The astrocyte reaction to cerebral trauma was reviewed in this paper,which included the study model,detection technique,as well as the astrocyte changes in the morphology and metabolism.It was also prospected to their significance in medicolegal expertise.

0.05). Conclusions Peroperative transcatheter arterial infusion chemotherapy resulting in apoptosis of adenocarnoma, can raise the radical operation rate, and prolong survival rate for colprectal carcinoma patients.

The patient is a 75 years old man complaining of ear plug and hearing loss for about three days. Physical examination shows liquid in two tympanic cavities. Chronic congestion occurs to nasal mucosa. Bilateral inferior turbinates are a little bigger than normal. Both inferior meatus are unblocked and pharyngeal recess is smooth. This patient is fat. Bilateral eye lids are swollen. A tumour could be touched in bilateral parotids with good movement and no tenderness. Its size is as big as an egg. Several lymph nodes could be touched under the jaw. The blood test is normal and IgG, IgA, IgM, ANA, anti-ENA, C3, C4, CRP and ESR is normal but RF is high. The function of liver and kidney is normal. B-mode ultrasonography result shows bilateral parotids are diffusely swollen and several swollen lymph nodes in cervix. Pathology examination of lower mandibular lymph node and parotid shows follicular lymphaticus hyperplasia with several plasmacytes and eosinophil granulocytes. The diagnosis accords with Kimura disease.
Aged ; Angiolymphoid Hyperplasia with Eosinophilia ; complications ; Humans ; Male ; Otitis Media with Effusion ; complications

Objective: To investigate the relationship between C-reactive protein(CRP)and its-717MG polymorphismin atrial fibrillation(AD of the population of the city of Nantong.Methods:The relationships between AF and AF risk factors were analyzed by comparing genders,ages and body nlagS index(BWI)in 92 AF patients and 60 non-AF control subjects.The serum CRP levels were detected by immunoturbidimetry in of the two groups.The CRP-717MG polymorphism wa8 detected by polymerage chain reaction-restriction fragment-length polymorphism in patients and control subjects.Results:The sel3utm CRP level wag positively correlated with the left atrium internal diameter(LAD)in AF patient group(r=0.58,P＜0.01).The level of CRP Wag significantly higher in AF patient group compared with that of control group(P＜0.01).The serum CRP level Wag higher in patients with non-paroxysmal atrial fibrillation than that of patients with paroxysmal atrial fibrillation(P＜0.05).There Wag no significant difference in the frequency of CRP genotype between AF and control groups(P＞0.05).But the alleles frequency of the G Wag lower in AF group than that of control group(P＜0.05).Conclusion:The semm CRP level is associated with AF and its subgroups.The serum CRP level is positively correlated with LAD.The results suggest that the inflammation influences the AF though atrium reconstruction.The relationship between CRP-7 17A/G and AF stir needs further large-scale perspective studies.

Objective To explore clinicopathologic features,diagnosis,treatment and prognosis of von Hippel-Lindau (VHL) type 2B mixed cutaneous leukocytoclastic vasculitis. Methods A 22-Year-Old Man who presented with constitutional symptoms,severe hypertension,and purpuric lesions over the knees.Clinical features,histopathological,IHC and anti-angiogenesis therapy of this case with VHL syndrome-2B mixed cutaneous leukocytoclastic vasculitis was studied based on the available follow-up data.He underwent laparoscopic adrenalectomy and nephron sparing nephrectomy.Clinical evaluation included ophthalmologic examination as well as imaging exams and endocrinal hormone test for tumors markers ; molecular analysis consisted of PCR amplification of the complete VHL gene coding sequence (three exons) and automated nucleotide sequencing. Results 24 h urine Norepinephrine was 295.84 μg and octreotide scan was positive.The VHL-2B patient suffered from leukocytoclastic vasculitis,a retinal hole,pancroatic tumors (endocrine tumor and microcystic cystadenoma),bilateral pheochromocyoma,clear renal cell carcinoma,renal cysts,hepatic hemangioma and epididymal cyst.The patient developed 5 different tumors related to VHL within a period of 6 years.The cutaneous vasculitis persisted despite treatment with high-dose systemic corticosteroids,but rapidly resolved after treatment with phenoxybenzamine and removal of bilateral pheochromocytomas.Tumor cells of resected PHEO samples stained positive for CgA and S-100,but negative for Melan-A.,and with less than 1％ Ki-67. Conclusions Cutaneous leukocytoclastic vasculitis is one of paraneoplastic syndrome of pheochromocytoma.Because new lesions may develop during the patient's lifetime,regular clinical inspection is recommended in order to check up the development of any new lesions.

ObjectiveTo investigate the clinical significance and characteristics of recurrent laryngeal nerve lymph node metastasis of thoracic esophageal cancer.MethodsOne hundred and twenty-four patients who had undergone thoracic esophageal resection with recurrent laryngeal nerve lymph node dissection in our hospital from March 2007 to February 2010.All clinical data were retrospectively analysed.ResultsRecurrent laryngeal nerve lymph node metastasis was found in 34 of 124 cases,with the metastatic rate of 27.41% (34/124).The left recurrent laryngeal nerve lymph node metastasis was 16.13% and the right was 8.06% .The recurrent laryngeal nerve lymph node metastasis was found in 9 patients with the upper segment esophageal cancer,20 with middle third esophageal cancer and 5 with lower segment esophageal cancer,6 patients with T2 disease had recurrent laryngeal nerve lymph node metastasis,while 27 with,T3 disease.Also there were 4,13,17 cases with metastasis in well-differentiated,moderately differentiated,poorly differentiated respectively.Poorly differentiated esophageal carcinoma was more susceptible to recurrent laryngeal lymph node metastasis than well-differentiated and moderately differentiated esophageal carcinoma.Recurrent laryngeal nerve injury was found in 11 cases,7 cases of them recovered.ConclusionNearly 1/3 of patients with esophageal carcinoma have recurrent laryngeal nerve lymph node metastasis,especially for tumor located in the upper third esophagus,poor differentiation or deep invasion (T2 or more) of esophageal carcinoma were more susceptible to recurrent laryngeal nerve lymph node metastasis.

Objective To discuss the clinical and pathological manifestations of paragangliomas of the urinary bladder (PUB) and improve the preoperative diagnosis and surgical treatment of PUB.Methods Clinical data of 11 patients treated for PUB from June 1985 to March 2010 were analyzed.All cases had mild-paroxysmal hypertension, palpitation, sweating, and 9 cases occasionally showed headache and micturition syncope during straining urination. Twenty-four hour urine catecholamine (CA) levels were estimated in all cases. B-ultrasound and CT and/or MRI scanning were used in the imaging of all cases. Nailfola microcirculation inspection was carried out in 5 cases. Scintigraphy 131I-MIBG in 4 patients was positive expression, 7 of 111 In-DTPA-Octreotide scintigraphy and I of PETCT were also positive expression. UICC bladder tumor classification was T1 (1 case), T2 (5 cases), T3(4 cases), T4 (1 case). Results All the patients underwent partial cystectomy, laparoscopy or TURBT. One patient received 131 I-MIBG therapy. Histopathological diagnosis was confirmed by HE staining in all of the removed tumors. The tumors consisted of discrete aggregates of zellballen cells separated by a network of vascular channels. Follow-up ranged from 3 to 291 months (mean, 45 months). There were 3 recurrences following surgery. One patient died after developing pelvic lymph nodes, liver and colon metastasis. Conclusions PUB should be suspected in patients below 40 years of age if the clinical manifestations of typical tetrad symptoms: headache and micturition syncope,sweating, palpitation and hematuria are present. Advanced classification, multifocal tumors and CgA (+) are risks of recurrence and metastasis. In those patients with unresectable multiple or recurrent tumors, chemotherapy and 131I-MIBG therapy may be helpful for controling hypertension and delaying progress.

The training of teaching ability is an important context of master course.Pathology Department of Xiang Ya School of Medicine take experimental teaching practice as the important way to improve their pathological experimental teaching skill.In this paper we introduced our experience.

Objective To investigate the special cases of distally based sural neurofasciocutaneous flap with muscle repairing the soft tissue defect of foot and ankle. Methods Since February 2004,distally based sural neurofasciocutaneous flap with muscle was applied for repairing the soft tissue defect of foot and ankle in 7 cases, the soft tissue defeat simultaneous chronic osteomylitis of tibia lower section 1 case, the soft tissue defeat simultaneous dead space of foot heel 3 cases, the soft tissue defeat of sole of foot simultaneous bone loss of calcaneus epicarp (5～8 mm) 3 cases, the scope of the flap was 16 cm?12 cm～10 cm?7 cm, the thickness of gastrocnemius flap was 1～4 cm, the muscle flap was smaller than the skin flap. Results Viewing 15 to 20 minutes during operation, muscle side of the muscle flap was errhysising actively, blood circulation fine, all flap were lively. All cases were followed up from 2 to 6 months, osteomyelitis cured, muscle flap outline satisfied, feels recoveried almost, and walk well. Conclusion Distally based sural neurofasciocutaneous flap with muscle can live, the operation is easy, and it is an good donner area in repairing the soft tissue defect of foot and ankle in special cases.

Objective To discuss and evaluate the clinical efficacy and safety of sunitinib for patients with advanced renal cell carcinoma and further to analyze the associated prognostic factors.Methods A retrospective analysis was performed in 78 cases with advanced renal cell carcinoma, receiving sunitinib therapy from April 2009 to December 2014.Patients consisted of 53 males and 25 females, with median age of 54 years old, ranged from 25-85 years old.Therapeutic regimen was described as following: 52 cases receiving sunitinib 50.0 mg/d 4 weeks on and 2 weeks off (4/2 regimen), 26 cases receiving 50.0 mg/d 2 weeks on and 1 weeks off (2/1 regimen).The dosage and regimen were adjusted according to the severity of side effects.Efficacy evaluation and drug-related toxicity were based on RECIST version 1.1 and CTCAE version 3.0.Progression-free survival (PFS) and overall survival (OS) were evaluated using the KaplanMeier method.Univariate and multivariate Cox proportional hazards model were used to assess the risk factors of PFS and OS.Results Nineteen cases switched from 4/2 to 2/1 regimen.Attenuated dosage was allowed in 49 cases to ameliorate drug-related toxicities.The most common drug-related toxicities were handfoot syndrome (HFS) in 63 cases (80.8％), diarrhea in 59 cases (75.6％), fatigue in 59 cases (75.6％) and thrombocytopenia in 6 cases (71.8％).The most common grade Ⅲ-Ⅳ toxicities were HFS in 9 cases (11.5％), thrombocytopenia in 6 cases (7.7％) and hypertension in 5 cases (6.4％).In RECIST evaluation, complete response (CR) was not recorded.8 cases (10.3％) achieved partial response (PR) , 59 cases (75.6％) kept stable disease (SD) and 11 cases (14.1％) suffered progressive disease (PD).The objective response rate (ORR) was 10.3％ and the disease control rate (DCR) was 85.9％.The median PFS was 11.0 months and median OS was 21.8 months.Multivariate Cox proportional hazards model showed two independent risk factors for PFS, including number of metastasis organs ≥ 2 and a high ECOG score.One independent risk factor for OS was number of metastasis organs ≥ 2.Conclusions Sunitinib shows encouraging efficacy and safety for patients with advanced renal cell carcinoma.Patients with multiple metastatic organs and poor performance status seems to be high risky of poor prognosis.