Objective To investigate the unusual CT features of pulmonary sclerosing hemangioma (SH). Methods Clinical and CT features of 25 patients of pulmonary SH proved with pathology were reviewed, among which 15 patients underwent plain and enhanced CT scan, 10 underwent only plain CT scan. Results Solitary nodules (20/25, 80.00%) and solitary mass (5/25, 20.00%) were found with CT. CT features included slight lobulation (6/25, 24.00%), calcification (6/25, 24.00%), ground glass opacity (2/25, 8.00%), emphysema (1/25, 4.00%), endobrochial variant (1/25, 4.00%), short speculation (1/25, 4.00%) and vascular bundle (2/25, 8.00%). Slight or remarkable enhancement was noticed in all 15 patients underwent contrast enhanced CT. Conclusion CT can reveal features and unusual manifestations of pulmonary SH, and is helpful to the diagnosis of pulmonary SH.

Objective To evaluate the effect of short-wave ultraviolet combined with millimeter-wave irradiation on pressure ulcers.Methods Fifty-three patients with 87 pressure ulcer wounds were randomly divided into 3 groups.Group A consisted of 17 patients with 28 pressure ulcers,group B had 18 patients with 29 ulcers and group C had 18 patients with 29 pressure ulcers.All the patients in the 3 groups accepted routine care.Group B was treated with short-wave ultraviolet radiation in addition,and group C received millimeter-wave combined with short-wave ultraviolet radiation.Braden's scale was used to evaluate the integrity of the patients' skin before treatment,and the pressure sore status tool (PSST) was used to evaluate exudation and skin recovery before and after treatment.Results Before treatment the patients demographics and pressure sores of the three groups had no significant differences.In group A there was no significant difference in the average PSST-5 score between before and after treatment.Compared with the scores before therapy,the average scores of groups B and C decreased significantly.They were also significantly lower than in group A after treatment.The effect in group C was better than in group B.With regard to improvement rate,the improvement percentages of groups B and C were significantly higher than that of group A,while there was no statistically significant difference between groups B and C.The rate of excellent recovery of group C was better than that of group A or B,but there was no significant difference between groups A and B.Conclusions Combining short-wave ultraviolet irradiation with millimeter-wave irradiation has remarkable effects on exudation from and the recovery of pressure ulcers.

Objective To analyze the levels and speciation of arsenic metabolites in urine of rats treated with sodium arsenite and sodium arsenate in order to investigate the different aspects of metabolism between sodium arsenite and sodium arsenate,thus to understand further the basic data about relationship between it's metabolism and mechanism of toxicity. Methods Seventy Wistar rats,weighting 80-120 g,were divided into 7 groups of 10 each,such as normal control group,high,middle and low sodium arsenite group and high,middle and low sodium arsenate group. After the animals were fed for one month,the urine was collected by metabolic cage in 12 hours. Applying the high efficiency liquid chromatography and hydride genesis atomic fluorescence spectroscopy (HPLC-HGAFS),the levels and speciation of arsenic metabolites were determined in urine of rats. Meanwhile,the recovery rate of dimethyl arsinic acid(DMA) would be determined to estimate the degree of accuracy of results. Results The levels of iAs~(3+),iAs~(5+) and DMA in middle sodium arsenite group[(121.66±1.26),(10.26±2.68),(200.91±0.56) μg/L]were higher than the high sodium arsenite group[(113.20±0.75),(5.16±1.32),(147.70±μ0.77)μg/L,all P < 0.05]and low sodium arsenite group[(79.35±2.12),(5.13±2.25),(56.35±1.23)μg/L,all P < 0.05]. The levels of iAs~(3+) and DMA in middle sodium arsenate group[(315.81±1.69),(245.12±1.18)μg/L]were higher than the high sodium arsenate group[(85.03±0.56),(110.34±1.04)μg/L,all P< 0.05]and low sodium arsenate group[(22.97±2.67),(15.75±2.15)μg/L,all P < 0.05]. Compared with sodium arsenate group,the levels of iAs~(3+) and DMA in high and low sodium arsenite group were higher(all P < 0.05) ; and the levels of iAs~(3+) and DMA in middle sodium arsenite group were lower(all P < 0.05). Meanwhile,the average urinary recovery rate of DMA of rats in different sodium arsenite group were 94.80%-102.70%,and the average urinary recovery rate of DMA of rats in different sodium arsenate group were 95.33%-108.40%. Conclusion The speciation and levels of arsenic are influenced by the external exposure dose,and some distinction appeared in the metabolism and metabolic path between sodium arsenite and sodium arsenate in urine in vivo.

Adenocarcinoma ; metabolism ; pathology ; surgery ; Aged ; Female ; Gastrectomy ; methods ; Gastrointestinal Stromal Tumors ; metabolism ; pathology ; surgery ; Humans ; Keratins ; metabolism ; Neoplasms, Multiple Primary ; metabolism ; pathology ; surgery ; Proto-Oncogene Proteins c-kit ; metabolism ; Stomach Neoplasms ; metabolism ; pathology ; surgery

Objective To establish an appropriate cut-off value of high sensitivity cardiac troponin T (hs-cTnT) and optimal combination measurement in the early diagnosis of acute myocardial infarction (AMI).Methods This research is a prospective study.342 patients admitted to emergency department with chest pain,43 patients with renal failure,40 patients with pneumonia and 18 premature with patent ductus arteriosus were involved from June 2012 to June 2013 in Peking University Third Hospital.The plasma hs-TnT,NT-proBNP,cardiac troponin Ⅰ (cTnI),CK-MB and copeptin were measured.The distribution of hs-cTnT among associated diseases was analyzed,the diagnostic performance of hs-cTnT and the role of combination hs-cTnT with NT-proBNP,CK-MB and copeptin were evaluated by receiver operating characteristic (ROC) curve.The statistical method was used to calculate the Sensitivity,specificity,negative predictive value and positive predictive value of hs-cTnT in the diagnosis of AMI.Results As compared to patients with STEMI(median 0.52 μg/L,range 0.037-7.610 μg/L),hs-cTnT was lower in the patients with Non-STEMI(median 0.127 5 μg/L,range 0.021-4.260 μg/L).However,the levels of hs-TnT in other diseases were also increased increased in varyng degrees (Chi-square =76.432,P ＜ 0.05)The areas under the curve (AUC) for hs-cTnT and cTnI in the diagnosis of AMI were 0.862 (95％ CI:0.729-0.928) and 0.748 (95％ CI0.666-0.818) respectively (Z =2.713,P ＜ 0.05).Taking 0.014μg/L and 0.035 μg/L as cut-off value of hs-TNT,the sensitivities were 100％ vs 95.1％,the specificities were 44.4％ vs 65.7％.The combination of hs-cTnT,NT-proBNP,CK-MB resulted in a increase in AUC (0.915,95％ CI:0.838-0.964) (Z =2.147,P ＜ 0.05) and the combination of hs-cTnT and copeptin resulted in a increase in AUC 0.921 (95％ CI:0.820-0.975) (Z =2.589,P ＜ 0.05).Conclusion With the cut-off value of 0.035 μg/L for diagnosis of AMI was appropriate,and the combination measurement can improve the accuracy of early diagnosis of AMI.

Objective To evaluate the clinical value of the oral contrast-enhanced three-dimensional spiral CT cholangiography to display better the intrahepatic and extrahepatic bile ducts. Methods Before spiral CT scanning, the preparation was similar to the conventional X-ray oral cholecystography. The collected parameters included 3-5 mm slice, 1 or 1.5 pitch, 120 kV, 220-250 mAs, and 1 mm reconstruction image. Volume rendering was used to construct the 3D bile duct images. Results In the 20 patients without serious biliary obstruction, oral three-dimensional CT cholangiography displayed the grade Ⅰ branch of hepatic ducts clearly and the displaying rate was 100%. The displaying of the grade Ⅱ branch of hepatic ducts was not good enough and the rate was 60%. The grade Ⅲ branch of hepatic ducts could not be displayed. Conclusion As the substitute and supplement of invasive ERCP, spiral CT 3D cholangiography is safe, simple, painless, and non-invasive. Furthermore, spiral CT 3D cholangiography can display the space structure of bile duct tree more clearly than ERCP. This technique is of great clinical value.

Background and purpose:Gemcitabine-based chemotherapy has been shown to have signiifcant activity and favourable safety in metastatic breast cancer patients, but the effectiveness is limited due to drug resistance. MicroRNAs are a family of small non-coding RNA molecules, acting as oncogenes or tumor suppressors. Although various mechanisms of chemoresistance have been uncovered, the aberrant microRNA expression and its relationship with drug resistance of breast cancer are still unclear. This study explored the potential role and underlying mechanism of microRNA-21 in gemcitabine resistant breast cancer. Methods:MDA-MB-231 cells were continuously exposed to the increasing concentrations of gemcitabine to induce drug resistance to gemcitabine, which was 10 times more resis-tant. Then multiple methods were used including real-time PCR (RT-PCR), CCK-8, Western blot, transfection, wound healing and Transwell assay to observe the effect of microRNA-21 on epithelial-mesenchymal transition (EMT) and chemosensitivity. Results:The expression of microRNA-21 was up-regulated in gemcitabine resistant breast cancer cell line and inversely correlated with gemcitabine sensitivity. Manipulation of microRNA-21 status could change microR-NA-21 level, and could result in corresponding changes in EMT status and drug sensitivity. Conclusion:MicroRNA-21 induces gemcitabine resistance possibly via EMT process in breast cancer.

Objective To analyze the changes of epidemiological and clinical features of patients with acute brucellosis over the past twenty years.Methods The epidemiological and clinieM data of patients with acute brucellosis in Harbin and counties around from 1982-1984 and 2002-2004 in our hospital were retrospeclively analyzed,and the routes of infection,epidemiologieal area,clinical manifestations,laboratory examination,time distribution and the treatment for relapse of different groups were compared.Results One hundred and sixty-five cases were collected.including 79 cases in 1982-1984 and 86 cases in 2002-2004.There were significant differences in routes of infection(X2＝11.758,P＜0.01)and epidemiological area(X2＝8.903,P＜0.05)between two groups of patients based on epidemiologieal data.Clinical manifestations were significantly different in two groups.such as sweating 74.7%(59/79)and 50.0%(43/86)(X2=10.629,P＜0.01);hepatomegaly 21.5%(17/79)and 9.3%(8/86)(X2＝4.780,P＜0.05);orchiditis,25.3%(20/79)and 8.1%(7/86)(X2＝8.877,P＜0.01);headache,20.3%(16/79)and 7.0%(6/86)(X2=6.281,P＜0.05);the distribution of fever severity(X2＝11.671,P＜0.01)and type(X2＝29.946,P＜0.01);the distribution of total white blood cells(X2=11.550,P＜0.01);rates of thrombocytopenia,2.5%(2/79)and 19.8%(17/86)(X2＝12.005,P＜0.01);and rates of liver dysfunction,21.5%(17/79)and 54.7%(47/86)(X2＝19.037,P7＜0.01).Relapse rate at 3-week 25.0%(6/24)was higher than that 6.5%(4/62)at 6-week(X2＝5.793,P＜0.05).Conclusion The epidemiologieal and clinical feature of acute burgeri infection has changed over the past twenty years due to the different strain of Bacterium.

Objective To assess the clinical threatment results of pilon fractures managed with arthroscopyassisted minimally invasive percutaneous plate osteosynthesis (MIPPO).Methods 33 patients with pilon fractures were classified into 3 groups according to the Ruedi-Allgower classification:type Ⅰ in 26 cases,type Ⅱ in 5 cases,type Ⅲ in 2 cases,including 29 males and 4 females,aged 22 to 51 years,mean 31.5 years of age.All patients were treated with arthroscopy-assisted MIPPO with the postoperative follow-up time of 12 to 84 months.Results The clinical surgery efficacy according to Mazur's criterion was evaluated as excellent in 22 cases,good in 8 cases,fair in 3 cases.The excellent and good rate was 90.9％.Conclusion Arthroscopy-assisted MIPPO surgical treatment is an effective method for Pilon fractures with the advantages of good healing,minimal trauma and less complications,it is worthy of clinical application.

Doctor WANG Zhi-zhong in the Southern Song Dynasty proposed the acupoint view of "location of disease", which explained the connotation of acupoints from the angle of clinic. Its meaning included two levels, one level meant pathological change on the body surface, that was the location of acupuncture diagnosis-treatment, and the other one indicated that the body surface which was the reflecting point of pathological change on the distal area or inside the body was the location of acupuncture diagnosis-treatment. The specific connotations of clinical acupoints were: location of pathogenic factors or reflection of pathogenic factors, regularity between acupoints un- der disease and specific organ, morphological differences and positioning variability after acupoints under disease, and acupoints examination, diagnosis and treatment.
Acupuncture Points ; Acupuncture Therapy ; history ; China ; History, Ancient ; Humans ; Medicine in Literature ; Meridians