The intestinal type of lung adenocarcinoma is a very rare subtype of lung adenocarcinoma, presenting with pulmonary symptoms, but without any gastrointestinal symptoms and pathological changes. The author found 1 case of double primary lung adenocarcinoma of the left lung, which was confirmed by surgery pathology, one for lung adenocarcinoma, one for a rare type of intestinal adenocarcinoma. This paper reviews the relevant literatures of the diagnosis and treatment of this case.

Objective:To observe the effect of PGE1 in treatment of heart failure caused by cor pulmonale.Method:100-200 μg of PGE1 was added to 250 mL of 10% glucose and administered by intravenous drip to patients once per day for 7-10 days.Results:Of the 34 cases,21 cases were significantly improved,10 cases improved while only 3 cases remained the same as before. The total effective rate was 91%. The mean time of improvement was 7 days.Conclusion:PGE1 is effective in treating cor pulmonale heart failure,it can help decrease the danger of digitalis toxication.

ObjectiveTo investigate the effects of the asphyxia as a Second Hit on renal function during early stage after birth in small for gestational age (SGA) infants.MethodsThe infants who were hospitalized within 24 hours after birth in Peking University Third Hospital between January 2013 and March 2015 were retrospectively enrolled, and divided into different groups depending on gestational age and asphyxia history. There were 40 preterm non-asphyxia SGA infants and 80 controls who were preterm non-asphyxia appropriate for gestational age (AGA) infants; 11 preterm asphyxia SGA infants and an equal number of preterm asphyxia AGA infants as controls; 33 term non-asphyxia SGA infants and 33 term non-asphyxia AGA infants as controls; and four term asphyxia SGA infants and 13 term asphyxia AGA infants as controls. Blood urea nitrogen (BUN), serum creatinine (SCr), and estimate glomerular filtration rate (eGFR) were tested within 48 h after admission and the incidence of abnormal indexes was compared between groups byt-test and Fisher exact test.Results(1) Compared with preterm non-asphyxia AGA group, BUN level significantly decreased in preterm non-asphyxia SGA group [(3.99±1.69) vs (5.11±2.08) mmol/L,t=2.948, P=0.004]. Compared with term non-asphyxia AGA group, term non-asphyxia SGA group had higher SCr level [(72.03±10.29) vs (62.58±12.27)μmol/L,t=3.390,P=0.001] and lower eGFR level [(25.19±4.07) vs (33.99±8.75) ml/(min·1.73 m2),t=5.238,P=0.000]. (2) Compared with preterm non-asphyxia AGA infants, preterm asphyxia AGA infants had higher BUN [(6.96±3.09) vs (5.11±2.08) mmol/L,t=2.602,P=0.011] and SCr [(76.45±10.11) vs (66.70±13.18)μmol/L,t=2.357,P=0.021] and lower eGFR level [(15.86±2.31) vs (19.54±5.08) ml/(min·1.73 m2),t=2.361,P=0.020]. Compared with preterm non-asphyxia SGA group, there was a significant increase in BUN level [(6.70±3.37) vs (3.99±1.69) mmol/L,t=2.581,P=0.025] and decrease in eGFR level [(14.80±4.67) vs (18.66±5.03) ml/(min·1.73 m2),t=2.285,P=0.027] in preterm asphyxia SGA group. Changes in term infants were similar to preterm infants. (3) Compared with asphyxia AGA group, asphyxia SGA group showed a higher frequency of abnormal eGFR in term infants (4/4 vs 4/13, Fisher exact test,P=0.029). ConclusionsAsphyxia as a probable Second Hit can influence the renal function during early stage in both preterm and term infants, especially in SGA infants.

Objective:To study the expression and clinical significance of GPRC5A and SOCS3 in colorectal carcinoma.Methods:SP immunochemical method was performed to detect the expression of GPRCSA and SOCS3 in 45 cases of colorectal carcinoma,25 cases of colorectal adenomas and 22 cases of normal colorectal tissues.Results:1)Expression of GPRC5A in colorectal cancinoma tissue (22.2％) was significantly lower than that in adenomas tissue (52.0％,P＞0.05).The Latter was significantly lower than that in normal colorectal tissue (81.8％,P＜0.05).GPRC5Awas closely related to lymph node metastasis,Duke's stages and the deepness of invasion (P＜0.05).2) Expression of SOCS3 in colorectal cancinoma tissue (24.4％) was significantly lower than that in adenomas tissue (56.0％,P＜0.01).The Latter was significantly lower than that in normal colorectal tissue (86.4％,P＜0.05).SOCS3 was closely related to pathological differentiation,the deepness of invasion,Duke's stages and lymph node metastasis (P＜0.05).3)The expression of GPRC5A was positive correlated with SOCS3 (P＜0.05).Conclusions:The reduced expressions of GPRC5A and SOCS3 may participate in the occurence and development of colorectal carcinorma,suggesting that GPRC5A and SOCS3 may act as biological markers for evaluating the malign degree,prognosis and therapeutic targets of colorectal carcinorma.

Objective:To investigate the relationship between psychological factors and the serum level of estrogen in menopausal women with glossdynia.Methods:87 menopausal women with glossdynia and a randomly selected control group (n=82) were comprehensively investigated with the method of case-control study.The serum level of estradiol(E2) and follicle stimulating hormone(FSH) were measured.All cases with glossdynia and control were evaluated by the Self-Rating Annxiety Scale(SAS) and Self-Rating Depression Scale(SDS). Results: The serum level of E2 was significantly lower in menopausal women with glossdynia than that in control group( P

Objective To analyze the multi-slices spiral CT (MSCT) findings of hepatic alveolar echinococcosis(HAE), and to evaluate the value of MSCT for diagnosis of HAE. Methods Twenty-six cases with HAE were scanning by MSCT. The raw data were transmitted to advanced workstation for reconstruction imaging. Correlated studies were made between the CT features and pathology or other imaging results. Results Altogether 28 lesions were detected. They all revealed as heterogeneous hypodense mass with ill-defined boundary in plain CT but were easily being distinguished from surrounding parenchyma after contrast medium injection.Characteristics of the lesions include different amount of calcification (26/26), liquefied necrosis in center area (20/26), peripheral lacunae or alveolar signs (15/26), compensatory hypertrophy of healthy hepatic part (18/26) and the retraction in the involved hepatic lobe or segment (12/26). The lesions that located at or extended to hepatic hilum caused dilatation of intra-hepatic biliary ducts(9/26), splenomegaly (12/26), and ascites (1/26). MSCT angiography (CTA) depicted signs of abnormalities of hepatic vessels such as compression, displacement, encasement and occlusion. Compared with findings of operation, the sensitivity, specificity and positive prediction value of CTA for evaluating the hepatic artery system disorders were 88%, 96% and 93%, respectively; and for portal venous system were 95%, 100% and 95%, respectively; while for hepatic venous system were 96%, 86% and 96%, respectively. Conclusion MSCT is able to comprehensive display the CT features and vessels complication of HAE. It provides reliable imaging for both accuracy diagnosis and proper treatment of the disease.

Objective To investigate the relationship between the expression of vascular endothelial growth factor C (VEGF-C) and vascular endothelial growth factor receptor-3 (VEGF-R3) in peripheral blood of patients with lung cancer and the pathological characteristics, and to assess the ability to evaluate lymphatic and distant metastasis of the two marks.Methods VEGF-C and VEGF-R3 were detected by enzyme-linked immunosorbent assay (ELISA) in 124 patients with lung cancer and 30 normal controls, and used to analyze the relationship with the pathological characteristics of lung cancer.Results The serum levels [M(QR)] of VEGF-C and VEGF-R3 in patients with lung cancer were 283.57 (120.70) pg/ml and 62.72 (43.02) ng/ml, significantly higher than the control whose VEGF-C and VEGF-R3 were 234.62 (129.20) ng/ml and 43.08 (17.07) pg/ml, respectively (Z=-2.840, P=0.005;Z=-3.834, P<0.001).No correlation was found between the expression of VEGF-C and age, sex, primary tumor site, T stage (Z=-0.949, P=0.343;Z=-0.454, P=0.649;Z=-1.168, P=0.243;Z=-1.694, P=0.090).But the expression of VEGF-C was significantly related with pathologic type, N stage and M stage (χ2=8.829, P=0.012;χ2=27.148, P<0.001;Z=-2.221, P=0.026).However, the expression of VEGF-R3 was not correlated with age, sex, the site of the primary lesion, pathological type and T, N, M stage (Z=-0.558, P=0.577;Z=-0.599, P=0.549;Z=-0.703, P=0.482;χ2=1.166, P=0.558;Z=-0.680, P=0.496;χ2=0.353, P=0.950;Z=-1.523, P=0.128).Conclusion The expressions of VEGF-C and VEGF-R3 in patients with lung cancer are higher than those in normal control, and the expression of VEGF-C is related with patho-logic type, N stage and M stage.The detection of VEGF-C in peripheral blood of lung cancer is expected to be an assistant marker for the evaluation of lymph node metastasis and blood metastasis, but VEGF-R3 does not show its value.

Objective To explore ihe physiological changes of the late-onset depressive(LOD) persons during sleep.Methods 15 cases of LOD patients formed a group and 10 healthy aging persons formed a control group.Hamilton Depression Scale (HAMD) was used to score the severity of depression and polysomnographic recorders were used to monitor the whole night long.The subjective feelings of the sleep and the daytime mental status were assessed in the morning.Results Compared with the controlde group, the LOD patients obviously possessed a disordered sleeping process: sleep efficiency was lower( ( 59.20 ± 2.90 ) %, ( 77.09 ± 1.55 ) %, P ＜0.01 ); their sleep latency was longer( (54.00 ± 4.97 ), ( 24.00 ± 2.91 ), P ＜ 0.01 ); the numbers of rapid eye movement(REM) sleep phase and rapid eye movement latency(REML) were strikingly different(P＜0.01 ).Compad with the control group, the LOD patients' awakening time and percent were significantly increased.Not only were the time and percentage of S2 sleep phase much higher, but the time of slow wave sleep was shorter.Besides,REM sleep activity, its density, and its intensity were raised (P ＜ 0.05 ).Conclusion There is a disturbance of the objective physiological indexes happening among the LOD patients.The increase of S2 sleeping time and percentage and the disinhibition of REM sleep can be used as the diagnosis indexes of LOD patients' specificity.

Objective:To study the expressions of vascular endothelial growth factor(VEGF), and thrombospondin (TSP) in oral submucous fibrosis(OSF), and to determine the relationship between VEGF and TSP, so as to investigate their roles in the pathogenesis of OSF. Methods:30 patients with OSF, including early (10 cases), middle (10 cases), late stage (10 cases) were studied. 5 healthy volunteers were chosen as control group. Buccal mucosa biopsies were taken in all samples. Expressions of VEGF and TSP were detected by immunohistochemistry. Results:The expression of VEGF increased in early stage compared with normal oral mucous, and decreased in middle and late stage. The expression of VEGF in early stage had statistical difference compared with control group, middle stage and late stage respectively(P<0.05).The expression of TSP upregulated in early and middle, and downregulated in late stage. There were no statistical significant differences among groups(P>0.05). The expressions of VEGF and TSP had negative correlation(r=-0.620,P<0.05). Conclusions: The abnormal expressions of VEGF and TSP may be a pathogenesis factor of OSF.

Objective Mining and exploring the positive experience of family caregivers of diabetic foot,aims to deepen the conceptual framework of positive aspects of caregiving and to provide a basis for interventions. Methods A qualitative study design was used guided by the conceptual framework of positive aspects of caregiving.Ten family caregivers of patients with diabetic foot were surveyed. The Colaizzi qualitative analysis method and the framework method were used to analysis the qualitative data. Results The caregivers′positive experience was described from 4 aspects:quality of caregiver/care receiver daily relationship, caregiver′s feeling of accomplishment, meaning of the caregiver′s role in daily life and the caregivers′gain. The caregivers′positive experience was influenced by the caregiver′s sense of self-efficacy and the enrichment events in daily life. Conclusions Family caregivers of diabetic foot get positive experiences in caregiving. The conceptual framework of positive aspects of caregiving explains the relationship between caregivers′positive experience and the determine factors, and it will be helpful to the designing and implementing of interventions. The positive experience should be considered when an intervention program will be conducted for supporting family caregivers.