Objective To analyze the causes of preoperative misdiagnosis of primary gallbladder carcinoma,and the effective measures of prevention of the misdiagnosis.Methods We retrospectively analyzed the clinicalrecords of 52 cases with primary gallbladder carcinoma that had been treated in our hospital in 10 years,and analyzed the causes of misdiagnosis.Results Nineteen cases were diagnosed preoperatively(36.5%),while 33 cases were misdiagnosed before operation(63.5%),including misdiagnsed as cholecystolithiasisin 13 cases,gallbladder polyps in 8cases,atrophic cholecystitis in 4cases,hepatic hilar cholangiocarcinoma in 3 cases,tumor of liver in 4 cases,and Mirizzi syndrome in 1 case.There were 29 casesdiagnosed during operation(55.8%),and 4 cases misdiagnosed intratoperatively(7.7%).Misdiagnosiswas due to several reasons:complicated with other gallbladder disease,lack of distinctive clinical features of gallbladder carcinoma,over dependence on imaging methods,and not doing fast frozen section duringoperation in dubious cases.Conclusions In suspected cases with high risk of gallbladder cancer,imagingstudies should be performed,and,if necessary,invasive studies and even exploratory laparotomy should be done.Also,intraoperative rapid frozen section can result in early discovery and treatment,and is conducive to improvement of prognosis of gallbladder carcinoma.

Objective To explore the diagnosis and treatment of liver trauma.Methods A retrospectively analysis of clinical data of 160 cases of liver trauma, including 96 cases of blunt trauma and 64 cases of open trauma, was made.Results Among the 160 cases, one case with stage IV trauma and severe thoracic injury died 30min after admission. Among the other 159 cases, 45cases (9 cases of stage Ⅰ, 31 cases of stage Ⅱ and 5cases of cases Ⅲ) received nonoperative treatment, and 114cases (7 cases of stage Ⅱ, 67 cases of stage Ⅲ and 50 cases of stage Ⅳ) received operative therapy. In non-operative treatment group, the cure rate was 100 %(45/45). In operation treatment group the cure rate was 98.2 %(112/114), the mortality rate was 1.8 %(2/114), 1 case died of hemorrhage after operation and 1 case died of ARDS. Five patients with postoperative complications were cured, including hepatic abscess in 2 cases, biliary fistula in 2 cases, and hemorrhage after operation in 1 case. Conclusions B-ultrasound is the method of choice for diagnosis of liver trauma, and CT can be used if conditions permit. Cases of lives truma of stages Ⅰ and Ⅱ and some cases of stage Ⅲ that have stable hemodynamics, can receive nonoperative treatment under close observation. Some cases of stage Ⅱ, most cases of stage Ⅲ and all cases of stages Ⅳ to Ⅵ injury should preferably undergo surgical treatment.

ObjectiveTo compare the performance of color Doppler utrasonography (CDUS) alone,magnetic resonance imagine (MRI) alone, and the combination of the two in the diagnosis of thyroid carcinona (TC). MethodsCDUS and MRI results of 54 focuses of carcinoma in 45 cases diagnosed as TC by postoperative pathological results were reviewed. The sensitivity of CDUS, MRI, and the combination of the two in the diagnosis of TC was compared. ResultsThe sensitivity of CDUS and MRI was 77.78％ (42/54)and 81.48％(44/54) respectively. The difference had no statistical significance (P ＞ 0.05 ). The specificity of CDUS and MRI was 88.17％ and 92.47％ respectively, the positive predictive value was 79.25％ and 86.27％ respectively,and the negative predictive value was 87.23％ and 89.58％ respectively. The sensitivity of the combination of CDUS and MRI was 94.44％ (51/54). The difference between the combination and CDUS or MRI alone had statistical significance( P ＜0.05). ConclusionsCDUS has higher detection rate than MRI in microcalcification of TC focus. However, MRI can show more clearly of the peripheral invasion and cervical lymph node metastasis.The combination of the two can improve the accuracy of TC diagnosis.

Objective To observe the expression of leukocyte-function-associated antigen-1(LFA-1)immunoreaction in children with febrile seizures(FS),and explore the neuroimmunomodulation mechanisms in the pathogenesis of FS.Methods Adopting flow cytometry(FCM),the levels of LFA-1 contained in blood serum and peripheral blood mononuclear cells(PBMC)of 60 cases [simple FS(SFS)30 cases;complex FS(CFS)30 cases] with febrile convulsion were analyzed,and compared with those in a normal group(30 cases).Out of 60 children with FS group,the LFA-1 mRNA in 20 cases with SFS and 20 cases with CFS was analyzed,and LFA-1 mRNA in19 health children taken out from control group(30 cases)was analyzed.The real-time PCR was used to detect the expression of PBMC LFA-1 mRNA.Results The expression of LFA-1 in the surface of PBMC of the 3 groups,the highest LFA-1 level was in the SFS group(50.89?21.36),the lowest LFA-1 level was in the CFS group(34.35?11.45),and control group was(41.39?16.30).Significant differences were found in 3 groups(Pa

AIM: To evaluate the therapeutic effect and safety of Rhadiola Extract Injection for treatment of stable angina pectoris of coronary heart disease with cariac blood stasis syndrome. METHODS: Arandomized,double-blind,positive drug parallel controlled,multi-center clinical trial was adopted.414 patients with stable angna pectoris of coronary heart disease with cariac blood stasis syndrome were randomly chosen and divided into two groups: test group(n=308 cases) and control group(n=106 cases).The test group was treated with Rhadiola Extract Injection and the control group received Xiangdan Injection.Treatment course of each group was 10 days.(RESULTS:) The therapeutic effect and changes of electrocardiogram in the test group were better than that of the control group(P0.05).The test group had no obvious side-effects. CONCLUSION: Rhadiola Extract Injection is safe and effective in treating stable angina pectoris of coronary heart disease with cariac blood stasis syndrome.

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Objective To introduce a kind of operative technique in repair for the prolapse of the anterior mitral valve leaflet.Methods From January 2004 to October 2010,the operation of chordal transfer based on theedge-to-edge technique was performed in 18 cases with serious mitral valve regurgitation because of prolapse of the anterior leaflet.First,the edge-to-edge suturing was performed at the free edge of the prolapsed anterior leaflet with corresponding posterior leaflet.After that,quadrangular resection was performed to transfer these segments of posterior leaflet with its attached chordae.At last,the posterior leaflet was repaired after a quadrangular resection which would be much easier for the surgeons.After the operation,echocardiography was performed in each patient before discharge and at the time of follow-up.Results All patients survived after the operation,1 case required the rnitral valve replacement because of anterior leaflet performation occurring 3 days after the operation,1 case with hemoglobinuria and 1 case with low cardiac output,who all got symptomatic treatment afterwards.All the other patients were well discharged.At the time of follow-up,all of the patients were in NYHA functional class I.In all these patients,pre-discharge and follow-up echocardiography showed neither stenosis nor significant regurgitation of the mitral valve:the cross-sectional area of the mitral valve was 2.8-4.8 (3.78 +0.52) cm2,the mean regurgitation area was (0.45 +0.22) cm２.At the same time,both dimension of left atrium and left ventricular reduced significantly [ left atrium diameter:pre-operation ( 48.26 + 11.12 ) mm,post-operation ( 37.57 ± 9.56) mm (P ＝ 0.028 );the end-diastolic diameter of the left ventricular:pre-operation(61.43 ± 8.24) mm,post-operation (42.35 ±10.79) mm (P＝0.008)].Conclusion Chordal transfer based on the edge-to-edge technique provides good results for repair of anterior leaflet prolapse.

S. The migration of CNE-2Z cells was inhibited by chloride channel blockers (ATP, NPPB and tamoxifen), but the inhibitory effect of the blockers varied with cells at different stages. CONCLUSIONS: The migratory ability is associated with the cell cycle in CNE-2Z cells. Chloride channels play an important role in cell migration of CNE-2Z cells.

Child, Preschool ; Chondromatosis, Synovial ; diagnosis ; diagnostic imaging ; surgery ; Diagnostic Errors ; Female ; Humans ; Tibial Fractures ; diagnosis ; Tomography, X-Ray Computed

Objective To investigate whether the effect of puerarin on right ventricle hypertrophy of pulmonary hypertensive rats induced by chronic hypoxia-hypercapnia was related to new peptide Apelin or its receptor(APJ).Methods Thirty male Sprague-Dawley rats were randomly divided into three groups, they are control group,hypoxia-hypercapnia 4-week model group,and hypoxia-hypercapnia 4-week plus puerarin group.The concentrations of Apelin-36 protein in plasma and homogenate of right ventricular muscle were detected by radioimmunoassay.The mRNA expressions of Apelin and APJ in right ventricu- lar muscle were measured by semi-quantitive reverse transcription polymerase chain reaction(RT-PCR). Results The weight ratio of right ventricle to left ventricle plus septum[RV/(LV+S)] in model group was significantly higher than that in control group(P0.05).The plasma concen- tration of Apelin-36 protein in model group was significantly higher than that in control group(P