To investigate the CT appearances in early stage of clustering lung paragonimiasis,9 cases of two clustering lung paragonimiasis caused by eating raw stone-crab and laboratory examination were included in the study.Eight cases consulted by doctors in the hospital and their appearances were retrospectively analyzed.There were pleural effusion of varying degree (n=8) and random distribution sub-pleural pulmonary infiltrative lesions (n=7).The accompany appearances of the latter had lunar halo sign,characteristic tunnel sign (n=1) and peri-bronchitis (n=1).If CT detects pulmonary infiltrative lesions of random distribution within sub-pleura or tunnel sign,combining with the history of eating raw stone crabs and other freshwater fishes,with the rise of eosinophilic granulocytes in peripheral blood,the diagnosis of paragonimiasis should be suggested.

Objective To assess the clinical efficacy of foam sclerotherapy with lauromacrogol for varicose veins of the lower extremities.Methods During the period from February to July 2011,we retrospectively analyzed 20 patients with varicose veins of the lower extremities,who were treated with lauromacrogol foam sclerosing agent injected directly at varicose veins,and in 5 extremities injected at the great saphenous vein(GSV) through a catheter at the same time.Elastic bandages were applied at the site of the injected varicosities after the therapy.The clogging of the varicose veins,the improvement of the clinical symptoms and the adverse reaction were observed. Results Lauromacrogol foam sclerosing agent was successfully injected under the guidance of fluoroscopy in 20 patients with 28 affected extremities. The average volume of foam sclerosing agent in each affected extremity was 7.8 ml. All patients presented selflimiting minor complications,including swelling and pain,which was obviously alleviated by the externallyapplied Mucopolysaccharide Polysulfate Cream.Two patients presented cough that was relieved after inhaling oxygen. Most of treated varicosities demonstrated pigmentation after the first week, which gradually disappeared after the four-month use of vitamin E capsule.A second foam sclerotherapy was carried out for 3 affected extremities of 3 patients two months after the first therapy. Two cases of leg venous ulcer were healed within a few weeks.All patients could walk immediately with no deep vein thrombosis,pulmonary embolism,anaphylaxis,or transient visual disturbance. Obvious abnormal varicose veins as well as the soreness and fatigue of the lower extremities disappeared in all patients at the 10th-month follow-up.The grading of the disease was significantly improved by the treatment (Z =5.103,P ＜ 0.01 ).Conclusions The efficacy of lauromacrogol foam sclerosing agent in the treatment of varicose veins of the lower extremities is confirmed,with advantages of lower complication,ease of treatment,repeatability,and outpatient treatment.the filling-defects technique under fluoroscopy is a method for tracing the sclerosing foam,and can effectively prevent the decp vcin thrombosis.

Humans ; Liver Neoplasms

Objective To subclone express and identify the immune mapped protein 1 IMP1 which encodes a surface an?tigen of Toxoplasma gondii. Methods The cDNA of T. gondii RH strain was synthesized by reverse transcription PCR the IMP1 open reading frame ORF was amplified by PCR using the T. gondii RH strain cDNA as template the PCR products were identified by TA?cloning and sequencing then the IMP1 ORF was subcloned into the NdeⅠand Xho I sites of the vector pET28b and the positive recombinant pET28b?IMP1 was identified by double?digesting and sequencing. The protein of 6 × His tagged IMP1 was inducibly expressed in E. coli strain BL21 DE3 with isopropylβ?D?1?thiogalactopyranoside IPTG and the induction time concentration of IPTG and temperature gradients to optimize protein expression conditions were determined. After the cells carried IMP1 were induced by the optimized conditions and harvested the resulting bacteria were suspended in resuspension buffer and lysed by sonication and the supernatants were loaded onto the Ni2+Chelating Sepharose Fast Flow col?umn for affinity chromatography of the N?terminal 6 × His tagged IMP1 protein. Finally the fusion IMP1 proteins were identified by Western blotting. Results The ORF sequence of IMP1 was successfully subcloned from the cDNA of Toxoplasma Gondii RH strain and the amplified product was sequenced and identified based on which the IMP1 ORF gene was inserted into the prokaryotic expression vector pET28b and the recombinant pET28b?IMP1 was constructed successfully. The double?digesting and sequencing results indicated the validity of the recombinant vector. And the optimized conditions for the expression of IMP 1 was determined namely 0.3 mmol/L IPTG induction for 9 h at 20℃. Furthermore IMP1 protein was expressed solubly and che?lated on Ni2+sepharose beads with high affinity thus this protein could be purified efficiently by affinity chromatography. The pure fusion protein was confirmed with fine immunocompetence by SDS?PAGE and Western blotting. Conclusions IMP1 pro? tein can be high efficiently expressed by the E. coli prokaryotic expression systems the protein of IMP1 is soluble and has stable characters. The study may lay a useful foundation for the following works including in vivo expression of IMP1 crystal structure study of IMP1 and anti?toxoplasmosis subunit vaccine development.

Objective To compare the detection performance of the modified serum test (TRUST) method and the traditional method in syphilis screening.Methods A series of TRUST high titer syphilis serum was diluted,and the positive rate of each method was calculated by using the improved method and the traditional method.Comparison of two detection methods of C50,C5 ～ C95 interval,as well as the accuracy of the density curve,and the consistency of the two methods were compared,and diagnostic performance were compared.Results The improved method of C50 was less than the traditional method of C50,and the improved method of C5 ～ C95 range was narrower than the traditional method,compared with the traditional method.The improved method of the non precision density curve was steeper than the traditional method,and the two confidence interval of the consistency degree of the 95％ methods was 73.4％ to 95.8％.The diagnostic sensitivity (SEN),diagnostic specificity (SPE),positive predictive value (PPV),negative predictive value (NPV) and diagnostic efficiency(DF) of the improved method were 64.29 ％,99.1％,85.71％,97.05 ％ and 96.39 ％,respectively.The SEN,SPE,PPV,NPV and DF of the traditional methods were 3.75 ％,98.49 ％,75 ％,96.18 ％ and 95 ％,respectively.The improved method was superior to the traditional methods in the two aspects of SEN and PPV (x2 =8.25,10.03,all P＜0.05),with the statistically significant difference.The improved method was slightly higher than the traditional method in SPE,NPV and DF (x2 =2.39,3.45,4.03,all P＞0.05),with the no statistically significant difference.Conclusion The precision,diagnostic sensitivity and diagnostic specificity of the improved method was higher than that of the traditional method,and it can be applied to the detection of large batch samples with the aid of the full automatic enzyme immunoassay instrument.The improved method can be used to replace the traditional method for syphilis screening.

Objective To summarize the computed tomography (CT) characteristics of primary hepatic angiosarcoma (PHA).Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 9 PHA patients who were admitted to the Wenzhou Chinese Medicine Hospital (3 patients),Second Affiliated Hospital of Wenzhou Medical College (3 patients) and Wenzhou People's Hospital (3 patients) between January 2006 and June 2017 were collected.All 9 patients were fasting 8 hours before CT examination,and received screen scans without abdominal pressure.Scanning area was from dome of diaphragm to lower pole of the kidneys.Two associate senior doctors made images analysis.After preoperative examinations,patients selected whether or not to undergo treatment,resection,liver transplantation or chemotherapy + targeted therapy of monoclonal antibodies.Observation indicators:(1) plain scan appearances of CT;(2) enhanced scan appearances of CT;(3) results of pathological examinations;(4) follow-up and survival situations.Follow-up using outpatient,inpatient and imaging examinations was performed to detect tumor recurrence and stable condition up to December 2017.Results (1) Plain scan appearances of CT:9 patients showed solitary tumor,and tumors were respectively located in the left lobe (3 cases) and right lobe (6 cases) of the liver,including 5 with round tumors,3 with oval tumors and 1 with patchy tumor.The maximum diameter of tumor was 5.8-16.0 cm,with an average of 10.8 cm,including maximum diameter ＞ 6.0 cm in 8 patients.Tumors of 9 patients showed low-density shadow,and CT value was 32-46 HU,with an average of 41 HU,including homogeneous density in 3 patients and heterogeneous density in 6 patients;clear tumor boundary in 6 patients and unclear tumor boundary in 3 patients;tumor necrosis and cystolization in 4 patients,slightly strip-shaped high-density shadow in the center of tumor in 4 patients,and small patch-shaped intratunoral calcification in 1 patient.(2) Enhanced scan appearances of CT:① Arterial phase:tumors of 9 patients showed mild and moderate heterogeneous enhancements,with CT value of 63-76 HU and an average of 68 HU,including small patch-shaped or nodular enhancement in 3 patients and punetate or flocculent enhancement in the center of tumor in 6 patients.Tumors of 4 patients showed moderate enhancements,and tumor density was higher than that of normal liver parenchyma.Tumors of 5 patients showed mild enhancements,and tumor density was equal to or slightly less than that of normal liver parenehyma.② Portal vein phase:tumors of 9 patients showed mild and moderate,continuous and progressive enhancements,with a heterogeneous density,CT value of 56-71 HU and an average of 63 HU,including extended enhancement region in 3 patients,with a fusion and filling trend;small patch-shaped or nodular and lattice network-shaped enhancements of center and periphery of tumor in 6 patients,showing center filling and enhancement features of hepatic angiosarcoma.Tumors of 2 patients showed moderate enhancements,and tumor density was higher than that of normal liver parenchyma;tumors of 7 patients showed mild enhancements and tumor density was equal to or slightly less than that of normal liver parenchyma.③ Delayed phase:tumor enhancements of 9 patients slowly seceded,with CT value of 50-60 HU and an average of 53 HU,including density decreasing of periphery of tumor in 3 patients;partial fusion and center filling of enhancements in 6 patients,without enhancement in necrotic area.Tumor density was slightly higher than that of normal liver parenchyma in 2 patients,equal to that of normal liver parenchyma in 1 patient,and slightly less than that of normal liver parenchyma in 6 patients.(3) Results of pathological examinations:① Pathological examinations:cut surface of tumors showed grayish yellow and drab gray,and parts of surface were fish flesh shape,with internal bleeding and necrosis.Tumors were found in diffuse hyperplasia under microscopy,tumor tissues were made up of irregular and mutual matching lacuna vasorum,with infiltrating growths along hepatic sinus gap;hepatic angiosarcoma cells were spindle,round or irregular;there were slightly eosinophilia cytoplasm and deep chromatin of the nucleus,long-shaped or irregular nucleus,and different sizes of nucleolus.② Immunohistochemical staining:CD31 and CD34 were strongly positive,vimentin and Nestine were positive,and CK19,actin and creatine kinase were negative.(4) Follow-up and survival situations:of 9 patients,3 without treatment respectively died at 3,6 and 7 months;2 had recurrence at 4 and 5 months after tumor resection,with angiosarcoma invading right renal capsule,diaphragm and right pleural hemorrhage induced to haemothorax,and survived respectively for 13 and 15 months;2 respectively died of systemic metastasis at 4 and 8 months after liver transplantation;2 underwent chemotherapy + targeted therapy of monoclonal antibodies,and survived for 12 months.Conclusions CT appearances of PHA have certain characteristics.The plain scans of CT show heterogeneous low-density shadow,and enhanced scans of CT show small patch,punctate or nodular-shaped,continuous and progressive enhancements,with a clear boundary between tumor and liver parenchyma.

Objective To investigate CT and MRI features of hepatoblastoma in adults.Methods CT and MRI findings of 8 cases of adult hepatoblastoma were retrospectively analyzed.Results (1) 75.0％ of the tumors was located in the right lobe of the liver and 25.0％ in the left lobe of the liver.(2) The maximum diameter of the tumor was averaged at (8.2±5.5)cm,and the maximum diameter of ＞ 5 cm was 62.5％.(3) Most tumors have a complete or incomplete false envelope,and the boundary is clear.(4) 75.0％ tumors were of necrocystic degeneration with calcification or bleeding in 25.0％ cases.(5) CT flat scan showing uniform low density or low density,MRI scanning T1WI was low signal,T2WI,T2WI fat suppression and DWI were high in parenchyma.(6) To strengthen substantial part in mild and moderate arterial uneven improved or ring slightly improved,portal venous phase continued mild reinforcement,delay slow exit accounted for 75.0％,reinforced psuedocapsule was mild.(7) The adjacent organs are under pressure deformation.(8) All patients underwent tumor resection and were followed up for 3 to 24 months.Conclusions CT and MRI characteristics of hepatblastoma in adult are specific and help improve the diagnostic accuracy of the disease.

Objective To explore the CT features of primary retroperitoneal liposarcoma.Methods A retrospective analysis of pathologically confirmed primary retroperitoneal liposarcoma was done.Results Tumors were located in left retroperitoneal space in 16 cases,in right retroperitoneal space in 10 cases,and in median retroperitoneal space in 3 cases.The maximum diameter ranged from 9-40 cm,with an average of (17 ±8) cm.Tumors were round in 8 cases,oval in 10 cases and irregular in 11 cases.The boundary of tumor was clear in 10 cases.CT plain scanning was mixed density in 20 cases,uniform density in 9 cases;Tumors of necrotic cysts in 11 cases,and with calcification in 9 cases;Enlarged intraperitoneal and retroperitoneal lymph nodes were found in 6 cases and intrahepatic metastases in 3 cases.The solid part was mild to moderate enhancement.Pathologically of the 29 cases,7 were dedifferentiated,4 were mucous,5 were polymorphic,1 1 were well differentiated and 2 were mixed.Conclusion The CT examination of primary retroperitoneal liposarcoma is of great value in locating tumor and judging the relationship between tumor and adjacent organs.

Objective To fully grasp the epidemic situation of drinking water type of endemic fluorosis in Jiaozuo City of Henan Province,evaluate the efficacy of the prevention and control measures,and to provide a basis for prevention and control of the disease.Methods According to "The Measures for Control and Elimination of Key Endemic Diseases",all the diseased villages in Jiaozuo City were investigated.For all diseased villages in accordance with the improved water or no improved water,drinking water samples were collected,the fluorine content in water samples was determined based on the standard testing method for drinking water (GB/T 5750.5-2006);all children aged 8 to 12 years old of the surveyed villages were examined and determined dental fluorosis using "Diagnostic of Dental Fluorosis" (WS/T 208-2011);all evaluations were based on the criteria for drinking water-based fluorosis control (National Health Control [2014] No.79).Results Totally 7 counties (cities) 59 townships 589 diseased villages were surveyed in the city,586 diseased villages had improved the water quality,the rate was 99.49％,the number of villages that used the water facility normally was 571,the normal utilization rate was 97.44％,and there were 15 villages with excessive fluoride in water.A total of 35 057 children aged 8 to 12 years old in the diseased villages of the city were examined and 13 846 cases were detected dental fluorosis,the detection rate of dental fluorosis was 39.50％,the index of dental fluorosis was 0.65,which was a moderate epidemic;147 villages reached the control of standard among the 586 diseased villages with improved water,and the compliance rate was 25.09％,and the 7 drinking water type local fluoride poisoning epidemic counties (cities) in the area all did not reached the control standards.Conclusion Totally 439 diseased villages in the city have not meet the control standard,we should strengthen the monitoring,implement measures to improve water quality,strengthen the management and maintenance of water projects to ensure that the disease affected population to have qualified drinking water in a long-term,and gradually achieve the target to control and eliminate city's drinking water type of endemic fluorosis.

Objective: To investigate the clinical significance of scheduled diclofenac sodium in gynecological hysteroscopic surgery. Methods: A total of 125 patients undergoing hysteroscopic surgery were divided into observation group(64 cases) and control group(61 cases) according to the operation date.The observation group received diclofenac sodium(50mg) 30min before operation and after operation.The control group was anesthetized with propofol 2mg·kg^-1·h^-1.The pain at 1h and 2h postoperatively, the incidence of adverse reactions within 12h after operation, the time from operation to bed ambulation, anesthetic cost and comfort of patients were compared between the two groups. Results: The pain scores of VAS in the observation group at 1h and 2h postoperatively were (3.23±1.75)points and (1.84±1.36)points, respectively, which were significantly lower than those in the control group[(5.07±1.73)points and (2.75±1.60)points, t=-5.875, -3.435, all P<0.05]. The incidence of nausea and vomiting in the observation group within 12h after operation was less than that in the control group(5 cases vs.27 cases)(χ²=12.175, P<0.05). The time spent on ambulation of the observation group[(11.17±2.18)min]was significantly shorter than that of the control group[(17.84±3.42)min](t=-12.933, P<0.05). The anesthetic cost of the observation group was significantly lower than that of the control group (1.24 CNY vs.71.30 CNY, t=18.130, P<0.05). Conclusion The diclofenac sodium plan anal preoperative analgesic effect in patients undergoing gynecological hysteroscopic surgery is better, so that out of bed activities ahead of time, can reduce the anesthesia costs, gynecological hysteroscopy can be used as the preferred method of anesthesia.