Objective To investigate the circadian rhythm of peripheral blood cell counts in Chinese healthy volunteers and nasopharyngeal carcinoma patients. Methods A total of 13 nasopharyngeal carcinoma patients and 14 healthy volunteers were enrolled in this study. Venous blood was sampled every 4 hours during a 24-hour period. EDTA anticoagulated whole-blood was tested for blood cell counts immediately by automated hematology analyzer. The plasma cortisol level was determined by Radioimmunoassay. Data were analyzed by Analysis of Variance for Repeated Measures using SPSS 13.0 software and by Cosinor Analysis using Cosinor Analysis Software. Results Both healthy volunteers and nasopharyngeal carcinoma patients displayed clear circadian rhythms in red blood cells, hemoglobin, leukocytes, lymphocytes, and possibly platelets. Those blood cell counts also showed a significant variation during 24h. Conclusion Peripheral blood cell counts display significant circadian rhythms in both healthy volunteers and advanced nasopharyngeal carcinoma patients, suggesting the possibility of performing the time-selective collection and transfusion of blood.

Objective To evaluate the preoperative CT scanning in cardiac carcinoma.Methods 52 cases of cardiac carcinoma proved by operation and pathology were analysed.Results By CT scanning,the size of the tumor,it′s local extension and relation to the adjacent structures and lymph node metastases could be demonstrated.Conclusion CT scanning plays important role in the operability of the cardiac carcinoma and the planning of treatment.

Objective To investigate the effect of low-dose hydrocortisone(HC)on hippocampus nuclear factor kappa B((NF-?B)),I?B expression in lipopolysaccharide(LPS)induced septic rats and the role of NF-?B signal transcription pathway in pathogenesis.Methods Fifty-four rats were randomly divided into 3 groups: control group(A group,n=6),model group(B group,n=24),low-dose HC treatment group(C group,n=24).The septic rat model was established by intraperitoneal injection LPS(1 mg/kg),as the intervention by caudal vein injection low-dose HC(6 mg/kg),each of B and C group was subdivied into 2,8,16,24 hours respectively after LPS injection(n=6).At serial time points,the animals in each group were sacrificed,brain tissue samples were harvested to determine NF-?B,I?B expression by immunhistochemistry in hippocampus.Results In B group: NF-?B expression was up regulated compared with A group(P

Objective To compare the safety and efficacy of intravenous thrombolysis for patients with acute cerebral infarction in a second-grand class-A hospital and a third-grand class-A hospital. Methods Twenty-one consecutive patients with cerebral infarction treated with alteplase for intravenous thrombolysis were enrolled in a second-grand class-A hospital (Fengtai Hospital,Beijing)prospectively from January 2012 to December 2013 as the study group,and 65 patients in a third-grand class-A teaching hospital (Xuanwu Hospital,Capital Medical University,Beijing)admitted at the same period for intravenous thrombolysis were used as a control group. The differences of efficacy and safety of intravenous thrombolysis in patients of both groups were compared. The primary outcome measures were Barthel Index (BI)at day14 after onset and the modified Rankin Scale (mRS)scores at discharge. The main safety indicator was the incidence of serious adverse events (SAEs)after thrombolysis (symptomatic intracranial hemorrhage and death). Results (1 )In the primary outcome measures,the proportions of mRS≤2 at discharge in the study group and the control group were 71. 4%(n=15)and 58. 5%(n=38)respectively. At day 14 after thrombolysis,the proportions of BI ≥60 were 61. 9%(n=13)and 64. 6%(n=42)respectively. There were no significant differences between the two groups (P>0. 05). (2)The incidences of the primary serious adverse events were 4. 8%(n=1)and 6. 2%(n=4). There was no significant difference (P>0. 05). Other secondary outcome measures,such as the early reperfusion rate,recanalization rate,and the proportion of neurological improvement at day 14 after thrombolysis and the overall incidence of cerebral hemorrhage had no significant differences. The case referral proportion (9. 5%,n=2)of the study group had a trend of lowering than the control group (27. 7%,n=18)P=0. 09. (3)The out-hospital time delay, in-hospital time delay,and overall time delay of the study group were less than those of the control group, and the mean time was 75 ± 33 vs. 102 ± 50 min,and 72 ± 41 vs. 111 ± 38 min,147 ± 41 vs. 212 ± 47 min. There were significant differences (P<0. 01). Conclusion The second-grand hospital selected by our study can relatively safely and effectively perform intravenous thrombolysis for acute cerebral infarction with alteplase. Moreover,the intravenous thrombolysis of the second-grand hospitals may reduce the case referral ratio and visiting time.

Objective To compare the value of two‐dimensional shear wave elastography (2D‐SWE) and real‐time tissue elastography (RTE) in the assessment of liver fibrosis in patients with chronic liver disease. Methods One hundred and ten patients with chronic liver disease scheduled for liver biopsy were studied. Both 2D‐SWE and RTE were performed on these patients in a same day. The correlation coefficient of liver fibrosis level, receiver operating characteristic (ROC) curve of S≥2, and S=4 of 2D‐SWE and RTE were compared according to pathologic results. Results The correlation coefficient of liver fibrosis level for 2D‐SWE ( r =0 7.76, 95% CI 0 6.83 -0 8.45, P =0.000) was higher than that of RTE ( r =0 5.61, 95% CI 0 4.07-0 6.84, P =0.000)( Z =2 9.3, P =0.003). The area under ROC curve for S≥2 and S=4 of 2D‐SWE were 0 8.66 and 0 9.57 respectively, RTE were 0 7.50 and 0 8.43 respectively, which indicated that 2D‐SWE was better than RTE. Conclusions The diagnostic performance of 2D‐SWE was better than RTE for the assessment of liver fibrosis and cirrhosis.

Objective To obtain the elasticity value of benign and malignant breast solid lesion with real-time shear wave elastography (SWE),in order to assess the value of quantitative elastography with SWE in diagnosis of benign and malignant breast solid lesions.Methods From June 2012 to November 2012,SWE was performed in 125 breast lesions of 103 female patients with pathologically confirmed results,to obtain the elastic modulus (mean,maximum,minimum).Taking pathologic results as reference,ROC curves were used to assess diagnostic performance.Results 87 lesions of 66 patients were pathologically confirmed benign whereas 38 lesions of 37 patients were malignant.The maximum,mean,and minimum elasticity value of benign lesions was 47.2 (7.4-192.0) kPa,22.4 (1.8-90.7) kPa,36.3 (5.3-124.7)kPa; whereas of malignant ones was 192.0(42.7-300.0)kPa,68.1 (0.1-192.0)kPa,138.0(23.9-271.1)kPa.The maximum,minimum and mean elasticity value between benign and malignant lesions had statistically significant difference(P ＜0.01).The area under the ROC curve of the maximum,minimum and mean elasticity value was 0.935,0.853 and 0.917(P ＜0.01).Taking 87.65 kPa as the threshold of the maximum elasticity value,the sensitivity was 91.4％ and the specificity was 88.5％.Taking 37.15 kPa as the threshold of the minimum elasticity value,the sensitivity was 80.0％ and the specificity was 83.9％.Taking 66.85 kPa as the threshold of the mean elasticity value,the sensitivity was 85.7％ and the specificity was 88.5％.Conclusions SWE can assess the stiffness of the breast solid neoplasm by quantitatively measuring the elastic modulus,thus providing diagnostic basis in differential diagnosis of breast lesions.SWE elastic modulus value measurement for breast solid lesions provides a new effective and objective diagnostic method.

Objective To explore the feasibility of detecting liver stiffness by real-time shear wave elastography (SWE) and establish a reference range of shear modulus in healthy liver of adults.Methods 335 adults underwent SWE detection to obtain the shear modulus of livers.The effects of different gender and age on the shear modulus in normal adult were analyzed.Thirty subjects were performed by two operators respectively to evaluate interobserver agreement.Results 329 health volunteers were detected successfully.The success rate was 98.2 ％.The mean value of SWE measurements in normal individuals was (5.023 ± 0.966)kPa.The liver shear modulus of healthy adults had a 95％ confidence interval from 4.918-5.128 kPa.There were no significant differences between the mean SWE values in men vs women (P =0.218),also among different age groups (P =0.271).No statistically significant was observed between the mean SWE values obtained by two different operators (P =0.498),interobserver ICC value was 0925.Conclusions SWE is a repeatability and stability method to access liver stiffness on healthy subjects.In our study the mean liver stiffness value obtained by SWE in healthy subjects was 5.023 kPa.The mean liver stiffness value obtained by SWE did not influenced by sex and age.

Objective To report our experience with minimally invasive percutaneous nephrolithotomy (MPCNL) in treatment of renal calculi in solitary kidneys. Methods From August 2000 to August 2010, 242 patients with renal calculi in solitary kidneys were treated by MPCNL, the data were reviewed retrospectively. Results The mean operative time was 68 min, the clearance rates were 79.3% (192/242) after first session and 88. 0% (213/242) after second-look MPCNL and ESWL, respectively. Postoperative fever happened in 18 cases. Twenty-one cases required transfusion, 10 cases received angiography and embolization. One case experienced perirenal hematoma and 1 case had pneumatothorax. Conclusions MPCNL has the advantages of less bleeding, high clearance rate and short hospital stay. MPCNL is an effective and feasible treatment option for renal calculi in solitary kidneys and should be the first line choice.

A 44-year-old male presented with a neoplasm on the buccal side of the right nasolabial fold for more than two months.Dermatological examination showed a hemispherical bulge sized 1.5 cm × 1.5 cm with central crater-like ulceration on the buccal side of the right nasolabial fold,as well as a crescent-shaped elevation measuring 1.5 cm × 2.5 cm above the hemispherical lesion.Histopathology of the hemispherical lesion revealed irregularly downward proliferation of epidermis,crater-like holes filled with eosinophilic keratinous plug in the center which were surrounded by collar-shaped epithelial cell projections.Small neutrophil abscesses were found in the clumps of epithelial cells,and massive lymphocyte infiltration with a clear bottom boundary was observed around the proliferating epithelial cells.Histopathologic examination of the crescent lesion showed multiple irregularly-shaped lobular-like structures of various sizes with sebaceous glands at different degrees of maturity in the mid dermis,which were surrounded by proliferating connective tissue.Immunohistochemical studies showed that the squamous cells stained positive for cytokeratin (CK),CK5,CK14,CK17,carcinoembryonic antigen (CEA) and epithelial membrane antigen (EMA) in the keratoacanthoma,and the sebaceous cells for CK,CK5,CK14 and EMA in the sebaceous adenoma.The pathological diagnosis was keratoacanthoma and sebaceous adenoma.The patient was diagnosed with moderately and poorly differentiated rectal adenocarcinoma in 2008.A diagnosis of Muir-Torre syndrome presenting as keratoacanthoma and sebaceous adenoma was finally made.

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.