Training pathologist's ability of rapid intraoperative diagnosis of central nervous system tumors is of great importance to decide ranges of clinical operation and to promote pathological diagnosis level.Pathologist made frozen section,fully understood the clinical data and operation,mastered correct method of slice reading,learned comprehensive analysis,and exercised psychological quality thus to make rapid intraoperative diagnosis correctly.

Objective Investigate the clinical efficacy of treating retreated smear-positive tuberculosis patients with conventional anti-tuberculosis chemotherapy combined with levofloxacin. Methods Divide 60 retreated smear-positive tuberculosis patients registered in our hospital between October 2012 and October 2014 into two groups using random number table method: levofloxacin group and conventional treatment group. Each group contains 30 patients that were treated for 9 months , and the efficacy the both treatment methods were compared. Results The sputum conversion rate in the levofloxacin group is 93.33% and 96.67% after treating for 6 months and 9 months , respectively; which are substantial higher than that of the conventional treatment group with sputum conversion rate of 70% and 73.33% after 6 months and 9 months of treatment , respectively (P < 0.05). The absorption rate of the levofloxacin group is significantly higher than that of the conventional treatment group (P < 0.05). The cavity improvement rate of the levofloxacin group is 73.33%, which is significantly higher than that of the conventional treatment group (33.33%) (P < 0.05). The clinical efficacy of the LVFX group is substantially higher than the routine treatment group (P < 0.05). The overall effectiveness of LVFX group reached 100% , which is significantly higher than that of the conventional treatment group (86.67%) (P < 0.05). Conclusions Levofloxacin combined with conventional anti-tuberculosis chemotherapy can effectively improve the clinical efficacy in the treatment of tuberculosis.

Objective To evaluate the feasibility and value of quantitatively assessing left ventricular systolic function in rats with myocardial infarction (MI) by myocardial contrast echocardiography (MCE) based on mathematical morphology algorithm.Methods SD rats model of MI were mede,then MCE were performed before MI and at 1,3 weeks after MI.In vitro study:based on the principle of binary morphology,segmentation of endocardium was acquired using dilation,erosion,closed operations and connected domain object tag-based.The automatic segmentation of endocardial contour was compared with the manual segmentation boundary.In vivo study:the left ventricular area was calculated using the software,and the area variation fraction (AVF),a new index of left ventricular systolic function,were acquired.The correlation between AVF and left ventricular ejection fraction (LVEF) was analyzed.The value of AVF for diagnosis for left ventricular dysfunction was evaluated by ROC curve.Results ① The cross-correlation coefficient (CCC) and percent error (PE) between automatic contours and manual boundary were more than 0.90 and less than 9％,respectively.② AVF correlated positively with LVEF (r =0.934,P ＜ 0.001).③ ROC analyses showed the area under curves for AVF diagnosing left ventricular dysfunction was 0.834.The best cutoff value was 27.5 ％ for diagnosing left ventricular dysfunction with the sensitivity of 85 ％ and specificity of 60 ％.Conclusions Left ventricular endocardium can be identificated automatically and rapidly by MCE based on mathematical morphology algorithm.AVF can assessed quantitatively left ventricular systolic function in rats with myocardial infarction.

AIM: To evaluate the expression of fibroblast growth factor receptor 3 (FGFR3) in acute lymphocytic leukemia (ALL) patients and its contribution to the proliferation of circulating endothelial cells (CECs).METHODS: The mRNA expression levels of FGFR3 in 44 patients with ALL were assayed by RT-PCR.Overall survival (OS) rates of the patients in FGFR3+ group and FGFR3-group were estimated by Kaplan-Meier analysis.The CECs were sorted from peripheral blood by magnetic-activated cell sorting and then counted by 3-color flow cytometry.The cell counts, antigen expression, growth curve and colony forming rate of the CECs in the 2 groups were determined.The FGFR3 expression of CECs was identified by immunofluorescence staining.RESULTS: The positive rate of FGFR3 mRNA expression was 43.2% in 44 ALL patients with normal karyotype.T-ALL expressed higher level of FGFR3 than B-ALL (P<0.05).FGFR3 was over-expressed in ALL patients with bone marrow blast proportion ≥5% (P<0.05).The probability of OS was significantly lower in FGFR3+ group than that in FGFR3-group (P<0.05).The sorted CECs highly expressed CD31, CD144, VEGFR-2 and CD146, and rarely expressed CD45.The counts of CECs and expression level of CD133 significantly increased in FGFR3+ group compared with FGFR3-group.The same result of the amount of colony formation was observed (P<0.05).There was significant difference at 3 time points of cultured CECs count in vitro between FGFR3+ group and FGFR3-group (P<0.05).The positive rate of FGFR3 expression of CECs from 19 ALL-FGFR3+ patients was (29.00±15.71)%.CONCLUSION: The over-expression of FGFR3 gene in ALL may be helpful to evaluate the prolife-ration of CECs, and become a double target with anti-tumor and anti-angiogenesis effects to offer more choice for molecular therapy in the future.

Background and purpose:Neoadjuvant chemotherapy with docetaxel was gaining more attention in the treatment for locoregionally advanced nasopharyngeal carcinoma (NPC). The prediction of the sensitivity to neoadjuvant chemotherapy with docetaxel could enable clinicians to individualize treatment protocols for NPC. Recently we found that 99mTc-MIBI imaging in NPC could predict tumor response to chemotherapy with cisplatin plus 5-FU. However, there was no study to support similar findings in NPC patients receiving chemotherapy containing docetaxel. This study was to evaluate the value of double-phase 99mTc-MIBI SPECT/CT in predicting response to neoadjuvant chemotherapy with docetaxel-based regimen for nasopharyngeal carcinoma. Methods:Thirty-one nasopharyngeal carcinoma patients participated in this prospective study. Before treatment, early and delayed single-photon emission computed tomography/compute tomography (SPECT/CT) images were obtained instantly and 2 hours after an intravenous injection of 25-30 mCi 99mTc-MIBI. All patients received neoadjuvant chemotherapy consisting of docetaxel, cisplatin plus 5-FU for two cycles. The relationships between efficacy of neoadjuvant chemotherapy and the early uptake ratio, late uptake ratio and washout rate of 99mTc-MIBI were evaluated.Results:According to the MRI, the early uptake of 99mTc-MIBI (2.67±0.83) in the lesions which were sensitive to chemotherapy was significantly higher compared with that (1.69±0.46) in the insensitive lesions(P=0.003). The difference of the late uptake between the sensitive(1.46±0.39) and the insensitive (1.06±0.62) was also statistically significant (P=0.026). However, the washout rate of 99mTc-MIBI was not significantly different between the two groups (P=0.23). Through ROC curve analysis, the AUC for early uptake of 99mTc-MIBI and late uptake were 0.84. The sensitivity, specificity, positive predictive value and negative predictive value were 74.2%, 87.5%, 95.8%and 46.7%for early uptake when the cut off value of 1.97 was used. Conclusion:The uptake of 99mTc-MIBI in both early phase and late phase could predict the efficacy of neoadjuvant chemotherapy with docetaxel-based regimen.

ObjectiveTo investigate the effect of perioperative use of fish oil on post-operative fatigue(POF) of rat.MethodsAfter one week's preoperative behavior training,12 rats presented poor behavior were excluded from 60 healthy adult male SD rats as the normal controls of serum parameters.The remaining 48 rats were randomly divided into model group and fish oil treatment group by random number table.The fish oil treatment group received 10 days' (3 days before surgery and 7 days after surgery) intraperitoneal injection of fish oil [2 ml/( kg · d) ],and the model group with saline.On the 1st,3rd,5th,and 7th post-operative day,rats were assessed by Morris water-maze and tail suspension test.Serum levels of interleukin ( IL)-1β,IL-6,tumor necrosis factor-α (TNF-α),superoxide dismutase (SOD),and glutathione peroxidase (GSH-PX) were measured.ResultsSerum parameters:on the 1st and 3rd post-operative day,the IL-6 level in the fish oil treatment group [ (66.22 ±8.80),(56.03 ± 1.19) pg/ml] was significantly lower than in model group [ (83.30 ± 10.69),(82.72 ± 24.27) pg/ml ] (P =0.034,P =0.038 ) ; on the 1 st,3rd,5th,and 7th post-operative day,the TNF-α level in the fish oil treatment group [ ( 104.36 ±5.02),(84.49 ±7.81 ),(64.47 ±2.89),(39.29 ±2.52)pg/ml ] was significantly lower than in model group [ ( 120.01 ± 14.99 ),( 119.68 ± 8.84),(75.29 ± 2.58 ),(41.96±1.65) pg/ml] (P=0.014,P=0.003,P=0.000,P=0.004); onthe1st,3rd,5th,and 7th postoperative day,the IL-1β level [(155.11 ±9.08),(79.39±5.86),(57.26±16.07),(35.42±1.53) pg/ml]was significantly lower than model group [ (204.87±30.61),(198.82±54.83),(152.12±29.06),(64.35 ± 2.70) pg/ml ] ( P =0.024,P =0.002,P =0.000,P =0.000) ; on the 5th postoperative day,SOD ( 1.08±0.08) μmol/L was significantly higher than model group (0.71±0.06) μmoL/L (P=0.000) ; on the 5th and 7th postoperative day,GSH-PX [ (31.21 ± 1.30), (30.78 ± 1.83) μmol/L] was significantly higher than model group [ (25.03 ±1.74),(27.57±3.57) μ mol/L](P=0.000,P=0.036).Behavior:in tail suspension test,on the 1st and 3rd postoperative day,value of struggle in fish oil treatment group [ (6620 ± 1390),(7011 ± 1472) mv · s] was significantly higher than in model group [ (4739 ± 1040),(4344 ± 1130) mv · s](P=0.048,P=0.043); cumulative fixed time [ (118.42±10.05), (101.02±8.68) s] and single rest time [ (55.39±7.70),(56.60±5.88) s] was lower thanin modelgroup [ (135.08+12.44),(131.02±9.24) s; (65.73±3.78),(64.93±3.25) s] (P=0.042,P=0.012,P=0.043,and P=0.042).In Morris water-maze,on the 3rd and 5th postoperative day,escape latent period of fish oil treatment group [ (48.263 ±1.815),(44.955±2.567) s] was lower than model group [ (51.543±1.990),(49.956±2.888) s] (P=0.035,P=0.035) ; on the 1st,3rd,5th,and 7th postoperative day,the cross platform number (1.04±0.25,1.95±0.49,2.42 ±0.41,3.21 ±0.53) was significantly higher than in model group (0.58 ±0.26,1.20±0.33,1.50±0.39,2.17±0.68) (P=0.002,P=0.003,P=0.018,P=0.035).ConclusionPerioperative use of fish oil can reduce postoperative inflammatory response,enhance antioxidant defense capability,and mitigate post-operative fatigue.

Objective To investigate the clinical significance of combined detection of serum CEA, SCC, CYFRA21-1 before and after radiotherapy in esophagus carcinoma. Methods 226 cases of esophagus carcinoma patient were collected from November, 2006 to December, 2008. ELISA was used to detect the serum CEA, SCC and CYFRA21-1 of patients with esophagus cancer before and after radiotherapy. SPSS13.0 was used for the statistical analysis. Results The positive rate of CEA, SCC and CYFRA21-1 was 11.1 %, 16.8%, 27.4 %, respectively and the combined positive rate was 39.8 % from 226 patient serums before radiotherapy. The longer the lesion length, the later the clinical stage,the deeper the tumor invasion, the higher the mean value of serum CEA, SCC, CYFRA21-1 was. The mean value was lower in the early stage. The mean value of CEA, SCC and CYFRA21-1 was found to be well correlated with tumor size, TNM stage and depth of tumor invasion. Among three tumor biomarkers, the individual difference of CEA and CYFRA21-1 was bigger and the pathological stage and prognosis correlation with CYFRA21-1 was the best. The biomarker value dropped to the level below the normal in 76.7% patient out of 90 cases after radiotherapy. Conclusion The combined detection of serum CEA, SCC, CYFRA21-1 may be used as adjuvant diagnosis for esophagus cancer and has better clinical value for prediction to treatment and prognosis.

Objective To analyse serum proteomic patterns'differences in esophageal carcinoma patients by proteinchip technology and study its clinical value.Methods Surface-enhanced laser desorption /ionization proteomic patterns and WCX-2 protein chip were respectively used to detect the serum proteomic patterns in esophageal carcinoma patients according to before and after radiation,IMRT or 2-dimensional radiotherapy and metastasis or not.The data were analyzed by using Biomarker Wizard software.Results 8 differential protein peaks whose M/Z were 2863,3884.213,1699.600,1371.126,8454.341,1141.881,1473.377,2086.908 and 2785.016 were significant before and after radiotherapy.8 protein peaks whose M/Z were 3470.098,2011.529,3395.789,2639.055,1511.632,11488.520,9546.555 and 4783.831 were significant between IMRT and 2-dimensional radiotherapy.2 protein peaks whose M/Z were 3470.098,3395.789 were significant between metastasis and not metastasis.Conclusion Serum surface-enhanced laser desorption / ionization proteomic patterns analysis has good prospects in evaluating therapeutic effect and prognosis of esophageal carcinoma patients.

Purpose To study the clinicopathological features of extraventricular neurocytoma. Methods 12 cases of extraventricular neurocytoma were retrospectively analyzed for their clinical information and histopathological features. Results The distribution of ex-traventricular neurocytoma was as follows: cerebral hemisphere (5 cases), right thalamus (2 cases), cerebellar vermis (2 cases), saddle area (2 cases), and spinal cord (1 case). The histological features were round uniform cells, round or oval nuclei, with peri-nuclear clearing commonly seen. Neuropil-like structure, ganglion cells or ganglion-like cells, perivascular rosettes, calcification, cap-illary wall thickening and hyaline degeneration and other pathological changes were also observed. All cases showed strong immunoreac-tivity for Syn. 7 cases exhibited Ki-67 labeling index of≤2%, and other 5 cases showed 3% ~8%. 3 cases were performed with fluo-rescence in situ hybridization ( FISH) to detect loss of chromosome 1p/19q, but no loss was detected. Postoperative follow-up for 4 months to 4 years showed one case had tumor recurrence and intracranial spread in postoperative 2 years. Conclusions Extraventricu-lar neurocytoma shares similar histological features with central neurocytoma, but often more complex. Ganglion cells or ganglion-like cells, calcification, capillary wall thickening and hyaline degeneration are more frequently seen, but neuropil-like structure is less seen. Extraventricular neurocytoma needs differential diagnoses from oligodendroglioma, ependymoma, dysembryoplastic neuroepitheli-al tumor and others. Immunohistochemistry and chromosome 1p/19q loss can help in the differential diagnosis. The treatment for ex-traventricular neurocytoma is grossly total resection, with post-operative radiotherapy for subtotal resection, atypical or recurrent cases.

This paper summarized the current ethical dilemmas of living will in our country including life ethical dilemmas, medical ethical dilemmas and family ethical dilemmas, and then proposed several suggestions for the promotion of living will in China:strengthening the theoretical research on related contents of living will, increasing the intensity of death education, carrying out related activities in the communities, strengthening the policy support and establishing hospital or regional pilots, to provide the feasible problems for the advancement of our country's living will.