OBJECTIVETo study the clinicopathological characteristics of papillary cystadenoma of the epididymis.

METHODSUsing routine pathology and immunohistochemistry, we observed the surgically obtained samples from 2 cases of papillary cystadenoma of the epididymis, analyzed their pathological features and clinical presentations, and reviewed the related literature.

RESULTSThe 2 patients were both adult males. The tumors typically manifested as painless swelling in the epididymis, with occasionally dull pain and tenesmus in 1 of the cases. Pathologically, the lesions exhibited three morphological features, i. e., dilated ducts and small cysts surrounded by fibrous connective tissue, adenoid papillary hyperplasia into the cysts embraced by fibrovascular stroma, and acidophil substance present in the cysts. Immunohistochemistry showed that the tumors were strongly positive for CK8/18, CK7, and EMA, but negative for CK20, CEA, MC, Calretenin, P53, P63, SMA, VHL, and CD10, with the positive rate of Ki-67 <1%. Follow-up visits revealed good prognosis in both cases.

CONCLUSIONPapillary cystadenoma of the epididymis is a rare benign tumor in the male urogenital system, which may be accompanied by the VHL syndrome. Surgery is the first choice for its treatment.

Adult ; Cystadenoma, Papillary ; chemistry ; pathology ; Epididymis ; Genital Neoplasms, Male ; chemistry ; pathology ; Humans ; Immunohistochemistry ; Male ; von Hippel-Lindau Disease

Microbe cell-surface engineering , which use the microbe cell surface display technology to display foreign proteins on the microbe cell surface to produce cell-surface proteins, was developed in recent years. I t can be utilizedto develop cell-catalyst, cell-adsorbent , live vaccine, biosensor and so on, and have a wide application perspective. But in our county, the microbe cell-surface engineering is studied just now. This review explain the development of the microbe cell surface engineering, overview the study and progress of microbe cell-surface engineering, and look this technology into the future.

Objective To investigate the correlation between specific features on contrast-enhanced CT and its clinical findings of adrenal tuberculosis so as to improve the diagnostic accuracy of the disease. Methods Contrast-enhanced CT features in 30 patients with documented adrenal tuberculosis were retrospectively evaluated blindly for the features of location,size,morphology,attenuation and enhancement patterns on CT images,and compared with clinical and pathological materials.Results The common CT manifestations were as follows:enlargement of the adrenal glands in all 30 cases(bilateral 90%,mfilateral 10%)including mass-like enlargement in 13 cases and enlargement but the contours preserved in 17 cases, heterogeneity(28 cases,93.3%),calcification(17 cases,56.7%),and low attenuation in the center with peripheral enhancement(16 cases,53.3%)of the lesions.After antituberculosis chemotherapy, 5 cases of enlarged adrenal glands decreased in size or returned to normal size and configuration,with disappearance of the central low attenuation and new appearance of dot-like calcification in 2 cases.Cochran Armitage trend test showed there was an increasing tendency of calcification rate with clinical duration(X~2= 7.47,P

Catheter ablation of atrial fibrillation is an evolving field,especially for chronic atrial fibrillation.Several approaches have been performed in clinic practice,which include circumferential pulmonary vein ablation/isolation,left atrial linear ablation,CFAE ablation,pulmonary vein denervation or stepwise ablation.However,a standard approach has not been established.The total successful rates vary from 21% to 95%.The investigations in the mechanism of chronic atrial fibrillation and methods of three-dimensional mapping,and the usage of new source and technique of ablation will increase the successful rate,decrease the recurrence rate and procedure time.The long-term result of ablation of chronic atrial fibrillation and its impact on the structure and function of heart need further investigations.

OBJECTIVETo observe the effect of Schisandra chinensis lignans (SCL) on neuronal apoptosis and PI3K/AKT signaling pathway of rats in the cerebral ischemia injury model, and study its possible mechanism.

METHODRats were orally administered SCL high, middle and low dose groups (100, 50, 25 mg x kg(-1)) for 14 days. The cerebral ischemia injury model was established by using the suture-occluded method to rate the neurological functions. The cerebral infarction area was observed by TTC staining. The pathological changes in brain tissues were determined by HE staining. Bcl-2 and Bax expressions were detected by immunohistochemical assay. The protein expressions of p-AKT and AKT were assayed by Western blotting.

RESULTCompared with the model group, SCL high, middle and low dose groups showed reduction in the cerebral infarction area to varying degrees, improve the pathological changes in brain tissues, promote the expression of apoptin Bcl-2 and p-AKT, and inhibit the expression of apoptin Bax.

CONCLUSIONSCL shows a protective effect on rats with cerebral ischemia injury. Its mechanism may be related to the increase in p-AKT ability and antiischemic brain injury capacity and the inhibition of nerve cells.

Administration, Oral ; Animals ; Apoptosis ; drug effects ; Blotting, Western ; Brain Ischemia ; metabolism ; pathology ; prevention & control ; Disease Models, Animal ; Dose-Response Relationship, Drug ; Immunohistochemistry ; Lignans ; administration & dosage ; pharmacology ; Male ; Neurons ; drug effects ; metabolism ; pathology ; Phosphatidylinositol 3-Kinases ; metabolism ; Phosphorylation ; Phytotherapy ; Proto-Oncogene Proteins c-akt ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Rats, Sprague-Dawley ; Schisandra ; chemistry ; Signal Transduction ; drug effects ; bcl-2-Associated X Protein ; metabolism

BACKGROUNDRepair of anterior mitral leaflet (AML) prolapse is still a technical challenge for cardiac surgeons. It is an important issue to find a way to repair the AML prolapse with a reliable and reproducible technique.

METHODSBetween January 2002 and June 2009, the operation of chordal transfer based on the "edge-to-edge" technique was performed in 21 patients with serious mitral valve regurgitation because of prolapse of the anterior leaflet. After the operation, echocardiography was performed in each patient before discharge and at the time of follow-up.

RESULTSAll patients survived the operation. One patient required mitral valve replacement because of anterior leaflet perforation 3 days after the operation. The other patients were free from reoperation. At the time of follow-up, all these patients were in New York Heart Association (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 3.3 - 4.8 cm(2) (mean (3.78 ± 0.52) cm(2)), the mean regurgitation area was (0.45 ± 0.22) cm(2). At the same time, both dimension of left atrium and left ventricle reduced significantly (left atrium diameter: pre-operation (48.26 ± 11.12) mm, post-operation (37.57 ± 9.56) mm, P < 0.05; the end-diastolic diameter of the left ventricle: pre-operation (61.43 ± 8.24) mm, post-operation (42.35 ± 10.79) mm, P < 0.01).

CONCLUSION"Edge-to-edge" chordal transfer technique is a simple, reliable, and reproducible technique that can provide good results for repair of anterior leaflet prolapse of mitral valve.

Adolescent ; Adult ; Aged ; Chordae Tendineae ; surgery ; Echocardiography ; Female ; Humans ; Male ; Middle Aged ; Mitral Valve ; surgery ; Mitral Valve Prolapse ; diagnostic imaging ; surgery ; Suture Techniques

BACKGROUNDIt is still a challenge for the cardiac surgeons to achieve adequate revascularization for diffused coronary artery disease (CAD). Coronary endarterectomy (CE) offers an alternative choice of coronary artery reconstruction and revascularization. In this study, short-term result of CE combined with coronary artery bypass graft (CABG) was discussed in the treatment for the diffused CAD.

METHODSFrom January 2012 to April 2014, 221 cases of CABG were performed by the same surgeon in our unit. Among these cases, 38 cases of CE + CABG were performed, which was about 17.2% (38/221) of the cohort. All these patients were divided into two groups: CE + CABG group (Group A) and CABG alone group (Group B). All clinical data were compared between the two groups, and postoperative complications and in-hospital mortality were analyzed. The categorical and continuous variables were analyzed by Chi-square test and Student's t-test respectively.

RESULTSDiabetes mellitus, hypertension, hyperlipidemia, and peripheral vascular disease were more common in group A. In this cohort, a total of 50 vessels were endarterectomized. Among them, CE was performed on left anterior descending artery in 11 cases, on right coronary artery in 29 cases, on diagonal artery in 3 cases, on intermediate artery in 2 cases, on obtuse marginal artery in 5 cases. There was no hospital mortality in both groups. The intro-aortic balloon pump was required in 3 cases in Group A (3/38), which was more often than that in Group B (3/183). At the time of follow-up, coronary computed tomography angiogram showed all the grafts with CE were patent (50/50). There is no cardio-related mortality in both groups. All these patients were free from coronary re-intervention.

CONCLUSIONSCoronary endarterectomy + CABG can offer satisfactory result for patients with diffused CAD in a short-term after the operation.

Aged ; Coronary Artery Bypass ; adverse effects ; methods ; Coronary Artery Disease ; surgery ; Endarterectomy ; methods ; Female ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Peripheral Vascular Diseases ; surgery ; Postoperative Complications ; Treatment Outcome

OBJECTIVETo investigate the clinicopathological characteristics, diagnosis and treatment of primary testicular yolk sac tumor (YST).

METHODSWe studied 8 cases of primary testicular YST by microscopy and immunohistochemistry.

RESULTSThe 8 cases of primary testicular YST, including 2 consultation cases, were confirmed from 1998 to 2013, accounting for 10.7% (8/75) of all the testicular germ cell tumors diagnosed in our hospital. The patients ranged in age from 7 to 43 years, 23.9 years on average. The main clinical manifestation of the patients was painless unilateral testis swelling. Microscopically, reticular tissues, schiller-duvaI (S-D) bodies, and eosin-stain transparent bodies were seen in the tumors. One of the cases was confirmed to be simple YST, while the other 7 mixed YST. AFP was a characteristic immunophenotype marker of the tumors.

CONCLUSIONPrimary testicular YST is a rare malignancyr with poor prognosis. Its diagnosis depends on preoperative AFP test and postoperative pathology. Comprehensive treatment, including orchiectomy, chemotherapy, and radiotherapy, can prolong the survival of the patients.

Adolescent ; Adult ; Child ; Endodermal Sinus Tumor ; metabolism ; pathology ; therapy ; Humans ; Immunohistochemistry ; Male ; Neoplasms, Germ Cell and Embryonal ; metabolism ; pathology ; therapy ; Orchiectomy ; Rare Diseases ; metabolism ; pathology ; therapy ; Testicular Neoplasms ; metabolism ; pathology ; therapy ; Young Adult

Objective To evaluate the CT features and implications of the pericardial sinuses and recesses effusion by combining the sectional cadavers and 16 mttlti-slice CT(MSCT)reformation.Methods The anatomy and communication of the pericardial sinuses and recesses on the axial,coronal and saggital sectional cadavers(respectively 1 case),and the morphologic features on MSCT reformatted images in 104 patients were observed,The detection rate of effusion was analyzed.Results The sectional cadavers and CT images showed that the pericardia] sinuses and recesses were formed by the reflections of the pericardium on the root of the great vessels.The detection rate of the sinuses and recesses was lower in small effusion than in moderate and large effusion(P

Objective To investigate the clinical characteristics,diagnosis,treatment and prognosis of human swine streptococcosis occurred in some areas of Jiangsu Province from late summer to autumn since 1998.Methods The epidemiologic and clinical features of 42 cases were collected and analyzed.The bio- chemical features of strains isolated from patient's blood or cerebrospinal fluid(CSF) were tested,and the homogeneity were compared among 15 Streptococcus suisⅡ.Results All patients had acute infection toxe- mic symptoms such as chill,fever,headache and malaise etc.Toxic shock syndrome or meningitis syndrome were the major clinical manifestations.Forty two cases of human swine streptococosis were classified into 3 types:the rates of general,shock and meningitis type were 7.1% (3/42),38.1% (16/42) and 54.7%(23/42),respectively.Ten patients were died of shock type,32 were cured.Strain isolated from patients was identified as Streptococcus suisⅡby API-Strep,the biochemical reactional code was 0641473,and appraised result was 99.9%.There was highly homogeneity in the strains of Streptococcus suisⅡisolated from patients and sick pigs identified by genomic fingerprinting.Com- bined therapy of large doses of penicillin G and ceftriaxone was effective in these patients.Conclusions Human swine streptococosis is zoonosis caused by Streptococcus suisⅡand the clinical manifesta- tions are variable.In the cases of shock type,the onset of disease is stormy and the fatality rate is very high.While the prognosis of general and meningitis type is good and the majority of the cases are cured by effective antibiotic therapy.