/ml on the first post-operative day is a reliable marker in predicting hypocalcemia after total thyroidectomy.