Blood Group Incompatibility ; complications ; Erythroblastosis, Fetal ; etiology ; Humans ; Infant, Newborn ; MNSs Blood-Group System ; immunology ; Male

Objective To evaluate the value of CT and bronchoscopy in diagnosis of solitary pulmonary nodules.Methods The CT,FOB and histologic data of 60 patients with solitary pulmonary nodules were analysed retrospectively.Results 60 pulmonary lesions were all detected by CT scan,the detected rate was 100%.The detected rate by endoscopy was 67%(40/60).Conclusion CT can be used as the routine method in evaluating pulmonary nodules and guiding biopsy by fibroptic bronchoscopy.

Objective To determine the planning target volume margins of head and neck cancers treated by image guided radiotherapy (IGRT).Methods 464 sets cone beam computed tomography (CBCT) images before setup correction and 126 sets CBCT images after correction were obtained from 51 head and neck cancer patients treated by IGRT in our department.The systematic and random errors were evaluated by either online or offline correction through registering the CBCT images to the planning CT.The data was divided into 3 groups according to the online correction times.Results The isocenter shift were 0.37 mm±2.37 mm, -0.43 mm±2.30 mm and 0.47 mm±2.65 mm in right-left (RL), anterior-posterior (AP) and superior-inferior (SI) directions respectively before correction, and it reduced to 0.08 mm±0.68 mm, -0.03 mm±0.74 mm and 0.03 mm±0.80 mm when evaluated by 126 sets corrected CBCT images.The planning target volume (PTV) margin from clinical target volume (CTV) before correction were:6.41 mm,6.15 mm and 7.10 mm based on two parameter model, and it reduced to 1.78 mm,1.80 mm and 1.97 mm after correction.The PTV margins were 3.8 mm,3.8 mm,4.0 mm;4.0 mm,4.0 mm,5.0 mm and 5.4 mm,5.2 mm,6.1 mm in RL, AP and SI respectively when online-correction times were more than 15 times, 11-15 times,5-10 times.Conclusions CBCT-based on online correction reduce the PTV margin for head and neck cancers treated by IGRT and ensure more precise dose delivery and less normal tissue complications.

BACKGROUND:Meniscal root damage is an important reason for meniscus extrusion. In recent years, there are many reports on the relationship between meniscus root injury and meniscus extrusion at abroad, but it is rare at home. OBJECTIVE:To investigate the correlation between knee medial meniscus extrusion and the medial meniscus posterior root tears. METHODS:A retrospective analysis of the MRI and arthroscopic findings of 84 patients with knee medial meniscus extrusion signs was conducted. Medial meniscus extrusion≥ 3 mm or length of medial meniscus extrusion/maximum diameter of meniscus extrusion ≥10%was defined as serious extrusion. The chi-square test analysis was used to analyze the correlation between posterior root tears and the medial meniscus extrusion. RESULTS AND CONCLUSION:MRI measurement results of medial meniscus extrusion (length of medial meniscus extrusion ≥ 3 mm or length of medial meniscus extrusion/maximum diameter of meniscus extrusion≥ 10%) was significantly related with the arthroscopic findings of posterior root tears (P<0.05) with the odds ratio and 95%confidence intervals of 25.04 (3.07-204.44) and 6.96 (1.38-35.19) respectively. The medial meniscus serious extrusion is closely related to posterior root tears of the medial meniscus, which is a significant feature of the meniscus posterior root tears.

Objective To explore the pathological changes of lung, expression of the relevant inflammatory factors and oxidative stress markers of Sprague-Dawley (SD) rats undergoing autologous orthotopic liver transplantation (AOLT). Methods Thirty SD rats were randomized into sham group and AOLT group. The pathological changes of lung, expression of the relevant inflammatory mediators and oxidative stress markers were detected . Results ( 1 ) Compared with the sham group , the pathological scores of lung tissue in AOLT group increased significantly and reached its peak at 8 h after surgery. Then the pathological scores decreased to the level of sham within 24 h to 48 h after surgery; (2)The relative expression of inflammatory mediators including TNF-α, IL-1β, IL-6 and IL-8 increased significantly and reached its peak at 8 h after surgery in AOLT group. Then decreased to the level of sham group within 24 h to 48 h after surgery; (3)The change trends of MDA and H2O2 were similar to inflammatory mediators.The relative SOD expression decreased significantly and touched the nadir at 8h after surgery and then increased. Conclusion The pathological changes of lung expression, the relevant inflammatory mediators and oxidative stress markers of rats underwent AOLT were consistent.

Objective By analyzing the clinical and pathological characteristics of small intestinal neoplasms of patients presenting at our hospital,this study was to improve our cognition of this disease and the prognosis.Methods We collected and reviewed the medical records of 121 patients suffering from small intestinal neoplasms,who underwent surgery at Ruijin hospital from January 2003 to June 2009.Diagnosis was confirmed by pathological examination,and patients were followed-up.Results Intestinal hemorrhage,anemia and abdominal pain were the three main symptoms for all patients.CT,and gastrointestinal endoscopy were valuable for the diagnosis of small intestine neoplasms.Compared with open surgery,laparoscopic procedures can shorten the operation time and the postoperative length of hospital stay.Conclusions Surgical procedure is the key treatment for patients with small intestinal neoplasms.Long term follow-up plays important role in the detection of other synchronous or metachronous gastrointestinal tumors and improves the prognosis.

Objective To investigate the expression of MTSS1 in cholangiocarcinoma tissue and its relationship with the prognosis of patients.Methods The specimens of bile duct of 49 patients with hilar cholangiocarcinoma who received surgical excision at the Eastern Hepatobiliary Surgery Hospital from January 2003 to December 2005 were collected.Tissue microarrays of the 49 samples of hilar cholangiocarcinomas and the 10samples of adjancent normal bile duct epithelial tissue were constructed.The expression of MTSS1 was detected by the immunohistochemical staining.The pcDNA3.1-MTSS1 was transferred into the RBE cells and the abilities of proliferation of REB cells were measured by MTT assay.The patients were followed up via out-patient examination and telephone till May 2012.The measurement data were analyzed using the t test,and the count data were analyzed using the chi-square test,the survival curve was drawn by the Kaplan-Meier method,the survival was analyzed using the Log-rank test,and multivariate analysis was done using the COX regression model.Results The results of immunohistochemical staining showed that the expression rate of MTSS1 was 10/10 in the adjacent normal epithelial tissue of bile duct,while 59.2％ (29/49) in the cholangiocarcinoma tissues.The proliferative rate of cholangiocarcinoma cells transfected with MTSS1 was 1.55 ±0.05,which was significantly lower than 2.32 ±0.08 of cholangiocarcinoma cells without transfection of MTSS1 (t =4.454,P ＜ 0.05).Gender,age,TNM stage,T stage,differentiation,neural invasion and diameter of tumor did not influence the expression of MTSS1 (x2=0.211,3.471,0.507,0.507,0.368,0.882,0.660,P ＜ 0.05),while lymph node metastasis influenced the expression of MTSS1 (x2=10.436,P ＜ 0.05).All the patients were followed up for 1-59 months,and the median time for follow-up was 16 months.The median tumor-free survival time was 17.9 months in patients with positive expression of MTSSI,and 11.3 months of patients with negative expression of MTSS1,with no significant difference (Log-rank value =3.707,P ＞ 0.05).The median survival time was 34.9 months in patients with positive expression of MTSS1,which was significantly longer than 18.7 months of patients with negative expression of MTSS1 (Log-rank value =5.671,P ＜0.05).Multivariate analysis showed that MTSS1 was not the independent risk factor influencing the prognosis of patients (x2 =0.406,P ＞ 0.05).Conclusions The expression of MTSS1 is decreased in cholangiocarcinoma tissue,which negatively correlates with lymph node metastasis.MTSS1 could be used as a biomarker in predicting the prognosis of patients with cholangiocarcinoma.

Objective To study diagnosis significance of neutrophil surface adhesion molecules including CD11b,in type 2 diabetes mellitus patients with cytomegalovirus (CMV)infection.Methods Blood samples from 139 cases of type 2 diabetes mellitus patients were collected including 99 male and 40 female cases between Septem-ber 2011 and January 2015.Healthy male 20 cases and female 13 cases were collected as healthy control group from outpatients in the same period.Type 2 diabetes mellitus patients were divided into high active CMV infection group, CMV infection group and the negative control group,and healthy group as normal control group according to CMV -pp65 antigen detection.Neutrophil surface adhesion molecule CD11b was analyzed by flow cytometry and compared respectively.ROC curve of CD11b in 2 diabetes mellitus patients was made.Results The expression ratio of CD11b in high active CMV infection group and CMV infection group in type 2 diabetes mellitus patients was (41.25 ± 5.33)%.There was significant difference (P =0.019)compared with negative control group (61.13 ±5.28)% and there was significant difference (P =0.009)compared with negative control group (64.21 ±6.02)%;optimal cut -off value of CD11b in high active CMV infection group was 45.65%,the sensitivity was 100.00%,the specificity in high active CMV infection group was 60.12%,and the area under the receiver -operating curve(ROC)was 0.628;optimal cut -off value of CD11b in CMV infection group was 70.21%,the sensitivity of CD11b was 87.69%,the specificity of CD11b was 99.22%,and the area under of ROC of CD11b was 0.991.Conclusion The neutrophils CD11b expression in type 2 diabetes mellitus patients with CMV infection is down regulation.CD11b expression can be used as a laboratory diagnosis basis of CMV infection.

Objective To compare the clinical effectiveness between puncture drainage and surgery in the treatment of pyogenic liver abscess.Methods Clinical date of 81 patients with pyogenic liver abscess were retrospectively analyzed.Patients were divided into the ultrasound-guided puncture drainage group (48 patients) and open surgical drainage group (33 patients).The demographic data,laboratory examination,efficient rate,complication rate,mortality,time for body temperature returned to normal and hospital stays were compared between the two groups.Results Klebsiella pneumoniae was positive in 45.45％ cases by blood culture,and in 62.50％ cases by pus culture.There was no statistically significant difference in the effective rate and mortality (x2 =0.91,2.05,P ＞ 0.05).For patients with puncture drainage hospital stay was (14 ± 5) days,significantly shorter than (17 ± 5) days in surgery group (t =-3.20,P ＜ 0.05).Time to normal temperature was (5.1 ± 1.6) days in puncture drainage group,which was shorter than (6.0 ± 1.1) days in open surgery group (t =-2.85,P ＜ 0.05).Postoperative complications were fewer in the puncture drainage group (6 cases) than open surgery group (10 cases) (x2=3.91,P ＜ 0.05).Conclusions Ultrasound-guided puncture drainage for liver abscess is safe,feasible,effective of low complication rate for the treatment of pyogenic liver abscess.

According to teaching practice of "microbial engineering", teaching reforms, such as conformity and optimization of the curriculum system, improvement of teaching methods and the construction of multilevels experimental teaching system, are investigated in this paper, in order to improve the teaching quality and enhance the overall quality and the abilities of operation and innovation of students.