Purpose To investigate the clinicopathological characteristics,diagnosis and differential diagnosis of benign metastasizing leiomyoma (BML).Methods The clinicopathological data in 6 patients with BML were collected.All cases of BLM were investigated by HE and immunohistochemistry of EnVision method.Results All cases were female,with age of 33 -65 years,and had undergone myomectomy.5 cases had lung metastasis,including abdominal wall metastasis and spinal metastasis in each of the 1 cases,and another case had inguinal metastasis.Morphology showed that the tumor cells were spindle without obvious atypia,nuclear mitoses and necrosis,some cases were cellular.Immunohistochemical staining showed that the tumor cells were positive for SMA,SM-MHC,desmin,ER,PR,vimentin,while negative for S-100,CD117,CD34.Ki-67 label index were less than 5％.3 patients were alive with tumor and 3 patients were alive without tumor in the follow up of 18,28,40,31,36,80 months.Conclusion BML often occurs in female patients that undergone uterine myomectomy.The lung is the most common site of metastasis,often accompanied by other sites.The disease progresses slowly,and most patients have a longer survival time.

Objective To establish a zebrafish IGFBP-2 gene knock-down model by morphilino modified antisense oligonucleotide injection, so as to investigate the abnormal phenotypes of heart and vessels in early stage of zebrafish development and the expression of zebrafish cardiogenesis related genes. Methods The spatiotemporal expression of IGFBP-2 gene in early stage of zebrafish development was testified by whole mount in situ hybridization with antisense RNA IGFBP-2 probe. The IGFBP-2 morpholino (IGFBP-2 MO) that especially inhibited the gene promoter and standard control morpholino (Con-MO) were designed and synthesized by Gene-tools Corporation. Four different concentration gradients (0.05, 0.10, 0.25 and 1.0 mmol/L) were set as IGFBP-MO injection groups with 0.25 mmol/L Con-MO injection group and wild type group as controls. Contribution to the incidence of heart abnormal phenotypes and mortality rate induced by 4 different IGFBP-2 concentrations injection group was recorded and compared with 2 control groups. Heart abnormal phenotypes at different developmental stages in 0.25 mmol/L IGFBP-2 injection group were observed in detail. To validate the effectiveness of IGFBP-2 MO, the expression of enhanced green fluorescence presented by wild type zebrafish embryos at 12hpf which received single injection of IGFBP-2 EGFP recombinant plasmid and those co-injected with Con-MO or IGFBP-2 MO were detected. To investigate the regulation relationship between IGFBP-2 gene and other cardiogenesis related genes, expression of atrium specific marker gene Amhc was detected in IGFBP-2 MO and wild type group by in situ hybridization. Ventricle specific green fluorescence of Vmhc-EGFP transgenic zebrafish embryos whose IGFBP-2 gene was knocked-down were compared with those untreated. Zebrafish peripheral vascular development in the IGFBP-2 MO group was also checked out by micro-angiography. Results Whole mount in situ hybridization revealed that IGFBP-2 gene expressed in turn at eyes, midbrain and then focused on liver in early stage of zebrafish development. The micro-injection of 0.25 mmol/L IGFBP-2 MO resulted in heart malformation in nearly 60% of all injected zebrafish embryos. Heart malformation phenotypes included slow heart beat, pericardial edema, weak ventricle systole contraction and heart tube looping disorder. Some of them represented atria dilation, blood regurgitation and ciculation obstruction. Wild type zebrafish embryos that received single injection of IGFBP-2 EGFP plasmid DNA or co-injected with Con-MO presented strong enhanced green fluorescence at 12hpf, meanwhile, the fluorescence was barely seen in the embryos co-injected with IGFBP-2 MO. This strongly validated the gene specific knock-down effect of IGFBP-2 MO. Amhc was down-regulated at 48hpf in IGFBP-2 MO group. Vmhc-EGFP transgenic zebrafish down-regulated by IGFBP-2 gene also resulted in attenuated expression of ventriclar-specific green fluorescence protein at 48hpf. Intersegmental blood vessels of IGFBP-2 MO group by micro-angiography at 60hpf demonstrated an sparsate and chaos image, which suggested that IGFBP-2 gene expression was involved in the regulation of normal vascular development. Conclusions Micro-injection of IGFBP-2 MO is an efficient way to knock-down IGFBP-2 gene in zebrafish embryos. IGFBP-2 gene expression down-regulation leads to heart and vessels maldevelopment and have an impact on the expression of cardiogenesis related genes of zebrafish embryos as well. In short, IGFBP-2 plays a critical role in the normal cardiovascular development of zebrafish embryos.

OBJECTIVETo analyze the perioperative complications of percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fracture.

METHODSFrom June 2009 to December 2011, 63 patients with osteoporotic vertebral compression fracture underwent PKP, there were 18 males and 45 females with an average age of 75.3 years ( ranged, 62 to 91). All patients with severe back pain and without neurological symptoms and signs, which were confirmed by X-ray and MRI. Among them,there were 63 cases with severe osteoporosis, 37 cases with hypertension, 10 with coronary artery disease, 29 with anemia, 26 with diabetes, 11 with chronic obstructive pulmonary diseases and 8 with gastritis and peptic ulcer. The common perioperative complications were retropectively reviewed.

RESULTSPreoperative complications occured in 9 cases (14.3%), including hypostatic pneumonia (1 case), electrolyte disturbances (2 cases), urinary tract infection (2 cases), moderate anemia(2 cases),electrolyte disturbances combined with moderate anemia (1 case), hypostatic pneumonia combined with delirium (1 case). Intraoperative and postoperative. complications occurred in 17 cases (26.9%), there were bone cement correlated complications in 9 cases (14.3%), in which 2 cases of toxic reaction of bone cement and 7 cases of leakage (2 cases had clinical symptoms); there were non-bone cement correlated complications in 3 cases (4.8%), in which 1 case of focal hematoma caused by paracentesis, 1 case of transient nerve injury, 1 case of left intercostal neuralgia;there were transient hyperpathia in 5 cases after operation. All complications result in no severe consequence after treatment.

CONCLUSIONPerioperative complications of percutaneous kyphoplasty are not uncommon,however,these complications may not cause serious consequence after active treatment,so prevention and treatment are important for it.

Aged ; Aged, 80 and over ; Female ; Fractures, Compression ; surgery ; Humans ; Intraoperative Complications ; etiology ; Kyphoplasty ; adverse effects ; Male ; Middle Aged ; Osteoporotic Fractures ; surgery ; Postoperative Complications ; etiology ; Retrospective Studies

Adolescent ; Adult ; Aged ; Biopsy ; Delayed Graft Function ; diagnosis ; pathology ; Female ; Graft Rejection ; diagnosis ; pathology ; Humans ; Kidney ; pathology ; physiopathology ; Kidney Function Tests ; Kidney Transplantation ; pathology ; Male ; Middle Aged ; Young Adult

OBJECTIVETo analyze the complications of percutaneous kyphoplasty except bone leakge for the treatment of osteoporotic thoracolumbar vertebral compression fractures.

METHODSFrom October 2008 to October 2012,178 patients with 224 osteoporotic vertebral compression fractures were treated with percutaneous kyphoplasty under local anethsia. There were 72 males and 106 females,ranging in age from 58 to 92 years old,with an average of 75.3 years,including 93 thoracic vertebrae and 131 lumbar vertebrae. The complications except bone cement leakage were analyzed during operation and after operation.

RESULTSAll operations were successful and all patients were followed up from 12 to 60 months with an average of 26.2 months. No death was found. Bone cement leakage occurred in 27 cases, about 15.1% in 178 cases; and complications except bone cement leakage occurred in 15 cases. There was 1 case with cardiac arrest,was completely recovery by cardiopulmonary resuscitation (CPR) immediately; and 1 case with temporary absence of breathing,was recovery after treatment. There were 3 cases with fall of blood pressure and slower of heart rate; 1 case with intestinal obstruction; 2 cases with local hematoma and 1 case with intercostal neuralgia. Vertebral body fractures of 2 cases were split by bone cement and the fractures of adjacent body occurred in 4 cases.

CONCLUSIONIt's uncommon complication except bone cement leakge in treatment of osteoporotic thoracolumbar vertebral compression fractures with percutaneous kyphoplasty. The complication of cardiopulmonary system is a high risk in surgery; and cytotoxicity of bone cement,nervous reflex,fat embolism and alteration of intravertebral pressure may be main reasons.

Aged ; Aged, 80 and over ; Female ; Fractures, Compression ; surgery ; Humans ; Kyphoplasty ; adverse effects ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Osteoporotic Fractures ; surgery ; Postoperative Complications ; etiology ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; surgery

OBJECTIVETo analyse the relationship between coping strategy and occupational stress in rail freight dispatchers.

METHODS115 rail freight dispatchers were investigated by using group sampling method, investigation contents included coping strategies, occupational stressors, strains and personalities.

RESULTSThe proportion of using coping strategy in rail freight dispatchers is lower. The scores of job future ambiguity, type A behavior and work locus of control in workers with insufficient coping strategy were higher than those in workers with sufficient strategy (P < 0.05 or P < 0.01), but the score of organization commitment score in workers with insufficient coping strategy was lower than those in workers with sufficient strategy (P < 0.05), the differences of scores of some occupational stressor, strain and personality variables between workers with insufficient and those with sufficient in social support, job-family balance, job involvement coping factors of coping strategy were remarkable significant (P < 0.05 or P < 0.01), the differences of scores of occupational stressor, strain and personality variables between workers with insufficient and those with sufficient in ask, logic and time management factors of coping strategy weren't significant (P > 0.05). Logistic regression analysis showed that risk of being job dissatisfaction and daily life stress in workers with insufficient social support coping was three or four times than those with sufficient coping (OR = 3.06 or 4.38, respectively), risk of being daily life stress in workers with insufficient job involvement coping was three times than those with sufficient coping (OR = 3.26).

CONCLUSIONThe proportion of using coping strategy in rail freight dispatchers is lower. Coping strategy has influence on the individual's perception of occuaptional stressors, strains and personalities.

Adaptation, Psychological ; Adult ; Burnout, Professional ; psychology ; China ; Humans ; Middle Aged ; Occupational Diseases ; psychology ; Occupational Health ; Personality ; Railroads ; Social Support ; Stress, Psychological ; psychology

AIM: To investigate the protective effect of huoxuehuayu decoction on macula after phacoemulsification. Into A, B groups. The 80 eyes of A group were treated by conventional phacoemulsification; the patients (60 eyes) of B group were given huoxuehuayu decoction orally for two courses after phacoemulsification. Best-corrected visual acuity(BCVA), corneal and aqueous conditions ,thickness of macular central fovea and changes of macular retinal tissue in A, B groups were observed before surgery, 1 day; 1 week,2,4,6,8 weeks and 3 months after surgery. Was significantly higher than that of group A. One week after surgery the ratio of mild aqueous flare in group B was significantly lower than that of group A. The thickness of central fixation was significantly increased in both groups 1 week, 2, 4, 6, 8 weeks and 3 months after phacoemulsification; the difference between 2 to 8 weeks after surgery and pre-operation showed statistical significance in both groups. 11 eyes in A group had macular edema during 2 to 6 weeks after surgery, including 9 eyes with fovea thickened and 2 eyes with cystoid macular edema, and seven eyes' edema disappeared in 3 months. 2 eyes in B group had macular edema, including 1 eye fovea thickened and 1 eye cystoid macular edema, during 4 to 6 weeks after surgery, and the two eyes' edema disappeared 3 months after surgery. The fovea thickness in group B during 2 to 8 weeks after surgery was statistically lower than group A. Phacoemulsification.

Background Macular edema following phacoemulsification with intraocular lens (IOL) implantation is a main factor to influent visual function.The administration of traditional medicine can relieve tissue edema,but its preventive and treatment efficacy on macular edema after phacoemulsification with IOL implantation remaines unclear.Objective This study was to investigate the protective effect of huoxuehuayu decoction on macula after phacoemulsification with IOL implantation.Methods A case-controlled observational study was designed.One hundred and eighty eyes of 150 patients with age-related cataract were randomized into operation group and operation + medicine group.Phacoemulsification with IOL implantation was performed in both groups,but huoxuehuayu decoction was orally administered for 14 days in operation+medicine group.The best corrected visual acuity,inflammatory reaction of the ocular anterior segment,and macular edema were recorded before operation and 1 week,2,4,6,8 and 12 weeks,and the central macular thickness was measured using optical coherence tomography.Results Twelve weeks after surgery,the ratio of visual acuity ≥ 1.0 was in significantly higher in operation+medition group than that of in operation group (x2 =1.066,P＞0.05).One week after surgery,the eyes of the aqueous flare were much nore in the operation group than that of operation+medicine group(x2 =9.341,P＜0.05).The thickness of the central fovea was significantly increased in both groups at 1 week,2,4,6,8 and 12 weeks after surgery,showing significant differences in comparison with preoperation (operation group:P ＜ 0.01 ; operation + medicine group:P ＜0.05).Macular edema occurred in 13 eyes in operation group during the following-up duration,including 11 eyes with thickened fovea and 2 eyes with cystoid macular edema.Maeular edema disappeared in 10 eyes 12 weeks later.In the operation+medition group,3 eyes happened macular edema,including thickened fovea in 2 eye and cystoid macular edema in 1 eye.Four to six weeks after surgery,macular edema disappeared in 3 eyes 12 weeks later.The fovea thickness in the operation+medicine group was statistically significantly lower from 2 through 8 weeks after surgery than that in the operation group(t=2.315,2.323,3.104,2.470,P＜0.05).Conclusions Oral administration of huoxuehuayu decoction is helpful for the restoration of the anterior ocular segment.Huoxuehuayu decoction can protect macula from the edema induced by phacoemulsification.

Objective: To investigate the association of parental weight related knowledge, attitude and practice (KAP) with abdominal obesity among primary and middle school students and to provide evidence for related intervention measures. Methods: In September 2013, the multistage random sampling method was used to select 17 307 primary and secondary school students with normal waist circumference in seven provinces/municipalities in China. After nine month follow up, 14 118 students aged 6-18 years were included in the final analysis. Questionnaires were used to assess parental weight related KAP, and students’ waist circumference was measured objectively at baseline and follow up. Multiple linear regression and multivariate Logistic regression were conducted to analyze the relationship between parents’ KAP with the change of students waist circumference and abdominal obesity, respectively. Results: The nine month cumulative incidence of pre and abdominal obesity among students was 6.67% and 0.85%, respectively. The scoring rates of parents knowledge, attitude and practice were 80.17%, 78.17%, 50.50%, respectively. The score of parents weight related attitude was inversely associated with the changes of waist circumference ( β=-0.18, 95%CI = -0.26- -0.10) and cumulative incidence of pre and abdominal obesity ( OR=0.90, 95%CI =0.82-0.98)( P <0.05). Conclusion Parental positive and correct weight related attitude is inversely associated with the incidence of abdominal obesity among children and adolescents. Interventions targeting establishing parents correct beliefs may be an effective way to prevent abdominal obesity in children and adolescents.

A Hoffa fracture is an uncommon clinical entity typically seen in adults after high-energy trauma. Nonunion of a Hoffa fracture appears to be even more uncommon. To our knowledge, only three cases of nonunion of a Hoffa fracture have been documented in the literature to date, including two children and one adult. This article presents a case of an adult who had nonunion of a Hoffa fracture for 27 years and was treated by open reduction and internal fixation, and the varus deformity corrected with xenogenous bone graft. An excellent result has been achieved to date. This unusual case reminds us that we cannot neglect the possibility of nonunion of a cancellous bone fracture, especially the Hoffa fractures of the medial femoral condyle if they are treated nonoperatively. It also demonstrates that internal fixation with bone graft is effective, even for the 27-year Hoffa fracture.
Bone Transplantation ; Femoral Fractures ; diagnostic imaging ; surgery ; Fracture Fixation, Internal ; Fractures, Ununited ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged