Objective To observe the characteristics of different blood perfusion in renal cell carcinoma by contrast-enhanced ultrasound and prove its diagnostic value.Methods One hundred and six cases of renal cell carcinoma confirmed by patholog were involved,and were divided into three groups:clear cell carcinoma group,papillary cell carcinoma group,and chromophobe cell carcinoma group.Their imaging characteristics were observed.Time-intensity curve was analyzed by using QLab software.The difference of time of beginning to increase (△AT =ATrenal cell carcinoma-AT surrounding normal renal parenchyma) and the difference of peak intensity(△PI =PIrenal cell carcinoma-PIsurrounding normal renal parenhyma) in three groups were compared.Results △AT and △PI in clear cell carcinoma group were different from those in the papillary cell carcinoma group and chromophobe cell carcinoma group (P ＜0.05).The difference between papillary carcinoma group and chromophobe carcinoma group was not significant (P ＞0.05).Contrast agent filled very fast in most clear cell carcinomas,filled speed and time to peak were early or synchronously with the surrounding renal tissue.Compared with renal papillary carcinoma and chromophobe carcinoma group,clear cell carcinoma group showed a high peak intensity and part of the surroundings appeared high increasing signs,like of a ring.Contrast agents filled slow in papillary carcinomas group and chromophobe carcinomas group,and the peak intensities were low.Conclasions Contrast enhanced ultrasound can provide important clinical value for the diagnosis of renal cell carcinoma and subtype diagnosis.

OBJECTIVEIn this study, the clinical data of 240 cases of data acquisition on ovulation in patients with anovulatory infertility.

METHODUsing the method of factor analysis, summed up the distribution situation of various syndromes and the relationship of disease-syndrome-symptom.

RESULTFrom the study we found that polycystic ocary syndrome > premature ovarian failure > corpus luteum insufficiency > luteinized unruptured follicle syndrome > hyperprolactinemia > anovulatory dysfunctional uterine bleeding. Using the factor analysis method, the syndromes of anovulatory infertility were divided into six types and the distribution proportion of them is: kidney Yang deficiency and blood stasis > kidney Yang deficiency > kidney Yin deficiency and blood stasis > kidney Yin deficiency and liver Qi stagnation syndrome > kidney Yang deficiency and phlegm dampness stagnation > kidney Yin deficiency. By means of statistics, the traditional Chinese medicine (TCM) symptoms as abdomen pain before menstrual onset, obfuscation colour, cold lower abdomen, insomnia, fatigue, eyes dark, face dark or ring lip dark, before and after menstruation breast swelling, chest tightness, irritable insomnia, depression and lower abdomen pain during menstruation etc contribute high degree in the process.

CONCLUSIONPolycystic ovary syndrome and premature are the main causes of ovulatory disorder infertility and the disease incidence rate assumed the tendency which rose year by year. The treatment of the disease of kidney yang deficiency syndrome scales biggest the disease degree of contribution. Blood stasis is the important factor in the process of pathogenesis evolution. In the study of disease distribution, we found that symptom distribution trend roughly the same and the same symptom severity in different diseases with different, which provides experience for the theory-different diseases with the same therapeutic method. These conclusions provide guidance and reference evidences for clinic practice.

Adult ; Diagnosis, Differential ; Female ; Humans ; Infertility, Female ; diagnosis ; physiopathology ; Ovulation

Objective To investigate the effect of a step-wise diversified teaching mode on cardiac electrophysiology (EP) education. Methods 64 young doctors (male:36, female:28) who studied in EP sub-specialty were enrolled. The atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardia (AVRT) were selected as teaching content. All the doctors were randomly divided into traditional teaching group (TT) and step-wise diversified teaching group (DT) according to cross-over design protocol. In TT group, only teaching and answering the questions by teachers were given to students, for the DT group, in different stages of teaching, multiple teach-ing strategy were combined to complete teaching. T test and Chi square test were used to compare the effect of two teaching methods. Results There was no difference of basic features and time of self-studying between the two groups. In examinations, the students in DT group got higher score than TT group[DT:(92.3±9.8) and (93.1±7.8),TT:(88.3±8.6) and (87.1±10.0),P<0.05], and had better perfor-mance of learning interest, initiative, ability of finding and resolving problems, teamwork spirit and so on. Conclusion The step-wise diversified teaching mode contributes improving the quality of instruction of cardiac EP, moreover, arousing learning interest and initiative, enhancing ability of find-ing and resolving problems, teamwork spirit and so on, which is worthy of wide-popularizing in cardiac EP training.

Objective We aimed to evaluate the role of CD4 + CD25 + T regulatory cells in predicting the prognoses of patients with sepsis.Methods Patients with sepsis in Shanghai Changzheng Hospital from December 2013 to April 2014 were identified and grouped into survival group (SG,n =19) and death group (DG,n =9) in accordance with their clinical outcomes.CD4 + CD25 +T regulatory cell ratio,C-replication protein,bilirubin,procalcitonin,and coagulation function were tested on the 1st day and 7th day,and APACHE Ⅱ and SOFA were analyzed to assess the predictability of this group of cells.Results Twentyeight patients were identified,with a mean age of (60.36 ± 15.30) years,a mean APACHE Ⅱ score of (16.68±7.00),and a mean SOFA score of (7.18 ±3.78).Twelve (42.9％) of the individuals were accompanied with severe multiple trauma,and 10 (35.7％) were in septic shock,and 9 (32.2％) died of severe sepsis.The first day CD4 + CD25 + T regulatory cell ratios on the first day were 2.10％ (0.80,3.10)％ (SG) vs.1.80％ (1.15,3.65)％ (DG) (Z=-0.148,P=0.883),andonday7 were 0.90％ (0.30,2.80)％ (SG) vs.5.70％ (2.60,8.30)％ (DG) (Z=-2.905,P=0.004) presented significant predictability.Conclusions Dynamic monitoring of CD4 + CD25 + T regulatory cells could predict the prognoses of patients with sepsis and should be generalized in clinical emergency practice.

Androstadienes ; therapeutic use ; Antineoplastic Agents, Hormonal ; administration & dosage ; Aromatase Inhibitors ; administration & dosage ; Breast Neoplasms ; drug therapy ; Drug Administration Schedule ; Female ; Humans ; Nitriles ; administration & dosage ; Postmenopause ; Triazoles ; administration & dosage

AIM:To explore the molecular mechanism of panaxadiol saponin(PDS)by observing Toll like receptor(TLR)2 and TLR9 mRNA expression induced by lipopolysaccharide(LPS).METHODS:Rats were divided into LPS,LPS+PDSL,LPS+PDSM and control group,respectively.Nitric oxide synthase(NOS)activity,nitric oxide(NO)content,LPO content,SOD activity and TLR2 and TLR9 mRNA expression were assayed 4 h after intravenous injection of LPS.RESULTS:NOS activity,NO content,LPO content of LPS+PDSL group and LPS+PDSM group were significantly lower than those in LPS group.TLR2 mRNA expression in the liver tissue of LPS+PDSL group and LPS+PDSM group was decreased compared with LPS group.CONCLUSION:PDS has a protective effect on liver tissues by triggering the down-regulation of TLR2 expression,reducing NOS activity,and NO content.

OBJECTIVETo summarize the clinical manifestation and diagnosis of ganglioneuroma in spine and investigate the clinical effect of surgical treatment.

METHODSThe clinical data of 6 patients underwent a surgery for ganglioneuroma in spine from January 2008 to January 2015 were retrospectively analyzed. There were 4 males and 2 females, aged from 2 to 63 years old with an average of 34.6 years. The courses of disease were from 3 days to 17 years. Five patients complicated with superficial hypesthesia in correlative level of tumor, and the muscle strength under tumor plane had decreased at different levels, with the strength of grade II-IV. Two cases complicated with hypermyotonia and positive bilateral Hoffmann's and Babinski sign. Five cases were sporadic lesion in correlative spinal canal and one case complicated with the giant occupying lesion in thoracic cavity.

RESULTSSix operations had been performed including 5 en bloc and 1 subtotal resection. Postoperative pathological results showed tumor cells scattered or fasciculated inserted into Schwann cells in the stroma. In 2 patients complicated with radiculalgia before operation, 1 case was relieved and 1 was invariant after operation. All 4 patients with preoperative dyscinesia in the limbs obtained improvement after operation. All the patients were followed up from 0.3 to 6.8 years with an average of 2.5 years. At the final follow-up, according to ASIA grade, 5 cases were good and 1 case was invariant. During the follow-up, only 1 patient experienced chemoradiation because of merging ganglioneuroblastoma and receiving subtotal resection. No recurrence in other 5 cases.

CONCLUSIONGanglioneuroma is a benign and rare tumors in spine. Clinically, radicular pain and sensory-motor disorders are the main manifestations. Its diagnosis depends on pathological examination. Prognosis of surgical treatment is good.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Ganglioneuroma ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Spinal Neoplasms ; diagnosis ; surgery

Objective To investigate the potential value of MR dynamic contrast enhanced imaging (DCE)in predicting short-term effects of(chemo-)radiation therapy on cervical cancers in vivo.Methods Thirty-two patients pathologically diagnosed as cervical cancers received MR-DCE scan before therapy.The following scans were taken at the 2nd to 3rd week after the radiation or(and)chemotherapy initiated,to calculate early size change.The fourth scan was performed within one month after the therapy to judge residues.DCE derived parameters include mean time to enhancement(MTE),positive enhancement integral (PEI),time to peak(TTP),maximum slope of increase(MSI)and maximum slope of decrease(MSD).Size and DCE parameters were compared and analyzed by Mann-Whitney test and Spearman teat Results There are 20 cases in non-residue group and 12 cases in residue group.In non-residue group,the maximal lengths in both horizontal and craniocaudal directions[(47.45±13.76)mm and(38.75±10.69)mm]were smaller than that in residue group [(61.08±13.73)mm and(53.67±16.05)mm],with statistical significance(Z=-2.455 and-2.650 respectively,P＜0.05).PEI in low-enhance areas of non-residue group(0.62±0.25)was significantly higher than that in residue group(0.39±0.14)(Z=-2.919,P＜0.05).At early time after radiation started,length changing rate and volume changing rate had medium to strong negative correlations with MSI in hish-enhance areas(r=-0.577 and-0.723 respectively,P＜0.05).Conclusions For cervical cancers,those with larger lengths and lower PEI in low-enhanced areas tend to have tumor residue when radiation therapy completed.Those low MSI in high-enhance areas tend to shrink quickly.It is suggested that volume and parameters of DCE before(chemo-)radiation therapy have the potential in predicting short-term therapeutic effect.

BACKGROUND: Sepsis is a common complication of infections, burns, traumas, surgeries, poisonings, and post-cardiopulmonary resuscitation. The present study aimed to investigate prognostic value of CD4+CD25+ regulatory T cells (Treg) in peripheral blood of patients with sepsis. METHODS: Periphery blood from 28 patients diagnosed with sepsis was collected on day 1 and 7 after hospitalization in the ICU of Shanghai Changzheng Hospital between December 2013 to April 2014. The blood was used for analyses of Treg ratio using flow cytometry and for analyses of blood routine test, C-reactive protein (CRP), bilirubin, procalcitonin (PCT), and coagulation. APACHE II and sequential organ failure assessment (SOFA) scores were also investigated. The results were compared between two outcome groups of survival or death to evaluate prognostic value for sepsis. RESULTS: The patients had an average age of 60.36±15.03 years, APACHE II score 16.68±7.00, and SOFA score 7.18±3.78. Among the 28 patients, 12 had severe trauma (42.9％), 10 had septic shock (35.7％), and 9 (32.2％) died. The median ratio of Tregs was 2.10％ (0.80％, 3.10％) in the survival group vs. 1.80％ (1.15％, 3.65％) in the death group (Z=–0.148, P=0.883) on day 1; however it was significantly changed to 0.90％ (0.30％, 2.80％) vs. 5.70％ (2.60％, 8.30％) (Z=–2.905, P=0.004). CONCLUSION: With better prospects for clinical application, dynamic monitoring of Tregs ratio in peripheral blood has potential value in predicting prognosis of sepsis.

OBJECTIVEThe multi-center, randomized, double-blind, double-simulated and positive-control trial was used to verify the contribution degree of Bushen Huoxue for the treatment of ovulatory dysfunction caused infertility, which provided scientific basis for clinical treatment.

METHODAccording to diagnostic, inclusion and exclusion criteria, we observed 349 patients which were divided into the treated group (n = 177, treated with Bushen Huoxue ricipe) and control group (n = 172, treated with clomiphene). Ovulation rate, pregnancy rate, clinical effective rate of traditional Chinese medicine, endometrium and diameter of dominant follicle were observed. Serum reproductive endocrine hormones were assayed before and after treatment.

RESULTThe treated group showed ovulation rate of 69.34%, with pregnancy rate of 41.35%. The clinical effective rate of treated group and control group were 91.73% and 80.77%. There was remarkable difference in endometrium (P < 0.05) and remarkbale difference in sex hormones PRL and E₂in treated group at prior-treatment and post-treatment (P < 0.05). No adverse effects were found in the experiment. Security indicators did not show abnormal change.

CONCLUSIONThe comparison between the two groups showed that the treated group was significantly different from control group in the pregnancy rate (P < 0.05), without notable difference in ovulation rate. There was significant difference in clinical effective rate between the treated group and control group. Both the two groups could contribute to the mature development and discharge of the follicles. The growth of endometrium and endometrial receptivity in the treated group were higher than control group. The treated group has regulatory effect on PRL and E₂.

Adult ; Double-Blind Method ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Fertility Agents, Female ; administration & dosage ; Humans ; Infertility, Female ; drug therapy ; physiopathology ; Ovary ; drug effects ; physiopathology ; Ovulation ; drug effects ; Pregnancy ; Treatment Outcome ; Young Adult