Objective To evaluate the usefulness of diffusion-weighted imaging(DWI) in the diagnosis and differential diagnosis of gallbladder wall thickening diseases.Methods 42 patients with gallbladder wall thickening (16 patients with carcinoma and 26 patients with benign lesion) were included in this study.All patients performed conventional MRI and DWI.The diagnostic performances of three methods (conventional MRI,visual assessment of color fusion image from DWI and T2WI,and ADC measurement) were evaluated by two radiologists.Results The area under the receiver operating characteristic curve were 0.570,0.849,0.901 for conventional MRI,visual assessment and ADC measurement respectively.The accuracy,sensitivity and specificity were 59.5%,62.5%,57.7% for conventional MRI,85.7%,81.2%,88.5% for visual assessment of color fusion image,and 83.3%,80.0%,85.2% for ADC measurement,respectivily.The mean ADC value of gallbladder cacinoma[(1.15±0.35)×10-3mm2/s]was significantly less than that of gallbladder benign lesion [(1.99±0.61)×10-3mm2/s](P<0.01).Conclusion The DWI(visual assessment of color fusion image and ADC measurement)might be a useful tool for diagnosis and differential diagnosis of the gallbladder wall thickening diseases.

OBJECTIVETo investigate the effects of modified vacuum sealing drainage (VSD) technique in treating refractory sinus in the lower leg.

METHODSFrom January 2010 to December 2011, 11 patients with refractory sinus in the lower leg, including 7 males and 4 females, with an average age of 34.5 years (ranged,23 to 56). These patients were treated with modified VSD technique after thorough cleaning sinus and continuous washing. After 14 to 21 days of treatment, removed VSD and re-debrided the sinus and sutured wound.

RESULTSInfections got control after operation, sinus in the lower leg healed. All patients were followed up from 6 to 14 months with an average of 10 months, no recidivations were found.

CONCLUSIONModified VSD technique is an effective method in the treatment of stubborn sinus in the lower leg.

Adult ; Drainage ; methods ; Female ; Fracture Fixation, Internal ; adverse effects ; Humans ; Leg Bones ; injuries ; surgery ; Male ; Middle Aged ; Postoperative Complications ; therapy ; Vacuum

OBJECTIVETo biomechanically compare the stability of the short and long iliac screw fixation constructs in lumbo-iliac reconstruction.

METHODSSeven adult human embalmed cadavers (L(3)-pelvis) were used. Using posterior spinal fixation system, L(4)-S(1) pedicle screw fixation was performed. This was defined as intact state of the sacroiliac joint. After the intact test, total sacrum resection and L(4)-L(5)-pelvis reconstruction by pedicle screw and iliac screw with different lengths were performed as follow: short screw group (as the length of exceeding 2 mm over ischial notch) and long screw group (as the length of exceeding 2 mm over anterior inferior iliac spine). Using the 858 MTS material testing machine, biomechanical testing was performed under 800 N compression and 7 Nm torsion loading modes. At last, the axial pullout test of two iliac screws was executed. Construct stiffness in compression and torsion test, and maximum pullout force were analyzed.

RESULTSInsertion lengths of the short and long iliac screw were (70 +/- 2) mm and (138 +/- 4) mm respectively. The lumbo-pelvic reconstruction using short and long iliac screw, respectively restored 53.3% +/- 13.6% and 57.6% +/- 16.2% of the initial stiffness in compression testing, and respectively harvested 55.1% +/- 11.9% and 62.5% +/- 9.2% of the initial stiffness in torsion testing. No significant difference was detected between the two reconstructions (P > 0.05), however, the compressive and torsional stiffness of the two techniques were markedly less than the intact condition (P < 0.05). The maximum pullout strength of long iliac screw was significantly higher than short screw (P < 0.05).

CONCLUSIONSUnder the physical loading, lumbo-pelvic fixation construct using the short iliac screw may obtain mechanical stability comparable to that by long iliac screw. The short iliac screw is only the half of the long iliac screw by length, could reduce the implantation risk. However, the long iliac screw behaves greater axial pullout force, should be applied as far as possible in the osteoporosis patient. The lumbo-pelvic reconstruction utilizing any length of iliac screw is difficult to restore the local stability.

Adult ; Aged ; Biomechanical Phenomena ; Bone Screws ; Female ; Humans ; Ilium ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Pelvic Bones ; surgery ; Sacrum ; surgery ; Spinal Fusion ; methods

OBJECTIVETo observe the chronicity decompression effect of Astragalus Membranaceus(AM) and evaluate the effect on baroreflex sensitivity (BRS).

METHODNineteen spontaneously hypertensive rats(SHR) were randomly divided into four groups. The AM groups were intraperitoneally administered with AM parenteral solution 0.9 mL, 1.2 mL and 1.8 mL respectively and the control group was not given AM for eight weeks. Then the change of blood pressure was observed successivly. After eight weeks, BRS were also determined. At last, the difference of blood pressure and BRS among the groups were compared.

RESULTBlood pressure in the control group became higher and higher frome the third week to the eighth week, but the other SHR admistered with AM showed no changein blood pressure level. We also found that the BRS in AM group was higher than that in the control group(P < 0.01).

CONCLUSIONAM can promote the BRS in SHR.

Animals ; Antihypertensive Agents ; isolation & purification ; pharmacology ; Astragalus membranaceus ; chemistry ; Baroreflex ; drug effects ; Blood Pressure ; drug effects ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Hypertension ; physiopathology ; Male ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Inbred SHR

OBJECTIVETo explore the prognostic factors in patients with gastrointestinal stromal tumors of the small intestine.

METHODSTumor slides stained with hematoxylin and eosin from these patients were reviewed. Two histomorphologically representative areas were identified and arrayed on a tissue microarray. Immunohistochemistry staining were performed using antibodies to detect the expression of c-kit protein (CD117), CD34, smooth muscle actin, desmin, S-100, Ki-67, P53 and bcl-2 protein. The relationship between clinicopathologic features and prognosis was analyzed by univariate analysis.

RESULTSThe 1-, 3-, 5-year survival rate of 58 such patients were 98.3%, 69.7%, and 50.9% respectively. The prognosis was related with tumor size and gender by univariate analysis (P< 0.05).

CONCLUSIONMore attention should be paid to the male patients with small intestine stromal tumors,especially those with tumors size> 5 cm, because those tumors are more likely to metastasize than smaller tumors (< or = 5 cm).

Adult ; Aged ; Female ; Gastrointestinal Stromal Tumors ; diagnosis ; pathology ; Humans ; Immunohistochemistry ; Intestinal Neoplasms ; diagnosis ; pathology ; Intestine, Small ; pathology ; Male ; Middle Aged ; Prognosis

The aim of current study was to detect intron 22 inversion of factor VIII gene in severe hemophilia A (HA) patients and screen the carriers of the gene inversion. Fifty-five cases of severe HA were involved and factor VIII gene inversion was detected and identified by long distance-PCR (LD-PCR) and 0.6% agarose gel electrophoresis. The 11 kb and 12 kb bands indicate the factor VIII gene inversion and non-inversion, respectively. Occurring of both 11 kb and 12 kb bands indicates a carrier of the inversion. The results showed that factor VIII gene inversion existed in 22 out of 55 cases, which accounted for about 40% of total detected patients. Five carriers of factor VIII gene inversion were diagnosed from the members in 15 families. In conclusion, LD-PCR assay is a simple, rapid and accurate method for detection of factor VIII gene inversion, and this approach is helpful in screening, carrier testing, and prenatal diagnosis of severe hemophilia A.
Adolescent ; Adult ; Antigens ; analysis ; Child ; Child, Preschool ; Chromosome Inversion ; Factor VIII ; genetics ; Hemophilia A ; blood ; genetics ; Humans ; Infant ; Male ; Polymerase Chain Reaction ; methods ; von Willebrand Factor ; immunology

OBJECTIVETo investigate prognostic factors of medullary thyroid carcinoma.

METHODSBy using univariate analysis and multivariate analysis, the prognostic factors were investigated in 102 patients with medullary thyroid carcinoma treated at this hospital.

RESULTSOverall survival rates of 5-year, 10-year and 15-year were 87.4%, 74.6% and 54.2% respectively by Kaplan-Meier method analysis. In univariate analysis, gender, age, bilateral thyroid lobe tumors, tumor size > 4 cm, invasion of thyroid capsule, distant metastasis, and non-radical tumor resection were significant poor prognostic factors. In multivariate analysis, tumor size > 4 cm (chi(2) = 7.43, P = 0.0035), distant metastasis (chi(2) = 23.50, P = 0.0000), and non-radical tumor resection (chi(2) = 25.90, P = 0.0000) remained as independent prognostic factors.

CONCLUSIONSTumor size > 4 cm, distant metastasis, and non-radical tumor resection are the independent predictors of patients survival. Early diagnosis and early therapy can improve significantly the prognosis of medullary thyroid carcinoma.

Adolescent ; Adult ; Aged ; Carcinoma, Medullary ; diagnosis ; mortality ; pathology ; Child ; Factor Analysis, Statistical ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Survival Rate ; Thyroid Neoplasms ; diagnosis ; mortality ; pathology ; Young Adult

OBJECTIVETo construct TIMP-1 siRNA eukaryotic expression vectors and evaluate their effect on TIMP-1 mRNA expression in hepatic stellate cells.

METHODSThe combinant lone DNA with cutting sites of BamH I and Xho I enzyme according to the sequences of 447-465, 552-540 TIMP-1 of rats and nonspecific sequence were selected and cloned to pGEM-T vector and sub-cloned to pRNAT-U6.2. They were then identified by double enzyme digestion analysis and DNA sequencing. Three plasmids were transfected into T6 separately through an oligofectamine package. TIMP-1 mRNA expression was evaluated by RT-PCR.

RESULTSTargeting sequences of TIMP-1 siRNA eukaryotic expression vectors were correct. TIMP-1 mRNA expression was significantly reduced by transfecting them into the T6.

CONCLUSIONWe successfully constructed two TIMP-1 siRNA eukaryotic expression vectors and the transfected cells can significantly suppress the TIMP-1 expression.

Animals ; Cell Line ; Gene Silencing ; Genetic Vectors ; Hepatic Stellate Cells ; Plasmids ; RNA, Small Interfering ; Rats ; Tissue Inhibitor of Metalloproteinase-1 ; genetics ; Transfection

OBJECTIVETo investigate the clinicopathological characteristics and prognostic factors in patients with intra-abdomen extragastrointestinal stromal tumors (EGISTs).

METHODSThe data of 47 patients of mesenchymal neoplasms that arose from the abdominal cavity and retroperitoneum, collected from July 1987 to June 2003 in our hospital with complete clinical and pathological data, were investigated retrospectively. EGISTs were diagnosed by reviewing the tumor slides stained with hematoxylin and eosin (H&E). Immunohistochemistry staining were performed on CD117, CD34, smooth muscle actin, Desmin and S-100 proteins. The relations of various clinicopathologic characteristics and outcomes were examined.

RESULTSAmong the 47 cases, 30 tumors were confirmed to be EGISTs. Twelve cases arose from the mesentery, six from small omentum, eight from retroperitoneum and four from the abdominal cavity. The size of tumors ranged from 4 to 30 cm (median 12.5 cm) in diameter and the tumor cell components mainly included spindle cells (23 cases), epithelioid cells (4 cases), and mixed cells (3 cases). The follow-up rate was 90% and the median follow up time was 44 months. The patient survival rates at 1, 5 and 10 years were 79.7%, 59.5% and 45.4% respectively. Univariate analysis showed that tumor size >10 cm, tumor necrosis, mitoses > or =5/50HPF, obvious nuclear atypia, moderate and poor differentiated tumor cells were predictors of poor prognosis.

CONCLUSIONSEGISTs have specific clinical behaviors. The parameters used for predicting GISTs prognosis are not completely applicable for EGISTs. Tumor necrosis, obvious nuclear atypia and mitoses > or =5/50HPF help to predict aggressive behaviors in EGISTs.

Adult ; Female ; Humans ; Immunohistochemistry ; Middle Aged ; Peritoneal Neoplasms ; pathology ; Retroperitoneal Neoplasms ; pathology ; Retrospective Studies

OBJECTIVETo identify prognostic factors in patients with gastrointestinal stromal tumors (GIST).

METHODSHematoxylin and eosin (H&E) stained histopathological slides of tumors from patients with mesenchymal neoplasms growing in the gastrointestinal tract and abdomen were reviewed. Two histologically representative areas were identified and chosen for tissue microarray. Immunohistochemical staining was performed to demonstrate c-kit protein (CD117), CD34, smooth muscle actin, desmin and S-100 protein. The relations of various clinicopathologic features to outcome were analyzed.

RESULTSThe overall disease-specific survival of 194 patients was 93.5% at 1 year, 72.1% at 3 years and 63.2% at 5 years. Univariate analysis indicated that the tumor size, mitotic count, primary location, necrosis, high cellularity, mucosal invasion, mixed cell type, hemorrhage, direct tumor invasion of surrounding tissue, male sex, incompleteness of resection, cytologic atypia were significant predictors of survival. Multivariate analysis showed that tumor size, mitotic count, necrosis, direct tumor invasion of surrounding tissue and male sex were poor prognostic signs.

CONCLUSIONTumor size and mitotic count are important prognostic factors. However, to evaluate the prognosis of these tumors, a surgical pathologist should incorporate multiple parameters into their histologic evaluation in attempt to reach an appropriate opinion on the aggressiveness of GIST.

Aged ; Female ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; diagnosis ; mortality ; pathology ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Prognosis ; Survival Rate