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 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 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 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 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 establish an effective laboratory examination system for carrier detection and prenatal diagnosis of haemophilia A (HA).

METHODSTwenty-five carriers of severe HA were directly detected by long-distance PCR (LD-PCR) in search of the factor FVIII (FVIII) gene inversion. Prenatal diagnosis was carried out using pregnant woman's venous blood sample, husband's venous blood sample and fetal navel venous sample at 20-24 weeks of gestation. The plasma coagulation factor VIII activity (FVIII:C) was detected by one-stage method. The concentration of von Willbrand factor (Vwf) was assayed by ELISA. Prenatal diagnosis was finally made by LD-PCR. The results of LD-PCR were proved by DNA sequencing.

RESULTSEight out of 25 cases were diagnosed as having FVIII geneinversion. Four of these 8 carriers underwent the LD-PCR for prenatal diagnosis, and 2 of them had to terminate pregnancy because their fetuses were diagnosed as having HA. The other two carriers were finally diagnosed to have normal fetuses by combined use of LD-PCR with plasma FVIII:C, vWF in pregnant woman's venous blood, husband's venous blood and fetal navel venous blood, and the one-year follow-up study demonstrated that the babies were normal and living well.

CONCLUSIONLD-PCR technique was adopted in this study to detect the factor VIII gene inversion; it could accurately and rapidly diagnose the severe cases of HA and could be used for the HA carriers in need of pregnant diagnosis.

Factor VIII ; genetics ; Female ; Hemophilia A ; diagnosis ; genetics ; Humans ; Polymerase Chain Reaction ; methods ; Pregnancy ; Prenatal Diagnosis ; methods ; Reproducibility of Results

OBJECTIVETo explore the mutation and amplification of RIT1 gene and their correlation with carcinogenesis of hepatocellular carcinoma (HCC).

METHODSThe polymerase chain reactioindirect sequencing method was used for detecting the mutations in the sequence of all 6 exons in the RIT1 gene of 50 HCC tissues and paratumor tissues. And the amplification of RIT1 gene was examined by fluorescence quantitative polymerase chain reaction method.

RESULTSA nucleotide 241 G --> C substitution in exon 5 of RIT1 gene was detected in one patient's HCC tissue, but not in paratumor tissue; this 241 G --> C substitution leads to Glu81Gln amino acid alteration in the conservative domain binding GTP. A nucleotide G --> C substitution in 5'-UTR (-21 bp from initial codon) was detected in all of the 50 HCC tissues and paratumor tissues, and 2- to 297-fold amplification of RIT1 gene was detected in 11 of 43 qualified cases, the amplification frequency being 25.6%.

CONCLUSIONGene amplification is one of the main activating ways of RIT1 gene in HCC, and its amplification might be correlated with HCC carcinogenesis, while point mutation might be not.

Adult ; Aged ; Base Sequence ; Carcinoma, Hepatocellular ; genetics ; DNA Mutational Analysis ; DNA, Neoplasm ; chemistry ; genetics ; Female ; Gene Amplification ; Humans ; Liver Neoplasms ; genetics ; Middle Aged ; Mutation ; Point Mutation ; ras Proteins ; genetics

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

OBJECTIVETo establish the methods of Polychlorinated Dibenzo-p-Dioxins and Dibenzofurans (PCDD/Fs), polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs) compounds determination by isotope dilution HRGC/HRMS simultaneously in human placenta tissue from mothers, and assess the human exposure risk to dioxins and PBDEs in study.

METHODSConcentrations of 17 PCDD/Fs and 12 dioxin-like PCBs as well as 7 PBDEs were measured in human placenta tissue samples by isotope dilution HRGC/HRMS. SigmaTEQ (PCDD + PCDFs + PCBs) concentration using WHO-TEF factor and PBDEs concentration was calculated respectively. Risk assessment of mother exposure to dioxins and PBDEs was evaluated.

RESULTSMedian of SigmaTEQ (PCDD + PCDFs + PCBs) concentration for six samples was 18.15 WHO-TEQ pg/g lipid, ranging from 5.14 - 67.01 WHO-TEQ pg/g lipid. Although the median of SigmaTEQ (PCDD + PCDFs + PCBs) was lower than that of human blood of EU and Japan, and close to that of Korea and Taiwan non-exposure as reported in the literatures, the highest SigmaTEQ (PCDD + PCDFs + PCBs) concentration of placenta sample exceeded the value of high dioxins exposure area subjects in Taiwan. The dominant contributor congener for WHO-TEQ were 2, 3, 4, 7, 8-PeCDF, 1, 2, 3, 7, 8-PeCDD, PCB126, totally accounted for 65 percent of SigmaWHO-TEQ. Median and average of PBDE concentration for six samples were 2.73 ng/g lipid and 7.17 ng/g lipid, respectively, ranging from 0.95 - 25.99 ng/g lipid. BDE47 was the dominant contributor congener for the total concentration, accounted for 35 percent.

CONCLUSIONThe methods of PCDD/Fs, PCBs and PBDEs compounds determined by isotope dilution HRGC/HRMS simultaneously in human placenta tissue from mothers were established successfully, and the human exposure risk to PCDD/Fs, PCBs and PBDEs should be surveyed for the donor with the highest SigmaTEQ (PCDD + PCDFs + PCBs) and PBDEs concentration of placenta sample in the future.

Benzofurans ; analysis ; Female ; Halogenated Diphenyl Ethers ; analysis ; Humans ; Maternal Exposure ; Placenta ; chemistry ; Polychlorinated Biphenyls ; analysis ; Polychlorinated Dibenzodioxins ; analogs & derivatives ; analysis ; Pregnancy