Purpose To measure the nuclear morphological parameters of breast cancer to study the relationship between nuclear mor-phological parameters and ER, PR, HER-2 expression, and clinicopathologic features of breast carcinoma. Methods 388 cases of breast cancer specimens were collected and molecular classification was made according to ER, PR and HER-2 expression. the nucleus parameters were measured by image analysis software after HE staining. The difference among groups was statistically analysed, and follow-up was done by phone or by hospitalization. Results Among the 4 groups of breast cancer case, the differences of circle diame-ter, area and perimeter edges of the nucleus were statistically significant (P<0.05). Nuclear morphometric quantitation between ER+/PR+ patients and ER-/PR- patients was statistically significantly differentice (P<0.05). The majority of patients with ER-/PR- were histological gradeⅢand poor survival rate (P<0.05). The disease-free survival in Luminal A type was higher than that of Basal-like type (P<0.05), and its overall survival was higher than HER-2 over-expression (P<0. 05) and Basal-like type (P<0.05) . Conclusion The nucleus morphological quantitation in breast cancer is of significant difference, which has certain reference value in its molecular typing. The result of ER, PR and HER-2 expression, combined with nuclear morphology measurement, are meaningful to the treatment and assessment of prognosis.

Aged ; Female ; Hearing Loss, Bilateral ; diagnosis ; etiology ; Humans ; Osteitis Deformans ; complications ; diagnosis

Objective To investigate the diagnosis and treatment of the blunt pancreatic injury.Methods The clinical data of 21 blunt pancreatic trauma patients admitted to our hospital in the past 5 years were analyzed retrospectively.Results 3 of 21 patients were simple blunt pancreatic injury, while the other 18 patients were complicated with other abdominal organs injuries.According to the grading criteria, the number of Ⅰ , Ⅱ, Ⅲ, Ⅳ, Ⅴ grade injury were 4, 7, 5, 3 and 2 cases, respectively, and only 9 patients were diagnosed by CT before operation, and the diagnosis was confirmed during the operation in 11 patients, and 1 was miediagnosed in the first operation.Single drainage or debridement and drainage were performed in 8 cases and distal pancreatectomy with and without spleen were performed in 5 and 3 cases, respectively, and 3patients received pancreaticojejunostomy, 1 received Whipple operation, the other 1 case underwent duodenorrhahy and diverticulation.The mortality rate was 9.5% (2/21), and the complications of pancreatic pseudocyst and fistula developed in 2 (9.5%, 2/21 ) and 5 (23.8%, 5/21 ) cases respectively, and they were cured by drainage, while the other 12 were cured completely.Conclusions The preoperative misdiagnosis rate of pancreatic trauma is high;CT scan should be used to confirm the diagnosis.Careful pancreatic exploration is mandatory and simple and effective surgical procedures with effective drainage is important for treatment success.

Objective To summarize the clinical characteristics and management of eosinophilic esophagitis (EoE) in China and improve the recognition of clinical doctor for this disease.Methods Electronic database was searched from 1993 to 2012 for case reports of EoE in Chinese patients.Data were enrolled according to the admission criterion,which included relatively complete medical records and cases confirmed by endoscopic biopsy and/or operation pathology.Results Data of 38 patients with EoE from 6 studies were included and analyzed.There were 24 males and 14 females.The age of onset was (47.2 ± 10.9)years.The process of the disease was (1.5 ± 1.8) years.The main symptoms included dysphagia (24/38,63％) and retrostemal pain (22/38,58％).Total 19 patients (83％,19/23) had allergy history and 20 patients (80％,20/25) had elevated blood eosinophil count.Lesions located at the mid-inferior esophagus mainly.Endoscopic manifestation included hyperaemia,erosion and fragile mucosa,and others such as mucosal nodular,ulcer,plaque and white exudates (18/38,47％).Eosinophil count in esophageal mucosa was (45.8 ± 34.1) numbers/HPF.Main treatment included corticosteroid and acid inhibitory medicine.Conclusions EoE is rare in Chinese people.EoE is more common in middle-aged males with chronic onset.Dysphagia and retrosternal pain is the common symptoms.Endoscopy and biopsy pathology are the methods for definition diagnosis.Corticosteroid and acid inhibitory medicine are the main treatment.

BACKGROUND: As a bone graft, coralline hydroxyapatite (CHA) has uniform and interacted pore structure, which is suitable for vascular regeneration, bone regeneration and bone deposition. It displays good biocompatibility and no immunogenicity. OBJECTIVE: To explore the clinical results of CHA in the treatment of benign osteolytic bone defects. DESIGN, TIME AND SETTING: A retrospective analysis was performed in the Department of Orthopaedics, Affiliated Hospital of Hainan Medical College from May 1996 to May 2007. PARTICIPANTS: A total of 32 cases of benign osteolytic bone defects were enrolled from Department of Orthopaedics, Affiliated Hospital of Hainan Medical College. Pathological diagnosis showed that the cause of bone defect included bone cyst for 8 cases, fibrous hyperplasia of bone for 9 cases, aneurysmal bone cyst for 4 cases, osteoenchondroma for 1 case; fracture complication for 5 cases consisting of femoral complete fracture for 2 cases and humeral complete fracture for 1 case, and humeral incomplete fracture for 2 cases. CHA was prepared by the Biomaterials Laboratory of Hainan Medical College. METHODS: According to routine approach of the operation, 32 cases of benign osteolytic bone defects were implant with CHA granules, chips or blocks after deleting tumor tissue and thinning cortical bone. Then the periosteum was sutured. Three cases with complete fracture received internal fixation, while other cases were untreated. None was fixed with plaster for external fixation. MAIN OUTCOME MEASURES: The X-ray films were observed to evaluate the bone healing at different time. RESULTS: All cases were followed up for average 6-24 months. No general abnormal reactions were found. The incisions were healed in two weeks. The lesion range of bone defect was from 3 cm?2 cm?2 cm to 12 cm?4 cm?4 cm before operation; At 1-3 months after operation, bone graft began to fuse with bone tissue around defects and fused completely at 3-6 months, which indicated the bone defect was almost repaired; At 6-24 months, bone graft was moulded and rebuilt, gradually substituted by newly formed born. CONCLUSION: The CHA is an idea bone graft substitute material for its good results in the treatment of benign osteolytic bone defects, shorter operating time and fewer complications.

Objective To explore the dynamic spiral CT findings of adrenal ganglioneuromas and to evaluate its clinical value.Methods All 7 cases patients with adrenal ganglioneuromas confirmed by surgical pathology underwent spiral CT plain scanning and two phases dynamic enhancement scanning before operation.The CT images were reviewed and analysed retrospectively in comparison with surgical and pathological results.Results Six of 7 lesions were located in the right adrenal gland,1 in the left.The diameter of the tumors was 3.7—7.5cm,with a mean diameter of 4.6cm.The CT value of the plain scans, AP phases and PVP phases was 16.2—31.7 HU(with a mean value of 24.3 HU),20.9—36.6 HU(with a mean value of 30.2 HU),and 27.4—45.5 HU(with a mean value of 36.0 HU),respectively.The masses were well defined and showed a tendency of wedging into the space between the adjacent organs and structures and encasing the large vessels such as IV,but didn't compress or occlude them.Conclusion The dynamic SCT features of adrenal ganglioneuromas were obvious,dynamic SCT scans could suggest the diagnose.

Objective To report clinical manifestations, electroencephalogram (EEG), and the genotypes of two siblings with type Ⅲ Gaucher disease.Methods Two patients with different features were siblings. Their clinical data, signs, peripheral leukocytes acid β-glucosidase activity, andGBA gene were analyzed.Results (1) The proband was a boy. He visited us at the age of nine years old because of hepatosplenomegaly, thrombocytopenia and growth retardation without any neurologic symp-toms. He had normal intelligence but abnormal EEG ifndings. The activity of acid β-glucosidase in his leucocytes decreased to 1.5 nmol h-1·mg-1 Pr (normal range 6.0-16.7 nmol h-1·mg-1 Pr), supporting the diagnosis of type Ⅲ Gaucher disease. (2) The elder sister of the proband was 12 years old. She had tonic-clonic seizure and myoclonus seizure from the age of seven years old. Mild hepatomegaly, abnormal EEG, poor effect for antiepileptics, and progressive deterioration of psychomotor abilities were found. Her blood leucocytes acid β-glucosidase activity decreased to 1.8 nmol h-1·mg-1 Pr (normal range 6.0-16.7 nmol h-1·mg-1 Pr). Two heterozygous missense mutations, c.680A>G, (p.N188S) and c.1342G>C (p.D409H) were detected from the two siblings, respec-tively.Conclusions Patients with type Ⅲ Gaucher disease usually have the onset in childhood with typical features of Gaucher disease without neurologic involvement. Abnormal EEG may be helpful to the differential diagnosis of type I or type Ⅲ. On the other hand, neurologic manifestations could be presented as the ifrst symptom in some patients without viscera enlargement. The patients of type Ⅲ Gaucher disease with the same genotype could have different phenotypes, even between the siblings.

Objective To synthesize the hydrophobic supraparamagnetic ironic oxide(SPIO) loaded and hydrophilic SPIO loaded polymeric nano-vesicles and to investigate the feasibility of using hydrophobic SPIO loaded and hydrophilic SPIO loaded polymeric nano-vesicles to display the tumor in MRI in vivo through animal experiments. Methods The polymeric nano-vesicles were prepared from poly (D, L-lactic acid) (PDLLA) and poly (ethylene glycol) (PEG) by a multiple emulsion/solvent evaporation method.The hydrophobic SPIO and hydrophilic SPIO were loaded in the polymeric nano-vesicles respectively.Eighteen nude mice models with human colorectal carcinoma xenograft were established. They were divided equally into three groups (n = 6). The three groups of nude mice models were injected with water-soluble SPIO, hydrophobic SPIO loaded and hydrophilic SPIO loaded vesicle via the mice caudal vein respectively.Dynamic MRI scan were performed in all the mice models. T2WI signal intensity and T2 relaxation time were measured in the tumor, liver and muscle by using T2 mapping software. ANOVA of repeated measurement was used to analyze if there were significant differences of signal intensity changes among the three groups, while Bonferroni method was used for pair-wise comparison. Results On T2 WI, tumors showed decrease in signal intensity after hydrophobic or hydrophilic SPIO loaded polymeric nano-vesicle injection, while no signal intensity decrease was found in the tumor after water-soluble SPIO administration. The maximum percentage of signal intensity decrease in tumor caused by hydrophobic SPIO loaded and hydrophilic SPIO loaded vesicle were 11.00%, 11.40%, respectively. There was statistical significant difference of signal intensity changes among these three groups (F = 10. 96, P ＜ 0. 01). The decrease in signal intensity in the groups with hydrophilic or hydrophobic SPIO loaded polymeric nano-vesicles injection were more pronounced as compared with that of water-soluble SPIO (P ＜ 0. 05), but there was no significant difference in signal intensity decrease between the groups of hydrophilic and hydrophobic SPIO-loaded polymeric vesicles injection (P ＞0. 05). The three agents could lead to signal intensity decrease in the liver. The maximum percentage of signal intensity decrease in liver caused by water-soluble SPIO, hydrophobic SPIO loaded and hydrophilic SPIO loaded vesicle were 32. 85%, 52. 77%, 56. 89%, respectively. There was statistical significant difference between these groups (F = 161.18, P ＜ 0. 01) . The groups of injecting hydrophilic and hydrophobic SPIO loaded polymeric nano-vesicles had the more obvious signal decrease than the one with water-soluble SPIO (P ＜ 0. 01). Hydrophilic SPIO loaded polymeric nano-vesicles exhibited more signal intensity decrease than hydrophobic SPIO loaded polymeric nano-vesicles (P ＜ 0. 01). All three agents could not lead to T2WI signal decrease in the muscle, and there was no significant difference in signal change on T2 WI among three groups (F = 0. 59, P ＞ 0. 05). Conclusion SPIO loaded polymeric nano-vesicles can cause significant T2WI signal loss in human colonic carcinoma on MR imaging in vivo. It can be used as tumor imaging contrast agents.

AIM: To investigate the effects of Yiqi Huoxue prescription and Bushen Shengsui prescription on the expression of Notch-1 and Jagged1 protein in ischemic penumbra after local cerebral ischemia/reperfusion in intraluminal thread occlusion of the middle cerebral artery (MCAO) rats. METHODS: The local cerebral ischemia/reperfusion model was established by intraluminal thread occlusion of the middle cerebral artery. The animals were randomly divided into pseudo surgery group (sham group), model (MCAO) group, Yiqi Huoxue prescription (MCAO+Yiqi Huoxue) and Bushen Shengsui prescription (MCAO+Bushen Shengsui) groups. Using the techniques of immuno-histochemical staining, the expression of Notch-1 and Jagged1 was observed at 1, 2 and 3 weeks in ischemic penumbra of the cortex of frontal and parietal lobe. RESULTS: A value and positive unit of Notch-1 and Jagged1 protein expression in model group were higher than those in sham in ischemic penumbra of the cortex of frontal or parietal lobe after local cerebral ischemia/reperfusion in MCAO rats (P<0.05 or P<0.01). A value and/or positive unit of the expression in Yiqi Huoxue prescription and Bushen Shengsui prescription groups were lower than those in model group (P<0.05 or P<0.01). CONCLUSION: Yiqi Huoxue prescription and Bushen Shengsui prescription affect the proliferation and differentiation of neural stem cells, depress Notch signal transduction after local cerebral ischemia/reperfusion in MCAO rats by inhibiting the expression of Notch-1and Jagged1 protein.

Objective To detect the expressions of nm23-H1 and heat shock protein 27 (HSP27) and their clinical significance on development and metastasis in non-small cell lung carcinoma (NSCLC).Methods 75 tumor tissues from patients with NSCLC were included as experimental group and 28 pulmonary benign lesion tissues were as control group.The expressions of nm23-H1 and HSP27 in patients with different clinical and pathological characters were detected by immunohistochemistry.Results nm23-H1 and HSP27 were mainly expressed in cytoplasm,the positive rates of nm23-H1 and HSP27 were significantly higher in the experimental group than that in control group [41.3 ％ (31/75) vs 7.1％ (2/28),x2 =10.946,P =0.001,80.0 ％ (60/75) vs 46.4 ％ (13/28),x2 =11.131,P =0.001].Compared with control group,the positive rate of HSP27 was correlated with the degree of tumor differentiation (x2 =4.191,P =0.041).nm23-H1 was related with HSP27 in lung cancer (r =0.284,P =0.013).Conclusion nm23-H1 and HSP27 are related to the occurrence and development of NSCLC.The joint detection of nm23-H1 and HSP27 should be helpful to the diagnosis and judge the biological behavior of NSCLC.