Objective To investigate the morphological features,biological behavior ,and diagnosis and treatment of gastric hepatoid adenocarcinoma(GHA).MethodsTwenty GHA cases were evaluated. Of the 20 patients,14 underwent radical gastrectomy, 3 total gastrectomy,3 total gastrectomy and wedge excision of the liver metastasis.ResultsHistologically,hyaline globules and venous invasion were common features of GHA.Tumor cells were immunohistochemically positive for alpha fetoprotein(AFP), alpha antitrypsin(AAT), and alpha antichymotrypsin(ACT). Ultrastructurally,tumor cells were arranged toward the lumens with microvilli on the luminal surfaces.There were junctional complexes between the lateral plasma membranes of adjacent tumor cells.Patients were followed up for 1～5 years with 12 deaths, 11 died of metastasis and one died of intraabdominal tumor seeding. The 1, 3 year survival rate was 44%(8/18), and 17%(3/18), respectively. Conclusions GHA deriving from gastric mucosa is characterized both by the histologic structures of hepatoid differentiation and adenocarcinoma.The prognosis is usually poor due to frequent liver metastasis.

Objective To investigate lead pollution of tap in market. Methods 16 taps (2 PPR taps and 14 metal taps)were collected and were sunk in distilled water for 4 hours,8 hours and 12 hours. Lead levels in the distilled waters were determined by atomic absorption spectrometry. Results No lead was detected for PPR taps. Of 14 metal taps,only one tap was not observed lead pollution. The top lead level was 56.54 ?g/L,the median was 5.79 ?g/L. These brass taps resulted in higher lead pollution than those taps with ceramic preformed core (P0.05). 72.2% of the samples with brass preformed core exceeded 10 ?g/L and only 9.5% for those taps with ceramic preformed core. These taps with registered trade mark had a slighter lead contamination than those without registered trade mark(P

Objective To investigate lead pollution of drinking water stagnated in household pipe and its characteristic, and provide the scientific basis for safe and health consumption of drinking water. Methods 30 taps in households were randomly chosen as objects. According to the stagnated time the water samples were divided into group A (12-13 hours), group B (7-8 hours) and group C (3-4 hours). The samples were collected in 0 min, 1 min and 2 min after opening taps. Lead levels in the samples were determined by atomic absorption spectrometry (AAS), whose comparative analysis was performed by SPSS software. In total, 320 samples were analyzed. Results In group A, lead concentrations (geometric mean, the same for latter) of water samples in 0 min, 1 min and 2 min were 61.33, 12.27and 5.47 ?g/L respectively, but they were 33.90, 9.13 and 4.59 ?g/L in group B,and 11.37, 6.29 and 4.27 ?g/L in group C. There were significant differences among three groups (P

Objective To investigate the clinical significance of prostate specific antigen density (PSAD)value in the differential diagnosis from malignant and benign prostate disease .Methods 56 patients who enrolled in this hospital during April 2008 to No-vember 2012 were reviewed ,all of them were suspected as prostate carcinoma with free total PSA value at 4-10 ng/mL .Prostate volume were determined via transrectal ultrasound ,while serum PSA was determined by chemiluminescence method ,and all patients were finally pathologically diagnosed via tissue biopsy or prostatectomy .21 cases were proved to be prostate carcinoma (prostate carcinoma group) ,and the other 35 cases were proved to be benign prostate hyperplasia(BPH) .And the statistical significances of tPSA ,prostate volume and PSAD values were compared between the two groups .Results Compared with BPH group ,serum level of tPSA was insignificant ,while the values of prostate volume and PSAD were significantly lower in the BPH group than in prostate carciboma group .Considering the mean prostate volume(39 .27 mL) as the reference point ,40 mL was set as the cut-off value of prostate volume .Therefore ,there were 80 .95% prostate carcinoma group patients whose prostate volume were less than 40 mL , and 68 .57% benign prostate hyperplasia group patients whose prostate volume were larger than 40 mL .Considering the PSAD val-ue(0 .147) as the reference point ,0 .15 was set as the cut-off value of PSAD .Therefore ,the sensitivity ,specificity ,positive predic-tive value and negative predictive value among patients with prostate volume less than 40 mL ,the datas were respectively as 80 .95% ,72 .73% ,85% and 61 .54% .While ,among patients with prostate volume larger than 40 mL ,were respectively as 75% , 66 .67% ,27 .27% and 94 .11% .Conclusion PSAD was of certain value in the differential diagnosis of prostate carcinoma in PSA gray zone cases .If PSAD=0 .15 was consider as the cut-off point ,the sensitivity and specificity of differential diagnosis for prostate carcinoma decreased as the prostate volume increase .However ,the influencing factors are still to be elucidated .

Objective To understand the relationship among junior college students' anxious status in testing and studying behaviors and studying result. Methods TAS anxiety scale was used for the evaluation of anxious status, and data were analyzed by SPSS software. Results Statistical significance was observed among different specialties. Sex, socioeconomic status and living environment did not affect TAS score. The higher the anxious status was, the worse the studying results will be. The anxious status was associated with some studying behaviors. Conclusions Anxiety was correlated with specialities and studying behaviors, and affected studying result.

Objective To investigate the clinical curative result of the new method of postermedial deepen of the fibular groove in the treatment of chronic peroneal tendon subluxation.Methods From March 2006 to October 2012,21 patients (15 male,6 female) with chronic peroneal tendon subluxation via a novel method of postermedial deepen of the fibular groove.In this group:Ⅰ grade 5 cases;Ⅱ grade 9 cases;Ⅲ grade 5 cases;Ⅳ grade 2 cases.All patients were followed up for at least 24 months.The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale score and visual analogue score (VAS) were used to evaluate the clinical outcomes.Operation time,time to heal and complications were also recorded.Results The average operation time was 50 minutes (30-70 minutes).The blood loss was 30-60 ml,average 40 ml.All incisions healed after operation,no case of incision infection,skin necrosis and sural nerve,vascular injuryed.Mean AOFAS score was significantly increased from (55.2±7.1) preoperative to (93.6±5.6) postoperative.15 patients with excellent,good for 1 cases.The excellent and good rate was 100％ (16/16).VAS score by an average of (5.3±2.1) points down to (1.2±1.1) points postperative.All the patients can wear normal shoes postoperative,waking with normal gait.No patients had peroneal tendon tenosynovitis,tendon adhesion,fracture of lateral malleolus and other serious complications,no dislocation recurrent,strength of the peroneal muscle returns to normal.Conclusion The novel method of postermedial deepen of the fibular groove in the treatment of chronic peroneal tendon subluxation was safe and effective for ankle instability with a relatively short time.

Objective To evaluate the significance of weight-bearing lateral radiographs in evaluation of malunited frac-tures of the ankle. Methods 17 patients with malunited fractures of the ankle were treated by different reconstructive operations be-tween March 2010 and October 2012, including 9 females and 8 males, aged from 17 to 64 years. According to the Takakura classifi-cation of ankle arthritis, there were 7 patients in grade 1, 4 in grade 2 and 6 in grade 3. Simple open reduction and internal fixation were performed in 5 patients, supramalleolar tibial osteotomy in 5, lengthening osteotomy of the fibula in 2, supramalleolar tibial and fibular osteotomy in 5. Tibiofibular clear space on the anteroposterior radiograph. Medial clear space, tibiofibular clear space and tib-iofibular overlap on ankle mortise radiographs were compared preoperatively and at last follow-up. Tibial lateral surface angle (TLS), the offset of the center of talar rotation from the tibial axis, and the displacement of tibiotalar articular surface center on weight-bear-ing lateral X-ray were also compared preoperatively and at last follow-up. AOFAS score was used to evaluate the function of the ankle. Results The duration of follow-up was 9 to 32 months. Bone healing was observed in all patients, and the average healing time was 11 to 14 weeks. Ankle joint degeneration grade had no exacerbation. The medial clear space, tibiofibular clear space and tibiofibular overlap had no significant difference between the pre and postoperative. Statistically significant change was seen postoperatively in the values of TLS (76.9°±4.1° vs 80.9°±5.2°). The offset of the center of rotation from the tibial axis and the displacement of tibiotalar articular surface center were changed from 10.8 ± 2.1 mm to 2.0 ± 0.5 mm and 4.5 ± 1.5 mm to 2.2 ± 1.0 mm, respectively. The average AOFAS score was improved from 45.7 ± 15.9 points preoperatively to 82.0 ± 9.9 points postoperatively. Conclusion Weight-bearing lateral radiographs can be used to judge the ankle restoration. Even if the mortise radiograph had relative good realignment, it may ap-pear obvious deformity on lateral radiographs. Good reduction of lateral radiographs requires that the mid axis of the tibia should pass through the center of talar rotation and tibiotalar articular surface be parallel on the lateral radiograph.

OBJECTIVETo discuss the value of P53mt and BCL-2 proteins in screening skin carcinoma due to arseniasis.

METHODSP53mt and BCL-2 proteins were detected by immunohistochemical staining. chi(2) test was used to analyze the difference of positive rate between two groups. Screening value of the two biomarkers was also evaluated through the analysis of relative indexes.

RESULTSPositive percentages of P53mt and BCL-2 in carcinoma group were 88.89% and 94.44% respectively, both were higher than those of 36.0% and 66.0% in non-carcinoma group (for P53mt, P < 0.01; for BCL-2, P < 0.05). ORs of P53mt and BCL-2 were 14.22 (2.93 - 68.97) and 8.76 (1.07 - 71.51), respectively. Youden's Index and specificity of P53mt were 0.529 and 64.0%, which were much higher than those of BCL-2. Serial tests improved the value of screening with Youden's Index 0.569, but parallel test lowered it to 0.244.

CONCLUSIONSP53mt and BCL-2 were practical biomarkers to screen skin carcinoma due to arseniasis, and the former was better than the latter. The value of screening can be improved by a series of tests.

Arsenic Poisoning ; complications ; Humans ; Immunohistochemistry ; Mass Screening ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Skin ; chemistry ; pathology ; Skin Neoplasms ; diagnosis ; etiology ; metabolism ; Tumor Suppressor Protein p53 ; metabolism

Objective To explore the application value of pulmonary artery monitoring program for intracranial and cervical artery angiography with dual-energy CT.Methods Sixty patients performed intracranial and cervical artery angiography with dual-energy CT were divided into two groups according to the random number table.Group A (optimization group,30 patients):the monitoring points were located in the main pulmonary artery,with threshold 150 HU,trigger delay time 8-9 s,pitch 0.9,and the iohexol (350 mg I/ml) 60-65 ml.Group B (conventional group,30 patients):the monitoring points were located in aortic arch,with threshold 100 HU,trigger delay time 5 s,and the iohexol (350 mg I/ml)60-70 ml.Patients with the body weight less than 75 kg were injected with the flow rate of 4.0 ml/s,and those weight greater than 75 kg or with body mass index (BMI) greater than 27 kg/m2 were 4.5 ml/s,following 40 ml saline solution with the same flow rate respectively.All images were transferred to Siemens Syngo workstation for further processing and analysis.The attenuation values were measured on axial images in the common carotid artery,internal and external carotid artery,vertebral and basilar artery,the horizontal segment of the middle cerebral artery,the subclavian vein of injection side,the proximal,middle and distal segment of jugular vein,the straight sinus and the superior sagittal sinus.Two experienced observers blinded independently evaluated the image quality of CTA,the impact of contrast material residues artifacts of subclavian vein of injected side and the affect of venous return factors on arterial image display.Images of volume rendering technique(VR),the maximum intensity projection (MIP),and curved planar reformation (CPR) were reconstructed using dual energy bone removal and Inspace and 3D software.The mean intraluminal attenuation of contrast material (HU),the volume of contrast material and the mean image quality scores were compared with t test between the two groups.Chi-square test was used to compare of image contrast agents residual artifacts,the absence segments of the root of the neck artery,and the degree of the jugular vein return in two groups.Results The mean CT values were 372-414 HU for each segment of artery showing no significant differences between two groups (P ＞ 0.05).In group A,the CT values of the jugular vein in proximal,middle,distal segment of the two sides were (95 ± 36),(95 ± 36),(131 ±58),(133 ± 57),(174 ± 68),and (180 ± 66) HU respectively.In group B,CT values were (135 ± 58),(137 ±59),(170 ±58),(181 ±58),(218 ±62),and (224 ±68) HU.The CT value of jugular venous in group A was significantly lower than that in group B (t =-3.30--2.54,P ＜ 0.05).Case numbers of contrast agent residual artifacts of injection side subclavian vein and the absence segments of root of the neck artery at the beginning in group A (5,11) were less than that in group B (12,24) (x2 =4.02,5.65,P ＜0.05).The degree of the jugular vein return in group A were lesser severely than that in group B (x2 =6.79,6.37,P ＜0.05).Below the level of carotid artery bifurcation:slight 5 patients,severe 1 patient in group A vs.slight 15 patients,severe 9 patients in group B.Above the level of carotid artery bifurcation:slight 9 patients,severe 6 patients in group A vs.slight 12 patients,severe 17 patients in group B.Image quality scores of group A (3.84 ± 0.40) was higher than that of group B (3.64 ± 0.63) (t =4.26,P ＜0.05).Conclusions Pulmonary Artery Monitoring combines with 60-65 ml contrast material optimization scheme for intracranial and cervical artery angiography with dual energy CT can significantly reduce the degree of jugular venous return and contrast material residues artifacts of subclavian vein of injected side.This technique is helpful to improve the work efficiency and image quality.

Objective To investigate and analyze the dwarf reasons for children in the area of Huai'an city,Jiangsu province.Methods A retrospective analysis of 92 cases of children with short stature in our hospital in recent 5 years had been made.Results The dwarf reasons for the 92 cases of undersized children were:lack of growth hormone (53.3％),physical sexual puberty delay (16.3％),hypothyroidism (9.8％),turner syndrome (7.6％),nanosoma essentialis (5.4％),familial short stature (4.3％),intrauterine growth retardation (2.2％)and glycogen storage disease type Ⅰ (1.1％).Conclusion The main dwarf reasons for children were growth hormone deficiency and physical sexual puberty delay,and medical treatment should be used as soon as possible.