Objective To study clinical efficacy of ganciclovir in the therapy of infectious mononucleosis in adults.Methods 66 adults with infectious mononucleosis in a hospital from January 2010 to December 2014 were studied retrospectively,according to drug therapy,patients were divided into ganciclovir therapy group(n=31)and symptomatic therapy group(n=35),clinical features before therapy,therapeutic efficacy,and Epstein-Barr virus(EBV)DNA negative conversion time were analyzed.Results The time of defervescence,sore throat improvement,EBV-DNA negative conversion,subside of enlarged lymph node,and transaminase recovery in ganciclovir therapy group were all shorter than symptomatic therapy group(all P<0.05).Blood routine recovery time between two groups was not significantly different(P>0.05).Conclusion Ganciclovir has a good antiviral effect on the therapy of adult infectious mononucleosis,it can rapidly relieve patients from clinical symptoms including fever,sore throat and so on.

Objective To investigate MR findings and analyze the misdiagnosed cases of pituitary macroadenoma.Methods MR features of 1 90 patients of pituitary macroadenoma confirmed by operation and pathology were reviewed.Results 1 6 cases were mis-diagnosed as craniopharyngioma,chordoma,or meningioma.Among the sixteen cases,eight cases with cyst degeneration and hemor-rhage were misdiagnosed as craniopharyngioma;five cases with clival and sphenoid sinus destruction were misdiagnosed as chordo-mas;three cases with suprasellar and anterior cranial fossa extension were misdiagnosed as meningiomas.Conclusion Craniophar-yngioma,chordoma and meningioma should be considered in the differential diagnosis of atypical pituitary macroadenoma.The com-prehensive analysis should be based on a variety of signs.

Objective To investigate the efficacy and safety of laparoscopic splenectomy (LS) in the treatment of immune throm-bocytopenia(ITP) .Methods 230 cases of ITP were collected in this hospital from December 2011 to December 2012 and randomly divided into two groups with 115 cases in each group .Among them ,the control group was treated by the conventional treatment of open splenectomy(OS) ,while the observation group was treated by LS .The differences of the operative time ,hospitalization dura-tion ,intraoperative blood loss and platelet count ,clinical effects and the occurrence situation of adverse reactions were compared be-tween the two kinds of operation method .Results The operative time and the length of hospital stay in the observation group were significantly shortened compared with the control group (t=14 .706 ,t=13 .625 ,P<0 .05);intraoperative blood loss was significant-ly decreased(t=18 .238 ,P<0 .05) and the platelet count was significantly increased (t=17 .248 ,P<0 .05);the total effective rate of the observation group was 96 .52% ,which was significantly higher than 86 .09% of the control group ,(χ2 =9 .35 ,P<0 .05);the adverse reaction rate and the recurrence rate in the observation group were 6 .09% and 6 .96% respectively ,which were significantly lower than 10 .43% and 19 .13% in the control group(χ2 =8 .35 ,χ2 =8 .75 ,P<0 .05) .Conclusion LS for treating immune throm-bocytopenia has definite efficacy with high effective rate ,low adverse reactions and low recurrence rate .

measured to compare the correlation between the changes of T lymphocyte subsets before and after operation and the change of platelet. Results Thirty-one patients were underwent laparoscopic splenectomy. The T lymphocyte subsets and CD3 + ,CD4 + and CD3 + / CD4 + in all patients showed an increase trend as the time prolonged after operation,and the differences were significant( F = 6. 91,3. 93,4. 18;P = 0. 023,0. 004,0. 011). While the ratio of CD3 + / CD8 + and CD3 + CD4 + / CD3 + CD8 + were decreased as time increased,and differences were statistically significant( F = 2. 59,3. 67;P = 0. 001,0. 002). They were related with platelet change after operation and correlation statistics analysis showed R values were 0. 332,0. 271,0. 345,- 0. 119,- 0. 164,and the P value were 0. 039,0. 021,0. 002,0. 017,0. 023. Conclusion ITP patients have the imbalance of T lymphocyte subsets,and splenectomy can improve the imbalance of T lymphocyte subsets in patients with ITP. T lymphocyte subsets may serve as a reference index to indicate the prognosis of the patients.

Background and purpose: Current colorectal cancer patient-derived xenografts (PDXs) models were established by samples taken during surgery. However, metastatic colorectal cancer (mCRC) patients have less surgical opportunities, and it was difcult to obtain enough tumor fragment. The aim of the present study was to es-tablish mCRC PDXs by image-guided biopsy. Methods: A total of 12 patients with colorectal cancer who underwent surgery were included. All patients had recurrent lesions or metastatic lesions needed to be histologically confirmed, and none of them had contraindication to biopsy. Tumor tissues not required for clinical diagnosis were used to establish mCRC PDXs. Results: Seven PDXs grew sufficiently for transfer into mice. The success rate was 77.8%. Conclusion:The PDXs established by image-guided biopsy had the advantage of convenient operation, good reproducibility, high achievement ratio, short experimental periodicity and reliably retain specific genetic and morphological features of the primary patient tumors.

Objective To evaluate the efficacy of systemic glucocorticoids and intravenous immunoglobulin (IVIG)for the treatment of toxic epidermal necrolysis (TEN). Methods Clinical data on TEN inpatients treated with systemic glucocorticoids alone or in combination with IVIG were collected from the Department of Dermatology, First Affiliated Hospital of Nanjing Medical University from January 2006 to December 2012. Therapeutic outcomes were evaluated in these patients. Statistical analysis was carried out by using a multiple linear regression analysis, binary logistic regression analysis and Cox regression analysis with the SPSS 16.0 software. Results A total of 48 inpatients with TEN were included in this study. Multiple linear regression analysis showed that the maximum daily dose of glucocorticoids for disease control was decreased gradually over years (β=-0.461, P=0.004). However, binary logistic regression analysis revealed no obvious changes in the frequency of administration of IVIG over years. Cox regression analysis showed that both hospitalization duration (RR=0.351, 95.0%CI:0.150-0.825)and the time required for the control of skin lesions (RR=0.492, 95.0%CI:0.245-0.986)decreased with the increase in the frequency of IVIG administration. In addition, with the increase in the maximum daily dose of glucocorticoids for disease control, the time required for the control of skin lesions was also shortened (RR=0.997, 95.0%CI:0.994 -1.000), while no obvious changes were observed in hospitalization duration. Conclusions IVIG shows superiority in controlling lesions, reducing complications and improving the prognosis of TEN. Compared with systemic glucocorticoids, IVIG shows better therapeutic efficacy and less adverse effects, and may be preferentially selected.

BACKGROUND:A variety of factors contribute to biliary injury that is difficult to be repaired. Stent implantation is extensively used for bile duct injury, but either scaffolds made by metal or plastics can lead to certain adverse reactions. OBJECTIVE:To explore the biological characteristics of a novel biodegradable scaffold and its repair effects on bile duct injury. METHODS:The biological characteristics of the novel biodegradable scaffold were detected by fresh bile, and its degradation was observed at different time points. Thirty Bama mini pigs were included and were randomly divided into observation group (n=15) and control group (n=15). After bile duct injury models were prepared, the control group was subjected to the bile duct interrupted suture, while the observation group was subjected to the novel biodegradable scaffold combined with omentum majus. The biological properties of the scaffolds were observed. Hepatic enzymes and serum total bilirubin levels were detected, as wel as hematoxylin-eosin staining, Masson staining and immunohistochemistry detection ofα-smooth muscle actin were performed. RESULTS AND CONCLUSION:Before and 1, 3 and 6 months after surgery, hepatic enzymes and total bilirubin of two groups were detected, and neither intra-group nor intergroup comparisons had significant differences (P>0.05). Hematoxylin-eosin staining and Masson staining revealed that inflammatory reactions and fiber hyperplasia at the anastomotic site in the observation group were lighter than those in the control group at different time points after surgery. Theα-smooth muscle actin-positive scores in both two groups were in a rise at 1 and 3 months after surgery, and peaked at the 3rd month, and then began to decline. Moreover, theα-smooth muscle actin-positive scores in the observation group were significantly lower than those in the control group at 3 and 6 months after surgery (P<0.05). These results show that the novel biodegradable scaffold has good biological characteristics and can obtain ideal repair effects in the bile duct injury.

Objective To explore the value of pretargeting technology in vitro MRI of L5 peptide guided streptavidin-conjugated and polyethylene glycol modification protected ultra-small superparamagnetic iron oxide(SA-PEG-USPIO) to hepatocellular carcinoma(HCC) via glypican-3(GPC3) receptor.Methods Direct immumofluorescence assay with carboxyfluorescein(FAM) labeled L5 and competitive inhibition was performed in HepG2 and HL-7702 cells.Imaging was obtained from fluorescent microscope.Immunoassay fluorescence images were carried out to determine the expression of GPC3 in HepG2 cell.PEG-USPIO conjugated with streptavidin was made by carbodiimide reaction,and the hydrodynamic diameters,Zeta potential and magnetic relaxivity of SA-PEG-USPIO and PEG-USPIO were measured.HL7702 cells were used for evaluate cells viability of SA-PEG-USPIO and PEG-USPIO.HepG2 and HL-7702 cells were used as experimental and control group respectively.Each of the two cell lines were further divided into three groups:L5-BT united SA-PEG-USPIO group,SA-PEG-USPIO group and control group.Prussian blue staining and MRI was preformed to observe the targeting efficacy of SA-PEG-USPIO respectively,and normalized T2 signal was recorded.The significant changes of normalized T2 signal intensity among groups was deterumine by using One-way analysis of variance.Results There were much more fluorescences on the membrane and cytoplasm of HepG2 cells than those on HL-7702 cells and cells of competition group.And indirect immunofluorescence images show the obvious expression of GPC3 in HepG2 cell.The SA-PEG-USPIO and PEG-USPIO nanoparticles had hydrodynamic diameters of (22.73 ± 3.31) and (35.97±5.19)nm,Zeta potential of them were (4.22±0.53) and (-7.91± 1.22)mV and magnetic relaxivity were 0.139 4× 103 and 0.103 9 × 103 mM-1s1.Although the highest concentration of SA-PEG-USPIO and PEG-USPIO was 2.4 mmol/L,cells viability was greater than 80％.The most iron particle was observed in L5-BT united SA-PEG-USPIO group of HepG2 cells.In vitro MR,the normalized T2 signal intensity of HepG2 cells in L5-BT united SA-PEG-USPIO group,SA-PEG-USPIO group and control group were 39±7,77 ± 12 and 93 ± 4.There was significant difference among those three groups (F=23.96,P＜0.01).The normalized T2 signal intensity of HL-7702 cells in each of three groups were 69± 11,78±8 and 95±5.There was no significant difference among those three groups (F=2.86,P＞0.05).Conclusion By the pretargeting method,L5 peptide guided SA-PEG-USPIO has effective targeting ability to HepG2 cells in vitro.

OBJECTIVETo evaluate the correlation of liver hardness testing

RESULTSobtained by FibroTouch and FibroScan and the liver pathological stage.

METHODSSeventy-five patients with chronic hepatitis B who presented to our clinic between January 2011 and April 2013 were examined with FibroTouch and FibroScan to evaluate the degree of liver fibrosis. Forty-six of those patients also underwent liver biopsy examination.

THE RESULTSfrom technology-based testing and histopathological evaluation of the biopsy were compared by statistical analysis to determine the consistency of FibroTouch and FibroScan in regard to histological stage.

RESULTSAnalysis by paired t-test showed that the

RESULTSfrom FibroTouch and FibroScan were not significantly different (t = -0.17, P =0.8616), and the correlation coefficient from Pearson's correlation analysis was 0.9949 (P less than 0.05), suggesting that the two technologies'

RESULTSare correlated. Based on the histopathology

RESULTSfor liver fibrosis stage, the FibroTouch diagnosis of liver fibrosis more than or equal to S 1 had a receiver operating characteristic (ROC) area under the curve (AUC) of 0.889, diagnosis of liver fibrosis more than or equal to S2 had a ROC AUC of 0.941, diagnosis of liver fibrosis more than or equal to S3 had a ROC AUC of 0.908, and diagnosis of liver fibrosis more than or equal to S4 had a ROC AUC of 0.911.

CONCLUSIONCompared to FibroScan, FibroTouch has a better ability for detecting liver fibrosis and a better consistency with liver pathological stage determined by histopathological analysis.

Adult ; Aged ; Area Under Curve ; Biopsy ; Case-Control Studies ; Elasticity Imaging Techniques ; instrumentation ; Female ; Hepatitis B, Chronic ; pathology ; Humans ; Liver ; pathology ; Male ; Middle Aged ; Prospective Studies ; Young Adult

Objective To investigate the CT and MRI features of supratentorial primitive neuroectodermal tumors (sPNET)in adults,and to analyze the reasons of misdiagnosis.Methods The CT and MRI features of 1 5 patients with sPNET confirmed by pathology were analyzed retrospective.13 of 15 patients were underwent plain and contrast enhanced MRI,4 patients were also performed CT scan and the other 2 patients were underwent CT plain scan only.Results Nine of 1 5 lesions were located in the temporal and/or frontal lobe,with clear margin in 12 lesions,and mild to moderate peritumoral was noted in most cases.The solid portion of the lesions were hyperdense on CT,isointense or slightly hypointense on T1WI,and isointense or hyperintense on T2WI compared to the gray matter.Calcification (2/6),necrosis or cystic degeneration(1 3/1 5),hemorrhage (8/1 5)and flow void signal (1 1/1 3)were seen.Twelve lesions showed significantly heterogeneous enhancement and 7 lesions showed irregular ring-enhancement.The solid parts in 5 lesions showed hyperintensity on diffusion-weighted imaging. Preoperatively,the lesions were misdiagnosed as glioma in 10 cases,ependymoma in 2 cases,meningioma in 1 case and germ cell tumor in 1 case, respectively;and 1 case was not diagnosed definitely.Conclusion Supratentorial PNET in adults has characteristic CT and MRI features,and the main reasons accounting for misdiagnosis are its extraordinary low incidence and that radiologists do no master its imaging features.